Acute Renal Failure in Association with Community-Acquired Clostridium difficile Infection and McKittrick-Wheelock Syndrome

We report the case of a 65-year-old Caucasian woman who experienced two separate episodes of acute renal failure within an 18-month period, both requiring emergency admission and complicated treatment. Each episode was precipitated by hypovolaemia from intestinal fluid losses, but from two rare and independent pathologies. Her first admission was attributed to community-acquired Clostridium difficile-associated diarrhoea (CDAD) and was treated in the intensive therapy unit. She returned 18 months later with volume depletion and electrolyte disturbances, but on this occasion a giant hypersecretory villous adenoma of the rectum (McKittrick-Wheelock syndrome) was diagnosed following initial abnormal findings on digital rectal examination by a junior physician. Unlike hospital-acquired C. difficile, community-acquired infection is not common, although increasing numbers are being reported. Whilst community-acquired CDAD can be severe, it rarely causes acute renal failure. This case report highlights the pathological mechanisms whereby C. difficile toxin and hypersecretory villous adenoma of the rectum can predispose to acute renal failure, as well as the values of thorough clinical examination in the emergency room, and early communication with intensivist colleagues in dire situations

Contributions of Early Childhood Development Programming to Sustainable Peace and Development

In order to advance the notion that young children and their families have a role to play in conflict prevention and peacebuilding, the Early Childhood Peace Consortium (ECPC) is pleased to introduce its first publication “Contributions of Early Childhood Development Programming to Promoting Peace and Sustainable Development”. This concept paper summarizes and combines evidence from developmental psychology, health and nutrition, with lessons learned from the peacebuilding and social services administration sectors. The paper will help practitioners appreciate how ECD services can prevent and mitigate conflict between individuals and among groups. This background paper thereby follows in the footsteps of the 2030 Agenda for Sustainable Development which acknowledges that “there can be no sustainable development without peace, and no peace without sustainable development.” It exemplifies the role of ECD in supporting the achievement of the SDGs, and in particular Goal 16. The concepts described in the paper align with recent directions in peacebuilding that aim to operationalize socio-economic development interventions so that they simultaneously transform relationships and build social support networks capable of mitigating violent conflict risks

Promoting social cohesion and peacebuilding through investment in early childhood development programs

Millions of children worldwide will not reach their potential in terms of education and development. However, it is widely known that investment in high-quality early childhood development (ECD) pays rich dividends throughout the lifespan of an individual, impacting their own lives, families, and communities in a positive way. Further evidence points to the importance of ECD in delivering the United Nations’ Sustainable Development Goals (SDGs). The multi-sectoral, integrated provision of ECD services is ideally placed to facilitate holistic positive change and enhance social cohesion in some of the most inequitable and vulnerable contexts. The LINKS project brings together an international network of researchers, who work in strategic partnership with United Nations Children’s Fund (UNICEF) and Early Years the Organisation for Young Children in Northern Ireland to support the development, implementation, and evaluation of ECD programs in low- and middle-income countries impacted by divisions and conflict. The project is designed to contribute to the international evidence base on ECD for social cohesion and sustaining peace to make a real difference in the lives of children, caregivers, and communities

Between speaking out in public and being person-centred: collaboratively designing an inclusive archive of learning disability history

The Living Archive of Learning Disability History is being developed by an inclusive team of researchers both with and without learning disabilities. We argue the archive is important in making publicly visible the lives of people with learning disabilities. Yet – drawing on thinking that came out of our collaborative workshops – we also identify alternative imperatives, that you might want to have control over how you share your personal memories and stories, with whom, when you share them and for how long. We show how we are responding to these different ideas in the design of the Living Archive in order to create pathways between two traditions that have emerged through self-advocacy: ‘speaking out in public’ and ‘being person-centred’. We outline our research on consent processes to ensure that our archive builds capacity for as many people as possible to consent while also offering a legally compliant ‘Best Interests’ process in line with the requirements of the Mental Capacity Act, England and Wales (2005). We argue that deploying and actively navigating between the different political logics of ‘speaking out in public’ and ‘being person-centred’ offers a way forward for ongoing debates concerning community engagement in archives, museums and heritage