Serum biomarkers are molecules produced by normal and abnormal cells. Prostate specific antigen (PSA) is an example of a serum biomarker used widely in the diagnosis and prognostication of prostate cancer. PSA has its limitations as it is organ- but not cancer-specific. The aim of this review is to summarize the current published data on the potential prognostic and predictive biomarkers in metastatic prostate cancer (mPC) that can be used in conjunction with PSA. These biomarkers include microRNAs, androgen receptor variants, bone metabolism, neuroendocrine and metabolite biomarkers, and could guide treatment selection and sequence in an era where we strive to personalized therapy.

Two studies examined the frequency of community and family contacts of 10 adults with severe and profound mental handicaps living in small, community-based homes, first with their previous institutional experience and second in comparison with adults with similar handicaps living in larger community units.Adults in the small homes used community amenities significantly more than they did when in institutions and also significantly more than residents of larger community units. They experienced greater family contact than when they lived in more distant institutions, but not significantly more than residents of larger community units which also served local areas. Within the small homes, people newly admitted from their family homes had significantly greater family involvement than those transferred from institutions. The results are related to the characteristics of the residential settings, such as location, staff factors, operational policy, and autonomy of management.

In a previous study (Felce, de Kock and Repp, 1986), appropriate client activity was found to be considerably higher in two community homes for severely and profoundly mentally handicapped adults than in a number of institutions. Client activity was also shown to be related to the extent of staff interaction. The method of this study was replicated in a two-year follow-up to investigate whether these desirable levels of staff interaction and client activity were maintained. Client engagement in appropriate activity remained similar for five subjects but had fallen slightly for a further five. The duration of instruction given to the majority of subjects by staff had declined but so too, for a variety of reasons, had staff-client ratios. Overall, the follow-up data give a general impression of the maintenance of client activity with some subjects engaging with greater independence. However, interpretation is dependent on the role that staff-client ratio may play in determining staff performance and in particular their level of interaction with clients.The development of community-based residential services in this country for even the most severely mentally handicapped people is increasing. Momentum for change stems from a growing belief that traditional institutions can only provide an inferior therapeutic environment (e.g.

The parents of 68 young children with learning disabilities were interviewed to assess the number and type of behaviour problems that their child exhibited. Parents' perceptions of their ability to cope with the behaviours were sought. The average number of behaviour problems was 7.4 per child, with poor concentration and sleep problems occurring most frequently. Fifty-seven per cent of parents who reported that their child hurt themself felt unable to cope with those behaviours. Scores of parents' perceived coping skills and malaise were associated with the number of behaviour problems. Parents who reported that their child hurt themself, hurt others or had a sleep problem were likely to have a higher malaise score.

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