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Introduction: The COVID-19 pandemic has introduced new stressors for parents ('caregivers') that may affect their own and their child's mental health (MH). We explored self-reported levels of caregiver strain (parents' perceived ability to meet parenting demands), and the MH and sociodemographic factors of caregivers to identify predictors of strain that can be used to guide MH service delivery for families. Methods: We administered a web-based survey to Ontario caregivers with a child between 4 and 25 years old, between April and June 2020. We analyzed information from 570 maternal caregivers on their sociodemographics, youngest (or only) child's MH, their own MH, and the degree of caregiver strain experienced since the pandemic. We used linear regressions (unadjusted and adjusted models) to explore the relationship between caregiver strain and sociodemographics, child MH and caregiver MH. Results: Over 75% of participants reported 'moderate-to-high' caregiver strain. More than 25% of caregivers rated their MH as 'poor' and 20% reported moderate-to-severe anxiety. Forty-five percent of the variance in caregiver strain was accounted for by child age, caregiver anxiety, and multiple child and caregiver MH variables. Younger child age and higher caregiver anxiety were the greatest predictors of caregiver strain. Conclusion: We found a relationship between child age, child and caregiver MH variables, and caregiver strain. Given the interrelatedness of these factors, supporting caregivers' MH and lessening their role strain becomes critical for family well-being. Evidence-based individual, family, and public health strategies are needed to alleviate pandemic-related strain. Keywords: parents, caregivers, caregiver strain, COVID-19, mental health, Introduction The COVID-19 pandemic has introduced new stressors for parents ('caregivers') by increasing their roles and responsibilities, while restricting their social supports and usual coping strategies (Fontanesi et al., 2020). [...]

This paper describes a solution approach for stochastic multi‐resource multi‐patient staff scheduling problems in inpatient units. Our solution approach has four steps. First, we classify patients into a number of groups with similar care‐provider requirements. Second, a predictive Markov model captures patients' flow in the inpatient unit and provides a prediction of the number of patients of each group in the future. This predictive model allows us to generate a potentially large set of possible system utilization scenarios over the planning horizon. Third, a mixed‐integer programming model with an expected value objective function seeks to minimize the expected over‐staffing and under‐staffing costs across all possible scenarios. Lastly, we use simulation to sample system utilization scenarios and the sample average approximation method to find a reliable and generalizable solution to the model across all possible scenarios. We evaluate the performance of the proposed solution using real data from the Children's Hospital of Eastern Ontario's inpatient mental health unit. The results show that the proposed approach significantly decreases the expected cost of the schedules in comparison to the traditional approaches. [ABSTRACT FROM AUTHOR]

Child and adolescent mental health (CAMH) problems are prevalent and inefficient mental health (MH) care systems can contribute to poor outcomes. The Choice and Partnership Approach (CAPA) is a MH care delivery model aiming to provide efficient, high-quality care. Although widely used, no CAPA research review exists. We conducted a scoping review to fill this gap. Medline, Embase, and PsycINFO databases were searched from inception to June 2021. Grey Matters and Google were used to search the grey literature. We identified 5322 records. Removal of duplicates left 4720 documents, which were successively screened and data extracted by pairs of co-authors. The final dataset comprised six published and three non-published studies, conducted primarily at CAMH sites in England, Scotland, Australia, or Canada. Each study had multiple research objectives, which we summarized into seven categories. Positive outcomes were reported for most objectives, but attributing causality to CAPA was hampered by research methodology. Observational designs were used in all studies and approaches to analyzing data varied considerably. Research gaps included the lack of healthcare economics studies of CAPA and no assessment of facilitators and barriers. Current research on CAPA provides intriguing findings meriting further investigation. We suggest strategies to improve future studies. [ABSTRACT FROM AUTHOR]

A study was conducted to determine whether neuropsychological function is poorer in girls with conduct disorder (CD) than in girls without any psychiatric disorder. It is concluded that girls with CD had deficits in several areas of neuropsychological function.

A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

This study investigates the function of the hypothalamic-pituitary-adrenal (HPA) axis in adolescent antisocial girls. This question is important because disturbance of HPA functioning has been found in populations of violent adult males and antisocial adolescent males, suggesting that it may be a marker of a physiological disorder associated with antisocial behavior. The investigators examined 228 pregnant or postpartum teenage girls, categorizing them as having conduct disorder (CD) or not having conduct disorder (NCD). HPA axis function was assessed with saliva cortisol samples obtained in the midmorning when the girls were 4 and 9 months postpartum. The hypothesis was that girls with CD would have lower cortisol levels than girls without CD. The investigators did not find any significant difference in cortisol levels between the two groups, an important but puzzling finding. Azar et al. suggested that this result may demonstrate a lack of clear HPA axis involvement in antisocial mothers.

Primary care providers (PCPs) report insufficient capacity for child and youth mental health care (CYMH). The telementoring program Project ECHO (Extension for Community Healthcare Outcomes) can build capacity, but 75- to 120-minute sessions are a participation barrier. Using a Lean health care paradigm, we designed a 60-minute session, and compared self-reported CYMH capacity strengthening (10 constructs) and satisfaction between 60- and 90-minute sessions. Pre-post (n = 139) and post-cycle (n = 146) survey data were analyzed using generalized linear mixed-effects logistic regression. Capacity strengthening was demonstrated when analyzing both groups together (all Ps ≤ .002). Session duration did not affect capacity strengthening for 9/10 constructs (all Ps > .05), but medication management development was higher with 90-minute sessions (P = .002). Satisfaction was high in both groups. The 60-minute ECHO CYMH sessions can be used without negative learning outcomes, but more mentoring may be needed to build capacity for psychopharmacologic treatment. [ABSTRACT FROM AUTHOR]