Teacher and child perceptions of relationship quality and ethnic minority children's behavioral adjustment in upper elementary school: A cross-lagged approach

In this study, cross-lagged longitudinal modeling was used to examine associations between teacher-child relationship quality and children's behavioral adjustment in a sample of sixth grade ethnic minority children. In comparison to previous cross-lagged studies, children were older and cross-informant models were used. Both teachers (N = 12) and children (N = 226) reported on the relationship quality (Closeness, Conflict, and Dependency or Negative Expectations), and children's behavioral adjustment (Externalizing Problems, Internalizing Problems, and Prosocial Behavior) at the beginning and the end of the school year. Children's externalizing behavior at the beginning of the school year was consistently and positively associated with conflict at the end of the school year. Interestingly, dependency at time 1 was associated with children's behavioral adjustment at time 2, whereas for closeness and conflict associations were the other way around (i.e., children's behavior at time 1 was associated with teacher-child closeness and conflict at time 2). Taken together, our results seem to indicate that bidirectional associations between teacher-child relationships and behavioral adjustment apply to older, ethnic minority children as well

The association between mental healthcare professionals' personal characteristics and their clinical lifestyle practices: A national cross-sectional study in the Netherlands

Background Lifestyle interventions are important to improve the mental and physical health outcomes of people with mental illness. However, referring patients to lifestyle interventions is still not a common practice for mental healthcare professionals (MHCPs) and their own lifestyle habits may impact this. The aim of this study was to investigate MHCPs' personal lifestyle habits, their lifestyle history and referral practices, and if these are associated with their lifestyle habits, gender, and profession. Methods In this cross-sectional study, an online questionnaire was distributed across relevant MHCP's in The Netherlands. Ordinal regression analyses on lifestyle habits, gender, profession, and lifestyle history and referral practices were conducted. Results A total of the 1,607 included MHCPs, 87.6% finds that lifestyle should be part of every psychiatric treatment, but depending on which lifestyle factor, 55.1-84.0% take a lifestyle history, 29.7-41.1% refer to interventions, and less than half (44.2%) of smoking patients are advised to quit. MHCPs who find their lifestyle important, who are physically more active, females, and MHCPs with a nursing background take more lifestyle histories and refer more often. Compared to current smokers, MHCPs who never or formerly smoked have higher odds (2.64 and 3.40, respectively, p < 0.001) to advice patients to quit smoking. Conclusions This study indicates that MHCPs' personal lifestyle habits, gender, and profession affect their clinical lifestyle practices, and thereby the translation of compelling evidence on lifestyle psychiatry to improved healthcare for patients

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

A values-affirmation intervention does not benefit negatively stereotyped immigrant students in the Netherlands

Previous research showed that a values-affirmation intervention can help reduce the achievement gap between African American and European American students in the US. In the present study, it was examined if these results would generalize to ethnic minority students in a country outside the US, namely the Netherlands, where there is also an achievement gap between native and ethnic minority students. This type of intervention was tested in two separate studies, the first among first-year pre-vocational students (n = 361, 84% ethnic minority), and the second among sixth grade students (n = 290, 96% ethnic minority). Most minority participants had a Turkish-Dutch or Moroccan-Dutch immigrant background. In the second study, a third condition was added to the original paradigm, in which students elaborated on either their affirmation- or a control exercise with the help of a teaching assistant. We also examined whether values affirmation affected the level of problem behavior of negatively stereotyped ethnic minority youth. Contrary to what was expected, multilevel analyses revealed that the intervention had no effect on the school achievement or the problem behavior of the ethnic minority students. Possible explanations for these findings, mainly related to contextual and cultural differences between the Netherlands and the US, are discussed

Tapering of psychotropic drugs: current practice and needs of patients and their relatives

BACKGROUND: The prevalence of mental illness has remained stable in recent decades, yet the use of psychotropic drugs has increased. This trend suggests that psychotropic drugs are being prescribed with an unnecessary frequency. Internationally, there is growing attention for deprescribing. AIM: To investigate what experiences and needs patients and their loved ones/relatives have with regard to deprescribing of psychotropics. METHOD: An online questionnaire was distributed among members of the MIND mental health care panel, which consists of (former) patients with a psychiatric disorder and their loved ones. RESULTS: A total of 564 respondents took part in this survey. Most patients have phased out/stopped their psychotropic drugs (83.8%). This was usually done at the initiative of the patient (66.7%), in consultation with the practitioner (72.9%). The practitioner only took the initiative to deprescribe in 15.1% of the cases. In 68.6% tapering was not discussed at the start of psychotropic drug use. Patients did not experience willingness from practitioners in deprescribing, and would like to discuss deprescribing more often (79.5%). CONCLUSION: There is an undeniable demand among patients and near ones for more emphasis on deprescribing of psychotropic drugs. We advise to include this topic in the shared decision making process