The feasibility of a strategy for the remote recruitment, consenting and assessment of recent referrals: a protocol for phase 1 of the On-Line Parent Training for the Initial Management of ADHD referrals (OPTIMA)

Background: In the UK, children with high levels of hyperactivity, impulsivity and inattention referred to clinical services with possible attention-deficit/hyperactivity disorder (ADHD) often wait a long time for specialist diagnostic assessment. Parent training (PT) has the potential to support parents during this difficult period, especially regarding the management of challenging and disruptive behaviours that often accompany ADHD. However, traditional face-to-face PT is costly and difficult to organise in a timely way. We have created a low-cost, easily accessible PT programme delivered via a phone app, Structured E-Parenting Support (STEPS), to address this problem. The overall OPTIMA programme will evaluate the efficacy and cost-effectiveness of STEPS as a way of helping parents manage their children behaviour while on the waitlist. To ensure the timely and efficient evaluation of STEPS in OPTIMA, we have worked with children’s health services to implement a remote strategy for recruitment, screening and assessment of recently referred families. Part of this strategy is incorporated into routine clinical practice and part is OPTIMA specific. Here, we present the protocol for Phase 1 of OPTIMA—a study of the feasibility of this remote strategy, as a basis for a large-scale STEPS randomised controlled trial (RCT). Methods: This is a single arm observational feasibility study. Participants will be parents of up to 100 children aged 5-11 years with high levels of hyperactivity/impulsivity, inattention and challenging behaviour who are waiting for assessment in one of five UK child and adolescent mental health or behavioural services. Recruitment, consenting and data collection will occur remotely. The primary outcome will be the rate at which the families, who meet inclusion criteria, agree in principle to take part in a full STEPS RCT. Secondary outcomes include acceptability of remote consenting and online data collection procedures; the feasibility of collecting teacher data remotely within the required timeframe, and technical difficulties with completing online questionnaires. All parents in the study will receive access to STEPS. Discussion: Establishing the feasibility of our remote recruitment, consenting and assessment strategy is a pre-requisite for the full trial of OPTIMA. It can also provide a model for future trials conducted remotely

Tides in colliding galaxies

Long tails and streams of stars are the most noticeable upshots of galaxy collisions. Their origin as gravitational, tidal, disturbances has however been recognized only less than fifty years ago and more than ten years after their first observations. This Review describes how the idea of galactic tides emerged, in particular thanks to the advances in numerical simulations, from the first ones that included tens of particles to the most sophisticated ones with tens of millions of them and state-of-the-art hydrodynamical prescriptions. Theoretical aspects pertaining to the formation of tidal tails are then presented. The third part of the review turns to observations and underlines the need for collecting deep multi-wavelength data to tackle the variety of physical processes exhibited by collisional debris. Tidal tails are not just stellar structures, but turn out to contain all the components usually found in galactic disks, in particular atomic / molecular gas and dust. They host star-forming complexes and are able to form star-clusters or even second-generation dwarf galaxies. The final part of the review discusses what tidal tails can tell us (or not) about the structure and content of present-day galaxies, including their dark components, and explains how tidal tails may be used to probe the past evolution of galaxies and their mass assembly history. On-going deep wide-field surveys disclose many new low-surface brightness structures in the nearby Universe, offering great opportunities for attempting galactic archeology with tidal tails.Comment: 46 pages, 13 figures, Review to be published in "Tidal effects in Astronomy and Astrophysics", Lecture Notes in Physics. Comments are most welcom

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Studies on an ulcerative stomatitis-obstructive rhinitis-pneumonia disease complex in hatchling and juvenile sea turtles Chelonia mydas and Caretta caretta

Three bacterial diseases (ulcerative stomatitis, obstructive rhinitis and pneumonia) and associated complexes were together responsible for mortality rates of up to 70% in farmed and oceanarium-reared turtles (Chelonia mydas and Caretta caretta). Hatchlings 5 to 12 wk old and juveniles 3 to 6 mo old were particularly susceptible to ulcerative stomatitis and bronchopneumonia respectively (58.6 and 58.3% of the cases diagnosed). Obstructive rhinitis was secondary to ulcerative stomatitis, being present in 70% of hatchlings with mouth rot or "canker." Focal pneumonia occurred more frequently in juveniles (81.8% or 9/11 affected). The 5 disease complexes observed (ulcerative stomatitis - bronchopneumonia; ulcerative stomatitis - obstructive rhinitis; ulcerative stomatitis - obstructive rhinitis - bronchopneumonia; obstructive rhinitis - bronchopneumonia; and ulcerative stomatitis - focal pneumonia) were equally distributed amongst hatchlings and juveniles. It was not possible to compare the relative susceptibility of green turtles and loggerheads, because of the small number of loggerheads involved (3). The percentage of farmed and oceanarium-reared turtles showing one or more of these diseases was similar (65% (65/100) and 66.6% (10/15) respectively). The clinico-pathological features of the major diseases are described. Three bacteria (Vibrio alginolyticus, Aeromonas hydrophila and Flavobacterium sp.) were repeatedly isolated from cases of ulcerative stomatitis and obstructive rhinitis. In addition to the above organisms 4 genera of fungi (Paecilomyces sp., Penicillium sp., Aspergillus sp. and Fusarium sp.) were recovered form caseous material lodged inside the trachea and bronchi of turtles with bronchopneumonia. A therapeutic regime was tested on 42 hatchlings, 7 to 8 wk old, using antibiotics and a topical disinfectant. The survival rate of individually-reared hatchlings (71.5%) was significantly higher than the control group (28.6%, p < 0.01) but significantly higher than their group-reared counterparts (57.2%, p < 0.05)

Trematode (Digenea: Bucephalidae) infection in the burrowing clam Tridacna crocea from the Great Barrier Reef

Larval trematode (Family Bucephalidae) infection of Tridacna crocea (Lamarck 1819) was investigated to determine pathological effects on the host. Of 108 T. crocea gonads examined, 13 (12%) were found to be parasitised. The bucephalid caused castration in heavily infected clams, gonadal tissue being completely replaced by sporocysts. The parasite was also found in the kidney, digestive gland and ctenidia. This is the first record of a bucephalid trematode in a member of the Tridacnidae. The parasite is of potential importance to tridacnid shellfisheries currently being developed

Effects of nutritional enhancement of live food organisms on growth and survival of barramundi, Lates calcarifer (Bloch), larvae

Larval and juvenile barramundi, Lates calcarifer (Bloch), were reared intensively on test diets comprising nutritionally supplemented and unsupplemented rotifers, Brachionus plicatilis Muller, and brine shrimp, Artemia salina L. Both growth and survival of barramundi larvae fed on nutritionally supplemented brine shrimp were superior to those of larvae fed on untreated brine shrimp. Barramundi larvae fed diets incorporating untreated brine shrimp exhibited a mortality syndrome which commenced from 20 to 30 days after hatching and resulted in almost total mortality within the next 10 days. Analyses of the proximate, fatty acid and amino acid composition of the live food organisms used in the test diets, and reference samples comprising barramundi egg yolk and extensively reared juvenile barramundi, suggest that this mortality syndrome was primarily associated with the fatty acid composition of the food organisms, particularly the relative amount of 20:5n-3 in the brine shrimp fed to the larvae. These results, and the work of other authors, indicate that there are two mortality syndromes which affect intensively cultured L. calcarifer larvae