Family-Centered Care and Collaboration: A Scoping Review of Medical Guidance for Parental Substance Use.

Background: A significant proportion of US families are affected by substance use disorders. Both child- and adult- serving systems are called upon to care for families, yet the disciplines involved inherently have different priorities, preventing a true family-centered care model.

Objectives: The purpose of the scoping review was to explore the alignment of current national guidance related to the medical care of families affected by substance use disorders (SUD).

Characterization of parental intention to vaccinate elementary school aged children in the state of California.

In October 2021, Emergency Use Authorization of Coronavirus Disease 2019 (COVID-19) vaccines was granted for children aged 5-11. To ensure vaccine uptake in children upon approval, California will implement a state-wide executive order mandating COVID-19 vaccination for school children following full US FDA approval. This study uses survey data collected between November 6th, 2020 and December 14th, 2020 (n = 2091) to identify how sociodemographic characteristics and attitudes towards childhood vaccines among California parents were associated with their intentions to vaccinate their child against COVID-19.

Family Engagement in Services During COVID-19: A Mixed-Methods Study of Caregiver and Staff Perspectives.

Introduction: We examined changes in family engagement before versus during the pandemic in pediatric and family services and perceived facilitators and barriers to family engagement.

Method: We employed a mixed-methods assessment of staff and caregiver perspectives related to pediatric and family medicine clinics and family resource centers in rural northern New England. We used narrative synthesis to analyze qualitative interviews (n = 29) and descriptive statistics for quantitative surveys (n = 108).

Difficulty Obtaining Behavioral Health Services for Children: A National Survey of Multiphysician Practices.

Purpose: In the United States, primary care practices rely on scarce resources to deliver evidence-based care for children with behavioral health disorders such as depression, anxiety, other mental illness, or substance use disorders. We estimated the proportion of practices that have difficulty accessing these resources and whether practices owned by a health system or participating in Medicaid accountable care organizations (ACOs) report less difficulty.

Methods: This national cross-sectional study examined how difficult it is for practices to obtain pediatric (1) medication advice, (2) evidence-based psychotherapy, and (3) family-based therapy.

Difficult binds: A systematic review of facilitators and barriers to treatment among mothers with substance use disorders.

Background: The United States and Canada have observed sharp increases in substance use disorder among women of child-bearing or child-rearing age. Substance use disorder can have deleterious effects on children, families, and communities. Many evidence-based treatments exist, but engaging mothers in treatment is difficult.

Psychotropic Polypharmacy and Antipsychotics in Children: A Survey of Caregiver's Perspectives.

Objective: We examined caregiver's knowledge, attitudes, and concerns about their child's psychotropic medication regimen and the potential side effects, describe how they seek information regarding treatment, and ascertain their perspectives toward deprescribing.

Methods: We surveyed 48 caregivers of children 6-17 years old treated with two or more psychotropic medications or an antipsychotic medication, analyzing outcomes using descriptive statistics.

Results: Almost all (N = 44, 92%) participants reported feeling very knowledgeable about why medications were prescribed, but only one-third (N = 16, 33%) reported feeling very knowledgeable about potential problems with long-term use or polypharmacy.

Deprescribing psychotropic medications in children: results of a national qualitative study.

Background And Objective: Prescriptions for psychotropic medications to children have risen dramatically in recent years despite few regulatory approvals and growing concerns about side effects. Government policy and numerous programmes are attempting to curb this problem. However, the perspectives of practising clinicians have not been explored.

State-wide implementation and clinical outcomes associated with evidence-based psychotherapies for traumatized youth.

Background: Highly efficacious evidence-based psychotherapies (EBPs) exist for children and youth exposed to trauma, yet very few who need the treatments in the community receive them. Research within real-world settings is needed to better understand what is required to translate treatments into the community.

Purpose: We aimed to examine the implementation and clinical outcomes of a multiyear project installing 2 EBPs for trauma-exposed youth in community agencies across the state of New Hampshire.

Effectiveness of a Trauma-Informed Care Initiative in a State Child Welfare System: A Randomized Study.

