ABSTRACT
Purpose: This study explores responses by domestic violence perpetrator programme (DVPP) providers of three Western countries (UK, USA and Australia) to the COVID-19 pandemic and population movement control measures on their practice. The purpose of this paper was to offer an evidence base for changes to programme and intervention delivery around domestic violence to sustain integrity of safe, effective working practices with perpetrators, survivors and staff. Design/methodology/approach: Based on 36 semi-structured qualitative interviews conducted from July to September 2020, the authors mapped the experiences of changes in service with frontline staff, managers and sector-wide representatives. Findings: The findings focus on how providers of DVPPs adapted to the increase in referrals and workload that had a positive impact on service delivery innovation but an adverse impact on staff wellbeing. Digital services were reported to be adopted into mainstream approaches but introduced new barriers to service access and group dynamics. Integrated safety support for survivors, if not adequately connected to programmes pre-pandemic, risked being disconnected from DVPP that may undermine positive programme outcomes. Originality/value: The paper provides a documentation of changes in DVPPs, and a cross-comparison of services across three Western countries during the first wave of COVID-19. The work offers implications of the development of digital modes of service delivery for DVPPs and highlights the need for focus on resource management and integration of safety services for survivors in DVPP services. © 2023, Emerald Publishing Limited.
ABSTRACT
Background: ACE2 is a carboxypeptidase homolog to the dipeptidase ACE but with different substrate specificity;while ACE principally acts as a carboxydipeptidase (peptidyldipeptidase) removing the C-terminal dipeptide from Ang I to form Ang II, ACE2 functions exclusively as a carboxypeptidase removing a single C-terminal amino acid from Ang II generating Ang- (1-7) or, much less efficiently, from Ang I forming Ang-(1-9). ACE and ACE2 than playing a key role in regulating the renin–angiotensin–aldosterone system (RAAS). In the normal lung, ACE2 mRNA is mainly expressed by type II alveolar epithelial cells and endothelial cells, but the level of expression increases in response to inflammation while is downregulated in response to SARS-CoV infection. ACE2, mRNA and protein, is highly expressed in the gastrointestinal tract, with the higher expression detected in epithelial cells of the ileum and the colon where mediates the absorption of amino acids. ACE2 expression in the intestine undergoes regulation in response to a variety of factors including intestinal microbiota and inflammation. Furthermore, previous studies have suggested that insulinotropic factor glucagon like peptide (GLP)-1 might regulate ACE2 expression in the heart, suggesting a potential interaction of GLP1 with ACE2. GPBAR1, G Protein Bile Acid Receptor, is robustly expressed in the gastrointestinal tract and its activation in the intestine promotes the release of GLP-1. Aim: to investigate the possible interaction between bile acids via GPBAR1 and the expression of ACE2 in the gastrointestinal tract. Materials and Methods: HT29 cells treated with TNF-α + IL-1β and mouse models of colitis were used to assess ACE2 expression and treatment with BAR501, a GPBAR1 agonist, was used to investigate its modulation. Results: The inflammatory stimulus increased the expression of Ace2 in HT29 cells and in colon of mice according to the data obtained in human samples from patient with IBD. GPBAR1 agonism by BAR501 relieved inflammation both in vitro and in vivo but in vitro this effect induced down-regulation of ACE2 while in vivo administration of BAR501 increased ACE2 expression. In mouse model of colitis, inflammation up-regulated also the GLP-1 gene expression that was further increased by BAR501 and instead, the administration of Exendina- 3, a GLP-1R antagonist was able to block the up-regulation of Ace2 expression exerted by BAR501. Conclusions: In conclusion, our results demonstrate that both in vivo and in vitro activation of GPBAR1 by a selective agonist exerts an anti-inflammatory effect. On the other hand, in vivo activation of GPBAR1 in the colon induces the release of GLP-1, which mediates some of the anti-inflammatory effects exerted by the receptor, and induces further upregulation of Ace2 by GPBAR1/GLP-1/GLP-1R axis.(Figure Presented)
ABSTRACT
Domestic violence perpetrator programmes are a frequently used intervention to respond to perpetrators of domestic violence. However, there is considerable concern about the use of 'online', 'virtual', or 'digital' programmes delivered remotely. Policy and practice have developed at pace through the COVID-19 pandemic and research is lacking. This exploratory research examined the challenges and opportunities associated with a pilot online programme in Minnesota, US, for court mandated men. It took place before the COVID-19 pandemic, making it the first study to investigate a `live' online programme. A mixed method design was used, consisting of 40 hours of observational data (covering 25 sessions);four interviews with programme facilitators, 12 interviews with programme observers, and six perpetrators enrolled on the programme. We did not investigate the experiences of partners or ex-partners or of partner organisations, which is a limitation. We found that while the online format solved some long-established issues with programme delivery (for example, providing an intervention for rural communities, a lack of transport, continuity of intervention for those who travel as part of their job), different issues arose in connection to the online programme. These problems included access to necessary broadband speeds, technical hardware and a private place to participate in the sessions.