Withholding and withdrawal of ‘futile’ life-sustaining treatment : unilateral medical decision-making in Australia and New Zealand

This article examines the law in Australia and New Zealand that governs the withholding and withdrawal of ‘futile’ life-sustaining treatment. Although doctors have both civil and criminal law duties to treat patients, those general duties do not require the provision of treatment that is deemed to be futile. This is either because futile treatment is not in a patient’s best interests or because stopping such treatment does not breach the criminal law. This means, in the absence of a duty to treat, doctors may unilaterally withdraw or withhold treatment that is futile; consent is not required. The article then examines whether this general position has been altered by statute. It considers a range of suggested possible legislation but concludes it is likely that only Queensland’s adult guardianship legislation imposes a requirement to obtain consent to withhold or withdraw such treatment.

Life on the edge : the effects of building facade three dimensionality on public social behaviour

Links between the built environment and human behaviour have long been of interest to those involved in the fields of urban planning and architecture, but direct assessments of the links between the three-dimensional building façade form and human behaviour are rare. Much work has been completed on subjects’ responses to the aesthetic of architectural frontages but this has generally been conducted using two-dimensional images of structures and in no way assesses human responses when in the presence of these structures. This research has set about observing the behaviour of individuals and groups in the public realm and recording their reactions to architecture which has a distinct three-dimensional character, with particular reference to the street level façade. The behaviour was recorded and quantified and indicated that there is significant differences in human behaviour around these various types of architecture.

A systematic review on quality of life among patients at 1 year after treatment for head and neck cancer

Introduction: Although advances in treatment modalities have improved the survival of head and neck (H&N) cancer patients over recent years, survivors’ quality of life (QoL) could be impaired for a number of reasons. The investigation of QoL determinants can inform the design of supportive interventions for this population. Objectives: To examine the QoL of H&N cancer survivors at 1 year after treatment and to identify potential determinants affecting their QoL. Methods: A systematic search of literature was done in December 2011 in five databases: Pubmed, Medline, Scopus, Sciencedirect and CINAHL, using combined search terms ‘head and neck cancer’, ‘quality of life���, ‘health-related quality of life��� and ‘systematic review’. The methodological qualities of selected studies were assessed by two reviewers using predefined criteria. The study characteristics and results were abstracted and summarized. Results: Thirty-seven studies met all inclusion criteria with methodological quality from moderate to high. The global QoL of H&N cancer survivors returned to baseline at 1 year after treatment. Significant improvement showed in emotional functioning while physical functioning, xerostomia, sticky/insufficient saliva, and fatigue were consistently worse at 12 months compared with baseline. Age, cancer sites and stages, social support, smoking, presence of feeding tube are significant QoL determinants at 12 months. Conclusions: Although the global QoL of H&N cancer survivors recover by 12 months after treatment, problems with physical functioning, fatigue, xerostomia and sticky saliva persist. Regular assessment should be carried out to monitor these problems. Further research is required to develop appropriate and effective interventions for this population.

Peer journeys : building graduate capabilities for life long learning

Students experience university as peers. Peer-to-peer interaction offers unique opportunities for fostering the academic, social and emotional wellbeing of students (Kuh, 2008). Peer programs provide a formalisation of this relationship enabling students to partake both as peer leaders and program participants. The success of such programs is reliant on the university having a reserve of motivated and trained peer leaders. From their initial experience of peer programs as participants in first year and their ongoing involvement as peer leaders, students grow their graduate capabilities and employability skills through scaffolded peer leadership and training opportunities. Universities aspire to produce graduates who are inspirational leaders, effective collaborators and competent professionals ready to participate in the global community (DEEWR, 2012; Shook & Keup, 2012). This poster describes a model which scaffolds the development of peer leaders’ graduate capabilities using a university-wide supporting framework to grow a range of peer-to-peer initiatives across a variety of coordinated peer programs underpinned by a social justice framework (Gidley, Hampson, Wheller & Bereded-Samuel, 2010; Nelson & Creagh, 2012).

