Facing society : A study of identity through head shaping practices among the indigenous peoples of the Caribbean in the ceramic age and colonial period

A mere day after his first footfall in the Americas, Columbus notes the broad foreheads of its inhabitants. These cranial shapes are deliberately created by applying pressure to the infant’s head after birth. Facing Society studies indigenous identities through head shaping practices against the backdrop of broader social developments in Caribbean communities before and after 1492 through a multi-disciplinary approach combining archaeology, (ethno)history, anthropology, and sociology. The first evidence of intentional cranial modification comes from the Early Ceramic Age, however by the Late Ceramic Age it was found across the Caribbean. Different regional patterns emerge in conjunction with diverging social developments. For example, the relatively homogeneous pattern of cranial modification seen in the Greater Antilles indicates a collective identity fostering social cohesion in expanding communities and connecting distant villages within the interaction sphere. The Early Colonial Period was transformative for indigenous communities and identities, and consequently caused a decline in head shaping practices. An unexpected revival was seen among the Black Carib, a community of free African descendants on St. Vincent. Traces of head shaping practices can still be found to this day demonstrating the lasting importance of indigenous social practices in the cultural mosaic of the current Caribbean.Archaeology of the America

Plano de desenvolvimento dum serviço de audiologia clínica. Estudos dos Centros de Saúde no Concelho de Albufeira

Este trabalho teve como objetivo elaborar um Plano de Desenvolvimento do Serviço de Audiologia Clínica nos Centros de Saúde do Concelho de Albufeira, baseado nas informações obtidas através de duas visões distintas, onde uma relaciona-se com a perspetiva do utente e a outra sob a ótica do profissional Médico e Enfermeiro. O processo de desenvolvimento deste trabalho de projeto foi realizado em três fases. Foi iniciado através de pesquisa e revisão bibliográfica que envolveu os temas sobre o Serviço Nacional de Saúde, o envelhecimento humano e o desenvolvimento comunitário. Na segunda fase foi iniciado a aplicação dos inquéritos com os utentes e entrevistas com os profissionais dos Centros de Saúde do Concelho de Albufeira, finalizando com a sua análise. Tendo este trabalho um enfoque sobre as perdas auditivas e por se tratar de um tema que pode abranger vários grupos etários foi dado ênfase as perdas auditivas decorrentes do processo de envelhecimento; ABSTRACT: The main objective of this research aimed to create a plan for the Development of Clinical Audiology Service in the Public Health Centres of the Municipality of Albufeira based on information obtained from two different views, where one relates to the perspective of the general public and the other from the perspective of the professional i.e. Doctors and Nurses. The development process of this project was conducted in three phases. In the first phase through research and literature review involving the themes of the National Health Service, human ageing and community development. The second phase started with the carrying out of surveys and interviews with the general public and with the health professionals of the Health Centers in the Municipality of Albufeira and ending with its analysis. Hearing loss being the main focus of this work, and because this is a subject that can span several age groups, emphasis was made on hearing loss resulting from the ageing process

Portrayal of Shared Decision-Making in Lifetime Documentary Series 'One Born Every Minute'

Background: Pregnant women use childbirth reality programs to prepare themselves for childbirth. It is unknown how shared decision-making in intrapartum midwifery care is represented in televised birth. We aimed to explore the portrayal of shared decision-making during labour and birth in lifetime documentary series One born every minute. Methods: We analysed a total of 41 labour and birth storylines, triangulating deductive and inductive content analysis methods. We described the participants’ personal and birth details. We coded, quantified and organised woman-midwife dialogues and selected the shared-decision making data. Content analysis of shared decision-making fragments was organised following the three-steps of shared decision-making.Results: A first investigation resulted in a classification of: ‘building-a-relationship’ and ‘decision-making’. The decision-making fragments included ‘unilateral decision-making’ and ‘shared decision-making’. 287 shared decision-making fragments were ordered in three themes: 1. Choice talk: Women presented their personal wishes, resonating their awareness of having intrapartum care options. More often, midwives introduced decision-making with implicit referral to the proposal of choices. 2. Option talk: Midwives predominantly provided detailed information of various options and the consequences of these options. 3. Decision talk mainly included the midwife’s support of women’s decisions for which consent was obtained, albeit it in a rather informal way. Choice talk and decision talk most often occurred, sometimes simultaneously. Listing women’s options, exploring her preferences, wishes and values and deliberation of women’s intrapartum choices were underexposed.Conclusion: Shared decision-making is being portrayed as both woman and midwife-initiated. The midwives in this study did not always follow the linear stepwise model but tended to utilise a more fluid transition between choice, option and decision talk. Shared decision-making is facilitated by the relationship between the woman and the midwife during the intrapartum period, requiring evaluation and reflection. Birth partners should not be disregarded in intrapartum shared decision-making processes