Trauma-informed care (TIC) initiatives in state child welfare agencies are receiving more attention, but little empirical evidence exists as to their efficacy. The purpose of this study was to assess changes in self-reported practices and perceptions of child welfare staff involved in a multifaceted, statewide TIC intervention. Ten child welfare offices were matched and randomized to an early or delayed cohort.

Children's behavioral health needs and satisfaction and commitment of foster and adoptive parents: Do trauma-informed services make a difference?

Objective: Caring for children in foster or adoptive care with behavioral health needs can severely stress parents, contributing to adverse outcomes for children and families. Trauma-informed services from the child welfare and mental health sectors may help prevent poor outcomes by helping children and parents identify and understand trauma and its impact on children's behavioral health and receive effective treatment. To help understand the role of trauma-informed services for the child welfare population, we examined whether trauma-informed child welfare and mental health services moderated the relationship between children's behavioral health needs and parent satisfaction and commitment.

Psychotropic medications for highly vulnerable children.

Introduction: At least 20% of children in the U.S. are highly vulnerable because they lack healthcare and protection.

COMP report: CPQR technical quality control guideline for medical linear accelerators and multileaf collimators.

The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities.

Foster and Adoptive Parent Perspectives on Needs and Services: a Mixed Methods Study.

Caring for children with complex needs severely stresses foster and adoptive parents, but few studies have examined their perspectives on needs and services. To examine parental views, the authors analyzed four focus groups (n = 27 participants) and one state-wide survey (n = 512 respondents, 42% of 1206 contacted) of foster and adoptive parents in one state. Results highlighted inadequate communication between providers and families, cultural and legal barriers, needs for parent training and preparation, the importance of several types of parent supports, and needs for specialized mental health treatment for the children.

Supporting Shared Decision-making for Children's Complex Behavioral Problems: Development and User Testing of an Option Grid™ Decision Aid.

There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid.

Comparison of Bolus Materials to Highly Absorbent Polypropylene and Rayon Cloth.

This study assesses the utility of a highly absorbent polypropylene and rayon cloth (HAPRC) as a bolus material in radiation therapy. A comparison of various bolus materials used clinically at our center to the test bolus material, water-saturated HAPRC, was conducted. The reproducibility of the physical density was assessed by computerized tomography (CT) scanning the water-saturated HAPRC on a uniform density block phantom on multiple occasions, allowing the cloth to dry fully between subsequent CT scans.

Use of Antipsychotic Medications for Nonpsychotic Children: Risks and Implications for Mental Health Services.

Antipsychotic medications, especially second-generation antipsychotics, have increasingly been prescribed to children under age 18 in the United States. They are approved to treat pediatric bipolar and psychotic disorders and aggressive behaviors among patients with autism, but they are often used off label to control disruptive behaviors of children without autism and treat mood problems of children without bipolar disorder. The most vulnerable children, such as those in foster care, are the most likely recipients.

Prescribing clinicians' perspectives on evidence-based psychotherapy for posttraumatic stress disorder.

Evidence-based psychotherapies (EBP) for Posttraumatic Stress Disorder are not utilized to their full extent within the Department of Veterans Affairs (VA). VA provides care to many persons with PTSD and has been in the forefront of clinical practice guidelines and EBP training and dissemination. Yet VA continues to find EBP implementation difficult.

Introduction of moderate deep inspiration breath hold for radiation therapy of left breast: Initial experience of a regional cancer center.

Purpose: Practical aspects of introducing moderate deep inspiration breath hold (mDIBH) for treatment of left breast cancer in a regional cancer program in terms of workflow and treatment delivery requirements are described. Differences in heart and lung doses between free breathing (FB) and mDIBH plans are presented as well as heart position reproducibility and resulting dosimetric impact using cone beam computed tomography (CBCT).

Methods And Materials: A mDIBH process was established.

Innovations in Practice: Dissemination and implementation of child-parent psychotherapy in rural public health agencies.

Background: Early trauma exposure can have long-term negative health effects. Few young children receive evidence-based trauma treatment. This article explores the feasibility of implementing Child-Parent Psychotherapy (CPP), an evidence-based intervention, in rural public health agencies.