Factors associated with the wish to hasten death : a study of patients with terminal illness

Background. There is considerable debate regarding the clinical issues surrounding the wish to hasten death (WTHD) in the terminally ill. The clinical factors contributing to the WTHD need further investigation among the terminally ill in order to enhance understanding of the clinical assessment and treatment needs that underlie this problem. A more detailed understanding may assist with the development of appropriate therapeutic interventions. Method. A sample of terminally ill cancer patients (N=256) recruited from an in-patient hospice unit, home palliative care service and a general hospital palliative care consulting service from Brisbane Australia between 1998–2001 completed a questionnaire assessing psychological (depression and anxiety), social (family relationship, social support, level of burden on others) and the impact of physical symptoms. The association between these factors and the WTHD was investigated. Results. A high WTHD was reported by 14% of patients. A discriminant function analysis revealed that the following variables were associated with a high WTHD (P<0·001): higher levels of depressive symptoms, being admitted to an in-patient hospice setting, a greater perception of being a burden on others, lower family cohesion, lower levels of social support, higher levels of anxiety and greater impact of physical symptoms. Conclusions. Psychological and social factors are related to a WTHD among terminally ill cancer patients. Greater attention needs to be paid to the assessment of psychological and social issues in order to provide appropriate therapeutic interventions for terminally ill patients.

The epistemology that maintains white race privilege, power and control of Indigenous Studies and Indigenous peoples' participation in universities

This paper represents my attempt to turn the gaze and demonstrate how Indigenous Studies is controlled in some Australian universities in ways that witness Indigenous peoples being further marginalised, denigrated and exploited. I have endeavoured to do this through sharing an experience as a case study. I have opted to write about it as a way of exposing the problematic nature of racism, systemic marginalisation, white race privilege and radicalised subjectivity played out within an Australian higher education institution and because I am dissatisfied with the on-going status quo. In bringing forth analysis to this case study, I reveal the relationships between oppression, white race privilege and institutional privilege and the epistemology that maintains them. In moving from the position of being silent on this experience to speaking about it, I am able to move from the position of object to subject and to gain a form of liberated voice (hooks 1989:9). Furthermore, I am hopeful that it will encourage others to examine their own practices within universities and to challenge the domination that continues to subjugate Indigenous peoples.

What is that place? Observations of the impact of environment colour through photographic analysis

Isolating the impact of a colour, or a combination of colours, is extremely difficult to achieve because it is difficult to remove other environmental elements such as sound, odours, light, and occasion from the experience of being in a place. In order to ascertain the impact of colour on how we interpret the world in day to day situations, the current study records participant responses to achromatic scenes of the built environment prior to viewing the same scene in colour. A number of environments were photographed in colour or copied from design books; and copies of the images saved as both colour and black/grey/white. An overview of the study will be introduced by firstly providing examples of studies which have linked colour to meaning and emotions. For example, yellow is said to be connected to happiness1 ; or red evokes feelings of anger2 or passion. A link between colour and the way we understand and/or feel is established however, there is a further need for knowledge of colour in context. In response to this need, the current achromatic/chromatic environmental study will be described and discussed in light of the findings. Finally, suggestions for future research are posed. Based on previous research the authors hypothesised that a shift in environmental perception by participants would occur. It was found that the impact of colour includes a shift in perception of aspects such as its atmosphere and youthfulness. Through studio-class discussions it was also noted that the predicted age of the place, the function, and in association, the potential users when colour was added (or deleted) were often challenged. It is posited that the ability of a designer (for example, interior designer, architect, or landscape architect) to design for a particular target group—user and/or clients will be enhanced through more targeted studies relating colour in situ. The importance of noting the perceptual shift for the participants in our study, who were young designers, is the realisation that colour potentially holds the power to impact on the identity of an architectural form, an interior space, and/or particular elements such as doorways, furniture settings, and the like.

