Screening for depression in children and adolescents in primary care or non-mental health settings: a systematic review update

Abstract Background The transition from childhood to adolescence is associated with an increase in rates of some psychiatric disorders, including major depressive disorder, a debilitating mood disorder. The aim of this systematic review is to update the evidence on the benefits and harms of screening for depression in primary care and non-mental health clinic settings among children and adolescents. Methods This review is an update of a previous systematic review, for which the last search was conducted in 2017. We searched Ovid MEDLINE® ALL, Embase Classic+Embase, PsycINFO, Cochrane Central Register of Controlled Trials, and CINAHL on November 4, 2019, and updated on February 19, 2021. If no randomized controlled trials were found, we planned to conduct an additional search for non-randomized trials with a comparator group. For non-randomized trials, we applied a non-randomized controlled trial filter and searched the same databases except for Cochrane Central Register of Controlled Trials from January 2015 to February 2021. We also conducted a targeted search of the gray literature for unpublished documents. Title and abstract, and full-text screening were completed independently by pairs of reviewers. Results In this review update, we were unable to find any randomized controlled studies that satisfied our eligibility criteria and evaluated the potential benefits and harms of screening for depression in children and adolescents. Additionally, a search for non-randomized trials yielded no studies that met the inclusion criteria. Conclusions The findings of this review indicate a lack of available evidence regarding the potential benefits and harms of screening for depression in children and adolescents. This absence of evidence emphasizes the necessity for well-conducted clinical trials to evaluate the effectiveness of depression screening among children and adolescents in primary care and non-mental health clinic settings. Systematic review registration PROSPERO CRD42020150373

Three wave mixing via electronic states at the surface of the noble metals

Presented here is a study of the nonlinear optical response of the surfaces of the noble metals. Second harmonic generation is forbidden, in the dipole approximation, in centrosymmetric materials. Nonetheless, using pulsed lasers, it is readily observed in reflection. The signal originates in a narrow layer at the surface where the center of inversion is removed by the termination of the lattice. The goal is to go beyond the jellium model, and incorporate into the formulation of the response the nature of the electronic states at the surface, including both surface modified bulk states and intrinsic surface states. The foundation of the approach is the description of the three wave mixing phenomenon as a superposition of three step processes in which each step consists of an electronic transition between states of the system accompanied by the annihilation or creation of a photon. The symmetries of the wavefunctions determine how the strength of a particular mechanism depends on the polarization of the photons, and the energies of the states determine the frequency dependence. The formulation is applied to the problem of second harmonic generation in reflection from Cu(110). Using the published results of bandstructure calculations, and photoemission and inverse photoemission experiments, important three step processes involving surface-modified bulk states and intrinsic surface states are identified, and the polarization properties of the input and output photons are ascertained for certain important processes. A frequency dependence for a model of the surface band structure near the Y point of the surface Brillouin zone is calculated, showing in particular that the contribution from the states at Y should be resonantly enhanced for the case of second harmonic generation using a Nd:YAG laser. An experiment of this type was conducted in ultrahigh vacuum, designed to test polarization properties. These, together with experiments on sensitivity to O\sb2 adsorption, support the conjecture that surface-modified band states and intrinsic surface states play an essential role in the nonlinear optical response

Modular Aneutronic Fusion Engine

NASA’s JUNO mission will arrive at Jupiter in July 2016, after nearly five years in space. Since operational costs tend to rise with mission time, minimizing such times becomes a top priority. We present the conceptual design for a 10 MW aneutronic fusion engine with high exhaust velocities that would reduce transit time for a Jupiter mission to eighteen months and enable more challenging exploration missions in the solar system and beyond. 1

IAC-12,C4,7-C3.5,10 Modular Aneutronic Fusion Engine

A compact aneutronic fusion engine will enable more challenging exploration missions in the solar system. This engine uses a deuterium-helium-3 reaction to produce fusion energy by employing a novel field-reversed magnetic field configuration (FRC). The FRC has a simple linear solenoidal coil configuration yet generates higher plasma pressures for a given magnetic field than other designs. Waste heat generated from bremsstrahlung and synchrotron radiation is recycled to maintain the fusion temperature. The charged reaction products, augmented by additional propellant, are exhausted through a magnetic nozzle. As an example, we present a mission to deploy the James Webb Space Telescope from LEO to an L2 halo orbit using a one MW compact aneutronic fusion rocket engine. The engine produces 20 N of thrust with an exhaust velocity of 55 km/s and has a specific power of 0.77 kW/kg. I

Validation des seuils cliniques dans la version remplie par les parents du Questionnaire sur les points forts et les points faibles au sein d’un vaste échantillon d’enfants et de jeunes canadiens

