657 resultados para Wills Hospital for the Relief of the Indigent Blind and Lame, Philadelphia.


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This article examines the legal principles governing the statutory work health and safety general duties of principals who engage expert contractors to carry out work beyond the expertise of the principal. The article examines recent case law in which superior courts accepted the principal’s argument that the engagement of the expert contractor was sufficient to discharge the principal’s statutory work health and safety general duty. It then reframes the debate within the principles of systematic work health and safety management, and key provisions in the harmonised Work Health and Safety Acts—the primary duty of care; the key underpinning principles; the positive and proactive officer’s duty; and the horizontal duty of consultation, cooperation and coordination. It argues that it is likely that courts examining the issue of the principal’s work health and safety obligations under the harmonised Work Health and Safety Acts will require principals to do more to actively manage the work of expert contractors to ensure the health and safety of all workers and others potentially affected by the work.

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Background: It is important to identify patients who are at risk of malnutrition upon hospital admission as malnutrition results in poor outcomes such as longer length of hospital stay, readmission, hospitalisation cost and mortality. The aim of this study was to determine the prognostic validity of 3-Minute Nutrition Screening (3-MinNS) in predicting hospital outcomes in patients admitted to an acute tertiary hospital through a list of diagnosis-related groups (DRG). Methods: In this study, 818 adult patients were screened for risk of malnutrition using 3-MinNS within 24 hours of admission. Mortality data was collected from the National Registry with other hospitalisation outcomes retrieved from electronic hospital records. The results were adjusted for age, gender and ethnicity, and matched for DRG. Results: Patients identified to be at risk of malnutrition (37%) using 3-MinNS had significant positive association with longer length of hospital stay (6.6 ± 7.1 days vs. 4.5 ± 5.5 days, p<0.001), higher hospitalisation cost (S$4540 ± 7190 vs. S$3630 ± 4961, p<0.001) and increased mortality rate at 1 year (27.8% vs. 3.9%), 2 years (33.8% vs. 7.2%) and 3 years (39.1% vs. 10.5%); p<0.001 for all. Conclusions: The 3-MinNS is able to predict clinical outcomes and can be used to screen newly admitted patients for nutrition risk so that appropriate nutrition assessment and early nutritional intervention can be initiated.

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In recent years, there has been a significant trend toward land acquisition in developing countries, establishing forestry plantations for offsetting carbon pollution generated in the Global North. Badged as “green economic development,” global carbon markets are often championed not only as solutions to climate change, but as drivers of positive development outcomes for local communities. But there is mounting evidence that these corporate land acquisitions for climate change mitigation—including forestry plantations—severely compromise not only local ecologies but also the livelihoods of the some of the world’s most vulnerable people living at subsistence level in rural areas in developing countries.

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In Australia, children with additional needs are now primarily educated in mainstream regular classes and schools. While discussion has focused on teacher attitudes, teacher preparation and professional development to support the academic progress of children with additional needs, there is limited research examining the educational contexts and services provided to such children in Australian schools. This descriptive paper examines the educational contexts of 563 Australian children with additional needs, in reference to 3600 of their typically developing peers. Data in relation to educational setting, retention, prevalence of additional needs, access to specialist services, learning support, and individual programming are reported.

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Recent literature acknowledges the need for new career development models to support the way that careers evolve in the 21st century workplace (Bloch 2005). This is particularly so within temporary organisation forms, and for those pursuing a career in project management (Hölzle 2010). Our research, explores how project managers working on projects and within temporary organisation forms and those working on project-linked contracts access the development opportunities they require to remain employable in an era of project-by-project employment. Set in Australia where a project-based economy (Crawford, French and Lloyd-Walker 2013) and contract work have led to casualisation of the workforce (Connell & Burgess, 2006; McKeown & Hanley (2009) the results suggest new approaches to career development may be required.

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The taxonomic position of the endemic New Zealand bat genus Mystacina has vexed systematists ever since its erection in 1843. Over the years the genus has been linked with many microchiropteran families and superfamilies. Most recent classifications place it in the Vespertilionoidea, although some immunological evidence links it with the Noctilionoidea (=Phyllostomoidea). We have sequenced 402 bp of the mitochondrial cytochrome b gene for M. tuberculata (Gray in Dieffenbach, 1843), and using both our own and published DNA sequences for taxa in both superfamilies, we applied different tree reconstruction methods to find the appropriate phylogeny and different methods of estimating confidence in the parts of the tree. All methods strongly support the classification of Mystacina in the Noctilionoidea. Spectral analysis suggests that parsimony analysis may be misleading for Mystacina's precise placement within the Noctilionoidea because of its long terminal branch. Analyses not susceptible to long-branch attraction suggest that the Mystacinidae is a sister family to the Phyllostomidae. Dating the divergence times between the different taxa suggests that the extant chiropteran families radiated around and shortly after the Cretaceous–Tertiary boundary. We discuss the biogeographical implications of classifying Mystacina within the Noctilionoidea and contrast our result with those classifications placing Mystacina in the Vespertilionoidea, concluding that evidence for the latter is weak.

