Parental responsibility and removal of life sustaining treatment : Re Baby D

The case of Re Baby D (No. 2) has been described as a “landmark decision” as to whether parents themselves can authorise medical staff to withdraw life-sustaining treatment from their child or are required to seek the permission of a court or tribunal. The reasons for the decision that the removal of an endotracheal tube from the airway of Baby D was to treat “a bodily malfunction or disease” and therefore could be authorised by the parents will be explored.

Community beliefs about intentional injury and responsibility for prevention

Community beliefs related to intentional injury inflicted by others were examined in a population-based telephone survey (n= 1032) in Queensland, Australia. Young adults 18-24 years were nominated as the most likely to be intentionally injured. 89.1% of respondents nominating this group believed that the injury incidents occur in alcohol environments. Though respondents from this age group also identified 18-24 yo as most likely to be intentionally injured, this was at a significantly lower level than did parents or 25-64 yo respondents. Responsibility for preventing injuries was placed on proprietors of licensed premises, schools and parents/family of the victim for alcohol, school and home environments respectively. Beliefs were aligned with prevalence data on intentional injury demonstrating a high level of awareness in the community about likely victims and situations where intentional injuries occur. Interventions could target families of young adults to capitalize on high levels of awareness about young adult vulnerability.

Capacity-building workshops on the responsibility to protect (R2P) and the protection of civilians (POC) in armed conflict - Summary Report

In June 2011, a research project team from the Institute for Ethics, Governance and Law (IEGL), Queensland University of Technology, the United Nations University, and the Australian Government’s Asia Pacific Civil-Military Centre of Excellence (APCMCOE) held three Capacity-Building Workshops (the Workshops) on the Responsibility to Protect (R2P) and the Protection of Civilians (POC) in Armed Conflict in Manila, Kuala Lumpur, and Jakarta. The research project is funded by the Australian Responsibility to Protect Fund, with support from APCMCOE. Developments in Libya and Cote d’Ivoire and the actions of the United Nations Security Council have given new significance to the relationship between R2P and POC, providing impetus to the relevance and application of the POC principle recognised in numerous Security Council resolutions, and the R2P principle, which was recognised by the United Nations General Assembly in 2005 and, now, by the Security Council. The Workshops considered the relationship between R2P and POC. The project team presented the preliminary findings of their study and sought contributions and feedback from Workshop participants. Prior to the Workshops, members of the project team undertook interviews with UN offices and agencies, international organisations (IOs) and non-government organisations (NGOs) in Geneva and New York as part of the process of mapping the relationship between R2P and POC. Initial findings were considered at an Academic-Practitioner Workshop held at the University of Sydney in November 2010. In addition to an extensive literature review and a series of academic publications, the project team is preparing a practical guidance text (the Guide) on the relationship between R2P and POC to assist the United Nations, governments, regional bodies, IOs and NGOs in considering and applying appropriate protection strategies. It is intended that the Guide be presented to the United Nations Secretariat in New York in early 2012. The primary aim of the Workshops was to test the project’s initial findings among an audience of diplomats, military, police, civilian policy-makers, practitioners, researchers and experts from within the region. Through dialogue and discussion, the project team gathered feedback – comments, questions, critique and suggestions – to help shape the development of practical guidance about when, how and by whom R2P and POC might be implemented.

China and the "Responsibility to Protect" (R2P) : the implications of the Libyan intervention

The emerging principle of a “responsibility to protect” (R2P) presents a direct challenge to China's traditional emphasis on the twin principles of non-intervention in the domestic affairs of other states and non-use of military force. This paper considers the evolution of China‟s relationship with R2P over the past ten years. In particular, it examines how China engaged with R2P during the recent Libyan crisis, and considers what impact this conflict may have first, on Chinese attitudes to R2P, and second, on the future development and implementation of the doctrine itself. This paper argues that China‟s decision to allow the passage of Security Council resolution 1973, authorising force in Libya, was shaped by an unusual set of pragmatic considerations, and should not be viewed as evidence of a dramatic shift in Chinese attitudes towards R2P. More broadly, controversy over the scope of NATO's military action in Libya has raised questions about R2P‟s legitimacy, which has contributed to a lack of timely international action in Syria and Yemen. In the short term at least, this post-Libya backlash against R2P is likely to constrain the Security Council‟s ability to respond decisively to other civilian protection situations.

