What’s the Harm in Having a “Harm Principle” Enshrined in Section 7 of the Charter?

To many, if not most, of us, it would seem like “common sense that you do not go to jail unless there is a potential that your activities will cause harm to others....” It has certainly long been accepted that government should not resort to the criminal law to control behaviour unless that behaviour creates a real risk of harm. But what if the government thought otherwise? What if the government decided to criminalize recreational activities that posed a neglible risk of harm to society? What if the government decided to criminalize conduct which, for the vast majority of the public who engage in that conduct, poses no real risk of harm? Does the Charter offer any protection against unnecessary criminal laws? Does section 7 of the Charter include a “harm principle” that restricts the imposition of criminal prohibitions to conduct that causes at least some measurable harm to society? in the recent trilogy of cases dealing with a section 7 Charter challenge to the criminal prohibition on marijuana, a majority of the Supreme Court of Canada decided that the “harm principle” was not a principle of fundamental justice. Despite the historical and widespread support for recognition of a “harm principle”, the majority’s decision wisely prevented the creation of a double-edged sword. In other words, constitutionalization of a “harm principle” could equally have led to challenges by public interest groups demanding that the government criminalize conduct that the group considers potentially injurious to society. Did we even need a “harm principle” to be enshrined within section 7 of the Charter? Ironically, prior to the majority’s decision in the trilogy of marijuana cases, the general balancing approach which the Supreme Court of Canada had recognized and applied, would have been reasonably well-suited to the task. Unfortunately, in the course of losing the battle to establish a firm footing for the “harm principle”, the appellants in the marijuana cases seem to also have severely narrowed the scope of substantive review afforded by previously decided cases

A Study of the Contextual Factors Influencing Emergency Department Clinician’s Diagnostic Test Ordering Decision Making

Australia’s total number of pathology tests and imaging services covered by the Medicare Benefits Schedule has increased by over 50% in the last decade. Given that 20-25% of the common pathology tests were considered inappropriate nationwide, an increasing burden is being placed on the whole healthcare system by unnecessary diagnostic tests (UDTs). The objective of this exploratory study is to identify the contextual factors that could influence a clinician’s diagnostic test ordering decision-making (DTODM) in an Emergency Department (ED). Semi-structured interviews were conducted with 19 ED clinicians. Four factors have been identified, including organizational context, patient/family preferences, resource availability, and influences by senior clinicians. The study offers new lenses in clinical reasoning for emergency medicine teaching and training through the eyes of ED clinicians. It also outlines an opportunity to introduce novel clinical decision support to assist with clinicians’ test ordering without causing alert fatigue or bringing stress

A Knowledge Management Framework for Sustainable Development: A Case of Natural Resource Management Policy Work in Indonesia

The development and implementation of government policy, which we term ‘policy work’, is a complex challenge that needs to address cooperation and collaboration between multiple agencies and coordination of activities occurring at multiple levels within agencies, stakeholder organisations and the community. This paper describes an action-oriented Task-based Knowledge Management (KM) framework aimed specifically at building capability for policy work in order to address the challenges of a complex policy environment. Our research is conducted in the context of current capacity-building initiatives in Indonesia focused on the dual policy challenges of sustainable development and natural resource management. In this context our KM approach supports the consolidation of diverse information streams including formal (science) and informal (tradition, social norms, local lore), and provides the means to build a shared understanding of problems (natural resource management) and innovative solutions to those problems (sustainable management practices) involving all stakeholders

How Do Students Enact Group Reasoning Within Online Interprofessional Education?

Background: The capability of an interprofessional healthcare team to reach a shared understanding through group reasoning is critical to good healthcare delivery. Models for clinical reasoning have proved useful but remain focused on individual cognitive processes. Whilst interprofessional education has steadily gained real-world traction, it is unclear how interprofessional student groups practice group reasoning when performing online tasks. Method: We analyzed the group reasoning processes with two teams of health professional students in an online interprofessional education task (n = 13). Two simulated interprofessional team meetings about a palliative case were audio recorded, transcribed, and deductively analyzed to determine the mechanisms of team deliberation using a previously published study of group reasoning.Results: The reasoning mechanisms outlined in a previous study (informationaccumulating, sense-making, and decision-making) were evident in an analysis of student group reasoning. In particular, students focused on sharing and agreeing on information, and to a lesser extent, recording information. Conclusion: Attention to the mechanisms of action may be useful to facilitate teaching interprofessional reasoning. Group reasoning may benefit from focusing student attention on these stages: 1) prioritizing and sequencing of options, methods for exposing agreement about shared information, shared understanding of the situation, and options; 2) techniques for critically evaluating information so that opportunities arise to identify when information may disrupt existing understandings; and 3) development of documentation tools to assist recording of the process

