Health cosmopolitanism: melding universality and difference – the case of childbirth in post-conflict Timor Leste

ABSTRACTThis study will consider the case of TBAs (traditional birth attendants) under the health cosmopolitan banner. Fifteen interviews with health administrators, obstetricians, midwives, traditional birth attendants and women in Timor Leste, provide evidence : (1) that the WHO (1992) directive to dismiss the inclusion of TBAs within the formal maternity care system has been precipitous (2) that TBAs could, with adequate training in emergency obstetric techniques and hygienic practices, assist in meeting MDG No 5, and (3) that TBAs may assist in sustaining hybrid cosmologies and serving other cultural aims. Although Millennium Development Goals embrace the idea of the universal right to health, a human rights framework remains abstract and legalistic. I argue that health cosmopolitanism offers a more inclusive lens. Applied to maternity care it shifts childbirth to a central focus of government policy, obliges all nations to contribute international aid yet recognises the interpretation of complex needs at the local level. It defines a philosophy of care that is person-centred (not professional or institution-centred), ensures equal access to quality care (based not on ability to pay or other obstacles such as geographical distance) and choice of carer and modality (Western, traditional or hybrid). It underlines the argument here that TBAs trained in emergency obstetric care and hygiene and funded by international agencies would ensure every woman has a known carer, plus choice of location, modality and provider. Health cosmopolitanism thus embraces universality, individual autonomy, reciprocal respect and global responsibility.

What makes a difference? Building a foundation for nationally consistent outcome measures

This project sought a solid, credible basis for measuring the effectiveness of homelessness services. It assumed that an effective service creates successful results for people experiencing homelessness, results which make a difference. To identify which results, which 'client outcomes', make a difference, the project used the international research evidence base and input from experienced practitioners and policy-makers.

Deconstructing religious identity, difference, and belonging : implications for anti-racist pedagogy

Increasing numbers of Australians identify with a multiplicity of religion groups or have no religious affiliation. Despite this, the representation of religious groups other than Christian—and the implications of this for anti-racist pedagogy in Australian schools—is seldom explored. This article interrogates the ways in which the most prominent of these minority religious groups (Buddhist, Hindu, Muslim, Jewish) were spoken about in two Melbourne newspapers and considers the implications of this interrogation for multicultural pedagogy in globally integrated local school contexts, such as those in Australia. Methodologies of social cultural theory and critical discourse analysis (CDA) are used to investigate newspaper discussions from the different viewpoints of their experiential, systemic, and normative focus. I find that notions of religious identity described in the media are stylized in form and an almost-silent normative self-identity is defined against clichéd typologies made within a crucible of race, identity, and belonging.

A neuropsychological study of prefrontal lobe function in the positive and negative subtypes of schizophrenia.

The symptoms of schizophrenia are frequently divided into positive and negative subtypes. It has been suggested that the negative symptoms are similar to those seen with prefrontal lobe cortical dysfunction. Several neuropsychological investigations of that hypothesis have been carried out, but none have directly compared a negative symptom group with a positive symptom group on the same test battery. In the present study, the Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein, & Opler, 1987) was used to distinguish two groups of 20 patients with schizophrenia with predominant positive or negative symptoms. A battery of 7 neuropsychological tests considered capable of isolating prefrontal lobe dysfunction was administered. A significant group difference was noted on 6 of the tests; the negative symptom group performed much worse than the positive symptom group. The results of this study support the hypothesis that a relationship exists between the negative symptoms of schizophrenia and prefrontal lobe dysfunction.

Promoting a respect for difference through language teaching

An emphasis on developing students’ moral and ethical characteris evident in the 2013 National Indonesian Curriculum. In this article, I lookat how respect for difference is reflected in the 2013 Indonesian NationalCurriculum, specifically referring to the second key competency area forsenior high school English language. I also draw reference from academicliterature that can be linked to this competency area of the English curriculum.Exploring theoretical links from the literature is useful to develop adeeper understanding of the importance of this key competency area. Discussionexplores the significance of respect for difference and the importantrole that English language teachers in Indonesia can play in promoting tolerance.By understanding how culture can be used as a divisive force, we canmore readily identify how teachers can develop a respect for difference intheir students to help overcome intolerant attitudes that can lead to discrimination.

