Building Culturally and Linguistically Competent Services to Support Young Children, Their Families, and School Readiness

Provides guidance, tools, and resources that promote cultural and linguistic competence in young children and families. Outlines a holistic approach to service delivery for preschool skills development

What Works? A Study of Effective Early Childhood Mental Health Consultation Programs

Examines factors that lead to desirable outcomes in mental health consultation programs: solid program infrastructure, highly qualified consultants, and quality support services. Analyzes targeted outcomes, measurements, and intensity of interventions

Doxycycline versus prednisolone as an initial treatment strategy for bullous pemphigoid: a pragmatic non-inferiority randomised controlled trial

Background: Bullous pemphigoid (BP) is a blistering skin disorder with increased mortality. We tested whether a strategy of starting treatment with doxycycline conveys acceptable short-term blister control whilst conferring long-term safety advantages over starting treatment with oral corticosteroids. Methods: Pragmatic multi-centre parallel-group randomised controlled trial of adults with BP (≥3 blisters ≥2 sites and linear basement membrane IgG/C3) plus economic evaluation. Participants were randomised to doxycycline (200 mg/day) or prednisolone (0·5 mg/kg/day). Localised adjuvant potent topical corticosteroids (<30 g/week) was permitted weeks 1-3. The non-inferiority primary effectiveness outcome was the proportion of participants with ≤3 blisters at 6 weeks. We assumed that doxycycline would be 25% less effective than corticosteroids with a 37% acceptable margin of noninferiority. The primary safety outcome was the proportion with severe, life-threatening or fatal treatment-related adverse events by 52 weeks. Analysis used a regression model adjusting for baseline disease severity, age and Karnofsky score, with missing data imputed. Results: 132 patients were randomised to doxycycline and 121 to prednisolone from 54 UK and 7 German dermatology centres. Mean age was 77·7 years and 68.4% had moderate to severe baseline disease. For those starting doxycycline, 83/112 (74·1%) had ≤3 blisters at 6 weeks compared with 92/101 (91·1%) for prednisolone, a difference of 18·6% favouring prednisolone (upper limit of 90% CI, 26·1%, within the predefined 37% margin). Related severe, life-threatening and fatal events at 52 weeks were 18·5% for those starting doxycycline and 36·6% for prednisolone (mITT analysis), an adjusted difference of 19·0% (95% CI, 7·9%, 30·1%, p=0·001). Conclusions: A strategy of starting BP patients on doxycycline is non-inferior to standard treatment with oral prednisolone for short-term blister control and significantly safer long-term

Early Childhood Mental Health Consultation: A Developing Profession

As a career path, early childhood mental health consultation MHC is an emerging and growing work force opportunity. In keeping with the vision of an effective transformed service system expressed in the final report of the Presidents\u27 New Freedom Commission, and communities are expanding capacity to meet the mental health needs of young children and caregivers through mental health sultation. ECMHC supports children in naturalistic community and avoids the excessively expert tude9 and works through collaboration with families and other providers who care for them. In addition, is growing experience and research evidence to suggest that ECMHC an effective service that, from a license health perspective, promotes and emotional development and vents or reduces the impact of mental health problems in young children. The early childhood mental health consultation workforce is in transition from one of broad diversity in terms of training, experience, roles, responsibilities, and work expectations to one that has specific expertise in early childhood mental health and the specific skills required to take on the role of consultant. The purpose of this article is to support the development of a transformed workforce with the attitudes, knowledge, skills, and behaviors to work as early childhood mental health consultants in a changing children\u27s mental health field

Early Childhood Mental Health Consultation: An Evaluation Tool Kit

For states, communities, agencies and programs investing in early childhood mental health consultation and committed to quality data. This web-based resource combines a brief review of the literature and current research addressing the effectiveness of early childhood mental health consultation with guidance for designing and implementing program evaluation. It will help states, communities, and programs increase their capacity for high-quality evaluation of early childhood mental health consultation in community-based settings. Researchers, policy makers and program evaluation teams will find: A brief review of the evidence base, current issues, and questions; Defining characteristics of early childhood mental health consultation; Components of high quality evaluation and sample logic models; Evaluation tools to measure both process and outcome, including outcomes for children, families, staff and programs; and Guidance for using evaluation data for program improvement and communicating outcomes