Can a professional development workshop with follow-up alter practitioner behaviour and outcomes for neck pain patients? A randomised controlled trial

Background: Continuing professional development (CPD) is a fundamental component of physiotherapy practice. Follow-up sessions provide opportunity for the refinement of skills developed during CPD workshops. However, it is necessary to identify if such opportunity translates to improved physiotherapist performance and patient outcomes

Foxes and hedgehogs in Canada

Indigenous rights under the government of Stephen Harper

And hast thou slain the Jabberwock?

Aboriginal myths for white voter

Paleo-Environment and C-14 Dating: The Key to the Depositional Age of the Tha Chang and Related Sand Pits, Northeastern Thailand

Tha Chang sand pits, Nakhon Ratchasima Province and many other sand pits in the area adjacent to the Mun River are characterized by their fluviatile environment in association with mass wasting deposits, along the paleo-river channel and the flood plain of the Mun River. Sediments of these deposits are characterized by clasts of various rock types especially the resistant ones with frequent big tree trunks, logs and wood fragments in different sizes and various stages of transformation from moldering stage to lignification and petrification. Widespread pyritization of the lower horizon suggests strongly reducing environment during burial. The Tha Chang deposits have been received much attention from geoscientists especially paleontologist communities, as they contain fragments of some distinct vertebrate species such as Stegadon sp., hominoid primate, rhinoceros Aceratherium and others. Based on the associated mammal fauna and hominoid fossils, the late Miocene ( 9 - 6 Ma) was given for the time of deposition of this sand and gravel unit. Some other reports believed that sediments and materials of these sand and gravel quarries (pits) were deposited by high-energy flood pulses contemporaneous with the tektites forming event during mid-Pleistocene at c. 0.8 Ma. Interpretation from Palynostratigraphical study suggested that the lower horizon of Tha Chang sand pit was deposited during Pliocene/Pleistocene period and the upper horizons are Pleistoncene/Holocene. It is crystal clear that all the fluviatile sediments including tektites and almost all fossil fragments being deposited in these sand pits were, likely a multiple times reworked materials. Only some old bamboo trees, some old crowling trees and fossils grasses observed on the old river bank are considered in situ. C-14 dating of 5 old wood specimens from Tha Chang Sand Pits, 15 old wood specimens from Chumpuang Sand Pits and one sample of old pottery from a Chumpuang Sand Pit were carried out in the NSF- Arizona AMS Laboratory. Although, there is no sharp boundary between the unconsolidated sedimentary horizons in the pits, C-14 ages obtained from the Tha Chang vary from 34,340 BP at the middle horizon (approx 10 m below ground zero) to >49,900 BP at the lower horizon with unknown basal formation (highly pyritized zone approx 20 - 25 m below ground zero). The ages for the Chumpuang vary from 41,700 BP, >45,900 BP and >49,900 BP from the upper most to the lower most of a broad horizon (approx 8 m to approx 12 m below ground zero). The C-14 age of the pottery collected from layer approximately 5 m below ground zero is 2,514 BP. The nature of fluviatile together with occasional mass wasting characteristics of all sand pits studies suggest the relatively faster depositional rate of the lower horizon which involved more flooding and mass wasting deposits than those of the upper horizons. The apparent of some mixing of the wood ages may indicate reworking and lag deposits nature of the area. The depositional rate of the upper most sand and soil horizon (5 m thick) is approximately 1 m per 500 years which mean both erosion and deposition had played a significant role during that time period. In term of the true age of the formation, we argue that since most of the materials deposited are reworked materials, all ages obtained from fossil fragments could not be the age of sand and gravel formation. Furthermore, the maximum age of all the tektite bearing horizons cannot be older than 0.8 Ma. The oldest C-14 age of 49,900 BP is interpreted as the minimum age of the Tha Chang and related sand pits formation when geomorphology of the area was a lot more hilly and much higher gradient than that of the present day

Interventions for Indigenous Peoples making health decisions: a systematic review

