239 resultados para more doctors


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In an environment where economic, political and technological change is the rule, a fundamental business strategy should be the defence of traditional markets and thoughtful entry into new markets, with an aim to increase market penetration and stimulate profit. The success of such a strategy will depend on the success of firms to do more and better for customers than their competitors. In other words, the firm’s primary competitive advantage will come from changes they implement to please their customers. In the construction industry, complexity of technical knowledge and construction processes have traditionally encouraged clients to play a largely passive role in the management of their project. However, today’s clients not only want to know about internal efficiency of their projects but also need to know how they and their contractors compare and compete against their competitors. Given the vulnerability of construction activities in the face of regional financial crisis, constructors need to be proactive in the search to improve their internal firm and project processes to ensure profitability and market responsiveness. In this context, reengineering is a radical design that emphasises customer satisfaction rather than cost reduction This paper discusses the crucial role of the client-project interface and how project networks could facilitate and improve information dissemination and sharing, collaborative efforts, decision-making and improved project climate. An intra-project network model is presented, and project managers’ roles and competencies in forming and coordinating project workgroups is discussed.

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This is the final article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in Victoria. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals’ legal knowledge in this area. The article examines the level of training that medical professionals receive on issues such as refusal of treatment certificates and substitute decision-making, and the available empirical evidence as to the state of medical professionals’ knowledge of the law at the end of life. It concludes that there are gaps in legal knowledge and that law reform is needed in Victoria. The article also draws together themes from the series as a whole, including conclusions about the need for more and better medical education and about law reform generally.

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The introduction by the Australian federal government of its Carbon Pollution Reduction Scheme was a decisive step in the transformation of Australia into a low carbon economy. Since the release of the Scheme, however, political discourse relating to environmental sustainability and climate change in Australia has focused primarily on political, scientific and economic issues. Insufficient attention has been paid to the financial opportunities which commoditisation of the carbon market may offer, and little emphasis has been placed on the legal implications for the creation of a "new" asset and market. This article seeks to shed some light on the discernable opportunities which the Scheme should provide to participants in the Australian and international debt markets.

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Background Concern about skin cancer is a common reason for people from predominantly fair-skinned populations to present to primary care doctors. Objectives To examine the frequency and body-site distribution of malignant, pre-malignant and benign pigmented skin lesions excised in primary care. Methods This prospective study conducted in Queensland, Australia, included 154 primary care doctors. For all excised or biopsied lesions, doctors recorded the patient's age and sex, body site, level of patient pressure to excise, and the clinical diagnosis. Histological confirmation was obtained through pathology laboratories. Results Of 9650 skin lesions, 57·7% were excised in males and 75·0% excised in patients ≥50years. The most common diagnoses were basal cell carcinoma (BCC) (35·1%) and squamous cell carcinoma (SCC) (19·7%). Compared with the whole body, the highest densities for SCC, BCC and actinic keratoses were observed on chronically sun-exposed areas of the body including the face in males and females, the scalp and ears in males, and the hands in females. The density of BCC was also high on intermittently or rarely exposed body sites. Females, younger patients and patients with melanocytic naevi were significantly more likely to exert moderate/high levels of pressure on the doctor to excise. Conclusions More than half the excised lesions were skin cancer, which mostly occurred on the more chronically sun-exposed areas of the body. Information on the type and body-site distribution of skin lesions can aid in the diagnosis and planned management of skin cancer and other skin lesions commonly presented in primary care.

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Prior to the decision of the High Court in Black v Garnock (2007) 230 CLR 438 it was an established principle in Queensland that a judgment creditor acting under an enforcement warrant could take no interest beyond what the judgment debtor could give. However, the decision of the High Court called this principle into question. This article examines the current position in the context of s 120 of the Land Title Act 1994 (Qld) , Queensland Titles Office practice and standard contractual provisions. This examination is further informed by the recent decision of Martin J in Secure Funding Pty Ltd v Doneley [2010] QSC 91.

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If a real estate agent describes a property as being “a golden opportunity to invest” the expression will be readily construed as mere “puffery”. The legal landscape changes when a real estate agent describes a property as “leased” and having a “guaranteed net income”. Can an agent avoid potential liability, for an inaccurate description, by arguing that they were merely acting as a messenger to pass on information received from their vendor client? The potential liability of real estate agent “messengers” was recently considered by the Queensland Court of Appeal in Banks & Anor v Copas Newnham Pty Ltd & Ors [2002] QCA 217.

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This article scrutinises the argument that decreasing hospital autopsy rates are outside the control of medical personnel, based as they are on families’ unwillingness to consent to autopsy procedures, and that, as a consequence, the coronial autopsy is the appropriate alternative to the important medical and educational role of the autopsy. It makes three points which are well supported by the research. First, that while hospital autopsy rates are decreasing, they have been doing so for more than 60 years, and issues beyond the simple notion of consent, like funding formulae in hospitals, increased technology and fear of litigation by doctors are all playing their part in this decline. Secondly, the issue of consent has as much to do with families not being approached as with families declining to give consent. This is well supported by recent changes in hospital policy and procedures which include senior medical personnel and detailed consent forms, both of which have been linked to rising consent rates in recent years. Finally, the perception that coronial autopsies are beyond familial consent has been challenged recently by legislative changes in both Australia and the United States of America which allow objections based on religion and culture to be heard by coroners. For these reasons, it is argued that medical personnel need to focus on increasing hospital autopsy rates, while also addressing the complex ethical issues associated with conducting medical research within the context of the coronial autopsy.

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This article compares YouTube and the National Film and Sound Archive (NFSA) as resources for television historians interested in viewing old Australian television programs. The author searched for seventeen important television programs, identified in a previous research project, to compare what was available in the two archives and how easy it was to find. The analysis focused on differences in curatorial practices of accessioning and cataloguing. NFSA is stronger in current affairs and older programs, while YouTube is stronger in game shows and lifestyle programs. YouTube is stronger than the NFSA on “human interest” material—births, marriages, and deaths. YouTube accessioning more strongly accords with popular histories of Australian television. Both NFSA and YouTube offer complete episodes of programs, while YouTube also offers many short clips of “moments.” YouTube has more surprising pieces of rare ephemera. YouTube cataloguing is more reliable than that of the NFSA, with fewer broken links. The YouTube metadata can be searched more intuitively. The NFSA generally provides more useful reference information about production and broadcast dates.

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Sample complexity results from computational learning theory, when applied to neural network learning for pattern classification problems, suggest that for good generalization performance the number of training examples should grow at least linearly with the number of adjustable parameters in the network. Results in this paper show that if a large neural network is used for a pattern classification problem and the learning algorithm finds a network with small weights that has small squared error on the training patterns, then the generalization performance depends on the size of the weights rather than the number of weights. For example, consider a two-layer feedforward network of sigmoid units, in which the sum of the magnitudes of the weights associated with each unit is bounded by A and the input dimension is n. We show that the misclassification probability is no more than a certain error estimate (that is related to squared error on the training set) plus A3 √((log n)/m) (ignoring log A and log m factors), where m is the number of training patterns. This may explain the generalization performance of neural networks, particularly when the number of training examples is considerably smaller than the number of weights. It also supports heuristics (such as weight decay and early stopping) that attempt to keep the weights small during training. The proof techniques appear to be useful for the analysis of other pattern classifiers: when the input domain is a totally bounded metric space, we use the same approach to give upper bounds on misclassification probability for classifiers with decision boundaries that are far from the training examples.