Determining essential elements and functionalities for a patient record system in community pharmacy.

BACKGROUND: As community-based pharmacy continues to evolve from a focus on product distribution to a practice focused on patient care, a key requirement is for pharmacists to document their patient care activities. Some community-based pharmacies are working to routinely use the Pharmacist eCare Plan standard in documenting their new care activities. OBJECTIVES: With the need for a robust patient record in community-based pharmacies, the purpose of this study was to identify key elements and functionalities for a community-based pharmacy patient record. METHODS: An expert panel of 26 individuals participated in 3 rounds of surveys using an online Delphi method to develop consensus about the key data elements and functionalities for a pharmacy patient record system. RESULTS: A total of 46 items reached consensus: 16 as essential elements for a longitudinal pharmacy patient record, 7 as essential elements for a patient encounter, and 23 functionalities for a pharmacy patient record system. A rubric was developed to assess community-based pharmacy patient record systems. CONCLUSION: The functionalities can support pharmacists in fully adopting a standard care process and providing and documenting patient care, while coordinating and improving communication with patients, providers, and payers. Pharmacists are encouraged to use the rubric in evaluating software for their practices.

Silver(I) Bromide Phosphines Induce Mitochondrial-Mediated Apoptosis in Malignant Human Colorectal Cells.

Due to its emerging resistance to current therapies, colon cancer remains one of the most difficult types of cancer to treat. Silver, a non-invasive metal, is well-known for its antimicrobial and anti-cancer properties. Two novel silver(I) phosphine complexes, [silver(I) diphenyl-2-pyridylphosphine]Br (1) and [silver(I) is 4-(dimethylamino)phenyldiphenylphosphine]Br (2), were synthesized and characterized by elemental analysis, infrared spectroscopy, and nuclear magnetic resonance (1H, 13C, 31P). To assess the complexes' potentials as antiproliferative agents, experiments were conducted on human colorectal cancer cells (HT-29) in vitro. The evaluation involved the analysis of morphological changes, the performance of an alamarBlue® proliferation assay, and the undertaking of flow cytometric analyses to detect mitochondrial alterations. Complex 1 displayed superior selectivity and significant inhibitory effects on malignant HT-29 cells while exhibiting minimal toxicity towards two non-malignant HEK-293 and MRHF cells. Moreover, after 24 h of treatment, complex 1 (IC50, 7.49 µM) demonstrated higher efficacy in inhibiting cell proliferation compared with complex 2 (IC50, 21.75 µM) and CDDP (IC50, 200.96 µM). Flow cytometric studies indicated that complex 1 induced regulated cell death, likely through mitochondrial-mediated apoptosis. Treatment with complex 1 induced morphological changes indicative of apoptosis, which includes membrane blebbing, PS externalization, increased levels of reactive oxygen species (ROS) and mitochondrial membrane depolarization (ΔΨm). These observations suggest that complex 1 targets the mitochondria and holds promise as a novel metal-based anti-cancer therapeutic for the selective treatment of colorectal cancer.

Listen to the Children: Elementary School Students' Perspectives on a Mindfulness Intervention.

In recent years, mindfulness-based practices in grade schools have been associated with students' improved cognitive skills and general classroom behavior. In the majority of studies, however, only teacher and parent feedback are elicited, omitting a considerably significant voice - that of the students. Our study aims to fill this gap by exploring student opinions and perceptions regarding the implementation of a classroom-based mindfulness program. Elementary school students (N = 51) took part in teacher-facilitated mindfulness activities which were incorporated into their daily classroom routines. Over the course of the 8-week intervention period, students participated in focus groups about their perceptions of the program. Through qualitative content analysis, two major findings emerged from the focus group data: student opinions about the mindfulness program varied substantially and the mindfulness activities were not always liked and enjoyed. Critically, if students do not enjoy classroom-based mindfulness programs, they may be less motivated to engage in mindful activities and in turn may not experience the benefits that mindfulness has to offer. To maximize student engagement with mindfulness while addressing their concerns, the following recommendations are made: A balance between the entertaining and educational aspects of the program, flexible program delivery, and encouraging students to pursue mindful living outside of the classroom. This research is important to educational and clinical practitioners as student insight will benefit the development and modification of classroom-based mindfulness programs to ensure that students are better able to engage with and benefit from these programs.

