Genomic instability in human lymphocytes irradiated with individual charged particles: Involvement of tumor necrosis factor a in irradiated cells but not bystander cells

Exposure to ionizing radiation can increase the risk of cancer, which is often characterized by genomic instability. In environmental exposures to high-LET radiation (e.g. Ra-222), it is unlikely that many cells will be traversed or that any cell will be traversed by more than one alpha particle, resulting in an in vivo bystander situation, potentially involving inflammation. Here primary human lymphocytes were irradiated with precise numbers of He-3(2+) ions delivered to defined cell population fractions, to as low as a single cell being traversed, resembling in vivo conditions. Also, we assessed the contribution to genomic instability of the pro-inflammatory cytokine tumor necrosis factor alpha (TNFA). Genomic instability was significantly elevated in irradiated groups ( greater than or equal totwofold over controls) and was comparable whether cells were traversed by one or two He-3(2+) ions. Interestingly, substantial heterogeneity in genomic instability between experiments was observed when only one cell was traversed. Genomic instability was significantly reduced (60%) in cultures in which all cells were irradiated in the presence of TNFA antibody, but not when fractions were irradiated under the same conditions, suggesting that TNFA may have a role in the initiation of genomic instability in irradiated cells but not bystander cells. These results have implications for low-dose exposure risks and cancer. (C) 2005 by Radiation Research Society.

Supported Housing for People with Severe Mental Disorders

Background There has been a significant reduction in the number of people with severe mental illness who spend extended periods in long-stay hospitals. District health authorities, local authorities, housing associations and voluntary organisations are jointly expected to provide support for people with severe mental disorder/s. This 'support' may well involve some kind of special housing. Objectives To determine the effects of supported housing schemes compared with outreach support schemes or 'standard care' for people with severe mental disorder/s living in the community. Search methods For the 2006 update we searched the Cochrane Schizophrenia Group Trials Register (April 2006) and the Cochrane Central Register of Controlled Trials (CENTRAL, 2006 Issue 2). Selection criteria We included all relevant randomised, or quasi-randomised, trials dealing with people with 'severe mental disorder/s' allocated to supported housing, compared with outreach support schemes or standard care. We focused on outcomes of service utilisation, mental state, satisfaction with care, social functioning, quality of life and economic data. Data collection and analysis We reliably selected studies, quality rated them and undertook data extraction. For dichotomous data, we would have estimated relative risks (RR), with the 95% confidence intervals (CI). Where possible, we would have calculated the number needed to treat statistic (NNT). We would have carried out analysis by intention-to-treat and would have summated normal continuous data using the weighted mean difference (WMD). We would have presented scale data for only those tools that had attained pre-specified levels of quality and undertaken tests for heterogeneity and publication bias. Main results Although 139 citations were acquired from the searches, no study met the inclusion criteria. Authors' conclusions Dedicated schemes whereby people with severe mental illness are located within one site or building with assistance from professional workers have potential for great benefit as they provide a 'safe haven' for people in need of stability and support. This, however, may be at the risk of increasing dependence on professionals and prolonging exclusion from the community. Whether or not the benefits outweigh the risks can only be a matter of opinion in the absence of reliable evidence. There is an urgent need to investigate the effects of supported housing on people with severe mental illness within a randomised trial.

Developing Evidence-Based Practice in Child Protection

This article argues for the adoption of an evidence-based approach to decision-making in child protection. Such a change hinges upon the availability of good quality, up-to-date evidence that is readily accessible to practitioners and policy-makers. Following a resume' of the arguments for recognizing controlled trials as methodologically superior to other forms of methodology in evaluating professional interventions, the article presents the case for adopting a similarly rigorous approach to synthesizing research findings. It then identifies a range of obstacles to promoting evidence-based practice and makes recommendations for changes in training, research, and practice which might facilitate improvement in both primary research and in reviews of the literature.

Changing one's mind: the final frontier?

Considerable interest is being shown these days in evidence-based approaches to social work. In both health and social care there is increased emphasis on the quality of original research and reviews of research, and on the organized dissemination of findings. However, a number of formidable obstacles stand in the way of the achievement of such aims in our field. Some are organizational ; some are to do with the way in which the social work training is organised and managed, and some are psychological. Each of these sets of factors is reviewed in this article .