Voluntary palliated starvation : A lawful and ethical way to die?

Increasingly, individuals want control over their own destiny. This includes the way in which they die and the timing of their death. The desire for self-determination at the end of life is one of the drivers for the ever-increasing number of jurisdictions overseas that are legalising voluntary euthanasia and/or assisted suicide, and for the continuous attempts to reform state and territory law in Australia. Despite public support for law reform in this field, legislative change in Australia is unlikely in the near future given the current political landscape. We argue that there may be another solution which provides competent adults with control over their death and to have any pain and symptoms managed by doctors, but which is currently lawful and consistent with prevailing ethical principles. ‘Voluntary palliated starvation’ refers to the process which occurs when a competent individual chooses to stop eating and drinking, and receives palliative care to address pain, suffering and symptoms that may be experienced by the individual as he or she approaches death. In this article, we argue that, at least in some circumstances, such a death would be lawful for the individual and doctors involved, and consistent with principles of medical ethics.

Two-way recommendation methods for social networks

In this work, we present the challenges associated with the two-way recommendation methods in social networks and the solutions. We discuss them from the perspective of community-type social networks such as online dating networks.

Go your own way : reporting of fundraising in Australian charity financial statements

Australian charities are facing increased public scrutiny of their financial reports, which must now be submitted to the national regulator, the Australian Charities and Not-for-profits Commission. Some may wish to use reports to create so-called 'fundraising efficiency league tables'. This article seeks to provide a description of current best practice in fundraising financial reporting by examining annual reports that have been recognised with industry awards. We find a wide variation in how terms have been used, with no patterns discernible. Moreoever, reporting is influenced by regulatory requirements in the relevant jurisdiction, which differ substantially. It is unlikely that league tables will be meaningful if constructed from charities' current annual financial statements.

GHG emissions standard on its way

Throughout the world, there is increasing pressure on governments, companies,regulators and standard-setters to respond to the global challenge of climate change. The growing number of regulatory requirements for organisations to disclose their greenhouse gas (GHG) emissions and emergent national, regional and international emissions trading schemes (ETSs) reflect key government responses to this challenge. Assurance of GHG emissions disclosures enhances the credibility of these disclosures and any associated trading schemes. The auditing and assurance profession has an important role to play in the provision of such assurance, highlighted by the International Auditing and Assurance Standards Board’s (IAASB) decision to develop an international GHG emissions assurance standard. This article sets out the developments to date on an international standard for the assurance of GHG emissions disclosures. It then provides information on the way Australian companies have responded to the challenge of GHG reporting and assurance. Finally, it outlines the types of assurance that assurance providers in Australia are currently providing in this area.

‘It’s about finding a way’ : children, sites of opportunity, and building everyday peace in Colombia

The multiple forms of violence associated with protracted conflict disproportionately affect young people. Literature on conflict-affected children often focuses on the need to provide stability and security through institutions such as schools but rarely considers how young people themselves see these sites as part of their everyday lives. The enduring, pervasive, and complex nature of Colombia’s conflict means many young Colombians face the challenges of poverty, persistent social exclusion, and violence. Such conditions are exacerbated in ‘informal’ barrio communities such as los Altos de Cazucá, just south of the capital Bogotá. Drawing on field research in this community, particularly through interviews conducted with young people aged 10 to 17 this article explores how young people themselves understand the roles of the local school and ngo in their personal conceptualisations of the violence in their everyday lives. The evidence indicates that children use spaces available to them opportunistically and that these actions can and should be read as contributing to local, everyday forms of peacebuilding. The ways in which institutional spaces are understood and used by young people as ‘sites of opportunity’ challenges the assumed illegitimacy of young people’s voices and experiences in these environments.

