Decolonising ideas of healing in medical education

The legacy of colonial rule has permeated into all aspects of life and contributed to healthcare inequity. In response to the increased interest in social justice, medical educators are thinking of ways to decolonise education and produce doctors who can meet the complex needs of diverse populations. This paper aims to explore decolonising ideas of healing within medical education following recent events including the University College London Medical School’s Decolonising the Medical Curriculum public engagement event, the Wellcome Collection’s Ayurvedic Man: Encounters with Indian Medicine exhibition and its symposium on Decolonising Health, SOAS University of London’s Applying a Decolonial Lens to Research Structures, Norms and Practices in Higher Education Institutions and University College London Anthropology Department’s Flourishing Diversity Series. We investigate implications of ‘recentring’ displaced indigenous healing systems, medical pluralism and highlight the concept of cultural humility in medical training, which while challenging, may benefit patients. From a global health perspective, climate change debates and associated civil protests around the issues resonate with indigenous ideas of planetary health, which focus on the harmonious interconnection of the planet, the environment and human beings. Finally, we look further at its implications in clinical practice, addressing the background of inequality in healthcare among the BAME (Black, Asian and minority ethnic) populations, intersectionality and an increasing recognition of the role of inter-generational trauma originating from the legacy of slavery. By analysing these theories and conversations that challenge the biomedical view of health, we conclude that encouraging healthcare educators and professionals to adopt a ‘decolonising attitude’ can address the complex power imbalances in health and further improve person-centred care

NON-DESTRUCTIVE EVALUATION OF STRENGTH GAIN OF ORDINARY PORTLAND CEMENT MORTAR BY ULTRASONIC PULSE VELOCITY METHOD

This research is based on the results of the study of ultrasonic pulse velocity and compressive strength of ordinary Portland cement mortar. Objectives of this study are to determine correlations between ultrasonic pulse velocity and compressive strength of cement mortar and to predict strength of cement mortar at 28 days within 02 days using ultrasonic pulse velocity of cement mortar. Ten samples of ordinary Portland cement obtained from ten different sources were used to prepare thirty (30) specimens of cement mortar. Water/cement ratio, sand content, method of specimen preparation, curing conditions were kept constant throughout the experiment. Portable Ultrasonic Nondestructive Digital Indicating Tester with a transducer of 54 kHz frequency was used to measure ultrasonic pulse velocity. Initially ultrasonic pulse velocity of ten samples of cement mortar was measured and compressive strength of same specimens was determined. Then the behavior of ultrasonic pulse velocity with cement hydration was studied. Graphs between ultrasonic pulse velocity and compressive strength of cement mortar, and graphs between ultrasonic pulse velocity and curing time were plotted for ten samples. Correlations obtained from above experiments were used to predict 28 days compressive strength of cement mortar within 02 days. In this research it was found that the relationship between ultrasonic pulse velocity and compressive strength was linear and Lime Saturation Factor of cement also has an influence on this relationship. Further it was seen that, with the increase of curing period, ultrasonic pulse velocity of all samples increased. At the end it was possible to obtain an equation that can predict the cement strength and that equation was verified using another five (05) cement mortar samples

Human rights in childbirth, narratives and restorative justice: a review

This review describes the emerging global debate on the role of human rights childbirth. It is also tailored to a UK perspective in view of the Montgomery v. Lanarkshire [2015] legal ruling and it implications to practice. We can never underestimate the power of humane care on health. The compassion and evidence based medicine agenda in healthcare is interconnected with human rights in healthcare, feeding into the principles of decision making and patient centred care. When this has not happened and there has been healthcare conflict, the power of storytelling serves to connect disparate parties to their common humanity. Narratives are an important aspect of restorative justice processes and we suggest that this could be beneficial in the field of human rights in childbirth

Development and evaluation of a diagnostic cytokine-release assay for Mycobacterium suricattae infection in meerkats (Suricata suricatta)

CITATION: Clarke, C., et al. 2017. Development and evaluation of a diagnostic cytokine-release assay for mycobacterium suricattae infection in meerkats (Suricata suricatta). BMC Veterinary Research, 13:2, doi:10.1186/s12917-016-0927-x.The original publication is available at http://bmcvetres.biomedcentral.comBackground: Sensitive diagnostic tools are necessary for the detection of Mycobacterium suricattae infection in meerkats (Suricata suricatta) in order to more clearly understand the epidemiology of tuberculosis and the ecological consequences of the disease in this species. We therefore aimed to develop a cytokine release assay to measure antigen-specific cell-mediated immune responses of meerkats. Results: Enzyme-linked immunosorbent assays (ELISAs) were evaluated for the detection of interferon-gamma (IFN-γ) and IFN-γ inducible protein 10 (IP-10) in meerkat plasma. An IP-10 ELISA was selected to measure the release of this cytokine in whole blood in response to Bovigam® PC-HP Stimulating Antigen, a commercial peptide pool of M. bovis antigens. Using this protocol, captive meerkats with no known M. suricattae exposure (n = 10) were tested and results were used to define a diagnostic cut off value (mean plus 2 standard deviations). This IP-10 release assay (IPRA) was then evaluated in free-living meerkats with known M. suricattae exposure, categorized as having either a low, moderate or high risk of infection with this pathogen. In each category, respectively, 24.7%, 27.3% and 82.4% of animals tested IPRA-positive. The odds of an animal testing positive was 14.0 times greater for animals with a high risk of M. suricattae infection compared to animals with a low risk. Conclusion: These results support the use of this assay as a measure of M. suricattae exposure in meerkat populations. Ongoing longitudinal studies aim to evaluate the value of the IPRA as a diagnostic test of M. suricattae infection in individual animals.http://bmcvetres.biomedcentral.com/articles/10.1186/s12917-016-0927-xPublisher's versio

