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Hoyt CR, Luo L, Rice HE, Shivakumar N, Housten AJ, Picinich A, Qashou N, Harris KM, Varughese T, King AA. "Everyone screens to some extent": Barriers and facilitators of developmental screening among children with sickle cell disease: A mixed methods study. Pediatr Blood Cancer 2024:e31060. [PMID: 38757454 DOI: 10.1002/pbc.31060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/12/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Developmental delays are common among children with sickle cell disease (SCD). Existing guidelines support consistent screening to increase the identification of deficits and support referral to rehabilitative interventions, yet adherence remains variable. This study sought to assess current practices and identify barriers and facilitators to improve developmental screening for children 0-3 years with SCD. PROCEDURE A mixed methods approach, guided by the Exploration and Preparation stages of the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, assessed developmental screening practices among primary care providers and hematologists. Phase 1 included the SCD Developmental Surveillance and Screening Guideline and Practice Survey. Phase 2 included the SCD Developmental Screening Organizational Survey alongside semi-structured interviews. Descriptive and qualitative methods summarized the findings. RESULTS Thirty-three providers from general pediatrics and hematology completed phase 1. Use of standardized developmental screening measures was variable, with the most frequently used being the Modified Checklist for Autism in Toddlers (77%) and the Ages and Stages Questionnaire (55%). Fifteen providers participated in phase 2, and reported they were most likely to engage in changes to improve their practice (mean = 4.4/5) and least likely to support spiritual health and well-being (mean = 3.5/5). Three themes emerged:(i) developmental screening is not standardized or specific to SCD, (ii) children with SCD benefit from a multidisciplinary team, and (iii) healthcare system limitations are a barrier. CONCLUSIONS Developmental screening is inconsistent and insufficient for young children with SCD. Providers are interested in supporting children with SCD, but report a lack of standardized measures and consistent guidance as barriers.
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Affiliation(s)
- Catherine R Hoyt
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Lingzi Luo
- School of Global Public Health, New York University, New York, New York, USA
| | - Hannah E Rice
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nirmala Shivakumar
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ashley J Housten
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Abigail Picinich
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nai Qashou
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kelly M Harris
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Taniya Varughese
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Allison A King
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Education, Washington University School of Medicine, St. Louis, Missouri, USA
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Pugh P, Hemingway P, Christian M, Higginbottom G. Key stakeholders' perspectives on the development of an early dietary phosphate self-management strategy for children and young people with chronic kidney disease stages 1-3: A modified Delphi consensus process. J Hum Nutr Diet 2024. [PMID: 38739861 DOI: 10.1111/jhn.13308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/29/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND An early dietary phosphate intervention (EPI) can provide vital medical benefits supporting self-management of chronic kidney disease (CKD) in childhood. OBJECTIVE To utilise expert consensus to provide early modelling for an EPI to guide clinical practice across a paediatric renal network. METHODS Forty-eight statements across six domains were constructed following a systematic review and semi-structured interviews with children and young people (CYP), parents and healthcare professionals (HCP). A three-round online Delphi survey with parents and paediatric renal multi-disciplinary healthcare experts was undertaken. RESULTS Twenty-one experts agreed on 56 statements over three Delphi rounds. Statements were accepted in all six domains: definition of an EPI (2), rationale (12), intended users (3), delivery (14) (when [1], where [3], who [2], how [8]), other considerations (16) and potential concerns (9). CONCLUSIONS Consensus was reached on a definition and a set of guiding principles, providing some early modelling for implementation and future research on the development of an EPI strategy for CYP with CKD.
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Affiliation(s)
- Pearl Pugh
- School of Health Sciences, University of Nottingham, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Nottingham Children's Hospital, Nottingham, UK
| | - Pippa Hemingway
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Martin Christian
- Nottingham University Hospitals NHS Trust, Nottingham Children's Hospital, Nottingham, UK
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D'Agostino SR, Frost KM, Pickard K. Considerations for effective dissemination of evidence-based early intervention approaches. Autism 2024:13623613241253117. [PMID: 38706194 DOI: 10.1177/13623613241253117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
LAY ABSTRACT Dissemination, or the widespread sharing of information, is important for moving research evidence into community practice. Early intervention programs for young autistic children have not yet been widely disseminated to the early childhood workforce. This letter describes factors that may support or prevent dissemination to community-based settings, such as packaging and branding early intervention approaches. We argue that an increased focus on dissemination research is needed.
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Affiliation(s)
| | - Kyle M Frost
- University of Massachusetts Chan Medical School, USA
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Boonstra A, van Amelsvoort TAMJ, Klaassen RMC, Popma A, Grootendorst-van Mil NH, Veling W, de Winter RFP, Boonstra N, Leijdesdorff SMJ. Evaluating changes in functioning and psychological distress in visitors of the @ease youth mental health walk-in centres. BJPsych Open 2024; 10:e101. [PMID: 38699887 PMCID: PMC11094437 DOI: 10.1192/bjo.2024.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/08/2024] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Highly accessible youth initiatives worldwide aim to prevent worsening of mental health problems, but research into outcomes over time is scarce. AIMS This study aimed to evaluate outcomes and support use in 12- to 15-year-old visitors of the @ease mental health walk-in centres, a Dutch initiative offering free counselling by trained and supervised peers. METHOD Data of 754 visitors, collected 2018-2022, included psychological distress (Clinical Outcomes in Routine Evaluation 10 (CORE-10)), social and occupational functioning (Social and Occupational Functioning Assessment Scale (SOFAS)), school absenteeism and support use, analysed with change indicators (first to last visit), and mixed models (first three visits). RESULTS Among return visitors, 50.5% were female, 79.4% were in tertiary education and 36.9% were born outside of The Netherlands (one-time visitors: 64.7%, 72.9% and 41.3%, respectively). Moreover, 29.9% of return visitors presented with suicidal ideations, 97.1% had clinical psychological distress levels, and 64.1% of the latter had no support in the previous 3 months (one-time visitors: 27.2%, 90.7% and 71.1%, respectively). From visit 1 to 3, psychological distress decreased (β = -3.79, 95% CI -5.41 to -2.18; P < 0.001) and social and occupational functioning improved (β = 3.93, 95% CI 0.51-7.36; P = 0.025). Over an average 3.9 visits, 39.6% improved reliably and 28.0% improved clinically significantly on the SOFAS, which was 28.4% and 8.8%, respectively, on the CORE-10, where 43.2% improved in clinical category. Counselling satisfaction was rated 4.5/5. CONCLUSIONS Reductions in psychological distress, improvements in functioning and high counselling satisfaction were found among @ease visitors, forming a basis for future research with a control group.
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Affiliation(s)
- Anouk Boonstra
- Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, The Netherlands
| | | | | | - Arne Popma
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, The Netherlands
| | | | - Wim Veling
- University Center for Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Remco F. P. de Winter
- Mental Health and Neuroscience (MHeNs) Research Institute, Maastricht University, The Netherlands; Mental Health Institute Rivierduinen, Leiden, The Netherlands; and Section Clinical Psychology, Vrije Universiteit Amsterdam, The Netherlands
| | - Nynke Boonstra
- Department of Healthcare, NHL Stenden University of Applied Sciences, The Netherlands; KieN VIP Metal Health Care Services, Friesland, The Netherlands; and Department of Psychiatry, UMC Utrecht Brain Center, Utrecht, The Netherlands
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Josvassen JL, Hedegaard VAM, Jørgensen ML, Percy-Smith L. The Effect of LENA (Language ENvironment Analysis) for Children with Hearing Loss in Denmark including a Pilot Validation for the Danish Language. J Clin Med 2024; 13:2688. [PMID: 38731217 PMCID: PMC11084579 DOI: 10.3390/jcm13092688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/27/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: This study aimed to investigate whether day-long recordings with Language Environment Analysis (LENA) can be utilized in a hospital-based Auditory Verbal Therapy (AVT) program in Denmark for children with hearing loss and to conduct a pilot validation in the Danish language. Methods and materials: A license for the LENA system (LENA SP) was purchased, and trials were offered to three families enrolled in the AVT program. Each family made two day-long recordings with 3-4 months in between and received feedback during the therapy sessions. From 18 × 10-min clips randomly pulled out of the recordings, a comparison of adult word counts (AWC) between the LENA algorithm counts and the counts made by two human transcribers was made and used for the pilot validation. Results: LENA proved to be valuable as a guiding tool for Danish parents. Pilot validation showed good correlations and an acceptable limit of agreement (LoA). Conclusions: LENA holds the potential for Danish validation and use in AVT/clinical practice. When used in clinical practice, parents must be informed of the biases and limitations, and possible ethical issues must be considered. Because of the GDPR rules, there is a need to discuss the possibility of implementing this tool clinically in Denmark and the EU.
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Affiliation(s)
- Jane Lignel Josvassen
- Copenhagen Hearing and Balance Center, Rigshospitalet, Inge Lehmannsvej 8, Opgang 8, 3. Sal, 2100 Copenhagen, Denmark; (V.A.M.H.); (L.P.-S.)
| | - Victoria Amalie Michael Hedegaard
- Copenhagen Hearing and Balance Center, Rigshospitalet, Inge Lehmannsvej 8, Opgang 8, 3. Sal, 2100 Copenhagen, Denmark; (V.A.M.H.); (L.P.-S.)
| | - Mie Lærkegård Jørgensen
- Department of Health Technology, Hearing Systems Section, Computational Auditory Modeling, Technical University of Denmark (DTU), Ørsteds Plads, Bygning 352, 2800 Kongens Lyngby, Denmark;
| | - Lone Percy-Smith
- Copenhagen Hearing and Balance Center, Rigshospitalet, Inge Lehmannsvej 8, Opgang 8, 3. Sal, 2100 Copenhagen, Denmark; (V.A.M.H.); (L.P.-S.)
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Reynolds K, Urbanowicz A, Mayston M, Foley S. Kids+ Parent Infant Program (PIP): a community model for supporting partnerships in early developmental follow-up and support. Front Pediatr 2024; 12:1354971. [PMID: 38756970 PMCID: PMC11096506 DOI: 10.3389/fped.2024.1354971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/19/2024] [Indexed: 05/18/2024] Open
Abstract
High-risk infants are discharged home from hospital with increased care needs and the potential for the emergence of developmental disabilities, contributing to high levels of parental stress and anxiety. To enable optimal outcomes for high-risk infants and their families, developmental follow-up programs need to continue following hospital discharge. However, current follow-up care for high-risk infants is variable in terms of type, access and equity, and there seems to be a gap in existing services such as supporting the transition home, parental support, and inclusion of all at-risk infants regardless of causality. Routine follow-up that identifies developmental delays or neuromotor concerns can facilitate timely referral and access to targeted intervention during critical periods of development. The Kids+ Parent Infant Program (PIP) is a unique model of developmental follow-up that shares some characteristics with established programs, but also includes additional key elements for a seamless, wrap-around service for all high-risk infants and their families living in a regional area of Australia. This community-based program provides integrated assessment and intervention of infants, alongside parent support and education, embracing a holistic model that accounts for the complexity and interrelatedness of infant, parent, medical and developmental factors. By prioritising the well-being of high-risk infants and their families, the Kids+ PIP paves the way for improved developmental outcomes and provides an innovative model for developmental follow-up, with the potential for reproduction in other healthcare settings.
