Cholesterol-lowering management of stroke : inconsistencies of evidence and practice

Cholesterol-lowering treatment by statins is an important and costly issue; however, its role in stroke has not been well documented. The aim of the present study was to review literature and current practice regarding cholesterol-lowering treatment for stroke patients. A literature review was conducted on lipids in stroke and their management with both statins and diet, including the cost-effectiveness of medical nutrition therapy. Qualifying criteria and prescription procedures of the Pharmaceutical Benefits Scheme (PBS) were also reviewed. Data on lipid levels and statin prescriptions were analysed for 468 patients admitted to a stroke unit. The literature shows that management with both medication and diet can be effective, especially when combined; however, 60% of patients with an ischaemic event had fasting total cholesterol measures ≥4 mmol/L (n = 231), with only 52% prescribed statins on discharge (n = 120). Hypercholesterolaemia is an underdiagnosed and undertreated risk factor within the stroke population. It appears that the PBS has not kept pace with advances in the evidence in terms of statin use in the stroke population, and review is needed. The present review should address the qualifying criteria for the stroke population and recommendations on referral to dietitians for dietary advice. Cholesterol-lowering treatment for both stroke patients and the wider population is an area that needs awareness raising and review by the PBS, medical practitioners and dietitians. The role of dietary and pharmacological treatments needs to be clearly defined, including adjunct therapy, and the cost-effectiveness of medical nutrition therapy realised.

Does a high UV environment ensure adequate vitamin D status?

This study assesses the Vitamin D status of 126 healthy free-living adults aged 18–87 years, in southeast Queensland, Australia (27°S) at the end of the 2006 winter. Participants provided blood samples for analysis of 25(OH)D (the measure of an individual’s Vitamin D status), PTH, Calcium, Phosphate, and Albumin, completed a questionnaire on sun-protective/sun-exposure behaviours, and were assessed for phenotypic characteristics such as skin/hair/eye colour and BMI. We found that 10.2% of the participants had serum 25(OH)D levels below 25 nmol/l (considered deficient) and a further 32.3% had levels between 25 nmol/l and 50 nmol/l (considered insufficient). Our results show that low levels of 25(OH)D can occur in a substantial proportion of the population at the end of winter, even in a sunny climate. 25(OH)D levels were higher amongst those who spent more time in the sun and lower among obese participants (BMI > 30) than those who were not obese (BMI < 30). 25(OH)D levels were also lower in participants who had black hair, dark/olive skin, or brown eyes, when compared with participants who had brown or fair hair, fair skin, or blue/green eyes. No associations were found between 25(OH)D status and age, gender, smoking status, or the use of sunscreen.

Mitigating surgical risk in patients undergoing hip arthroplasty for fractures of the proximal femur

Recently the National Patient Safety Agency in the United Kingdom published a report entitled "Mitigating surgical risk in patients undergoing hip arthroplasty for fractures of the proximal femur". A total of 26 deaths had been reported to them when cement was used at hemiarthroplasty between October 2003 and October 2008. This paper considers the evidence for using cement fixation of a hemiarthroplasty in the treatment of hip fractures.

A multiliteracies project in the middle school : Parents as coteachers

This paper examines the experiences of one middle years’ English and Studies of Society and Environment (SoSE) teacher who adopted a multiliteracies project-based orientation to a unit on War and Refugees. It details the multiliteracies teaching and learning cycle, which is based on four non-hierarchical, pedagogical orientations: situated practice, overt instruction, critical framing and transformed practice (New London Group, 2000; Kalantzis & Cope, 2005a). Following the work of Kalantzis and Cope (2005a), it draws out the knowledge processes exacted in each of these four phases: experiencing the known and the new; conceptualising by naming and theorising; analysing functionally and critically; and, applying appropriately and creatively. Two parents were invited to enter the study as coteachers with the teacher and researcher. Using Bourdieu’s (1992) construct of capital, the findings report on how the multiliteracies approach enabled them to engage in school-based literacy practices differently than they had done previously in classrooms. An unexpected finding concerns the teacher’s altered view about how his role and status were perceived by the parents.

