The right to choose an assisted death : time for legislation?

The legal framework that operates at the end of life in Australia needs to be reformed. • Voluntary euthanasia and assisted suicide are currently unlawful. • Both activities nevertheless occur not infrequently in Australia, in part because palliative care cannot relieve physical and psychological pain and suffering in all cases. • In this respect, the law is deficient. The law is also unfair because it doesn’t treat people equally. Some people can be helped to die on their own terms as a result of their knowledge and/or connections while some are able to hasten their death by the refusal of life-sustaining treatment. But others do not have access to the means for their life to end. • A very substantial majority of Australians have repeatedly expressed in public opinion polls their desire for law reform on these matters. Many are concerned at what they see is happening to their loved ones as they reach the end of their lives, and want the confidence that when their time comes they will be able to exercise choice in relation to assisted dying. • The most consistent reason advanced not to change the law is the need to protect the vulnerable. There is a concern that if the law allows voluntary euthanasia and assisted suicide for some people, it will be expanded and abused, including pressures being placed on highly dependent people and those with disabilities to agree to euthanasia. • But there is now a large body of experience in a number of international jurisdictions following the legalisation of voluntary euthanasia and/or assisted suicide. This shows that appropriate safeguards can be implemented to protect vulnerable people and prevent the abuse that opponents of assisted dying have feared. It reveals that assisted dying meets a real need among a small minority of people at the end of their lives. It also provides reassurance to people with terminal and incurable disease that they will not be left to suffer the indignities and discomfort of a nasty death. • Australia is an increasingly secular society. Strong opposition to assisted death by religious groups that is based on their belief in divine sanctity of all human life is not a justification for denying choice for those who do not share that belief. • It is now time for Australian legislators to respond to this concern and this experience by legislating to enhance the quality of death for those Australians who seek assisted dying.

Stage-specific embryonic antigen-4 is not a marker for chondrogenic and osteogenic potential in cultured chondrocytes and mesenchymal progenitor cells

One important challenge for regenerative medicine is to produce a clinically relevant number of cells with consistent tissue-forming potential. Isolation and expansion of cells from skeletal tissues results in a heterogeneous population of cells with variable regenerative potential. A more consistent tissue formation could be achieved by identification and selection of potent progenitors based on cell surface molecules. In this study, we assessed the expression of stage-specific embryonic antigen-4 (SSEA-4), a classic marker of undifferentiated stem cells, and other surface markers in human articular chondrocytes (hACs), osteoblasts, and bone marrow-derived mesenchymal stromal cells (bmMSCs) and characterized their differentiation potential. Further, we sorted SSEA-4-expressing hACs and followed their potential to proliferate and to form cartilage in vitro. Cells isolated from cartilage and bone exhibited remarkably heterogeneous SSEA-4 expression profiles in expansion cultures. SSEA-4 expression levels increased up to approximately 5 population doublings, but decreased following further expansion and differentiation cultures; levels were not related to the proliferation state of the cells. Although SSEA-4-sorted chondrocytes showed a slightly better chondrogenic potential than their SSEA-4-negative counterparts, differences were insufficient to establish a link between SSEA-4 expression and chondrogenic potential. SSEA-4 levels in bmMSCs also did not correlate to the cells' chondrogenic and osteogenic potential in vitro. SSEA-4 is clearly expressed by subpopulations of proliferating somatic cells with a MSC-like phenotype. However, the predictive value of SSEA-4 as a specific marker of superior differentiation capacity in progenitor cell populations from adult human tissue and even its usefulness as a stem cell marker appears questionable.

Polymer nanocarrier system for endosome escape and timed release of siRNA with complete gene silencing and cell death in cancer cells

An influenza virus-inspired polymer mimic nanocarrier was used to deliver siRNA for specific and near complete gene knockdown of an osteoscarcom cell line (U-2SO). The polymer was synthesized by single-electron transfer living radical polymerization (SET-LRP) at room temperature to avoid complexities of transfer to monomer or polymer. It was the only LRP method that allowed good block copolymer formation with a narrow molecular weight distribution. At nitrogen to phosphorus (N/P) ratios of equal to or greater than 20 (greater than a polymer concentration of 13.8 μg/mL) with polo-like kinase 1 (PLK1) siRNA gave specific and near complete (>98%) cell death. The polymer further degrades to a benign polymer that showed no toxicity even at polymer concentrations of 200 μg/mL (or N/P ratio of 300), suggesting that our polymer nanocarrier can be used as a very effective siRNA delivery system and in a multiple dose administration. This work demonstrates that with a well-designed delivery device, siRNA can specifically kill cells without the inclusion of an additional clinically used highly toxic cochemotherapeutic agent. Our work also showed that this excellent delivery is sensitive for the study of off-target knockdown of siRNA.