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Affiliation(s)
- K. Reynolds
- Kids Plus Foundation (Kids+), Geelong, VIC, Australia
- Childrens Therapy Services, Geelong, VIC, Australia
| | - A. Urbanowicz
- Kids Plus Foundation (Kids+), Geelong, VIC, Australia
- Australian Institute for Health Transformation, Determinants of Health, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - M. Mayston
- Division of Biosciences, Neurosciences, Physiology & Pharmacology, University College London, London, United Kingdom
| | - S. Foley
- Kids Plus Foundation (Kids+), Geelong, VIC, Australia
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Walton KM, Borowy AR, Gordon RA, Wainer AL. Enhancing stakeholder roles in autism early interventions in the United States: A stakeholder-driven research agenda. Autism 2024; 28:1120-1134. [PMID: 37679945 PMCID: PMC10918025 DOI: 10.1177/13623613231195743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
LAY ABSTRACT In this article, we outline a stakeholder-driven research agenda to guide future early intervention research for children with autism. Our research team collaborated with autism service providers, parents of individuals with autism, and autistic people to create this research agenda by (1) conducting workshops with community members and (2) distributing a survey to a larger number of community members around the country. The finalized research agenda includes (1) Guiding Principles for current and future research, (2) Research Priorities focused on early intervention for individuals with autism, and (3) Systems Implications to consider in future clinical, research, and policy efforts for early intervention. The full version of the research agenda is available in Supplemental Material. This article lists the main points of the research agenda and discusses unique themes highlighted by the community members. One main conclusion is that researchers need to include community members in decision-making and consultant positions throughout the research process to best meet the needs of the broader autism community. We have created a researcher workbook which we hope may facilitate these community consultation efforts. This workbook is available in Supplemental Material.
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Le Dantec L, Kassis M, Kanoute M, Thimbo A, Di Stefano S, Bouvier C, Tenne C, Yehouetome M. [Post-hospital support for families: current situation and outlook]. Soins Pediatr Pueric 2024; 45:32-36. [PMID: 38697723 DOI: 10.1016/j.spp.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
After neonatal hospitalization, our healthcare system offers multidisciplinary care for premature babies and their families during the first years of life. However, there are disparities and gaps, particularly in the case of medium prematurity. Maternal and child protection, a major player in early prevention and family follow-up, is a partner likely to be able to deploy post-hospital support perspectives in favor of child development and parenting support.
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Affiliation(s)
- Laurène Le Dantec
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France
| | - Marie Kassis
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France
| | - Mariam Kanoute
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France
| | - Andrea Thimbo
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France
| | - Sol Di Stefano
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France
| | - Chloé Bouvier
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France
| | - Camille Tenne
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France
| | - Marielle Yehouetome
- Centre de PMI, Institut Paris-Brune, 26 boulevard Brune, 75014 Paris, France; Laboratoire de psychologie clinique, psychopathologie, psychanalyse (PCPP), Université Paris-Cité, 71 avenue Édouard-Vaillant, 92100 Boulogne-Billancourt, France; Hôpital de pédiatrie et de rééducation, Longchêne, 78830 Bullion, France.
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Thompson K, Choi E, Artis J, Dubay M, Baranek GT, Watson LR. An observational study of parental language during play and mealtime in toddlers at variable likelihood for autism. J Child Lang 2024; 51:681-709. [PMID: 38247286 PMCID: PMC11052673 DOI: 10.1017/s0305000923000739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Parental language input influences child language outcomes but may vary based on certain characteristics. This research examined how parental language differs during two contexts for toddlers at varying likelihood of autism based on their developmental skills. Parental language (quantity, quality, and pragmatic functions) was analyzed during dyadic play and mealtime interactions as a secondary data analysis of observational data from a study of toddlers at elevated and lower likelihood of autism. Child developmental skills and sensory processing were also assessed. Parents used more words per minute, directives, and verbs during play and more adjectives, descriptions, and questions during mealtime. Parental language differed based on child fine motor skills, receptive language, and levels of sensory hyporesponsiveness but not autism likelihood. Overall, this study found that parental language varies based on context and child developmental skills. Future research examining parental language should include pragmatic functions and context across developmental trajectories.
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Affiliation(s)
- Kelsey Thompson
- Department of Allied Health Sciences, University of North Carolina Chapel Hill
- Program for Early Autism Research, Leadership, and Service (PEARLS), University of North Carolina Chapel Hill
| | - Elizabeth Choi
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California
- Program for Early Autism Research, Leadership, and Service (PEARLS), University of North Carolina Chapel Hill
| | - Jonet Artis
- University of Maryland College Park
- Program for Early Autism Research, Leadership, and Service (PEARLS), University of North Carolina Chapel Hill
| | - Michaela Dubay
- Department of Human Services, University of Virginia
- Program for Early Autism Research, Leadership, and Service (PEARLS), University of North Carolina Chapel Hill
| | - Grace T Baranek
- Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California
- Program for Early Autism Research, Leadership, and Service (PEARLS), University of North Carolina Chapel Hill
| | - Linda R Watson
- Department of Allied Health Sciences, University of North Carolina Chapel Hill
- Program for Early Autism Research, Leadership, and Service (PEARLS), University of North Carolina Chapel Hill
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Bailey B, Solida A, Andreou C, Plessen KJ, Conus P, Mercapide M, Kasparidi A, Conchon C, Sprüngli-Toffel E, Genoud D, Caron C, Golay P, Curtis L, Herbrecht E, Huber CG, Alameda L, Armando M. Pathways to care in youth and young adults at clinical high risk for psychosis in Switzerland: Current situation and clinical implementation of the PsyYoung project. Early Interv Psychiatry 2024. [PMID: 38676537 DOI: 10.1111/eip.13540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 03/22/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024]
Abstract
AIM We aim to give an insight into the current situation in Switzerland concerning the pathways to care of young people with clinical high risk of psychosis. In a second step we propose a procedure of optimizing pathways to care developed within the project PsyYoung. METHODS A qualitative survey derived and adapted from Kotlicka-Antczak et al. (2020) was conducted in large early detection services of three Swiss cantons (Geneva, Basel-Stadt, Vaud) focusing on pathways to care. More specifically, using questionnaires delivered to the heads of participating services, information was collected on referral sources, on activities to implement outreach campaigns and on the use of a pre-screening tool. RESULTS Main results on referral source indicated that sources were variable but seemed to come primarily from the medical sector and more so from the psychiatric sector. Very few referrals came from non-medical sectors. Outreach activities included the contact to other clinics as well as through brochures and posters. All services but one used the Prodromal Questionnaire - 16 as pre-screening tool. CONCLUSIONS All in all, the results indicate a referral and care pathway system implemented mostly within the medical and particularly mental health sector. Accordingly, the PsyYoung project proposes a procedure for pathways to care which could help overcome the obstacle of referrals being restrained to a narrow field of mental health and to harmonize the referral process within services dedicated to the same aim of helping young people at high risk of developing a psychosis.
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Affiliation(s)
- Barbara Bailey
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | | | - Christina Andreou
- Department of Psychiatry and Psychotherapy, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
- SRO Spital Oberaargau, Psychiatric Services, Langenthal, Switzerland
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mathieu Mercapide
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
| | - Afrodite Kasparidi
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
| | - Caroline Conchon
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Elodie Sprüngli-Toffel
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Davina Genoud
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
| | - Camille Caron
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | - Philippe Golay
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Logos Curtis
- Unité de Psychiatrie du Jeune Adulte, Service des spécialités psychiatriques, Département de psychiatrie, Hôpital Universitaire de Geneve, Geneve, Switzerland
| | - Evelyn Herbrecht
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | - Christian G Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Basel, Switzerland
| | - Luis Alameda
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Psychology and Neuroscience, King's College of London, London, UK
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM); Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Marco Armando
- Division of Child and Adolescent Psychiatry, Lausanne Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Wiesepape CN, Smith EA, Hillis-Mascia JD, Queller Soza SE, Morris MM, James AV, Stokes A. Metacognition as a Transdiagnostic Determinant of Recovery in Schizotypy and Schizophrenia Spectrum Disorders. Behav Sci (Basel) 2024; 14:336. [PMID: 38667132 PMCID: PMC11047686 DOI: 10.3390/bs14040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/24/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
The term schizotypy refers to the latent personality organization that is thought to underpin the liability to develop schizophrenia and associated disorders. Metacognition, or the ability to understand and form increasingly complex and integrated ideas of oneself, others, and one's community, has been proposed to be an important transdiagnostic construct across schizophrenia spectrum disorders and a range of both clinical and non-clinical manifestations of schizotypy. In this paper, we review evidence that deficits in metacognition are present in individuals with relatively high levels of schizotypy and that these deficits are related to symptomology, function, and quality of life. We address the idea that decrements in metacognition may also contribute to the progression from schizotypy to more severe manifestations, while the amelioration of these deficits may enhance aspects of recovery, including the ability to form an integrated sense of self, others, and the wider world. We also review the following two recovery-oriented psychotherapies that target metacognition to promote recovery in individuals with clinical manifestations of schizotypy: Evolutionary Systems Therapy for Schizotypy (ESTS) and Metacognitive Reflection and Insight Therapy (MERIT).
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Affiliation(s)
- Courtney N Wiesepape
- Austin VA Clinic, Veterans Affairs Central Texas Health Care, Austin, TX 78744, USA
| | - Elizabeth A Smith
- Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA
| | | | | | - Madyson M Morris
- Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA
- Richard L. Roudebush VA Medical Center, Indianapolis, IN 46202, USA
| | | | - Alexis Stokes
- Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA
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Eapen V, Gerstl B, Ahinkorah BO, John JR, Hawker P, Nguyen TP, Brice F, Winata T, Bowden M. Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review. BJPsych Open 2024; 10:e78. [PMID: 38602192 PMCID: PMC11060074 DOI: 10.1192/bjo.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition. AIMS To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0-17 years) presenting with an acute mental health condition. METHOD A systematic literature search was conducted, and the studies' methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022. RESULTS We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent-child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects. CONCLUSIONS This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and School of Public Health, University of Technology Sydney, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Patrick Hawker
- Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Mental Health Team, School of Medicine, Western Sydney University, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Australia
| | - Michael Bowden
- Child and Youth Mental Health, New South Wales Ministry of Health, Australia; Sydney Medical School, University of Sydney, Australia; and Department of Psychological Medicine, Sydney Children's Hospitals Network, Australia
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Bowman LR, McDougall C, Doucet R, Pooran B, Xu Y, Campbell J. Funding employment inclusion for Ontario youth with disabilities: a theoretical cost-benefit model. Front Sociol 2024; 9:1281088. [PMID: 38659714 PMCID: PMC11041630 DOI: 10.3389/fsoc.2024.1281088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/07/2024] [Indexed: 04/26/2024]
Abstract
Early engagement in employment-related activities is associated with greater lifetime labor force attachment, which correlates with positive health, social, and quality of life outcomes. People with disabilities often require vocational intervention to enter and remain in the workforce and reap the employment-related health and social benefits. Their labor force attachment brings about the added societal-level benefits of increased tax contributions and reduced social assistance funding. Reason and evidence both support the need for early intervention to facilitate young people with disabilities' workforce entry. Based on available evidence and best practices, and in conjunction with expert input, a cost-benefit model was constructed to provide support for public investment in early employment intervention by demonstrating the societal-level benefits that could be projected. Results indicate the potential benefits for investment in early, targeted employment intervention at a societal level. Two personas were crafted to demonstrate the lifetime societal-level impact of investment in intervention for an individual with disabilities. The results provide relevant arguments for advocates, policy makers, program directors, and people entering adulthood with disabilities to understand the benefits of investing in interventions with the goal of long-term public savings.
