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301.
The clinicopathologic features of four infants with undiagnosed total anomalous pulmonary venous return who died suddenly and unexpectedly are presented. Two infants were found dead in their beds and two collapsed following very non-specific episodes of mild tachypnoea and tachycardia, respectively. Pulmonary venous blood drained via a common channel to the left innominate vein, the superior vena cava, the inferior vena cava at the junction of the hepatic vein and the supradiaphragmatic portion of the inferior vena cava. All cases demonstrated right atrial and ventricular hypertrophy and in one case there was associated hypoplastic left heart syndrome. Although those mechanisms responsible for sudden infant death syndrome could not definitely be excluded in two cases, the presence of anomalous pulmonary drainage with significant right-sided cardiac cardiac hypertrophy in each patient strongly suggests a contributing role for the vascular malformation in the aetiology of sudden unexpected death. The importance of careful in situ dissection of the major vessels in all cases of paediatric sudden death is emphasised, particularly in the presence of other congenital cardiac anomalies. 相似文献
302.
B. N. Moore 《Australian Journal of Public Administration》1968,27(4):371-381
- 1 Whether to delegate or not to delegate has been an active issue in the New South Wales Public Service since 1960.
- 2 There has been considerable delegation of personnel authority to department heads during the period 1960–68, and the benefits of this programme have been significant.
- 3 The following rules seem to govern the selection of areas ripe for further delegation:
- 4 The following limitations to delegation of further personnel authority are seen to exist:
303.
Fadem P Minkler M Perry M Blum K Moore LF Rogers J Williams L 《Journal of health politics, policy and law》2003,28(6):977-1001
This article presents the methods, findings, and implications of a participatory action research project that attempted to shed additional light on the debate over death with dignity (DWD) or physician-assisted suicide (PAS) legislation. In-depth, qualitative interviews with forty-five physically disabled residents of the San Francisco Bay Area, conducted by others with disabilities, revealed a wide breadth of opinions about and attitudes toward such legislation. For close to half of the participants, the desire for autonomy in making end-of-life decisions was a primary concern, yet fear that PAS legislation could violate this autonomy in various ways was a deep concern as well. Also reported were widespread accounts of disability-based discrimination and frequent expressions of fear about openly discussing positions that diverge from the official, publicly held opinions of disability leaders who oppose such legislation. The findings support those of a recent Harris poll demonstrating considerable diversity of opinion about PAS legislation among people with disabilities. The findings further suggest the need for additional research on the apparent disjunction between the diversity of attitudes held by those interviewed and the more unified position taken by many disability activists. Use of the study findings to promote greater dialogue within the community and to better position people with disabilities to take their place at the policy table also is discussed. In addition, the findings are seen as reinforcing the need for the public health community to become more engaged in this central ethical debate. 相似文献
304.
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M K Moore J H Stewart W F McCormick 《The American journal of forensic medicine and pathology》1988,9(4):348-354
Anomalies of the sternal rib ends and costal cartilages, sternal foramina, and epi(supra)sternal bones from a large, modern autopsy population have been described. Rib abnormalities (duplications, fusions, and spurs) were found in 55 of 2,016 plastron roentgenograms, sternal foramina were found in 135, and episternal bones were found in 51. Sternal foramina were significantly more common in blacks than in whites and episternal bones more common in whites than blacks; rib anomalies had no recognizable racial predilection. Rib anomalies were almost three times more common in males than females, whereas episternal bones were only slightly more common in males. Sternal foramina had no sex predilection. Episternal bones were slightly more often unilateral than bilateral and, when unilateral, were twice as often located on the left. While none of the malformations studied appeared to be of clinical significance, they are of potential forensic value in individual identification. 相似文献
306.
307.
Barry Moore 《Australian Journal of Public Administration》1989,48(2):109-122
There are probably more changes taking place in public administration than at any previous time. In some sectors (like health) staff are now used to change; it has become a normal part of their everyday life. In other sectors (like road transport) it is a new experience. Some changes are the latest chapter in a long and continuing story. Clear objectives, downstream autonomy and performance monitoring have been issues for as long as most public servants can remember. The fresh ingredients added by New South Wales Incorporated are the management incentives that make a direct appeal to the self-interest of senior executives, and the ideology of competitive neutrality that mimics the price signals which motivate private enterprise. The intended results are less political patronage, smaller government, more accountability, better morale and higher productivity. Stated in these terms they are unlikely to cause controversy; the current political consensus is that they would constitute worthy goals for any government. However important differences of opinion will probably emerge over the order of priority for these goals. For example, how much should higher productivity be sought if it threatens accountability or morale? There is also likely to be debate between those who want everything in place immediately, even if it means industrial strife, and those who prefer a softly-softly approach. 相似文献
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