Building a Model and Framework for Child Welfare Supervision

This report, Building a Model and Framework for Child Welfare Supervision, presents the findings from an extensive review of the most recent literature combined with interviews of experts in the field of child welfare, currently practicing child welfare administrators, supervisors, frontline practitioners, and trainers. The report is organized into three sections: • Section I introduces seven elements of an emerging model of supervision in child welfare. • Section II presents an integrated organizational framework consisting of four components required to empower child welfare supervisors to effectively carry out their administrative, educational, and supportive functions. • Section III incorporates supports useful to agencies in implementing the recommendations contained in this report. These include our interview protocols, the annotated results of our extensive literature review, a sample job description, and our methodology

Biophysical Characterization of the Strong Stabilization of the RNA Triplex poly(U)•poly(A)*poly(U) by 9-O-(ω-amino) Alkyl Ether Berberine Analogs

Background: Binding of two 9-O-(v-amino) alkyl ether berberine analogs BC1 and BC2 to the RNA triplex poly(U)Npoly(A)*poly(U) was studied by various biophysical techniques. Methodology/Principal Findings: Berberine analogs bind to the RNA triplex non-cooperatively. The affinity of binding was remarkably high by about 5 and 15 times, respectively, for BC1 and BC2 compared to berberine. The site size for the binding was around 4.3 for all. Based on ferrocyanide quenching, fluorescence polarization, quantum yield values and viscosity results a strong intercalative binding of BC1 and BC2 to the RNA triplex has been demonstrated. BC1 and BC2 stabilized the Hoogsteen base paired third strand by about 18.1 and 20.5uC compared to a 17.5uC stabilization by berberine. The binding was entropy driven compared to the enthalpy driven binding of berbeine, most likely due to additional contacts within the grooves of the triplex and disruption of the water structure by the alkyl side chain. Conclusions/Significance: Remarkably higher binding affinity and stabilization effect of the RNA triplex by the amino alkyl berberine analogs was achieved compared to berberine. The length of the alkyl side chain influence in the triplex stabilization phenomena

Ventilação mecânica volume-controlada versus pressão controlada em modelo canino de lesão pulmonar aguda: efeitos cardiorrespiratórios e sobre o custo de oxigênio da respiração Volume controlled ventilation versus pressure controlled ventilation in a canine acute lung injury model: effects on cardiorespiratory parameters and oxygen cost of breathing

Introdução: Persiste a questão sobre se há vantagens mecânicas ou de trocas gasosas no uso da ventilação pressão-controlada (VPC) sobre a ciclada a volume (VCV). Objetivos: Comparar, de forma randômica, a VPC com a VCV com fluxo desacelerado nos modos assistido e controlado em modelo experimental de lesão pulmonar aguda. Métodos: Sete cães com lesão pulmonar aguda grave (PaO2/FIO2 < 100mmHg) induzida por ácido oléico intravenoso (0,05mg/kg) foram ventilados em VPC ou VCV, mantidos constantes o volume corrente e o tempo inspiratório. Nas duas modalidades os animais foram ventilados por 40 minutos no modo assistido seguido do modo controlado após curarização. Resultados: Não houve diferenças em relação às trocas gasosas (PaO2 e PaCO2), ao débito, ao transporte de oxigênio e à mecânica respiratória entre a VCV e a VPC. O consumo de oxigênio (VO2) após a curarização foi semelhante (124 &plusmn; 48 na VCV versus 143 &plusmn; 50ml/min na VPC, com p = 0,42). Entretanto, no modo assistido, houve tendência de maior VO2 na VPC (219 &plusmn; 72 versus 154 &plusmn; 67ml/min na VCV, p = 0,06). Isso associou-se a tendência de maior custo de oxigênio da respiração (COR) naquela modalidade, embora sem diferença estatística significante (31 &plusmn; 77 na VCV versus 75 &plusmn; 96ml/min na VPC, p = 0,23) e menor PvO2 (34 &plusmn; 7 versus 42 &plusmn; 6ml/min na VCV, p = 0,02). O pico de fluxo inspiratório nos ciclos assistidos foi maior na VPC (58 &plusmn; 9 versus 48 &plusmn; 4L/min na VCV, p = 0,01). A instituição da ventilação controlada por curarização reduziu em cerca de 20% o débito cardíaco e o DO2 em relação ao modo assistido, tanto na VCV quanto na VPC. Conclusões: Em um modelo de insuficiência respiratória grave, com elevado COR, a manutenção da ventilação controlada em relação à assistida melhorou a relação entre oferta e consumo de oxigênio. A VPC não trouxe benefícios às trocas gasosas ou à mecânica pulmonar em relação à VCV, podendo aumentar o COR no modo assistido no presente modelo.<br>Background: It is questionable whether pressure-controlled ventilation (PCV) has advantages over volume-cycled ventilation (VCV). Objectives: To compare PCV to VCV with decelerating flow profile during assisted and controlled modes in an acute lung injury experimental model. Methods: Severe acute lung injury (PaO2/FIO2 < 100 mmHg) was induced by oleic acid IV infusion (0.05 mg/kg) in seven dogs. The animals were submitted to PCV and VCV in a randomized sequence. After 40 minutes in the assisted mode, ventilation was changed to the controlled mode after neuromuscular blockade. The tidal volume and the inspiratory time were kept constant throughout the experiment. Results: There were no differences in gas exchange (PaO2 and PaCO2), cardiac output or oxygen delivery (DO2) between VCV and PCV. The same was observed regarding maximum airway and plateau pressures, and also to the static compliance. Oxygen consumption (VO2) after neuromuscular blockade was 124 &plusmn; 48 in VCV versus 143 &plusmn; 50 ml/min in PCV, p = 0.42. In the assisted mode, there was a statistical trend of a higher VO2 in PCV (219 &plusmn; 72 versus 154 &plusmn; 67 ml/min in VCV, p = 0.06), that was associated with a statistical trend of a higher oxygen cost of breathing (OCB) during assisted PCV, although without statistical significance (31 &plusmn; 77 in VCV versus 75 &plusmn; 96 ml/min in PCV, p = 0.23), and also in a lower PvO2 (34 &plusmn; 7 in PCV versus 42 &plusmn; 6 ml/min in VCV, p = 0.02). These occurred despite a higher maximum inspiratory flow in the assisted mode in PCV (58 &plusmn; 9 versus 48 &plusmn; 4 L/min in VCV, p = 0.01). In both VCV and PCV the institution of controlled ventilation reduced cardiac debit and DO2 in as much as 20% relative to the assisted mode. Conclusions: The implementation of controlled ventilation improved the oxygen delivery/consumption relationship in this severe and with high OCB acute lung injury model. The PCV offered no additional benefits to VCV and it was associated with a higher OCB during the assisted mode