May 06, · This case study is on a young girl named Hannah. She was observed in a classroom at the Early Learning Center. She is 4 years old. She is the only child, and lives with her father and grandmother. Throughout the paper, it compares Hannah’s development to what develop mentalist say is normal. The paper is focused primarily on Sep 17, · How to Write a Case Study Outline. A case study outline is a useful way for an educational instructor to see that a student is on track to successfully complete writing a case study analysis and identify any potential problems before the student begins working on the study Table of Contents. 1 Case Study Templates; 2 Common types of case study templates; 3 Case Study Examples; 4 Benefits of using case study templates in businesses; 5 Case Study Formats; 6 Tips for writing a case study template; 7 Case Analysis Formats. Decide on the type of case study you will perform; Reach out to potential participants for your case study; Prepare your questions
Case Study Template - RCOT
For more information about PLOS Subject Areas, click here. The presence of measles virus MV RNA in bowel tissue from children with autism spectrum disorders ASD and gastrointestinal GI disturbances was reported in Subsequent investigations found no associations between MV exposure and ASD but did not test for the presence of MV RNA in bowel or focus on children with ASD and GI disturbances. Failure to replicate the original study design may contribute to continued public concern with respect to the safety of the measles, mumps, and rubella MMR vaccine.
The sample was an age-matched group of US children undergoing clinically-indicated ileocolonoscopy. Ileal and cecal tissues from 25 children with autism and GI disturbances and 13 children with GI disturbances alone controls were evaluated by real-time reverse transcription RT -PCR for presence of MV RNA in three laboratories blinded to diagnosis, including one wherein the original findings suggesting a link between MV and ASD were reported, case study template for children.
The temporal order of onset of GI episodes and case study template for children relative to timing of MMR administration was examined. We found no differences between case and control groups in the presence of MV RNA in ileum and cecum. Results were consistent across the three laboratory sites.
GI symptom and autism onset were unrelated to MMR case study template for children. Eighty-eight percent of ASD cases had behavioral regression. This study provides strong evidence against association of autism with persistent MV RNA in the GI tract or MMR exposure. Case study template for children with GI disturbances is associated with elevated rates of regression in language or other skills and may represent an endophenotype distinct from other ASD.
Citation: Hornig M, Briese T, Buie T, case study template for children, Bauman ML, Lauwers G, Siemetzki U, et al. PLoS ONE 3 9 : e Editor: Mark R. Cookson, National Institutes of Health, United States of America.
Received: June 29, ; Accepted: August 8, ; Published: September 4, case study template for children, This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. Funding: This work was supported by CDC grant U50 CCU to AAP and by National Institutes of Health awards AI Northeast Biodefense Center-LipkinHL, and NS Role of Study Sponsors: Members of the funding organization AAP and its sponsor CDC participated along with experts in virology and neurovirology, case study template for children, autism pathogenesis, and vaccine design and safety; representatives of the autism advocacy community; and study collaborators in an Oversight Committee that reviewed and agreed to all aspects of study design prior to data collection.
The final decision to submit for publication was the responsibility of all study collaborators. Competing interests: Authors JOL and OS were compensated for expert witness statements concerning MMR vaccine and autism on behalf of claimants in litigation in the United Kingdom. Beginning inWakefield and colleagues reported intestinal abnormalities, including reactive lymphoid hyperplasia in ileum, in children with autism and other developmental disturbances [1] — [8].
These findings, combined with parent-reported associations of timing of onset of behavioral abnormalities with MMR administration, case study template for children to the hypothesis that MMR contributed to autism pathogenesis [1]. Subsequent studies from this group reported MV RNA in bowel biopsies and peripheral blood mononuclear cells PBMC from children with ASD [9] — [12]. Over 20 epidemiologic studies reported no temporal relationship between MMR and ASD [13] — [33]and three studies found no MV RNA in PBMC of ASD children [34] — [36] ; however, no published studies from other research groups have addressed whether MV RNA is present in bowel of ASD children with GI disturbances.
Here we report independent, blinded analysis of ileal and cecal tissues from children with ASD and GI disturbances and children with GI disturbances but no neurological deficits for the presence of MV RNA in three laboratories, including the one where the original reports of an association between ASD and MV were obtained.
