Economic evaluations of child and adolescent mental health interventions : a systematic review.

BACKGROUND : The need has grown over recent years for economic information on the impacts of child and adolescent mental helath problems and the cost-effectiveness of interventions. METHODS : A range of electronic databases were searched using a predefined search strategy. To identify economic studies which focused on services, pharmacological interventions and other treatments for children and adolescents with a diagnosed mental health problem or identified as at risk of mental illness. Published studies were included in the review if they assessed both costs and outcomes, with cost-effectiveness being the primary interest. Articles meeting the criteria for inclusion were assessed for quality. RESULTS : Behavioural disorders have been given relatively large attention in economic evaluations of child and adolescent mental health. These studies tentatively suggest child behavioural gains and parent satisfaction from parent and child training programmes, however the cost effectiveness of the location of delivery for behvaioural therapies is less clear. In general the quality of economic evaluations was limited by small sample sizes, a narrow conceptualisation of costs, narrow perspectives and limited statistical and econometric methods. CONCLUSIONS : Economic evaluations in the field of child and adolescent mental health services are few in number and generally poor in quality, although the number of studies being undertaken is now rising relatively quickly.

The Effects of a Violence Assessment Checklist on the Incidence of Violence for Emergency Department Nurses

Workplace violence (WV) is commonplace in American culture, and nurses working in emergency departments (ED) are not immune to its effects. Violence against emergency department nurses is prominent in current nursing literature, and a cause for major concern. Regrettably there is no consistent tool being used to assess for potential patient violence specific to the emergency department. Current assessment tools have been developed and are commonly used in the mental health arena. This evidence-based practice project concentrated on answering the clinical question of whether or not a violence risk assessment checklist reduced the incidence of violence and increased perception of safety of WV experienced by emergency department nurses. Erickson, Tomlin and Swain’s (1983) Modeling and Role-Modeling (MRM) Theory was employed as the theoretical framework to support implementation for this EBP project. Answers to the clinical question noted above were provided following the implementation of the Bröset Violence Checklist (BVC) by a convenience sample of nurses employed in a community hospital system in Indiana. Data were collected using pre and post intervention staff assessment surveys. Data were analyzed using descriptive statistics and by paired t-test, allowing for a comparison of the mean pre and post-education staff assessment scores. Results demonstrated a clinically significant improvement in five types of violence experienced by nurses: names called, kicked, pushed, threatened with physical harm and yelled at. There was no statistically significant increase in the perception of overall safety from WV after the implementation of the BVC (p \u3e.05). However, there was a statistically significant decrease of overall violence experienced by nurses after the educational intervention (p\u3c.05). The findings suggest that the use of the BVC resulted in a decreased incidence of violence towards emergency department nurses. Results from this evidence-based practice project indicate the BVC could be effective in other clinical areas to decrease the incidence of patient violence

Design studies in Canada?

Dans ce bref article, nous traçons l’histoire de l’enseignement du design au Canada pendant les quarante dernières années et la comparons avec celle au Royaume-Uni, où l’on a assisté à une croissance significative des études du design et des programmes d’histoire du design. Nous soutenons qu’il est impératif de créer de nouveaux programmes d’études du design au Canada afin, d’une part, de renforcer l’éducation pratique en design et, de l’autre, de retenir les jeunes chercheurs et chercheures

College Women and Body Image Perception: The Influence of Peers, Television, and Print Media

This study sought to identify how college women\u27s image of self and their bodies are impacted by their peers, as well as by television and print media. The findings were based on qualitative research methodology by conducting in-depth interviews with four college-aged women at a rural, Midwestern university. The findings were not substantially different from other researchers findings on women in previous literature. The women in this study faced similar problems that other women had encountered before them: peer influence, body image dissatisfaction, their own college development path, and how they perceive their body image in comparison to other women. It was found in this study that the women had an awareness of how the media could negatively affect their body image, but ultimately their peers influenced the women more than any other factor questioned in the study

Muscogee Constitutional Jurisprudence: Vhakv Em Pvtakv (The Carpet Under the Law)

In 1974, a group of Mvskoke citizens from Oklahoma sued the federal government in federal court. Hanging in the balance was the future of Mvskoke self-determination. The plaintiffs insisted that their 1867 Constitution remained in full effect, and that they still governed themselves pursuant to it. The United States argued that the constitution had been nullified by federal law passed in the early 1900s. To find in favor of the plaintiffs, the court would have to rule that the United States had been ignoring the most basic civil rights of Mvskoke citizens and flouting the law for over seventy years. It would also have to find that a tribal government had been operating legitimately in the shadows—that the Mvskoke people had continued to operate under their constitution for most of the twentieth century despite official federal antagonism. It was definitely a long shot, but they won. This article explores factors that have helped the Mvskoke people create, nurture, and sustain a constitutional government under hostile circumstances for centuries. We focus on the history and structure of the constitutional government of the Muscogee (Creek) Nation of Oklahoma. We consider several aspects of Creek conceptions of government structure and balance, which are also evidenced in the constitutional jurisprudence of the Muscogee (Creek) Nation Supreme Court. At first glance, the contemporary Mvskoke government today bears little resemblance to the ancient etvlwv town-based system of governance, but a more penetrating analysis reveals common threads of political theory and cosmogony, or world view, that have continued unabated

What was life like for autistic children during the pandemic?

