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Against the background of the Sharma decisions, this article considers the meaning and potential of a human rights-based approach to climate change for Australia. It examines the human right to a healthy environment as recently recognised by the United Nations Human Rights Council and considers how recognition of this right has shaped climate litigation. Beyond formal legal recognition and climate litigation, this article argues that there is significant potential for a human rights-based approach to climate change in driving a rethinking of policy making which places people on the frontline of the climate crisis at the centre of responses to climate change and treats them as rights-holders rather than victims of a hostile climate.

The undergraduate medical programme at Newcastle University (NU) includes a fundamental 'Essentials of Medical Practice' (EOMP) phase comprising the first 2 years of study. This period is designed to support entrants in their transition from further education into the advanced study and practice of clinical medicine. The anatomical sciences of gross anatomy, histology and embryology, and life sciences including physiology, pharmacology and genetics are key disciplines taught within the integrated case-based EOMP curriculum. Learners apply basic science knowledge to clinical scenarios during training in practical examination, communication and reasoning skills. Within the modern pedagogic landscape, the development and introduction of technology-enhanced learning strategies have enhanced the provision of remote learning resources in pre-clinical education. However, the emergence of COVID-19 has resulted in widespread technological challenges for educators and learners, and has raised pedagogic, logistical and ethical concerns. Nonetheless, the pandemic has produced favourable conditions for the creation of valuable digital visualisation strategies for learning and teaching, and for developing and modernising universal approaches to remote education. Here, we describe our technology-enhanced adaptations to COVID-19 across the domains of teaching, learning and academic support for pre-clinical learners studying basic life sciences and clinical skills. Moreover, we outline research-informed digital visualisation solutions to pandemic-era challenges and reflect upon experiences gained within our own educational context. In doing so, we provide insights into the impacts and successes of our interventions. While providing a record of unprecedented contemporary circumstances, we also aim to utilise our observations and experiences of COVID-19 pedagogy when developing ongoing strategies for delivering curricula and futureproofing educational practice.

Although health inequities among Black same gender loving men (SGLM) are well documented (e.g., chronic psychological disorders, HIV, suicide), there are few accessible, culturally affirming, and community-led interventions designed to reduce these inequities. The present manuscript describes the process through which we developed iTHRIVE 365, a multicomponent health-promotion intervention designed by Black SGLM for Black SGLM. We utilized a community-based participatory research approach (CBPR) that included collaboration between THRIVE SS, a Black SGLM-run community-based organization, and a multisectoral team of public health, research, and digital design professionals to develop the intervention. A five-phase development process included four phases of focus groups and a technical pilot to assess community priorities and incorporate input on each feature of the intervention. Directed content analysis indicated that participants wanted a multicomponent and technology-mediated intervention that promotes health knowledge and motivation, Black SGLM social support, access to affirming healthcare, and housing and economic resources. iTHRIVE 365 combines multilevel and culturally affirming intervention features to combat the effects of oppression and ultimately promote Black SGLM’s biopsychosocial health.

The six Gulf Cooperation Council (GCC) countries have received criticism for being slow to conform to global human rights norms. They have lagged in signing global treaties and covenants and have not enforced many of the laws they have on the books. However, for three key reasons, hope exists that continued engagement with these countries on human rights issues may lead to progress. First, despite a lack of progress in some areas, such as political and civil rights, the region has made great progress overall in just a few decades, especially regarding economic and social rights. Second, GCC countries have begun incorporating human rights language into domestic legislation and their own local discourse. Third, economic and social changes are on the horizon for the region in the medium to long term, which may lead to political changes in the next few decades.

