Recognising the co-occurance of domestic and child abuse: a comparison of community and hospital-based midwives

This study aimed to compare and contrast how midwives working in either hospital or community settings are currently responding to the cooccurrence of domestic and child abuse (CA), their perceived role and willingness to identify abuse, record keeping, reporting of suspected or definite cases of CA and training received. A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland which resulted in 488 midwives completing the questionnaire, leading to a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation, and the questionnaire was validated using exploratory factor analysis. Community midwives reported receiving more training on domestic and CA. Although a high percent of both hospital and community midwives acknowledged a link between domestic violence (DV) and CA, it was the community midwives who encountered more suspected and definite (P <0.001) cases of CA. More community midwives reported to be aware of the mechanisms for reporting CA. However, an important finding is that although 12% of community midwives encountered a definite case of CA, only 2% reported the abuse, leaving a 10% gap between reporting and identifying definite cases of CA. Findings suggest that lack of education and training was a problem as only a quarter of hospital-based midwives reported to have received training on DV and 40% on CA. This was significantly less than that received by community midwives, as 57% received training on DV, and 62% on CA. The study suggests that midwives need training on how to interact with abused mothers using non-coercive, supportive and empowering mechanisms. Many women may not spontaneously disclose the issues of child or domestic abuse in their lives, but often respond honestly to a sensitively asked question. This issue is important as only 13% of the sample actually asked a woman a direct question about DV.

Anti-adherent and antifungal activities of surfactant-coated poly (ethylcyanoacrylate) nanoparticles

Application of non-drug-loaded poly(ethylcyanoacrylate) nanoparticles (NP) to buccal epithelial cells (BEC) imparted both anti-adherent and antifungal effects. NP prepared using emulsion polymerisation and stabilised using cationic, anionic and non-ionic surfactants decreased Candida albicans blastospore adhesion, an effect attributable to the peripheral coating of surfactant. Cetrimide and Pluronic (R) P 123 were shown to be most effective, producing mean percentage reductions in blastospore adherence of 52.7 and 37.0, respectively. Resultant zeta potential matched the polarity of the surfactant, with those stabilised using cetrimide being especially positive (+31.3 mV). Preparation using anionic surfactants was shown to be problematic, with low yield and wide particle size distribution. Evaluation of the antifungal effect of the peripheral coat was evaluated using zones of inhibition and viable counts assays. The former test revealed poor surfactant diffusion through agar, but did show evidence of limited kill. However, the latter method showed that cationic surfactants associated with NP produced high levels of kill, in contrast to those coated with anionic surfactants, where kill was not evident. Non-ionic surfactant-coated NP produced intermediate kill rates. Results demonstrate that surfactant-coated NP, particularly the cationic types, form the possible basis of a prophylactic formulation that primes the candidal target (BEC) against fungal adhesion and infection. (c) 2007 Elsevier B.V. All rights reserved.

Wholeness of healing: an innovative Student-Selected Component introducing United Kingdom medical students to the spiritual dimension in healthcare.

Objective: This Student Selected Component (SSC) was designed to equip United Kingdom (UK) medical students to engage in whole-person care. The aim was to explore students' reactions to experiences provided, and consider potential benefits for future clinical practice.

Methods: The SSC was delivered in the workplace. Active learning was encouraged through facilitated discussion with and observation of clinicians, the palliative team, counselling services, hospital chaplaincy and healing ministries; sharing of medical histories by patients; and training in therapeutic communication. Assessment involved reflective journals, literature appraisal, and role-play simulation of the doctor-patient consultation. Module impact was evaluated by analysis of student coursework and a questionnaire.

Results: Students agreed that the content was stimulating, relevant, and enjoyable and that learning outcomes were achieved. They reported greater awareness of the benefit of clinicians engaging in care of the "whole person" rather than "the disease." Contributions of other professions to the healing process were acknowledged, and students felt better equipped for discussion of spiritual issues with patients. Many identified examples of activities which could be incorporated into core teaching to benefit all medical students.

Conclusion: The SSC provided relevant active learning opportunities for medical students to receive training in a whole-person approach to patient care.