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Affiliation(s)
- Laura R. Bowman
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Carolyn McDougall
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | | | | | - Ying Xu
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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Toma AI, Dima V, Alexe A, Bojan C, Nemeș AF, Gonț BF, Arghirescu A, Necula AI, Fieraru A, Stoiciu R, Mirea A, Calomfirescu Avramescu A, Isam AJ. Early Intervention Guided by the General Movements Examination at Term Corrected Age-Short Term Outcomes. Life (Basel) 2024; 14:480. [PMID: 38672751 PMCID: PMC11050901 DOI: 10.3390/life14040480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/17/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND AND AIM The early identification of the former premature neonates at risk of neurologic sequelae could lead to early intervention and a better prognosis. This pilot study aimed to investigate whether the General Movement patterns observed at term-equivalent age in former premature infants could serve as predictors for guiding early intervention and improving prognosis. MATERIALS AND METHODS In a population of 44 premature neonates (mean gestational age 33.59 weeks (+2.43 weeks)) examined at term-equivalent age, 10 neonates with a cramped-synchronized General Movements motor pattern were identified. These neonates were included in an early intervention program consisting of physiotherapy executed both by the therapist and by the parents at home. They were again examined at a corrected age of 12 weeks. The presence or absence of fidgety movements and the MOS-R (motor optimality score revised) was noted. The examinations were performed by certified specialists. RESULTS Normal fidgety movements and a MOS-R of 20-24 were presented in 9/10 of the former premature infants, with normal foot to foot contact present in 7/10, and normal hand to hand contact present in 5/10. The atypical patterns noted were side to side movements of the head in 5/10, a non-centered head in 9/10, asymmetric tonic neck reflex in 9/10 and jerky movements in 10/10. One patient presented with no fidgety movements and a MOS-R score of 9. CONCLUSION Early intervention in our group of patients allowed for an improvement in the neurologic status, demonstrated by the presence of fidgety movements. We suggest that early intervention should be indicated in all premature infants that present with a cramped-synchronized GM pattern during examination at term-equivalent age. However, due to the small sample size, the absence of statistical analysis and a control group, and the limited follow-up period, the conclusions must be approached with caution.
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Affiliation(s)
- Adrian Ioan Toma
- Life Memorial Hospital, 010719 Bucharest, Romania
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | - Vlad Dima
- Neonatology Department Filantropia Clinical Hospital, 011132 Bucharest, Romania
| | | | - Cristina Bojan
- Kinetotherapy Department, Pediatric Neurology Alexandru Obregia Hospital, 041914 Bucharest, Romania
| | - Alexandra Floriana Nemeș
- Life Memorial Hospital, 010719 Bucharest, Romania
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
| | | | | | | | | | | | - Andrada Mirea
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Al Jashi Isam
- Faculty of Medicine, University Titu Maiorescu, 040441 Bucharest, Romania
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Aceituno D, Razzouk D, Jin H, Pennington M, Gadelha A, Bressan R, Noto C, Crossley N, Prina M. Cost-effectiveness of early intervention in psychosis in low- and middle-income countries: economic evaluation from São Paulo, Brazil. Epidemiol Psychiatr Sci 2024; 33:e21. [PMID: 38576239 PMCID: PMC11022262 DOI: 10.1017/s2045796024000222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/16/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
AIMS The effectiveness and cost-effectiveness of early intervention for psychosis (EIP) services are well established in high-income countries but not in low- and middle-income countries (LMICs). Despite the scarcity of local evidence, several EIP services have been implemented in LMICs. Local evaluations are warranted before adopting speciality models of care in LMICs. We aimed to estimate the cost-effectiveness of implementing EIP services in Brazil. METHODS A model-based economic evaluation of EIP services was conducted from the Brazilian healthcare system perspective. A Markov model was developed using a cohort study conducted in São Paulo. Cost data were retrieved from local sources. The outcome of interest was the incremental cost-effectiveness ratio (ICER) measured as the incremental costs over the incremental quality-adjusted life-years (QALYs). Sensitivity analyses were performed to test the robustness of the results. RESULTS The study included 357 participants (38% female), with a mean (SD) age of 26 (7.38) years. According to the model, implementing EIP services in Brazil would result in a mean incremental cost of 4,478 Brazilian reals (R$) and a mean incremental benefit of 0.29 QALYs. The resulting ICER of R$ 15,495 (US dollar [USD] 7,640 adjusted for purchase power parity [PPP]) per QALY can be considered cost-effective at a willingness-to-pay threshold of 1 Gross domestic product (GDP) per capita (R$ 18,254; USD 9,000 PPP adjusted). The model results were robust to sensitivity analyses. CONCLUSIONS This study supports the economic advantages of implementing EIP services in Brazil. Although cultural adaptations are required, these data suggest EIP services might be cost-effective even in less-resourced countries.
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Affiliation(s)
- D. Aceituno
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, David Goldberg Centre, London, UK
- Mental Health Service, Complejo Asistencial Dr. Sotero del Rio, Puente Alto, Chile
| | - D. Razzouk
- Centre of Mental Health Economics, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - H. Jin
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, David Goldberg Centre, London, UK
| | - M. Pennington
- King’s Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, David Goldberg Centre, London, UK
| | - A. Gadelha
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - R. Bressan
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - C. Noto
- Schizophrenia Program (PROESQ), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - N. Crossley
- Department of Psychiatry, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M. Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
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Nelson CA, Sullivan E, Engelstad AM. Annual Research Review: Early intervention viewed through the lens of developmental neuroscience. J Child Psychol Psychiatry 2024; 65:435-455. [PMID: 37438865 DOI: 10.1111/jcpp.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 07/14/2023]
Abstract
The overarching goal of this paper is to examine the efficacy of early intervention when viewed through the lens of developmental neuroscience. We begin by briefly summarizing neural development from conception through the first few postnatal years. We emphasize the role of experience during the postnatal period, and consistent with decades of research on critical periods, we argue that experience can represent both a period of opportunity and a period of vulnerability. Because plasticity is at the heart of early intervention, we next turn our attention to the efficacy of early intervention drawing from two distinct literatures: early intervention services for children growing up in disadvantaged environments, and children at elevated likelihood of developing a neurodevelopmental delay or disorder. In the case of the former, we single out interventions that target caregiving and in the case of the latter, we highlight recent work on autism. A consistent theme throughout our review is a discussion of how early intervention is embedded in the developing brain. We conclude our article by discussing the implications our review has for policy, and we then offer recommendations for future research.
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Affiliation(s)
- Charles A Nelson
- Department of Pediatrics and Neuroscience, Harvard Medical School, Boston, MA, USA
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Eileen Sullivan
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Anne-Michelle Engelstad
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
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McDermott E, Eastham R, Hughes E, Johnson K, Davis S, Pryjmachuk S, Mateus C, McNulty F, Jenzen O. "What Works" to Support LGBTQ+ Young People's Mental Health: An Intersectional Youth Rights Approach. Int J Soc Determinants Health Health Serv 2024; 54:108-120. [PMID: 38385356 PMCID: PMC10955791 DOI: 10.1177/27551938241230766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 02/23/2024]
Abstract
Despite overwhelming international evidence of elevated rates of poor mental health in LGBTQ+ youth compared to their cis-heterosexual peers, we know relatively little about effective mental health services for this population group. This study aims to produce the first early intervention model of "what works" to support LGBTQ+ youth with emerging mental health problems. Utilizing a mixed method case study, we collected data across 12 UK mental health service case study sites that involved: (a) interviews with young people, parents, and mental health practitioners (n = 93); (b) documentary analysis; (c) nonparticipant observation. The data analysis strategy was theoretical using the "explanation-building" analytical technique. Our analysis suggests an intersectional youth rights approach with 13 principles that must be enacted to provide good mental health services as advocated by the United Nations Convention on the Rights of the Child and World Health Organization. This approach should address the multiple forms of marginalization and stigmatization that LGBTQ+ youth may experience, enable informed independent decision-making, and uphold the right to freedom of safe self-expression. A rights-based approach to mental health services for LGBTQ+ young people is not prominent. This needs to change if we are to tackle this mental health inequality and improve the mental well-being of LGBTQ+ youth worldwide.
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Affiliation(s)
| | - Rachael Eastham
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Elizabeth Hughes
- School of Health and Social Policy, Edinburgh Napier University, Edinburgh, UK
| | | | - Stephanie Davis
- School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Steven Pryjmachuk
- School of Health Science, The University of Manchester, Manchester, UK
| | - Ceu Mateus
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Felix McNulty
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Olu Jenzen
- School of Art and Media, University of Brighton, Brighton, UK
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Moyes A, McGough S, Wynaden D. Hidden and unacknowledged: The mental health and psychosocial interventions delivered by school nurses in Western Australia. Int J Ment Health Nurs 2024; 33:463-472. [PMID: 37994283 DOI: 10.1111/inm.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/24/2023]
Abstract
Schools are an important setting for the early identification, assessment and intervention of mental health problems in children and young people. Internationally, many nurses work in schools, but the role of this group with young people experiencing mental health problems has had only limited investigation. This study explored the activities school nurses undertook with young people experiencing mental health problems in Australia. Reporting was guided by the COREQ checklist. Thirty-one nurses participated in a semi-structured interview. Data were analysed using the constant comparative method of analysis as developed by Glaser and Strauss (1967). The findings identified that nurses working in schools undertake a complex and sophisticated workload to support this cohort. In addition to assessment and referral for treatment, interventions assisted young people to manage challenging life circumstances, cope with intensely difficult emotions and improve their social and occupational functioning. The work of school nurses with young people experiencing mental health problems is hidden and unacknowledged. A better understanding of the mental health work school nurses undertake can inform enhanced service provision for children, young people and their families. The research findings will be of interest to mental health nurses, education professionals, parents, policy makers and governments.
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Affiliation(s)
- Anita Moyes
- Edith Cowan University, Perth, Western Australia, Australia
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Ellis PK, Scherer NJ, Lien KM. Enhanced milieu teaching with phonological emphasis: A pilot, telepractice study for parent training in early intervention. Int J Speech Lang Pathol 2024; 26:179-193. [PMID: 37265060 DOI: 10.1080/17549507.2023.2199176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE This pilot study evaluated enhanced milieu teaching with phonological emphasis (EMT + PE) parent training intervention delivered through telepractice and its impact on parent implementation, child speech outcomes, and child language outcomes. METHOD A multiple baseline design across behaviours was used to assess response to parent training and child outcomes. The intervention was delivered to four parents and their young children with repaired cleft palate. Speech production, receptive language, and expressive language were assessed prior to intervention. EMT + PE strategies including matched turns, modelling and expansions, and prompting/speech recasting were taught to parents using the teach-model-coach-review model. Social validity questionnaires were administered pre- and post-intervention to assess parents' rating of competence and confidence for managing their child's early development. Reliability and procedural fidelity were conducted. RESULT All parents increased their use of modelling and expansions, and prompting and speech recasting in response to training, as evidenced by large effect sizes. Children also responded positively to these strategies by increasing percentage of consonants correct (PCC) and target vocabulary, although PCC gains were less than observed in a prior hybrid telepractice and face-to-face intervention. Social validity measures indicated parents increased their confidence to provide intervention for their children. CONCLUSION This pilot study indicated that effective parent training in EMT + PE strategies can be delivered through telepractice.
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Affiliation(s)
- Paige K Ellis
- Paradise Valley Unified School District, Scottsdale, AZ, USA
| | - Nancy J Scherer
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Kari M Lien
- Communication Sciences and Disorders University of Utah, Salt Lake City, UT, USA
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Chi H, Peng H, Zhao X, Zhou G, Shen L, Cai M. The Effectiveness of 595-nm Pulsed Dye Laser for the Treatment of Bilateral Cleft-Lip Scars in Asian Patients: A 6-Month Prospective, Randomized, Self-Controlled Trial. Adv Wound Care (New Rochelle) 2024. [PMID: 38258794 DOI: 10.1089/wound.2023.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
Objective: This study is the first prospective within-patient self-controlled research seeking to investigate the safety and efficacy of 595 nm pulsed-dye laser (PDL) for the treatment of cleft-lip scars. Approach: This prospective, randomized, self-controlled study is based on the clinical records of the patients who received laser-assisted treatment due to bilateral cleft-lip scars. The bilateral scars were randomly assigned to the 595 nm PDL group with five consecutive sessions at 2-week intervals or control group in a blinded manner of evaluators, with subsequent follow-up for 6 months after the final treatment. Clinical efficacy and safety outcomes were evaluated by Vancouver Scar Scale (VSS), Patient Scar Assessment Questionnaire (PSAQ), and other objective evaluations. Results: A total of 18 patients were included. The 595 nm PDL-treated sides showed statistically significant improvement in VSS after treatment at follow-up compared with the baseline (p < 0.05). Interestingly, the 595 nm-PDL-treated side achieved significantly better improvement in scar pigmentation and pliability (p < 0.05). Though there was statistically significant difference between two groups (p < 0.05), the gap in overall PSAQ is not obvious. And comparison by area and coloring evaluation (E/M index) also suggests that the responses of scars to treatment by PDL were slightly improved (p < 0.05). Innovation and Conclusion: It is the first time to apply the 595nm PDL for cleft-lip scars. It would be a better choice for the early treatment of red scar with proliferative tendency after cleft-lip surgery.
