Protocol for a prospective, longitudinal mixed-methods case study: supporting a Model of Care for Healthier Adolescents (The MoCHA study)

INTRODUCTION

Improving mental healthcare for adolescents is a global policy priority. Despite demands for community-based services, many adolescents require more intensive interventions, such as an inpatient admission. This is typically at a point of crisis, often accompanied by intense emotional dysregulation, impairment of coping function and impulsivity. However, limited evidence exists on how best to support this group while they are in inpatient care, aside from pharmacological treatments which have a limited role in adolescents. Little is known about the models of care (MoC) offered in inpatient units, whether adolescents perceive these as helpful and the perspectives of caregivers and clinicians. Here, we describe a protocol which aims to explore and evaluate an inpatient MoC.

METHODS AND ANALYSIS

We designed a longitudinal, mixed-methods, case study. The population consists of adolescents, caregivers and clinicians at a single inpatient unit in Melbourne, Australia. Standardised outcome measures, including semi- structured interviews, will be administered to adolescents at three time-points, T1 (admission), T2 (discharge) and T3 (6 months post discharge). Caregivers will also be interviewed at T1, T2 and T3. Clinicians will be interviewed once. The measures include: Life Problems Inventory, Quick Inventory of Depressive Symptomatology, Kessler Psychological Distress Scale and the Youth Self-Report. Health of the Nation Outcome Scales for Children and Adolescents will be collected at T1 and T2. Quantitative analysis will include descriptive statistics and paired t-tests summarising adolescents admitted to the unit, clinical characteristics and longitudinal data on symptomatology. Qualitative data will be analysed using both thematic and trajectory analysis. Data collection began in May 2017 and will cease with T3 interviews by October 2018. ETHICS AND DISSEMINATION.

Measurement of the Charm-Mixing Parameter y_{CP}

A measurement of the charm-mixing parameter y_{CP} using D^{0}→K^{+}K^{-}, D^{0}→π^{+}π^{-}, and D^{0}→K^{-}π^{+} decays is reported. The D^{0} mesons are required to originate from semimuonic decays of B^{-} and B[over ¯]^{0} mesons. These decays are partially reconstructed in a data set of proton-proton collisions at center-of-mass energies of 7 and 8 TeV collected with the LHCb experiment and corresponding to an integrated luminosity of 3  fb^{-1}. The y_{CP} parameter is measured to be (0.57±0.13(stat)±0.09(syst))%, in agreement with, and as precise as, the current world-average value.

Observation of Two Resonances in the Λ_{b}^{0}π^{±} Systems and Precise Measurement of Σ_{b}^{±} and Σ_{b}^{*±} Properties

The first observation of two structures consistent with resonances in the final states Λ_{b}^{0}π^{-} and Λ_{b}^{0}π^{+} is reported using samples of pp collision data collected by the LHCb experiment at sqrt[s]=7 and 8 TeV, corresponding to an integrated luminosity of 3  fb^{-1}. The ground states Σ_{b}^{±} and Σ_{b}^{*±} are also confirmed and their masses and widths are precisely measured.

Prevention and Recovery Care Services in Australia: Describing the Role and Function of Sub-Acute Recovery-Based Residential Mental Health Services in Victoria

Background: Prevention and Recovery Care (PARC) services are relatively new sub-acute residential services that have supported people with mental ill-health in Victoria since 2003. Operated from a partnership model between non-governmental agencies and clinical mental health services, PARC services integrate intensive recovery-focused psychosocial input with clinical mental health care. Aim: To describe and contrast the 19 PARC services operating in Victoria at the time of the study, in terms of structures and function, resources, and content and quality of care. Method: Nineteen participants, one representing each PARC, completed two surveys: the first, a purpose-designed survey relating to the government guidelines for PARC services, and the second, the Quality Indicator for Rehabilitative Care. Results: Descriptive analyses highlighted that PARC services have operated in inner-city, urban, and regional areas of Victoria, from between 1 and 14 years. Participants reported that a recovery approach was at the core of service delivery, with a vast array of group and individual programs on offer. Across the state, there was variation in the quality of services according to the Quality Indicator for Rehabilitative Care domains. Conclusions: This study has identified that there is variation in the structure and function, resourcing, and content and quality of care offered across Victoria's PARC services even though, in the main, they are guided by government guidelines. Hence it appears that the services adapt to local needs and changes in service systems occurring over time. The findings indicate emerging evidence that PARCs are providing recovery-oriented services, which offer consumers autonomy and social inclusion, and therefore likely enable a positive consumer experience. The range of individual and group programs is in line with the Victorian guidelines, offering practical assistance, therapeutic activities, and socialization opportunities consistent with consumer preferences. Further research into implementation processes and their impacts on quality of care is warranted concerning this and similar service models.

