bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using the case study approach for improved programme evaluations
Authors: Spath Robin , Pine Barbara A 
Published: January 2004

ABSTRACTThis paper discusses the case study approach to programme evaluation in the human services and its multiple benefits to the evaluator and to the various stakeholders in the programme being evaluated. Of particular importance is the use of a case study to examine programme processes which then inform the design of the outcome study of programme effects. Following a brief overview of the case study approach in research and its applications, the authors delineate its benefits and illustrate these using the evaluation of a model programme designed to reunify families separated by a child's placement in foster care. The results of the case study more clearly defined the programme's processes for both the researchers and the programme staff, and illuminated the desired outcomes which then were delineated in measurable terms. The result was a design for an outcome evaluation that was consistent with programme goals, processes, and intended benefits. The case study also facilitated communication and collaboration between the researchers and the programme's stakeholders, provided important information for agency decision‐makers, and contributed greatly to the potential for the success of the overall evaluation.
Parental mental health: disruptions to parenting and outcomes for children
Authors: Smith Marjorie 
Published: January 2004

ABSTRACTThe association between parental mental health problems and negative outcomes for children has been long known. This paper addresses three issues in relation to this. First, the scale of the problem is outlined, in terms of both the prevalence of mental health problems in parents and the likelihood of children exhibiting negative outcomes in these circumstances. Secondly, the specificity, or lack of it, of particular outcomes in the child in relation to different parental mental health problems is explored. Thirdly, the paper focuses on the importance of disruptions to parenting as a mechanism in the transmission of mental health problems to negative impacts on the child. Examples are given of how parenting is disrupted in non‐clinical community populations, and the subsequent impacts on the child. The case is made for the preventative importance of parenting and family support in mediating between parental mental health problems and negative impacts on the child.
From policy to practice: the implementation of a new framework for social work assessments of children and families
Authors: Cleaver Hedy , Walker Stephen 
Published: January 2004

ABSTRACTThis paper describes a two‐year study conducted in 24 English councils to evaluate the implementation of the Framework for the Assessment of Children in Need and their Families. The Framework promotes a holistic, multi‐agency approach towards the assessment of children in need. The study was carried out in two phases. Phase one explored how councils implemented the Framework and accompanying assessment records. Phase two used a variety of methods to assess the impact of the Framework on practice, including an audit of completed assessment records, postal questionnaires to practitioners and managers in social services and partner agencies, and a qualitative study of 52 cases which included interviews with parents, children over 10 and social workers. A time record was used to gather information on the time social workers spent on the various elements of the core assessment process. The study suggests that councils had to overcome a number of organizational and other barriers in order to implement the Framework. However, the Framework and supporting materials appear to have provided the foundations to improve the quality of social work recording and promote interagency working, and have strengthened the involvement of children and families in the assessment process.
Effective interventions to promote child and family wellness: a study of outcomes of intervention through Children's Family Centres
Authors: Fernandez Elizabeth 
Published: January 2004

ABSTRACTThis paper reports research carried out in Australia designed to evaluate the impact of family support interventions by comparing the views of families and their caseworkers with respect to the perceived benefits and outcomes of the interventions in the context of changes in family functioning and parent–child relationships, and the extent to which changes led to reduced involvement in protective services. The intervention was monitored over a six‐month period using a pre‐ and post‐test design, incorporating quantitative and qualitative approaches in the methodology. The paper discusses: problem domains identified; changes in caregivers’ level of distress, problem solving and learning ability, bonding style and use of discipline; parents’ and children's cooperation with the programme; and implications of the findings for policy and research methodology.
Relating outcomes to objectives in child protection
Authors: Devaney John 
Published: January 2004

ABSTRACTWith the introduction of the Children (Northern Ireland) Order 1995, Health and Social Care Trusts in Northern Ireland have been engaged in a refocusing of children's services, shifting resources and interventions towards supporting families at an earlier stage in order to reduce the likelihood of crisis, breakdown or abuse at a later stage. Alongside this development the Government wishes to see a clearer link between the objectives of the child protection system and the outcomes for children and their families. This paper critiques the current system of performance management in the child protection system. Using data from a study exploring the characteristics and careers of children in the children protection system in Northern Ireland it is argued that the current measurements of performance are too basic and are designed principally to monitor the operation of the system rather than the impact of services and interventions on the lives of children and their families.
Working with managers to improve services: changes in the role of research in social care
Authors: Ward Harriet 
Published: January 2004