Towards ubiquitous city : concept, planning, and experiences in the Republic of Korea

Information and communication technologies (ICTs) had occupied their position on knowledge management and are now evolving towards the era of self-intelligence (Klosterman, 2001). In the 21st century ICTs for urban development and planning are imperative to improve the quality of life and place. This includes the management of traffic, waste, electricity, sewerage and water quality, monitoring fire and crime, conserving renewable resources, and coordinating urban policies and programs for urban planners, civil engineers, and government officers and administrators. The handling of tasks in the field of urban management often requires complex, interdisciplinary knowledge as well as profound technical information. Most of the information has been compiled during the last few years in the form of manuals, reports, databases, and programs. However frequently, the existence of these information and services are either not known or they are not readily available to the people who need them. To provide urban administrators and the public with comprehensive information and services, various ICTs are being developed. In early 1990s Mark Weiser (1993) proposed Ubiquitous Computing project at the Xerox Palo Alto Research Centre in the US. He provides a vision of a built environment which digital networks link individual residents not only to other people but also to goods and services whenever and wherever they need (Mitchell, 1999). Since then the Republic of Korea (ROK) has been continuously developed national strategies for knowledge based urban development (KBUD) through the agenda of Cyber Korea, E-Korea and U-Korea. Among abovementioned agendas particularly the U-Korea agenda aims the convergence of ICTs and urban space for a prosperous urban and economic development. U-Korea strategies create a series of U-cities based on ubiquitous computing and ICTs by a means of providing ubiquitous city (U-city) infrastructure and services in urban space. The goals of U-city development is not only boosting the national economy but also creating value in knowledge based communities. It provides opportunity for both the central and local governments collaborate to U-city project, optimize information utilization, and minimize regional disparities. This chapter introduces the Korean-led U-city concept, planning, design schemes and management policies and discusses the implications of U-city concept in planning for KBUD.

Research monograph : emergence of smart urban ecosystems : application of ICT for capacity building in environmental decision making

Since the industrial revolution, our world has experienced rapid and unplanned industrialization and urbanization. As a result, we have had to cope with serious environmental challenges. In this context, explanation of how smart urban ecosystems can emerge, gains a crucial importance. Capacity building and community involvement have always been the key issues in achieving sustainable development and enhancing urban ecosystems. By considering these, this paper looks at new approaches to increase public awareness of environmental decision making. This paper will discuss the role of Information and Communication Technologies (ICT), particularly Web-based Geographic Information Systems (Web-based GIS) as spatial decision support systems to aid public participatory environmental decision making. The paper also explores the potential and constraints of these web-based tools for collaborative decision making.

School students and part-time work: Workplace problems and challenges.

This paper uses data from a large national project on student-working to examine problems and challenges for school students working in part-time jobs. While literature has identified some potential problems and challenges, and some potential difficulties can be extrapolated from the nature of a young teenage workforce and the nature of the workplaces, these were largely absent in the two companies researched because the companies already had policies in place that addressed the potential problems. Some suggestions are made about how problems and challenges could be avoided in a wider range of adolescent workplaces.

Career development and personal functioning differences between work-bound and non-work bound students

We surveyed 506 Australian high school students on career development (exploration, planning, job-knowledge, decision-making, indecision), personal functioning (well-being, self-esteem, life satisfaction, school satisfaction) and control variables (parents’ education, school achievement), and tested differences among work-bound, college-bound and university-bound students. The work-bound students had the poorest career development and personal functioning, the university-bound students the highest, with the college-bound students falling in-between the other two groups. Work-bound students did poorest, even after controlling for parental education and school achievement. The results suggest a relationship between career development and personal functioning in high school students.

