Nursing care of children in general practice settings: roles and responsibilities

Aims. To examine roles and responsibilities of Practice Nurses in the area of child health and development and in advising parents about child health issues. Background. As the focus of Australia’s health care system shifts further towards the primary health care sector, governmental initiatives require that Practice Nurses are knowledgeable, confident and competent in providing care in the area of child health and development. Little is known about roles and responsibilities of Practice Nurses in this area. Design. Cross-sectional survey design. Methods. Practice Nurses completed a national online survey examining the roles and responsibilities in child health and development, professional development needs and role satisfaction. Data were collected from June 2010–April 2011. Results. Respondents (N = 159) reported having a significant role in well and sick child care and were interested in extending their role. Frequent activities included immunization, phone triage/advice, child health/development advice, wound care and Healthy Kids Checks. However, few had paediatric/child nursing backgrounds or postgraduate qualifications in paediatric nursing and they reported limited preparation for the role. Practice Nurses reported difficulties with keeping up-to-date with child health information and advising parents confidently. Satisfaction was relatively low regarding opportunities and encouragement to undertake professional development and expand scope of practice. Conclusion. Practice Nurses are largely unprepared to meet the demands of their child health role and need support to develop and maintain the skills and knowledge base necessary for high-quality, evidence-based practice. Both financial and time support is needed to enable Practice Nurses to access child health professional development.

Sports anti-siphoning laws and the controversy of sports broadcasting: A case study of Pakistan

Controversies between private and public broadcasters over the broadcasting of live sports, especially cricket, during important sports events have emerged as a serious legal issue in Pakistan. Controversy between Geo Super and Pakistan Television over live telecast of the ICC Cricket World Cup is a typical example of such controversies. An aggressive legal battle, during a most important cricketing event, not only hampered the enjoyment of cricket viewers across the country but also gave Pakistan a bad name across the globe. This article discusses in detail this controversy and highlights lacunas in the existing sports broadcasting regime of Pakistan. There are no clear and well defined sports broadcasting laws in Pakistan. The Pakistan Electronic Media Regulatory Authority (PEMRA) rules are of general nature. Secondly, PEMRA rules are not comprehensive and explicit enough to provide clear guidelines about sports broadcasting. This may be a possible reason why sports broadcasting controversies reach the highest court in Pakistan, the Supreme Court of Pakistan. Despite these ugly battles between broadcasters, the government of Pakistan has never given due importance to this issue and no efforts have been made at any level to come up with legislation on sports broadcasting to avoid such controversies or to resolve them amicably in the light of well-defined laws on this subject. The purpose of this article is to draw the attention of the concerned authorities towards this important issue because in future more such controversies may be expected in the absence of a sports broadcasting regime in the country.

The Australian litigation landscape - Oral and Maxillofacial Surgery and general dentistry (oral surgery procedures): An analysis of litigation cases

Background: There are persistent concerns about litigation in the dental and medical professions. These concerns arise in a setting where general dentists are more frequently undertaking a wider range of oral surgery procedures, potentially increasing legal risk. Methods: Judicial cases dealing with medical negligence in the fields of general dentistry (oral surgery procedure) and Oral and Maxillofacial Surgery were located using the three main legal databases. Relevant cases were analysed to determine the procedures involved, the patients’ claims of injury, findings of negligence, and damages awarded. A thematic analysis of the cases was undertaken to determine trends. Results: Fifteen cases over a twenty-year period were located across almost all Australian jurisdictions (eight cases involved general dentists; seven cases involved Oral and Maxillofacial Surgeons). Eleven of the fifteen cases involved determinations of whether or not the practitioner had failed in their duty of care; negligence was found in six cases. Eleven of the fifteen cases related to molar extractions (eight specifically to third molar). Conclusions: Dental and medical practitioners wanting to manage legal risk should have regard to circumstances arising in judicial cases. Adequate warning of risks is critical, as is offering referral in appropriate cases. Pre-operative radiographs, good medical records, and processes to ensure appropriate follow-up are also important.

