Measuring Quality in Family, Friend, and Neighbor Child Care: Conceptual and Practical Issues

This brief explores challenges in measuring quality in family, friend, and neighbor child care including: parent choice and definitions of quality; concerns with commonly used quality measures originally designed for other settings; quality measurement advances for family, friend, and neighbor care; and testing measures for cultural appropriateness and competency

Addressing Unaddressed Needs: Helping Agencies Target Services to Children and Caregivers in Child Welfare

Each year in the United States, hundreds of thousands of children are reported to the child welfare system for abuse or neglect. In 2014, 702,000 children were deemed victims of child maltreatment, and 147,462 entered foster care.Despite contact with a child protection agency, many families struggle to obtain the right services to ensure a safe and nurturing environment for their children. It'a vital to understand these families' health care needs and how to meet them effectively and efficiently, especialyl given the limited resources for child welfare services. This brief presents current data on this topic and highlights areas for future research

Darius Milhaud in the United States, 1940–71: Transatlantic Constructions of Musical Identity

When the French Jewish composer Darius Milhaud (1892–1974) fled his homeland with his wife and son at the time of the German invasion in 1940, this displacement marked the beginning of three decades of engagement with the musical culture and institutions of the United States. After seven years of wartime exile in Oakland, California, Darius and Madeleine Milhaud divided their time between Oakland and Paris, taking on a transatlantic existence that enabled them to assume distinct roles in U.S. musical life. Both during and after World War II, the composer taught on the faculty of Mills College, participated in intersecting musical networks, and continued to compose prolifically. He also continually renegotiated his identity as a composer—and as a Frenchman in the United States—in response to professional opportunities, personal circumstances, and cultural shifts. This dissertation presents the first in-depth study of Milhaud’s activity in the United States, interpreting the results of new archival research through frameworks of identity construction and transnational mobility. In exile, Milhaud emphasized Frenchness to create space for himself in the U.S. musical landscape while also “defending French culture” through music. After the war, he continued to present himself as a “French composer,” while Jewish identity also took on an increasingly prominent place in his professional life as new institutions and ideologies of “Jewish music” emerged. Milhaud established a reputation as an aesthetically open-minded teacher, and when his neoclassical idiom began to fall out of favor, he attempted to exert continued authority by positioning himself as a mediator between the musical establishment and the new avant-garde, connected to U.S. and French musical communities through his yearly travels. During this time, Madeleine Milhaud carried out her own creative activity, but also oriented her public image around that of her husband, whose postwar reputation was complicated by factors including age and disability. Through an exploration of one composer’s construction of identity, this dissertation asks questions about the goals and effects of musical biography while contributing to scholarly conversations on exile and migration, French and Jewish identities, and the generational shifts of postwar modernism.Doctor of Philosoph

A Research and Practice Brief: Measuring Compliance with the Indian Child Welfare Act

This research and practice brief by Casey Family Programs is a useful resource for states that seek to document compliance with ICWA. We document different approaches for measuring compliance and make some recommendations including increased resources to support and to develop training mechanisms for child protective services and judicial staff. Standard measures for compliance across jurisdictions would be beneficial

The amplification controversy in Drum Corps International: technological change and the meaning of tradition

Drum Corps International (DCI), the principal organization for competitive drum and bugle corps in the United States, caused controversy in 2003 when the Board of Directors voted to legalize amplification of voices and certain instruments. Before this ruling, DCI had not allowed any electronic technology in competitive performance. Supporters of amplification viewed it as a way to expand creative possibilities and make drum corps more viable in the twenty-first century, while many opponents considered it a threat to the future of drum corps as a unique activity with a strong connection to its history and traditions. In this thesis, I situate the recent controversy in the history of technological change and resistance in drum corps, examine the ideology and values behind the amplification ruling and the varied responses to it, and consider intersections between ideological and practical issues in the way this technology has been implemented

Effect of two behavioural 'nudging' interventions on management decisions for low back pain: A randomised vignette-based study in general practitioners

