Early education pilot for two year old children : evaluation

This report provides the findings of the evaluation of the early education pilot for disadvantaged two year old children (the pilot). This study aimed to assess the impact of the pilot by looking at: how well the pilot was targeted, parents’ experiences of taking up a pilot place, the quality of the pilot settings, the impact on the children’s behaviour, and parents’ views and experiences of using a pilot place. The pilot provided free early years education to over 13,500 disadvantaged two year olds between 2006 and 2008. The main purpose of the pilot was to improve children’s social and cognitive outcomes, e.g. their social confidence and independence, and their verbal skills and reasoning ability. Additional aims were to have a positive impact on children’s parents and wider family e.g. on the relationship between parents and their children, or on parent’s emotional wellbeing. The funding offered these children 7.5 or in a small number of local authorities 12.5 hours of early years education per week for 38 weeks of the year. The pilot places were available in a variety of early years settings e.g. nurseries, play groups and with childminders, but all were required to operate the Birth to Three Matters curriculum.© National Centre for Social Research 2009. The full text of this report is not available in ORA. You may be able to access the report at https://www.gov.uk/government/publications/early-education-pilot-for-2-year-old-children-evaluation (URL checked 26 March 2014) or via the publication website link above

Opportunities for topical antimicrobial therapy: permeation of canine skin by fusidic acid

BACKGROUND: Staphylococcal infection of the canine epidermis and hair follicle is amongst the commonest reasons for antimicrobial prescribing in small animal veterinary practice. Topical therapy with fusidic acid (FA) is an attractive alternative to systemic therapy based on low minimum inhibitory concentrations (MICs, commonly <0.03 mg/l) documented in canine pathogenic staphylococci, including strains of MRSA and MRSP (methicillin-resistant Staphylococcus aureus and S. pseudintermedius). However, permeation of canine skin by FA has not been evaluated in detail. This study aimed to define the degree and extent of FA permeation in canine skin in vitro from two sites with different hair follicle density following application of a licensed ophthalmic formulation that shares the same vehicle as an FA-betamethasone combination product approved for dermal application in dogs. Topical FA application was modelled using skin held in Franz-type diffusion cells. Concentrations of FA in surface swabs, receptor fluid, and transverse skin sections of defined anatomical depth were determined using high-performance liquid chromatography and ultraviolet (HPLC-UV) analysis. RESULTS: The majority of FA was recovered by surface swabs after 24 h, as expected (mean ± SEM: 76.0 ± 17.0%). FA was detected within 424/470 (90%) groups of serial sections of transversely cryotomed skin containing follicular infundibula, but never in 48/48 (100%) groups of sections containing only deeper follicular structures, nor in receptor fluid, suggesting that FA does not permeate beyond the infundibulum. The FA concentration (mean ± SEM) in the most superficial 240 μm of skin was 2000 ± 815 μg/g. CONCLUSIONS: Topically applied FA can greatly exceed MICs for canine pathogenic staphylococci at the most common sites of infection. Topical FA therapy should now be evaluated using available formulations in vivo as an alternative to systemic therapy for canine superficial bacterial folliculitis.Peer reviewedFinal Published versio

An investigation of the complexities of successful and unsuccessful guide dog matching and partnerships.

Matching a person who is blind or visually impaired with a guide dog is a process of finding the most suitable guide dog available for that individual. Not all guide dog partnerships are successful, and the consequences of an unsuccessful partnership may result in reduced mobility and quality of life for the handler (owner), and are costly in time and resources for guide dog training establishments. This study examined 50 peoples' partnerships with one or more dogs (118 pairings) to ascertain the outcome of the relationship. Forty-three of the 118 dogs were returned to the guide dog training establishment before reaching retirement age, with the majority (n = 40) being categorized as having dog-related issues. Most (n = 26) of these dogs' issues were classified as being behavioral in character, including work-related and non-work-related behavior, and 14 were due to physical causes (mainly poor health). Three dogs were returned due to matters relating to the handlers' behavior. More second dogs were returned than the handlers' first or third dogs, and dogs that had been previously used as a guide could be rematched successfully. Defining matching success is not clear-cut. Not all dogs that were returned were considered by their handlers to have been mismatched, and not all dogs retained until retirement were thought to have been good matches, suggesting that some handlers were retaining what they considered to be a poorly matched dog. Almost all the handlers who regarded a dog as being mismatched conceded that some aspects of the match were good. For example, a dog deemed mismatched for poor working behavior may have shown good home and/or other social behaviors. The same principle was true for successful matches, where few handlers claimed to have had a perfect dog. It is hoped that these results may help the guide dog industry identify important aspects of the matching process, and/or be used to identify areas where a matching problem exists

The end of the partnership with a guide dog: emotional responses, effects on quality of life and relationships with subsequent dogs