Sarah Pais and Martin Knapp (LSE) look at the impact school closures had on autistic children

Muscogee Constitutional Jurisprudence: Vhakv Em Pvtakv (The Carpet Under The Law)

In 1974, a group of Mvskoke citizens from Oklahoma sued the federal government in federal court. Hanging in the balance was the future of Mvskoke self-determination. The plaintiffs insisted that their 1867 Constitution remained in full effect, and that they still governed themselves pursuant to it. The United States argued that the constitution had been nullified by federal law passed in the early 1900s. To find in favor of the plaintiffs, the court would have to rule that the United States had been ignoring the most basic civil rights of Mvskoke citizens and flouting the law for over seventy years. It would also have to find that a tribal government had been operating legitimately in the shadows—that the Mvskoke people had continued to operate under their constitution for most of the twentieth century despite official federal antagonism. It was definitely a long shot, but they won. This article explores factors that have helped the Mvskoke people create, nurture, and sustain a constitutional government under hostile circumstances for centuries. We focus on the history and structure of the constitutional government of the Muscogee (Creek) Nation of Oklahoma. We consider several aspects of Creek conceptions of government structure and balance, which are also evidenced in the constitutional jurisprudence of the Muscogee (Creek) Nation Supreme Court. At first glance, the contemporary Mvskoke government today bears little resemblance to the ancient etvlwv town-based system of governance, but a more penetrating analysis reveals common threads of political theory and cosmogony, or world view, that have continued unabated

Fostering Critical Thinking Through Simulation: An Integrative Review

Over the past decade simulation has become a staple of nursing education with increasing use during the COVID-19 pandemic. Both manikin-based and virtual simulation are used to increase the preparedness of nursing students for their roles at the bedside. With the increasing experience-complexity gap, it is important that students enter the workforce prepared to effectively care for patients. Simulation allows students to work with a patient scenario without the possibility of injury; in simulation, mistakes are opportunities instead of harm. This integrative review searched the literature questioning if in pre-licensure Bachelor of Science in Nursing students, do virtual simulation and manikin-based simulation increase critical thinking? Looking through the research, four major themes were found: traits of the nursing program, traits of the simulation, traits of the student, and parallel outcomes. Overall, simulation was shown to have a positive impact on critical thinking as long as the complexity of the simulation was preceded by a foundational knowledge of the material. Critical thinking also had a positive relationship with knowledge and confidence growth as well. As nursing education continues to evolve to a more competency-based curriculum, advancements and use of simulation will need to be carefully developed with critical thinking as the primary outcome

The Impact of COVID-19 on Autistic People in the United Kingdom

PURPOSE: The aim of this rapid research was to examine the impact of COVID-19 on autistic people (of all ages) and their families within the United Kingdom, and identify how to mitigate any adverse consequences. KEY FINDINGS: Every autistic person is different. This diversity is reflected in the range of experiences described in this report. Communication from government: Government communication regarding COVID-19 was difficult to understand and follow for many autistic people. Clear communication and transparency of decision-making from government are important and can help autistic people follow advice and guidance. Schools and education: Access to education for autistic children during lockdown was not consistent. Continued input from schools and maintaining contact with parents and families are vital if schools need to be closed in the future. Grocery shopping: Accessing groceries during lockdown was a struggle for many autistic people. Ensuring everyone has access to necessary grocery shopping, especially vulnerable groups like autistic people, must be a priority. Mental health and access to medical care: COVID-19 and its consequences affected the mental health of autistic people in a range of ways. Mental and physical health care should be accessible to all members of the population. This is particularly the case for autistic people who are more likely to have mental health problems and may find it harder to access services. Caring responsibilities and respite: Renewed support for family members and carers is needed. Many were exhausted during lockdown, especially when external support and respite care were stopped or reduced. The COVID-19 pandemic has both immediate and enduring effects. Ongoing attention to the longer-term implications for autistic people and their families is imperative; particularly in relation to educational opportunity, health, employment and social inclusion, all of which can have profound effects on quality of life