Isotopic constraints on the origin of meteoritic organic matter

Salient features of the isotopic distribution of H, C and N in the organic material found in carbonaceous meteorites are noted. Most organic fractions are strongly enriched in D with respect to the D/H ratio characteristic of H2 in the protosolar system; substantial variations in C-13/C-12 ratio are found among different molecular species, with oxidised species tending to be C-13 enriched relative to reduced species; some homologous series reveal systematic decrease in C-13/C-12 with increasing C number; considerable variation in N-15/N-14 ratio is observed within organic matter, though no systematic pattern to its distribution has yet emerged; no interelement correlations have been observed between isotope enrichments for the different biogenic elements. The isotopic complexity echoes the molecular diversity observed in meteoritic organic matter and suggests that the organic matter was formed by multiple processes and/or from multiple sources. However, existence of a few systematic patterns points towards survival of isotopic signatures characteristic of one or more specific processes. The widespread D enrichment implies either survival of many species of interstellar molecule or synthesis from a reservoir containing a significant interstellar component. Several of the questions raised above can be addressed by more detailed determination of the distribution of the H, C and N isotopes among different well-characterized molecular fractions. Thus, the present study is aimed at discovering whether the different amino acids have comparable D enrichments, which would imply local synthesis from a D-enriched reservoir, or very viable D enrichments, which would imply survival of some interstellar amino acids. The same approach is also being applied to polycyclic aromatic hydrocarbons. Because the analytical technique employed (secondary ion mass spectrometry) can acquire data for all three isotopic systems from each molecular fraction, any presently obscured interelement isotopic correlation should also be revealed, which will aid in identifying pertinent synthetic processes

Primordial material in meteorites

Primordial is a term which applied to material that entered the solar system early and became incorporated into a meteorite without totally losing its identity. Identification of such material surviving in meteorites is so far solely through recognition of anomalous isotopic compositions of generally macroscopic entities contained within those meteorites. Isotopic anomalies are, by definition, isotopic compositions which differ from the canonical solar system abundances in ways which cannot be explained in terms of local processes such as mass dependent fractionation, cosmic ray induced spallation or decay of radionuclides. A comprehensive account of isotopic anomalies is impractical here, so it is necessary to be selective. Issues which are potentially addressable through the study of such primordial material are examined. Those issues will be illustrated with specific, but not exhaustive, examples

Market orientation and service quality of public sector sport and recreation providers: a case study approach.

This study examines market orientation and service quality constructs within the public sector sport and recreation providers in the U.K. A preliminary review of the literature regarding marketing as a concept, its implementation and the constructs of service quality concludes that two models measure the constructs of market orientation and service quality adequately. These are the Kohli and Jaworski (1990) market orientation model and the Cronin and Taylor (1992; 1994) service quality measure. The market orientation model has been effectively linked to performance in other studies. Related studies concerning marketing in this sector have either concentrated upon generic issues, or attempts to measure service quality, but not the implementation of the marketing concept i.e. market orientation, simultaneously combined with the measurement of service quality. This research thus attempts to ful a void in knowledge by examining the market orientation and service quality constructs, and the link to organisational performance measured directly by income, expenditure and attendance for this service sector. This is in order to make a contribution to the more effective marketing and service quality management practice for this service industry. Employing a combined research design this study investigates the dimensional structures of the two constructs and the link to performance vía quantitative means. This approach also determines the existence of other related dimensions via the qualitative research methods adopted. Finally, evaluating the results against performance criteria to determine, where appropriate statistical significance. The nature of this service provisión enabled staff to be used for the quantitative study to measure the market orientation and service quality constructs to gain a surrogate "customer perspective". The two construct models proved to be reasonably robust, with many of the elements being retaíned in both after the iterative removal of elements via Cronbach alpha reliability tests. After principal component analysis, the dimensional constructs of both models were confirmed with the retained elements, although some dimensions subdivided due to questionnaire content (negatively worded items) and contextually specific items discovered in the service quality constructs (staff and physical facilities being considered as tangibles, but in two dimensional constructs). Múltiple analysis of variance identifíed some significant differences between the four cases, identifying a statistically significant link with performance for market orientation and service quality against the more extreme measurements of income, and attendance. This was only for two of the dimensional constructs of "Reliability" and "Tangibles" for the service quality dimensions however but still providing a useful method to determine a "non management" perspective for these two elements. The qualitative phase identifíed the possibility of other important dimensions whích included elements of the Narver and Slater (1990) market orientation dimensional construct, "competitor orientation" and "interfunctional coordination", and a further dimensión of "resources", which is probably unique to this service sector. lt was concluded that use could be made of the statistically significant elements that were found from this study of the dimensions of market orientation and service quality as a single measurement instrument. They could provide an indicative means of identifying important measures linked to functional issues underlying the marketing processes i.e. intelligence gathering, intelligence dissemination and responsiveness, as well as effective perceptual measurements of the "reliability" and "tangibles" which make up this service provisión

The shock of the new: ethics, law and the introduction of public access defibrillation

There have been recent moves to include Public Access Defibrillation (PAD) in emergency response strategies. The value of this development is explored in this article. The benefits and limitations of extending AutomaticExternal Defibrillator (AED) use to non-traditional first responders, minimally trained witnesses and citizens are examined and the cost-effectiveness of such developments is discussed. The authors contend that, at the present time, enthusiasm for PAD would seem misplaced and that there is a series of economic, ethical and legal uncertainties that need to be addressed before widespread distribution of AED technology should be pursued

Defining Medical Futility in Ethics, Law and Clinical Practice: An Exercise in Futility?

