Post exposure prophylaxis among Ugandan nurses accidents do happen

Purpose: In 2009 we conducted a study to explore Ugandan nurses’ practice of universal precautions while caring for persons living with HIV. During our interviews about universal precautions, nurses’ also shared their experience with post-exposure prophylaxis (PEP) following needle-stick injuries. We present findings related to nurses’ understanding of PEP and their experience with, and reporting of, needle stick injuries. Background: Nurses have high rates of exposure to blood-borne pathogens. Although there is minimal risk of the transmission of blood-borne pathogens from health care workers (HCWs) to patients and vice versa, post-exposure prophylaxis, has become routine following the occupational exposure of HCWs to HIV. Methods: Focused ethnography was used to guide the data collection and in-depth interviews were used to collect the data between October and November 2009. Results: Sixteen nurses from a variety of units in a large teaching hospital participated. Needle-stick injuries were a fairly common occurrence, but written policies were frequently inaccessible to nurses and they did not have adequate knowledge of PEP. Some nurses were reluctant to report injuries and avoided following PEP procedures due to lack of knowledge about PEP, concerns about anti-retroviral side effects and the stigma associated with PEP. Participants were aware of PEP however there was a wide variation in their understanding of the procedure to follow after a needle-stick injury. Conclusion: Employers have a responsibility to update PEP guidelines and to orientate HCWs to these. Educators must ensure that undergraduate nurses have a comprehensive understanding of universal precautions and current practice for PEP

The Two Phases of Galaxy Formation

Cosmological simulations of galaxy formation appear to show a two-phase character with a rapid early phase at z>2 during which in-situ stars are formed within the galaxy from infalling cold gas followed by an extended phase since z<3 during which ex-situ stars are primarily accreted. In the latter phase massive systems grow considerably in mass and radius by accretion of smaller satellite stellar systems formed at quite early times (z>3) outside of the virial radius of the forming central galaxy. These tentative conclusions are obtained from high resolution re-simulations of 39 individual galaxies in a full cosmological context with present-day virial halo masses ranging from 7e11 M_sun h^-1 < M_vir < 2.7e13 M_sun h^-1 and central galaxy masses between 4.5e10 M_sun h^-1 < M_* < 3.6e11 M_sun h^-1. The simulations include the effects of a uniform UV background, radiative cooling, star formation and energetic feedback from SNII. The importance of stellar accretion increases with galaxy mass and towards lower redshift. In our simulations lower mass galaxies ($M_* < 9e10 M_sun h^-1) accrete about 60 per cent of their present-day stellar mass. High mass galaxy ($M_* > 1.7e11 M_sun h^-1) assembly is dominated by accretion and merging with about 80 per cent of the stars added by the present-day. In general the simulated galaxies approximately double their mass since z=1. For massive systems this mass growth is not accompanied by significant star formation. The majority of the in-situ created stars is formed at z>2, primarily out of cold gas flows. We recover the observational result of archaeological downsizing, where the most massive galaxies harbor the oldest stars. We find that this is not in contradiction with hierarchical structure formation. Most stars in the massive galaxies are formed early on in smaller structures, the galaxies themselves are assembled late.Comment: 13 pages, 13 figures, accepted for publication in Ap

Tradition and Prudence in Locke's Exceptions to Toleration

Why did Locke exclude Catholics and atheists from toleration? Not, I contend, because he was trapped by his context, but because his prudential approach and practica ljudgments led him to traditiona ltexts. I make this argumentfirst by outlining the connections among prudential exceptionality, practical judgments, and traditional texts. I then describe important continuities betweenc onventional English understandings of the relationship between state and religion and Locke's writings on toleration, discuss Locke's conception of rights, and illustrate his use of prudential exceptions and distinctions. I conclude by arguing that Locke's problems are relevant to assessingc ontemporary liberal discussions of tolerationa nd the separation of state and religion that lean heavily on practical justification

A role for CaV1 and calcineurin signalling to depolarization-induced changes in neuronal DNA methylation

