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Aim: The aim of this paper is to describe the implementation and evaluation of the Growing Strong Brains® (GSB) toolkit in a remote Aboriginal community in Western Australia (WA) over a 2-year period, 2018–2019. Background: Ngala, a community service organisation in WA, developed the GSB toolkit in 2014, a culturally appropriate and interactive resource to build knowledge of early childhood development within Aboriginal communities. This was in response to evidence that a higher percentage of children in Aboriginal communities were developmentally vulnerable compared to the rest of the population. The GSB toolkit promotes awareness and understanding of early brain development pre-birth and in the early years of a child’s life. Methods: The project was underpinned by participatory action research (PAR). Reflective PAR review cycles (n = 5) monitored local community engagement, navigated challenges and utilised community strengths. Fifty-nine local service providers attended a 2-day formal training. Data were collected by using various methods throughout the project, including feedback following training, focus groups, surveys, one-on-one interviews using yarning techniques and reflective feedback from the Project Lead. Findings: Establishing local Aboriginal project staff was pivotal to the success of the project. When delivering services for and with Aboriginal people, it is essential that cultural competence, safety and decision-making is carried through from planning to implementation and evaluation, and involves genuine, respectful and authentic relationships. Sufficient time allocation directed towards building relationships with other service providers and local community members needs to be considered and built into future projects. The Growing Strong Brains® project is embedded within the local community, and anticipated implementation outcomes were achieved. The support of the local people and service providers was beyond expectation, enabling the building of local capacity, and the development of a common understanding of the key messages from the GSB toolkit to allow integration throughout all levels of the community. This project has been important to build on the strategies necessary to introduce, implement and evaluate the GSB toolkit in other remote Aboriginal communities.

Aim: The successful embedding of father inclusive practice (FIP) in parenting and early childhood organisations is relatively new and therefore challenging to assess. The purpose of this study was to describe the process of adapting an existing tool, the Knowledge about fatherhood checklist (KAFC), to suit the parenting service context and apply the modified survey to establish a baseline of attitudes and practice of all staff at an established parenting and early childhood service in Western Australia, Ngala. Method: Following the application of the KAFC at Ngala in 2016, feedback provided by the staff led to a reflective and iterative process of review to adapt the KAFC. In 2018, all staff were asked to complete the adapted survey – the 23-item Father inclusive practice survey (FIP survey) – in order to assess the attitudes and behaviours of everyone in the organisation. The FIP survey covers aspects of competency as well as knowledge and attitudes in relation to fatherhood or father engagement. Results: Results indicated generally high levels of appreciation of the fathering role by Ngala staff. However, a number of areas for improvement in staff knowledge and attitudes were identified, including the benefit of reflecting on personal experiences of fathering, the awareness of the gendered stereotyped view of men, and the importance of the influence fathers can make in the context of attachment and breastfeeding. Conclusions: The implementation of this FIP survey informs improvements to staff orientation and training in FIP, and provides insights into staff attitudes, beliefs and practice regarding acknowledgement of the important contribution fathers make to the development and wellbeing of their children.

"Background: Early parenting services (EPS) in Australia provide a range of expanding and rapidly changing services, including innovative digital technologies to improve service access for metropol...

The present publication surveys several applications of in silico (i.e., computational) toxicology approaches across different industries and institutions. It highlights the need to develop standardized protocols when conducting toxicity-related predictions. This contribution articulates the information needed for protocols to support in silico predictions for major toxicological endpoints of concern (e.g., genetic toxicity, carcinogenicity, acute toxicity, reproductive toxicity, developmental toxicity) across several industries and regulatory bodies. Such novel in silico toxicology (IST) protocols, when fully developed and implemented, will ensure in silico toxicological assessments are performed and evaluated in a consistent, reproducible, and well-documented manner across industries and regulatory bodies to support wider uptake and acceptance of the approaches. The development of IST protocols is an initiative developed through a collaboration among an international consortium to reflect the state-of-the-art in in silico toxicology for hazard identification and characterization. A general outline for describing the development of such protocols is included and it is based on in silico predictions and/or available experimental data for a defined series of relevant toxicological effects or mechanisms. The publication presents a novel approach for determining the reliability of in silico predictions alongside experimental data. In addition, we discuss how to determine the level of confidence in the assessment based on the relevance and reliability of the information.

Accessible summaryWhat is known on the subject? According to estimates more than half of adult mental health service users are parents, but their experiences are largely lacking from research literature. Parental mental illness can often be viewed from a risk perspective. Parents with mental illness and their families have unmet support needs. What this paper adds to existing knowledge? Parents with mental illness want acknowledgement that they can be able and responsible. Many parents adopt an expert by experience identity. Fathers can feel their parental role is not recognized and mothers express fears of being judged if they discuss their illness. What are the implications for practice? Adult mental health services need to recognize and support parental role of service users. Joint care planning and family oriented care should be promoted. Professionals should take advantage of the knowledge of these parents and they could be more actively engaged in service development. AbstractIntroduction Parental mental illness is often viewed from a risk perspective. Despite this, being a parent can be both valuable and motivating. Research literature lacks the perspective of mothers and fathers, who have experienced mental illness. Aim This study explores how parents with mental illness construct their identities as mothers and fathers and their experiences with health and social care services. Method Three focus groups with 19 participants were conducted in Finland and Scotland. Methods of discourse analysis have been used in to analyse the interview data. Results Adult service users want their parenting role recognized and supported. Parents have knowledge and skills which can be utilized and many have adopted an expert by experience identity. Discussion Being able to see oneself as a ‘good’ parent can be challenging but important. Parents may require support, but want to be included in the planning of their care. Services could make more use of the knowledge and skills parents and families have, and joint working could lessen parents’ anxieties. Implications for practice Mental health practitioners are in a key position in providing more family centred, resource focused care. Service user expertise should be acknowledged in clinical practice.

