The authors assessed the relative benefits of 3 styles of adult book reading for preschoolers' emergent literacy. A describer style focused on describing pictures during the reading, a comprehender ...style focused on story meaning, and a performance-oriented style introduced the book and discussed story meaning on completion. Forty-eight 4-year-olds were randomly assigned to receive 1 of the 3 reading styles over a 6-week period. Pretests and posttests measured children's receptive vocabulary, print, and story comprehension skills. A describer style of reading resulted in the greatest overall benefits for children's vocabulary and print skills, but a performance-oriented style was also beneficial when children's initial skill levels were taken into account. Future book-reading interventions should be tailored to children's initial skill levels.
Because parental recognition of overweight in young children is poor, we need to determine how best to inform parents that their child is overweight in a way that enhances their acceptance and ...supports motivation for positive change. This study will assess 1) whether weight feedback delivered using motivational interviewing increases parental acceptance of their child's weight status and enhances motivation for behaviour change, and 2) whether a family-based individualised lifestyle intervention, delivered primarily by a MInT mentor with limited support from "expert" consultants in psychology, nutrition and physical activity, can improve weight outcomes after 12 and 24 months in young overweight children, compared with usual care.
1500 children aged 4-8 years will be screened for overweight (height, weight, waist, blood pressure, body composition). Parents will complete questionnaires on feeding practices, physical activity, diet, parenting, motivation for healthy lifestyles, and demographics. Parents of children classified as overweight (BMI > or = CDC 85th) will receive feedback about the results using Motivational interviewing or Usual care. Parental responses to feedback will be assessed two weeks later and participants will be invited into the intervention. Additional baseline measurements (accelerometry, diet, quality of life, child behaviour) will be collected and families will be randomised to Tailored package or Usual care. Parents in the Usual care condition will meet once with an advisor who will offer general advice regarding healthy eating and activity. Parents in the Tailored package condition will attend a single session with an "expert team" (MInT mentor, dietitian, physical activity advisor, clinical psychologist) to identify current challenges for the family, develop tailored goals for change, and plan behavioural strategies that best suit each family. The mentor will continue to provide support to the family via telephone and in-person consultations, decreasing in frequency over the two-year intervention. Outcome measures will be obtained at baseline, 12 and 24 months.
This trial offers a unique opportunity to identify effective ways of providing feedback to parents about their child's weight status and to assess the efficacy of a supportive, individualised early intervention to improve weight outcomes in young children.
Australian New Zealand Clinical Trials Registry ACTRN12609000749202.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
In New Zealand, people receiving care from specialist mental health and addiction services experience poorer health outcomes compared to the general population. Māori (Indigenous) specialist mental ...health and addiction service users experience disproportionate inequities. This study aims to: (1) Describe and understand mental health staff perspectives on the quality of care delivered to specialist mental health and addiction service users in their service – including specifically for Māori; and (2) Identify areas staff report as opportunities for quality improvement. In 2020, Southern District Health Board (now Te Whatu Ora – Southern) mental health staff were invited to participate in a cross‐sectional study assessing their perceptions of a range of service aspects. This paper presents quantitative and qualitative analyses about quality of care. Among the 319 staff who completed the questionnaire; 272 provided quality‐of‐care responses. Among these, 78% reported the quality of care delivered to service users as ‘good’ or ‘excellent’; only 60% reported this for Māori service users. Participants identified individual, service and broader system level factors influencing the quality of care delivered to service users, including factors specific for Māori. This study has identified, for what appears to be the first time, empirical and concerning differences in staff ratings of the quality of care delivered to Māori and SMHAS users overall. Findings highlight the need for institutional and managerial prioritization of hauora Māori, and incorporating tikanga Māori and Te Tiriti into practice.
Integrated care approaches have been recommended to remove barriers to healthcare and improve the physical health outcomes of people living with serious mental illness (SMI) and/or substance use ...disorders (SUDs). The aim of this systematic scoping review was to describe empirical investigations of interventions designed to integrate physical, mental, and addiction healthcare for this population. An iterative and systematic search of five electronic databases (Medline (Ovid), PsycINFO, CINAHL, Embase (Ovid) and Scopus) was conducted to identify peer-reviewed articles published between January 2000 and April 2019. Two reviewers independently screened publications in two successive stages of title and abstract screening, followed by full-text screening of eligible publications. Data from each included publication were extracted independently by two reviewers using a standardised spreadsheet. A total of 28 eligible publications were identified, representing 25 unique studies. Over half of the included studies investigated the use of case managers to provide self-management skills or to coordinate mental and physical healthcare (n = 14). Other interventions examined the co-location of services (n = 9) and the implementation of screening and referral pathways to specialist treatment (n = 2). Less than half of the included studies described a framework, theory or model that was underpinning the intervention tested. While some aspects of integrated care have been identified and addressed by interventions, other key dimensions have not been considered, such as shared decision-making. Identification of a comprehensive model of integrated care is recommended to inform the development and evaluation of future interventions for people with SMI/SUDs.
To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care.
Two hundred and six ...overweight and obese (BMI ≥85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months.
BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed.
Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.
Aim
To determine whether a single session of motivational interviewing (MI) for feedback of a child's overweight status promotes engagement in treatment following screening.
