The views of older people and health professionals about dignity in acute hospital care.

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.

Practitioner-recommended policies and procedures for children exposed to domestic violence.

Children exposed to domestic violence experience higher rates of psychosocial, behavioral, and physical problems. Current policy recommendations are that health care providers offer regular screening and treatment for childhood exposure to domestic violence (CEDV). However, screening recommendations have been slow to take hold. The purpose of this study was to identify recommended practices of CEDV, as reported by practitioners. Interviews were held with 24 experienced service providers from 14 agencies. Respondents provided practical suggestions for CEDV screening and intervention. Suggestions included refinement of screening tools for maximum validity and reliability, improved integration of DV education into medical training and practice, on-site DV resources in pediatric settings, and establishment of formal partnerships between human service organizations that promoted ongoing collaborative activities. Next steps are to evaluate outcomes for evidence-based practice.

Translating the Olweus Bullying Prevention Program into real-world practice.

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.

Comparing the Clinical Severity of Disease Caused by Enteroviruses and Human Parechoviruses in Neonates and Infants.

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.

Plasmodium falciparum Rab5B is an N-terminally myristoylated Rab GTPase that is targeted to the parasite's plasma and food vacuole membranes.

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.

Subcellular location, phosphorylation and assembly into the motor complex of GAP45 during Plasmodium falciparum schizont development.

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.

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