Practice and Procedure - offers to settle - no costs benefit if no compromise

In Jones v Millward [2005]QCA76 the Queensland Court of Appeal held that an offer to settle under the UCPR will not attract a costs benefit unless it involves some element of compromise

Right to trial by jury - construction of Uniform Civil Procedure r474

In Smit v Chan [2001] QSC 493 (Supreme Court of Queensland, S1233 of 1995, Mullins J, 21.12.2001) the sixth defendant successfully obtained an order that a complex medical negligence action be tried without a jury. This was the first application to be decided under r474 of UCPR 1999, and the decision is a significant precedent for defendants in similar cases who want to avoid the unpredictability of outcome and the inflated damages awards sometimes associated with jury trials.

Practice and procedure : solicitors' liens for costs

In Patterson v Cohen [2005] NSWSC 635 Hamilton J examined the authorities in relation to what are commonly called 'fruits of litigation' liens. The judgment provides a very useful summary of the principles which apply.

Practice and procedure : Personal Injuries Proceedings Act 2002 s56

In Amos v Brisbane City Council [2005] QCA 433 the Queensland Court of Appeal was called upon to determine the scope of s56 of the Personal Injuries Proceedings Act 2002. The decision makes it clear that the section does not provide a complete code governing awards of damages and does not deprive the court of power to award costs against a plaintiff who fails to succeed on liability.

Practice and Procedure - Proceedings claiming damages for personal injuries commenced before June 18, 2002

In Inglis v Connell [2003] QDC 029 the court considered s6(3) of the Personal Injuries Proceedings Act 2002 in relation to the application of the Act. The conclusion reached was that the provision should be interpreted as providing that the requirements of the Act do not apply in respect of personal injury the subject of any proceeding commenced before June 18, 2002.

Stop and revive? The effectiveness of nap and active rest breaks for reducing driver sleepiness

Objectives The purpose for this study was to determine the relative benefit of nap and active rest breaks for reducing driver sleepiness. Methods Participants were 20 healthy young adults (20-25 years), including 8 males and 12 females. A counterbalanced within-subjects design was used such that each participant completed both conditions on separate occasions, a week apart. The effects of the countermeasures were evaluated by established physiological (EEG theta and alpha absolute power), subjective (Karolinska Sleepiness Scale), and driving performance measures (Hazard Perception Task). Participants woke at 5am, and undertook a simulated driving task for two hours; each participant then had either a 15-minute nap opportunity or a 15-minute active rest break that included 10 minutes of brisk walking, followed by another hour of simulated driving. Results The nap break reduced EEG theta and alpha absolute power and eventually reduced subjective sleepiness levels. In contrast, the active rest break did not reduce EEG theta and alpha absolute power levels with the power levels eventually increasing. An immediate reduction of subjective sleepiness was observed, with subjective sleepiness increasing during the final hour of simulated driving. No difference was found between the two breaks for hazard perception performance. Conclusions Only the nap break produced a significant reduction in physiological sleepiness. The immediate reductions of subjective sleepiness following the active rest break could leave drivers with erroneous perceptions of their sleepiness, particularly as physiological sleepiness continued to increase after the break.

An enhanced procedure for the rapid digestion of high silicate archeological specimens followed by ICP-MS determination of traces of rare earth elements (REE's)

A straightforward procedure for the acid digestion of geological samples with SiO2 concentrations ranging between about 40 to 80%, is described. A powdered sample (200 mesh) of 500 mg was used and fused with 1000 mg spectroflux at about 1000 degreesC in a platinum crucible. The molten was subsequently digested in an aqueous solution of HNO3 at 100 degreesC. Several systematic digestion procedures were followed using various concentrations of HNO3. It was found that a relationship could be established between the dissolution-time and acid concentration. For an acid concentration of 15% an optimum dissolution-time of under 4 min was recorded. To verify that the dissolutions were complete, they were subjected to rigorous quality control tests. The turbidity and viscosity were examined at different intervals and the results were compared with that of deionised water. No significant change in either parameter was observed. The shelf-life of each solution lasted for several months, after which time polymeric silicic acid formed in some solutions, resulting in the presence of a gelatinous solid. The method is cost effective and is clearly well suited for routine applications on a small scale, especially in laboratories in developing countries. ICP-MS was applied to the determination of 13 Rare Earth Elements and Hf in a set of 107 archaeological samples subjected to the above digestion procedure. The distribution of these elements was examined and the possibility of using the REE's for provenance studies is discussed.