Class contestations and Australia’s resource boom : the emergence of the ‘cashed-up bogan’

This article examines the figure of the ‘Cashed-up Bogan’ or ‘Cub’ in Australian media from 2006 to 2009. It explains that ‘Bogan’, like that of ‘Chav’ in Britain, is a widely engaged negative descriptor for the white working-class poor. In contrast, ‘Cubs’ have economic capital. This capital, and the Cub’s emergence, is linked to Australia’s resource boom of recent decades when the need for skilled labour allowed for a highly demarcated segment of the working class to earn relatively high incomes in the mining sector and to participate in consumption. We argue that access to economic capital has provided the Cub with mobility to enter the everyday spaces of the middle class, but this has caused disruption and anxiety to middle-class hegemony. As a result, the middle class has redrawn and reinforced class-infused symbolic and cultural boundaries, whereby, despite their wealth, pernicious media representations mark Cubs as ‘other’ to the middle-class deservingness, taste and morality.

The introduction of an interactive teaching and learning activity (TLA) in class and its relationship to students’ learning-outcomes

In the university education arena, it is becoming apparent that traditional methods of conducting classes are not the most effective ways to achieve desired learning outcomes. The traditional class/method involves the instructor verbalizing information for passive, note-taking students who are assumed to be empty receptacles waiting to be filled with knowledge. This method is limited in its effectiveness, as the flow of information is usually only in one direction. Furthermore, “It has been demonstrated that students in many cases can recite and apply formulas in numerical problems, but the actual meaning and understanding of the concept behind the formula is not acquired (Crouch & Mazur)”. It is apparent that memorization is the main technique present in this approach. A more effective method of teaching involves increasing the students’ level of activity during, and hence their involvement in the learning process. This technique stimulates self- learning and assists in keeping these students’ levels of concentration more uniform. In this work, I am therefore interested in studying the influence of a particular TLA on students’ learning-outcomes. I want to foster high-level understanding and critical thinking skills using active learning (Silberman, 1996) techniques. The TLA in question aims to promote self-study by students and to expose them to a situation where their learning-outcomes can be tested. The motivation behind this activity is based on studies which suggest that some sensory modalities are more effective than others. Using various instruments for data collection and by means of a thorough analysis I present evidence of the effectiveness of this action research project which aims to improve my own teaching practices, with the ultimate goal of enhancing student’s learning.

China and the "Responsibility to Protect" : the implications of the Libyan intervention

The emerging principle of a “responsibility to protect” (R2P) presents a direct challenge to China’s traditional emphasis on the twin principles of non-intervention in the domestic affairs of other states and non-use of military force. This paper considers the evolution of China’s relationship with R2P over the past ten years. In particular, it examines how China engaged with R2P during the recent Libyan crisis, and considers what impact this conflict may have first, on Chinese attitudes to R2P, and second, on the future development and implementation of the doctrine itself. This paper argues that China’s decision to allow the passage of Security Council resolution 1973, authorising force in Libya, was shaped by an unusual set of political and factual circumstances, and should not be viewed as evidence of a dramatic shift in Chinese attitudes towards R2P. More broadly, controversy over the scope of NATO’s military action in Libya has raised questions about R2P’s legitimacy, which have contributed to a lack of timely international action in Syria. In the short term at least, this post-Libya backlash against R2P is likely to constrain the Security Council’s ability to respond decisively to other civilian protection situations.