A phenomenological explication of dream interpretation among rural and urban Nguni people

Psychologists investigating dreams in non-Western cultures have generally not considered the meanings of dreams within the unique meaning-structure of the person in his or her societal context. The majority of dream studies in African societies are no exception. Researchers approaching dreams within rural Xhosa and Zulu speaking societies have either adopted an anthropological or a psychodynamic orientation. The latter approach particularly imposes a Western perspective in the interpretation of dream material. There have been no comparable studies of dream interpretation among urban blacks participating in the African Independent Church Movement. The present study focuses on the rural Xhosa speaking people and the urban black population who speak one of the Nguni languages and identify with the African Independent Church Movement. The study is concerned with understanding the meanings of dreams within the cultural context in which they occur. The specific aims of the study are: 1. To explicate the indigenous system of dream interpretation as revealed by acknowledged dream experts. 2. To examine the commonalities and the differences between the interpretation of dreams in two groups, drawn from a rural and urban setting respectively. 3. To elaborate upon the life-world of the participants by the interpretations gained from the above investigation. One hundred dreams and interpretations are collected from two categories of participants referred to as the Rural Group and the Urban Group. The Rural Group is made up of amagqira [traditional healers] and their clients, while the Urban Group consists of prophets and members of the African Independent Churches. Each group includes acknowledged dream experts. A phenomenological methodology is adopted in explicating the data. The methodological precedure involves a number of rigorous stages of expl ication whereby the original data is reduced to Constituent Profiles leading to the construction of a Thematic Index File. By searching and reflect ing upon the data, interpretative themes are identified. These themes are explicated to provide a rigorous description of the interpretative-reality of each group. Themes explicated w i thin the Rural Group are: the physiognomy of the dreamer's life-world as revealed by ithongo, the interpretation of ithongo as revealed through action, the dream relationship as an anticipatory mode-of-existence, iphupha as disclosing a vulnerable mode-of-being, human bodiliness as revealed in dream interpretations and the legitimation of the interpretative-reality within the life-world. Themes explicated within the Urban Group are: the phys iognomy of the dreamer's life-world revealed in their dream-existence, the interpretative-reality revealed through the enaction of dreams, tension between the newer Christian-based cosomology and the traditional cultural-based cosmology, a moral imperative, prophetic perception and human bodiliness, as revealed in dream interpretations and the legitimation of the interpretative-reality within the life-world. The essence of the interpretative-reality of both groups is very similar and is expressed in the notion of relatedness to a cosmic mode-of-being. The cosmic mode-of-being includes a numinous dimension which is expressed through divine presence in the form of ancestors, Holy Spirit or God. These notions cannot be apprehended by theoretical constructs alone but may be grasped and given form in meaning-disclosing intuitions which are expressed in the lifeworld in terms of bodiliness, revelatory knowledge, action and healing. Some differences b e tween the two groups are evident and reveal some conflict between the monotheistic Christian cosmology and the traditional cosmology. Unique aspects of the interpetative-reality of the Urban Group are expressed in terms of difficulties in the urban social environment and the notion of a moral imperative. It is observed that cul tural self-expression based upon traditional ideas continues to play a significant role in the urban environment. The apparent conflict revealed between the respective cosmologies underlies an integration of the aditional meanings with Christian concepts. This finding is consistent with the literature suggesting that the African Independent Church is a syncretic movement. The life-world is based upon the immediate and vivid experience of the numinous as revealed in the dream phenomenon. The participants' approach to dreams is not based upon an explicit theory, but upon an immediate and pathic understanding of the dream phenomenon. The understanding is based upon the interpreter's concrete understanding of the life-world, which includes the possibility of cosmic integration and continuity between the personal and transpersonal realms of being. The approach is characterized as an expression of man's primordial attunement with the cosmos. The approach of the participants to dreams may not b e consistent with a Western rational orientation, but neverthele ss, it is a valid approach . The validity is based upon the immediate life-world of experience which is intelligible, coherent, and above all, it is meaning-giving in revealing life-possibility within the context of human existence.