SELinux policy management framework for HIS

Health Information Systems (HIS) make extensive use of Information and Communication Technologies (ICT). The use of ICT aids in improving the quality and efficiency of healthcare services by making healthcare information available at the point of care (Goldstein, Groen, Ponkshe, and Wine, 2007). The increasing availability of healthcare data presents security and privacy issues which have not yet been fully addressed (Liu, Caelli, May, and Croll, 2008a). Healthcare organisations have to comply with the security and privacy requirements stated in laws, regulations and ethical standards, while managing healthcare information. Protecting the security and privacy of healthcare information is a very complex task (Liu, May, Caelli and Croll, 2008b). In order to simplify the complexity of providing security and privacy in HIS, appropriate information security services and mechanisms have to be implemented. Solutions at the application layer have already been implemented in HIS such as those existing in healthcare web services (Weaver et al., 2003). In addition, Discretionary Access Control (DAC) is the most commonly implemented access control model to restrict access to resources at the OS layer (Liu, Caelli, May, Croll and Henricksen, 2007a). Nevertheless, the combination of application security mechanisms and DAC at the OS layer has been stated to be insufficient in satisfying security requirements in computer systems (Loscocco et al., 1998). This thesis investigates the feasibility of implementing Security Enhanced Linux (SELinux) to enforce a Role-Based Access Control (RBAC) policy to help protect resources at the Operating System (OS) layer. SELinux provides Mandatory Access Control (MAC) mechanisms at the OS layer. These mechanisms can contain the damage from compromised applications and restrict access to resources according to the security policy implemented. The main contribution of this research is to provide a modern framework to implement and manage SELinux in HIS. The proposed framework introduces SELinux Profiles to restrict access permissions over the system resources to authorised users. The feasibility of using SELinux profiles in HIS was demonstrated through the creation of a prototype, which was submitted to various attack scenarios. The prototype was also subjected to testing during emergency scenarios, where changes to the security policies had to be made on the spot. Attack scenarios were based on vulnerabilities common at the application layer. SELinux demonstrated that it could effectively contain attacks at the application layer and provide adequate flexibility during emergency situations. However, even with the use of current tools, the development of SELinux policies can be very complex. Further research has to be made in order to simplify the management of SELinux policies and access permissions. In addition, SELinux related technologies, such as the Policy Management Server by Tresys Technologies, need to be researched in order to provide solutions at different layers of protection.

Investigating the links between muscle strength, sun exposure, dietary vitamin D intake and the vitamin D status of ambulatory older adults in South East Queensland

Vitamin D deficiency and insufficiency are now seen as a contemporary health problem in Australia with possible widespread health effects not limited to bone health1. Despite this, the Vitamin D status (measured as serum 25-hydroxyvitamin D (25(OH)D)) of ambulatory adults has been overlooked in this country. Serum 25(OH)D status is especially important among this group as studies have shown a link between Vitamin D and fall risk in older adults2. Limited data also exists on the contributions of sun exposure via ultraviolet radiation and dietary intake to serum 25(OH)D status in this population. The aims of this project were to assess the serum 25(OH)D status of a group of older ambulatory adults in South East Queensland, to assess the association between their serum 25(OH)D status and functional measures as possible indicators of fall risk, obtain data on the sources of Vitamin D in this population and assess whether this intake was related to serum 25(OH)D status and describe sun protection and exposure behaviors in this group and investigate whether a relationship existed between these and serum 25(OH)D status. The collection of this data assists in addressing key gaps identified in the literature with regard to this population group and their Vitamin D status in Australia. A representative convenience sample of participants (N=47) over 55 years of age was recruited for this cross-sectional, exploratory study which was undertaken in December 2007 in south-east Queensland (Brisbane and Sunshine coast). Participants were required to complete a sun exposure questionnaire in addition to a Calcium and Vitamin D food frequency questionnaire. Timed up and go and handgrip dynamometry tests were used to examine functional capacity. Serum 25(OH)D status and blood measures of Calcium, Phosphorus and Albumin were determined through blood tests. The Mean and Median serum 25-Hydroxyvitamin D (25(OH)D) for all participants in this study was 85.8nmol/L (Standard Deviation 29.7nmol/L) and 81.0nmol/L (Range 22-158nmol/L), respectively. Analysis at the bivariate level revealed a statistically significant relationship between serum 25(OH)D status and location, with participants living on the Sunshine Coast having a mean serum 25(OH)D status 21.3nmol/L higher than participants living in Brisbane (p=0.014). While at the descriptive level there was an apparent trend towards higher outdoor exposure and increasing levels of serum 25(OH)D, no statistically significant associations between the sun measures of outdoor exposure, sun protection behaviors and phenotypic characteristics and serum 25(OH)D status were observed. Intake of both Calcium and Vitamin D was low in this sample with sixty-eight (68%) of participants not meeting the Estimated Average Requirements (EAR) for Calcium (Median=771.0mg; Range=218.0-2616.0mg), while eighty-seven (87%) did not meet the Adequate Intake for Vitamin D (Median=4.46ug; Range=0.13-30.0ug). This raises the question of how realistic meeting the new Adequate Intakes for Vitamin D is, when there is such a low level of Vitamin D fortification in this country. However, participants meeting the Adequate Intake (AI) for Vitamin D were observed to have a significantly higher serum 25(OH)D status compared to those not meeting the AI for Vitamin D (p=0.036), showing that meeting the AI for Vitamin D may play a significant role in determining Vitamin D status in this population. By stratifying our data by categories of outdoor exposure time, a trend was observed between increased importance of Vitamin D dietary intake as a possible determinant of serum 25(OH)D status in participants with lower outdoor exposures. While a trend towards higher Timed Up and Go scores in participants with higher 25(OH) D status was seen, this was only significant for females (p=0.014). Handgrip strength showed statistically significant association with serum 25(OH)D status. The high serum 25(OH)D status in our sample almost certainly explains the limited relationship between functional measures and serum 25(OH)D. However, the observation of an association between slower Time Up and Go speeds, and lower serum 25(OH)D levels, even with a small sample size, is significant as slower Timed Up and Go speeds have been associated with increased fall risk in older adults3. Multivariable regression analysis revealed Location as the only significant determinant of serum 25(OH)D status at p=0.014, with trends (p=>0.1) for higher serum 25(OH)D being shown for participants that met the AI for Vitamin D and rated themselves as having a higher health status. The results of this exploratory study show that 93.6% of participants had adequate 25(OH)D status-possibly due to measurement being taken in the summer season and the convenience nature of the sample. However, many participants do not meet their dietary Calcium and Vitamin D requirements, which may indicate inadequate intake of these nutrients in older Australians and a higher risk of osteoporosis. The relationship between serum 25(OH)D and functional measures in this population also requires further study, especially in older adults displaying Vitamin D insufficiency or deficiency.

