Interprofessional Collaboration to Develop and Deliver Domestic Violence Curriculum to Dental Students

Domestic violence (DV) is a serious social problem that impacts significantly on communities globally. While dentists are uniquely positioned to identify patients who experience DV, there is limited content specifically addressing the issue in their undergraduate training. James Cook University (JCU) dental students revealed this gap, and, in response, an interprofessional collaboration between JCU Social Work, JCU Dentistry and the Cairns Regional Domestic Violence Service was established to codesign and deliver the Dentists and Domestic Violence—Recognise, Respond and Refer program, evaluated through Participatory Action Research (PAR) cycles. The program is informed by critical and feminist social work theory with a gendered analysis of DV. The authors present the program’s evolution and examine the four elements identified as central to its success: interprofessional collaboration, critical and feminist theory and gendered analysis, scaffolded content, and skills-based activities. This article will provide a guide for others starting work in this space. IMPLICATIONS - Designing and implementing an interprofessional domestic violence curriculum informed by critical theory and tailored for dental students’ can help meet their learning needs. - Collaboratively educating dental students to recognise and respond to domestic violence cases will enable appropriate clinical interactions with patients who are victim-survivors of domestic violence and improve the quality of referrals and interactions with community support services. - Undertaking evaluation research that guides effective domestic violence training for students across disciplines contributes to addressing domestic violence

Improved genome assembly and evidence-based global gene model set for the chordate Ciona intestinalis: new insight into intron and operon populations

An improved assembly of the Ciona intestinalis genome reveals that it contains non-canonical introns and that about 20% of Ciona genes reside in operons

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

Empowering Women? Family Planning and Development in Post-Colonial Fiji

Family planning initiatives have been critical to development strategies since the 1950s. Family planning has been justified on various grounds including its contribution to poverty alleviation, improved maternal and infant health and the advancement of women's rights and choices. More recently, the discourse of 'women's empowerment' has been used in the advocacy of family planning. This discourse integrates a number of earlier justifications for fertility control promoting family planning as a strategy to enhance women's access to higher standards of living and improved health. It associates family planning with advances in women's rights as individual citizens in 'modern' economies and their greater involvement in paid work. This thesis investigates whether this empowerment discourse is evident in family planning programmes in Fiji and its relationship to the socio-economic development of that country. Critical analyses of the operation of power, development strategies and western assumptions about family size, human rights and economic wellbeing inform this research. In particular, Foucault's concept of 'biopower' is used to analyse narratives about family planning articulated by health practitioners, women's rights activists and officials in the Ministry of Health. The analysis of key informants' statements is complemented by consideration of official statistics, and existing empirical data such as documents and pamphlets. The thesis argues that an empowerment discourse is strongly evident in Fiji with respect to the statements made by key informants and available written sources. It looks critically at the narratives that construct family planning as empowering for women, particularly the tropes of choice, health and full citizenship. Close analysis of these narratives demonstrate that the 'stories' uniformly position women as potentially empowered 'modern' subjects. However, critical analysis of these stories about choice, health and citizenship found that family planning strategies were sometimes disempowering. The generic stories embodied by the empowerment discourse did not allow for the diversity of women's needs; this finding supported critiques of one-size-fits-all development strategies. I demonstrate that while the empowerment discourse provided women with the opportunity to control their fertility, engage in paid work and be empowered, it simultaneously created new challenges and different forms of subordination. This thesis found that the empowerment discourse was an unmistakable example of biopower at wor

A qualitative interpretivemeta-synthesis of social workers’ experience in end-of-life care

Summary: Social workers are an integral part of end-of-life (EOL) care interdisciplinary services and provide comprehensive psychosocial support to dying people. However, despite the rewards, EOL care social work is wrought with challenges. There is currently limited research into the experience of EOL care social workers. Therefore, this qualitative interpretive meta-synthesis (QIMS) study examines the experience of EOL care social workers as revealed in existing literature. The QIMS methodology was used to synthesize and interpret findings from four original qualitative studies to elicit an in-depth response to the research question: What is the experience of social workers who work in EOL care? Findings: The theme “EOL care social work is a privilege and a struggle” emerged, with six associated contributing factors: Privilege—(1) death is sacrosanct, (2) death is an opportunity for growth and healing, and (3) the religious/spiritual element of EOL care. Struggle—(1) ongoing pain and heightened emotions, (2) conflict of values, and (3) contextual challenges. This QIMS study serves as a preliminary phase to a subsequent, larger study. Applications: This QIMS study provides a foundation for further narrative research into the experience of EOL care social workers. In addition, findings from this QIMS study highlights areas for further attention to foster the well-being of EOL care social workers. Finally, findings from this QIMS study could augment relevant EOL care content in undergraduate social work education

Critical reflections on an interprofessional collaboration to develop domestic violence curriculum in an undergraduate dentistry program

There is growing recognition of the critical need to incorporate Domestic Violence (DV) curriculum into dentistry degrees. Interprofessional collaboration between Social Work, DV sector and Dentistry developed and delivered the Dentistry and Domestic Violence – Recognise, Respond and Refer (DDV-RRR) program within an undergraduate dentistry degree in Australia. This article presents our critical reflections on the collaboration, development and delivery of this program. Selected questions from Fook’s critical reflection model were utilised to guide the reflection process. Key learnings from this process include acknowledging inherent challenges, power and barriers in collaborative projects; importance of interprofessional collaboration for best practice; and the importance of interpersonal/professional relationships for forming and maintaining interprofessional collaborations. We share the learnings from our critical reflections as an example of how interprofessional collaboration enhances the development and delivery of DV curriculum in one undergraduate dentistry course

N,N-Dimethyl-4-(pyren-1-yl)aniline

In the title compound, C24H19N, the dimethylamino group is inclined to the benzene ring by 2.81 (9)°. Their mean plane makes a dihedral angle of 64.12 (2)° with the mean plane of the pyrene ring system [r.m.s. deviation = 0.031 (1) Å]. In the crystal, molecules are linked via C—H...π interactions, which connect neighbouring molecules into columns along the c axis