Unsettling assumptions about community engagement : a new perspective on Indigenous Blackfoot participation in museums and heritage sites in Alberta, Canada

In post-colonial nations such as Canada, sharing power and authorship is increasingly used as a strategy by museums to attempt to pluralise, democratise and decolonise relations with, and representations of, Indigenous peoples. While honourable in its intentions, the increasingly ubiquitous practice of community engagement in museums has been under analysed, and its difficulties and complexities understated. This thesis critically analyses engagement in museum and heritage practice and carefully unpicks the nuances of, and naturalised assumptions about, collaboration and self-representation. Power relations and their tangible manifestations in the form of exhibits, employment, relations, and new curatorial practices, are at the core of the analysis. As a comparative study the research provides a cross-disciplinary analysis of mainstream and community museums and heritage sites through four case-studies. Each of the case-studies engaged with Indigenous Blackfoot communities in southern Alberta, Canada, through consultation, partnership, co-ownership or community control. Between 2006 and 2009 I spent twenty-four months in Alberta researching the casestudies and conducting forty-eight in-depth interviews with museum and community members. This research makes a new contribution to the field through its emphasis on community participants’ perspectives; the importance of inter-community collaboration; and its development of the concept of ‘engagement zones’ which builds on James Clifford’s theory of the museum as contact zone. I argue that engagement creates risks and costs for participants and is not necessarily as empowering or beneficial as current discourse purports. The research illustrates that sharing power is neither simple nor conclusive, but a complex and unpredictable first step in building new relations between museums and Indigenous communities. Understanding the current limits of engagement and restrictions to museum indigenisation will enable collaborative efforts to be strategically utilised to work within and go beyond current boundaries and facilitate reciprocities that can begin to decolonise relations and enrich both museums and communities.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Benefit, cost and risk analysis on extending the forest roads network: A case study in Crasna Valley (Romania)

The paper presents how the Analytic Hierarchy Process can be used to select the most suitable combination of new forest roads to build onto a forested area provided that social or ecological aspects are not jeopardized. All important features worth being considered when a new network of forest roads is designed were grouped in three types of criteria, which are benefits, costs and risks. Further, in order to ease the pairwise comparisons between criteria, both benefits and costs have been divided into private and social, while the risks refer to the events that might be triggered or favoured by the construction of new roads, like habitat fragmentation, landslides in case of heavy rainfall during the construction phase or even illegal cuttings. The outcome consists of a series of benefit-cost-and-risk indices and benefit-cost ratios, one for each combination of forest roads, including the status quo. The method has been tested on three combinations of new forest roads already designed for a small forest management unit located in Prahova County, encompassing 838.0 ha of mountainous forest.</p

KONGENITALNA CISTIČNA ADENOMATOIDNA MALFORMACIJA

Cystic adenomatoid lung malformation (CCAM) is a rare disease, with a prevalence 1/25 000 to 1/35 000 pregnancies, a developmental abnormality arising from an overgrowth of the terminal respiratory bronchioles. Prenatal diagnosis is based on the ultrasonographic demonstration of a hyperechogenic pulmonary tumor, which is microcystic or macrocystic. The disease may be associated with a mediastinal shift, hydrops fetalis or polyhydramnios. The outcome is bad in bilateral cases, in those with pulmonary hypoplasia and with fetal hydrops. In unilateral and isolated cases the prognosis may be good. Spontaneous resolution occurs prenatally only in the third trimester of pregnancy. Three cases of CCAM are presented. The case of type I was diagnosed at 28 weeks and regression occured in the third trimester, at 36 weeks of gestation. The prenatal and postnatal pictures of a case of the lung type II and of a case of CCAM type III with echogenic appearance of a uniformly solid mass, are presented too.Cistična adenomatoidna malformacija pluća (CACM) je rijetka bolest s pojavnošću od 1/25 000 do 1/35 000 trudnoća, razvojna pogrješka koja nastaje preraštanjem terminalnih respiratornih mjehurića. Prenatalna dijagnoza se zasniva na ultrazvučnom prikazu hiperehogenog tumora pluća, koji može biti mikrocističan i makrocističan. Pri bolesti može nastati pomak medijastinuma, fetalni hidrops ili polihidramnios. Ishod je loš u bilateralnim slučajevima, u onima s hipolazijom pluća i fetalnim hidropsom. U jednostranim i izoliranim slučajevima prognoza može biti dobra. Spontani nestanak se zbiva u trećem tromjesečju trudnoće. Prikazana su tri ploda s CCAM. Tip 1 bolesti je bio dijagnosticiran u fetusa s 28 tjedana i regresija je nastupila s 36 tjedana. Prikazane su prenatalne i postnatalne slike slučaja s ultrazvučnim nalazom jednakomjerno solidne mase s tipom II i s tipom III bolesti

State of the art neurosurgical OP Theater Necesity, not option!

