The Herts and Minds study: feasibility of a randomised controlled trial of Mentalizationbased Treatment versus usual care to support the wellbeing of children in foster care

© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.Background: There is a lack of well-designed randomized controlled trials (RCTs) to investigate the efficacy of psychological therapies for children in foster care with emotional and behavioural difficulties. Mentalization-based therapy (MBT) focuses on supporting the carer-child relationship by promoting reflective capacity. This study examined the feasibility and acceptability of an RCT of MBT, delivered in a family-format, for children who are in foster care in the UK. Method: Herts and Minds was a phase II, blinded feasibility RCT with follow-up of at 12 and 24 weeks post-randomisation. Participants were children (age 5-16) in foster care referred to a targeted mental health service, who had some level of difficulty as identified by the Strengths and Difficulties Questionnaire (SDQ). Aims were to assess: the feasibility of recruitment processes and study uptake; capacity to train mental health practitioners to deliver MBT to an acceptable level of treatment integrity; establish acceptability and credibility of MBT as an intervention for children in foster care; establish feasibility and acceptability to participants of conducting an RCT; and estimate the likely treatment efficacy effect size. Participants were randomly allocated to either MBT (n = 15) or Usual Clinical Care (UCC) (n = 21) individually or in sibling groups. A range of qualitative and quantitative data was gathered to assess feasibility. Results: Feasibility was established with regard to: capacity to recruit participants to a study; capacity to train mental health practitioners to deliver MBT to an acceptable level of treatment integrity; acceptability and credibility of MBT; and feasibility and acceptability to participants of conducting an RCT. A number of issues made it difficult to estimate a likely treatment efficacy effect size. Conclusion: With modifications, it is feasible to run an RCT of MBT for children in foster care. Both the therapy and research design were acceptable to participants, but modifications may be needed regarding both the timing of assessments and the identification of appropriate primary outcome measures. Given the lack of evidenced based therapies for this population, such a trial would be a significant contribution to the field. Findings may be useful for other groups planning clinical trials of psychological therapies for children in foster care. Trial registration: ISRCTN 90349442. The trial was retrospectively registered on 6 May 2016.Peer reviewedFinal Published versio

The rigid syntomic ring spectrum

The aim of this paper is to show that Besser syntomic cohomology is representable by a rational ring spectrum in the motivic homotopical sense. In fact, extending previous constructions, we exhibit a simple representability criterion and we apply it to several cohomologies in order to get our central result. This theorem gives new results for syntomic cohomology such as h-descent and the compatibility of cycle classes with Gysin morphisms. Along the way, we prove that motivic ring spectra induces a complete Bloch-Ogus cohomological formalism and even more. Finally, following a general motivic homotopical philosophy, we exhibit a natural notion of syntomic coefficients.Comment: Final version to appear in the Journal de l'institut des Math\'ematiques de Jussieu. Many typos have been corrected and the exposition has been improved according to the suggestions of the referees: we thank them a lot

A qualitative analysis of goals set by foster carers seeking support for their child’s emotional well-being

The needs of foster carers are complex as children in their care often present with complex emotional and behavioural difficulties. Previous studies have examined foster carers’ perceptions of the unmet needs of the children in their care but there is a lack of knowledge regarding carers’ own goals when seeking professional help. The present study seeks to fill this gap by examining the goals that carers who are looking after children with emotional and/or behavioural difficulties set at the start of an intervention, the Reflective Fostering Programme, designed to support them. Twenty-six foster carers were asked to complete a Goal-Based Outcome Measure (GBOM) before starting the programme. Qualitative content analysis revealed five main categories of goals. Three were child focused (child’s relationships, challenging behaviours and emotions) and two were foster carer focused (personal goals and goals related to participating in the programme). By understanding the types of goals meaningful to foster carers, interventions can be developed to better target their specific needs and allow outcome measures to be more closely aligned to their goals. Results are discussed in terms of implications for the development and evaluation of interventions to support foster carers and the children they look after

Geogenomic segregation and temporal trends of human pathogenic Escherichia coli o157:H7, Washington, USA, 2005-2014

The often-noted and persistent increased incidence of Escherichia coli O157:H7 infections in rural areas is not well understood. We used a cohort of E. coli O157:H7 cases reported in Washington, USA, during 2005–2014, along with phylogenomic characterization of the infecting isolates, to identify geographic segregation of and temporal trends in specific phylogenetic lineages of E. coli O157:H7. Kernel estimation and generalized additive models demonstrated that pathogen lineages were spatially segregated during the period of analysis and identified a focus of segregation spanning multiple, predominantly rural, counties for each of the main clinical lineages, Ib, IIa, and IIb. These results suggest the existence of local reservoirs from which humans are infected. We also noted a secular increase in the proportion of lineage IIa and IIb isolates. Spatial segregation by phylogenetic lineage offers the potential to identify local reservoirs and intervene to prevent continued transmission

