The ethics of surrogate decision making in medicine : autonomy, paternalism, or a different approach?

Knowing who to involve in treatment decisions when a patient is incapacitated has been the subject of discussion in bioethical, health law and clinical research. The major issues tend to revolve around the tension between exercising a degree of medical paternalism and respecting patient autonomy. Patients are encouraged to exert their autonomy even when they may not be capable of doing so, by means of surrogate consent or advanced directives. While liberal concepts of autonomy are exemplified in western bioethics and legal systems, clinically these decisions remain difficult, and input from medical professionals is sought, raising the issue of paternalism. A framework of bioethics, which places the patient in a relational context rather than a strictly autonomous one, may be a more helpful way of deliberating these difficult decisions

Measuring quality of life in alcohol and other drug users - the need for improvement

Objective : The use of Quality of Life (QoL) -related measures in Alcohol and Other Drug-related research has increased dramatically over the past decade. However, there remains a great deal of confusion about which type of QoL measure is most valid, what each constrict actually measures and the ethicality of the process of QoL measurement and its subsequent transfer to monetary value. This is particularly important in regard to subsequent resource allocation on the basis of Quality Adjusted Life Years (QALYs). We aim to review the logic of current QoL -related measurement and determine the most conceptually valid way of measuring QoL.

Methods : This review considers some of the broad principles that concern quality of life assessment. These are discussed in relation to health-related quality of life (HRQoL) and the measurement of subjective well-being.

Results : We argue that there are serious logical and methodological issues concerning HRQoL measurement, to the extent that the instruments may not be regarded as valid measures of life quality as this term is generally understood.

Conclusions : It is recommended that HRQoL measurement be abandoned in favour of three separate forms of measurement as medical symptoms, subjective well-being and specific dimensions of psychological ill-being.

The element of sacrifice in romantic love

In romantic love, the link with transgression is made very frequently indeed, so frequently that we cannot simply be dealing with a way of construing as real an obstacle that is imagined because the actual satisfaction is prohibited. Rather, the fact that access to the object is seen as transgressive must be due to the fact that the object itself has something that prevents the relationship from occurring. That is, it is not the case that the object is merely imagined to be inaccessible when in actual fact there is no obstacle to satisfaction by means of it. Rather, the relationship to the object as source of love is also and at the same time a perverse relationship that, at least for a neurotic, causes anxiety.

Individual, social and physical environmental correlates of children's active free-play : a cross-sectional study

Background
Children's unstructured outdoor free-play (or active free-play) has the potential to make an important contribution to children's overall physical activity levels. Limited research has, however, examined physical activity in this domain. This study examined associations between individual, social and physical environmental factors and the frequency with which children play in particular outdoor locations outside school hours. This study also investigated whether the frequency of playing in outdoor locations was associated with children's overall physical activity levels.

Methods
Participants including 8-9 year old children and their parents (n = 187) were recruited from a selection of primary schools of varying socioeconomic status across metropolitan Melbourne, Australia. Parents completed a survey and children's overall physical activity levels were measured by accelerometry. Regression models examined the odds of children playing in various outdoor settings according to particular correlates.

Results
Inverse associations were found between preference for activities not involving physical activity, and the likelihood of children playing in the yard at home on the weekend (OR = 0.65; CI = 0.45,0.95). Positive correlates of children playing in their own street included: parental perceptions that it was safe for their child to play in their street (weekdays [OR = 6.46; CI = 2.84,14.71], weekend days [OR = 6.01; CI = 2.68,13.47]); children having many friends in their neighbourhood (OR = 2.63; CI = 1.21,5.76); and living in a cul-de-sac (weekdays [OR = 3.99; CI = 1.65,9.66], weekend days [OR = 3.49; CI = 1.49,8.16]). Positive correlates of more frequent play in the park/playground on weekdays included family going to the park together on a weekly basis on weekdays (OR = 6.8; CI = 3.4,13.6); and on weekend days (OR = 7.36; CI = 3.6,15.0). No differences in mean mins/day of moderate-vigorous physical activity were found between children in the highest and lowest tertiles for frequency of playing in particular outdoor locations.

