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Health literacy - the degree to which people can access, understand and use health information - is essential for shared decision-making and improved health outcomes. Health consumers' ability to engage with health care professionals (HCPs) is influenced by their health literacy capabilities. This research sought to understand health literacy-related barriers and enablers to engage with non-physician HCPs as experienced by consumers.A qualitative descriptive approach was undertaken. A semi-structured interview guide was used, incorporating five health literacy domains described in the Health Literacy Questionnaire that related to consumers' engagement with health professionals. Audio- or digitally-recorded interviews were conducted with Australian health consumers, and transcribed and themed using the Patient-centred Access to Care framework as a template.Interviewing 30 consumers revealed that HCPs' clinical skills often enabled consumers to seek engagement; however, during active engagement their interpersonal skills became a key enabler. Conversely, a lack of developed interpersonal skills in HCPs was frequently seen as a barrier to consumer engagement. Barriers to engagement were also created when HCPs' information did not match what consumers discovered from other sources. However, consumers self-reported that they were unable to appraise health information at least some of the time.Barriers and enablers to consumers' engagement with HCPs were identified across each of the five relevant health literacy domains. SO WHAT?: HCPs should be aware of the importance of interpersonal skills and clear health information suitable for consumers with lower health literacy. Additionally, time dedicated to educating consumers on information appraisal could act as a further enabler to effective engagement.

Study Design Literature Review (Narrative) Objective To introduce the number one research priority for Degenerative Cervical Myelopathy (DCM): Raising Awareness. Methods Raising awareness has been recognized by AO Spine RECODE-DCM as the number one research priority. This article reviews the evidence that awareness is low, the potential drivers, and why this must be addressed. Case studies of success from other diseases are also reviewed, drawing potential parallels and opportunities for DCM. Results DCM may affect as many as 1 in 50 adults, yet few will receive a diagnosis and those that do will wait many years for it. This leads to poorer outcomes from surgery and greater disability. DCM is rarely featured in healthcare professional training programs and has received relatively little research funding (Conclusion Despite the devastating burden on the patient, recognition across research, clinical practice, and healthcare policy are limited. DCM represents a significant unmet need that must become an international public health priority.

BACKGROUND In shared decision-making (SDM), clinicians and patients collaborate to reach evidence-based choices that reflect the unique circumstances, values, and preferences of each individual. This approach to clinical care is uniquely beneficial when embedded in the context of chronic illness where ongoing decisions and management are required and patients frequently face complex or difficult treatment decisions. SDM is, therefore, likely highly relevant to degenerative cervical myelopathy (DCM), a type of non-traumatic spinal cord injury caused by degenerative and/or congenital pathology. The chronicity, clinical heterogeneity, management complexity, and disease course of DCM engender an imperative for a patient-centric decision-making approach that diligently accounts for the unique needs, experiences, and priorities of each individual afflicted with this condition. Inadequate patient knowledge about the condition and an incomplete understanding of the critical decision points that arise along the course of care currently hinder the fruitful participation of healthcare providers and patients in SDM. This study protocol presents the rationale for deploying SDM in DCM and delineates the groundwork required to achieve this. OBJECTIVE The study’s primary outcome is the development of a comprehensive checklist to be implemented upon diagnosis that provides patients with essential information necessary to support their onward informed decision-making. This is known as a Core Information Set (CIS). The secondary outcome is the creation of a detailed process map (PM) that provides a diagrammatic representation of the global care workflows and cognitive processes involved in DCM care. Characterising the critical decision points along a patient's journey will allow an effective exploration of SDM tools for routine clinical practice towards enhancing patient-centered care and improving clinical outcomes. METHODS Co-production of CISs and PMs is achieved through a collaborative and iterative process involving input and consensus from multiple stakeholders. This will be facilitated by Myelopathy.org, a global DCM Charity, and its Research Objectives and Common Data Elements for Degenerative Cervical Myelopathy (RECODE-DCM) community. To develop the CIS, a three-round, web-based Delphi process will be employed, starting with a baseline list of information items derived from a recent scoping review of educational materials in DCM, patient interviews, and a qualitative survey of professionals. A priori criteria for achieving consensus are specified. The PM will be developed iteratively using semi-structured interviews with patients and professionals and validated by all key stakeholders to ensure its accuracy and completeness. RESULTS A multimethod approach to lay the foundations for SDM in DCM. The Delphi and PM studies are scheduled to commence in March and April 2023, respectively. CONCLUSIONS This study will inform the investigation, development, and evaluation of SDM tools in DCM clinical practice. By engaging international stakeholders in this preliminary work, we provide an exhaustive launchpad for formulating SDM tools suitable for the DCM community at large.

