13361 research outputs found
Sort by
“Consent” and Trespass to the Person: Denial of Liability or Defence?’
No full textThe question of whether consent is a defence to battery or whether the absence of consentis an element of the claim is unresolved in Australian law and has received little attention.Different conclusions have been reached on the issue in other jurisdictions and the samequestion is equally raised by other trespass claims. Yet, how consent is classified (ie as adefence or a denial of an element of a claim) and which party (ie plaintiff or defendant)bears the onus of proving consent (or its absence) may be of practical importance and oftheoretical interest, thereby raising fundamental taxonomic questions. The primary aim ofthis article is to tease out the underlying conceptual, theoretical and practical issues thatcontribute to the ongoing uncertainties as to who bears the burden of proving, and thecorrect classification of, consent (or the absence of consent)
From compliance to excellence: how can ISO 13485 standards transform quality, safety, and innovation in medical devices?
No full textThe medical device industry operates in a high-stakes environment where quality and safety are paramount. The recent published paper in the Journal by Pacheco et al. (2025) explores strategies to improve International Organization for Standardization (ISO) standard 13 485:2016 implementation in the medical device industry [1]. ISO 13 485, the gold standard for medical device Quality Management Systems (QMS), provides a structured approach to regulatory compliance and risk management. Pacheco et al. emphasize that advancing ISO 13 485 maturity requires a structured framework to evaluate compliance, leadership commitment, and resource allocation for digital tools and operational excellence—key drivers for minimizing risks and ensuring patient safety. However, successful implementation of the standard remains an ongoing challenge due to the complexities of integration, operational excellence, and the evolving regulatory landscape [1, 2]. The authors argue that fostering a culture of continuous improvement, aligned with ISO 13 485’s lifecycle requirements from design to post-market surveillance, is critical for addressing inherent industry complexities and maintaining regulatory adherence. For example, integration with hospital information systems for tracking device traceability and managing recall protocols demands significant investment in digital infrastructure. In one documented instance, a hospital struggled with integrating supplier data and tracking device performance due to siloed data systems, delaying compliance [3]. Smaller medical device companies, in particular, face resource constraints that complicate efforts to align supply chain management systems with ISO 13 485. Pacheco et al. emphasize that maturity models, tailored to ISO 13 485 requirements and incorporating Plan-Do-Study-Act cycles, can guide organizations from ad hoc practices to optimized processes, bridging gaps in empirical evidence, and providing actionable benchmarks [1]
Mapping complex interdependencies through higher order moments: Cross-market spillovers and shocks in BRICS
No full textThe interdependence of stock markets is crucial for systemic risk management and policy formulation. While most studies focus on returns and volatility, our paper explores higher-order moment risk linkages among BRICS equity markets. It also investigates how geopolitical conflicts affect the transmission of higher-order moments. The findings reveal that risk spillovers between these markets are time-varying, with kurtosis spillovers being more prominent than those from volatility and skewness. The dynamic evolution of these spillovers intensifies during major financial crises.</p
Exploring the effectiveness of Mental Health First Aid training in reducing self-stigma in medical students: Preliminary findings
No full textIntroduction/BackgroundMedical students and doctors often experience high levels of psychological distress and mental health concerns compared to the general population. Despite various prevention and treatment strategies, participation in mental health interventions remains low, largely due to stigma within the medical profession. This stigma manifests as negative attitudes from others (public stigma) and as internalised societal prejudice (self-stigma), both of which can discourage medical professionals and those in training from seeking help.Although the detrimental effects of stigma on help-seeking are well-documented, targeted interventions to reduce mental health stigma in this group, particularly self-stigma, remain scarce (see Bannatyne et al., 2023, for a review). As self-stigma interventions are being developed, there is an opportunity to examine the effectiveness of existing programs like Mental Health First Aid (MHFA). While not specifically aimed at reducing stigma, MHFA has been shown to reduce public stigma by improving knowledge and attitudes toward mental health. However, its impact on self-stigma is currently unknown. Therefore, this study aimed to assess the effectiveness of MHFA in reducing self-stigma among first-year medical students, contributing to the broader effort to promote systemic change and enhance the well-being of doctors and medical students.MethodsThis within-subjects study (pre-intervention vs post-intervention vs follow-up) involved first year medical students at Bond University. Participants completed blended MHFA training as part of their compulsory coursework, led by a Licensed MHFA Instructor. A range of brief, yet comprehensive instruments were administered to consenting participants via Qualtrics at pre-intervention, post-intervention, and follow-up. The primary outcome measures were the Modified Internalised Stigma of Mental Illness Inventory and the Opening Minds Scale for Health Professionals. ResultsPreliminary findings will be presented. DiscussionPreliminary findings will be presented, with the expectation that MHFA will have a positive impact in reducing self-stigma among first-year medical students
Collaborative decision-making for localized emergency response in major railroad projects
Get PDFThis paper examines major railroad projects’ emergency response decision-making process, focusing on timeliness, cost-effectiveness, and public involvement. It explores the optimal collaborative strategies of local governments, enterprises, and the public during the construction phase. A novel tripartite decision-making framework is proposed, based on an asymmetric evolutionary game model and dynamic simulation methods. The results show a stable equilibrium in emergency response strategies emerges when public engagement is prioritized. Government subsidy policies are found to significantly influence the strategic choices of all agents, emphasizing the critical role of coordinated collaboration. The study highlights the importance of public participation and multi-agent cooperation in addressing complex emergency challenges. These findings provide valuable guidance for improving localized emergency response strategies, enhancing collaborative decision-making, optimizing resource allocation, increasing response efficiency, and supporting policy formulation in major railroad projects.</p