Conclusion
The presence of friends, safety issues and aspects of the built environment were reported by parents to be associated with children's active free-play in outdoor locations. Future research needs to further examine associations with time spent in active free-play and objectively-measured overall physical activity levels. It is also important to investigate strategies for developing a supportive social and physical environment that provides opportunities for children to engage in active free-play.

The educative value of Dewey's religious attitude for spirituality

John Dewey's 'religious attitude' has great potential for the educative development of children's spirituality. This is because it enables their spiritual understandings to become more intelligently composed - not just in a cognitive or hyper-rational sense, but as a way of being. This paper provides an outline of Dewey's approach, which is described as being democratic, inquiry based, and 'scientific'. Such an approach therefore offers a contrast to other more epistemologically focused curricula which attempt to educate a person's spirituality. In order to make the case for the potential educative value of such an attitude, a brief review of Dewey's approach to education shall be offered, in which the notions of inquiry, democracy, and 'science' shall be highlighted to make the case that such attributes might be necessary for spiritual education if the United Nations Educational and Scientific Organization's goal of attaining world peace is to ever become possible.

From profiles to rich tasks : the situated nature of 'authenticity' in the context of reforming curriculum and assessment practices

Outcome based education that has dominated Australian education in the 1990s is under review in the early years of the twenty first century. The available historical 'texts' produced during the first half of the 1990s, which include the national Statements and Profiles, and the state Curriculum and Standards Frameworks, provide us with documents that we can engage with not simply for 'history's sake', but with an opportunity to, in the words of the feminist author Dorothy Smith, 'displace[s] the analysis from the text as originating in writer or thinker, to the discourse itself as an ongoing intertextual process' bringing into view the social relations in which texts are embedded and which they organise' (1990, p. 161-2). Most Australian states and territories have now commenced significant situated, local curriculum renewal and reform. This renewed interest in curriculum offers insights into the character of recent assessment practices in Australia, recognising the tensions inherent in assessment practices and authentic assessment models. This paper explores, by way of an overview of the broad curriculum and assessment practices adopted in Australia over the past twenty-five years, the situated nature of 'authenticity' in the context of curriculum and assessment practices and how as teacher educators we are responding through our everyday work.

Need to know : lessons from Sino-Australian business negotiators on the importance of guanxi, emotions and generational differences in Chinese negotiation behaviour

The forces of globalisation over the last few decades have created opportunities for intemational business as never before, whilst leaving no organisation immune to competition. With the Global Financial Crisis impacting the world economy, the BRIC economies as a group - Brazil, Russia, India and China, have steadily benefited from continuing growth in 2008 and 2009 (Bhattacharya, Hemerling and Waltermann,2010). Despite China being a key international trading partner for Australia, the number of successful joint ventures and negotiations between the two countries remains limited. A closer examination of the international business interactions between Australia and China is thus urgently needed. When negotiating with the Chinese, Western managers may not always be aware of what they are really negotiating for. To be successful, they have to be equipped with the 'specialised knowledge', a form of 'tacit or implicit knowledge', which comes with experience (Nonaka, 1994, Pavesi, 2003) in communicating and negotiating with their Chinese counterparts. The Chinese way of business negotiation can challenge the logic of Western business thinking. This, coupled with possible generational differences or changes in the Chinese business counterpart's way of doing business, means we must try to understand the business communication and negotiation process from not only the Western but also the Chinese perspective. In particular, in addition to the contextual (Phatak, & Habib, 1996; Risberg, 1997), social (Ghauri, & Fang, 2001), and cognitive factors (George, Gareth, & Gonzalez, 1998) focused on by past researchers, the intangible aspects of negotiation must also be considered. These include trust, reputation, relationship quality (guanxi in the case of the Chinese), and the moods and emotions that shape the processes and outcomes of communication and negotiation (Griffith, 2002; Hartel & Ma, 2006; Ma & Hartel 2005; and Zhao & Krohmer, 2006). This paper reports on a qualitative investigation of the communication processes occurring in negotiations between Australian and Chinese managers and entrepreneurs. The examination is based on a theoretical framework looking at emotions and culture from an affective events theory (AET) perspective. Both interview and focus groups techniques were used. Findings identified guanxi, core to relationship development and maintenance in Chinese culture, together with emotions as major determining factors of negotiation outcomes. Findings also suggest there are generational differences in attitudes among Chinese managers with Gen. X and Gen. Y placing a different emphasis on guanxi in business. These findings suggest that the popular advice to people doing business in China is out of date.

