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Background: We investigated the effectiveness of Nurse‐Family Partnership (NFP), a prenatal‐to‐age‐two‐years home‐visiting programme, in British Columbia (BC), Canada. Methods: For this randomised controlled trial, we recruited participants from 26 public health settings who were: <25 years, nulliparous, <28 weeks gestation and experiencing socioeconomic disadvantage. We randomly allocated participants (one‐to‐one; computer‐generated) to intervention (NFP plus existing services) or comparison (existing services) groups. Prespecified outcomes were prenatal substance exposure (reported previously); child injuries (primary), language, cognition and mental health (problem behaviour) by age two years; and subsequent pregnancies by 24 months postpartum. Research interviewers were masked. We used intention‐to‐treat analyses. (ClinicalTrials.gov, NCT01672060.) Results: From 2013 to 2016 we enrolled 739 participants (368 NFP, 371 comparison) who had 737 children. Counts for child injury healthcare encounters [rate per 1,000 person‐years or RPY] were similar for NFP (223 [RPY 316.17]) and comparison (223 [RPY 305.43]; rate difference 10.74, 95% CI ‐46.96, 68.44; rate ratio 1.03, 95% CI 0.78, 1.38). Maternal‐reported language scores (mean, M [SD]) were statistically significantly higher for NFP (313.46 [195.96]) than comparison (282.77 [188.15]; mean difference [MD] 31.33, 95% CI 0.96, 61.71). Maternal‐reported problem‐behaviour scores (M [SD]) were statistically significantly lower for NFP (52.18 [9.19]) than comparison (54.42 [9.02]; MD ‐2.19, 95% CI −3.62, −0.75). Subsequent pregnancy counts were similar (NFP 115 [RPY 230.69] and comparison 117 [RPY 227.29]; rate difference 3.40, 95% CI ‐55.54, 62.34; hazard ratio 1.01, 95% CI 0.79, 1.29). We observed no unanticipated adverse events. Conclusions: NFP did not reduce child injuries or subsequent maternal pregnancies but did improve maternal‐reported child language and mental health (problem behaviour) at age two years. Follow‐up of long‐term outcomes is warranted given that further benefits may emerge across childhood and adolescence. [ABSTRACT FROM AUTHOR]

The goal of the present intervention research was to test whether guided invented spelling would facilitate entry into reading for at-risk kindergarten children. The 56 participating children had poor phoneme awareness, and as such, were at risk of having difficulty acquiring reading skills. Children were randomly assigned to one of three training conditions: invented spelling, phoneme segmentation, or storybook reading. All children participated in 16 small group sessions over 8 weeks. In addition, children in the three training conditions received letter-knowledge training and worked on the same 40 stimulus words that were created from an array of 14 letters. The findings were clear: on pretest, there were no differences between the three conditions on measures of early literacy and vocabulary, but, after training, invented spelling children learned to read more words than did the other children. As expected, the phoneme-segmentation and invented-spelling children were better on phoneme awareness than were the storybook-reading children. Most interesting, however, both the invented spelling and the phoneme-segmentation children performed similarly on phoneme awareness suggesting that the differential effect on learning to read was not due to phoneme awareness per se. As such, the findings support the view that invented spelling is an exploratory process that involves the integration of phoneme and orthographic representations. With guidance and developmentally appropriate feedback, invented spelling provides a milieu for children to explore the relation between oral language and written symbols that can facilitate their entry in reading.

Oral narrative skills are assumed to develop through parent-child interactive routines. One such routine is shared reading. A causal link between shared reading and narrative knowledge, however, has not been clearly established. The current research tested whether an 8-week shared reading intervention enhanced the fictional narrative skills of children entering formal education. Dialogic reading, a shared reading activity that involves elaborative questioning techniques, was used to engage children in oral interaction during reading and to emphasize elements of story knowledge. Participants were 40 English-speaking 5- and 6-year-olds who were assigned to either the dialogic reading group or an alternative treatment group. Analysis of covariance results found that the dialogic reading children's posttest narratives were significantly better on structure and context measures than those for the alternative treatment children, but results differed for produced or retold narratives. The dialogic reading children also showed expressive vocabulary gains. Overall, this study concretely determined that aspects of fictional narrative construction knowledge can be learned from interactive book reading. (Contains 3 tables.)

Books can be a rich source of learning for children and adults alike. In the present study, the contribution of shared reading and parent literacy to a variety of child outcomes was tested. Child outcomes included measures of expressive vocabulary, morphological and syntax comprehension, and narrative ability (story grammar, cohesion, and language complexity) for book stories as well as personal stories. A total of 106 English-speaking 4-year-old children and their parents participated. As predicted, shared reading accounted for unique variance in children's expressive vocabulary and morphological knowledge after controlling for child nonverbal intelligence, parent education, and parent literacy (i.e., book exposure). Although shared reading predicted syntax comprehension, the effect was mediated by parents' own level of literacy. Contrary to expectation, shared reading was not correlated with any of the narrative measures. Interestingly, the narrative measures for telling stories from a book and telling a personal story were not related to each other and were differentially related to the other child measures, suggesting that book and personal stories may represent different genres requiring different skills. (Contains 3 tables.)

