Exploring screening for borderline personality disorder in pediatric inpatients with psychiatric Illness.

Borderline Personality Disorder (BPD) is a severe psychiatric illness associated with poor personal and interpersonal functioning. Screening for BPD in adolescents and provision of specialized treatment may improve life circumstances in vocations and relationships. The purpose of this study was to determine the number of pediatric inpatients who would screen positive for BPD with a self-rating measure, and to compare their personal and interpersonal characteristics with youth who did not screen positive. A survey with self-report measures was administered to patients to screen for BPD. The mean age of the sample was 15 years and 71% identified as female gender. Of 109 patients 72 (66%) screened positive for BPD while only eight (7%) patients were diagnosed by psychiatrists with BPD or features of BPD. There were no statistically significant differences between those who scored positive versus negative for BPD in age, gender, or avoidant anxiety. There were statistically significant differences in anxious attachment, distress, clinical symptoms, problematic use of electronic devices, considered suicide, past trauma and prior suspensions from school. This exploration in pediatric inpatients suggests that many of these patients may be at risk for a diagnosis of BPD later in life and may benefit from early identification and specialized intervention.

Sexual health needs and psychosocial well-being of patients with prostate cancer in a regional cancer Center.

Prostate cancer is the most common cancer for men. The cancer diagnosis and treatment can affect patients' psychosocial and sexual health. The purpose of this research project was to identify the sexual health concerns of patients with prostate cancer. An anonymous survey was administered to patients while accessing Grand River Regional Cancer Center (GRRCC) that included measures of sexual health and perceived stress and social support, ratings for preferred modes of sexual health programming, and open-ended questions on sexual health and masculinity. Seventy-five patients completed the survey; their mean age was 73.9 years (SD 7.2), the majority were in a couple relationship and identified as heterosexual. The concerns most endorsed were physical changes in sexual functioning and being able to satisfy their partner sexually. These findings can inform sexual health programming and psychosocial oncology for men with prostate cancer.

A Systematic Review of Tools Measuring Nutrition Knowledge of Pre-Adolescents and Adolescents in a School-Based Setting.

BACKGROUND: Measurement of nutrition knowledge is common in interventions targeting dietary modifications in a school-based setting. Previous research has noted a general lack of disclosure regarding the details and psychometric properties of nutrition knowledge tools, which makes uptake of previously used instruments extremely difficult. METHODS: Our systematic literature review sought to identify interventions measuring nutrition knowledge in school settings to students aged 9 to 18. Studies were categorized according to content subject and relevant descriptive characteristics and psychometric properties were extracted. RESULTS: Following the initial screening of 16,868 articles, 308 papers were evaluated for eligibility. Sixty-seven studies consistent with the inclusion criteria were included in the review. A minority of studies reported analysis of validity (31.3%) and/or reliability (40.3%), and 73.1% of studies had at least one unknown relevant descriptive characteristic. The majority (68.7%) of studies were custom developed, of which only 13 reproduced the tool in the publication. CONCLUSION: Overall, there was an alarming lack of reporting across studies, both in terms of the description of knowledge tools as well as their psychometric properties. These omissions make the selection of appropriate instruments for use in novel contexts difficult, and highlight the need for greater disclosure and pre-intervention testing.

The Health and Well-being of Children and Adolescents Accessing In-Patient Psychiatry: A Brief Report.

OBJECTIVE: People with mental illness have high rates of physical illness that are not detected and that shorten their lifespan. Health behaviours are central to physical health, and many children and adolescents with psychiatric illness may be at risk for poor physical health. The purpose for this study was to explore the self-reported health behaviours and well-being of pediatric psychiatric patients and their association with mental health problems. METHODS: Pediatric patients hospitalized for psychiatric care were invited to complete a survey containing items on amount of physical activity, nutrient intake and sleep, a standardized perceived stress scale, and the Strengths and Difficult Questionnaire. RESULTS: Informed consent was provided by 161 patients who completed the survey. Youth reported: engaging in very little physical activity, eating fruits and vegetables about 2-3 times per week, not sleeping well and very high perceived stress. DISCUSSION: Implications for practice include increasing opportunities for and monitoring of health behaviours in youth hospitalized for psychiatric illness. Further research is needed to explore interventions designed to improve the physical health and mental well-being of youth with psychiatric illness and possibly the inpatient environment.

