Reframing reporting of childhood sexual exploitation: three journalists reflect

This article explores three national and local journalists’ experiences of reporting on child sexual exploitation by so-called “Asian street grooming gangs” in UK towns and cities, with a particular emphasis on journalists framing journalists. In response to coverage of a series of cases, journalists have been accused by academics, policymakers and rival media organizations of fixating on perpetrators’ ethnicity and creating distorted, racist media frames. Few, if any, studies have garnered practitioners’ perspectives on how framing occurs, so we interview three prominent journalists who have covered such cases in order to deepen our understanding of the processes and causative factors behind particular editorial angles. While offering only a snapshot view, our findings reveal these individual journalists to be caught at the nexus of a range of factors that impact upon their work, both internally and externally driven.

Levosimendan for the Prevention of Acute Organ Dysfunction in Sepsis

BACKGROUND Levosimendan is a calcium-sensitizing drug with inotropic and other properties that may improve outcomes in patients with sepsis. 
METHODS We conducted a double-blind, randomized clinical trial to investigate whether levosimendan reduces the severity of organ dysfunction in adults with sepsis. Patients were randomly assigned to receive a blinded infusion of levosimendan (at a dose of 0.05 to 0.2 μg per kilogram of body weight per minute) for 24 hours or placebo in addition to standard care. The primary outcome was the mean daily Sequential Organ Failure Assessment (SOFA) score in the intensive care unit up to day 28 (scores for each of five systems range from 0 to 4, with higher scores indicating more severe dysfunction; maximum score, 20). Secondary outcomes included 28-day mortality, time to weaning from mechanical ventilation, and adverse events. 
RESULTS The trial recruited 516 patients; 259 were assigned to receive levosimendan and 257 to receive placebo. There was no significant difference in the mean (±SD) SOFA score between the levosimendan group and the placebo group (6.68±3.96 vs. 6.06±3.89; mean difference, 0.61; 95% confidence interval [CI], −0.07 to 1.29; P=0.053). Mortality at 28 days was 34.5% in the levosimendan group and 30.9% in the placebo group (absolute difference, 3.6 percentage points; 95% CI, −4.5 to 11.7; P=0.43). Among patients requiring ventilation at baseline, those in the levosimendan group were less likely than those in the placebo group to be successfully weaned from mechanical ventilation over the period of 28 days (hazard ratio, 0.77; 95% CI, 0.60 to 0.97; P=0.03). More patients in the levosimendan group than in the placebo group had supraventricular tachyarrhythmia (3.1% vs. 0.4%; absolute difference, 2.7 percentage points; 95% CI, 0.1 to 5.3; P=0.04). 
CONCLUSIONS The addition of levosimendan to standard treatment in adults with sepsis was not associated with less severe organ dysfunction or lower mortality. Levosimendan was associated with a lower likelihood of successful weaning from mechanical ventilation and a higher risk of supraventricular tachyarrhythmia. (Funded by the NIHR Efficacy and Mechanism Evaluation Programme and others; LeoPARDS Current Controlled Trials number, ISRCTN12776039.)

The impact of childhood residential mobility on mental health outcomes in adolescence and early adulthood: a record linkage study.

Background Understanding the causes of poor mental health in early childhood and adolescence is important as this can be a significant determinant of mental well-being in later years. One potential and relatively unexplored factor is residential mobility in formative years. Previous studies have been relatively small and potentially limited due to methodological issues. The main aim of this study was to investigate the relationship between early residential instability and poor mental health among adolescents and young adults in Northern Ireland.

Methods A Census-based record linkage study of 28% of children aged 0–8 years in 2001 in Northern Ireland (n=49 762) was conducted, with six monthly address change assessments from health registration data and self-reported mental health status from the 2011 Census. Logistic regression models were built adjusting for socioeconomic status (SES), household composition and marital dissolution.

Results There was a graded relationship between the number of address changes and mental ill-health (adjusted OR 3.67, 95% CIs 2.11 to 6.39 for 5 or more moves). This relationship was not modified by SES or household composition. Marital dissolution was associated with poor mental health but did not modify the relationship between address change and mental health (p=0.206). There was some indication that movement after the age of five was associated with an increased likelihood of poor mental health.