Physical education teacher training in fundamental movement skills makes a difference to instruction and assessment practices

The purpose of this study was to investigate instruction and assessment of fundamental movement skills (FMSs) by Physical Education (PE) teachers of Year 7 girls. Of 168 secondary school PE teachers, many had received little FMSs professional development, and although most assessed student FMSs proficiency, the quality of assessment was variable. Neither years of experience nor confidence influenced the quality of assessment tools used; however, greater FMSs training improved assessment practice regularity. Teachers more recently out of preservice were more confident in demonstrating FMSs. The results suggest that FMSs education for teachers should be a priority inclusion in both the training of preservice teachers and the ongoing professional development of in-service teachers.

Nearshore-offshore-basin species diversity and body size variation patterns in Late Permian (Changhsingian) brachiopods

 B.V. Body size is a fundamental and defining character of an organism, and its variation in space and time is generally considered to be a function of its biology and interactions with its living environment. A great deal of body size related ecological and evolutionary research has been undertaken, mostly in relation to extant animals. Among the many body size-related hypotheses proposed and tested, the size-bathymetry relationship is probably the least studied. In this study, we compiled a global body size dataset of Changhsingian (Late Permian, ca. 254. Ma-252. Ma) brachiopod species from low-latitude areas (30°S-30°N) and analyzed their species diversity and body size distribution patterns in relation to the nearshore-offshore-basin bathymetric gradient. The dataset contained 1768 brachiopod specimens in 435 species referred to 159 genera and 9 orders, from 135 occurrences (localities) of 18 different palaeogeographic regions. Treating the whole of the Changhsingian Stage as a single time slice, we divided the nearshore-offshore-basin bathymetric gradient into three broad depth-related environments: nearshore, offshore and basinal environments, and compared how the species diversity and body size varied along this large-scale bathymetric gradient.Here, we report an array of complex patterns. First, we found a clear overall inverse correlation between species diversity and water depth along the nearshore-offshore-basin gradient, with most species concentrating in the nearshore environment. Second, when the median sizes of all low-latitude brachiopod species from the three environments were compared, we found that there was no significant size difference between the nearshore and offshore environments, suggesting that neither the wave base nor the hydrostatic pressure exerts a critical influence on the body size of brachiopods. On the other hand, the median sizes of brachiopods from the nearshore environment and, to a lesser extent, the offshore environment were found to be significantly larger than that of basinal brachiopods. This trend of significant size reduction in basinal brachiopods mirrors the relative low species diversity in the basinal environment, and neither can be easily explained by the tendency of decreasing food availability towards deeper sea environments. Rather, both trends are consistent with the hypothesis of an expanding Oxygen Minimum Zone (OMZ) in the bathyal (slope to deepsea) environments, where hypoxic to anoxic conditions are considered to have severely restricted the diversification of benthos and favored the relative proliferation of small-sized brachiopods. Finally, a significant difference was also found between eurybathic and stenobathic species in their body size response to the nearshore-offshore-basin gradient, in that eurybathic species (species found in all three environments) did not tend to change their body size significantly according to depth, whereas stenobathic forms (species restricted to a single environment) exhibit a decline in body size towards the basinal environment. This pattern is interpreted to suggest that bathymetrically more tolerant species are less sensitive to depth control with respect to their body size change dynamics, in contrast to stenobathic species which tend to grow larger in shallower water depths.

Revisiting the mediating role of trust in transformational leadership effects: Do different types of trust make a difference?

This study examines the mediating effects of cognitive and affective trust on the relationship between follower perceptions of transformational leadership behavior and their work outcomes. Using data obtained from 318 supervisor-subordinate dyads from a manufacturing organization located in mainland China, structural equation modeling results revealed that affective trust fully mediated the relationships between transformational leadership and the work outcomes of followers, including their affective organizational commitment, organizational citizenship behaviors (OCBs), and job performance. In contrast, cognitive trust negatively mediated the relationship between transformational leadership and follower job performance, and had insignificant effects on their affective organizational commitment and organizational citizenship behaviors. These findings highlight the importance of affective trust as a mechanism which translates transformational leadership into positive work outcomes for the organization. © 2012 Elsevier Inc.

