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Background: National policy statements increasingly espouse the delivery of comprehensive mental health services in schools. In response to the limited evidence supporting this recommendation, the purpose of this study was to assess the need for, and feasibility, desirability, and outcomes of a full model of comprehensive mental health services in 2 public elementary schools in inner-city neighborhoods. Methods: The program, based upon a national model for comprehensive school mental health services, comprised universal and indicated preventive as well as clinical interventions designed to target needs identified in a baseline screening survey. The program was implemented over 1 school year by mental health professionals in collaboration with school teachers. Mental health outcomes comparing baseline to follow-up data were assessed in multiple domains among students and teachers. Results: After 1 year of intervention, students had significantly fewer mental health difficulties, less functional impairment, and improved behavior, and reported improved mental health knowledge, attitudes, beliefs, and behavioral intentions. Teachers reported significantly greater proficiency in managing mental health problems in their classrooms. School staff overwhelmingly endorsed satisfaction with the program. Conclusion: If the observed favorable findings from this pilot demonstration can be replicated in methodologically rigorous studies, additional support would be garnered for national policy recommendations about comprehensive school mental health services. (Contains 4 tables and 1 figure.)

This study examined the role of pretreatment demographic and clinical predictors of attendance as well as barriers to treatment and consumer satisfaction on attendance at therapist-led parent training with 86 families of children ages 3 to 6 years conducted in pediatric primary care settings. Only socioeconomic status (SES) and minority group membership were significantly associated with not completing treatment. Using optimal data analysis procedures, high SES correctly predicted treatment completion 83.6% of the time. Being from a low SES, minority group family correctly predicted noncompletion of treatment 72.7% of the time, but being from a low SES, white family predicted treatment completion 80% of the time. Since barriers to treatment, such as stressors, obstacles to treatment, and treatment demands were unrelated to attendance in the present study, other factors related to social class and minority status that could contribute to better consumer satisfaction and treatment attendance must be investigated. (Contains 2 tables and 1 figure.)

The risk of CO2 leakage from damaged wellbore is identified as a critical issue for the feasibility and environmental acceptance of CO2 underground storage. For instance, Portland cement can be altered if flow of CO2-rich water occurs in hydraulic discontinuities such as cement-tubing or cement-caprock interfaces. In this case, the raw cement matrix is altered by diffusion of the solutes. This fact leads to the formation of distinctive alteration fronts indicating the dissolution of portlandite, the formation of a carbonate-rich layer and the decalcification of the calcium silicate hydrate, controlled by the interplay between the reaction kinetics, the diffusion-controlled renewing of the reactants and products, and the changes in the diffusion properties caused by the changes in porosity induced by the dissolution and precipitation mechanisms. In principle, these mass transfers can be easily simulated using diffusion-reaction numerical models. However, the large uncertainties of the parameters characterizing the reaction rates (mainly the kinetic and thermodynamic coefficients and the evolving reactive surface area) and of the porosity-dependent diffusion properties prevent making reliable predictions required for risk assessment. In this paper, we present the results of a set of experiments consisting in the alteration of a holed disk of class-G cement in contact with a CO2-rich brine at reservoir conditions (P = 12 MPa and T = 60 °C) for various durations. This new experimental protocol allows producing time-resolved data for both the spatially distributed mass transfers inside the cement body and the total mass transfers inferred from the boundary conditions mass balance. The experimental results are used to study the effect of the fluid salinity and the pCO2 on the overall reaction efficiency. Experiments at high salinity triggers more portlandite dissolution, thinner carbonate layers, and larger alteration areas than those at low salinity. These features are accompanied with different spatial distribution of the alteration layers resulting from a complex interplay between salinity-controlled dissolution and precipitation mechanisms. Conversely, the effect of the pCO2 is more intuitive: Increasing pCO2 results in increasing the overall alteration rate without modifying the relative distribution of the reaction fronts.

