Conspicuous by its absence: Domestic violence intervention in South African pre-hospital emergency care

Domestic violence (DV) is common globally. In South Africa, emergency care providers (ECPs) lack a clear policy framework and the necessary training to identify DV and intervene when it is encountered. We investigate the knowledge, attitudes and beliefs of ECPs towards DV, and identify factors affecting early identification and its appropriate management in South Africa. A survey of 154/266 registered operational ECPs of different qualification levels and employed by a provincial emergency medical service was conducted. Each participant voluntarily and anonymously self-completed a customised questionnaire. Some 75 (49%) ECPs had an acceptable understanding of DV, although those with higher level qualifications were significantly more knowledgeable (p = 0.017). Most (147,97%) identified that alcohol and drugs were the main cause of DV. A few ECPs (15, 10%) reported having had experience of safety-focused and appropriate gender-sensitive handling of DV victims. The ECPs’ qualification levels were not significantly associated with their knowledge of the legislation about DV or with whether they had referred victims of DV. Only 49 (22%) ECPs reported having occasionally referred victims. By their own admission these ECPs expressed inadequate ability to assess and manage DV cases in current ECP practices. There was poor understanding of the extent, nature, detection and referral of DV cases by ECPs relative to their incidence. This may be due to incorrect beliefs or myths about DV, inadequate training and problematic emergency system design. Our findings support the need for a comprehensive emergency care response to guide and standardise DV management with better understanding of gender-based violence in order for the emergency medical service to play a more preventive and holistic role in its responses.Keywords: Emergency care provider, domestic violence, crisis intervention, universal/selective screening, clinical case finding, emergency medical servic

High prevalence of urinary incontinence and poor knowledge of pelvic floor exercises among women in a health district in Kwazulu-Natal, South Africa

Introduction: The purpose of the study was to determine the prevalence and health seeking behaviour of women with urinary incontinence andtheir knowledge of pelvic floor exercises, in a health district in KwaZulu-Natal.Methods: An observational cross-sectional study design was used. BetweenSeptember 2005 and November 2005, a questionnaire was administered to 99 womenaged 21 – 76 years at randomly selected from. Results: The study found that the prevalence of the urinary incontinence was 35% (95% Confidence Interval, 26 to 45).  The most common type of incontinencewas stress urinary incontinence, 63% (95% CI, 46 to 79).  Of the 99 women, 32%(95% CI, 23 to 42) had heard of pelvic floor muscle exercises, while only 18% (95%CI, 11 – 26) had actually carried out the intervention.  Of the 35 women with urinary incontinence, 26% had soughtprofessional help, the most common reason for seeking help being a worsening in condition.Conclusion: The prevalence of urinary incontinence in KwaZulu-Natal is high, knowledge of urinary incontinenceas a disease and its management, among both women and health service providers is poor

The contribution of animal models to understanding the role of the immune system in human idiopathic pulmonary fibrosis

Pulmonary fibrosis occurs in a heterogeneous group of lung disorders and is characterised by an excessive deposition of extracellular matrix proteins within the pulmonary interstitium, leading to impaired gas transfer and a loss of lung function. In the past 10 years, there has been a dramatic increase in our understanding of the immune system and how it contributes to fibrogenic processes within the lung. This review will compare some of the models used to investigate the pathogenesis and treatment of pulmonary fibrosis, in particular those used to study immune cell pathogenicity in idiopathic pulmonary fibrosis, highlighting their advantages and disadvantages in dissecting human disease

Ultrahigh sensitivity of slow-light gyroscope

Slow light generated by Electromagnetically Induced Transparency is extremely susceptible with respect to Doppler detuning. Consequently, slow-light gyroscopes should have ultrahigh sensitivity

Full quantum solutions to the resonant four-wave mixing of two single-photon wave packets

We analyze both analytically and numerically the resonant four-wave mixing of two co-propagating single-photon wave packets. We present analytic expressions for the two-photon wave function and show that soliton-type quantum solutions exist which display a shape-preserving oscillatory exchange of excitations between the modes. Potential applications including quantum information processing are discussed.Comment: 7 pages, 3 figure

Genetic partitioning of interleukin-6 signalling in mice dissociates Stat3 from Smad3-mediated lung fibrosis

