The anuric preterm newborn infant with a normal renal ultrasound: a diagnostic and ethical challenge

Diagnosis and treatment of an anuric premature infant with severe respiratory compromise and a normal renal ultrasound (US), is a difficult task that requires a multidisciplinary approach. A 29-week gestation premature male infant, born after 5 weeks of worsening oligohydramnios, was ventilated for respiratory distress and remained anuric. Intensive clinical investigations and pediatric nephrology consultation that predicted very poor prognosis were followed by progressive renal failure, electrolyte imbalance, respiratory failure, ventricular arrhythmia, and finally cardiac arrest and death on day 5. In view of the predicted poor outcome, and after discussion with the parents, a decision was made not to start peritoneal dialysis (PD), and to offer only palliative therapy, with comfort care alone. Pre and postnatal diagnosis lead, in this case, to an ethical challenge that focuses on the question of futility. Copyright © 2006 John Wiley & Sons, Ltd.     

Planning for global environmental change in Bangkok's informal settlements

Government agencies in cities across Asia recognise that municipalities must take steps to adapt to projected climate changes if people and places are to be kept above water. This paper focuses on planning for climate change in Bangkok because it ranks among the top 10 port cities vulnerable to climate change related flooding. It is also understood that the most devastating impacts of climate change will be suffered by the city's most vulnerable residents: the poor. Not only do impoverished people occupy physically vulnerable space, such as riverbanks, but they are also the least equipped to recover from the disruption of their livelihoods.

Several scholars have identified “institutional traps” that prevent the Thai government from successfully aiding poor and marginalised flood victims in the past. These include poor coordination, lack of monitoring and evaluation, rigidity, crisis management and elite capture. Lebel, Manuta, and Garden (2011, 56) Lebel, L., J.B. Manuta, and P. Garden. 2011. “Institutional Traps and Vulnerability to Changes in Climate and Flood Regimes in Thailand.” Regional Environmental Change 11 (1): 45–58.[Crossref], [Web of Science ®] , [Google Scholar] pose the crucial question: “How have individuals – from local community leaders through to national level politicians and bureaucrats – successfully influenced policy and programmes to avoid institutional traps and improve adaptive capacities to climate change?”

In this paper, we begin to address this question through examining emergent methods of “community based adaptation” and reviewing case studies of adaptation action from other vulnerable communities in the Global South. These lessons – such as overcoming institutional rigidity and avoiding elite capture – are important for Bangkok and other cities in the Global South that face many different challenges by global environmental change.     

Microbial communities and greenhouse gas emissions associated with the biodegradation of specified risk material in compost

Provided that infectious prions (PrP^Sc) are inactivated, composting of specified risk material (SRM) may be a viable alternative to rendering and landfilling. In this study, bacterial and fungal communities as well as greenhouse gas emissions associated with the degradation of SRM were examined in laboratory composters over two 14 day composting cycles. Chicken feathers were mixed into compost to enrich for microbial communities involved in the degradation of keratin and other recalcitrant proteins such as prions. Feathers altered the composition of bacterial and fungal communities primarily during the first cycle. The bacterial genera Saccharomonospora, Thermobifida, Thermoactinomycetaceae, Thiohalospira, Pseudomonas, Actinomadura, and Enterobacter, and the fungal genera Dothideomycetes, Cladosporium, Chaetomium, and Trichaptum were identified as candidates involved in SRM degradation. Feathers increased (P < 0.05) headspace concentrations of CH₄ primarily during the early stages of the first cycle and N₂O during the second. Although inclusion of feathers in compost increases greenhouse gas emissions, it may promote the establishment of microbial communities that are more adept at degrading SRM and recalcitrant proteins such as keratin and PrP^Sc.     

Developing safer passengers through a school-based injury prevention program

Motor vehicle crashes are a leading cause of death among young people. Fourteen percent of adolescents aged 13–14 report passenger-related injuries within three months. Intervention programs typically focus on young drivers and overlook passengers as potential protective influences. Graduated Driver Licensing restricts passenger numbers, and this study focuses on a complementary school-based intervention to increase passengers’ personal- and peer-protective behavior. The aim of this research was to assess the impact of the curriculum-based injury prevention program, Skills for Preventing Injury in Youth (SPIY), on passenger-related risk-taking and injuries, and intentions to intervene in friends’ risky road behavior. SPIY was implemented in Grade 8 Health classes and evaluated using survey and focus group data from 843 students across 10 Australian secondary schools. Intervention students reported less passenger-related risk-taking six months following the program. Their intention to protect friends from underage driving also increased. The results of this study show that a comprehensive, school-based program targeting individual and social changes can increase adolescent passenger safety.     

Lifestyle: suggesting mechanisms and a definition from a cognitive science perspective

The concept of lifestyle is rather difficult to pin down. It is used in a variety of disciplines and related to many different problems. In our highly modern society, lifestyle is more often mentioned as something we need to change in order to achieve a sustainable development. Our main interest then is how we create and change a lifestyle. How can we understand why it is sometimes difficult to achieve change? In relation to terms like beliefs, desires, intentions, habits and artefacts six factors will be suggested. Within these factors we may have a foundation for a mechanism underlying the creation and change of lifestyle. A definition of the concept of lifestyle from a cognitive science perspective will also be suggested, as derived from the same foundation and terms related to it.