Review of local alcohol harm reduction strategies in Cheshire and Merseyside

This report reviews local alcohol strategies in Cheshire and Merseyside.ChaMPs Public Health Networ

Parental participation in Sure Start Jolly Giraffe The role and effectiveness of the Parents’ Forum

Copyright © Centre for Public Health Research, University College Chester. Reprinted April 2008.The aim of the commissioned research project was to examine Sure Start Jolly Giraffe’s model for facilitating parental participation. Commitment to, and evidence of, user involvement is now included as a central theme in the design and delivery of initiatives which impact upon individuals and their communities. An additional and increasingly prominent issue for scrutiny is the effectiveness and significance of the methods selected by service providers for promoting consultation and participation. A key principle of the Sure Start initiative is the transparent involvement of service users in all aspects of programme decision making. A further requirement of local programmes is to provide evidence of parental consultation and participation. Sure Start guidance places significant emphasis on the need for local programmes to provide relevant and appropriate services to match the needs of their communities. In acknowledging Jolly Giraffe’s parents’ group, the Parents’ Forum, as the primary arena for parental feedback in the programme, a need was identified for an in-depth examination of its role, processes and impact

Evaluation of services for younger parents at Halton Lodge Children’s Centre

© University of ChesterIn 1999 a report by the Social Exclusion Unit (SEU) identified that the children of younger parents, and indeed younger parents themselves, were more likely to experience poor outcomes. The government’s ten year Teenage Pregnancy Strategy marked a renewed focus on teenage pregnancy as a priority area for intervention. Central to its aims are the reduction of teenage pregnancy rates and; the provision of support which will improve the life chances of teenage parents and their children. Sure Start local programmes are expected to reach certain targets regarding contact with, and registration of, pregnant women in their areas. In acknowledging the ‘apprehensions of teenage parents about taking part in activities with older parents’ (Sure Start Unit, 2005, p.571) the advice for working with teenage parents also highlights the need for centres to adopt a specialised, young person-centred approach to providing services for younger parents. The aim of this commissioned research project was to examine the provision of services for younger parents by Sure Start Jolly Giraffe at Halton Lodge Children’s Centre

Evaluation of the Dads group at Blacon Children's Centre

This study was designed to evaluate Blacon Children’s Centre Dads Group. A mixed method approach was used, incorporating both quantitative and qualitative methods. Through combining the findings from the various sources, some key issues were identified, as well as areas for development. Nearly all of the dads who were attending the Dads Group, along with all of the regular service providers, participated in this study, and thus the findings should accurately reflect perceptions of the service

A novel deletion in proximal 22q associated with cardiac septal defects and microcephaly: a case report

<p>Abstract</p> <p>Background</p> <p>Proximal 22q is rich in low copy repeats (LCRs) which mediate non-allelic homologous recombination and give rise to deletions and duplications of varying size depending on which LCRs are involved.</p> <p>Methods</p> <p>A child with multiple septal defects and other congenital anomalies was investigated for genome imbalance using multiplex ligation-dependent probe amplification (MLPA) for subtelomeres and microdeletion loci, followed by array comparative genomic hybridization (CGH) using oligonucleotide arrays with 44,000 probes across the genome.</p> <p>Results</p> <p>MLPA identified a single probe deletion in the SNAP29 gene within band 22q11.21. Follow-up array CGH testing revealed a ~1.4-Mb deletion from 19,405,375 bp to 20,797,502 bp, encompassing 28 genes.</p> <p>Conclusion</p> <p>This deletion is likely to be causally associated with the proband's congenital anomalies. Previous publications describing deletions in proximal 22q have reported deletions between LCRs 1 to 4, associated with 22q11 deletion syndrome; in addition, deletions between LCRs 4 and 6 have been described associated with "distal 22q11 deletion syndrome". To our knowledge, this is the first deletion which spans LCR4 and is not apparently mediated by LCRs. Comparison of the phenotypes found in conjunction with previously reported deletions, together with the function and expression patterns of genes in the deleted region reported here, suggests that haploinsufficiency for the Crk-like (CRKL) gene may be responsible for the reported cardiac abnormalities.</p

Joint stiffness is heritable and associated with fibrotic conditions and joint replacement

ObjectiveJoint stiffness is a common, debilitating, age-related symptom, which may be seen after total joint replacement (TJR). Stiffness also occurs in fibrotic conditions such as shoulder capsulitis and Dupuytren's contracture. We speculated that the two traits (TJR and fibrotic disease) are linked pathogenically.MethodsUsing the TwinsUK NIHR BRC BioResource we tested the hypotheses that 1) joint (hip and knee) stiffness, TJR (hip and knee), and fibrotic conditions are associated and 2) genetic factors contribute to them.ResultsParticipating twins (n = 9718) had completed self-reported questionnaires on the traits of interest. All three traits were significantly associated with increasing age and body mass index (BMI), as well as female sex, on univariate analysis. Multivariable logistic regression analyses showed a significant association between TJR and joint stiffness (OR = 3.96, 95% confidence interval, CI 2.77-5.68) and between fibrotic conditions and joint stiffness (OR = 2.39, 1.74-3.29), adjusting for age, sex, BMI and twin relatedness. Monozygotic versus dizygotic intraclass correlations gave heritability estimates for TJR = 46% and joint stiffness = 32%.ConclusionThat fibrotic conditions, joint stiffness and TJR are significantly associated suggests a common disease process, possibly fibrosis, which is genetically mediated

