691 resultados para Physicians - History - Australia


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Age estimates for striped trumpeter (Latris lineata) from Tasmanian waters were produced by counting annuli on the transverse section of sagittal otoliths and were validated by comparison of growth with known-age individuals and modal progression of a strong recruitment pulse. Estimated ages ranged from one to 43 years; fast growth rates were observed for the first five years. Minimal sexual dimorphism was shown to exist between length, weight, and growth characteristics of striped trumpeter. Seasonal growth variability was strong in individuals up to at least age four, and growth rates peaked approximately one month after the observed peak in sea surface temperature. A modified two-phase von Bertalanffy growth function was fitted to the length-at-age data, and the transition between growth phases was linked to apparent changes in physiological and life history traits, including offshore movement as fish approach maturity. The two-phase curve was found to represent the mean length at age in the data better than the standard von Bertalanffy growth function. Total mortality was estimated by using catch curve analysis based on the standard and two-phase von Bertalanffy growth functions, and estimates of natural mortality were calculated by using two empirical models, one based on longevity and the other based on the parameters L∞ and k from both growth functions. The interactions between an inshore gillnet fishery targeting predominately juveniles and an offshore hook fishery targeting predominately adults highlight the need to use a precautionary approach when developing harvest strategies.

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Seven species of the marine enchytraeid genus Grania Southern, 1913 are described from sediments sampled during the 2003 International Workshop on the Marine Flora and Fauna of Esperance Bay and the Recherche Archipelago, on the southern coast of Western Australia. Two species are new to science, the euryhaline Tasmanian G. dolichura Rota and Erseus, 2000 represents a new record for the state, and the remaining four species were known from other parts of Western Australia. Grania quaerens sp. n. is recognized by having a high chaetal index (= 5 short chaetal foot), small coelomocytes, penial apparati with long whip-like terminal stylets, conspicuous spermathecae with ectally bulbous ducts, and ectally granulated ampullae housing sperm rings in their ental region. Grania sperantia sp. n. is readily distinguishable by the complete lack of lateral chaetae, a multiple-banded pattern of the clitellum, extremely long sperm funnels, and the intrasegmental location of the spermathecal pores. The latter new species and four others in the collection (G. bykane Coates, 1990, G. crassiducta Coates, 1990, G. dolichura, and G. ersei Coates, 1990) are remarkable in possessing the head organ, a sensory structure unique to Grania that was not noted previously in Western Australian species. When considering the whole genus, the geographic pattern of the head organ appears southern-centred: of the 17 species of Grania reported to possess it, as many as 13 inhabit the southern latitudes. The seventh species of the Esperance collection, G. vacivasa Coates and Stacey, 1993, is notable for the kind of items found in its gut and the unusual appearance of its pygidium.

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A prevalence study of primary biliary cirrhosis was carried out in the state of Victoria, Australia, by means of a mail survey of specialist physicians and a review of hospital records. Eighty four cases were identified, giving a prevalence of 19.1 per million population (95% confidence limits (CI) 15.3, 23.7), which is among the lowest in published reports. The prevalence in the Australian born, at risk population (women over the age of 24) was 51 per million (95% CI 37.5, 67.9). Both these figures are considerably lower than those in populations of similar age distribution in the UK and northern Europe. Since most Victorians are descended from British or European settlers, the low prevalence of primary biliary cirrhosis in this study supports the hypothesis that local environmental factors may be important in the pathogenesis of this disease.

