Characteristics of doctors transitioning to a non-clinical role in the MABEL study

Objective: To investigate the characteristics and satisfaction of medical doctors transitioning from a clinical into an entirely non-clinical role.

Design and setting: Wave 1 to Wave 5 data from 2008- 2012 in the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal, populationbased survey were analysed.

Participants: Medical doctors including general practitioners (GPs), specialists, specialists in training (SIT) and hospital non-specialists (HNS). Hospital nonspecialists represent doctors working in a hospital who were not enrolled in a specialty training program. The total number of participants surveyed across the 5 waves was 15,195 doctors.

Main outcome measures: The number of medical doctors making the transition from a clinical role to a nonclinical role from one wave of data to the subsequent wave of data. Individuals who responded 'Yes' to the question 'Are you currently doing any clinical medical work in Australia?' were defined as working in a clinical role. Individuals who stated that they were 'Doing medical work in Australia that is non-clinical' were defined as working in a completely non-clinical role. Each doctor's characteristics while partaking in clinical work prior to making the change to a non-clinical role were noted.

Results: Over 5 years, there were a total of 498 individuals who made the transition from a clinical role to a completely non-clinical role out of a possible 15,195 doctors. Increasing age was the strongest predictor for transition to a non-clinical role. With regards to doctor type, specialists, hospital non-specialists and specialists-in- training were more likely to make the transition to a totally non-clinical role compared to GPs. There was minimal evidence of a relationship between lower job satisfaction and making a transition, and also between higher life satisfaction and making a transition.

Conclusions: Understanding the characteristics of, and reasons for non-clinical career transition are important for workforce training, planning and development.

Australian doctors’ non-clinical activities: results from the MABEL survey of doctors

Objective. The aim of the present study was to investigate non-clinical work conducted by Australian doctors.
Methods. This study was an exploratory descriptive study using data from Wave 5 of the Medicine in Australia: Balancing Employment and Life (MABEL) longitudinal survey, collected in 2012 from Australian medical practitioners (2200 general practitioners (GPs), 3455 specialists, 1270 specialists in training and 1656 hospital non-specialists). The main outcome measure was the number of hours worked per week in non-clinical work. Regression analysis was used to determine associations between non-clinical activities (i.e. education-related, management and administration and other) and personal and professional characteristics, including age, gender, job and life satisfaction, total clinical working hours, sector of practice
(public or private) and doctor type.
Results. Australian doctors spend an average of just under 7 h per week, or 16% of their working time, on non-clinical activities. Doctors who worked more hours on non-clinical activities overall, and in education-related and management and
administration specifically, were male, younger, had lower life satisfaction and generally spent fewer hours on clinical work. Lower job satisfaction was associated with longer management and administration hours, but not with time spent in
education-related activities. Specialists were more likely to work long non-clinical hours, whereas GPs were more likely to report none. Hospital non-specialists reported relatively high management and administration hours.
Conclusions. Further work is required to better understand the full range of non-clinical activities doctors are involved in and how this may impact future workforce projections.

The use of high dynamic range luminance mapping in the assessment, understanding and defining of visual issues in post occupancy building assessment

The international focus on embracing daylighting for energy efficient lighting purposes and the corporate sector’s indulgence in the perception of workplace and work practice “transparency” has spurned an increase in highly glazed commercial buildings. This in turn has renewed issues of visual comfort and daylight-derived glare for occupants. In order to ascertain evidence, or predict risk, of these events; appraisals of these complex visual environments require detailed information on the luminances present in an occupant’s field of view. Conventional luminance meters are an expensive and time consuming method of achieving these results. To create a luminance map of an occupant’s visual field using such a meter requires too many individual measurements to be a practical measurement technique. The application of digital cameras as luminance measurement devices has solved this problem. With high dynamic range imaging, a single digital image can be created to provide luminances on a pixel-by-pixel level within the broad field of view afforded by a fish-eye lens: virtually replicating an occupant’s visual field and providing rapid yet detailed luminance information for the entire scene. With proper calibration, relatively inexpensive digital cameras can be successfully applied to the task of luminance measurements, placing them in the realm of tools that any lighting professional should own. This paper discusses how a digital camera can become a luminance measurement device and then presents an analysis of results obtained from post occupancy measurements from building assessments conducted by the Mobile Architecture Built Environment Laboratory (MABEL) project. This discussion leads to the important realisation that the placement of such tools in the hands of lighting professionals internationally will provide new opportunities for the lighting community in terms of research on critical issues in lighting such as daylight glare and visual quality and comfort.