This article draws on the work of Raymond Williams to argue that under covid-19 the dominant ‘ways of seeing’ the countryside and the city in Britain are working to obscure the structural violence of capitalism. Cultural narratives of ‘exodus’ from the city abound in British media, fuelling a material ‘race for space’ as the middle class rush to buy up rural properties. The ‘cottagecore’ social media aesthetic has proliferated, offering privatized solutions to the crisis through nostalgic imagery of pastoral escape. At the same time, nineteenth-century discourses of dark, diseased cities have been rearticulated, providing ideological support for racist migration policies. Exploited migrant workers in Leicester are framed as ‘modern slaves’ in the city’s ‘dark factories’;their bodies are transcoded as ‘dirt’ which must be ‘rooted out’ of the nation. We argue that these binary narratives and aesthetics of a bountiful, white countryside and an infested, racialized city lead to an ‘unseeing’ of the deep structural causes of inequality. We develop Williams’s analysis to show how these cultural imaginaries also sustain the gendered and racialized division of labour under capitalism, arguing that the country-city distinction, and the material injustices it obscures, ought to become a central focus for cultural studies. [ FROM AUTHOR] Copyright of Continuum: Journal of Media & Cultural Studies is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all Abstracts.)

BACKGROUND Degenerative cervical myelopathy (DCM) is a common and disabling neurodegenerative condition. Surgical decompression is the only evidence-based treatment to halt disease progression; however, diagnosis and access to timely treatment are often delayed, which contribute to significant disability and dependence. Supporting early diagnosis and access to timely treatment is a critical priority. Exploring these challenges, Myelopathy.org has observed that people with DCM may seek osteopathy care for their symptoms, both before and after diagnosis. OBJECTIVE This study aimed to describe the current interaction between osteopaths and people with DCM and understand how this may be targeted to enhance the DCM diagnostic pathway. METHODS Registered osteopaths in the United Kingdom completed a web-based survey hosted by the Institute of Osteopathy, as part of their institute’s 2021 census. Responses were collected from February to May 2021. Demographic information about the respondents was captured, including age, gender, and ethnicity. Professional information captured included the year of qualification; region of practice; type of practice; and number of undiagnosed, operated diagnosed, and unoperated diagnosed DCM cases encountered per year. The completion of the survey was voluntary; however, a prize draw incentive was offered to participants. RESULTS The demographics were heterogenous for the 547 practitioners who completed the survey. There was representation from a wide range of demographic groups, including the level of experience, gender, age, and the region of United Kingdom. At least 68.9% (377/547) of osteopaths reported encounters with DCM each year. Osteopaths most frequently encountered patients with undiagnosed DCM, with a mean of 3 patient encounters per year. This compares to 2 encounters per year with patients with diagnosed DCM. The level of practitioner experience was positively correlated with the detection of undiagnosed DCM (P CONCLUSIONS Osteopaths reported that they frequently consult people with DCM, including those suspected to have undiagnosed or presurgical DCM. Given this concentrated presentation of early DCM and a workforce professionally trained to examine musculoskeletal disease, osteopaths could have an important role in accelerating access to timely treatment. We included a decision support tool and specialist referral template as a tool to support onward care.

UNSTRUCTURED Promoting online peer support beyond the informal sector to statutory health services, requires ethical considerations and evidence-based knowledge about its impact on patients, healthcare professionals and the wider healthcare system. Evidence on the effectiveness of digital interventions in primary care is sparse, and definitive guidance is lacking on the ethical concerns arising from the use of social media as a means for health-related interventions and research. Existing literature examining ethical issues with digital interventions in healthcare mainly focuses on apps, electronic health records, wearables, telephone/video consultations etc., without necessarily covering digital social interventions, and/or does not always account for primary care settings specifically. Here we address the ethical and information governance aspects of undertaking research on the promotion of online peer support to patients by primary care clinicians, related to medical and public health ethics.

