Are Intensive Family Preservation Services Useful?: A Study in the United Kingdom

This evaluation of the first year of an Intensive Family Preservation Service in England is based on the analysis of eighty-six families: fifty-seven families who received the service and a comparison group of twenty-nine families who did not. The study considered whether the program was fulfilling its objectives of reducing the number of children and young people in the public care system; offering a safe, supportive service for children who need protection; integrating the program into family support services as a whole, and improving family functioning. The findings were complex to interpret. Child protection was improved but there was not a reduction in the number of children needing out of home care (indeed there was an increase) meaning that short term savings in costs could not be made. Nor were there lasting improvements in the children’s behavior. There were instead a number of more subtle, arguably more sensitive outcomes: parents’ capacity to tolerate their child’s behavior was greater and overall family functioning was better for most families who received the service. Also families were, on the whole, able to make better use of follow up services

Evaluating an mRNA based body fluid identification test using SYBR green fluorescent dye and real-time PCR

The requirement to have more definitive and wider ranging body fluid identification (BFID) tests has resulted in a range of mRNA based real-time PCR BFI assays utilising Taqman fluorescent dye. An attempt to make a reliable and cost effective BFI test utilising the alternative SYBR Green fluorescent dye was carried out. RNA was extracted from blood and saliva stains from both male and female donors, this was then reverse transcribed using M-MLV and random hexamers. Using real-time PCR, relative quantitation of blood and saliva specific markers was carried out on the cDNA from the blood and saliva samples using the SYBR® Green fluorescent dye. Melting curve analysis was also performed immediately following PCR amplification. The relative quantitation values were calculated using the formula 2-ΔΔCT and all samples were normalised to reference gene 18s rRNA. The results revealed good specificity for a number of markers using this chemistry, however some markers were undetected. Blood markers NCF2, SPTB, PBDG and saliva specific markers HTN3, SPRR1A, KRT4 and KRT13 were investigated. In the SYBR green studies, the most specific markers were NCF2, KRT4, KRT13 and SPRR1A, showing reproducible results in a number of studies. Blood marker SPTB also appeared to be specific to blood however the melt curve data for this marker in each study was questionable given the low melting temperature for the amplified products. Blood specific marker PBGD, and saliva specific marker HTN3 were not detected using SYBR Green and saliva marker STATH was detected however in each case appeared to be non-specific in nature when them melt curves were analysed. Analysis of the 18s rRNA Ct values showed a higher expression in saliva than in blood in almost all instances, this may be due to collection of a higher number of cells when using a buccal swab, coupled with the inability to accurately quantify the RNA extracts before reverse transcription. Taqman assays were run on all markers as an additional test, to compare with the SYBR green data. All markers except SPTB showed very good specificity for their respective body fluids. SPTB, like in the SYBR green studies was detected in blood more than saliva, however detection was never consistent in each sample. It can therefore be said that real-time PCR using SYBR Green dye was capable of identifying specific mRNA markers blood and saliva however, the lack of specificity for this type of assay makes its use as a routine identification of body fluids in forensic casework not suitable. The main aim of this study was to develop a more cost effective BFID and as such involved the use of SYBR Green as a cheaper alternative to TaqMan. However, throughout these studies, it appeared to be quite costly in terms of validating a SYBR Green experiment, as more reagents were required in the long run due to vast amount of no template controls required per experiment. It therefore would appear that while SYBR Green is cheaper to buy, the cost to validate these type of experiments can be quite high, due to the non-specific nature of the dye itself. The SYBR Green studies were also much more time consuming with regards to data interpretation as post analysis of the amplification plot and melt curves is a necessity with this detection chemistry to ensure successful interpretation of the data

Effective treatment with rituximab for the maintenance of remission in frequently relapsing minimal change disease

AIM: Treatment of frequently relapsing or steroid-dependent minimal change disease (MCD) in children and adults remains challenging. Glucocorticoids and/or other immunosuppressive agents are the mainstay of treatment, but patients often experience toxicity from prolonged exposure and may either become treatment dependent and/or resistant. Increasing evidence suggests that rituximab (RTX) can be a useful alternative to standard immunosuppression and allow withdrawal of maintenance immunosuppressants; however, data on optimal treatment regimens, long-term efficacy and safety are still limited. METHODS: We undertook a prospective study of RTX to allow immunosuppression minimization in 15 young adults with frequently relapsing or steroid-dependent, biopsy-proven MCD. All patients were in remission at the start of treatment and on a calcineurin inhibitor. Two doses of RTX (1 gr) were given 6 months apart. A subset of patients also received an additional dose 12 months later, in order to examine the benefit of re-treatment. Biochemical and clinical parameters were monitored over an extended follow-up period of up to 43 months. RESULTS: Median steroid-free survival after RTX was 25 months (range 4-34). Mean relapse frequency decreased from 2.60 ± 0.28 to 0.4 ± 0.19 (P < 0.001) after RTX. Seven relapses occurred, five of which (71%) when CD19 counts were greater than 100 µ. Immunoglobulin levels remained unchanged, and no major side effects were observed throughout the follow-up period. CONCLUSIONS: Rituximab therapy is effective at maintaining prolonged steroid-free remission and reducing relapse frequency in this group of patients. Our study lends further support for the role of RTX in the treatment of patients with frequently relapsing or steroid-dependent MCD