The lack of pan-European guidelines for empowering children of parents with mental illness led to the EU project CAMILLE - Empowerment of Children and Adolescents of Mentally Ill Parents through Training of Professionals working with children and adolescents. The aim of this initial task in the project was to analyse needs, expectations and consequences for children with respect to living with a parent with mental illness from the perspective of professionals and family members. This qualitative research was conducted in England, Finland, Germany, Italy, Norway, Poland and Scotland with 96 professionals, parents with mental illness, adult children and partners of parents with mental illness. A framework analysis method was used. Results of the study highlighted that the main consequences described for children of parental mental illness were role reversal; emotional and behavioural problems; lack of parent's attention and stigma. The main needs of these children were described as emotional support, security and multidisciplinary help. Implications for practice are that professionals working with parents with mental illness should be aware of the specific consequences for the children and encourage parents in their parental role; multi-agency collaboration is necessary; schools should provide counselling and prevent stigma.

Background: Detection of clinically relevant pain relief in cats with degenerative joint disease (DJD) is complicated bya lack of validated outcome measures and a placebo effect.Hypothesis/Objectives: To evaluate a novel approach for detection of pain relief in cats with DJD.Animals: Fifty-eight client-owned cats.Methods: Prospective, double-masked, placebo-controlled, stratified, randomized, clinical study. Enrolled cats were6–21 years of age, with owner-observed mobility impairment, evidence of pain in at least 2 joints during orthopedic exami-nation, and overlapping radiographic evidence of DJD, and underwent a 2-week baseline period, 3-week treatment periodwith placebo or meloxicam, and 3-week masked washout period. Outcome measures were evaluated at days 0, 15, 36, and57.Results: Both groups significantly improved after the treatment period (day 36) on client-specific outcome measures(CSOM) and feline musculoskeletal pain index (FMPI) (P

A training package (pre-tested in a pilot phase) about supporting children who have parents with a mental illness and/or with substance misuse (COPMI) was developed and delivered to 131 different professionals from six different European Countries. A questionnaire about importance, awareness and competence on the issue (8 items on knowledge and 15 items on skills) was developed and completed by participants before and after the training. The training was evaluated by participants as generally very successful in terms of improving the importance, awareness and competence of their knowledge and skills, with a statistically significant difference in the pre-/post-analyses (no decreases occurred). Different professional groups performed differently in the pre-training self-rating scores. The participants in some countries were mainly drawn from one professional group (i.e. teachers in Finland, social workers in Germany and psychologists in Poland). It was found that stigma was considered an extremely important concern even before the training, whilst country-specific legal issues were not taken into proper account in the training. Some possibilities for further refinement of the training programme are suggested.

Toxicological risk assessments in the 21st century are increasingly being driven by the Adverse Outcome Pathways (AOP) conceptual framework in which the Molecular Initiating Event (MIE) is of fundamental importance to pathway progression. For those MIEs that involve covalent chemical reactions, such as protein haptenation, determination of relative rates and mechanisms of reactions is a prerequisite for their understanding. The utility of NMR spectroscopy as an experimental technique for effectively providing reaction rate and mechanistic information for early assessment of likely MIE(s) has been demonstrated. To demonstrate the concept, model systems exemplifying common chemical reactions involved in the covalent modification of proteins were utilized; these involved chemical reactions of electrophilic species (representing different mechanistic classes) with simple amine and thiol nucleophiles acting as surrogates for the reactive groups of lysine and cysteine protein side chains respectively. Such molecular interactions are recognized as critical mechanisms in a variety of chemical and drug toxicities, including respiratory and skin sensitization and liver toxicity as well as being the key mechanism of action for a number of therapeutic agents.

Rationale: The robust advances in pain management for companion animals underlie the decision of the American Animal Hospital Association (AAHA) and American Association of Feline Practitioners (AAFP) to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines. The 2015 Guidelines summarize and offer a discriminating review of much of this new knowledge. Relevance: Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian–client–patient relationship. These Guidelines support veterinarians in incorporating pain management into practice, improving patient care. Approaches: The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual patient basis. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention and treatment of pain in animals. Evidence base: The Guidelines include both pharmacologic and non-pharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. Post-surgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Chronic pain is dominated by degenerative joint disease (DJD), which is one of the most significant and under-diagnosed diseases of cats and dogs. DJD is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats.