OBJECTIF: Les personnes souffrant de maladie mentale ont des taux élevés de maladie physique qui ne sont pas détectés et qui réduisent leur durée de vie. Les comportements liés à la santé sont au centre de la santé physique, et bien des enfants et adolescents souffrant de maladie psychiatrique peuvent être à risque d'une mauvaise santé physique. Le but de cette étude était d'explorer les comportements liés à la santé et au bien-être auto-déclarés par des patients psychiatriques pédiatriques et leur association aux problèmes de santé mentale. MÉTHODES: Les patients pédiatriques hospitalisés pour des soins psychiatriques ont été invités à remplir un sondage dont les items portaient sur la quantité d'activité physique, l'apport en nutriments et le sommeil, une échelle normalisée du stress perçu, et un questionnaire sur les forces et difficultés. RÉSULTATS: Un consentement éclairé a été donné par les 161 patients qui ont rempli le sondage. Les adolescents déclaraient très peu d'activité physique, mangeaient fruits et légumes environ 2 à 3 fois par semaine, ne dormaient pas bien et leur perception du stress était très élevée. DISCUSSION: Les implications pour la pratique sont notamment de plus grandes possibilités d'améliorer et de surveiller les comportements liés à la santé chez les adolescents hospitalisés pour une maladie psychiatrique. Il faut plus de recherche pour explorer les interventions destinées à améliorer la santé physique et le bien-être mental des adolescents souffrant de maladie psychiatrique et possiblement, l'environnement des patients hospitalisés.

Youths' Experiences of School Re-Integration Following Psychiatric Hospitalization.

OBJECTIVE: The purpose of this study was to report youths' experiences of school re-integration post-discharge from psychiatric hospital. No reports of school reintegration from the patient perspective could be located; hence, a second objective was to explore school-related and clinical factors associated with youth who reported an unfavourable school re-integration experiences. METHODS: Patients were recruited while in hospital for acute psychiatric care. They provided informed consent to be contacted post discharge regarding their perceptions of their school reintegration experience. About ten weeks after discharge youth were surveyed via telephone (n=40) or online (n=22) surveys. RESULTS: Of the 121 youth who agreed to be contacted after discharge, 62 youth completed the post-discharge survey. Almost half (n=29) of the youth reported that they had considerable difficulty with school reintegration. Youth reported managing social situations, academic pressures and emotions as substantial problems. Youth who reported a negative transition experience had significantly worse scores on self-reported Total and emotion subscale of the Strength and Difficulties Questionnaire, and concern about the impact of emotions on school re-entry, and significantly less psychiatrist-reported improvement than youth who reported a neutral or positive transition experience. There were no differences between the two groups on school-related variables. Youth with prior admission reported greater difficulties with peers and significantly worse clinical factors than youth without prior admissions. CONCLUSIONS: High emotional difficulty scores and concern about the impact of emotions on reintegration prior to discharge distinguished youths with negative school reintegration experiences. These patients may benefit from greater assistance with managing their emotional problems, and coping and social skills training before and during school reintegration.