Aneurysmal dilatation secondary to HIV vasculitis is well described being more common in patients under 45 years of age with advanced stage HIV infection (CD4 200 cells/µl). Tuberculous meningitis is far more common than previously anticipated with centres in Cape Town publishing that more than half of all cases of adult meningitis were secondary to tuberculosis. But aneurysmal dilatation of the cerebral vessels is exceedingly rare complication in this population. We report a 14-year-old male presenting to Robert Mangaliso Sobukwe Hospital in South Africa, with a first seizure and Tuberculous Meningitis. The patient was lost to follow-up with subsequent representation 2 years later with worsening clinical picture and imaging revealing marked anterior circulation aneurysmal dilatation. The patient was newly diagnosed as being HIV positive giving uncertainty of the aetiology of his vascular malformations. Aneurysmal dilatation in HIV associated cerebral vasculitis is rare. It is more frequently encountered in young adults with advanced disease who are severely immunocompromised. Tuberculous involvement in the central nervous system is thought to be due to secondary reactivation of quiescent foci of micro infection. Aneurysmal dilatation in the setting of Tuberculous Meningitis is infrequently reported in medical literature.

Aim The purpose of this study was to survey all United States Air Force (USAF) general dentists regarding their experience with computer-aided design/computer-aided manufacturing (CAD/CAM) while in a dental school. Dental school graduation year and location was compared to the type and amount of CAD/CAM training and clinical experience during dental school to better understand the differences and influence of this technology. Materials and methods A survey consisting of six questions was sent through e-mail to 546 general dentists in the AF Dental Corps in 2018 of which 306 replied (56% response rate). Results Dentists who graduated in 2005 or earlier and between 2006 and 2009 stated they did not receive CAD/CAM training in dental school, while more respondents in the group of graduation years 2014-2017 stated that they did receive training. About 11% of the respondents who graduated in 2014-2017 completed 6-10 restorations and 9% completed 11 or more restorations compared to the other year groups. More respondents who graduated from a dental school in the southwest and southeast regions of the United States reported completing more restorations compared to other school regions. Conclusion Computer-aided design/computer-aided manufacturing is now becoming a prevalent curriculum in US dental schools, both as a core requirement and an elective. Its training platforms varied from lectures and literature reviews to preclinical laboratory. Clinical significance More respondents in the groups of graduation years 2014-2017 had completed more CAD/CAM restorations compared to other year groups; however, most of the respondents did not feel their training was sufficient enough to use CAD/CAM technology independently.

Speaking and singing are activities linked to increased aerosol particle emissions from the respiratory system, dependent on the utilized vocal intensity. As a result, these activities have experienced considerable restrictions in enclosed spaces since the onset of the COVID-19 pandemic due to the risk of infection from the SARS-CoV-2 virus, transmitted by virus-carrying aerosols. These constraints have affected public education and extracurricular activities for children as well, from in-person music instruction to children’s choirs. However, existing risk assessments for children have been based on emission measurements of adults. To address this, we measured the particle emission rates of 15 pre-adolescent children, all eight to ten years old, with a laser particle counter for the test conditions: breathing at rest, speaking, singing and shouting. Compared with values taken from 15 adults, emission rates for breathing, speaking and singing were significantly lower for children. Particle emission rates were reduced by a factor of 4.3 across all conditions, whereas emitted particle volume rates were reduced by a factor of 4.8. These data can supplement SARS-CoV-2 risk management scenarios for various school and extracurricular settings.

Employee turnover is a disruptive and costly phenomenon for organizations. Understanding the causes of turnover and how to mitigate such causes offers a tangible benefit to organizations, especially as it relates to Millennials which are the largest portion of the workforce in 2020. The study herein sought to determine whether Millennial generation employee perceptions of leadership style have an association with job satisfaction for college-educated, full-time employees at a mid-sized professional services firm in the United States. The relationship between perceptions of leadership style and employee job satisfaction were evaluated via a non-experimental quantitative study. The research design was a cross-sectional survey administered to 1,567 participants with 354 usable responses obtained. Data collected via a survey demonstrated there is a statistically significant moderate correlation (rs = .32, p < .01) between perceptions of leadership style and job satisfaction at the scale level and that the relationship is stable regardless of gender, tenure, ethnicity, or age. The findings support previous studies of various generational cohorts and extend the knowledge base specific to a Millennial subgroup. This study extends the body of knowledge related to the Full Range of Leadership Theory and adds information for a specific generational cohort in one industry segment. Implications include opportunities for organizations to implement leadership development programs focused on specific behaviors that will increase employee satisfaction.