Forty-seven children were recruited. Six recruits did not complete the study: 3 potential cases dropped out prior to colonoscopy; 1 potential case and 2 potential controls completed colonoscopy but had incomplete clinical assessments.
No differences were found in age, sex, or case-control status between study completers and non-completers. An additional 2 potential cases were excluded for failure to meet diagnostic inclusion criteria below cutoffs case study template for children autistic disorder [AUT] on ADI-R ; and 1 case was excluded because no bowel biopsy material was available.
Age at biopsy was similar for cases and controls [median interquartile range, IQRcases, 5. There were no significant differences between cases and controls in their distribution by sex within the three age groups Table 1.
Median age at receipt of first MMR was similar for cases [ None of the children received MV-containing vaccines other than MMR. Clearance of MV depends on development of adaptive immunity. As cell-associated MV RNA may be present transiently after receiving MMR [38] — [39]timing of vaccination relative to biopsy was potentially important. Parental reports of timing of MMR receipt 6 months or more prior to biopsy were in accord with pediatric provider immunization charts for the final study population with the exception of one control boy whose immunization record revealed receipt of a second MMR 3.
This subject was retained in final analyses after determining results to be the same both with and without inclusion of his data. The median MMR-biopsy interval was similar for cases [ Controls received a greater median number of all types of vaccines than cases [20 1 vaccines vs.
Total number of vaccines received was not related to age or sex. The study sample included two sibling pairs; three of these children were controls 2 males, 1 female and one was a case male. Data from sibling pairs were retained after determining that patterns of results were unaltered by sibling pair exclusion. AUT diagnoses were confirmed for all cases. Absence of AUT, other ASD, or other developmental disturbances was confirmed for controls.
For one control, ADI-R was incomplete; this subject was retained after determining that CDI and clinical assessment were consistent with typical development.
Median AUT onset age was Prior to examination of study samples, performance of the four different primer sets two for H gene, two for F gene was evaluated for the 12 cloned target regions using synthetic RNA standards. A lower limit of detection of 50 RNA molecules per reaction was confirmed for each primer set in all laboratories. All laboratories correctly identified all positive controls using pre-established criteria for positivity positive results in at least two of three wells with at least one of the primer pairs for F and one of the primer pairs for H.
All laboratories correctly identified all negative controls. Concordance across laboratories was achieved in the initial round of real-time RT-PCR assays for all positive and negative results with the exception of a single study sample, an ileal biopsy from a control. An additional three samples, one ileal sample from a control and two case study template for children samples one case, one control yielded signal in at least one assay in one laboratory but did not meet criteria for positivity.
All four samples were retested as below to resolve discrepancies. As detailed above, only one sample met the pre-established definition of discordance; in this instance, case study template for children, an ileal sample from a control was positive with all four MV primer pairs in a single laboratory. The amplification product from this reaction was sequenced and determined to contain the engineered restriction site, confirming that it represented the synthetic transcript control.
This sample was classified as negative. Aliquots of the three other samples that had yielded signal in one assay in a single laboratory were shipped to all three laboratory sites for retesting under new IDs. Two negative and one positive control were included to ensure blinding and monitor assay performance.
In all three instances, results were negative on second round testing, including the one laboratory initially reporting positive results for a single primer pair. Real-time RT-PCR indicated a range of 2—7 molecules per PCR reaction, corresponding to approximately 50— MV RNA molecules per ng of total RNA extract Table 3. Sequence analysis confirmed that products of these samples were authentic. MV RNA was not detected in cecum of these subjects, or in ileum or cecum of any other subject.
Both subjects with positive samples had reactive lymphoid follicles RLF. Endoscopy revealed inflammation in both subjects: the case had nonspecific gastritis; the control had acute distal esophagitis. If MMR is causally related to either GI disturbances or AUT it should precede their onset. Similarly, if GI disturbances contribute to AUT they should precede onset of AUT.
We approached temporal relationships in the following manner: subjects with MMR administration and GI onset in the same month were considered to have MMR administration before the onset of GI episodes; subjects with GI episode and AUT onset within the same month were considered to have GI onset before AUT onset; and subjects with MMR and AUT onset within the same month were considered to have MMR onset before the onset of AUT. To examine whether the MMR-GI onset interval differed for cases and controls, survival analysis was pursued, using only those children with onset of GI episodes after MMR administration.