Water uptake of aerosols with a focus on seeded aerosols and instrumentation techniques

This thesis focuses on the volatile and hygroscopic properties of mixed aerosol species. In particular, the influence organic species of varying solubility have upon seed aerosols. Aerosol studies were conducted at the Paul Scherrer Institut Laboratory for Atmospheric Chemistry (PSI-LAC, Villigen, Switzerland) and at the Queensland University of Technology International Laboratory for Air Quality and Health (QUT-ILAQH, Brisbane, Australia). The primary measurement tool employed in this program was the Volatilisation and Hygroscopicity Tandem Differential Mobility Analyser (VHTDMA - Johnson et al. 2004). This system was initially developed at QUT within the ILAQH and was completely re-developed as part of this project (see Section 1.4 for a description of this process). The new VHTDMA was deployed to the PSI-LAC where an analysis of the volatile and hygroscopic properties of ammonium sulphate seeds coated with organic species formed from the photo-oxidation of á-pinene was conducted. This investigation was driven by a desire to understand the influence of atmospherically prevalent organics upon water uptake by material with cloud forming capabilities. Of particular note from this campaign were observed influences of partially soluble organic coatings upon inorganic ammonium sulphate seeds above and below their deliquescence relative humidity (DRH). Above the DRH of the seed increasing the volume fraction of the organic component was shown to reduce the water uptake of the mixed particle. Below the DRH the organic was shown to activate the water uptake of the seed. This was the first time this effect had been observed for á-pinene derived SOA. In contrast with the simulated aerosols generated at the PSI-LAC a case study of the volatile and hygroscopic properties of diesel emissions was undertaken. During this stage of the project ternary nucleation was shown, for the first time, to be one of the processes involved in formation of diesel particulate matter. Furthermore, these particles were shown to be coated with a volatile hydrophobic material which prevented the water uptake of the highly hygroscopic material below. This result was a first and indicated that previous studies into the hygroscopicity of diesel emission had erroneously reported the particles to be hydrophobic. Both of these results contradict the previously upheld Zdanovksii-Stokes-Robinson (ZSR) additive rule for water uptake by mixed species. This is an important contribution as it adds to the weight of evidence that limits the validity of this rule.

