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Punk is often thought of as a culture of resistance—resistance to conventional music, to conservative politics, to standards of appearance, to parental authority. Few portrayals do much to clarify what specifically qualifies as punk and what does not, but rather favor a general, though impassioned, description of punk as quintessentially resistant. This is appealing largely due to conflicts within the punk community about how to define its borders. Angela McRobbie, in Postmodernism and Popular Culture writes that this struggle is central to many youth subcultures, that "perhaps the emphasis on authenticity is a precondition for acquiring subjectivity and identity in adolescence, one of the attractions of subcultures being precisely that it offers strong subjectivity through the collective meanings that emerge from the distinctive combination of signs, symbols, objects, styles, and other 'signifying texts." As punks grow past adolescence, they often lean toward more inclusive definitions. Although the struggle for authenticity within the punk scene can manifest in emotional and physical violence, I argue the attempts to push back these borders can be equally oppressive. I highlight the ways that, in the midst of this violence, women and people of color in the punk scene are exercising agency, through combining various discourses in self-determined representations.

The Community Peace and Restoration Fund was established to provide a peace dividend to alienated Solomon Islands communities. This article reflects critically on how the Fund engaged with these communities and its relative success in meeting key peacebuilding indicators. The Fund increased equitable and equal access to resources and contributed to the rebuilding of associational life, utilising peacebuilding methodologies to enhance its community engagement processes. However, the Fund was less successful on a number of fronts, particularly in its interaction with government structures at meso and macro levels. The article analyses why the Fund was so successful at local-level community peacebuilding but failed to capitalise on opportunities at the macro level.

AbstractThis article explores the concept and dynamics of the newly formed, and increasingly popular, Friendship Agreements, between local councils in Australia, and their counterpart district administrations in Timor Leste. The history and purpose of international municipal links are explored and contrasted with current Friendship Agreement policy and practice. The key elements of making international municipal links a success are examined and the main impediments to forging and maintaining sustainable partnerships are discussed and contrasted with the Australian/Timorese experience. The article offers suggestions for creating sustainable, vibrant links. It argues that those Agreements built on notions of paternalism are less likely to succeed than those that are committed to relationship and trust building between and within communities in Australia and Timor Leste. Copyright © 2007 John Wiley & Sons, Ltd.

The Community Peace and Restoration Fund was established to provide a peace dividend to alienated Solomon Islands communities. This article reflects critically on how the Fund engaged with these communities and its relative success in meeting key peacebuilding indicators. The Fund increased equitable and equal access to resources and contributed to the rebuilding of associational life, utilising peacebuilding methodologies to enhance its community engagement processes. However, the Fund was less successful on a number of fronts, particularly in its interaction with government structures at meso and macro levels. The article analyses why the Fund was so successful at local-level community peacebuilding but failed to capitalise on opportunities at the macro level. Adapted from the source document.

This article reflects on the motives, process, and outcomes of efforts to develop a dynamic course structure in which to teach current community development practice and peacemaking. We recognize the need for more applied learning to better support a student profile that is increasingly made up of community development practitioners and peace workers. The learning environment we seek to provide at the University of New England, a regional university in New South Wales, Australia, offers students the opportunity to: (1) consolidate and monitor their own practice in the field; (2) evaluate their own workplace environment and learning experiences in the field with reference to other students' comparative experience; and (3) interact with teaching staff who act as providers of resources, networking contacts, and people with whom to engage in critical reflection. The paper concludes that a dynamic, flexible, and cooperative approach to learning is highly appropriate to contemporary adult and professional workplace education.

Genomic discoveries have transformed the practice of oncology and cancer prevention. Diagnostic and therapeutic advances based on cancer genomics developed during a time when it was possible to patent genes. A case before the Supreme Court, Association for Molecular Pathology v Myriad Genetics, Inc seeks to overturn patents on isolated genes. Although the outcomes are uncertain, it is suggested here that the Supreme Court decision will have few immediate effects on oncology practice or research but may have more significant long-term impact. The Federal Circuit court has already rejected Myriad's broad diagnostic methods claims, and this is not affected by the Supreme Court decision. Isolated DNA patents were already becoming obsolete on scientific grounds, in an era when human DNA sequence is public knowledge and because modern methods of next-generation sequencing need not involve isolated DNA. The Association for Molecular Pathology v Myriad Supreme Court decision will have limited impact on new drug development, as new drug patents usually involve cellular methods. A nuanced Supreme Court decision acknowledging the scientific distinction between synthetic cDNA and genomic DNA will further mitigate any adverse impact. A Supreme Court decision to include or exclude all types of DNA from patent eligibility could impact future incentives for genomic discovery as well as the future delivery of medical care. Whatever the outcome of this important case, it is important that judicial and legislative actions in this area maximize genomic discovery while also ensuring patients' access to personalized cancer care.

