The financial support by the EPSRC for studentship funding (SSC) through the M3S Doctoral Training Centre (Grant EP/L015862/1) and Altro Ltd. The impact of emergent pathogens Since the 1970s, more ...than 1,500 new pathogens have been discovered, and many of these have had major impacts on public health 1. ...MDR pathogens are now considered a global threat to public health 3,4. ...even after cleaning, there remains a risk of transmission particularly for pathogens with a low infective dose. Persistence of viral pathogens on common dry inanimate surfaces (e.g., plastics, stainless steel, or flooring). https://doi.org/10.1371/journal.ppat.1008880.t002 There are two broadly different, but not mutually exclusive, strategies used in developing antimicrobial surfaces: biocidal surfaces that kill microbes, and anti-biofouling surfaces that reduce microbial adhesion and prevent subsequent biofilm formation (Fig 1).
Hepatocyte transplantation has been investigated in patients with liver-based metabolic disorders and acute liver failure. We report the first use of hepatocyte transplantation in two brothers with ...severe inherited coagulation factor VII deficiency. Patient 1 received a total of 1.09x10(9) cryopreserved hepatocytes, and patient received 2.18x10(9) fresh and cryopreserved hepatocytes through a Hickman line inserted in the inferior mesenteric vein. Infusion of isolated human hepatocytes improved the coagulation defect and markedly decreased the requirement for exogenous recombinant factor VII (rFVIIa) to approximately 20% of that before cell transplantation. In both patients, episodes of line sepsis were associated with an increase in rFVIIa requirement. Six months posthepatocyte transplantation, higher rFVIIa doses were required, suggesting loss of transplanted hepatocyte function. Because of increasing problems with venous access and long-term uncertainty of the efficacy of hepatocyte transplantation, orthotopic liver transplantation was performed successfully in both cases.
Although research on the experiences of unaccompanied asylum‐seeking young people in the UK has grown steadily in recent years, their experience of fostering and of the role played by foster carers ...in helping their adjustment have been neglected. This paper reports findings from the first UK study into these experiences, describing issues arising from initial assessment and preparation for fostering and the ways in which young people and foster carers adjusted to their lives together. It assesses the progress made by young people during placement, the strategies that appeared helpful to relationship building, and the extent to which young people had become integrated within the wider network of family relationships. Given that most young people first arrive as teenagers, it also considers the ways in which foster carers and social workers helped young people prepare for adult life in the context of uncertainties arising from the asylum process.
Most unaccompanied asylum-seeking young people arrive in the UK in their mid teen years. Preparation and planning for transition to adulthood should therefore be at the forefront of the minds of ...care-givers and social workers. This paper reviews current research evidence on the response of social work services to this group of young people in England, with a particular focus on what is known about the circumstances in which young people may be best prepared for adult life, how they fare in comparison to other young people in public care, and on the challenges presented for pathway planning that arise at the intersection between social work and the asylum determination process. The evidence for England is situated, wherever possible, against evidence drawn from international literature in this field and the need for a broader research agenda (incorporating more longitudinal work on care and leaving care pathways) is highlighted in order to strengthen the evidence base to support policy and practice in this field.
► The paper reviews evidence on planning and support for unaccompanied minors in England. ► Changes to the legal duties of agencies have led to some increase in legal protection. ► Stable, supportive placements are important for education, health and well-being. ► Pathway planning must take account of likely outcomes of asylum claims. ► Current pathway planning and support arrangements for this group are highly variable.
: Solid‐organ transplant recipients are at risk from various infectious diseases, many of which can be prevented by immunizations that could reduce morbidity and mortality. However, it is not ...uncommon for children requiring transplantation to have received inadequate or no immunizations pre‐transplant. Every effort should be made to immunize transplant candidates early in the course of their disease according to recommended schedules prior to transplantation. It is also important to immunize their household contacts and healthcare workers. In this review, we summarize the major immunization issues for children undergoing transplantation, the data currently available on immunization safety and efficacy, and suggest immunization practices to reduce vaccine‐preventable disease. There is a real need for a standardized approach to the administration and evaluation of immunizations in this group of patients.