PurposeThe study's purpose is to examine market returns around dividend announcements that contrast with a pattern of prior dividend announcements.Design/methodology/approachThe paper identifies firms that have a smooth dividend pattern of once-a-year dividend increases but at some point break that pattern and announce an unchanged dividend. The sample design allows the opportunity to investigate the market reaction to unchanged dividend announcements when an increase was likely to have been expected.FindingsThe results indicate that failing to increase the dividend is associated with significantly positive abnormal returns that are greater in magnitude for more entrenched dividend-increase records, supporting a contrast-effect hypothesis.Originality/valueThe results indicate that dividends are interpreted not only relative to the immediate dividend amount but also how the decision contrasts with dividends over a prolonged period. This finding suggests that the information content of the announcement of an unchanged dividend can vary according to the prior dividend pattern.

The magnitude of the underreaction following a stock split is different depending on the number of splits that have already occurred. The first three splits are followed by abnormal profitability and significant underreaction, which are outcomes consistent with managers using splits to signal favorable information about the firm's prospects. However, abnormal profitability fails to materialize and the underreaction gradually dissipates with each subsequent split suggesting the efficacy of a split announcement as a vehicle to convey information is not constant but steadily reduces with each successive split. The underreaction is distinct from any short-term announcement effects and indicates the market does not immediately impound the split's information content. There is no significant change in liquidity around each consecutive split confirming that the underreaction is not explained by microstructure effects. As is the case with other corporate events, the market interprets the content of announcements already made multiple times differently from announcements made less often.

Background: Sudden cardiac death in a young athlete is a catastrophic event with an incidence of approximately 1:40,000 to 1:80,000. Pre-participation sports screening in adolescents and young adults utilizes a history, physical, and 14-point targeted questionnaire. Countries such as Italy and Japan have added electrocardiogram (EKG) screening programs, however, in the USA no national mandate exists. The reasons for this include concerns for the constraints on the healthcare system, manpower, cost, access to follow-up care, and false-positive results. Recently, some states and local municipalities have implemented pre-participation EKG screenings. …

Finasteride is not commercially available in a liquid format, which stimulated the development of a stable and simple finasteride suspension formulation. The objectives of this work were to develop and test a finasteride suspension for 1) simplicity to compound, 2) pharmaceutical acceptability, 3) stability, and 4) potential for occupational exposure. The stability of commercial 5-mg finasteride tablets (50 mg/150 mL) was evaluated in water, Oral Mix, and OralMix SF in amber polyethylene terephthalate bottles at 25°C or 4°C. Additional stability studies were carried out using sugar-free Finasteride Powder USP in amber polyethylene terephthalate bottles and tablets in water in polypropylene oral syringes. On study days 0, 1, 3, 7, 14, 28, 38, 49, 63, and 90, the finasteride concentration was determined using a validated stability-indicating liquid chromatographic method. The potential occupational airborne exposure was evaluated by attempting to measure finasteride in 1000 liters of room air following shaking and nebulization. Finasteride suspension/dispersion formulations were prepared in water, Oral Mix, and Oral Mix SF from tablets and pure powder. All formulations retained more than 94.3% of the initial finasteride concentration, with 95% confidence, when stored for up to 90 days at room temperature or 4°C. Simulations of occupational exposure failed to demonstrate the presence of finasteride in room air following attempts to nebulize finasteride mixtures. We conclude that 333-µg/mL suspension/dispersions of finasteride in water or Oral Mix products will have more than 94.3% of the initial finasteride concentration remaining after 90 days, regardless of the formulation, container, or storage temperature. Although we could not detect finasteride in room air, given the analytical limits of the study, we estimate that exposure would unlikely exceed 3.6-µg/1000 liters of room air. Nevertheless, since current regulations are based on "no safe limit," use of primary engineering controls and personal protective equipment as appropriate is recommended.

