Friday, April 5, 2019

Literature Review: Looked After Children

Literature Review Looked After ChildrenLooked after sm all in all fryren is the legislative term for children and preadolescent people in public cautiousness introduced in the 1989 Children Act and includes children who ar flying field to supervision and live with family members as hale as looked after and accommodated children who live with foster c arrs or in residential aims or c are homes. (Scottish executive director 2007) The Children (Scotland) Act 1995 adopted the term looked after, taking a adept from the earlier Children Act 1989 in England and Wales, be commence the expression in care had become pejorative and stigmatising. (Connelly, Seibelt and Furniv all 2008) These children receive a right to expect to achieve the same facts of lifeal outcomes the Govern handst want for every child -to weaken the knowledge, skills and attributes they will destiny if they are to succeed in life, development and work, now and in the future. (Scottish Executive 2004 to date) (Department For Children, shoals And Families 2010)To result LAC to achieve these outcomes successfully, local authorities as corporate parents (meaning the formal and local partnerships needed between all local authority departments and services, and associated agencies, who are responsible for working together to meet the needs of looked after children and young people) should demonstrate the strongest commitment to helping every child to achieve the highest procreational standards he or she whitethornbe fuel. (Scottish Executive 2007)Looked after children and young people face many barriers to their success in education. We take these children into care to improve their life chances, though some do well, despite the difficulties faced in different aspects of their lives, the educational achievement of looked after children as a group remains unacceptably low. (Department For Children, Schools And Families 2010) (Scottish Executive 2007)(Connelly and Chakrabarti 2008) (Depa rtment For Children, Schools And Families 2009)(Coulling 2000)Table 1 shows both information about the judge levels for most children at different school stages and overly a comparison between the assessed levels for looked after children and non-looked after children nationally in 2003. This information has just been made ready(prenominal) publicly once and is no eight-day collected as a result of the developments associated with Curriculum for Ex cadrephoneence. The delay shows clearly the overall low achievement of looked after pupils compared with their non-looked after peers.Table 1 National opinion Data 2003 (Scottish Government 2004)School stageLevel attainedEnglish instructionEnglish ReadingEnglish WritingEnglish WritingMathsMathsNot LACLACNot LACLACNot LACLACP2A or higher up52%29%42%20%76%57%P3A or above88%74%85%69%95%89%P4B or above81%56%75%50%79%52%P5B or above92%73%88%64%92%73%P6C or above86%59%75%40%80%46%P7D or above73%34%60%20%69%24%However, as stated by the Scottish Government, this information is not complete. It only films information from two thirds of local authority areas. Lack of complete data on Looked after Children is an appear spoken about frequently in articles and floors. (Jacklin, Robinson, and Torrance 2006)However, it is believed that the overall trends, which show a widening of the growth go between children who are and are not looked after, with each(prenominal) school stage, are accurate.The Social Exclusion units report A Better Education for Children in fright (2003) set atomic play 23 key reasons why looked after children underachieve in educationtheir lives are characterised by instabilitythey spend too much date out of schoolthey do not bewilder sufficient help with their education if they fall tardilyprimary carers are not expected or equipped to provide sufficient support and rise for learning and development andthey have unmet emotional, mental and physical health needs that dissemble on their educationThese reasons are mirrored in new(prenominal) reports (Scottish Executive date unknown)(Scottish Government 2008)(Connelly, Seibelt and Furnivall 2008) but these in addition hint that some LAC face so many difficulties in their lives that schooling seems to be of low priority to them and to the agencies providing support. They send word that schooling is also often hapn insufficient priority when making and reviewing care plans.Despite the general perception in society that children in care are simply uninterested in learning, the vast major(ip)ity (97 per cent) consider education important, with nearly two-thirds (61 per cent) giving future employment as the reason8. Many admire school, with around a third (35 per cent) identifying specific subjects or learning as their favourite aspect. (Social Exclusion Unit 2003) The stigma of being looked after can cause isolation, low self-esteem, difficulty in making friends, and bullying. shop moves of placement and school disrupt