This article analyses (broadly lower middle-class) women’s responses to the arrival of commercial television in the UK in the 1950s, and seeks to contribute to a more nuanced understanding of Briti...

Background:This review investigated the role of neurovascular clinical nurse specialists in telephone clinics following subarachnoid haemorrhage (SAH) and arteriovenous malformations (AVM).Aims:To review telephone clinic letters to assess frequency of support provided.Methods:Clinic letters for all neurovascular clinical nurse specialist telephone clinics from July 2016–June 2018 were reviewed using a locally developed standardised template.Findings:Some 133 telephone clinic letters were included. The most common theme was clinical advice for SAH complications: fatigue (n=63) and headache (n=60). Psychological support was the second most common theme: emotional issues (n=41) and short–term memory concerns (n=41). Information was most frequently provided on lifestyle (n=61).Conclusions:The role of the neurovascular clinical nurse specialist following SAH and AVM involves clinical advice on complications. Psychological support after SAH and AVM is required for almost two–thirds of patients, which is significantly higher than previous studies. While a single site audit, this study indicates the important role in supporting psychological care that clinical nurse specialists have in a neurovascular service.

Peer support work is now recognized as a valuable component of mental health services. Although a number of studies have been published, the evidence base is inconsistent. There is relatively littl...

Objective:To evaluate the impact of changes to urine testing orderables in computerized physician order entry (CPOE) system on urine culturing practices.Design:Retrospective before-and-after study.Setting:A 1,250-bed academic tertiary-care referral center.Patients:Hospitalized adults who had ≥1 urine culture performed during their stay.Intervention:The intervention (implemented in April 2017) consisted of notifications to providers, changes to order sets, and inclusion of the new urine culture reflex tests in commonly used order sets. We compared the urine culture rates before the intervention (January 2015 to April 2016) and after the intervention (May 2016 to August 2017), adjusting for temporal trends.Results:During the study period, 18,954 inpatients (median age, 62 years; 68.8% white and 52.3% female) had 24,569 urine cultures ordered. Overall, 6,662 urine cultures (27%) were positive. The urine culturing rate decreased significantly in the postintervention period for any specimen type (38.1 per 1,000 patient days preintervention vs 20.9 per 1,000 patient days postintervention; P < .001), clean catch (30.0 vs 18.7; P < .001) and catheterized urine (7.8 vs 1.9; P < .001). Using an interrupted time series model, urine culture rates decreased for all specimen types (P < .05).Conclusions:Our intervention of changes to order sets and inclusion of the new urine culture reflex tests resulted in a 45% reduction in the urine cultures ordered. CPOE system format plays a vital role in reducing the burden of unnecessary urine cultures and should be implemented in combination with other efforts.

This entry will draw on the wider historical and theoretical ideas about the way in which the body operates as a key site of social calibration, where symbolic markers draw the boundaries of social hierarchies. The classed body is not only a telling sign of access to wealth and economic resources, but also importantly a key means of communicating social “value” and therefore also a site of struggle and contestation. The classed body is also always a racialized body and key intersections are threaded together by the varying intensities of “respectability politics”: the struggle for oppressed groups to claim some access to legitimate citizenship while being subject to the governing logics of propriety that function as structures of power and exclusion. Beauty cultures are at the heart of these classed and racialized struggles and still figure in the ongoing battles of social regulation. In this entry, we move through the related formations of classificatory systems, taste cultures, forms of expertise, and questions of respectability politics through visiting sociological work on beauty work, ethnographies of working-class women, writing about popular culture and television, and the algorithmic implications of beauty apps. We end with the possibilities of transgression and the reframing of classed bodily “excesses” as politicized (if not political) acts of hyperbole in the media frame.

Ultraviolet light (UVL) room disinfection has emerged as an adjunct to manual cleaning of patient rooms. Two different no-touch UVL devices were implemented in 3 health system hospitals to reduce Clostridioides difficile infections (CDI). CDI rates at all 3 facilities remained unchanged following implementation of UVL disinfection. Preintervention CDI rates were generally low, and data from one hospital showed high compliance with manual cleaning, which may have limited the impact of UVL disinfection.

