Aims and objectives
To report the findings from interviews conducted as part of a wider study on interventions to support dignified care in older people in acute hospital care. The data in this study ...present the interview data.
Background
Dignity is a complex concept. Despite a plethora of recommendations on how to achieve dignified care, it remains unclear how to attain this in practice and what the priorities of patients and staff are in relation to dignity.
Design
A purposive sample of older patients and staff took part in semi‐structured interviews and gave their insight on the meaning of dignity and examples of what sustains and breaches a patient's dignity in acute hospital care.
Method
Thirteen patients and 38 healthcare professionals in a single metropolitan hospital in the UK interviewed. Interviews were transcribed verbatim and underwent a thematic analysis.
Results
The meaning of dignity was broadly agreed on by patients and staff. Three broad themes were identified: the meaning of dignity, staffing level and its impact on dignity, and organisational culture and dignity. Registered staff of all healthcare discipline and student nurses report very little training on dignity or care of the older person.
Conclusion
There remain inconsistencies in the application of dignified care. Staff behaviour, a lack of training and the organisational processes continue to result in breaches to dignity of older people. Clinical nurses have a major role in ensuring dignified care for older people in hospital.
Relevance to clinical practice
There needs to be systematic dignity‐related training with regular refreshers. This education coupled with measures to change the cultural attitudes in an organisation towards older peoples’ care should result in long‐term improvements in the level of dignified care. Hospital managers have an important role in changing system to ensure that staff deliver the levels of care they aspire to.
Comparison of children hospitalized with enterovirus or human parechovirus (HPeV) detected in their cerebrospinal fluid revealed that HPeV infections presented with more persistent fever, ...irritability and feeding problems, more frequent leukopenia and lymphopenia and higher admission rates to high dependency or intensive care units. Few HPeV cases were followed up, further studies on long-term outcomes are needed.
An actomyosin motor complex assembled below the parasite's plasma membrane drives erythrocyte invasion by Plasmodium falciparum merozoites. The complex is comprised of several proteins including ...myosin (MyoA), myosin tail domain interacting protein (MTIP) and glideosome associated proteins (GAP) 45 and 50, and is anchored on the inner membrane complex (IMC), which underlies the plasmalemma. A ternary complex of MyoA, MTIP and GAP45 is formed that then associates with GAP50. We show that full length GAP45 labelled internally with GFP is assembled into the motor complex and transported to the developing IMC in early schizogony, where it accumulates during intracellular development until merozoite release. We show that GAP45 is phosphorylated by calcium dependent protein kinase 1 (CDPK1), and identify the modified serine residues. Replacing these serine residues with alanine or aspartate has no apparent effect on GAP45 assembly into the motor protein complex or its subcellular location in the parasite. The early assembly of the motor complex suggests that it has functions in addition to its role in erythrocyte invasion.
Plasmodium falciparum (Pf) has a family of 11 Rab GTPases to regulate its vesicular transport. However, PfRab5B is unique in lacking a C-terminal geranyl-geranylation motif, while having N-terminal ...palmitoylation and myristoylation motifs. We show that the N-terminal glycine is required for PfRab5B myristoylation in vitro and when an N-terminal PfRab5B fragment possessing both acylation motifs is fused to GFP and expressed in transgenic P. falciparum parasites, the chimeric PfRab5B protein localizes to the plasma membrane. Upon substitution of the modified glycine by alanine the staining becomes diffuse and GFP is found in soluble subcellular fractions. Immuno-electron microscopy shows endogenous PfRab5B decorating the parasite's plasma and food vacuole membranes. Using reverse genetics rab5b couldn't be deleted from the haploid genome of asexual blood stage P. berghei parasites. The failure of PbRab5A or PbRab5C to complement for loss of PbRab5B function indicates non-overlapping roles for the three Plasmodium Rab5s, with PfRab5B involved in trafficking MSP1 to the food vacuole membrane and CK1 to the plasma membrane. We discuss similarities between Plasmodium Rab5B and Arabidopsis thaliana ARA6, a similarly unusual Rab5-like GTPase of plants.
Bullying negatively impacts the mental and physical health of student victims, bullies and bystanders. The Olweus Bullying Prevention Programme is an internationally recognized school based programme ...demonstrated effective in research. The purpose of this study was to determine if the Bullying Prevention Programme was effective for urban youth from diverse ethnic backgrounds. The programme was implemented in one large urban school district in the United States. Bullying incident density was used to evaluate programme outcomes. An independent evaluator performed 319 observation sets, 7,589 minutes. Data were standardized to incident density and reported back to school committees who developed and implemented culturally and developmentally relevant interventions based on the Olweus model. At baseline, incident density was 65 incidents per 100 student hours. After four years, incident density decreased by 45 percent to 36 incidents per 100 student hours. Programme components associated with decreased incidents were posting of rules, consistent enforcement of positive and negative consequences and training adult monitors to engage students in activities. Supplementary strategies were socialized recess, providing pro-social activities, reorganization of lunches and recess and separation of grades or genders. Results suggest that the Bullying Prevention Programme reduces incident density by up to 65 percent.
INTRODUCTIONTransplant perfusion fluid (TPF) optimises the storage of organs for transplantation; however it can be a culture medium for pathogenic bacteria. Clinical practice in UK involves routine ...culture of TPF however results take several days. We did a retrospective study to assess the value of TPF in deceased donor renal transplant recipients.
MATERIALS AND METHODS173 patients who received renal transplants between January 2014 and October 2016 were included in the study. Electronic data records were used to collect TPF culture result, antibiotics used, length of hospital stay and presence of septic complication in recipients.