Guide dogs are mobility aids that facilitate independent travel of people who are blind or visually impaired. Additional benefits imparted to the guide dog handler include companionship, and increased: social-function, self-esteem and confidence. Some evidence shows that the end of the guide dog partnership can result in reduced mobility, and may have profound psychosocial effects on the handler due to feelings of bereavement and loss of self-esteem. However, this evidence is limited. This study examined the experiences and feelings of 36 people across New Zealand, who experienced the ending of at least one partnership with a guide dog (77 pairings), to explore issues arising at the end of the partnership and how this may impact on relationships with subsequent dogs. Results indicate that the majority of handlers experienced a reduction in their quality of life due to a decrease in independent mobility followed by the loss of a friend and companion, curtailment of social interactions, and loss of self-esteem/confidence. The end of the partnership affected people in different ways. Most handlers “accepted” the partnership had ended, but some felt guilty or angry with the guide dog school. Most applied for another dog immediately, as the need for mobility was high, while others preferred to wait and a smaller number did not reapply. Feelings at this time also affected the handlers’ relationships with subsequent guide dogs, with over a quarter expressing a negative effect. Retiring a guide dog (for whatever reason) is not only difficult for the handler, but also for the handler’s family, friends, co-workers, and doubtlessly, the dog. The majority of handlers expressed feelings of extreme grief when the partnership ended, whether it was successful or not. Feelings of extreme grief were more common for first than subsequent dogs. The depth of emotion was compared to losing a family member or other loved one, which has been reported in some person and pet relationships. A better understanding of issues surrounding the end of the partnership, including the human-animal bond, will help inform the guide dog industry of how best to support their clients during this time and when transitioning to another dog. Findings may be applied to other service/assistance dog users and the pet owning community

An investigation of the complexities of successful and unsuccessful guide dog matching and partnerships

Matching a person who is blind or visually impaired with a guide dog is a process of finding the most suitable guide dog available for that individual. Not all guide dog partnerships are successful, and the consequences of an unsuccessful partnership may result in reduced mobility and quality of life for the handler (owner), and are costly in time and resources for guide dog training establishments. This study examined 50 peoples' partnerships with one or more dogs (118 pairings) to ascertain the outcome of the relationship. Forty-three of the 118 dogs were returned to the guide dog training establishment before reaching retirement age, with the majority (n = 40) being categorized as having dog-related issues. Most (n = 26) of these dogs' issues were classified as being behavioral in character, including work-related and non-work-related behavior, and 14 were due to physical causes (mainly poor health). Three dogs were returned due to matters relating to the handlers' behavior. More second dogs were returned than the handlers' first or third dogs, and dogs that had been previously used as a guide could be rematched successfully. Defining matching success is not clear-cut. Not all dogs that were returned were considered by their handlers to have been mismatched, and not all dogs retained until retirement were thought to have been good matches, suggesting that some handlers were retaining what they considered to be a poorly matched dog. Almost all the handlers who regarded a dog as being mismatched conceded that some aspects of the match were good. For example, a dog deemed mismatched for poor working behavior may have shown good home and/or other social behaviors. The same principle was true for successful matches, where few handlers claimed to have had a perfect dog. It is hoped that these results may help the guide dog industry identify important aspects of the matching process, and/or be used to identify areas where a matching problem exists

Localization of inhibins and activins in normal endocrine cells and endocrine tumors of the gut and pancreas: an immunohistochemical and in situ hybridization study

Activins and inhibins, which belong to the TGF beta family, are composed of different combinations of alpha-, betaA-, and betaB-subunits, resulting in inhibin A (alphabetaA), inhibin B (alphabetaB), activin A (betaAbetaA), activin B (betaBbetaB), and activin AB (betaAbetaB). They regulate several cell functions, acting as paracrine/autocrine factors. Their actions, which depend on binding to specific receptors, are also modulated by follistatin. Gastroenteropancreatic (GEP) endocrine cells and endocrine tumors (ETs) produce several growth factors, but it is not well known whether they express follistatin and the various inhibin/activin subunits. We studied their expression in 65 GEP ETs using immunohistochemistry (IHC) and in situ hybridization (ISH). The alpha-subunit and follistatin were not identified in normal GEP endocrine cells and were poorly expressed in ETs. A betaA-subunit immunoreactivity (IR) was detected in A-, G-, EC-, and GIP-cells, while betaB-chain IR was present only in D-cells. The mRNAs encoding for these molecules were poorly expressed in normal tissues. BetaA- and betaB-subunits were identified in several ETs by both IHC and ISH: betaA-subunit mainly in G-cell and A-cell ETs, and betaB-subunit in D-cell, A-cell, and EC-cell ETs. Our results demonstrate a differential expression of activin/inhibin subunits among different types of GEP endocrine cells and related tumors, suggesting a role in modulation of biological functions of these normal and neoplastic endocrine cell