The aims of this study were threefold: (1) to compare prevalence of sensory regulation dysfunction based on previously established criteria to rates established with a more representative community sample of 796 4-year-olds; (2) to examine ethnic/racial and gender differences in prevalence according to the different criteria; and (3) to examine the co-occurrence of sensory regulation dysfunction and preschool psychiatric disorders. Prevalence rates ranged from 3.4% (current criteria) to 15.6% (previous criteria). In contrast to previous studies with less representative samples, there were no significant ethnic or racial differences using the current criteria. Boys were more likely to have sensory regulation dysfunction than girls according to all criteria. Depending upon impairment criteria used, 33-63% of children meeting criteria for sensory dysregulation also had a psychiatric disorder; 37-67% had only a sensory dysregulation disorder, indicating that sensory regulation dysfunction exists independent of psychiatric disorder, and is also a significant risk factor for disorder.

Few studies have examined the epidemiology of preschoolers' psychopathology. This study included 796 4-year-old children recruited from schools and pediatric practices in a diverse, urban area. Psychiatric disorder was assessed by a structured interview adapted for preschool children and by questionnaire. The most common disorders were oppositional defiant disorder (ODD) and attention deficit hyperactivity disorder (ADHD). Generalized anxiety disorder (GAD) and depressive disorders were reported in less than 1% of the sample. Race/ethnicity differences were not significant. Gender differences showed ADHD-inattentive type more common among boys, with no gender differences for GAD, major depressive disorder, dysthymia, separation anxiety disorder, or ODD at any level of impairment. The overall comorbidity rate was 6.4%. Approximately 3% of individuals receiving a diagnosis had received mental health services. (Contains 3 tables.)

Objective: To survey teachers' beliefs about mental health service needs in inner city elementary schools. Method: A total of 119 teachers from six elementary schools in a major city in the midwestern United States were surveyed to assess their beliefs about the major mental health problems facing their schools, the major barriers to surmounting those problems, their preferences for mental health topics for in-service education, and their education, experience, knowledge, attitudes, and self-efficacy pertaining to mental health issues. Results: Disruptive behavior was endorsed by approximately 50% of teachers as the largest mental health problem facing their schools, and lack of information/training was endorsed as the greatest barrier to surmounting mental health problems. The highest-rated topics for in-service education were disruptive behavior disorders and implementing behavior plans. Although most teachers had taught students with mental health problems, most had had little education in mental health and little consultation with mental health professionals. Correspondingly, teachers' knowledge about mental health issues was limited, and they did not feel confident about their ability to manage mental health problems in their classrooms. Conclusions: Teachers would benefit from education, training, and consultation from mental health professionals if they serve as effective gatekeepers to mental health services. (Contains 3 tables and 2 figures.)

Thirty years ago, leaders in psychiatry expressed hope for more interdisciplinary collaboration with family therapy. Since then marriage and family therapy (MFT) has entered the mainstream of clinical practice in psychiatry and psychology. It is mandated for training in psychiatry and psychology. We propose a model for collaboration, training, and treatment in interdisciplinary mental health settings that strives to integrate empirical bodies of knowledge in MFT, psychiatry, and psychology and to provide a usable and testable clinical approach to treatment. It can be taught to trainees with various or limited training in MFT. This model delineates nine critical domains that guide treatment. Flexibility is central to this model, focusing on techniques and clinical methods based on empirically supported treatments, when available, and best-practice standards.

The full-scale deployment of underground storage of CO2 in permeable sedimentary reservoirs depends strongly on the sealing capacity of the caprocks and wellbore cement that may be degraded leading to hydraulic discontinuities. Remediation technologies consisting in rebuilding the sealing capacity of the degraded material, or adding a new sealing layer, is a critical issue as part of the risk mitigation procedure required for underground CO2 storage. Actually, engineered Portland cement injection is the foremost available industrial technique; however, alternative products offering, for instance, better injection properties, are currently investigated with variable success so far. In this study, a new technique aimed at using a low viscosity hydrated solgel as sealant product in case of leakage is presented. Its low cost, high injectivity capacity and low density of the hydrated product (hydrogel) makes this technique attractive. The solgel synthesis was optimized for (1) reducing energetic and material costs; (2) improving the chemical and mechanical properties of the emplaced product and (3) controlling the duration of the aging process in order to form a solid hydrogel after a few days. Permeability tests that consisted of injecting the synthesized solgel in different porous media confirmed the sealant capacity of the emplaced hydrogel to significantly reduce rock permeability.