Tooth Fairy guilty of favouritism!

OBJECTIVES: To determine the proportion of children visited by the Tooth Fairy, the child-related factors that influence the likelihood of her visit, and the parent-related variables that affect the amount of money the Tooth Fairy leaves. DESIGN: Cross-sectional questionnaire study. SETTING: Zürich, Switzerland. PARTICIPANTS: 3617 parents of children (mean age of children, 6.8 years; 51.9% girls) who had lost at least one deciduous tooth received a self-developed questionnaire; 1274 questionnaires were returned (35.2%). MAIN OUTCOME MEASURES: Primary outcome variables were the Tooth Fairy's visit after tooth loss and the amount of money given in case of a visit. Child- and parent-related variables were assessed as predictors of the main outcomes. RESULTS: Most parents (71.0%) reported that the Tooth Fairy visited their child. She usually exchanged the lost tooth for money (55.8% of visits) or placed money next to the tooth (40.7%); rarely did she take the tooth without pecuniary substitution. The Tooth Fairy left an average of 7.20 Swiss francs (approximately AU$9.45). The Tooth Fairy favoured visiting for the teeth of older children (odds ratio [OR], per year, 1.87; 95% CI, 1.09-3.21), of boys (OR, 2.65; 95% CI, 1.09-6.42), and of children who believed in her (OR, 4.12; 95% CI, 1.77-9.64). The amount of money was influenced by maternal, but not paternal socio-demographic factors, including level of education (OR, per level, 0.78; 95% CI, 0.66-0.92) and country of origin (OR, Western countries v non-Western countries, 2.35; 95% CI, 1.20-4.62). CONCLUSIONS: The Tooth Fairy does not visit all children after tooth loss, displaying clear preferences in her choice of business partners. The odds of a visit are dramatically increased if she is believed in, and the value of a deciduous tooth is influenced by socio-demographic factors.

Society of Pediatric Psychology Workforce Survey: Factors Related to Compensation of Pediatric Psychologists.

Objective: To summarize compensation results from the 2015 Society of Pediatric Psychology (SPP) Workforce Survey and identify factors related to compensation of pediatric psychologists. Methods: All full members of SPP ( n = 1,314) received the online Workforce Survey; 404 (32%) were returned with usable data. The survey assessed salary, benefits, and other income sources. The relationship between demographic and employment-related factors and overall compensation was explored. Results: Academic rank, level of administrative responsibility, and cost of living index of employment location were associated with compensation. Compensation did not vary by gender; however, women were disproportionately represented at the assistant and associate professor level. Conclusions: Compensation of pediatric psychologists is related to multiple factors. Longitudinal administration of the Workforce Survey is needed to determine changes in compensation and career advancement for this profession over time. Strategies to increase the response rate of future Workforce Surveys are discussed.

Targeting Health Behaviors to Reduce Health Care Costs in Pediatric Psychology: Descriptive Review and Recommendations.

OBJECTIVE: Recent efforts to enhance the quality of health care in the United States while reducing costs have resulted in an increased emphasis on cost containment and the introduction of new payment plans. The purpose of this review is to summarize the impact of pediatric health behavior change interventions on health care costs. METHODS: A review of PubMed, PsycINFO, and PEDE databases identified 15 articles describing the economic outcomes of pediatric health behavior change interventions. Data describing the intervention, health outcome, and economic outcome were extracted. RESULTS: All interventions targeting cigarette smoking (n = 3) or the prevention of a chronic medical condition (n = 5) were predicted to avert hundreds of dollars in health care costs per patient. Five of the seven interventions targeting self-management were associated with reductions in health care costs. CONCLUSIONS: Pediatric health behavior change interventions may be a valuable component of efforts to improve population health while reducing health care costs.

Financial Analysis of Behavioral Health Services in a Pediatric Endocrinology Clinic.