Resistance to androgen receptor (AR) targeting therapeutics in prostate cancer (PC) is a significant clinical problem. Mechanisms by which this is accomplished include AR amplification and expression of AR splice variants, demonstrating that AR remains a key therapeutic target in advanced disease. For the first time we show that IKBKE drives AR signalling in advanced PC. Significant inhibition of AR regulated gene expression was observed upon siRNA-mediated IKBKE depletion or pharmacological inhibition due to inhibited AR gene expression in multiple cell line models including a LNCaP derivative cell line resistant to the anti-androgen, enzalutamide (LNCaP-EnzR). Phenotypically, this resulted in significant inhibition of proliferation, migration and colony forming ability suggesting that targeting IKBKE could circumvent resistance to AR targeting therapies. Indeed, pharmacological inhibition in the CWR22Rv1 xenograft mouse model reduced tumour size and enhanced survival. Critically, this was validated in patient-derived explants where enzymatic inactivation of IKBKE reduced cell proliferation and AR expression. Mechanistically, we provide evidence that IKBKE regulates AR levels via Hippo pathway inhibition to reduce c-MYC levels at cis-regulatory elements within the AR gene. Thus, IKBKE is a therapeutic target in advanced PC suggesting repurposing of clinically tested IKBKE inhibitors could be beneficial to castrate resistant PC patients.

The fact that many companies have a long track record of consistent dividend increases suggests that managers believe there is some benefit to establishing and maintaining such a pattern. Many companies, for example, follow a perennial policy of increasing the dividend in a particular quarter, maintaining it at the same level for the next three quarters, and then increasing it in the same quarter of the following year. But does the capital market reward companies for maintaining a consistent dividend policy? Do companies with a history of repeated dividend increases earn long‐term positive abnormal returns; and if so, how long do the returns persist? The authors find that companies earned significantly positive abnormal returns following each of the first five annual dividend increases, over and above the positive announcement‐month returns. Nevertheless, the reward decreases as the track record of dividend increases becomes longer. After the first dividend increase, companies enjoy significantly positive returns for the next two years. Companies that increase the dividend in the same quarter of the following year also enjoy significant positive returns, but returns that are smaller (and less statistically significant) than in the case of first‐time dividend increases. And as the dividend‐increase track record further lengthens, the size and statistical significance of the abnormal returns continues to shrink; and after the sixth dividend increase, the abnormal returns in the next twelve months are statistically indistinguishable from zero. In sum, although there is some support for maintaining a consistent dividend policy, the market response diminishes over time, and investors do not earn abnormal returns by buying stocks whose annual dividend has already been increased six or more times.

The cyclic nature of the stick-slip phenomenon may cause catastrophic failures in drill-strings or at the very least could lead to the wear of expensive equipment. Therefore, it is important to study the drilling parameters which can lead to stick-slip, in order to develop appropriate control methods for suppression. This paper studies the stick-slip oscillations encountered in drill-strings from both numerical and experimental points of view. The numerical part is carried out based on path-following methods for non-smooth dynamical systems, with a special focus on the multistability in drill-strings. Our analysis shows that, under a certain parameter window, the multistability can be used to steer the response of the drill-strings from a sticking equilibrium or stick-slip oscillation to an equilibrium with constant drill-bit rotation. In addition, a small-scale downhole drilling rig was implemented to conduct a parametric study of the stick-slip phenomenon. The parametric study involves the use of two flexible shafts with varying mechanical properties to observe the effects that would have on stick-slip during operation. Our experimental results demonstrate that varying some of the mechanical properties of the drill-string could in fact control the nature of stick-slip oscillations.

Recent research indicates that the signal sent by a dividend change is more powerful for longer histories of unchanged dividends. We study the dividend history of Australian firms to investigate whether the signalling power of a dividend increase varies with the frequency of repetition. We find that the first three consecutive dividend increases are associated with significantly positive abnormal returns, and subsequent increases are generally not significant, even after controlling for the interaction effect with the simultaneously announced earnings information. Our results support the hypothesis that repeating a dividend increase eventually leads to a reputation for further increases and weakens the value of subsequent increases as a means of disseminating management's private information.