Investigation of pedestrian crashes on two-way two-lane rural roads in Ethiopia

Understanding pedestrian crash causes and contributing factors in developing countries is critically important as they account for about 55% of all traffic crashes. Not surprisingly, considerable attention in the literature has been paid to road traffic crash prediction models and methodologies in developing countries of late. Despite this interest, there are significant challenges confronting safety managers in developing countries. For example, in spite of the prominence of pedestrian crashes occurring on two-way two-lane rural roads, it has proven difficult to develop pedestrian crash prediction models due to a lack of both traffic and pedestrian exposure data. This general lack of available data has further hampered identification of pedestrian crash causes and subsequent estimation of pedestrian safety performance functions. The challenges are similar across developing nations, where little is known about the relationship between pedestrian crashes, traffic flow, and road environment variables on rural two-way roads, and where unique predictor variables may be needed to capture the unique crash risk circumstances. This paper describes pedestrian crash safety performance functions for two-way two-lane rural roads in Ethiopia as a function of traffic flow, pedestrian flows, and road geometry characteristics. In particular, random parameter negative binomial model was used to investigate pedestrian crashes. The models and their interpretations make important contributions to road crash analysis and prevention in developing countries. They also assist in the identification of the contributing factors to pedestrian crashes, with the intent to identify potential design and operational improvements.

Towards a consistent definition of a significant delta troponin with z-scores: A way out of chaos?

Aims: We assessed the diagnostic performance of z-scores to define a significant delta cardiac troponin (cTn) in a cohort of patients with well-defined clinical outcomes. Methods: We calculated z-scores, which are dependent on the analytical precision and biological variation, to report changes in cTn. We compared the diagnostic performances of a relative delta (%Δ), actual delta (Δ), and z-scores in 762 emergency department patients with symptoms of suspected acute coronary syndrome. cTn was measured with sensitive cTnI (Beckman Coulter), highly sensitive cTnI (Abbott), and highly sensitive cTnT (Roche) assays. Results: Receiver operating characteristic analysis showed no statistically significant differences in the areas under the curve (AUC) of z-scores and Δ with both superior compared to %Δ for all three assays (p<0.001). The AUCs of z-scores measured with the Abbott hs-cTnI (0.955) and Roche hs-cTnT (0.922) assays were comparable to Beckman Coulter cTnI (0.933) (p=0.272 and 0.640, respectively). The individualized Δ cut-off values that were required to emulate a z-score of 1.96 were: Beckman Coulter cTnI 30 ng/l, Abbott hs-cTnI 20 ng/l, and Roche hs-cTnT 7 ng/l. Conclusions: z-scores allow the use of a single cut-off value at all cTn levels, for both cTnI and cTnT and for sensitive and highly sensitive assays, with comparable diagnostic performances. This strategy of reporting significant changes as z-scores may obviate the need for the empirical development of assay-specific cut-off rules to define significant troponin changes.

The way schools cope with learning difficulties is doing more harm than good

We fail children who experience difficulty in school and with learning almost every day in Australia and in so many ways. These children can fall through a myriad of cracks: cracks that appear in some schools and not others, cracks that exist for different reasons whether they be capacity, belief or resource-related, and cracks that are exacerbated by industrial relations and education policy. Whatever their origin, these cracks need to be addressed.

Smart Cities, Social Capital, and Citizens at Play: A Critique and a Way Forward

Digital transformations are not contained within the digital domain but are increasingly spilling over into the physical world. In this chapter, we analyse some of the transformations undergoing in cities today towards becoming smart cities. We offer a critique of smart cities and a way forward, divided into three parts: First, we explore the concept of Smart Citizens in terms of both localities, the move towards a hyperlocal network and also the citizen’s role in the creation and use of data. We use the ‘Smart London’ plan drawn up by the Mayor of London, as a way to illustrate our discussion. Second, we turn to the civic innovations enabled by digital transformations and their potential impact on citizens and citizenship. Specifically, we are interested in the notion of social capital as an alternative form of in-kind currency and its function as an indicator of value, in order to ask, can digital transformations give rise to ‘civic capital,’ and how can such a concept help, for instance, a local government invite more representative residents and community champions to participate in community engagement for better urban planning. Third, we introduce a hybrid, location-based game under development by design agency Preliminal Games in London, UK. This illustrative case critiques and highlights the current challenges to establishing a new economic model that bridges the digital / physical divide. The game provides a vehicle for us to explore how established principles and strategies in game design such as immersive storytelling and goal setting, can be employed to encourage players to think of the interconnections of their hybrid digital / physical environments in new ways.