Understanding the psychosocial factors influencing the risky behaviour of young drivers

Young people aged 17–24 years are at high risk of being killed in road crashes around the world. Road safety interventions consider some influences upon young driver behaviour; for example, imposing passenger restrictions on young novice drivers indirectly minimises the potential negative social influences of peers as passengers. To change young driver risky behaviour, the multitude of psychosocial influences upon its initiation and maintenance must be identified. A study questionnaire was developed to investigate the relationships between risky driving and Akers’ social learning theory, social identity theory, and thrill seeking variables. The questionnaire was completed by 165 participants (105 women,60 men) residing in south-east Queensland, Australia. The sociodemographic variables of age, gender, and exposure explained 19% of the variance in self-reported risky driving behaviour, whilst Akers’ social learning variables explained an additional 42%. Thrill seeking and social identity variables did not explain any significant additional variance. Significant predictors of risky driving included imitation of the driving behaviours of, and anticipated rewards and punishments administered by, parents and peers. Road safety policy that directly considers and incorporates these factors in their design, implementation, and enforcement of young driver road safety interventions should prove more efficacious than current approaches.

Exploring how parents and peers influence the behaviour of young drivers

Despite ongoing enhancements to graduated licensing systems, young drivers continue to have a high risk of being killed or injured in car crashes. This study investigated the influence of parents and peers on the risky behaviour of young drivers, utilising Akers’ social learning theory. The specific factors examined related to parent and peer norms perceived by the young driver, and the rewards and punishments anticipated by the young driver from their parents and peers. A questionnaire was completed by 165 young drivers. Regression analysis revealed that these factors explained 54% of the variance in risky driving. The strongest predictor was anticipated parent rewards, followed by peer norms, and anticipated peer rewards. Exploratory analyses however revealed the profile of predictors varied for male and female participants, and for self-reported offenders and non-offenders. The results highlight the role of psychosocial factors in the risky behaviour of young drivers and the need for road safety policies and programs to consider the influence of both parents and peers upon this behaviour.

Velocity and Concentration field of discharge from a boat propeller

Two-stroke outboard boat engines using total loss lubrication deposit a significant proportion of their lubricant and fuel directly into the water. The purpose of this work is to document the velocity and concentration field characteristics of a submerged swirling water jet emanating from a propeller in order to provide information on its fundamental characteristics. Measurements of the velocity and concentration field were performed in a turbulent jet generated by a model boat propeller (0.02 m diameter) operating at 1500 rpm and 3000 rpm. The measurements were carried out in the Zone of Established Flow up to 50 propeller diameters downstream of the propeller. Both the mean axial velocity profile and the mean concentration profile showed self-similarity. Further, the stand deviation growth curve was linear. The effects of propeller speed and dye release location were also investigated.

The failure of Australian legislation on indirect discrimination to detect the systemic racism which prevents Aboriginal people from fully participating in the workforce

Government figures put the current indigenous unemployment rate at around 23%, 3 times the unemployment rate for other Australians. This thesis aims to assess whether Australian indirect discrimination legislation can provide a remedy for one of the causes of indigenous unemployment - the systemic discrimination which can result from the mere operation of established procedures of recruitment and hiring. The impact of those practices on indigenous people is examined in the context of an analysis of anti-discrimination legislation and cases from all Australian jurisdictions from the time of the passing of the Racial Discrimination Act by the Commonwealth in 1975 to the present. The thesis finds a number of reasons why the legislation fails to provide equality of opportunity for indigenous people seeking to enter the workforce. In nearly all jurisdictions it is obscurely drafted, used mainly by educated middle class white women, and provides remedies which tend to be compensatory damages rather than change to recruitment policy. White dominance of the legal process has produced legislative and judicial definitions of "race" and "Aboriginality" which focus on biology rather than cultural difference. In the commissions and tribunals complaints of racial discrimination are often rejected on the grounds of being "vexatious" or "frivolous", not reaching the required standard of proof, or not showing a causal connection between race and the conduct complained of. In all jurisdictions the cornerstone of liability is whether a particular employment term, condition or practice is reasonable. The thesis evaluates the approaches taken by appellate courts, including the High Court, and concludes that there is a trend towards an interpretation of reasonableness which favours employer arguments such as economic rationalism, the maintenance of good industrial relations, managerial prerogative to hire and fire, and the protection of majority rights. The thesis recommends that separate, clearly drafted legislation should be passed to address indigenous disadvantage and that indigenous people should be involved in all stages of the process.