It is well-recognized that patients with atopic dermatitis handle certain cutaneous viral infections poorly. As natural killer (NK) cell activity is considered to contribute to the immune response to viral infection, seven young adults with atopic dermatitis had their NK cell function assessed over a 12-month period. Natural killer cell activity was found to correlate inversely with disease activity. The more active the disease, the greater was the reduction in NK cell function (P < 0.01). In addition, a strong correlation between clinical activity and IgE was shown (P < 0.001). [ABSTRACT FROM AUTHOR]

Peripheral blood natural killer (NK) cell activity of a group of 10 healthy non-atopic volunteers was reduced following the topical application of 15 g of 0.1 % betamethasone valerate ointment to the skin nightly for 1 week. In contrast, no such effect was observed when the inactive base of the steroid ointment was used. NK cell activity dropped significantly by day 7 (P<005) and then recovered, although NK cell activity at day 22 was still lower than that observed at the start of the experiment. These findings suggest that topically applied steroid is absorbed in sufficient amounts to cause a systemic effect on NK cell function. This may have implications in a number of dermatological disorders, including atopic dermatitis, where topical steroids form the mainstay of treatment. [ABSTRACT FROM AUTHOR]

Nineteen young adults with chronic resistant atopic dermatitis participated in an open study of oral sodium cromoglycate given, in addition to standard topical therapy, over a 12-week period. Nine patients improved clinically. A significant improvement was demonstrated in the group as a whole when re-assessed clinically 8 weeks after the initial pre-treatment measurement. Side-effects were minimal. [ABSTRACT FROM AUTHOR]

In a controlled clinical trial, patients with atopic dermatitis carried out house dust mite eradication procedures on their mattresses, using natamycin or a matched placebo spray, with or without vacuum cleaning, for 4 months. For the two groups that used vacuum cleaning, mite numbers fell significantly both by comparison of mean initial and final numbers and by calculating mean rates of reduction from regression analyses (P < 0.01 in all cases). There were no differences between the groups in the magnitude of the decreases. For the two groups that did not use vacuum cleaning, mite populations remained virtually unchanged. These results indicate vacuum cleaning not natamycin had the major effect on mite eradication. Mean symptom scores of patients in all four groups were slightly reduced by the end of the trial, but there was a greater reduction rate (P < 0.01) in the combined scores of the groups that did not use vacuum cleaning, demonstrating a lack of correlation between improvement in clinical score and lowered mite numbers. No patients entered remission and the maximum improvement in clinical score was only 47%. Natamycin and vacuum cleaning neither alone nor in combination proved valuable in reducing mite numbers sufficiently to provide clinical benefit. [ABSTRACT FROM AUTHOR]

Forty-nine patients with atopic dermatitis entered a double blind placebo controlled cross-over study of mupirocin, a new topical antistaphylococcal antibiotic. Forty-five patients were evaluable. Quantitative bacteriological assessment before treatment showed that heavy colonization of the skin with Staphylococcus aureus was present in nearly all patients even in the absence of overt infection. However, the bacterial count was significantly reduced by 2 weeks' treatment with topical mupirocin, but not by the placebo. Moreover, a significant reduction of clinical severity was also observed after treatment with mupirocin, which was maintained over the following 4 weeks, although recolonization occurred during this period, with bacterial counts rising to pre-treatment levels. Despite recolonization, clinical deterioration was not observed during the trial period. No serious side-effects were observed. Phage typing showed that 50% of patients carried more than one bacterial phage type. Recolonization in eight patients (17%) was with a ‘new’ strain that had not previously been isolated. [ABSTRACT FROM AUTHOR]

Fourteen patients who received a bone marrow transplant (BMT) as treatment for leukaemia were included in a prospective study of the histological changes in the skin. The aim of this study was to improve the early diagnosis of graft-versus-host disease (GVHD). It was found that the clinically ‘normal’ pre-transplant skin was in some cases histologically abnormal on H & E examination in patients who were on regular maintenance cytotoxic chemotherapy. These changes were similar to some of the features of GVHD. Immunocytochemistry, although not specific, was found to be helpful in the diagnosis of some cases of GVHD. Suggestive features included a reduction in the numbers of Langerhans cells, an increase in the number of suppressor (OKT8+) cells in the dermal infiltrate and the presence of la positivity of the keratinocytes in the epidermis. [ABSTRACT FROM AUTHOR]

Fourteen adult patients with chronic atopic dermatitis and active skin lesions had a skin biopsy and venous blood sample taken on the same day. Absolute numbers of circulating lymphocytes were normal in all patients. Fluorescence-activated cell sorter (FACS) analysis revealed normal numbers of total T lymphocytes and T-helper and T- suppressor subsets (helper:suppressor ratio, 2:1) in the atopic patients' peripheral blood, but an increase in circulating B lymphocytes and in HLA-D-related antigen-bearing cells. The skin biopsy showed a dermal infiltrate of predominantly T-helper lymphocytes (helper: suppressor ratio, 7: 1). These cells showed strong HLA-DR plasma membrane staining. There was no HLA-DR staining in the membranes of epidermal keratinocytes. Using a monoclonal antihuman IgE, positive staining was observed in the dermis, though none was identified in the epidermis. The dermal anti-IgE staining was concentrated around clusters of T lymphocytes. [ABSTRACT FROM AUTHOR]