968 resultados para Medical Negligence and Failure to Warn


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Because of China's extremely rapid economic growth, the scale and seriousness of environmental problems is no longer in doubt. Whether pollution abatement technologies are utilized more efficiently is crucial in the analysis of environmental management in China. This study analyzes how the performance of environmental management has changed over time using province level data for 1992-2003. Mixed results for environmental performance are shown using nonparametric estimation technique. We find that environmental performance index, abatement effort, and increasing returns to pollution abatement play important roles in determining the pollution level over the period of the study.

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It is not uncommon for firms to explore a new venture under the belief it will generate profits, only to find out later that although costs accumulated, profits did not materialize. To manage the high level of uncertainty involved in this process, new ventures are generally designed as vehicles of exploration (Wu, 2012) that allow for a staged investment of resources, starting with small initial investments that can be scaled up or discontinued as uncertainty is resolved over time (Folta, 1998; Li and Chi, 2013). As such, new ventures provide firms a vehicle by which they can probe an uncertain future (Brown and Eisenhardt, 1997) without fully committing early on to an irreversible course of action (Folta, Johnson, and O’Brien, 2006). Our focus in the present paper is on the timing of strategic decisions that firms make regarding their exploration ventures. Prior research in the fields of entrepreneurship, real options reasoning, and decision speed has demonstrated a link between the timing of making decisions and performance (Baum and Wally, 2003; Eisenhardt, 1989; Judge and Miller, 1991). The antecedents to the timing of decisions, however, are less understood and pose an interesting dilemma.

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Using a state, pressure, response framework, we provide an evidence-based reflection on environmental outcomes in Australia and New Zealand across the domains of climate change, biodiversity, freshwater and marine management, emphasising the role of Indigenous and business perspectives. Significant developments have occurred in the past 20 years through affirmation of Indigenous rights and responsibilities. Responses to climate change have tended to emphasise passive risk management with unclear outcomes. Despite meeting biodiversity protection targets, outcomes are worsening, suggesting a need to challenge the dualistic preservation/production land categorisations. In freshwater and marine management, a mix of collaborative and market-based responses has emerged, although their efficacy remains untested. A reliance on voluntary approaches by business makes critical assessment of progress difficult. Thus, despite strong progress in some areas, the adaptiveness of environmental management remains limited, and many indicators suggest continuing decline in environmental condition. Our responses have been largely pacifying in nature, leading to perverse outcomes and failure to acknowledge alternatives that might address deteriorating environmental conditions. A shift is needed towards deliberative policy experimentation that truly values the application of novel and diversified approaches and facilitates integrated learning across environmental domains.

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Introduction Better integration of health services and redefinition of health workforce roles through expanding and extending traditional scope of clinical practice have been explored nationally and internationally. This paper aims to extend our earlier work by examining models of expanded and extended scope of paramedic practice for attributes which facilitate such a practice. Methods An exploratory multi-case study analysis of Australia, New Zealand, Canada and the United Kingdom expanded and extended paramedic practices were analysed. Results Successful models of advanced practice harness the capacity and personality of the paramedic practitioner, and are supported by enabling infrastructures, specifically: professional development/ education; clinical guideline and policy (boundary); access to physical infrastructure and clinical support from senior medical practitioners; and, ability to directly refer to other health services (service integration). The scope of advanced practice is however influenced by individual employers’ capacity, perceived needs and preference/ prioritises. The potential for advanced paramedic practice is equally applicable to urban as well as rural Australia. The Council of Ambulance Authorities’ Professional Competency Standard provides the form and functions for building on advanced paramedic practice. Recognition of such advanced paramedic practice provides a structure for professional growth, process for career progression and will support workforce retention. Conclusion The achievement of advanced knowledge and skills has positioned the paramedic profession to be recognized as a valuable clinician. The Council of Ambulance Authorities’ Professional Competency Standards provides the form and function for supporting advanced paramedic practice.

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Conjugation of chemicals with glutathione (GSH) can lead to decreased or increased toxicity. A genetic deficiency in the GSH S-transferase μ class gene M1 has been hypothesized to lead to greater risk of lung cancer in smokers. Recently a gene deletion polymorphism involving the human θ enzyme T1 has been described; the enzyme is present in erythrocytes and can be readily assayed. A rat θ class enzyme, 5-5, has structural and catalytic similarity and the protein was expressed in the Salmonella typhimurium tester strain TA1535. Expression of the cDNA vector increased the mutagenicity of ethylene dibromide and several methylene dihalides. Mutations resulting from the known GSH S-transferase substrate 1,2-epoxy-3-(4′nitrophenoxy)propane were decreased in the presence of the transferase. Expression of transferase 5-5 increased mutations when 1,2,3,4-diepoxybutane (butadiene diepoxide), 4-bromo-1,2-epoxybutane, or 1,3-dichloracetone were added. The latter compound is a model for the putative 1,2-dibromo-3-chloropropane oxidation product 1-bromo-3-chloroacetone. These genotoxicity and genotyping assays may be of use in further studies of the roles of GSH S-transferase θ enzymes in bioactivation and detoxication and any changes in risk due to polymorphism.