A review of prostate-specific antigen screening prevalence and risk perceptions for first-degree relatives of men with prostate cancer

First-degree relatives of men with prostate cancer have a higher risk of being diagnosed with prostate cancer than men without a family history. The present review examines the prevalence and predictors of testing in first-degree relatives, perceptions of risk, prostate cancer knowledge and psychological consequences of screening. Medline, PsycInfo and Cinahl databases were searched for articles examining risk perceptions or screening practices of first-degree relatives of men with prostate cancer for the period of 1990 to August 2007. Eighteen studies were eligible for inclusion. First-degree relatives participated in prostate-specific antigen (PSA) testing more and perceived their risk of prostate cancer to be higher than men without a family history. Family history factors (e.g. being an unaffected son rather than an unaffected brother) were consistent predictors of PSA testing. Studies were characterized by sampling biases and a lack of longitudinal assessments. Prospective, longitudinal assessments with well-validated and comprehensive measures are needed to identify factors that cue the uptake of screening and from this develop an evidence base for decision support. Men with a family history may benefit from targeted communication about the risks and benefits of prostate cancer testing that responds to the implications of their heightened risk.

Contradictions : Genre, causal layered analysis and analysis of institutional change

In what follows, I put forward an argument for an analytical method for social science that operates at the level of genre. I argue that generic convergence, generic hybridity, and generic instability provide us with a powerful perspectives on changes in political, cultural, and economic relationships, most specifically at the level of institutions. Such a perspective can help us identify the transitional elements, relationships, and trajectories that define the place of our current system in history, thereby grounding our understanding of possible futures.1 In historically contextualising our present with this method, my concern is to indicate possibilities for the future. Systemic contradictions indicate possibility spaces within which systemic change must and will emerge. We live in a system currently dominated by many fully-expressed contradictions, and so in the presence of many possible futures. The contradictions of the current age are expressed most overtly in the public genres of power politics. Contemporary public policy—indeed politics in general-is an excellent focus for any investigation of possible futures, precisely because of its future-oriented function. It is overtly hortatory; it is designed ‘to get people to do things’ (Muntigl in press: 147). There is no point in trying to get people to do things in the past. Consequently, policy discourse is inherently oriented towards creating some future state of affairs (Graham in press), along with concomitant ways of being, knowing, representing, and acting (Fairclough 2000).

'Homophobia' in the university classroom : law and justice students' conceptualizations of queer identity

Heteronormative discourses provide the most common lens through which sexuality is understood within university curricula. This means that sexuality is discussed in terms of categories of identity, with heterosexuality accorded primacy and all ‘others’ indeed ‘othered.’ This paper reports on research carried out by the authors in a core first year university justice class, in which students of law and/or justice were required to engage with, discuss, and reflect on discourses on sexuality. It uses a poststructural framework to identify how students understand non-heterosexualities and how they personally relate to queer identities, in the sense that it asks questions about gender and sexual identity, and the discourses surrounding them. It was found that strongly negative attitudes to non-heterosexualities are quite resistant to challenge, and that some students express being confronted with queerness as a deep-seated fear of being drawn into otherness against their will. The result was that, while many students were able to unpack their attitudes towards queerness and engage in critical reflection and re-evaluation of their attitudes, students with strongly negative views towards non-heterosexualities conversely refused to engage at all, typically perceiving even the engagement itself as a threat to their core heterosexual identity. However, the authors caution against relying on the idea that students are simply “homophobic” to explain this reluctance, as this term does not necessarily account for the complexity of the discourses that inform students’ reactions in this context. This “homophobia” may simply be related to a way of performing gender and sexual identity as opposed to overt discrimination and fear.