The artful life story : the oral history interview as fiction

This practice-led PhD project consists of two parts. The first is an exegesis documenting how a fiction writer can enter a dialogue with the oral history project in Australia. I identify two philosophical mandates of the oral history project in Australia that have shaped my creative practice: an emphasis on the analysis of the interviewee’s subjective experience as a means of understanding the past, and the desire to engage a wide audience in order to promote empathy towards the subject. The discussion around fiction in the oral history project is in its infancy. In order to deepen the debate, I draw on the more mature discussion in ethnographic fiction. I rely on literary theorists Steven Greenblatt, Dorrit Cohn and Gerard Genette to develop a clear understanding of the distinct narrative qualities of fiction, in order to explore how fiction can re-present and explore an interviewee’s subjective experience, and engage a wide readership. I document my own methodology for producing a work of fiction that is enriched by oral history methodology and theory, and responds to the mandates of the project. I demonstrate the means by which fiction and the oral history project can enter a dialogue in the truest sense of the word: a two-way conversation that enriches and augments practice in both fields. The second part of the PhD is a novel, set in Brisbane and based on oral history interviews and archival material I gathered over the course of the project. The novel centres on Brisbane artist Evelyn, who has been given an impossible task: a derelict old house is about to be demolished, and she must capture its history in a sculpture that will be built on the site. Evelyn struggles to come up with ideas and create the sculpture, realising that she has no way to discover who inhabited the house. What follows is a series of stories, each set in a different era in Brisbane’s history, which take the reader backwards through the house’s history. Hidden Objects is a novel about the impossibility of grasping the past and the powerful pull of storytelling. The novel is an experiment in a hybrid form and is accompanied by an appendix that identifies the historically accurate sources informing the fiction. The decisions about the aesthetics of the novel were a direct result of my engagement with the mandates of the oral history project in Australia. The novel was shortlisted in the 2012 Queensland Literary Awards, unpublished manuscript category.

Life in the baby boomer library world : a survival guide

According to Australian Job Search, just 14% of librarians are under the age of 35. As a Generation Y librarian, flexibility is a key factor to ensuring survival in the Baby Boomer library and overcoming employment, promotion and in particular stereotype barriers. This paper draws upon generational and library workforce research, coupled with industry experience to provide practical advice and strategies to break through both personal and professional barriers for the Generation Y librarian in the Baby Boomer library world. Industry understanding, drawn from personal experiences of working in public, education and special libraries, utilises my journey as a librarian since graduation in 2005 to discuss barriers faced and methods for breaking through. In my previous position as Teaching and Learning Librarian at Northern Melbourne Institute of TAFE from 35 library staff I was the sole member under 30. In addition I was the youngest member of the Library Management Team by 20 years, providing a perfect example of the Generation Y librarian within a Baby Boomer environment. This experience provides the platform for exploring strategies for understanding and overcoming ageist ideas, generational stereotypes, and employment barriers. Discussion regarding the need to develop sound industry knowledge for survival within the library world will also be raised.

Postcard from another life

Poem

Life Drama : an arts education response to social and cultural challenges in Papua New Guinea

The Life Drama program is a theatre-based experiential learning program developed in Papua New Guinea over the past seven years. The Life Drama team recognises that a significant proportion of “education” for learners of all ages takes place outside formal education systems, particularly in developing nations such as Papua New Guinea. If arts education principles and practices are to contribute meaningfully and powerfully to resolving social and cultural challenges, it is important to recognise that many learners and educators will encounter and use these principles and practices outside of school or university settings. This paper briefly describes the Life Drama program and its context, highlights its two streams of operation (community educators and teacher educators) and indicates some ways in which an arts-based education initiative like Life Drama contributes to Goal 3 of the Seoul Agenda:“Apply arts education principles and practices to contribute to resolving the social and cultural challenges facing today‟s world.” In particular, the project addresses sub-goal 3b:“Recognize and develop the social and cultural well-being dimensions of arts education”.

Life Drama Papua New Guinea : contextualising practice

This article presents the Life Drama project as a case study in how theoretical and contextual factors may inform the development of an applied theatre initiative. Life Drama is a workshop-based, participatory form of applied theatre and performance being developed in Papua New Guinea. At this time, the aim of Life Drama is to address the gap between ‘awareness’and behaviour change in relation to sexual health, particularly HIV. The paper situates Life Drama within three fields of theory and practice – applied theatre, theatre for development and HIVeducation – and critically reflects on the ways in which this program is attempting to meet key challenges identified in the literatures of these fields.

