‘Children not trophies’: an ethnographic study of private family law practice in England

The welfare of the child in the context of private family law proceedings is of significant international interest. This paper presents findings from an ethnographic study of private law proceedings in England, which explored legal professionals’ experiences of and practice within space and place. Data are derived from interviews with professionals, and observations from the waiting areas, canteens, interview rooms and offices of lawyers who represent parents in private family law proceedings. The paper focuses on winners and losers in the area of private family law, and the ‘trophy’, the child, who appears to be lost in the battleground of legal proceedings, but remains the ultimate prize. The concept of space is explored before moving to reflect upon the data from the interviews. The themes that emerge from the data are the relationships between the public space of the court and the vulnerability of the parties as they attempt with greater or less ease, to navigate the complexities of this formal and procedurally driven space. This paper explores the idea of the child as the ultimate ‘trophy’ within private law proceedings to consider its significance for family justice practice in England, and to elicit a greater understanding of the importance of space and place in private law proceedings that have remained largely unexplored

Comparative Anatomy of a Presorted Pot-load of Yearling Steers

One load (n = 72; initial BW = 745 ± 54.5) of grass-raised Angus-cross yearling steers was purchased from a sale barn in north central South Dakota. The steers were sorted into load lots by sale barn personnel from a larger group of 1200. Upon arrival, steers were used in the 4-day Feedlot Shortcourse before being weighed and appraised for visual differences. Cattle were divided (randomly) into 8 groups of 9 head each. One steer was randomly selected from each of the eight groups to make a 9th group of steers comprised of each classification. The steers were fed until they reached an average visual ribfat depth of 0.40 in. The data would show that even though cattle came from one owner, variation does exist for feedlot and carcass characteristics. This variation can affect marketing endpoints, and if not managed properly, can cause a decrease in profitability

Treating Central Catheter–Associated Bacteremia Due to Methicillin-Resistant Staphylococcus aureus: Beyond Vancomycin

Methicillin-resistant Staphylococcus aureus is a frequent cause of hospital-associated infections, including central catheter-associated bacteremia. Vancomycin has been the drug of choice for treating this type of bacteremia for decades in patients who have no contraindications to the antibiotic. However, resistance to vancomycin is an emerging problem. Newer antibiotics approved by the Food and Drug Administration have activity against methicillin-resistant S aureus Some of the antibiotics also have activity against strains of S aureus that are intermediately susceptible or resistant to vancomycin. This article uses a case study to highlight the clinical signs of vancomycin failure and describes the indications for and appropriate use of alternative antimicrobials such as ceftaroline, daptomycin, linezolid, tigecycline, and telavancin. (Critical Care Nurse 2016;36[4]:46-57)

META-ANALYSIS OF MEDICAL AND NON-MEDICAL TREATMENTS OF THE PRODROMAL PHASE OF PSYCHOTIC ILLNESS IN AT-RISK MENTAL STATES

Introduction: There are now many existing studies which assess the treatments available for ‘at risk mental states’, as patients who are believed to be in the prodromal phase of psychotic illness are referred to. However, concerns regarding side effects of possible treatments remain. We here conduct a meta-analysis of the studies available up to October 2010. The aim of this study is to decide what would be the best treatment for ‘at high risk patients’. Results: All the available studies examining potential treatments during the prodromal phase of psychotic illness were collected. They all showed comparable efficacy, which reached statistical significance, excluding the one study using olanzapine, which in fact ‘tended towards significance’. Discussion: Treatments appear promising but a balance needs to be kept between adverse events and effectiveness of preventing psychosis. Conclusion: It is necessary to search further for treatments in order to identify effective treatments with fewer adverse side effects in this phase of psychotic illness

The Potential Mechanisms of High-Velocity, Low-Amplitude, Controlled Vertebral Thrusts on Neuroimmune Function:A Narrative Review

The current COVID-19 pandemic has necessitated the need to find healthcare solutions that boost or support immunity. There is some evidence that high-velocity, low-amplitude (HVLA) controlled vertebral thrusts have the potential to modulate immune mediators. However, the mechanisms of the link between HVLA controlled vertebral thrusts and neuroimmune function and the associated potential clinical implications are less clear. This review aims to elucidate the underlying mechanisms that can explain the HVLA controlled vertebral thrust--neuroimmune link and discuss what this link implies for clinical practice and future research needs. A search for relevant articles published up until April 2021 was undertaken. Twenty-three published papers were found that explored the impact of HVLA controlled vertebral thrusts on neuroimmune markers, of which eighteen found a significant effect. These basic science studies show that HVLA controlled vertebral thrust influence the levels of immune mediators in the body, including neuropeptides, inflammatory markers, and endocrine markers. This narravtive review discusses the most likely mechanisms for how HVLA controlled vertebral thrusts could impact these immune markers. The mechanisms are most likely due to the known changes in proprioceptive processing that occur within the central nervous system (CNS), in particular within the prefrontal cortex, following HVLA spinal thrusts. The prefrontal cortex is involved in the regulation of the autonomic nervous system, the hypothalamic–pituitary–adrenal axis and the immune system. Bi-directional neuro-immune interactions are affected by emotional or pain-related stress. Stress-induced sympathetic nervous system activity also alters vertebral motor control. Therefore, there are biologically plausible direct and indirect mechanisms that link HVLA controlled vertebral thrusts to the immune system, suggesting HVLA controlled vertebral thrusts have the potential to modulate immune function. However, it is not yet known whether HVLA controlled vertebral thrusts have a clinically relevant impact on immunity. Further research is needed to explore the clinical impact of HVLA controlled vertebral thrusts on immune function

Diversity and evolution of surface polysaccharide synthesis loci in Enterobacteriales.

Bacterial capsules and lipopolysaccharides are diverse surface polysaccharides (SPs) that serve as the frontline for interactions with the outside world. While SPs can evolve rapidly, their diversity and evolutionary dynamics across different taxonomic scales has not been investigated in detail. Here, we focused on the bacterial order Enterobacteriales (including the medically relevant Enterobacteriaceae), to carry out comparative genomics of two SP locus synthesis regions, cps and kps, using 27,334 genomes from 45 genera. We identified high-quality cps loci in 22 genera and kps in 11 genera, around 4% of which were detected in multiple species. We found SP loci to be highly dynamic genetic entities: their evolution was driven by high rates of horizontal gene transfer (HGT), both of whole loci and component genes, and relaxed purifying selection, yielding large repertoires of SP diversity. In spite of that, we found the presence of (near-)identical locus structures in distant taxonomic backgrounds that could not be explained by recent exchange, pointing to long-term selective preservation of locus structures in some populations. Our results reveal differences in evolutionary dynamics driving SP diversity within different bacterial species, with lineages of Escherichia coli, Enterobacter hormaechei and Klebsiella aerogenes most likely to share SP loci via recent exchange; and lineages of Salmonella enterica, Citrobacter sakazakii and Serratia marcescens most likely to share SP loci via other mechanisms such as long-term preservation. Overall, the evolution of SP loci in Enterobacteriales is driven by a range of evolutionary forces and their dynamics and relative importance varies between different species