Two-way strong: A study of vertebrates using Queensland Indigenous knowledges and Montessori Linnaean materials to engage Indigenous secondary school students

The marginalisation that Indigenous secondary students experience in zoology science lessons can be attributed to a chasm they experience between their life in community and the classroom. The study found that the integration of Indigenous and Western science knowledge can provide transformative learning experiences for students which work to strengthen their sense of belonging to community and school. Using action research, the study investigated the integration of both-ways science education into students' zoology lessons. It privileged the community's cultural expertise, practices and connections with students and their families, which worked to enhance student engagement in their learning.

Researching with us, our way

Chapter titled 'Researching with us, our way' in the book 'Yatdjuligin: Aboriginal and Torres Strait Islander nursing and midwifery care'

The ASAS criteria for axial spondyloarthritis: Strengths, weaknesses, and proposals for a way forward

Classification criteria should facilitate selection of similar patients for clinical and epidemiologic studies, therapeutic trials, and research on etiopathogenesis to enable comparison of results across studies from different centers. We critically appraise the validity and performance of the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA). It is still debatable whether all patients fulfilling these criteria should be considered as having true axSpA. Patients with radiographically evident disease by the ASAS criteria are not necessarily identical with ankylosing spondylitis (AS) as classified by the modified New York criteria. The complex multi-arm selection design of the ASAS criteria induces considerable heterogeneity among patients so classified, and applying them in settings with a low prevalence of axial spondyloarthritis (SpA) greatly increases the proportion of subjects falsely classified as suffering from axial SpA. One of the unmet needs in non-radiographic form of axial SpA is to have reliable markers that can identify individuals at risk for progression to AS and thereby facilitate early intervention trials designed to prevent such progression. We suggest needed improvements of the ASAS criteria for axSpA, as all criteria sets should be regarded as dynamic concepts open to modifications or updates as our knowledge advances.

The Milky Way's Dark Matter Halo Appears To Be Lopsided

The atomic hydrogen gas (H I) disk in the outer region (beyond similar to 10 kpc from the center) of Milky Way can provide valuable information about the structure of the dark matter halo. The recent three-dimensional thickness map of the outer H I disk from the all sky 21 cm line Leiden/Argentine/Bonn survey, gives us a unique opportunity to investigate the structure of the dark matter halo of Milky Way in great detail. A striking feature of this new survey is the north-south (N-S) asymmetry in the thickness map of the atomic hydrogen gas. Assuming vertical hydrostatic equilibrium under the total potential of the Galaxy, we derive the model thickness map of the H I gas. We show that simple axisymmetric halo models, such as softened isothermal halo (producing a flat rotation curve with V-c similar to 220 km s(-1)) or any halo with density falling faster than the isothermal one, are not able to explain the observed radial variation of the gas thickness. We also show that such axisymmetric halos along with different H I velocity dispersion in the two halves, cannot explain the observed asymmetry in the thickness map. Amongst the nonaxisymmetric models, it is shown that a purely lopsided (m = 1, first harmonic) dark matter halo with reasonable H I velocity dispersion fails to explain the N-S asymmetry satisfactorily. However, we show that by superposing a second harmonic (m = 2) out of phase onto a purely lopsided halo, e. g., our best fit and more acceptable model A (with parameters epsilon(1)(h) = 0.2, epsilon(2)(h) = 0.18, and sigma(H I) = 8.5 km s(-1)) can provide an excellent fit to the observation and reproduce the N-S asymmetry naturally. The emerging picture of the asymmetric dark matter halo is supported by the. cold dark matter halos formed in the cosmological N-body simulation.