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Affiliation(s)
- Haoshu Chi
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Hao Peng
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinran Zhao
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Guoyu Zhou
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingyue Shen
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ming Cai
- Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
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Warrier V, Chamberlain SR, Thomas SA, Bowden-Jones H. Genetics of gambling disorder and related phenotypes: The potential uses of polygenic and multifactorial risk models to enable early detection and improve clinical outcomes. J Behav Addict 2024; 13:16-20. [PMID: 38224367 PMCID: PMC10988411 DOI: 10.1556/2006.2023.00075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024] Open
Abstract
Gambling Disorder (GD) is an impactful behavioural addiction for which there appear to be underpinning genetic contributors. Twin studies show significant GD heritability results and intergenerational transmission show high rates of transmission. Recent developments in polygenic and multifactorial risk prediction modelling provide promising opportunities to enable early identification and intervention for at risk individuals. People with GD often have significant delays in diagnosis and subsequent help-seeking that can compromise their recovery. In this paper we advocate for more research into the utility of polygenic and multifactorial risk modelling in GD research and treatment programs and rigorous evaluation of its costs and benefits.
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Affiliation(s)
- Varun Warrier
- Department of Psychiatry, University of Cambridge, UK
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, Southern Health NHS Foundation Trust, Southampton, UK
| | - Shane A. Thomas
- Vice Chancellor's Office and Institute of Health and Wellbeing, Federation University, Australia
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University of Cambridge, UK
- National Problem Gambling Clinic & National Centre for Gaming Disorders, London, UK
- Department of Brain Sciences, University College London, London, UK
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Heitzer AM, MacArthur E, Tamboli M, Wilson A, Hankins JS, Hoyt CR. Awareness, access, and communication: provider perspectives on early intervention services for children with sickle cell disease. Front Pediatr 2024; 12:1366522. [PMID: 38590772 PMCID: PMC11000123 DOI: 10.3389/fped.2024.1366522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
Purpose This study aimed to identify determinants influencing the utilization of early intervention services among young children with sickle cell disease (SCD) based on perspectives from medical and early intervention providers. Design and methods Early intervention and medical providers from the catchment area surrounding St. Jude Children's Research Hospital and Washington University were recruited (20 total providers). Interviews were completed over the phone and audio recorded. All interviews were transcribed verbatim, coded, and analyzed using inductive thematic analysis. Results Three overarching themes were identified from both groups: Awareness (e.g., lack of awareness about the EI system and SCD), Access (e.g., difficulties accessing services), and Communication (e.g., limited communication between medical and early intervention providers, and between providers and families). Although these three themes were shared by medical and early intervention providers, the differing perspectives of each produced subthemes unique to the two professional fields. Conclusions Early intervention services can limit the neurodevelopmental deficits experienced by young children with SCD; however, most children with SCD do not receive these services. The perspectives of early intervention and medical providers highlight several potential solutions to increase early intervention utilization among young children with SCD.
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Affiliation(s)
- Andrew M. Heitzer
- Department of Psychology and Biobehavioral Sciences, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Erin MacArthur
- Department of Psychology and Biobehavioral Sciences, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Mollie Tamboli
- Department of Psychology and Biobehavioral Sciences, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Ashley Wilson
- Program in Occupational Therapy, Washington University in St. Louis, St. Louis, MO, United States
| | - Jane S. Hankins
- Department of Global Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, United States
- Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN, United States
| | - Catherine R. Hoyt
- Program in Occupational Therapy, Departments of Neurology and Pediatrics, Washington University in St. Louis, St. Louis, MO, United States
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Ben Pazi H, Jahashan S, Har Nof S, Zibman S, Yanai-Kohelet O, Prigan L, Intrator N, Bornstein NM, Ribo M. Pre-hospital stroke monitoring past, present, and future: a perspective. Front Neurol 2024; 15:1341170. [PMID: 38585364 PMCID: PMC10995241 DOI: 10.3389/fneur.2024.1341170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Integrated brain-machine interface signifies a transformative advancement in neurological monitoring and intervention modalities for events such as stroke, the leading cause of disability. Historically, stroke management relied on clinical evaluation and imaging. While today's stroke landscape integrates artificial intelligence for proactive clinical decision-making, mainly in imaging and stroke detection, it depends on clinical observation for early detection. Cardiovascular monitoring and detection systems, which have become standard throughout healthcare and wellness settings, provide a model for future cerebrovascular monitoring and detection. This commentary reviews the progression of continuous stroke monitoring, spotlighting contemporary innovations and prospective avenues, and emphasizes the influential roles of cutting-edge technologies in shaping stroke care.
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Affiliation(s)
| | | | - Sagi Har Nof
- Neurosurgery, Rabin Medical Center, Petach Tikva, Israel
| | | | | | | | | | - Natan M. Bornstein
- Stroke Unit, Neurology, Shaare Zedek Medical Center, Jerusalem, Israel
- Tel Aviv Medical School, Tel Aviv University, Tel Aviv, Israel
| | - Marc Ribo
- Stroke Unit, Neurology, Barcelona, Spain
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Maluleke NP. A call for linguistic and culturally congruent family-centred early hearing detection and intervention programmes in South Africa. S Afr J Commun Disord 2024; 71:e1-e4. [PMID: 38572898 PMCID: PMC11019058 DOI: 10.4102/sajcd.v71i1.992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 04/05/2024] Open
Abstract
Early Hearing Detection and Intervention (EHDI) programmes are recognised as the standard of care for newborns and infants presenting with hearing impairment, globally. However, widespread implementation of these programmes is far from being realised and faces numerous challenges within the South African context. The United Nations' sustainable development goal 3.8 and South Africa's national development plan seek to achieve equitable access to healthcare service, including EHDI. However, healthcare access is a complex concept which encompasses the dimensions: availability, affordability, acceptability and accommodation in healthcare. South Africa has made great progress towards universal implementation of EHDI programmes. Despite this progress, availability and affordability of these programmes are limited and their acceptability has received limited research focus in this context. Furthermore, accommodation of caregivers, as co-drivers of EHDI programmes and ensuring that EHDI programmes are linguistically and culturally congruent have also been overlooked within the South African context.Contribution: Increased robust efforts in improving access through availability and affordability of EHDI programmes are warranted in South Africa. However, improving access to these programmes through availability and affordability initiatives alone will not result in a pragmatic improvement in their accessibility. Acceptability of these programmes and accommodations such as involving caregivers and family members of children with hearing impairment as equal partners in EHDI programmes and being cognisant of their linguistic and cultural needs must be considered.
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Affiliation(s)
- Ntsako P Maluleke
- Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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25
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Robles-Bello MA, Barba-Colmenero F, Valencia-Naranjo N, Sánchez-Teruel D. The validity of learning potential for predicting educational adjustment in preschoolers with Down syndrome: A longitudinal study. J Intellect Disabil 2024:17446295241239984. [PMID: 38498696 DOI: 10.1177/17446295241239984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Learning Potential tests aim to assess cognitive functioning using mediation strategies by observing subsequent changes in learning patterns. In this study, this methodology was applied with the Preschool Learning Potential and Abilities Scale and two additional tests, the Kaufman Brief Intelligence Test and the Battery of Aptitudes for School Learning I, to a total of 58 children with Down Syndrome, at four and six years of age. The results demonstrate improvements in general intelligence, learning potential, and school aptitudes between the two timepoints. There was a significant, positive relationship between the variables measured in the different tests, as well as on the predictive variables of school aptitudes, in these children at six years of age. There is evidence that supports the use of this dynamic evaluation methodology, opening new fields of action in child evaluation processes.
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26
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Salazar de Pablo G, Guinart D, Armendariz A, Aymerich C, Catalan A, Alameda L, Rogdaki M, Martinez Baringo E, Soler-Vidal J, Oliver D, Rubio JM, Arango C, Kane JM, Fusar-Poli P, Correll CU. Duration of Untreated Psychosis and Outcomes in First-Episode Psychosis: Systematic Review and Meta-analysis of Early Detection and Intervention Strategies. Schizophr Bull 2024:sbae017. [PMID: 38491933 DOI: 10.1093/schbul/sbae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND The role of duration of untreated psychosis (DUP) as an early detection and intervention target to improve outcomes for individuals with first-episode psychosis is unknown. STUDY DESIGN PRISMA/MOOSE-compliant systematic review to identify studies until February 1, 2023, with an intervention and a control group, reporting DUP in both groups. Random effects meta-analysis to evaluate (1) differences in DUP in early detection/intervention services vs the control group, (2) the efficacy of early detection strategies regarding eight real-world outcomes at baseline (service entry), and (3) the efficacy of early intervention strategies on ten real-world outcomes at follow-up. We conducted quality assessment, heterogeneity, publication bias, and meta-regression analyses (PROSPERO: CRD42020163640). STUDY RESULTS From 6229 citations, 33 intervention studies were retrieved. The intervention group achieved a small DUP reduction (Hedges' g = 0.168, 95% CI = 0.055-0.283) vs the control group. The early detection group had better functioning levels (g = 0.281, 95% CI = 0.073-0.488) at baseline. Both groups did not differ regarding total psychopathology, admission rates, quality of life, positive/negative/depressive symptoms, and employment rates (P > .05). Early interventions improved quality of life (g = 0.600, 95% CI = 0.408-0.791), employment rates (g = 0.427, 95% CI = 0.135-0.718), negative symptoms (g = 0.417, 95% CI = 0.153-0.682), relapse rates (g = 0.364, 95% CI = 0.117-0.612), admissions rates (g = 0.335, 95% CI = 0.198-0.468), total psychopathology (g = 0.298, 95% CI = 0.014-0.582), depressive symptoms (g = 0.268, 95% CI = 0.008-0.528), and functioning (g = 0.180, 95% CI = 0.065-0.295) at follow-up but not positive symptoms or remission (P > .05). CONCLUSIONS Comparing interventions targeting DUP and control groups, the impact of early detection strategies on DUP and other correlates is limited. However, the impact of early intervention was significant regarding relevant outcomes, underscoring the importance of supporting early intervention services worldwide.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Daniel Guinart
- Institut de Salut Mental, Hospital del Mar, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
- Department of Psychiatry, Hospital del Mar Medical Research Institute, Barcelona, Spain
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Alvaro Armendariz
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Etiopatogenia i Tractament Dels Trastorns Mental Severs (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Barakaldo, Bizkaia, Spain
| | - Ana Catalan
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Barakaldo, Bizkaia, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Department of Psychiatry, Centro Investigación Biomedica en Red de Salud Mental (CIBERSAM), Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío, University of Sevilla, Sevilla, Spain
| | - Maria Rogdaki
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Estrella Martinez Baringo
- Department of Child and Adolescent Psychiatry, Hospital Sant Joan de Déu de Barcelona, Esplugues de Llobregat, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), ISCIII, Barcelona, Spain
- Hospital Benito Menni CASM, Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Dominic Oliver
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
- OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- OASIS Service, South London and Maudsley NHS Foundation Trust, London, UK
- Maudsley Biomedical Research Centre, National Institute for Health Research, South London and Maudsley NHS Foundation Trust, London, UK
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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McGrath LA, Bloomfield E. Prevention, Surveillance, and Treatment of Breast Cancer-Related Lymphedema: The Role of the Advanced Practice Provider. Clin J Oncol Nurs 2024; 28:122-127. [PMID: 38511916 DOI: 10.1188/24.cjon.122-127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Breast cancer-related lymphedema is a lifelong disease associated with decreased quality of life and increased healthcare costs. Evidence supports early detection and prompt treatment through prospective surveillance models.
