Developmental trajectories of child to adolescent externalizing behavior and adult DSM-IV disorder: results of a 24-year longitudinal study

Objective: Childhood externalizing behavior is found to be relatively persistent. Developmental pathways within types of externalizing behavior have been recognized from childhood to adolescence. We aimed to describe the prediction of adult DSM-IV disorders from developmental trajectories of externalizing behavior over a period of 24 years on a longitudinal multiple birth cohort study of 2,076 children. This has not been examined yet. Methods: Trajectories of the four externalizing behavior types aggression, opposition, property violations, and status violations were determined separately through latent class growth analysis (LCGA) using data of five waves, covering ages 4-18 years. Psychiatric disorders of 1,399 adults were assessed with the CIDI. We used regression analyses to determine the associations between children's trajectories and adults' psychiatric disorders. Results: All externalizing behavior types showed significant associations with disruptive disorder in adulthood. In all antisocial behavior types high-level trajectories showed the highest probability for predicting adult disorders. Particularly the status violations cluster predicted many disorders in adulthood. The trajectories most often predicted disruptive disorders in adulthood, but predicted also anxiety, mood, and substance use disorders. Conclusions: We can conclude that an elevated level of externalizing behavior in childhood has impact on the long-term outcome, regardless of the developmental course of externalizing behavior. Furthermore, different types of externalizing beh

Aboveground forest biomass varies across continents, ecological zones and successional stages: refined IPCC default values for tropical and subtropical forests

For monitoring and reporting forest carbon stocks and fluxes, many countries in the tropics and subtropics rely on default values of forest aboveground biomass (AGB) from the Intergovernmental Panel on Climate Change (IPCC) guidelines for National Greenhouse Gas (GHG) Inventories. Default IPCC forest AGB values originated from 2006, and are relatively crude estimates of average values per continent and ecological zone. The 2006 default values were based on limited plot data available at the time, methods for their derivation were not fully clear, and no distinction between successional stages was made. As part of the 2019 Refinement to the 2006 IPCC Guidelines for GHG Inventories, we updated the default AGB values for tropical and subtropical forests based on AGB data from >25 000 plots in natural forests and a global AGB map where no plot data were available. We calculated refined AGB default values per continent, ecological zone, and successional stage, and provided a measure of uncertainty. AGB in tropical and subtropical forests varies by an order of magnitude across continents, ecological zones, and successional stage. Our refined default values generally reflect the climatic gradients in the tropics, with more AGB in wetter areas. AGB is generally higher in old-growth than in secondary forests, and higher in older secondary (regrowth >20 years old and degraded/logged forests) than in young secondary forests (20 years old). While refined default values for tropical old-growth forest are largely similar to the previous 2006 default values, the new default values are 4.0-7.7-fold lower for young secondary forests. Thus, the refined values will strongly alter estimated carbon stocks and fluxes, and emphasize the critical importance of old-growth forest conservation. We provide a reproducible approach to facilitate future refinements and encourage targeted efforts to establish permanent plots in areas with data gaps

A scenario analysis of the future residential requirements for people with mental health problems in Eindhoven

Abstract Background Despite large-scale investments in mental health care in the community since the 1990 s, a trend towards reinstitutionalization has been visible since 2002. Since many mental health care providers regard this as an undesirable trend, the question arises: In the coming 5 years, what types of residence should be organized for people with mental health problems? The purpose of this article is to provide mental health care providers, public housing corporations, and local government with guidelines for planning organizational strategy concerning types of residence for people with mental health problems. Methods A scenario analysis was performed in four steps: 1) an exploration of the external environment; 2) the identification of key uncertainties; 3) the development of scenarios; 4) the translation of scenarios into guidelines for planning organizational strategy. To explore the external environment a document study was performed, and 15 semi-structured interviews were conducted. During a workshop, a panel of experts identified two key uncertainties in the external environment, and formulated four scenarios. Results The study resulted in four scenarios: 1) Integrated and independent living in the community with professional care; 2) Responsible healthcare supported by society; 3) Differentiated provision within the walls of the institution; 4) Residence in large-scale institutions but unmet need for care. From the range of aspects within the different scenarios, the panel was able to work out concrete guidelines for planning organizational strategy. Conclusions In the context of residence for people with mental health problems, the focus should be on investment in community care and their re-integration into society. A joint effort is needed to achieve this goal. This study shows that scenario analysis leads to useful guidelines for planning organizational strategy in mental health care.</p

Towards the diversification of drivers and barriers for the adoption of eMental health by professionals: a conceptual model

Introduction: The Internet and mediated communication technologies offer major opportunities in supporting mental healthcare, and evidence for the effectiveness of eMental health is growing. However, their acceptance and use in clinical practice remains low. Material &amp; methods: The current study deployed a qualitative descriptive approach to gain structured insight into the experienced drivers and barriers to adoption of eMental health from the perspective of clinical psychologists. Results: Multiple drivers and barriers emerged from the analysis of the data, several of which are new to the literature. Importantly, particular drivers and barriers are experienced differently by practitioners depending on the extent to which they have adopted online treatment. Based on these findings, we constructed the Levels of Adoption of eMental Health (LAMH) model, which distinguishes several categories of adoption of eMental health, and characterizes experienced drivers and barriers as a function of them. The LAMH model was then supported through a communicative validation. Conclusion: The LAMH model provides a more structured understanding of the process of adopting eMental health, thereby facilitating future research on this topic, and informs targeted recommendations with respect to technology, training and clinical practice that take into account the individual level of adoption

Perceived drivers and barriers to the adoption of eMental health by psychologists:the construction of the levels of adoption of eMental health model

