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In 2004, Second Step (Committee for Children, 2002), a violence prevention program, was implemented in the Cleveland Heights-University Heights school district for 1,416 K through second grade students. Both process and outcome measures were used to evaluate program impact and examine issues related to the implementation and evaluation of evidence-based practices. Process measures indicated a high level of implementation fidelity, while pre/post outcome testing on a 20% random sample of students demonstrated significant reductions in reactive aggression scores, t = 2.221, df = 238, p less than 0.05, and evidence of declines in proactive aggression. Authors discuss challenges and opportunities related to implementing and evaluating evidence-based programming in Safe Schools/Health Students sites, particularly regarding strategies for the assessment of differential intervention effects to evaluate program outcomes. (Contains 4 tables.)

A sample of 126 consecutively admitted residential treatment children (mean age = 9.86, SD=1.84; 70.6% male; 42.1% African American; 50% Caucasian) were studied over a five-year period to identify predictors of length-of-stay. Cox regression was the primary statistical method used to analyze psychiatric and behavioral rating data for children assessed by teachers and treatment staff using the Devereux Scales of Mental Disorders (DSMD). Parental alcohol abuse, and children's age, medication status, race, initial DSMD total and critical pathology scores, were predictive of length-of-stay. Residential length-of-stay was strongly linked to initial levels of psychiatric symptomatology. Models that can help forecast length of stay are vital tools in helping to improve both clinical and utilization management strategies.

Using cross-sectional analyses in conjunction with dynamic modeling (hierarchical linear modeling), the authors profiled 119 treatment foster care youth and constructed behavioral change trajectories for a subset of 97 children. Children generally showed improvements in internalizing and critical pathology problem domains but remained the same on measures of externalizing behaviors and total problem score. The number of previous out-of-home placements was positively associated with increased levels of psychiatric symptomatology and served as the most robust predictor for modeling treatment response trajectories across problem domains. Placement instability places the well-being of children at heightened risk, therefore, accurate assessment of child need and risk in relation to caregiver capacities is critical.

Forecasting treatment outcomes is essential to improving service delivery. Hierarchical linear modeling was used to construct behavioral change trajectories and help predict treatment responsiveness for 97 partial hospitalization children. Overall, children evidenced statistically significant improvement in psychiatric symptomatology. Younger age, female gender, number of previous out-of-home placements, and lower IQ scores were associated with increased psychopathology and poorer treatment response. Properly configured day treatment can provide an effective organizing platform for implementing complex treatment regimes.

A comprehensive community status assessment of an Ohio urban county's crisis response (CR) system explored the experiences of its behavioral health services' clients and providers to surface themes characterizing the system's responsiveness and identifying opportunities for improvements. Forty‐eight focus groups and two online surveys were conducted. Data were analyzed using qualitative content analysis and descriptive statistics. The greatest areas of needed improvement ascertained by this effort are in increased CR system resources, more efficient use of resources, and capacity enhancements in nine areas: the mobile crisis team, CR protocols, psychiatric inpatient and crisis stabilization beds, stabilization admission for eligible persons, stabilization services for in‐crisis but admission‐ineligible persons, continuity of care, research into child versus adult CR systems, Provider Emergency Support Program, and first responder crisis intervention training. The assessment provides a foundation for the county to identify further opportunities for system scale‐up. [ABSTRACT FROM AUTHOR]

Objective: Dentin-bonded crowns are a comparatively recent addition to the dentist's armamentarium. Although 1-year data cannot predict the long-term performance of restorations, it may be useful for new treatment modalities, given that it will describe early, catastrophic failures. In this study, the 1-year performance of 109 dentin-bonded crowns mas assessed. Method and materials: The crowns were placed in two locations (Glasgow. Scotland, and Belfast, Northern Ireland) for 27 patients. The principal reasons for crown placement were tooth substance loss, esthetic reasons, and tooth fracture. Minimal preparations were used. Ninety-eight crowns were available for review at 1 year. Results: Ninety crowns were found to be intact, six had a crack visible on transillumination and two had fractured. No crowns had debonded. No secondary caries was noted. No unsatisfactory scores were recorded for marginal adaptation, adjacent gingival health, or color match. Conclusion: The dentin-bonded crowns placed during this study provided good overall performance at 1 year. (Quintessence Int 2001 ;32:593-601) [ABSTRACT FROM AUTHOR]

Knowledge about the concordance of parent- and child-reported child physical abuse is scarce, leaving researchers and practitioners with little guidance on the implications of selecting either informant. Drawing from a 2008–2009 sample of 11- to 17-year-olds (N = 636) from Wave 1 of the second National Survey of Child and Adolescent Well-Being, this study first examined parent–child concordance in physical abuse reporting (Parent–Child Conflict Tactic Scale). Second, it applied multivariate regression analysis to relate parent–child agreement in physical abuse to parent-reported (Child Behavior Checklist) and child-reported (Youth Self Report) child behavioral problems. Results indicate low parent–child concordance of physical abuse (κ = .145). Coreporting of physical abuse was related to clinical-level parent-reported externalizing problems ( y ̄ = 64.57), whereas child-only reports of physical abuse were the only agreement category related to child-reported internalizing problems (B = 4.17, p < .001). Attribution bias theory may further understanding of reporting concordance and its implications. [ABSTRACT FROM AUTHOR]