Book review : "Community engagement in contemporary legal education : Pro Bono, Clinical legal education and services learning"

The result of a forum on community engagement held in November 2008 at Bond University, Community Engagement in Contemporary Legal Education is a compilation of papers presented at the forum by academics and professionals throughout Australia. Although found initially to be a topic of legal interest, it was not until the reviewer came across the Council of Australian Law Deans (CALD) “Standards for Australian Law Schools” (adopted 17 November 20093) then the full importance and potential of this book was revealed. Clause 2.2.4 of the CALD Standards recognises the importance of “experiential learning opportunities” for law students and cites examples such as clinical programs, internships, practical experience and pro-bono work. Clause 2.3.3 acknowledges the need to develop professional ethics and again cites pro-bono obligations as an example. Clause 9.6.2 encourages interaction of law schools with the profession and the community and again, pro-bono community service is identified as one method of doing so. Yet nowhere in the document are there any uniform standards or binding obligations that law schools must commit to. In the current climate where the importance of practical experience is continually emphasised and student numbers exceed the number of available paid legal positions, there should be more focus on the details of how these commitments should be converted to be included in a law school’s curriculum.

Corporate governance in China

So far as Asia is concerned, corporate governance is an import. The concept itself was virtually unknown in China ¬a decade ago. Yet corporate governance has now been enthusiastically embraced in China, to the point that the year 2005 was declared the Year of Corporate Governance and extensive amendments have been made to several laws and regulations with an emphasis on corporate governance. This essay will consider the effectiveness of China’s corporate governance law on paper and in practice with the OECD’s Principles of Corporate Governance acting as a general guide.

Access to medicine and the dangers of patent linkage : lessons from Bayer Corp v. Union of India

In February 2010, the Delhi High Court delivered its decision in Bayer Corp v Union of India in which Bayer had appealed against an August 2009 decision of the same court. Both decisions prevented Bayer from introducing the concept of patent linkage into India’s drug regulatory regime. Bayer appealed to the Indian Supreme Court, the highest court in India, which agreed on 2 March 2010 to hear the appeal. Given that India is regarded as a global pharmaceutical manufacturer of generic medications, how its judiciary and government perceive their international obligations has a significant impact on the global access to medicines regime. In rejecting the application of patent linkage, the case provides an opportunity for India to further acknowledge its international human rights obligations.

Inactivation of the Huntington's disease gene (Hdh) impairs anterior streak formation and early patterning of the mouse embryo

Background Huntingtin, the HD gene encoded protein mutated by polyglutamine expansion in Huntington's disease, is required in extraembryonic tissues for proper gastrulation, implicating its activities in nutrition or patterning of the developing embryo. To test these possibilities, we have used whole mount in situ hybridization to examine embryonic patterning and morphogenesis in homozygous Hdhex4/5 huntingtin deficient embryos. Results In the absence of huntingtin, expression of nutritive genes appears normal but E7.0–7.5 embryos exhibit a unique combination of patterning defects. Notable are a shortened primitive streak, absence of a proper node and diminished production of anterior streak derivatives. Reduced Wnt3a, Tbx6 and Dll1 expression signify decreased paraxial mesoderm and reduced Otx2 expression and lack of headfolds denote a failure of head development. In addition, genes initially broadly expressed are not properly restricted to the posterior, as evidenced by the ectopic expression of Nodal, Fgf8 and Gsc in the epiblast and T (Brachyury) and Evx1 in proximal mesoderm derivatives. Despite impaired posterior restriction and anterior streak deficits, overall anterior/posterior polarity is established. A single primitive streak forms and marker expression shows that the anterior epiblast and anterior visceral endoderm (AVE) are specified. Conclusion Huntingtin is essential in the early patterning of the embryo for formation of the anterior region of the primitive streak, and for down-regulation of a subset of dynamic growth and transcription factor genes. These findings provide fundamental starting points for identifying the novel cellular and molecular activities of huntingtin in the extraembryonic tissues that govern normal anterior streak development. This knowledge may prove to be important for understanding the mechanism by which the dominant polyglutamine expansion in huntingtin determines the loss of neurons in Huntington's disease.

