No abstract

Direct non‐operative injection of radio‐opaque material through a cannula introduced at the duodenal papilla by means of a fibre‐optic duodenoscope achieved opacification of the bile ducts, the pancreatic duct or the entire biliary pancreatic ductal system in 392 (89 per cent) of 439 patients in whom it was attempted. The desired ducts were opacified in 75 per cent of cases; the bile ducts in 206 out of 278 and the pancreatic duct in 120 out of 161 cases. The anatomical conditions found were: long common biliary pancreatic channel, 30 per cent; short common biliary pancreatic channel, 28per cent; two orifices in the hepatopancreatic ampulla, 24 per cent; two orifices on the duodenal papilla, 18 per cent; two orifices on the duodenum, there being no papilla, less than I per cent. Morbidity resulting from the procedure consisted of infectious reactions in 20 out of 295 patients in whom the bile ducts were opacified and hyperamylasaemia and abdominal pain in 28 out of 300 patients in whom the pancreatic duct was opacified. The method is of value in diagnosing the cause of cholestatic jaundice. In non‐jaundiced subjects it may complement or clarify inconclusive cholangiograms or cholecystograms obtained by other techniques. If it shows dilated bile ducts operation should not be delayed, otherwise there is a risk of cholangitis. Pancreatic carcinoma may be revealed by stenosis, partial or total, of the pancreatic duct or by filling defects in the pancreatic parenchyma. Both chronic pancreatitis and pancreatic carcinoma may cause partial stenosis of the pancreatic duct. A filiform appearance of the pancreatic duct suggests chronic pancreatitis.

This paper explores and summarizes a three year research program into contextualizing bullying in an Aboriginal cultural environment for youth and children. Bullying is not a new concept; it has been passed down from one generation to the next for many years. Effects of bullying can be long term and often manifest as being the causal pathway to other undesirable behaviours. Among children and youth effects of bullying are seen in many forms, for Aboriginal children and youth these effects are magnified. Aboriginal children and youth are already over represented in truancy, juvenile detention and anti social behaviours, bullying is in the mix and it is preventable. Intra racial bullying and turning inward on one’s own cultural group is surely a cry for help with these complex and intricate relationship issues. This paper concludes by considering some of the implications of these findings for future research and conceptualization and has practical solutions for those who are in the care and position to influence the outcomes for Aboriginal communities.

No abstract

No abstract