Representative Democracy in Australian Local Government

In an assessment of representative democracy in Australian local government, this paper considers long-run changes in forms of political representation, methods of vote counting, franchise arrangements, numbers of local government bodies and elected representatives, as well as the thorny question of constitutional recognition. This discussion is set against the background of ongoing tensions between the drive for economic efficiency and the maintenance of political legitimacy, along with more deep-seated divisions emerging from the legal relationship between local and state governments and the resultant problems inherent in local government autonomy versus state intervention

The Fast Track FIT study : diagnostic accuracy of faecal immunochemical test for haemoglobin in patients with suspected colorectal cancer

BACKGROUND: The faecal immunochemical test (FIT) is now available to support clinicians in the assessment of patients at low risk of colorectal cancer (CRC) and within the Bowel Cancer Screening Programme. AIM: To determine the diagnostic accuracy of FIT for CRC and clinically significant disease in patients referred because they were judged by their GP to fulfil NICE NG12 criteria for suspected CRC. DESIGN AND SETTING: Patients referred from primary care with suspected CRC, meeting NG12 criteria, to 12 secondary care providers in Yorkshire and Humber were asked to complete a FIT prior to investigation. METHOD: The diagnostic accuracy of FIT based upon final diagnosis was evaluated using receiver operating characteristics analysis. Clinicians and patients were blinded to the FIT results. RESULTS: 5040 patients were fully evaluated and CRC was detected in 151 (3%). An optimal cut-off value of 19 g Hb/g faeces for CRC was determined, giving a sensitivity of 85.4% (78.8-90.6%) and specificity of 85.2% (84.1-86.2%). The negative predictive value at this cut-off value was 99.5% (99.2-99.7%) and the positive predictive value 15.1% (12.8-17.7%). Sensitivity and specificity of FIT for CRC and significant premalignant polyps at this cut-off value were 62.9% (57.5-68.0%) and 86.4% (85.4-87.4%) respectively and when including all organic enteric disease were 35.7% (32.9-38.5%) and 88.6% (87.5-89.6%). CONCLUSIONS: FIT used in patients fulfilling NICE NG12 criteria should allow for a more personalised CRC risk assessment. FIT should permit effective, patient-centred decision-making to inform the need for, type and timing of further investigation

Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer in the randomised UK TACT2 trial (CRUK/05/19): a multicentre, phase 3, open-label, randomised, controlled trial.

BACKGROUND: Adjuvant chemotherapy for early breast cancer has improved outcomes but causes toxicity. The UK TACT2 trial used a 2×2 factorial design to test two hypotheses: whether use of accelerated epirubicin would improve time to tumour recurrence (TTR); and whether use of oral capecitabine instead of cyclophosphamide would be non-inferior in terms of patients' outcomes and would improve toxicity, quality of life, or both. METHODS: In this multicentre, phase 3, randomised, controlled trial, we enrolled patients aged 18 years or older from 129 UK centres who had histologically confirmed node-positive or high-risk node-negative operable breast cancer, had undergone complete excision, and were due to receive adjuvant chemotherapy. Patients were randomly assigned to receive four cycles of 100 mg/m2 epirubicin either every 3 weeks (standard epirubicin) or every 2 weeks with 6 mg pegfilgrastim on day 2 of each cycle (accelerated epirubicin), followed by four 4-week cycles of either classic cyclophosphamide, methotrexate, and fluorouracil (CMF; 600 mg/m2 cyclophosphamide intravenously on days 1 and 8 or 100 mg/m2 orally on days 1-14; 40 mg/m2 methotrexate intravenously on days 1 and 8; and 600 mg/m2 fluorouracil intravenously on days 1 and 8 of each cycle) or four 3-week cycles of 2500 mg/m2 capecitabine (1250 mg/m2 given twice daily on days 1-14 of each cycle). The randomisation schedule was computer generated in random permuted blocks, stratified by centre, number of nodes involved (none vs one to three vs four or more), age (≤50 years vs >50 years), and planned endocrine treatment (yes vs no). The primary endpoint was TTR, defined as time from randomisation to first invasive relapse or breast cancer death, with intention-to-treat analysis of standard versus accelerated epirubicin and per-protocol analysis of CMF versus capecitabine. This trial is registered with ISRCTN, number 68068041, and with ClinicalTrials.gov, number NCT00301925. FINDINGS: From Dec 16, 2005, to Dec 5, 2008, 4391 patients (4371 women and 20 men) were recruited. At a median follow-up of 85·6 months (IQR 80·6-95·9) no significant difference was seen in the proportions of patients free from TTR events between the accelerated and standard epirubicin groups (overall hazard ratio [HR] 0·94, 95% CI 0·81-1·09; stratified p=0·42). At 5 years, 85·9% (95% CI 84·3-87·3) of patients receiving standard epirubicin and 87·1% (85·6-88·4) of those receiving accelerated epirubicin were free from TTR events. 4358 patients were included in the per-protocol analysis, and no difference was seen in the proportions of patients free from TTR events between the CMF and capecitabine groups (HR 0·98, 95% CI 0·85-1.14; stratified p=0·00092 for non-inferiority). Compared with baseline, significantly more patients taking CMF than those taking capecitabine had clinically relevant worsening of quality of life at end of treatment (255 [58%] of 441 vs 235 [50%] of 475; p=0·011) and at 12 months (114 [34%] of 334 vs 89 [22%] of 401; p<0·001 at 12 months) and had worse quality of life over time (p<0·0001). Detailed toxicity and quality-of-life data were collected from 2115 (48%) of treated patients. The most common grade 3 or higher adverse events in cycles 1-4 were neutropenia (175 [16%]) and fatigue (56 [5%]) of the 1070 patients treated with standard epirubicin, and fatigue (63 [6%]) and infection (34 [3%]) of the 1045 patients treated with accelerated epirubicin. In cycles 5-8, the most common grade 3 or higher adverse events were neutropenia (321 [31%]) and fatigue (109 [11%]) in the patients treated with CMF, and hand-foot syndrome (129 [12%]) and diarrhoea (67 [6%]) in the 1044 patients treated with capcitabine. INTERPRETATION: We found no benefit from increasing the dose density of the anthracycline component of chemotherapy. However, capecitabine could be used in place of CMF without significant loss of efficacy and with improved quality of life. FUNDING: Cancer Research UK, Amgen, Pfizer, and Roche