Life-history constraints in grassland plant species : a growth-defence trade-off is the norm

Plant growth can be limited by resource acquisition and defence against consumers, leading to contrasting trade-off possibilities. The competition-defence hypothesis posits a trade-off between competitive ability and defence against enemies (e.g. herbivores and pathogens). The growth-defence hypothesis suggests that strong competitors for nutrients are also defended against enemies, at a cost to growth rate. We tested these hypotheses using observations of 706 plant populations of over 500 species before and following identical fertilisation and fencing treatments at 39 grassland sites worldwide. Strong positive covariance in species responses to both treatments provided support for a growth-defence trade-off: populations that increased with the removal of nutrient limitation (poor competitors) also increased following removal of consumers. This result held globally across 4 years within plant life-history groups and within the majority of individual sites. Thus, a growth-defence trade-off appears to be the norm, and mechanisms maintaining grassland biodiversity may operate within this constraint.

Review : "For the Term of His Natural Life" -- Norman Dawn

Synopsis and review of For the Term of His Natural Life (Norman Dawn, 1927). Includes cast and credits. For the Term of His Natural Life was one of the last Australian silent films, and also one of the most significant in the history of Australian cinema. At the time of its production, controversy raged over its depiction of convict life, its scale and cost (which was reported to be around 50,000 pounds at a time when most Australian films had budgets of less than 2,000 pounds1) and the fact that the director, several of the crew and the leading cast members were American. Australasian Films launched a publicity campaign of unprecedented scale to counter opposition to the film’s subject matter and the charge that they were “seeking to make capital out of the drab and sordid days of Australia”.2 The film’s expense was turned into a virtue: hundreds of unemployed men were used as extras, while the film also provided work for many within the Australian film industry and, according to Australasian, enabled the establishment of new production companies. The American imports who earlier had been accused of being “party to the slaughtering” of the Australian film industry, were feted for their artistic contributions, and the concerns raised in federal parliament about an American “invasion” were deflected by claims about what the local industry could learn from those with Hollywood experience.3 The publicity campaign was successful, as the film proved enormously popular at the Australian box office in its initial run. But the coming of sound film in 1928 had a considerable impact on audiences for silent films like For the Term, and its early local success was not repeated in subsequent seasons or in overseas markets...

Criminal desistance : life opportunities and hermeneutic circles of self-definition

The emic perspective of criminal desistance (ex-offenders’ personal explanations of how they gave up crime) is largely ignored by criminology. This thesis attempts to address this absence of the storyteller’s perspective by inviting desisters to participate in the exploration and interpretation of their individual desistance journeys. Significant attention is drawn to the importance of philosophical self-enquiry to personal change. This detailed journey through the desistance stories of five ex-offenders has produced an emphatic re-statement of the need for the non-judgemental listener as the beginning point of cathartic healing in damaged lives.

Towards better end-of-life care : a major opportunity for nurses to contribute to the debate

Integrated care pathways are documents which outline the essential steps of multidisciplinary care in addressing a specific clinical problem (Rotter et al., 2010). They can be used to introduce clinical guidelines and systematic audits of clinical practice, and to ensure that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. The Liverpool Care Pathway (LCP) is an example of an integrated care pathway, designed in the 1990s to guide care for people who are in their last days of life (Ellershaw et al., 1997, Ellershaw and Ward, 2003)...

Information organisation behaviours within everyday life : an exploration using the diary method

This paper presents the results from a study of information behaviours (IB), with specific focus on information- organisation-related behaviours conducted as part of a larger daily diary study with 40 participants. The findings indicate that organisation of information in everyday life is problematic due to various factors, specifically temporal and spatial ones, i.e., the passage of time, along with the difference in the physical environment between when the information was organised and when the information is retrieved. These have implications for information organisation schemas, and point toward the need for a context-sensitive model of information organisation that reflects the relation between information objects, information representation, and information users.

Quality of life for older people in residential care is related to connectedness, willingness to enter care, and co-residents

Aim: To establish associations with quality of life (QOL) of older people in long-term residential care facilities in two New Zealand cities. Methods: The outcome measure of QOL was the Life Satisfaction Index. We used multiple linear regression to explore how broad categories of factors might contribute to QOL. Results: A total of 599 people (median age of 85 years; 74% women) participated. Response rates were 85% for facilities and 83% for residents. A resident's QOL was significantly related to the QOL of co-residents. QOL was higher for people who were more positive about entry to residential care, more physically able, and not depressed, and for those with more family and emotional support. Conclusion: Attending to the circumstances around entry to residential care may enhance QOL, as may promoting physical activity, treating depression and ensuring older people remain emotionally connected to their families. In choosing a facility, noting the QOL of co-residents is important.