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Aim Estimate the prevalence of cannabis dependence and its contribution to the global burden of disease. Methods Systematic reviews of epidemiological data on cannabis dependence (1990-2008) were conducted in line with PRISMA and meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Culling and data extraction followed protocols, with cross-checking and consistency checks. DisMod-MR, the latest version of generic disease modelling system, redesigned as a Bayesian meta-regression tool, imputed prevalence by age, year and sex for 187 countries and 21 regions. The disability weight associated with cannabis dependence was estimated through population surveys and multiplied by prevalence data to calculate the years of life lived with disability (YLDs) and disability-adjusted life years (DALYs). YLDs and DALYs attributed to regular cannabis use as a risk factor for schizophrenia were also estimated. Results There were an estimated 13.1 million cannabis dependent people globally in 2010 (point prevalence0.19% (95% uncertainty: 0.17-0.21%)). Prevalence peaked between 20-24 yrs, was higher in males (0.23% (0.2-0.27%)) than females (0.14% (0.12-0.16%)) and in high income regions. Cannabis dependence accounted for 2 million DALYs globally (0.08%; 0.05-0.12%) in 2010; a 22% increase in crude DALYs since 1990 largely due to population growth. Countries with statistically higher age-standardised DALY rates included the United States, Canada, Australia, New Zealand and Western European countries such as the United Kingdom; those with lower DALY rates were from Sub-Saharan Africa-West and Latin America. Regular cannabis use as a risk factor for schizophrenia accounted for an estimated 7,000 DALYs globally. Conclusion Cannabis dependence is a disorder primarily experienced by young adults, especially in higher income countries. It has not been shown to increase mortality as opioid and other forms of illicit drug dependence do. Our estimates suggest that cannabis use as a risk factor for schizophrenia is not a major contributor to population-level disease burden.

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Organisations at the centre of the state’s industry, such as Screen Queensland, have undergone substantial and ongoing changes in the last five years. Other organisations funded by Screen Queensland, such as QPIX, Queensland’s only film development centre, have recently closed. The Brisbane International Film Festival has been restructured to become the Brisbane Asia Pacific Film Festival as of 2014. In an uncertain industry currently characterised by limited funding and diminishing support structures, local emerging filmmakers require significant initiatives and a sophisticated understanding of how to best utilise fledgling distribution models as part of a tailored strategy for their content. This essay includes interviews with emerging Brisbane filmmakers who have used a combination of traditional and contemporary approaches to exhibition and distribution thus far in their careers. It argues that for these filmmakers, while film festivals do function as crucial platforms for exposure, in the current digital market they cannot be relied upon as the only platform in securing further mainstream or commercial release. They can, however, be incorporated into an alternative distribution model that shows awareness of the contemporary situation in Australia. The research findings are arguably indicative of the challenges faced by filmmakers statewide, and suggest that further support strategies need to be considered to revive Queensland’s film culture and provide immediate support for emerging filmmakers. Queensland’s film sector is currently in the midst of significant change.

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Although the notion of wellbeing is popular in contemporary literature, it is variously interpreted and has no common definition. Such inconsistencies in definition have particular relevance when considering wellbeing programs designed for children. By developing a broader conceptualisation of wellbeing and its key elements, the range of programs and services developed in the name of wellbeing will achieve a more consistent cross-disciplinary focus to ensure that the needs of the individual, including children, can more accurately be addressed. This paper presents a new perspective on conceptualising wellbeing. The authors argue that conceptualising wellbeing as an accrued process has particular relevance for both adults and children. A definition for accrued wellbeing is presented in an attempt to address some of the current deficiencies in existing understandings of an already complicated construct. The potential for the ideas presented when considering wellbeing as a process of accrual may have further application when considered beyond childhood.

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The 15 members of the kallikrein-related serine peptidase (KLK) family have diverse tissue-specific expression profiles and roles in a range of cellular processes, including proliferation, migration, invasion, differentiation, inflammation and angiogenesis that are required in both normal physiology as well as pathological conditions. These roles require cleavage of a range of substrates, including extracellular matrix proteins, growth factors, cytokines as well as other proteinases. In addition, it has been clear since the earliest days of KLK research that cleavage of cell surface substrates is also essential in a range of KLK-mediated cellular processes where these peptidases are essentially acting as agonists and antagonists. In this review we focus on these KLK-regulated cell surface receptor systems including bradykinin receptors, proteinase-activated receptors, as well as the plasminogen activator, ephrins and their receptors, and hepatocyte growth factor/Met receptor systems and other plasma membrane proteins. From this analysis it is clear that in many physiological and pathological settings KLKs have the potential to regulate multiple receptor systems simultaneously; an important issue when these peptidases and substrates are targeted in disease.

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Objectives: To identify the groups of patients with high prevalence and poor control of hypertension in South Africa. Methods: In the first national Demographic and Health Survey, 12 952 randomly selected South Africans, aged 15 years and older were surveyed. Trained interviewers completed questionnaires on socio-demographic characteristics, lifestyle and the management of hypertension. This cross-sectional survey also included blood pressure, height and weight measurements. Logistic regression analyses identified the determinants of hypertension and the treatment status in this dataset. Results: A high risk of hypertension was associated with less than tertiary education, older age groups, overweight and obese people, using alcohol in excess, and a family history of stroke and hypertension. Rural Africans had the lowest risk of hypertension, which was significantly higher in obese African women than in women with normal body mass index. Improved hypertension control was found in the wealthy, women, older persons, being Asian, and having medical insurance. Conclusions: Rural African people had lower hypertension prevalence rates than the other groups. The poorer, younger men, without health insurance had the worst level of hypertension control.

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Society is increasingly calling for professionals across government, industry, business and civil society to be able to problem-solve issues related to climate change and sustainable development as part of their work. In particular there is an emerging realisation of the fundamental need to swiftly reduce the growing demand for energy across society, and to then meet the demand with low emissions options. A key ingredient to addressing such issues is equipping professionals with emerging knowledge and skills to address energy challenges in all aspects of their work. The Council of Australian Governments has recognised this need, signing the National Partnership Agreement on Energy Efficiency in July 2009, which included a commitment to assist business and industry obtain the knowledge, skills and capacity to pursue cost-effective energy efficiency opportunities.2 Engineering will play a critical part among the professions, with Engineers Australia acknowledging that, ‘The need to make changes in the way energy is used and supplied throughout the world represents the greatest challenge to engineers in moving toward sustainability.’