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This article addresses optimal deterrence and its limits in the context of creating a more effective mechanism for antitrust compliance to take hold in businesses. We suggest the need for the creation of proactive encouragement of compliance programmes. Antitrust authorities should work with the business community to create a regulatory scheme that rewards good behaviour while punishing bad behaviour. To do so, antitrust authorities need to understand how to create and sustain compliance efforts within a company. The proper role of an antitrust compliance programme should be to ensure compliance with the law and to promote ethical behaviour by and between companies as part of good corporate governance. Antitrust authorities should play a role in encouraging and supporting this in the same way other enforcement authorities do (eg in relation to Foreign Corrupt Practices Act/anti-bribery enforcement). We argue that from a policy perspective, antitrust enforcement should not just be about punishment but about changing normative values within organizations. [ABSTRACT FROM AUTHOR]

Purpose: The Patient Reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health initiative that has produced self-report outcome measures, using a framework of physical, mental, and social health defined by the World Health Organization in 1948 (WHO, in Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, ). The World Health Organization's International Classification of Functioning, Disability and Health (ICF) is a comprehensive classification system of health and health-related domains that was put forward in 2001. The purpose of this report is to compare and contrast PROMIS and ICF conceptual frameworks to support mapping of PROMIS instruments to the ICF classification system . Methods: We assessed the objectives and the classification schema of the PROMIS and ICF frameworks, followed by content analysis to determine whether PROMIS domain and sub-domain level health concepts can be linked to the ICF classification. Results: Both PROMIS and ICF are relevant to all individuals, irrespective of the presence of health conditions, person characteristics, or environmental factors in which persons live. PROMIS measures are intended to assess a person's experiences of his or her health, functional status, and well-being in multiple domains across physical, mental, and social dimensions. The ICF comprehensively describes human functioning from a biological, individual, and social perspective. The ICF supports classification of health and health-related states such as functioning, but is not a specific measure or assessment of health, per se. PROMIS domains and sub-domain concepts can be meaningfully mapped to ICF concepts. Conclusions: Theoretical and conceptual similarities support the use of PROMIS instruments to operationalize self-reported measurement for many body function, activity and participation ICF concepts, as well as several environmental factor concepts. Differences observed in PROMIS and ICF conceptual frameworks provide a stimulus for future research and development. [ABSTRACT FROM AUTHOR]

Purpose: To examine the impact of cochlear implant (CI) intervention on health-related quality of life (HRQOL) assessed by both self- and parent-reported measures. Methods: In this national study of children implanted between ages 6 months and 5 years, HRQOL of 129 children 6-year post-CI was compared to 62 internal study (NH1) and 185 external (NH2) samples of hearing children frequency-matched to the CI group on sociodemographic variables. HRQOL ratings of children and their parents in each group, measured using the Child Health and Illness Profile-Child Edition, were compared, and their associations with the Family Stress Scale were investigated. Results: CI children reported overall and domain-specific HRQOL that was comparable to both NH1 and NH2 peers. CI parents reported worse child scores than NH1 parents in Achievement, Resilience, and Global score ( p's < 0.01) but similar or better scores than socioeconomically comparable NH2 parents. Higher family stress was negatively associated with all parent-reported HRQOL outcomes ( p's < 0.01). Parent-child correlations in HRQOL global scores trended higher in CI recipients ( r = 0.50) than NH1 ( r = 0.42) and NH2 ( r = 0.35) controls. Conclusions: CI recipients report HRQOL comparable to NH peers. These results, from both child and parent perspective, lend support to the effectiveness of CI intervention in mitigating the impact of early childhood deafness. Family stress was associated with worse HRQOL, underscoring a potential therapeutic target. Parent-child agreement in HRQOL scores was higher for CI families than NH families, which may reflect higher caregiver insight and involvement related to the CI intervention. [ABSTRACT FROM AUTHOR]

