A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter.

Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a 'now window' of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.

Language phylogenies reveal expansion pulses and pauses in Pacific settlement.

Debates about human prehistory often center on the role that population expansions play in shaping biological and cultural diversity. Hypotheses on the origin of the Austronesian settlers of the Pacific are divided between a recent "pulse-pause" expansion from Taiwan and an older "slow-boat" diffusion from Wallacea. We used lexical data and Bayesian phylogenetic methods to construct a phylogeny of 400 languages. In agreement with the pulse-pause scenario, the language trees place the Austronesian origin in Taiwan approximately 5230 years ago and reveal a series of settlement pauses and expansion pulses linked to technological and social innovations. These results are robust to assumptions about the rooting and calibration of the trees and demonstrate the combined power of linguistic scholarship, database technologies, and computational phylogenetic methods for resolving questions about human prehistory.

Teoria, prática e realidade social: uma perspectiva integrada para o ensino de fisioterapia / Theory, practice and social reality: an integrated perspective to physical therapy education

Este trabalho teve como objetivo refletir sobre as possibilidades de intervenção da fisioterapia na atenção primária à saúde, rompendo com a prática do profissional historicamente centrada em ações curativas. Em geral, os currículos oferecidos pelos cursos de graduação em fisioterapia no país estão muito voltados para práticas hospitalares e ambulatoriais valorizando a reabilitação em detrimento aos novos modelos assistenciais. A atuação do fisioterapeuta não se restringe somente ao campo curativo e de reabilitação. As ações de prevenção e educação em saúde são fundamentais para propiciar a melhora da qualidade de vida da população e as intervenções no atendimento domiciliar podem produzir um impacto positivo na relação do paciente com o meio, tanto físico quanto social. Tendo como proposta a superaão do modelo tradicional de formação de fisioterapeutas, o curso de fisioterapia d aUFMG oferece estágio em Unidades Básicas de Saúde para o aluno do último período do curso. Nessas unidades, o aluno tem a oportunidade de vivenciar um trabalho com profissionais inseridos no Programa de Saúde d Família (PSF). Este trabalho foi desenvolvido no Centro de Saúde São Gabriel (CSSG), no município de Belo Horizonte, onde foi aplicado um protocolo para cadastramento e monitoramento dos usuários impossibilitados de se dirigirem ao Centro de Saúde. Após o levantamento das informações, foram realizadas reuniões com as equipes do PSF e oficinas que possibilitaram aos alunos e supervisor de estágio, refletirem sobre as possibilidades e desafios da intervenção da fisioterapia na atenção primária á saúde

Legal claims in Scottish National Health Service Dermatology Departments 1989-2001.

BACKGROUND: An area of current National Health Service (NHS) interest is risk management as it is one of the requirements of clinical governance. If there are aspects of dermatological practice prone to mishap or dispute then a review of legal claims in dermatology may highlight these areas. This would then allow input into these specific areas of practice to try and minimize future risk. OBJECTIVES: To review all legal claims relating to NHS Dermatology in Scotland and characterize the main areas of risk. METHODS: Staff at the Central Legal Office in Edinburgh reviewed all legal claims in NHS Dermatology between 1989 and 2001. Details provided were general, and claimants, staff, hospitals and regions of Scotland could not be identified. RESULTS: Thirty claims were identified relating to five main areas of dermatological practice: (i) phototherapy (eight claims); (ii) therapeutics (eight); (iii) cryosurgery/cryotherapy (six); (iv) surgery (four); and (v) misdiagnosis (three) and one alleged neurological problem after fainting. As well as consultants, nurses featured in phototherapy claims and junior medical staff in cryosurgery claims. Twelve of the 30 (40%) claims have reached settlement; three claims are presently outstanding. CONCLUSIONS: Given the numbers of patients seen annually at Scottish NHS Hospital Dermatology units the absolute number of claims is low. Five main areas within dermatology were highlighted as at risk of litigation and this has implications for all U.K. dermatology departments with regard to funding, staff training and patient information and consent.

The ovarian phenotype of the aromatase knockout (ArKO) mouse.

Targeted disruption of exon 9 of the cyp19 gene gives rise to a non-functional aromatase enzyme incapable of converting androgens to oestrogens. The aromatase knockout (ArKO) mouse is, thus, characterised by a dysfunctional pituitary-gonadal axis, which manifests in non-detectable levels of oestrogen in serum. These mice also exhibit elevated levels of circulating gonadotrophins (luteinising hormone (LH) and follicle stimulating hormone (FSH)) and testosterone. The ArKO mouse is infertile due to folliculogenic disruption and a failure to ovulate. The age-dependent ovarian phenotype revealed a block in follicular development at the antral stage and a complete absence of corpora lutea. By 21-23 weeks of age haemorrhagic cystic follicles were present and by 1 year there were abnormal follicles, an absence of secondary and antral follicles and atretic primary follicles. Interstitial tissue remodelling was extensive and exemplified by an increase in collagen deposition and an influx of macrophages, coincident with the loss of follicles. In mice, maintained on a soy-free and, thus, phytoestrogen-free diet, the ovarian phenotype was accelerated and exacerbated. In conclusion, the ovarian phenotype of the ArKO mouse can be attributed to the altered hormonal environment brought about by the absence of aromatase and the failure of androgens to be converted to oestrogens in the presence of elevated gonadotropins.

The treatment of visual neglect using feedback of eye movements: a pilot study.

Feedback of eye movements was evaluated as a treatment for visual neglect in right hemisphere stroke patients. Patients with visual neglect identified on the Behavioural Inattention Test (BIT) were randomly allocated to two groups. One group (n = 9) was treated for 2 h 40 min a week for 4 weeks, by wearing glasses which provided a reminder bleep if patients failed to move their eyes to the left in a 15 s interval. The control group (n = 9) received no treatment for their visual inattention. Comparison of the groups after 4 weeks treatment and a further 4 weeks follow-up showed no significant difference either in eye movements or on the BIT. However, there was a trend towards a difference between eye movements in the two groups at 8 weeks, suggesting treatment may have influenced eye movements without changing neglect.

One-shot high-dose pamidronate disodium (APD): effective, simple treatment for hypercalcaemia in haematological malignancy.

Fifteen patients with haematological malignancy and hypercalcaemia (mean +/- SEM calcium 3.44 +/- 0.14 mmol/l) received pamidronate (1 mg/kg) by infusion on 17 occasions (two patients were retreated 2 and 6 months after the first dose). After 4 days the plasma calcium had fallen to 2.84 +/- 0.14 mmol/l (P less than 0.001; n = 17), and in 10/17 episodes was less than 2.6 mmol/l. The mean fall was 0.61 mmol/l (95% confidence intervals 0.49-0.72 mmol/l). By 7 days a further decrease to 2.53 +/- 0.10 mmol/l had occurred, continuing to 2.38 +/- 0.11 mmol/l after 14 days. Plasma phosphate fell from 1.18 +/- 0.16 to 0.74 +/- 0.07 mmol/l at 7 days (P less than 0.001; n = 12). In 9 of the 17 episodes plasma creatinine initially exceeded 120 mumol/l (four of these greater than 300 mumol/l). This did not impair the response to pamidronate and there was no significant change in plasma creatinine following treatment. A single large dose of pamidronate was a simple, well-tolerated and very reliable treatment for hypercalcaemia complicating haematological malignancy, irrespective of renal function.