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This discursive paper provides a call to action from an international collective of Indigenous nurse academics from Australia, Canada, Aotearoa New Zealand and the USA, for nurses to be allies in supporting policies and resources necessary to equitably promote Indigenous health outcomes.
Indigenous Peoples with experiences of colonisation have poorer health compared to other groups, as health systems have failed to address their needs and preferences. Achieving health equity will require leadership from Indigenous nurses to develop and implement new systems of care delivery. However, little is known about how Indigenous nurses influence health systems as levers for change.
A Kaupapa Māori case study design.
Using a Kaupapa Māori case study methodology, coupled with expert Indigenous nursing knowledge, we developed a consensus on key themes. Themes were derived from three questions posed across the four countries. Themes were collated to illustrate how Indigenous nurses have provided nursing leadershipurse leaders around the world is essential for improving models of healthcare delivery and health outcomes for Indigenous Peoples.
To (i) characterise prevalence of distress amongst people diagnosed with cancer, (ii) determine factors associated with increasing distress, (iii) describe reported problems for those with clinically significant distress and (iv) investigate the factors associated with referral to support services.
International studies report a high prevalence of clinically significant distress in people with cancer. Australian studies are notably lacking. Additionally, clinicians still do not fully understand the factors associated with cancer-related distress.
Period prevalence study.
Distress screening data were analysed for 1,071 people accessing the Cancer Council Western Australia information and support line between 01/01/2016-31/12/2018. These data included people's demographics, cancer diagnoses, level of distress, reported problems and the service to which they were referred. Distress and reported problems were measured using the National Comprehensive Cancer Network Distress Thermometer and Problem List. A may be more influential to referral decisions.
Not all factors associated with referral to support services were those associated with increasing levels of distress. This suggests that other factors may be more influential to referral decisions.The aim of the current study was to investigate the performance of integrated RF transmit arrays with high channel count consisting of meander microstrip antennas for body imaging at 7 T and to optimize the position and number of transmit elements. RF simulations using multiring antenna arrays placed behind the bore liner were performed for realistic exposure conditions for body imaging. Simulations were performed for arrays with as few as eight elements and for arrays with high channel counts of up to 48 elements. The B1 + field was evaluated regarding the degrees of freedom for RF shimming in the abdomen. Worst-case specific absorption rate (SARwc ), SAR overestimation in the matrix compression, the number of virtual observation points (VOPs) and SAR efficiency were evaluated. Constrained RF shimming was performed in differently oriented regions of interest in the body, and the deviation from a target B1 + field was evaluated. Results show that integrated multiring arrays are able to generate homogeneous B1 + field distributions for large FOVs, especially for coronal/sagittal slices, and thus enable body imaging at 7 T with a clinical workflow; however, a low duty cycle or a high SAR is required to achieve homogeneous B1 + distributions and to exploit the full potential. In conclusion, integrated arrays allow for high element counts that have high degrees of freedom for the pulse optimization but also produce high SARwc , which reduces the SAR accuracy in the VOP compression for low-SAR protocols, leading to a potential reduction in array performance. Smaller SAR overestimations can increase SAR accuracy, but lead to a high number of VOPs, which increases the computational cost for VOP evaluation and makes online SAR monitoring or pulse optimization challenging. Arrays with interleaved rings showed the best results in the study.Although it is accepted that oncologists should plan for a future beyond full-time oncology, there is little practical guidance for a successful transition into retirement. Previously, we provided strategies for various aspects of retirement planning. However, this became significantly more complicated as we face newer issues such as the COVID-19 pandemic, the move to virtual patient care, greater awareness of burnout, and the increasing burden of regulatory issues such as the electronic medical record. It is evident that more prospective information is needed to guide oncologists in planning their retirement.
Hereditary elliptocytosis (HE) is a heterogeneous red blood cell membrane disorder characterized by the presence of elliptocytes on a peripheral blood smear. Clinical manifestations of HE vary widely from asymptomatic carriers to patients with severe transfusion-dependent anemia. Microbiology inhibitor Most patients are asymptomatic or have mild anemia, which hinders diagnosis. The proband in this case had mild anemia and jaundice over a period of 4years, the etiology of which was unclear. Hence, he was admitted to our hospital for further diagnosis.
Peripheral blood smears and routine blood tests were performed and biochemical parameters of the proband, and his family members were determined. To confirm the diagnosis, gene mutations were screened in the proband using next-generation sequencing (NGS) and verified by Sanger sequencing in other family members.
A novel mutation (c.1294delA, p.Ser432fs) in exon 15 of the EPB41 gene was detected in the proband and his family members. This mutation results in a frameshift and a premature stop codon at position 455, encoding a truncated protein. The variant was likely pathogenic according to the criteria of the American College of Medical Genetics and Genomics. SWISS-MODEL protein structure prediction indicated partial loss of the spectrin and actin binding and C-terminal domains.
A heterozygous mutation 1294delA in exon 15 of the EPB41 gene was identified using NGS and Sanger sequencing in members of a Chinese family. This identification expands the spectrum of EPB41 mutations and contributes to the genetic diagnosis of families with HE.
A heterozygous mutation 1294delA in exon 15 of the EPB41 gene was identified using NGS and Sanger sequencing in members of a Chinese family. This identification expands the spectrum of EPB41 mutations and contributes to the genetic diagnosis of families with HE.