A cluster RCT and process evaluation of an implementation optimisation intervention to promote parental engagement enrolment and attendance in a childhood obesity prevention programme: results of the Optimising Family Engagement in HENRY (OFTEN) trial.

BACKGROUND: Poor and variable implementation of childhood obesity prevention programmes reduces their population impact and sustainability. We drew upon ethnographic work to develop a multi-level, theory-based implementation optimisation intervention. This intervention aimed to promote parental enrolment and attendance at HENRY (Health Exercise Nutrition for the Really Young), a UK community obesity prevention programme, by changing behaviours of children's centre and local authority stakeholders. METHODS: We evaluated the effectiveness of the implementation optimisation intervention on HENRY programme enrolment and attendance over a 12-month implementation period in a cluster randomised controlled trial. We randomised 20 local government authorities (with 126 children's centres) to HENRY plus the implementation optimisation intervention or to HENRY alone. Primary outcomes were (1) the proportion of centres enrolling at least eight parents per programme and (2) the proportion of centres with a minimum of 75% of parents attending at least five of eight sessions per programme. Trial analyses adjusted for stratification factors (pre-randomisation implementation of HENRY, local authority size, deprivation) and allowed for cluster design. A parallel mixed-methods process evaluation used qualitative interviews and routine monitoring to explain trial results. RESULTS: Neither primary outcome differed significantly between groups; 17.8% of intervention centres and 18.0% of control centres achieved the parent enrolment target (adjusted difference - 1.2%; 95% CI - 19.5%, 17.1%); 17.1% of intervention centres and 13.9% of control centres achieved the attendance target (adjusted difference 1.2%; 95% CI - 15.7%, 18.1%). Unexpectedly, the trial coincided with substantial national service restructuring, including centre closures and reduced funds. Some commissioning and management teams stopped or reduced delivery of both HENRY and the implementation optimisation intervention due to competing demands. Thus, at follow-up, HENRY programmes were delivered to approximately half the number of parents compared to baseline (n = 433 vs. 881). CONCLUSIONS: During a period in which services were reduced by external policies, this first definitive trial found no evidence of effectiveness for an implementation optimisation intervention promoting parent enrolment to and attendance at an obesity prevention programme. TRIAL REGISTRATION: ClinicalTrials.gov NCT02675699 . Registered on 4 February 2016.

Children's ability to edit their memories when learning about the environment from credible and noncredible websites.

One of the many sources of information easily available to children is the internet and the millions of websites providing accurate, and sometimes inaccurate, information. In the current investigation, we examined children's ability to use credibility information about websites when learning about environmental sustainability. In two studies, children studied two different websites and were tested on what they had learned a week later using a multiple-choice test containing both website items and new distracters. Children were given either no information about the websites or were told that one of the websites (the noncredible website) contained errors and they should not use any information from that website to answer the test. In both studies, children aged 7- to 9-years reported information from the noncredible website even when instructed not to, whereas the 10- to 12-year-olds used the credibility warning to 'edit out' information that they had learned from the noncredible website. In Study 2, there was an indication that the older children spontaneously assessed the credibility of the website if credibility markers were made explicit. A plausible explanation is that, although children remembered information from the websites, they needed explicit instruction to bind the website content with the relevant source (the individual websites). The results have implications for children's learning in an open-access, digital age where information comes from many sources, credible and noncredible. Education in credibility evaluation may enable children to be critical consumers of information thereby resisting misinformation provided through public sources.

The influence of culture on children's immediate and delayed retrieval.

Culture shapes children's memories. However, scant attention has been given to the influence of culture on specific memory stages. Thus, we conducted two controlled experiments to examine cultural differences in memory recall at immediate and delayed retrieval phases. In Studies 1 and 2 (n = 217), 7- to 10-year-old Chinese and Euro-Canadian children watched a story involving both social- and individual-focused scenarios. Participants then recalled the story immediately afterwards (Study 1) and 5-7 days later (Studies 1 and 2). Findings reveal that Chinese children accurately reported more details from the social-focused events than did their Euro-Canadian counterparts in the immediate interview, and this result was replicated after a delay in both studies. Moreover, as expected, within-country comparisons showed that Euro-Canadian children had better memory for individual- than for social-focused events in both studies. Chinese children, however, showed better memory for social- than for individual-focused events only in the immediate interview in Study 1; their delayed retrieval was not affected by event focus. These findings reveal that cultural variations in memory are evident in both immediate and delayed retrieval. Implications for future research are discussed.