This article focuses on the BBC1 three-part drama Three Girls, broadcast in July 2017, which dramatised the Rochdale child sex-grooming gang scandal of 2011 and won five BAFTAs in 2018. While many of the dominant press narratives focused on the ethnicity of the perpetrators, few accounts of the scandal spoke to the need for a sustained public discussion of the class location of the victims. This article considers how the process of recognising the social problem of sex-grooming is set up for the audience through a particular mode of address. In many ways the drama rendered visible the structural conditions that provided the context for this abuse by drawing on the expanded repertoires of television social realism: the representation of the town as abuser; the championing of heroic working-class women; and the power of working-class vernacular. However, ultimately, the narrative marginalises the type of girl most likely to be the victim of this form of sexual abuse. By focusing on the recognisable journey of the girl ‘who can be saved’ this renders the impoverished girl as already constitutive of the social problem. The analysis draws attention to the difficulties of recognising alternative classed subjectivities on television because of the way that boundary-markers are placed between the working class and the poor and suggests that the consequence of these representations is to reify ideas about the victims of poverty and exploitation.

This paper attempts to counter legal studies’ common reading of court TV shows by starting with an understanding of themastelevision, rather comparing them to ‘real courts’. It analyses two recent examples of British court TV shows –Judge Rinder(ITV, 2014–) andJudge Geordie(MTV, 2015) – to draw out how the text'sformestablishes particular kinds of ‘televisual legal consciousness’.Judge Rinder’s daytime address and his camped authority allow a frame in which humour can disarm conflict and reveal wider political injustice.Judge Geordie’s irreverent upturning of the judged into judge draws upon the registers of youth reality television to privilege affect and emotion. In staging some of the tensions between law's masculine rationality and popular culture's feminine emotionality, these shows enact their interdependence. Such an analysis that includes attention to form, address and genre allows us a deeper exploration of the relationship between television, law and the everyday.

It has been hypothesized that capacity for reflection is a key metacognitive skill in therapist development. However, the measurement of reflection in psychotherapy has proved problematic. The prim...

Introduction Sexually transmitted infection (STI) screening is a crucial initiative that aims to reduce the increasing global prevalence of many common STIs such as chlamydia, gonorrhea, and herpes simplex virus (HSV). Many STIs are either asymptomatic or show mild symptoms that are often attributed to other infections; hence, screening is the only way to identify - and by extension, treat - them. In this way, the spread of STIs can be reduced, and the health implications of an untreated STI are minimized. Community pharmacies could provide an avenue to convenient, confidential STI screening by using noninvasive or minimally invasive sample collection techniques that are used by the consumer or pharmacist. We identified the most common STIs found globally and investigated the current and potential role of pharmacists in provision of STI screening interventions. Discussion There is sufficient evidence for pharmacy-based chlamydia screening, with many consumers and pharmacists finding it an acceptable and highly valued service. Some evidence was found for pharmacy-based gonorrhea, hepatitis B virus (HBV), and human immunodeficiency virus (HIV) screening. Appropriate sample collection for gonorrhea screening needs to be further examined in a pharmacy setting. HBV screening presented an increased risk of personal injury to pharmacists through the collection of whole blood specimens, which could be reduced through consumer self-sampling. Pharmacist-collected specimens for HIV is less risky as an oral swab can be used, nullifying the risk of transmission; but pre- and post-screen consultations can be time-intensive; hence, pharmacists would require remuneration to provide an ongoing HIV screening service. Not enough evidence was found for syphilis screening through community pharmacies; more studies are required that consider sampling methods other than pharmacist-collected whole blood specimens. There is no evidence to date for pharmacist-led trichomoniasis or HSV screening. Conclusion Pharmacists are well-positioned to provide STI screening services, but further investigations are needed to overcome financial, safety, and confidentiality barriers.

