The National Disability Insurance Scheme ('NDIS') commenced in 2013 and is designed to give effect to Australia's obligations under the Convention on the Rights of Persons with Disabilities 2006 ...('CRPD'). Criticism of the NDIS has been widespread since the rollout, raising questions regarding compliance with the CRPD. This article specifically examines the shortcomings of the review process that persons with disabilities may encounter when they disagree with a decision made by the National Disability Insurance Agency, the body administering the NDIS, relating to their funding. It highlights inconsistencies with the CRPD article 13 'Access to justice', article 12 'Equal recognition before the law' and article 9 'Accessibility'. The reader will gain a deeper knowledge of the human rights weaknesses of the NDIS review process and how this impacts persons with disabilities. Opportunities to enhance compliance with the CPRD and start restoring confidence in the NDIS for persons with disabilities will be identified.
Zoonotic introduction of novel coronaviruses may encounter preexisting immunity in humans. Using diverse assays for antibodies recognizing SARS-CoV-2 proteins, we detected preexisting humoral ...immunity. SARS-CoV-2 spike glycoprotein (S)-reactive antibodies were detectable using a flow cytometry-based method in SARS-CoV-2-uninfected individuals and were particularly prevalent in children and adolescents. They were predominantly of the immunoglobulin G (IgG) class and targeted the S2 subunit. By contrast, SARS-CoV-2 infection induced higher titers of SARS-CoV-2 S-reactive IgG antibodies targeting both the S1 and S2 subunits, and concomitant IgM and IgA antibodies, lasting throughout the observation period. SARS-CoV-2-uninfected donor sera exhibited specific neutralizing activity against SARS-CoV-2 and SARS-CoV-2 S pseudotypes. Distinguishing preexisting and de novo immunity will be critical for our understanding of susceptibility to and the natural course of SARS-CoV-2 infection.
Structural changes in the retinal vasculature have been linked to increased cardiovascular risks and also change as a function of age. Because multiparity has been associated with poorer ...cardiovascular health scores, we hypothesized that changes in retinal vascular caliber would be observed in multiparous, compared to nulliparous, females and retired breeder males. Age-matched nulliparous (
= 6) and multiparous (
= 11, retired breeder females with 4 ± 1 litters), and male breeder (
= 7) SMA-GFP reporter mice were included for assessment of retinal vascular structure. Multiparous females had higher body mass, heart weight, and kidney weight compared to nulliparous mice, with lower kidney and higher brain weight compared to male breeders. There was no difference in number of retinal arterioles or venules, or arteriole or venule diameter among groups; however, venous pericyte density (number per venule area) decreased in multiparous vs. nulliparous mice and was negatively associated with the time since last litter and with age. Our results suggest that the time elapsed since delivery is an important factor to be considered in multiparity studies. Taken together, changes in vascular structure and potentially function, are time- and age-dependent. Ongoing and future work will determine whether structural changes are associated with functional consequences at the blood-retinal barrier.
The Safe Systems Pyramid: A new framework for traffic safety Ederer, David J.; Panik, Rachael Thompson; Botchwey, Nisha ...
Transportation research interdisciplinary perspectives,
September 2023, 2023-09-00, 2023-09-01, Volume:
21
Journal Article
Peer reviewed
Open access
Civil engineers play an outsize role in shaping the built environment, which plays an outsize role in health, especially in transportation safety. While there is growing interest in integrating ...public health and transportation engineering and planning to improve safety outcomes, existing efforts fall short.
We review prior efforts to integrate public health into transportation safety, and frameworks from injury prevention and control and risk management.
Based on the Hierarchy of Controls and the Health Impact Pyramid, we present a framework for prioritizing policies and interventions, known as the Safe Systems Pyramid, that contains five ascending levels – Socioeconomic Factors, Built Environment, Latent Safety Measures, Active Measures, and Education. The levels of the framework prioritize increased population health impact and decreased individual effort.
Frameworks like “The 3 E’s” emphasize collaboration rather than a change in thinking and action among transportation safety professionals, and do not prioritize specific actions. We argue that Vision Zero and other “Safe Systems” prioritize implementation of policies, programs, and infrastructure to increase population health impact by considering the individual effort necessary to obtain a protective effect.
This framework is designed to shift the thinking of engineers, planners, and policy makers that shape the transportation system. We conclude this work by applying the Safe Systems Pyramid to a hypothetical Vision Zero program, highlighting how the framework can be used to prioritize efforts using a Safe Systems approach.
•Public health practice is founded on the ideas that health problems are preventable when addressed at the population level, and that one should focus on preventing and controlling risk factors while promoting protective factors when possible.•The E’s framework, which is widely cited in transportation safety, implies a false equivalency engineering, enforcement, and education. This neglects public health principles stipulating that population level interventions that require less individual effort should be prioritized, and that one need focus on the pathologic agent (in this case, the transfer of energy).•Vision Zero and the Safe Systems approach call for a paradigm shift in transportation safety which requires transportation professionals to understand their roles as public health professionals and incorporate public health principles into their thinking and practice. The Safe Systems Pyramid provides a framework for such thinking.