Conclusions This large study clearly confirms the close relationship between address change in early years and later poor mental health. Residential mobility may be a useful marker for children at risk of poorer mental health in adolescence and early adulthood

The international evidence on the prevention of drug and alcohol use Summary and examples of implementation in England

The United Nations Office of Drug Control (UNODC) published ‘International Standards on Drug Use Prevention’ in 2013. The Standards were developed through a systematic assessment of the international evidence on prevention and they provide a summary of the available scientific evidence. The briefing provides a summary of the UNODC prevention standards and gives corresponding examples of relevant UK guidelines,programmes and interventions currently available in England. Its aim is to help people who commission, develop and implement prevention strategies and interventions to translate the standards into the English operating landscape. It also aims to support local authority commissioners to develop their prevention strategies and implement them in line with evidence.  

A systematic review of the effectiveness of lifestyle interventions for the prevention of type 2 diabetes mellitus (T2DM) in routine practice.

This document updates and extends a previously conducted systematic review and meta-analysis assessing the effectiveness of ‘real-world’ interventions for the prevention of type 2 diabetes mellitus (T2DM) in high risk populations.

Consultation on the development of an Obesity Policy and Action Plan for Ireland

A report developed for the Department of Health by the institute of Public Health in Ireland. This report presents a summary of the feedback of key stakeholders based on a consultation document presenting options for action to address Ireland’s overweight and obesity epidemic. There was a very significant level of engagement by a wide range of stakeholders which has resulted in a useful set of considerations for policy development. The findings from this consultation strand along with those from the other two strands of consultation will be studied to inform and enrich the forthcoming Obesity Policy and Action Plan.

Prevention of bacterial translocation using β-(1-3)-D-glucan in small bowel ischemia and reperfusion in rats

To investigate the role of β-(1-3)-D-glucan on 99mTc labelled Escherichia coli translocation and cytokines secretion in rats submitted to small bowel ischemia/reperfusion injury. Methods: Five groups (n=10 each) of Wistar rats were subjected to control(C), sham(S), group IR subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R), and group I/R+glucan subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R) and injected with 2mg/Kg intramuscular. Translocation of labelled bacteria to mesenteric lymph nodes, liver, spleen, lung and serum was determined using radioactivity/count and colony forming units/g(CFU/g). Serum TNFα, IL-1β, IL-6, IL-10 were measured by ELISA. Results: CFU/g and radioactivity/count were higher in I/R than in I/R+glucan rats. In C, S and S+glucan groups, bacteria and radioactivity/count were rarely detected. The I/R+glucan rats had enhancement of IL-10 and suppressed production of serum TNFα, IL-1β and, IL-6, compared to I/R untreated animals. Conclusion: The β-(1-3)-D-glucan modulated the production of pro-inflammatory and anti-inflammatory cytokines during bowel ischemia/reperfusion, and attenuated translocation of labelled bacteria

Occupied childhoods: discourses and politics of childhood and their place in Palestinian and Pan-­Arab screen content for children

This thesis explores changing discourses of childhood and the ways in which power relations intersect with socio-cultural norms to shape screen-based media for Palestinian children. Situated within the interdisciplinary study of childhood, the research is an institutional and textual analysis that includes discursive and micro-level analysis of the socio-political circumstances within which children consume media in present-day Palestine. The thesis takes a social constructionist view, arguing that ‘childhood’ is not a fixed universal concept and that discourses of childhood are produced at specific historical moments as an effect of power. The study has a three-part research agenda. The first section uses secondary literature to explore theories and philosophies relating to definitions of childhood in Arab societies. The second employs participant observation and semi-structured interviews to understand the history and politics of children’s media in the West Bank. The final part of the research activity focuses on the impact that definitions of childhood and the politics of children’s media have on broadcasting outcomes through an analysis of (a) discourses on children’s media that circulate in Palestinian society, and (b) local and pan-Arab cultural texts consumed by Palestinian children. The analysis demonstrates that complex ideological and political factors are at play, which has led to the marginalisation, politicisation and internationalisation of local production for children. Due to the lack of alternatives, local producers often rely on international funding, and are hence forced to negotiate competing definitions of childhood, which while fitting with an international agenda of normalising the Israeli occupation, conflict culturally and politically with local conceptions of childhood and hopes for the Palestinian nation. While the Palestinian community appreciates the positive potential of local production, discourses and strategies around children’s media show that Palestinian children are constructed as vulnerable, incomplete and in constant need of guidance. Pan-Arab content presents a slightly less didactic approach and in certain cases presents childhood as a dynamic space of empowerment. However, by constructing children as ‘consumercitizens’, it alienates Arab (and Palestinian) children from disadvantaged backgrounds,as the preferred audience is middle-class children living in oil-rich countries of the Gulf.