Background: Assessment is a critical component of therapeutic intervention as it serves as the basis from which clinical goals and objectives are derived. Unfortunately, there is a dearth of reliable group therapy assessment instruments, especially for children and preadolescents who have severe emotional disturbances. Objective: The purpose of this study was to test reliability of a newly developed group therapy assessment instrument for use with children who have serious emotional disturbances that require placement in a residential or partial hospitalization treatment program. Methods: After conducting an extensive literature review, the authors developed, refined, and tested a group therapy assessment tool for use in both music therapy and traditional therapy, measuring nine items: attention to task (physical and verbal), eye contact, pro-social skills (physical and verbal), empathy (physical and verbal), and managing negative affect (physical and verbal). Six participants with a mean age of 9.5 (SD = 1.85) years were randomly selected to test the group therapy assessment tool from a pool of 60 eligible children receiving group partial hospitalization therapy. Participants were scored by three raters across two partial hospitalization therapy groups for inter-rater reliability. Content and construct validity were also examined. Results: Intraclass Coefficients (ICC) averaged 0.994 across all nine items indicating excellent inter-rater reliability. Content and construct validity was established and the instrument demonstrated good external validity potential. Conclusions: The Beech Brook Therapy Assessment Instrument has demonstrated excellent inter-rater reliability in measuring important behaviors of functioning central in the treatment of youth with severe and emotional disturbances. The measure has potential for wide utility and application in practice and research; however, future studies are needed to establish external validity. [ABSTRACT FROM AUTHOR]

• Summary: In 2001, federal research funding (#90-CO-0960) was awarded to conduct an in-depth study of one agency’s experience with domestic special needs adoption placements (US Department of Health and Human Services, 2001). This private Ohio agency has been involved in the placement of special needs children since the beginning of the US special needs adoption movement in 1976. A rigorous and comprehensive chart review was conducted profiling 362 consecutively referred special needs adoption cases from 1997 to 2005, providing one of the most accurate and in-depth profiles of both special needs adoption children and their biological mothers to date.• Findings: In summing the major child and biological mother risk factors reported in this study (i.e. child neglect + child physical abuse + child sexual abuse + child prenatal drug exposure + child positive toxicology screen at birth + maternal mental illness + maternal substance abuse + maternal homelessness + maternal history of domestic violence + parental incarceration + and death of a significant person), youth averaged 4.7 (SD = 1.61) cumulative risk factors, not including poverty, multiple placement disruptions, and other undocumented risk factors.• Applications: Accurate and comprehensive profiling of child and biological parent characteristics are required to inform the service needs of at-risk families, domestic special needs adopted children, and adoptive parents. Implications for adoptive parent recruitment, training, and support, as well child monitoring and treatment are discussed. [ABSTRACT FROM PUBLISHER]

Unlabelled: Endodontic lubricants, irrigating solutions and medicaments help reduce the microbial load within root canals. Primary and secondary cases involve different microbes. Each'solution'or combinations thereof could play a significant role but no detailed guidelines exist on their use. An audit was undertaken to compare current practice in Belfast Dental School to the others across the UK and Republic of Ireland (ROI). This audit highlighted three main differences between Belfast and other dental schools. Many other institutions utilized other irrigants besides sodium hypochlorite (NaOCl), different intracanal medicaments, including calcium hydroxide, and higher concentrations of NaOCl. Having gathered this information, we ask, 'Is there sufficient evidence to change the endodontic regime currently used at Belfast Dental School?'. Using the findings from the literature review (Part 1), we introduce new evidence-based protocols for primary and secondary cases for use in Belfast Dental School.Clinical Relevance: In the absence of detailed clinical guidelines on the use of endodontic lubricants, irrigants and medicaments in primary and secondary cases, it is important to be aware of current practice in UK and ROI dental schools where dentists and specialists are trained. [ABSTRACT FROM AUTHOR]

Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of'solutions'could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic 'solution'usage within dental schools. The literature review was undertaken under the following headings: preoporal rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases. The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2. Clinical Relevance: As our clinical practice should reflect evidence-based dentistry, it is important to be aware of the current literature on endodontic lubricant, irrigant and medicament use. [ABSTRACT FROM AUTHOR]

Endodontic lubricants, irrigants and medicaments help prepare and disinfect root canal systems (RCS) but primary and secondary cases involve different microbes and therefore it is unlikely that one protocol will be effective for both case types. Each individual 'solution' or sequence of'solutions' could play a significant role in each case type, but there are no detailed published guidelines in existence. To help inform clinical practice it was decided to undertake a literature review followed by a UK and Republic of Ireland wide audit on current endodontic'solution' usage within dental schools. The literature review was undertaken under the following headings: pre-op oral rinse; file lubricants; root canal irrigants and intracanal medicaments and provides an evidence base for protocol development for both primary and retreatment cases.The audit project and the protocols developed from the findings of both the literature review and audit will be presented in Part 2. [ABSTRACT FROM AUTHOR]

The purpose of this study was to pilot a music therapy assessment instrument for severely emotionally disturbed children. The subjects in this pilot were 20 children, 13 male and 7 female, at a residential treatment center in Cleveland, Ohio. After conducting an extensive literature review, the authors developed a music therapy assessment instrument measuring 4 relevant domains: behavioral/social functioning, emotional responsiveness, language/communication abilities, and music skills. Responses were coded into 3 categories: defensive/withdrawn, target behavior, and disruptive/intrusive. Results demonstrated that subjects displayed significantly more behaviors in the disruptive/intrusive domain. High inter-rater reliability scores of 91.5% for percent agreement and .808 for Cohen's kappa were achieved utilizing this assessment instrument. [ABSTRACT FROM AUTHOR]