Autonomy versus futility? Barriers to good clinical practice in end-of-life care : a Queensland case

Findings from a Queensland coronial inquest highlight the complex clinical, ethical and legal issues that arise in end-of-life care when clinicians and family members disagree about a diagnosis of clinical futility. The tension between the law and best medical practice is highlighted in this case, as doctors are compelled to seek family consent to not commence a futile intervention. Good communication between doctors and families, as well as community and professional education, is essential to resolve tensions that can arise when there is disagreement about treatment at the end of life.

A roadside survey of unlicensed driving in Queensland

Unlicensed driving remains a serious problem in many jurisdictions, and while it does not play a direct causative role in road crashes, it undermines driver licensing systems and is linked to other high risk driving behaviours. Roadside licence check surveys represent the most direct means of estimating the prevalence of unlicensed driving. The current study involved the Queensland Police Service (QPS) checking the licences of 3,112 drivers intercepted at random breath testing operations across Queensland between February and April 2010. Data was matched with official licensing records from Transport and Main Roads (TMR) via the drivers’ licence number. In total, 2,914 (93.6%) records were matched, with the majority of the 198 unmatched cases representing international or interstate licence holders (n = 156), leaving 42 unknown cases. Among the drivers intercepted at the roadside, 20 (0.6%) were identified as being unlicensed at the time, while a further 11 (0.4%) were driving unaccompanied on a Learner Licence. However, the examination of TMR licensing records revealed that an additional 9 individuals (0.3%) had a current licence sanction but were not identified as unlicensed by QPS. Thus, in total 29 of the drivers were unlicensed at the time, representing 0.9% of all the drivers intercepted and 1% of those for whom their licence records could be checked. This is considerably lower than the involvement of unlicensed drivers in fatal and serious injury crashes in Queensland, which is consistent with other research confirming the increased crash risk of the group. However, the number of unmatched records suggest that it is possible the on-road survey may have under-estimated the prevalence of unlicensed driving, so further development of the survey method is recommended.

Repeat speeding offenders : results from research in Queensland, Australia

- Speeding and crash involvement in Australia - Speeding recidivist research in Queensland - Challenges from an Australian perspective - Auditor-General reviews of speed camera programs - Implications for future speed management

The prevalence and crash involvement of unlicensed drivers in Queensland

- Road safety implications of unlicensed driving - Present results from two studies conducted in Queensland examining: - the crash involvement of unlicensed drivers and the risks associated with the behaviour - the prevalence of unlicensed driving using a roadside survey method - Countermeasure options

An examination of recent taxation amendments, corporate law reforms and Queensland legislative reforms affecting nonprofit organisations

There is a tax amendment bill which will be debated. The Government has promised to outline its plan for the reform of the taxation system sometime this year. The plans appear to go beyond the mere introduction of some sort of goods and services tax to reform of the whole taxation system including fiscal relations with the States. Not for profit organisations will find their taxation environment will change. Governments are reluctant to permit exemptions to a GST style arrangements. GST trade offs such as reduced income tax rates and abolishing indirect taxes are useless to nonprofit organisations, as many are already exempt from such imposts. Administrative changes to tax collections may also have an impact. If the government decides to make an individual PAYE taxpayer return optional in exchange for no or standard deductions, this may have an effect on fundraising. The FBT and salary packaging schemes that not for profit organisations use will be under intense scrutiny. A regionalisation of the ATO along the successful model of the ASC would see discrete areas such as not for profit exemptions being centralised in one regional office for the whole of Australia. For example the Tasmanian ASC Office has the responsibility for much work in respect of corporate charities and not for profit companies.

Art unions legislation in Queensland

In Queensland, the legislation governing the conduct of art unions such as bingo, raffles and lucky envelopes is the Art Unions Act 1992 (ΑAct≅). The Act is administered by the Queensland Office of Gaming Regulation (ΑQOGR≅) which is part of the Queensland Treasury portfolio. The Act and other legislation such as the Criminal Code, Vagrants Gaming and Other Offences Act, generally makes it unlawful for a person to conduct art unions unless they are authorised to do so. The Art Unions Act allows Αeligible≅ nonprofit associations such as charities, schools, sporting and community groups to raise funds for their stated objects. Art unions were legalised in the early part of this century primarily to assist charities and other approved associations to raise funds for worthwhile causes. This principle is continued in the 1992 Act. The Queensland art union industry had a turnover of over$190M in 1996/97 and our Queensland art unions continue to attract not just sales from Queensland residents but also interstate and overseas buyers. Art unions continue to be an attractive form of fundraising for many nonprofit associations.

The relative risk of second primary cancers in Queensland, Australia: A retrospective cohort study

Background Cancer survivors face an increased likelihood of being subsequently diagnosed with another cancer. The aim of this study was to quantify the relative risk of survivors developing a second primary cancer in Queensland, Australia. Methods Standardised incidence rates stratified by type of first primary cancer, type of second primary cancer, sex, age at first diagnosis, period of first diagnosis and follow-up interval were calculated for residents of Queensland, Australia, who were diagnosed with a first primary invasive cancer between 1982 and 2001 and survived for a minimum of 2 months. Results A total of 23,580 second invasive primary cancers were observed over 1,370,247 years of follow-up among 204,962 cancer patients. Both males (SIR = 1.22; 95% CI = 1.20-1.24) and females (SIR = 1.36; 95% CI = 1.33-1.39) within the study cohort were found to have a significant excess risk of developing a second cancer relative to the incidence of cancer in the general population. The observed number of second primary cancers was also higher than expected within each age group, across all time periods and during each follow-up interval. Conclusions The excess risk of developing a second malignancy among cancer survivors can likely be attributed to factors including similar aetiologies, genetics and the effects of treatment, underlining the need for ongoing monitoring of cancer patients to detect subsequent tumours at an early stage. Education campaigns developed specifically for survivors may be required to lessen the prevalence of known cancer risk factors.