Review essay -- Weber L and Pickering S (2011) Globalization and borders : death at the global frontier

The pertinence of this book cannot be overemphasised. The world’s refugee crisis has reached a two‐decade high with the United Nations recently announcing that ‘displacement is the new 21st century challenge’ (UNHCR 2013). The transnational movement of dislocated peoples fleeing conflict, persecution and poverty is a global responsibility requiring nation states to collaborate for humanitarian resolutions embedded in human rights. However, in times of human rights expansionism, and the relaxation of borders for maximising free‐trade and fiscal prosperity, the movement of people experiencing immense abuse and deprivation has witnessed an increase in draconian regulation within discourses of intolerance and deterrence. Weber and Pickering cogently and emphatically emphasise the human cost of inhumane and populist government immigration and border‐entry polices underpinned by ideologies of retribution, suspicion, and demonisation. It is a moving and engaging narrative: a book that exposes state prejudice and abuse, whilst advocating for the victims who undertake perilous journeys in search of safety from lives of violence and persecution. Moreover, it is a book that pushes ideological boundaries and seeks new criminological horizons, for which the authors must be sincerely congratulated. It is a text of innovation, inspired thinking and long lasting criminological value.

Distinguishing between mean-field, moment dynamics and stochastic descriptions of birth-death-movement processes

Mathematical descriptions of birth–death–movement processes are often calibrated to measurements from cell biology experiments to quantify tissue growth rates. Here we describe and analyze a discrete model of a birth–death-movement process applied to a typical two–dimensional cell biology experiment. We present three different descriptions of the system: (i) a standard mean–field description which neglects correlation effects and clustering; (ii) a moment dynamics description which approximately incorporates correlation and clustering effects, and; (iii) averaged data from repeated discrete simulations which directly incorporates correlation and clustering effects. Comparing these three descriptions indicates that the mean–field and moment dynamics approaches are valid only for certain parameter regimes, and that both these descriptions fail to make accurate predictions of the system for sufficiently fast birth and death rates where the effects of spatial correlations and clustering are sufficiently strong. Without any method to distinguish between the parameter regimes where these three descriptions are valid, it is possible that either the mean–field or moment dynamics model could be calibrated to experimental data under inappropriate conditions, leading to errors in parameter estimation. In this work we demonstrate that a simple measurement of agent clustering and correlation, based on coordination number data, provides an indirect measure of agent correlation and clustering effects, and can therefore be used to make a distinction between the validity of the different descriptions of the birth–death–movement process.

The increased risks of death and extra lengths of hospital and ICU stay from hospital-acquired bloodstream infections : a case-control study

Objectives Hospital-acquired bloodstream infections are known to increase the risk of death and prolong hospital stay, but precise estimates of these two important outcomes from well-designed studies are rare, particularly for non-intensive care unit (ICU) patients. We aimed to calculate accurate estimates, which are vital for estimating the economic costs of hospital-acquired bloodstream infections.

Changes of mortality and causes of death from 1970 to 2005 and decomposition analysis in Shandong province [山东省1970-2005年人群死亡率极死因变化与差别分解分析]

Objective To describe the trend of overall mortality and major causes of death in Shandong population from 1970 to 2005,and to quantitatively estimate the influential factors. Methods Trends of overall mortality and major causes of death were described using indicators such as mortality rates and age-adjusted death rates by comparing three large-scale mortality surveys in Shandong province. Difference decomposing method was applied to estimate the contribution of demographic and non-demographic factors for the change of mortality. Results The total mortality had had a slight change since 1970s,but had increased since 1990s.However,both the mortality rates of age-adjusted and age-specific decreased significantly. The mortality of Group Ⅰ diseases including infectious diseases as well maternal and perinatal diseases decreased drastically. By contrast, the mortality of non-communicable chronic diseases (NCDs)including cardiovascular diseases(CVDs),cancer and injuries increased. The sustentation of recent overall mortality was caused by the interaction of demographic and non-demographic factors which worked oppositely. Non-demographic factors were responsible for the decrease of Group Ⅰ disease and the increase of injuries. With respect to the increase of NCDs as a whole. Demographic factors might take the full responsibility and the non-demographic factors were the opposite force to reduce the mortality. Nevertheless, for the increase of some leading NCD diseases as CVDs and cancer, the increase was mainly due to non-demographic rather than demographic factors. Conclusion Through the interaction of the aggravation of ageing population and the enhancement of non-demographic effect, the overall mortality in Shandong would maintain a balance or slightly rise in the coming years. Group Ⅰ diseases in Shandong had been effectively under control. Strategies focusing on disease control and prevention should be transferred to chronic diseases, especially leading NCDs, such as CVDs and cancer.