A two-stage SVM method to predict membrane protein types by incorporating amino acid classifications and physicochemical properties into a general form of Chou's PseAAC

Membrane proteins play important roles in many biochemical processes and are also attractive targets of drug discovery for various diseases. The elucidation of membrane protein types provides clues for understanding the structure and function of proteins. Recently we developed a novel system for predicting protein subnuclear localizations. In this paper, we propose a simplified version of our system for predicting membrane protein types directly from primary protein structures, which incorporates amino acid classifications and physicochemical properties into a general form of pseudo-amino acid composition. In this simplified system, we will design a two-stage multi-class support vector machine combined with a two-step optimal feature selection process, which proves very effective in our experiments. The performance of the present method is evaluated on two benchmark datasets consisting of five types of membrane proteins. The overall accuracies of prediction for five types are 93.25% and 96.61% via the jackknife test and independent dataset test, respectively. These results indicate that our method is effective and valuable for predicting membrane protein types. A web server for the proposed method is available at http://www.juemengt.com/jcc/memty_page.php

General practitioners learning qualitative research: A case study of postgraduate education

Background Qualitative research is increasingly being recognised as a vital aspect of primary healthcare research. Teaching and learning how to conduct qualitative research is especially important for general practitioners and other clinicians in the professional educational setting. This article examines a case study of postgraduate professional education in qualitative research for clinicians, for the purpose of enabling a robust discussion around teaching and learning in medicine and the health sciences. Method A series of three workshops was delivered for primary healthcare academics. The workshops were evaluated using a quantitative survey and qualitative free-text responses to enable descriptive analyses. Results Participants found qualitative philosophy and theory the most difficult areas to engage with, and learning qualitative coding and analysis was considered the easiest to learn. Discussion Key elements for successful teaching were identified, including the use of adult learning principles, the value of an experienced facilitator and an awareness of the impact of clinical subcultures on learning.

A 3-hour quantitative comparison of glucose-based versus rice-based oral rehydration solution intake by children with diarrhoea in Port Moresby General Hospital

Measurements were made of the intake of a WHO/UNICEF glucose-based and a rice cereal-based oral rehydration solution (ORS) by children with diarrhoea. Twenty children who presented to the Children's Outpatient Department at Port Moresby General Hospital with acute diarrhoea and mild dehydration were randomly assigned to an ORS and measurements were taken over the following 3 hours. For data analysis, the patients were paired by weight. Testing the means of the paired samples by t test showed that there was no significant difference between the amount of rice ORS and the amount of glucose ORS taken over 3 hours. The discovery of oral rehydration solution (ORS) for the treatment of diarrheal disease has been heralded as the most important medical discovery of the century. Cereal-based ORS is able to decrease stool output and the duration of diarrheal illness more than the standard glucose-based ORS, through the increased absorption provided by oligosaccharides without the imposition of a greater osmotic penalty. Moreover, the peptides in cereals enhance amino acid and water absorption, while providing nutritional benefits. UNICEF's glucose-based ORS is becoming more widely used in Papua New Guinea (PNG). 20 children aged 6-37 months (mean age, 15 months) who presented to the Children's Outpatient Department at Port Moresby General Hospital during September-October 1993 with acute diarrhea and mild dehydration were randomly assigned to receive either a rice-based ORS or standard glucose ORS, and measurements were taken over the following 3 hours. The patients were paired by weight for analysis. No statistically significant difference was found between the amount of rice ORS and the amount of glucose ORS taken over 3 hours.

