Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review

Background: Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services.

Methods: Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement.

Results: Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse.

Conclusions: Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base.

Male Perpetrators of Domestic Violence: How should we hold them to account?

Domestic violence is now widely acknowledged as being a significant social, health and legal issue. At both a national and transnational level governments have sought to develop strategies built upon prevention, support for victims and holding perpetrators to account through criminal justice sanctions. However, the current paradigm that informs the policy response to most perpetrators of domestic violence has failed to deliver the outcomes required, in terms of a reduction in levels of recidivism or the improved safety of women and children. It is argued that holding men to account through external controls has failed and that interventions should support men to take responsibility for their own behaviour.

Loss-of-Mains Protection System by Application of Phasor Measurement Unit Technology with Experimentally Assessed Threshold Settings

Loss-of-mains protection is an important component of the protection systems of embedded generation. The role of loss-of-mains is to disconnect the embedded generator from the utility grid in the event that connection to utility dispatched generation is lost. This is necessary for a number of reasons, including the safety of personnel during fault restoration and the protection of plant against out-of-synchronism reclosure to the mains supply. The incumbent methods of loss-of-mains protection were designed when the installed capacity of embedded generation was low, and known problems with nuisance tripping of the devices were considered acceptable because of the insignificant consequence to system operation. With the dramatic increase in the installed capacity of embedded generation over the last decade, the limitations of current islanding detection methods are no longer acceptable. This study describes a new method of loss-of-mains protection based on phasor measurement unit (PMU) technology, specifically using a low cost PMU device of the authors' design which has been developed for distribution network applications. The proposed method addresses the limitations of the incumbent methods, providing a solution that is free of nuisance tripping and has a zero non-detection zone. This system has been tested experimentally and is shown to be practical, feasible and effective. Threshold settings for the new method are recommended based on data acquired from both the Great Britain and Ireland power systems.

A Smart Grid Information System for Demand Side Participation: Remote Control of Domestic Appliances to Balance Demand

Due to the intermittent nature of renewable generation it is desirable to consider the potential of controlling the demand-side load to smooth overall system demand. The architecture and control methodologies of such a system on a large scale would require careful consideration. Some of these considerations are discussed in this paper; such as communications infrastructure, systems architecture, control methodologies and security. A domestic fridge is used in this paper as an example of a controllable appliance. A layered approach to smart-grid is introduced and it can be observed how each smart-grid component from physical cables, to the end-devices (or smart-applications) can be mapped to these set layers. It is clear how security plays an integral part in each component of the smart-grid so this is also an integral part of each layer. The controllable fridge is described in detail and as one potential smart-grid application which maps to the layered approach. A demonstration system is presented which involves a Raspberry Pi (a low-power, low-cost device representing the appliance controller).

The European Court of Human Rights and Domestic Violence: Valiuliene v Lithuania

This article analyses the recent jurisprudence of the European Court of Human Rights on the issue of domestic violence, with a particular focus on Valiuliene v Lithuania. It seems that to date the Court’s jurisprudence on this issue is somewhat inconsistent, and with Valiuliene v Lithuania the Court was given an opportunity to clarify its approach in this area. There are certainly a number of positive aspects to the Court’s judgment, however there are also difficulties with the approach of the Court in this case. Overall it is to be hoped that the judgment in Valiuliene v Lithuania will mark the beginning of a more coherent jurisprudence as regards domestic violence.

Assessment of Domestic Load Suitable for Smart Consumer Load Participation

This study characterizes the domestic loads suitable to participate in the load participation scheme to make the power system more carbon and economically efficient by shifting the electricity demand profile towards periods when there is plentiful renewable in-feed.

A series of experiments have been performed on a common fridge-freezer, both completely empty and half full. The results presented are ambient temperature, temperature inside the fridge, temperature inside the drawer of the fridge, temperature inside the freezer, thermal time constants, power consumption and electric energy consumed.

The thermal time constants obtained clearly demonstrate the potential of such refrigeration load for Smart Customer Load Participation.

OLDER WOMEN’S LIFELONG EXPERIENCES OF DOMESTIC VIOLENCE IN NORTHERN IRELAND

Violence against women is a serious criminal and public health issue with devastating consequences for women, families and society. To date, little international research has been given to understanding the needs of older women, who are experiencing domestic violence; that is, physical, sexual, emotional or financial abuse carried out by a spouse or partner. This study fills a significant gap in the literature as the needs of older women who have experienced a lifetime of domestic violence in Northern Ireland are unknown. Health professionals, service providers and policy makers often assume that violence stops at age 55 and there is a noticeable lack of literature, research and guidelines on the issue. The greatest challenge for health visitors is that abuse remains hidden, with women remaining silent and finding it difficult to speak openly or seek help.

PKC-β exacerbates in vitro brain barrier damage in hyperglycemic settings via regulation of RhoA/Rho-kinase/MLC2 pathway

Stroke patients with hyperglycemia (HG) develop higher volumes of brain edema emerging from disruption of blood-brain barrier (BBB). This study explored whether inductions of protein kinase C-β (PKC-β) and RhoA/Rho-kinase/myosin-regulatory light chain-2 (MLC2) pathway may account for HG-induced barrier damage using an in vitro model of human BBB comprising human brain microvascular endothelial cells (HBMEC) and astrocytes. Hyperglycemia (25 mmol/L D-glucose) markedly increased RhoA/Rho-kinase protein expressions (in-cell westerns), MLC2 phosphorylation (immunoblotting), and PKC-β (PepTag assay) and RhoA (Rhotekin-binding assay) activities in HBMEC while concurrently reducing the expression of tight junction protein occludin. Hyperglycemia-evoked in vitro barrier dysfunction, confirmed by decreases in transendothelial electrical resistance and concomitant increases in paracellular flux of Evan's blue-labeled albumin, was accompanied by malformations of actin cytoskeleton and tight junctions. Suppression of RhoA and Rho-kinase activities by anti-RhoA immunoglobulin G (IgG) electroporation and Y-27632, respectively prevented morphologic changes and restored plasma membrane localization of occludin. Normalization of glucose levels and silencing PKC-β activity neutralized the effects of HG on occludin and RhoA/Rho-kinase/MLC2 expression, localization, and activity and consequently improved in vitro barrier integrity and function. These results suggest that HG-induced exacerbation of the BBB breakdown after an ischemic stroke is mediated in large part by activation of PKC-β.