Roads and Traffic Authority of New South Wales v Dederer

This case note examines the decision of the High Court of Australia in Roads and Traffic Authority of New South Wales v Dederer, which marks the common law's continued departure from shared liability, for tragic accidents into the realm of personal liability The decision has particular significance for children and young people who may be held accountable for their reckless actions, notwithstanding the 'exuberance of youth. In particular the case note analyses the High Court's emphasis on obvious risks and personal responsibility and the Court's attempt to limit liability through a consideration of the plaintiffs conduct on questions of the scope of the duty of care and at the breach of duty enquiry rather than confining it to the issue of the plaintiff's contributory negligence

Compensation for survivors of Institutional Child Sexual Abuse in Australia: Tortious rights and challenges for reform

The risk and incidence of sexual abuse of children in an institutional context has been brought to increasingly greater public attention since the 1990’s, both in Australia and around the world. In Australia, several state inquiries since the mid-1990’s addressed sexual abuse of children in state care and religious institutions in Australia, and there have been numerous other state and federal inquiries in that time which have considered in some way the issue of child sexual abuse in the context of a broader or different remit. However, on 11 January 2013 a national Royal Commission into Institutional Responses to Child Sexual Abuse (“the Royal Commission”) was established to focus specifically on how to better prevent, report and respond to child sexual abuse in an institutional context. It is expected to deliver its final report by the end of 2017. The Royal Commission’s work is revealing the nature and extent of child abuse in a wide range of different institutional contexts in Australia. As at 10 September 2015, the Royal Commission had received allegations relating to 3,566 different institutions. In its Consultation Paper on Redress and Civil Litigation (“Consultation Paper”), the Royal Commission analysed the data obtained from private sessions held between 7 May 2013 and 31 August 2014 in relation to reported incidents of child sexual abuse and categorised it by institution type, or activity. The incidence per category was as follows: 34.6% in out-of-home residential care; 28.1% in educational day and boarding schools; 16.6% in religious activities; 7.6% in out-of-home foster or kinship care; 4.2% in recreational, sporting and hobby groups or institutions; 2.1% in health and allied fields or by medical practitioners; 1.1% in juvenile justice; 0.9% in childcare centres, and smaller representation of incidents in other institutional categories. A significant proportion of this reported abuse related to faith-based institutions. For example, of reported incidents of sexual abuse in out-of-home residential care, 64% was in faith-based residential homes. Of reported incidents of sexual abuse in a school setting, 77.1% of incidents was in a faith-based day or boarding school. It has been estimated that there may be at least 60,000 survivors of institutional child abuse who may be eligible for compensation if a national redress scheme were established. As noted by the Royal Commission, ‘when a child is sexually abused while in the care of an institution, the impact can be devastating and last for a lifetime.’ The harm can be physical as well as psychological and emotional, and the trauma associated with it can impact significantly on the survivor’s future capacity for work, the ability to maintain personal relationships and a survivor’s psychological wellbeing. Many survivors of institutional child sexual abuse have experienced considerable difficulty in seeking financial compensation for such harm. There have been several state government ex gratia payment schemes to date, however they have been limited in scope to abuse in government care in institutions of those states. Some survivors have obtained payments through private schemes such as Towards Healing and the Melbourne Response run by the Catholic Church and other private settlements such as the Procedures for Complaints of Sexual and Other Abuse against Salvationists and Workers 1996 by the Salvation Army. There is no comprehensive national redress scheme currently in place, although this has been recommended by the Royal Commission. Another option is for survivors to bring proceedings in tort seeking an order from the court for damages by way of financial compensation for harm from either the perpetrator of the abuse or from the institution in which the abuse occurred. The focus of this chapter is on the ways in which survivors can bring claims in tort and the obstacles to such claims under the current state of the law in Australia. Tort law is the law dealing with civil wrongs at common law. Sexual abuse of a child is of course a criminal offence, but it is also capable of giving rise to an action in tort against the perpetrator of the abuse and in some cases against the institution in which the abuse occurred. If successful, proceedings in tort can lead to remedies in damages. Damages are an award of money ordered by the court to be paid by the defendant to the plaintiff. Damages are ‘real’ in the sense of being awarded as real compensation for harm suffered, and can be potentially substantial in amount. The amount of damages can be significantly higher than amounts typically paid under ex gratia payment schemes. Successful proceedings can also have a very significant vindicating effect for a plaintiff, affirming their story on public record in a judgment of the court. An award of damages also has the effect of punishing perpetrators or responsible institutions. There are of course well known difficulties for plaintiffs in court proceedings that can be particularly difficult for survivors of institutional child sexual abuse: court proceedings can be expensive, uncertain, drawn-out and lengthy, as well as being emotionally and psychologically traumatic through revisiting the abuse in evidence and cross-examination. However, for some survivors, the opportunity to seek formal recognition of the wrongdoing and potentially substantial financial compensation will warrant commencing proceedings. This chapter highlights some of the procedural and doctrinal obstacles and uncertainties in the common law which currently prevent many survivors having a clearly available action in tort under Australian law. The possibility of Australian law reform to address some of the difficulties is also examined briefly in light of the recommendations of the Royal Commission for civil litigation reform. The recommendations made by the Family and Community Development Committee of the Victorian Parliament Inquiry into the Handling of Child Abuse by Religious and Other Non-Government Organisations in its Betrayal of Trust Report in 2013 are also considere

Dissociation of μ- and δ-opioid inhibition of glutamatergic synaptic transmission in superficial dorsal horn

