Not by Word Alone: Cross-cultural Communication between Highlanders and Missionaries (SVD) in the Jimi Valley, Western Highlands, Papua New Guinea

Is communication (especially of complex religious ideas!) between peoples of different cultures possible and if it is, then under what conditions? This is a vexing question in these post-colonial, post-totalitarian times when peoples in various parts of the world express their ethnic, religious and cultural identities in an atmosphere freed from the politics bent on fabrication of the fiction of consensus and unity extending over social border

The Relationship between Energy and Socio-Economic Development in the Southern and Eastern Mediterranean. MEDPRO Technical Report No. 27/February 2013

This report aims to identify, explain and detail the links and interactions in southern and eastern Mediterranean countries (SEMCs) between energy supply and demand and socio-economic development, as well as the potential role of energy supply and demand policies on both. Another related aim is to identify and analyse, in a quantitative and qualitative way, the changing role of energy (both demand and supply) in southern Mediterranean economies, focusing on its positive and negative impact on socio-economic development. This report investigates in particular: o The most important channels through which resource wealth can contribute to or hamper economic and social development in the analysed region; o Mechanisms and channels of relations between energy supply and demand policies and economic and social development. The burdens of energy subsidies and ‘oil syndrome’ are of particular relevance for the region. An integrated socio-economic development and energy policy scenario approach showing the potential benefits and synergies within countries and the region is developed in the final part of the report

A line to heaven : the Gamagai religious imagination

The thesis is an ethnography and interpretation of the Gamagai people's response to the Catholic mission in Rulna, Western Highlands Province, Papua New Guinea. The Gamagai saw the mission the way they viewed their own social universe, i.e. in a holistic manner in which individual conduct and the resultant health or sickness, personal success or defeat were interwoven in mutually reactive relationships with the ghosts and spirits. The Gamagai assumed a degree of responsibility and autonomy for their situation in the world by practicing techniques aimed at enhancing personal assertiveness and slarity of judgement. Their cosmology constituted a totality of meanings able to explain every aspect of experience. The Gamagai thus attempted to assimilate the mission by giving it a place in their world and so in their own terms. The Gamagai perceived the differences between their and the nission's views and attitudes as being the same ones which separated :hem from the modern world they found so appealing. They strove to -hange their own culture, modifying their sociality, their practice of justice and group loyalties. A special problem the Gamagai had to race was the modern was the modern Western rationality in which particularly the issues of health and sickness are divorced from moral ronsiderations and group loyalties. The mission's activities in jenerai were grounded in this rationality. The mission conducted not pnly religious activities by introducing Christian teachings but also issisted in the development of local infrastructure, school, clinic md various successful economic activities, but it benyed the .ntrinsic interrelationship between all these elements, especially the relationship of piousness to sickness or misfortune. In response to this ideological challenge the Gamagai started their own grassroots moral movement in which they combined Christian notions and characters (saints, God, Satan) with their own cosmological imperative of the interdependency of spirit-being with everyday experience and all human activities. They blended the originally opposing values and ethos of the clan and tribe with the elements of Christian teachings. The movement, centred around a big man Kints, achieved a cultural convergence by extending the strict moral code of the clan to the social formation of the tribe as a whole, making it into a basic Christian community. This was in response to the mission's demands. At the same time the movement preserved the consideration central to the traditional system, the inescapable responsibility of the individual conduct even though it, like the behaviour predetermined by the clan's moral code, or influenced by the "bad spirits"(tipokic) f was beyond the scope of individual choice. The Kints movement adopted the notions of God, saints and Satan and imbued them with a power to exercise control over tribes(wo)men's behaviour and fate much in the same manner as the clan ghosts, kur manga rapa, and the bad tipokit spirits had been doing prior to the arrival of the mission . The newly developed powers, encompassing both the original clan and Christian notions, had larger social reference than the traditional spirit beings, concomitant with the transformation and restructuring of the tribal universe of human relationships. A dualistic emphasis on good and bad spirits, tipokai and tipokit, was further articulated in reference to the Gamagai territory which also acquired good (kai) and bad (kit) determinations. The Gamagai, engaged now with powers (God, Saints, Satan) stronger than before, had created more demanding requirements for intratribal moral relationships and as such risked more personal damage. This was so because the transfigured spirit beings had the ability to send on them sickness Required and misfortunes. Simultaneously, the Gamagai had also a sense of their own strength as the whole tribe and so the prospects of bigger than ever assertiveness on the local political scene

