An exploration of the factors influencing career choice in mental health.

AIMS AND OBJECTIVES: To identify the factors that are associated with considering a career in mental health. BACKGROUND: The mental health specialty is facing a recruitment crisis in the United Kingdom but there is limited evidence about which factors encourage and discourage people from considering a career in mental health. DESIGN: Quantitative, observational, online survey using a multiple ordinal logistic regression model to identify if there were any significant predictors of the extent to which participants would consider a career in mental health. The design and write up of the study were guided by the STROBE checklist. METHOD: We gathered the views of 231 participants (female = 188, 81.7%) aged between 16-65 (mean = 22.7, SD = 8.9), using an online survey, the majority of whom were studying on, or graduates of, psychology/social studies degrees. Information was gathered about the extent to which a range of factors influenced consideration of a career in mental health. RESULTS: The majority (71.2%) of participants reported that they would definitely or probably consider undertaking a career in mental health, and over half (51.4%) would consider a career as a mental health nurse. The ability to help others and receiving appropriate training required for the role were important career choice factors. Being female, having a mental health condition and greater knowledge of mental health were associated with a significantly greater likelihood of considering a career in mental health, while having had experience of working with people with mental health difficulties was significantly negatively associated. CONCLUSIONS: Students and graduates of psychology and social studies degrees appear to be a large, untapped recruitment pool for mental health services. RELEVANCE TO CLINICAL PRACTICE: The results can inform more targeted recruitment strategies and development of suitable career pathways for those interested in a career in mental health.

Child and Adolescent Intellectual Disability Screening Questionnaire to identify children with intellectual disability.

AIM: To evaluate the psychometric properties of the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) in paediatric neurodevelopment clinics. METHOD: Participants were 181 children (aged 6-18y) attending paediatric services in Scotland, divided into three age groups according to previous CAIDS-Q standardization cut-off scores. Fifty-four children (37 males, 17 females; mean age 117mo [SD 29.9mo]) met the criteria for intellectual disability and 127 did not (88 males, 39 females; mean age 120.1mo [SD 32.7mo]). A number of psychometric properties of the CAIDS-Q were evaluated, including test-retest and interrater reliability, convergent validity, sensitivity, specificity, and positive and negative predictive values based on existing cut-off scores. RESULTS: Significant positive relationships were found for all three age groups between CAIDS-Q scores and measures of intellectual and adaptive functioning. Test-retest reliability ranged from 'moderate' to 'almost perfect', whereas interrater reliability ranged from 'fair' to 'almost perfect'. Sensitivity and positive predictive value were 100% for all groups and specificity was between 83% and 94%, depending on age. Negative predictive values ranged from 75% to 91%. INTERPRETATION: The CAIDS-Q appears to show psychometric properties that support its use as a screen for intellectual disability in paediatric neurodevelopmental settings. WHAT THIS PAPER ADDS: The Child and Adolescent Intellectual Disability Screening Questionnaire showed good psychometric properties. It identified all participating children who met the criteria for intellectual disability. Between 83% and 94% of children without intellectual disability were also correctly identified.

CUESTIONARIO DE PESQUISA DE DISCAPACIDAD INTELECTUAL EN NIÑOS Y ADOLESCENTES PARA IDENTIFICAR DISCAPACIDAD INTELECTUAL: OBJETIVO: Evaluar las propiedades psicométricas del Cuestionario de Detección de Discapacidad Intelectual en Niños y Adolescentes (CAIDS-Q, siglas en inglés) en clínicas pediátricas de neurodesarrollo. MÉTODO: Participaron 181 niños (de 6 a 18 años) que asistían a servicios pediátricos en escocia, divididos en tres grupos de edad de acuerdo con los puntajes de corte de estandarización para la CAIDS-Q. Cincuenta y cuatro niños (37 varones, 17 mujeres, edad media 117 meses (DS 29.9 meses) cumplían con los criterios de discapacidad intelectual y 127 no cumplían con los criterios estipulados (88 varones, 39 mujeres, con una edad media de 120,1 meses (DS 32,7 meses). Se evaluaron varias propiedades psicométricas del CAIDS-Q, incluidas la repetibilidad y la confiabilidad entre evaluadores, la validez convergente, la sensibilidad, la especificidad y los valores predictivos positivos y negativos basados en los puntajes de corte preexistentes. RESULTADOS: Se encontraron correlaciones positivas significativas para los tres grupos de edad entre los puntajes CAIDS-Q y las mediciones de funcionamiento intelectual y adaptativo. La confiabilidad test-retest (repetibilidad) fue de 'moderada' a 'casi perfecta', mientras que la confiabilidad entre evaluadores fue de 'buena' a 'casi perfecta'. La sensibilidad y el valor predictivo positivo fueron del 100% para todos los grupos y la especificidad fue del 83% al 94%, según la edad. Los valores predictivos negativos fueron del 75% al ​​91%. INTERPRETACIÓN: El CAIDS-Q parece mostrar propiedades psicométricas que respaldan su uso como instrumento de pesquisa para la discapacidad intelectual en contextos de neurodesarrollo pediátrico.

