Euthanasia and Physician-Assisted Suicide in Patients with Multiple Geriatric Syndromes

Importance: The Dutch Regional Euthanasia Review Committees (RTEs) reviewed and reported an increasing number of cases of euthanasia and physician-Assisted suicide (EAS) requested by older people with multiple geriatric syndromes (MGS). Knowledge of the characteristics of cases of EAS for MGS is important to facilitate societal debat

A new integral management model and evaluation method to enhance sustainability of renewable energy projects for energy and sanitation services

Autonomous systems based on the use of renewable energy (RE) have proven suitable for providing energy and sanitation services to isolated communities. However, most of these projects fail due to managerial weaknesses. Designing an appropriate management model is a key issue for sustainability and it is especially complex when includes different RE technologies. This paper is aimed at developing a novel management model for RE projects to provide energy and sanitation services with any kind of technology. Moreover, a new method to evaluate the sustainability is proposed regarding technical, economic, social/ethical, environmental and institutional/organisational dimensions. The case study of Pucara (Peru) is presented, in which a RE project with six different technologies was implemented and the integral community management model was designed in 2011. The project sustainability was evaluated in 2013 and results showed that the management model has succeeded to strengthen sustainability, especially in the institutional/organisational aspects.The authors would like to thank the anonymous reviewers for their valuable comments, which have helped to enhance this paper. The authors are grateful for all the assistance and support provided by Practical Action-ITDG from Peru.Lillo Rodrigo, P.; Ferrer-Martí, L.; Fernández-Baldor, Á.; Ramírez, B. (2015). A new integral management model and evaluation method to enhance sustainability of renewable energy projects for energy and sanitation services. Energy for Sustainable Development. 29:1-12. doi:10.1016/j.esd.2015.08.003S1122

Rural electrification: utilities' chafe or challenge?

The earlier research on electricity supply to rural areas has tended to address the technical and financial performance of both grid connected and decentralised power systems and the socio-economic impact of electrification. However, this study has chosen to examine the impact of the developments and trends on the approach to rural electrification and its implications for developing countries in particular. The study includes a comprehensive historical analysis of rural electrification programmes implemented in both industrialised and developing countries. A general conclusion is that rural electricity supply has always been considerably more expensive than the supply to urban areas and, as a consequence, utilities have been reluctant to extend the service to rural areas. In most cases government subsidies were needed to make rural electrification programmes feasible. In many industrialised countries, and some developing countries, separate organisations were made responsible for the implementation of these programmes. These organisations have met with varying degrees of success in reaching customers. In particular small-scale private rural utilities have seldom proved to be successful. Evidence suggests that, from a development point of view, electrification should preferably be a component of an integrated rural development programme. The electrification of rural areas has traditionally been based on electricity supply from a central grid. However in the future, the electrification of rural areas in developing countries will be increasingly based on decentralised power facilities. In this respect it is also emphasised that small-scale independent power producers should be seen as fully fledged suppliers of electricity to the public grid. The all-round unsatisfactory performance of the electricity sector of several developing countries calls for urgent reforms. However the results of the historical analysis and recent experiences in industrialised countries with privatisation in the power sector suggest that developing countries should ask themselves the questions what is the minimum amount of power sector reform that is needed. The study reveals that political stability, autonomy, and an appropriate utility organisation which is based on an analysis of the business environment and contemporary management, are needed to successfully implement future rural electrification programmes

"Completed life": Older adults who have a death wish without being severely ill

This dissertation is about older adults who have a death wish without being severely ill. Some older adults may come to the conclusion that even though they are not severely ill, the quality and the meaning of their life has deteriorated to such extent that they do no longer see a future for themselves and prefer death over life, leading to a death wish and sometimes also to a wish for a self-directed death. One commonly used expression for this experience is “completed life”. In the beginning of 2019 when the work for this dissertation started, there was an ongoing public and political debate about “completed life”. The debate centered around the question whether older adults with “completed life” who are not eligible for EAS but wish for a self-directed death should have legal options for assisted dying. At the same time, due to the limited empirical knowledge that was available, arguments for and against offering such legal options were mainly ideological and theoretical in nature. For well-informed policymaking on how the death wish of older adults with “completed life” can be appropriately responded to, more empirical knowledge was required. There was insufficient empirical knowledge on how many older adults have a death wish without being severely ill, who these older adults are, what the background of their death wishes is, and how their requests for EAS are handled by medical professionals. This dissertation aimed to address this knowledge gap by answering the following research questions: 1. What is the prevalence of older adults with a death wish without severe illness? 2. How can older adults with a death wish without severe illness be described in terms of characteristics and circumstances? 3. What is the background of the death wish of older adults without severe illness considering the nature of the death wish, motivations and needs behind the death wish, and communication about the death wish? 4. How are requests for euthanasia and assisted suicide (EAS) of older adults with a death wish without severe illness decided upon by Euthanasia Expertise Center (EEC) and assessed by the Regional Euthanasia Review Committees (RTEs)? 5. In what ways can be appropriately responded to the death wish of older adults without severe illness in light of empirical findings

Combined HPLC analysis of organic acids and furans formed during organosolv pulping of fiber hemp

During organosolv pulping of fiber hemp (Cannabis sativa L) with a mixture of ethanol/water, delignification is catalyzed by released acetic acid and formic acid in the effluent. The major sources of acetic acid are the acetyl groups, as determined by means of the acetyl balance, whereas formic acid is mainly formed as degradation product of polysaccharides. Trace amounts of other short chain organic acids and furans, formed from cellulose and hemicellulose, are also present in the effluent. A relatively simple and reliable HPLC method is described to analyze simultaneously the carboxylic acids and furans quantitatively. Acetyl and formyl contents of hemp core (4.3% and 0.2% respectively) and hemp bast (1.3% and 0.2%) are also analyzed with HPLC after an alkaline saponification