The learning health care system (LHS) was designed to enable real-time learning and research by harnessing data generated during patients' clinical encounters. This novel approach begets ethical questions regarding the oversight of users and uses of patient data. Understanding patients' perspectives is vitally important. MATERIALS AND METHODS: We conducted democratic deliberation sessions focused on CancerLinQ, a real-world LHS. Experts presented educational content, and then small group discussions were held to elicit viewpoints. The deliberations centered around whether policies should permit or deny certain users and uses of secondary data. De-identified transcripts of the discussions were examined by using thematic analysis. RESULTS: Analysis identified two thematic clusters: expectations and concerns, which seemed to inform LHS governance recommendations. Participants expected to benefit from the LHS through the advancement of medical knowledge, which they hoped would improve treatments and the quality of their care. They were concerned that profit-driven users might manipulate the data in ways that could burden or exploit patients, hinder medical decisions, or compromise patient-provider communication. It was recommended that restricted access, user fees, and penalties should be imposed to prevent users, especially for-profit entities, from misusing data. Another suggestion was that patients should be notified of potential ethical issues and included on diverse, unbiased governing boards. CONCLUSION: If patients are to trust and support LHS endeavors, their concerns about for-profit users must be addressed. The ethical implementation of such systems should consist of patient representation on governing boards, transparency, and strict oversight of for-profit users.

PURPOSE: We sought to generate informed and considered opinions regarding acceptable secondary uses of deidentified health information and consent models for oncology learning health care systems. METHODS: Day-long democratic deliberation sessions included 217 patients with cancer at four geographically and sociodemographically diverse sites. Patients completed three surveys (at baseline, immediately after deliberation, and 1-month follow-up). RESULTS: Participants were 67.3% female, 21.7% black, and 6.0% Hispanic. The most notable changes in perceptions after deliberation related to use of deidentified medical-record data by insurance companies. After discussion, 72.3% of participants felt comfortable if the purpose was to make sure patients receive recommended care (v 79.5% at baseline; P = .03); 24.9% felt comfortable if the purpose was to determine eligibility for coverage or reimbursement (v 50.9% at baseline; P < .001). The most notable change about secondary research use related to believing it was important that doctors ask patients at least once whether researchers can use deidentified medical-records data for future research. The proportion endorsing high importance decreased from baseline (82.2%) to 68.7% immediately after discussion (P < .001), and remained decreased at 73.1% (P = .01) at follow-up. At follow-up, non-Hispanic whites were more likely to consider it highly important to be able to conduct medical research with deidentified electronic health records (96.8% v 87.7%; P = .01) and less likely to consider it highly important for doctors to get a patient's permission each time deidentified medical record information is used for research (23.2% v 51.6%; P < .001). CONCLUSION: This research confirms that most patients wish to be asked before deidentified medical records are used for research. Policies designed to realize the potential benefits of learning health care systems can, and should be, grounded in informed and considered public opinion.

The expansion of learning health care systems (LHSs) promises to bolster research and quality improvement endeavors. Stewards of patient data have a duty to respect the preferences of the patients from whom, and for whom, these data are being collected and consolidated. METHODS: We conducted democratic deliberations with a diverse sample of 217 patients treated at 4 sites to assess views about LHSs, using the example of CancerLinQ, a real-world LHS, to stimulate discussion. In small group discussions, participants deliberated about different policies for how to provide information and to seek consent regarding the inclusion of patient data. These discussions were recorded, transcribed, and de-identified for thematic analysis. RESULTS: Of participants, 67% were female, 61% were non-Hispanic Whites, and the mean age was 60 years. Patients' opinions about sharing their data illuminated 2 spectra: trust/distrust and individualism/collectivism. Positions on these spectra influenced the weight placed on 3 priorities: promoting societal altruism, ensuring respect for persons, and protecting themselves. In turn, consideration of these priorities seemed to inform preferences regarding patient choices and system transparency. Most advocated for a policy whereby patients would receive notification and have the opportunity to opt out of including their medical records in the LHS. Participants reasoned that such a policy would balance personal protections and societal welfare. CONCLUSION: System transparency and patient choice are vital if patients are to feel respected and to trust LHS endeavors. Those responsible for LHS implementation should ensure that all patients receive an explanation of their options, together with standardized, understandable, comprehensive materials.