QUESTIONÁRIO DE RASTREIO DE DEFICIÊNCIA INTELECTUAL DA CRIANÇA E DO ADOLESCENTE PARA IDENTIFICAR CRIANÇAS COM DEFICIÊNCIA INTELECTUAL: OBJETIVO: Avaliar as propriedades psicométricas do Questionário de Rastreio da Deficiência Intelectual da Criança e do Adolescente (CAIDS-Q) em clínicas de neurodesenvolvimento pediátrico. MÉTODO: Os participantes foram 181 crianças (idades 6-18 anos) que frequentam serviços pediátricos na Escócia, divididos em três grupos etários de acordo com pontos de corte da padronização do CAIDS-Q. Cinquenta e quatro crianças (37 do sexo masculino, 17 do sexo feminino; média de idade 117m [DP 29,9m]) atenderam aos critérios para deficiência intelectual e 127 não atenderam (88 do sexo masculino, 39 do sexo feminino; média de idade 120,1m [DP 32,7m]). Um número de propriedades psicométricas do CAIDS-Q foram avaliadas, incluindo confiabilidade teste-reteste e entre examinadores, validade convergente, sensibilidade, especificidade, e valores preditivos positivos e negativos, com base em pontos de corte existentes. RESULTADOS: Relações positivas significativas foram encontradas para todos os três grupos etários entre os escores CAIDS-Q e medidas de funcionamento intelectual e adaptativo. A confiabilidade teste-reteste variou de "moderada" a "quase-perfeita", enquanto a confiabilidade entre examinadores variou de "leve" a "quase perfeita". Os valores de sensibilidade e valores preditivo positivos foram 100% para todos os grupos, e a especificidade variou de 83% a 94%, dependendo da idade. Valores preditivos negativos variaram de 75% a 91%. INTERPRETAÇÃO: O CAIDS-Q parece mostrar propriedades psicométricas que sustentam seu uso para rastrear deficiência intelectual em ambientes de neurodesenvolvimento pediátrico.

Screening for intellectual disability with the Child and Adolescent Intellectual Screening Questionnaire: a modified Delphi approach.

AIM: To develop a consensus framework to evaluate the impact of screening for intellectual disability, using the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q) in paediatric neurodevelopment clinics. METHOD: A modified Delphi survey with four phases (literature review; initial development of framework [participants=11 parents, 8 professionals]; qualitative interviews [participants=4 parents, 15 professionals]; questionnaire development [participants=31 parents, 14 professionals] was used to develop the consensus framework. The framework was used to evaluate the impact of screening on six paediatricians and 31 parents of children who had participated in a previous paediatric screening project. RESULTS: Twelve of the original 20 items were retained based on levels of endorsement of 60 per cent or above. Direct benefits of using the CAIDS-Q were: indicating the child's level of functioning, increasing awareness of intellectual disability, helping to identify children with intellectual disability, and identifying potentially vulnerable children. Benefits related to subsequent diagnostic assessment were: promoting greater understanding of the child, identification of support needs, and receipt of support, particularly for the child at school. INTERPRETATION: The use of the CAIDS-Q had a number of direct and indirect benefits for children, families, and services as reported by parents and paediatricians. WHAT THIS PAPER ADDS: A 12-item framework was developed to evaluate the impact of screening for intellectual disability. Direct benefits of the Child and Adolescent Intellectual Disability Screening Questionnaire include increasing awareness and identification of intellectual disability. Indirect benefits included increased identification of support needs and receipt of support.

The impact of contextual information on the emotion recognition of children with an intellectual disability.

BACKGROUND: Research suggests that having relevant contextual information can help increase the accuracy of emotion recognition in typically developing (TD) individuals and adults with an intellectual disability. The impact of context on the emotion recognition of children with intellectual disability is unknown. METHOD: Emotion recognition tasks, which varied in terms of contextual information, were completed by 102 children (45 with and 57 without intellectual disability). RESULTS: There was a significant effect of age and group, with older and TD children performing better on average. There were significant group by condition interactions, whereby children with intellectual disability were more accurate at identifying emotions depicted by line drawings compared with photos with contextual information that was not directly related to the emotion being depicted. The opposite was found for TD children. CONCLUSIONS: These results have implications for socio-emotional interventions, such as universal school programmes.