ABSTRACTThe setting of specific objectives for children's services and the identification of key outcome indicators, together with the development of a core information specification for children's services with its practical application in the implementation of the Integrated Children's System, all mean that substantially more data are now available to child welfare agencies. Not so long ago in the UK it was the role of research teams to collect and analyse such data. Now that so much of it is already available to agencies, are researchers who work in this area of applied social policy research becoming redundant?Using data from the cohorts of looked after children being studied at the Centre for Child and Family Research, Loughborough University, the paper demonstrates how researchers can work in consultation with the managers of child welfare agencies to make better sense of the data at their disposal. It considers three issues: what additional variables need to be explored to help agencies better understand their performance; how groups of children could be identified who follow predictable pathways through social care; and how qualitative information is necessary to gain a true picture of what is happening. All of these examples demonstrate a fundamental role for researchers in working with social services personnel to identify how services can be improved.
Use of population measures and norms to identify resilient outcomes in young people in care: an exploratory study
Authors: Flynn Robert J. , Ghazal Hayat , Legault Louise , Vandermeulen Gail , Petrick Susan 
Published: January 2004

ABSTRACTThe purposes of this study were to derive a new method for identifying resilience (i.e. positive adaptation in spite of serious adversity) among young people in care and to determine the percentage of the latter who experienced resilience on selected outcomes, as conceptualized from within the developmental approach of Looking After Children. The participants comprised two samples of young people who were living in out‐of‐home care (mainly foster care) in the province of Ontario, Canada, 340 aged 10–15 years and 132 aged 5–9 years. Virtually all had experienced severe adversity in their families of origin, such that in most cases the legal custody, care, and control of the young people had been permanently transferred from their parents to a local Children's Aid Society. Corresponding to each in‐care sample was a general‐population sample of the same age range that served as a normative comparison group and was drawn from the National Longitudinal Survey of Children and Youth (NLSCY). The NLSCY is an ongoing, long‐term social‐policy study of the development of a nationally representative sample of Canadian children into adolescence and early adulthood. The general‐population samples were composed, respectively, of 5539 young people aged 10–15 years and 11 858 children aged 5–9 years. Resilience among the young people in care was operationally defined, on each outcome variable, as average or above‐average functioning relative to that of the general‐population sample of the same age range. The percentage experiencing resilience was relatively high on the outcomes of health, self‐esteem, and pro‐social behaviour, moderate on the outcomes of relationship with friends and anxiety and emotional distress, and low on the outcome of academic performance. The implications of the findings are discussed.
Trends in asthma, allergic rhinitis and eczema among Swedish conscripts from farming and non‐farming environments. A nationwide study over three decades
Authors: Bråbäck L. , Hjern A. , Rasmussen F. 
Published: January 2004

SummaryBackground
Asthma and allergies are less common in children who have been raised in farming environments.Objectives
To assess whether children who grow up in a farming environment have been protected against the general increase in atopic disorders in Sweden and whether other rural environments could also be protective.Method
Linkage at an individual level of three national registers in Sweden: The Swedish Military Service Conscription Register (MSCR), the Register of the Total Population (RTP) and the Population and Housing Censuses (PHC). Asthma, allergic rhinitis and eczema at conscription were analysed in relation to area of residence, parental occupation, maternal age, family size and being the first born for 1 309 652 male conscripts in three successive cohorts born between 1952 and 1981.Results
Allergic rhinitis and eczema displayed a continuous increase throughout the study period, whereas the rise in asthma mainly occurred in conscripts born after 1961. Farming environments and rural living already provided protection from allergic rhinitis in conscripts born during the 1950s, but the protective effect was greater in later cohorts. An inverse association was observed between farm living and asthma, but mainly in conscripts born after 1970. The adjusted risk ratios for asthma in conscripts from farming vs. non‐farming families were 1.00 (95% CI 0.93–1.07), 0.94 (95% CI 0.88–1.01) and 0.85 (95% CI 0.79–0.91) in conscripts born in 1952–1961, 1962–1971 and 1972–1981, respectively. Rural living per se had no effect on the occurrence of asthma. Eczema was less common in rural areas, but the time trend was similar in urban and rural areas.Conclusions
Our findings suggest that environmental changes affecting the whole of society have promoted an increase in asthma, allergic rhinitis and eczema in both farming and non‐farming environments. A lower risk of allergic rhinitis in conscripts whose parents were involved in farming was observed in all birth cohorts, whereas the protective effect of growing up on a farm on the risk of asthma appears to be a fairly recent phenomenon.
Eosinophilia in nasal polyposis: its objective quantification and clinical relevance
Authors: Gerstner A. O. H. , Gutsche M. , Bücheler M. , Machlitt J. , Emmrich F. , Sommerer F. , Tárnok A. , Bootz F. 
Published: January 2004

