The experience of adolescents participating in a randomised clinical trial in the field of mental health: a qualitative study

Background This descriptive study aimed to investigate adolescents’ motivations for participating in a randomised controlled trial (RCT), to explore the understanding that the young people had regarding a number of aspects of the trial design, to examine whether or not they found participation in the trial to be acceptable and what affected this, and to identify whether and how the young people felt that their participation in the RCT impacted on their experience of therapy and on therapeutic change. Methods Seventy-six adolescents who were taking part in a large-scale RCT to evaluate the clinical and cost effectiveness of psychological therapies for depression were interviewed at two time-points after completing therapy. The semi-structured interviews, which included a focus on the young people’s experience of the research study, were analysed using framework analysis. Results The vast majority of adolescents found it acceptable to participate in the clinical trial, and many agreed to participate for reasons of ‘conditional altruism’. However consent was often given without great understanding of the key elements of the trial, including the difference between treatment arms and the randomisation process. Although the adolescents were largely positive about their experiences from taking part, the study raises questions about whether clinical outcomes may be influenced by participation in the research elements of the trial. Conclusions Although adolescents are under-represented in clinical trials, those who do participate are generally positive about the experience; however, careful thought needs to be given to key elements of the trial design and the potential impact of the research participation on clinical outcomes

Parents' experience of child contact within entrenched conflict families following separation and divorce: a qualitative study

Child contact arrangements with parents following separation and divorce are strongly endorsed for children in both public policy and law where safe, but can be difficult to sustain. Entrenched high-conflict post-separation relationships between parents can cause substantial emotional risks to children as well as impacting severely on parents’ mental health. This paper describes a qualitative study, aimed at examining parents’ experiences of contact arrangements post-separation, undertaken within a mixed methods random allocation study of therapeutic outcomes for parents in entrenched conflict over their children. Two established semi-structured interviews with 22 parents were jointly subjected to thematic analyses. A thematic analysis across interviews revealed three main themes: ‘Dealing with contact evokes extreme states of mind’ for parents; when speaking of contact, the child is ‘everywhere and nowhere’ in the parents’ minds; ‘the hardest thing about contact is dealing with my ex-partner’. These findings indicate the immense strain children and parents are under and shed much light on the desperate states of mind for parents, particularly the anxieties driving relentless child contact disputes. This paper may contribute to the understanding of parents’ experiences of contact arrangements post-separation, potentially providing important information which can inform best practice for professionals working with this population

Parents’ understanding and motivation to take part in a randomized controlled trial in the field of adolescent mental health: A Qualitative Study

Background Little is known about why parents agree to take part in randomized controlled trials for adolescent mental health. This study aimed to investigate parents’ perspectives on participating in a trial for psychological treatment of depression. The study explored parents’ motivations, understanding of the trial and perspectives on the acceptability of the trial. Methods Sixty-five parents took part in this qualitative study. Their adolescent children had been randomly allocated to one of three active psychological treatments for depression as part of the IMPACT trial and were interviewed about their experiences of participating in the study. Semi-structured interviews were analysed using framework analysis. Results For seven of the sixty-five parents, their experience of taking part in the trial was not covered in their interview so they were excluded from the analysis. The analysis was therefore based on the data from the parents of 58 adolescents taking part in the trial. The most commonly cited motivation for taking part in the study reported by parents was a desire to help others going through similar difficulties. Parents generally reported finding trial participation acceptable, although there were aspects that some reported finding less acceptable, including randomization and the burden of research assessments. Others spoke positively about the experience of trial participation and found it enjoyable or even therapeutic. Importantly, some did not appear to have a good understanding of the trial design, including randomization and treatment allocation. Conclusions This study indicates that trial participation can be a positive experience for parents, yet it raises concerns about how trialists can ensure that consent is fully informed, given that some parents appeared to have a poor understanding of the trial. Future studies should seek to explore how communication with trial participants can be improved, to ensure that trial participation is fully informed. Patient and public involvement will be crucial in ensuring this communication is accessible to stakeholders