BackgroundUrinalysis and urine culture are commonly ordered tests in the emergency department (ED). We evaluated the impact of removal of order sets from the ‘frequently ordered test’ in the computerised physician order entry system (CPOE) on urine testing practices.MethodsWe conducted a before (1 September to 20 October 2015) and after (21 October to 30 November 2015) study of ED patients. The intervention consisted of retaining ‘urinalysis with reflex to microscopy’ as the only urine test in a highly accessible list of frequently ordered tests in the CPOE system. All other urine tests required use of additional order screens via additional mouse clicks. The frequency of urine testing before and after the intervention was compared, adjusting for temporal trends.ResultsDuring the study period, 6499 (28.2%) of 22 948 ED patients had ≥1 urine test ordered. Urine testing rates for all ED patients decreased in the post intervention period for urinalysis (291.5 pre intervention vs 278.4 per 1000 ED visits post intervention, P=0.03), urine microscopy (196.5vs179.5, P=0.001) and urine culture (54.3vs29.7, PConclusionsA simple intervention of retaining only ‘urinalysis with reflex to microscopy’ and removing all other urine tests from the ‘frequently ordered’ window of the ED electronic order set decreased urine cultures ordered by 46.6% after accounting for temporal trends. Given the injudicious use of antimicrobial therapy for asymptomatic bacteriuria, findings from our study suggest that proper design of electronic order sets plays a vital role in reducing excessive ordering of urine cultures.

Twenty years of the European Journal of Cultural Studies is a cause for celebration. We do so with a festive issue that comes together with our first free open access top articles in three areas that readers have sought us out for: postfeminism, television beyond textual analysis and cultural labour in the creative industries. The issue opens with freshly commissioned introductory essays to these three thematic areas by key authors in those fields. In addition, the issue offers new articles showcasing the range of the broad field of cultural studies today, including pieces on the politics of co-working, punk in China, Black British women on YouTube, trans-pedagogy and fantasy sports gameplay, featuring work by emerging as well as established scholars. Our editorial introduction to this celebratory issue offers reflections on how both the journal and the field of cultural studies have developed, and on our thoughts and ambitions for the future within the current conjuncture as we ‘move on’ as a new editorial team.

OBJECTIVETo describe the frequency of urine cultures performed in inpatients without additional testing for pyuriaDESIGNRetrospective cohort studySETTINGA 1,250-bed academic tertiary referral centerPATIENTSHospitalized adultsMETHODSThis study included urine cultures drawn on 4 medical and 2 surgical wards from 2009 to 2013 and in the medical and surgical intensive care units (ICUs) from 2012 to 2013. Patient and laboratory data were abstracted from the hospital’s medical informatics database. We identified catheter-associated urinary tract infections (CAUTIs) in the ICUs by routine infection prevention surveillance. Cultures without urinalysis or urine microscopy were defined as “isolated.” The primary outcome was the proportion of isolated urine cultures obtained. We used multivariable logistic regression to assess predictors of isolated cultures.RESULTSDuring the study period, 14,743 urine cultures were obtained (63.5 cultures per 1,000 patient days) during 11,820 patient admissions. Of these, 2,973 cultures (20.2%) were isolated cultures. Of the 61 CAUTIs identified, 31 (50.8%) were identified by an isolated culture. Predictors for having an isolated culture included male gender (adjusted odds ratio [aOR], 1.22; 95%; confidence interval [CI], 1.11–1.35], urinary catheterization (aOR, 2.15; 95% CI, 1.89–2.46), ICU admission (medical ICU aOR, 1.72; 95% CI, 1.47–2.00; surgical ICU aOR, 1.82; 95% CI, 1.51–2.19), and obtaining the urine culture ≥1 calendar day after admission (1–7 days aOR, 1.91; 95% CI. 1.71–2.12; >7 days after admission aOR, 2.81; 95% CI, 2.37–3.34).CONCLUSIONSIsolated urine cultures are common in hospitalized patients, particularly in patients with urinary catheters and those in ICUs. Interventions targeting inpatient culturing practices may improve the diagnosis of urinary tract infections.Infect Control Hosp Epidemiol2017;38:455–460

This collection acts as a feminist project but does not straight-forwardly renounce the wedding spectacle. Rather, these contributions offer an interrogation of its myriad forms and practices to illuminate the paradoxes, contradictions and disappointments of heteronormative love. Written by leading and emerging feminist scholars, the essays here range across different media forms, genres and cultural practices, to explore how the visibility of weddings changes and adapts across a new cultural and social landscape.