Detection of hydrodynamic stimuli by the postcranial body of Florida manatees (Trichechus manatus latirostris) A Neuroethology, sensory, neural, and behavioral physiology

Manatees live in shallow, frequently turbid waters. The sensory means by which they navigate in these conditions are unknown. Poor visual acuity, lack of echo- location, and modest chemosensation suggest that other modalities play an important role. Rich innervation of sen- sory hairs that cover the entire body and enlarged soma- tosensory areas of the brain suggest that tactile senses are good candidates. Previous tests of detection of underwater vibratory stimuli indicated that they use passive movement of the hairs to detect particle displacements in the vicinity of a micron or less for frequencies from 10 to 150 Hz. In the current study, hydrodynamic stimuli were created by a sinusoidally oscillating sphere that generated a dipole field at frequencies from 5 to 150 Hz. Go/no-go tests of manatee postcranial mechanoreception of hydrodynamic stimuli indicated excellent sensitivity but about an order of magnitude less than the facial region. When the vibrissae were trimmed, detection thresholds were elevated, suggest- ing that the vibrissae were an important means by which detection occurred. Manatees were also highly accurate in two-choice directional discrimination: greater than 90% correct at all frequencies tested. We hypothesize that mana- tees utilize vibrissae as a three-dimensional array to detect and localize low-frequency hydrodynamic stimul

Identifying Loneliness and Social Isolation in Care Home Residents with Sight Loss : Lessons from Using the De Jong Gierveld Scale

Context: Experience of loneliness amongst care home residents with sight loss is associated with limitations in activities of daily living, poor self-reported health, and increased rates of depression. Care homes are encouraged to use screening tools to identify those at risk of loneliness. Objectives: The study aimed to describe the findings and experience of applying a validated, multi-item scale to identify loneliness and isolation in care home residents with sight loss in England, UK. Methods: The six-item De Jong Gierveld Loneliness Scale was administered to residents residing in long-term care homes with sight loss. Participants were aged 65+ years old with vision impairment that could not be corrected by glasses. Descriptive analysis of loneliness scale data was undertaken supplemented with observational field notes of implementation challenges. Findings: Only 42 applications of the De Jong Gierveld Loneliness Scale were possible. The mean sub-scale scores for emotional loneliness, social loneliness and the mean overall loneliness score were 1.36 (sd = 1.16), 1.19 (sd = 1.04) and 2.55 (sd = 1.9) respectively. Challenges observed in scale administration and understanding of scale items by residents might preclude it as a loneliness case-identification tool in busy care home environments. Limitations: The study reports on the challenges implementing a questionnaire which achieved a low rate of data collection. Implications: For case-identification of loneliness, care homes may wish to consider use of a single-item loneliness question rather than multi-item scales due to variable length of administration and resident comprehension

Individual Participant Data Meta-Analysis: Impact of Conduct Problem Severity, Comorbid Attention-Deficit/Hyperactivity Disorder and Emotional Problems, and Maternal Depression on Parenting Program Effects

Objective: There is concern whether established parenting programs for children’s conduct problems meet the needs of families with severe and complex mental health problems. For example, many children with conduct problems show comorbid ADHD or emotional problems, or have parents who are depressed, but families with such complex mental health problems typically seen in real life are often underrepresented in evaluation trials. We tested whether children with more severe conduct problems, and those with more complex mental health problems, benefit less from the Incredible Years parenting program, using individual participant data meta-analysis of randomized trials in Europe. Method: In 1,696 families from 13 trials (child age 2−11; 37% girls; 58% low income; 30% ethnic minority; 98% mothers), we used moderator analysis within a multilevel model to test whether initial conduct problem severity, comorbid ADHD or emotional problems and maternal depression diminished intervention effects for children’s conduct problems. Results: The Incredible Years program reduced children’s conduct problems overall (Cohen’s d = −0.35), but more so in children with more severe conduct problems. There was no evidence that children’s comorbid ADHD and emotional problems changed the intervention benefits. Children of mothers with more depressive symptoms benefited more. Conclusion: Children with more severe conduct problems derive greater, rather than lesser, benefits from a high-quality group parenting program, and comorbid ADHD and emotional problems do not reduce effects; maternal depression, rather than being linked to less child change, were associated with greater reductions in children’s conduct problems