The state of the art defence : defining the Australian experience in the context of pharmaceuticals

One of the defences within Part 3-5 of the Australian Consumer Law is the state of the art, or development risk defence. This defence, although significant, has often been neglected in Australian jurisprudential analysis and has triggered at most generic academic analysis. However, with the rise of pharmaceutical and medical device litigation in Australia, it could become a vital weapon for Australian manufacturers against product liability claims. This paper will firstly review the two ways this defence could operate. It will also discuss the three types of defects which the defence could apply to. This paper aims to determine exactly when and how this defence should apply in Australia, in the context of pharmaceutical product liability claims.

An analysis of Australia's legal regime for imposing liability on manufacturers of pharmaceutical drugs

Following a trial in June 2009 where the Federal Court heard submissions regarding whether Merck Sharpe and Dohme Australia should be held liable for an increased risk of cardiovascular conditions noted in patients who had taken the anti-inflammatory drug Vioxx, a judgment was handed down against MSDA in March 2010. MSDA appealed to the Full Federal Court, where they were successful. Special leave to appeal to the High Court of Australia was rejected in May 2012. This article will examine the themes raised in the trial judgment and the appropriateness of Australia’s statutory consumer protection regime through the lens of pharmaceutical drug injuries and side effects.

Book review - Richard Goldberg, Medicinal Product Liability and Regulation (Hart Publishing, Oxford, 2013) 214pp

In December 2013, settlement was reached between approximately 100 Australian and New Zealand Thalidomide victims and the company which had acted as the Australian distributor of the infamous drug, thus putting to rest the possibility of litigation. Around the same time, Thalidomide victims in the United Kingdom (UK) launched a similar bid for compensation against the manufacturer and distributor. It is clear that despite a lengthy amount of time having passed ever since the thalidomide disaster commenced in 1962, the controversy over compensation continues. Indeed, the author of Medicinal Product Liability and Regulation (published before the announcement of the British legal claim), Professor Goldberg, notes that claims for resulting birth defects continue to emerge right into the present day. His prescient insight into the contemporary relevance of compensation for pharmaceutical injuries thus makes Medicinal Product Liability and Regulation a very relevant addition to the small body of scholarship that is available on this rather specific and complex issue.

Nuorten osallisuus ja osallistuminen maaseudun kehitysstrategioissa : osuuskunnat ja Feria Francat Koillis-Argentiinassa

