Inter-Organizational Collaboration in the Implementation of Evidence-based Practices Among Public Agencies Serving Abused and Neglected Youth

This study examined the role of inter-organizational collaboration in implementing new evidence-based practices for addressing problem behaviors in at-risk youth. Semi-structured interviews were conducted with 38 systems leaders of probation, mental health, and child welfare departments of 12 California counties participating in a large randomized controlled trial to scale-up the use of Multidimensional Treatment Foster Care. Three sets of collaboration characteristics were identified: (1) characteristics of collaboration process, (2) characteristics of the external environment, and (3) characteristics of participating organizations and individuals. Inter-organizational collaboration enables an exchange of information and advice and a pooling of resources individual agencies may require for successful implementation.     

Low temperature sintering of fluorapatite glass-ceramics

Fluorapatite glass-ceramics have been shown to be excellent candidates as scaffold materials for bone grafts, however, scaffold production by sintering is hindered by concurrent crystallization of the glass. Objective, our goal was to investigate the effect of Ca/Al ratio on the sintering behavior of Nb-doped fluorapatite-based glasses in the SiO₂–Al₂O₃–P₂O₅–MgO–Na₂O–K₂O–CaO–CaF₂ system. Methods, glass compositions with Ca/Al ratio of 1 (A), 2 (B), 4 (C) and 19 (D) were prepared by twice melting at 1525 °C for 3 h. Glasses were either cast as cylindrical ingots or ground into powders. Disk-shaped specimens were prepared by either sectioning from the ingots or powder-compacting in a mold, followed by heat treatment at temperatures ranging between 700 and 1050 °C for 1 h. The density was measured on both sintered specimens and heat treated discs as controls. The degree of sintering was determined from these measurements. Results and Significance XRD showed that fluorapatite crystallized in all glass-ceramics. A high degree of sintering was achieved at 775 °C for glass-ceramic D (98.99 ± 0.04%), and 900 °C for glass-ceramic C (91.31 ± 0.10). Glass-ceramics A or B were only partially sintered at 1000 °C (63.6 ± 0.8% and 74.1 ± 1.5%, respectively). SEM revealed a unique microstructure of micron-sized spherulitic fluorapatite crystals in glass-ceramics C and D. Increasing the Ca/Al ratio promoted low temperature sintering of fluorapatite glass-ceramics, which are traditionally difficult to sinter.     

Gastro-oesophageal reflux disease and eosinophilic oesophagitis: What is the relationship?

Eosinophilic oesophagitis(EoE) and gastro-oesophageal reflux disease(GORD) are the most common causes of chronic oesophagitis and dysphagia associated with oesophageal mucosal eosinophilia. Distinguishing between the two is imperative but challenging due to overlapping clinical and histological features. A diagnosis of EoE requires clinical, histological and endoscopic correlation whereas a diagnosis of GORD is mainly clinical without the need for other investigations. Both entities may exhibit oesophageal eosinophilia at a similar level making a histological distinction between them difficult. Although the term proton-pump inhibitor responsive oesophageal eosinophilia has recently been retracted from the guidelines, a relationship between Eo E and GORD still exists. This relationship is complex as they may coexist, either interacting bidirectionally or are unrelated. This review aims to outline the differences and potential relationship between the two conditions, with specific focus on histology, immunology, pathogenesis and treatment.     

Structure-activity relationships leading to WAY-121,520, a tris aryl-type,indomethacin-based,phospholipase A2 (PLA2)/leukotriene biosynthesis inhibitor

We were intrigued by reports of the inhibition of phospholipase A₂ (PLA₂) by indomethacin. In order to increase the potency of the indomethacin system as an inhibitor of PLA₂, it was decided to make more lipophilic analogs. Indeed, covalent attachment of a quinoline ring to the methoxy substituent of indomethacin affords WAY-122,220 which is almost an order of magnitude more potent than indomethacin in inhibiting human synovial fluid PLA₂ (IC₅₀=15 and 145 μM, respectively). TheN−p-chloro-benzyl analog of this compound, WAY-121,520, was an even more potent inhibitor of PLA₂ (IC₅₀=4 μM). Structural analyses and molecular modeling suggest that these compounds may inhibit PLA₂ by mimicking arachidonic acid. WAY-121,520 is also a potent leukotriene biosynthesis inhibitor both in the rat PMN and mouse macrophage assays (IC₅₀=10 and 4 nM, respectively), possibly acting via a 5-LO (5-lipoxygenase) translocation inhibition mechanism. The multiple actions of WAY-121,520 may contribute to its favorable anti-inflammatory profile.