Antibiofilm activities of 1-alkyl-3-methylimidazolium chloride ionic liquids

Microbial biofilms are ubiquitous in nature and represent the predominant mode of growth of microorganisms. A general characteristic of biofilm communities is that they tend to exhibit significant tolerance to antimicrobial challenge compared with planktonic bacteria of the same species The antibiofilm activity of a series of 1-alkyl-3-methylimidazolium chloride ionic liquids has been evaluated against a panel of clinically significant microbial pathogens, including MRSA. A comparison of antimicrobial activity against planktonic bacteria and established biofilms is presented. In general, these ionic liquids possess potent, broad spectrum antibiofilm activity.

Antimicrobial and antibiofilm activities of 1-alkylquinolinium bromide ionic liquids

Quinoline derivatives are known to possess a range of bioactive and medicinal activities, which have been exploited in the design of antibacterial, antifungal and antimalarial compounds. In this study, we report on the microbiological toxicity of a series of 1-alkylquinolinium bromides against a range of clinically relevant microorganisms, in both planktonic and sessile (biofilm) cultures. A comparison of antimicrobial activity against planktonic bacteria and established biofilms is presented. In general, 1-alkylquinolinium ionic liquids possess excellent, broad spectrum antimicrobial activity against microorganisms grown in both the planktonic and sessile, or biofilm, mode of growth. Importantly, these compounds are potent against Gram positive and Gram negative bacteria, as well as fungi, with a clear dependency on length of the alkyl substituent for activity, with compounds containing twelve and fourteen carbons in the alkyl group exhibiting highest antimicrobial and antibiofilm activity. © 2010 The Royal Society of Chemistry.

Characterization of bafinivirus main protease autoprocessing activities

The production of functional nidovirus replication-transcription complexes involves extensive proteolytic processing by virus-encoded proteases. In this study, we characterized the viral main protease (Mpro) of the type species, White bream virus (WBV), of the newly established genus Bafinivirus (order Nidovirales, family Coronaviridae, subfamily Torovirinae). Comparative sequence analysis and mutagenesis data confirmed that the WBV Mpro is a picornavirus 3C-like serine protease that uses a Ser-His-Asp catalytic triad embedded in a predicted two-ß-barrel fold, which is extended by a third domain at its C terminus. Bacterially expressed WBV Mpro autocatalytically released itself from flanking sequences and was able to mediate proteolytic processing in trans. Using N-terminal sequencing of autoproteolytic processing products we tentatively identified Gln?(Ala, Thr) as a substrate consensus sequence. Mutagenesis data provided evidence to suggest that two conserved His and Thr residues are part of the S1 subsite of the enzyme's substrate-binding pocket. Interestingly, we observed two N-proximal and two C-proximal autoprocessing sites in the bacterial expression system. The detection of two major forms of Mpro, resulting from processing at two different N-proximal and one C-proximal site, in WBV-infected epithelioma papulosum cyprini cells confirmed the biological relevance of the biochemical data obtained in heterologous expression systems. To our knowledge, the use of alternative Mpro autoprocessing sites has not been described previously for other nidovirus Mpro domains. The data presented in this study lend further support to our previous conclusion that bafiniviruses represent a distinct group of viruses that significantly diverged from other phylogenetic clusters of the order Nidovirales.

Home Confined Consumers’ Freedom through Surrogate Activities: the Role of Personal Communities

This article explores the nature of surrogate consumption activity with three cases of non-institutionalised home confined consumers. The role played by personal communities in their daily lives is explored from the constrained rural contexts in which they consume. Despite the barriers to achieving normalcy in the marketplace, home confined consumers are able to realise freedom and agency, and express identity through engagement in surrogate consumption activity. Surrogate consumption activity also provides home confined consumers with opportunities to reinforce and challenge traditional family practices (discourses of care) through the ability for relationship culture development and social capital creation. Findings in this study show that home confined consumers, labeled as 'limited-choice' (Gabel, 2005) have the ability to display power, make choices, and find their voice despite non-interaction in the marketplace.