Simulation and visualization of fire using extended Lindenmayer systems

This research introduces a method of using Lindenmayer Systems to model the spreading and behavior of fire inside a factory building. The research investigates the use of L-System propagated fires for determining factors such as where the fire is most likely to spread first and how fast. It also looks at an alternative way of storing the Lindenmayer System, not in the form of a string but rather as a graph. A variation on the building and traversal process is also investigated, in which the L-System is traversed depth first instead of breadth first. Results of fire propagation are presented and we conclude that L-Systems are a suitable tool for fire propagation.

Impact of nursing information systems on residential care provision in an aged care provider

The challenge of an ageing population has placed a great pressure on the Australian aged care sector in the coming decades. Technology-enabled solutions such as health information systems (HIS) can be seen as a way to improve care quality, safety and process efficiency. Compared to the overall healthcare sector, the adoption of HIS in the aged care sector has been slower. One reason for this is that aged care providers are not well informed therefore not yet convinced of the positive impacts of technology solutions on their service provision. This paper reports findings from an evaluation of the impact of HIS adoption at an aged care provider in Victoria. The evaluation was conducted in two distinct areas, residential aged care and residential disability services. Overall, the findings show positive impacts of the system on individual work of the care staff and on service provision of the organisation as well as suggesting opportunities for improvement in later implementation stages. The evaluation will also inform other aged care and disability service providers of the benefits of HIS and useful lessons in adoption of technology solutions.

Towards a theory and practice of policy engagement : higher education research policy in the making

Academic engagement with higher education research policy in Australia, and with education policy more generally, is in crisis. This time around, it is not just that our theoretical tools are blunt and irrelevant (Ball 1990), so are our politics. It seems our attention has been so consumed by ‘what is policy’ (Ball 1994a) and with challenging its claims to authority, that we have missed or ignored imperatives to engage with its production. Even though some have attempted contributions, for the most part we have been ‘coerced into an era of cooperation’. Getting ourselves out of this mess will take more than just better theories and new politics. It will require a degree of cooperation, to advance a theory and practice of policy engagement and to re-establish a field of education that resists the tendency to fragment and/or the temptation to defend itself ‘against’ policy. In this paper I attempt an assessment of where we are theoretically and politically with regard to education policy and where we need to look to find new forms of policy engagement. By way of illustration, I draw on examples from AARE (the Australian Association for Research in Education) and the Australian RQF (Research Quality Framework) although the analysis is by no means restricted to these.

Has equity's time come for VET? Observations and principles for equity policy and practice in Australian education

Equity has a long history in education. When compulsory schooling was first introduced in industrialising nations in the mid 1800s, many advocates saw it as a way of improving the circumstances of the poorest and most disadvantaged in their communities. But access to schooling did not prove to be the great equaliser that some had hoped. Instead, it became central in the reproduction of social and economic inequalities (Bourdieu & Passeron 1977). High academic achievement became highly correlated with high socioeconomic status, and vice versa (Teese & Polesel 2003). In Australia, the Karmel Report (1973) proved to be a watershed moment in naming the equity problem in schooling and, among other things, gave rise to the Disadvantaged Schools Program (DSP): an attempt to level the playing field albeit by ‘running twice as hard’ (Connell at al. 1991). Almost two decades later, A Fair Chance for All (1990) signalled official concern for equity in Australian higher education. While access to university was not to be universal, it was to be equitable; all social groups in the Australian population were to be proportionally represented among its university students. Today, Australia is still grappling with the inequities in its schooling and higher education systems, highlighted by renewed interest by governments to address the issues. Although not of the same order of magnitude, there now appears to be an emerging policy agenda around equity in VET. Has equity’s time come for VET? This paper canvasses the history of equity in Australian schooling and higher education, with a view to drawing out principles to inform a rejuvenated equity agenda in vocational education and training.