OBJECTIF: Le but de cette étude était de faire état d'expériences de réinsertion scolaire d'adolescents après avoir obtenu leur congé de l'hôpital psychiatrique. Aucun rapport sur la réinsertion scolaire du point de vue du patient n'a pu être trouvé, ainsi, un deuxième objectif était d'explorer les facteurs liés à l'école et cliniques associés aux adolescents qui déclaraient des expériences défavorables de réinsertion scolaire. MÉTHODES: Les patients ont été recrutés alors qu'ils étaient à l'hôpital pour des soins psychiatriques actifs. Ils ont donné leur consentement éclairé pour qu'on puisse les contacter après leur congé au sujet de leurs perceptions de leur expérience de réinsertion scolaire. Environ 10 semaines après leur congé, les adolescents ont été interrogés par des sondages au téléphone (n = 40) ou en ligne (n = 22). RÉSULTATS: Sur les 121 adolescents qui ont accepté d'être contactés après leur congé, 62 ont rempli le sondage post-congé. Près de la moitié (n = 29) des adolescents ont déclaré avoir éprouvé des difficultés considérables avec la réinsertion scolaire. Les adolescents ont considéré que gérer les situations sociales, les pressions scolaires et les émotions était des problèmes substantiels. Les adolescents qui déclaraient une expérience de transition négative avaient des scores significativement pires au total auto-déclaré et à la sous-échelle des émotions du questionnaire des forces et des difficultés, s'inquiétaient de l'effet des émotions sur le retour à l'école, et avaient significativement moins d'amélioration attestée par le psychiatre que les adolescents qui déclaraient une expérience de transition neutre ou positive. Il n'y avait pas de différences entre les deux groupes en ce qui concerne les variables liées à l'école. Les adolescents ayant été hospitalisés auparavant déclaraient de plus grandes difficultés avec les camarades et des facteurs cliniques significativement pires que les adolescents n'ayant jamais été hospitalisés. CONCLUSIONS: Des scores élevés de difficultés émotionnelles et des préoccupations quant à l'effet des émotions sur la réintégration avant le congé distinguaient les adolescents ayant eu des expériences négatives de réinsertion scolaire. Ces patients peuvent bénéficier d'une aide accrue pour gérer leurs problèmes émotionnels, et d'une formation aux aptitudes d'adaptation et sociales avant et pendant la réinsertion scolaire.

Barriers and Facilitators to Intake of Dairy Products in Adolescent Males and Females With Different Levels of Habitual Intake.

Background: Dairy products and alternatives can contribute to overall good health including positive body composition and decreased adiposity; however, these foods are grossly underconsumed by youth, and worldwide, almost 25% of children are overweight or obese. Objective: The study investigated the barriers and facilitators toward dairy consumption by Grade 7 youth. Methods: Thirty 50-minute, audio-recorded focus groups were conducted with 134 students in eight Grade 7 classes across 5 elementary schools. Focus groups were led by trained facilitators in the elementary schools and participants were separated based on dairy consumption and gender. Recorded data were transcribed and thematically analyzed using qualitative analysis software to identify themes related to barriers and facilitators to dairy product intake by each gender. Results: Factors considered important by males and females across different levels of habitual intake include personal knowledge about dairy products and misconceptions regarding dairy foods and their associated health benefits; food characteristics, including taste; personal behaviors such as habits or routines including dairy products; social environments including parental and peer influence; physical environments factors such as availability and skipping meals; and the convenience of dairy products. Interestingly, only males noted sports as a positive influence for dairy product intake. Also, there were differences in the way males and females perceived dining out as affecting their dairy intake. Conclusion: Results suggest several potential factors that nutrition education interventions aiming to increase dairy consumption could target.

The experience of parental cancer among emerging adult university students.

Cancer is a disease that can have negative as well as some positive outcomes for the survivor, caregiver, and offspring. To date, there has been little research on the experiences of emerging adult offspring. When these offspring are also university students, they can experience unique challenges. In this phenomenological study, we explored the lived experience of parental cancer among emerging adult university students by interviewing 17 university students and using thematic analysis. The overarching themes were perceptions and beliefs about cancer, the outcomes of having a parent with cancer, influence of parental cancer on life as a university student, coping with having a parent with cancer, and attitudes and experiences around health and personal lifestyle. These results will be particularly useful to practitioners who provide services to university students experiencing parental cancer.

The Ottawa Self-Injury Inventory: Evaluation of an assessment measure of nonsuicidal self-injury in an inpatient sample of adolescents.