Evidence for an η c ( 1 S ) π - resonance in B 0 → η c ( 1 S ) K + π - decays

A Dalitz plot analysis of B 0 → η c ( 1 S ) K + π - decays is performed using data samples of pp collisions collected with the LHCb detector at centre-of-mass energies of s = 7 , 8 and 13 Te V , corresponding to a total integrated luminosity of 4.7 fb - 1 . A satisfactory description of the data is obtained when including a contribution representing an exotic η c ( 1 S ) π - resonant state. The significance of this exotic resonance is more than three standard deviations, while its mass and width are 4096 ± 20 - 22 + 18 Me V and 152 ± 58 - 35 + 60 Me V , respectively. The spin-parity assignments J P = 0 + and J P = 1 - are both consistent with the data. In addition, the first measurement of the B 0 → η c ( 1 S ) K + π - branching fraction is performed and gives B ( B 0 → η c ( 1 S ) K + π - ) = ( 5.73 ± 0.24 ± 0.13 ± 0.66 ) × 10 - 4 , where the first uncertainty is statistical, the second systematic, and the third is due to limited knowledge of external branching fractions.

Search for lepton-flavour-violating decays of Higgs-like bosons

A search is presented for a Higgs-like boson with mass in the range 45 to 195 GeV / c 2 decaying into a muon and a tau lepton. The dataset consists of proton-proton interactions at a centre-of-mass energy of 8 TeV , collected by the LHCb experiment, corresponding to an integrated luminosity of 2 fb - 1 . The tau leptons are reconstructed in both leptonic and hadronic decay channels. An upper limit on the production cross-section multiplied by the branching fraction at 95% confidence level is set and ranges from 22 pb for a boson mass of 45 GeV / c 2 to 4 pb for a mass of 195 GeV / c 2 .

Measurement of Antiproton Production in p-He Collisions at sqrt[s_{NN}]=110 GeV

The cross section for prompt antiproton production in collisions of protons with an energy of 6.5 TeV incident on helium nuclei at rest is measured with the LHCb experiment from a data set corresponding to an integrated luminosity of 0.5  nb^{-1}. The target is provided by injecting helium gas into the LHC beam line at the LHCb interaction point. The reported results, covering antiproton momenta between 12 and 110  GeV/c, represent the first direct determination of the antiproton production cross section in p-He collisions, and impact the interpretation of recent results on antiproton cosmic rays from space-borne experiments.

Identifying essential information to support patient decision-making regarding participation in cancer clinical trials: A Delphi study

PURPOSES

This research set out to contribute to ongoing efforts to improve the quality of informed consent information provided to patients by specifically focusing on establishing consensus with regard to essential information to enhance the informed consent process.

DESIGN AND METHODS

A Delphi consensus method was used to conduct three rounds of online surveys. Five groups of experts directly or indirectly involved in the informed consent process were invited to participate: patients, family members/friends, physicians, other health professionals and other key informants, including ethicists, contract research staff and pharmaceutical company staff.

FINDINGS

Of 156 eligible participants, 101 participants (64.7%) completed all three rounds. In round 1, 994 information items were reported and generated into 74 statements. These were grouped under eight headings essential to the informed consent process. In rounds 2 and 3, the list was reduced to 15 statements representing consensus on essential information to be included in a summarised patient information document to support decision-making regarding trial participation. Risks and discomforts, participation requirements and trial governance were identified as important considerations.

CONCLUSIONS

The 15 essential statements identified in this study could be used as components of a summarised information sheet given to potential cancer clinical trial participants, as an adjunct to the informed consent process. A robust evaluation of the impact of these statements on the quality of the informed consent process is needed.

First Observation of the Doubly Charmed Baryon Decay Ξ_{cc}^{++}→Ξ_{c}^{+}π^{+}

The doubly charmed baryon decay Ξ_{cc}^{++}→Ξ_{c}^{+}π^{+} is observed for the first time, with a statistical significance of 5.9σ, confirming a recent observation of the baryon in the Λ_{c}^{+}K^{-}π^{+}π^{+} final state. The data sample used corresponds to an integrated luminosity of 1.7  fb^{-1}, collected by the LHCb experiment in pp collisions at a center-of-mass energy of 13 TeV. The Ξ_{cc}^{++} mass is measured to be 3620.6±1.5(stat)±0.4(syst)±0.3(Ξ_{c}^{+})  MeV/c^{2} and is consistent with the previous result. The ratio of branching fractions between the decay modes is measured to be [B(Ξ_{cc}^{++}→Ξ_{c}^{+}π^{+})×B(Ξ_{c}^{+}→pK^{-}π^{+})]/[B(Ξ_{cc}^{++}→Λ_{c}^{+}K^{-}π^{+}π^{+})×B(Λ_{c}^{+}→pK^{-}π^{+})]=0.035±0.009(stat)±0.003(syst).