Ensuring reliable gastrointestinal drug absorption of orally administered immunosuppressive medications posttransplant is critical to ensuring graft survival.A 66-year-old man of East Asian origin with a previous total gastrectomy was evaluated for living donor kidney transplantation. Pretransplant pharmacokinetic testing was performed to determine the most appropriate posttransplant medication strategy. The Gastrointestinal Quality of Life Index and Gastrointestinal Rating Scale questionnaires were administered to gauge immunosuppressive medication-related side effects in the absence of a stomach.The patient's ability to absorb cyclosporin, tacrolimus (Tac), enteric-coated mycophenolate sodium (EC-MPS) and sirolimus (SRL) in oral dosage forms was well-preserved. Compared to nongastrectomy reference populations, the rate and extent of absorption of SRL and mycophenolic acid from EC-MPS were similar. The absorption of Tac and cyclosporin was greater than expected. Mycophenolate mofetil did not provide mycophenolic acid absorption as well as EC-MPS. The patient had worsened gastrointestinal symptoms with mycophenolate mofetil or EC-MPS in combination with Tac and cyclosporin, but this was not seen with isolated SRL.This case demonstrates that commonly used postkidney transplantation immunosuppressive regimes may be prescribed after total gastrectomy as long as their limitations are noted.

Fracture behavior of adhesively bonded joints subjected to mixed-mode (i.e. mode I+II) loading conditions is of importance in many industrial applications. This research therefore aims to characterise the failure behaviour of metal-to-metal (i.e. both aluminium adherends) adhesive joints using the mixed mode bending test (MMB), adapted from ASTM D6671/D6671M standard, along with instrumentation using acoustic emission (AE) sensor. Twenty-four adhesively bonded specimens were prepared using two types of adhesive bond materials (acrylic, cyanoacrylate) with two different bonded area 65% and 100%. To understand the effect of mixed-mode loading conditions on the failure behavior, two different mixity ratios were achieved through the design of the MMB test fixture and tested for each bonded joint. The AE results during mechanical testing shows that the time domain signals were spread over the loading phase with distinct features for different mixity ratios. They successfully identified the moment of adhesive fracture during every test. Also, the fracture behavior of the bonded joints was simulated using virtual crack closure technique (VCCT) method using finite element method to understand the loading dynamics in specimen when considering a combination of various design parameters. In addition, an analytical method (e.g. corrected beam theory or CBT) was used to determine strain energy release rates of each specimen. The results show that both the brittle and ductile specimens exhibited higher energy release rates when mode II proportion of loading was increased during the crack initiation phase. The proposed measurement can be useful to assess the overall structural health of bonded systems.

Magnetic resonance imaging (MRI) is commonly used to evaluate soft tissue pathology of the foot and ankle. Prior investigations have reported limitations of this modality, however, in evaluation of pathologies related to the peroneal tendons. This article investigates the correlation of pre-operative MRI studies with intraoperative findings. Five board-certified radiologists interpreted MRIs of 80 ankles that subsequently underwent surgical procedures performed by one board-certified foot and ankle surgeon, after which comparison was made between their findings. Statistically significant disagreement was found between radiologist and surgeon findings of a normal peroneus brevis (PB), PB and peroneus longus (PL) tendinosis, PB and PL hypertrophy, PB and PL partial linear tears, PB and PL flattening, PB longitudinal split tears, and the PB attritional spectrum (combined analysis of flattening, partial linear tearing, and longitudinal split tears). These results suggest that given the disconcordance between MRI and intraoperative findings, surgeons should remain cautious in their reliance upon this imaging modality when evaluating this anatomic region.

This chapter introduces the concept of Forced Democracy (FD) interventions. The first part of the chapter offers a definition of FD interventions and offers a discussion of the degree to which a desire to bring about democracy is at the heart of these actions. The second part discusses the liberal and realist traditions that underpin the FD strategy. The third part of the chapter focuses historical roots of the FD strategy in American foreign policy. The fourth part discusses the academic treatment of the FD phenomenon over the last several decades. The chapter concludes that while academic research has discovered much about the dynamics of FD interventions (the “how”), it has focused much less on the equally important question of the role that the desire to bring about democracy actually plays in American foreign policy (the “why”).

This chapter examines the American intervention in the Dominican crisis of 1965. The first part of the chapter outlines the buildup to the intervention and the subsequent American invasion. The second part of the chapter evaluates the degree to which the intervention was truly focused on delivering democracy to the country. It first attempts to identify the degree that a desire to install democracy played in the Johnson administration’s decision to intervene. Subsequently, it investigates the degree to the post-intervention American actions were focused on delivering democracy in the Dominican Republic.