Visual support for work assignment in process-aware information systems : framework formalisation and implementation

Process-aware information systems, ranging from generic workflow systems to dedicated enterprise information systems, use work-lists to offer so-called work items to users. In real scenarios, users can be confronted with a very large number of work items that stem from multiple cases of different processes. In this jungle of work items, users may find it hard to choose the right item to work on next. The system cannot autonomously decide which is the right work item, since the decision is also dependent on conditions that are somehow outside the system. For instance, what is “best” for an organisation should be mediated with what is “best” for its employees. Current work-list handlers show work items as a simple sorted list and therefore do not provide much decision support for choosing the right work item. Since the work-list handler is the dominant interface between the system and its users, it is worthwhile to provide an intuitive graphical interface that uses contextual information about work items and users to provide suggestions about prioritisation of work items. This paper uses the so-called map metaphor to visualise work items and resources (e.g., users) in a sophisticated manner. Moreover, based on distance notions, the work-list handler can suggest the next work item by considering different perspectives. For example, urgent work items of a type that suits the user may be highlighted. The underlying map and distance notions may be of a geographical nature (e.g., a map of a city or office building), but may also be based on process designs, organisational structures, social networks, due dates, calendars, etc. The framework proposed in this paper is generic and can be applied to any process-aware information system. Moreover, in order to show its practical feasibility, the paper discusses a full-fledged implementation developed in the context of the open-source workflow environment YAWL, together with two real examples stemming from two very different scenarios. The results of an initial usability evaluation of the implementation are also presented, which provide a first indication of the validity of the approach.

Hospital outpatient responses to potential driving impairment due to prescribed medications