Background: Shared decision-making facilitates collaboration between patients and health care providers for informed health decisions. Our review identified interventions to support Indigenous Peoples making health decisions. The objectives were to synthesize evidence and identify factors that impact the use of shared decision making interventions. Methods: An Inuit and non-Inuit team of service providers and academic researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to organize and describe the shared decision making processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a comprehensive search of electronic databases from September 2012 to March 2022, with a grey literature search. Two independent team members screened and quality appraised included studies for strengths and relevance of studies’ contributions to shared decision making and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework and reported using guidelines to ensure transparency and completeness in reporting and for equity-oriented systematic reviews. Results: Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: those inclusive of Indigenous knowledges and governance (“Indigenous-oriented”)(n = 6); and those based on Western academic knowledge and governance (“Western-oriented”)(n = 3). The studies were found to be of variable quality for contributions to shared decision making and self-determination, with Indigenous-oriented studies of higher quality overall than Western-oriented studies. Four themes are reflected in an updated conceptual framework: 1) where shared decision making takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in shared decision making processes, 3) community is a partner in shared decision making, 4) the shared decision making process involves trust-building. Conclusions: There are few studies that report on and evaluate shared decision making interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to shared decision making for Indigenous Peoples, while Western-oriented studies distanced shared decision making from the health care settings. Further studies that are solutions-focused and support Indigenous self-determination are needed

Cosmogenic C-14 in Antarctic and non-Antarctic meteorites and lunar samples

We were able to develop measurements of C-14 in meteorites as a useful tool for estimates of terrestrial age. Prior to this accomplishment, only a few measurements of C-14 terrestrial ages had been made. The sample sizes were larger, and there had been no systematic study of the various parameters affecting production of C-14, such as depth dependence, and the production cross sections for C-14 from spallation amounted to a few data points. Presently, C-14 ages are an accepted terrestrial age estimate in the meteorite community, whereas before this work the few data available were difficult to interpret. We have obtained terrestrial ages not only on groups of meteorites from different geographic areas but also information on unique meteorites from particularly interesting groups, such as meteorites originating from the Moon, or SNC meteorites, which many researchers believe are derived from Mars

Solar control of Southwest monsoon on centennial timescales

Solar forcing is proposed to be a major governing factor for the southwest monsoon (SWM) strength during the Holocene. The southeastern Arabian Sea is significantly affected by monsoon run-off and is an ideal testing ground. We analysed stable oxygen isotopic composition (δ18O) of three species of planktonic foraminifera (Globigerinoides ruber, Gs. sacculifer and Globarotalia menardii) with high time-resolution (~50 yrs) in a sediment core raised from the region, and documented past variations in SWM precipitation. High-resolution isotopic and spectral analyses show that solar forcing indeed played a major role in governing the past variations in SWM precipitation on centennial timescales

Prescribing for the management of venous leg ulceration

Venous leg ulceration affects a large proportion of the elderly population and can have a profound impact on quality of life. Most patients with leg ulcers receive care from community nurses who are principally responsible for prescribing decisions in the management of venous leg ulceration. There is evidence to support the use of potable tap water for cleansing. Evidence supports the use of compression bandaging or compression hosiery for all patients with adequate arterial supply to the lower leg. There is also good evidence to support the prescription of oral pentoxifylline, preferably as an adjunct to compression or, for patients unable to tolerate compression, as a stand-alone therapy. The evidence base for dressings is less robust, but simple low-cost, low-adherent dressings are a reasonable first-line choice for under-compression

Transdisciplinary working to shape systematic reviews and interpret the findings: Commentary

This is the final version. Available from BMC via the DOI in this record. Important policy questions tend to span a range of academic disciplines, and the relevant research is often carried out in a variety of social, economic and geographic contexts. In efforts to synthesise research to help inform decisions arising from the policy questions, systematic reviews need conceptual frameworks and ways of thinking that combine knowledge drawn from different academic traditions and contexts; in other words, transdisciplinary research. This paper considers how transdisciplinary working can be achieved with: conceptual frameworks that span traditional academic boundaries; methods for shaping review questions and conceptual frameworks; and methods for interpreting the relevance of findings to different contexts. It also discusses the practical challenges and ultimate benefits of transdisciplinary working for systematic reviews.World Health OrganizationUK Department for International DevelopmentUK aidNational Institute for Health Research (NIHR