Just Click Here : A Brief Glance at Absurd Electronic Contracts and the Law Failing to Protect Consumers

As e-commerce explodes around the world, consumers’ rights have been left behind. Before the completion of virtually every transaction on the Internet, the onus is placed on consumers to read and agree to an onslaught of terms and conditions. Often hidden in the middle of this extremely lengthy list of terms are massive exemption and limitation of liability clauses that deny consumers most if not all of their rights as “equal” trading partners. The common law principle that all onerous clauses in a contract need to be brought to the attention of the consumer for them to be binding seems to have been lost with the invention of the “click here to agree” button for signing online contracts. As the courts in Canada have not provided clear guidance on this issue thus far, other means must be pursued in order to protect consumers from the near-tyrannical control of unencumbered electronic standard form contracts in e-commerce. This paper will describe the principle of sufficiency of notice as it applies to paper contracts, and then contrast it with the newer jurisprudence that has refused to apply the principle to electronic contracts. The reasons for the refusal will be explored, followed by an examination of why the principle of sufficiency of notice needs to be applied and strengthened to respond to the increasingly onerous provisions hidden in electronic contracts. Finally, some other options for achieving the goal of consumer protection from hidden onerous clauses will be briefly explored. These other options include introducing stiffer consumer protection legislation domestically, the creation of international treaties, developing voluntary standards of contracting, and relying on Internet self-regulation

Studies on delirium and associated cognitive and functional decline in older surgical patients:The time is now to improve perioperative care and outcomes

Delirium is a syndrome that is frequently encountered by older hospitalized patients. The acute symptoms of confusion, agitation and drowsiness often subdue within days, but it is also known to negatively impact cognitive and functional performance over a longer period of time. As delirium is often observed after surgery, this might be an important factor to consider when deciding whether or not to perform surgery on an older patient. In this thesis we investigated several factors that show a temporal relation with delirium in the perioperative period, and the long term effects of delirium on cognitive and functional performance after surgery. We studied cohorts of older patients undergoing surgery for hip fracture or aortic stenosis. We found that it was difficult to learn more about the hypothesis of brain damage occurring during delirium by studying a biomarker, because of the heterogeneity of delirium itself, and the many factors that can both precipitate delirium and are of influence on the level of the biomarker we studied. Secondly, it appeared that a blood transfusion might serve as a preventive measure for delirium in patients with anemia after surgery. Lastly our findings underline that delirium occurring in the perioperative period has long lasting effects on cognitive and functional performance, and that this effect is partly predictable before surgery. Our findings can aid in the process of shared decision making that is conducted by clinicians and patients to establish the need for surgery, and might aid in improving outcomes for patients

De computer als leermiddel in het lager onderwijs

In het S. V.0.-project ' Leren met computers in het ondenvijs' werd de computer in het lager onderwijs vooral gebruikt voor 1. remediële doeleinden, en 2. het leren programmeren. Oefenprogramma's benutten bij uitstek de interactieve mogelijkheden van de computer. Gebruiksvormen: remedieel (voor enkele achterblijvers), aanvullend bij klassikaal onderwijs (voor alle leerlingen), verrijkend (voor enkele voorlopers). Computergestuurde oefening bleek statistisch geen significant grotere prestatiestijging op te leveren dan overeenkomstige schriftelijke oefening. Wel werd de motivatie en de concentratie er door vergroot. In het onderwijs van de toekomst zal de informatietechnogie een steeds belangrijker plaats innemen. Hierdoor zullen niet alleen leerlingen zelfstandiger kunnen leren maar zal ook het schoolse onderwijs effectiever kunnen verlopen

Interfacing the ICU with the general practitioner

For many reasons it is crucial that treating intensivists have (regular) contact with general practitioners (GPs). Information about the premorbid condition of the patient, their will and wishes, is of importance to be able to set appropriate treatment goals. The GP is the doctor who is responsible for the patient once discharged from the hospital. Additionally, the GP can play an important early role in the support of relatives, provided the GP is timely informed. This kind of communication should be organized in a structured way within the intensive care unit department