The effectiveness of information-sharing interventions to reduce anxiety in families waiting for surgical patients undergoing an elective surgical procedure: A systematic review

Background Whilst waiting for patients undergoing surgery, a lack of information regarding the patient’s status and the outcome of surgery, can contribute to the anxiety experienced by family members. Effective strategies for providing information to families are therefore required. Objectives To synthesize the best available evidence in relation to the most effective information-sharing interventions to reduce anxiety for families waiting for patients undergoing an elective surgical procedure. Inclusion criteria Types of participants All studies of family members over 18 years of age waiting for patients undergoing an elective surgical procedure were included, including those waiting for both adult and pediatric patients.   Types of intervention All information-sharing interventions for families of patients undergoing an elective surgical procedure were eligible for inclusion in the review. Types of studies All randomized controlled trials (RCTs) quasi-experimental studies, case-controlled and descriptive studies, comparing one information-sharing intervention to another or to usual care were eligible for inclusion in the review. Types of outcomes Primary outcome: The level of anxiety amongst family members or close relatives whilst waiting for patients undergoing surgery, as measured by a validated instrument such as the S-Anxiety portion of the State-Trait Anxiety Inventory (STAI). Secondary outcomes: Family satisfaction and other measurements that may be considered indicators of stress and anxiety, such as mean arterial pressure (MAP) and heart rate. Search strategy A comprehensive search, restricted to English language only, was undertaken of the following databases from 1990 to May 2013: Medline, CINAHL, EMBASE, ProQuest, Web of Science, PsycINFO, Scopus, Dissertation and Theses PQDT (via ProQuest), Current Contents, CENTRAL, Google Scholar, OpenGrey, Clinical Trials, Science.gov, Current Controlled Trials and National Institute for Clinical Studies (NHMRC). Methodological quality Two independent reviewers critically appraised retrieved papers for methodological quality using the standardized critical appraisal instruments for randomized controlled trials and descriptive studies from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI). Data extraction Two independent reviewers extracted data from included papers using a customized data extraction form. Data synthesis Statistical pooling was not possible, mainly due to issues with data reporting in two of the studies, therefore the results are presented in narrative form. Results Three studies with a total of 357 participants were included in the review. In-person reporting to family members was found to be effective in comparison with usual care in which no reports were provided. Telephone reporting was also found to be effective at reducing anxiety, in comparison with usual care, although not as effective as in-person reporting. The use of paging devices to keep family members informed were found to increase, rather than decrease anxiety. Conclusions Due to the lack of high quality research in this area, the strength of the conclusions are limited. It appears that in-person and telephone reporting to family members decreases anxiety, however the use of paging devices increases anxiety.

“Do I really need a nap?”: The role of sleep science in informing sleep practices in early childhood education and care settings

A compelling body of studies identifies the importance of sleep for children’s learning, behavioral regulation, and health. These studies have primarily focused on nighttime sleep or on total sleep duration. The independent contribution of daytime sleep, or napping, in childhood is an emerging research focus. Daytime sleep is particularly pertinent to the context of early childhood education and care (ECEC) where, internationally, allocation of time for naps is commonplace through to the time of school entry. The biological value of napping varies with neurological maturity and with individual circumstance. Beyond the age of 3 years, when monophasic sleep patterns become typical, there is an increasing disjuncture between children’s normative sleep requirements and ECEC practice. At this time, research evidence consistently identifies an association between napping and decreased quality and duration of night sleep. We assess the implications of this evidence for educational practice and health policy. We identify the need to distinguish the functions of napping from those of rest, and assert the need for evidence-based guidelines on sleep–rest practices in ECEC settings to accommodate individual variation in sleep needs. Given both the evidence on the impact of children’s nighttime sleep on long-term trajectories of health and well-being and the high rates of child attendance in ECEC programs, we conclude that policy and practice regarding naptime have significant implications for child welfare and ongoing public health.

