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

Applications of aptamers in nanodelivery systems in cancer, eye and inflammatory diseases

Aptamers are an interesting class of molecules that have potential in many facets of human health. They are characterized by high affinity and specificity to their targets, are small in size, have similar properties to antibodies, but are made synthetically. All of these properties, among others, give aptamers the potential to diagnose, image and treat like no other molecules. By combining the unique properties of aptamers with the ever expanding field of nanotechnology and all it has to offer, we are entering a very promising new area of targeted nanodelivery treatments. These treatments have found success in the complex disease processes of cancer, eye and inflammatory diseases.

Net energy analysis of solar and conventional domestic hot water systems in Melbourne, Australia

It is commonly assumed that solar hot water systems save energy and reduce greenhouse gas emissions. The net energy requirement of solar hot water systems has rarely been analysed, including their embodied energy. The extent to which solar hot water systems save energy compared to conventional systems in Melbourne, Australia, is shown through a comparative net energy analysis. It was shown that the embodied energy component of the net energy requirement of solar and conventional hot water systems was insignificant. The solar hot water systems provided a net energy saving compared to the conventional systems after 0.5–2 years, for electric- and gas-boosted systems respectively.

Net energy analysis of solar and conventional domestic hot water systems in Melbourne, Australia

It is commonly assumed that solar hot water systems save energy and reduce greenhouse gas emissions. Very rarely has the life-cycle energy requirements of solar hot water systems been analysed, including their embodied energy. The extent to which solar hot water systems save energy compared to conventional systems in Melbourne, Australia, is shown through a comparative net energy analysis. The solar systems provided a net energy saving compared to the conventional systems after 0.5 to 2 years, for electricity and gas systems respectively.

Performance of ventilated hollow core concrete panel systems in Australia

Performance of advanced fabric energy storage systems has not been reported for Australian conditions. The influence pf slab thickness and air flow rate on the annual thermal load, and maximum heating and cooling demands for a typical office module using a ventilated hollow core concrete slab system has been investigated by simulation. Performance results for Melbourne are presented and comments made on other locations.

Occupational safety and health management systems in Australia: barriers to success

The growing popularity of occupational safety and health management systems in Australia has stimulated critical debate about their effectiveness. This paper asks whether the performance of such systems lives up to expectations. Making use of a research review and an extensive interviewing programme, the paper draws several conclusions. First, it observes that the definitional requirements for an occupational safety and health management system have been watered down, making it more likely that organisations can claim to have a system, but less likely that it will be effective. Second, a review of empirical research reinforces the view that systems can improve health and safety outcomes, but only if they meet strict conditions concerning senior management commitment, effective workforce involvement and programme integration. Third, several barriers to successful implementation are identified, including the failure to meet essential success factors, the inappropriate application of audit tools to ensure compliance, and their problematic application in certain sectors such as small business, contractors, and the part-time and temporary workforce. The paper concludes that occupational safety and health management systems can live up to their promise, but often fail to do so because of inadequate implementation or application in hostile environments.

Advanced fabric energy storage systems in Australia

There is a growing interest in the use of advanced fabric energy storage (FES) systems in Australia. The influence of slab thickness and ventilation rate on the annual thermal load, and maximum heating and cooling demands for an office module using a ventilated hollow core concrete slab system has been investigated by simulation. Airflow through the panels was set at 1, 2 or 4 air changes per hour (ACH) for slab thicknesses of 205, 220 and 300 mm. These configurations were simulated using two different FES operational strategies for six capital cities in mainland Australia. The simulations show that FES systems can offer either energy and/or peak load savings in almost all locations investigated. Overall, compared to a conventional AC system, the tempering of incoming fresh air combined with night flushing of the FES system appears to be the most successful operational strategy.

Seasonal storage for solar thermal systems in Australia?

Seasonal storage systems have been operating in various European countries since 1985. Combined with solar collectors, these systems are known as ‘central solar heating plants with seasonal storage’ (CSHPSS). While these systems have been shown to be technically feasible, their cost is still too high to make them competitive with fossil fuels.

In Australia, we have quite different conditions to those countries where CSHPSS have been trialled. In general, we experience higher radiation levels, ambient temperatures and cooling loads. Our heating loads and energy prices are also usually lower. As a result, any evaluation of CSPSS operating in a European context may not be valid for Australian conditions. To the authors’ knowledge, no evaluation of these systems has been carried out for Australia.

This paper therefore attempts an initial assessment of these systems and their viability for Australia. The paper first describes the various types of CSHPSS and then reviews their current status. The performance of one type of CSHPSS operating in several locations of Australia has been predicted using a TRNSYS model. The simulations indicated that the design guidelines for Europe are inappropriate for Australia and would result in greatly over-sized systems.

An indication of the financial viability of the system was determined by calculating a simple payback period for a variety of fossil fuels. This type of seasonal storage systems appears to be financially attractive in areas of southern Australia where the solar system is displacing LPG.

Solar versus fossil fuels : A net energy analysis of domestic solar hot water systems in Australia

It is commonly assumed that solar hot water systems save energy and reduce greenhouse gas emissions compared to conventional electric and gas hot water systems. Very rarely has the life-cycle energy requirements (including the embodied energy of manufacture) of solar hot water systems been analysed. The extent to which solar hot water systems can save energy compared to conventional electric or gas hot water systems can be shown through a comparative net energy analysis. This method determines the ‘energy payback period’, including consideration of the difference in operational energy savings and energy embodied in the devices relative to a base case. Dr Robert Crawford, Deakin University, Australia presents the results of a net energy analysis that compared solar and conventional hot water systems for a southern (Melbourne) and a northern (Brisbane) Australian climate.