Efficacy and cost-effectiveness of an automated screening algorithm in an inpatient clinical trial

Screening and recruitment for clinical trials can be costly and time-consuming. Inpatient trials present additional challenges because enrollment is time sensitive based on length of stay. We hypothesized that using an automated prescreening algorithm to identify eligible subjects would increase screening efficiency and enrollment and be cost-effective compared to manual review of a daily admission list.

Moving a randomized clinical trial into an observational cohort

The Selenium and Vitamin E Cancer Prevention Trial (SELECT) was a randomized, double-blind, placebo-controlled prostate cancer prevention study funded by the National Cancer Institute (NCI) and conducted by the Southwest Oncology Group (SWOG). A total of 35,533 men were assigned randomly to one of the four treatment groups (vitamin E + placebo, selenium + placebo, vitamin E + selenium, and placebo + placebo). The independent Data and Safety Monitoring Committee (DSMC) recommended the discontinuation of study supplements because of the lack of efficacy for risk reduction and because futility analyses demonstrated no possibility of benefit of the supplements to the anticipated degree (25% reduction in prostate cancer incidence) with additional follow-up. Study leadership agreed that the randomized trial should be terminated but believed that the cohort should be maintained and followed as the additional follow-up would contribute important information to the understanding of the biologic consequences of the intervention. Since the participants no longer needed to be seen in person to assess acute toxicities or to be given study supplements, it was determined that the most efficient and cost-effective way to follow them was via a central coordinated effort.

Severe Adenovirus Infection: An Under-Recognised Disease with Limited Treatment Options

Response to Catherine Pettiford

Children's strategies for making friends when starting school

STARTING SCHOOL IS A critical and potentially stressful time for many young children, and having supportive relationships with parents, teachers and peers and friends offer better outcomes for school adjustment and social relationships. This paper explores matters of friendship when young children are starting school, and how they initiate friendships. In audio-recorded conversations with researchers, the children proposed a number of strategies, including making requests, initiating clubs and teams, and peer intervention to support a friend. Their accounts drew on social knowledge and relational understandings, and showed that having someone, a friend, to play with was important for starting school. Children gave serious attention to developing strategies to initiate friendships.

Factors Affecting the Transition to School for Young Children with Disabilities

THIS QUALITATIVE STUDY EXAMINED the factors involved in school transitions for a sample of 17 children with a range of disabilities, aged from 5.25 to 6.16 years, their parents, and their Year 1 teachers. Parents and teachers were interviewed and asked for their retrospective views on how the transition process had occurred for their children in the period immediately before and after school entry. Certain practices emerged as most successful for this sample, particularly good ongoing levels of communication and collaboration between families and schools. Holding meetings to plan the transition and allowing children multiple opportunities for pre-entry visits to the new school contributed to this. Following school entry, teachers' use of differentiation practices also aided the transition. We conclude that the home–school partnership is the most critical factor determining school transitions for this sample of children with disabilities. Recommendations are made for educational practice.

In vitro Antimicrobial Properties and Chemical Composition of Santolina chamaecyparissus Essential Oil from Algeria

The chemical composition of the essential oil obtained from the aerial parts of Santolina chamaecyparissus L., growing in Algeria, was investigated by GC-MS analyses. A total of 36 compounds were identified, accounting for 91.7% of the essential oil obtained. Camphor (31.1%) and cubenol (17.0%) were the predominant compounds. The potential of the antimicrobial activity was also investigated and the tested sample proved to be very active against Klebsiella pneumonia and Candida albicans (34.1 ± 0.02 mm and 35.0 ± 0.01 mm, respectively). Transverse sections of the leaf and stem of the plant suggest that the essential oil is localized in endogenous and exogenous sites.

Gain-of-Function Activity of Mutant p53 in Lung Cancer through Up-Regulation of Receptor Protein Tyrosine Kinase Axl

p53 mutations are present in up to 70% of lung cancer. Cancer cells with p53 mutations, in general, grow more aggressively than those with wild-type p53 or no p53. Expression of tumor-derived mutant p53 in cells leads to up-regulated expression of genes that may affect cell growth and oncogenesis. In our study of this aggressive phenotype, we have investigated the receptor protein tyrosine kinase Axl, which is up-regulated by p53 mutants at both RNA and protein levels in H1299 lung cancer cells expressing mutants p53-R175H, -R273H, and -D281G. Knockdown of endogenous mutant p53 levels in human lung cancer cells H1048 (p53-R273C) and H1437 (p53-R267P) led to a reduction in the level of Axl as well. This effect on Axl expression is refractory to the mutations at positions 22 and 23 of p53, suggesting that p53's transactivation domain may not play a critical role in the up-regulation of Axl gene expression. Chromatin immunoprecipitation (ChIP) assays carried out with acetylated histone antibodies demonstrated induced histone acetylation on the Axl promoter region by mutant p53. Direct mutant p53 nucleation on the Axl promoter was demonstrated by ChIP assays using antibodies against p53. The Axl promoter has a p53/p63 binding site, which however is not required for mutant p53-mediated transactivation. Knockdown of Axl by Axl-specific RNAi caused a reduction of gain-of-function (GOF) activities, reducing the cell growth rate and motility rate in lung cancer cells expressing mutant p53. This indicates that for lung cancer cell lines with mutant p53, GOF activities are mediated in part through Axl.

Neuroleptic malignant syndrome associated with quetiapine and venlafaxine use: a case report and discussion

Community Capacity Building for Health

There is a great deal of literature examining the benefits andrelevance of community participation and community capacity building in health promotionand disease prevention endeavors. Academic literature embracing principles andcommitment to community participation in health promotion practices often neglects thecomplexities involved and the flexibility required to work within this approach. Thisarticle addresses some of these challenges through a case study of two projects fundedby Provincial Wellness Grants in Newfoundland and Labrador, a province in Canada with astrong tradition of community ties and support systems. In addition to addressing theunique circumstances of the community groups, this research allowed the authors toexamine the situational context and power relations involved in the provision ofservices as well as the particular forms of subjectivity and citizenship that theinstitutional practices support. Recognizing this complex interdependency is animportant step in creating more effective intervention practices