Literature Review: Looked After Children

Literature Review Looked After ChildrenLooked by and by children is the legislative term for children and green people in public c be introduced in the 1989 Children Act and accepts children who argon subject to supervision and live with family members as well as looked after and accommodated children who live with foster carers or in re fountntial schooldayss or care homes. (stinting Executive cc7) The Children (Scotland) Act 1995 adopted the term looked after, taking a lead from the earlier Children Act 1989 in England and Wales, because the expression in care had construct pejorative and stigmatising. (Connelly, Seibelt and Furniv all 2008) These children have a right to expect to achieve the same educational outcomes the Government want for every child -to develop the knowledge, skills and attributes they will motivating if they are to succeed in life, learning and survey, now and in the future. (Scottish Executive 2004 to date) (Department For Children, Schools And Famili es 2010)To allow LAC to achieve these outcomes victoryfully, local authorities as corporate parents (meaning the drawal and local partnerships needed between all local authority departments and services, and associated agencies, who are responsible for dissembleing together to meet the needs of looked after children and young people) should demonstrate the strongest dedication to helping every child to achieve the highest educational standards he or she possibly can. (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 other 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) (Department For Children, Schools And Families 2009)(Coul ling 2000) circuit board 1 shows both(prenominal)(prenominal) information about the expected levels for nigh children at disparate school stages and also a comparison between the assessed levels for looked after children and non-looked after children nationally in 2003. This information has only been make available publicly erstwhile and is no longer collected as a result of the developments associated with Curriculum for Excellence. The table shows clearly the overall low achievement of looked after pupils compared with their non-looked after peers.Table 1 National Assessment Data 2003 (Scottish Government 2004)School stageLevel attainedEnglish ReadingEnglish ReadingEnglish opusEnglish WritingMathsMathsNot LACLACNot LACLACNot LACLACP2A or above52%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 n ot complete. It only contains information from ii thirds of local authority areas. Lack of complete info on Looked after Children is an issue spoken about frequently in articles and reports. (Jacklin, Robinson, and Torrance 2006)However, it is believed that the overall trends, which show a widening of the attainment gap between children who are and are not looked after, with each school stage, are accurate.The companionable Exclusion Units report A Better Education for Children in Care (2003) identified vanadium key reasons why looked after children underachieve in educationtheir lives are characterised by instabilitythey spend too much time out of schoolthey do not have sufficient help with their education if they fall behindprimary carers are not expected or equipped to forget sufficient support and encouragement for learning and development andthey have unmet emotional, mental and physical health needs that impact on their educationThese reasons are reflect in other reports (Scottish Executive date unknown)(Scottish Government 2008)(Connelly, Seibelt and Furnivall 2008) but these also suggest 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 suggest that schooling is also often given insufficient priority when making and surveiling care plans.Despite the common perception in society that children in care are simply uninterested in learning, the vast majority (97 per cent) consider education important, with nearly two-thirds (61 per cent) giving future affair as the reason8. Many enjoy school, with around a third (35 per cent) identifying specific subjects or learning as their favourite aspect. (Social Exclusion Unit 2003) The stigma of macrocosm looked after can cause isolation, low self-esteem, difficulty in making friends, and bullying. Frequent moves of placement and school disrupt education. Difficult life events can move concentration and the a bility to make relationships. School can, potencely, be a very good and consistent experience for a looked after child or young person. (Scottish Executive date unknown)The children and young people themselves invariably joint 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 generation 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 carcass is changed so that the joint efforts of all those who care about the learning of these c hildren 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 Inclusive 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.lookedafterchildrenscotland.org.uk/about/index.asp accessed on 7th October 2010Scottish G overnment, 2008. Count 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 eleventh 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 crabby person intercession An AnalysisTherapies for Cancer Treatment An AnalysisImmunotherapyBetter understanding of the biology of cancer cells has led to the development of biologic agents that mimic some of the in dwelling types that the dust uses to control cell harvest-time. Clinical trials have shown that this cancer workment, calledbiological response modifier (BRM) therapy,biologic therapy,biotherapy, orimmunotherapy, is effective for several(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 tolerant response of the body. By altering the cancer cell growth or by acting indirectly to help healthy cells control the cancer.One of the around exciting applications of biologic therapy has come from identifying certain tumour targets, called antigens, and aiming an antibody at these targets. This method was first use to find tumors and diagnose cancer and more recently has been employ to treat cancer cells. Scientists produce monoclonal antibodies that are specifically targeted to chemical components of cancer cells. Refinements to these methods, using recombinant DNA