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Universities supply a range of services to students. These include most obviously, tuition services in relation to undergraduate and postgraduate courses; research supervision services in relation to research degrees; as well as consultancy services in relation to Government and industry work. For the purposes of the CCA, universities are trading corporations. They engage in trade or commerce through the provision of a range of services for reward. As such Universities are subject to the same rules and regulations that govern the conduct of other trading corporations, such Coles and Woolworths. As senior officers and managers of a trading corporation you need to acquire some basic understanding of the rules that govern competition in the education sector. In other sectors, companies generally undertake a risk assessment of those areas where they are most at risk of contravening the CCA; to ascertain in advance how problems might arise so that they can put in place strategies to mitigate the risk of inadvertent contraventions.

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This study developed an understanding of hydrological processes within the Cressbrook Creek catchment of the upper Brisbane River, in particular for the alluvial aquifers. Those aquifers within the lower catchment are used for intensive irrigation, and have been impacted by long-term drought followed by flooding. The study utilised water chemistry, isotopic characters and hydraulic measurements to determine factors such as recharge, links between creeks and groundwater, and variations in water quality. The catchment-wide study will enable improved management of the local water resources.

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Purpose Musculoskeletal conditions can impair people’s ability to undertake physical activity as they age. The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing ambulatory hospital clinics for musculoskeletal disorders. Patients and methods A questionnaire with open-ended items was administered to patients (n=217, 73.3% of 296 eligible) from three clinics providing ambulatory services for nonsurgical treatment of musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them to be physically active. Participants’ responses to the two open-ended questions were read, coded, and thematically analyzed independently by two researchers, with a third researcher available to arbitrate any unresolved disagreement. Results The mean (standard deviation) age of participants was 53 (15) years; n=113 (52.1%) were male. A total of 112 (51.6%) participants reported having three or more health conditions; n=140 (64.5%) were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were "health conditions", "time restrictions", "poor physical condition", "emotional, social, and psychological barriers", and "access to exercise opportunities". Perceived physical activity facilitators were also aligned under five themes, namely "improved health state", "social, emotional, and behavioral supports", "access to exercise environment", "opportunities for physical activities", and "time availability". Conclusion It was clear from the breadth of the data that meaningful supports and interventions must be multidimensional. They should have the capacity to address a variety of physical, functional, social, psychological, motivational, environmental, lifestyle, and other perceived barriers. It would appear that for such interventions to be effective, they should be flexible enough to address a variety of specific concerns.

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In this chapter, we draw on our experiences facilitating community storytelling workshops in regional Queensland in partnership with the Queensland branch of Oral History Association of Australia (OHAA Qld) in order to develop a best practice model for promoting creative approaches to recording oral narratives using digital tools, informed by creative writing practice and embedded evaluation (Klaebe 2012 & 2013). These experiences offer an insight into how creative approaches to training can facilitate the sharing and preservation of stories in regional communities.

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Over the last two decades, "green criminology" has emerged as a unique area of study, bringing together criminologists and sociologists from a wide range of research backgrounds and varying theoretical orientations. It spans the micro to the macro—from individual-level environmental crimes and victimization to business/corporate violations and state transgressions. There have been few attempts, however, to explicitly or implicitly integrate cultural criminology into green criminology (or vice versa). This book moves towards articulating a green cultural criminological perspective. Brisman and South examine existing overlapping research and offer a platform to support future excursions by green criminologists into cultural criminology’s concern with media images and representations, consumerism and consumption, and resistance. At the same time, they offer an invitation to cultural criminologists to adopt a green view of the consumption landscape and the growth (and depictions) of environmental harms.

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Although local food consumption is growing in importance there remains a lack of research addressing local food consumption preferences in less-developed countries. This paper aims to examine the drivers of local food purchase intentions for Chilean consumers. A model of local food behavioral intention was developed from consumer behavior theory. The model was tested using structural equation modeling with data from Chilean shoppers located in Santiago (n=283). The analysis revealed that Chilean consumers are willing to purchase local food based on their positive attitude towards buying local food and their feelings of connectedness with the environment, but not because they have a desire to support local businesses. These findings have implications for retailers, marketers and food producers.

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This research provides a critical link to ensure designers remain at the forefront of developing safe, sustainable and innovative products and services in the future. The four key findings of this research contribute to the advancement of knowledge and provide an understanding of the relationships between designers' co-evolution approach and their use of analogy. The behavioural relationships between sketching and gesture were investigated. The outcome of this research is a Design Activity Framework. This framework demonstrates a novel understanding how designers design by concentrating on co-evolution, problem-framing and solution seeking.