Clinical whole-body skin examination reduces the incidence of thick melanomas

Survival from melanoma is strongly related to tumour thickness, thus earlier diagnosis has the potential to reduce mortality from this disease. However, in the absence of conclusive evidence that clinical skin examination reduces mortality, evidence-based assessments do not recommend population screening. We aimed to assess whether clinical whole-body skin examination is associated with a reduced incidence of thick melanoma and also whether screening is associated with an increased incidence of thin lesions (possible overdiagnosis). A population-based case-control study of all Queensland residents aged 20-75 years with a histologically confirmed first primary invasive cutaneous melanoma diagnosed between January 2000 and December 2003. Telephone interviews were completed by 3,762 eligible cases (78.0%) and 3,824 eligible controls (50.4%) Whole-body clinical skin examination in the three years before diagnosis was associated with a 14% lower risk of being diagnosed with a thick melanoma (>0.75mm) (OR= 0.86, 95% CI=0.75, 0.98). Risk decreased for melanomas of increasing thickness: the risk of being diagnosed with a melanoma 0.76-1.49mm was reduced by 7% (OR=0.93, 95% CI 0.79, 1.10), by 17% for melanomas 1.50-2.99mm (OR=0.83, 95% CI=0.65, 1.05) and by 40% for melanomas ≥3mm (OR=0.60, 95% CI=0.43, 0.83). Screening was associated with a 38% higher risk of being diagnosed with a thin invasive melanoma (≤0.75mm) (OR=1.38, 95% CI=1.22, 1.56). This is the strongest evidence to date that whole-body clinical skin examination reduces the incidence of thick melanoma. Because survival from melanoma is strongly related to tumour thickness, these results suggest that screening would reduce melanoma mortality.

Identifying the learning development of students who are refugees

Students who are refugees need understanding and support to settle successfully into mainstream Australian classrooms. Teachers not aware of students’ prior learning and the process of second language acquisition may have difficulty providing the most appropriate learning environments to meet these students’ needs. This study found that, with no coordination of information on students’ learning backgrounds nor of their learning needs and development, students were in danger of being identified as at-risk of having a learning disability, with little support to substantiate such claims.

The Sociology of Cosmopolitanism:Globalization, Identity, Culture and Government

The dream of a cosmopolitical utopia has been around for thousands of years. Yet the promise of being locally situated and at the same time globally connected and mobile has never seemed more possible than it is today. The question remains as to whether it is positive and realistic for us to have multiple loyalties. Can we sustain community and solidarity with our neighbours while we look beyond our nation? And if we can't - or won't – consider distant strangers as part of our own world, are there increasingly dire consequences? This book reconnects classical sociological theory and contemporary ideas on mobility, otherness, material assemblages, consumption and surveillance to render the idea of a global cosmopolitan utopia amenable to sociological investigation. The book takes a realistic approach to the development of cosmopolitical arrangements. It embraces the imaginative impulses the cosmopolitan dream provides, but takes into account the political, ethical and cultural dimensions of such cosmopolitan developments. In revisiting the relevance of classical sociological approaches in the context of contemporary theoretical challenges, the distinctive approach this book takes to understanding cosmopolitanism will be of use to scholars and students alike.

A proposed qualitative framework for heterogeneous burning of metallic materials : the 'melting rate triangle'

This paper presents a proposed qualitative framework to discuss the heterogeneous burning of metallic materials, through parameters and factors that influence the melting rate of the solid metallic fuel (either in a standard test or in service). During burning, the melting rate is related to the burning rate and is therefore an important parameter for describing and understanding the burning process, especially since the melting rate is commonly recorded during standard flammability testing for metallic materials and is incorporated into many relative flammability ranking schemes. However, whilst the factors that influence melting rate (such as oxygen pressure or specimen diameter) have been well characterized, there is a need for an improved understanding of how these parameters interact as part of the overall melting and burning of the system. Proposed here is the ‘Melting Rate Triangle’, which aims to provide this focus through a conceptual framework for understanding how the melting rate (of solid fuel) is determined and regulated during heterogeneous burning. In the paper, the proposed conceptual model is shown to be both (a) consistent with known trends and previously observed results, and (b)capable of being expanded to incorporate new data. Also shown are examples of how the Melting Rate Triangle can improve the interpretation of flammability test results. Slusser and Miller previously published an ‘Extended Fire Triangle’ as a useful conceptual model of ignition and the factors affecting ignition, providing industry with a framework for discussion. In this paper it is shown that a ‘Melting Rate Triangle’ provides a similar qualitative framework for burning, leading to an improved understanding of the factors affecting fire propagation and extinguishment.