education. Difficult life events can affect concentration and the ability to ramp up relationships. School can, potentially, be a very good and consistent escort for a looked after child or young person. (Scottish Executive date unknown)The children and young people themselves invariably theorize that education and educational attainment are important to them. They understand that how well they do at school with have an impact in their achievements in adulthood. (Scottish Government 2008)However, not all children in care have good experiences of school.They are 10 times more likely than others to be permanently excluded from school.Over a third say they have been excluded at some point.Six out of 10 say they have been bullied at school compared to roughly one in six of all children.One in eight missed five or more weeks schooling in 2001-2. (Social Exclusion Unit 2003)We believe the current levels of educational attainment can be transformed if the organization is changed so that the joint efforts of all those who care about the learning of these children can have their maximum effect. (Department For Children, Schools And Families 2009)Executive, S., 2007. Looked after Children Young People We can and must do Better.(Scottish Executive 2004 to date)Department For Children, S.A.F., 2010. Promoting the Educational Achievement of Looked After Children Statutory Guidance for Local Authorities,Connelly, G. Chakrabarti, M., 2008. Improving the educational experience of children and young people in public care a Scottish perspective. International Journal of comprehensive Education, 12(4), pp.347-361Department For Children, S.A.F., 2009. Improving the Educational Attainment of Children in care ( Looked after Children ) Attainment of Children in Care ( Looked after Children ),Social Exclusion Unit, 2003. Social Exclusion Unit Report A better education for children in care.,Scottish Executive (date unknown) About looked after children. http//www.looked afterchildrenscotland.org.uk/about/index.asp accessed on 7th October 2010Scottish Government, 2008. keep down Us In. Improving the Education of our Looked after Children.,Scottish Government (2004) Childrens Social Work Statistics 2003-04. Available online at http//www.scotland.gov.uk/Publications/2004/10/20121/45478 accessed 11th January 2011Connelly, G., Seibelt, L. Furnivall, J., 2008. Glasgow Project Report Supporting Looked After Children and Young People at School A Scottish Case Study. Assessment.Jacklin, A., Robinson, C. Torrance, H., 2006. When lack of data is data do we really know who our lookedafter children are? European Journal of Special Needs Education, 21(1), pp.1-20.Coulling, N., 2000. Definitions of Successful Education for the Looked After Child a Multi-agency Perspective. Support for Learning, 15(1), pp.30-35.Therapies for Cancer Treatment An AnalysisTherapies for Cancer Treatment An AnalysisImmunotherapyBetter understanding of the biota of crabmeat cells h as led to the development of biologic agents that mimic some of the natural signals that the body uses to condition cell growth. Clinical trials have shown that this crabmeat doment, calledbiological response modifier (BRM) therapy,biologic therapy,biotherapy, orimmunotherapy, is effective for some(prenominal) cancers. Some of these biologic agents, which occur naturally in the body, can now be made in the lab. Examples are interferons, interleukins, and other cytokines. These agents imitate or influence the natural immune response of the body. By fixture the cancer cell growth or by acting indirectly to help healthy cells control the cancer.One of the most exciting applications of biologic therapy has come from identifying certain tumor targets, called antigens, and aiming an antibody at these targets. This method was original use to find tumors and diagnose cancer and more recently has been used to treat cancer cells. Scientists commence monoclonal antibodies that are spec ifically targeted to chemical components of cancer cells. Refinements to these methods, using recombinant DNA technology, have improved the strong suit and decreased the side effects of these treatments. The first healing(p) monoclonal antibodies, rituximab (Rituxan) and trastuzumab (Herceptin) were approved during the late 1990s to treat lymphoma and breast cancer, respectively. Monoclonal antibodies are now routinely used to treat certain cancers.Scientists are also studying vaccines that boost the bodys immune response to cancer cells. For instance, a 2009 lymphoma study looked at personalized vaccines made from tissue from each patients tumor. Encouraging results showed that patients who received the vaccine lived longer disease-free than those who did not.In 2010, the FDA approved Sipuleucel-T (Provenge), a cancer vaccine for metastatic hormone-refractory prostate cancer (prostate cancer that has overspread and is no longer responding to hormone treatment). Unlike a preventi ve vaccine, which is given to prevent