Community-based pharmacy use of the Pharmacist eCare Plan: A retrospective review.

BACKGROUND: Pharmacists in community-based settings document patient care using the Pharmacist eCare Plan (PeCP). OBJECTIVE: To conduct a pilot evaluation of the PeCP use and documentation of Systemized Nomenclature of Medicine Clinical Terms (SNOMED CT) codes within select community-based pharmacies. PRACTICE DESCRIPTION: Moose Pharmacy operates 7 locations in rural North Carolina that are part of the Community Pharmacy Enhanced Services Network (CPESN). The Moose Pharmacy Medication Adherence Program (MooseMAP) targets patients with a chronic condition who would benefit from medication synchronization, adherence packaging, and monthly calls. PRACTICE INNOVATION: CPESN pharmacies use the PeCP to track a patient's concerns, goals, interventions, and medication-related information. The PeCP standard requires pharmacies to detail a patient's current medication regimen and health concerns as well as the pharmacy's interventions and patient's health over time. EVALUATION METHODS: Data were included if the patient was enrolled in MooseMAP and had a free-text note in the eCare Plan. Data were excluded if the medication-related problem (MRP) or intervention was a general health problem without a valid SNOMED CT code. Data were categorized into MRPs, medication interventions, education, and referrals. The International SNOMED CT browser and pharmacy health information technology (PHIT) value sets were searched; data sets without existing codes were submitted to the appropriate oversight authorities for future inclusion. Data were analyzed using descriptive statistics. RESULTS: Emerging codes were identified that resulted in 91 recommendations to PHIT for development of new SNOMED CT codes and 113 recommendations to PHIT for inclusion in the PHIT value sets. In total, 66% of MRPs did not have a valid SNOMED CT code, and 78% of MRPs were not included in a PHIT value set. The most prevalent gap in MRP or intervention documentation related to medication use issues. CONCLUSION: Incorporating emerging codes into documentation systems should enable the profession to better communicate value to health care stakeholders.

Testing the feasibility of a sustainable preschool obesity prevention approach: a mixed-methods service evaluation of a volunteer-led HENRY programme.

BACKGROUND: Over the last 10 years HENRY has been working to reduce and prevent child obesity by training health and early years professionals to deliver its evidence-based programme to parents. The aim and unique contribution of this study was to evaluate whether training volunteers to deliver this programme on a one-to-one basis was feasible. METHODS: Mixed-methods service evaluation with parent-reported pre- and post-programme outcomes and focus groups conducted with parents and volunteer facilitators. The programme consisted of 8 one-to-one sessions delivered weekly by volunteers (n = 18) to build food and activity-related knowledge, skills, and understanding, and improve parenting efficacy, and parent and child eating and physical activity. Programmes took place at parent's (n = 69) home or local community venues in four London boroughs, United Kingdom. Parent-reported parenting efficacy, emotional wellbeing, eating, and physical activity data were captured, alongside parent ratings of the programme and volunteer ratings of the training. Parent and volunteer focus groups explored involvement, expectations, and experiences of the programme, training and delivery, feedback, and impact. RESULTS: Parents were mostly female, had varied ethnic backgrounds, and were often not working but well educated. There were statistically significant improvements of a medium-to-large size in parent and child emotional wellbeing, parenting efficacy, fruit and vegetable consumption, family eating and food purchasing behaviours. Parent ratings of the programme were positive and qualitative data highlighted the holistic nature of the programme, which focused on more than just food, and the relationships with volunteers as key facets. Volunteers were also mostly female, had varied ethnic backgrounds, and were often well educated, but more likely to be employed than parents. Volunteers rated the training and delivery as useful in enabling them to deliver the programme confidently and for their own wellbeing. Despite finding some sessions challenging emotionally, volunteers reported positive family lifestyle improvements by parents and children and that the experience would be useful for future employment. CONCLUSIONS: It is feasible to recruit and train volunteers to deliver a structured preschool obesity prevention programme, which parents considered acceptable and enjoyable, with preliminary reports of parent and child benefits.