Methods
One thousand ...ninety‐three children aged 4–8 years were recruited through primary and secondary care to attend health screening, including assessment of parenting practices and motivation (questionnaire). Families with normal‐weight children were informed about their child's weight but had no further involvement. Parents of overweight (body mass index ≥85th percentile) children (n = 271) were randomised to receive weight feedback via MI or best practice care (BPC) using a traffic light concept to indicate degree of health risk. Follow‐up interviews were held 2 weeks later to examine intervention uptake, changes to motivation and behaviour, and parental response to feedback.
Results
Recruitment into the intervention was high (76%) and not altered by feedback condition (percentage difference 6.6 (95% confidence interval −2.9, 16.0). High scores on the Health Care Climate Questionnaire (rating of the interviewer) indicated satisfaction with how the information was provided to parents. No differences were observed in multiple indicators of harm. However, self‐determined motivation for healthy life‐styles was significantly higher in the MI condition at follow‐up (0.18: 0.00, 0.35), after only a single session of MI.
Conclusions
MI and BPC were both successful in encouraging parents to participate in a family‐based intervention, with MI offering little significant benefit over BPC. A traffic light approach to weight feedback is a suitable way of providing sensitive information to parents not expecting such news.
Emerging evidence has implicated a pivotal role for lysyl oxidase (LOX) in cancer progression and metastasis. Whilst the majority of work has focused on the extracellular matrix cross-linking role of ...LOX, the exact function of intracellular LOX localisation remains unclear. In this study, we analysed the LOX expression patterns in the nuclei of rectal cancer patient samples and determined the clinical significance of this expression. Nuclear LOX expression was significantly increased in patient lymph node metastases compared to their primary tumours. High nuclear LOX expression in tumours was correlated with a high rate of distant metastasis and increased recurrence. Multivariable analysis showed that high nuclear LOX expression was also correlated with poor overall survival and disease free survival. Furthermore, we are the first to identify LOX enzyme isoforms (50 kDa and 32 kDa) within the nucleus of colon cancer cell lines by confocal microscopy and Western blot. Our results show a powerful link between nuclear LOX expression in tumours and patient survival, and offer a promising prognostic biomarker for rectal cancer patients.
Abstract
Emerging evidence implies that the complex and seemingly paradoxical role of lysyl oxidase (LOX) in cancer may depend on its subcellular localization. LOX expression has been reported ...extracellularly, as well as intracellularly in both the cytoplasmic and nuclear compartments. In this study we analyze previously unreported LOX expression patterns in the nucleus of rectal cancer patient samples and determine the clinical significance of this expression.
LOX expression was examined by immunohistochemistry in 137 primary rectal cancer patients who participated in the randomized Swedish rectal cancer trial of preoperative radiotherapy between 1987 and 1990. Location and expression of LOX protein were detected by confocal microscopy and Western blot in three colon cancer cell lines.
LOX nuclear expression was high in normal mucosal and showed a significant decrease in primary rectal cancer (P<0.001). Furthermore, a significant increase was observed from primary cancer to lymph node metastasis (P<0.01). High nuclear LOX expression was correlated with a high rate of distant metastasis and total recurrence (P = 0.046, P = 0.048, respectively). It was also confirmed that LOX (50-kDa and 32-kDa isoforms) are located in the nucleus of in vitro colon cancer cells. High nuclear LOX expression was found in the metastatic cell line SW620 compared to the parental primary cancer cell line SW480. Radiotherapy had no effect on LOX expression and localization in cancer tissues as well as in in vitro culture. Moreover, multivariable analysis showed that high nuclear LOX expression correlated with poor overall survival (P = 0.003) and disease free survival (P = 0.006), independent of age, gender, TNM stage, differentiation and radiotherapy treatment. Nuclear LOX also correlated with other biological factors (such as NF-κB) known to be associated with patient survival suggesting a possible mechanism. Cytoplasmic LOX is high in primary cancer and metastasis compared with normal tissue, but not prognostic.
So here we firstly proved the nuclear expression of LOX enzyme both in patient rectal cancer tissues and in in vitro colon cancer cells. The strong correlation of nuclear LOX expression to survival offers a promising prognostic biomarker in rectal cancer.
Citation Format: Na Liu, Thomas R. Cox, Weiyingqi Cui, Gunnar Adell, Birgitta Holmlund, Janine T. Erler, Xiaofeng Sun. Nuclear expression of lysyl oxidase enzyme is an independent prognostic factor in rectal cancer patients. abstract. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 5012.
The complete amino acid sequence of the alpha chain of the dimeric sarcoplasmic Ca2+‐binding protein (SCP‐I=α2) from crayfish (Astacus leptodactylus) has been determined by partial automatic ...sequencing of the peptides derived from tryptic digests of the protein after citraconylation or treatment with 1,2‐cyclohexanedione. Overlapping peptides were obtained by cleavage with o‐iodosobenzoic acid, or digestion with Staphylococcus aureus protease, thermolysin and pepsin. The acetylated N‐terminus was identified by fast atom bombardment mass spectrometry. The monomeric protein contains 192 amino acids and has an M
r of 21 643. The sequence shows the presence of three calcium‐binding sites and perhaps of two others that may be degenerated.
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