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L’évaluation économique en santé consiste en l’analyse comparative d’alternatives de services en regard à la fois de leurs coûts et de leurs conséquences. Elle est un outil d’aide à la décision. La grande majorité des décisions concernant l’allocation des ressources sont prises en clinique; particulièrement au niveau des soins primaires. Puisque chaque décision est associée à un coût d’opportunité, la non-prise en compte des considérations économiques dans les pratiques des médecins de famille peut avoir un impact important sur l’efficience du système de santé. Il existe peu de connaissances quant à l’influence des évaluations économiques sur la pratique clinique. L’objet de la thèse est de comprendre le rôle de l’évaluation économique dans la pratique des médecins de famille. Ses contributions font l’objet de quatre articles originaux (philosophique, théorique, méthodologique et empirique). L’article philosophique suggère l’importance des questions de complexité et de réflexivité en évaluation économique. La complexité est la perspective philosophique, (approche générale épistémologique) qui sous-tend la thèse. Cette vision du monde met l’attention sur l’explication et la compréhension et sur les relations et les interactions (causalité interactive). Cet accent sur le contexte et le processus de production des données souligne l’importance de la réflexivité dans le processus de recherche. L’article théorique développe une conception nouvelle et différente du problème de recherche. L’originalité de la thèse réside également dans son approche qui s’appuie sur la perspective de la théorie sociologique de Pierre Bourdieu; une approche théorique cohérente avec la complexité. Opposé aux modèles individualistes de l’action rationnelle, Bourdieu préconise une approche sociologique qui s’inscrit dans la recherche d’une compréhension plus complète et plus complexe des phénomènes sociaux en mettant en lumière les influences souvent implicites qui viennent chaque jour exercer des pressions sur les individus et leurs pratiques. L’article méthodologique présente le protocole d’une étude qualitative de cas multiples avec niveaux d’analyse imbriqués : les médecins de famille (niveau micro-individuel) et le champ de la médecine familiale (niveau macro-structurel). Huit études de cas furent réalisées avec le médecin de famille comme unité principale d’analyse. Pour le niveau micro, la collecte des informations fut réalisée à l’aide d’entrevues de type histoire de vie, de documents et d’observation. Pour le niveau macro, la collecte des informations fut réalisée à l’aide de documents, et d’entrevues de type semi-structuré auprès de huit informateurs clés, de neuf organisations médicales. L’induction analytique fut utilisée. L’article empirique présente l’ensemble des résultats empiriques de la thèse. Les résultats montrent une intégration croissante de concepts en économie dans le discours officiel des organisations de médecine familiale. Cependant, au niveau de la pratique, l'économisation de ce discours ne semble pas être une représentation fidèle de la réalité puisque la très grande majorité des participants n'incarnent pas ce discours. Les contributions incluent une compréhension approfondie des processus sociaux qui influencent les schèmes de perception, de pensée, d’appréciation et d’action des médecins de famille quant au rôle de l’évaluation économique dans la pratique clinique et la volonté des médecins de famille à contribuer à une allocation efficiente, équitable et légitime des ressources.

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This thesis entitled Systematics,life history traits ,abundance and stock assessment of cobia rachycentron canadum (linnaeus ,1766) occurring in indian waters with special reference to the northwest coast of india.Cobia, Rachycentron canadum is a fast growing pelagic fish belonging to the monotypic family Rachycentridae. They show worldwide distribution in tropical and sub tropical waters. Cobia is exploited commercially in various countries like Taiwan, Pakistan, India, United State of America, Australia, Gulf of Mexico and the Caribbean. Recreational fishery of Cobia exists in different parts of the world. In India Cobia is caught as bycatch of trawlers, gillnet and hook and line fishery.This study also focuses on to bring out the distribution pattern and also to assess the biomass and estimate sustainable yield of Cobia inhabiting in Indian EEZ. In addition to above, present study standardised live collection methods and also reviewed culture prospects.Results of osteological study and morphological studies indicate its close resemblance to Remora and support the view that Cobia was evolved from Dolphin fishes and remoras followed it. Study also confirmed that Cobia does not have any relative or similar species and is a monotypic species belonging to the family Rachycentridae. Re description of the species was done based on the characters identified. In this study, feeding intensity was also assessed following methods like Gastrosomatic index, Mean index of feeding intensity and Index of fullness. Sex wise, month wise and length group wise fluctuations in the feeding intensity also were studied. Cobia actively fed during post monsoon period. In general, adult fed actively than the juveniles. Trophic level value estimated (4.36) indicates that Cobia occupy top level position in the food chain.