ABSTRACT
Background and objective: Gastro‐oesophageal reflux has been implicated in the pathogenesis of chronic cough. Guidelines on management suggest a therapeutic trial of anti‐reflux medication. ...Esomeprazole is a proton pump inhibitor licensed for the long‐term treatment of acid reflux in adults and we compared the effects of esomeprazole and placebo on patients with chronic cough.
Methods: This was a prospective, single‐centre, randomized, double‐blind, placebo‐controlled, parallel group study conducted over 8 weeks. Fifty adult non‐smokers with chronic cough and normal spirometry were randomized. Patients completed cough‐related quality‐of‐life and symptom questionnaires and subjective scores of cough frequency and severity at the beginning and end of the study. They also kept a daily diary of symptom scores. Citric acid cough challenge and laryngoscopic examination were performed at baseline and the end of the study. The primary outcome was improvement in cough score.
Results: There were no differences in cough scores in the placebo and treatment arms of the study although some significant improvements were noted when compared to baseline. In the cough diary scores there was a trend towards greater improvement in the treatment arm in patients with dyspepsia.
Conclusions: Esomeprazole did not have a clinically important effect greater than placebo in patients with cough. It suggests a marked placebo effect in the treatment of cough.
There is paucity of evidence on which to base the treatment of reflux‐associated cough. We demonstrate that acid suppressive therapy does not lead to a significant clinical effect in these patients. There may be some improvement in those with coexisting dyspeptic symptoms and therapy should be restricted to this group.
Followership Identity Work Thompson, Rachael
New directions for student leadership,
09/2020, Volume:
2020, Issue:
167
Journal Article
This chapter focuses on notions of identity and followership, and presents a process for follower identity development. As areas separately seeing growth in academic popularity over the years, the ...author is keen to bring them together in the hope of further enabling students to connect with their own followership identities, much in the way that they are supported to become aware of and to develop their leadership identities.
PurposeThis preliminary small-scale research aims to achieve an insight into drug use offenders’ rehabilitation experiences both in and out of prison, as well as considering how perceptions of the ...public may inhibit their successful reintegration into society.Design/methodology/approachA mixed-methods approach was used, with five semi-structured interviews conducted alongside the distribution of the Attitude towards prisoners questionnaire among the general public (n = 106) in the North-West region of England.FindingsParticipants recalled a mixture of experiences, highlighting the presence of contraband in prisons to be an inhibiting factor of successful rehabilitation. Additionally, participants expressed the need for more support when preparing for release such as confirmation of accommodation and possible employment. Questionnaires also indicated the public to perceive offenders negatively (M = 76, SD = 16.99), thus presenting a further challenge in the resettlement of drug use offenders.Practical implicationsFindings highlight that improving practices to decrease the presence of contraband in prisons, monitoring an individual’s use of methadone, preparing an individual for their release from prison and educating the public would reduce some of the obstacles experienced by drug use offenders.Originality/valueThis study outlines some of the obstacles that drug use offenders experience when attempting to end their drug use activity and criminal engagement.
The COVID-19 pandemic disrupted typical travel behavior worldwide. In the United States (U.S.), government entities took action to limit its spread through public health messaging to encourage ...reduced mobility and thus reduce the spread of the virus. Within statewide responses to COVID-19, however, there were different responses locally. Likely some of these variations were a result of individual attitudes toward the government and health messaging, but there is also likely a portion of the effects that were because of the character of the communities. In this research, we summarize county-level characteristics that are known to affect travel behavior for 404 counties in the U.S., and we investigate correlates of mobility between April and September (2020). We do this through application of three metrics that are derived via changepoint analysis—initial post-disruption mobility index, changepoint on restoration of a “new normal,” and recovered mobility index. We find that variables for employment sectors are significantly correlated and had large effects on mobility during the pandemic. The state dummy variables are significant, suggesting that counties within the same state behaved more similarly to one another than to counties in different states. Our findings indicate that few travel characteristics that typically correlate with travel behavior are related to pandemic mobility, and that the number of COVID-19 cases may not be correlated with mobility outcomes.
Section 166.046 of the Texas Advance Directives Act (TADA) gives physicians and hospitals the ability to discontinue life-sustaining care even if a patient or patient's family desires to continue ...treatment. Due process concerns are inherent in the TADA procedure, yet the Texas legislature has not made progress in changing the law to help vulnerable patients. This Comment proposes a new approach to use when such disputes come before Texas courts: to place the burden on those wishing to withdraw life-sustaining treatment and to apply the clear and convincing evidence standard. The clear and convincing evidence standard strikes an appropriate balance between the parties in these cases and provides a way for courts to handle disputes involving the flawed legislation.
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