SummaryBackground
Eosinophilia within nasal polyps is often taken as a criterion for adjuvant medical treatment postoperatively such as topical steroids.Objective
This study was performed in order to validate a new technique for objective quantification of eosinophilia by using laser scanning cytometry (LSC), to compare these results with manual scoring and routine histopathology, and to correlate them with the history of allergy or recurrence.Methods
LSC was used for semi‐automated analysis of single‐cell preparations from representative ethmoidal polyps obtained during routine paranasal sinus surgery (n=41). This microscope‐based instrument scans the cells after immobilization of cells on a glass slide and after triple staining of cytokeratin, eosinophilic granula, and DNA. The location of each cell is stored with the fluorescence data. Therefore, the morphology of every cell can be documented by re‐staining with haemotoxylin and eosin and re‐localization on the slide. Subsequently, slides were subjected to manual scoring. The remaining polyps were analysed by routine histopathology.Results
Data from LSC and manual scoring showed good correlation (r=0.81, P<0.001), whereas there were discrepancies with histopathology. Eosinophilia scored by LSC and histopathology was neither correlated with the history of allergy nor with recurrence as determined by Fisher's exact test independent of the definition of eosinophilia (2%, 3%, or 5% of all cells).Conclusion
Scoring eosinophilia by LSC in comparison with histopathology does not contribute to a more reliable basis for adjuvant medical therapy in nasal polyposis. Instead, functional parameters (cytokine production, apoptosis) may serve better.
C5a delays apoptosis of human neutrophils via an extracellular signal‐regulated kinase and Bad‐mediated signalling pathway
Authors: Perianayagam M. C. , Balakrishnan V. S. , Pereira B. J. G. , Jaber B. L. 
Published: January 2004

AbstractAims  We recently demonstrated that complement fragment C5a delays apoptosis of human neutrophils via induction of the phosphatidylinositol‐3 kinase (PI 3‐K) pathway. In the present study, we examined whether C5a modulates neutrophil survival through the extracellular signal‐regulated kinase (ERK) and Bad‐mediated signalling pathway.Methods  Human neutrophils were isolated by percoll gradient and preincubated for 1 h with or without PD98059 (20 µM), a specific ERK inhibitor, followed by incubation with C5a (1 µg mL−1) for 24 h. Apoptosis was quantified by flow cytometry, using propidium iodide nuclear staining. Extracellular signal‐regulated kinase downstream signalling events were evaluated by measuring the expression of cytosolic total and phosphorylated p44/p42 proteins, and Bad phosphorylation using immunoblot analyses. These time‐dependent analyses were performed over a brief exposure to C5a (0–30 min). Modulation of cytosolic caspase‐9 and caspase‐3 activity was measured by Western blot analyses.Results  C5a inhibited neutrophil apoptosis (P = 0·04), which was abrogated in the presence of PD98059 (P = 0·04). Time‐dependent effect of C5a on p44/p42 phosphorylation was rapid, peaked at 5 min, and was abrogated by the ERK inhibitor (P = 0·04). In addition, brief stimulation of neutrophils with C5a induced phosphorylation of Bad, which was inhibited by the ERK inhibitor (P = 0·03). Further, C5a suppressed the proteolytic cleavage of caspase‐9 and caspase‐3, which was reversed by ERK inhibition. Finally, blockade of both the ERK (with PD98059) and PI 3‐K (with wortmannin) pathways did not induce additive inhibition of neutrophil apoptosis by C5a.Conclusion  This study demonstrates that in addition to the PI 3‐K pathway, C5a also inhibits neutrophil apoptosis via an ERK‐signalling pathway, resulting in phosphorylation of Bad and blockade of proteolytic cleavage of caspases. The activation of this additional survival‐signalling pathway may be another important cellular mechanism that enhances neutrophil survival in inflammatory states.
Metabolic effects of Troglitazone in patients with diet‐controlled type 2 diabetes
Authors: Robinson A. C. J. , Jeffs J. A. R. , Gray R. G. , Bannister P. A. , Mather H. , Gallagher J. J. , Robinson S. , Nattrass M. , Venkatesan S. , Halliday D. , Johnston D. G. 
Published: January 2004

