Experiences of parenting and clinical intervention for mothers affected by personality disorder: a pilot qualitative study combining parent and clinician perspectives

Background: Evidence-based parenting programmes are recommended for the treatment of child mental health difficulties. Families with complex psychosocial needs show poorer retention and outcomes when participating in standard parenting programmes. The Helping Families Programme (HFP) is a 16-week community-based parenting intervention designed to meet the needs of these families, including families with parental personality disorder. This study aimed to explore the help seeking and participatory experiences of parents with a diagnosis of personality disorder. It further aimed to examine the acceptability of referral and intervention processes for the HFP from the perspectives of (i) clinicians referring into the programme; and (ii) referred parents. Method: Semi-structured interviews were conducted with parents recruited to receive HFP (n = 5) as part of a research case series and the referring NHS child and adolescent mental health service (CAMHS) clinicians (n = 5). Transcripts were analysed using Interpretive Phenomenological Analysis. Results: Four themes were identified for parents: (i) the experience of parenthood, (ii) being a parent affected by personality disorder, (iii) experience of the intervention, and (iv) qualities of helping. Three themes emerged for clinicians: (i) challenges of addressing parental need, (ii) experience of engaging parents with personality disorders and (iii) limited involvement during HFP. Comparison of parent and clinician themes led to the identification of two key interlinked themes: (i) concerns prior to receiving the intervention, and (ii) the challenges of working together without a mutual understanding. Conclusions: This pilot study identifies potentially significant challenges of working with parents affected by personality disorder and engaging them in HFP and other similar interventions. Results have important wider clinical implications by highlighting potential barriers to engagement and participation and providing insights on how these barriers might be overcome. Findings have been used to inform the referral and intervention processes of a pilot RCT and further intervention development

Induction of Erythroid Differentiation in Human Erythroleukemia Cells by Depletion of Malic Enzyme 2

Malic enzyme 2 (ME2) is a mitochondrial enzyme that catalyzes the conversion of malate to pyruvate and CO2 and uses NAD as a cofactor. Higher expression of this enzyme correlates with the degree of cell de-differentiation. We found that ME2 is expressed in K562 erythroleukemia cells, in which a number of agents have been found to induce differentiation either along the erythroid or the myeloid lineage. We found that knockdown of ME2 led to diminished proliferation of tumor cells and increased apoptosis in vitro. These findings were accompanied by differentiation of K562 cells along the erythroid lineage, as confirmed by staining for glycophorin A and hemoglobin production. ME2 knockdown also totally abolished growth of K562 cells in nude mice. Increased ROS levels, likely reflecting increased mitochondrial production, and a decreased NADPH/NADP+ ratio were noted but use of a free radical scavenger to decrease inhibition of ROS levels did not reverse the differentiation or apoptotic phenotype, suggesting that ROS production is not causally involved in the resultant phenotype. As might be expected, depletion of ME2 induced an increase in the NAD+/NADH ratio and ATP levels fell significantly. Inhibition of the malate-aspartate shuttle was insufficient to induce K562 differentiation. We also examined several intracellular signaling pathways and expression of transcription factors and intermediate filament proteins whose expression is known to be modulated during erythroid differentiation in K562 cells. We found that silencing of ME2 leads to phospho-ERK1/2 inhibition, phospho-AKT activation, increased GATA-1 expression and diminished vimentin expression. Metabolomic analysis, conducted to gain insight into intermediary metabolic pathways that ME2 knockdown might affect, showed that ME2 depletion resulted in high orotate levels, suggesting potential impairment of pyrimidine metabolism. Collectively our data point to ME2 as a potentially novel metabolic target for leukemia therapy

A Meta-analysis of Attachment to Parents and Delinquency

To investigate the link between attachment to parents and delinquency, and the potential moderating effects of age and sex, 74 published and unpublished manuscripts (N = 55,537 participants) were subjected to a multilevel meta-analysis. A mean small to moderate effect size was found (r = 0.18). Poor attachment to parents was significantly linked to delinquency in boys and girls. Stronger effect sizes were found for attachment to mothers than attachment to fathers. In addition, stronger effect sizes were found if the child and the parent had the same sex compared to cross-sex pairs of children and parents. Age of the participants moderated the link between attachment and delinquency: larger effect sizes were found in younger than in older participants. It can be concluded that attachment is associated with juvenile delinquency. Attachment could therefore be a target for intervention to reduce or prevent future delinquent behavior in juveniles

Screening op congenitale hypothyreoidie en fenylketonurie: overzicht gegevensverwerking per computer

Dit rapport beschrijft in grote lijnen de automatisering van de gegevensverwerking van de screening op congenitale hypothyreoidie (CHT) en fenylketonurie (PKU) zoals toegepast bij de Bijzondere Afdeling Automatisering Serologisch Onderzoek (ASO). Het rapport is in hoofdzaak bedoeld als overzicht, naslagwerk en algemene "Standard Operational Procedure" (SOP) voor diegenen die zich (weer) vertrouwd moeten maken met de gang van zaken. Het is zeker niet geschreven als een volledige handleiding. Momenteel (oktober 1984) maakt alleen de Provinciale Ent Administratie (PEA) van Utrecht gebruik van de mogelijkheid rechtstreeks via het RIVM Computer systeem de uitslagen op te vragen. Dit zou gemakkelijk kunnen worden uitgebreid met de andere PEA's waarvoor ASO fungeert als CHT-laboratorium

Preliminary actions concerning the (further) automation of the clerical treatment of the PKU/CHT screeningresults

Een werkgroep bestaande uit vertegenwoordigers van de entadministraties en de PKU- en CHT-laboratoria, gesteund door enkele automatiseringsdeskundigen, heeft een model uitgewerkt voor de automatisering van de administratie van de PKU- en CHT-screening bij pasgeborenen. De voordelen zijn 1. de tijdswinst in de rapportage van de analyse uitslagen, 2. een vermindering van de kans op administratieve fouten en 3. vereenvoudigde bewaking van de "kwaliteit" van zowel het analystische als het logistieke deel van de screening. Hiertegenover staat voor het totale project een investering van apparatuur die, rekening houdend met een afschrijving van 20% per jaar neerkomt op f. 60.000,- a f. 80.000,- (incl. BTW). De programmatuur- en telecommunicatiekosten belopen f. 150.000,- a f. 170 .000,- per jaar.RIV