Using axially loaded MRI to investigate the biomechanics of adolescent idiopathic scoliosis

Introduction. Spinal flexibility measurement is an important aspect of pre-operative clinical assessment in the treatment of Adolescent Idiopathic Scoliosis (AIS). Clinically, curve flexibility is a combined measure for all vertebral levels. We propose that in vivo flexibility for individual spinal joints could provide valuable additional information in planning treatment for scoliosis. Methods. Individual spinal joint flexibility in the coronal plane was measured for a series of AIS patients using axially loaded magnetic resonance imaging. Each patient underwent magnetic resonance imaging in the supine position, with no axial load, and then following application of an axial compressive load equal to half the patient’s bodyweight. Coronal plane disc wedge angles in the unloaded and loaded configurations were measured. Joint moments exerted by the axial compressive load were used to derive estimates of individual joint compliance. Results. Fifteen AIS patients were included in the study (mean clinical Cobb angle 46 degrees, mean age 15.3 years). Mean intra-observer measurement error for endplate inclination was 1.6˚. The mean increase in measured major Cobb angle between unloaded and loaded scans was 7.6˚. For certain spinal levels (+2,+1,-2 relative to the apex) there was a statistically significant relationship between change in wedge angle under load and initial wedge angle, such that initially highly wedged discs demonstrated a smaller change in wedge angle than less wedged discs. Highly wedged discs were observed near the apex of the curve, which corresponded to lower joint compliance in the apical region. Conclusion. Approaches such as this can provide valuable biomechanical data on in vivo spinal biomechanics in AIS. Knowledge of individual joint flexibility may assist surgeons to determine which spinal procedure is most appropriate for a patient, which levels should be included in a spinal fusion and the relative mobility of individual joints in the deformed region of the spine.

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.

Postprocedural effects of gastrointestinal endoscopy performed as a day case procedure in children : implications for patient and family education

A prospective design that included a survey tool, nursing care records, and telephone interview was used to determine postprocedural effects experienced by children and families following gastrointestinal endoscopy performed as a day procedure. One hundred twenty-one children attending a pediatric gastroenterology unit for endoscopy under general anesthesia participated in the study. Physical symptoms, day care/school attendance, behavioral issues, and economic factors in the 72 hours post procedure were identified. Over half the children (n = 69, 57%) experienced pain in the hospital post procedure. Pain was reported by 73 children (60%) at home on the day of the procedure, by 55 children (45%) on Day 1 post procedure, and by 37 children (31%) on Day 2 post procedure. The throat was the most common site of pain. Nausea or vomiting was experienced by 37 children (31%) at some time following their procedure but was not associated with procedure type, age, or fasting time. Over half the children (n = 53, 51%) who usually attended day care or school did not attend the day following their procedure. Twenty-four parents (40%) who would normally have worked on the day after the procedure did not attend employment. These findings have been used to improve the preprocedural information and discharge management of patients treated in a pediatric gastroenterology ambulatory setting. © The Society of Gastroenterology Nurses & Associates 2007. All Rights Reserved.