Tutkin Pro Gradu -työssäni nuorten osallisuutta ja osallistumista suhteessa maaseutukehitykseen Argentiinan maaseudulla. Vaikka nuorison tärkeä strateginen asema maaseudun kehityksen kannalta mainitaan usein sekä akateemisessa että poliittisessa diskurssissa, on nuoriso jäänyt vähälle huomiolle tutkijoiden, yhteiskunnallisten päättäjien, ja muiden toimijoiden silmissä Latinalaisessa Amerikassa. Maaseudun nuorten ”näkymättömyys” on johtanut siihen, että heidän asemansa erillisenä sosiaalisena toimijana on jäänyt heikoksi. Oman tutkimukseni ensisijaisena tavoitteena on siis saada paljon kaivattua lisätietoa argentiinalaisista maaseudun nuorista. Lähestyn maaseudun kehitysproblematiikkaa osallisuuden ja osallistumisen käsitteiden kautta tutkimalla nuorten osallisuutta ja osallistumista maaseutuympäristössä yleisesti sekä muutamissa maaseudun yhteisötaloudellisissa instituutioissa erityisesti. Tutkimiani instituutioita ovat maatalousosuuskunnat ja pientuottajien verovapaat torit eli Feria Francat. Kutsun kyseisiä instituutioita kehitysstrategioiksi. Suhteutan aineistoani territoriaaliseen maaseudun kehitysnäkemykseen (desarrollo territorial rural) ja erityisesti argentiinalaisen Mabel Manzanalin paikallisväestön järjestäytyneen osallistumisen roolia korostavaan versioon siitä. Tutkimukseni perustuu pääasiassa vuoden 2009 syksyllä Koillis-Argentiinassa toteutetun kenttätyön antiin. Tutkimusotteeni oli melko etnografinen ja aineisto sisältää osallistuvan havainnoinnin kautta hankittua informaatiota, haastatteluja, keskusteluja sekä kirjallista materiaalia. Tutkimukseni tärkeimpänä tuloksena voidaan todeta, että Koillis-Argentiinan maaseudulla nuorilla ei juurikaan ole tilaa osallistua ja heidän asemansa erillisenä sosiaalisen toimijana on erittäin heikko. Vaikka tilanne näyttää huolestuttavalta, onneksi jotkut osuuskunnat ja erityisesti Feria Francat ovat pystyneet tarjoamaan uudenlaisia mahdollisuuksia maaseudun nuorille ja niillä on muutenkin potentiaalia toimia järjestäytyneen osallistumisen areenoina sekä kokonaisvaltaisen territoriaalisen maaseutukehityksen edistäjinä. Maaseudun kehityksen kannalta olisi erittäin tärkeää, että nuorten sosiaalista pääomaa vahvistettaisiin, he tuntisivat itsensä osallisiksi ja pääsisivät oikeasti osallistumaan ja vaikuttamaan. Nuoret nimittäin usein omaavat sellaista tietotaitoa ja ideoita, joita vanhemmilta sukupuolilta ei välttämättä löydy. Mutta jos nuoret kokevat, että heitä ei arvosteta eikä heille tarjota mahdollisuuksia, he lähtevät etsimään onneaan yhä suuremmiksi paisuvista kaupungeista ja samalla maaseudun tulevaisuus vaarantuu kun se menettää kehityksensä kannalta tärkeitä voimavaroja ja sosiaalista pääomaa.

Nuorten osallisuus ja osallistuminen maaseudun kehitysstrategioissa: Osuuskunnat ja Feria Francat Koillis-Argentiinassa

