“Best interests” and withholding and withdrawing life-sustaining treatment from an adult who lacks capacity in the parens patriae jurisdiction

Disputes about withholding and withdrawing life-sustaining treatment are increasingly coming before Australian Supreme Courts. Such cases are generally heard in the parens patriae jurisdiction where the test applied is what is in the patient’s “best interests”. However, the application of the “best interests” test, and its meaning, remains unclear in this context. To shed light on this emerging body of jurisprudence, this article analyses the Australian superior court decisions that consider an adult’s best interests in the context of decisions about life-sustaining treatment. We identify a number of themes from the current body of cases and consider how these themes may guide future decision-making. After then considering the law in the United Kingdom, we suggest an approach for assessing best interests that could be adopted by Australian Supreme Courts. We argue that the suggested approach will lead to a more structured and systematic decision-making process that better promotes the best interests of the patient.

Genetic and phenotypic evidence supports evolutionary divergence of the American flamingo (Phoenicopterus ruber) population in the Galapagos islands

The Galapagos archipelago is characterized by a high degree of endemism across many taxa, linked to the archpelago's oceanic origin and distance from other colonizing land masses. A population of ~ 500 American Flamingos (Phoenicopterus ruber) resides in Galapagos, which is thought to share an historical origin with the American Flamingo currently found in the Caribbean region. Genetic and phenotypic parameters in American Flamingos from Galapagos and from the Caribbean were investigated. Microsatellite and microchondrial DNA markers data showed that the American Flamingo population in Galapagos differs genetically from that in the Caribbean. American Flamingos in Galapagos form a clade which differs by a single common nucleotide substitution from American Flamingos in the Caribbean. The genetic differentiation is also evident from nuclear DNA in that microsatellite data reveal a number of private alleles for the American Flamingo in Galapagos. Analysis of skeletal measurements showed that American Flamingos in Galapagos are smaller than those in the Caribbean primarily due to shorter tarsus length, and differences in body shape sexual dimorphism. American Flamingo eggs from Galapagos have smaller linear dimensions and volumes than those from the Caribbean. The findings are consistent with reproductive isolation of American Flamingo population in Galapagos.

Gravity-induced coronal plane joint moments in the adolescent scoliotic spine

INTRODUCTION Calculating segmental (vertebral level-by-level) torso masses in Adolescent Idiopathic Scoliosis (AIS) patients allows the gravitational loading on the scoliotic spine during relaxed standing to be estimated. METHODS Existing low dose CT scans were used to calculate vertebral level-by-level torso masses and joint moments occurring in the spine for a group of female AIS patients with right-sided thoracic curves. Image processing software, ImageJ (v1.45 NIH USA) was used to reconstruct the torso segments and subsequently measure the torso volume and mass corresponding to each vertebral level. Body segment masses for the head, neck and arms were taken from published anthropometric data. Intervertebral joint moments at each vertebral level were found by summing each of the torso segment masses above the required joint and multiplying it by the perpendicular distance to the centre of the disc. RESULTS AND DISCUSSION Twenty patients were included in this study with a mean age of 15.0±2.7 years and a mean Cobb angle 52±5.9°. The mean total trunk mass, as a percentage of total body mass, was 27.8 (SD 0.5) %. Mean segmental torso mass increased inferiorly from 0.6kg at T1 to 1.5kg at L5. The coronal plane joint moments during relaxed standing were typically 5-7Nm at the apex of the curve (Figure 1), with the highest apex joint of 7Nm. CT scans were performed in the supine position and curve magnitudes are known to be 7-10° smaller than those measured in standing [1]. Therefore joint moments produced by gravity will be greater than those calculated here. CONCLUSIONS Coronal plane joint moments as high as 7Nm can occur during relaxed standing in scoliosis patients, which may help to explain the mechanics of AIS progression. The body mass distributions calculated in this study can be used to estimate joint moments derived using other imaging modalities such as MRI and subsequently determine if a relationship exists between joint moments and progressive vertebral deformity.

