31 research outputs found
Is Child Discipline Changing?
Does the kind of authority your child experiences at home make any difference in the way he will rear his children? Or, to put it another way, is the type of authority you use with him related to the kind you experienced in your own childhood home? Perhaps it is-more than you think
Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14–17 years presenting to Emergency Departments (SIPS junior)
Background: Alcohol is a major global threat to public health. Although the main burden of chronic alcohol-related disease is in adults, its foundations often lie in adolescence. Alcohol consumption and related harm increase steeply from the age of 12 until 20 years. Several trials focusing upon young people have reported significant positive effects of brief interventions on a range of alcohol consumption outcomes. A recent review of reviews also suggests that electronic brief interventions (eBIs) using internet and smartphone technologies may markedly reduce alcohol consumption compared with minimal or no intervention controls.
Interventions that target non-drinking youth are known to delay the onset of drinking behaviours. Web based alcohol interventions for adolescents also demonstrate significantly greater reductions in consumption and harm among ‘high-risk’ drinkers; however changes in risk status at follow-up for non-drinkers or low-risk
drinkers have not been assessed in controlled trials of brief alcohol interventions
Empirical Legal Studies Before 1940: A Bibliographic Essay
The modern empirical legal studies movement has well-known antecedents in the law and society and law and economics traditions of the latter half of the 20th century. Less well known is the body of empirical research on legal phenomena from the period prior to World War II. This paper is an extensive bibliographic essay that surveys the English language empirical legal research from approximately 1940 and earlier. The essay is arranged around the themes in the research: criminal justice, civil justice (general studies of civil litigation, auto accident litigation and compensation, divorce, small claims, jurisdiction and procedure, civil juries), debt and bankruptcy, banking, appellate courts, legal needs, legal profession (including legal education), and judicial staffing and selection. Accompanying the essay is an extensive bibliography of research articles, books, and reports
The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study
Background:
Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy.
Methods:
Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored.
Results:
A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays.
Conclusions:
IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients
Preterm Neuroimaging and School-Age Cognitive Outcomes.
BACKGROUND AND OBJECTIVES:
Children born extremely preterm are at risk for cognitive difficulties and disability. The relative prognostic value of neonatal brain MRI and cranial ultrasound (CUS) for school-age outcomes remains unclear. Our objectives were to relate near-term conventional brain MRI and early and late CUS to cognitive impairment and disability at 6 to 7 years among children born extremely preterm and assess prognostic value.
METHODS:
A prospective study of adverse early and late CUS and near-term conventional MRI findings to predict outcomes at 6 to 7 years including a full-scale IQ (FSIQ) <70 and disability (FSIQ <70, moderate-to-severe cerebral palsy, or severe vision or hearing impairment) in a subgroup of Surfactant Positive Airway Pressure and Pulse Oximetry Randomized Trial enrollees. Stepwise logistic regression evaluated associations of neuroimaging with outcomes, adjusting for perinatal-neonatal factors.
RESULTS:
A total of 386 children had follow-up. In unadjusted analyses, severity of white matter abnormality and cerebellar lesions on MRI and adverse CUS findings were associated with outcomes. In full regression models, both adverse late CUS findings (odds ratio [OR] 27.9; 95% confidence interval [CI] 6.0-129) and significant cerebellar lesions on MRI (OR 2.71; 95% CI 1.1-6.7) remained associated with disability, but only adverse late CUS findings (OR 20.1; 95% CI 3.6-111) were associated with FSIQ <70. Predictive accuracy of stepwise models was not substantially improved with the addition of neuroimaging.
CONCLUSIONS:
Severe but rare adverse late CUS findings were most strongly associated with cognitive impairment and disability at school age, and significant cerebellar lesions on MRI were associated with disability. Near-term conventional MRI did not substantively enhance prediction of severe early school-age outcomes
Brief intervention to prevent hazardous drinking in young people aged 14–15 in a high school setting (SIPS JR-HIGH): study protocol for a randomized controlled trial
Background: Whilst the overall proportion of young people drinking alcohol in the United Kingdom has decreased
in recent years, those who do drink appear to drink a larger amount, and more frequently. Early and heavy drinking
by younger adolescents is a significant public health problem linked to intellectual impairment, increased risk of
injuries, mental health issues, unprotected or regretted sexual experience, violence, and sometimes accidental
death, which leads to high social and economic costs. This feasibility pilot trial aims to explore the feasibility of
delivering brief alcohol intervention in a school setting with adolescents aged 14 and 15 and to examine the
acceptability of study measures to school staff, young people and parents.
Methods and design: Seven schools across one geographical area in the North East of England will be recruited.
Schools will be randomly allocated to one of three conditions: provision of an advice leaflet (control condition,
n= 2 schools); a 30-minute brief interactive session, which combines structured advice and motivational
interviewing techniques delivered by the school learning mentor (level 1 condition, n= 2 schools); and a 60-minute
session involving family members delivered by the school learning mentor (level 2 condition, n= 3 schools).
Participants will be year 10 school pupils (aged 14 and 15) who screen positively on a single alcohol screening
question and who consent to take part in the trial. Year 10 pupils in all seven schools will be followed up at 6 and
12 months. Secondary outcome measures include the ten-question Alcohol-Use Disorders Identification Test. The
EQ-5D-Y and a modified short service use questionnaire will inform the health and social resource costs for any
future economic evaluation.
Young people recruited into the trial will also complete a 28-day timeline follow back questionnaire at 12-month
follow-up. A qualitative evaluation (with young people, school staff, learning mentors, and parents) will examine
facilitators and barriers to the use of screening and brief intervention approaches in the school setting in this age
group