Cachimbos europeus de cerâmica branca, séculos XVI ao XIX: parâmetros básicos para análise arqueológica

O tabaco foi introduzido na Europa no final do século XV. Desde então, uma das formas mais comuns para o seu consumo foi o cachimbo, além do rapé, do tabaco de mascar, do charuto e, mais recentemente, dos cigarros. Os cachimbos de cerâmica branca, largamente produzidos e utilizados na Europa desde o século XV, são encontrados em sítios arqueológicos históricos ao redor do mundo, incluindo no Brasil, em decorrência do comércio internacional, que gradualmente se intensificou após o início da conquista europeia. Eles funcionam como excelentes elementos para datação de sítios e estratos arqueológicos, tendo sido estudados em vários países a partir dessa abordagem. Ainda, esse tipo de artefato, mais que fornecer datações, permite identificar redes comerciais entre nações e desenvolver discussões de cunho social e cultural. Contudo, eles foram pouco estudados no Brasil. Visando contribuir com os estudos nacionais dessa categoria material, este artigo oferece uma revisão da literatura internacional acerca do histórico da produção dos cachimbos europeus de caulim, incluindo apresentação dos principais centros produtores; da morfologia e decoração desses produtos, considerando a cronologia do fabrico; e dos métodos de análise dos diferentes cachimbos de caulim no âmbito da arqueologia histórica.Tobacco was introduced in Europe at the end of the 15th century. Since then, one of the most traditional means for its use has been the pipe, next to the powder version, chewing, cigars, and, more recently, cigarettes. White clay tobacco pipes, widely produced and used in Europe since the 15th century, are found in historical archaeological sites around the world, including Brazil, due to international trade, which gradually intensified with the European conquest of the New World. They are excellent guides for dating archaeological sites and layers. In addition, this type of artifact, more than a dating tool, permits identifying trading networks between nations and developing discussions of cultural and social nature. These pipes, however, have been understudied in Brazil. In order to contribute to studies of this type of artifact in our country, this paper offers a revision of the international literature on the history of clay pipe production in Europe, including the presentation of main production centers; morphology and decoration of these products, considering issues of fabrication chronology; and the methods used in Historical Archaeology for analyzing clay tobacco pipes

Adorno and the Modern Ethos of Freedom

Delivering a concise and lucid account of Adorno's response to the modern question of freedom, Hearfield sets into critical relief six other modern philosophies of freedom from Kant, Hegel, Nietzchem Heideggerm Foucault and Habermas. The book presents a broad variety of perspectives concerning the question of freedom, and draws out the contrasting and superior merit of Adorno's response. Hearfield employs an interpretive framework that makes a distinction between a conceptual ratio (Kantm Hegel and Habermas) and an existential 'poiesis' (Nietzsche, Heidegger and Foucault). The book includes singular reconstructions of Adorno's immanent critiques of Kant, Hegel, Nietzsche and Heidegger, and demonstrates the theoretical instabilities peculiar to Foucault and Habermas. The book concludes by revealing the respective 'blind spots' in the conceptual ratio and existential 'poiesis' modes of thinking, which block our capacity for becoming free