Introduction : Understanding Connections between Time, Space and the Body

The experiences and constructs of time, space and bodies saturate human discourse—naturally enough, since they are fundamental to existence—yet there has long been a tendency for the terms to be approached somewhat independently, belying the depth of their interconnections. It was a desire to address that apparent shortcoming that inspired this book, and the interdisciplinary meetings from which it was born, the 1st Global Conferences on ‘Time, Space and the Body’ and ‘Body Horror’ held in Sydney in February 2013. Following the lively, often provocative, exchange of ideas throughout those meetings, the writing here crosses conventional boundaries inhabiting everyday life and liminal experiences, across cultures, life circumstances, and bodily states. Through numerous theoretical frameworks and with reference to a variety of media, the authors problematize or deconstruct commonplace assumptions to reveal challenging new perspectives on the diverse cultures and communities which make our world. If there is an overarching theme of this collection it is diversity itself. The writers here come from numerous academic fields, but a good number of them also draw on first-hand cultural production in the arts: photography, sculpture and fine art instillation, for example. Of course, however laudable it might be, there is a potential problem in such diversity: does it produce fruitful dialogue moving toward creative, workable syntheses or simply a cacophony of competing, incomprehensible, barely comprehending voices? To a large degree this depends upon the intellectual, existential ambitions as well as the old-fashioned goodnatured tolerance of both writers and readers. But we hope three unifying characteristics are discernable in the following chapters viewed as a whole: firstly, a genuine concern for the world humans inhabit and the communities they form as bodies in space and time; secondly, an emphasis upon the experience of the human subject, exemplified perhaps by the number of chapters drawing on phenomenology; thirdly, an adventurous, explorative impulse associated with an underlying sense that being, since it is inseparable from the body’s temporality, is always becoming, and here the presence of poststructuralist influences is unmistakable, often explicit. Our challenge as editors has been to present the enormous variety of subjects and views in a way that would render the book coherent and at the same time encourage readers to make explorations themselves into realms they might usually consider beyond their field of interest. To that end we have divided the book into six sections around loosely defined themes, each offering different angles on how time and/or space unfold in and around bodies.

New laws for off the plan contracts in Queensland

The Land Sales Act 1984 regulates “off the plan” sales in Queensland in conjunction with several provisions in the Body Corporate and Community Management Act 1997. Together the Acts regulate sales in both unit developments and housing estates. From 2010 to 2013 the Queensland Government undertook a comprehensive review of the Land Sales Act 1984 to identify opportunities to modernise and improve the legislation. Significant changes were recommended by the Review to align the Land Sales Act 1984 (LSA) with current surveying and conveyancing practice and to overcome a number of practical issues faced by developers under the current legislation. A significant outcome of the review is the removal of provisions related to off the plan community title sales from the LSA to the Body Corporate and Community Management Act 1997 (BCCMA) and the Building Units and Group Titles Act 1980 (BUGTA). This article examines the Land Sales and Other Legislation Amendment Act 2014 due to commence in November 2014.

Development of a new regulatory model for occupational health and safety in the New South Wales coal industry: an issues paper for the New South Wales Department of Mineral Resources

This paper addresses the regulatory issues arising in developing a new regulatory model for the New South Wales Coal Industry. As such, it identifies the relevant literature on this subject, the options available for reform, and the experience of Australian and key international bodies responsible for the development of regulatory standards in this area. In particular it: Identifies the main shortcomings in the existing regulatory approach; Identifies the potential roles/main strengths and weaknesses of different types of standards (eg specification, performance, process and systems-based rules) and potential “best practice’ combinations of standards; Examines the appropriateness of the current regulatory regime whereby the general OHS legislation (including the general duty provisions) applies to mining in addition to the large body of regulation which is specific to mining; Identifies the importance of, and possible means of addressing, issues of worker participation within the coal mining industry; Draws on the literature on what motivates companies and individuals for the purpose of recommending key provisions for inclusion in new legislation to provide appropriate personal and organisational incentives; Draws on the literature on major hazards facilities to suggest the appropriate roles for OHS management systems and safety reports or comparable approaches (eg mine safety management plans); Draws on the United Kingdom (UK) and United States of America (USA) experience of coal mine safety and its regulation for comparative purposes, and for insights as to what sort of regulation most effectively reduces work related injury and disease in coal mining; Examines the relevant roles of International Labour Organisation (ILO) Conventions; Examines the extent to which different regulatory regimes would be appropriate to open cut and underground coal mining; and Examines options for reform. This paper is focussed specifically on the issues identified above.