Driving and using prescription medicines that have the potential to impair driving is an emerging research area. To date it is characterised by a limited (although growing) number of studies and methodological complexities that make generalisations about impairment due to medications difficult. Consistent evidence has been found for the impairing effects of hypnotics, sedative antidepressants and antihistamines, and narcotic analgesics, although it has been estimated that as many as nine medication classes have the potential to impair driving (Alvarez & del Rio, 2000; Walsh, de Gier, Christopherson, & Verstraete, 2004). There is also evidence for increased negative effects related to concomitant use of other medications and alcohol (Movig et al., 2004; Pringle, Ahern, Heller, Gold, & Brown, 2005). Statistics on the high levels of Australian prescription medication use suggest that consumer awareness of driving impairment due to medicines should be examined. One web-based study has found a low level of awareness, knowledge and risk perceptions among Australian drivers about the impairing effects of various medications on driving (Mallick, Johnston, Goren, & Kennedy, 2007). The lack of awareness and knowledge brings into question the effectiveness of the existing countermeasures. In Australia these consist of the use of ancillary warning labels administered under mandatory regulation and professional guidelines, advice to patients, and the use of Consumer Medicines Information (CMI) with medications that are known to cause impairment. The responsibility for the use of the warnings and related counsel to patients primarily lies with the pharmacist when dispensing relevant medication. A review by the Therapeutic Goods Administration (TGA) noted that in practice, advice to patients may not occur and that CMI is not always available (TGA, 2002). Researchers have also found that patients' recall of verbal counsel is very low (Houts, Bachrach, Witmer, Tringali, Bucher, & Localio, 1998). With healthcare observed as increasingly being provided in outpatient conditions (Davis et al., 2006; Vingilis & MacDonald, 2000), establishing the effectiveness of the warning labels as a countermeasure is especially important. There have been recent international developments in medication categorisation systems and associated medication warning labels. In 2005, France implemented a four-tier medication categorisation and warning system to improve patients' and health professionals' awareness and knowledge of related road safety issues (AFSSAPS, 2005). This warning system uses a pictogram and indicates the level of potential impairment in relation to driving performance through the use of colour and advice on the recommended behaviour to adopt towards driving. The comparable Australian system does not indicate the severity level of potential effects, and does not provide specific guidelines on the attitude or actions that the individual should adopt towards driving. It is reliant upon the patient to be vigilant in self-monitoring effects, to understand the potential ways in which they may be affected and how serious these effects may be, and to adopt the appropriate protective actions. This thesis investigates the responses of a sample of Australian hospital outpatients who receive appropriate labelling and counselling advice about potential driving impairment due to prescribed medicines. It aims to provide baseline data on the understanding and use of relevant medications by a Queensland public hospital outpatient sample recruited through the hospital pharmacy. It includes an exploration and comparison of the effect of the Australian and French medication warning systems on medication user knowledge, attitudes, beliefs and behaviour, and explores whether there are areas in which the Australian system may be improved by including any beneficial elements of the French system. A total of 358 outpatients were surveyed, and a follow-up telephone survey was conducted with a subgroup of consenting participants who were taking at least one medication that required an ancillary warning label about driving impairment. A complementary study of 75 French hospital outpatients was also conducted to further investigate the performance of the warnings. Not surprisingly, medication use among the Australian outpatient sample was high. The ancillary warning labels required to appear on medications that can impair driving were prevalent. A subgroup of participants was identified as being potentially at-risk of driving impaired, based on their reported recent use of medications requiring an ancillary warning label and level of driving activity. The sample reported previous behaviour and held future intentions that were consistent with warning label advice and health protective action. Participants did not express a particular need for being advised by a health professional regarding fitness to drive in relation to their medication. However, it was also apparent from the analysis that the participants would be significantly more likely to follow advice from a doctor than a pharmacist. High levels of knowledge in terms of general principles about effects of alcohol, illicit drugs and combinations of substances, and related health and crash risks were revealed. This may reflect a sample specific effect. Emphasis is placed in the professional guidelines for hospital pharmacists that make it essential that advisory labels are applied to medicines where applicable and that warning advice is given to all patients on medication which may affect driving (SHPA, 2006, p. 221). The research program applied selected theoretical constructs from Schwarzer's (1992) Health Action Process Approach, which has extended constructs from existing health theories such as the Theory of Planned Behavior (Ajzen, 1991) to better account for the intention-behaviour gap often observed when predicting behaviour. This was undertaken to explore the utility of the constructs in understanding and predicting compliance intentions and behaviour with the mandatory medication warning about driving impairment. This investigation revealed that the theoretical constructs related to intention and planning to avoid driving if an effect from the medication was noticed were useful. Not all the theoretical model constructs that had been demonstrated to be significant predictors in previous research on different health behaviours were significant in the present analyses. Positive outcome expectancies from avoiding driving were found to be important influences on forming the intention to avoid driving if an effect due to medication was noticed. In turn, intention was found to be a significant predictor of planning. Other selected theoretical constructs failed to predict compliance with the Australian warning label advice. It is possible that the limited predictive power of a number of constructs including risk perceptions is due to the small sample size obtained at follow up on which the evaluation is based. Alternately, it is possible that the theoretical constructs failed to sufficiently account for issues of particular relevance to the driving situation. The responses of the Australian hospital outpatient sample towards the Australian and French medication warning labels, which differed according to visual characteristics and warning message, were examined. In addition, a complementary study with a sample of French hospital outpatients was undertaken in order to allow general comparisons concerning the performance of the warnings. While a large amount of research exists concerning warning effectiveness, there is little research that has specifically investigated medication warnings relating to driving impairment. General established principles concerning factors that have been demonstrated to enhance warning noticeability and behavioural compliance have been extrapolated and investigated in the present study. The extent to which there is a need for education and improved health messages on this issue was a core issue of investigation in this thesis. Among the Australian sample, the size of the warning label and text, and red colour were the most visually important characteristics. The pictogram used in the French labels was also rated highly, and was salient for a large proportion of the sample. According to the study of French hospital outpatients, the pictogram was perceived to be the most important visual characteristic. Overall, the findings suggest that the Australian approach of using a combination of visual characteristics was important for the majority of the sample but that the use of a pictogram could enhance effects. A high rate of warning recall was found overall and a further important finding was that higher warning label recall was associated with increased number of medication classes taken. These results suggest that increased vigilance and care are associated with the number of medications taken and the associated repetition of the warning message. Significantly higher levels of risk perception were found for the French Level 3 (highest severity) label compared with the comparable mandatory Australian ancillary Label 1 warning. Participants' intentions related to the warning labels indicated that they would be more cautious while taking potentially impairing medication displaying the French Level 3 label compared with the Australian Label 1. These are potentially important findings for the Australian context regarding the current driving impairment warnings about displayed on medication. The findings raise other important implications for the Australian labelling context. An underlying factor may be the differences in the wording of the warning messages that appear on the Australian and French labels. The French label explicitly states "do not drive" while the Australian label states "if affected, do not drive", and the difference in responses may reflect that less severity is perceived where the situation involves the consumer's self-assessment of their impairment. The differences in the assignment of responsibility by the Australian (the consumer assesses and decides) and French (the doctor assesses and decides) approaches for the decision to drive while taking medication raises the core question of who is most able to assess driving impairment due to medication: the consumer, or the health professional? There are pros and cons related to knowledge, expertise and practicalities with either option. However, if the safety of the consumer is the primary aim, then the trend towards stronger risk perceptions and more consistent and cautious behavioural intentions in relation to the French label suggests that this approach may be more beneficial for consumer safety. The observations from the follow-up survey, although based on a small sample size and descriptive in nature, revealed that just over half of the sample recalled seeing a warning label about driving impairment on at least one of their medications. The majority of these respondents reported compliance with the warning advice. However, the results indicated variation in responses concerning alcohol intake and modifying the dose of medication or driving habits so that they could continue to drive, which suggests that the warning advice may not be having the desired impact. The findings of this research have implications for current countermeasures in this area. These have included enhancing the role that prescribing doctors have in providing warnings and advice to patients about the impact that their medication can have on driving, increasing consumer perceptions of the authority of pharmacists on this issue, and the reinforcement of the warning message. More broadly, it is suggested that there would be benefit in a wider dissemination of research-based information on increased crash risk and systematic monitoring and publicity about the representation of medications in crashes resulting in injuries and fatalities. Suggestions for future research concern the continued investigation of the effects of medications and interactions with existing medical conditions and other substances on driving skills, effects of variations in warning label design, individual behaviours and characteristics (particularly among those groups who are dependent upon prescription medication) and validation of consumer self-assessment of impairment.

