Supervision and culture: Meetings at thresholds

Counsellors are required to engage in supervision in order to reflect on, reflexively review, and extend their practice. Supervision, then, might be understood as a partnership in which the focus of practitioners and supervisors is on ethical and effective practice with all clients. In Aotearoa/New Zealand, there has recently been interest in the implications for supervision of cultural difference, particularly in terms of the Treaty of Waitangi as a practice metaphor, and when non-Māori practitioners counsel Māori clients. This article offers an account of a qualitative investigation by a group of counsellors/supervisors into their experiences of supervision as cultural partnership. Based on interviews and then using writing-as-research, the article explores the playing out of supervision’s contribution to practitioners’ effective and ethical practice in the context of Aotearoa/New Zealand, showing a range of possible accounts and strategies and discussing their effects. Employing the metaphor of threshold, the article includes a series of reflections and considerations for supervision practice when attention is drawn to difference

Characterization of Ceriporiopsis subvermispora Bicupin Oxalate Oxidase Expressed in Pichia pastoris

Oxalate oxidase (E.C. 1.2.3.4) catalyzes the oxygen-dependent oxidation of oxalate to carbon dioxide in a reaction that is coupled with the formation of hydrogen peroxide. Although there is currently no structural information available for oxalate oxidase fromCeriporiopsis subvermispora (CsOxOx), sequence data and homology modeling indicate that it is the first manganese-containing bicupin enzyme identified that catalyzes this reaction. Interestingly, CsOxOx shares greatest sequence homology with bicupin microbial oxalate decarboxylases (OxDC). We show that CsOxOx activity directly correlates with Mn content and other metals do not appear to be able to support catalysis. EPR spectra indicate that the Mn is present as Mn(II), and are consistent with the coordination environment expected from homology modeling with known X-ray crystal structures of OxDC from Bacillus subtilis. EPR spin-trapping experiments support the existence of an oxalate-derived radical species formed during turnover. Acetate and a number of other small molecule carboxylic acids are competitive inhibitors for oxalate in the CsOxOx catalyzed reaction. The pH dependence of this reaction suggests that the dominant contribution to catalysis comes from the monoprotonated form of oxalate binding to a form of the enzyme in which an active site carboxylic acid residue must be unprotonated

Living clinical guidelines for stroke: Updates, challenges and opportunities

Continued growth in the number of published clinical studies has necessitated changes to the way evidence-based resources such as clinical guidelines are developed and updated. The Australian and New Zealand Clinical Guidelines for Stroke Management (https://informme.org.au/guidelines/clinical-guidelines-for-stroke-management) are based on continual evidence surveillance and timely updates to recommendations as new research is published. In this article, we outline the main updates to recommendations since the guidelines moved into a living mode in 2018, and discuss key challenges and benefits of living guidelines

A cleaner burning biomass-fuelled cookstove intervention to prevent pneumonia in children under 5 years old in rural Malawi (the Cooking and Pneumonia Study): a cluster randomised controlled trial

Medical Research Council, UK Department for International Development, and Wellcome Trust

3 to 12 millimetre studies of dense gas towards the western rim of supernova remnant RX J1713.7-3946

The young X-ray and gamma-ray-bright supernova remnant RXJ1713.7-3946 (SNR G347.3-0.5) is believed to be associated with molecular cores that lie within regions of the most intense TeV emission. Using the Mopra telescope, four of the densest cores were observed using high-critical density tracers such as CS(J=1-0,J=2-1) and its isotopologue counterparts, NH3(1,1) and (2,2) inversion transitions and N2H+(J=1-0) emission, confirming the presence of dense gas >10^4cm^-3 in the region. The mass estimates for Core C range from 40M_{\odot} (from CS(J=1-0)) to 80M_{\odot} (from NH3 and N2H+), an order of magnitude smaller than published mass estimates from CO(J=1-0) observations. We also modelled the energy-dependent diffusion of cosmic-ray protons accelerated by RXJ1713.7-3946 into Core C, approximating the core with average density and magnetic field values. We find that for considerably suppressed diffusion coefficients (factors \chi=10^{-3} down to 10^{-5} the galactic average), low energy cosmic-rays can be prevented from entering the inner core region. Such an effect could lead to characteristic spectral behaviour in the GeV to TeV gamma-ray and multi-keV X-ray fluxes across the core. These features may be measurable with future gamma-ray and multi-keV telescopes offering arcminute or better angular resolution, and can be a novel way to understand the level of cosmic-ray acceleration in RXJ1713.7-3946 and the transport properties of cosmic-rays in the dense molecular cores.Comment: 17 pages, 13 figures and 5 tables. Accepted for publication in MNRAS 2012 February 1

Household air pollution in low- and middle-income countries: health risks and research priorities

Household air pollution (HAP), which results from incomplete combustion of the solid fuels traditionally used for cooking and heating, affects the homes of nearly 3 billion people. It is the leading environmental cause of death and disability worldwide, with highest risks for women and children due to their domestic roles. The high levels of pollutants found in HAP cause a range of diseases, in addition to burns and scalds and injuries or violence experienced during fuel collection. Additionally, household solid fuel use can pose substantive environmental risks, including degradation from fuel gathering as well as climate change from release of both CO2 and short-lived climate forcers, such as black carbon, during combustion. Despite the broad support to find solutions, only a few solid fuel interventions have shown that they might improve health over the long term, especially when implemented at the scale required (Box 1)