Objective With the growing number of childhood cancer survivors in the US, it is important to assess the well-being of these individuals, particularly during the transitional phase of adolescence. Data about adolescent survivors' overall health and quality of life will help identify survivor subgroups most in need of targeted attention to successfully transition to adulthood. Participants and methods This ancillary study to the Childhood Cancer Survivor Study focused on children 15-19 years of age who had been diagnosed with cancer before the age of 4 years. A cohort of siblings of pediatric cancer survivors of the same ages served as a comparison sample. Adolescent health was assessed using the Child Health and Illness Profile-Adolescent Edition (CHIP-AE) survey. Results The teen survey was sent to 444 survivor teens and 189 siblings. Of these, 307(69%) survivors and 97 (51%) siblings completed and returned the survey. The overall health profiles of siblings and survivors were similar. Among survivors, females scored significantly below males on satisfaction, discomfort, and disorders domains. Survivors diagnosed with central nervous system tumors scored less favorably than leukemia survivors in the global domains of satisfaction and disorders. Conclusion In general, adolescent survivors fare favorably compared to healthy siblings. However, identification of the subset of pediatric cancer survivors who are more vulnerable to medical and psychosocial disorders in adolescence provides the opportunity for design and implementation of intervention strategies that may improve quality of life. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To describe the qualitative development of the Patient-Reported Outcome Measurement Information System (PROMIS®) Pediatric Stress Response item banks.Methods: Stress response concepts were specified through a literature review and interviews with content experts, children, and parents. A library comprising 2,677 items derived from 71 instruments was developed. Items were classified into conceptual categories; new items were written and redundant items were removed. Items were then revised based on cognitive interviews (n = 39 children), readability analyses, and translatability reviews.Results: 2 pediatric Stress Response sub-domains were identified: somatic experiences (43 items) and psychological experiences (64 items). Final item pools cover the full range of children's stress experiences. Items are comprehensible among children aged ≥8 years and ready for translation.Conclusions: Child- and parent-report versions of the item banks assess children's somatic and psychological states when demands tax their adaptive capabilities. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Normative biopsychosocial stressors that occur during entry into adolescence can affect school performance. As a set of resources for adapting to life''s challenges, good health may buffer a child from these potentially harmful stressors. This study examined the associations between health (measured as well-being, functioning, symptoms, and chronic conditions) and school outcomes among children aged 9–13 years in 4th–8th grades. Methods: We conducted a prospective cohort study of 1,479 children from 34 schools followed from 2006 to 2008. Survey data were obtained from children and their parents, and school records were abstracted. Measures of child self-reported health were dichotomized to indicate presence of a health asset. Outcomes included attendance, grade point average, state achievement test scores, and child-reported school engagement and teacher connectedness. Results: Both the transition into middle school and puberty had independent negative influences on school outcomes. Chronic health conditions that affected children''s functional status were associated with poorer academic achievement. The number of health assets that a child possessed was positively associated with school outcomes. Low levels of negative stress experiences and high physical comfort had positive effects on teacher connectedness, school engagement, and academic achievement, whereas bullying and bully victimization negatively affected these outcomes. Children with high life satisfaction were more connected with teachers, more engaged in schoolwork, and earned higher grades than those who were less satisfied. Conclusions: As children enter adolescence, good health may buffer them from the potentially negative effects of school and pubertal transitions on academic success. [Copyright &y& Elsevier]

Purpose: To describe the development of the Healthy Pathways Parent-Report Scales, measures of health, illness, well-being, and achievement among youth in middle childhood and adolescence. Methods: The Healthy Pathways Scales were derived from the Child Health and Illness Profile (CHIP) instruments. The CHIP domains of Comfort, Risk Avoidance, Satisfaction, and Resilience were modified to reflect advances in child health conceptualization. Classical test and modern psychometric analyses were conducted using data collected from 1,527 parents of children aged 9-14 years. Intra-class correlation and differential item functioning analyses were used to evaluate the extent of child-parent agreement on the Healthy Pathways Scales. Results: After minor revisions, 11 of the 12 scales were found to measure unidimensional parent-assessed outcomes comprehensively (full range of the latent trait) and efficiently (a minimal number of items). Scales were unbiased by age, gender, and geographic location. The construct validity of the scales was supported by their capacity to differentiate children with and without chronic illnesses and to detect expected age and gender differences. Child-parent agreement was poor to moderate at both the scale and item levels. Conclusions: The Healthy Pathways Parent-Report Scales may be used to reliably, accurately, and efficiently assess unidimensional aspects of health, illness, well-being, and achievement in clinical and population-based research studies involving youth in middle childhood and adolescence. [ABSTRACT FROM AUTHOR]

