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Litigation in the National Health Service continues to rise with a 9.4 per cent increase in clinical negligence claims from the period 2018 and 2019 to the period 2019 and 2020. The cost of these claims now accounts for 1.8 per cent of the National Health Service 2019 to 2020 budget. This study aimed to identify the characteristics of clinical negligence claims in the subspecialty of otology.
This study was a retrospective review of all clinical negligence claims in otology in England held by National Health Service Resolution between April 2013 and April 2018.
There were 171 claims in otology, 24 per cent of all otolaryngology claims, with a potential cost of £24.5 million. Over half of these were associated with hearing loss. Stapedectomy was the highest mean cost per claim operation at £769 438. The most common reasons for litigation were failure or delay in treatment (23 per cent), failure or delay in diagnosis (20 per cent), intra-operative complications (15 per cent) and inadequate consent (13 per cent).
There is a risk of high-cost claims in otology, especially with objective injuries such as hearing loss and facial nerve injury.
Given its absence from the university curriculum and the apparent indifference of ‘scholasticism’ to the subject, it has been assumed that medieval university scholars neither wrote nor read history. Although the universities were indeed not centres of historical writing, several friars and monks who had studied at university did write history, and many university alumni owned historical works and donated them to their college and university libraries. Moreover, evidence for university scholars’ interest in history increases considerably when one discards the modern historicist/positivist definition of historiography and regards it instead as its medieval readers did, as encompassing texts about past deeds and sayings which offered timeless moral and practical lessons. This chapter argues that university scholars’ reading and writing of history was closely tied to their interest in the classics and devotion to pastoral care. It also identifies the historical works at the universities and their owners and donors.
Evaluating the effectiveness of the Army Aboriginal Community Assistance Programs (AACAPs) from a military participant perspective provides the objective of this research. The study will identify areas of concern and provide guidance on current military policy, doctrine and protocol.
Army Aboriginal Community Assistance Programs (AACAPs) represent a co-operative initiative between the Australian Army and Australian Government, that delivers complex support for Disaster Relief and Humanitarian Assistance (HA/DR) to improve the health and well-being of indigenous communities. Since 1997, the Army has conducted a number of AACAPs in remote Indigenous communities within continental Australia. No previous evaluations of these programs exist.
A ‘Quality Improvement’ study underpins this evaluation. Shewhart’s “Plan, Do, Study, Act” Model provides the guiding framework for the study. Allen’s Logic Model exemplifies the most appropriate framework to articulate the program needs and objectives, and to delineate the processes inherent in the program for this evaluation. The Center for Disease Control (CDC) evaluation model for public health programs, provides the evaluation standards to examine the delivery of health care to the deployed force in an austere environment. Part 1 of the study will be a desktop examination of current military policy, doctrine and protocol relating to AACAP. Part 2 will overlay personal experience from military participants in the AACAPs through a semi-structured interview, to enable deployed health personnel the opportunity to comment on their experiences. Analysis will comprise quantitative and qualitative method, specifically descriptive statistics and thematic analysis respectively. Army has approved all required governance, and ethics approval will be sought from Monash University.
This is a proposed study, no results are available.
The benefit of this research will be gaining new knowledge with context of a humanitarian focused military task, through the lens of quality improvement to build capacity and enhance capability.
We have compiled a catalogue of H ii regions detected with the Murchison Widefield Array between 72 and 231 MHz. The multiple frequency bands provided by the Murchison Widefield Array allow us identify the characteristic spectrum generated by the thermal Bremsstrahlung process in H ii regions. We detect 306 H ii regions between 260° < l < 340° and report on the positions, sizes, peak, integrated flux density, and spectral indices of these H ii regions. By identifying the point at which H ii regions transition from the optically thin to thick regime, we derive the physical properties including the electron density, ionised gas mass, and ionising photon flux, towards 61 H ii regions. This catalogue of H ii regions represents the most extensive and uniform low frequency survey of H ii regions in the Galaxy to date.
