cis-3-(tert-Butoxy­carbonyl­amino)cyclo­hexa­necarboxylic acid

The title compound, C12H21NO4, a γ-aminobutyric acid derivative, crystallizes with two mol­ecules in the asymmetric unit. The crystal structure is stabilized by inter­molecular N—H⋯O and O—H⋯O hydrogen bonds, forming a strand. An intramolecular N—H⋯O hydrogen bond is also observed

The influence of the Milan approach—Part 2. The legacy of Boscolo and Cecchin and their Paduan connection: A conversation with Andrea Mosconi

The Milan approach, pioneered by Selvini-Palazzoli, Boscolo, Cecchin, and Prata, has significantly contributed to the field of psychotherapy, particularly in the realm of systemic and family psychotherapy. While rooted in systemic principles and concepts, over time the original Milan group demonstrated differences in their clinical orientations and practices which led to their regrouping into two teams. The paper explores the divergences in their views and directions on family dynamics and the role of symptoms within the system. It delves into the influence of Boscolo and Cecchin, two of the ‘Milan Four’ on the Centro Padovano di Terapia della Famiglia. Drawing from a conversation with Andrea Mosconi, a mentee and collaborator of Boscolo and Cecchin, the paper examines the reconfiguration of the original ‘Milan Four’ team and its impact on their clinical approach. Key Milan principles and concepts such as hypothesising, circularity, and neutrality are examined with particular emphasis on the work of Boscolo and Cecchin\u27s systemic work. These principles, intertwined and interconnected, provide a fertile ground for the construction of multiple hypotheses and circular questioning. The paper also highlights the concept of reflexivity, which originates from Bateson\u27s work and plays a crucial role in family relations and communication while explaining the birthplace of paradox taking place when two levels of meaning are ‘confused.’ The Milan approach continues to be highly regarded, as its early concepts and ideas have evolved and left a lasting impact on the field of family therapy. By reflecting on the distinct contributions of Boscolo and Cecchin, and using examples, Mosconi offers valuable insights into the rich legacy and ongoing relevance of the Milan approach to contemporary therapeutic practice

La metafora: The power of metaphors and creative resources in working systemically with families and children with autism—A conversation with Carmine Saccu

Metaphors are valuable tools of expression, which give meaning to situations and allow the spontaneous processing of feelings and emotions. As therapists, we can support clients to develop and create their individual metaphor to explain their own meaning of experiences or communicate their perception of problems. Creativity provides us with a rich landscape to explore, expand, and enrich ourselves as therapists and consequently our clients. As systemic therapists, we are responsible for the co-creation of a human process, which has at its core safety in allowing expression, connection, and movement. Through a respectful and curious approach, we can develop pathways to tap organically into our ‘creative selves’ while reaching into our clients\u27 creativity and selves as catalysts for connection and positive change. Creative resources and therapies have been successfully used in psychotherapy to enhance the mental and emotional well-being of children, particularly children with autism who have limited verbal capacity or who are non-verbal. These children also wish to be understood in expressing their thoughts and feelings; however, they use other methods of communication – sometimes obvious, sometimes not. Therefore, it is important that a therapist can access diverse ways to support the child through this process. The creative use of animals in therapy neutralises spaces, eliciting calm, safety, and healing. This is particularly the case when working with this group of children. This paper is derived from my conversation with an elder statesman of the family therapy profession, Professor Carmine Saccu. He is a jovial master storyteller who craftfully communicates via metaphors. Through creative means, play, and humour, he has developed a remarkably unique way of working with children, especially non-verbal children with autism. He uses his canine, co-therapist Mafalda, as a powerful resource and intervention strategy to safely elicit engagement and connection in the therapeutic space

Economic Viability of the Use of Local Pseudo-Oils for Drilling Fluid Formulation

The initial cost of formulating Synthetic Base Muds (SBM) compared to conventional Oil Base Muds (OBM) may be doubled but after considering the cost of containment, hauling, and disposal of OBM after use, the cost of using SBM becomes relatively cheaper. The formulation and disposal options (onshore and offshore) and the cost benefit of using seven local antioxidated pseudo-oils (vegetable esters) SBM compared to commercial OBM at an average offshore and onshore temperature operations were simulated in this work using API standard performance benchmarks. The average cost percent of savings on the use of the seven local vegetable oils over the use of commercial synthetic base fluid offshore and onshore were 48.32% and 56.30% respectively. Thus the use of local ester oils for drilling fluids formulation are more economical compared to currently imported oil based drilling fluids. The cultivation and production of these local pseudo-oils are on the increase guaranteeing its adoption and application to be very sustainable.Keywords: Antioxidants, Disposals, Economics, Esters, Formulation

RESEARCH IN THE FIELD OF MEDICINE THAT ELICIT LEGISLATIVE CHANGES IN THE HEALTH BUDGET

Regarding the psychological factors as etiologic agents that trigger the somatic diseases has gained more and more ground in the past few years, successfully repeating that the human being is a bio-psycho-social entity. In order to render the psychological interventions more efficient for the management of the diabetes mellitus diseases, we must detect and modify those configurations of the early maladaptive schemes and coping styles that stick together in the so-called acquired vulnerability which makes the person liable to an inappropriate reaction against stress