Acceptability of a rice-based oral rehydration solution in Port Moresby General Hospital's Children's Outpatient Department

The guardians of children brought to the Port Moresby General Hospital's Children's Outpatient Department with a chief complaint of diarrhoeal disease were questioned regarding their preference of glucose-based vs rice-based oral rehydration solution (ORS) in order to determine the acceptability of a rice-based ORS. Of the 93 guardians interviewed, greater than 60% preferred the glucose-based solution in its mixability, appearance and taste, and 65% initially reported that their children preferred the taste of the glucose solution. However, after a 30-minute trial, only 58% of children still preferred the glucose solution. In a country where diarrhoeal disease is a leading cause of child death and guardians are the primary health care providers, the acceptability of an ORS is critical to the morbidity and mortality of Papua New Guinea's children. Killing an estimated 2.9 million children annually, diarrheal disease is the second leading cause of child mortality worldwide. Diarrheal disease is also the second leading cause of child mortality in Papua New Guinea (PNG), killing an average 193 inpatient children per year over the period 1984-90. However, despite the high level of diarrhea-related mortality and the proven efficacy of oral rehydration therapy (ORT) in managing diarrhea-related dehydration, standardized ORT has been underutilized in PNG. The current glucose-based oral rehydration solution (ORS) does not reduce the frequency or volume of a child's diarrhea, the most immediate concern of caregivers during episodes of illness. Cereal-based ORS, made from cereals which are commonly available as food staples in most countries, better address the short-term concerns of caregivers while offering a superior nutritional profile. A sample of guardians of children brought to the Port Moresby General Hospital's Children's Outpatient Department complaining of child diarrhea were asked about their preferences on glucose-based versus rice-based ORS in order to determine the acceptability of a rice-based ORS. More than 60% of the 93 guardians interviewed preferred the glucose-based solution for its mixability, appearance, and taste. 65% initially reported that their children preferred the taste of the glucose solution. However, after a 30-minute trial, only 58% of children still preferred the glucose solution.

Gaussian Schell-model beams and general shape invariance

We present two six-parameter families of anisotropic Gaussian Schell-model beams that propagate in a shape-invariant manner, with the intensity distribution continuously twisting about the beam axis. The two families differ in the sense or helicity of this beam twist. The propagation characteristics of these shape-invariant beams are studied, and the restrictions on the beam parameters that arise from the optical uncertainty principle are brought out. Shape invariance is traced to a fundamental dynamical symmetry that underlies these beams. This symmetry is the product of spatial rotation and fractional Fourier transformation.

A growing good faith in contracts

The Supreme Court of Canada's ruling in Bhasin v Hrynew represents a significant step forward in harmonising the multiple strands of debate surrounding the existence of a good faith provision in common law contracting. Although a general principle of good faith (derived from Roman Law) is recognized by most civil law systems and a growing number of common law countries have embraced statutory provisions towards this end, Bhasin v Hrynew is argued to be a critical advance in catalysing uniform acceptance of good faith as a fundamental principle essential to support an increasingly integrated global commercial environment.

An analytical study revisiting debate on interpretation of Article 38 of the Statute of International Court of Justice

Article 38(1) of the Statute of International Court of Justice (hereinafter ICJ) is today generally seen as a direction to the significant sources of international law, which the world court must consider in resolving disputes; however, the list is not exhaustive nor encompasses all the formal and material sources of the international legal system. Article 38 of the Statute of ICJ was written ninety years ago in a different world, a question is under debate in many states, whether or not sources mentioned in Article 38 of the statute are compatible with needs of 21st century ? In recent decade, many new actors come on the stage which have transformed international law and now it is not only governs relations among states but also covers many International Organizations. Article 38(2) does refer to the other possible sources but does not define them. Moreover, law is a set of rules that citizens must follow to regulate peace and order in society. These laws are binding on both the individual and the state on a domestic and international level. Do states regard this particular rule as a rule of international law? The modern legal system of states is in the form of a specified and well organized set of rules, regulating affairs of different organs of a state. States also need a body of rules for their intercourse with each other. These sets of rules among states are called “International Law.” This article examines international law, its foundation and sources. It considers whether international conventions and treaties can be the only way states can considerably create international law, or there is a need for clarity about the sources of international law. Article is divided into two parts, the first one deals with sources of international law discussed in Article 38 of the statute of International Court of Justice whereas the second one discusses the material and formal sources of law, which still need reorganization as sources of law.