We compare first-order (refractive) ionospheric effects seen by the MWA with the ionosphere as inferred from GPS data. The first-order ionosphere manifests itself as a bulk position shift of the observed sources across an MWA field of view. These effects can be computed from global ionosphere maps provided by GPS analysis centres, namely the CODE. However, for precision radio astronomy applications, data from local GPS networks needs to be incorporated into ionospheric modelling. For GPS observations, the ionospheric parameters are biased by GPS receiver instrument delays, among other effects, also known as receiver DCBs. The receiver DCBs need to be estimated for any non-CODE GPS station used for ionosphere modelling. In this work, single GPS station-based ionospheric modelling is performed at a time resolution of 10 min. Also the receiver DCBs are estimated for selected Geoscience Australia GPS receivers, located at Murchison Radio Observatory, Yarragadee, Mount Magnet and Wiluna. The ionospheric gradients estimated from GPS are compared with that inferred from MWA. The ionospheric gradients at all the GPS stations show a correlation with the gradients observed with the MWA. The ionosphere estimates obtained using GPS measurements show promise in terms of providing calibration information for the MWA.
GLEAM, the GaLactic and Extragalactic All-sky MWA survey, is a survey of the entire radio sky south of declination + 25° at frequencies between 72 and 231 MHz, made with the MWA using a drift scan method that makes efficient use of the MWA’s very large field-of-view. We present the observation details, imaging strategies, and theoretical sensitivity for GLEAM. The survey ran for two years, the first year using 40-kHz frequency resolution and 0.5-s time resolution; the second year using 10-kHz frequency resolution and 2 s time resolution. The resulting image resolution and sensitivity depends on observing frequency, sky pointing, and image weighting scheme. At 154 MHz, the image resolution is approximately 2.5 × 2.2/cos (δ + 26.7°) arcmin with sensitivity to structures up to ~ 10° in angular size. We provide tables to calculate the expected thermal noise for GLEAM mosaics depending on pointing and frequency and discuss limitations to achieving theoretical noise in Stokes I images. We discuss challenges, and their solutions, that arise for GLEAM including ionospheric effects on source positions and linearly polarised emission, and the instrumental polarisation effects inherent to the MWA’s primary beam.
The Murchison Widefield Array is a Square Kilometre Array Precursor. The telescope is located at the Murchison Radio–astronomy Observatory in Western Australia. The MWA consists of 4 096 dipoles arranged into 128 dual polarisation aperture arrays forming a connected element interferometer that cross-correlates signals from all 256 inputs. A hybrid approach to the correlation task is employed, with some processing stages being performed by bespoke hardware, based on Field Programmable Gate Arrays, and others by Graphics Processing Units housed in general purpose rack mounted servers. The correlation capability required is approximately 8 tera floating point operations per second. The MWA has commenced operations and the correlator is generating 8.3 TB day−1 of correlation products, that are subsequently transferred 700 km from the MRO to Perth (WA) in real-time for storage and offline processing. In this paper, we outline the correlator design, signal path, and processing elements and present the data format for the internal and external interfaces.
The Murchison Widefield Array is a new low-frequency interferometric radio telescope built in Western Australia at one of the locations of the future Square Kilometre Array. We describe the automated radio-frequency interference detection strategy implemented for the Murchison Widefield Array, which is based on the aoflagger platform, and present 72–231 MHz radio-frequency interference statistics from 10 observing nights. Radio-frequency interference detection removes 1.1% of the data. Radio-frequency interference from digital TV is observed 3% of the time due to occasional ionospheric or atmospheric propagation. After radio-frequency interference detection and excision, almost all data can be calibrated and imaged without further radio-frequency interference mitigation efforts, including observations within the FM and digital TV bands. The results are compared to a previously published Low-Frequency Array radio-frequency interference survey. The remote location of the Murchison Widefield Array results in a substantially cleaner radio-frequency interference environment compared to Low-Frequency Array’s radio environment, but adequate detection of radio-frequency interference is still required before data can be analysed. We include specific recommendations designed to make the Square Kilometre Array more robust to radio-frequency interference, including: the availability of sufficient computing power for radio-frequency interference detection; accounting for radio-frequency interference in the receiver design; a smooth band-pass response; and the capability of radio-frequency interference detection at high time and frequency resolution (second and kHz-scale respectively).
