Caregiver Participation Engagement in Child Mental Health Prevention Programs: a Systematic Review

Prevention programs are a key method to reduce the prevalence and impact of mental health disorders in childhood and adolescence. Caregiver participation engagement (CPE), which includes caregiver participation in sessions as well as follow-through with homework plans, is theorized to be an important component in the effectiveness of these programs. This systematic review aims to (1) describe the terms used to operationalize CPE and the measurement of CPE in prevention programs, (2) identify factors associated with CPE, (3) examine associations between CPE and outcomes, and (4) explore the effects of strategies used to enhance CPE. Thirty-nine articles representing 27 unique projects were reviewed. Articles were included if they examined CPE in a program that focused to some extent on preventing child mental health disorders. There was heterogeneity in both the terms used to describe CPE and the measurement of CPE. The majority of projects focused on assessment of caregiver home practice. There were no clear findings regarding determinants of CPE. With regard to the impact of CPE on program outcomes, higher levels of CPE predicted greater improvements in child and caregiver outcomes, as well as caregiver-child relationship quality. Finally, a small number of studies found that motivational and behavioral strategies (e.g., reinforcement, appointment reminders) were successful in promoting CPE. This review highlights the importance of considering CPE when developing, testing, and implementing prevention programs for child mental health disorders. Increased uniformity is needed in the measurement of CPE to facilitate a better understanding of determinants of CPE. In addition, the field would benefit from further evaluating strategies to increase CPE as a method of increasing the potency of prevention programs

Pursuit-Evasion Games and Zero-sum Two-person Differential Games

International audienceDifferential games arose from the investigation, by Rufus Isaacs in the 50's, of pursuit-evasion problems. In these problems, closed-loop strategies are of the essence, although defining what is exactly meant by this phrase, and what is the Value of a differential game, is difficult. For closed-loop strategies, there is no such thing as a " two-sided Maximum Principle " , and one must resort to the analysis of Isaacs' equation, a Hamilton Jacobi equation. The concept of viscosity solutions of Hamilton-Jacobi equations has helped solve several of these issues

Identifying Trauma-Related and Mental Health Needs: The Implementation of Screening in California’s Child Welfare Systems

A central aspect of trauma-informed care in child welfare (CW) systems is the use of a trauma-informed screening process. This includes the use of a broadly administered measurement approach to assist professionals in identifying current trauma-related symptomology or a history of potentially traumatizing events. With a high prevalence of unmet mental health needs among CW-involved children, screening can be a crucial step as systems strive to identify children impacted by trauma. This paper offers a summary of CW screening approaches in county-administered CW systems across California. Through a web-administered survey, 46 county administrators reported on their screening practices and perceptions. Information about ages of children screened and screening tools used, perceptions of screening implementation priorities, degree of implementation and satisfaction with screening processes is provided. Several implementation considerations for future trauma-informed care efforts are offered including maintaining a focus on childhood trauma, closing the science-practice gap, and evaluating the state of the science

Wavelet analysis of piezoelectric transducer signals to detect rib fracture during impact tests

International audienc

Wavelet analysis of piezoelectric transducer signals to detect rib fractures during impact tests

International audienceUnderstanding when rib fractures occurred during an impact would provide valuable data to develop improved thoracic injury risk functions and ultimately safer restraint systems. The strain-gage based method commonly used has limited sensitivity and requires up to six gauges per rib to obtain a good spatial resolution. An approach based on time-scale analysis (TSA) of signals obtained from piezoelectric transducers (PZT) was evaluated with the view to overcoming these limitations. A white-tailed deer ribcage was instrumented with fifteen PZT affixed to the left and right ribs and vertebrae (consecutive rib levels 2-5). Six non-injurious impact tests and one fracture test were performed. The continuous wavelet transform (CWT) - a specific type of TSA - was used to track the impact and fracture signals in the ribcage. It was shown that the impacts could be detected by all the PZT within a few milliseconds, and that the peak value of the CWT of the PZT signals greatly decreased for the PZT contralateral to the impact location. As for the fracture, the PZT affixed to the neighbouring ribs could detect the time of fracture within milliseconds. Further analysis of the PZT signals allowed to characterise the transmission of the impact/fracture signals through the ribcage structure (rib, sternum, vertebrae). The next step in the development of this method is to include the vibratory response of the ribcage to refine the algorithm used to process the PZT signals

Opportunities for Early Identification: Implementing Universal Depression Screening with a Pathway to Suicide Risk Screening in a Pediatric Health Care System

ObjectivesTo describe the implementation process and assess results of a large-scale universal depression screening program with pathways to suicide risk screening in a pediatric integrated delivery network.Study designThis retrospective study analyzes depression and suicide risk screening data for 95 613 patients ages 12-17 years.ResultsOf the 95 613 adolescent patients who were screened for depression, 2.4% (2266) screened positive for risk for moderate-severe depression (>10 Patient Health Questionnaire; 9-item version) and 4.1% (3942) endorsed elevated suicide risk (≥1 Columbia Suicide Severity Rating Scale). Overall, 51% of screened patients who present with a primary psychiatric concern screened positive for elevated risk of suicide (2132). Two percent of screened patients who presented with a primary medical concern screened positive for elevated risk of suicide. Nearly one-half (45.9%) of all elevated suicide risk screenings were from patients with a primary medical concern.ConclusionsA large-scale universal depression screening program with a pathway to identify elevated suicide risk was implemented in a pediatric health care system using the Patient Health Questionnaire and the Columbia Suicide Severity Rating Scale. This screening program identified youth with moderate-severe depression and elevated risk for suicide with and without presenting psychiatric concerns across service settings

Mental health symptoms of youth initiating psychiatric care at different phases of the COVID-19 pandemic

ObjectiveTo examine differences in caregiver and youth reported mental health symptoms for youth initiating mental health treatment through phases of the Coronavirus Disease (COVID-19) pandemic, compared with symptomology reported the prior year.Study designThis retrospective study analyzes group differences in mental health symptoms (Pediatric Symptom Checklist; PSC-35) based on 7874 youth seeking treatment in publicly funded mental health treatment programs during California's Stay-At-Home order (March-May, 2020) and the prolonged pandemic (May-December, 2020) phases of the COVID-19 pandemic as compared with matching groups in 2019.ResultsYouth entering mental health treatment services, and their caregivers, reported significantly increased internalizing, externalizing, and attention-related symptoms during the prolonged pandemic phase, but not during the acute stay-at-home phase of the COVID-19 pandemic, and with small effect sizes. Group comparison analyses did not detect a significantly larger effect for Sexual and Gender Diverse (SGD) youth who identify as lesbian, gay, bisexual, asexual, transgender, Two-Spirit, queer, and/or intersex, and Black, Indigenous, People of Color (BIPOC).ConclusionsA large-scale comparison of youth mental health symptoms before and during the COVID-19 pandemic suggests that mental health was disrupted for youth seeking treatment as the pandemic prolonged throughout 2020