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28
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López M, Mira A, Mauricia D, Acevedo P, Lopez R, Molina P, Gutiérrez L, de Billerbeck E, Breinbauer C. Are children under five with disabilities' educational rights acknowledged and supported in Chile? Front Public Health 2024; 12:1304152. [PMID: 38560435 PMCID: PMC10979822 DOI: 10.3389/fpubh.2024.1304152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/14/2024] [Indexed: 04/04/2024] Open
Affiliation(s)
- Mauricio López
- Millennium Nucleus Studies on Disability and Citizenship (DISCA), Santiago, Chile
| | - Andrea Mira
- Exercise and Rehabilitation Sciences Institute, School of Occupational Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Daniela Mauricia
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | - Paulina Acevedo
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | - Ruth Lopez
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | | | | | - Eloisa de Billerbeck
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
| | - Cecilia Breinbauer
- Department of Child and Adolescent Development, Center for Healthy Development, Round Hill, VA, United States
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Radez J, Causier C, Maughan D, Waite F, Johns L. The experience of seeking and accessing help from mental health services among young people of Eastern European backgrounds: A qualitative interview study. Psychol Psychother 2024. [PMID: 38456496 DOI: 10.1111/papt.12524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 12/02/2023] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Most lifetime mental health problems (MHP) start before the age of 25. Yet young people-particularly those of minority backgrounds-often do not seek or access professional help. In the UK, young people of Eastern European (EE) backgrounds represent a large minority group; however, little is known about their experiences of MHP and help-seeking. In this study, we aim to understand the help-seeking process from the perspectives of EE young people. DESIGN We used a qualitative study design with semi-structured individual interviews. The results were analysed using reflexive thematic analysis. METHOD Twelve young people (18-25 years) of EE backgrounds, living in Oxfordshire, UK, took part. All participants had experienced a severe MHP and were identified in the community. RESULTS EE young people's experiences of MHP and help-seeking were driven by a sense of being caught between different cultures and simultaneously needing to navigate the potentially contrasting expectations of both cultures. This process was reinforced or tempered by the perceived continuing influence of young people's families, that is, families with more open views about MHP made it easier for young people to navigate through the process of help-seeking. Young people's internalised cultural and familial beliefs about MHP affected their decision-making when experiencing difficulties, their levels of trust in services, and perceived sense of resourcefulness and ability to cope. CONCLUSIONS Recognising and responding to the cultural tension that young people of EE backgrounds may experience can help us to develop more accessible and inclusive mental health services.
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Affiliation(s)
- Jerica Radez
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - Daniel Maughan
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Felicity Waite
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Louise Johns
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Institute of Clinical Psychology Training and Research, Medical Sciences Division, University of Oxford, Oxford, UK
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Formica MJC, Fuller-Tyszkiewicz M, Reininghaus U, Kempton M, Delespaul P, de Haan L, Nelson B, Mikocka-Walus A, Olive L, Ruhrmann S, Rutten B, Riecher-Rössler A, Sachs G, Valmaggia L, van der Gaag M, McGuire P, van Os J, Hartmann JA. Associations between disturbed sleep and attenuated psychotic experiences in people at clinical high risk for psychosis. Psychol Med 2024:1-10. [PMID: 38450445 DOI: 10.1017/s0033291724000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND Pre-diagnostic stages of psychotic illnesses, including 'clinical high risk' (CHR), are marked by sleep disturbances. These sleep disturbances appear to represent a key aspect in the etiology and maintenance of psychotic disorders. We aimed to examine the relationship between self-reported sleep dysfunction and attenuated psychotic symptoms (APS) on a day-to-day basis. METHODS Seventy-six CHR young people completed the Experience Sampling Methodology (ESM) component of the European Union Gene-Environment Interaction Study, collected through PsyMate® devices, prompting sleep and symptom questionnaires 10 times daily for 6 days. Bayesian multilevel mixed linear regression analyses were performed on time-variant ESM data using the brms package in R. We investigated the day-to-day associations between sleep and psychotic experiences bidirectionally on an item level. Sleep items included sleep onset latency, fragmentation, and quality. Psychosis items assessed a range of perceptual, cognitive, and bizarre thought content common in the CHR population. RESULTS Two of the seven psychosis variables were unidirectionally predicted by previous night's number of awakenings: every unit increase in number of nightly awakenings predicted a 0.27 and 0.28 unit increase in feeling unreal or paranoid the next day, respectively. No other sleep variables credibly predicted next-day psychotic symptoms or vice-versa. CONCLUSION In this study, the relationship between sleep disturbance and APS appears specific to the item in question. However, some APS, including perceptual disturbances, had low levels of endorsement amongst this sample. Nonetheless, these results provide evidence for a unidirectional relationship between sleep and some APS in this population.
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Affiliation(s)
- M J C Formica
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - M Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - U Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - M Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, King's College London, London, UK
| | - P Delespaul
- Facalty of Health, Medicine and Life Sciences, Psychiatrie & Neuropsychologie, Maastricht University, Maastricht, The Netherlands
- Mondriaan Mental Health Centre, Maastricht/Heerlen, The Netherlands
| | - L de Haan
- Department of Psychiatry, Early Psychosis, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - B Nelson
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - A Mikocka-Walus
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
| | - L Olive
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, Australia
- Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - S Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - B Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), European Graduate School of Neuroscience (EURON), Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - G Sachs
- Medical University of Vienna, Vienna, Austria
| | - L Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M van der Gaag
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - P McGuire
- Department of Psychiatry, University of Oxford, Warneford Hospital OX3 7JX, UK
| | - J van Os
- Department of Psychiatry, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - J A Hartmann
- Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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31
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Dyne H, Bergsten U, Carlsson E. "Aha, so that's how it's done!" - parents' voices on an early language and literacy intervention. LOGOP PHONIATR VOCO 2024:1-10. [PMID: 38445640 DOI: 10.1080/14015439.2024.2304139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/08/2024] [Indexed: 03/07/2024]
Abstract
The early intervention Språkstart Halland targets children aged 0-3 years. During home visits at 6 and 11 months, library staff deliver gift-packs containing books, toys, songs, and rhymes to promote early language stimulation. Parents are encouraged to engage in 'talk, play, sing, read' activities to support language development. The aim of the present study was to examine parents' experiences of the 6- and 11-month visits and develop an understanding of their general impressions and thoughts regarding the perceived impact of the visits. Parents (n = 15) were interviewed in four focus groups and two one-on-one interviews. Data was analysed using qualitative content analysis. The findings show that the intervention changed the parents' mindset and increased their knowledge regarding early language stimulation. Tools and strategies benefitting the parent-child interaction were gained. A positive experience and personal guidance created motivation for the parents to carry out the language stimulating activities after the visit. Social gains were described. The findings imply usefulness of the intervention in supporting children's language and literacy development.
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Affiliation(s)
- Hanna Dyne
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulrika Bergsten
- Research and Development Department, Region Halland, Halmstad, Sweden
| | - Emilia Carlsson
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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32
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Salazar de Pablo G, Aymerich C, Guinart D, Catalan A, Alameda L, Trotta G, Armendariz A, Martinez Baringo E, Soler-Vidal J, Rubio JM, Garrido-Torres N, Gómez-Vallejo S, Kane JM, Howes O, Fusar-Poli P, Correll CU. What is the duration of untreated psychosis worldwide? - A meta-analysis of pooled mean and median time and regional trends and other correlates across 369 studies. Psychol Med 2024; 54:652-662. [PMID: 38087871 DOI: 10.1017/s0033291723003458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Duration of untreated psychosis (DUP) has been associated with poor mental health outcomes. We aimed to meta-analytically estimate the mean and median DUP worldwide, evaluating also the influence of several moderating factors. This PRISMA/MOOSE-compliant meta-analysis searched for non-overlapping individual studies from inception until 9/12/2022, reporting mean ± s.d. or median DUP in patients with first episode psychosis (FEP), without language restrictions. We conducted random-effect meta-analyses, stratified analyses, heterogeneity analyses, meta-regression analyses, and quality assessment (PROSPERO:CRD42020163640). From 12 461 citations, 369 studies were included. The mean DUP was 42.6 weeks (95% confidence interval (CI) 40.6-44.6, k = 283, n = 41 320), varying significantly across continents (p < 0.001). DUP was (in descending order) 70.0 weeks (95% CI 51.6-88.4, k = 11, n = 1508) in Africa; 48.8 weeks (95% CI 43.8-53.9, k = 73, n = 12 223) in Asia; 48.7 weeks (95% CI 43.0-54.4, k = 36, n = 5838) in North America; 38.6 weeks (95% CI 36.0-41.3, k = 145, n = 19 389) in Europe; 34.9 weeks (95% CI 23.0-46.9, k = 11, n = 1159) in South America and 28.0 weeks (95% CI 20.9-35.0, k = 6, n = 1203) in Australasia. There were differences depending on the income of countries: DUP was 48.4 weeks (95% CI 43.0-48.4, k = 58, n = 5635) in middle-low income countries and 41.2 weeks (95% CI 39.0-43.4, k = 222, n = 35 685) in high income countries. Longer DUP was significantly associated with older age (β = 0.836, p < 0.001), older publication year (β = 0.404, p = 0.038) and higher proportion of non-White FEP patients (β = 0.232, p < 0.001). Median DUP was 14 weeks (Interquartile range = 8.8-28.0, k = 206, n = 37 215). In conclusion, DUP is high throughout the world, with marked variation. Efforts to identify and intervene sooner in patients with FEP, and to promote global mental health and access to early intervention services (EIS) are critical, especially in developing countries.
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Affiliation(s)
- Gonzalo Salazar de Pablo
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Daniel Guinart
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Institut de Salut Mental, Hospital del Mar Research Institute (CIBERSAM), Barcelona, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Psychiatry Department, Basurto University Hospital, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) Barakaldo, Bizkaia, Spain
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- TiPP Program Department of Psychiatry, Service of General Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alvaro Armendariz
- Unidad Terapéutica Centre Educatiu Els Til·lers, Parc Sanitari Sant Joan de Déu, Barcelona
- Grup MERITT: Etiopatogènia i tractament dels trastorns mentals greus
| | - Estrella Martinez Baringo
- Department of Psychiatry and Psychology, Hospital Sant Joan de Déu de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Soler-Vidal
- FIDMAG Germanas Hospitalàries Research Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Benito Menni CASM, Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Jose M Rubio
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Nathalia Garrido-Torres
- University Hospital Virgen del Rocio-IBIS Sevilla, CIBERSAM, ISCIII Spanish Network for Research in Mental Health, Sevilla, Spain
| | - Sandra Gómez-Vallejo
- Child and Adolescent Psychiatry and Psychology Department, Institute of Neurosciences, Hospital Clínic, Barcelona, Spain
| | - John M Kane
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Oliver Howes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Faculty of Medicine, Institute of Clinical Sciences, Imperial College London, London, UK
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) service, South London and Maudsley (SLaM) NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/ Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Berlin, Germany
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Thaineua V, Sirithongthaworn S, Kanshana S, Isaranurak S, Karnkawinpong O, Benjaponpitak A, Wattanayingcharoen S, Piensrivachara E, Srikummoon P, Thumronglaohapun S, Nakharutai N, Traisathit P, Tangviriyapaiboon D. A 9-year retrospective cohort study of the monitoring and screening of childhood developmental delay in Thailand. Child Care Health Dev 2024; 50:e13233. [PMID: 38345164 DOI: 10.1111/cch.13233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/31/2023] [Accepted: 01/25/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Developmental delay in early childhood can have negative long-term cognitive and psychiatric sequelae, along with poor academic achievement, so early screening and surveillance are paramount. The aim of this study is to evaluate the impact of screening and surveillance on child developmental delay using the Developmental Surveillance and Promotion Manual (DSPM) and the Thai Early Developmental Assessment for Intervention (TEDA4I) for Thai children aged 0-5 years old. METHODS Data were obtained from the routine developmental screening for specific disorders at ages 9, 18, 30, 42 and 60 months conducted using DSPM and TEDA4I from 2013 to 2021. Descriptive statistics were used to analyse the data, and the results are visualised graphically herein. RESULTS Only 56% of the children were screened for child developmental delay using DSPM. The proportion of children screened increased from <1% in 2013 to 90% in 2021. Suspected developmental delay prevalence increased significantly from 3.91% in 2013-2015 to 10.00% in 2016-2018 and 26.48% in 2019-2021. Moreover, of the children with suspected developmental delay who received developmental stimulation within a month, only 87.9% returned for follow-up visits when they were evaluated again using TEDA4I to ascertain any abnormalities and specific areas of deficit. The overall proportion of children diagnosed with developmental delay was 1.29%. During the pandemic, the proportion of screening tests for child developmental delay at routine vaccination visits and follow-ups decreased but was still at least 80% in each region. CONCLUSIONS Since 1%-3% of children have suspected developmental delay, early detection is key to treating it as soon as possible. We anticipate that our findings will raise awareness in parents and caregivers about childhood developmental delay and lead to the implementation of early intervention and follow-up at the rural level in Thailand.