The Surf Industry
No full textThis chapter utilizes the social theories of identity, authenticity, subculture, and hegemony to explain how and why the surf industry has managed to attract a customer base that is far larger than surfing’s participant base. It suggests surfing’s aspirational appeal is a key driver of consumer demand and, because of this, surf brands place a high emphasis on demonstrating the authenticity of their links to the subculture. From the consumer perspective, the chapter considers how surf culture appeals to the personal and group identity needs of the consumer and how emerging demographic trends could challenge the cultural hegemony. This chapter also introduces a new theoretical construct, called subcultural power, which recognizes the relative value of a subculture’s aspirational appeal that affords it the ability to attract its share of mainstream societal interest.</p
Fair pricing and reserving of variable annuities with guarantees under the benchmark approach
No full textIn this paper we consider the pricing of variable annuities (VAs) with guaranteed minimum withdrawal benefits. Among three models of the equity index, we consider two pricing approaches, the classical risk-neutral approach and the real-world pricing under the benchmark approach, and we examine the associated static and optimal behaviors of both the investor and insurer. The first model considered is the so-called minimal market model, where real-world pricing is achieved using the benchmark approach, introduced by Platen (2001. A minimal financial market model. In Trends in mathematics (pp. 293–301). Birkhäuser). Under this approach, valuing an asset involves determining the minimum-valued replicatingportfolio, with reference to the growth optimal portfolio under the real-world probability measure, and it both subsumes classical risk-neutral pricing as a particular case and extends it to situations where risk-neutral pricing is impossible. The second and third models are the Black–Scholes model and the Heston model for the equity index, where the pricing of contracts is performed within the risk-neutral framework. We demonstrate that when the insurer prices and reserves using the minimal market model, the reserves are significantly lower than those under either the Black–Scholes or the Heston model. Furthermore, when the insured employs a dynamic withdrawal strategy based on the minimal market model, the total withdrawal amount exceeds that received when using either the Black–Scholes or the Heston model. We employ a novel approximation to the valuation of the VA having GMWB features, which permits fast valuation and multiple backtests of reserving strategies to be performed that would otherwise be impractical
Antibiotic-associated drug-related problems and pharmacist interventions during the Hajj pilgrimage in Saudi Arabia: insights from a retrospective analysis
No full textBackground: The Hajj pilgrimage offers a unique clinical setting because of the increased risk of infectious diseases, the larger number of elderly patients, and polypharmacy. Numerous factors contribute to the rise in drug-related problems (DRPs), particularly those involving antibiotics. Data on antibiotic-associated DRPs and pharmacists’ interventions during Hajj are lacking. This study aimed to characterize DRPs related to antibiotic use among individuals who attended the 2024 Hajj pilgrimage.Methods:A retrospective cohort study was conducted across five hospitals in the Al-Mashair region (Mina, Arafat, and Muzdalifah) during the Hajj season (June 12–July 6, 2024). The Hospital Information System and Google Drive were employed to acquire data using a custom form. The form recorded patient demographics, drug-related issues, pharmacist interventions, and patient outcomes. Clinical pharmacists identified DRPs by assessing improper drug selection, dosage problems, adverse responses, and drug interactions. Outcomes were clinical improvement, worsening, or stability, confirmed by laboratory values and infection status.Results: A total of 411 patients with DRPs were identified, with most being male (74.9%) and older adults (mean age 55.01 years). Respiratory conditions (44.0%) and infections (20.7%) were the most common diagnoses. The most frequent DRPs included improper drug selection (43.3%), inappropriate dosing (25.5%), and dose administration issues (25.1%). Penicillin-beta-lactamase inhibitor combinations were the most implicated drug class. DRPs occurred most often in non-intensive care unit inpatient wards (38.4%), with East Arafat Hospital reporting the highest number of cases (46%). Pharmacist interventions such as dose modifications and alternative therapies were widely accepted (86.79% and 98.94%, respectively). Patient outcomes were assessed based on clinical improvement, deterioration, or stability,along with changes in laboratory values and infection status. Older patients were significantly more likely to experience clinical improvement following pharmacist interventions (odds ratio =2.12, 95% confidence interval: 1.358–3.311, P=0.001).Conclusions: This research emphasizes the significant role of pharmacists in detecting and addressing antibiotic-associated DRPs during the 2024 Hajj season. Pharmacist-led interventions, particularly dose modifications and alternative therapy recommendations, were associated with high physician acceptance and improved patient outcomes, especially among older adults. These findings underscore the significance of pharmacist-led stewardship programs in high-risk environments, such as mass gatherings, underscoring thenecessity of ongoing monitoring and intervention to ensure patient safety and optimize antibiotic utilization
Validity and Reliability of Resting Energy Expenditure Measured by Indirect Calorimetry in Adults with Overweight and Obesity: a Rapid Systematic Review
No full textThis rapid systematic review aimed to evaluate the diagnostic accuracy (concurrent validity, predictive ability, reliability) of indirect calorimetry (IC) for measuring resting energy expenditure (REE) in adults with overweight or obesity. PubMed and Web of Science searched for studies measuring REE by IC in adults with overweight or obesity and reported primary outcomes: concurrent validity, predictive ability, or reliability. N = 22 studies were included that evaluated n = 10 IC devices. A handheld IC device was reported to have poor concurrent validity and poor reliability. Standard desktop IC devices were reported to have inconsistent concurrent validity, inconsistent predictive ability for weight loss, and good to excellent reliability. Whole-room IC devices were reported to have excellent reliability. Further research is needed.</p