Managing asymptomatic severe rheumatic mitral stenosis in pregnancy: a case report

Background Rheumatic heart disease (RHD) is a disease of disparity most prevalent in developing countries and among immigrant populations. Mitral stenosis (MS) is a common sequalae of RHD and affects females disproportionately more than males. Rheumatic MS remains a significant management challenge as severe MS is usually poorly tolerated in pregnancy due to haemodynamic changes and increased cardiovascular demands of progressing pregnancy. Pregnancy remains contraindicated in current management guidelines based on expert consensus, due to a paucity of evidence-based literature. Case summary A 28-year-old aboriginal woman with known severe MS was found to be pregnant during routine health review, despite contraceptive efforts. Echocardiography demonstrated mean mitral valve (MV) gradient 14 mmHg; stress echocardiography demonstrated increased MV gradient 28–32 mmHg at peak exercise and post-exercise pulmonary artery pressure 56 + 3 mmHg with marked dynamic D-shaped septal flattening. Left ventricular systolic function remained preserved. She remained remarkably asymptomatic and underwent successful elective induction of labour at 34 weeks. Postpartum, she remained euvolaemic despite worsening MV gradients and new atrial fibrillation (AF). She subsequently underwent balloon mitral valvuloplasty with good result. Discussion Severe rheumatic MS in pregnancy carries significant morbidity and mortality, due to an already fragile predisposition towards heart failure development compounded by altered haemodynamics. Pregnancy avoidance and valvular intervention prior to conception or in the second trimester remain the mainstay of MS management; however, we present an encouraging case of successful near-term pregnancy with minimal complications in a medically managed asymptomatic patient with critical MS, who subsequently underwent valvular intervention post-partum.

The need for a community-led, holistic service response to Aboriginal young people with cognitive disability in remote areas: a case study

There are multiple structural and practical barriers to Aboriginal young people with cognitive disability in remote areas receiving the support and services they need. Multidisciplinary mixed-methods research over the past decade has provided evidence of the ways that many such young people end up with complex support needs and being ‘managed’ by police and justice agencies in the absence of appropriate early intervention, transition support and community-based options. This article presents and synthesises knowledge generated by this body of work and contextualises it within the experiences and trajectory of a young Aboriginal woman with cognitive disability and complex support needs from a remote town. This case study is drawn from a New South Wales linked administrative dataset containing data from health, housing, disability, human services, police, legal, court and justice agencies on a cohort of people who have been incarcerated. The article draws out key principles and strategies to suggest what a community-led, holistic service response could have looked like for Casey.

SUBALTERNISM IN OODGEROO NOONUCCAL’S SELECTED POEMS

This study focuses on the subalternism in Oodgeroo Noonuccal’s selected poems. The approach used in this research is post-colonial approach, which focused on the context of literary works contained the effects of colonialism both on societies and cultures. The result of this research shows that the selected poems of Oodgeroo are portraying the subalternism in the matter of the superior domination and the effects which illustrate the British superiority that lead to their domination against Aboriginal people as the weaker party and resulting the great predicaments for them. Woman as subaltern which show how Aboriginal women are forced to be slaves to serve and satisfy the lust of British colonists until the end of their lives. Lastly, the voiceless which show how the Aboriginal people must live surrounding by representations and misrepresentations of the privileged parties who hold domination that makes it more difficult for them to get their rights. This research also revealed that Oodgeroo is successfully speak for the Aboriginal people supported with the fact that she is an Aboriginal woman who write poetry to voice her people.

Moth

An Aboriginal woman was walking in a city street. It is suburban Melbourne. She has bought a small axe from the hardware store. To her this axe is a traditional woman’s tool. She paid for the axe. She has not done anything wrong. She has broken no laws. She is no threat to herself or to any other person. An armed policeman challenges her. He draws his pistol and shoots her dead.

Relocating Aborigines in Sally Morgan’s My Place

Sally Morgan’s novel My Place explicitly portrays the resistance of Aborigines subalterns against the prevailing social, economic, cultural and political issues. Focusing on identity, hybridity, ethnicity, and racism, the paper argues how Aborigines undergo social injustice, racial distortion, class disparity and adversarial displacement by Neo-colonialism. Investigating the Aborigines’ academic endeavours, genealogical suppressive destitutions, groundbreaking reattachment, matrilineal links, it is hypothesized that My Place foregrounds the contemporary status of modern Aboriginal Woman. Illustrating the Aborigines’ altruistic patriotism and excruciating their sufferings during Neo-colonialism in the novel, it is spotlighted how lost generation and stolen generation and extortive afflictions imposed on the Aborigines by the Whites in Australia have shaped the formers’ collective socio-cultural and political consciousnes

Relocating Aborigines in Sally Morgan’s My Place

Sally Morgan’ s novel My Place explicitly portrays the resistance of Aborigines subalterns against the prevailing social, economic, cultural and political issues. Focusing on identity, hybridity, ethnicity, and racism, the paper argues how Aborigines undergo social injustice, racial distortion, class disparity and adversarial displacement by Neo-colonialism. Investigating the Aborigines’ academic endeavours, genealogical suppressive destitutions, groundbreaking reattachment, matrilineal links, it is hypothesized that My Place foregrounds the contemporary status of modern Aboriginal Woman. Illustrating the Aborigines’ altruistic patriotism and excruciating their sufferings during Neo-colonialism in the novel, it is spotlighted how lost generation and stolen generation and extortive afflictions imposed on the Aborigines by the Whites in Australia have shaped the formers’ collective socio-cultural and political consciousness.

Using bridges made by others as scaffolding and establishing footings for those that follow: Indigenous women in the Academy

The first recorded Aboriginal person to graduate with an undergraduate qualification from any Australian university was Aboriginal woman Margaret Williams-Weir in 1959 ( Melbourne University, 2018 ). Williams-Weir graduated with a Diploma in Education. There have now been six decades of graduating Indigenous Australian women in the discipline of education, and many other disciplines. In this article, we explore Indigenous women’s presence in higher education through the narratives of our lives as Aboriginal women within education and the lives of other Indigenous women, noting their achievements and challenges. We acknowledge that while the number of Aboriginal and Torres Strait Islander women participating in university study and becoming engaged in education as a discipline at undergraduate and postgraduate levels has increased, we are still significantly underrepresented. Similarly, while we have seen increases in Indigenous university staff within the education discipline, the employment of Indigenous academics has not reached parity with non-Indigenous academics levels and too few are employed in the professoriate and in senior management positions. We will show how we would not have been able to develop our education careers within higher education without the bridges built by those like Dr Williams-Weir and others who went before us. We will share how we have worked to establish the footings for those Indigenous women who will follow us and others. In this way, we work within the context that is for the now and the future.