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El consentimiento informado (CI) en medicina corre el riesgo de quedar reducido a un formalismo legal sin valor moral; esto puede suceder por dos cosas: 1) como consecuencia de que el paciente no comprenda con suficiencia el concepto de autonomía y 2) debido a la disminución de la autonomía práctica del paciente por efecto de la autoridad del personal médico o de las instituciones de salud. Este artículo tiene como fin mostrar bajo qué condiciones se puede evitar la reducción del CI a un formalismo legal desprovisto de valor moral. Para servir a este propósito, se considera el concepto de autonomía relacional como eje articulador que pone en relación al paciente con su comunidad moral y con el médico, lo que impulsa al personal de la salud a proporcionar las condiciones para tal fin. Así, se afirma que la valía moral del CI puede conservarse, primero, a partir de una concepción relacional de la autonomía y, segundo, mediante la aplicación, por parte del médico y de la institución, de un protocolo que disminuya la posibilidad de choque entre la autonomía y la autoridad.

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By the mid-1930s the major Hollywood studios had developed extensive networks of distribution subsidiaries across five continents. This article focuses on the operation of American film distributors in Australia – one of Hollywood's largest foreign markets. Drawing on two unique primary datasets, the article compares and investigates film distribution in Sydney's first-run and suburban-run markets. It finds that the subsidiaries of US film companies faced a greater liability of foreignness in the city centre market than in the suburban one. Our data support the argument that film audiences in local or suburban cinema markets were more receptive to Hollywood entertainment than those in metropolitan centres.

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This paper argues that popular history magazines may be a welcome complement toother forms of historical media in history teaching. By outlining a theoretical framework thatcaptures uses of history, the paper analyses popular history magazine articles from five Europeancountries all dealing with the outbreak of World War I. The study finds that while the studiedarticles provide a rather heterogeneous view of the causes of the Great War, they can be used todiscuss and analyse the importance of perspective in history, thus offering an opportunity tofurther a more disciplinary historical understanding.

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Bathurst Harbour in World Heritage southwest Tasmania, Australia, is one of the world’s most pristine estuarine systems. At present there is a lack of data on pollution impacts or long-term natural variability in the harbor. A ca. 350-year-old 210Pb-dated sediment core was analysed for trace metals to track pollution impacts from local and long-range sources. Lead and antimony increased from AD 1870 onwards, which likely reflects remote (i.e. mainland Australian and global) atmospheric pollution sources. Variability in the concentrations of copper and zinc closely followed the history of mining activities in western Tasmania, which began in the AD 1880s. Tin was generally low throughout the core, except for a large peak in AD 1989 ± 0.5 years, which may be a consequence of input from a local small-scale alluvial tin mine. Changes in diatom assemblages were also investigated. The diatom flora was composed mostly of planktonic freshwater and benthic brackish-marine species, consistent with stratified estuarine conditions. Since mining began, however, an overall decrease in the proportion of planktonic to benthic taxa occurred, with the exception of two distinct peaks in the twentieth century that coincided with periods of high rainfall. Despite the region’s remoteness, trace metal analyses revealed evidence of atmospheric pollution from Tasmanian and possibly longer-range mining activities. This, together with recent low rainfall, appears to have contributed to altering the diatom assemblages in one of the most pristine temperate estuaries in the world.