Developmental trends in children's source and destination memory.

Destination memory (the ability to remember who one has told information to) has been studied in adult samples, but not with child participants. The goals of the current research were to describe the development of children's destination memory abilities across early to middle childhood and to compare destination memory with source-monitoring abilities within the same age range. In two studies, children aged 5-10 years had conversations with two puppets and were later asked to recall which puppet they had disclosed specific information to. Study 1 (N = 86) revealed age to be a significant predictor of destination memory accuracy. Study 2 (N = 90) demonstrated that source memory and destination memory were related and shared a similar developmental trajectory but that source accuracy was higher on average than destination accuracy. This research contributes to our theoretical understanding of children's memory development, and directions for future research are highlighted in the Discussion. Implications for investigative interviews in which children are asked about prior disclosures are discussed.

Synthesis and anti-cancer activity of bis-amino-phosphine ligand and its ruthenium(II) complexes.

The development of both chemotherapeutic drug resistance as well as adverse side effects suggest that the current chemotherapeutic drugs remain ineffective in treating the various types of cancers. The development of new metallodrugs presenting anti-cancer activity is therefore needed. Ruthenium complexes have gained a great deal of interest due to their promising anti-tumour properties and reduced toxicity in vivo. This study highlighted the effective induction of cell death in a malignant melanoma cell by two novel bis-amino-phosphine ruthenium(II) complexes referred to as GA105 and GA113. The IC50 concentrations were determined for both the complexes, the ligand and cisplatin, for comparison. Both complexes GA105 and GA113 displayed a high anti-cancer selectivity profile as they exhibited low IC50 values of 6.72 µM and 8.76 µM respectively, with low toxicity towards a non-malignant human cell line. The IC50 values obtained for both complexes were lower than that of cisplatin. The new complexes were more effective compared to the free ligand, GA103 (IC50 = >20 µM). Morphological studies on treated cells induced apoptotic features, which with further studies could indicate an intrinsic cell death pathway. Additionally, flow cytometric analysis revealed that the mode of cell death of complex GA113 was apoptosis. The outcomes herein give further insight into the potential use of selected Ru(II) complexes as alternative chemotherapeutic drugs in the future.

What is the evidence in evidence-based mindfulness programs for children?

The prevalence of "mindfulness" in popular media, academia, and professional circles is difficult to miss. Newspapers, magazines, online articles, clinical programs, podcasts, scholarly and professional meetings, sports organizations, and many other outlets focus on the benefits of mindfulness. Despite the intense focus on mindfulness in Western society, it is astonishing that the evidence base (i.e., documented, scholarly, peer-reviewed evaluations) for these programs is woefully inadequate. Varying definitions of what mindfulness is, what it entails, what specific benefits to psychological functioning are observed (if any), and inadequate scientific testing all contribute to a lean knowledge base. Evaluation of potential benefits of mindful practice with children is even more difficult because children are a more heterogeneous group than adults; the differing developmental levels are likely to have profound effects on the efficacy of mindfulness-based programming with children. We review these issues and provide an explanation of the strength of different kinds of evidence, with suggestions for (a) researchers who study mindfulness with children and (b) clinical professionals and educators interested in developing mindful attitudes and techniques with children.

Exploring the Applicability of Robot-Assisted UV Disinfection in Radiology.