Emotional, physical, and social needs among 0-5-year-old children displaced by the 2010 Chilean earthquake: associated characteristics and exposures.

An 8.8-magnitude earthquake occurred off the coast of Chile on 27 February 2010, displacing nearly 2,000 children aged less than five years to emergency housing camps. Nine months later, this study assessed the needs of 140 displaced 0-5-year-old children in six domains: caregiver stability and protection; health; housing; nutrition; psychosocial situation; and stimulation. Multivariate regression was applied to examine the degree to which emotional, physical, and social needs were associated with baseline characteristics and exposure to the earthquake, to stressful events, and to ongoing risks in the proximal post-earthquake context. In each domain, 20 per cent or fewer children had unmet needs. Of all children in the sample, 20 per cent had unmet needs in multiple domains. Children's emotional, physical, and social needs were associated with ongoing exposures amenable to intervention, more than with baseline characteristics or epicentre proximity. Relief efforts should address multiple interrelated domains of child well-being and ongoing risks in post-disaster settings.

Facing discomfort: Avoided negative affect shapes the acknowledgment of systemic racism.

Why can some Americans acknowledge the deeply rooted racism in the United States while others cannot? Past research suggests that the more people want to avoid feeling negative ("avoided negative affect; ANA"), the less likely they focus on and even perceive someone's suffering. Because acknowledging racism is one specific instance of noticing and acknowledging that people are suffering, the present research investigates whether ANA might also affect the degree to which people acknowledge racism. We predicted that the more people want to avoid feeling negative, the less they will acknowledge systemic racism and the more they will deny negative aspects of their country's history and current policies, that is, the more blindly patriotic they will be. In Study 1, 104 undergraduates reported their ANA and patriotism and rated how much racism they perceived in certain situations. As predicted, the more participants wanted to avoid feeling negative, the less they acknowledged systemic racism. These findings held even after controlling for political ideology, ethnicity, moral foundations, and how people actually feel. However, ANA did not predict blind patriotism. In Study 2, we randomly assigned 116 participants to either an increase ANA, decrease ANA, or control condition. As predicted, participants in the increase ANA condition acknowledged systemic racism less than those in the decrease ANA and control conditions. Wanting to avoid feeling negative might be one barrier to dismantling racial inequalities. Given the high degree of ANA in the United States, we discuss the implications of this work. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An evaluation of the distribution properties, factor structure, and item response profile of an assessment of emotion recognition.

Many people with developmental disabilities, such as autism spectrum disorder and intellectual disability have emotion recognition (ER) difficulties compared with typically developing (TD) peers. Accurate assessment of the extent and nature of differences in ER requires an understanding of the response profiles to ER assessment stimuli. We analysed data from 504 TD individuals in response to an ER assessment in respect of distribution properties, factor structure, and item response profile. Eighteen emotion items discriminated better at lower levels of ER ability in TD participants. Neutral expressions were the hardest to interpret; surprise, anger, happy, and bored were easiest. The amount of contextual information in combination with the emotion being depicted also appeared to influence level of difficulty. Similar psychometric research is needed with people with developmental disabilities.

A World Wide Web-based antimicrobial stewardship program improves efficiency, communication, and user satisfaction and reduces cost in a tertiary care pediatric medical center.

BACKGROUND: Antimicrobial stewardship programs aim to reduce inappropriate hospital antimicrobial use. At the Johns Hopkins Children's Medical and Surgical Center (Baltimore, MD), we implemented a World Wide Web-based antimicrobial restriction program to address problems with the existing restriction program. METHODS: A user survey identified opportunities for improvement of an existing antimicrobial restriction program and resulted in subsequent design, implementation, and evaluation of a World Wide Web-based antimicrobial restriction program at a 175-bed, tertiary care pediatric teaching hospital. The program provided automated clinical decision support, facilitated approval, and enhanced real-time communication among prescribers, pharmacists, and pediatric infectious diseases fellows. Approval status, duration, and rationale; missing request notifications; and expiring approvals were stored in a database that is accessible via a secure Intranet site. Before and after implementation of the program, user satisfaction, reports of missed and/or delayed doses, antimicrobial dispensing times, and cost were evaluated. RESULTS: After implementation of the program, there was a $370,069 reduction in projected annual cost associated with restricted antimicrobial use and an 11.6% reduction in the number of dispensed doses. User satisfaction increased from 22% to 68% and from 13% to 69% among prescribers and pharmacists, respectively. There were 21% and 32% reductions in the number of prescriber reports of missed and delayed doses, respectively, and there was a 37% reduction in the number of pharmacist reports of delayed approvals; measured dispensing times were unchanged (P = .24). In addition, 40% fewer restricted antimicrobial-related phone calls were noted by the pharmacy. CONCLUSION: The World Wide Web-based antimicrobial approval program led to improved communication, more-efficient antimicrobial administration, increased user satisfaction, and significant cost savings. Integrated tools, such as this World Wide Web-based antimicrobial approval program, will effectively enhance antimicrobial stewardship programs.