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OBJECTIVE Poison centres offer rapid and comprehensive support for emergency physicians managing poisoned patients. This study investigates institutional, case-specific and poisoning-specific factors which influence the decision of emergency physicians to contact a poison centre. METHODS Retrospective, consecutive review of all poisoning-related admissions to the emergency departments (EDs) of a primary care hospital and a university hospital-based tertiary referral centre during 2007. Corresponding poison centre consultations were extracted from the poison centre database. Data were matched and analysed by logistic regression and generalised linear mixed models. RESULTS 545 poisonings were treated in the participating EDs (350 (64.2%) in the tertiary care centre, 195 (35.8%) in the primary care hospital). The poison centre was consulted in 62 (11.4%) cases (38 (61.3%) by the tertiary care centre and 24 (38.7%) by the primary care hospital). Factors significantly associated with poison centre consultation included gender (female vs male) (OR 2.99; 95% CI 1.69 to 5.29; p<0.001), number of ingested substances (>1 vs 1) (OR 2.84; 95% CI 1.65 to 4.9; p<0.001) and situation (accidental vs intentional) (OR 2.76; 95% CI 1.05 to 7.25; p=0.039). In contrast, age, medical history and hospital size did not influence poison centre consultation. Poison centre consultation was significantly higher during the week, and significantly less during night shifts. The poison centre was consulted significantly more when patients were admitted to intensive care units (OR 5.81; 95% CI 3.25 to 10.37; p<0.001). Asymptomatic and severe versus mild cases were associated with more frequent consultation (OR 4.48; 95% CI 1.78 to 11.26; p=0.001 and OR 2.76; 95% CI 1.42 to 5.38; p=0.003). CONCLUSIONS We found low rates of poison centre consultation by emergency physicians. It appears that intensive care unit admission and other factors reflecting either complexity or uncertainty of the clinical situation are the strongest predictors for poison centre consultation. Hospital size did not influence referral behaviour.

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Ascertaining the family health history (FHH) may provide insight into genetic and environmental susceptibilities specific to a variety of chronic diseases, including type II diabetes mellitus. However, discussion of FHH during patient-provider encounters has been limited and uncharacterized. A longitudinal, observational study was conducted in order to compare the content of FHH topics in a convenience sample of 37 patients, 13 new and 24 established. Each patient had an average of three follow-up encounters involving 6 staff physicians at the Audie L. Murphy Memorial Veterans Hospital (VHA) in San Antonio, TX from 2003 to 2005. A total of 131 encounters were analyzed in this study. The average age of the selected population was 68 years and included 35 males and two females. Transcriptions of encounters were obtained, coded and analyzed, in NVIVO 8. Of the 131 total encounters transcribed among the 37 patients, only 24 encounters (18.3%) included discussion of FHH. Additionally, the relationship between FHH discussion and discussion of self-care management (SCM) topics were assessed. In this study, providers were more likely to initiate discussion on family health history among new patients in the first encounter (ORnew = 8.55, 95% CI: 1.49–52.90). The discussion of FHH occurred sporadically in established patients throughout the longitudinal study with no apparent pattern. Provider-initiated FHH discussion most frequently had satisfactory level(s) of discussion while patient-initiated FHH discussion most frequently had minimal level(s) of discussion. FHH discussion most oftentimes involved topics of cancer and cardiovascular disease among primary-degree familial relationships. Overall, family health histories are largely, an underutilized tool in personalized preventive care.^

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Second Edition. Pp.5-61 General Surgical Necessities, Gauze, Antiseptic Sundries, Surgical Sundries, Rubber Bandages, Catheters, Bougies, Splints, Tents, Emergency Bags, Surgeon's Needles, Operating Instruments, Amputating, Forceps, Aspiration, Cases, Catheters and Directors, Pocket Case Instruments, Dissecting and Post-Mortem Pp.62-118 General Operating - Osteotomy, Mastoid, Trephining, Eye Instruments, Aural, Nasal, Mouth and Throat, Tooth Forceps, Laryngoscopic Sets, Hydraulic Air Compressor, Variocele, Genito Urinary Pp. 119-167 Genito Urinary-Lithotrity, Alimentary, Anal and Rectal, Gynaecological, Pessaries, Microscopes, Syringes Pp.168-205 Chemical Apparatus and Glassware, Physician's Cabinets, Office Furniture, Operating Chairs and Tables, Hospital Beds, Cautery, Electrolytic, Batteries Pp.206-246 Cases, Varicose, Braces, Abdominal Supporters, Trusses, Invalid Chairs and Supplies, Sterilizers, Saddle-Bags, Deformity Apparatus Advertisements: Bandages, Abdominal Supporters, Rubber Supplies, Bags, Batteries, Cotton, Microscopes, Hypodermic Tablets, Atomizers, Furniture, Sterilizers, Syringes