BACKGROUND: The Ottawa Self-Injury Inventory (OSI) is a self-report measure that offers a comprehensive assessment of nonsuicidal self-injury (NSSI), including measurement of its functions and addictive features. In a preliminary investigation of self injuring college students who completed the OSI, exploratory analysis revealed four function factors (Internal Emotion Regulation, Social Influence, External Emotion Regulation and Sensation Seeking) and a single Addictive Features factor. Rates of NSSI are particularly high in inpatient psychiatry youth. The OSI can assistin both standardizing assessment regarding functions and potential addictive features and aid case formulation leading to informed treatment planning. This report will describe a confirmatory factor analysis (CFA) of the OSI on youth hospitalized in a psychiatric unit in southwestern Ontario. METHODS: Demographic and self-report data were collected from all youth consecutively admitted to an adolescent in-patient unit who provided consent or assent. RESULTS: The mean age of the sample was 15.71 years (SD = 1.5) and 76 (81 %) were female. The CFA proved the same four function factors relevant, as in the previous study on college students (χ (2)(183) = 231.98, p = .008; χ (2)/df = 1.27; CFI = .91; RMSEA = .05). The model yielded significant correlations between factors (rs = .44-.90, p < .001). Higher NSSI frequency was related to higher scores on each function factor (rs = .24-.29, p < .05), except the External Emotion Regulation factor (r = .11, p > .05). The factor structure of the Addictive Features function was also confirmed (χ (2)(14) = 21.96, p > .05; χ (2)/df = 1.57; CFI = .96; RMSEA = .08). All the items had significant path estimates (.52 to .80). Cronbach's alpha for the Addictive Features scale was .84 with a mean score of 16.22 (SD = 6.90). Higher Addictive Features scores were related to more frequent NSSI (r = .48, p < .001). CONCLUSIONS: Results show further support for the OSI as a valid and reliable assessment tool in adolescents, in this case in a clinical setting, where results can inform case conceptualization and treatment planning.

Integrated Knowledge Translation: illustrated with outcome research in mental health.

Through this article the authors present a case summary of the early phases of research conducted with an Integrated Knowledge Translation (iKT) approach utilizing four factors: research question, research approach, feasibility, and outcome. iKT refers to an approach for conducting research in which community partners, referred to as knowledge users, are engaged in the entire research process. In this collaborative approach, knowledge users and researchers jointly devise the entire research agenda beginning with the development of the research question(s), determination of a feasible research design and feasible methods, interpretation of the results, dissemination of the findings, and the translation of knowledge into practice or policy decisions. Engaging clinical or community partners in the research enterprise can enhance the utility of the research results and facilitate its uptake. This collaboration can be a complex arrangement and flexibility may be required to accommodate the various configurations that the collaboration can take. For example, the research question can be jointly determined and refined; however, one person must take the responsibility for orchestrating the project, including preparing the proposal and application to the Research Ethics Board. This collaborative effort also requires the simultaneous navigation of barriers and facilitators to the research enterprise. Navigating these elements becomes part of the conduct of research with the potential for rewarding results, including an enriched work experience for clinical partners and investigators. One practice implication is that iKT may be considered of great utility to service providers due to its field friendly nature.

The Psychosocial Characteristics Associated with NSSI and Suicide Attempt of Youth Admitted to an In-patient Psychiatric Unit.

INTRODUCTION: The purpose of this study was to explore the prevalence of self-harm and the psychosocial factors associated with self-harming behaviours in youth admitted to an in-patient psychiatric unit. METHODS: Cross-sectional surveys of standardized measures were administered to youth and a separate survey to their caregivers while the youth were in hospital. RESULTS: The mean age of the 123 youth who participated was 15.74 (SD 1.51) years, and 90 of 121 (74.38%) reported being female. Of the 115 who completed this question, 101 (87.83%) indicated that they thought of injuring themselves and 89 (77.39%) did engage in NSSI within the past month, and 78 of 116 (67%) reported that they had made an attempt to take their life. Youth who reported that they had attempted suicide (lifetime) reported significantly less difficulty with emotion regulation than youth who engaged in NSSI only, or both NSSI and suicide attempts. CONCLUSIONS: These youth reported a very high prevalence of self-harm, and in general substantial difficulty with regulating their emotions, and difficulty with their interpersonal relationships. The psychosocial distinctions evident between groups may have practical utility.