The importance of infection control procedures in hospital radiology departments has become increasingly apparent in recent months as the impact of COVID-19 has spread across the world. Existing disinfectant procedures that rely on the manual application of chemical-based disinfectants are time consuming, resource intensive and prone to high degrees of human error. Alternative non-touch disinfection methods, such as Ultraviolet Germicidal Irradiation (UVGI), have the potential to overcome many of the limitations of existing approaches while significantly improving workflow and equipment utilization. The aim of this research was to investigate the germicidal effectiveness and the practical feasibility of using a robotic UVGI device for disinfecting surfaces in a radiology setting. We present the design of a robotic UVGI platform that can be deployed alongside human workers and can operate autonomously within cramped rooms, thereby addressing two important requirements necessary for integrating the technology within radiology settings. In one hospital, we conducted experiments in a CT and X-ray room. In a second hospital, we investigated the germicidal performance of the robot when deployed to disinfect a CT room in <15 minutes, a period which is estimated to be 2-4 times faster than current practice for disinfecting rooms after infectious (or potentially infectious) patients. Findings from both test sites show that UVGI successfully inactivated all of measurable microbial load on 22 out of 24 surfaces. On the remaining two surfaces, UVGI reduced the microbial load by 84 and 95%, respectively. The study also exposes some of the challenges of manually disinfecting radiology suites, revealing high concentrations of microbial load in hard-to-reach places. Our findings provide compelling evidence that UVGI can effectively inactivate microbes on commonly touched surfaces in radiology suites, even if they were only exposed to relatively short bursts of irradiation. Despite the short irradiation period, we demonstrated the ability to inactivate microbes with more complex cell structures and requiring higher UV inactivation energies than SARS-CoV-2, thus indicating high likelihood of effectiveness against coronavirus.

The impact of HENRY on parenting and family lifestyle: Exploratory analysis of the mechanisms for change.

BACKGROUND: Childhood obesity is a major public health concern. In the United Kingdom, a quarter of children are overweight or obese at age 5 years. Overweight and obese children are more likely to develop serious health issues such as diabetes later in life. Consequently, there is an urgent need for effective, early obesity prevention and intervention. This study investigated the impact of an 8-week child obesity intervention-HENRY (Health Exercise Nutrition for the Really Young)-designed to help parents with preschool children develop the skills and knowledge needed to improve family lifestyle and well-being. We were particularly interested in exploring the potential mechanisms by which HENRY may have a positive impact. METHOD: Focus groups (n = 7, total participants = 39) were completed with mothers attending the HENRY programme at one of seven locations across England. They took place within 2 weeks of programme completion. Follow-up telephone interviews were completed with a subsample of participants (n = 10) between 17 and 21 weeks later. RESULTS: Parents consistently reported enhanced self-efficacy in terms of improved confidence in their ability to encourage healthier behaviours such as eating fruit and vegetables and increasing physical activity, and improvements to family health behaviours. Many changes were reportedly sustained at follow-up. Data provided insights into the potential mechanisms that created the conditions for the positive changes. Participants described the importance of mutual support, being listened to by facilitators, and encouragement to identify their own ideas. Their comments indicated the success of a solution-focused, strength-based, partnership approach to supporting family lifestyle change. CONCLUSION: The results of this study contribute to the body of evidence suggesting that HENRY may have a positive impact on parenting and family lifestyle behaviour. Although data were collected in 2011, the findings contribute to an understanding of the components of effective obesity prevention in young children.

Observational analysis of disparities in obesity in children in the UK: Has Leeds bucked the trend?

BACKGROUND: The prevalence of obesity in childhood is of high concern, especially in deprived populations. We explored trends in obesity following the introduction of a citywide strategy focused on preschool children. METHODS: Analysis of obesity prevalence using the National Child Measurement Programme 2009 to 2017 for primary-school children in Leeds using 5-year aggregated data for Leeds, comparable cities, and England as a whole. RESULTS: Prevalence of obesity in Leeds for school entry children fell significantly (9.4% to 8.8%), whilst comparable cities (CC) and England as a whole showed no change (comparison of trends: P < 0.001 and P < 0.001). The reduction in Leeds was primarily in the most deprived (11.5% to 10.5%; trend comparison CC: P < 0.001, Eng: P < 0.001), but also amongst the affluent (6.8% to 6.0%; trend comparison CC: P = 0.087, Eng: P = 0.012). Prevalence in older children in Leeds was unchanged whilst it increased for comparable cities and England (trend comparison CC: P < 0.001, Eng: P < 0.001). In the deprived, obesity increased: Leeds by 1.4%; CC 1.3%, England 1% (trend comparison Eng: P = 0.004). In the affluent, obesity prevalence reduced more in Leeds than elsewhere: 2% in Leeds, 0.8% in CC, and 0.7% in England (trend comparison CC: P < 0.001, Eng: P ≤ 0.001). CONCLUSIONS: There has been a notable decrease in the prevalence of obesity especially amongst the most disadvantaged children at entry to primary school in Leeds. How this was achieved merits in-depth consideration.