Expertise in the illustrative context of BPM

As Business Process Management (BPM) is evolving and organisations are becoming more process oriented, the need for Expertise in BPM amongst practitioners has increased. Proactively managing Expertise in BPM is essential to unlock the potential of BPM as a management paradigm and competitive advantage. Whilst great attention is being paid by the BPM community to the technological aspects of BPM, relatively little research or work has been done concerning the expertise aspect of BPM. There is a substantial body of knowledge on expertise itself, however there is no common framework in existence at the time of writing, describing the fundamental attributes characterising Expertise in the illustrative context of BPM. There are direct implications of the understanding and characterisation of Expertise in the context of BPM as a key strategic component and success factor of BPM itself, as well as for those involved in BPM. Expertise in the context of BPM needs to be characterised to understand it, and be able to proactively manage it. Given the relative infancy of research into Expertise in the context of BPM, an exploration of the relevance and importance of Expertise in the context of BPM was considered essential, to ensure the study itself was of value to the BPM field. The aims of this research are firstly to address the two research questions 'why is expertise important and relevant in the context of BPM?', and 'how can Expertise in the context of BPM be characterised?', and secondly, the development of a comprehensive and validated A-priori model characterising Expertise in the illustrative context of BPM. The study is theory-guided. It has been undertaken via an extensive literature review across relevant literature domains, and a revelatory case study utilising several methods: informal discussions, an open-ended survey, and participant observation. An a-priori model was then developed which comprised of several Constructs and Sub-constructs, and several overall aspects of Expertise in BPM. This was followed by the conduct of interviews in the validation phase of the revelatory case study. The primary contributions of this study are to the fields of expertise, BPM and research. Contributions to the field of expertise include a comprehensive review of expertise literature in general and synthesised critique on expertise research, characterisation of expertise in an illustrative context as a system, and a comprehensive narrative of the dynamics and interrelationships of the core attributes characterising expertise. Contributions to the field of BPM include firstly, the establishment of the importance of understanding Expertise in the context of BPM, including a comprehensive overview of the role the relevance and importance of Expertise in the context of BPM, through explanation of the effect of Expertise in BPM. Secondly, a model characterising Expertise in the context of BPM, which can be used by BPM practitioners to clearly articulate and illuminate the state of Expertise in BPM in organisations. Contributions to the field of research include an extended view of Systems Theory developed, reflecting the importance of the system context in systems thinking, and a narrative on ontological innovation through the positioning of ontology as a meta-model of Expertise in the context of BPM.

Individual differences in the processing of punishment and reward cues : an application to road safety messages

This thesis examined the extent to which individual differences, as conceptualised by the revised Reinforcement Sensitivity Theory, influenced young drivers' information processing and subsequent acceptance of anti-speeding messages. Using a multi-method approach, the findings highlighted the utility of combining objective measures (a cognitive response time task and electroencephalography) with self-report measures to assess message processing and message acceptance, respectively. This body of research indicated that responses to anti-speeding messages may differ depending on an individual's personality disposition. Overall, the research provided further insight into the development of message strategies to target high risk drivers.

Evolution of brain size in the palaeognath lineage, with an emphasis on New Zealand ratites

Brain size in vertebrates varies principally with body size. Although many studies have examined the variation of brain size in birds, there is little information on Palaeognaths, which include the ratite lineage of kiwi, emu, ostrich and extinct moa, as well as the tinamous. Therefore, we set out to determine to what extent the evolution of brain size in Palaeognaths parallels that of other birds, i. e., Neognaths, by analyzing the variation in the relative sizes of the brain and cerebral hemispheres of several species of ratites and tinamous. Our results indicate that the Palaeognaths possess relatively smaller brains and cerebral hemispheres than the Neognaths, with the exception of the kiwi radiation (Apteryx spp.). The external morphology and relatively large size of the brain of Apteryx, as well as the relatively large size of its telencephalon, contrast with other Palaeognaths, including two species of historically sympatric moa, suggesting that unique selective pressures towards increasing brain size accompanied the evolution of kiwi. Indeed, the size of the cerebral hemispheres with respect to total brain size of kiwi is rivaled only by a handful of parrots and songbirds, despite a lack of evidence of any advanced behavioral/ cognitive abilities such as those reported for parrots and crows. In addition, the enlargement in brain and telencephalon size of the kiwi occurs despite the fact that this is a precocial bird. These findings form an exception to, and hence challenge, the current rules that govern changes in relative brain size in birds. Copyright (c) 2007 S. Karger AG, Basel.

Kiwi Forego Vision in the Guidance of Their Nocturnal Activities

Background In vision, there is a trade-off between sensitivity and resolution, and any eye which maximises information gain at low light levels needs to be large. This imposes exacting constraints upon vision in nocturnal flying birds. Eyes are essentially heavy, fluid-filled chambers, and in flying birds their increased size is countered by selection for both reduced body mass and the distribution of mass towards the body core. Freed from these mass constraints, it would be predicted that in flightless birds nocturnality should favour the evolution of large eyes and reliance upon visual cues for the guidance of activity. Methodology/Principal Findings We show that in Kiwi (Apterygidae), flightlessness and nocturnality have, in fact, resulted in the opposite outcome. Kiwi show minimal reliance upon vision indicated by eye structure, visual field topography, and brain structures, and increased reliance upon tactile and olfactory information. Conclusions/Significance This lack of reliance upon vision and increased reliance upon tactile and olfactory information in Kiwi is markedly similar to the situation in nocturnal mammals that exploit the forest floor. That Kiwi and mammals evolved to exploit these habitats quite independently provides evidence for convergent evolution in their sensory capacities that are tuned to a common set of perceptual challenges found in forest floor habitats at night and which cannot be met by the vertebrate visual system. We propose that the Kiwi visual system has undergone adaptive regressive evolution driven by the trade-off between the relatively low rate of gain of visual information that is possible at low light levels, and the metabolic costs of extracting that information.