Pharmacological interventions for self-harm in adults

Background
Self-harm (SH; intentional self-poisoning or self-injury) is common, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for deliberate SH, first published in 1998 and previously updated in 1999. We have now divided the review in to three separate reviews. This review is focused on pharmacological interventions in adults who self harm.
Objectives
To identify all randomised controlled trials of pharmacological agents or natural products for SH in adults, and to conduct meta-analyses (where possible) to compare the effects of specific treatments with comparison types of treatment (e.g., placebo/alternative pharmacological treatment) for SH patients.
Search methods
For this update the Cochrane Depression, Anxiety and Neurosis Review Group (CCDAN) Trials Search Co-ordinator searched the CCDAN Specialised Register (September 2014). Additional searches of MEDLINE, EMBASE, PsycINFO, and CENTRAL were conducted to October 2013.
Selection criteria
We included randomised controlled trials comparing pharmacological treatments or natural products with placebo/alternative pharmacological treatment in individuals with a recent (within six months) episode of SH resulting in presentation to clinical services.
Data collection and analysis
We independently selected trials, extracted data, and appraised trial quality. For binary outcomes, we calculated odds ratios (ORs) and their 95% confidence intervals (CIs). For continuous outcomes we calculated the mean difference (MD) and 95% CI. Meta-analysis was only possible for one intervention (i.e. newer generation antidepressants) on repetition of SH at last follow-up. For this analysis, we pooled data using a random-effects model. The overall quality of evidence for the primary outcome was appraised for each intervention using the GRADE approach.
Main results
We included seven trials with a total of 546 patients. The largest trial included 167 participants. We found no significant treatment effect on repetition of SH for newer generation antidepressants (n = 243; k = 3; OR 0.76, 95% CI 0.42 to 1.36; GRADE: low quality of evidence), low-dose fluphenazine (n = 53; k = 1; OR 1.51, 95% CI 0. 50 to 4.58; GRADE: very low quality of evidence), mood stabilisers (n = 167; k = 1; OR 0.99, 95% CI 0.33 to 2.95; GRADE: low quality of evidence), or natural products (n = 49; k = 1; OR 1.33, 95% CI 0.38 to 4.62; GRADE: low quality of evidence). A significant reduction in SH repetition was found in a single trial of the antipsychotic flupenthixol (n = 30; k = 1; OR 0.09, 95% CI 0.02 to 0.50), although the quality of evidence for this trial, according to the GRADE criteria, was very low. No data on adverse effects, other than the planned outcomes relating to suicidal behaviour, were reported.
Authors’ conclusions
Given the low or very low quality of the available evidence, and the small number of trials identified, it is not possible to make firm conclusions regarding pharmacological interventions in SH patients. More and larger trials of pharmacotherapy are required. In view of an indication of positive benefit for flupenthixol in an early small trial of low quality, these might include evaluation of newer atypical antipsychotics. Further work should include evaluation of adverse effects of pharmacological agents. Other research could include evaluation of combined pharmacotherapy and psychological treatment.

The effect of fibrous structural difference on thermal insulation properties of biological composites: silkworm cocoons

As a biological fibrous structure, silkworm cocoon provides multiple protective functionalities to safeguard the silk moth pupa’s metabolic activity. The mechanism of this protection could be adopted in clothing manufacture to provide more comfortable apparel. In this study, the thermal insulation properties of both domestic Bombyx mori (B. mori) and wild Antheraea pernyi (A. pernyi) cocoons were investigated under both warm and cold environmental conditions. Computational fluid dynamics models have been developed to simulate the heat transfer process through both types of cocoon wall structures. The simulation results show that the wild A. pernyi cocoon reduces the intensity of convection and heat flux between the environment and the cocoon interior and has higher wind resistance than its domestic counterpart. Compared with A. pernyi cocoon, the B. mori cocoon facilitates easy air transfer and decreases the temperature lag when the surrounding conditions are changed. The new knowledge has significant implications for developing biomimetic thermal functional materials.

Cost-effectiveness of recruitment methods in a population-based epidemiological study: the Melbourne Visual Impairment Project

The cost-effectiveness of five recruitment methods was evaluated to determine the best method of encouraging eligible persons to participate in the Melbourne Visual Impairment Project (a population-based epidemiological study). The evaluation was divided into two phases. Phase 1 included one of two types of initial contact, by direct personal contact or by telephone. Phase 2 involved recruiting residents after an attempt had been made by either the telephone or the doorstep approach, and included a second attempt by a field interviewer, subsequent attempts by senior field staff, and finally, financial incentives. The cost-effectiveness of each method was determined by dividing the approach's cost by the effectiveness ratio. We identified 269 eligible households with 356 eligible residents. An 89 per cent response rate was achieved at the examination centre, comprising 61 per cent from Phase 1 and 28 per cent from Phase 2. Although both recruitment methods in Phase 1 were equally cost-effective, there was a significant difference in the effectiveness of each method in actually recruiting residents. The doorstep method was more costly per attender but was far more effective at 76 per cent recruitment than the telephone method at 47 per cent (P < 0.001). We have demonstrated a practical two-stage approach (the doorstep method in Phase 1 and follow-up strategies in Phase 2) to population-based recruitment involving the middle to elderly age group that should be relevant to many epidemiological studies.