The evaluation of a framework for measuring the non-technical ward round skills of final year nursing students: An observational study.

BACKGROUND: The importance of non-technical skills (NTS) to patient outcomes is increasingly being recognised, however, there is limited research into how such skills can be taught and evaluated in student nurses in relation toward rounds. OBJECTIVES: This pilot study describes an evaluation of a NTS framework that could potentially be used to measure ward round skills of student nurses. DESIGN AND METHODS: The study used an observational design. Potential key NTS were identified from existing literature and NTS taxonomies. The proposed framework was then used to evaluate whether the identified NTS were evident in a series of ward round simulations that final year general nursing students undertook as part of their training. Finally, the views of a small group of qualified nurse educators, qualified nurses and general nursing students were sought about whether the identified NTS were important and relevant to practice. RESULTS: The proposed NTS framework included seven categories: Communication, Decision Making, Situational Awareness, Teamwork and Task Management, Student Initiative and Responsiveness to Patient. All were rated as important and relevant to practice. CONCLUSION: The pilot study suggests that the proposed NTS framework could be used as a means of evaluating student nurse competencies in respect of many non-technical skills required for a successful ward round. Further work is required to establish the validity of the framework in educational settings and to determine the extent to which it is of use in a non-simulated ward round setting.

Assessing the accuracy of the WISC-IV seven-subtest short form and the child and adolescent intellectual disability screening questionnaire in identifying intellectual disability in children.

Little research has been conducted into the accuracy of abbreviated assessments in identifying children and young people with an intellectual disability (ID). The present study compared two such methods in a clinical population of individuals with (n = 106) and without (n = 170) ID: a 7-subtest short form of the Wechsler Adult Intelligence Scales for Children--fourth edition (WISC-IV) proposed by Crawford and colleagues and the Child and Adolescent Intellectual Disability Screening Questionnaire (CAIDS-Q). Both the CAIDS-Q and the WISC-IV short form had high and comparable levels of predicting group classification (88% and 91% correct classification, respectively). Both methods would appear to offer clinicians and researchers an efficient and accurate means of identifying those who are likely to have ID. The WISC-IV short form was slightly more accurate, but the CAIDS-Q may offer the advantages of being shorter to administer and having no requirement for the user to have a particular qualification or training.

Mokken scales for testing both pre- and postintervention: an analysis of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) before and after counseling.

Mokken scaling is increasingly being applied to assessing the extent to which clinical scales possess clinically useful properties, especially invariant item ordering (IIO). These scales are often used to track progress in symptoms over time to evaluate the success of an intervention. Such interventions are designed to affect psychopathological trait levels overall but may in some cases act disproportionately on some symptoms over others. As a result, there is no guarantee that the item orderings of a clinical scale will be preserved between the point at which individuals begin treatment and the point at which they can be considered recovered. In these situations, many of the potential benefits of IIO are undermined because an IIO identified at either time point will not be informative about changes in symptoms over time. In this study, we aimed to assess the extent to which the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) retained the same item orderings in a sample of individuals when initially presenting for counseling treatment and when discharged. From the 34 items of the CORE-OM we found a subset of 10 items exhibiting monotonicity, invariant item ordering, and highly similar item orderings when measured at both time points.

Implementation of standardized pediatric i.v. medication concentrations.

PURPOSE: The development and implementation of a comprehensive and standardized list of pediatric i.v. medication concentrations across a large healthcare system are described. SUMMARY: In accordance with National Patient Safety Goals, facilities affiliated with the Hospital Corporation of America system had independently standardized and limited the number of drug concentrations in use. This resulted in variation among facilities, which prevented the systemwide standardization of drug dictionaries within the computerized pharmacy and prescriber-order-entry systems, complicated the movement of providers among facilities, and contributed to inconsistency in medication prescribing. A team of experts collaborated to create a comprehensive standard list that included 119 medications and 372 concentrations for pediatric i.v. medications. Implementation of this standard list was driven through a financial incentive from the malpractice insurance provider; facilities that completed the required activities for this optional program could apply for a credit of a portion of their malpractice insurance cost. For the standardization of pediatric i.v. medications, required activities included approval of the standard medication list, incorporation of this list into facility pharmacy dictionaries, and update of all smart pump software to include only the new standard medications and concentrations. Of the 145 facilities that were eligible for the implementation of standard pediatric i.v. medication concentrations, 141 (97%) completed all requirements and received the 2% malpractice insurance cost credit. CONCLUSION: The use of a financial incentive strategy, in the form of a malpractice insurance credit, successfully motivated the implementation of standardized pediatric medication concentrations across a large healthcare system.