Objective €Nudges' are subtle cognitive cues thought to influence behaviour. We investigated whether embedding nudges in a general practitioner (GP) clinical decision support display can reduce low-value management decisions. Methods Australian GPs completed four clinical vignettes of patients with low back pain. Participants chose from three guideline-concordant and three guideline-discordant (low-value) management options for each vignette, on a computer screen. A 2×2 factorial design randomised participants to two possible nudge interventions: €partition display' nudge (low-value options presented horizontally, high-value options listed vertically) or €default option' nudge (high-value options presented as the default, low-value options presented only after clicking for more). The primary outcome was the proportion of scenarios where practitioners chose at least one of the low-value care options. Results 120 GPs (72% male, 28% female) completed the trial (n=480 vignettes). Participants using a conventional menu display without nudges chose at least one low-value care option in 42% of scenarios. Participants exposed to the default option nudge were 44% less likely to choose at least one low-value care option (OR 0.56, 95%CI 0.37 to 0.85; p=0.006) compared with those not exposed. The partition display nudge had no effect on choice of low-value care (OR 1.08, 95%CI 0.72 to 1.64; p=0.7). There was no interaction between the nudges (OR 0.94, 95% CI 0.41 to 2.15; p=0.89). Interpretation A default option nudge reduced the odds of choosing low-value options for low back pain in clinical vignettes. Embedding high value options as defaults in clinical decision support tools could improve quality of care. More research is needed into how nudges impact clinical decision-making in different contexts

Development and Evaluation of the Family Asset Builder: A New Child Protective Services Intervention to Address Chronic Neglect

Over the past 20 years, neglect has been the most pervasive form of child maltreatment in the United States, affecting more than half a million children annually. Further, neglect is more likely than other forms of maltreatment to occur repeatedly within child welfare-involved families. Children experiencing neglect, especially early in childhood and with regularity, face long-term deleterious effects on their physical, cognitive, social, and emotional development. Despite the ubiquity of neglect throughout child welfare and the potentially devastating consequences, interventions designed to target families chronically reported to Child Protective Services (CPS) for neglect are scant. The Family Asset Builder intervention asserts that a strengths-based, supportive model of service delivery is essential to break the cycle of neglect early along the continuum of CPS involvement for families. Informed by current theory and practice, the solution-focused intervention offers intensive case management services (including more frequent contact and extended service delivery duration) to families with a history of neglect. Early in 2011, the Family Asset Builder intervention was piloted in two Minnesota counties; this study evaluates the development of the model, lessons learned from implementation, and early findings from the intervention, all of which set the stage for replication of the model and expansion of practice knowledge around chronic neglect

Interactions of Neuroimmune Signaling and Glutamate Plasticity in Addiction

Chronic use of drugs of abuse affects neuroimmune signaling; however, there are still many open questions regarding the interactions between neuroimmune mechanisms and substance use disorders (SUDs). Further, chronic use of drugs of abuse can induce glutamatergic changes in the brain, but the relationship between the glutamate system and neuroimmune signaling in addiction is not well understood. Therefore, the purpose of this review is to bring into focus the role of neuroimmune signaling and its interactions with the glutamate system following chronic drug use, and how this may guide pharmacotherapeutic treatment strategies for SUDs. In this review, we first describe neuroimmune mechanisms that may be linked to aberrant glutamate signaling in addiction. We focus specifically on the nuclear factor-kappa B (NF-κB) pathway, a potentially important neuroimmune mechanism that may be a key player in driving drug-seeking behavior. We highlight the importance of astroglial-microglial crosstalk, and how this interacts with known glutamatergic dysregulations in addiction. Then, we describe the importance of studying non-neuronal cells with unprecedented precision because understanding structure-function relationships in these cells is critical in understanding their role in addiction neurobiology. Here we propose a working model of neuroimmune-glutamate interactions that underlie drug use motivation, which we argue may aid strategies for small molecule drug development to treat substance use disorders. Together, the synthesis of this review shows that interactions between glutamate and neuroimmune signaling may play an important and understudied role in addiction processes and may be critical in developing more efficacious pharmacotherapies to treat SUDs

The effect of a lumbopelvic compression belt on load transfer during the active straight leg test: A proof of concept study using ultrasound imaging