<p>Abstract</p> <p>Background</p> <p>There is anatomical and behavioural evidence that μ- and δ-opioid receptors modulate distinct nociceptive modalities within the superficial dorsal horn. The aim of the present study was to examine whether μ- and δ-opioid receptor activation differentially modulates TRP sensitive inputs to neurons within the superficial dorsal horn. To do this, whole cell patch clamp recordings were made from lamina I - II neurons in rat spinal cord slices <it>in vitro </it>to examine the effect of opioids on TRP agonist-enhanced glutamatergic spontaneous miniature excitatory postsynaptic currents (EPSCs).</p> <p>Results</p> <p>Under basal conditions the μ-opioid agonist DAMGO (3 μM) reduced the rate of miniature EPSCs in 68% of neurons, while the δ- and κ-opioid agonists deltorphin-II (300 nM) and U69593 (300 nM) did so in 13 - 17% of neurons tested. The TRP agonists menthol (400 μM) and icilin (100 μM) both produced a Ca²⁺-dependent increase in miniature EPSC rate which was unaffected by the voltage dependent calcium channel (VDCC) blocker Cd²⁺. The proportion of neurons in which deltorphin-II reduced the miniature EPSC rate was enhanced in the presence of icilin (83%), but not menthol (0%). By contrast, the proportion of DAMGO and U69593 responders was unaltered in the presence of menthol (57%, 0%), or icilin (57%, 17%).</p> <p>Conclusions</p> <p>These findings demonstrate that δ-opioid receptor activation selectively inhibits inputs activated by icilin, whereas μ-opioid receptor activation has a more widespread effect on synaptic inputs to neurons in the superficial dorsal horn. These findings suggest that δ-opioids may provide a novel analgesic approach for specific, TRPA1-like mediated pain modalities.</p

Lower Bounds for Heights in Relative Galois Extensions

The goal of this paper is to obtain lower bounds on the height of an algebraic number in a relative setting, extending previous work of Amoroso and Masser. Specifically, in our first theorem we obtain an effective bound for the height of an algebraic number $\alpha$ when the base field $\mathbb{K}$ is a number field and $\mathbb{K}(\alpha)/\mathbb{K}$ is Galois. Our second result establishes an explicit height bound for any non-zero element $\alpha$ which is not a root of unity in a Galois extension $\mathbb{F}/\mathbb{K}$, depending on the degree of $\mathbb{K}/\mathbb{Q}$ and the number of conjugates of $\alpha$ which are multiplicatively independent over $\mathbb{K}$. As a consequence, we obtain a height bound for such $\alpha$ that is independent of the multiplicative independence condition

Multiple volcanic episodes of flood basalts caused by thermochemical mantle plumes

The hypothesis that a single mushroom-like mantle plume head can generate a large igneous province within a few million years has been widely accepted(1). The Siberian Traps at the Permian Triassic boundary(2) and the Deccan Traps at the Cretaceous Tertiary boundary(3) were probably erupted within one million years. These large eruptions have been linked to mass extinctions. But recent geochronological data(4-11) reveal more than one pulse of major eruptions with diverse magma flux within several flood basalts extending over tens of million years. This observation indicates that the processes leading to large igneous provinces are more complicated than the purely thermal, single-stage plume model suggests. Here we present numerical experiments to demonstrate that the entrainment of a dense eclogite-derived material at the base of the mantle by thermal plumes can develop secondary instabilities due to the interaction between thermal and compositional buoyancy forces. The characteristic timescales of the development of the secondary instabilities and the variation of the plume strength are compatible with the observations. Such a process may contribute to multiple episodes of large igneous provinces.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/62705/1/nature03697.pd

Measuring the impact and costs of a universal group based parenting programme : protocol and implementation of a trial

Background Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base. Methods/Design A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures. Discussion Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these

Estrogen as therapy for breast cancer

High-dose estrogen was generally considered the endocrine therapy of choice for postmenopausal women with breast cancer prior to the introduction of tamoxifen. Subsequently, the use of estrogen was largely abandoned. Recent clinical trial data have shown clinically meaningful efficacy for high-dose estrogen even in patients with extensive prior endocrine therapy. Preclinical research has demonstrated that the estrogen dose-response curve for breast cancer cells can be shifted by modification of the estrogen environment. Clinical and laboratory data together provide the basis for developing testable hypotheses of management strategies, with the potential of increasing the value of endocrine therapy in women with breast cancer

What is the real impact of acute kidney injury?

Background: Acute kidney injury (AKI) is a common clinical problem. Studies have documented the incidence of AKI in a variety of populations but to date we do not believe the real incidence of AKI has been accurately documented in a district general hospital setting. The aim here was to describe the detected incidence of AKI in a typical general hospital setting in an unselected population, and describe associated short and long-term outcomes. Methods: A retrospective observational database study from secondary care in East Kent (adult catchment population of 582,300). All adult patients (18 years or over) admitted between 1st February 2009 and 31st July 2009, were included. Patients receiving chronic renal replacement therapy (RRT), maternity and day case admissions were excluded. AKI was defined by the acute kidney injury network (AKIN) criteria. A time dependent risk analysis with logistic regression and Cox regression was used for the analysis of in-hospital mortality and survival. Results: The incidence of AKI in the 6 month period was 15,325 pmp/yr (adults) (69% AKIN1, 18% AKIN2 and 13% AKIN3). In-hospital mortality, length of stay and ITU utilisation all increased with severity of AKI. Patients with AKI had an increase in care on discharge and an increase in hospital readmission within 30 days. Conclusions: This data comes closer to the real incidence and outcomes of AKI managed in-hospital than any study published in the literature to date. Fifteen percent of all admissions sustained an episode of AKI with increased subsequent short and long term morbidity and mortality, even in those with AKIN1. This confers an increased burden and cost to the healthcare economy, which can now be quantified. These results will furnish a baseline for quality improvement projects aimed at early identification, improved management, and where possible prevention, of AKI