The science cases for incorporating high time resolution capabilities into modern radio telescopes are as numerous as they are compelling. Science targets range from exotic sources such as pulsars, to our Sun, to recently detected possible extragalactic bursts of radio emission, the so-called fast radio bursts (FRBs). Originally conceived purely as an imaging telescope, the initial design of the Murchison Widefield Array (MWA) did not include the ability to access high time and frequency resolution voltage data. However, the flexibility of the MWA’s software correlator allowed an off-the-shelf solution for adding this capability. This paper describes the system that records the 100 μs and 10 kHz resolution voltage data from the MWA. Example science applications, where this capability is critical, are presented, as well as accompanying commissioning results from this mode to demonstrate verification.
We present the results of an approximately 6 100 deg2 104–196 MHz radio sky survey performed with the Murchison Widefield Array during instrument commissioning between 2012 September and 2012 December: the MWACS. The data were taken as meridian drift scans with two different 32-antenna sub-arrays that were available during the commissioning period. The survey covers approximately 20.5 h < RA < 8.5 h, − 58° < Dec < −14°over three frequency bands centred on 119, 150 and 180 MHz, with image resolutions of 6–3 arcmin. The catalogue has 3 arcmin angular resolution and a typical noise level of 40 mJy beam− 1, with reduced sensitivity near the field boundaries and bright sources. We describe the data reduction strategy, based upon mosaicked snapshots, flux density calibration, and source-finding method. We present a catalogue of flux density and spectral index measurements for 14 110 sources, extracted from the mosaic, 1 247 of which are sub-components of complexes of sources.
Significant new opportunities for astrophysics and cosmology have been identified at low radio frequencies. The Murchison Widefield Array is the first telescope in the southern hemisphere designed specifically to explore the low-frequency astronomical sky between 80 and 300 MHz with arcminute angular resolution and high survey efficiency. The telescope will enable new advances along four key science themes, including searching for redshifted 21-cm emission from the EoR in the early Universe; Galactic and extragalactic all-sky southern hemisphere surveys; time-domain astrophysics; and solar, heliospheric, and ionospheric science and space weather. The Murchison Widefield Array is located in Western Australia at the site of the planned Square Kilometre Array (SKA) low-band telescope and is the only low-frequency SKA precursor facility. In this paper, we review the performance properties of the Murchison Widefield Array and describe its primary scientific objectives.
Driftscan methods are highly efficient, stable techniques for conducting extragalactic surveys in the 21 cm line of neutral hydrogen. Holding the telescope still while the beam scans the sky at the sidereal rate produces exceptionally stable spectral baselines, increased stability for RFI signals, and excellent diagnostic information about system performance. Data can be processed naturally and efficiently by grouping long sequences of spectra into an image format, thereby allowing thousands of individual spectra to be calibrated, inspected and manipulated as a single data structure with standard tools that already exist in astronomical software. The behaviour of spectral standing waves (multi-path effects) can be appraised and excised in this environment, making observations possible while the Sun is up. The method is illustrated with survey data from Arecibo and Nançay.