INTRODUCTION: The active straight leg raise (ASLR) test assesses load transfer through the pelvis. During the ASLR, intraabdominal pressure (IAP) rises, increasing the load on the lumbopelvic region. Several studies have shown a correlation between the magnitude of bladder base displacement (BBD) during the ASLR and lumbopelvic instability. Additionally, greater depression of the bladder and pelvic floor muscles is associated with motor control impairments associated with form and force closure. Pelvic stability belts are a common therapeutic intervention for individuals who report pelvic girdle pain. Their mechanism of action is to improve form closure and assist force closure and motor control. Impaired form and force closure mechanisms through the lumbopelvic area are associated poor load transfer, low back pain, sacroiliac pain, stress urinary incontinence and chronic pelvic pain. OBJECTIVES: This study aimed to observe and determine the impact of the ASLR test with and without a Serola lumbopelvic belt on BBD and participant self-reported level of difficulty score. METHODS: A convenience sample of fifteen physical therapy students (mean age 25 years) who were previously identified as having lumbopelvic instability were recruited for this study. PCOM\u27s institutional review board approved the study, and each participant provided informed consent. All participants completed a bladder filling protocol via natural diuresis to standardize bladder volumes to allow for bladder and pelvic floor delineation on ultrasound imaging. A Clarius C3 curvilinear wireless ultrasound unit was used for image acquisition with images displayed on an IPAD. The ultrasound transducer was placed suprapublically on the lower abdomen, oriented transversely, and manipulated until a clear image of the bladder base was apparent. A standard script was read to each participant to standardize testing. The magnitude of BBD was captured with cine loops across two testing conditions: the ASLR test without a lumbopelvic belt which was repeated with the participant wearing a belt. Participants also self-reported the level of difficulty for each testing condition. Participants were fitted with the lumbopelvic belt according to manufacturer’s recommendation. The belt tension was standardized using a manometer set to 20mmHG placed between the belt\u27s anterior aspect and the participant\u27s lower abdomen. On-screen calipers identified the lateral and medial aspects of the bladder base. All images were saved for post hoc analysis to determine the magnitude and direction of BBD between both testing conditions. RESULTS: Descriptive statistics will be reported, and a repeated measures ANOVA will be completed to determine whether there is a statistically significant difference between the means with the level of significance set at p=.05. CONCLUSION: TB

Circulating tumour DNA for monitoring colorectal cancer—a prospective cohort study to assess relationship to tissue methylation, cancer characteristics and surgical resection

© The Author(s). 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Abstract Background Cell-free circulating tumour-derived DNA (ctDNA) can be detected by testing for methylated BCAT1 and IKZF1 DNA, which has proven sensitivity for colorectal cancer (CRC). A prospective correlative biomarker study between presence of methylated BCAT1 and IKZF1 in tissue and blood was conducted in cases with CRC to explore how detection of such ctDNA biomarkers relates to cancer characteristics, methylation in tissue and surgical resection of the primary cancer. Methods Enrolled patients with invasive CRC had blood collected at diagnosis, prior to any treatment or surgery (peri-diagnostic sample). A subgroup of patients also had cancer and adjacent non-neoplastic tissue collected at surgical resection, as well as a second blood sample collected within 12 months of surgery (post-surgery sample). DNA was extracted from all samples and assayed for methylated BCAT1 and IKZF1 to determine the degree of methylation in tissue and the presence of ctDNA in blood. Results Of 187 cases providing peri-diagnostic blood samples, tissue was available in 91, and 93 provided at least one post-surgery blood sample for marker analysis. Significant methylation of either BCAT1 or IKZF1 was seen in 86/91 (94.5%) cancer tissues, with levels independent of stage and higher than that observed in adjacent non-neoplastic specimens (P < 0.001). ctDNA methylated in BCAT1 or IKZF1 was detected in 116 (62.0%) cases at diagnosis and was significantly more likely to be detected with later stage (P < 0.001) and distal tumour location (P = 0.004). Of the 91 patients who provided pre-and post-surgery blood samples, 47 patients were ctDNA-positive at diagnosis and 35 (74.5%) became negative after tumour resection. Conclusion This study has shown that BCAT1 and IKZF1 methylation are common events in CRC with almost all cancer tissues showing significant levels of methylation in the two genes. The presence of ctDNA in blood is stage-related and show rapid reversion to negative following surgical resection. Monitoring methylated BCAT1 and IKZF1 levels could therefore inform adequacy of surgical resection. Trial registration Australian New Zealand Clinical Trial Registry number 12611000318987 . Registered 25 March 2011