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Affiliation(s)
- Vallop Thaineua
- Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Siripon Kanshana
- Thai Breastfeeding Center Foundation, Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Opart Karnkawinpong
- Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
| | | | | | | | - Pimwarat Srikummoon
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Medical Statistics and Data Analytics for Child and Youth Well-Being Research Group, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Salinee Thumronglaohapun
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Medical Statistics and Data Analytics for Child and Youth Well-Being Research Group, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Nawapon Nakharutai
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Medical Statistics and Data Analytics for Child and Youth Well-Being Research Group, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
- Medical Statistics and Data Analytics for Child and Youth Well-Being Research Group, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
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An X, Zhang Y, Sun W, Kang X, Ji H, Sun Y, Jiang L, Zhao X, Gao Q, Lian F, Tong X. Early effective intervention can significantly reduce all-cause mortality in prediabetic patients: a systematic review and meta-analysis based on high-quality clinical studies. Front Endocrinol (Lausanne) 2024; 15:1294819. [PMID: 38495794 PMCID: PMC10941028 DOI: 10.3389/fendo.2024.1294819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
Background Reducing the occurrence of diabetes is considered a primary criterion for evaluating the effectiveness of interventions for prediabetes. There is existing evidence that early lifestyle-based interventions can significantly decrease the incidence of diabetes. However, whether effective interventions can reduce long-term outcomes in patients, including all-cause mortality, cardiovascular risks, and the occurrence of microvascular complications, which are the most concerning issues for both patients and clinicians, remains a subject of inconsistent research findings. And there is no direct evidence to answer whether effective intervention has long-term benefits for prediabetic patients. Therefore, we conducted a systematic review and meta-analysis to assess the relationship between early effective intervention and macrovascular and microvascular complications in prediabetic patients. Methods PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for the randomized controlled trials of lifestyle or/and drugs intervention in prediabetes from inception to 2023.9.15. Two investigators independently reviewed the included studies and extracted relevant data. Random or fixed effects model meta-analysis to derive overall relative risk (RR) with 95% CI for all-cause mortality, cardiovascular events, and microvascular complications. Results As of September 15, 2023, a total of 7 effective intervention studies were included, comprising 26 articles out of 25,671 articles. These studies involved 26,389 patients with a total follow-up duration of 178,038.6 person-years. The results indicate that effective intervention can significantly reduce all-cause mortality in prediabetic patients without a history of cardiovascular disease by 17% (RR 0.83, 95% CI 0.70-0.98). Additionally, effective intervention reduced the incidence of retinopathy by 38% (RR 0.62, 95% CI 0.70-0.98). Furthermore, the study results suggest that women and younger individuals have lower all-cause mortality and cardiovascular mortality. Subsequently, we conducted an in-depth analysis of patients without a history of cardiovascular disease. The results revealed that prediabetic patients with a 10-year cardiovascular risk >10% experienced more significant benefits in terms of all-cause mortality (P=0.01). When comparing the results of all-cause mortality and cardiovascular mortality from the Da Qing Diabetes Prevention Outcome Study longitudinally, it was evident that the duration of follow-up is a key factor influencing long-term benefits. In other words, the beneficial effects become more pronounced as the intervention duration reaches a certain threshold. Conclusion Early effective intervention, which significantly reduces the incidence of diabetes, can effectively lower all-cause mortality in prediabetic patients without a history of cardiovascular disease (especially those with a 10-year cardiovascular risk >10%), with women and younger individuals benefiting more significantly. Additionally, the duration of follow-up is a key factor influencing outcomes. The conclusions of this study can provide evidence-based guidance for the clinical treatment of prediabetic patients to prevent cardiovascular and microvascular complications. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42020160985.
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Affiliation(s)
- Xuedong An
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuehong Zhang
- Fangshan Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Wenjie Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaomin Kang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hangyu Ji
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuting Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Linlin Jiang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xuefei Zhao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Gao
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fengmei Lian
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaolin Tong
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Loomis AM, McLaughlin RX, Lyon M, Mitchell J. Infant and early childhood teleconsultation and training: Program description and feasibility outcomes from a statewide implementation. Infant Ment Health J 2024; 45:185-200. [PMID: 38230980 DOI: 10.1002/imhj.22101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/22/2023] [Accepted: 12/28/2023] [Indexed: 01/18/2024]
Abstract
To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.
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Affiliation(s)
- Alysse M Loomis
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Rose X McLaughlin
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - McCall Lyon
- The Children's Center Utah, West Valley City, Utah, USA
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36
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Fayyaz S, Nkire N, Nwosu B, Amjad N, Kinsella A, Gill M, McDonough C, Russell V, Waddington JL. Carepath for overcoming psychosis early (COPE): first 5 years of clinical operation and prospective research in the Cavan-Monaghan early intervention service. Ir J Psychol Med 2024; 41:23-36. [PMID: 34353408 DOI: 10.1017/ipm.2021.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES As Ireland confronts the many challenges of broadening the introduction of early intervention services (EIS) for first episode psychosis (FEP) as national policy, this article describes Carepath for Overcoming Psychosis Early (COPE), the EIS of Cavan-Monaghan Mental Health Service, and presents prospective research findings during its first 5 years of operation. METHODS COPE was launched as a rural EIS with an embedded research protocol in early 2012, following an education programme for general practitioners (GPs). Here, operational activities are documented and research findings presented through to late 2016. RESULTS During this period, 115 instances of FEP were incepted into COPE, 70.4% via their GP and 29.6% via the Emergency Department. The annual rate of inception was 24.8/100,000 of population aged > 15 years and was 2.1-fold more common among men than women. Mean duration of untreated psychosis was 5.7 months and median time from first psychotic presentation to initiation of antipsychotic treatment was zero days. Assessments of psychopathology, neuropsychology, neurology, premorbid functioning, quality of life, insight, and functionality compared across 10 DSM-IV psychotic diagnoses made at six months following presentation indicated minimal differences between them, other than more prominent negative symptoms in schizophrenia and more prominent mania in bipolar disorder. CONCLUSIONS COPE illustrates the actuality of introducing and the challenges of operating a rural EIS for FEP. Prospective follow-up studies of the 5-year COPE cohort should inform on the effectiveness of this EIS model in relation to long-term outcome in psychotic illness across what appear to be arbitrary diagnostic boundaries at FEP.
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Affiliation(s)
- S Fayyaz
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland
| | - N Nkire
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - B Nwosu
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland
| | - N Amjad
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland
| | - A Kinsella
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - M Gill
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - C McDonough
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland
- Louth Mental Health Service, St. Brigid's Hospital, Ardee, Ireland
| | - V Russell
- Cavan-Monaghan Mental Health Service, Drumalee Primary Care Centre, Cavan, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
| | - J L Waddington
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
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37
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Black MM, Kowalski AJ. Commentary: A nurturing care perspective on bundling interventions - a reflection on Jeong et al. (2023). J Child Psychol Psychiatry 2024. [PMID: 38411216 DOI: 10.1111/jcpp.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/28/2024]
Abstract
Bundling multiple interventions have been implemented and evaluated in response to global recognition that young children benefit from the multiple components of nurturing care. Engaging Fathers for Effective Child Nutrition and Development in Tanzania Study evaluated the impact of adding a parenting intervention to a nutrition program and involving fathers on children's development. The study found that the bundled nutrition-parenting intervention improved children's short-term cognitive and receptive language scores over the nutrition only intervention, with no difference between involving mother-father couples versus mothers only. This study adds to recommendations for future multiple component interventions, including to investigate the mechanisms driving interventions, to address the potential for both benefits and harms, to involve household and community caregivers, and to incorporate implementation research to transition evidence-based programs to scale. Expanding nurturing care through multiple component interventions has the potential to promote equity by ensuring that all children have opportunities for healthy growth and development.
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Affiliation(s)
- Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA
- RTI International, Research Triangle Park, NC, USA
| | - Alysse J Kowalski
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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38
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Andrewes HE, Cavelti M, Hulbert C, Cotton SM, Betts JK, Jackson HJ, McCutcheon L, Gleeson J, Davey CG, Chanen AM. An analysis of real-time suicidal ideation and its relationship with retrospective reports among young people with borderline personality disorder. Suicide Life Threat Behav 2024. [PMID: 38375970 DOI: 10.1111/sltb.13058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION This study aimed to analyze the real-time variability of suicidal ideation intensity and the relationship between real-time and retrospective reports of suicidal ideation made on the Beck Scale for Suicidal Ideation (BSS), among young people with borderline personality disorder (BPD). METHODS Young people (15-25-year olds) with BPD (N = 46), recruited from two government-funded mental health services, rated the intensity of their suicidal ideation six times per day for 7 days before completing the BSS. RESULTS For 70% of participants, suicidal ideation changed in intensity approximately five times across the week, both within and between days. BSS ratings were most highly correlated with the highest real-time ratings of suicidal ideation. However, this was not significantly different from the relationship between the BSS and both the average and most recent ratings. Median ratings of suicidal ideation intensity were higher on the BSS compared with an equivalent question asked in real time. CONCLUSION Findings suggest that young people with BPD experience high levels of fluctuation in their intensity of suicidal ideation across a week and that retrospective reports of suicidal ideation might be more reflective of the most intense experience of suicidal ideation across the week.
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Affiliation(s)
- Holly E Andrewes
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marialuisa Cavelti
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Translational Research Centre, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Carol Hulbert
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susan M Cotton
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer K Betts
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Henry J Jackson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Louise McCutcheon
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Christopher G Davey
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew M Chanen
- Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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Tahmazov E, Blachier A, Nabbe P, Guillou-Landreat M, Walter M, Lemey C. Effect of early intervention for early-stage psychotic disorders on suicidal behaviours - a systematic review protocol. Front Psychiatry 2024; 15:1359764. [PMID: 38435977 PMCID: PMC10904604 DOI: 10.3389/fpsyt.2024.1359764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
Background The early stages of psychotic disorders correspond to the early phases of the disease and include the prodromal phase and first-episode psychosis; they constitute a period at high risk of suicidal behaviour. A long duration of untreated psychosis (DUP) is among the risk factors of suicidal behaviour identified in this early period. Many studies have shown the effectiveness of early interventions on the overall prognosis of psychotic disorders in the early stages, and early intervention strategies have been developed and tested worldwide. Several authors reported an improvement in suicidal behaviours; however, all these data have not been systematically analysed yet. The main objective of this systematic review was to collect evidence on the effect on suicidal behaviour of early interventions for patients in the early stages of psychotic disorders. Methods We will carry out a systematic review of the literature according to the PRISMA criteria by searching articles in five databases (PubMed, Cochrane, PsycINFO, Scopus, EMBASE), without restriction on the publication date. The selection criteria are: articles (any type; e.g. prospective, retrospective, controlled or uncontrolled, and literature reviews) on early interventions for psychotic disorders in the early stages with data on suicide attempts, death by suicide, suicidal ideation; articles written in English or French. Exclusion criteria are: articles on suicidal behaviours in patients with psychotic disorders in the early stages, but without early intervention, and articles on early-stage psychotic disorders without data on suicidal behaviours. Discussion If this review confirms the effectiveness on suicidal behaviours of early interventions for young patients with psychotic disorders, the development/implementation of such intervention programmes should be better promoted. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42021237833.