Prevention of bacterial translocation using β-(1-3)-D-glucan in small bowel ischemia and reperfusion in rats

To investigate the role of β-(1-3)-D-glucan on 99mTc labelled Escherichia coli translocation and cytokines secretion in rats submitted to small bowel ischemia/reperfusion injury. Methods: Five groups (n=10 each) of Wistar rats were subjected to control(C), sham(S), group IR subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R), and group I/R+glucan subjected to 45 min of bowel ischemia/60 min of reperfusion(I/R) and injected with 2mg/Kg intramuscular. Translocation of labelled bacteria to mesenteric lymph nodes, liver, spleen, lung and serum was determined using radioactivity/count and colony forming units/g(CFU/g). Serum TNFα, IL-1β, IL-6, IL-10 were measured by ELISA. Results: CFU/g and radioactivity/count were higher in I/R than in I/R+glucan rats. In C, S and S+glucan groups, bacteria and radioactivity/count were rarely detected. The I/R+glucan rats had enhancement of IL-10 and suppressed production of serum TNFα, IL-1β and, IL-6, compared to I/R untreated animals. Conclusion: The β-(1-3)-D-glucan modulated the production of pro-inflammatory and anti-inflammatory cytokines during bowel ischemia/reperfusion, and attenuated translocation of labelled bacteria

Workforce Patterns and the Prevention of Mother-to-Child Transmission of HIV Option B Cascade in Côte d'Ivoire

Thesis (Master's)--University of Washington, 2016-08

Mothers’ perception of recovery and satisfaction with patent medicine dealers’ treatment of childhood febrile conditions in rural communities

Background Infant mortality in rural areas of Nigeria can be minimized if childhood febrile conditions are treated by trained health personnel, deployed to primary healthcare centres (PHCs) rather than the observed preference of mothers for patent medicine dealers (PMDs). However, health service utilization/patronage is driven by consumer satisfaction and perception of services/product value. The objective of this study was to determine ‘mothers’ perception of recovery’ and ‘mothers’ satisfaction’ after PMD treatment of childhood febrile conditions, as likely drivers of mothers’ health-seeking behaviour, which must be targeted to reverse the trend. Methods Ugwuogo-Nike, in Enugu, Nigeria, has many PMDs/PHCs, and was selected based on high prevalence of childhood febrile conditions. In total, 385 consenting mothers (aged 15–45 years) were consecutively recruited at PMD shops, after purchasing drugs for childhood febrile conditions, in a cross-sectional observational study using a pre-tested instrument; 33 of them (aged 21–47 years) participated in focus group discussions (FGDs). Qualitative data were thematically analysed while a quantitative study was analysed with Z score and Chi square statistics, at p < 0.05. Results Most participants in FGDs perceived that their child had delayed recovery, but were satisfied with PMDs’ treatment of childhood febrile conditions, for reasons that included politeness, caring attitude, drug availability, easy accessibility, flexibility in pricing, shorter waiting time, their God-fearing nature, and disposition as good listeners. Mothers’ satisfaction with PMDs’ treatment is significantly (p < 0.05) associated with mothers’ perception of recovery of their child (χ2 = 192.94, df = 4; p < 0.0001; Cramer’s V = 0.7079). However, predicting mothers’ satisfaction with PMDs’ treatment from a knowledge of mothers’ perception of recovery shows a high accord (lambda[A from B] = 0.8727), unlike when predicting mothers’ perception of recovery based on knowledge of mothers’ satisfaction with PMDs’ treatment (lambda[A from B] = 0.4727). Conclusions Mothers’ satisfaction could be the key ‘driver’ of mothers’ health-seeking behaviour and is less likely to be influenced by mothers’ perception of recovery of their child. Therefore, mothers’ negative perception of their child’s recovery may not induce proportionate decline in mothers’ health-seeking behaviour (patronage of PMDs), which might be influenced mainly by mothers’ satisfaction with the positive attributes of PMDs’ personality/practice and sets an important agenda for PHC reforms.