     

Measurement of premorbid intellectual ability following brain injury.

Prediction of premorbid intellectual ability in brain-injured patients was investigated using two sets of regression equations and the Intellectual Correlates Scale (ICS). Eighty subjects completed the WAIS-R and the ICS. The four subject groups included a control group and right-hemisphere, left-hemisphere, and diffuse brain-injured groups. As expected, brain-injured groups obtained lower IQs than controls. Also, estimated IQs approximated obtained IQs for controls, while overestimating IQs for brain-injured groups. Support was provided for the continued use of the Barona, Reynolds, and Chastain (1984) and the Barona and Chastain (1986) regression equations as measures of premorbid intellectual functioning. Previous findings (Schlottmann & Johnsen, 1991), suggesting the ICS may also serve as a measure of premorbid intellectual functioning, were not replicated.     

A dyadic analysis of the effects of setting and communication partner on elicited and spontaneous communication of children with Autism Spectrum Disorder and typically developing children

The study examined the effects of condition and communication partner on spontaneous and elicited communication in children with Autism Spectrum Disorder (ASD) in comparison to age matched typically developing children. Eighteen children participated in the study (nine children diagnosed with ASD and nine typically developing children). Each participant was video recorded for 2 h 15 min periods across two conditions (academic activity and free-time). The two conditions represented a naturalistic view of the children's environment. Spontaneous and elicited communication were further analysed in terms of verbal behavior functions including requests, mands for information, mands for attention, greetings, terminating an activity, comments/tacts, language of negotiation, specifying using autoclitics and reject. Communication partner was further analysed at two levels, peer and adult. There was no difference between the frequency of functions of communication emitted and diagnosis of the participant. There was a significant difference for communication partner, whereby the main communicative partner for children with ASD was an adult in contrast to typically developing children who spoke more to their peers. Typically developing children engaged in more spontaneous communication than children diagnosed with ASD.     

Anaesthesia for proximal femoral fracture in the UK: first report from the NHS Hip Fracture Anaesthesia Network*

The aim of this audit was to investigate process, personnel and anaesthetic factors in relation to mortality among patients with proximal femoral fractures. A questionnaire was used to record standardised data about 1195 patients with proximal femoral fracture admitted to 22 hospitals contributing to the Hip Fracture Anaesthesia Network over a 2‐month winter period. Patients were demographically similar between hospitals (mean age 81 years, 73% female, median ASA grade 3). However, there was wide variation in time from admission to operation (24–108 h) and 30‐day postoperative mortality (2–25%). Fifty percent of hospitals had a mean admission to operation time < 48 h. Forty‐two percent of operations were delayed: 51% for organisational; 44% for medical; and 4% for ‘anaesthetic’ reasons. Regional anaesthesia was administered to 49% of patients (by hospital, range = 0–82%), 51% received general anaesthesia and 19% of patients received peripheral nerve blockade. Consultants administered 61% of anaesthetics (17–100%). Wide national variations in current management of patients sustaining proximal femoral fracture reflect a lack of research evidence on which to base best practice guidance. Collaborative audits such as this provide a robust method of collecting such evidence.     

Elevation increases in moth assemblages over 42 years on a tropical mountain

Physiological research suggests that tropical insects are particularly sensitive to temperature, but information on their responses to climate change has been lacking—even though the majority of all terrestrial species are insects and their diversity is concentrated in the tropics. Here, we provide evidence that tropical insect species have already undertaken altitude increases, confirming the global reach of climate change impacts on biodiversity. In 2007, we repeated a historical altitudinal transect, originally carried out in 1965 on Mount Kinabalu in Borneo, sampling 6 moth assemblages between 1,885 and 3,675 m elevation. We estimate that the average altitudes of individuals of 102 montane moth species, in the family Geometridae, increased by a mean of 67 m over the 42 years. Our findings indicate that tropical species are likely to be as sensitive as temperate species to climate warming, and we urge ecologists to seek other historic tropical samples to carry out similar repeat surveys. These observed changes, in combination with the high diversity and thermal sensitivity of insects, suggest that large numbers of tropical insect species could be affected by climate warming. As the highest mountain in one of the most biodiverse regions of the world, Mount Kinabalu is a globally important refuge for terrestrial species that become restricted to high altitudes by climate warming.