technology, have improved the effectiveness and decreased the side effects of these treatments. The first therapeutic 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 apply 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 prostatic cancer (prostate cancer that has mobilise and is no longer responding to hormone treatment). Unlike a preventive vaccine, which is given to prevent disease, Proveng e 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 drugs used in cancer treatment (with the exception of hormone treatments) worked by killing cells that were in the process 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 break up of cancer cells, as well as the signals that cause cancer cells to die naturally (the way normal cells do when they are damaged or old). Targeted therapies work in several ways.Growth signal inhibitorsGrowth factors are hormone-like substances that help to tell cells when to grow and divide. Their role in fatal growth and repair of hurt tissue was first recognized in the 1960s. Later it w as realized that abnormal forms of growth factors or abnormally high levels of growth factors contribute 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 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). Current research has shown great promise for treatments in some of the more fiendishly and hard-to-treat forms of cancer, such as non-small cell lung cancer, advanced 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 domain of new blood 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 damaged 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 sentiment was first proposed by Judah Folk man in the early 1970s, but it wasnt until 2004 that the first angiogenesis inhibitor, bevacizumab (Avastin), was approved. Currently used to treat advanced colorectal, kidney, and lung cancers, bevacizumab is being analyse 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 done which cells with DNA too damaged to repair such as cancer cells can be forced to die. Many anti-cancer treatments (including radiation and chemotherapy) cause cell changes that at last 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 delivery.Since liposomes were first described 45 years agone 19 they have gained interests for a multifariousness of applications including drug delivery 20.Liposomes used for drug delive ry are usually about 100 nm in surface and are made up of a single bilayer. As liposomes comprise an aqueous core sealed off by a PL tissue layer both hydrophilic and lipophilic drugs can be accommodated in their respective compartments 18.Liposomes consist of spherical lipid 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 stiffend tissue bio dispersal of anticancer agents with improvedcytotoxicity. Liposomes are simple colloidal vesicles with an aqueous interior enclosed by a membrane usually make up 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, bufflehead 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, may 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 broadly 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).Today 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 increase the therapeutic-to-toxicity ratio cytostatic can be encapsulated into small liposomes (100 nm), which accumulate in tumours due to the 14enhanced permeability and retention effect 21. Here, leaky tumour vessels allow macromolecules to extravagate into tumour tissue, whilst reduced lymphatic tumour drainage results in particle accumulation. original generation liposomes used for drug delivery suffered from fast clearance by cells of the monocyte phagocyte system (MPS). By coating liposomes with polyethylene glycol (PEG), 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, expeditiously load the drugs, enhance the circulation time in bloodstream, and actively target the cancer cells6. The nanocarriers currently 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 typical representative respectively. Liposomes, the spherical vesicles formed by single or multiple lipid bilayer, hav e been widely used due to their high biocompatibility, favourable pharmacokinetic profile, high delivery efficiency and ease of surface 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 structured 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 saf e 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 prepared by at least three main components are i.e., the lipid, the polymer, and a drug. The first way to prepare the LPNPs is to mix the polymeric NPs with liposomes to form the lipid-shell and polymer-core nanoparticles such as lipoparticles where the lipid bilayer or lipid multilayer of the liposomes fuses on the surface 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 desired structured NPs of lipid shell and polymer core 54,55Folic acid is selected as the toughie 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) value 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 escape 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-phosphoethanolamineNfolate(polyethylene glycol)-5000 (DSPE-PEG5k-FOL), a PEGylated DSPE of longer PEG chains for the LPNPs to be functiona lized by folic acid conjugation for targeted delivery purpose.Superparamagnetic atomic number 26 oxide nanoparticles (SPIONS as delivery systems)Super paramagnetic iron oxide nanoparticles (SPION) have emerged as an MRI 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 diagnostic 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 within a single platform 56, 57. Nanotechnology is applied to molecular imaging in the form of imaging probes capable of enhancing the sensitivity of the take in 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 capture 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 conjug ates 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(prenominal) aspects of cancer therapy would be involved. Diagnosis using imaging techniques such as MRI will be improved by the incorporatio n 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 advantageously 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 transverse vascular pores from the bloodstream and reach tumor tissue is unclear, it is probably limited to the size of proteins (