scholarly journals Methylphenidate and the risk of psychotic disorders and hallucinations in children and adolescents in a large health system

2016 ◽  
Vol 6 (11) ◽  
pp. e956-e956 ◽  
Author(s):  
K K C Man ◽  
D Coghill ◽  
E W Chan ◽  
W C Y Lau ◽  
C Hollis ◽  
...  
Keyword(s):  
Health System ◽  
Children And Adolescents ◽  
Psychotic Disorders

Predictors of clinical trial enrollment and impact on outcome in children and adolescents with acute lymphoblastic leukemia: A population based study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 7031-7031
Author(s):  
Paul James Gibson ◽  
Uma H. Athale ◽  
Vicky Rowena Breakey ◽  
Nicole Mittmann ◽  
Mylene Bassal ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Acute Lymphoblastic Leukemia ◽  
Health System ◽  
Children And Adolescents ◽  
Lymphoblastic Leukemia ◽  
Income Quintile ◽  
Factors Associated ◽  
Income Status ◽  
Single Payer

7031 Background: Outcomes in pediatric acute lymphoblastic leukemia (ALL) have shown remarkable improvements in large part due to sequential clinical trials. Concerns however persist around whether access to clinical trials is equitable. It is also unclear whether patient outcomes are improved simply by enrolling on a clinical trial. Our objective was to therefore determine which patient and disease-related factors are associated with enrollment, and whether enrollment was associated with clinical outcomes among children and adolescents with ALL in a single-payer health system in Ontario, Canada. Methods: We included all Ontario patients diagnosed with ALL between 0-18 years of age from 2002-2012 treated at a pediatric center, identified through a provincial pediatric cancer registry. Clinical trial availability was determined by whether each patient’s primary institution had an open frontline trial for which the patient was eligible at the time of their diagnosis, considering individual disease characteristics such as lineage, central nervous system (CNS) status and risk group. Demographic, disease, trial enrolment, and outcome data were obtained through chart abstraction. Logistic regression models determined factors associated with trial enrolment, while Cox proportional hazard models determined factors associated with event-free and overall survival (EFS, OS). Results: Of 858 patients, 693 (81%) were eligible for an open clinical trial at their time of diagnosis. 476 (69%) enrolled on a trial. In adjusted analyses, age > 15 years (odds ratio 0.4 vs. age 5-9, 95th confidence interval (95CI) 0.2-0.8; p = 0.01) and CNS3 disease (OR 0.38 vs. CNS1, 95CI 0.17-0.83; p = 0.01) were significantly associated with decreased likelihood of enrolment, while sex and neighborhood income quintile were not associated with enrolment. Adjusted for disease and demographic factors, clinical trial enrolment was not significantly associated with either EFS (hazard ratio (HR) 1.1, 95CI 0.7-1.7; p = 0.83) or OS (HR 1.3, 95CI 0.7-2.5; p = 0.44). Conclusions: The majority of patients with ALL eligible for available clinical trials at their time of diagnosis were enrolled. While no disparities in enrolment by income status were noted, adolescents were substantially less likely to participate in trials even within pediatric centers. Studies of mechanisms underlying this disparity are warranted in order to design and implement effective interventions targeting increased enrolment rates in this patient population. Our results however also suggest that clinical trial enrolment on its own is not associated with improved outcomes in the context of a single payer health system.

Mental health care in Madrid

2005 ◽  
Vol 20 (S2) ◽  
pp. s279-s284 ◽  
Author(s):  
F. Ferre Navarete ◽  
I. Palanca
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Health System ◽  
Children And Adolescents ◽  
Health Plan ◽  
Mental Health System ◽  
Terrorist Attack

AbstractAimTo describe principles and characteristics of mental health care in Madrid.MethodBased on existing data, service provision, number of professionals working in services, funding arrangements, pathways intocare, user/carer involvement and specific issues are reported.ResultsIn Madrid, mental health services are organized into 11 zones/areas, divided into 36 districts, where there is a mental healthoutpatient service with a multi-disciplinary team. Home treatment and psychosocial rehabilitation services have been developed. Specialist programmes exist for vulnerable client groups, including Children and Adolescents, Addiction/Alcohol and Older People. The Madrid Mental Health Plan (2003–2008) is regarded as the key driver in implementing service improvement and increased mental health and well-being in Madrid. It has a meant global budget increase of more than 10% for mental health services. Results of the first 2 years are: an increase in mental health staff employed (17%), four new hospitalization units, 50% increase in places for children and adolescents Day Hospitals, 62 new beds in long care residential units, development of specific programmes for the homeless and gender-based violence, a significant investment in information systems (450 new computers) and development of best practice and operational guidelines. Mental health system was put to the test with Madrid's March 11th terrorist attack. A Special Mental Health Plan for Affected people was developed.DiscussionUnlike some European countries, public mental health service is the main heath care provider. There are no voluntary agenciescollaborating with mental health care. Continuity of care and coordination between all mental health resources is essential in service delivery. Increased demand of care for minor psychiatric disorders, children and adolescent mental health care, and implementation of rehabilitation and residential facilities for chronic patients are outstanding challenges similar to those in other European capitals. Overall, the mental health system had successfully coped with last year's increased care demand after March 11th terrorist attack in Madrid.

494. A longitudinal MRI study of children and adolescents with atypical psychotic disorders

2000 ◽  
Vol 47 (8) ◽  
pp. S150
Author(s):  
R. Nicolson ◽  
J.N. Giedd ◽  
J. Blumenthal ◽  
S.D. Hamburger ◽  
M. Lenane ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Psychotic Disorders ◽  
Longitudinal Mri ◽  
Mri Study

Suicidal behaviors in children and adolescents with psychotic disorders

2017 ◽  
Vol 179 ◽  
pp. 13-16 ◽  
Author(s):  
Sarah Hope Lincoln ◽  
Emily Norkett ◽  
Kelsey Graber ◽  
Sahil Tembulkar ◽  
Nicholas Morelli ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Psychotic Disorders ◽  
Suicidal Behaviors

scholarly journals Neuroleptic prescribing in an adolescent psychiatric in-patient unit

1996 ◽  
Vol 20 (9) ◽  
pp. 538-540 ◽  
Author(s):  
K. Lowe ◽  
H. Smith ◽  
A. Clark
Keyword(s):  
Clinical Practice ◽  
Children And Adolescents ◽  
Antipsychotic Medication ◽  
Royal College ◽  
Psychotic Disorders ◽  
Consensus Statement ◽  
Comprehensive Evaluation ◽  
High Dose ◽  
Age Group ◽  
Antipsychotic Prescribing

The Royal College of Psychiatrists' consensus statement suggests that prescribing high dose antipsychotic medication in children and adolescents should rarely be necessary. Our objective was to study the prescribing of antipsychotic medication in a regional adolescent unit during a three-year period. We found that antipsychotic prescribing on this unit is common in psychotic disorders and often high closes are required. This is not in keeping with the recommendations of the consensus statement. Review of clinical practice on other adolescent units is needed, together with a more comprehensive evaluation of the outcome of psychotic disorders in this age group.

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