Promjene intra-abdominalnog, ilijačno venskog i centralnog venskog tlaka u bolesnika podvrgnutih abdominalnom kirurškom zahvatu zbog velikih tumora debelog crijeva – probno ispitivanje

Changes in intra-abdominal pressure during bowel tumor surgery have not been documented. The purpose of the present study was to analyze changes in intra-abdominal pressure (IAP), central venous pressure (CVP) and iliac venous pressure (IVP) in patients undergoing laparotomy due to large tumor of the bowel. Twenty-one adult patients undergoing elective abdominal surgery were examined. Intra-abdominal pressure, CVP and IVP were measured during anesthesia, surgery and early postoperative period. The mean IAP before anesthesia was 12.76±1.09 mm Hg and mean bowel tumor volume 1550±227.48 mL. Anesthesia induction decreased IAP to 10.52±1.32 mm Hg and excision of intra-peritoneal tumors to 5.24±1.51 mm Hg (49.7%). Ten minutes after anesthesia, IAP increased to 7.47±1.2 mm Hg and one hour after surgery decreased to 6.19±1.43 mm Hg. There was a strong overall correlation between IAP and CVP (P=0.0000; r=0.7779), as well as between IAP and IVP (P=0.0000; r=0.8635). Moreover, IAP correlated with IVP immediately after anesthesia and one hour after anesthesia. In conclusion, induction of anesthesia decreased IAP; excision of large bowel tumors decreased IAP; and IAP strongly correlated with CVP and IVP.Promjene intra-abdominalnog tlaka tijekom operacijskog zahvata zbog crijevnog tumora nisu dokumentirane. Svrha ovoga ispitivanja bila je ispitati promjene intra-abdominalnog tlaka (IAT), centralnog venskog tlaka (CVT) i ilijačno venskog tlaka (IVT) u bolesnika podvrgnutih laparotomiji zbog velikog crijevnog tumora. Ispitan je 21 odrasli bolesnik podvrgnut elektivnoj abdominalnoj kirurgiji. IAT, CVT i IVT mjereni su tijekom anestezije, operacije i ranog poslijeoperacijskog razdoblja. Srednji IAT prije anestezije bio je 12,76±1,09 mm Hg, a srednji volumen crijevnog tumora 1550±227,48 mL. Indukcija anestezije snizila je IAT na 10,52±1,32 mm Hg, a ekscizija intraperitonejskog tumora na 5,24±1,51 mm Hg (49,7%). Deset minuta nakon anestezije IAT se povisio na 7,47±1,2 mm Hg, a jedan sat nakon operacije snizio na 6,19±1,43 mm Hg. Zabilježena je visoka sveukupna korelacija između IAT i CVT (P=0,0000; r=0,7779) te između IAT i IVT (P=0,0000; r=0,8635). Štoviše, IAT je korelirao s IVT odmah nakon anestezije i jedan sat nakon anestezije. U zaključku, indukcijom anestezije snizio se IAT, uklanjanje velikog crijevnog tumora dovelo je do sniženja IAT, te je utvrđena visoka korelacija IAT s CVT i IVT

The use of bio-electrical impedance analysis (BIA) to guide fluid management, resuscitation and deresuscitation in critically ill patients : a bench-to-bedside review