OBJECTIVE: This article addresses a current need in psychological practice by describing a financially feasible model that moves toward integrated care of behavioral health services in a pediatric endocrinology clinic. METHODS: Financial information (costs and revenue associated with behavioral health services) for the clinic, over an 18-month period (July 2012 to December 2013), was obtained through the hospital's financial department. The clinic meets one half day per week. RESULTS: Over the 18-month period, the behavioral health services generated a net gain of $3661.45 in the favor of the clinic. We determined that the psychologist and clinical psychology residents needed to see a total of four patients per half-day clinic for the clinic to "break-even." CONCLUSIONS: We describe one financially feasible way of integrating behavioral health services into a pediatric endocrinology clinic in the hope that this will be generalizable to other medical settings.

Integrating Behavioral Health into Pediatric Primary Care: Implications for Provider Time and Cost.

OBJECTIVES: Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not. METHODS: Data were collected across a 10-day period when a BHC provided services and 10 days when she was not available. Data included time stamps of patient direct care; providers' direct reports of problems raised; and a review of medical and administrative records, including billing codes and reimbursement. This study took place in a rural, stand-alone private pediatric primary care practice. The participants were five pediatric primary care providers (PCPs; two doctors of medicine, 1 doctor of osteopathy, 2 nurse practitioners) and two supervised doctoral students in psychology (BHCs). Pediatric patients (N = 668) and their parents also participated. RESULTS: On days when a BHC was present, medical providers spent 2 fewer minutes on average for every patient seen, saw 42% more patients, and collected $1142 more revenue than on days when no consultant was present. CONCLUSIONS: The time savings demonstrated on days when the consultant was available point to the efficiency and potential financial viability of this model. These results have important implications for the feasibility of hiring behavioral health professionals in a fee-for-service system. They have equally useful implications for the utility of moving to a bundled system of care in which collaborative practice is valued.

[Concept of budget-based remuneration system for the fields of psychiatry and psychotherapy, psychosomatic medicine and psychotherapy, child and adolescent psychiatry and psychotherapy]. / Konzept eines budgetbasierten Entgeltsystems für die Fachgebiete Psychiatrie und Psychotherapie, Psychosomatische Medizin und Psychotherapie, Kinder- und Jugendpsychiatrie und -psychotherapie.

A new remuneration system is currently being developed for the hospital care of people with mental disorders. Last year, because of sharp criticism the option phase of the planned Flat-rate Charges in Psychiatry and Psychosomatics (Pauschalierende Entgelte Psychiatrie und Psychosomatik, PEPP) was extended by 2 years. During this time the Federal Ministry of Health wants to look for alternatives and possible starting points for the further development of care. Now, 16 scientific professional associations and organisations have presented a joint concept for a sustainable solution: the budget-based remuneration system. The system is suitable for ensuring that people with mental disorders are treated according to their particular needs and for promoting the appropriate further development of regional care in all treatment settings. It corresponds with the objectives as formulated in Section 17d of the Hospital Finance Act (Krankenhausfinanzierungsgesetz, KHG) and translates the PEPP system, which is currently being developed and focusses on average prices, into a performance-oriented, transparent budgetary system. The fundamental principle is the separation of the individual hospitals' budgeting on the basis of evidence-based, feature- and performance-related modules and billing in the form of advance payments from the agreed budget.

Commentary: demonstrating cost-effectiveness in pediatric psychology.

OBJECTIVE: Changes in the health care system and payment plans will likely require pediatric psychologists to illustrate the impact of their services. Cost-effectiveness analyses are one method of demonstrating the potential economic benefits of our services but are rarely used by pediatric psychologists. METHOD: A hypothetical cost-effectiveness analysis was conducted, comparing the costs and outcomes between a behavioral adherence intervention and no intervention for youth with acute lymphoblastic leukemia. RESULTS: Results illustrate how pediatric psychologists can use cost-effectiveness analyses to demonstrate the economic impact of their work. CONCLUSIONS: Efforts to conduct economic analyses could allow pediatric psychologists to advocate for their services. Implications and future directions are discussed.