Nutritional risk of cancer patients receiving chemotherapy in the ambulatory care setting : a prospective study

Background Cancer itself can alter the metabolic and physiologic of the body's nutritional needs. As a result, some patients experience some degree of weight loss before the start of the treatment. Aim The aim of the study was to determine at which chemotherapy treatment cycle patients with cancer begin to exhibit signs and symptoms of malnutrition. Methods A prospective descriptive correlational design was used to assess the nutritional risk of 111 patients with cancer receiving chemotherapy in the ambulatory setting. The data were collected by using a nutritional screening tool. Findings The prevalence of malnutrition risk was 45% in patients undergoing the first cycle of chemotherapy. Patients who received the first three cycles of chemotherapy were 2.62 times more likely to develop malnutrition than those who received seven or more cycles. The risk of developing malnutrition varies depending on the type of cancer, the types of chemotherapy regime, the number of chemotherapy cycles, body mass index and the stage of cancer. Conclusion The study found about half of the patients had developed signs and symptoms of nutritional risk at cycle one. Hence, nutritional support may be required even before the start of chemotherapy.

Reflection on the SIA Ltd professional project and the body of knowledge

In the last five years the Safety Institute of Australia Limited (SIA) has developed and implemented a number of strategies to gain professional recognition for the ‘generalist occupational health and safety (OHS) professional’ in Australia and internationally. Despite a considerable amount of work by the SIA aimed at gaining professional status, there does not appear to have been any published debate or reflection about how the drive for professionalism (the ‘professional project’) will contribute to the prevention of occupational disease and injury. Professionalisation has been promoted as a sign of maturity for the SIA and as an unquestionably good outcome, as it has been assumed that professionalisation will provide unmitigated benefits for workplace health and safety. The aim of this paper is to critically reflect on the processes of professionalisation (the professional project) and discuss the ways in which this project may shape the field of occupational health and safety.

Organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs) in the Australian population: Levels in human milk

This study arose out of the 2002 Review of the PCB Management Plan by the Scheduled Waste Management Network (SWMN) and the National Advisory Body (NAB). The Review indicated it would be beneficial to obtain some data on the levels of organochlorine pesticides (OCPs) in the Australian population. In 2002, the Environment Protection and Heritage Standing Committee (EPHSC) agreed and noted that the Australian Government Department of the Environment and Heritage (DEH) would commission a study using the same samples from the National Dioxins Program (NDP) breast milk study collected in 2002- 03. The study, however, was also broadened to include polybrominated diphenyl ethers (PBDEs).

Crystal structures and hydrogen bonding in the proton transfer salts of nicotine with 3,5-dinitrosalicylic acid and 5-sulfosalicylic acid

The structures of the 1:1 anhydrous salts of nicotine (NIC) with 3,5-dinitrosalicylic acid (DNSA) and 5-sulfosalicylic acid (5-SSA), namely (1R,2S)-1-methyl-2-(3-pyridyl)-1H-pyrrolidin-1-ium 2-carboxy-4,6-dinitrophenolate, C10H15N2+ C7H3N2O7-, (I) and (1R,2S)-1-methyl-2-(3-pyridyl)-1H-pyrrolidin-1-ium 3-carboxy-4-hydroxybenzenesulfonate, C10H15N2+ C7H5O6S-, (II) are reported. The asymmetric units of both (I) and (II) comprise two independent nicotinium cations (C and D) and either two DNSA or two 5-SSA anions (A and B), respectively. One of the DNSA anions shows a 25% rotational disorder in the benzene ring system. In the crystal of (I), inter-unit pyrrolidinium N-H...N(pyridine) hydrogen bonds generate zigzag NIC cation chains which extend along a while the DNSA anions are not involved in any formal inter-species hydrogen bonding but instead form pi--pi associated stacks which parallel the NIC chains along a [ring centroid separation, 3.857(2)A]. Weak C-H...O interactions between chain substructures give an overall three-dimensional structure. With (II), A and B anions form independent zigzag chains with C and D cations, respectively, through carboxylic acid O-H...N(pyridine) hydrogen bonds. These chains, which extend along b are pseudo-centrosymmetrically related and give pi--pi interactions between the benzene rings of anions A and B and the pyridine rings of the NIC cations C and D, respectively [ring centroid separations, 3.6422(19) and 3.7117(19)A]. Present also are weak intermolecular C-H...O hydrogen-bonding interactions between the chains, giving an overall three-dimensional structure.