The transport sector is one of the largest sources of greenhouse gas emissions in New Zealand. To address this issue, the government is planning a set of actions to be implemented in the next 15 years. One of these actions deals with transport emissions and targets for a reduction in light vehicle travel. However, to achieve this goal, there is a need for both an updated assessment of effective interventions and an analysis of their relevance and applicability to the New (...) Zealand context. This report seeks to close the gap by conducting a narrative literature review of a collection of existing literature, supplemented with some targeted searches. With the focus on evidence relevant to New Zealand’s largest and fastest growing urban environments, the report identified 24 publicly available research outputs from around the world (mainly from Western European countries). The papers assessed differ not only in the type of research method and analysis applied but also the form of intervention (s) evaluated, the duration of the intervention and follow-up periods, the characteristics of the population groups or intervention sites studied, the measures, results and metrics relevant to New Zealand, and the outcomes of the interventions. Although these differences may represent a challenge in terms of comparability and transferability, they also provide opportunities and lessons for policy-and decision-makers. Finally, the report discusses the implications of the review and its findings and provides some directions and recommendations for future research, policy and practice for the measurement and evaluation of interventions. (shrink)

Wayne Martin and colleagues argue that decisions about patients’ best interests must sometimes take into account the interests of others Doctors often find themselves in circumstances where they must make decisions on behalf of an incapacitated patient. As a matter of both ethics and law, such decisions must be taken in the best interests of the patient, but uncertainty remains about what is meant by best interests, especially in relation to the interests of others. Should the interests of others enter (...) into a determination of the patient’s best interests? We believe that they should and argue against a recent trend to focus solely on the patient. It only takes a moment’s reflection to appreciate that the interests of one person are often wrapped up with the interests of others. A patient has an interest in recovering from her illness, but so do her family, employer, care providers, etc. Sometimes these various interests can be independently specified, but in other cases they are inextricably intertwined. Suppose that I am a single parent whose overriding interest is to ensure the wellbeing of my children. In that case the proper specification of my best interest is a function of theirs; I simply cannot determine the one without considering the other. This can create an ethical problem in medical decision making. In circumstances where medical staff must make a decision in the best interests of an incapacitated patient, to what extent can or should they take account of the interests of other people whose lives are affected by the outcome? These ethical issues have taken on a concrete legal shape in the UK with the implementation of the Mental Capacity Act 2005, which specifies that, “An act done, or decision made, under this Act for or on behalf of a person who lacks capacity …. (shrink)