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Despite the implementation of various national legal frameworks and global policies such as the UN Convention on the Rights of the Child to combat violence against young people, family violence against young people is prevalent, especially in WHO African region. Although, research on child maltreatment, specifically, for young children has received considerable attention in Ghana recently, there is little research on adolescents' experiences of such family violence. In this paper, we report the experiences and perceptions of adolescents with respect to family violence they had suffered or witnessed, and analyze the socio-ecological factors and power dynamics at home that contribute to such violence. The study employs a qualitative approach and the data comprise focus group discussion with 56 adolescents from 14 schools in seven districts of Ghana. The findings show that several adolescents in Ghana feel unsafe at home. They experience physical, psychological, and sexual violence as well as exposure to intimate partner violence, exploitation, and neglect. These violent acts were severe, with dire consequences such as permanent impairment and suicide. Perpetrators include all types of carers. The violent acts are often surreptitious and poly-victimization is common. The results also reveal that three main socio-ecological factors perpetuate and legitimize family violence: patriarchy, the normalization of corporal punishment as a method of child discipline, and superstitious beliefs about health. In general, carers demonstrate their superiority and control over the adolescents in an authoritarian manner, thereby, making the adolescents powerless. Implications of the study for policy and practice are discussed.

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BACKGROUND: The recent interest in recovery from mental health problems has not meaningfully addressed the perspectives of ethnic minorities. AIM: To contribute to the discussion of recovery-oriented service with a study on the experience of Chinese people using UK mental health services. METHODS: In-depth life history interviews were carried out with the users. The qualitative data were analysed using thematic analysis. RESULTS: Four themes emerged as hindrances to personal recovery: (1) language difficulty creates hurdles, (2) diagnostic label is experienced as a double-edged sword, (3) treatment-related stigma and (dis)empowerment are identified, and (4) grievances are found in hospitalisation. DISCUSSION: Having mental illness and being an ethnic minority in the UK experienced double hazard in their recovery journey. While the deprivation of agency and the stigma process in the health care system hinders their recovery, they are further disadvantaged by their ethnic minority status. Four pointers for service improvement, that apply to Chinese users in the United Kingdom and have general implications for users beyond this group, are proposed.

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Natural isolates of Burkholderia pseudomallei (Bp), the causative agent of melioidosis, can exhibit significant ecological flexibility that is likely reflective of a dynamic genome. Using whole-genome Bp microarrays, we examined patterns of gene presence and absence across 94 South East Asian strains isolated from a variety of clinical, environmental, or animal sources. 86% of the Bp K96243 reference genome was common to all the strains representing the Bp "core genome", comprising genes largely involved in essential functions (eg amino acid metabolism, protein translation). In contrast, 14% of the K96243 genome was variably present across the isolates. This Bp accessory genome encompassed multiple genomic islands (GIs), paralogous genes, and insertions/deletions, including three distinct lipopolysaccharide (LPS)-related gene clusters. Strikingly, strains recovered from cases of human melioidosis clustered on a tree based on accessory gene content, and were significantly more likely to harbor certain GIs compared to animal and environmental isolates. Consistent with the inference that the GIs may contribute to pathogenesis, experimental mutation of BPSS2053, a GI gene, reduced microbial adherence to human epithelial cells. Our results suggest that the Bp accessory genome is likely to play an important role in microbial adaptation and virulence.

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OBJECTIVES: To evaluate rapid molecular approaches for the detection of pyrazinamide (PZA) and ofloxacin resistance, by screening 100 known drug-resistant Mycobacterium tuberculosis isolates. METHODS: Mycobacterium tuberculosis isolates were tested for phenotypic resistance to pyrazinamide and ofloxacin using the BACTEC 460 radiometric method and the E-test, respectively. Mutation screening was done by amplifying the pncA, gyrA, and gyrB genes by the polymerase chain reaction (PCR) and direct automated sequencing. RESULTS: Twelve isolates were PZA-resistant and 8 of 12 (66.7%) isolates had missense mutations or deletions at the pncA gene, suggesting that mutation or deletion at the pncA gene is the major molecular mechanism of PZA resistance among the Singaporean isolates. Using the E-test, 48 isolates were resistant to ofloxacin, with minimum inhibitory concentrations of 4 microg/mL or higher. No mutations were observed at the quinolone resistance-determining region (QRDR) of gyrA in all isolates. At the QRDR of gyrB, mutations were present in 1 of 48 ofloxacin-resistant isolates and 0 of 19 ofloxacin-susceptible isolates. CONCLUSIONS: In Singapore, genotypic analysis of resistance to PZA and ofloxacin is inadequate and should be complemented by conventional methods.

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Seven isoniazid-resistant isolates with mutations in the NADH dehydrogenase (ndh) gene were molecularly typed by IS6110-based restriction fragment length polymorphism analysis. All seven isolates with the R268H mutation had identical 1.4-kb IS6110 fingerprints. High-resolution minisatellite-based typing discriminated five of these isolates; two isolates were identical.

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