Australian court holds Google is responsible for linking to defamatory website

The South Australian Supreme Court this week found that Google is legally responsible when its search results link to defamatory content on the web. In this long-running case, Dr Janice Duffy has been trying for more than six years to clear her name and remove links to defamatory material when people search for her using Google. The main culprit is the US based website Ripoff Reports, where people have posted negative reviews of Dr Duffy. Under United States law, defamation is very hard to prove, and US websites are not liable for comments made by their users. Since it was not possible to get harmful or abusive comments removed from the source, Dr Duffy instead asked Google to remove the links from its search results. Google removed some of these links, but only from its Australian domain (google.com.au), and it left many of them active. This latest court decision is a big win for Dr Duffy. The court found that once Google was alerted to the defamatory material, it was then under an obligation to act to censor its search results and prevent further harm to Dr Duffy’s reputation.

Submission on NSW Attorney-General's Discussion Paper on Amendment of Limitation of Actions Act 1969 to remove time limit for civil claims for child abuse

The New South Wales Attorney-General and Justice Policy Division released a Discussion Paper about reform of the Limitation of Actions Act 1969. The key question was whether and how to amend the statute to better provide access to justice for civil claimants in child abuse cases. This submission draws on published literature and multidisciplinary research to support the Discussion Paper's Option A, namely, to abolish the time limit for civil claims for injuries in criminal child abuse cases, and for this to be made retrospective.

General practitioner utilisation amongst urban Aboriginal and Torres Strait Islander children aged less than 5 years

Aim There are limited studies documenting the frequency and reason for attendance to primary health care services in Australian children, particularly for urban Aboriginal and Torres Strait Islander children. This study describes health service utilisation in this population in an urban setting. Methods An ongoing prospective cohort study of Aboriginal and Torres Strait Islander children aged <5 years registered with an urban Aboriginal and Torres Strait Islander primary health care centre in Brisbane, Australia. Detailed demographic, clinical, health service utilisation and risk factor data are collected by Aboriginal researchers at enrolment and monthly for a period of 12 months on each child. The incidence of health service utilisation was calculated according to the Poisson distribution. Results Between 14 February 2013 and 31 October 2014, 118 children were recruited, providing data for 535 child-months of observation. Ninety-one percent of children were Aboriginal, 4% Torres Strait Islander and 5% were both Aboriginal and Torres Strait Islander. The incidence of presentations to see a doctor for any reason was 43.9 episodes/100 child months (95%CI 38.4 – 49.9) The most common reasons for presentation were for immunisations (23%), respiratory illnesses (19%) and for Australian Government funded Indigenous child health check (16%). The primary health services used, for majority of these visits were Aboriginal and Torres Strait Islander specific medical services (61%). Conclusions Within a cultural-specific service for an urban Aboriginal and Torres Strait Islander people, there is a high frequency of childhood attendance at for primary health care services. Well-health checks and respiratory illnesses were the most common reasons. The high proportion of visits for well child services suggests a potential for opportunistic health promotion, education and early interventions across a range of child health issues.

From court to QCAT, or not

In Sutton v Tang [2015] QDC 191 Reid DCJ considered the circumstances that may be relevant to the exercise of the discretion to order a transfer of a proceeding to the Queensland Civil and Administrative Tribunal (the tribunal) under s53 of the Queensland Civil and Administrative Tribunal Act 2009 (Qld) (the Act).

Can a court protect an ex-addict from themselves?

In Hewitt v Bayntum & Allianz Australia Insurance Ltd [2015] QSC 250 the court was asked to sanction a compromise of a proceeding by a plaintiff who, though a recovering drug addict, was able to give instructions and understand the proposed compromise.