Commentary: the use of health and behavior codes in pediatric psychology: where are we now?

This article focuses on the current status of the use of Health and Behavior (H&B) codes by pediatric psychologists. We address the rationale for the use of these codes in a pediatric psychology setting, practice updates since the codes were initiated, and our experience with utilizing these codes in one pediatric hospital. We conclude with a summary of our assertions and future directions for policy and practice.

Effect of socioeconomic status on children's psychological well-being in China: The mediating role of family social capital.

This study aimed to examine the relationship between socioeconomic status and children's psychological well-being and to investigate the mediating effect of family social capital. A sample of 19,487 school-aged children was collected from 2013-2014 China Education Panel Survey. Structural equation modeling was applied to test the hypothesized model. The results showed that socioeconomic status was not significantly related to the children's psychological well-being. However, two indicators of family social capital, namely, parent involvement and parent-child relationship, played a complete mediating role in the direct mechanism. The theoretical and practical contributions were discussed.

The interface between publicly funded and industry-funded research in pediatric psychopharmacology: opportunities for integration and collaboration.

Pediatric psychopharmacology research is undergoing a major expansion consequent to increasing use of psychotropic medications in children and recent legislative incentives to industry. In this rapidly changing context, the interface between publicly and privately funded research needs to be reconsidered to integrate activities and avoid unnecessary duplication of efforts. Once, by default, the almost exclusive domain of public research, child research is now increasingly funded by industry. There are, however, important issues unlikely to be addressed through private funding for which public support is needed, such as direct comparisons between active medications, between pharmacological and psychosocial interventions, or between combined and single treatment modalities; development of effective treatment strategies for patients unresponsive to first-line treatments; development of better research methods to assess efficacy and safety; identification of moderators and mechanisms of treatment response; and impact of treatment on illness course and prognosis. Industry-sponsored research is limited by the restricted access to proprietary databases, which impedes independent analyses and meta-analyses. Translation of basic neuroscience discoveries into treatment applications for children with mental illness is a critical area of inquiry that can benefit from integration of efforts and collaborations among academia, government, and industry.

Child participation in disaster risk reduction: the case of flood-affected children in Bangladesh.

Children are particularly vulnerable to the effects of natural disasters. This article aims to gain a deeper understanding of the specific effects of natural disasters on children and how they could better be involved in the disaster risk reduction (DRR) process. The article begins with a review of the literature published on the Child-led Disaster Risk Reduction (CLDRR) approach and describes the key issues. Then it identifies the effects of floods on children in Bangladesh and analyses the traditional coping mechanisms developed by communities, highlighting where they could be improved. Finally, it analyses how DRR stakeholders involve children in the DRR process and identifies the opportunities and gaps for the mainstreaming of a CLDRR approach in Bangladesh. This should contribute to a better understanding of how key DRR stakeholders can protect children during natural disasters. Encouraging the building of long-term, child-sensitive DRR strategies is an essential part of this process.

Complejidad, conflicto armado y vulnerabilidad de niños y niñas desplazados en Colombia / Complexity, armed conflict, and vulnerability of displaced children in Colombia

Este trabajo tiene como objetivo realizar una reflexión acerca de la vulnerabilidad de los niños y niñas víctimas del conflicto armado en Colombia. Para ello se recurriro al principio de auto-eco-organización y de Bucle inter-retroactivo. La violencia es un fenómeno complejo de múltiples interacciones, de características no-lineales y tendencia auto-eco-organizativa que afecta la noción de sujeto y altera el modo como los niños y niñas interpretan el mundo y sus interacciones.

This paper aims to carry out a reflection on the vulnerability of children, who are victims of the armed conflict in Colombia. This was used at the beginning of the self-eco-organization and the inter-retroactive loop. Violence is a complex phenomenon of multiple interactions, non-linear features, and a self-eco-organizational tendency, which affects the notion of subject and alters the way that children interpret the world and their interactions.