Differentiating patterns of violence in the family

The feasibility and prevalence of Reciprocal, Hierarchical and Paternal patterns of family aggression hypothesised by Dixon and Browne (2003) were explored within a sample of maltreating families. The psychological reports of 67 families referred to services for alleged child maltreatment that evidenced concurrent physical intimate partner violence and child maltreatment were investigated. Of these, 29 (43.3%) cases were characterised by hierarchical; 28 (41.8%) Reciprocal and 10 (14.9%) Paternal patterns. Significant differences in the form of child maltreatment perpetrated by mothers and fathers and parent dyads living in different patterns were found. In Hierarchical sub-patterns, fathers were significantly more likely to have been convicted for a violent and/or sexual offence than mothers and were significantly less likely to be biologically related to the child. The findings demonstrate the existence of the different patterns in a sample of families involved in the Child Care Protection process in England and Wales, supporting the utility of a holistic approach to understanding aggression in the family

Вибір моделі системи управління охороною здоров’я та безпекою праці підприємства з урахуванням вимог міжнародних стандартів

Article 43 of the Constitution of Ukraine guarantees proper, safe and healthy working conditions for every employee, according to Article 13 of the Law “On Labor Protection” the employer must ensure the functioning of the labor protection management system. Accordingly, the Concept approved by the Order of the Ministry of Labor dated 22.10. No. 432 of 2001, every enterprise, institution or organization (hereinafter – the enterprise) of any form of ownership, which uses the labor of employees in its activities, is obliged to comply with the necessary requirements established by the legislation of Ukraine, in order to guarantee the safety of work and the preservation of life, health and working capacity of employees in the process of work. In order to ensure healthy, safe and highly productive working conditions, improve working life, prevent injuries and occupational diseases, the company operates a health and safety management system, which is an integral part of the management system of the business entity. The occupational health and safety management system (OH&S) is a set of enterprise management bodies that, on the basis of a set of regulatory documentation, carry out purposeful, planned activities regarding the implementation of management tasks and functions in order to ensure healthy, safe and highly productive working conditions.To build an effective occupational safety management system, it is necessary to choose its optimal model. A scientific and applied problem is the choice of the most suitable system in the conditions of a particular enterprise. An analysis of the approaches available in international practice regarding the formation of health and safety management system models, taking into account quality management systems, environmental protection and social responsibility, was carried out. Recommendations aregiven for choosing a basic methodological approach that will contribute to the creation of an effective labor safety management system with the aim of ensuring safe and highly productive working conditions and creating a positive image of the enterprise.Статтею 43 Конституції України гарантовано кожному працівнику належні, безпечні і здорові умови праці, згідно статті 13 Закону “Про охорону праці” роботодавець повинен забезпечити функціонування системи управління охороною праці. Відповідно, Концепції затвердженої Наказом Мінпраці від 22.10. 2001 р. № 432 кожне підприємство, установа чи організація (далі – підприємство) будь-якої форми власності, що використовують у своїй діяльності праці найманих працівників, зобов’язані дотримуватись необхідних вимог, встановлених законодавством України, з метою гарантування безпеки праці та збереження життя, здоров’я і працездатності працівників у процесі трудової діяльності. З метою забезпеченням здорових, безпечних і високопродуктивних умов праці, поліпшення виробничого побуту, запобігання травматизму та професійним захворюванням на підприємстві діє система управління охороною здоров’я та безпекою праці підприємства, що є невід’ємною складовою системи управління суб’єктом господарювання. Система управління охороною праці (СУОП) — це сукупність органів управління підприємством, які на підставі комплексу нормативної документації проводять цілеспрямовану, планомірну діяльність щодо здійснення завдань і функцій управління з метою забезпечення здорових, безпечних і високопродуктивних умов праці. Для побудови ефективної системи управління безпекою праці необхідно обрати її оптимальну модель. Науково-прикладною проблемою є вибір найбільш придатної в умовах конкретного підприємства системи. Здійснено аналіз підходів, наявних в міжнародній практиці, щодо формування моделей системи управління охороною здоров’я та безпекою праці, з урахуванням систем управління якістю, охороною довкілля та соціальною відповідальністю. Наведено рекомендації щодо вибору базового методологічного підходу, що сприятиме створенню ефективної системи управління безпекою праці з метою забезпечення безпечних і високопродуктивних умов праці та створення позитивного іміджу підприємства