The impact of a positive fluid balance on morbidity and mortality has been well established. However, little is known about how to monitor fluid status and fluid overload. This narrative review summarises the recent literature and discusses the different parameters related to bio-electrical impedance analysis (BIA) and how they might be used to guide fluid management in critically ill patients. Definitions are listed for the different parameters that can be obtained with BIA; these include among others total body water (TBW), intracellular water (ICW), extracellular water (ECW), ECW/ICW ratio and volume excess (VE). BIA allows calculation of body composition and volumes by means of a current going through the body considered as a cylinder. Reproducible measurements can be obtained with tetrapolar electrodes with two current and two detection electrodes placed on hands and feet. Modern devices also apply multiple frequencies, further improving the accuracy and reproducibility of the results. Some pitfalls and conditions are discussed that need to be taken into account for correct BIA interpretation. Although BIA is a simple, noninvasive, rapid, portable, reproducible, and convenient method of measuring body composition and fluid distribution with fewer physical demands than other techniques, it is still unclear whether it is sufficiently accurate for clinical use in critically ill patients. However, the potential clinical applications are numerous. An overview regarding the use of BIA parameters in critically ill patients is given, based on the available literature. BIA seems a promising tool if performed correctly. It is non-invasive and relatively inexpensive and can be performed at bedside, and it does not expose to ionising radiation. Modern devices have very limited between-observer variations, but BIA parameters are population-specific and one must be aware of clinical situations that may interfere with the measurement such as visible oedema, nutritional status, or fluid and salt administration. BIA can help guide fluid management, resuscitation and de-resuscitation. The latter is especially important in patients not progressing spontaneously from the Ebb to the Flow phase of shock. More research is needed in critically ill patients before widespread use of BIA can be suggested in this patient population.The impact of a positive fluid balance on morbidity and mortality has been well established. However, little is known about how to monitor fluid status and fluid overload. This narrative review summarises the recent literature and discusses the different parameters related to bio-electrical impedance analysis (BIA) and how they might be used to guide fluid management in critically ill patients. Definitions are listed for the different parameters that can be obtained with BIA; these include among others total body water (TBW), intracellular water (ICW), extracellular water (ECW), ECW/ICW ratio and volume excess (VE). BIA allows calculation of body composition and volumes by means of a current going through the body considered as a cylinder. Reproducible measurements can be obtained with tetrapolar electrodes with two current and two detection electrodes placed on hands and feet. Modern devices also apply multiple frequencies, further improving the accuracy and reproducibility of the results. Some pitfalls and conditions are discussed that need to be taken into account for correct BIA interpretation. Although BIA is a simple, noninvasive, rapid, portable, reproducible, and convenient method of measuring body composition and fluid distribution with fewer physical demands than other techniques, it is still unclear whether it is sufficiently accurate for clinical use in critically ill patients. However, the potential clinical applications are numerous. An overview regarding the use of BIA parameters in critically ill patients is given, based on the available literature. BIA seems a promising tool if performed correctly. It is non-invasive and relatively inexpensive and can be performed at bedside, and it does not expose to ionising radiation. Modern devices have very limited between-observer variations, but BIA parameters are population-specific and one must be aware of clinical situations that may interfere with the measurement such as visible oedema, nutritional status, or fluid and salt administration. BIA can help guide fluid management, resuscitation and de-resuscitation. The latter is especially important in patients not progressing spontaneously from the Ebb to the Flow phase of shock. More research is needed in critically ill patients before widespread use of BIA can be suggested in this patient population

Perinatal complications associated with neuraxial blocks

Regional techniques are the gold standard of obstetric anaesthesia. In both vaginal and Caesarean section deliveries, neuraxial blocks are the most frequently used methods for relieving pain. Although it provides excellent analgesia, regional anaesthesia is associated with certain adverse side effects and possible complications. In this narrative review, we bring together all available data and create a catalogue of complications resulting from the use of perinatal neuraxial anaesthesia which we divide according to their severity and the duration of their impact on patients’ health. We focus on complications that have significant or long-term consequences. Even though their incidence is low at 1:1600 neuraxial anaesthetics performed, we believe that better understanding of the possible severe problems that can result from regional anaesthesia procedures would enhance the overall safety of patients during labour, delivery, and the postpartum period. Despite the pivotal role neuraxial techniques play in providing anaesthesia for parturients, there is a lack of good quality studies on the incidence of complications. We believe that a thorough assessment of the occurrence of complications should be carried out by analysing data from nationwide medical databases. By analysing the adverse side effects, both qualitatively and quantitatively, we think it possible to further improve the quality of patient care

Plasma magnesium concentration in patients undergoing coronary artery bypass grafting

