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Indigenous peoples and local communities interact with approximately two-thirds of the world's land area through their worldviews and customary tenure regimes and offer significant knowledge contributions and lessons about sustainability. We worked with Tuawhenua Māori to document domains, concepts, and mechanisms within the worldview representation in a way that could guide environmental conservation in New Zealand. We then applied the framework to a cultural keystone species for Tuawhenua, the kererū ([New Zealand pigeon [(Hemiphaga novaeseelandiae]) to elucidate this human-environment relationship. Whakapapa (genealogy), whenua (land), and tangata (people) were interconnected domains that formed the conceptual basis of our framework. Within these domains, the concepts of mauri (life essence), mana (authority), and ihi (vitality) guided the expression of the community's relationship with the environment. Cultural expressions related to the kererū demonstrated the cultural significance of the bird to Tuawhenua that went well beyond the ecological and intrinsic value of the species. The Tuawhenua worldview representation also emphasized the human-nature relationship and the role that metaphor plays in expressing this relationship. Indigenous peoples and local community worldviews are important for establishing priorities, reconciling the human relationship with the environment, and facilitating the coproduction of knowledge in response to pressing local and global environmental conservation issues.

The pseudocysts of the pancreas usually occur in cases of acute or chronic pancreatitis due to damage to the pancreatic ducts. Alcohol abuse is the most common cause of acute or chronic pancreatitis. Hemorrhage into the pseudocyst is one of the most lethal complications of pancreatic pseudocyst. In this article, we present the case of a 49-year-old male patient who presented to the emergency room with primary symptoms of pain in the upper abdomen and vomiting that had been occurring for two days and had worsened over the past eight hours. He is a follow-up case of chronic pancreatitis, as well as stable pseudocysts located in the lesser sac, peripancreatic, and epigastric regions. Additionally, the patient had a history of alcohol misuse. The contrast-enhanced computed tomography (CECT) examination of the abdomen and pelvis revealed an enlarged pancreas, hypodense and heterogeneously enhancing pancreatic parenchyma, diffuse peripancreatic fat stranding, and fluid collections. There are a few well-defined hypodense, peripherally enhancing lesions in the lesser sac, peripancreatic, and epigastric regions. On a plain computed tomography (CT) scan, the lesion in the lesser sac showed hyperdense (65 HU) and heterogeneous areas, indicating intracystic hemorrhage. On CT angiography and digital subtraction angiography (DSA), there was no detectable source of bleeding into the pseudocyst. The patient was diagnosed with acute-on-chronic pancreatitis with pseudocysts and spontaneous hemorrhage in the pseudocyst without the presence of a pseudoaneurysm. Conservative treatment was recommended as the patient was hemodynamically stable, and no pseudoaneurysms were detected on the CECT or DSA. The patient exhibited a positive response to the treatment and was discharged in stable condition. The patient was recommended to have a conclusive procedure at a later date. A cystogastrostomy was performed after a period of one month. The postoperative recovery was unremarkable. The purpose of this case report is to highlight the significance of using computed tomography (CT) and angiography for promptly identifying the rare occurrence of hemorrhage into the pseudocyst of the pancreas. Additionally, it emphasized the uncommon occurrence of hemorrhage in the pseudocysts, along with their typical presentation and radiological evaluation., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kummari et al.)

Gastrointestinal stromal tumours (GISTs), are an extremely uncommon form of different types of gastrointestinal (GI) malignant neoplasms. While GISTs are the most prevalent type of mesenchymal tumours in the GI tract, they are mainly located in the stomach. Gastrointestinal stromal tumours in the rectum are rarely observed. Some individuals may exhibit symptoms such as constipation, pain in the rectum, bleeding per rectum, or palpable growth, while others may be discovered incidentally. The prevalence of GISTs has been increasing, potentially as a result of developments in imaging techniques. In the present case report, we describe a 47-year-old male patient who initially complained of pain in the lower abdomen, rectum, and occasional constipation. A contrast-enhanced CT (CECT) scan revealed a well-defined hypodense, enhancing lesion with a small calcified area at its periphery in the rectum. The lesion caused a significant luminal narrowing of the rectum. During colonoscopy, a mass located in the submucosal region was identified on the side of the rectal wall, approximately 1 cm away from the anus. After performing the biopsy, the specimen was subjected to histological examination, which revealed a spindle cell tumour with a mild cellular appearance. This finding was in line with the diagnosis of a GIST located in the rectum. The purpose of the current case report is to highlight the significance of CT, colonoscopy, and biopsy in promptly identifying rare GISTs in the colon and rectum, emphasising the uncommon occurrence of GISTs along with their typical locations and imaging features., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kummari et al.)

Background: Mental-health-related stigma among physicians towards people with mental illnesses remains a barrier to quality care, yet few curricula provide training with a proactive focus to reduce the potential negative impacts of stigma. The aim of our study was to explore medical students' perspectives on what areas of learning should be targeted (where stigma presents) and how they could be supported to prevent the formation of negative attitudes., Methods: Six focus group discussions were conducted with second, third, and fourth-year postgraduate medical students (n = 34) enrolled at The University of Melbourne Medical School in September - October 2021. Transcripts were analysed using inductive thematic analysis., Results: In terms of where stigma presents, three main themes emerged - (1) through unpreparedness in dealing with patients with mental health conditions, (2) noticing mentors expressing stigma and (3) through the culture of medicine. The primary theme related to 'how best to support students to prevent negative attitudes from forming' was building stigma resistance to reduce the likelihood of perpetuating stigma towards patients with mental health conditions and therefore enhance patient care. The participants suggest six primary techniques to build stigma resistance, including (1) reflection, (2) skills building, (3) patient experiences, (4) examples and exemplars, (5) clinical application and (6) transforming structural barriers. We suggest these techniques combine to form the ReSPECT model for stigma resistance in the curriculum., Conclusions: The ReSPECT model derived from our research could provide a blueprint for medical educators to integrate stigma resistance throughout the curriculum from year one to better equip medical students with the potential to reduce interpersonal stigma and perhaps self-stigma. Ultimately, building stigma resistance could enhance care towards patients with mental health conditions and hopefully improve patient outcomes., (© 2023. BioMed Central Ltd., part of Springer Nature.)