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Background: Real‐world evidence is an essential component of evidence‐based medicine. The aim of the BICSTaR (BICtegravir Single Tablet Regimen) study is to assess effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in antiretroviral treatment‐naïve (TN) and treatment‐experienced (TE) people with HIV. Methods: BICSTaR is a prospective, observational cohort study. Participants (≥18 years) are being followed for 24 months. A pooled analysis is presented at 12 months, with the primary endpoint of effectiveness (HIV‐1 RNA <50 copies/mL) and secondary endpoints of safety and tolerability (as per protocol). An exploration of patient‐reported outcome measures using standardized questionnaires is included. Results: Between June 2018 and May 2021, 1552 people with HIV were enrolled across 12 countries. The analysed population comprised 1509 individuals (279 TN, 1230 TE); most were white (76%), male (84%) and had one or more comorbid conditions (68%). Median age was 47 years. After 12 months of B/F/TAF treatment, HIV‐1 RNA was <50 copies/mL in 94% (221/236) of TN participants and 97% (977/1008) of TE participants. Median CD4 cell count increased by 214 cells/μL (p < 0.001) in TN participants and 13 cells/μL (p = 0.014) in TE participants; median CD4/CD8 ratios increased by 0.30 and 0.03, respectively (both p < 0.001). Persistence was high at 12 months (TN, 97%; TE, 95%). No resistance to B/F/TAF emerged. Study drug‐related adverse events occurred in 13% of participants through 12 months, leading to B/F/TAF discontinuation in 6%. Conclusions: The findings of this study provide robust real‐world evidence to support the broad use of B/F/TAF in both TN and TE people with HIV. [ABSTRACT FROM AUTHOR]

This article provides evidence from a study of the careers of children in an English local authority from the point of the child protection investigation with a follow up of one year. The study demonstrates the way that for the vast majority welfare needs are ignored in the process of investigation and identifies the need to refocus investigations. The authors suggests criteria that can be used to provide a clearer focus on whether to investigate a referral. Copyright © 1998 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

A commonly used expression in child protection is the term ‘physical abuse’. This paper consists of a quantitative and qualitative analysis of a 100% sample of ‘physical abuse’ child protection cases drawn from research in an Australian state child welfare agency, which shows that about 90% of these concerned incidents in which parents used physical punishment to control children. Resulting physical harms to children (where they occurred) were generally of a very minor nature. The paper examines these results in the light of research findings in the UK and Australia on patterns of physical punishment used by parents to control children. Such findings suggest that those child rearing practices that make frequent and systematic use of physical punishment are located largely amongst lower social class parents, who believe that such practices are an essential and normal component of effective parenting behaviour. One interpretation of child protection services in respect of these cases is that they are concerned primarily with the normalization of child rearing practices. The paper concludes with a discussion of the limited impact of the Swedish anti-spanking law of 1979, which appears to have only reduced the use of physical punishment by those parents who may not necessarily have believed in such measures in the first place. However, legislation of this nature has the potential to criminalize a substantial sector of the population, but at least state intervention under the aegis of a specific criminal law provides a clearer mandate than does intervention under much looser, broader and subjectively interpreted child protection legislation. [ABSTRACT FROM AUTHOR]