Numerical methods and analysis for a class of fractional advection-dispersion models

In this paper, a class of fractional advection–dispersion models (FADMs) is considered. These models include five fractional advection–dispersion models, i.e., the time FADM, the mobile/immobile time FADM with a time Caputo fractional derivative 0 < γ < 1, the space FADM with two sides Riemann–Liouville derivatives, the time–space FADM and the time fractional advection–diffusion-wave model with damping with index 1 < γ < 2. These equations can be used to simulate the regional-scale anomalous dispersion with heavy tails. We propose computationally effective implicit numerical methods for these FADMs. The stability and convergence of the implicit numerical methods are analysed and compared systematically. Finally, some results are given to demonstrate the effectiveness of theoretical analysis.

Risk and Responsibility in Women's Prisons

I have been invited to discuss Risk and Responsibility in Women’s Prisons, a task which, is slightly intimidating for one such as I, who, having never worked in a prison, have never experienced the risks and responsibilities working in a prison entails. However, this discussion is based on what prisons’ staff have told me, as they have ruminated on the complexities of their jobs in women’s prisons and many of the examples which I will be using are taken from cross-national research which I did in 2000 and 2001 and which set out to analyse the fortunes of some innovatory programmes in relation to women’s prisons in England, Scotland, North America, Australia and Israel (Carlen 2002). The discussion draws in particular on the imaginative way in which the Scottish women’s prison, Cornton Vale, responded to the spate of suicides which it had in the late 1990s and which resulted in far reaching organizational change.

The Road to Whatever: Middle Class Cultgure and the Crisis of Adolescence

In this groundbreaking book, acclaimed sociologist and Pulitzer Prize finalist Elliott Currie draws on years of interviews to offer a profound investigation of what has gone wrong for so many “mainstream” American adolescents. Rejecting such predictable answers as TV violence, permissiveness, and inherent evil, Currie links this crisis to a pervasive “culture of exclusion” fostered by a society in which medications trump guidance and a punitive “zero tolerance” approach to adolescent misbehavior has become the norm. Broadening his inquiry, he dissects the changes in middle-class life that stratify the world into "winners" and "losers," imposing an extraordinarily harsh culture—and not just on kids. Vivid, compelling, and deeply empathetic, The Road to Whatever is a stark indictment of a society that has lost the will—or the capacity—to care.