disease, Provenge boosts the bodys immune systems ability to attack cancer cells in the body. This treatment helps certain men with prostate cancer live longer, though it does not cure the disease.Targeted therapyUntil the late 1990s nearly all medicines used in cancer treatment (with the exception of hormone treatments) worked by killing cells that were in the abut of replicating their DNA and dividing to form 2 new cells. These chemotherapy drugs also killed some normal cells but had a greater effect on cancer cells.Targeted therapies work by influencing the processes that control growth, division, and spread of cancer cells, as well as the signals that cause cancer cells to die naturally (the way normal cells do when they are shamed or old). Targeted therapies work in several ways.Growth signal inhibitorsGrowth factors are hormone-like substances that help to secernate cells when to grow and divide. Their role in fatal growth and repair o f injured tissue was first recognized in the 1960s. Later it was realized that abnormal forms of growth factors or abnormally high levels of growth factors generate to the growth and spread of cancer cells. Researchers also started to understand how cells recognize and respond to these factors, and how that can lead to signals inside(a) the cells that cause the abnormal features found in cancer cells. Changes in these signal pathways have also been identified as a cause of the abnormal behaviour of cancer cells.During the 1980s, scientists found that many of the growth factors and other substances responsible for recognizing and responding to growth factor are actually products of oncogenes. Among the earliest targeted therapies that block growth signals are trastuzumab (Herceptin), gefitinib (Iressa), imatinib (Gleevec), and cetuximab (Erbitux). real enquiry has shown great promise for treatments in some of the more deadly and hard-to-treat forms of cancer, such as non- littler cell lung cancer, innovational kidney cancer, and glioblastoma. Second-generation targeted therapies, like dasatinib (Sprycel) and nilotinib (Tasigna), have already been found to produce faster and stronger responses in certain types of cancer and were better tolerated.Angiogenesis inhibitorsAngiogenesis is the creation of new line of credit vessels. The term comes from 2 Greek words angio, meaning blood vessel, and genesis, meaning beginning. Normally, this is a healthy process. New blood vessels, for instance, help the body heal wounds and repair damage tissues. But in a person with cancer, this same process creates new, very small blood vessels that give a tumor its own blood supply and allow it to grow.Anti-angiogenesis agents are types of targeted therapy that use drugs or other substances to stop tumors from making the new blood vessels they need to keep growing. This concept was first proposed by Judah kinship group man in the early 1970s, but it wasnt until 2004 that th e first angiogenesis inhibitor, bevacizumab (Avastin), was approved. Currently used to treat advanced colorectal, kidney, and lung cancers, bevacizumab is being studied as treatment for many other types of cancer, too. Many new drugs that block angiogenesis have become available since 2004.Apoptosis-inducing drugsApoptosis is a natural process by means of which cells with DNA too shamed to repair such as cancer cells can be forced to die. Many anti-cancer treatments (including radiation and chemotherapy) cause cell changes that eventually lead to apoptosis. But targeted drugs in this group are different, because they are aimed specifically at the cell substances that control cell survival and death.Novel Approaches for Cancer TreatmentLiposomes Liposomes were first introduced by Bangham in 1965 and afterwards became the most popular and versatile tool in controlled and targeted drug tar.Since liposomes were first described 45 years ago 19 they have gained interests for a variet y of applications including drug saving 20.Liposomes used for drug beary are usually about light speed nm in size and are made up of a single bilayer. As liposomes comprise an aqueous core sealed off by a PL membrane both hydrophilic and lipophilic drugs can be accommodated in their respective compartments 18.Liposomes consist of global lipidee bilayers that can be produced from phospholipids and cholesterol. Liposomes can encapsulate a variety of molecules, such as small drug molecules, proteins and many other bioactive(s). These vesicles are generally considered as biodegradable and imperceptibly immunogenic,and can also be used for a large number of biomedical applications. Recently, DOX and fluoxetine encapsulated liposomes have been reported to be effective formulation against drug-resistant MCF-7 cells. It was observed that liposomes significantly reduced tissue bio distribution of anticancer agents with improvedcytotoxicity. Liposomes are childly colloidal vesicles with an aqueous interior enclosed by a membrane usually composed of phospholipid (PL) molecules. PLs, the major components of biological membrane are amphiphilic compounds with a polar head group and lipophilic acyl chains. PLs can be classified according to type of polar head group, fatty acid chain length and degree of saturation.When bilayer forming PLs are dispersed in aqueous media they will spontaneously align themselves in a manner to reduce interactions between the polar media and the hydrophobic fatty acid chains. Consequently, bilayer structures, i.e. liposomes, whitethorn be formed. Liposomes may consist of one or more bilayers (lamellae) and of sizes ranging from tens of nanometres to tens of micrometres in diameter. For a review see 17. Liposomes are mostly classified into small unilamellar vesicles (SUV) single bilayer, size 10 100 nm), large unilamellar vesicles (LUV) single bilayer, size 100 1000 nm), multilamellar vesicles (MLV), several bilayers, size 100 nm 20 um and multivesicular vesicles (MVV), size 100 nm 20um). directly there are about 15 liposomal based formulationdrugs approved for clinical applications or undergoing clinical evaluation,Liposomes in cancer treatment Conventional cytostatic used in cancer treatment are small molecular weight molecules 4. Such molecules distribute non-specifically to both healthy and tumour tissue resulting in therapy limiting toxicities. To ontogeny the healing(predicate)-to-toxicity ratio cytostatic can be encapsulated into small liposomes (100 nm), which accumulate in tumours delinquent to the 14enhanced permeability and memory board effect 21. Here, leaky tumour vessels allow macromolecules to extravagate into tumour tissue, whilst reduced lymphatic tumour drainage results in particle accumulation. First generation liposomes used for drug legal transfer suffered from fast clearance by cells of the monocyte scavenger cell system (MPS). By coating liposomes with polyethylene glycol ( arrest), i .e. PEGylated liposomes, adhesion of plasma proteins and opsonin to liposomes are decreased. Consequently, immune system recognition is reduced, decreasing MPS uptake and prolongs circulation time 22. Today, most liposomes used for drug delivery are PEGylated. Cancer is a class of diseases. Which is characterized by out-of-control cell growth.There are over 100 different types of cancer, and each is classified by the type of cell that is initially affected.Nanotechnology has been extensively exploited to improve conventional cancer therapy in the recent years 15. The designed nanocarriers for achieving precise drug delivery to cancer cells are expected to be non-cytotoxic, efficiently load the drugs, enhance the circulation time in bloodstream, and actively target the cancer cells6. The nanocarriers presently under intensive investigation can be divided into two categories in generalise. The lipid-based and the polymer-based with liposomes and polymeric nanoparticle as their typica l representative respectively. Liposomes, the spherical vesicles formed by single or multiple lipid bilayer, have been widely used due to their high biocompatibility, favourable pharmacokinetic profile, high delivery efficiency and ease of approach modification. In the recent years, several liposomal drug formulations have been approved for clinical use 7.Limitations of liposomal drug delivery include insufficient drug loading, fast drug release, and instability in storage 8.Historically, lipids have been used for several decades in various drug delivery systems including liposomes solid lipid NPs, nano merged lipid carriers, andlipiddrug conjugates. Over the last decade, lipid based nano carriers are viewed as potential tool to encapsulate and deliver variety of pharmaceutical actives44,45. The solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) are the first and second generation of lipid nanoparticles, respectively. The SLNs are composed of solid lipid or a blend of solid lipids while NLCs contain a mixed lipid core (solid fat and oil)45. generally regarded as safe GRAS nature of lipid and the structural integrity of the polymer. Thus far, the polymers such as polylactic-co-glycolic acid (PLGA) 46,47, hydrolysed polymer of epoxidized soybean oil (HPESO) 48,49, dextran 50, polyethyleneimine (PEI) 51, LPNs, are alert by at least three main components are i.e., the lipid, the polymer, and a drug. The first way to get to the LPNPs is to mix the polymeric NPs with liposomes to form the lipid- pillory and polymer-core nanoparticles such as lipoparticles where the lipid bilayer or lipid multilayer of the liposomes fuses on the come in of the polymeric NPs.5253 The second way to prepare the LPNPs has advantage over the first way in formulating the structured NPs in a single step and thus provides a simpler technology, which combines the nanoprecipiation method and the self-assembly technique to produce the desire structured NPs of lipid shell and polymer core 54,55Folic acid is selected as the model molecular probe for targeted delivery of the drug to the cancer