Our institution sought to evaluate our antimicrobial stewardship empiric treatment recommendations for Salmonella. Results from 36 isolates demonstrated reduced susceptibilities to fluoroquinolones with 1 isolate susceptible only to ceftriaxone. Analysis supports the current recommendation of empiric ceftriaxone therapy for severe infection and updated recommendation for sulfamethoxazole-trimethoprim in non-severe infections.

Neoliberalism as economic orthodoxy has facilitated the onset of social and public policy that is required to ‘fit’ with the common sense of our times. This article critiques the growth of government-supported financial capability programs in Australia. We explore the experiences of a sample of rural South Australians who have accessed microcredit. We found that microcredit provides an avenue for poverty survival by reducing the stresses associated with financial shocks through consumption smoothing, yet that the extent to which microcredit contributes to addressing poverty and inequality is questionable. We critique how the discourse of financial resilience aims to produce deserving neoliberal citizens who are moving toward self-reliance. We conclude that effort should be directed at developing a structural, proportionate universal approach that does not rely on financially vulnerable individuals navigating a regulatory environment that rewards and punishes in accordance to a market logic.

Background: Patient outcomes in multiple sclerosis (MS) have generally been measured by their neurological impairment using specific scales such as the Kurtzke Expanded Disability Status Scale (EDSS). However, this scale does not measure the multiple dimensions of health-related quality of life (HRQOL) such as functional status and general well-being, which are also important outcomes along with disease-specific measurements. Methods: HRQOL was measured in a group of 97 MS patients using the RAND 36-item Health Survey 1.0. The EDSS score was assigned by the clinic neurologist. Additional data were collected from the clinical record for each patient. Results: MS patients scored poorly in a number of HRQOL domains such as physical and role functioning and energy or vitality. Disability as quantified by the EDSS correlated only with the physical functioning domain. Regression models were developed to measure the relationship between patient characteristics (independent variables) and HRQOL domains (dependent variables). Discussion: A number of patient characteristics were associated with higher or lower scores on the HRQOL domains. Of particular interest is the finding that a family history of MS was associated with poorer physical and social functioning as well as more pain and less vitality. The occurrence of seizures had a negative impact on role functioning, social functioning and general health perceptions. HRQOL gives caregivers a broader measure of disease burden than the EDSS alone, and should be useful in planning and monitoring interventions.

Domestic abuse policy increasingly uses language which indicates that abuse is patterned according to structural factors. However, practicing according to these structural accounts of abuse is problematic because of the policy and organisational contexts that practitioners work within and, we argue, because the implications of the structured nature of victims’ experiences is not fully understood by all practitioners.

We ask whether women's differential use and experiences of services with a remit to address abuse can be illuminated using two theoretical perspectives – ‘candidacy’ and intersectionality. We report the findings of a literature synthesis that investigates how these improve our understanding of women's help-seeking and service utilisation and of the responses that they receive. Both concepts were highly congruent with the literature and we conclude that, together, candidacy and intersectionality offer a means of enhancing knowledge of how the political becomes enacted in the personal. Embedding such knowledge within practice repertoires offers the potential to develop more nuanced structural understandings of women's experiences and constraints.

The concept of systematic inequalities in social and health outcomes has come to form part of contemporary policy discourse. This rhetoric is deployed even in the face of policy decisions widely viewed as iniquitous. Moreover, there is a widespread view, expressed across the political spectrum, that those in more deprived circumstances are less likely than their more affluent counterparts to be in receipt of optimal public services. Such individuals and communities are variously described as excluded, disadvantaged, underserved or hard to reach. Across countries and policy domains the term ‘hard to reach’ is used to refer to those deemed not to be in optimal receipt of public sector services which are intended to increase some aspect of material, social or physical wellbeing. It is increasingly used in health policy documents which aim to address health inequalities. However, it is an ill-defined and contested term. The purpose of this paper is two-fold. First, it offers a critical commentary on the concept of hard-to-reachness and asks: who are viewed as hard to reach and why? Second, using a case-study of a Scottish health improvement programme that explicitly aims to reach and engage the ‘hard to reach’ in preventive approaches to cardiovascular disease, it tests the policy and practice implications of the concept. It finds that a lack of conceptual clarity leads to ambiguous policy and practice and argues for possible theoretical refinements.