A novel pathway producing dimethylsulphide in bacteria is widespread in soil environments

The volatile compound dimethylsulphide (DMS) is important in climate regulation, the sulphur cycle and signalling to higher organisms. Microbial catabolism of the marine osmolyte dimethylsulphoniopropionate (DMSP) is thought to be the major biological process generating DMS. Here we report the discovery and characterisation of the first gene for DMSP-independent DMS production in any bacterium. This gene, mddA, encodes a methyltransferase that methylates methanethiol (MeSH) and generates DMS. MddA functions in many taxonomically diverse bacteria including sediment-dwelling pseudomonads, nitrogen-fixing bradyrhizobia and cyanobacteria, and mycobacteria, including the pathogen Mycobacterium tuberculosis. The mddA gene is present in metagenomes from varied environments, being particularly abundant in soil environments, where it is predicted to occur in up to 76% of bacteria. This novel pathway may significantly contribute to global DMS emissions, especially in terrestrial environments, and could represent a shift from the notion that DMSP is the only significant precursor of DMS

The formation of professional identity in medical students: considerations for educators

<b>Context</b> Medical education is about more than acquiring an appropriate level of knowledge and developing relevant skills. To practice medicine students need to develop a professional identity – ways of being and relating in professional contexts.<p></p> <b>Objectives</b> This article conceptualises the processes underlying the formation and maintenance of medical students’ professional identity drawing on concepts from social psychology.<p></p> <b>Implications</b> A multi-dimensional model of identity and identity formation, along with the concepts of identity capital and multiple identities, are presented. The implications for educators are discussed.<p></p> <b>Conclusions</b> Identity formation is mainly social and relational in nature. Educators, and the wider medical society, need to utilise and maximise the opportunities that exist in the various relational settings students experience. Education in its broadest sense is about the transformation of the self into new ways of thinking and relating. Helping students form, and successfully integrate their professional selves into their multiple identities, is a fundamental of medical education

'We have the time to listen’: community Health Trainers, identity work and boundaries

This article contributes empirical findings and sociological theoretical perspectives to discussions of the role of community lay health workers, including in improving the health of individuals and communities. We focus on the role of the Health Trainer (HT), at its inception described as one of the most innovative developments in UK Public Health policy. As lay health workers, HTs are tasked with reducing health inequalities in disadvantaged communities by supporting clients to engage in healthier lifestyles. HTs are currently sociologically under-researched, particularly in relation to occupational identity work, and the boundary work undertaken inter-occupationally with other health workers. To address this research lacuna, a qualitative study was undertaken with 25 HTs based in the Midlands region of the UK. In theorising our findings, we employ a combination of symbolic interactionist conceptualisation of 1) identity work, and of 2) boundary work. The article advances knowledge in the field of health and exercise by investigating and theorising how HTs construct, work at, manage, and communicate about professional/occupational boundaries, in order to provide personalised support to their clients in achieving and sustaining healthy behaviour change within the constraints of clients’ lifeworlds

A grounded theory of female adolescents' dating experiences and factors influencing safety: the dynamics of the Circle

<p>Abstract</p> <p>Background</p> <p>This paper describes the nature and characteristics of the dating relationships of adolescent females, including any of their experiences of abuse.</p> <p>Methods</p> <p>A grounded theory approach was used with 22 theoretically sampled female adolescents ages 15–18.</p> <p>Results</p> <p>Several important themes emerged: Seven stages of dating consistently described the relationships of female adolescents. A circle consisting of two interacting same sex peer groups provided structure for each teen as they navigated the dating course. The circle was the central factor affecting a female adolescent's potential for risk or harm in dating relationships. Teens defined abuse as an act where the intention is to hurt. Having once succumbed to sexual pressure, teens felt unable to refuse sex in subsequent situations.</p> <p>Conclusion</p> <p>An awareness of both the stages of dating and the dynamics of the circle will assist health care providers to plan and implement interventions in the female adolescent population. Study findings on factors and influences that support non-abusive versus abusive relationship might help identify female teens at risk and/or support interventions aimed at preventing dating violence.</p