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The item was written by the Historical Committee of the Harris County Medical Society and signed on October 28, 1948. A brief history of medicine in Texas is given before the focus shifts to the Harris County and Houston area. Information on the early years is taken from various sources such as Pat Ireland Nixon’s The Medical Story of Early Texas and the writings of George Plunkett (Mrs. S. C.) Red. Significant information comes from the Minutes of the Harris County Medical Society.

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The spatial and temporal dynamics of seagrasses have been well studied at the leaf to patch scales, however, the link to large spatial extent landscape and population dynamics is still unresolved in seagrass ecology. Traditional remote sensing approaches have lacked the temporal resolution and consistency to appropriately address this issue. This study uses two high temporal resolution time-series of thematic seagrass cover maps to examine the spatial and temporal dynamics of seagrass at both an inter- and intra-annual time scales, one of the first globally to do so at this scale. Previous work by the authors developed an object-based approach to map seagrass cover level distribution from a long term archive of Landsat TM and ETM+ images on the Eastern Banks (~200 km**2), Moreton Bay, Australia. In this work a range of trend and time-series analysis methods are demonstrated for a time-series of 23 annual maps from 1988 to 2010 and a time-series of 16 monthly maps during 2008-2010. Significant new insight was presented regarding the inter- and intra-annual dynamics of seagrass persistence over time, seagrass cover level variability, seagrass cover level trajectory, and change in area of seagrass and cover levels over time. Overall we found that there was no significant decline in total seagrass area on the Eastern Banks, but there was a significant decline in seagrass cover level condition. A case study of two smaller communities within the Eastern Banks that experienced a decline in both overall seagrass area and condition are examined in detail, highlighting possible differences in environmental and process drivers. We demonstrate how trend and time-series analysis enabled seagrass distribution to be appropriately assessed in context of its spatial and temporal history and provides the ability to not only quantify change, but also describe the type of change. We also demonstrate the potential use of time-series analysis products to investigate seagrass growth and decline as well as the processes that drive it. This study demonstrates clear benefits over traditional seagrass mapping and monitoring approaches, and provides a proof of concept for the use of trend and time-series analysis of remotely sensed seagrass products to benefit current endeavours in seagrass ecology.

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During Leg 194, a series of eight sites was drilled through Oligocene-Holocene mixed carbonate and siliciclastic sediments on the Marion Plateau, northeast Australia. The major objective was to constrain the magnitude and timing of sea level changes in the Miocene. Site 1193, located on the Marion Plateau in 348 m of water ~80 km from the south central Great Barrier Reef margin, is probably the most important site for constraining the major middle to late Miocene sea level drop and reconstructing the evolution history of the Marion Plateau during the Miocene (Isern, Anselmetti, Blum, et al., 2002, doi:10.2973/odp.proc.ir.194.2002). However, there is no biostratigraphic or other chronological data for the critical interval between 36 and 211 meters below seafloor (mbsf) (virtually the entire late and middle Miocene) due to poor core recovery and a virtual absence of planktonic microfossils in the core catcher samples examined aboard the ship (Isern, Anselmetti, Blum, et al., 2002, doi:10.2973/odp.proc.ir.194.2002). The main purpose of this report is to refine the shipboard nannofossil biostratigraphy through examination of new samples and more detailed examination of those samples reported on board the ship. This results in a refinement for most of the nannofossil datums and provides some useful age information to fill the critical data gap for the middle Miocene. Previous Neogene nannofossil biostratigraphic studies of the Marion Plateau and Queensland Plateau include Gartner et al. (1993, doi:10.2973/odp.proc.sr.133.213.1993) and Wei and Gartner (1993, doi:10.2973/odp.proc.sr.133.216.1993).