Dense Gas Towards the RX J1713.7–3946 Supernova Remnant

We present results from a Mopra 7 mm-wavelength survey that targeted the dense gas-tracing CS(1-0) transition towards the young γ-ray-bright supernova remnant, RX J1713.7–3946 (SNR G 347.3−0.5). In a hadronic γ-ray emission scenario, where cosmic ray (CR) protons interact with gas to produce the observed γ-ray emission, the mass of potential CR target material is an important factor. We summarise newly discovered dense gas components, towards Cores G and L, and Clumps N1, N2, N3, and T1, which have masses of 1 – 104 M ☉. We argue that these components are not likely to contribute significantly to γ-ray emission in a hadronic γ-ray emission scenario. This would be the case if RX J1713.7–3946 were at either the currently favoured distance of ~1 kpc or an alternate distance (as suggested in some previous studies) of ~6 kpc. This survey also targeted the shock-tracing SiO molecule. Although no SiO emission corresponding to the RX J1713.7–3946 shock was observed, vibrationally excited SiO(1-0) maser emission was discovered towards what may be an evolved star. Observations taken 1 yr apart confirmed a transient nature, since the intensity, line-width, and central velocity of SiO(J = 1-0,v = 1,2) emission varied significantly

Self-rated health among Mayan women participating in a randomised intervention trial reducing indoor air pollution in Guatemala

<p>Abstract</p> <p>Background</p> <p>Indoor air pollution (IAP) from solid fuels is a serious health problem in low-income countries that can be alleviated using improved stoves. Although women are the principal users, few studies have investigated the self-assessed impact of the stoves on their health and lives.</p> <p>Methods</p> <p>This study was conducted in rural highland Guatemala, involving 89 intervention and 80 control Mayan Indian young women (mean 27.8 years, SD 7.2). Outcomes were assessed after approximately 18 months use of the new stove. Our objectives were to compare self-rated health and change in health among women participating in a randomised control trial comparing a chimney stove with an open fire, to describe impacts on women's daily lives and their perceptions of how reduced kitchen smoke affects their own and their children's health.</p> <p>Results</p> <p>On intention-to-treat analysis, 52.8% of intervention women reported improvement in health, compared to 23.8% of control women (p < 0.001). Among 84 intervention women who reported reduced kitchen smoke as an important change, 88% linked this to improvement in their own health, particularly for non-respiratory symptoms (for example eye discomfort, headache); 57% linked reduced smoke to improvement in their children's health, particularly sore eyes.</p> <p>Conclusion</p> <p>Women's perception of their health was improved, but although smoke reduction was valued, this was linked mainly with alleviation of non-respiratory symptoms like eye discomfort and headache. More focus on such symptoms may help in promoting demand for improved stoves and cleaner fuels, but education about more severe consequences of IAP exposure is also required.</p

Living clinical guidelines for stroke: updates, challenges and opportunities

Continued growth in the number of published clinical studies has necessitated changes to the way evidence-based resources such as clinical guidelines are developed and updated. The Australian and New Zealand Clinical Guidelines for Stroke Management (https://informme.org.au/guidelines/clinical-guidelines-for-stroke-management) are based on continual evidence surveillance and timely updates to recommendations as new research is published. In this article, we outline the main updates to recommendations since the guidelines moved into a living mode in 2018, and discuss key challenges and benefits of living guidelines

Implementation Science to Accelerate Clean Cooking for Public Health

Clean cooking has emerged as a major concern for global health and development because of the enormous burden of disease caused by traditional cookstoves and fires. The World Health Organization has developed new indoor air quality guidelines that few homes will be able to achieve without replacing traditional methods with modern clean cooking technologies, including fuels and stoves. However, decades of experience with improved stove programs indicate that the challenge of modernizing cooking in impoverished communities includes a complex, multi-sectoral set of problems that require implementation research. The National Institutes of Health, in partnership with several government agencies and the Global Alliance for Clean Cookstoves, has launched the Clean Cooking Implementation Science Network that aims to address this issue. In this article, our focus is on building a knowledge base to accelerate scale-up and sustained use of the cleanest technologies in low- and middle-income countries. Implementation science provides a variety of analytical and planning tools to enhance effectiveness of clinical and public health interventions. These tools are being integrated with a growing body of knowledge and new research projects to yield new methods, consensus tools, and an evidence base to accelerate improvements in health promised by the renewed agenda of clean cooking.Fil: Rosenthal, Joshua. National Institutes Of Health. Fogarty International Center; Estados UnidosFil: Balakrishnan, Kalpana. Sri Ramachandra University; IndiaFil: Bruce, Nigel. University of Liverpool; Reino UnidoFil: Chambers, David. National Institutes of Health. National Cancer Institute; Estados UnidosFil: Graham, Jay. The George Washington University; Estados UnidosFil: Jack, Darby. Columbia University; Estados UnidosFil: Kline, Lydia. National Institutes Of Health. Fogarty International Center; Estados UnidosFil: Masera, Omar Raul. Universidad Nacional Autónoma de México; MéxicoFil: Mehta, Sumi. Global Alliance for Clean Cookstoves; Estados UnidosFil: Mercado, Ilse Ruiz. Universidad Nacional Autónoma de México; MéxicoFil: Neta, Gila. National Institutes of Health. National Cancer Institute; Estados UnidosFil: Pattanayak, Subhrendu. University of Duke; Estados UnidosFil: Puzzolo, Elisa. Global LPG Partnership; Estados UnidosFil: Petach, Helen. U.S. Agency for International Development; Estados UnidosFil: Punturieri, Antonello. National Heart, Lung, and Blood Institute; Estados UnidosFil: Rubinstein, Adolfo Luis. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sage, Michael. Centers for Disease Control and Prevention; Estados UnidosFil: Sturke, Rachel. National Institutes Of Health. Fogarty International Center; Estados UnidosFil: Shankar, Anita. University Johns Hopkins; Estados UnidosFil: Sherr, Kenny. University of Washington; Estados UnidosFil: Smith, Kirk. University of California at Berkeley; Estados UnidosFil: Yadama, Gautam. Washington University in St. Louis; Estados Unido