Identifying signs of intimate partner violence.

Intimate partner violence is a major public health and social problem that affects people in every community, culture and country. Nurses can play a very important role in identifying victims who present to healthcare settings domestic abuse-related health issues. Evidence suggests that the majority of women who present to emergency departments have experienced domestic abuse at some point in their life, however, only 5% are identified by healthcare professionals. To be able to effectively identify and respond to victims, emergency nurses need to understand domestic abuse and its associated complexities. This article provides an overview of the issue, including the different types of abuse, prevalence, causes and effects on health. It also explores emergency nurses’ roles in identifying and managing various situations they may encounter at wor

Silent voices: exploring narratives of women's experiences of health care professional responses to domestic violence and abuse

The impact of domestic violence and abuse (DVA) is far reaching not least in terms of both the immediate and longer term physical and mental wellbeing of those who have experienced abuse. DVA also exerts a considerable detrimental impact on the wider family including children. While professional perspectives of working with DVA survivors is increasingly well documented, there remains a paucity of accounts of encounters with healthcare services and/or healthcare professionals from survivors of DVA themselves. A central aim of this study was the exploration of women’s experiences of healthcare encounters told purely as personal narrative rather than framed in more traditional research terms. The focus of this paper therefore is unedited personal stories of encounters with healthcare professionals. The position of narrative as research method and the presentation of narratives in this particular instance are also considered

Healthcare professionals’ knowledge, attitudes, and experiences of FGM in sub-Saharan Africa: a systematic scoping review

Background Female Genital Mutilation (FGM) remains a challenge as evidence indicates that healthcare professionals (HCPs) who are required to play a role in the elimination of FGM, support the practice. The reasons some HCPs in Sub Saharan Africa still perpetuate FGM is unclear. Thus, this review aims to provide an overview of the existing evidence surrounding HCPs knowledge, attitudes, and experiences of FGM in order to determine the factors that may influence support for the continuation of FGM. Methods A search was conducted utilising six databases (CINHAL, PubMed, Embase, MEDLINE, PsycINFO and ASSIA) and using key terms such as female genital mutilation, FGM, knowledge, attitudes, experiences, practices, and healthcare professionals. At the end of the search, 12 studies were identified. The 12 studies were situated in sub-Saharan African countries (SSA) and they examined HCPs knowledge, attitudes, and experiences of FGM. Findings This review revealed three overarching themes: (1) Knowledge of FGM (2) attitudes towards the practice of FGM and (3) experiences of FGM. The review revealed that HCPs have limited knowledge of FGM and its health implications. Furthermore, some HCPs openly disapprove the practice of FGM, but may undermine abandonment messages and perform FGM in secret due to cultural affiliations and financial rewards. This is indicative of HCPs moving towards medicalising FGM by upholding cultural beliefs and practices rather than adhering to professional policies, codes of conduct and the legal position. This review identifies determinants for the preservation of FGM among some HCPs in SSA countries to include pervading cultural beliefs, poor design of professional trainings in the field of FGM and limited knowledge by HCP

Two color satellite laser ranging upgrades at Goddard's 1.2m telescope facility

The ranging laboratory at Goddard's 1.2 m telescope tracking facility has recently been upgraded to include a single photoelectron sensitive Hamamatsu streak camera-based range receiver which uses doubled and tripled Nd:YAG frequencies for satellite laser ranging. Other ranging system upgrades include a new continuum laser, which will deliver up to 30 millijoules (mJ) at both 532 and 355 nm at a pulsewidth of 30 picoseconds (FWHM), and replacement of both ranging and tracking computers with COMPAQ 386 based systems. Preliminary results using a photomultiplier-tube based receiver and waveform digitizer indicate agreement within the accuracy of the measurement with the theoretical Marini and Murray model for atmospheric refraction. Two color streak camera measurements are used to further analyze the accuracy of these and other atmospheric refraction models

Prolactin

During an oral glucose tolerance test (OGTT) glucose and insulin levels were measured in 26 patients with prolactin-producing pituitary tumours without growth hormone excess. Basal glucose and insulin levels did not differ from the values of an age-matched control group. After glucose load the hyperprolactinaemic patients showed a decrease in glucose tolerance and a hyperinsulinaemia. Bromocriptine (CB 154), which suppressed PRL, improved glucose tolerance and decreased insulin towards normal in a second OGTT. — Human PRL or CB 154 had no significant influence on insulin release due to glucose in the perfused rat pancreas. — These findings suggest a diabetogenic effect of PRL. CB 154 might be a useful drug in improving glucose utilization in hormone-active pituitary tumours

Reflections on the past, present, and potential futures of knowledge hierarchies in ocean biodiversity governance research

Governance of the ocean and its biodiversity is deeply entangled within social, political and cultural histories. The evolution of marine science has been subject to similar influences, and we (the authors) consider these factors to create, embed and reinforce knowledge hierarchies in ocean governance processes and associated research that set societal patterns of prioritisation and exclusion. Such knowledge hierarchies have constructed dominant Western-oriented knowledge systems as ‘rational’ and ‘objective’ approaches to environmental governance in contrast to non-Western knowledge systems and have led to a dominance of natural (normal) sciences over centralised biodiversity governance. The extraction and incorporation of traditional knowledge into the Western-oriented scientific canon through myriad historical and contemporary processes in ocean biodiversity governance often reproduce knowledge hierarchies, do not benefit knowledge holders and are often considered incomplete, inappropriate or absent. As we address current ocean biodiversity and conservation challenges, researchers must be aware of the history of knowledge extraction, impositions and assumptions within their fields. Researchers must also actively acknowledge and address these histories in their work to avoid marginalisation and support ethical, empathetic, and rigorous knowledge production that meets the needs of society. In this paper, through a development of the concept of knowledge hierarchies, we explore case studies of research diverse in geography and discipline ranging from action research in Namibia, the application of arts-based methodologies in legal proceedings to research focused at an international level, and the concept of ocean literacies, all of which are located under the umbrella of a project specifically targeting transformative ocean governance. It becomes evident that knowledge hierarchies are multi-layered, perpetuating, and often reproduced even when attempting to address hierarchies through such methods as the integration or ‘bringing together’ of diverse knowledge systems. Effective change will therefore require sensitive and multi-faceted approaches to knowledge hierarchies, including processes of embracing discomfort, which will be important to work with, as well as through. While there will be continued tensions between hierarchies, it is a sine qua non that researchers need to build a commitment to understanding where powers lie, rather than ignoring such imbalances or, similarly, by idealising approache

Modelled evaluation of multi-component meningococcal vaccine (Bexsero®) for the prevention of invasive meningococcal disease in infants and adolescents in the UK

Neisseria meningitidis is the main cause of bacterial meningitis and sepsis in the UK, and can potentially be lethal or cause long-term sequelae. Bexsero® (4CMenB) is a new multi-component vaccine approved by the European Commission for use in individuals aged ⩾2 months. A theoretical transmission model was constructed to assess the long-term effectiveness of Bexsero compared to standard care. The model was populated with UK-specific demographic data and calibrated to ensure that the transmission dynamics of meningococcal disease in the UK were adequately simulated. The model showed the best strategy to be a routine vaccination programme at ages 2, 3, 4, 12 months and 14 years combined with a 5-year catch-up programme in toddlers aged 12-24 months and adolescents aged 15-18 years. This would lead to a 94% reduction in meningococcal cases or 150000 cases and 15000 deaths over a 100-year time-fram