AbstractBackground  In order to study the mechanisms of action of Troglitazone (TGZ) in vivo in Type 2 diabetes, its effects were studied on glucose metabolism, lipolysis and very low‐density lipoprotein (VLDL) apolipoprotein B100 (apoB) kinetics.Materials and methods  A placebo‐controlled, double‐blind study was performed in 24 diet‐treated patients randomized to receive TGZ 600 mg day−1, TGZ 200 mg day−1 or placebo for 8 weeks. Glucose and glycerol turnover were assessed after an overnight fast, and during sequential low‐dose insulin infusions (0·01 U kg−1 h−1 followed by 0·015 U kg−1 h−1) using 6,6‐2H Glucose and 1,2,3‐2H Glycerol. Very low‐density lipoprotein apoB secretion was measured using l‐13C‐leucine, monitoring isotopic enrichment by gas chromatography‐mass spectrometry. Treatment effects were analyzed by analysis of covariance, adjusting for baseline.Results  Therapy resulted in a significant group differences in fasting plasma glucose adjusting for baseline (P = 0·039). This was most evident at TGZ 600 mg daily [glucose decrease from (mean ± SD) 9·2 ± 2·7 to 6·6 ± 0·9 mmol L−1]. HbA1c and insulin levels did not change significantly. Plasma nonesterified fatty acid (NEFA) levels decreased (P = 0·045), most evidently at TGZ 200 mg daily, but glycerol was not significantly affected. Although no significant effects were observed on VLDL apoB or triglyceride concentrations, there were treatment differences in the absolute secretion rate of VLDL apoB of borderline (P = 0·056) statistical significance, with a decrease observed at TGZ 600 mg daily [geometric mean, SD range, 0·94 (0·41–2·15) to 0·40 (0·14–1·13 mg kg−1 h−1)]. Very low‐density lipoprotein apoB fractional secretion rate and pool size were unaffected. The VLDL triglyceride: apoB molar ratio differed between treatment groups (P = 0·013), being higher in the TGZ 600 mg group [5714 (4128–7741) to 8092 (5669–11552)]. Neither glucose nor glycerol rates of appearance were significantly altered by TGZ and nor did TGZ affect their suppression by insulin.Discussion  The PPARγ agonist, troglitazone, decreases fasting glucose and NEFA levels in diet‐treated Type 2 diabetes. It may also decrease VLDL particle secretion. These effects would be considered beneficial. The biological importance of the increase in VLDL‐triglyceride enrichment warrants further study.
Global assessment for quality and safety of control in type 2 diabetic patients
Authors: Monnier L. , Colette C. , Lapinski H. 
Published: January 2004