Digital signal processing is one of many valuable tools for suppressing unwanted signals or inter-ference. Building hardware processing engines seems to be the way to best implement some classes of interference suppression but is, unfortunately, expensive and time-consuming, especially if several miti-gation techniques need to be compared. Simulations can be useful, but are not a substitute for real data. CSIRO’s Australia Telescope National Facility has recently commenced a ‘software radio telescope’ project designed to fill the gap between dedicated hardware processors and pure simulation. In this approach, real telescope data are recorded coherently, then processed offline. This paper summarises the current contents of a freely available database of base band recorded data that can be used to experiment with signal processing solutions. It includes data from the following systems: single dish, multi-feed receiver; single dish with reference antenna; and an array of six 22 m antennas with and without a reference antenna. Astronomical sources such as OH masers, pulsars and continuum sources subject to interfering signals were recorded. The interfering signals include signals from the US Global Positioning System (GPS) and its Russian equivalent (GLONASS), television, microwave links, a low-Earth-orbit satellite, various other transmitters, and signals leaking from local telescope systems with fast clocks. The data are available on compact disk, allowing use in general purpose computers or as input to laboratory hardware prototypes.
Analyses of QSO absorption lines show that the HI content has evolved over the redshift range z = 5 to z = 0. The 21-cm line measurements of the z = 0 HI content avoid several biases inherent in the absorption-line technique, such as the influence of evolving dust content in the absorbers, and will produce a reliable measure to anchor theories of galaxy evolution. Examples of important questions to be addressed by local HI surveys are: (1) Is there a significant population of gas-rich galaxies or intergalactic clouds that is missing from the census of optically selected galaxies? (2) Is there an adequate reservoir of neutral gas to substantially prolong star formation at its present rate? (3) Are there massive objects of such low HI column density that they can have escaped detection in the ‘unbiased’ HI surveys that have been conducted so far?
The Murchison Widefield Array (MWA) is one of three Square Kilometre Array Precursor telescopes and is located at the Murchison Radio-astronomy Observatory in the Murchison Shire of the mid-west of Western Australia, a location chosen for its extremely low levels of radio frequency interference. The MWA operates at low radio frequencies, 80–300 MHz, with a processed bandwidth of 30.72 MHz for both linear polarisations, and consists of 128 aperture arrays (known as tiles) distributed over a ~3-km diameter area. Novel hybrid hardware/software correlation and a real-time imaging and calibration systems comprise the MWA signal processing backend. In this paper, the as-built MWA is described both at a system and sub-system level, the expected performance of the array is presented, and the science goals of the instrument are summarised.
To review our experience of cochlear implant failure and subsequent revision surgery, and to illustrate the experience we have gained by presenting a series of lessons learned.
A combined retrospective and prospective study of revision surgery in a UK regional cochlear implant centre.
Of the 746 cochlear implantations undertaken, 33 (4.7 per cent of adults and 4.1 per cent of children) had a registered failure requiring re-implantation. The mean time to device failure was 60 months in adults and 35 months in children. Causes of cochlear implant failure were medical (n = 11), electrode displacement (n = 2), ‘hard device failure’ (n = 15) and ‘soft device failure’ (n = 5). Chronic suppurative otitis media and post-auricular mastoid abscess were the commonest causes of medical failure. There was one case of electrode array displacement as a direct result of skin flap revision surgery. In 80 per cent of cases, audiological performances were stable or improved following re-implantation.
As the number of cochlear implants increase and patients outlive the lifespan of their devices, we will face a growing number of revision procedures. Audiologists and otologists should be competent in diagnosing and managing device failure and medical complications requiring cochlear re-implantation.
Permian and Triassic lacustrine and fluvial-system deposits in the Beardmore Glacier area of the Transantarctic Mountains preserve a superb record of continental environments and evidence of life on extensive bedding plane exposures. They yielded the first invertebrate trackways reported from continental Permo-Triassic deposits of Antarctica, here assigned to the ichnogenera Diplichnites and Diplopodichnus, which were probably produced by myriapodous arthropods. A resting trace is compared to Orbiculichnus and interpreted as generated by a jumping insect. Plant life is represented by leaf impressions, fossil forests and peat, vertebrates by body and trace fossils, and invertebrate shallow infauna by near surface burrows. The small number and diversity of trackways recovered from the large bedding plane exposures suggest that trackway-producing arthropods were rare at these high southern palaeolatitudes.