Teacher-child relationship quality for young children with parent reported language concerns

Previous research has demonstrated the importance of the qualities of the teacher-child relationship on children’s development. Close teacher-child relationships are especially important for children at risk. Positive relationships have been shown to have beneficial effects on children’s social and academic development (Birch & Ladd, 1997; Pianta & Stuhlman, 2004). Children with language difficulties are likely to face increased risks with regard to long term social and academic outcomes. The purpose of the current research was to gain greater understanding of the qualities of teacher-child relationships for young children with parent reported language concerns. The research analyses completed for this thesis involved the use of data from the public-access database of Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC). LSAC is a longitudinal study involving a nationally representative sample of 10,000 Australian children. Data are being collected biennially from 2004 (Wave 1 data collection) until 2010 (Wave 4 data collection). LSAC has a cross-sequential research design involving two cohorts, an infant cohort (0-1 year at age of recruitment) and a kindergarten cohort (4-5 years at age of recruitment). Two studies are reported in this thesis using data for the LSAC Kindergarten Cohort which had 4983 child participants at recruitment. Study 1 used Wave 1 data to identify the differences between teacher-child relationship qualities for children with parent reported language concerns and their peers. Children identified by parents for whom concerns were held about their receptive and expressive language, as measured by items from the Parents’ Evaluation of Developmental Status (PEDS) (Glascoe, 2000) were the target (at risk) group in the study (n = 210). A matched case control group of peers (n = 210), matched on the child characteristics of sex, age, cultural and linguistic differences (CALD), and socio-economic positioning (SEP), were the comparison group for this analysis. Teacher-child relationship quality was measured by teacher reports on the Closeness and Conflict scales from the short version of the Student-Teacher Relationship Scale (STRS) (Pianta, 2001). There were statistically significant differences in the levels of closeness and conflict between the two groups. The target group had relationships with their teachers that had lower levels of closeness and higher levels of conflict than the control group. Study 2 reports analyses that examined the stability of the qualities of the teacher-child relationships at Wave 1 (4-5 years) and the qualities of the teacher-child relationships at Wave 2 (6-7 years). This time frame crosses the period of the children’s transition to school. The study examined whether early patterns in the qualities of the teacher-child relationship for children with parent reported language concerns at Wave 1 predicted the qualities of the teacher-child relationship outcomes in the early years of formal school. The sample for this study consisted of the group of children identified with PEDS language concerns at Wave 1 who also had teacher report data at Wave 2 (n = 145). Teacher-child relationship quality at Wave 1 and Wave 2 was again measured by the STRS scales of Closeness and Conflict. Results from multiple regression models indicated that teacher-child relationship quality at Wave 1 significantly contributed to the prediction of the quality of the teacher-child relationship at Wave 2, beyond other predictor variables included in the regression models. Specifically, Wave 1 STRS Closeness scores were the most significant predictor for STRS Closeness scores at Wave 2, while Wave 1 STRS Conflict scores were the only significant predictor for Wave 2 STRS Conflict outcomes. These results indicate that the qualities of the teacher-child relationship experienced prior to school by children with parent reported language concerns remained stable across transitions into formal schooling at which time the child had a different teacher. The results of these studies provide valuable insight into the nature of teacher-child relationship quality for young children with parent reported language concerns. These children experienced teacher-child relationships of a lower quality when compared with peers and, additionally, the qualities of these relationships prior to formal schooling were predictive of the qualities of the relationships in the early years of formal schooling. This raises concerns, given the increased risks of poorer social and academic outcomes already faced by children with language difficulties, that these early teacher-child relationships have an impact on future teacher-child relationships. Results of these studies are discussed with these considerations in mind and also discussed in terms of the implications for educational theory, policy and practice.

General practitioners’ experiences of the psychological aspects in the care of a dying patient

Objective: General practitioners (GPs) play an integral role in addressing the psychological needs of palliative care patients and their families. This qualitative study investigated psychosocial issues faced by GPs in the management of patients receiving palliative care and investigated the themes relevant to the psychosocial care of dying patients. Method: Fifteen general practitioners whose patient had been recently referred to the Mt. Olivet Palliative Home Care Services in Brisbane participated in an individual case review discussions guided by key questions within a semistructured format. These interviews focused on the psychosocial aspects of care and management of the referred patient, including aspects of the doctor/patient relationship, experience of delivering diagnosis and prognosis, addressing the psychological concerns of the patients' family, and the doctors' personal experiences, reactions, and responses. Qualitative analysis was conducted on the transcripts of these interviews. Results: The significant themes that emerged related to perceived barriers to exploration of emotional concerns, including spiritual issues, and the discussion of prognosis and dying, the perception of patients' responses/coping styles, and the GP's personal experience of the care (usually expressed in terms of identification with patient). Significance of results: The findings indicate the significant challenges facing clinicians in discussions with patients and families about death, to exploring the patient's emotional responses to terminal illness and spiritual concerns for the patient and family. These qualitative date indicate important tasks in the training and clinical support for doctors providing palliative care.

