Poly-ligand profiling differentiates trastuzumab-treated breast cancer patients according to their outcomes.

Assessing the phenotypic diversity underlying tumour progression requires the identification of variations in the respective molecular interaction networks. Here we report proof-of-concept for a platform called poly-ligand profiling (PLP) that surveys these system states and distinguishes breast cancer patients who did or did not derive benefit from trastuzumab. We perform tissue-SELEX on breast cancer specimens to enrich single-stranded DNA (ssDNA) libraries that preferentially interact with molecular components associated with the two clinical phenotypes. Testing of independent sample sets verifies the ability of PLP to classify trastuzumab-treated patients according to their clinical outcomes with ROC-AUC of 0.78. Standard HER2 testing of the same patients gives a ROC-AUC of 0.47. Kaplan-Meier analysis reveals a median increase in benefit from trastuzumab-containing treatments of 300 days for PLP-positive compared to PLP-negative patients. If prospectively validated, PLP may increase success rates in precision oncology and clinical trials, thus improving both patient care and drug development.

Is it trichotillomania? Hair pulling in childhood: a developmental perspective.

A cohort of children with hair pulling as the presenting symptom was followed up to enhance clinical understanding of the nature of hair-pulling behaviour in childhood. Thirty-eight children were clinically assessed for a diagnosis of trichotillomania, co-morbidity, co-existing habits and other relevant factors. Intervention consisted of a combination of behavioural strategies, self-esteem work, supportive family approaches, attachment-focused parenting models and medication. In this group of children it was difficult to define their symptoms as a clinical diagnosis of trichotillomania, using ICD-1O/DSM-IV. This article concludes that hair pulling, as a symptom in children, is a heterogeneous condition. It is useful to approach this issue from a developmental perspective. Our data warrant reappraisal of the diagnosis of trichotillomania in childhood. We explore the framework of a developmental continuum to understand and manage the problem of hair pulling in childhood.

Dealing with suicidal thoughts in schools: information and education directed at secondary schools.

OBJECTIVE: Current practice in Australia is to avoid discussing suicide or suicidal ideation directly with students in school suicide prevention programs. This paper examines why there is a strong argument to question this approach in the context of a continuing unacceptable rate of youth suicide in this country. METHODS: A review of the literature that informs the debate was conducted. Using an action research methodology, a more direct intervention approach was taken based on the use of the 'Toughin' it out' pamphlet. RESULTS: A misrepresentation of the evidence surrounding school-based suicide intervention programs in Australia has made educators and guidance officers wary of being more direct with suicide prevention programs. The experience of several practitioners in northern Australia suggests that it is highly beneficial to engage students in discussions about suicide and how to deal with suicidal thoughts. Their impression is that this has led to a lessening of suicide attempts in high-risk situations and there has been no evidence of any adverse outcome. CONCLUSION: The ongoing tragedy of Indigenous adolescent suicide in Australia demands that all possible interventions should be considered. Taking a more direct approach to school suicide prevention and life-promoting programs using the brief intervention tool, the 'Toughin' it out' pamphlet, appeared to be associated with a positive impact on suicide in high-risk secondary schools in northern Australia. The positive experience in northern Australia would support a similar approach being considered in school programs nationally.

Adapting the 'family wellbeing' empowerment program to the needs of remote indigenous school children.

OBJECTIVE: To adapt the Family Wellbeing empowerment program, which was initially designed to support adults to take greater control and responsibility for their decisions and lives, to the needs of Indigenous school children living in remote communities. METHOD: At the request of two schools in remote Indigenous communities in far north Queensland, a pilot personal development and empowerment program based on the adult Family Wellbeing principles was developed, conducted and evaluated in the schools. The main aims of the program were to build personal identity and to encourage students to recognise their future potential and be more aware of their place in the community and wider society. RESULTS: Participation in the program resulted in significant social and emotional growth for the students. Outcomes described by participating students and teachers included increased analytical and reflective skills, greater ability to think for oneself and set goals, less teasing and bullying in the school environment, and an enhanced sense of identity, friendship and 'social relatedness'. CONCLUSION: This pilot implementation of the Family Wellbeing Program adapted for schools demonstrated the program's potential to enhance Indigenous young people's personal growth and development. Challenges remain in increasing parental/ family involvement and ensuring the program's sustainability and transferability. The team has been working with relevant stakeholders to further develop and package the School-based Family Wellbeing program for Education Queensland's New Basics curriculum framework.