Emerging Directions in Public Sector Management in New South Wales

This article describes some of the changes taking place within the NSW public sector to enable it to meet efficiently the future demands of a diverse community. It features a range of major reforms that are under way across legislative, administrative and financial frameworks to enhance the sector's ability to cope with technological advances and enhance service delivery.     

The reunion of adoptees and birth relatives

An increasing number of adult adoptees are insisting that they have a constitutionally based civil right to have access to their sealed birth records which would reveal the true identity of their natural parents. This study investigated the outcome of 11 cases of reunion between adoptees and birth mothers. The majority felt that they had personally benefitted from the reunion even though in some of the cases the adoptees were disillusioned and disappointed in their birth relatives. There are many reasons why an adoptee feels a need to search for more information on his birth parents or to seek out a reunion; in many cases, the true purpose remains unconscious. It would appear that very few adoptees are provided with enough background information to be incorporated into their developing ego and sense of identity. Feelings of genealogical bewilderment cannot be discounted as occurring only in maladjusted or emotionally disturbed individuals.Received M.D. from the University of Miami (Florida) and psychiatry training at UCLA. Private practice of adult and child psychiatry in Encino, California. Interests lie in identity problems of young adults, adoption, and the training of psychology paraprofessionals.Received M.S.W. from the University of Southern California. Prior experience in adoption, working with children, birth parents, and adoptive parents, and in supervision. Interests lie in specific problems related to adoption, working with adolescents, and legislative aspects of child welfare.Received M.S.W. from Columbia University, New York. Interests lie in work with unwed fathers, adoptions, problems related to illegitimacy, and residential treatment.     

Geschlechtergleichheit oder „exklusive Emanzipation“? Ungleichheitssoziologische Implikationen der aktuellen familienpolitischen Reformen*

Focusing on gender and social inequalities, we analyse two current reforms in German family policy: the 2007 parental leave reform and the discussion on a reform of the joint taxation of married couples. These reforms lead to changes in policy instruments and objectives that are not adequately described by the thesis of a change towards an adult worker model. Rather, so our first argument, the reforms lead to a thoroughgoing change of the interplay between (de-)familialization and (de-)commodification, as they not only put a stronger focus on labour market activation, but also try to increase birth rates via financial incentives. However, both reform projects mainly provide incentives for higher labour market participation and birth rates among highly qualified women, which means an important shift away from the objective of redistribution that has been an important impetus for German familiy policy so far. This development has severe consequences for social inequalities, as it promises an ?exclusive emancipation“ for highly qualified women only.     

Fatal Candida tropicalis infection in an 8-month-old infant with an aplasia of the thymus as a rare cause of death in infancy

Anomalies of the thymus can lead to immunodeficiencies that are often associated with complex syndromes. The clinical relevance of those anomalies varies a lot. Regarding mortality and morbidity, opportunistic infections play a major role in immunocompromised individuals. Case report: An 8-month-old infant died of a sepsis with multi-organ failure after 32 days in intensive care. At autopsy, no thymus gland could be found; toxicological examinations yielded high morphine concentrations. Autopsy findings and the results of further examinations performed postmortem are discussed in view of the clinical findings, the classification and the cause of death.     

Immunocytochemical examination of biological traces on knife blades

In cases of penetrating stab wounds by different knives it is highly relevant to prove which knife caused which injury, especially if one of the injuries was lethal. This is possible by immunocytochemical examination of cellular material remaining on the injuring blade because some organs have organ-specific antigen determinants such as alpha-l-fetoprotein in the liver cells or cardiac troponin I in the heart muscle cells, to which antibodies can bind. Even when penetrations occur through several layers of clothing, enough cells from the injured organ remain on the blade of a knife to allow immunohistochemical examination. These cells can be collected by means of adhesive film or wiping the blade and can be stained immunocytochemically. The organ specificity of the examined proteins allows proof of their origin. The present study shows that immunocytochemical alpha-l-fetoprotein and cardiac troponin I staining of the cells remaining on a knife blade enables proof of whether the knife blade injured the heart or the liver, or both.     

Suicide with acetylsalicylic acid

The authors report on a suicide of a 41-year-old man with acetylsalicylic acid. According to his own statement the man had taken about 200 tablets of Aspirin (65 g acetylsalicylic acid) and initially showed no symptoms of intoxication. 4-5 hours after ingestion he vomited twice, but clear intoxication symptoms like convulsions and cardiac arrhythmia occurred not earlier than 11 hours after ingestion. Resuscitation by the emergency physician was not successful. The chemical-toxicological analysis (HPLC-DAD) of blood samples taken in the hospital approximately 12 h after ingestion showed salicylate in concentrations of 475 mg/L to 557 mg/L. The post-mortem concentrations of salicylate were within the lethal-toxic range, i.e. 762 mg/L in heart blood and 215 mg/L in femoral blood. All tested organs contained equally lethal salicylate levels (e.g. 503 mg/L in the liver and 251 mg/L in the brain).     

Negotiating barriers,navigating the maze: First Nation peoples' experience of medical relocation

This study documents the policy framework that shapes First Nations' experience of relocating to access medical care. We analyzed policy documents and government websites, interviewed individuals who have experienced relocation, family members, healthcare providers, health administrators, and conducted two focus groups with government representatives. Federal and provincial program managers interpret policies, make decisions on eligibility, to extend or deny coverage. Decisions are shaped by shrinking budgets, fragmented program coverage, and jurisdictional confusion. Provider advocacy can help, but also perpetuate perceptions of arbitrariness and distrust. National policy renewal is required to redress this issue.