Assessment of damages in wrongful birth cases

More than ten years has passed since the High Court of Australia confirmed the recoverability of damages for the cost of raising a child in the well know decision of Cattanach v Melchior . A recent decision of the Supreme Court of New South Wales was widely anticipated as potentially providing a comprehensive discussion of the principles relevant to the assessment of damages in wrongful birth cases.

Metal artifacts from titanium and steel screws in CT, 1.5T and 3T MR images of the tibial Pilon: A quantitative assessment in 3D

Radiographs are commonly used to assess articular reduction of the distal tibia (pilon) fractures postoperatively, but may reveal malreductions inaccurately. While Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) are potential 3D alternatives they generate metal-related artifacts. This study aims to quantify the artifact size from orthopaedic screws using CT, 1.5T and 3T MRI data. Three screws were inserted into one intact human cadaver ankle specimen proximal to and along the distal articular surface, then CT, 1.5T and 3T MRI scanned. Four types of screws were investigated: titanium alloy (TA), stainless steel (SS) (Ø = 3.5 mm), cannulated TA (CTA) and cannulated SS (CSS)(Ø = 4.0 mm, Ø empty core = 2.6 mm). 3D artifact models were reconstructed using adaptive thresholding. The artifact size was measured by calculating the perpendicular distance from the central screw axis to the boundary of the artifact in four anatomical directions with respect to the distal tibia. The artifact sizes (in the order of TA, SS, CTA and CSS) from CT were 2.0 mm, 2.6 mm, 1.6 mm and 2.0 mm; from 1.5T MRI they were 3.7 mm, 10.9 mm, 2.9 mm, and 9 mm; and 3T MRI they were 4.4 mm, 15.3 mm, 3.8 mm, and 11.6 mm respectively. Therefore, CT can be used as long as the screws are at a safe distance of about 2 mm from the articular surface. MRI can be used if the screws are at least 3 mm away from the articular surface except SS and CSS. Artifacts from steel screws were too large thus obstructed the pilon from being visualised in MRI. Significant differences (P < 0.05) were found in the size of artifacts between all imaging modalities, screw types and material types, except 1.5T versus 3T MRI for the SS screws (P = 0.063). CTA screws near the joint surface can improve postoperative assessment in CT and MRI. MRI presents a favourable non-ionising alternative when using titanium hardware. Since these factors may influence the quality of postoperative assessment, potential improvements in operative techniques should be considered.

Reflexive writers : re-thinking writing development and assessment in schools

Writing is a complex and highly individual activity, which is approached in different ways by different writers. Writers reflexively mediate subjective and objective conditions in specific and nuanced ways to produce a product in time and place. This paper uses a critical realist theory of reflexivity to argue that the teaching and assessment of writing must account for the different ways that students manage and make decisions in their writing. Data from linguistically and culturally diverse primary students in Australia are used to illustrate how four distinct reflexive modalities constitute the ways in which students approach writing. The paper offers a new approach to assessing writing for and of learning that considers writers as reflexive and agentic in different ways. It posits the importance of making visible and explicit the context and reflexive decision-making as writers shape a product for a purpose and audience.

A multidisciplinary review of the teaching and assessment of prescribing : how do professions perform?

Aim To investigate the methods employed to teach and assess the principles of effective prescribing across five non-medical professions in a tertiary institution. Methods The National Prescribing Service MedicineWise Prescribing Competencies Framework was employed as the prescribing standard. A curriculum mapping exercise was undertaken to determine whether the prescribing articulated in the competency standards were addressed within the following courses: Master of Nursing Science (Nurse Practitioner), Bachelor of Vision Science, Master of Optometry, Bachelor of Pharmacy, Bachelor of Podiatry, Bachelor of Paramedic Science. The methods employed to teach and assess prescribing principles were documented. For each profession, identified gaps in teaching and/or assessment were noted.

Assessment of the mortality displacement in temperature-related deaths in Brisbane, Australia

This thesis is a population-based ecological study designed to investigate the issue of mortality displacement (or "harvesting" effect) in the assessment of temperature-related deaths in Brisbane, Australia. It examines the temperature impacts on mortality, and assesses the harvesting effects on the temperature–related deaths. This study contributes to the knowledge base of understanding the temperature-mortality relationship and assists in formulating and evaluating public health intervention strategies within the context of climate change.

Assessment of the effects of maternal exposure to heatwave on birth outcomes in Brisbane, Australia

Even though heatwave events have become more frequent and intense in most regions around the world, little is known about the impact of heatwave on birth outcomes. This thesis uses a population-based study design to investigate the relationship between maternal heatwave exposure and adverse birth outcomes in Brisbane, Australia. This study found that heatwave exposure at any stage of pregnancy can be harmful to fetal growth, and further increase the risk of adverse birth outcomes. Both short- and long-term effects of heatwave on adverse birth outcomes were found. The findings in this thesis may have significant public health implications.