INTRODUCTION: Cette étude avait pour but d'explorer la prévalence de l'automutilation et des facteurs psychosociaux associés aux comportements d'automutilation chez des adolescents hospitalisés dans une unité psychiatrique. MÉTHODES: Des questionnaires transversaux de mesure normalisées ont été administrés à des adolescents et un questionnaire distinct a été administré à leurs soignants pendant que les adolescents étaient à l'hôpital. RÉSULTATS: L'âge moyen des 123 adolescents qui ont participé était 15,74 ans (ET 1,51 an), et 90 sur 121 (74,38 %) disaient être de sexe féminin. Sur les 115 qui ont répondu à cette question, 101 (87,83 %) ont indiqué qu'ils pensaient à se mutiler et 89 (77,39 %) se sont adonnés à l'automutilation non suicidaire (AMNS) le mois précédent, et 78 sur 116 (67 %) ont déclaré qu'ils avaient tenté de s'enlever la vie. Les adolescents qui déclaraient avoir tenté de se suicider (de durée de vie) indiquaient significativement moins de difficulté avec la régulation émotionnelle que ceux qui s'adonnaient seulement à l'AMNS, ou à l'AMNS et aux tentatives de suicide. CONCLUSIONS: Ces adolescents rapportaient une prévalence très élevée d'automutilation, et en général, une difficulté substantielle à réguler leurs émotions, et une difficulté avec les relations interpersonnelles. Les distinctions psychosociales manifestes entre les groupes peuvent avoir une utilité pratique.

Exploratory survey of patients' needs and perceptions of psychosocial oncology.

Cancer is a major disease that affects a significant proportion of the population worldwide. With a decrease in mortality due to advancements in oncology treatment, there is an expanding role for psychosocial oncology. A satellite clinic for medical treatment (only chemotherapy) of cancer is available at the Guelph General Hospital (GGH). Patients accessing the chemotherapy clinic at GGH have minimal access to psychosocial or supportive care and it is not known if the existing services are addressing the psychosocial symptoms of cancer patients. Participants were asked to complete an anonymous survey which included self-report measures of depression, symptom severity, quality of life, and social support while receiving treatment at this facility. There was a great deal of variability in the patients' emotional symptoms at this satellite clinic, though many patients reported emotional difficulties. Greater social work presence may lead to better identification of patients who would benefit from psychosocial oncology services.

Non-suicidal self-injury and suicidal behaviour in children and adolescents accessing residential or intensive home-based mental health services.

OBJECTIVE: There is a dearth of Canadian research with clinical samples of youth who self-harm, and no studies could be located on self-harm in children and youth accessing residential or intensive home-based treatment. The purposes of this report were to explore the proportion and characteristics of children and youth identified as self-harming at admission by clinicians compared to youth not identified as self-harming, compare self-harming children to adolescents, and to compare caregiver ratings of self-harm at intake to clinician ratings at admission. METHOD: This report was developed from a larger longitudinal, observational study involving 210 children and youth accessing residential and home-based treatment and their caregivers in partnership with five mental health treatment centres in southwestern Ontario. Agency data were gleaned from files, and caregivers reported on symptom severity at 12 to 18 months and 36 to 40 months post-discharge. RESULTS: Fifty-seven (34%) children and youth were identified as self-harming at admission. The mean age was 11.57 (SD 2.75). There were statistically significant differences on symptom severity at intake between those identified as self-harming and those not so identified; most of these differences were no longer present at follow up. Children were reported to have higher severity of conduct disorder symptoms than adolescents at intake, and there was some consistency between caregiver-rated and clinician-rated self-harm. Children were reported to engage in a wide range of self-harming behaviours. CONCLUSION: These findings suggest that youth who were identified as self-harming at admission have elevated scores of symptom severity, self-harm can occur in young children and while many improve, there remains a concern for several children and youth who did not improve by the end of service. Children engage in some of the same types of self-harm behaviours as adolescents, and they also engage in behaviours unique to children.

Patients' satisfaction and wait times at Guelph General Hospital Emergency Department before and after implementation of a process improvement project.