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Affiliation(s)
- Elkhan Tahmazov
- Unité de Recherche Clinique Intersectorielle (URCI), Service hospitalo-universitaire de psychiatrie adulte, Centre Hospitalo-Universitaire (CHU) de Brest, Hôpital de Bohars, Bohars, France
| | - Athéna Blachier
- Unité de Recherche Clinique Intersectorielle (URCI), Service hospitalo-universitaire de psychiatrie adulte, Centre Hospitalo-Universitaire (CHU) de Brest, Hôpital de Bohars, Bohars, France
| | - Patrice Nabbe
- ER 7479 SPURBO, University of Western Brittany, Brest, France
- Department of general practice – University of Western Brittany, Brest, France
| | | | - Michel Walter
- Unité de Recherche Clinique Intersectorielle (URCI), Service hospitalo-universitaire de psychiatrie adulte, Centre Hospitalo-Universitaire (CHU) de Brest, Hôpital de Bohars, Bohars, France
- ER 7479 SPURBO, University of Western Brittany, Brest, France
| | - Christophe Lemey
- Unité de Recherche Clinique Intersectorielle (URCI), Service hospitalo-universitaire de psychiatrie adulte, Centre Hospitalo-Universitaire (CHU) de Brest, Hôpital de Bohars, Bohars, France
- ER 7479 SPURBO, University of Western Brittany, Brest, France
- IMT Atlantique, Lab-STICC, Campus de Brest, Technopôle Brest-Iroise, Brest, France
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Whiting D, Glogowska M, Fazel S, Lennox B. Approaches and challenges to assessing risk of violence in first episode psychosis: A qualitative interview study of clinicians, patients and carers. Early Interv Psychiatry 2024. [PMID: 38356414 DOI: 10.1111/eip.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/06/2023] [Accepted: 01/24/2024] [Indexed: 02/16/2024]
Abstract
AIM Clinical services for early psychosis seek to improve prognosis for a range of adverse outcomes. For some individuals, perpetration of violence is an important potential outcome to reduce. How these clinical services currently assess this risk however is uncertain. This study aimed to address this gap by using qualitative methods to examine in depth current approaches, attitudes and challenges to assessing violence risk in this clinical setting, from the perspectives of multidisciplinary clinicians, patients and carers. METHODS Participants were recruited from two UK Early Intervention in Psychosis services. Semi-structured individual interviews were undertaken using a topic guide. In addition, clinical vignettes were presented to clinician participants as a probe to prompt discussion. Data were analysed using thematic analysis, informed by the constant comparative method. RESULTS We conducted 30 qualitative interviews, of 18 clinicians and 12 patients and carers. Themes developed from clinician interviews included key difficulties of low confidence, limited training, accessing collateral information and variation in how risk is appraised and communicated. Potential stigma and sensitivity of the topic of violence were perceived as barriers to its discussion. Patient and carer perspectives provided insight into how to address barriers, and highlighted the importance of an open approach, including with families. CONCLUSIONS We recommend developing contextually appropriate pathways to collaboratively assess violence risk and identify modifiable needs to reduce this risk, and for practical improvements in training and information-sharing.
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Affiliation(s)
- Daniel Whiting
- Institute of Mental Health, University of Nottingham, Nottingham, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Margaret Glogowska
- Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Belinda Lennox
- Department of Psychiatry, University of Oxford, Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
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Mendez AI, McQueen E, Gillespie S, Klin A, Klaiman C, Pickard K. Access to Part C, Early Intervention for children younger than 4 years evaluated for autism spectrum disorder. Autism 2024:13623613241229150. [PMID: 38360525 DOI: 10.1177/13623613241229150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
LAY ABSTRACT Health disparities are defined as preventable differences in the opportunities to achieve optimal health outcomes experienced by marginalized and underrepresented communities. For families with autistic children, health disparities limit accessing early intervention services-which have been found to improve quality of life and other outcomes. One specific early intervention service in the United States is Individuals with Disabilities Education Act, Part C Early Intervention programs, which are federally funded interventions for children birth-to-three with developmental delays. This study adds to this topic by examining which factors impact accessing Part C, Early Intervention services for children who were evaluated for autism. Results showed that only half of the sample received these services despite there being concerns about development for all children. In addition, results showed that those who identified as Black had decreased odds of having accessed Part C, Early Intervention compared to those who identified as White. These results suggest that there are disparities when it comes to accessing important early intervention services that may be negatively impacting the Black autistic community.
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Affiliation(s)
- Adriana I Mendez
- Emory University, USA
- Marcus Autism Center, USA
- Children's Healthcare of Atlanta, USA
| | | | - Scott Gillespie
- Emory University, USA
- Marcus Autism Center, USA
- Children's Healthcare of Atlanta, USA
| | - Ami Klin
- Emory University, USA
- Marcus Autism Center, USA
- Children's Healthcare of Atlanta, USA
| | - Cheryl Klaiman
- Emory University, USA
- Marcus Autism Center, USA
- Children's Healthcare of Atlanta, USA
| | - Katherine Pickard
- Emory University, USA
- Marcus Autism Center, USA
- Children's Healthcare of Atlanta, USA
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Brian JA, Dowds EM, Bernardi K, Velho A, Kantawalla M, de Souza N. Transporting and implementing a caregiver-mediated intervention for toddlers with autism in Goa, India: evidence from the social ABCs. Front Rehabil Sci 2024; 5:1214009. [PMID: 38420365 PMCID: PMC10900983 DOI: 10.3389/fresc.2024.1214009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024]
Abstract
Introduction Autism is a global health priority with an urgent need for evidence-based, resource-efficient, scalable supports that are feasible for implementation in low- and middle-income countries (LMICs). Initiating supports in the toddler years has potential to significantly impact child and family outcomes. The current paper describes the feasibility and outcomes associated with a Canadian-developed caregiver-mediated intervention for toddlers (the Social ABCs), delivered through a clinical service in Goa, India. Methods Clinical staff at the Sethu Centre for Child Development and Family Guidance in Goa, India, were trained by the Canadian program development team and delivered the program to families seen through their clinic. Using a retrospective chart review, we gathered information about participating families and used a pre-post design to examine change over time. Results Sixty-four families were enrolled (toddler mean age = 28.5 months; range: 19-35), of whom 55 (85.94%) completed the program. Video-coded data revealed that parents learned the strategies (implementation fidelity increased from M = 45.42% to 76.77%, p < .001, with over 90% of caregivers attaining at least 70% fidelity). Toddler responsivity to their caregivers (M = 7.00% vs. 46.58%) and initiations per minute (M = 1.16 vs. 3.49) increased significantly, p's < .001. Parents also reported significant improvements in child behaviour/skills (p < .001), and a non-significant trend toward reduced parenting stress (p = .056). Discussion Findings corroborate the emerging evidence supporting the use of caregiver-mediated models in LMICs, adding evidence that such supports can be provided in the very early years (i.e., under three years of age) when learning may be optimized.
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Affiliation(s)
- Jessica A. Brian
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Rehabilitation Hospital, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Erin M. Dowds
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Rehabilitation Hospital, Toronto, ON, Canada
| | - Kate Bernardi
- Autism Research Centre, Bloorview Research Institute, Holland Bloorview Rehabilitation Hospital, Toronto, ON, Canada
| | - Andre Velho
- Sethu Centre for Child Development and Family Guidance, Goa, India
| | | | - Nandita de Souza
- Sethu Centre for Child Development and Family Guidance, Goa, India
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Jung W, Ahn A, Lee G, Kong S, Kang D, Lee D, Kim TE, Shim YM, Kim HK, Cho J, Cho J, Shin DW. Supporting Life Adjustment in Patients With Lung Cancer Through a Comprehensive Care Program: Protocol for a Controlled Before-and-After Trial. JMIR Res Protoc 2024; 13:e54707. [PMID: 38349712 PMCID: PMC10900087 DOI: 10.2196/54707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND Lung cancer diagnosis affects an individual's quality of life as well as physical and emotional functioning. Information on survivorship care tends to be introduced at the end of treatment, but early intervention may affect posttreatment adjustment. However, to the best of our knowledge, no study has explored the effect of early information intervention on the return to work, family, and societal roles of lung cancer survivors. OBJECTIVE We report the study protocol of a comprehensive care prehabilitation intervention designed to facilitate lung cancer survivors' psychological adjustment after treatment. METHODS A comprehensive care program was developed based on a literature review and a qualitative study of patients with lung cancer and health professionals. The Lung Cancer Comprehensive Care Program consists of educational videos and follow-up visits by a family medicine physician. To prevent contamination, the control group received routine education, whereas the intervention group received routine care and intervention. Both groups completed questionnaires before surgery (T0) and at 1-month (T1), 6-month (T2), and 1-year (T3) follow-up visits after surgery. The primary outcome was survivors' psychological adjustment to cancer 6 months after pulmonary resection. RESULTS The historical control group (n=441) was recruited from September 8, 2021, to April 20, 2022, and the intervention group (n=350) was recruited from April 22, 2022, to October 17, 2022. All statistical analyses will be performed upon completion of the study. CONCLUSIONS This study examined the effectiveness of an intervention that provided general and tailored informational support to lung cancer survivors, ranging from before to the end of treatment. TRIAL REGISTRATION ClinicalTrials.gov NCT05078918; https://clinicaltrials.gov/ct2/show/NCT05078918. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54707.
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Affiliation(s)
- Wonyoung Jung
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Alice Ahn
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, TX, United States
| | - Genehee Lee
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Sunga Kong
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Danbee Kang
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Seoul, Republic of Korea
| | - Dongok Lee
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Tae Eun Kim
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hong Kwan Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jongho Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Juhee Cho
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Dong Wook Shin
- Department of Family Medicine and Supportive Care Center, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science & Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Sandbank M, Bottema-Beutel K, Syu YC, Caldwell N, Feldman JI, Woynaroski T. Evidence-b(i)ased practice: Selective and inadequate reporting in early childhood autism intervention research. Autism 2024:13623613241231624. [PMID: 38345030 DOI: 10.1177/13623613241231624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
LAY ABSTRACT When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better.
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Affiliation(s)
| | | | - Ya-Cing Syu
- The University of North Carolina at Chapel Hill, USA
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Battistin T, Mercuriali E, Borghini C, Reffo ME, Suppiej A. Parental Satisfaction with the Quality of Care in an Early Intervention Service for Children with Visual Impairment: A Retrospective Longitudinal Study. Children (Basel) 2024; 11:230. [PMID: 38397342 PMCID: PMC10887141 DOI: 10.3390/children11020230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
The fundamental role of vision during development and the nurturing role of early intersubjectivity have enabled the Robert Hollman Foundation to develop an early intervention program providing holistic support to visually impaired children and their families, where fostering parent-infant interactions is at the heart of our care. The aim of this study is to understand how parents perceive this approach. It is an eleven-year retrospective study of children following the Robert Hollman Foundation's early intervention program, in which parents' (n = 1086) perceptions of quality of care were measured through the administration of a specifically designed 4-point scale questionnaire. Annual longitudinal trends of parents' perceptions were calculated for every single response. Parents reported a very high satisfaction value in 21/23 questions (Mean > 3.7 out of a maximum score of 4, with the highest scores in human and soft skills of professionals) with a statistically positive trend (p < 0.05), throughout the period considered. Our core approach, based on an individualized nurturing relational support, has been appreciated and confirmed by the high satisfaction reported in the questionnaires by parents of children with visual impairment. We therefore hypothesize that parent-infant relationship-based and individualized approaches may help parents achieve better health, well-being, and quality of daily life for their children.