Measurement of Angular and CP Asymmetries in D^{0}→π^{+}π^{-}μ^{+}μ^{-} and D^{0}→K^{+}K^{-}μ^{+}μ^{-} Decays

The first measurements of the forward-backward asymmetry of the dimuon pair (A_{FB}), the triple-product asymmetry (A_{2ϕ}), and the charge-parity-conjugation asymmetry (A_{CP}), in D^{0}→π^{+}π^{-}μ^{+}μ^{-} and D^{0}→K^{+}K^{-}μ^{+}μ^{-} decays are reported. They are performed using data from proton-proton collisions collected with the LHCb experiment from 2011 to 2016, corresponding to a total integrated luminosity of 5  fb^{-1}. The asymmetries are measured to be A_{FB}(D^{0}→π^{+}π^{-}μ^{+}μ^{-})=(3.3±3.7±0.6)%, A_{2ϕ}(D^{0}→π^{+}π^{-}μ^{+}μ^{-})=(-0.6±3.7±0.6)%, A_{CP}(D^{0}→π^{+}π^{-}μ^{+}μ^{-})=(4.9±3.8±0.7)%, A_{FB}(D^{0}→K^{+}K^{-}μ^{+}μ^{-})=(0±11±2)%, A_{2ϕ}(D^{0}→K^{+}K^{-}μ^{+}μ^{-})=(9±11±1)%, A_{CP}(D^{0}→K^{+}K^{-}μ^{+}μ^{-})=(0±11±2)%, where the first uncertainty is statistical and the second systematic. The asymmetries are also measured as a function of the dimuon invariant mass. The results are consistent with the standard model predictions.

Measurement of the Ω_{c}^{0} Baryon Lifetime

We report a measurement of the lifetime of the Ω_{c}^{0} baryon using proton-proton collision data at center-of-mass energies of 7 and 8 TeV, corresponding to an integrated luminosity of 3.0  fb^{-1} collected by the LHCb experiment. The sample consists of about 1000  Ω_{b}^{-}→Ω_{c}^{0}μ^{-}ν[over ¯]_{μ}X signal decays, where the Ω_{c}^{0} baryon is detected in the pK^{-}K^{-}π^{+} final state and X represents possible additional undetected particles in the decay. The Ω_{c}^{0} lifetime is measured to be τ_{Ω_{c}^{0}}=268±24±10±2  fs, where the uncertainties are statistical, systematic, and from the uncertainty in the D^{+} lifetime, respectively. This value is nearly four times larger than, and inconsistent with, the current world-average value.

Observation of a New Ξ_{b}^{-} Resonance

From samples of pp collision data collected by the LHCb experiment at sqrt[s]=7, 8 and 13 TeV, corresponding to integrated luminosities of 1.0, 2.0 and 1.5  fb^{-1}, respectively, a peak in both the Λ_{b}^{0}K^{-} and Ξ_{b}^{0}π^{-} invariant mass spectra is observed. In the quark model, radially and orbitally excited Ξ_{b}^{-} resonances with quark content bds are expected. Referring to this peak as Ξ_{b}(6227)^{-}, the mass and natural width are measured to be m_{Ξ_{b}(6227)^{-}}=6226.9±2.0±0.3±0.2  MeV/c^{2} and Γ_{Ξ_{b}(6227)^{-}}=18.1±5.4±1.8  MeV/c^{2}, where the first uncertainty is statistical, the second is systematic, and the third, on m_{Ξ_{b}(6227)^{-}}, is due to the knowledge of the Λ_{b}^{0} baryon mass. Relative production rates of the Ξ_{b}(6227)^{-}→Λ_{b}^{0}K^{-} and Ξ_{b}(6227)^{-}→Ξ_{b}^{0}π^{-} decays are also reported.