OBJECTIVE: A process improvement program (PIP) was implemented in the emergency department (ED) at Guelph General Hospital in July 2009. The purpose of this study was to examine patients' satisfaction and wait times by level of Canadian Triage and Acuity Scale (CTAS) score before and 6 months after implementation of this program. METHODS: Two samples were recruited: one was recruited before implementation of the PIP, January to June 2009 (T1), and one was recruited 6 months after implementation, January to June 2010 (T2). Patients were contacted by telephone to administer a survey including patient satisfaction with quality of care. Time to physician initial assessment, numbers left without being seen, and length of stay (LOS) were obtained from hospital records to compare wait times before and 6 months after implementation of the PIP. RESULTS: Patients (n = 301) reported shorter wait times after implementation (e.g., 12% reported seeing a physician right away at T1 compared to 29% at T2). Time to physician initial assessment improved for patients with CTAS scores of III, IV, and V (average decrease from 2.1 to 1.7 hours), fewer patients (n = 425) left without being seen after implementation, and the mean and 90th percentile of LOS decreased for all patients except the mean LOS for discharged patients with a CTAS score of I. Total time spent in the ED for admitted patients decreased from 11.11 hours in the 2009 period to 9.95 in the 2010 period, and for nonadmitted patients, the total time decreased from 3.94 to 3.29 hours. The overall satisfaction score improved from a mean of 3.17 to 3.4 (of 4; p < 0.001). CONCLUSION: Implementation of the ED PIP corresponded with decreased wait times, increased patient satisfaction, and improved patient flow for patients with CTAS scores of III, IV, and V.

Treatment fidelity in psychosocial intervention for children and adolescents with comorbid problems.

BACKGROUND: Intervention fidelity has important implications for the interpretation of intervention outcomes. Reviews on fidelity implementation for psychosocial interventions targeting children and adolescents with comorbid mental health problems are scarce. The purpose of this study was to systematically review reported fidelity of psychosocial interventions for children with comorbid mental health conditions. METHOD: Fidelity and quality ratings were calculated based on an analysis of articles resulting from a previously reported systematic search of the literature (using PsycINFO, MEDLINE and ERIC databases between 1994 and 2009), using the Intervention Fidelity Assessment Checklist for the fidelity measure and the Cochrane Collaboration's tool for assessing risk of bias for the quality measure. RESULTS: Overall, few studies were found to have a high level of fidelity adherence. Only 1 of the 10 studies met the 'high' intervention fidelity cutoff. CONCLUSIONS: Findings suggest that current psychosocial interventions for children and adolescents with comorbid mental health disorders must be interpreted with caution, given many studies either do not measure intervention fidelity or have variable levels of fidelity adherence. Including fidelity components in future studies would aid in determining the effectiveness and generalizability of interventions targeted at children with comorbid disorders.

Evidence-based risk factors for adverse health outcomes in older patients after discharge home and assessment tools: a systematic review.

The current health care system is discharging elderly patients "quicker" and "sicker" from acute care facilities. Consequently, hospital readmission is common; however, readmission may be only one aspect of adverse outcomes of importance to social work discharge planners. The early recognition of risk factors might ensure a successful transition from the hospital to the home. A systematic review was conducted to identify factors associated with adverse outcomes in older patients discharged from hospital to home. Using a content analysis, factors were characterized in five domains: demographic factors, patient characteristics, medical and biological factors, social factors, and discharge factors. The most frequently reported risks were depression, poor cognition, comorbidities, length of hospital stay, prior hospital admission, functional status, patient age, multiple medications, and lack of social support. A systematic search identified four discharge assessment tools for use with the general population of elderly patients. Practice and research implications are offered.

Intervention fidelity in psychosocial oncology.