Cultural Influences on the Development of Children's Memory and Cognition.

Memory is socially constructed. The types of information that children pay attention to and remember, as well as how children organize and recall their memories can differ as a function of sociocultural background. This chapter presents an overview of cultural variations on children's memory and cognition. We draw attention to the necessity of conducting controlled experiments to examine cultural differences in the specific processes involved in episodic memory (e.g., encoding, retention, discrimination skills). We highlight potential challenges (e.g., language, measurement equivalence) that researchers need to overcome to conduct valid cross-cultural research. In light of cultural transformations in recent decades, we outline promising avenues for future research as well as the applications of this research to important issues for forensics and immigrants and asylum-seekers.

Cluster randomised controlled feasibility study of HENRY: a community-based intervention aimed at reducing obesity rates in preschool children.

BACKGROUND: In the UK and beyond, public funding is used to commission interventions delivered in public health early years settings aimed at improving health and well-being and reducing inequalities in order to promote school readiness. This is a key setting for obesity prevention programmes, which are often commissioned despite the limited evidence base. The HENRY (Health, Exercise, Nutrition for the Really Young) programme is an 8-week programme delivered to parents of preschool children, designed to support families to optimise healthy weight behaviours. Early evidence suggests that it may be effective, but a robust evaluation using a randomised controlled design has not been conducted. This study begins this process by evaluating the feasibility of conducting a multi-centre definitive trial to evaluate the effectiveness and cost-effectiveness of HENRY to prevent obesity in the early years. METHODS: This is a multi-centre, open labelled, two group, prospective, cluster randomised, controlled, feasibility study aiming to recruit 120 parents from 12 children's centres, based in two local authority areas. Within each of the two local authorities, three centres will be randomised to HENRY and three will be randomised to a control arm of standard care (usual provision of services within children's centres). We will explore HENRY commissioning, provision and delivery and assess the feasibility of local authority, centre and parent recruitment, the processes and time required to train and certify staff to deliver the intervention, the potential sources (and associated risk) of contamination and the feasibility of the trial procedures. Research includes a process evaluation, feasibility of cost-effectiveness evaluation, with progression to the definitive trial judged against pre-defined criteria. DISCUSSION: This feasibility study will support the decision to proceed to, and the design of, a future definitive trial, providing an evidence base of an approach to prevent childhood obesity, which has been deemed attractive to all stakeholders, including parents. Given the widespread adoption of the intervention, this has the potential to impact on public health in the UK and beyond. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT03333733 registered 6th November 2017Protocol date: 25th October 2017Protocol version: 4.0.

Supporting Community Pharmacies with Implementation of a Web-Based Medication Management Application.

OBJECTIVE: Community pharmacists' role in clinical care is expanding in the United States and information systems are needed that extend beyond a dispensing workflow. As pharmacies adopt new systems, implementation support will be needed. This study identifies the barriers and facilitators experienced by community pharmacies in implementing a Web-based medication management application and describes the implementation strategies used to support these pharmacies. METHODS: Semistructured interviews were conducted with 28 program and research staff that provides support to community pharmacies participating in a statewide pharmacy network. Interviews were recorded, transcribed verbatim, and analyzed for themes using the Expert Recommendations for Implementing Change (ERIC). RESULTS: Findings suggest that leadership support, clinical training, and computer literacy facilitated implementation, while lack of system integration, staff resistance to change, and provider reluctance to share data served as barriers. To overcome the barriers, implementation support was provided, such as assessing readiness for implementation, developing a standardized and interoperable care plan, and audit and feedback of documentation quality. CONCLUSION: Participants used a wide array of strategies to support community pharmacies with implementation and tailored approaches to accommodate pharmacy-specific preferences. Most of the support was delivered preimplementation or in the early phase of implementation and by program or research staff rather than peer-to-peer. Implementing new pharmacy information system requires a significant amount of implementation support to help end-users learn about program features, how to integrate the software into workflow, and how to optimize the software to improve patient care. Future research should identify which implementation strategies are associated with program performance.

Effectiveness of an implementation optimisation intervention aimed at increasing parent engagement in HENRY, a childhood obesity prevention programme - the Optimising Family Engagement in HENRY (OFTEN) trial: study protocol for a randomised controlled trial.