High temperature phases in the 0.98PbZrO3–0.02Pb(Ni1/3Nb2/3)O3 ceramic

The phase evolution with temperature in the 0.98PbZrO3–0.02Pb(Ni1/3Nb2/3)O3ceramic was investigated with dielectricpermittivity and polarization measurements, hot stage transmission electron microscopy, and high temperature x-ray diffraction. Below 190 °C, the ceramic is in the antiferroelectric phase with characteristic 14{110}csuperlatticediffractions. In this stage, typical antiferroelectric 180° domains were observed. Between 190 and 220 °C, an intermediate phase, which is characterized by 12{110}c-type superlatticediffractions, was detected. Evidences are found to suggest that this intermediate phase is ferroelectric. The 12{110}c-type superlatticediffraction persists even into the paraelectric phase above 220 °C. In addition, there exists an incommensurate phase between the low temperature antiferroelectric phase and the intermediate ferroelectric phase

Phase transitions for PP-adic Potts model on the Cayley tree of order three

In the present paper, we study a phase transition problem for the $q$-state $p$-adic Potts model over the Cayley tree of order three. We consider a more general notion of $p$-adic Gibbs measure which depends on parameter \rho\in\bq_p. Such a measure is called {\it generalized $p$-adic quasi Gibbs measure}. When $\rho$ equals to $p$-adic exponent, then it coincides with the $p$-adic Gibbs measure. When $\rho=p$, then it coincides with $p$-adic quasi Gibbs measure. Therefore, we investigate two regimes with respect to the value of $|\rho|_p$. Namely, in the first regime, one takes $\rho=\exp_p(J)$ for some J\in\bq_p, in the second one $|\rho|_p<1$. In each regime, we first find conditions for the existence of generalized $p$-adic quasi Gibbs measures. Furthermore, in the first regime, we establish the existence of the phase transition under some conditions. In the second regime, when $|\r|_p,|q|_p\leq p^{-2}$ we prove the existence of a quasi phase transition. It turns out that if $|\r|_p<|q-1|_p^2<1$ and \sqrt{-3}\in\bq_p, then one finds the existence of the strong phase transition.Comment: 27 page

From fossils to phylogenies

The research question address in this study is, “To what extent will the use of hands-on activities for introducing concepts in bioinformatics promote student engagement in after-school STEM club settings?” It is hypothesized that high school students' engagement in hands-on bioinformatics activities promotes their awareness of, and interest in, STEM careers. Therefore the purpose of creating our curriculum is to get high school students excited about STEM careers. The activities created will be used in after-school science clubs, the students will gain hands-on experience with programs that real scientists use in bioinformatics research. Our team partners with SMILE (Science and Math Investigative Learning Experiences) a STEM Outreach group, in order to create a program to best suit the students

Osteogenic lineage restriction by osteoprogenitors cultured on nanometric grooved surfaces – the role of focal adhesion maturation

The differentiation of progenitor cells is dependent on more than biochemical signalling. Topographical cues in natural bone extracellular matrix guide cellular differentiation through the formation of focal adhesions, contact guidance, cytoskeletal rearrangement and ultimately gene expression. Osteoarthritis and a number of bone disorders present as growing challenges for our society. Hence, there is a need for next generation implantable devices to substitute for, or guide, bone repair in vivo. Cellular responses to nanometric topographical cues need to be better understood in vitro in order to ensure the effective and efficient integration and performance of these orthopaedic devices. In this study, the FDA approved plastic polycaprolactone, was embossed with nanometric grooves and the response of primary and immortalised osteoprogenitor cells observed. Nanometric groove dimensions were 240 nm or 540 nm deep and 12.5 μm wide. Cells cultured on test surfaces followed contact guidance along the length of groove edges, elongated along their major axis and showed nuclear distortion, they formed more focal complexes and a lower proportions of mature adhesions relative to planar controls. Down-regulation of the osteoblast marker genes RUNX2 and BMPR2 in primary and immortalised cells was observed on grooved substrates. Down-regulation appeared to directly correlate with focal adhesion maturation, indicating the involvement of ERK 1/2 negative feedback pathways following integrin mediated FAK activation

Human Bocaviruses Are Highly Diverse, Dispersed, Recombination Prone, and Prevalent in Enteric Infections

International audienceA new species of parvovirus, tentatively named human bocavirus 4 (HBoV4), was genetically characterized. Among 641 feces samples obtained from children and adults, the most commonly detected bocavirus species were, in descending order, HBoV2, HBoV3, HBoV4, and HBoV1, with an HBoV2 prevalence of 21% and 26% in Nigerian and Tunisian children, respectively. HBoV3 or HBoV4 species were found in 12 of 192 patients with non-polio acute flaccid paralysis in Tunisia and Nigeria and 0 of 96 healthy Tunisian contacts (P = .01). Evidence of extensive recombination at the NP1 and VP1 gene boundary between and within bocavirus species was found. The high degree of genetic diversity seen among the human bocaviruses found in feces specimens, relative to the highly homogeneous HBoV1, suggest that this worldwide-distributed respiratory pathogen may have recently evolved from an enteric bocavirus after acquiring an expanded tropism favoring the respiratory tract. Elucidating the possible role of the newly identified enteric bocaviruses in human diseases, including acute flaccid paralysis and diarrhea, will require further epidemiological studies