Proactive safety assessment in roadwork zones : a synthesis of surrogate measures of safety

Work zone safety studies have traditionally relied on historical crash records—an approach which is reactive in nature as it requires crashes to accumulate first before taking any preventive actions. However, detailed and accurate data on work zone crashes are often not available, as is the case for Australian road work zones. The lack of reliable safety records and the reactive nature of the crash-based safety analysis approach motivated this research to seek alternative and proactive measures of safety. Various surrogate measures of safety have been developed in the traffic safety literature including time to collision, time to accident, gap time, post encroachment time, required deceleration rate, proportion of stopping distances, lateral distance to departure, and time to departure. These measures express how close road-user(s) are from a potential crash by analysing their movement trajectories. A review of this fast-growing literature is presented in this paper from the viewpoint of applying the measures to untangle work zone safety issues. The review revealed that the use of the surrogate measures is very limited for analysing work zone safety, although numerous studies have used these measures for analysing safety in other parts of the road network, such as intersections and motorway ramps. There exist great opportunities for adopting this proactive safety assessment approach to transform work zone safety for both roadworkers and motorists.

Psycho-educational assessment of specific learning disabilities: Views and practices of Australian psychologists and guidance counsellors

This paper reports an investigation of the views and practices of 203 Australian psychologists and guidance counsellors with respect to psycho-educational assessment of students with Specific Learning Disabilities (SLDs). Results from an online survey indicated that practitioners draw upon a wide-range of theoretical perspectives when conceptualising and identifying SLDs, including both response to intervention and IQ – achievement discrepancy models. Intelligence tests (particularly the Wechsler scales) are commonly employed, with the main stated reasons for their use being ‘traditional’ perspectives (including IQ-achievement discrepancy-based definitions of SLDs), to exclude a diagnosis of intellectual disability, and to guide further assessment and intervention. In contrast participants reported using measures of academic achievement and tests of specific cognitive deficits known to predict SLDs (e.g., phonological awareness) relatively infrequently.

Making sense of inconsistencies in psycho-educational assessment: A case report

The case is presented of an 8-year-old young boy who was referred for psycho-educational assessment because of difficulties with writing. The paper provides an example of the way in which a case unfolds as further assessment data become available, and describes a number of challenging aspects of the assessment process. In this case, dilemmas arose when test results were inconsistent at different time points, and when the results were inconsistent with clinical observations. The case report illustrates the ways in which practitioners can collaborate to make sense of such discrepancies, with each contributing a slightly different perspective or set of skills that, in combination, assist to better understand a child’s difficulties.

Evaluation of assessment in the context of work-based learning: Qualitative perspectives of new graduates

Aim Evaluation or assessment of competence is an important step to ensure the safety and efficacy of health professionals, including dietitians. Most competency-based assessment studies are focussed on valid and reliable methods of assessment for the preparation of entry-level dietitians, few papers have explored student dietitians’ perceptions of these evaluations. This study aimed to explore the perceptions of recent graduates from accredited nutrition and dietetics training programs in Australia. It also aimed to establish the relevance of competency-based assessment to adequately prepare them for entry-level work roles. Methods A purposive sample of newly-graduated dietitians with a range of assessment experiences and varied employment areas was recruited. A qualitative approach, using in-depth interviews with 13 graduates, with differing assessment experiences was undertaken. Graduates were asked to reflect upon their competency-based assessment experiences whilst a student. Data was thematically analysed by multiple authors. Results Four themes emerged from the data analysis: (i) Transparency and consistency are critical elements of work-based competency assessment. (ii) Students are willing to take greater responsibility in their assessment process. (iii) Work-based competency assessment prepares students for employment. (iv) The relationship between students and their assessors can impact on the student experience and their assessment performance. Conclusions Understanding this unique perspective of students can improve evaluation of future health professionals and assist in designing valid competency-based assessment approaches.

A national satellite-based land-use regression model for air pollution exposure assessment in Australia

Land-use regression (LUR) is a technique that can improve the accuracy of air pollution exposure assessment in epidemiological studies. Most LUR models are developed for single cities, which places limitations on their applicability to other locations. We sought to develop a model to predict nitrogen dioxide (NO2) concentrations with national coverage of Australia by using satellite observations of tropospheric NO2 columns combined with other predictor variables. We used a generalised estimating equation (GEE) model to predict annual and monthly average ambient NO2 concentrations measured by a national monitoring network from 2006 through 2011. The best annual model explained 81% of spatial variation in NO2 (absolute RMS error=1.4 ppb), while the best monthly model explained 76% (absolute RMS error=1.9 ppb). We applied our models to predict NO2 concentrations at the ~350,000 census mesh blocks across the country (a mesh block is the smallest spatial unit in the Australian census). National population-weighted average concentrations ranged from 7.3 ppb (2006) to 6.3 ppb (2011). We found that a simple approach using tropospheric NO2 column data yielded models with slightly better predictive ability than those produced using a more involved approach that required simulation of surface-to-column ratios. The models were capable of capturing within-urban variability in NO2, and offer the ability to estimate ambient NO2 concentrations at monthly and annual time scales across Australia from 2006–2011. We are making our model predictions freely available for research.