Copyright © 2015 The Authors Published by Elsevier Inc.Direct manipulations of neuronal activity have been shown to induce changes in DNA methylation (DNAm), although little is known about the cellular signaling pathways involved. Using reduced representation bisulfite sequencing, we identify DNAm changes associated with moderate chronic depolarization in dissociated rat hippocampal cultures. Consistent with previous findings, these changes occurred primarily in the vicinity of loci implicated in neuronal function, being enriched in intergenic regions and underrepresented in CpG-rich promoter regulatory regions. We subsequently used 2 pharmacological interventions (nifedipine and FK-506) to test whether the identified changes depended on 2 interrelated signaling pathways known to mediate multiple forms of neuronal plasticity. Both pharmacological manipulations had notable effects on the extent and magnitude of depolarization-induced DNAm changes indicating that a high proportion of activity-induced changes are likely to be mediated by calcium entry through L-type CaV1 channels and/or downstream signaling via the calcium-dependent phosphatase calcineurin.Wellcome TrustMRC 4-year PhD studentshipKCL CDN-SGDP collaborative seed fundin

European “freedoms”: a critical analysis

Faced with the present migrant crisis and the dismal record of Europe in protecting vulnerable refugees’ and migrants’ rights, what could be the view of the moral philosopher? The contrast between the principles enshrined in the European Charter of Fundamental Rights and the reality of present policies is shocking, but more scrutiny will show that it is the result of a larger trend towards an understanding of freedom mostly in economic terms, at a time when economists such as Amartya Sen have revised their approach to economic growth and prosperity, noting the central role played by a much richer conception of freedom. The paper will scrutinize these inconsistencies and the conception of the person from which they derive and will provide an alternative and more coherent moral vision that could strengthen the legitimacy of the European Charter, at a time of growing dissatisfaction and so-called democratic deficit. Such a vision could help reconnect the Charter with a conception of the human person as in need not solely of passive legal protection, but also of active promotion of her self-respect and capabilities, and of her aspiration to a valuable life

Topological partition relations to the form omega^*-> (Y)^1_2

Theorem: The topological partition relation omega^{*}-> (Y)^{1}_{2} (a) fails for every space Y with |Y| >= 2^c ; (b) holds for Y discrete if and only if |Y| <= c; (c) holds for certain non-discrete P-spaces Y ; (d) fails for Y= omega cup {p} with p in omega^{*} ; (e) fails for Y infinite and countably compact

The community of advantage

This paper gives an overview of my recently published book, The Community of Advantage: A Behavioural Economist’s Defence of the Market. I explain that my stance as author is that of a behavioural economist and an economic liberal. The book is an attempt to counter the widespread belief that the findings of behavioural economics justify regulatory interventions in the economy that would previously have been thought unacceptably paternalistic. I argue that competitive markets are desirable, not as an efficient means for satisfying the given preferences of assumedly rational individuals, but as an institutional structure that provides opportunities for whatever voluntary transactions people might want to make

The Birmingham Boron Neutron Capture Therapy (BNCT) project : developments towards selective internal particle therapy

This paper will review progress on two aspects of the Birmingham BNCT project. Firstly on evaluation of the effects of high and low LET radiations when delivered simultaneously, and secondly on attempts to optimise delivery of the boron carrier compound BPA through pharmacokinetic studies. Simultaneous or non-simultaneous irradiations of V79 cells with alpha-particle and X-ray irradiations were performed. Alpha doses of 2 and 2.5 Gy were chosen and the impact on survival when delivered separately or simultaneously with variable doses of X-rays was evaluated. The pharmacokinetics of the delivery of a new formulation of BPA (BPA-mannitol) are being investigated in brain tumour patients through a study with 2 × 2 design featuring intravenous and intracarotid artery infusion of BPA, with or without a mannitol bolus. On the combined effect of low and high LET radiations, a synergistic effect was observed when alpha and X-ray doses are delivered simultaneously. The effect is only present at the 2.5 Gy alpha dose and is a very substantial effect on both the shape of the survival curve and the level of cell killing. This indicates that the alpha component may have the effect of inhibiting the repair of damage from the low LET radiation dose delivered simultaneously. On the pharmacokinetics of BPA, data on the first three cohorts indicate that bioavailability of BPA in brain ECF is increased substantially through the addition of a mannitol bolus, as well as by the use of intracarotid artery route of infusion. In both cases, for some patients the levels after infusion approach those seen in blood, whereas the ECF levels for intravenous infusion without mannitol are typically less than 10% of the blood values