Switching from Biosimilar to Biosimilar Adalimumab, Including Multiple Switching, in Crohn’s Disease: A Prospective Study

No data are available regarding the safety and effectiveness of the biosimilar-to-biosimilar switch of adalimumab in any disease, and in particular in Crohn’s disease (CD). The aim of our study was to provide real world data on switching from biosimilar adalimumab to another biosimilar, including multiple switching. We conducted a prospective, single-centre observational study in which we consecutively recruited all CD patients who switched from adalimumab biosimilar ABP 501 to biosimilar SB5 from January to July 2021. Sixty-one patients were included in the final analysis, of whom 43/61 (70.5%) were multiple switches (Humira® → ABP 501 → SB5). After 6 months of follow up, 88.5% (54/61) of patients maintained SB5 on therapy. The success of the switch (defined as no systemic corticosteroids within 6 months, non-discontinuation of SB5, no dose escalation) was achieved by 82.0% (50/61) of patients. At multivariate analysis, C-reactive protein > 5 mg/L predicted switch failure (p = 0.03). Seven patients (11.5%) experienced side effects, compared to one patient (1.6%) in the 6 pre-switch months (p = 0.03). In conclusion, switching from biosimilar to biosimilar of adalimumab did not lead to signs of safety or loss of efficacy other than those already known in the literature for the class of drugs.

‘She Made You Feel like There’s Hope’: Gaining a Better Understanding of How Children Negotiate Their Relationships with Social Workers from Their Own Accounts

Recent years have seen a re-emergence of international interest in relationship-based social work. This article uses children’s accounts of their relationships with social workers to build on previous research to promote children’s safety and well-being. Interviews were undertaken with 111 children aged six- to eighteen-years old across ten different local authorities in England, as part of the evaluation of Munro, Turnell and Murphy’s Signs of Safety pilots within the Department for Education’s Children’s Social Care Innovation Programme. The interviews reveal four key findings: that children look for care and reciprocity in their relationships with social workers and this can be achieved through listening and small acts of kindness; that they are adept at recognising aspects of social workers’ verbal and non-verbal communications which indicate to the child whether they are listening and interested in them; that there are times in which children are particularly vulnerable especially if parents are resistant to engagement or children’s trust is broken; and that children actively use their agency to control their communication and engagement. The article concludes by highlighting children’s relational resilience and the importance of ensuring opportunities for children to develop new relationships with social workers when previous relationships have broken down.

Protection as a Human Fundamental Need: Re-Conceiving Signs of Safety for Social Work in the Republic of Ireland

Large-scale reform of statutory child protective services in the Republic of Ireland is underway, prompted by adoption of the national strengths-based and safety-organised practice approach, known as ‘Signs of Safety’ (SoS). Despite the radical change it impels, critical commentary from the academy on the conventions of SoS remains conspicuous by its absence. One reading of the ecological systems approach is that to appreciate implications of SoS for children and families at risk, we must surpass a sequestered concern with child protection and welfare alone. To substantiate this, and embed a reconceived Signs of Safety, human scale development theory is critically deployed through an augmented, rather than exclusive focus, on the axis of protection needs within the typology of fundamental human needs. To aid this, critical application of theory is partially reworked and appropriated through a life course perspective, to better account for lifespan positioning. Overall, the sustaining proposition of the paper is that academic interrogation of SoS is both a practical and ethical imperative, and a necessary complement to large-scale organisational change underway.

The Framework for the Assessment of Children in Need and Their Families and Signs of Safety: Competing or Complementary Frameworks?

Signs of Safety (SoS) is a comprehensive assessment framework (AF) used in some form in most English children’s service departments as well as in many other countries. The Framework for the Assessment of Children in Need and their Families (AF) was introduced nearly twenty years ago to address identified failures to adopt a holistic approach to assessments of families where there were concerns that children were in need of protection or support. The AF is not only a statutory requirement in England but it has influenced the development of approaches to assessment globally. An evaluation of SoS in pilot local authorities in England provided opportunities to examine the extent to which the two frameworks were being used together. Findings from interviews, case record analysis and a survey indicate that while recording processes were aligned with the AF, it was not central to many of the assessments conducted and it proved difficult to detect its influence on their content. It appears timely to examine the extent to which the AF is used across England, to assess its relevance to current practice and the extent to which frameworks such as SoS have supplemented or replaced it.

Analysis of NOM-026-STPS-2008 in the manufacturing laboratory to improve productivity

This paper presents a diagnostic to detect that the safety and health signals comply was made with the requirements of NOM-026-STPS-2008 within a manufacturing laboratory, the study was carried out in concordance with the provisions of the afore mentioned regulations pertaining to the Secretaría del Trabajo y Previsión Social, which is the government entity in charge of carrying out the corresponding compliance inspections in Mexico in terms of colors and signs of safety and hygiene which a work center is operating. This study was made based on the measurements of the architectural plan of the place to the location of the machinery and tools. Was made to the location of safety and hygiene signs within the place, the identification of the existence of emergency facilities, of risks and hazards within the work area, the detection of the use of signage of obligation and prohibition that helps to control the risks. The most important limitation for the arrangement of the signals is the inadequate distribution in the work area, however, the study had to adapt to this circumstance. With the aforementioned, a proposal is made to rearrange the signage that is located in incorrect points, as well as mentioning the safety signals that are needed in the points identified within the site with their technical specifications. Finally, an area of opportunity is detected to improve the working conditions manufacturing laboratory and thereby contribute to avoid accidents and occupational diseases therefore preventive and corrective measures are applied with the proper use of signage in an area of work.