Star Clusters in M 31. IV. A Comparative Analysis of Absorption Line Indices in Old M 31 and Milky Way Clusters

We present absorption line indices measured in the integrated spectra of globular clusters both from the Galaxy and from M 31. Our samples include 41 Galactic globular clusters, and more than 300 clusters in M 31. The conversion of instrumental equivalent widths into the Lick system is described, and zero-point uncertainties are provided. Comparison of line indices of old M 31 clusters and Galactic globular clusters suggests an absence of important differences in chemical composition between the two cluster systems. In particular, CN indices in the spectra of M 31 and Galactic clusters are essentially consistent with each other, in disagreement with several previous works. We reanalyze some of the previous data, and conclude that reported CN differences between M 31 and Galactic clusters were mostly due to data calibration uncertainties. Our data support the conclusion that the chemical compositions of Milky Way and M 31 globular clusters are not substantially different, and that there is no need to resort to enhanced nitrogen abundances to account for the optical spectra of M 31 globular clusters.Comment: 72 pages, including 15 figures and 14 tables. Published by the Astronomical Journa

Star Clusters in M31: I. A Catalog and a Study of the Young Clusters

We present an updated catalog of 1300 objects in the field of M31, including 670 likely star clusters of various types. Archival images were inspected to confirm cluster classifications where possible, but most of the classifications were based on spectra taken of ~1000 objects with the Hectospec fiber positioner and spectrograph on the 6.5m MMT. The spectra and images of young clusters are analyzed in detail in this paper. Ages, reddenings and masses of 140 young clusters are derived by comparing the observed spectra and photometry with model spectra. We find these to have masses as great as 10^5 with a median of 10^4 M_sun, and a median age of 0.25 Gyr. Thus these clusters are similar in mass to the LMC young massive clusters, and are in between Milky Way open clusters and the globulars of M31 and the Milky Way. Most of the M31 young clusters have the low concentration typical of Milky Way open clusters, and we expect that most of these will be disrupted in the next Gyr, but a few have high concentrations and will likely survive longer. The spatial distribution of the young clusters is well correlated with the star-forming regions as mapped out by mid-IR emission. A kinematic analysis likewise confirms the spatial association of the young clusters with the young disk in M31.Comment: 18 pages of text and figures, 23 of tables, to appear in AJ. http://www.cfa.harvard.edu/oir/eg/m31clusters/M31_Hectospec.html is a new M31 web site containing tables and postage stamp images of the entire catalo

Identification of a New Class of Molecules, the Arachidonyl Amino Acids, and Characterization of One Member That Inhibits Pain

In mammals, specific lipids and amino acids serve as crucial signaling molecules. In bacteria, conjugates of lipids and amino acids (referred to as lipoamino acids) have been identified and found to possess biological activity. Here, we report that mammals also produce lipoamino acids, specifically the arachidonyl amino acids. We show that the conjugate of arachidonic acid and glycine (N-arachidonylglycine (NAGly)) is present in bovine and rat brain as well as other tissues and that it suppresses tonic inflammatory pain. The biosynthesis of NAGly and its degradation by the enzyme fatty acid amide hydrolase can be observed in rat brain tissue. In addition to NAGly, bovine brain produces at least two other arachidonyl amino acids: N-arachidonyl gamma-aminobutyric acid (NAGABA) and N-arachidonylalanine. Like NAGly, NAGABA inhibits pain. These findings open the door to the identification of other members of this new class of biomolecules, which may be integral to pain regulation and a variety of functions in mammals

Exploring reasoning mechanisms in ward rounds: a critical realist multiple case study

Abstract Background Ward rounds are an important and ubiquitous element of hospital care with a history extending well over a century. Although originally intended as a means of educating medical trainees and junior doctors, over time they have become focused on supporting clinical practice. Surprisingly, given their ubiquity and importance, they are under-researched and inadequately understood. This study aims to contribute knowledge in human reasoning within medical teams, meeting a pressing need for research concerning the reasoning occurring in rounds. Methods The research reported here aimed to improve the understanding of ward round reasoning by conducting a critical realist case study exploring the collaborative group reasoning mechanisms in the ward rounds of two hospitals in Victoria, Australia. The data collection involved observing rounds, interviewing medical practitioners and holding focus group meetings. Results Nine group reasoning mechanisms concerning sharing, agreeing and recording information in the categories of information accumulation, sense-making and decision-making were identified, together forming a program theory of ward round reasoning. In addition, themes spanning across mechanisms were identified, further explaining ward round reasoning and suggesting avenues for future exploration. Themes included the use of various criteria, tensions involving mechanisms, time factors, medical roles and hierarchies. Conclusions This paper contributes to the literature by representing rounds in a manner that strengthens understanding of the form of the group reasoning occurring within, thus supporting theory-based evaluation strategies, redesigned practices and training enhancements