Introduction Magnesium (Mg) plays a crucial role in cell physiology and its deficiency may cause many disorders which often require intensive treatment. The aim of this study was to analyse some factors affecting preoperative plasma Mg concentration in patients undergoing coronary artery bypass grafting (CABG). Material and Methods Adult patients scheduled for elective CABG with cardio-pulmonary bypass (CPB) under general anaesthesia were studied. Plasma Mg concentration was analysed before surgery in accordance with age, domicile, profession, tobacco smoking and preoperative Mg supplementation. Blood samples were obtained from the radial artery just before the administration of anaesthesia. Results 150 patients were studied. Mean preoperative plasma Mg concentration was 0.93 ± 0.17 mmol/L; mean concentration in patients – 1.02 ± 0.16; preoperative Mg supplementation was significantly higher than in patients without such supplementation. Moreover, intellectual workers supplemented Mg more frequently and had higher plasma Mg concentration than physical workers. Plasma Mg concentration decreases in elderly patients. Patients living in cities, on average, had the highest plasma Mg concentration. Smokers had significantly lower plasma Mg concentration than non-smokers. Conclusions 1. Preoperative magnesium supplementation increases its plasma concentration. 2. Intellectual workers frequently supplement magnesium. 3. Smoking cigarettes decreases plasma magnesium concentration

Elective lung resection increases spatial QRS-T angle and QTc interval

Background: Lung resection changes intra-thoracic anatomy, which may affect electrocardiographic results. While postoperative cardiac arrhythmias have been recognized after lung resection, no study has documented changes in vectorcardiographic variables in patients undergoing this surgery. The purpose of this study was to analyse changes in spatial QRS-T angle (spQRS-T) and corrected QT interval (QTc) after lung resection.Methods: Adult patients undergoing elective lung resection under general anaesthesia were studied. The patients were allocated into four groups: those undergoing (1) left lobectomy (LL); (2) left pneumonectomy (LP); (3) right lobectomy (RL); and (4) right pneumonectomy (RP). The spQRS-T angle and QTc interval were measured one day before surgery (baseline) and 24, 48 and 72 h after surgery.Results: Seventy-one adult patients (47 men and 24 women) aged 47–80 (65 ± 7) years were studied. In the study group as a whole, lung resection was associated with significant increases in spQRS-T (p < 0.001) and QTc (p < 0.05 at 24 and 48 h and p < 0.01 at 72 h). The greatest changes were noted in patients undergoing LP. Postoperative atrial fibrillation (AF) was noted in 6.4% of patients studied, in whom the widest spQRS-T angle and the most prolonged QTc intervals were also noted.Conclusions: Lung resection widens the spQRS-T angle and prolongs the QTc interval, especially in patients undergoing LP. While postoperative AF was a relatively rare complication after lung resection in this study, it was associated with the widest spQRS-T angles and most prolonged QTc intervals

An in vivo model of anti-inflammatory activity of subdural dexamethasone following the spinal cord injury

Current therapies to limit the neural tissue destruction following the spinal cord injury are not effective. Our recent studies indicate that the injury to the white matter of the spinal cord results in a severe inflammatory response where macrophages phagocytize damaged myelin and the fluid-filled cavity of injury extends in size with concurrent and irreversible destruction of the surrounding neural tissue over several months. We previously established that a high dose of 4mg/rat of dexamethasone administered for 1 week via subdural infusion remarkably lowers the numbers of infiltrating macrophages leaving large amounts of un-phagocytized myelin debris and therefore inhibits the severity of inflammation and related tissue destruction. But this dose was potently toxic to the rats. In the present study the lower doses of dexamethasone, 0.125–2.0mg, were administered via the subdural infusion for 2 weeks after an epidural balloon crush of the mid-thoracic spinal cord. The spinal cord cross-sections were analyzed histologically. Levels of dexamethasone used in the current study had no systemic toxic effect and limited phagocytosis of myelin debris by macrophages in the lesion cavity. The subdural infusion with 0.125–2.0mg dexamethasone over 2 week period did not eliminate the inflammatory process indicating the need for a longer period of infusion to do so. However, this treatment has probably lead to inhibition of the tissue destruction by the severe, prolonged inflammatory process