Art, Truth and Freedom: Contemplating Heidegger's Categorial Vision

Categorial vision may seem a strange, if not erroneous way of naming the manner in which Heidegger discloses the ontological essence of art, truth and freedom. For with Heidegger, the term "categorial" pertains solely to the ontological characteristics of things present-at-hand (Heidegger, 1962a: 79); that is, things which remain categorially distinct from the temporal structures or "existentialia" of 'Dasein'. Furthermore, categorial vision is usually associated with Husserl's scientifically nuanced phenomenology concerning the intuited revelation of objective essences beyond the psychological relativism of subjectively constituted facts. Yet Heidegger's ontology of Being, despite its more poetic, hermeneutic mode of thinking, is nonetheless closely modeled on Husserl's anti-idealist attempt to overcome the intractable dualism of subject/object relations through the categorial vision of pre-reflective essences. Both are concerned with dismantling the transcendental conditions of categorical or conceptual identity. what Heidegger refers to as the metaphysics of presence dominant since Plato

Buildings Archaeology and Elite Housing in 19th Century Christchurch

The field of buildings archaeology in New Zealand is understudied and has resulted in the provision of architectural history rather than an archaeological investigation into what the design of the buildings tells us about the owners executing those architectural choices. This thesis set out to construct a comprehensive description of the archaeological record of buildings from one component of society in Christchurch, that could be compared in the future with similar studies of other social sectors to answer broader questions about how social status is reflected in the archaeological record. The focus of this research was on the elite end of society in Christchurch and the twelve case studies that fitted into my selection criteria were compared against each other to understand what features they shared. These features were grouped into four categories; architectural style, building size, exterior features and interior features to narrow down the comparisons between the buildings. This study found many overlapping elements between the elite buildings and the findings show that there are several features that can be used to identify elite buildings. There is also evidence that there are markers of a person’s status in the building they have built for themselves and their family. In the terms of this research it has shown that they used their buildings to display their wealth and social standing within the Canterbury society. In particular, with the size and architectural style of the buildings as well as the added decorated features both on the exterior and interior

The Dialectic of the Concept and its Nonidentical Other: An Historical Exegesis from Heraclitus to Adorno

While philosophy has retreated in large part to a specialist science of cognitive modalities, and is organised on this basis into formal codes of ethical conduct for the professional and business classes, critical reflection upon the concept's claim to self-sufficient truth and its ideological role in society has all but evaporated. Otherwise distracted by still prevalent concerns with transcendent meaning and epistemological methods based on mathematical principles of noncontradiction, the student of philosophy remains diverted from the question of the concept's own determination by the nonconceptual other to which it gives expressive form. This question raises a seemingly unresolvable dilemma, since it is only through the concept that such determination may be expressed. For this very reason such a problematic and the logic to which it gives rise has been virtually ignored. The absolute constituting form of the concept has been either implicitly or explicitly upheld throughout the history of philosophy. As a result the privileged concept from which all others are deduced, invariantly discloses its own immanent contradiction; a contradiction which is then covered over by the claim to indubitable certainty, to the absolute truth inherent in that concept's transcendental status

Criminal justice, Indigenous youth and social democracy

The political question of how the will of a community is to be democratically formed and adhered to, the question of social democracy, is normatively tied to the mode of criminal justice employed within that democratic public sphere. Liberal, republican, procedural and communitarian forms of democratic will-formation respectively reflect retributive, restorative, procedural and cooperative modes of criminal justice. After first elaborating these links through the critical response of republican and procedural theories of democracy to the liberal practice of democratic will-formation and its retributive mode of justice, our discussion considers the recent practice of restorative and procedural justice with respect to Indigenous youth; and this in the context of a severely diminished role for Indigenous justice agencies in the public sphere. In light of certain shortcomings in both the restorative and procedural modes of justice, and so too with republican and procedural understandings of the democratic public sphere, we turn to a discussion of procedural communitarianism, anchored as it is in Dewey's (1989) notion of social cooperation. From here we attempt a brief formulation of what a socially cooperative mode of justice might consist of; a mode of justice where historically racial and economically coercive injustices are sufficiently recognised