My impetus for writing this comes from noticing just how many times the word “fuck” comes up in contemporary feminist protests against injustice. In April 2019 Huffpost reports on Julia Louis-Dreyf...

This article discusses MTV’s Geordie Shore against the backcloth of current social conditions for working-class youth. It suggests that the aesthetic, physical and discursive features of excess represent hyperbole, produced from within an affective situation of precariousness and routed through the labour relations of media visibility. Hyper-glamour, hyper-sex and hyper-emotion are responses to the ideologies of the future-projected, self-governing neoliberal subject and to the contemporary gendered contradictions of sexually proclivity and monogamous heteronormativity. By ‘flaunting’ the realities of self-work and making the labour of themselves more/most visible, the participants of Geordie Shore are claiming an animated type of ill/legitimate subjectivity.

Background: In the UK, denosumab is usually started by hospital clinicians and continued by primary care physicians in the community, but in the authors' region denosumab is a ‘green light’ drug, only prescribed by the primary care team. The authors suspected that a proportion of patients who were recommended to start the drug after a neck of femur fracture were not receiving this on discharge. They aimed to improve the prescribing of denosumab by implementing a quality improvement project. Methods: A retrospective review of electronic records and case notes in primary and secondary care was undertaken, focusing on patients who were admitted with a neck of femur fracture and recommended denosumab. Following cycle 1 of the project two interventions were implemented: Denosumab written on the inpatient prescription chart at point of treatment decision, promoting inclusion in the discharge summary A consultant letter recommending denosumab was sent separately to primary care, in addition to inclusion in the discharge summary. Following these interventions this project cycle was repeated. Results: A total of 91 patients with a neck of femur fracture were identified during cycle 1 and 22/91 (24%) were recommended denosumab. However, only five of these 22 patients (22%) received the drug. Following the interventions 23/26 eligible patients (88%) were prescribed denosumab (three patients did not have a prescription with no reason given), and 17/23 (74%) had the injection given. Four patients who did not receive the denosumab injection had no obvious reason for not starting treatment. In the other two patients, one discharge summary misleadingly stated that the injection had been given as an inpatient and one patient had recurrent admissions following discharge after their neck of femur fracture so primary care had not had any opportunity to administer the injection. Conclusions: Prescribing denosumab on the inpatient drug chart and highlighting its use in a consultant-written letter to the primary care team improved prescribing and administering of denosumab in the community.

Background: Proper care and maintenance of central lines is essential to prevent central-line–associated bloodstream infections (CLABSI). Our facility implemented a hospital-wide central-line maintenance bundle based on CLABSI prevention guidelines. The objective of this study was to determine whether maintenance bundle adherence was influenced by nursing shift or the day of week. Methods: A central-line maintenance bundle was implemented in April 2018 at a 1,266-bed academic medical center. The maintenance bundle components included alcohol-impregnated disinfection caps on all ports and infusion tubing, infusion tubing dated, dressings, not damp or soiled, no oozing at insertion site greater than the size of a quarter, dressings occlusive with all edges intact, transparent dressing change recorded within 7 days, and no gauze dressings in place for >48 hours. To monitor bundle compliance, 4 non–unit-based nurse observers were trained to audit central lines. Observations were collected between August 2018 and October 2019. Observations were performed during all shifts and 7 days per week. Just-in-time feedback was provided for noncompliant central lines. Nursing shifts were defined as day (7:00 a.m. to 3:00 p.m.), evening (3:00 p.m. to 11:00 p.m.), and night (11:00 p.m. to 7:00 a.m.). Central-line bundle compliance between shifts were compared using multinomial logistic regression. Bundle compliance between week day and weekend were compared using Mantel-Haenszel 2 analysis. Results: Of the 25,902 observations collected, 11,135 (42.9%) were day-shift observations, 11,559 (44.6%) occurred on evening shift, and 3,208 (12.4%) occurred on the night shift. Overall, 22,114 (85.9%) observations occurred on a week day versus 3,788 (14.6%) on a Saturday or Sunday (median observations per day of the week, 2,570; range, 1,680–6,800). In total, 4,599 CLs (17.8%) were noncompliant with >1 bundle component. The most common reasons for noncompliance were dressing not dated (n = 1,577; 44.0%) and dressings not occlusive with all edges intact (n = 1340; 37.4%). The noncompliant rates for central-line observations by shift were 12.8% (1,430 of 1,1,135) on day shift, 20.4% (2,361 of 11,559) on evening shift, and 25.2% (808 of 3,208) on night shift. Compared to day shift, evening shift (OR, 1.74; 95% CI, 1.62–1.87; P < .001) and night shift (OR, 2.29; 95% CI, 2.07–2.52; P < .001) were more likely to have a noncompliant central lines. Compared to a weekday, observations on weekend days were more likely to find a noncompliant central line: 914 of 3,788 (24.4%) weekend days versus 3,685 of 22,114 (16.7%) week days (P < .001). Conclusions: Noncompliance with central-line maintenance bundle was more likely on evening and night shifts and during the weekends.Funding: NoneDisclosures: None