A New, Convenient Reductive Procedure For The Deprotection Of 4-Methoxybenzyl (Mpm) Ethers To Alcohols

Selective introduction and removal of protecting groups is of great significance in organic synthesis.l The benzyl ether function is one of the most common protecting groups for alcohols. Selective oxidative removal of the 4-methoxybenzyl (MPM) ethers in the presence of benzyl ethers made the MPM moiety an alternative protecting group, and its utility in carbohydrate chemistry is well established. Several procedures have been developed for the cleavage of the 4-methoxybenzyl moiety, e.g. DDQ oxidation (eq 1),2e lectrochemical ~xidationh,~om ogeneous electron t r a n~f e rp,~ho toinduced single electron t r an~f e rb,o~ro n trichloride-dimethyl sulfide,6e tc. However, in all these methods isolation of the alcohol from the inevitable byproduct, 4-methoxybenzaldehyde [also dichlorodicyanohydroquinone (DDHQ) in the most commonly used method employing DDQI can be troublesome. Recently Wallace and Hedgetts7 discovered that acetic acid at 90 "C cleaves the aromatic MPM ethers into the corresponding phenols and 4-methoxybenzyl acetate (eq 21, whereas the aliphatic MPM ethers generated, instead of alcohols, the corresponding acetates (eq 3). Complimentary to this methodology, herein we report that sodium cyanoborohydride and boron trifluoride etherate reductively cleaves, cleanly and efficiently, the aliphatic MPM ethers to an easily separable mixture of the corresponding alcohols and 4-methylanisole

Image processing and classification procedure for the analysis of Australian frog vocalisations

Frog species have been declining worldwide at unprecedented rates in the past decades. There are many reasons for this decline including pollution, habitat loss, and invasive species [1]. To preserve, protect, and restore frog biodiversity, it is important to monitor and assess frog species. In this paper, a novel method using image processing techniques for analyzing Australian frog vocalisations is proposed. An FFT is applied to audio data to produce a spectrogram. Then, acoustic events are detected and isolated into corresponding segments through image processing techniques applied to the spectrogram. For each segment, spectral peak tracks are extracted with selected seeds and a region growing technique is utilised to obtain the contour of each frog vocalisation. Based on spectral peak tracks and the contour of each frog vocalisation, six feature sets are extracted. Principal component analysis reduces each feature set down to six principal components which are tested for classification performance with a k-nearest neighbor classifier. This experiment tests the proposed method of classification on fourteen frog species which are geographically well distributed throughout Queensland, Australia. The experimental results show that the best average classification accuracy for the fourteen frog species can be up to 87%.

Standardised antibacterial Manuka honey in the management of persistent post-operative corneal oedema: A case series

Background Corneal oedema is a common post-operative problem that delays or prevents visual recovery from ocular surgery. Honey is a supersaturated solution of sugars with an acidic pH, high osmolarity and low water content. These characteristics inhibit the growth of micro-organisms, reduce oedema and promote epithelialisation. This clinical case series describes the use of a regulatory approved Leptospermum species honey ophthalmic product, in the management of post-operative corneal oedema and bullous keratopathy. Methods A retrospective review of 18 consecutive cases (30 eyes) with corneal oedema persisting beyond one month after single or multiple ocular surgical procedures (phacoemulsification cataract surgery and additional procedures) treated with Optimel Antibacterial Manuka Eye Drops twice to three times daily as an adjunctive therapy to conventional topical management with corticosteroid, aqueous suppressants, hypertonic sodium chloride five per cent, eyelid hygiene and artificial tears. Visual acuity and central corneal thickness were measured before and at the conclusion of Optimel treatment. Results A temporary reduction in corneal epithelial oedema lasting up to several hours was observed after the initial Optimel instillation and was associated with a reduction in central corneal thickness, resolution of epithelial microcysts, collapse of epithelial bullae, improved corneal clarity, improved visualisation of the intraocular structures and improved visual acuity. Additionally, with chronic use, reduction in punctate epitheliopathy, reduction in central corneal thickness and improvement in visual acuity were achieved. Temporary stinging after Optimel instillation was experienced. No adverse infectious or inflammatory events occurred during treatment with Optimel. Conclusions Optimel was a safe and effective adjunctive therapeutic strategy in the management of persistent post-operative corneal oedema and warrants further investigation in clinical trials.