IntroductionLe Questionnaire sur les points forts et les points faibles (Strengths and Difficulties Questionnaire, ou SDQ), qui permet d’évaluer les difficultés comportementales et émotionnelles, est un outil de dépistage des problèmes de santé mentale utilisé dans plusieurs pays. Notre objectif était de valider les seuils (cut-points) actuels, britanniques, du SDQ au sein d’un échantillon d’enfants et de jeunes canadiens et, au besoin, de fixer de nouveaux seuils canadiens pour le SDQ. MéthodologieCette étude est fondée sur les données d’enfants et de jeunes de 6 à 17 ans provenant de l’Enquête canadienne sur les mesures de la santé (n = 3 435) et de dossiers de consultations externes du Centre hospitalier pour enfants de l’est de l’Ontario (n = 1 075). Nous avons recueilli les données issues du SDQ rempli par les parents. Nous avons ajusté les seuils actuels du SDQ à l’aide d’une approche fondée sur la distribution et d’une approche par courbe ROC (Receiver Operating Characteristic, ou courbe caractéristique de la performance d’un test). Nous avons ensuite calculé, à l’aide de ces deux méthodes analytiques, la sensibilité, la spécificité et le rapport de cotes diagnostique des seuils cliniques actuels et des nouveaux seuils cliniques du SDQ afin de déterminer si de nouveaux seuils offriraient une meilleure utilité clinique. RésultatsLes données recueillies révèlent des différences entre les seuils cliniques britanniques et les seuils cliniques canadiens en matière d’efficacité de dépistage. L’utilisation des valeurs canadiennes obtenues à l’aide de la technique fondée sur la distribution a permis de maximiser la spécificité, c’est-à-dire qu’elle a permis d’améliorer la probabilité de détecter les vrais négatifs. Le score total au SDQ atteignait le seuil d’utilité clinique (rapport de cotes diagnostiques > 20) tant avec les seuils actuels qu’avec les nouveaux seuils, mais les échelles individuelles n’atteignaient pas ce seuil d’utilité clinique, et ce, avec aucun des deux seuils. ConclusionLes chercheurs canadiens travaillant avec le SDQ devraient tenir compte à la fois des nouveaux seuils calculés avec notre population à l’étude et des seuils britanniques afin de permettre les comparaisons au fil du temps et entre pays

Validating existing clinical cut-points for the parent-reported Strengths and Difficulties Questionnaire in a large sample of Canadian children and youth

IntroductionThe Strengths and Difficulties Questionnaire (SDQ), for assessing behavioural and emotional difficulties, has been used internationally as a screening measure for mental health problems. Our objective was to validate the existing (British) SDQ cut-points in a sample of Canadian children and youth, and develop new Canadian SDQ cut-points if needed. MethodsThis study includes data from children and youth aged 6 to 17 years from the Canadian Health Measures Survey (n = 3435) and outpatient records from the Children’s Hospital of Eastern Ontario (n = 1075). The parent-reported SDQ data were collected. We adjusted the existing SDQ cut-points using a distributional and receiver-operating characteristic (ROC) curve approach. We subsequently calculated the sensitivity, specificity and diagnostic odds ratio of the existing and new SDQ clinical cut-points to determine whether the new cut-points had better clinical utility, using both analytic approaches. ResultsOur data show differences in the screening effectiveness between the existing British and the Canadian-specific clinical cut-points. Specificity is maximized using the Canadian distributional cut-points, improving the likelihood of identifying true negative results. The total SDQ score met the threshold for clinical utility (diagnostic odds ratio > 20) using both the existing and new cut-points; however, the individual scales did not reach clinical utility threshold using either cut-points. ConclusionFuture Canadian SDQ research should consider the new cut-points derived from our study population and the existing British cut-points to allow for historical and international comparisons

Screening for depression in children and adolescents: a protocol for a systematic review update

Abstract Background Major depressive disorder is common, debilitating, and affects feelings, thoughts, mood, and behaviors. Childhood and adolescence are critical periods for the development of depression and adolescence is marked by an increased incidence of mental health disorders. This protocol outlines the planned scope and methods for a systematic review update that will evaluate the benefits and harms of screening for depression in children and adolescents. Methods This review will update a previously published systematic review by Roseman and colleagues. Eligible studies are randomized controlled trials (RCTs) assessing formal screening in primary care to identify children or adolescents not already self-reporting symptoms of, diagnosed with, or treated for depression. If no or only a single RCT is available, we will consider controlled studies without random assignment. Studies of participants with characteristics associated with an elevated risk of depression will be analyzed separately. Outcomes of interest are symptoms of depression, classification of major depressive disorder based on a validated diagnostic interview, suicidality, health-related quality of life, social function, impact on lifestyle behavior (e.g., substance use, school performance, lost time at work, or school), false-positive results, overdiagnosis, overtreatment, labeling, and other harms such as those arising from treatment. We will search MEDLINE, Embase, PsycINFO, CINAHL, the Cochrane Library, and grey literature sources. Two reviewers will independently screen the titles and abstracts using the liberal accelerated method. Full-text screening will be performed independently by two reviewers using pre-specified eligibility criteria. Data extraction and risk of bias assessments will be performed independently by two reviewers. Pre-planned analyses, including subgroup and sensitivity analyses, are detailed within this protocol. Two independent reviewers will assess and finalize through consensus the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, and prepare GRADE evidence profiles and summary of findings tables for each outcome of interest. Discussion The systematic review will provide a current state of the evidence of benefits and harms of depression screening in children and adolescents. These findings will be used by the Canadian Task Force on Preventive Health Care to inform the development of recommendations on depression screening. Systematic review registration PROSPERO CRD4202015037

Snowmass Theory Frontier: Astrophysics and Cosmology

International audienceWe summarize progress made in theoretical astrophysics and cosmology over the past decade and areas of interest for the coming decade. This Report is prepared as the TF09 "Astrophysics and Cosmology" topical group summary for the Theory Frontier as part of the Snowmass 2021 process