The guide dog as a mobility aid part 2: perceived changes to travel habits

This article describes the second of a two-part study that examined the effects of a guide dog as an aid to mobility. The first part, which is also published in this issue, showed that dogs were perceived to significantly improve travel performance, irrespective of the participants' orientation and mobility skills before receiving the dog. The second part of the study describes the changes a dog makes to travel habits. In this second part, the travel habits of 50 people who were blind or vision impaired were examined retrospectively before and after they received a dog. The results indicate that dogs were used more frequently than other mobility aids except when it was more convenient to use a human guide or a long cane, as for example on a very short journey. People travelled independently more often and went further, with greater ease and enjoyment when travelling with a dog. The use of a dog appeared to reduce problems with access and the need to avoid certain journeys. However, dogs also caused difficulties, especially in social situations where they were no/welcomed,and in crowded, cramped or dog-populated environments. More advantages than disadvantages were identified when comparing a dog to other mobility aids

Probing the Effects of the Well-mixed Assumption on Viral Infection Dynamics

Viral kinetics have been extensively studied in the past through the use of spatially well-mixed ordinary differential equations describing the time evolution of the diseased state. However, emerging spatial structures such as localized populations of dead cells might adversely affect the spread of infection, similar to the manner in which a counter-fire can stop a forest fire from spreading. In a previous publication (Beauchemin et al., 2005), a simple 2-D cellular automaton model was introduced and shown to be accurate enough to model an uncomplicated infection with influenza A. Here, this model is used to investigate the effects of relaxing the well-mixed assumption. Particularly, the effects of the initial distribution of infected cells, the regeneration rule for dead epithelial cells, and the proliferation rule for immune cells are explored and shown to have an important impact on the development and outcome of the viral infection in our model.Comment: LaTeX, 12 pages, 22 EPS figures, uses document class REVTeX 4, and packages float, graphics, amsmath, and SIunit

Exploring the behavioural drivers of veterinary surgeon antibiotic prescribing: a qualitative study of companion animal veterinary surgeons in the UK

Background: Multi-drug resistant bacteria are an increasing concern in both human and veterinary medicine. Inappropriate prescribing and use of antibiotics within veterinary medicine may be a contributory factor to antimicrobial resistance (AMR). The ‘One Health’ Initiative aims to work across species and environments to reduce AMR, however; little is currently known about the factors which influence antibiotic prescribing among veterinary surgeons in companion animal practice. This paper reports on qualitative data analysis of interviews with veterinary surgeons whose practice partially or wholly focuses on companion animals (N = 16). The objective of the research was to explore the drivers of companion animal veterinary surgeons’ antibiotic prescribing behaviours. The veterinary surgeons interviewed were all practising within the UK (England (n = 4), Scotland (n = 11), Northern Ireland (n = 1)). A behavioural thematic analysis of the data was undertaken, which identified barriers and facilitators to specific prescribing-related behaviours. Results: Five components of prescribing behaviours were identified: 1) confirming clinical need for antibiotics; 2) responding to clients; 3) confirming diagnosis; 4) determining dose, duration and type of antibiotic; and 5) preventing infection around surgery (with attendant appropriate and inappropriate antibiotic prescribing behaviours). Barriers to appropriate prescribing identified include: business, diagnostic, fear, habitual practice and pharmaceutical factors. Facilitators include: AMR awareness, infection prevention, professional learning and regulation and government factors. Conclusion: This paper uses a behavioural lens to examine drivers which are an influence on veterinary surgeons’ prescribing behaviours. The paper contributes new understandings about factors which influence antibiotic prescribing behaviours among companion animal veterinary surgeons. This analysis provides evidence to inform future interventions, which are focused on changing prescribing behaviours, in order to address the pressing public health concern of AMR

External validation of anti-Müllerian hormone based prediction of live birth in assisted conception

&lt;p&gt;Background - Chronological age and oocyte yield are independent determinants of live birth in assisted conception. Anti-Müllerian hormone (AMH) is strongly associated with oocyte yield after controlled ovarian stimulation. We have previously assessed the ability of AMH and age to independently predict live birth in an Italian assisted conception cohort. Herein we report the external validation of the nomogram in 822 UK first in vitro fertilization (IVF) cycles.&lt;/p&gt; &lt;p&gt;Methods - Retrospective cohort consisting of 822 patients undergoing their first IVF treatment cycle at Glasgow Centre for Reproductive Medicine. Analyses were restricted to women aged between 25 and 42 years of age. All women had an AMH measured prior to commencing their first IVF cycle. The performance of the model was assessed; discrimination by the area under the receiver operator curve (ROCAUC) and model calibration by the predicted probability versus observed probability.&lt;/p&gt; &lt;p&gt;Results - Live births occurred in 29.4% of the cohort. The observed and predicted outcomes showed no evidence of miscalibration (p = 0.188). The ROCAUC was 0.64 (95% CI: 0.60, 0.68), suggesting moderate and similar discrimination to the original model. The ROCAUC for a continuous model of age and AMH was 0.65 (95% CI 0.61, 0.69), suggesting that the original categories of AMH were appropriate.&lt;/p&gt; &lt;p&gt;Conclusions - We confirm by external validation that AMH and age are independent predictors of live birth. Although the confidence intervals for each category are wide, our results support the assessment of AMH in larger cohorts with detailed baseline phenotyping for live birth prediction.&lt;/p&gt