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The mental health needs of children and youth involved in the child welfare system remain largely unmet. Service cascades are an emerging approach to systematizing mental health screening, assessment, and treatment referral processes. However, evidence is minimal and inconsistent regarding the effectiveness of such approaches for improving mental health service access and outcomes. In an effort to address this gap, this study presents a case-study of the implementation fidelity and treatment outcomes of the Gateway CALL service cascade. Study analyses involved longitudinal data collected as part of a larger evaluation of Gateway CALL. Specifically, descriptive and linear mixed model analyses were conducted to assess the implementation of service cascade components, and changes in mental health outcomes (behavior problems) among 175 children placed out-of-home during the study. Study analyses found that although fidelity was strong early in the service cascade, implementation began to break down once components involved more than one service system (child welfare, mental health). However, results also indicated that parent-reported child behavior problems decreased significantly over time, despite later cascade components being implemented with poor fidelity to the Gateway CALL service model. For children and youth involved in child welfare systems, service cascades like Gateway CALL have the potential to significantly improve both mental health service receipt and outcomes. To maximize the effectiveness of such approaches, later phases of implementation may require increased attention and support, particularly regarding processes and outcomes that cross child welfare and mental health service systems., (© 2022. The Author(s).)

Background: Unmet mental health service needs among children in out-of-home care are sometimes attributed to poor assessments and referrals in child welfare. The Gateway CALL project implemented mental health screening, diagnostic assessment, and referral to treatment practices., Objective: We examined the effectiveness of Gateway CALL for improving children's mental health service receipt, safety, and permanency outcomes., Participants and Setting: Participants included 538 children (birth to 18 years) in out-of-home placements through a county-based child welfare agency over a 17-month period., Methods: We compared the mental health service receipt, safety, and permanency outcomes for 175 children who received Gateway CALL with 175 children who received "services as usual" identified through propensity score matching. Participant demographics, safety, and permanency outcomes were drawn from child welfare administrative records, and mental health service visits and diagnoses were drawn from Medicaid billing records., Results: Gateway CALL appeared to increase the number of mental health service visits children received (z = 2.14, p = 0.032), although not the likelihood of receiving services. In terms of child safety, children in Gateway CALL had a greater number of screened-in calls after the intervention than those in the comparison group [t(348) = -1.92, p = 0.03]; there were no differences in substantiations. There were also no observed effects on permanency., Conclusions: Despite systematic efforts to identify, assess, and refer children to mental health services through the Gateway CALL intervention, substantial unmet mental health service needs among children persisted. Results have implications for designing interventions that promote cross-system service access., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Cytotoxic T lymphocytes (CTL) are hypothesized to play a role in clearance during primary dengue virus (DENV) infections, and contribute to immunopathology during secondary heterologous infections in humans. We previously reported skewed T-cell responses to secondary DENV infection in BALB/c (H-2(d)) mice, reproducing characteristics of human DENV infection. To set the stage for using widely available transgenic and knockout mice, we extended these studies to identify DENV-specific T-cell responses in C57BL/6 (H-2(b)) mice. We identified dominant CD8+ T-cell responses to H-2D(b)-restricted epitopes on the DENV NS4a (aa 249-265) and NS5 (aa 521-537) proteins. High frequencies of IFN-γ- and TNF-α-producing T cells directed at both epitopes were detected following primary infection with all four DENV serotypes, and were augmented by secondary DENV infections. In vivo cytotoxicity assays demonstrated rapid clearance of target cells pulsed with the NS4a peptide; in contrast, NS5 peptide-pulsed target cells were poorly cleared in vivo. These data characterize two H-2(b)-restricted T-cell epitopes displaying divergent in vivo function. These results should facilitate further studies of the in vivo effects of DENV-specific T cells, including the use of genetically modified mouse strains.

Our study investigated the convergent and discriminant validity of five of Chapman's Schizotypia Scales (i.e., Physical Anhedonia, Revised Social Anhedonia, Perceptual Aberration, Magical Ideation, and Impulsive Nonconformity; L.J. Chapman, J.P. Chapman, & Raulin 1976, 1978; Eckblad & L.J. Chapman, 1983) and Meehl's Schizoidia Scale (Meehl, 1964) within a sample of 50 personality disordered subjects, many of whom possessed schizotypic traits. It was hypothesized in part that all five of the Chapman scales and the Schizoidia Scale would correlate with the schizotypal personality disorder; the Physical Anhedonia and Revised Social Anhedonia Scales would correlate with the schizoid personality disorder, whereas the Magical Ideation and Perceptual Aberration Scales would not; the Physical and Revised Social Anhedonia Scales would not correlate with the avoidant personality disorder; and the Impulsive Nonconformity Scale would correlate with the borderline and antisocial personality disorders. Only the hypotheses concerning the avoidant personality disorder and the Schizoidia Scale were not supported. The findings remained even when the effects of state anxiety and state depression were controlled. Implications of the findings with respect to the validity of the Chapman and Schizoidia Scales and the personality disorders are discussed.