Tutkin Pro Gradu -työssäni nuorten osallisuutta ja osallistumista suhteessa maaseutukehitykseen Argentiinan maaseudulla. Vaikka nuorison tärkeä strateginen asema maaseudun kehityksen kannalta mainitaan usein sekä akateemisessa että poliittisessa diskurssissa, on nuoriso jäänyt vähälle huomiolle tutkijoiden, yhteiskunnallisten päättäjien, ja muiden toimijoiden silmissä Latinalaisessa Amerikassa. Maaseudun nuorten ”näkymättömyys” on johtanut siihen, että heidän asemansa erillisenä sosiaalisena toimijana on jäänyt heikoksi. Oman tutkimukseni ensisijaisena tavoitteena on siis saada paljon kaivattua lisätietoa argentiinalaisista maaseudun nuorista. Lähestyn maaseudun kehitysproblematiikkaa osallisuuden ja osallistumisen käsitteiden kautta tutkimalla nuorten osallisuutta ja osallistumista maaseutuympäristössä yleisesti sekä muutamissa maaseudun yhteisötaloudellisissa instituutioissa erityisesti. Tutkimiani instituutioita ovat maatalousosuuskunnat ja pientuottajien verovapaat torit eli Feria Francat. Kutsun kyseisiä instituutioita kehitysstrategioiksi. Suhteutan aineistoani territoriaaliseen maaseudun kehitysnäkemykseen (desarrollo territorial rural) ja erityisesti argentiinalaisen Mabel Manzanalin paikallisväestön järjestäytyneen osallistumisen roolia korostavaan versioon siitä. Tutkimukseni perustuu pääasiassa vuoden 2009 syksyllä Koillis-Argentiinassa toteutetun kenttätyön antiin. Tutkimusotteeni oli melko etnografinen ja aineisto sisältää osallistuvan havainnoinnin kautta hankittua informaatiota, haastatteluja, keskusteluja sekä kirjallista materiaalia. Tutkimukseni tärkeimpänä tuloksena voidaan todeta, että Koillis-Argentiinan maaseudulla nuorilla ei juurikaan ole tilaa osallistua ja heidän asemansa erillisenä sosiaalisen toimijana on erittäin heikko. Vaikka tilanne näyttää huolestuttavalta, onneksi jotkut osuuskunnat ja erityisesti Feria Francat ovat pystyneet tarjoamaan uudenlaisia mahdollisuuksia maaseudun nuorille ja niillä on muutenkin potentiaalia toimia järjestäytyneen osallistumisen areenoina sekä kokonaisvaltaisen territoriaalisen maaseutukehityksen edistäjinä. Maaseudun kehityksen kannalta olisi erittäin tärkeää, että nuorten sosiaalista pääomaa vahvistettaisiin, he tuntisivat itsensä osallisiksi ja pääsisivät oikeasti osallistumaan ja vaikuttamaan. Nuoret nimittäin usein omaavat sellaista tietotaitoa ja ideoita, joita vanhemmilta sukupuolilta ei välttämättä löydy. Mutta jos nuoret kokevat, että heitä ei arvosteta eikä heille tarjota mahdollisuuksia, he lähtevät etsimään onneaan yhä suuremmiksi paisuvista kaupungeista ja samalla maaseudun tulevaisuus vaarantuu kun se menettää kehityksensä kannalta tärkeitä voimavaroja ja sosiaalista pääomaa.

Letras, 1985, nº 13 (número completo)

Contenido: Algo más sobre la estructura de “El buscón” / Raquel Minian de Alfie – La función de las aguas en las églogas de Garcilaso de la Vega / María Rosa Lojo de Beuter – Tradición y originalidad en el romance de “El prisionero” / Hugo Oscar Bizzarri – Afectividad y expresión / María Luisa Fernández – “Sujeto”, “verbo” y “objeto” en tres gramáticos españoles del Renacimiento / Graciela Mabel Giammatteo – Focalización sinecdóquica y desplazamiento metonímico en poemas de Jorge Guillén / Delfina Muschietti – El traslado de un mito: el itinerario Argos-Nueva Inglaterra-Palermo y “El reñidero” de Sergio de Cecco / Eithel Orbit Negri – Las supuestas dos versiones del Antídoto de Juan de Jáuregui a la luz de los manuscritos conservados / Melchora Romanos – El sueño en “Amor y pedagogía” de Miguel de Unamuno / Marcela Tabanera – Espacios y comprensión estética en “Nada” de Carmen Laforet / Verónica Zumárraga – Reseñas bibliográficas

Estudios de Historia de España, 2007, vol. 9 (número completo)

Contenido: La Campaña de Muza en el Noroeste en el año 713 y la capitulación de Astorga / Julio Montenegro ; Arcadio del Castillo – La villa de Tordesillas y sus relaciones regionales / Cecilia Bahr – La estructura de la propiedad de la tierra en Murcia durante la conquista castellana / Antonio Vicente Frey Sánchez – La diplomacia y las embajadas como expresión de los contactos interculturales entre cristianos y musulmanes en el Mediterráneo occidental durante la Baja Edad Media / Roser Salicrú i Lluch – El Barón de Rozmital en la Corona de Aragón (nuevos datos sobre la presencia de un ilustre bohemio del siglo XV en la Península Ibérica) / Miguel Raufast Chico – Tres hermanas hispano-judías judaizantes condenadas por la Inquisición. Sus personalidades / Susana Mabel Likerman de Portnoy – Evolución demográfica en Lleida desde la Guerra de la Independencia hasta el final del Trienio liberal / Antonio Sánchez Carcelén – La historia de las relaciones internacionales en España: un marco interpretativo / José Luis Neila Hernández -- Reseñas