The Influence of Childcare Arrangements on Child Well Being from Infancy to Middle Childhood

In 2012, the Family Support Agency (now Túsla, the Child and Family Agency) in collaboration with the Irish Research Council commissioned this study to investigate the wellbeing of children from families in which the parents are in employment and the children are minded by others. The study set out to describe the uptake of non-parental care from infancy to middle childhood, and to determine how such uptake influences the wellbeing of children. This is the first national study of the well-being of children from infancy to midd le childhood in the Irish context. The key research objectives were: 1. To explore the relationship between childcare arrangements in early childhood and out-of- school care in middle childhood and children’s physical, cognitive and socio-emotional outcomes; and, 2. To identify the key risk factors associated with children’s well-being from infancy to middle childhood

SAVI and SAVI Revisited

SAVI and SAVI Revisite

Factors associated with higher levels of grief and support needs among people bereaved during the pandemic: results from a national online survey

We identified factors associated with higher levels of grief and support needs among 711 people bereaved during the COVID-19 pandemic in the UK (deaths 16 March 2020-2 January 2021). An online survey assessed grief using the Adult Attitude to Grief (AAG) scale, which calculates an overall index of vulnerability (IOV) (range 0-36), and practical and emotional support needs in 13 domains. Participants’ mean age was 49.5 (SD 12.9); 628 (88.6%) female. Mean age of deceased 72.2 (SD 16.1). 311 (43.8%) deaths were from confirmed/suspected COVID-19. High overall levels of grief and support needs were observed; 28.2% exhibited severe vulnerability (IOV ≥ 24). Grief and support needs were higher for close relationships with the deceased (versus more distant) and reported social isolation and loneliness (P < 0.001), and lower with age of deceased above 40-50. Other associated factors were place of death and health professional support post-death (P < 0.05

Troponin in Acute chest pain to Risk stratify and Guide EffecTive use of Computed Tomography Coronary Angiography (TARGET-CTCA):A randomised controlled trial

Background: The majority of patients with suspected acute coronary syndrome presenting to the emergency department will be discharged once myocardial infarction has been ruled out, although a proportion will have unrecognised coronary artery disease. In this setting, high-sensitivity cardiac troponin identifies those at increased risk of future cardiac events. In patients with intermediate cardiac troponin concentrations in whom myocardial infarction has been ruled out, this trial aims to investigate whether outpatient computed tomography coronary angiography (CTCA) reduces subsequent myocardial infarction or cardiac death. Methods: TARGET-CTCA is a multicentre prospective randomised open label with blinded endpoint parallel group event driven trial. After myocardial infarction and clear alternative diagnoses have been ruled out, participants with intermediate cardiac troponin concentrations (5 ng/L to 99th centile upper reference limit) will be randomised 1:1 to outpatient CTCA plus standard of care or standard of care alone. The primary endpoint is myocardial infarction or cardiac death. Secondary endpoints include clinical, patient-centred, process and cost-effectiveness. Recruitment of 2270 patients will give 90% power with a two-sided P value of 0.05 to detect a 40% relative risk reduction in the primary endpoint. Follow-up will continue until 97 primary outcome events have been accrued in the standard care arm with an estimated median follow-up of 36 months. Discussion: This randomised controlled trial will determine whether high-sensitivity cardiac troponin-guided CTCA can improve outcomes and reduce subsequent major adverse cardiac events in patients presenting to the emergency department who do not have myocardial infarction. Trial registration: ClinicalTrials.gov Identifier: NCT03952351. Registered on May 16, 2019

Melflufen and dexamethasone in heavily pretreated relapsed and refractory multiple myeloma

Clinical trial information: NCT02963493Altres ajuts: Oncopeptides A