cells of folate overexpression such as certain breast cancer and ovarian cancer cells. Poly (lactide-co-glycolide) (PLGA), one of the most popular FDA approved non-cytotoxic and biodegradable polymers,is used to form the polymer core matrix, which is wrapped by the mixed lipid monolayer shell of three distinct functional components(i) 1,2-dilauroylphosphatidylocholine (DLPC), a phospholipid of an appropriate hydrophilic-lipophilic balance (HLB) treasure which is employed to stabilize the NPs in the aqueous phase(ii) 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy(polyethylene glycol)-2000 (DSPE-PEG2k), a PEGlyated DSPE to facilitate stealth NPs formulation to range from recognition by the reticuloendothelial system (RES) and thus increase the systemic circulation time of the LPNPs28,29,and(iii)1,2-distearoyl-snglycero-3-phosphoethanolamineNfola te(polyethylene glycol)-5000 (DSPE-PEG5k-FOL), a PEGylated DSPE of longer PEG chains for the LPNPs to be functionalized by folic acid conjugation for targeted delivery purpose. extremelyparamagnetic compress oxide nanoparticles (SPIONS as delivery systems)Super paramagnetic iron oxide nanoparticles (SPION) have emerged as an magnetic resonance imagery contrast agent for tumor imaging due to their efficacy and safety. Their utility has been proven in clinical applications with a series of marketed SPION-based contrast agents. Extensive research has been performed to study various strategies that could improve SPION by tailoring the surface chemistry and by applying additional therapeutic functionality. Research into the dual-modal contrast uses of SPION has developed because these applications can save time and effort by reducing the number of imaging sessions. In addition to multimodal strategies, efforts have been made to develop multifunctional nanoparticles that carry both diag nostic and therapeutic cargos specifically for cancer. Advances in nanotechnology have permitted new possibilities for theranostics, which are defined as the combination of therapy and imaging inwardly a single platform 56, 57. Nanotechnology is apply to molecular imaging in the form of imaging probes open of enhancing the sensitivity of the image and the specificity toward the target tissue. Usually, the imaging probeconsists of nanoparticles conjugated with active targeting ligands 58, 59.Superparamagnetic iron oxide nanoparticles (SPION) have a superparamagnetic iron core, which makes them useful as T2 contrast agents for MRI. SPION can be detected withhigh sensitivity, and both the iron and polymer components of SPION are biocompatible and degradable 60.The size of iron oxide nanoparticles plays a major rolein target cell uptake and elimination from the body. Spleen and liver mystify nanoparticles of more than 200 nm in diameter whereas particles having sizes below 10 nm are selectively filtered by renal systems and eliminated from body 61.The majority of nanoparticles in development include drug conjugates and complexes, micelles, dendrimers, vesicles, coreshell particles, microbubbles, and carbon nanotubes 62.Dendrimer-based Nanoparticles for Cancer TreatmentNanotechnology has led to a remarkable convergence of disparate fields including biology, applied physics, optics, computational analysis, and modeling, as well as materials science. Because of this, the application of nano scale analytical, computational, and synthetic approaches to understanding and manipulating complex biological systems offers incredible potential for advances in the diagnosis and treatment of cancer. Recent work has suggested that nanoparticles in the form of dendrimers may be a keystone in the future of therapeutics. The field of oncology could soon be revolutionized by novel strategies for diagnosis and therapy employing dendrimer-based nano therapeutics. Several aspects of cancer therapy would be subscribe tod. Diagnosis using imaging techniques such as MRI will be improved by the incorporation of dendrimers as advanced contrast agents. This might involve novel contrast agents targeted specifically to cancer cells. Dendrimers can also be being applied to a variety of cancer therapies to improve their safety and efficacy. A strategy, somewhat akin to the Trojan horse, involves targeting anti-metabolite drugs via vitamins or hormones that tumors need for growth. Further applications of dendrimers in photodynamic therapy, boron neutron capture therapy, and gene therapy for cancer are being examined.Most cancer therapeutics are small drug molecules that after being ingested or injected into the bloodstream can easily diffuse through vascular pores and the extracellular matrix to reach tumors. Complex therapeutics that involve drug delivery mechanisms or imaging moieties have tended to be much larger. While the exact size of molecules thatcan easily tr ansverse vascular pores from the bloodstream and reach tumor tissue is unclear, it is probably limited to the size of proteins (

No comments:

Post a Comment