Breastfeeding in Custody Proceedings: A Modern-Day Manifestation of Liberal and Conservative Family Traditions

This Comment contends that cultural and legal representations of breastfeeding in custody determinations highlight contradictory notions of motherhood and family that mirror liberal and conservative family traditions thought to be long dead

Frequently Asked Questions on Food Regulations for Small Market Food Producers

Interest and demand for local food in Iowa and across the nation have increased dramatically in the past few years. Iowa small market producers are finding markets for their food products at farmers markets, community supported agriculture enterprises, farm stands, and institutions such as restaurants, hospitals, schools, and conference centers. As farmers have entered these markets across the state, questions about food regulations have increased. This document answers the most common questions most often asked by producers. Responses were crafted by state agency and university specialists with expertise in food safety and food regulations

Fact Sheet: Primary Health Care Matters

This Fact Sheet includes definitions, position statements and suggested reading about primary health care (PHC) as well as outlining the differences between comprehensive and selected PHC. And as a hard copy it can be disseminated at conferences and workshops or around the office

IMMUNOPATHOGENESIS AND CONTROL OF SINDBIS VIRUS IN THE CENTRAL NERVOUS SYSTEM DURING NONFATAL ALPHAVIRUS ENCEPHALOMYELITIS

Sindbis virus (SINV), the prototypic alphavirus, is neurotropic in mice, providing a valuable model for studying nonfatal alphavirus encephalomyelitis. Infectious virus is cleared from the brain within a week after infection, but viral RNA is cleared slowly and persists for the life of the animal. To better understand the immunopathogenesis and control of SINV infection, C57BL/6 mice were infected with the nonfatal TE strain of SINV, and clinical disease, virus clearance, and the immune response were examined. During the height of active infection, mice developed clinical signs of encephalomyelitis and exhibited neurological deficits. Following recovery from clinical disease, hippocampus-dependent memory deficits persisted, concurrent with the presence of viral RNA. Treatment with 6-diazo-5-oxo-l-norleucine (DON), a glutamine antagonist that inhibits both lymphocyte proliferation and glutamate excitotoxicity, partially prevented development of clinical disease and neurological sequelae. Mice treated with DON exhibited decreased CNS inflammation and pathology but delayed virus clearance, indicating that the immune response mediates both processes. Previous studies have shown that clearance of SINV is cooperatively facilitated by anti-SINV antibody and the cytokine interferon gamma (IFN-γ). To further examine the role IFN-γ plays in SINV clearance and control, neuronal cell cultures and mice deficient in IFN-γ (Ifng-/-) or IFN-γ receptor (Ifngr1-/-) were infected with SINV TE. IFN-γ facilitated clearance of both infectious virus and viral RNA in vitro, but mice with impaired IFN-γ signaling displayed accelerated viral RNA clearance from the CNS despite delayed clearance of infectious virus, suggesting IFN-γ-induced immunomodulation. IFN-γ promoted local production of anti-SINV antibody but inhibited infiltration of granzyme B-producing CD8+ T cells. Memory T cells, which persist in the brain following clearance of infectious virus, were also affected by IFN-γ signaling, with Ifng-/- and Ifngr1-/- mice possessing fewer CD8+ tissue resident memory T cells. Therefore, IFN-γ plays a multi-faceted role in SINV clearance and control during CNS infection

Towards a practical framework for managing the risks of selecting technology to support independent living

Information and communication technology applications can help increase the independence and quality of life of older people, or people with disabilities who live in their own homes. A risk management framework is proposed to assist in selecting applications that match the needs and wishes of particular individuals. Risk comprises two components: the likelihood of the occurrence of harm and the consequences of that harm. In the home, the social and psychological harms are as important as the physical ones. The importance of the harm (e.g., injury) is conditioned by its consequences (e.g., distress, costly medical treatment). We identify six generic types of harm (including dependency, loneliness, fear and debt) and four generic consequences (including distress and loss of confidence in ability to live independently). The resultant client-centred framework offers a systematic basis for selecting and evaluating technology for independent living

Vision rehabilitation services : what is the evidence? Final report.