Choosing the best child assessment instrument for a specific context: a methodology for engaging local experts applied in Chile.

OBJECTIVE: Chile is considering expanding its system for early childhood development to include 5- to 7-year olds, but it has no consensus about how to identify at-risk children. This study facilitated a process for incorporating local priorities and best practices to choose a child assessment instrument. METHODS: Using the priority-setting method of the Child Health and Nutrition Research Initiative (CHNRI), 21 Chilean experts defined and weighted ideal assessment instrument characteristics; 130 instruments were scored according to how closely they matched experts' ideal definitions. Instruments were ranked by score under different inclusion criteria. RESULTS: Experts weighted instrument quality highest (95 on 1-100 scale), followed by administration site (87), domains assessed (82), cost (80), administrator (76), Spanish version (75), time (75), and prior use in Chile (53). Experts agreed that an ideal instrument (1) would reliably assess language, socioemotional well-being, mental health, and parenting abilities, (2) could be administered at schools or home, and (3) could be administered by teachers or parents. No single instrument matched all Chilean priorities. Three instruments met 11 of 13 priorities (age; quality; administration at school, home, or waiting rooms; assess language and socioemotional domains; administered by teachers, parents, or psychologists; time ≤30 minutes). Including mental health or parenting abilities ranked instruments whose composite scores were 35% lower. CONCLUSION: Decisions about how to assess children at developmental risk should be informed by local context. The CHNRI method provided a useful process that made explicit mutually exclusive priorities, quantified trade-offs of different assessment strategies, and identified 3 of the instruments that best met local needs and priorities.

Lessons from the Chilean earthquake: how a human rights framework facilitates disaster response.

The earthquake of 2010 in Chile holds important lessons about how a rights-based public health system can guide disaster response to protect vulnerable populations. This article tells the story of Chile Grows With You (Chile Crece Contigo), an intersectoral system created three years before the earthquake for protection of child rights and development, and its role in the disaster response. The creation of Chile Grows With You with an explicit rights-oriented mandate established intersectoral mechanisms, relationships, and common understanding between governmental groups at the national and local levels. After the earthquake, Chile Grows With You organized its activities according to its founding principles: it provided universal access and support for all Chilean children, with special attention and services for those at greatest risk. This tiered approach involved public health and education materials for all children and families; epidemiologic data for local planners about children in their municipalities at-risk before the earthquake; and an instrument developed to assist in the assessment and intervention of children put at risk by the earthquake. This disaster response illustrates how a rights-based framework defined and operationalized in times of stability facilitated organization, prioritization, and sustained action to protect and support children and families in the acute aftermath of the earthquake, despite a change in government from a left-wing to a right-wing president, and into the early recovery period.

Dietary supplement use in pediatric patients with cystic fibrosis.

PURPOSE: The use of dietary supplements and their perceived effectiveness in pediatric patients with cystic fibrosis (CF) were studied. METHODS: A descriptive survey, comprising both open- and closed-ended questions, was developed to assess current and past use of dietary supplements, identify sources of dietary supplement information, determine the perceived effectiveness of these dietary supplements, and evaluate families' knowledge of regulations regarding dietary supplements. RESULTS: A total of 121 pediatric CF patients and their families completed the survey. Assessment of dietary supplement use showed that 19% of patients (n = 23) were currently using dietary supplements and 10% (n = 12) reported past dietary supplement use. A total of 5 patients reported both current and past use of dietary supplements. Almost 40% of the patients who reported dietary supplement use did not inform their primary care provider about their use. While many factors may influence a patient's decision to begin therapy with a dietary supplement, 20% (n = 6) of patients felt their physician was most influential. Most patients (n = 104, 86%) correctly believed that dietary supplements are not regulated in the same manner as other prescription medications; however, only 60% (n = 72) would change the way dietary supplements are regulated. CONCLUSION: The use of dietary supplements in pediatric patients with CF was common, although few patients and families perceived it as effective for treating CF.