The unseen cost of falls: the environmental impact of attending falls call out by the emergency ambulance services

Falls in older people are a major public health problem. This has major consequences to the individual, which can ultimately lead to injury, functional decline, psycho-social impairment and increased risk of mortality. It is also a major burden on healthcare resources. In the United Kingdom (UK), falls account for 3% (about £980 million) of the total National Health Service (NHS) expenditure [1] and the prevention of falls in older people has been highlighted as a priority area [2] and [3]. Older people commonly call out an emergency ambulance following a fall. This group account for 8% of emergency ambulance responses, which is similar to the proportion reported in Australia [4] and an urban Emergency Medical Service system in USA [5]. Transfer of these patients to the emergency department is also high, close to 60% and account for 60,000 of attendances in the UK [6], with similar proportions in the USA [7] and as high as 75% in Australia [4]. Previous studies examining healthcare cost of falls suggest costs of approximately £2000–£3000 per faller, with hospital costs accounting from 50% to 80% of these costs [8] and [9]. Global warming is becoming an increasing concern. In a natural carbon cycle, carbon dioxide is re-absorbed by plants and trees but this excess has now reached dangerous levels not seen in the last 3 million years and has led to an overall rise in atmospheric temperature-global warming. The transportation sector is the second largest source of anthropogenic carbon dioxide emissions. Transporting goods and people around the world produced 22% of fossil fuel related carbon dioxide emissions in 2010. Since the 1990s, transport related emissions have grown rapidly, increasing by 45% in less than 2 decades. Road traffic accounts for 74% of this sector's carbon dioxide emissions. Automobiles, freight and light-duty trucks are the main sources of emissions for the whole transport sector and emissions from these three have steadily grown since 1990 [10]. The NHS itself accounts for 3% of the UK's carbon footprint, which makes it a bigger polluter than some small countries [11]. The direct contribution related to the ambulance service and more specifically to falls is unknown. The aim of this study was to assess the environmental implication of falls in older people who call out an emergency ambulance

Bluecap: A geospatial model to assess regional economic-viability for mineral resource development

© 2020 Frontier mineral exploration is often exclusively focused on assessing geological potential without consideration for the economic viability of resource development. This strategy may overlook potentially prosperous zones for more geologically-favoured but financially-disadvantageous regions, or conversely, may introduce implicit biases against potential developments without due regard to underlying economies of scale or proximity to infrastructure. Accordingly, in this paper, we introduce a numerical model aimed at identifying economic fairways, i.e. areas permissive to mineral development from an economic perspective. The model, Bluecap, combines large-scale infrastructure and geological datasets to conduct geospatial analysis of the economic-viability of mining operations across Australia. We provide a detailed description of the inputs and assumptions that underlie the cost models employed in Bluecap, outlining the methods used to evaluate mining, processing, administrative and infrastructure expenses. We also describe the databases used by the model to evaluate available infrastructure, transportation distances and depth of cover. Finally, we present examples that demonstrate the use of the Bluecap model on regions around Mount Isa and the Murray Basin to verify its ability to evaluate commercially feasible mineral prospects. While the immediate utility of this model stands to benefit mineral explorers, its ability to map mineral economic fairways also provides an objective, evidence base to underpin government decision making with respect to position of new infrastructure and consideration of competing land use claims

Carcinoma-associated fucosylated antigens are markers of the epithelial state and can contribute to cell adhesion through CLEC17A (Prolectin)