Measurement of the Lifetime of the Doubly Charmed Baryon Ξ_{cc}^{++}

The first measurement of the lifetime of the doubly charmed baryon Ξ_{cc}^{++} is presented, with the signal reconstructed in the final state Λ_{c}^{+}K^{-}π^{+}π^{+}. The data sample used corresponds to an integrated luminosity of 1.7  fb^{-1}, collected by the LHCb experiment in proton-proton collisions at a center-of-mass energy of 13 TeV. The Ξ_{cc}^{++} lifetime is measured to be 0.256_{-0.022}^{+0.024}(stat)±0.014(syst)  ps.

Amplitude Analysis of the Decay B[over ¯]^{0}→K_{S}^{0}π^{+}π^{-} and First Observation of the CP Asymmetry in B[over ¯]^{0}→K^{*}(892)^{-}π^{+}

The time-integrated untagged Dalitz plot of the three-body hadronic charmless decay B[over ¯]^{0}→K_{S}^{0}π^{+}π^{-} is studied using a pp collision data sample recorded with the LHCb detector, corresponding to an integrated luminosity of 3.0  fb^{-1}. The decay amplitude is described with an isobar model. Relative contributions of the isobar amplitudes to the B[over ¯]^{0}→K_{S}^{0}π^{+}π^{-} decay branching fraction and CP asymmetries of the flavor-specific amplitudes are measured. The CP asymmetry between the conjugate B[over ¯]^{0}→K^{*}(892)^{-}π^{+} and B^{0}→K^{*}(892)^{+}π^{-} decay rates is determined to be -0.308±0.062.

Studies of the resonance structure in D 0 → K ∓ π ± π ± π ∓ decays

Amplitude models are constructed to describe the resonance structure of D 0 → K - π + π + π - and D 0 → K + π - π - π + decays using pp collision data collected at centre-of-mass energies of 7 and 8 TeV with the LHCb experiment, corresponding to an integrated luminosity of 3.0  f b - 1 . The largest contributions to both decay amplitudes are found to come from axial resonances, with decay modes D 0 → a 1 ( 1260 ) + K - and D 0 → K 1 ( 1270 / 1400 ) + π - being prominent in D 0 → K - π + π + π - and D 0 → K + π - π - π + , respectively. Precise measurements of the lineshape parameters and couplings of the a 1 ( 1260 ) + , K 1 ( 1270 ) - and K ( 1460 ) - resonances are made, and a quasi model-independent study of the K ( 1460 ) - resonance is performed. The coherence factor of the decays is calculated from the amplitude models to be R K 3 π = 0.459 ± 0.010 ( stat ) ± 0.012 ( syst ) ± 0.020 ( model ) , which is consistent with direct measurements. These models will be useful in future measurements of the unitary-triangle angle γ and studies of charm mixing and C P violation.

Evidence for the Rare Decay Σ^{+}→pμ^{+}μ^{-}

A search for the rare decay Σ^{+}→pμ^{+}μ^{-} is performed using pp collision data recorded by the LHCb experiment at center-of-mass energies sqrt[s]=7 and 8 TeV, corresponding to an integrated luminosity of 3  fb^{-1}. An excess of events is observed with respect to the background expectation, with a signal significance of 4.1 standard deviations. No significant structure is observed in the dimuon invariant mass distribution, in contrast with a previous result from the HyperCP experiment. The measured Σ^{+}→pμ^{+}μ^{-} branching fraction is (2.2_{-1.3}^{+1.8})×10^{-8}, where statistical and systematic uncertainties are included, which is consistent with the standard model prediction.

Measurement of the Ratio of the B^{0}→D^{*-}τ^{+}ν_{τ} and B^{0}→D^{*-}μ^{+}ν_{μ} Branching Fractions Using Three-Prong τ-Lepton Decays

The ratio of branching fractions R(D^{*-})≡B(B^{0}→D^{*-}τ^{+}ν_{τ})/B(B^{0}→D^{*-}μ^{+}ν_{μ}) is measured using a data sample of proton-proton collisions collected with the LHCb detector at center-of-mass energies of 7 and 8 TeV, corresponding to an integrated luminosity of 3  fb^{-1}. For the first time, R(D^{*-}) is determined using the τ-lepton decays with three charged pions in the final state. The B^{0}→D^{*-}τ^{+}ν_{τ} yield is normalized to that of the B^{0}→D^{*-}π^{+}π^{-}π^{+} mode, providing a measurement of B(B^{0}→D^{*-}τ^{+}ν_{τ})/B(B^{0}→D^{*-}π^{+}π^{-}π^{+})=1.97±0.13±0.18, where the first uncertainty is statistical and the second systematic. The value of B(B^{0}→D^{*-}τ^{+}ν_{τ})=(1.42±0.094±0.129±0.054)% is obtained, where the third uncertainty is due to the limited knowledge of the branching fraction of the normalization mode. Using the well-measured branching fraction of the B^{0}→D^{*-}μ^{+}ν_{μ} decay, a value of R(D^{*-})=0.291±0.019±0.026±0.013 is established, where the third uncertainty is due to the limited knowledge of the branching fractions of the normalization and B^{0}→D^{*-}μ^{+}ν_{μ} modes. This measurement is in agreement with the standard model prediction and with previous results.