Medical records where tepoxalin (Zubrin) or meloxicam (Metacam) were prescribed in cats were reviewed and data extracted. Comparisons were performed for exploring changes between pre- and post-non-steroidal anti-inflammatory drug course laboratory tests. Seventy-nine medical records fit the inclusion criteria (n = 57 and n = 22, tepoxalin and meloxicam, respectively). The median dosages administered were 13 and 0.029 mg/kg/day (tepoxalin and meloxicam, respectively). Median prescription durations were 11 (2–919) and 93 (4–1814) days for tepoxalin and meloxicam, respectively. Suspected adverse events were reported for tepoxalin (9%, 5/57 cats) and meloxicam (18%, 4/22 cats) a median of 774 and 448 days, respectively, after the prescription started. For cats prescribed meloxicam, there were several statistically significant changes for serum biochemistry and hematology parameters, but median values were within normal limits. These valuable clinical data suggest that tepoxalin and meloxicam are well tolerated in the clinical setting at the doses prescribed in this study.

This study evaluated the types of items owners consider important to their cats’ quality of life (QoL). We hypothesized that items contributing to QoL in cats are predominantly items requiring mobility. The objectives of the study were to describe the types of items considered important by owners for their cats’ QoL; to describe the proportion of these items that involve mobility; to evaluate what patient factors, including severity of degenerative joint disease (DJD), affect this distribution; and to evaluate whether the proportion of QoL items involving mobility chosen by owners is different in cats presenting for a DJD study compared with a randomly selected population. A total of 830 client-generated items were evaluated. Regardless of DJD status, 40% of items listed by owners involved mobility, while 60% were ‘inactive’ items, rejecting our hypothesis. This highlights the need to assess non-active items that owners consider to constitute QoL to fully assess the impact of diseases like DJD and, therefore, the success of therapeutic interventions.

Progress in establishing if therapies provide relief to cats with degenerative joint disease (DJD)-associated pain is hampered by a lack of validated owner-administered assessment methods.That an appropriately developed subjective owner-completed instrument (Feline Musculoskeletal Pain Index-FMPI) to assess DJD-associated impairment would have responsiveness and criterion validity.Twenty-five client-owned cats with DJD-associated pain.FMPI responsiveness (ability to detect the effect of an analgesic treatment) and validity (correlation with an objective measure) were explored through a stratified, randomized, double blinded, placebo-controlled, crossover 10-week clinical study. Meloxicam was administered to effect pain relief. A linear mixed model, backward stepwise regression, and Pearson correlations were used to assess responsiveness and criterion validity with the assumption that the NSAID would increase activity.Positive responses of cats to placebo (P = .0001) and meloxicam treatment (P = .0004) were detected; however, the instrument did not detect any difference between placebo and meloxicam (linear mixed model), even for the high impairment cases. Percent meloxicam target dose administered, temperament, and total baseline FMPI score were covariates that most affected FMPI scores. Controlling for significant covariates, most positive effects were seen for placebo treatment. Positive treatment effects on activity were detected, but only for the cases designated as most highly impaired.Neither responsiveness nor criterion validity were detected by the inclusion criteria for cases in this study. The data suggest that further work is indicated to understand factors affecting activity in cats to optimize inclusion criteria.

Objective—To determine the items (question topics) for a subjective instrument to assess degenerative joint disease (DJD)–associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners. Animals—100 randomly selected client-owned cats from 6 months to 20 years old. Procedures—Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system. Two groups were identified: high DJD pain and low DJD pain. Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain. Interviews with 45 cat owners were performed to generate items. Fifty-three cat owners who had not been involved in any other part of the study, 19 veterinarians, and 2 statisticians assessed 6 preliminary instrument designs. Results—22 cats were selected for each group; 19 important items were identified, resulting in 12 potential items for the instrument; and 3 additional items were identified from owner interviews. Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats. Conclusions and Clinical Relevance—Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain. Fifteen items were identified as being potentially useful, and the preferred instrument design was identified. This information could be used to construct an owner-based questionnaire to assess feline DJD-associated pain. Once validated, such a questionnaire would assist in evaluating potential analgesic treatments for these patients.

La Base de donnees compatibles sur le commerce et la production (COMTAP) de l'OCDE a ete etablie par la Banque mondiale, sous la supervision generale du Professeur Jean Waelbroeck de l'Universite Libre de Bruxelles. La Division des Statistiques Economiques et des Comptes Nationaux du Departement des Affaires Economiques et Statistiques est maintenant responsable de la gestion de cette base de donnees.Ce document decrit le contenu de la base de donnees, ainsi que certaines des exploitations analytiques auxquelles elle peut donner lieu. En suite, il examine certains problemes que posait la constitution de cette base. Il donne enfin des exemples de l'utilisation de COMTAP pour le calcul d'un indicateur determine de la "penetration du marche". Les annexes jointes presentent sous forme resumee certaines des donnees figurant dans les fichiers COMTAP.Contenu de la base de donneesLa Base de donnees compatibles sur le commerce et la production (COMTAP) comprend des statistiques annuelles ...