International audienceTerminal fucosylated motifs of glycoproteins and glycolipid chains are often altered in cancer cells. We investigated the link between fucosylation changes and critical steps in cancer progression: epithelial-to-mesenchymal transition (EMT) and lymph node metastasis. Using mammary cell lines, we demonstrate that during EMT, expression of some fucosylated antigens (e.g.: Lewis Y) is decreased as a result of repression of the fucosyltransferase genes FUT1 and FUT3. Moreover, we identify the fucose-binding bacterial lectin BC2L-C-Nt as a specific probe for the epithelial state. Prolectin (CLEC17A), a human lectin found on lymph node B cells, shares ligand specificities with BC2L-C-Nt. It binds preferentially to epithelial rather than to mesenchymal cells, and microfluidic experiments showed that prolectin behaves as a cell adhesion molecule for epithelial cells. Comparison of paired primary tumors/ lymph node metastases revealed an increase of prolectin staining in metastasis and high FUT1 and FUT3 mRNA expression was associated with poor prognosis. Our data suggest that tumor cells invading the lymph nodes and expressing fucosylated motifs associated with the epithelial state could use prolectin as a colonization factor

Conceptualising sustainability in UK urban Regeneration: a discursive Formation

Despite the wide usage and popular appeal of the concept of sustainability in UK policy, it does not appear to have challenged the status quo in urban regeneration because policy is not leading in its conceptualisation and therefore implementation. This paper investigates how sustainability has been conceptualised in a case-based research study of the regeneration of Eastside in Birmingham, UK, through policy and other documents, and finds that conceptualisations of sustainability are fundamentally limited. The conceptualisation of sustainability operating within urban regeneration schemes should powerfully shape how they make manifest (or do not) the principles of sustainable development. Documents guide, but people implement regeneration—and the disparate conceptualisations of stakeholders demonstrate even less coherence than policy. The actions towards achieving sustainability have become a policy ‘fix’ in Eastside: a necessary feature of urban policy discourse that is limited to solutions within market-based constraints

The self-deceiving state

Summary While change accelerates in rural conditions in the South, professionalism and bureaucracy are buffered against change. In their top?down mode they produce and promote standard programmes, packages and technologies. Rural development programmes in India for agriculture, canal irrigation, watershed development, and poverty alleviation illustrate how there is a mismatch between such standardization and diverse needs and conditions. This mismatch is underperceived, and status at the cores is sustained, by misleading positive feedback from the peripheries. Falsely favourable impressions and information have five sources: misreporting; selected perception; misleading methods; diplomacy and prudence; and defences against dissonance. Error and myth among the development professions further aggravate the misfit between belief and reality. The costs of the resulting psychosis of the state are colossal. Therapy can be sought through policies and practices which empower poor people: reversals for local diversity; clarifying and communicating people's rights; and personal choices by the powerful. Résumé L'état auto?décepteur Pendant que les changements accélèrent dans les conditions rurales du Sud, le professionnalisme et la bureaucratie sont protégés contre le changement. Dans leur mode haut?bas, elles produisent et encouragent des programmes, des contrats globaux et des technologies standardisés. Les programmes de développement rural en Inde pour l'agriculture, pour l'irrigation, pour le développement des lignes de partage des eaux, et d'allégement de la pauvreté offrent d'amples illustrations du manque d'harmonisation entre cette standardisation et les besoins et les conditions divers. Ce décalage reste peu commenté, et le statut actuel au niveau des défavorisés reste état de maintien en raison des réactions positives mais trompeuses générées en périphérie de ces programmes. Ces impressions favorables mais trompeuses, et ces informations décevantes ont cinq sources: les faux rapports; les perceptions sélectives; les méthodologies erronées; la diplomatie et la prudence; et des défenses contre la dissonance. L'erreur et les mythes au sein de la profession du développement rendent encore pire le décalage entre les croyances et la réalité. Les coûts de la psychose étatique résultante sont colossaux. Les thérapies requises se présenteront par voie des politiques et pratiques qui rendent le pouvoir aux pauvres: par le renversement de la diversité; par la clarification et la communication des droits de l'individu; et par les choix personnels des puissants. Resumen El Estado auto?engañado: Psicosis Y Terapia Mientras los cambios se aceleran en las condiciones rurales en el Sur, el profesionalismo y la burocracia están taponados contra los cambios. En su modalidad ‘de arriba hacia abajo’ producen programas, tecnologías y convenios ‘standard’. En la India, los programas de desarrollo rural para agricultura, canales de irrigación, mejoramientos de cuencas, y mitigación de la pobreza ilustran la discordancia entre esta estandardización, y las diversas necesidades y condiciones. Esta discordancia no se percibe suficientemente, y se mantiene la posición en los núcleos por medio de reacciones positivas engañosas desde la periferia. Estas impresiones e informaciones falsamente favorables provienen de cinco fuentes principales: malinformación, percepción selectiva, métodos engañosos, diplomacia y prudencia, y defensas contra la disonancia. El error y el mito entre las profesiones de desarrollo agravan aun más el desajuste entre creencia y realidad. Para el Estado los costos de la psicosis resultante son colosales. Se puede hallar una terapia a través de criterios y prácticas que den más poder a la gente pobre; cambios de acuerdo a la diversidad local; clarificación y communicación de los derechos del pueblo; y preferencias personales por parte de los poderosos