Models for the Clustering of Far-Infrared and Sub-millimetre selected Galaxies

We discuss and compare two alternative models for the two-point angular correlation function of galaxies detected through the sub-millimetre emission using the Herschel Space Observatory. The first, now-standard Halo Model, which represents the angular correlations as arising from one-halo and two-halo contributions, is flexible but complex and rather unwieldy. The second model is based on a much simpler approach: we incorporate a fitting function method to estimate the matter correlation function with approximate model of the bias inferred from the estimated redshift distribution to find the galaxy angular correlation function. We find that both models give a good account of the shape of the correlation functions obtained from published preliminary studies of the HerMES and H-ATLAS surveys performed using Herschel, and yield consistent estimates of the minimum halo mass within which the sub-millimetre galaxies must reside. We note also that both models predict an inflection in the correlation function at intermediate angular scales, so the presence of the feature in the measured correlation function does not unambiguously indicate the presence of intra-halo correlations. The primary barrier to more detailed interpretation of these clustering measurements lies in the substantial uncertainty surrounding the redshift distribution of the sources.Comment: 5 pages, 6 figures, 1 table, accepted for publication in MNRA

Integrated care for children living with complex care needs: an evolutionary concept analysis

Children with complex care needs (CCNs) are in need of improved access to healthcare services, communication, and support from healthcare professionals to ensure high-quality care is delivered to meet their needs. Integrated care is viewed as a key component of care delivery for children with CCNs, as it promotes the integration of healthcare systems to provide family and child-centred care across the entire health spectrum. There are many definitions and frameworks that support integrated care, but there is a lack of conceptual clarity around the term. Furthermore, it is often unclear how integrated care can be delivered to children with CCNs, therefore reinforcing the need for further clarification on how to define integrated care. An evolutionary concept analysis was conducted to clarify how integrated care for children with CCNs is defined within current literature. We found that integrated care for children with CCNs refers to highly specialised individualised care within or across services, that is co-produced by interdisciplinary teams, families, and children, supported by digital health technologies. Conclusion: Given the variation in terms of study design, outcomes, and patient populations this paper highlights the need for further research into methods to measure integrated care.Add citation details on check dat

Tumor and serum DNA methylation in women receiving preoperative chemotherapy with or without vorinostat in TBCRC008

BACKGROUND: Methylated gene markers have shown promise in predicting breast cancer outcomes and treatment response. We evaluated whether baseline and changes in tissue and serum methylation levels would predict pathological complete response (pCR) in patients with HER2-negative early breast cancer undergoing preoperative chemotherapy. METHODS: The TBCRC008 trial investigated pCR following 12 weeks of preoperative carboplatin and albumin-bound paclitaxel + vorinostat/placebo (n = 62). We measured methylation of a 10-gene panel by quantitative multiplex methylation-specific polymerase chain reaction and expressed results as cumulative methylation index (CMI). We evaluated association between CMI level [baseline, day 15 (D15), and change] and pCR using univariate and multivariable logistic regression models controlling for treatment and hormone receptor (HR) status, and performed exploratory subgroup analyses. RESULTS: In univariate analysis, one log unit increase in tissue CMI levels at D15 was associated with 40% lower chance of obtaining pCR (odds ratio, OR 0.60, 95% CI 0.37-0.97; p = 0.037). Subgroup analyses suggested a significant association between tissue D15 CMI levels and pCR in vorinostat-treated [OR 0.44 (0.20, 0.93), p = 0.03], but not placebo-treated patients. CONCLUSION: In this study investigating the predictive roles of tissue and serum CMI levels in patients with early breast cancer for the first time, we demonstrate that high D15 tissue CMI levels may predict poor response. Larger studies and improved analytical procedures to detect methylated gene markers in early stage breast cancer are needed. TBCRC008 is registered on ClinicalTrials.gov (NCT00616967)

Children and older adults exhibit distinct sub-optimal cost-benefit functions when preparing to move their eyes and hands