Kaplan-Meier analysis showed no differences between cases and controls in latency from MMR to initial GI disturbances Mantel-Cox logrank test, case study template for children. To determine whether our data supported the hypothesis that GI pathology contributes to ASD pathogenesis, we examined the temporal relationship between MMR immunization, first GI episode, and AUT onset. If the putative relationship of MMR to GI pathology and AUT is valid, MMR must precede GI dysfunction and AUT, and GI dysfunction must precede AUT.
If GI dysfunction contributes to AUT independent of MMR, it is necessary only that GI dysfunction precede development of AUT. X 2 analyses indicated no role for MMR in either the pathogenesis of AUT or GI dysfunction Table 4.
Cases first receiving MMR prior to onset of Case study template for children complaints were older at index GI episodes [ Conversely, cases with GI episodes preceding AUT onset had much earlier onset of GI problems than cases with initiation of GI episodes after onset of AUT [2. Real-time RT-PCR assays with molecular controls engineered to allow differentiation of products arising from synthetic vs.
bone fide MV RNA produced consistent results across three laboratories, with each laboratory site reporting less than 10 cDNA copies of MV F and H gene in ileal biopsies from one child with autism and one child without neurological disorder. Discrepancies are unlikely to represent differences in experimental technique because similar primer and probe sequences, cycling conditions and instruments were employed in this and earlier reports; furthermore, one of the three laboratories participating in this study performed the assays described in earlier reports.
Other factors to consider include differences in patient age, sex, origin Europe vs. North AmericaGI disease, case study template for children, recency of MMR vaccine administration at time of biopsy, and methods for confirming neuropsychiatric status in cases and case study template for children. Participation in the current study required confirmation in cases of the presence of an AUT diagnosis and exclusion in controls of AUT or other developmental disturbances.
MV in MMR has been proposed to induce GI inflammation, increasing permeability to neuroactive chemicals that promote developmental neuropathology [42] — [43]. If this model is correct, MMR immunization should precede GI complaints, and both MMR and GI complaints should precede onset of ASD. We found the age at the time of exposure to MMR relative to onset of GI problems in cases and controls and the temporal order of MMR administration, GI episodes, and AUT onset in cases to case study template for children inconsistent with a causal role for MMR vaccine as a trigger or exacerbator of either GI disturbances or autism.
ASDs comprise a wide range of endophenotypes that may represent different routes to pathogenesis. The work reported here eliminates the remaining support for the hypothesis that ASD with GI complaints is related to MMR exposure, case study template for children.
We found no relationship between the timing of MMR and the onset of either GI complaints or autism. We also could not confirm previous work linking the presence of MV RNA in GI tract to ASD with GI complaints. The origin, nature, and frequency of GI disturbances within the larger ASD population remain unclear; focused research strategies are required to define these endophenotypes and determine their significance for causal hypotheses.
Families of potential subjects were invited to participate if ileocolonoscopy with biopsy was specifically indicated case study template for children part of clinical care, case study template for children.
Routine informed consent for clinical procedures was obtained by the gastroenterologist. Case study template for children consent procedures detailed additional research procedures to be performed, and specific written permission was provided by consenting parents and guardians and children capable of providing assent 7 years or older.
Eligible children received at least one prior immunization containing MV vaccine strain. Children reported by parents to have received MV immunization within 6 months of planned biopsy were excluded. Neuropsychiatric status was established for all subjects by child neurologists, case study template for children, psychiatrists or developmental pediatricians LADDERS using Diagnostic and Statistical Manual-Fourth Edition, Text Revision DSM-IV-TR [44] diagnostic criteria.
Cases failing to meet full DSM-IV-TR criteria for AUT
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8+ Clinical Case Study Templates and Examples. Clinical case studies can focus on a person, group, or community. In contrast to case reports, these studies don’t end in reporting about the diagnosis, treatment, and follow-up of blogger.com studies abide by the research methodology and design to understand an experience May 06, · This case study is on a young girl named Hannah. She was observed in a classroom at the Early Learning Center. She is 4 years old. She is the only child, and lives with her father and grandmother. Throughout the paper, it compares Hannah’s development to what develop mentalist say is normal. The paper is focused primarily on Royal College of Occupational Therapists Borough High Street London SE1 1LB. T:
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