Abstract Little is known about decision-making regarding the reunification of children in care, or about the consequences of these decisions for the children concerned. This study compared ...decision-making and outcomes for 149 maltreated children in seven English authorities (68 reunified, 81 who remained in care). Children were followed up six months after their return home or, for those who were not reunified, six months after the ‘effective decision’ that they should remain in care. They were followed up again four years (on average) after the return or effective decision. Data were extracted from case files at baseline and six month follow-up and were gathered from surveys of social workers and teachers at final follow-up. The two key predictors of reunification were assessments that parental problems had improved and that risks to the child were not unacceptably high. Two-thirds returned to improved family circumstances, sometimes due to a change in the household they returned to, but others were reunified despite persisting concerns. However 35% re-entered care within six months and 63% re-entered at some point during the four-year follow-up period, often due to recurring abuse or neglect. At final follow-up remaining in care was the strongest predictor of positive outcomes on a range of dimensions, even once children's characteristics and histories were taken into account. Outcomes were especially poor for neglected children who were reunified, irrespective of whether reunification was stable or unstable. Results show the potential of the care system to produce positive outcomes for maltreated children.
This paper reviews current research evidence on the response of social work services to unaccompanied asylum-seeking young people in England, taking account of recent developments in immigration law ...and policy. It focuses on the reception and support arrangements that are provided for these young people by local authorities, their experiences of care and the pathways they may take through care towards adulthood. Since most unaccompanied minors (UAM) come to the UK in their mid-teen years, preparation and planning for leaving care should be a central feature of the work undertaken by those social workers, foster parents and residential workers who provide them with support. In this context, evidence is provided on the challenges presented for preparation, planning and aftercare support that arise from the tensions inherent in child welfare and immigration policy and practice. The strategies young people develop to move forward with their life plans, despite continuing uncertainty about their right to residency, are also highlighted. Research on UAM is a relatively new field of enquiry. As such, the need for a sustained program of research, including longitudinal studies that capture young people’s experiences into adulthood and their experiences of enforced return is emphasized.
This paper draws on findings from a study of outcomes for young people leaving care funded by the Department for Education and Skills. It explores the informal support networks available to a sample ...of 106 young people over a period of 12–15 months after leaving care. It examines patterns of contact with birth families and caregivers, the support that emanated from these links and the strategies of leaving care professionals to strengthen these connections. It also considers the new families created by many young people through relationships with partners and the onset of parenthood and discusses the continuing support needs of young parents. The paper situates the needs and experiences of care leavers in a wider youth transitions framework and highlights the need for continuing professional attention to be given to strengthening family links as one strategy for helping care leavers to negotiate the transition to adulthood.
This paper reviews current research evidence on the response of social work services to unaccompanied asylum-seeking young people in England, taking account of recent developments in immigration law ...and policy. It focuses on the reception and support arrangements that are provided for these young people by local authorities, their experiences of care and the pathways they may take through care towards adulthood. Since most unaccompanied minors (UAM) come to the UK in their mid-teen years, preparation and planning for leaving care should be a central feature of the work undertaken by those social workers, foster parents and residential workers who provide them with support. In this context, evidence is provided on the challenges presented for preparation, planning and aftercare support that arise from the tensions inherent in child welfare and immigration policy and practice. The strategies young people develop to move forward with their life plans, despite continuing uncertainty about their right to residency, are also highlighted. Research on UAM is a relatively new field of enquiry. As such, the need for a sustained program of research, including longitudinal studies that capture young people’s experiences into adulthood and their experiences of enforced return is emphasized.
Children in out-of-home care are consistently found to have poor mental health compared to children in the general population. However, UK research has so far failed to disentangle the impact of the ...care system on children’s mental health outcomes from the effects of the adverse circumstances that led to their admission to care.
This research investigated the association between care placement and the presence of child mental health problems after controlling for children’s pre-care experiences. It also identified factors associated with mental health problems among children in care.
The sample comprised three groups of children involved with child welfare services due to maltreatment, including children in out-of-home care (n = 122), reunified children (n = 82) and those who had never been in care (n = 159).
The mental health of the children in the three groups was compared, using information collected from their parents/foster carers and social workers.
The odds of a child in out-of-home care having a mental health problem were not significantly higher than those of a child who had never been in care (AOR = 1.24; p = 0.462). However, the odds of a child in out-of-home care having reactive attachment disorder (RAD) were significantly higher than those of a child who had never been in care (AOR=1.92; p = 0.032).
These findings make an important contribution to international debates about whether placing children in care is beneficial or detrimental to their wellbeing, and highlight a range of inter-linking factors associated with the mental health of children in out-of-home care.
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