How does a practice-based research network facilitate evidence-informed practice within the chiropractic profession in Australia? A commentary

This commentary summarises the background, rationale, structure and context of Practice-Based Research Networks (PBRNs) with an emphasis on chiropractic within the Australian health care setting. Following an overview of the importance and value of research based within practice-based settings and a summary of international developments in chiropractic PBRN’s there is a brief description of the genesis, construction and implementation of the Australian Chiropractic Research Network (ACORN) project. The role of the ACORN PBRN is to help facilitate the development and promotion of a research agenda; improve the uptake of best clinical practice; address issues relevant to chiropractors and their patients; and build research capacity and output for the Australian chiropractic profession. The commentary identifies how the chiropractic profession in Australia is already starting to see the tangible results from the establishment of the ACORN PBRN

One service, many voices: enhancing consumer participation in a primary health service for multicultural women

Background: Consumer participation in primary health care is important in providing quality consumer-focused care but challenging when working with disadvantaged groups of diverse cultural and linguistic backgrounds. Women's Health Services (WHS) works with women from over sixty different nationalities, including many newly arrived migrants and refugees. New arrivals access a wide range of WHS programs including medical services, counselling, information, community talks and workshops, referral, and outreach, but few ethnic women attended the alcohol and other drug (AOD) services offered by the organisation.Aim: To establish an active consumer reference group to assist understanding and reducing the barriers to AOD services for a heterogeneous disadvantaged group that includes individuals from different cultural, language and educational backgrounds. Results: Leaning heavily on experiences from the mental health field, WHS overcame many practical and philosophical considerations which included: agreeing upon the purpose of the group and how it would operate within the structure of the organisation; the level of English language required by participants for the group to function; issues of resourcing the group; and ensuring an appropriate, workable demographic mix in terms of age, language, and migration experiences. Conclusion: The process and the outcome of establishing a Consumer Reference Group (CRG) in a primary health care setting has been valuable for consumers and health service providers within the organisation

Stepped vitrification technique for human ovarian tissue cryopreservation

The advantage of stepped vitrification (SV) is avoiding ice crystal nucleation, while decreasing the toxic effects of high cryoprotectant concentrations. We aimed to test this method for human ovarian tissue cryopreservation. Ovarian cortex was taken from 7 fertile adult women. Samples were subjected to an SV protocol performed in an automatic freezer, which allowed sample transfer to ever higher concentrations of dimethyl sulfoxide (DMSO) as the temperature was reduced. Histological evaluation of the vitrified-warmed tissue showed large numbers of degenerated follicles after 24 hours of in vitro culture. We therefore evaluated DMSO perfusion rates by X-ray computed tomography, ice crystal formation by freeze-substitution, and cell toxicity by transmission electron microscopy, seeking possible reasons why follicles degenerated. Although cryoprotectant perfusion was considered normal and no ice crystals were formed in the tissue, ultrastructural analysis detected typical signs of DMSO toxicity, such as mitochondria degeneration, alterations in chromatin condensation, cell vacuolization and extracellular matrix swelling in both stromal and follicular cells. The findings indicated that the method failed to preserve follicles due to the high concentrations of DMSO used. However, adaptations can be made to avoid toxicity to follicles caused by elevated levels of cryoprotectants.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) 2016/22947-

The use of nutritional guidance within chiropractic patient management: A survey of 333 chiropractors from the ACORN practice-based research network

© 2018 The Author(s). Background: Food consumption and nutritional status affect an individual's health throughout their life-course and an unhealthy diet is a major risk factor for the current global burden of chronic disease. The promotion of health and good nutrition through healthy eating requires the active involvement of all health professionals including chiropractors. This paper reports findings from the first nationally representative examination of the use of nutritional guidance within chiropractic patient management in Australia. Methods: A sample of 1000 practising chiropractors was randomly selected from the Australian Chiropractic Research Network (ACORN) practice-based research network database for a cross-sectional study and 33% participated in the online survey in November 2016. The questionnaire, based on previous designs used in similar surveys and nutrition resources developed by the National Health and Medical Research Council, was pretested prior to the survey. Pearson's Chi square and bivariate logistic regression were undertaken to explore relationships with variables of interest. Results: The demographic details of the respondents are similar to those of the chiropractic workforce registered in Australia. Most chiropractors provided nutritional advice as part of their patient care and around a quarter provided specific dietary advice to their patients, including the use of nutrition supplements. Nutrition-related conditions most commonly encountered by the chiropractors were musculoskeletal, usually inflammatory in origin. Common nutritional assessment methods used included questioning patients to assess their nutritional and health status and physical appearance. Most of the participants provided nutritional resources to their patients in their clinics. However, the Australian Dietary Guidelines and the accompanying Australian Guide to Healthy Eating were not well utilised by the respondents. Australian chiropractors often referred patients with nutrition issues to qualified dietitians and other health professionals when deemed necessary. Conclusions: Australian chiropractors regularly provide nutritional advice and appear to acknowledge the importance of nutrition in their clinical practice especially for patients presenting with chronic disease. If chiropractors are to fulfil their potential in providing such wider public health and preventative health advice to patients, further research examining the utilisation of evidence-based nutrition resources within chiropractic patient management is recommended