Although the connection between early life experiences and later health is becoming increasingly clear, what is needed, now, is a new organizing framework for childhood health promotion, grounded in the latest science. We review the evidence base to identify the steps in the overall pathway to ensuring better health for all children. A key factor in optimizing health in early childhood is building capacities of parents and communities. Although often overlooked, capacities are integral to building the foundations of lifelong health in early childhood. We outline a framework for policymakers and practitioners to guide future decision-making and investments in early childhood health promotion. [ABSTRACT FROM AUTHOR]

Objectives: To assess the reliability and validity of the Spanish version of the CHIP-CE/CRF. Methods: Cross-sectional study was conducted in a representative sample of primary school children in Spain. Children were administered the Spanish version of the CHIP-CE/CRF. The Achenbach Child Behavioral Checklist was given to parents. Results: The overall response rate was 75% ( n = 979). Internal consistency was >0.70 for 3 out of 5 domains, and the intraclass correlation coefficient for test-retest stability ranged from 0.69 to 0.80. Confirmatory factor analysis replicated the original model. Younger children scored higher in Satisfaction than older children. Girls scored lower in Comfort but higher in Risk Avoidance than boys. Conclusions: The Spanish version of the CHIP-CE/CRF has shown acceptable reliability and validity, similar to the properties of the original US version. Future studies should analyze the instrument's sensitivity to change. [ABSTRACT FROM AUTHOR]

Objective: This study used a controlled research design to examine the effects on children of treating their mothers' depression and of remission of the mothers' depression. Method: The sample consisted of 60 low-income women with major depression, who were predominantly from minority racial-ethnic groups, and their children ages four to 11. Women were randomly assigned to receive one of two active treatments (medication or cognitive-behavioral therapy) or a referral to existing community services. The mothers' depression was assessed by self-report on the Hamilton Depression Rating Scale, and the children's symptoms and adaptive skills were assessed by their mothers at baseline and six-month and 12-month follow-ups with the Behavior Assessment System for Children. Results: Mixed-effects random intercept and random slope repeated-measures analyses using an intent-to-treat approach indicated that active treatment of mothers did not result in improvement in their children's behavior problems or adaptive skills. However, at both the six- and the 12-month follow-ups, children of mothers whose depression had remitted, regardless of treatment assignment, had significantly fewer behavior problems than children whose mothers remained depressed. Conclusions: The results support the need to expand access to, and support participation in, depression treatment among low-income women from minority racial-ethnic groups. Although treatment alone of this undertreated population was not associated with improvement in children's outcomes, it is a necessary first step to prevent psychopathology among offspring of depressed parents. (Psychiatric Services 63:357-363, 2012; doi: 10.1176/appi.ps.201100126) [ABSTRACT FROM AUTHOR]

A breach of a seal affixed by the European Commission during an unannounced inspection (or ‘dawn raid’) of itself constitutes a serious infringement of European competition law which is likely to attract a very heavy fine.There is no requirement on the European Commission to show any intention on the part of a company being investigated to breach the seal, or to show evidence that documents were actually taken from the site.The article considers the factual differences in the European Commission's reported decisions fining companies for obstruction by tampering with a European Commission seal affixed during a dawn raid.The article seeks to draw out some practical suggestions that companies and their advisors may wish to take into account when dealing with antitrust investigations. [ABSTRACT FROM PUBLISHER]

To investigate patterns of mental health services, psychotropic treatments, and psychiatric diagnoses received by youth diagnosed with bipolar disorder, insurance claims of 323 youth (ages 6-18 years) were examined from the 2000-2001 Thomson/Medstat-MarketScan(c) database. Longitudinal patterns are assessed 6 months prior and following a new treatment episode of bipolar disorder. Youth subgroups (i.e., continuous, intermittent, and discontinuous services), defined by persistence of claims associated with a bipolar diagnosis, are compared by demographic and clinical characteristics. Virtually all youth had high rates of mental health service use and treatment immediately following initial bipolar diagnosis, but only half continued to receive services 6 months following diagnosis. A continuous pattern of claims associated with a bipolar diagnosis was associated with using more resources, receiving initial diagnosis from a mental health professional, being in a managed care plan, and having more psychiatric diagnoses following index bipolar diagnosis. Further research should examine how continuity of claims for bipolar is related to treatment quality and clinical outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The Child Health and Illness Profile (CHIP) has separate child (6-11 years) and adolescent (12-21 years) editions that measure youth's self-assessed health, illness, and well-being. The purpose of this study was to revise the CHIP by combining the two editions to create the Healthy Pathways Child-Report Scales. Methods: We modified the original CHIP domains of Comfort, Risk Avoidance, Satisfaction, and Resilience to reflect advances in child health conceptualization. Classical test and item response theory psychometric analyses were conducted using data collected from 2,095 children (49% boys, 80% White, 17% African-American, 3% Hispanic, Age: M = 10.6, SD = 1.0) in grades 4-6 at 34 schools. Results: After minor revisions, 16 of the 17 scales were found to measure unidimensional self-assessed health, illness, and well-being constructs comprehensively, but with a minimal number of items. Scales were unbiased by age, gender, survey modality, and geographic location. Construct validity was demonstrated by the instrument's capacity to differentiate among children with and without chronic illnesses and to detect expected age and gender differences. Conclusions: The Healthy Pathways Child-Report Scales may be used to reliably and accurately assess unidimensional aspects of health, illness, and well-being in clinical and population-based research studies involving youth in transition from childhood to adolescence. [ABSTRACT FROM AUTHOR]