‘Just like talking to someone about like shit in your life and stuff, and they help you’: hopes and expectations for therapy among depressed adolescents

Objective: To explore hopes and expectations for therapy among a clinical population of depressed adolescents. Method: As part of a randomised clinical trial, 77 adolescents aged 11 to 17, with moderate to severe depression, were interviewed using a semi-structured interview schedule. The interviews were analysed qualitatively, using Framework Analysis. Results: The findings are reported around five themes: “The difficulty of imagining what will happen in therapy”, "the 'talking cure'"; “the therapist as doctor”, “therapy as a relationship” and “regaining the old self or developing new capacities”. Conclusions: Differing expectations are likely to have implications for the way young people engage with treatment, and failure to identify these expectations may lead to a risk of treatment breakdown

Major commercial crises in the United States since the Civil War

Thesis (M.A.)--Boston University, 1934. This item was digitized by the Internet Archive

Los valores morales y su influencia en el buen vivir de la comunidad del CNH Gotitas de Amor de la ciudadela las Piñas en el año lectivo 2011-2012.

El presente proyecto de investigación se basa en realizar proyectos motivadores e incluidores de valores morales que fomenten el buen vivir en la comunidad. La realización de talleres de valores morales proporcionan al estudiante, comunidad y docente la oportunidad de establecer nuevos conocimientos sobre ellos y con el fin de ir a la práctica activa; así que de esta manera se fortalecerá la relación socio afectiva entre familias y entorno social. Estas actividades permite desarrollar el mejoramiento del buen vivir, prácticas que nos harán valorar, respetar opiniones propias y ajenas teniendo el compromiso de realizar las cosas con amor, humildad y perseverancia valores enfocados en dicho proyecto de investigación. Aunque la realidad propia de este establecimiento educativo es la baja influencia de valores morales de padres hacia hijos ya que la práctica de estos es muy irregular y por lo tanto no se ven latentes. Frente a este evidente problema de la Unidad de Atención del CNH Gotitas de Amor se pudo apreciar en algunos estudiantes la poca práctica de los valores morales; así como también la falta de unión y organización entre los padres de familia. Observando este problema decidí realizar esta investigación, la misma que está formada por cinco capítulos diagnóstico, referencias, ejecución, interpretación de datos, planificación, ejecución, aportes y referencias de algunos expertos en los temas involucrados que nos ayudara a la solución del problema así como también la importancia de los talleres que fomenten los valores morales y el buen vivir de la comunidad por eso es recomendable incitar al promotor a darse un espacio para dar talleres que proporcionen conocimientos positivos para la mejora de los padres de familia, sus hijos y la comunidad

Glycogen Utilization during Running: Intensity, Sex, and Muscle-specific Responses.

PURPOSE: To quantify net glycogen utilisation in the vastus lateralis (VL) and gastrocnemius (G) of male (n=11) and female (n=10) recreationally active runners during three outdoor training sessions. METHODS: After 2 days standardisation of carbohydrate (CHO) intakes (6 g.kg body mass per day), glycogen was assessed before and after 1) a 10-mile road run (10-mile) at lactate threshold, 2) 8 x 800 m track intervals (8 x 800 m) at velocity at V[Combining Dot Above]O2max and 3) 3 x 10 minute track intervals (3 x 10 min) at lactate turnpoint. RESULTS: Resting glycogen concentration was lower in the G of females compared with males (P0.05). Net glycogen utilisation was greater in males than females in both VL (P=0.02) and G (P=0.07) during the 10-mile road run. With the exception of males during the 3 x 10 min protocol (P=0.28), greater absolute glycogen utilisation was observed in the G versus the VL muscle in both males and females and during all training protocols (all comparisons, P<0.05). CONCLUSION: Data demonstrate 1) prolonged steady state running necessitates a greater glycogen requirement than shorter but higher intensity track running sessions, 2) females display evidence of reduced resting muscle glycogen concentration and net muscle glycogen utilisation when compared with males and 3), net glycogen utilisation is higher in the gastrocnemius muscle compared with the vastus lateralis

