Home IV Antibiotic Therapy and Exercise Capacity in Children with CF: A Case Series

Purpose: This case series describes the effect of home intravenous (IV) antibiotic therapy on spirometry and exercise capacity in a group of children with cystic fibrosis (CF). Methods: Outcomes from 10 children with CF who were prescribed a 14-day course of home IV antibiotics for a respiratory exacerbation are reported. All children performed spirometry and a modified shuttle test (MST) before and after 14-days of home IV therapy. Results: After 14 days, FEV₁ increased by mean (± SE) 12 ± 4 % (p < 0.05) but mean MST did not improve compared to baseline. All children improved or maintained spirometry values with treatment, however, only 5 improved MST distance. Conclusion: After 14 days of home IV antibiotic therapy, a significant improvement in spirometry, but not exercise capacity, was seen in this small series of children with CF. The lack of improvement in exercise capacity for all children following home IV antibiotic therapy suggests factors other than spirometry determine exercise capacity. Identifying and investigating the factors that influence exercise capacity during home IV antibiotic therapy requires further investigation.Key Words: cystic fibrosis, home IV therapy, FEV₁, Modified Shuttle Test     

The Concept of Pastoral Care: A Genealogical Analysis

This article considers the implications of a small‐scale research project, undertaken by the authors, which used the example of the Massage in Schools Programme (a simple peer massage programme) to ascertain whether the planned use of touch‐based activity can support the growth of social and emotional skills in the primary classroom. Such claims are considered within the context of a modern society that is ill at ease with touch. Data, including observations of children and interviews with children and staff, were collected in two primary school classrooms pre, during and post the introduction of a six‐week massage programme, led by Massage in Schools practitioners. The findings of this project demonstrate that the number of social relationships reported by children did increase post intervention. The article goes on to consider the possible mechanisms by which this was achieved and features of the classroom context that may mediate the impact of the intervention. The authors conclude that a touch‐based intervention such as the Massage in Schools Programme may have a positive and potentially educational value for children and schools and support the growth of social and emotional skills.     

Quantifying risk associated with clinical trial termination: A text mining approach

Clinical trials that terminate prematurely without reaching conclusions raise financial, ethical, and scientific concerns. Scientific studies in all disciplines are initiated with extensive planning and deliberation, often by a team of highly trained scientists. To assure that the quality, integrity, and feasibility of funded research projects meet the required standards, research-funding agencies such as the National Institute of Health and the National Science Foundation, pass proposed research plans through a rigorous peer review process before making funding decisions. Yet, some study proposals successfully pass through all the rigorous scrutiny of the scientific peer review process, but the proposed investigations end up being terminated before yielding results. This study demonstrates an algorithm that quantifies the risk associated with a study being terminated based on the analysis of patterns in the language used to describe the study prior to its implementation. To quantify the risk of termination, we use data from the clinicialTrials.gov repository, from which we extracted structured data that flagged study characteristics, and unstructured text data that described the study goals, objectives and methods in a standard narrative form. We propose an algorithm to extract distinctive words from this unstructured text data that are most frequently used to describe trials that were completed successfully vs. those that were terminated. Binary variables indicating the presence of these distinctive words in trial proposals are used as input in a random forest, along with standard structured data fields. In this paper, we demonstrate that this combined modeling approach yields robust predictive probabilities in terms of both sensitivity (0.56) and specificity (0.71), relative to a model that utilizes the structured data alone (sensitivity = 0.03, specificity = 0.97). These predictive probabilities can be applied to make judgements about a trial's feasibility using information that is available before any funding is granted.     

The reliability of The Spatial Memory subtest on the K-ABC

The Spatial Memory subtest appears on the Simultaneous Processing scale of the Kaufman Assessment Battery for Children, and is intended for children from 5-0 through 12-5 years of age. The purpose of this study was to evaluate the interscorer reliability of this subtest, due to reported scoring difficulties. Nineteen gifted children between the ages of 8-10 and 12-2 were administered the Spatial Memory subtest, and two independent examiners scored each subject's item responses. Results showed that the Spatial Memory subtest may be prone to scoring errors because there is no permanent record of responses. It is suggested that a permanent record of responses could improve interscorer reliability significantly and simplify the task of scoring this subtest for practcing psychologists.