Chlamydia trachomatis is the most frequently-notified sexually transmitted infection in Australia. Effective and timely partner treatment of chlamydia is essential to reduce overall prevalence and the burden of infection. Currently in most of Australia, the only avenue for partner treatment of chlamydia ("standard partner therapy") is a tedious, and often inconvenient, process. The barriers and facilitators of standard partner therapy, and newer models of accelerated partner therapy (APT), need to be identified in the Australian setting. Additionally, the potential role of community pharmacists need to be explored. Semi-structured interview guides for two key stakeholder groups (prescribers and pharmacists) were developed and piloted. Eleven prescribers (general practitioners, sexual health clinicians and nurse practitioners) and twelve pharmacists practicing in the Perth metropolitan region were interviewed. Key reported barriers to standard partner therapy were lack of or delayed chlamydia testing. Key facilitators included ability to test and educate sexual partner. Key barriers for APT included prescribers' legal responsibility and potential for medication-related adverse effects. Healthcare provider consultation and chlamydia testing were seen as potential facilitators of APT. Pharmacists were receptive to the idea of expanding their role in chlamydia treatment, however, barriers to privacy must be overcome in order to be acceptable to prescribers and pharmacists.

Pain is a common symptom in many types of cancer. Interdisciplinary team management, including pain assessment, explanation to the patient/family, treating the reversible, non-pharmacological treatments and reassessment are essential. This article focuses on the pharmacological management of cancer pain, and overviews and updates on the recent advances in this field. Both non-opioid and opioid analgesia as well as coanalgesics (adjuvants) are reviewed. Within non-opioid analgesia the risks of non-steroidal anti-inflammatory drugs (NSAIDs) are considered and recommendations for NSAIDs in patients at risk of gastrointestinal and cardiovascular toxicity are made. For opioid analgesics, side effects of opioids are discussed alongside practical guidance on opioid prescribing and converting between opioids. Newer drugs such as tapentadol are considered in this update. Amitriptyline, duloxetine, gabapentin and pregabalin, and the guidance for their use are reviewed in the coanalgesics (adjuvants) section.

This article considers the responses of women, many of whom describe themselves as housewives, in the 1949 Mass Observation Television Directive, in order to interrogate some of the broader assumptions around television's relationship with ‘the housewife’ as key to its success. Against the backcloth of social histories revising ideas about gender, modernity and suburbia in the post-war period, this article considers some of the ways in which initial reluctance towards television was recorded and negotiated. It presents three themes around tensions between home and leisure, the domestication of entertainment and ‘going out’, and the appreciation of particular genre, which suggest that the adoption of television as mass entertainment by women might not have been as smooth a process as we have come to understand.

This chapter interrogates the ways in which the terms of labour are deployed in the literature around "reality" celebrity. It outlines the structural changes within the media industries that have facilitated the rise of ordinary celebrity, and how reality television and social media in particular have generated new labour models and forms of exploitation. The celebrity offers an "opportunity structure" amidst the fast-retreating possibility of working-class people obtaining any kind of secure or high-status careers in media, creative, and cultural work. The chapter provides a general plea for more sustained and situated investigation into the labour politics, practices, and organisation of ordinary celebrity. It argues for attending closely to the labour of ordinary celebrity, its relation to broader inequalities within work and employment, its denigration as a form of "illegitimate" labour, and its relationship to the structural formations of class.