Patterns of behavioral health service utilization were examined among youth diagnosed with bipolar disorder ( n = 832). Youth were categorized as high, moderate, and low restrictive service users (43, 7, and 50%, respectively). Factors associated with receiving care in highly restrictive settings included: numerous co-occurring diagnoses and being enrolled in managed care. Youth with regular outpatient visits were less likely to receive care in highly restrictive settings. This analysis provides a broad and dramatic picture of the intensity of services needed by most youth with bipolar. Having regular outpatient services shows promise with regard to reducing costly care in restrictive settings. [ABSTRACT FROM AUTHOR]

Depression is a family matter. It not only diminishes the quality-of-life of the depressed person, but also strains the resources of the family unit and increases the children’s risk of developing significant problems that start early and persist into adulthood. Although treatment of a parent’s depression is critical, many families also need professional intervention to reduce children’s risk. This article reviews the evidence on needs of these families and shows that the theoretical and clinical evidence exists to support the design of interventions for families affected by maternal depression. A preventive intervention developed from this foundation is described, the Keeping Families Strong (KFS) program, that is designed to promote resilience and reduce the risk for psychological disorders in children of parents with depression. The pilot study on the KFS program, conducted in adult mental health outpatient settings, is described. Families participate in 10 meetings 90 min each, with a group for parents and for children (10 years and older) conducted concurrently. The program structure and content are described, the challenges of implementing a family preventive intervention in actual clinical settings are discussed, and a case example is provided, as well as preliminary outcome data on ten families. In sum, we provide a strong rationale for the potential of preventive interventions for families affected by maternal depression. [ABSTRACT FROM AUTHOR]

The relationship between academic problems and delinquency is well documented among incarcerated populations but has not been examined among nonincarcerated youth involved with the juvenile justice system. This research examined the school functioning and academic achievement of 157 youth who had brief contact with a state department of juvenile justice and then returned to the community. More than half (62.4%) demonstrated problems in school functioning or academic performance, as measured with well-validated instruments. Standard achievement scores were below average and as low as 5 standard deviations below the normative mean. Non-Caucasian youth, and those who received special education services or lived in an urban area demonstrated significantly lower achievement. Juvenile justice agencies and schools should collaboratively address the education needs of these youth. [ABSTRACT FROM AUTHOR]

A multiple case study was conducted to examine how staff in child out-of-home care programs used data from an Outcomes Management System (OMS) and other sources to inform decision-making. Data collection consisted of thirty-seven semi-structured interviews with clinicians, managers, and directors from two treatment foster care programs and two residential treatment centers, and individuals involved with developing the OMS; and observations of clinical and quality management meetings. Case study and grounded theory methodology guided analyses. The application of qualitative data analysis software is described. Results show that although staff rarely used data from the OMS, they did rely on other sources of systematically collected information to inform clinical, quality management, and program decisions. Analyses of how staff used these data suggest that improving the utility of OMS will involve encouraging staff to participate in data-based decision-making, and designing and implementing OMS in a manner that reflects how decision-making processes operate. [ABSTRACT FROM AUTHOR]

The article presents a study on the identification of psychosocial problems among youth during pediatric primary care visits in the U.S. The Gateway Provider Model (GPM) of child mental health services was applied. The relationship between characteristics of the child, family, and provider with the identification of youth psychosocial problems during primary care visits is investigated. Primary care providers had positive attitudes and beliefs about treating psychosocial problems.