Suchergebnisse

There are major obstacles to the effective delivery of mental health services to poor families, particularly for those families in rural areas. The rise of Internet use, however, has created potentially new avenues for service delivery, which, when paired with the many recent advances in computer networking and multimedia technology, is fueling a demand for Internet delivery of mental health services. The authors report on the adaptation of a parenting program for delivery via the Internet, enhanced with participant-created videos of parent-infant interactions and weekly staff contact, which enable distal treatment providers to give feedback and make decisions informed by direct behavioral assessment. This Internet-based, parent-education intervention has the potential to promote healthy and protective parent-infant interactions in families who might not otherwise receive needed mental health services.

Purpose: Few cost-effectiveness studies have been conducted on social-emotional interventions for students in preschool settings. The current study is a cost-effectiveness analysis of the First Step Next (FSN) intervention for preschool students. Method: Our approach involved a secondary analysis of a randomized control trial that utilized the ingredients method to estimate costs (Levin & McEwan, 2001). In addition, effect sizes were used to generate incremental cost-effectiveness ratios representing the cost of improving student outcomes by one standard deviation (1 SD). Results: FSN was more cost-effective for improving behavior in the school setting than in the home setting, with an average cost per 1 SD improvement of $3,833 and $6,329, respectively. Additionally, the intervention had greater cost-effectiveness for social skill-related outcomes than problem behavior-related outcomes among preschool students. Discussion: This study advances our understanding of the costs and outcomes of practices designed to improve the school success of our youngest learners.

The study was supported by grants from the UKCRC Translational Infection Research Initiative, and the Medical Research Council Grant Number G1000803) with contributions to the Grant from the Biotechnology and Biological Sciences Research Council, the National Institute for Health Research on behalf of the Department of Health, and the Chief Scientist Office of the Scottish Government Health Directorate (to Prof. Peacock); and by Wellcome Trust grant number 098051 awarded to the Wellcome Trust Sanger Institute. MET is Clinician Scientist Fellow supported by the Academy of Medical Sciences and the Health Foundation. ; The correct interpretation of microbial sequencing data applied to surveillance and outbreak investigation depends on accessible genomic databases to provide vital genetic context. Our aim was to construct and describe a UK MRSA database containing over 1,000 methicillin-resistant Staphylococcus aureus (MRSA) genomes drawn from England, Northern Ireland, Wales, Scotland and the Republic of Ireland over a decade. We sequenced 1,013 MRSA submitted to the British Society for Antimicrobial Chemotherapy by 46 laboratories between 2001 and 2010. Each isolate was assigned to a regional healthcare referral network in England, and otherwise grouped based on country of origin. Phylogenetic reconstructions were used to contextualise MRSA outbreak investigations, and to detect the spread of resistance. The majority of isolates (n=783, 77%) belonged to CC22, which contains the dominant UK epidemic clone (EMRSA-15). There was marked geographic structuring of EMRSA-15, consistent with widespread dissemination prior to the sampling decade followed by local diversification. The addition of MRSA genomes from two outbreaks and one pseudo-outbreak demonstrated the certainty with which outbreaks could be confirmed or refuted. We identified local and regional differences in antibiotic resistance profiles, with examples of local expansion, as well as widespread circulation of mobile genetic elements across the bacterial population. We have generated a resource for the future surveillance and outbreak investigation of MRSA in the UK and Ireland, and have shown the value of this during outbreak investigation and tracking of antimicrobial resistance. ; Publisher PDF ; Peer reviewed