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Prediction models in first-episode psychosis: systematic review and critical appraisal
- Rebecca Lee, Samuel P. Leighton, Lucretia Thomas, Georgios V. Gkoutos, Stephen J. Wood, Sarah-Jane H. Fenton, Fani Deligianni, Jonathan Cavanagh, Pavan K. Mallikarjun
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- Journal:
- The British Journal of Psychiatry / Volume 220 / Issue 4 / April 2022
- Published online by Cambridge University Press:
- 24 January 2022, pp. 179-191
- Print publication:
- April 2022
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- Article
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Background
People presenting with first-episode psychosis (FEP) have heterogenous outcomes. More than 40% fail to achieve symptomatic remission. Accurate prediction of individual outcome in FEP could facilitate early intervention to change the clinical trajectory and improve prognosis.
AimsWe aim to systematically review evidence for prediction models developed for predicting poor outcome in FEP.
MethodA protocol for this study was published on the International Prospective Register of Systematic Reviews, registration number CRD42019156897. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance, we systematically searched six databases from inception to 28 January 2021. We used the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies and the Prediction Model Risk of Bias Assessment Tool to extract and appraise the outcome prediction models. We considered study characteristics, methodology and model performance.
ResultsThirteen studies reporting 31 prediction models across a range of clinical outcomes met criteria for inclusion. Eleven studies used logistic regression with clinical and sociodemographic predictor variables. Just two studies were found to be at low risk of bias. Methodological limitations identified included a lack of appropriate validation, small sample sizes, poor handling of missing data and inadequate reporting of calibration and discrimination measures. To date, no model has been applied to clinical practice.
ConclusionsFuture prediction studies in psychosis should prioritise methodological rigour and external validation in larger samples. The potential for prediction modelling in FEP is yet to be realised.
2442: Alcohol reduces the ability to regulate emotion when exposed to evocative partner stimuli in individuals with a history of intimate partner violence
- Brandi Fink, Eric D. Claus, James F. Cavanagh, Derek A. Hamilton, Sarah Salway
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- Journal:
- Journal of Clinical and Translational Science / Volume 1 / Issue S1 / September 2017
- Published online by Cambridge University Press:
- 10 May 2018, p. 65
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OBJECTIVES/SPECIFIC AIMS: The objective of this research was to investigate the effect of alcohol and evocative stimuli on heart rate variability (HRV) in partners with a history of intimate partner violence in a placebo-controlled alcohol administration study with an emotion-regulation task. METHODS/STUDY POPULATION: In total, 17 partners (9 females, 8 males) with a history of partner violence participated in a placebo-controlled alcohol administration study with an emotion-regulation task during which HRV measures were collected. In the alcohol condition, participants were administered a mixture of 100 proof vodka and cranberry juice calculated to raise their blood alcohol concentration (BAC) to 0.08%. In the placebo condition, participants consumed a volume of juice equivalent to that consumed in the alcohol condition, but without alcohol. Alcohol and placebo conditions were counter-balanced across participants as were the presentation the blocks of evocative and neutral partner stimuli. RESULTS/ANTICIPATED RESULTS: Controlling for baseline HRV, there was a significant main effect of stimuli (evocative vs. neutral partner stimuli) on HRV in intoxicated partners, F1,16=16.28, p=0.004. There was also a significant main effect of regulation on HRV under conditions acute alcohol intoxication, F1,16=23.55, p=0.001. These effects tell us that intoxicated partners experienced reduced HRV when exposed to evocative stimuli from their partners. These effects also tell us that under acute alcohol intoxication, partners were less able to regulate their emotion when exposed to evocative stimuli than when they consumed a placebo beverage. DISCUSSION/SIGNIFICANCE OF IMPACT: These results suggest that increases in intimate partner violence under acute alcohol intoxication may be the result of reduce HRV. This reduction in HRV would contribute to partners’ inability to response with adaptively in conflict when intoxicated. They also suggest that HRV may be an important target for intervention with partner with a history of intimate partner violence. One method may be Heart Rate Variability Biofeedback which has been shown to increase parasympathetic nervous system functioning, autonomic stability, and emotion regulation.
Chapter 23 - Building the Capacity of Early Childhood Educators to Promote Children's Mental Health: Learnings from Three New Programs
- from Part 4 - Leadership and Innovations
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- By Sarah Cavanagh, Clinical Psychologist and Manager at the Australian Psychological Society (APS)., Jo Cole, Clinical Psychologist with 20 years experience in perinatal, infant, child and adolescent mental health, and mental health promotion, prevention and early intervention., Judy Kynaston, General Manager of KidsMatter Early Childhood at Early Childhood Australia (ECA)., Kim-Michelle Gilson, Research Fellow within the Jack Brockhoff Child Health and Wellbeing Program at the University of Melbourne, Australia., Elise Davis, Associate Director, Jack Brockhoff Child Health and Wellbeing Program at the University of Melbourne, Australia., Gavin Hazel, Program Leader at the Hunter Institute of Mental Health, Newcastle, Australia where he focuses on the development, implementation and evaluation of evidence-informed resources, practices, and professional education.
- Edited by Susanne Garvis, Göteborgs Universitet, Sweden, Donna Pendergast, Griffith University, Queensland
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- Book:
- Health and Wellbeing in Childhood
- Published online:
- 21 June 2018
- Print publication:
- 01 September 2017, pp 362-379
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Summary
Acknowledgement
The authors would like to acknowledge the contribution of Jo Cole, who contributed to the ideas and writing that appeared in a similar chapter in the first edition of this book. While the chapter in this second edition has been updated and revised from the first edition, we acknowledge Jo's earlier contributions that appear here.
Introduction
Early childhood is a critical time for children's brain development. The experiences children are exposed to shape brain development and the skills and capacities developed during this time provide the foundation for lifelong learning and mental health and wellbeing. While children's primary caregivers and the family environment have the most significant impact on children's early development, children learn within the context of all their relationships and, increasingly, children experience significant relationships with early childhood educators. The number of children attending an early childhood education and care (ECEC) service is growing in Australia, as is the amount of time each child spends in the service. This provides an opportunity to influence ECEC services and educator knowledge and skills to support positive social and emotional development and good mental health. Educators can build the ‘social and emotional capacities of infants and children by supporting predictably available, adequately sensitive and responsive care giving’ (Australian Association for Infant Mental Health and Australian Research Alliance for Children & Youth, 2013, p. 3). Educators who are consistently engaged with children and families, can also assist in preventing or mitigating the consequences of mental health problems by buffering young children from serious threats to their wellbeing (National Scientific Council on the Developing Child, 2007).
ECEC sector reform in Australia has led to a National Quality Framework (NQF), which is the result of an agreement between state and Commonwealth governments, to improve the quality of early childhood education and care. This Framework comprises the Early Years Learning Framework (EYLF) (Council of Australian Government (COAG), 2009) and National Quality Standard (NQS) (Australian Children's Education and Care Quality Authority (ACECQA), 2013), and applies to most long day care, family day care, and preschools/ kindergartens in Australia. Quality in early childhood education has been shown to lead to better outcomes in learning, health and wellbeing for children.