Activité physique durant la grossesse: associations avec le poids de naissance et la composition corporelle du nouveau-né

Plusieurs études se sont penchées sur les effets de l’activité physique maternelle sur le poids du nouveau-né, un paramètre reflétant l’environnement intra-utérin associé au risque ultérieur d’obésité et de problèmes métaboliques. Devant les taux alarmants d’obésité infantile à travers le monde, l’identification d’interventions préventives efficaces devient un enjeu majeur dans la lutte contre l’obésité et ses complications. L’activité physique maternelle pourrait être une avenue intéressante, étant donné ses effets bénéfiques sur le gain de poids et le profil métabolique maternels et son potentiel de diminution du poids de naissance de l’enfant. Cependant, la dose optimale d’activité physique et ses effets sur la composition corporelle du nouveau-né sont encore méconnus. Par ailleurs, la majorité des femmes enceintes ne rencontrent pas les recommandations en matière d’activité physique durant la grossesse et les femmes obèses, chez qui les bienfaits de l’activité physique pourraient possiblement avoir le plus grand impact, présentent souvent les niveaux les plus bas. Curieusement, peu d’études ont évalué les effets d’une intervention d’activité physique durant la grossesse dans cette population. Ainsi, avant d’envisager l’activité physique comme une intervention thérapeutique non-pharmacologique durant la grossesse, il importe d’en évaluer la faisabilité et la sécurité et d’en connaître extensivement les effets. Notamment, il s’avère primordial de vérifier s’il est possible d’augmenter en toute sécurité les niveaux d’activité physique durant la grossesse, particulièrement chez les femmes obèses, et de distinguer les effets spécifiques de différents stimuli d’activité physique (variant en type, volume, intensité et moment de la grossesse) sur la croissance fœtale. Dans ce contexte, nous avons dans un premier temps entrepris une revue systématique de la littérature des études observationnelles portant sur l’association entre l’activité physique maternelle et les paramètres de croissance fœtale mesurés à la naissance. Dans un deuxième temps, 2 études de cohortes évaluant l’impact du type, du volume, de l’intensité et du trimestre de pratique de l’activité physique ont été menées afin de complémenter et d’approfondir les résultats de la revue systématique. Finalement, une étude d’intervention randomisée a été réalisée afin d’évaluer s’il est possible d’améliorer les niveaux d’activité physique durant la grossesse chez les femmes enceintes obèses. Nos travaux ont permis d’illustrer l’influence variable que différents stimuli d’activité physique maternelle peuvent avoir sur l’anthropométrie néonatale. La revue systématique a montré qu’un volume moyen d’activité physique est associé à une augmentation du poids de naissance comparativement à un volume plus faible, alors qu’un volume élevé est associé à une diminution du poids de naissance, comparativement à un volume plus faible. Nos données suggèrent également que l’association entre l’activité physique maternelle et le poids de naissance varie en présence de certaines caractéristiques maternelles. Notamment, nous avons montré pour la première fois que l’activité physique vigoureuse pratiquée en début de grossesse était associée à une diminution importante du poids de naissance chez les femmes qui reçoivent un diagnostic de pré-éclampsie en fin de grossesse. L’importance de l’intensité de l’activité physique dans la relation entre l’activité physique maternelle et la croissance fœtale a également été soulignée pour la première fois dans notre étude de cohorte avec mesure de la composition corporelle néonatale. Contrairement à l’activité physique d’intensité modérée, l’activité physique vigoureuse en début de grossesse est associée à une diminution du poids de naissance, principalement en raison d’une adiposité néonatale réduite. Finalement, les résultats de l’essai randomisé ont permis d’établir la faisabilité d’une intervention d’activité physique supervisée visant à augmenter la pratique d’activité physique chez des femmes enceintes obèses et le potentiel d’une telle intervention à favoriser le maintien de la condition physique et une meilleure gestion du gain de poids chez ces femmes. L’ensemble de ces résultats permet de mieux cerner l’impact de l’activité physique maternelle sur la croissance fœtale, en fonction des caractéristiques spécifiques du stimulus d’activité physique mais également de la population étudiée. La faisabilité d’une intervention d’activité physique prénatale dans une population de femmes obèses laisse entrevoir de nouvelles possibilités dans la prévention de l’obésité infantile et de ses complications. L’identification d’une dose optimale d’activité physique favorisant la santé de l’enfant à court et à long terme dans diverses populations de femmes enceintes et l’identification des facteurs permettant une meilleure adhérence aux recommandations qui en découleront constituent des pistes de recherche essentielles à la lutte contre l’obésité.

Iliohypogastric neurectomy in the prevention of postoperative pain following inguinal hernioplasty

Chronic postoperative pain is a common complication of inguinal hernia repair. An important Danish study revealed that 28.7% of patients undergoing hernioplasty suffered a varying degree of chronic pain, severe enough to interfere with normal daily activities in 11% of cases. The difficulty in treating this complication has led numerous surgeons to complete the surgical procedure ilioinguinal or iliohypogastric neurectomy. This method is proving effective in preventing the onset of chronic postoperative pain. We report the results obtained in patients undergoing neurectomy of the iliohypogastric nerve during anterior inguinal hernioplasty.