BACKGROUND: Family-based interventions to prevent childhood obesity depend upon parents' taking action to improve diet and other lifestyle behaviours in their families. Programmes that attract and retain high numbers of parents provide an enhanced opportunity to improve public health and are also likely to be more cost-effective than those that do not. We have developed a theory-informed optimisation intervention to promote parent engagement within an existing childhood obesity prevention group programme, HENRY (Health Exercise Nutrition for the Really Young). Here, we describe a proposal to evaluate the effectiveness of this optimisation intervention in regard to the engagement of parents and cost-effectiveness. METHODS/DESIGN: The Optimising Family Engagement in HENRY (OFTEN) trial is a cluster randomised controlled trial being conducted across 24 local authorities (approximately 144 children's centres) which currently deliver HENRY programmes. The primary outcome will be parental enrolment and attendance at the HENRY programme, assessed using routinely collected process data. Cost-effectiveness will be presented in terms of primary outcomes using acceptability curves and through eliciting the willingness to pay for the optimisation from HENRY commissioners. Secondary outcomes include the longitudinal impact of the optimisation, parent-reported infant intake of fruits and vegetables (as a proxy to compliance) and other parent-reported family habits and lifestyle. DISCUSSION: This innovative trial will provide evidence on the implementation of a theory-informed optimisation intervention to promote parent engagement in HENRY, a community-based childhood obesity prevention programme. The findings will be generalisable to other interventions delivered to parents in other community-based environments. This research meets the expressed needs of commissioners, children's centres and parents to optimise the potential impact that HENRY has on obesity prevention. A subsequent cluster randomised controlled pilot trial is planned to determine the practicality of undertaking a definitive trial to robustly evaluate the effectiveness and cost-effectiveness of the optimised intervention on childhood obesity prevention. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02675699 . Registered on 4 February 2016.

Prosecutors' Perceptions on Questioning Children about Repeated Abuse.

The purpose of this study is to elicit guidance from prosecutors across Australia on questioning children about repeated events. Two focus groups were conducted. The first sought broad feedback concerning questioning children about repeated events. The second focused more specifically on eliciting feedback about techniques for aiding children in describing specific instances of repeated events. The techniques used are derived from a combination of empirical research and best practice interview guidelines. Data from both focus groups were compiled because themes were highly similar. Thematic analysis of the focus group discussions revealed three broad themes in prosecutors' perceptions about questioning children about repeated abuse: a) permitting children to provide a full generic account before describing individual episodes of abuse, b) using the information obtained during the generic account to create episode labels, and c) probing incidences of abuse chronologically. These themes are discussed within the context of the child development and mnemonic literature, and implications for interviewing protocols are drawn.

A novel anti-viral role for STAT3 in IFN-α signalling responses.

The cytokine, Interferon (IFN)-α, induces a wide spectrum of anti-viral mediators, via the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway. STAT1 and STAT2 are well characterised to upregulate IFN-stimulated gene (ISG) expression; but even though STAT3 is also activated by IFN-α, its role in anti-viral ISG induction is unclear. Several viruses, including Hepatitis C and Mumps, reduce cellular STAT3 protein levels, via the promotion of ubiquitin-mediated proteasomal degradation. This viral immune evasion mechanism suggests an undiscovered anti-viral role for STAT3 in IFN-α signalling. To investigate STAT3's functional involvement in this Type I IFN pathway, we first analysed its effect upon the replication of two viruses, Influenza and Vaccinia. Viral plaque assays, using Wild Type (WT) and STAT3-/- Murine Embryonic Fibroblasts (MEFs), revealed that STAT3 is required for the inhibition of Influenza and Vaccinia replication. Furthermore, STAT3 shRNA knockdown also enhanced Influenza replication and hindered induction of several, well characterised, anti-viral ISGs: PKR, OAS2, MxB and ISG15; while STAT3 expression had no effect upon induction of a separate ISG group: Viperin, IFI27, CXCL10 and CCL5. These discoveries reveal, for the first time, an anti-viral role for STAT3 in the IFN-α pathway and characterise a requirement for STAT3 in the expression of specific ISGs. These findings also identify STAT3 as a therapeutic target against viral infection and highlight it as an essential pathway component for endogenous and therapeutic IFN-α responsiveness.