Measurement of the Ratio of Branching Fractions B(B_{c}^{+}→J/ψτ^{+}ν_{τ})/B(B_{c}^{+}→J/ψμ^{+}ν_{μ})

A measurement is reported of the ratio of branching fractions R(J/ψ)=B(B_{c}^{+}→J/ψτ^{+}ν_{τ})/B(B_{c}^{+}→J/ψμ^{+}ν_{μ}), where the τ^{+} lepton is identified in the decay mode τ^{+}→μ^{+}ν_{μ}ν[over ¯]_{τ}. This analysis uses a sample of proton-proton collision data corresponding to 3.0  fb^{-1} of integrated luminosity recorded with the LHCb experiment at center-of-mass energies of 7 and 8 TeV. A signal is found for the decay B_{c}^{+}→J/ψτ^{+}ν_{τ} at a significance of 3 standard deviations corrected for systematic uncertainty, and the ratio of the branching fractions is measured to be R(J/ψ)=0.71±0.17(stat)±0.18(syst). This result lies within 2 standard deviations above the range of central values currently predicted by the standard model.

Search for Dark Photons Produced in 13 TeV pp Collisions

Searches are performed for both promptlike and long-lived dark photons, A^{'}, produced in proton-proton collisions at a center-of-mass energy of 13 TeV, using A^{'}→μ^{+}μ^{-} decays and a data sample corresponding to an integrated luminosity of 1.6  fb^{-1} collected with the LHCb detector. The promptlike A^{'} search covers the mass range from near the dimuon threshold up to 70 GeV, while the long-lived A^{'} search is restricted to the low-mass region 214<m(A^{'})<350  MeV. No evidence for a signal is found, and 90% confidence level exclusion limits are placed on the γ-A^{'} kinetic-mixing strength. The constraints placed on promptlike dark photons are the most stringent to date for the mass range 10.6<m(A^{'})<70  GeV, and are comparable to the best existing limits for m(A^{'})<0.5  GeV. The search for long-lived dark photons is the first to achieve sensitivity using a displaced-vertex signature.

First Observation of the Rare Purely Baryonic Decay B^{0}→pp[over ¯]

The first observation of the decay of a B^{0} meson to a purely baryonic final state, B^{0}→pp[over ¯], is reported. The proton-proton collision data sample used was collected with the LHCb experiment at center-of-mass energies of 7 and 8 TeV and corresponds to an integrated luminosity of 3.0  fb^{-1}. The branching fraction is determined to be B(B^{0}→pp[over ¯])=(1.25±0.27±0.18)×10^{-8}, where the first uncertainty is statistical and the second systematic. The decay mode B^{0}→pp[over ¯] is the rarest decay of the B^{0} meson observed to date. The decay B_{s}^{0}→pp[over ¯] is also investigated. No signal is seen and the upper limit B(B_{s}^{0}→pp[over ¯])<1.5×10^{-8} at 90% confidence level is set on the branching fraction.

χ_{c1} and χ_{c2} Resonance Parameters with the Decays χ_{c1,c2}→J/ψμ^{+}μ^{-}

The decays χ_{c1}→J/ψμ^{+}μ^{-} and χ_{c2}→J/ψμ^{+}μ^{-} are observed and used to study the resonance parameters of the χ_{c1} and χ_{c2} mesons. The masses of these states are measured to be m(χ_{c1})=3510.71±0.04(stat)±0.09(syst)  MeV and m(χ_{c2})=3556.10±0.06(stat)±0.11(syst)  MeV, where the knowledge of the momentum scale for charged particles dominates the systematic uncertainty. The momentum-scale uncertainties largely cancel in the mass difference m(χ_{c2})-m(χ_{c1})=45.39±0.07(stat)±0.03(syst)  MeV. The natural width of the χ_{c2} meson is measured to be Γ(χ_{c2})=2.10±0.20(stat)±0.02(syst)  MeV. These results are in good agreement with and have comparable precision to the current world averages.