Sight loss affects all aspects of well-being including daily functioning and mental health. Demographic trends suggest that the number of people with visual impairment is set to rise significantly, with many people experiencing an additional disability or health problems. By 2050, the number of blind and partially sighted people in the UK is estimated to increase by around 122 per cent, to approximately four million. Promoting preventive and rehabilitation interventions is recognised as a high priority for all care settings as a way of reducing demands on health and social care services. This research, funded by the Thomas Pocklington Trust, aimed to provide an overview of the evidence base for community-based vision rehabilitation services for people over the age of 18 with visual impairment. The study focused on rehabilitation services funded by local authorities to find out how these services are currently supporting people with visual impairment, what possible outcomes they might achieve and to identify gaps in the evidence base about current service arrangements. The study was carried out in England. Findings were intended to inform a future full scale evaluation as well as inform services

Estimating the unit costs of vision rehabilitation services

Sight loss is a major health issue that impacts on all aspects of wellbeing including daily functioning and mental health. Vision rehabilitation services aim to help people learn how to live as independently as possible, to build confidence and to maintain quality of life following full or partial sight loss. Vision rehabilitation services are provided by qualified vision rehabilitation officers. The services they offer include a range of interventions such as: orientation and mobility training; emotional support; communication skills; independent living skills; equipment training; and risk assessments. Vision rehabilitation services are usually funded by local councils and provided either by in-house teams or contracted-out services. As with other preventive services, early access to vision rehabilitation is recommended (ADASS, 2013; Vision2020UK, 2013; UK Vision Strategy Advisory Group, 2013). A literature review undertaken as part of a wider study (Rabiee et al., 2015) showed that there have been few economic studies of vision rehabilitation services and none that estimates unit costs. This short article therefore uses data from Rabiee et al. (2015) to estimate the unit costs of vision rehabilitation services in England. The calculations are based on detailed data from three case studies with additional data collected from a national survey

People who fund their own social care

Very little is known about the many adults in England who purchase social care services and support using their own, private resources. However, rising eligibility thresholds for local authority-funded care combined with population ageing means the numbers of self funders are likely to increase. The importance to local authorities of self-funders is also increasing with the implementation of the Care Act 2014.This review sought evidence on: the size of the evidence base, characteristics of the self-funding population, information and advice sought by and available to self-funders, and providers' experiences of self-funders. A self-funder was defined as someone who pays for all of their social care or support from their own private resources or 'tops up' their local authority residential or domiciliary care funding with additional private spending. Social care was defined as care homes (both with and without nursing), domiciliary care, day care and care received as part of extra-care housing

Evaluation of the personal health budget pilot programme

1. The personal health budget initiative is a key aspect of personalisation across health care services in England. Its aim is to improve patient outcomes, by placing patients at the centre of decisions about their care. Giving people greater choice and control, with patients working alongside health service professionals to develop and execute a care plan, given a known budget, is intended to encourage more responsiveness of the health and care system. 2. The personal health budget programme was launched by the Department of Health in 2009 after the publication of the 2008 Next Stage Review. An independent evaluation was commissioned alongside the pilot programme with the aim of identifying whether personal health budgets ensured better health and care outcomes when compared to conventional service delivery and, if so, the best way for personal health budgets to be implemented

Acoustofluidic measurements on polymer-coated microbubbles: primary and secondary Bjerknes forces

The acoustically-driven dynamics of isolated particle-like objects in microfluidic environments is a well-characterised phenomenon, which has been the subject of many studies. Conversely, very few acoustofluidic researchers looked at coated microbubbles, despite their widespread use in diagnostic imaging and the need for a precise characterisation of their acoustically-driven behaviour, underpinning therapeutic applications. The main reason is that microbubbles behave differently, due to their larger compressibility, exhibiting much stronger interactions with the unperturbed acoustic field (primary Bjerknes forces) or with other bubbles (secondary Bjerknes forces). In this paper, we study the translational dynamics of commercially-available polymer-coated microbubbles in a standing-wave acoustofluidic device. At increasing acoustic driving pressures, we measure acoustic forces on isolated bubbles, quantify bubble-bubble interaction forces during doublet formation and study the occurrence of sub-wavelength structures during aggregation. We present a dynamic characterisation of microbubble compressibility with acoustic pressure, highlighting a threshold pressure below which bubbles can be treated as uncoated. Thanks to benchmarking measurements under a scanning electron microscope, we interpret this threshold as the onset of buckling, providing a quantitative measurement of this parameter at the single-bubble level. For acoustofluidic applications, our results highlight the limitations of treating microbubbles as a special case of solid particles. Our findings will impact applications where knowing the buckling pressure of coated microbubbles has a key role, like diagnostics and drug delivery