The effects of habitat fragmentation on the demography and population genetic structure of Uromys Caudimaculatus

Habitat fragmentation can have an impact on a wide variety of biological processes including abundance, life history strategies, mating system, inbreeding and genetic diversity levels of individual species. Although fragmented populations have received much attention, ecological and genetic responses of species to fragmentation have still not been fully resolved. The current study investigated the ecological factors that may influence the demographic and genetic structure of the giant white-tailed rat (Uromys caudimaculatus) within fragmented tropical rainforests. It is the first study to examine relationships between food resources, vegetation attributes and Uromys demography in a quantitative manner. Giant white-tailed rat densities were strongly correlated with specific suites of food resources rather than forest structure or other factors linked to fragmentation (i.e. fragment size). Several demographic parameters including the density of resident adults and juvenile recruitment showed similar patterns. Although data were limited, high quality food resources appear to initiate breeding in female Uromys. Where data were sufficient, influx of juveniles was significantly related to the density of high quality food resources that had fallen in the previous three months. Thus, availability of high quality food resources appear to be more important than either vegetation structure or fragment size in influencing giant white-tailed rat demography. These results support the suggestion that a species’ response to fragmentation can be related to their specific habitat requirements and can vary in response to local ecological conditions. In contrast to demographic data, genetic data revealed a significant negative effect of habitat fragmentation on genetic diversity and effective population size in U. caudimaculatus. All three fragments showed lower levels of allelic richness, number of private alleles and expected heterozygosity compared with the unfragmented continuous rainforest site. Populations at all sites were significantly differentiated, suggesting restricted among population gene flow. The combined effects of reduced genetic diversity, lower effective population size and restricted gene flow suggest that long-term viability of small fragmented populations may be at risk, unless effective management is employed in the future. A diverse range of genetic reproductive behaviours and sex-biased dispersal patterns were evident within U. caudimaculatus populations. Genetic paternity analyses revealed that the major mating system in U. caudimaculatus appeared to be polygyny at sites P1, P3 and C1. Evidence of genetic monogamy, however, was also found in the three fragmented sites, and was the dominant mating system in the remaining low density, small fragment (P2). High variability in reproductive skew and reproductive success was also found but was less pronounced when only resident Uromys were considered. Male body condition predicted which males sired offspring, however, neither body condition nor heterozygosity levels were accurate predictors of the number of offspring assigned to individual males or females. Genetic spatial autocorrelation analyses provided evidence for increased philopatry among females at site P1, but increased philopatry among males at site P3. This suggests that male-biased dispersal occurs at site P1 and female-biased dispersal at site P3, implying that in addition to mating systems, Uromys may also be able to adjust their dispersal behaviour to suit local ecological conditions. This study highlights the importance of examining the mechanisms that underlie population-level responses to habitat fragmentation using a combined ecological and genetic approach. The ecological data suggested that habitat quality (i.e. high quality food resources) rather than habitat quantity (i.e. fragment size) was relatively more important in influencing giant white-tailed rat demographics, at least for the populations studied here . Conversely, genetic data showed strong evidence that Uromys populations were affected adversely by habitat fragmentation and that management of isolated populations may be required for long-term viability of populations within isolated rainforest fragments.

"Get new lawyers!"

In James Rubin's account of the Kosovo war, he describes an exchange between Secretary Albright and Robin Cook (the British Foreign Secretary). Cook was explaining that it is difficult for Britain to commit to the war without UN Security Council approval because the legal advice he had received was that such action would be illegal under international law. Albright's response was, simply, "get new lawyers". Rubin "credits" Blair with a "push" that swung the British to "finally agree" that a UN Security Council resolution was "not legally required". Robin Cook later stated in Parliament and that the war was legal. Interestingly, Blair did not. This article does not look at whether or not such an exchange took place; rather look at the ethical issues that such a situation would generate. The article suggests what the ethical obligations of the key legal players in such institutional dramas should be—including governments seeking advice, the lawyers giving it, the ministers reporting it and the opposition in Parliament. The article sets out the particular responsibilities of the lawyers and officials of a Westminster system. It also sets out some of the institutional mechanisms for making it more likely that those obligations are fulfilled—as always through the interaction of obligations by different players that make it more risky for any player to breach his or her ethical obligations. Analogous duties would be faced by the relevant actors in other systems.