Surveillance report on cardiovascular causes of death in Shouguang, 1993-1997 [寿光市疾病监测点1993～1997年心血管疾病死亡监测报告]

This analysis showed that cardiovascular diseases were the number cause of death claiming 34% of all deaths. More than half (52%) of all cardiovascular deaths were due to Cerebrovascular diseases and about one-third (32%) were due to ischaemic heart disease. The mortality of cardiovascular diseases showed an increasing trend during this period (1993-1997). Abstract in Chinese 心血管疾病是威胁人们健康的重要疾病之一，在居民死因中占主要位置。为了解心血管疾病死亡状况，我们对寿光市农村疾病监测点１９９３～１９９７年居民死亡资料进行了统计分析，现报告如下。（标化死亡率采用１９９０年全国标准人口构成计算）。１９９３～１９９７年监测...

Analysis on causes of death of rural residents in Shouguang City [寿光市农村人群慢性病死因分析]

Among people living in rural areas of Shouguang City, Shandong, China, 88% of deaths were caused by chronic non-communicable diseases. Cardiovascular diseases, respiratory diseases and cancers accounted for 97% of all chronic disease causes and 85% of all causes of death. The proportion of chronic causes increased by 27% from 1993 to 2000. However, the mortality of respiratory diseases showed a decreasing trend over time. Abstract in Chinese 篇首： 随着生活水平的提高,慢性非传染性疾病在居民死因谱中所占比重越来越大,为准确反映居民的死因状况,为农村地区慢性病的控制工作提供科学依据,本文对寿光市农村疾病监测点1993～2000年居民的慢性病死因进行了分析.

Cuases of death among rural residents in Shouguang City, 1993-1997 [寿光市1993～1997年农村居民死因分析]

In this rural population, cardiovascular diseases, respiratory diseases, cancers and injuries were identified as the major causes of death, responsible for 34%, 30%, 20% and 9%, respectively. Abstract in Chinese 寿光市地处山东半岛中部,渤海莱洲湾南畔,是全国有名的“蔬菜之乡”。为全面了解我市农村居民的死因分布状况,我们对寿光市部分农村居民1993~1997年的死亡资料进行了统计分析。对象与方法自1993年始,从我市选取有代表性的两个乡镇49个自然村约5000..

Death of a five year old from meningococcal disease in Darwin : a case of unprecedented public alarm

On Saturday, 25 October 1997 a five year old boy died in the Intensive Care Unit (ICU) of Royal Darwin Hospital (RDH) from meningococcal disease. While disease is expected throughout Australia during the late winter and early spring months, and deaths occur, this case was remarkable in the Northern Territory with respect to the unprecedented public response to media reports of the death.

Perceptions of organ donors and willingness to donate organs upon death : a test of the prototype/willingness model

Understanding people's organ donation decisions may narrow the gap between organ supply and demand. In two studies, participants who had not recorded their posthumous organ donation decision (Study 1, N = 210; Study 2, N = 307) completed items assessing prototype/willingness model (PWM; attitude, subjective norm, donor prototype favorability and similarity, willingness) constructs. Attitude, subjective norm, and prototype similarity predicted willingness to donate. Prototype favorability and a Prototype Favorability × Similarity interaction predicted willingness (Study 2). These findings provide support for the PWM in altruistic health contexts, highlighting the importance of people's perceptions about organ donors in their donation decisions.

Mainstream monsters : the otherness of humans in Twilight, the Vampire Diaries and True Blood

The representation of vampires in horror movies and television programmes has changed considerably over the last two decades. No longer is the vampire portrayed simply as a monster or representation of death. Now, the vampire on our screen such as True Blood’s Bill Compton, or Twilight’s Edward Cullen, passes as human, chooses to make morally sound decisions, becomes an upstanding assimilated citizen, works in the community, and aspires to be a husband to mortal women. The success of recent series such as The Twilight Saga (2009, 2010, 2011, 2012), The Vampire Diaries (2009 - ) and True Blood (2008 - ) has popularised the idea of vampires who cling to remnants of their humanity (or memories of what it means to be human) and attempt to live as human, which builds upon similar – albeit embryonic – themes which emerged from the vampire sub-genre in the 1990s. Within these narratives, representations of the other have shifted from the traditional idea of the monster, to alternative and surprising loci. As this chapter argues, humans themselves, and the concept of the human body, now represent, in many instances, both abject and other. The chapter begins by considering the nature of the abject and otherness in relation to representations of classical vampires and how they have traditionally embodied the other. This provides a backdrop against which to examine the characteristics of the contemporary mainstreaming vampire ‘monster’. An examination of the broad thematic and representational shifts from other to mainstream vampire demonstrates how mainstream monsters are increasingly assimilating into mortal lifestyles with trappings that many viewers may find appealing. The same shifts in theme and representation also reveal that humans are frequently cast as mundane and unappealing in contemporary vampire narratives.