\u3cp\u3eBackground: The internet offers major opportunities in supporting mental health care, and a variety of technology-mediated mental and behavioral health services have been developed. Yet, despite growing evidence for the effectiveness of these services, their acceptance and use in clinical practice remains low. So far, the current literature still lacks a structured insight into the experienced drivers and barriers to the adoption of electronic mental health (eMental health) from the perspective of clinical psychologists. Objective: The aim of this study was to gain an in-depth and comprehensive understanding of the drivers and barriers for psychologists in adopting eMental health tools, adding to previous work by also assessing drivers and analyzing relationships among these factors, and subsequently by developing a structured representation of the obtained findings. Methods: The study adopted a qualitative descriptive approach consisting of in-depth semistructured interviews with clinical psychologists working in the Netherlands (N=12). On the basis of the findings, a model was constructed that was then examined through a communicative validation. Results: In general, a key driver for psychologists to adopt eMental health is the belief and experience that it can be beneficial to them or their clients. Perceived advantages that are novel to literature include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities due to eMental health. More importantly, a relation was found between the extent to which psychologists have adopted eMental health and the particular drivers and barriers they experience. This differentiation is incorporated in the Levels of Adoption of eMental Health (LAMH) model that was developed during this study to provide a structured representation of the factors that influence the adoption of eMental health. Conclusions: The study identified both barriers and drivers, several of which are new to the literature and found a relationship between the nature and importance of the various drivers and barriers perceived by psychologists and the extent to which they have adopted eMental health. These findings were structured in a conceptual model to further enhance the current understanding. The LAMH model facilitates further research on the process of adopting eMental health, which will subsequently enable targeted recommendations with respect to technology, training, and clinical practice to ensure that mental health care professionals as well as their clients will benefit optimally from the current (and future) range of available eMental health options.\u3c/p\u3

Foregrounding everyday sounds in dementia

There has been an increased interest in researching the beneficial effects of everyday sounds, other than music on people with dementia. However, to turn this potential into concrete design applications, a qualitative understanding of how people engage with sound is needed. This paper presents the outcomes of three workshops, exploring the personal experiences evoked by soundscapes of people in early to mid-stages of dementia. Using the dementia soundboard, we provide key insights into how sounds from everyday life triggered personal associations, memories of the past, emotional responses, and the sharing of experiences. Furthermore, we identified several design considerations and practical insights for sound-based technologies in the context of dementia care. This paper sets out a path for further design-research explorations and development of concrete sound-based interventions, for enriching the everyday lives of people with dementia. There has been an increased interest in researching the beneficial effects of everyday sounds, other than music on people with dementia. However, to turn this potential into concrete design applications, a qualitative understanding of how people engage with sound is needed. This paper presents the outcomes of three workshops, exploring the personal experiences evoked by soundscapes of people in early to mid-stages of dementia. Using the dementia soundboard, we provide key insights into how sounds from everyday life triggered personal associations, memories of the past, emotional responses, and the sharing of experiences. Furthermore, we identified several design considerations and practical insights for sound-based technologies in the context of dementia care. This paper sets out a path for further design-research explorations and development of concrete sound-based interventions, for enriching the everyday lives of people with dementia

The role of everyday sounds in advanced dementia care

The representation of sounds derived from everyday life can be beneficial for people with dementia by evoking memories and emotional responses. Despite this potential, integrating sound and sound-based interventions in care facilities has not received much research attention. In this paper, we present the findings from a field study that explored the responses of 19 people with advanced dementia to a selection of everyday sounds presented to them in a care home and the role of these responses in the care environment. To study this, we deployed Vita, a ‘pillow-like’ sound player, in two dementia care facilities for four weeks, during which observations were recorded. Afterwards, we conducted interviews with caregivers who used Vita in everyday care practice. Our findings reveal how everyday sounds provided by Vita stimulated meaningful conversation, playfulness, and connection between residents and caregivers. Furthermore, we propose design implications for integrating everyday sounds in dementia care

Supporting the adoption of eHealth: addressing needs of mental healthcare professionals

Background:Online and mobile technologies offer major opportunities in supporting mental healthcare. Online treatment carries several distinct advantages and convincing evidence is available for its clinical efficacy. However, adoption rates of online tools in clinical practice remain low. Our work is aimed to support mental healthcare professionals in exploring eHealth options, and to address some of the inherent limitations of eHealth technology – specifically in mediated interpersonal communication. \u3cbr/\u3e\u3cbr/\u3eMethods:Knowledge and experience of mental healthcare professionals regarding eHealth tools were probed using in-depth interviews (N=12). Insights drawn from these interviews were structured by developing a levels-of-adoption model, and will be used to inform ways to enhance online treatment tools. \u3cbr/\u3e\u3cbr/\u3eFindings: From the data, several drivers and barriers to the adoption of online treatment emerged. Main barriers consist of lack of skills, knowledge and experience regarding eHealth tools, as well as technological issues and lack of organizational support. Perceived drivers include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities. All participants emphasized that a minimum amount of face-to-face contact is vital to the quality of their treatment, indicating that current technological solutions do not entirely address their needs. Moreover, it was found that the particular drivers and barriers that are experienced differ between psychologists, depending on the extent to which they have adopted online treatment.\u3cbr/\u3e\u3cbr/\u3eDiscussion: Based on the current findings we can already identify several potential design improvements to current eHealth technologies to ameliorate experienced barriers. In addition, our results also provide inspiration for novel ways to enhance online treatment tools, including the use of social biofeedback and virtual reality. In the end, our project will develop a game-based environment that challenges and supports therapists to playfully explore a variety of online tools, allowing them to improve their skills in online psychological treatment.\u3cbr/\u3