Idiopathic pulmonary fibrosis (IPF) is a fatal disease that is unresponsive to current therapies and characterized by excessive collagen deposition and subsequent fibrosis. While inflammatory cytokines, including interleukin (IL)-6, are elevated in IPF, the molecular mechanisms that underlie this disease are incompletely understood, although the development of fibrosis is believed to depend on canonical transforming growth factor (TGF)-β signalling. We examined bleomycin-induced inflammation and fibrosis in mice carrying a mutation in the shared IL-6 family receptor gp130. Using genetic complementation, we directly correlate the extent of IL-6-mediated, excessive Stat3 activity with inflammatory infiltrates in the lung and the severity of fibrosis in corresponding gp130757F mice. The extent of fibrosis was attenuated in B lymphocyte-deficient gp130757F;µMT−/− compound mutant mice, but fibrosis still occurred in their Smad3−/− counterparts consistent with the capacity of excessive Stat3 activity to induce collagen 1α1 gene transcription independently of canonical TGF-β/Smad3 signalling. These findings are of therapeutic relevance, since we confirmed abundant STAT3 activation in fibrotic lungs from IPF patients and showed that genetic reduction of Stat3 protected mice from bleomycin-induced lung fibrosis

Electromagnetically induced transparency and controlled group velocity in a multilevel system

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Mitochondrial dysfunction contributes to the senescent phenotype of IPF lung fibroblasts

Increasing evidence highlights that senescence plays an important role in idiopathic pulmonary fibrosis (IPF). This study delineates the specific contribution of mitochondria and the superoxide they form to the senescent phenotype of lung fibroblasts from IPF patients (IPF-LFs). Primary cultures of IPF-LFs exhibited an intensified DNA damage response (DDR) and were more senescent than age-matched fibroblasts from control donors (Ctrl-LFs). Furthermore, IPF-LFs exhibited mitochondrial dysfunction, exemplified by increases in mitochondrial superoxide, DNA, stress and activation of mTORC1. The DNA damaging agent etoposide elicited a DDR and augmented senescence in Ctrl-LFs, which were accompanied by disturbances in mitochondrial homoeostasis including heightened superoxide production. However, etoposide had no effect on IPF-LFs. Mitochondrial perturbation by rotenone involving sharp increases in superoxide production also evoked a DDR and senescence in Ctrl-LFs, but not IPF-LFs. Inhibition of mTORC1, antioxidant treatment and a mitochondrial targeting antioxidant decelerated IPF-LF senescence and/or attenuated pharmacologically induced Ctrl-LF senescence. In conclusion, increased superoxide production by dysfunctional mitochondria reinforces lung fibroblast senescence via prolongation of the DDR. As part of an auto-amplifying loop, mTORC1 is activated, altering mitochondrial homoeostasis and increasing superoxide production. Deeper understanding the mechanisms by which mitochondria contribute to fibroblast senescence in IPF has potentially important therapeutic implications

Dense, viscous brine behavior in heterogeneous porous medium systems

The behavior of dense, viscous calcium bromide brine solutions used to remediate systems contaminated with dense nonaqueous phase liquids (DNAPLs) is considered in laboratory and field porous medium systems. The density and viscosity of brine solutions are experimentally investigated and functional forms fit over a wide range of mass fractions. A density of 1.7 times, and a corresponding viscosity of 6.3 times, that of water is obtained at a calcium bromide mass fraction of 0.53. A three-dimensional laboratory cell is used to investigate the establishment, persistence, and rate of removal of a stratified dense brine layer in a controlled system. Results from a field-scale experiment performed at the Dover National Test Site are used to investigate the ability to establish and maintain a dense brine layer as a component of a DNAPL recovery strategy, and to recover the brine at sufficiently high mass fractions to support the economical reuse of the brine. The results of both laboratory and field experiments show that a dense brine layer can be established, maintained, and recovered to a significant extent. Regions of unstable density profiles are shown to develop and persist in the field-scale experiment, which we attribute to regions of low hydraulic conductivity. The saturated-unsaturated, variable-density ground-water flow simulation code SUTRA is modified to describe the system of interest, and used to compare simulations to experimental observations and to investigate certain unobserved aspects of these complex systems. The model results show that the standard model formulation is not appropriate for capturing the behavior of sharp density gradients observed during the dense brine experiments

Role of electromagnetically induced transparency in resonant four-wave-mixing schemes.

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