Portrayal of Shared Decision-Making in Lifetime Documentary Series 'One Born Every Minute'

Background: Pregnant women use childbirth reality programs to prepare themselves for childbirth. It is unknown how shared decision-making in intrapartum midwifery care is represented in televised birth. We aimed to explore the portrayal of shared decision-making during labour and birth in lifetime documentary series One born every minute. Methods: We analysed a total of 41 labour and birth storylines, triangulating deductive and inductive content analysis methods. We described the participants’ personal and birth details. We coded, quantified and organised woman-midwife dialogues and selected the shared-decision making data. Content analysis of shared decision-making fragments was organised following the three-steps of shared decision-making.Results: A first investigation resulted in a classification of: ‘building-a-relationship’ and ‘decision-making’. The decision-making fragments included ‘unilateral decision-making’ and ‘shared decision-making’. 287 shared decision-making fragments were ordered in three themes: 1. Choice talk: Women presented their personal wishes, resonating their awareness of having intrapartum care options. More often, midwives introduced decision-making with implicit referral to the proposal of choices. 2. Option talk: Midwives predominantly provided detailed information of various options and the consequences of these options. 3. Decision talk mainly included the midwife’s support of women’s decisions for which consent was obtained, albeit it in a rather informal way. Choice talk and decision talk most often occurred, sometimes simultaneously. Listing women’s options, exploring her preferences, wishes and values and deliberation of women’s intrapartum choices were underexposed.Conclusion: Shared decision-making is being portrayed as both woman and midwife-initiated. The midwives in this study did not always follow the linear stepwise model but tended to utilise a more fluid transition between choice, option and decision talk. Shared decision-making is facilitated by the relationship between the woman and the midwife during the intrapartum period, requiring evaluation and reflection. Birth partners should not be disregarded in intrapartum shared decision-making processes

The reliability of the patellotrochlear index on magnetic resonance imaging for measuring patellofemoral height

Background: The purpose of this study was to determine the inter-and intra-observer reliability of the patellotrochlear index (PTI) on magnetic resonance images (MRI) in patients with patellofemoral pain. The correlation between the PTI measured on MRI and the modified Insall-Salvati (MIS) ratio measured on radiographs was also assessed. Methods: The PTI was assessed on MRI images and the MIS ratio on radiographs of 66 knees of 62 patients. Assessment was performed by two orthopaedic surgeons, one orthopaedic surgery registrar, two radiologists and one radiology registrar. Correlation coefficients, standard errors of measurement and limits of agreement were calculated for the PTI. To assess the association between the PTI and the MIS ratio, the Pearson's correlation coefficient was calculated. Results: The PTI showed good interobserver reliability (intraclass correlation coefficient (ICC) 0.79; 95% confidence interval (CI) 0.73-0.85) and excellent intra-observer reliability (ICC 0.90; 95% CI 0.89-0.91). The standard error of measurement was 0.05 and limits of agreement with the mean +/- 0.09. A very weak and not significant correlation was found between the PTI and the MIS (r = 0.02; P = 0.77). Conclusions: The PTI showed good interobserver reliability and excellent intra-observer reliability. In order to conclude which measurement method of assessing patellar height is truly the most reliable, future studies should investigate agreement parameters (standard error of measurement, limits of agreement) besides solely correlation coefficients. We found a very weak correlation between the PTI and the MIS which suggests that at least one index has poor validity. Future validity studies on indices to assess patellar height are necessary. (c) 2021 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)