Pharmacologically directed strategies in academic anticancer drug discovery based on the European NCI compounds initiative

Background: The European NCI compounds programme, a joint initiative of the EORTC Research Branch, Cancer Research Campaign and the US National Cancer Institute, was initiated in 1993. The objective was to help the NCI in reducing the backlog of in vivo testing of potential anticancer compounds, synthesised in Europe that emerged from the NCI in vitro 60-cell screen. Methods: Over a period of more than twenty years the EORTC—Cancer Research Campaign panel reviewed ~2000 compounds of which 95 were selected for further evaluation. Selected compounds were stepwise developed with clear go/no go decision points using a pharmacologically directed programme. Results: This approach eliminated quickly compounds with unsuitable pharmacological properties. A few compounds went into Phase I clinical evaluation. The lessons learned and many of the principles outlined in the paper can easily be applied to current and future drug discovery and development programmes. Conclusions: Changes in the review panel, restrictions regarding numbers and types of compounds tested in the NCI in vitro screen and the appearance of targeted agents led to the discontinuation of the European NCI programme in 2017 and its transformation into an academic platform of excellence for anticancer drug discovery and development within the EORTC-PAMM group. This group remains open for advice and collaboration with interested parties in the field of cancer pharmacology

Predictors of outcome in infant and toddlers functional or behavioral disorders after a brief parent–infant psychotherapy

The efficacy of parent–child psychotherapies is widely recognized today. There are, however, less data on predictive factors for outcome in infants and toddlers and their parents. The aim of this study was to highlight predictive factors for outcome after a brief psychotherapy in a population of 49 infants and toddlers aged 3–30 months presenting functional or behavioral disorders. Two assessments were performed, the first before treatment and the second a month after the end of the therapy. These assessments included an evaluation of the child’s symptoms, and of depressive or anxiety symptoms in the parents. The assessments after therapy show complete or partial improvement in the child’s symptoms for nearly three quarters, and a decrease in the number of anxious and depressive mothers, and also in the number of depressive fathers. Three independent factors appear as predictive of unfavorable outcome for the child: frequency and intensity of behavioral problems and fears, and the absence of the father at more than two-thirds of consultations. The outcome for the mother is associated solely with her anxiety score at the start of the therapy. This study underlines the particular difficulties involved in the treatment of infants and toddlers presenting behavioral disturbances and emotional difficulties, and the value of involving the father in treatment

Social-Skills and Parental Training plus Standard Treatment versus Standard Treatment for Children with ADHD – The Randomised SOSTRA Trial

To investigate the effects of social-skills training and parental training programme for children with attention deficit hyperactivity disorder (ADHD).We conducted a randomized two-armed, parallel group, assessor-blinded superiority trial consisting of social-skills training plus parental training and standard treatment versus standard treatment alone. A sample size calculation showed at least 52 children should be included for the trial with follow up three and six months after randomization. The primary outcome measure was ADHD symptoms and secondary outcomes were social skills and emotional competences. RESULTS 56: children (39 boys, 17 girls, mean age 10.4 years, SD 1.31) with ADHD were randomized, 28 to the experimental group and 27 to the control group. Mixed-model analyses with repeated measures showed that the time course (y  =  a + bt + ct(2)) of ADHD symptoms (p = 0.40), social skills (p = 0.80), and emotional competences (p = 0.14) were not significantly influenced by the intervention.Social skills training plus parental training did not show any significant benefit for children with attention deficit hyperactivity disorder when compared with standard treatment. More and larger randomized trials are needed.ClinicalTrials.gov NCT00937469