Cerebral activity is extremely complex and requires a super diagnosis investigation - there is no limit to this super investigation, especially in the case of expansive tumor or non-tumoral le-sions. Modernization of the diagnosis in these lesions has gained Science Fiction aspects. Adapting to those changes, operatory blocks and neurosurgeons all around the world have been improved to the same extent in order to obtain the most perfect results with keeping the quality of life. The modern slogan of neurosurgery is “MAXIMAL SAFE RESACTION". Continu-ing on this theme we can state that the equipment of the surgical apparatus is very special and extremely expensive. Complex but in accordance with one of the most exquisite agglomeration of atoms in the entire known Universe, the human brain

Heart Failure Etiology in Patients Undergoing Cardiac Resynchronization Therapy: Is It Relevant?

Background: Cardiac resynchronization therapy (CRT) is an established treatment for heart failure with reduced ejection fraction (HfrEF). Etiology may influence the outcome of patients undergoing CRT. Objective: to evaluate whether etiology (ischemic vs non-ischemic) influences the response to CRT and overall outcome. Methods: Our study included HFrEF patients undergoing CRT between January 2017-November 2019. We assessed right ventricle (RV) and left ventricle (LV) function using transthoracic echocardiography at baseline and one year after CRT. The response to CRT was defined by a decrease of more than 15% of left ventricle systolic volume. Patients were divided in two groups: ischemic and non-ischemic based on personal history. Adverse events (HF related hospitalizations and deaths) were tracked for 33± 12.8 months. Results: 52 patients undergoing CRT were included (64±13.5 years, 55.7% male, 70% non-ischemic etiology) The two groups were similar considering LV systolic baseline parameters and volumes. Ischemic etiology was associated with non-LBBB morphology on ECG (p=0.03), a more severe LV diastolic dysfunction using E/e ratio (p<0.05), and a more severe RV dysfunction using TAPSE (p=0.008) and RV fractional area change (FAC) (p<0.05). There was no significant difference in CRT response between ischemic and non-ischemic etiology. 14 (26.9%) patients had events (10 hospitalizations and 4 deaths) with a higher prevalence in the ischemic group (58.33% vs 25%, p=0.01). Univariate Cox regression analysis reported a higher risk of cardiovascular events for ischemic etiology (HR 2.4, 95% CI [0.8-8.1], p <0.05). In our cohort there was no significant difference in use of an implantable cardioverter-defibrillator in addition to CRT between ischemic and non-ischemic group (64.2% respectively 63.3%, p =0.3). Conclusion: Our study shows that ischemic and nonischemic HF patients had similar response to CRT. However, ischemic etiology was associated with a higher risk ofadverse cardiovascular events and a worse RV systolic dysfunction at baseline

CMR quantitation of change in mitral regurgitation following transcatheter aortic valve replacement (TAVR): impact on left ventricular reverse remodeling and outcome.

Current echocardiographic data reporting the impact of concomitant mitral regurgitation (MR) on outcome in patients who undergo transcatheter aortic valve replacement (TAVR) are conflicting. Using cardiovascular magnetic resonance (CMR) imaging, this study aimed to assess the impact of MR severity on cardiac reverse remodeling and patient outcome. 85 patients undergoing TAVR with CMR pre- and 6 m post-TAVR were evaluated. The CMR protocol included cines for left (LV) and right ventricular (RV) volumes, flow assessment, and myocardial scar assessment by late gadolinium enhancement (LGE). Patients were dichotomised according to CMR severity of MR fraction at baseline ('non-significant' vs 'significant') and followed up for a median duration of 3 years. Forty-two (49%) patients had 'significant MR' at baseline; they had similar LV and RV size and function compared to the 'non-significant MR' group but had greater LV mass at baseline. In those with significant MR at baseline, 77% (n = 32) had a reduction in MR post-TAVR, moving them into the 'non-significant' category at 6-months, with an overall reduction in MR fraction from 34 to 17% (p < 0.001). Improvement in MR was not associated with more favourable cardiac reverse remodeling when compared with the 'non-improvers'. Significant MR at baseline was not associated with increased mortality at follow-up. Significant MR is common in patients undergoing TAVR and improves in the majority post-procedure. Improvement in MR was not associated with more favourable LV reverse remodeling and baseline MR severity was not associated with mortality