The debate as to the meaning of medical futility and what physicians should do in clinical practice dates back to the time of the writings of Hippocrates and Plato where it was said, "To attempt futile treatment is to display an ignorance that is allied to madness". In simpler times assertions regarding the obvious were sufficient to indicate what was thought "fitting" as a medical practitioner. In recent times, however, modern technology, professional values and power, patient autonomy, limited health care resources and societal expectations, make for a much more potent and potentially explosive mixture. In this article we argue that futility is a problem that will not go away, both because of increased health expectations and emerging technologies that keep making possible what was previously impossible. The problem of definition and its ramifications in terms of institutional policies is one in which the legal profession and its process (which often represents and reflects societal values) has a key role to play by way of critical reflection and appraisal

Towards a dialogical ethics of interprofessionalism

Contemporary medical practice brings a diverse range of professions and disciplines together in greater and closer contact. This situation of increasing complexity and changing professional roles gives rise to multifaceted ethical dilemmas and theoretical and practical concerns. In this essay we argue that for multidisciplinary relationships to be facilitated and to progress towards interdisciplinary teamwork, moral agents have to go beyond orthodox ethical systems and appeal to normative theory. We will argue that conceptualising ethics as a shared social practice may provide a useful starting point. This dialogic approach places greater emphasis on open deliberation and the articulation, negotiation, exploration and generation of new ethical perspectives in the here and now of clinical practice

The law of gifts, conditional donation and biobanking

Tissue banks are critical to research efforts into the causes and treatment of many diseases. Biobanks are created from donated tissue but property concepts have not played a major role in understanding methods of the collection and use of tissue. Little work has been done to study the proprietary dimensions of these gifts primarily because of the influence of the res nullius rule. Instead, the primary focus of studies has been the concept of informed consent, but this has proven to be problematic. This article examines how the law of gifts can help to resolve these difficulties. It argues that the concept of conditional donation is a more useful way to understand and explain how tissue can be donated to biobanks. The article also suggests ways that conditional donation could be regulated so as to balance the needs of researchers and the concerns of donors

Building Clinical Ethics Capacity, Final Report of the Developing Clinical Ethics Capacity in NSW Partnership project 2014

Clinical ethics support services are an established feature of health care in the US and Canada and are becoming so in the UK, France, Belgium and elsewhere in Europe. They are yet to be widely established in NSW or elsewhere Australia. Clinical ethics support typically involves the provision of expert ethics input into clinical education, policy development and the care of individual patients, particularly where this involves value, rather than clinical, or scientific, conflict. Ethics support is generally provided by an individual consultant, an ethics committee or some combination of the two. In its case consultation function, expert support is intended to clarify the values that are in tension and through promoting open and inclusive discussion, facilitate consensus on the appropriate next steps. Internationally, the guidance and recommendations issued by a support service on a particular case are, in most cases, advisory and not binding. Advocates argue that clinical ethics support is necessary because contemporary clinical work takes place in a technologically, socially and ethically complex environment. The medical encounter has become far more open to scrutiny and is accountable to a more diverse public holding often quite different interests, ideas and values. In a more pluralist society, professional training, professional codes and institutional polices aren’t sufficient to establish ethical practices and procedures or resolve the ethical dilemmas that arise in the care of individual patients. The ethics expertise provided by an ethicist or a panel of ethically trained clinicians is necessary to astutely appraise the values and arguments and generate consensus. Without such expertise the ethicality of practices cannot be assured. Clinical ethics support is intended to promote ethically sound clinical and organisational practices and decision-making and thereby contribute to health organisation and system quality improvement. The under-developed state of clinical ethics support in Australia and NSW prompted NSW Health, in partnership with the Centre of Values Ethics and Law in Medicine and the Centre for Health Law and Governance , to ask: 1. Do changes to the environment in which clinical practice occurs mean there is a need to change the way we deal with ethical dilemmas? 2. Is more formalised support for clinicians, when making difficult and possibly controversial ethical decisions, desirable or warranted? 3. If it is agreed that clinical ethics support should be enhanced, what model is most appropriate for local conditions?funding provided by the Centre for Epidemiology and Evidence, NSW Ministry of Healt

How clinical and research failures lead to suboptimal prescribing: the example of chronic gout

Despite the existence of several effective drugs for chronic tophaceous gout, management is often neither rational nor effective. Wendy Lipworth and colleagues examine the possible reasons An evidence based or “rational” approach to prescribing is thought to maximise the benefit and minimise the harm from prescription drugs. Unfortunately, prescribing often does not meet this ideal despite clinicians’ best intentions. We use treatment of chronic tophaceous gout to show how apparently irrational prescribing arises from several interacting “failures” in both clinical practice and drug development

Dilemmas in the Compassionate Supply of Investigational Cancer Drugs

In Australia, patients who want to access medicines that are not yet approved have only two options: to enrol in a clinical trial if they are eligible, or obtain their medicine through ‘compassionate supply’, which is provided at the discretion of the manufacturer. In this article, we explore ethical issues associated with the provision of oncology medicines that are still in development, either prior to regulatory approval or government reimbursement. Keywords: ethics; evidence-based medicine; health services accessibility; oncolog