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Affiliation(s)
- Tiziana Battistin
- Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
| | - Elena Mercuriali
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
| | - Carlotta Borghini
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35131 Padua, Italy;
| | - Maria Eleonora Reffo
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
| | - Agnese Suppiej
- Robert Hollman Foundation, 35143 Padova, Italy; (E.M.); (M.E.R.); (A.S.)
- Robert Hollman Foundation, 28821 Cannero Riviera, Italy
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
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Sloan M, Sturner R, Addington J, Cornblatt B, Granholm E, Cadenhead KS. Negative self-reference as a component of subthreshold psychotic symptoms in clinical high-risk youth. Early Interv Psychiatry 2024. [PMID: 38334214 DOI: 10.1111/eip.13515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 12/08/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024]
Abstract
AIM Schizophrenia is a leading cause of disability worldwide; early detection and intervention are critical. Early in their illness, individuals at clinical high-risk (CHR) for psychosis have subthreshold psychotic symptoms that are often derogatory and self-directed. We hypothesized that CHR participants with negative self-reference (NSR) as a component of subthreshold psychosis would also have higher levels of social anxiety and depression, lower self-esteem and lower social/role/global functioning as compared with CHR participants without NSR. METHODS One hundred and sixty-eight participants from the National Institute of Mental Health (NIMH) funded Regroup Cognitive Behavioural Social Skills Training (CBSST) study were included. Clinical vignettes that included the Scale of Psychosis-Risk Symptoms were coded categorically to indicate whether NSR was present. t-tests were used to determine the association between NSR, symptom, and functional measures. RESULTS Participants with NSR demonstrated significantly more social interaction anxiety (p < .001), negative beliefs about the self (p ≤ .001), defeatist beliefs (p < .05), depressive symptoms (p < .05) and positive symptoms (p < .005). There were no significant differences in social self-efficacy, positive or negative beliefs about others, positive beliefs about the self or psychosocial functioning between the two groups. CONCLUSIONS Clinically significant differences were found between CHR participants with and without NSR, suggesting that this may be a useful factor to identify and address. Follow-up studies are needed to determine whether NSR responds to CBSST and whether or not its resolution would be associated with improvement in other symptom domains.
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Affiliation(s)
- Michelle Sloan
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Rebecca Sturner
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
- Department of Child and Adolescent Psychiatry, NYU Langone Hospital, New York City, New York, USA
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Barbara Cornblatt
- Department of Psychiatry Research, The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, New York, USA
| | - Eric Granholm
- San Diego Veterans Affairs Medical Center, Department of Psychiatry, University of California, La Jolla, California, USA
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
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Chambers N, de Vries PJ, Wetherby AM. Feasibility of the Autism Navigator ® JumpStart to Coaching in Everyday Activities course in South Africa. Autism 2024:13623613231223784. [PMID: 38332664 DOI: 10.1177/13623613231223784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
LAY ABSTRACT In low-resource settings, non-profit organisations play an essential role in providing services and support for families with young children with autism, including in Africa. However, non-profit organisation service providers may not have access to quality training in proven intervention methods. Web-based or online courses may help to meet this need. In this study, we invited a group of specialist (10) and non-specialist (16) non-profit organisation providers in South Africa to complete a web-based course, Autism Navigator® JumpStart to Coaching in Everyday Activities, a 20-h self-paced course that provides training in an evidence-based parent coaching intervention called Early Social Interaction. We evaluated acceptability, appropriateness, and feasibility of the training. Of the 26 who enrolled, 16 completed the course (7 specialists and 9 non-specialists). All providers found it difficult to find time to do the course until the lockdown restrictions due to COVID-19, when most completed the course. Those whose first language was not English experienced more difficulties with two of six learner assessments and those who were not clinical specialists had more difficulty with the coaching strategies learner assessment. Most providers rated the course highly feasible, acceptable, and appropriate stating that the course content was very valuable and helpful in equipping them to serve their families. They felt the extensive video clips and regular meetings with a local trainer helped them engage with and understand the material. They suggested that including South African video clips would make the course more relatable. The fact that the course was web-based was identified as a strong benefit, especially during COVID-19 restrictions.
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Radunz M, Pritchard L, Steen E, Williamson P, Wade TD. Addressing the gap of early intervention for eating disorders in primary health care. Early Interv Psychiatry 2024. [PMID: 38318750 DOI: 10.1111/eip.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/20/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
AIM Only one in four individuals with eating disorders (EDs) seek help, with many barriers to treatment-seeking present. Placing an early intervention model in primary mental health care settings is one approach to reducing these barriers. To date, only one model (emerge-ED) has been evaluated in the literature. METHODS We aimed to replicate findings from the initial emerge-ED evaluation. We report on treatment outcomes in a new cohort and their views on barriers to treatment-seeking. We then examine how this early intervention model in primary health care has evolved to overcome the barriers to treatment delivery cited by health professionals in the initial evaluation. RESULTS Eighty participants commenced treatment between July 2020 and March 2022 and completed a mean of 8.98 sessions, 70 (87.5%) completed >1 sessional measure on ED cognitions and behaviours, but only 31% (n = 24) completed lengthier assessments. Findings replicated initial emerge-ED outcomes, with small to moderate effect size decreases in the ED sessional measure at 70 days since treatment commencement for cognitions (d = .63) and ED behaviours (d = .09., .69). The most cited barrier by participants was "belief that my problem is not bad enough", reflective of denial of illness. Lastly, to overcome barriers to treatment delivery clinicians had to deviate from treatment protocols and work collaboratively with other healthcare providers. CONCLUSIONS Our findings replicated the initial emerge-ED evaluation and highlight the importance of considering primary health care settings as an essential site in delivering early intervention services for EDs.
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Affiliation(s)
- Marcela Radunz
- College of Education, Psychology & Social Work, Flinders University, Adelaide, Australia
- Blackbird Initiative, Flinders Institute for Mental Health, and Wellbeing, Adelaide, Australia
| | | | | | - Paul Williamson
- College of Education, Psychology & Social Work, Flinders University, Adelaide, Australia
| | - Tracey D Wade
- College of Education, Psychology & Social Work, Flinders University, Adelaide, Australia
- Blackbird Initiative, Flinders Institute for Mental Health, and Wellbeing, Adelaide, Australia
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Ferrara M, Zaffarami G, Simonelli G, Domenicano I, Vecchioni L, Toffanin T, Folesani F, Zotos S, Scrignoli C, Bertelli R, Carozza P, Grassi L. Dimensions and predictors of clinical and personal recovery in first-episode psychoses: Results from a cross-sectional study. Early Interv Psychiatry 2024. [PMID: 38318707 DOI: 10.1111/eip.13513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/18/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
INTRODUCTION First episode psychosis (FEP) services ensure higher recovery rates compared to usual care. The aim of this study was to investigate the different dimensions of recovery and its predictors. METHODS This cross-sectional study recruited within those admitted to the Ferrara FEP service since 2012 that at the time of analysis were still receiving psychiatric care. At admission, demographic, social and clinical information were collected. In September 2022, patients were assessed with the Health of the Nation Outcome Scale to evaluate clinical/functional recovery, the Recovery Assessment Scale to evaluate personal recovery, and the G12 item of the Positive and Negative Syndrome Scale to evaluate insight. Patients in recovery were compared to those not in recovery by bivariate analyses. Adjusted logistic regressions were performed to investigate predictors of recovery. RESULTS Within 141 admitted, and 105 still receiving care, 54 patients completed the assessment. Most (51.9%) were in clinical/functional, 61.1% in personal recovery, and 38.8% both. Psychiatric hospitalization positively predicted clinical/functional recovery, whereas being prescribed oral antipsychotics was a negative predictor. Personal recovery was predicted by male sex and showed a negative association with overall severity of symptomatology. Those in personal recovery were more likely to have been prescribed long-acting antipsychotics, but this was not significant in the multivariable analysis. Poor insight negatively predicted clinical/functional recovery but had no impact on personal recovery. CONCLUSION Our findings confirm that clinical/functional and personal recovery are semi-independent dimensions and not always overlap. Further research is needed to promote interventions targeted at all recovery dimensions.
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Affiliation(s)
- Maria Ferrara
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Giulia Zaffarami
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Gabriele Simonelli
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Ilaria Domenicano
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Ludovica Vecchioni
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Tommaso Toffanin
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Federica Folesani
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Spyridon Zotos
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Chiara Scrignoli
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Raffaella Bertelli
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Paola Carozza
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
| | - Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
- Department of Mental Health and Pathological Addiction, Local Health Trust (AUSL) Ferrara, Ferrara, Italy
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Carruthers S, Pickles A, Charman T, McConachie H, Le Couteur A, Slonims V, Howlin P, Collum R, Salomone E, Tobin H, Gammer I, Maxwell J, Aldred C, Parr J, Leadbitter K, Green J. Mediation of 6-year mid-childhood follow-up outcomes after pre-school social communication (PACT) therapy for autistic children: randomised controlled trial. J Child Psychol Psychiatry 2024; 65:233-244. [PMID: 37095645 PMCID: PMC10953331 DOI: 10.1111/jcpp.13798] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND There are very few mechanistic studies of the long-term impact of psychosocial interventions in childhood. The parent-mediated Paediatric Autism Communication Therapy (PACT) RCT showed sustained effects on autistic child outcomes from pre-school to mid-childhood. We investigated the mechanism by which the PACT intervention achieved these effects. METHODS Of 152 children randomised to receive PACT or treatment as usual between 2 and 5 years of age, 121 (79.6%) were followed 5-6 years after the endpoint at a mean age of 10.5 years. Assessors, blind to the intervention group, measured Autism Diagnostic Observation Scale Calibrated Severity Score (ADOS CSS) for child autistic behaviours and Teacher Vineland (TVABS) for adaptive behaviour in school. Hypothesised mediators were child communication initiations with caregivers in a standard play observation (Dyadic Communication Measure for Autism, DCMA). Hypothesised moderators of mediation were baseline child non-verbal age equivalent scores (AE), communication and symbolic development (CSBS) and 'insistence on sameness' (IS). Structural equation modelling was used in a repeated measures mediation design. RESULTS Good model fits were obtained. The treatment effect on child dyadic initiation with the caregiver was sustained through the follow-up period. Increased child initiation at treatment midpoint mediated the majority (73%) of the treatment effect on follow-up ADOS CSS. A combination of partial mediation from midpoint child initiations and the direct effect of treatment also contributed to a near-significant total effect on follow-up TVABS. No moderation of this mediation was found for AE, CSBS or IS. CONCLUSIONS Early sustained increase in an autistic child's communication initiation with their caregiver is largely responsible for the long-term effects from PACT therapy on autistic and adaptive behaviour outcomes. This supports the theoretical logic model of PACT therapy but also illuminates fundamental causal processes of social and adaptive development in autism over time: early social engagement in autism can be improved and this can have long-term generalised outcome effects.
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Affiliation(s)
- Sophie Carruthers
- Department of PsychologyInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Andrew Pickles
- Department of Biostatistics and Health InformaticsInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Tony Charman
- Department of PsychologyInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Helen McConachie
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Ann Le Couteur
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Vicky Slonims
- Department of PsychologyInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- Evelina London Children's HospitalLondonUK
| | - Patricia Howlin
- Department of PsychologyInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Rachel Collum
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | - Erica Salomone
- Department of PsychologyInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
- Department of PsychologyUniversity of Milano‐BicoccaMilanItaly
| | | | - Isobel Gammer
- Department of PsychologyInstitute of Psychiatry, Psychology & Neuroscience, King's College LondonLondonUK
| | - Jessica Maxwell
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | | | - Jeremy Parr
- Population Health Sciences InstituteNewcastle UniversityNewcastle upon TyneUK
| | | | - Jonathan Green
- Manchester Academic Health Sciences Centre, Royal Manchester Children's HospitalUniversity of ManchesterManchesterUK
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