Residential treatment is arguably the most costly and intensive part of the children's mental health system. Yet, research suggests that a subset of the emotionally disordered children and youth admitted to intensive tertiary care treatment facilities fail to demonstrate symptom reductions upon discharge, with many continuing to deteriorate in their adjustment during the follow-up period. This study reports on the factors that characterize the children and youth that, while showing marginal benefit from residential treatment, continue to show community conduct problems at a two-year follow-up period. The results are discussed in the context of how knowledge of these factors can help inform future treatment and research directions.
Children's centres are intended to be a mainstream, universal service. They began in 2004 and their origins are diverse. Some replaced various forms of local provision, most notably Sure Start programmes; others were established from scratch. Issues for exploratory empirical work have been identified from the guidance issued by central government. Using interview data from three urban local authorities, this article explores the nature of the 'core offer' that centres are expected to provide and the way in which they have pursued the goal of integrating staff and services. The article highlights the problems of balancing a focus on the child and on the parent; of reconciling childcare provision as part of the employability agenda and as a means to educational achievement for the child; of permitting local variation while achieving consistency; of the role of monitoring in relation to developing good practice; and of achieving integration in a mixed economy of care. We find that despite the greater specification of the core offer for children's centres compared to that for Sure Start, there are substantial differences between children's centres in terms of services, while the mixed economy of provision poses considerable challenges to the goal of integration.
The response of cold shock proteins to exercise and environmental temperature in human skeletal muscle is not known. The purpose of this study was to determine the early mRNA response of human stress proteins to endurance exercise and environmental temperatures. Seven recreationally trained males cycled for 1 hour at 60% VO 2peak in 7°C, 20°C, and 33°C with biopsies taken preand 3 hours post-exercise. Gene expression for heat shock and cold shock proteins were analyzed using qRT-PCR on muscle biopsy samples from the vastus lateralis. RBM3 mRNA was reduced 1.43 ± 0.10 fold (p = 0.006) while there was a trend for CIRP to decrease1.27 ± 0.14 fold (p = 0.059) from pre-to 3 h post-exercise. CIRP and RBM3 mRNA were not different between temperatures (p = 0.273 and p = 0.686, respectively). HSP70 mRNA was 2.27 ± 0.23 fold higher 3 h post-exercise when compared to pre-exercise (p = 0.002) but was not significantly different between temperatures (p = 0.103). HSP27, HSP90, and HSF1 mRNA did not change from pre-to post-exercise (p = 0.052, p = 0.324, p = 0.795) and were not different between temperatures (p = 0.247, p = 0.134, p = 0.808). These data indicate that exposure to mild heat and cold during aerobic exercise have limited effect on the skeletal muscle mRNA expression of heat shock and cold shock proteins. However, skeletal muscle mRNA of cold shock proteins decrease, while HSP70 mRNA increases in response to a low to moderate intensity aerobic exercise bout.
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