"© 2015 Gonzalez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited"Numerous activities require an individual to respond quickly to the correct stimulus. The provision of advance information allows response priming but heightened responses can cause errors (responding too early or reacting to the wrong stimulus). Thus, a balance is required between the online cognitive mechanisms (inhibitory and anticipatory) used to prepare and execute a motor response at the appropriate time. We investigated the use of advance information in 71 participants across four different age groups: (i) children, (ii) young adults, (iii) middle-aged adults, and (iv) older adults. We implemented 'cued' and 'non-cued' conditions to assess age-related changes in saccadic and touch responses to targets in three movement conditions: (a) Eyes only; (b) Hands only; (c) Eyes and Hand. Children made less saccade errors compared to young adults, but they also exhibited longer response times in cued versus non-cued conditions. In contrast, older adults showed faster responses in cued conditions but exhibited more errors. The results indicate that young adults (18 -25 years) achieve an optimal balance between anticipation and execution. In contrast, children show benefits (few errors) and costs (slow responses) of good inhibition when preparing a motor response based on advance information; whilst older adults show the benefits and costs associated with a prospective response strategy (i.e., good anticipation)

Photometric Redshifts of Quasars

We demonstrate that the design of the Sloan Digital Sky Survey (SDSS) filter system and the quality of the SDSS imaging data are sufficient for determining accurate and precise photometric redshifts (``photo-z''s) of quasars. Using a sample of 2625 quasars, we show that photo-z determination is even possible for z<=2.2 despite the lack of a strong continuum break that robust photo-z techniques normally require. We find that, using our empirical method on our sample of objects known to be quasars, approximately 70% of the photometric redshifts are correct to within delta z = 0.2; the fraction of correct photometric redshifts is even better for z>3. The accuracy of quasar photometric redshifts does not appear to be dependent upon magnitude to nearly 21st magnitude in i'. Careful calibration of the color-redshift relation to 21st magnitude may allow for the discovery of on the order of 10^6 quasars candidates in addition to the 10^5 quasars that the SDSS will confirm spectroscopically. We discuss the efficient selection of quasar candidates from imaging data for use with the photometric redshift technique and the potential scientific uses of a large sample of quasar candidates with photometric redshifts.Comment: 29 pages, 8 figures, submitted to A

Study protocol: can a school gardening intervention improve children's diets?

BACKGROUND: The current academic literature suggests there is a potential for using gardening as a tool to improve children's fruit and vegetable intake. This study is two parallel randomised controlled trials (RCT) devised to evaluate the school gardening programme of the Royal Horticultural Society (RHS) Campaign for School Gardening, to determine if it has an effect on children's fruit and vegetable intake. METHOD/DESIGN: Trial One will consist of 26 schools; these schools will be randomised into two groups, one to receive the intensive intervention as "Partner Schools" and the other to receive the less intensive intervention as "Associate Schools". Trial Two will consist of 32 schools; these schools will be randomised into either the less intensive intervention "Associate Schools" or a comparison group with delayed intervention. Baseline data collection will be collected using a 24-hour food diary (CADET) to collect data on dietary intake and a questionnaire exploring children's knowledge and attitudes towards fruit and vegetables. A process measures questionnaire will be used to assess each school's gardening activities. DISCUSSION: The results from these trials will provide information on the impact of the RHS Campaign for School Gardening on children's fruit and vegetable intake. The evaluation will provide valuable information for designing future research in primary school children's diets and school based interventions. TRIAL REGISTRATION: ISRCTN11396528

Weak Lensing with SDSS Commissioning Data: The Galaxy-Mass Correlation Function To 1/h Mpc

(abridged) We present measurements of galaxy-galaxy lensing from early commissioning imaging data from the Sloan Digital Sky Survey (SDSS). We measure a mean tangential shear around a stacked sample of foreground galaxies in three bandpasses out to angular radii of 600'', detecting the shear signal at very high statistical significance. The shear profile is well described by a power-law. A variety of rigorous tests demonstrate the reality of the gravitational lensing signal and confirm the uncertainty estimates. We interpret our results by modeling the mass distributions of the foreground galaxies as approximately isothermal spheres characterized by a velocity dispersion and a truncation radius. The velocity dispersion is constrained to be 150-190 km/s at 95% confidence (145-195 km/s including systematic uncertainties), consistent with previous determinations but with smaller error bars. Our detection of shear at large angular radii sets a 95% confidence lower limit $s>140^{\prime\prime}$, corresponding to a physical radius of $260h^{-1}$ kpc, implying that galaxy halos extend to very large radii. However, it is likely that this is being biased high by diffuse matter in the halos of groups and clusters. We also present a preliminary determination of the galaxy-mass correlation function finding a correlation length similar to the galaxy autocorrelation function and consistency with a low matter density universe with modest bias. The full SDSS will cover an area 44 times larger and provide spectroscopic redshifts for the foreground galaxies, making it possible to greatly improve the precision of these constraints, measure additional parameters such as halo shape, and measure the properties of dark matter halos separately for many different classes of galaxies.Comment: 28 pages, 11 figures, submitted to A