Нутритивно-метаболическая коррекция в интенсивной терапии перитонита

Introduction. The current concept of the metabolic and nutritional support of patients with peritonitis considers the early enteral administration of corrective solutions, special pharmaconutrients, and feeding formulas as a component of the pathogenetic treatment that contributes to recovery of the intestinal morphofunctional status, to resolution of intestinal failure (IF), to correction of metabolic disturbances, and to adequate provision of the body’s energy-plastic needs.Objective: to improve treatment results in patients with peritonitis due to early enteral feeding of special formulas in order to resolve IF and to correction of nutritional and metabolic disorders.Subjects and methods. A unicenter randomized study was conducted in 54 patients with generalized purulent peritonitis. In Group 1 (a comparison group; n = 25), enteral therapy for IF encompassed intestinal lavage, enterosorption, stepwise intraintestinal administration of glucose saline solution (3–4 days) and then the standard formula Nutrient Standard (1.0 kcal/ml) (5–6 days). In Group 2 (a study group; n = 29), the multi-elemental (oligopeptide) formula Nutrient Elemental was used in the first step and switched to the metabolic formula Nutrient Hepa in the second step, and then to the standard balanced nutrition formula Nutrient Standard. Hemodynamic parameters, oxygen budget, volemia, metabolism, immune system, gastrointestinal function, levels of enzymes, and hormonal status were studied.Results. In Group 2 patients, the processes of absorption of glucose saline ingredients started to recover on days 2–3 and those of digestion of the semi-elemental formula Nutrient Elemental did on days 3–4. The early enteral feeding of the semi-elemental formula in combination with a formula with a high content of branched amino acids and the lowest level of aromatic amino acids, and the presence of serum proteins facilitated the resolution of IF within a shorter time period than in Group 1 patients and could also adequately meet the body’s energy and plastic needs.Conclusion. Active small bowel decompression, intestinal lavage, enterosorption in combination with artificial therapeutic feeding that has been properly selected and performed in accordance with the given technology with the obligatory and early inclusion of a semi-elemental nutrition formula are shown to be powerful therapeutic factors that contribute to the resolution of IF and thus to the improvement of the results of peritonitis treatment. Введение. Современная концепция метаболического лечения и нутритивной поддержки больных перитонитом рассматривает раннее энтеральное введение корригирующих растворов, специальных фармаконутриентов и питательных смесей как компонент патогенетического лечения, способствующего восстановлению морфофункционального состояния кишечника, разрешению синдрома кишечной недостаточности (СКН), коррекции метаболических расстройств и адекватному обеспечению энергопластических потребностей организма.Цель работы – улучшение результатов лечения больных перитонитом за счет включения в комплекс интенсивной терапии раннего энтерального питания специальными смесями в целях разрешения СКН и коррекции нутритивно-метаболических нарушений.Материалы и методы. Проведено одноцентровое рандомизированное исследование 54 больных с разлитым гнойным перитонитом. В 1-й группе (группа сравнения, n = 25) энтеральная терапия СКН включала декомпрессию, кишечный лаваж, энтеросорбцию, поэтапное внутрикишечное введение глюкозо-солевого раствора (3–4-е сутки), а затем (5–6-е сутки) стандартной смеси Нутриэн Стандарт (1,0 ккал/мл). У больных 2-й (основной, n = 29) группы на первом этапе применяли полуэлементную (олигопептидную) смесь (Нутриэн Элементаль), на втором поэтапно переходили на метаболически ориентированную смесь (Нутриэн Гепа), а затем на стандартную сбалансированную питательную смесь Нутриэн Стандарт. Использовали методы исследования параметров гемодинамики, кислородного бюджета, волемии, метаболизма, иммунной системы, функционального состояния желудочно-кишечного тракта, уровня ферментов и гормонального статуса.Результаты. У пациентов 2-й группы со 2–3-х суток начинали восстанавливаться процессы всасывания ингредиентов глюкозо- солевого раствора, а на 3–4-е сутки – процессы переваривания полуэлементной смеси (Нутриэн Элементаль). Раннее энтеральное питание полуэлементной смесью в сочетании с применением смеси с высоким содержанием разветвленных аминокислот и минимизированным содержанием ароматических аминокислот, наличием сывороточных белков способствовало разрешению СКН в более короткие сроки, чем у больных 1-й группы, а также позволило адекватно обеспечить энергетические и пластические потребности организма.Выводы. Показано, что активная декомпрессия тонкой кишки, кишечный лаваж, энтеросорбция в сочетании с правильно подобранным и проведенным по представленной технологии искусственным лечебным питанием с обязательным ранним включением полуэлементной питательной смеси являются мощными лечебными факторами, способствующими разрешению СКН и тем самым улучшению результатов лечения перитонита.