RESULTS106 patients received DBD and 67 had DCD organs. 54.3% (n=94) had a negative TPF culture (Cl 46.88-61.72) and 45.7% (n=79) had a positive TPF culture (CI 38.28-53.12).21% (n=36) were diabetic and 4.3% (n=6) had post transplantation diabetes mellitus.Coagulase negative staphylococci represented 55% of positive samples. E.Coli was the most common pathogenic bacteria found (11.3%, n= 9). Infection developed in 45.7% (n=43) of patients receiving a kidney with negative TPF culture compared with 32.9% (n=26) with a positive TPF culture. 7.7% (n=6) of patients with a positive TPF culture developed an infection identified to be caused as the same organism as that from the TPF.Recipients with delayed graft function (DGF) had an infection rate of 54.9% (n =51). Patients without DGF had infection rate of 32.8% (n=116). This association is not statically significant (p=0.07) but may warrant further investigation.Patients with positive TPF culture who received prophylactic antibiotics had similar length of hospital stay as patients not receiving antibiotics. Urinary tract was the commonest site of infection (50%). Patients with diabetic nephropathy or chronic pyelonephritis had higher rates of infection.(Figure is included in full-text article.)
CONCLUSIONPositive TPF culture was not associated with higher rates of infection or DGF. The likelihood of infection was higher in diabetic patients. Length of hospital stay was not reduced by use of prophylactic antibiotic, even in patients with positive TPF culture. We suggest that a decision to give antibiotic should be based on patientʼs clinical status and virulence of pathogens found. Further studies are needed to establish role of prophylactic antibiotics in preventing septic complication in recipients with positive TPF culture results.
INTRODUCTIONPerfusion fluid has been developed to optimise the storage of organs for transplantation, however it acts as a culture medium for pathogenic bacteria. Although clinical practice in UK ...involves routine culture of perfusion fluid, there is a delay in identification of pathogens. We did a retrospective study to assess the value of transport fluid (TPF) in deceased donor renal transplant recipients.
MATERIALS AND METHODS173 patients who received renal transplants between January 2014 and October 2016 were included in the study. Electronic data base was used to record culture result of perfusion fluid, pathogen identified, antibiotics used, length of hospital stay and presence of septic complication in recipients.
RESULTS106 patients received DBD and 67 had DCD organs.54.3% (n=94) had a negative TPF culture (Cl 46.88-61.72) and 45.7% (n=79) had a positive TPF culture (CI 38.28-53.12).21% (n=36) were diabetic and 4.3% (n=6) had post transplantation diabetes mellites.Coagulase negative staphylococci was found in 55.7% all positive samples. E.Coli was the most common pathogenic bacteria found (10%, n= 8). 45.7% (n=43) with a negative TPF culture developed infection as compared with 32.9% (n=26) with a positive TPF.Recipients with delayed graft function (DGF) had an infection rate of 54.9% (n =51). Patients without DGF had infection rate of 32.8% (n=116). This association is not statically significant (p=0.07), it may warrant further investigations.Patients who received prophylactic antibiotic (based on TPF culture results) had similar length of hospital stay compared with patients not receiving antibiotics. Urinary tract was the commonest site of infection (50%).Patients with diabetic nephropathy or chronic pyelonephritis had higher rates of infection.
CONCLUSIONPositive TPF culture samples was not associated with higher rates of infection or DGF. The likelihood of infection was higher in diabetic patients. Length of hospital stay was not reduced by use of prophylactic antibiotic. We suggest that a decision to give antibiotic should be based on patientʼs clinical status and virulence of pathogens found. Further studies are needed to establish role of prophylactic antibiotics in preventing septic complication in recipients with positive TPF culture results.(Figure is included in full-text article.)
Firearms account for the majority of deaths among young Black men in America. This article presents a qualitative investigation of youth temptations, emotional reactions, and subsequent behavior with ...respect to guns. Twenty-three youth enrolled in a community-based firearm reduction program have participated in interviews on retrospective experiences with guns. Common temptations for gun carrying are protection during drug dealing, protection from disrespect, and protection from repeated aggression and bullying. Gun handling produces two diverse responses, fear and excitement. Interviews reveal a dangerous form of gunplay known as flossing and cognitive distortions of peer attitudes toward carriers. Results suggest the need to promote normal adolescent development through increased social opportunities, reduced exposure to guns, and empowering bystanders to prevent escalation of conflict.
One of the most commonly recommended strategies for youth to stop bullying is to report incidents to an adult. Although reporting is preferred, ultimately, victims will use strategies that they ...perceive to be most effective. This study investigated victims’ strategies to stop bullying, as well as their perceptions of each strategy’s effectiveness. In all, 50% of participating school students (n = 2,615) reported at least one form of victimization. The most common strategies used against bullying were fighting back (63%), ignoring the bullying (52%), telling an adult at home (44%), and reporting the abuse to a peer (42%). The most successful strategies reported were counter-aggression (75%), making a safety plan (74%), and telling a peer (71%) or an adult at home (71%). Implications for practice are for school staff to deconstruct the idea of counter-aggression as an effective strategy against violence and to improve perceptions of staff responses to victimization.
This article describes the application of a community collaboration model implementing an evidence-based bullying-prevention program in elementary and middle schools. Between 2001 and 2006, the ...Office of School Climate and Safety, Office of Research and Evaluation, the local chapter of Physicians for Social Responsibility, and a local researcher partnered to implement the Olweus Bullying Prevention Program (BPP). The BPP is a blueprints program for youth violence prevention, following the public health model of needs assessment, problem definition, planning, implementation, and evaluation. This article describes the practical application of the model in a large urban district with multiple obstacles to implementation. The description provides a model for other community collaborations in community public health practice. A strength of collaborative practice is the ability to draw on the different capabilities of partners to provide a seamless program. A suggestion for policy is to promote community collaborations of evidence-based programs through preferential funding.
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