A Comparative Assessment of Suicide Risk for Young People in Youth Detention

The aim of this study was to compare levels of agreement in the assessment of suicide risk by detention center staff procedures compared with those completed by a mental health clinician. Over a 6-month period, 64 young people (mean age 15.0 years; SD+/?1.3) assessed as being acutely suicidal were referred for a clinical mental health assessment and completion of the Adolescent Suicide Questionnaire (ASQ). Cohen's kappa statistic was used to determine inter-judgmental agreement between the detention center, a clinical assessment and ASQ scores. Weak levels of agreement existed in the assessment of suicide. We recommend further work in this area and broad discussion toward development of national guidelines to standardize the assessment of suicide risk for young people in youth detention.     

Service user involvement in cancer care: the impact on service users

Background Service user involvement is embedded in the United Kingdom’s National Health Service, but knowledge about the impact of involvement on service users, such as the benefits and challenges of involvement, is scant. Our research addresses this gap. Objective To explore the personal impact of involvement on the lives of service users affected by cancer. Design We conducted eight focus groups with user groups supplemented by nine face‐to‐face interviews with involved individuals active at a local, regional and national level. Thematic analysis was conducted both independently and collectively. Setting and participants Sixty‐four participants, engaged in involvement activities in cancer services, palliative care and research, were recruited across Great Britain. Results We identified three main themes: (i) ‘Expectations and motivations for involvement’– the desire to improve services and the need for user groups to have a clear purpose, (ii) ‘Positive aspects of involvement’– support provided by user groups and assistance to live well with cancer and (iii) ‘Challenging aspects of involvement’– insensitivities and undervaluing of involvement by staff. Conclusions This study identified that involvement has the capacity to produce varied and significant personal impacts for involved people. Involvement can be planned and implemented in ways that increase these impacts and that mediates challenges for those involved. Key aspects to increase positive impact for service users include the value service providers attach to involvement activities, the centrality with which involvement is embedded in providers’ activities, and the capacity of involvement to influence policy, planning, service delivery, research and/or practice.     

Efficient gene transfer in skeletal muscle with AAV-derived bicistronic vector using the FGF-1 IRES

IRESs (internal ribosome entry sites) are RNA elements behaving as translational enhancers in conditions of global translation blockade. IRESs are also useful in biotechnological applications as they allow expression of several genes from a single mRNA. Up to now, most IRES-containing vectors use the IRES from encephalomyocarditis virus (EMCV), highly active in transiently transfected cells but long and not flexible in its positioning relative to the gene of interest. In contrast, several IRESs identified in cellular mRNAs are short and flexible and may therefore be advantageous in gene transfer vectors such as those derived from the adeno-associated virus (AAV), where the size of the transgene expression cassette is limited. Here, we have tested bicistronic AAV-derived vectors expressing two luciferase genes separated by the EMCV- or fibroblast growth factor 1 (FGF-1) IRES. We demonstrate that the AAV vector with the FGF-1 IRES, when administrated into the mouse muscle, leads to efficient expression of both transgenes with a stable stoechiometry, for at least 120 days. Interestingly, the bicistronic mRNA containing the FGF-1 IRES leads to transgene expression 10 times superior to that observed with EMCV, in vivo. AAV vectors featuring the FGF-1 IRES may thus be advantageous for gene therapy approaches in skeletal muscle involving coexpression of genes of interest.