AbstractBackground  HbA1c (glycated haemoglobin) suffers from obvious limitations in type 2 diabetic patients at risk of hypoglycaemia or requiring rapid therapeutic adjustments. This study was conducted to discern whether the monitoring of one particular plasma glucose (PG) value of the diurnal profile can be used in such situations.Design  Four diurnal PG concentrations (at 08:00, 11:00, 14:00 and 17:00 h) were measured in standardized conditions in 480 (246 men, 234 women) noninsulin‐using type 2 diabetic patients. Sensitivities for predicting treatment success, i.e. HbA1c < 7%, with a specificity ≥ 90% were calculated and compared using receiver‐operating characteristic (ROC) curves.Results  The probabilities (areas under ROC curves) for predicting HbA1c < 7% were significantly higher at 11:00, 14:00 and 17:00 h than at 08:00 h. The optimal PG cut‐off values for predicting treatment success were, respectively, 6, 9, 7 and 6 mmol L−1 at 08:00 h, 11:00, 14:00 and 17:00 h. In most patients the lowest PG values of the diurnal profile were at 17:00 h, and 17·5% of the patients with HbA1c < 7% (54·5% of them treated with sulphonylureas) exhibited a PG value less than 4·4 mmol L−1 at 17:00 h (P = 0·0034 vs. the other timepoints).Conclusions  Glucose monitoring at 17:00 h, i.e. during the extended postlunch period, appears as a global marker of control in noninsulin‐using type 2 diabetic patients both for detecting patients at risk of hypoglycaemia and for assessing the short‐term quality of diabetic control.
Cholesteryl ester transfer protein concentration is associated with progression of atherosclerosis and response to pravastatin in men with coronary artery disease (REGRESS)
Authors: Klerkx A. H. E. M. , De Grooth G. J. , Zwinderman A. H. , Jukema J. W. , Kuivenhoven J. A. , Kastelein J. J. P. 
Published: January 2004

AbstractBackground  The TaqIB polymorphism in the cholesteryl ester transfer protein (CETP) gene is associated with HDL‐C, progression of coronary artery disease (CAD) and response to pravastatin treatment in men with angiographically proven CAD (REGRESS). We hypothesized that differences in CETP concentration could explain these associations and now investigated whether CETP concentration is an independent determinant of these parameters.Materials and methods  Plasma CETP concentrations at baseline and after 2 years’ treatment with pravastatin or placebo were measured (n = 674), and correlations with lipid and angiographic parameters (mean segment‐ and obstruction‐diameter; MSD and MOD), and TaqIB genotype were studied.Results  After segregation into three groups (baseline CETP < 1·58, 1·58–2·21, > 2·21 mg L−1), subjects with the highest CETP had significantly higher baseline total cholesterol, LDL‐C and triglycerides (P < 0·01), while HDL‐C, MSD and MOD were not different among these groups. After 2 years of placebo, the MSD decreased threefold (P < 0·001) and the MOD decreased 2·4‐fold (P = 0·042) more in the highest compared with the lowest CETP quartile. Pravastatin treatment reduced total cholesterol LDL‐C and triglycerides significantly more in the highest CETP quartile. Moreover, only in the highest CETP quartile, pravastatin significantly reduced the MSD‐ (P = 0·003) and MOD‐decrease (P = 0·014) compared with placebo, and, notably, this was independent of baseline lipids and differential lipid changes in these quartiles. Strikingly, baseline associations and treatment responses according to baseline CETP were independent of TaqIB genotype.Conclusions  High CETP concentration is associated with faster progression of coronary atherosclerosis in men with proven CAD. Second, pravastatin yielded the highest improvement of lipid and angiographic parameters in patients with high baseline CETP independent of baseline lipids, lipid changes and TaqIB genotype, indicating that the plasma CETP level itself is an important determinant of the response to statins.
Multiple effects of HIV‐1 trans‐activator protein on the pathogenesis of HIV‐1 infection
Authors: Huigen M. C. D. G. , Kamp W. , Nottet H. S. L. M. 
Published: January 2004

AbstractThe HIV‐1 trans‐activator (Tat) protein is proposed as an important factor in the complex HIV‐induced pathogenesis of AIDS. In this paper, multiple effects of this viral protein are described. Originally discovered as an intracellular activator of HIV‐1 transcription, Tat was found to regulate viral reverse transcription as well. Trans‐activator was found to be secreted by HIV‐infected cells and taken up by neighbouring cells. In this way, Tat is able to affect both infected and uninfected cells. Intracellularly, Tat can deregulate the expression of several heterologous cellular and viral genes. Extracellular Tat can contribute to the spreading of HIV‐1 and immunosuppression of uninfected cells. Finally, there is evidence that exogenous Tat is involved in AIDS‐associated pathologies such as Kaposi's sarcoma and HIV‐associated dementia. These capacities together accelerate the progression towards AIDS and make Tat an interesting candidate as a constituent of an anti‐AIDS vaccine.