Sleepwalking into the mirror : panic and the thin skin of a writer

This text interwoven with artworks by Elizabeth McQueen explores the act of writing and this writer’s search for a narrative form which, after Kafka, fuses dream and reality. Escaping from the back door of my PhD research, which has entered such liminal realities as sleepwalking and autism as a way of challenging familiar boundaries of western normative thought, this text explores a slightly different boundary transgression: a terrifying fusion of reality and writing when late one dark (but not stormy) night a character from my novel appeared at my back window.

A modern audience for the ancient mysteries of the occult : the evolution of Rudolf Steiner's esoteric architecture

In today’s secular society, occult conceptions of architecture may seem somewhat anachronistic, but at the turn of the twentieth century the bourgeoisie, alongside society’s artistic and intellectual elite, were enthusiastically embracing a myriad of esoteric doctrines and mystical impulses. One of the most prominent and enduring examples of this cultural phenomenon is to be found in Rudolf Steiner’s quasi-philosophical system of Anthroposophy. As a path of spiritual development based on ancient mysteries of the occult, Anthroposophy offered people the belief that there existed a way out of the chaos and meaninglessness of modern industrialised society. Steiner used the medium of architecture as a way of repackaging the occult’s venerable secrets into a tangible, material form that made their hidden message more readily accessible to his contemporary audience. While he was striving towards creating a totally new architectural language appropriate to the modern age, he perceived architectural style as an evolutionary process that revealed its spiritual content in a particular way in every epoch. As such, Steiner made free use of historical and mythological precedents as archetypal references in his work, thus giving his architecture a genealogy that has, until now, remained largely undefined. By investigating Steiner’s indebtedness to ancient temples and the architecture of the baroque, a greater understanding of his architectural heritage is made possible, which not only helps to locate him within the cultural milieu of his day, but also within the broader context of architectural history. A spiritual thread runs through this history that demonstrates that Steiner’s architecture is not as idiosyncratic as it may initially seem, though whether his work represents an original step forward in the development of modern architecture, or is merely a hangover of nineteenth century eclecticism, must also be considered in order to determine the architectural value of Steiner’s esoteric ideas.

Resisting immigrant myths : everyday consumer practices of Asian immigrants in America

Projective, depth interviews with U.S. Asian immigrants revealed their ambivalence toward the U.S. commercial sector’s colonial-era representations of Asian people. These commercial representations provide polarized depictions of Asian immigrants as either threatening aliens or as model citizens. These portrayals reflect “racialized otherness,” or racial stereotyping that represent Asian immigrants as inferior. Our findings indicate that Chinese immigrants strategically use everyday consumption related to foodways to resist the reverberation of American immigrant myths. In some instances, immigrants’ consumption practices instantiate a regional Asian identity. In other instances, however, immigrants’ consumption practices reflect a separation from the past and an acceptance of a new although not exclusively American way of life. Notwithstanding immigrant consumers’ resistance practices, the findings call for future research into immigrant consumers’ reactions to visual representations of race, ethnicity, and gender.

When, where and how am I now? Researching identity in university communities of practice

The establishment of communities of practice (CoPs) has emerged nationally as a strategy to promote ‘excellence’ in teaching and learning in Australian universities. CoPs in Australian universities have been reported as fostering the development of identity in practice and collegial academic identity. In these accounts identity development is associated with storytelling around everyday practice, although the relationship between narrative and identity development has not been explored or described in detail. Similarly, although the complex and changeable university contexts in which these CoPs operate is noted and described in the literature, there is currently no detailed account published of the relationship between the broader discourses that shape these contexts and the process of identity development in university CoPs. We argue in this paper that there is a need for a new way of researching identity formation in university CoPs. Drawing on Trinh Minh Ha’s work (1992), we propose that fragmentation be used as a working metaphor for thinking about and researching identity development in university CoPs, with direct reference to the contexts in which they operate. 
The proposed new approach takes into account the complexities and variety of discourses that influence identity formation in CoPs and the changeable and sometimes contradictory Enterprise University contexts in which Australian CoPs operate. In this paper fragmentation is described and applied to the process of researching identity formation in university CoPs. This paper also describes how fragmentation guides the combined narrative research and discourse analysis methods used in the proposed approach. This paper argues that fragmentation provides the means for developing practical (or experiential) insights as well as conceptually structuring a useful method for investigating discursive factors, to open up a variety of potential new understandings about identity formation in university CoPs.