More Than 500 Kids Could Be Saved Each Year! Ten Consensus Actions to Improve Quality of Pediatric Resuscitation in DACH-Countries (Austria, Germany, and Switzerland)

• Quality and outcome of pediatric resuscitation often does not achieve recommended goals. • Quality improvement initiatives with the aim of better survival rates and decreased morbidity of resuscitated children are urgently needed. • These initiatives should include an action framework for a comprehensive, fundamental, and interprofessional reorientation of clinical and organizational structures concerning resuscitation and post-resuscitation care of children. • The authors of this DACH position statement suggest the implementation of 10 evidence-based actions (for out-of-hospital and in-house cardiac arrests) that should improve survival rates and decrease morbidity of resuscitated children with better neurological outcome and quality of life.

Introduction: Just Say No? New Insights About Change Versus Constancy in Substance Use Behavioral Decisions in Youth With and Without ADHD

Despite enormous social-psychological and economic consequences of substance abuse in youth and young adults, too little is known about effective interventions among substance users, both with and without ADHD. This special issue reports on four linked investigations that employed a novel research strategy when the Multimodal Treatment Children with ADHD Study (MTA) participants were between ages 21.7 and 27.3 years old (14-16 years after initial assessments). Using combination of in-depth qualitative narrative interviews and quantitative analyses ("mixed methods") of 183 participants from four to six original MTA sites, investigators sought to obtain a more complete understanding of factors contributing to youths' substance use (SU) initiation, maintenance, and desistence, (both among youth with ADHD and control participants). The articles in this special issue illuminate important new insights about possible influences contributing to SU, particularly persistent use/abuse. Findings also illustrate the benefits of mixed-methods studies, not only to better understand the linkages between ADHD and SU, but also to understand other areas of child/adult psychopathology.

Turning Points in the Lives of Youth of With/Without ADHD: Are They Linked to Changes in Substance Use?

OBJECTIVE

This study examines the behavior beliefs, social supports, and turning points in individuals with/without ADHD related to their substance use/abuse (SU/A) decisions.

METHOD

The coded interviews from 60 participants with/without ADHD were compared for their SU/A decisions and precipitants with these decisions among abstainers, persisters, and desisters.

RESULTS

ADHD participants reported fewer social advantages to avoid SU/A than non-ADHD participants. Desisters and persisters reported more social advantages of using drugs than abstainers. Persisters reported both more negative and positive psychological/physiological effects of SU/A. ADHD participants reported fewer positive role models in their lives. Non-ADHD patients reported more positive turning points than ADHD participants, regardless of SU/A status.

CONCLUSION

ADHD individuals face challenges in making healthy decisions about SU/A due to lack of positive role models. Reinforcing accurate behavioral beliefs may be important to change behaviors in individuals with SU/A or to prevent SU/A initiation in ADHD individuals.

A Good Friend is Hard to Find: Friendship Among Adolescents With Disabilities

We asked 27 Euro American teens ages 16 to 17 with developmental disabilities in Los Angeles to describe friendships. Eleven characteristics of friendship reported in the research literature (similarity, proximity, transcending context, companionship, reciprocity, mutuality, intimacy, support, trust/loyalty, conflict management, and stability) were mentioned by at least some teens. However, most teens focused on companionship, doing activities across contexts, similarity in interests/personality, sheer proximity, and stability. Gender did not influence number or types of themes reported. Teens with higher IQ/Vineland Communication scores mentioned more friendship themes and were less positive about their friendships. Most teens reported some satisfying friendships, and friendships between peers with developmental disability usually were more stable and positive than friendships with typically developing peers.

Outcome correlates of parent-child bedsharing: an eighteen-year longitudinal study

We report results of the first longitudinal study of outcome correlates of parent-child bedsharing. Two hundred five families in nonconventional and conventional family lifestyles have been followed since 1975. A target child in each family was followed from the third trimester of mother's pregnancy through age 18 years. Bedsharing in early childhood was found to be significantly associated with increased cognitive competence measured at age 6 years, but the effect size was small. At age 6 years, bedsharing in infancy and early childhood was not associated with sleep problems, sexual pathology, or any other problematic consequences. At age 18 years, bedsharing in infancy and childhood was unrelated to pathology or problematic consequences, nor was it related to beneficial consequences. We discuss these results in light of widespread fears of harm caused by parent-child bedsharing. We suggest that such fears are without warrant if bedsharing is practiced safely as part of a complex of valued and related family practices.

Family responses to children with early developmental delays. II: Accommodation intensity and activity in early and middle childhood

Families were interviewed about functional accommodations made to sustain daily routines for a child with disabilities. Accommodation intensities were unchanged from ages 3 to 7 and declined from 7 to 11. However, number of accommodation types increased dramatically from 3 to 11. By late childhood, on average, families broadened the scope of their accommodations but reduced the intensity with which they made them. Accommodations are a continuing feature of family adaptation to developmental disabilities in late childhood rather than a feature of certain developmental periods. They are most consistently associated with child characteristics that directly impact the daily routine.