Intervention fidelity refers to strategies that practitioners and researchers use to monitor, enhance, or evaluate the accuracy and consistency of the delivery of an intervention to ensure that it is implemented according to how it was planned. The purpose of the authors in this article was to evaluate intervention fidelity in the psychosocial oncology intervention effectiveness research. Twenty-eight studies located in a previous systematic review on psychosocial oncology intervention effectiveness comprised the sample for this research. A treatment fidelity checklist was applied to each study independently by each author (MP & PB). Percent agreement between raters ranged from 68% to 100% (M = 89%). Overall, the mean proportion of adherence was 0.57 (SD 0.12), which may be considered to be moderate fidelity. Critical examination and applicability of the checklist in examining and assessing intervention fidelity were highlighted and discussed. Overall, intervention fidelity was adequately addressed in the psychosocial oncology intervention effectiveness research, and integrity was confirmed in the majority of studies reviewed. Suggestions for future psychosocial oncology effectiveness research were made.

Effectiveness of psychosocial intervention for children and adolescents with comorbid problems: a systematic review.

BACKGROUND: Comorbidity is common among child clinical samples. Reviews on effective intervention for comorbid problems are lacking. METHOD: Based on a literature search of three databases (PsycINFO, MEDLINE and ERIC), initial data analysis was carried out on 865 studies; of these,10 randomised trials fully met study inclusion criteria and were subject to final analysis, with quality assessments and effect sizes calculated. RESULTS: Overall, effect sizes for externalising (M = 1.12) and internalising (M = 1.09) outcomes were large. Effect sizes were large for family-based (M = 1.80) compared to individual (M = 0.78) and group-based (M = 0.54) interventions. Studies with homotypic comorbidity (M= 1.18) displayed larger treatment effect sizes than ones with heterotypic comorbidity (M = 0.54). CONCLUSIONS: While the overall quality ratings of the reviewed studies varied from mediocre to good, with a variety of measures used across studies to assess the same outcomes, findings suggest that current interventions are effective for reducing internalising and externalising problems in children with comorbidity. More substantive evidence for the beneficial effects of psychosocial interventions for children with comorbid problems may arise as more robust studies, which more explicitly address and describe comorbidity, become available.

Exploratory survey of patients' needs and perceptions of psychosocial oncology.

Cancer is a major health issue that affects a significant proportion of the population. Advancements in oncology treatment have reduced mortality, creating an ever-greater need for psychosocial oncology. Patients with cancer at Grand River Regional Cancer Centre (GRRCC) have access to some psychosocial intervention (e.g., wellness workshops, social work intervention); however, the extent to which these efforts meet patients' current needs is not known. The purpose of the exploratory survey was to assess patients' psychosocial needs and psychosocial oncology service needs. Patients receiving treatment for cancer at GRRCC were asked to participate in the anonymous survey. Two research assistants from the University of Guelph obtained informed consent, then with assistance from volunteers from the GRRCC, collected all data. The two screening tools, and standardized, self-report measures of depression and social support (Perceived Social Support Scale) were administered. Patients rated the psychosocial oncology services as very helpful, though 100% indicated the presence of distress. The main source of distress concerned not knowing what their personal outcomes will be. Implications for practice and research are discussed.

Sexual identity and sexual well-being in female heterosexual university students.

Sexual identity has generally been studied with a focus on sexual orientation and has not incorporated a general identity framework. Low levels of identity exploration and commitment have been shown to predict poor well-being in adolescents, but the relationship between sexual identity and sexual well-being has not been examined. The current cross-sectional survey was administered to 293 heterosexual female undergraduate students from a mid-sized university in Ontario, Canada. Participants completed the Measure of Sexual Identity Exploration and Commitment (Worthington, Navarro, Savoy, & Hampton, 2008), as well as several measures to assess sexual well-being. These included the Sexuality Scale (Snell & Papini, 1989), the Sexual Awareness Questionnaire (Snell, Fisher, & Miller, 1991), the Body Esteem Scale for Adolescents and Adults (Mendelson, Mendelson, & White, 2001; Mendelson, White, & Mendelson, 1997), and four individual items assessing sexual satisfaction (Laumann et al., 2006). Confirmatory factor analysis was used to test the measurement models of sexual identity and sexual well-being, and structural equation modeling was used to examine the relationship between sexual identity and sexual well-being. Results indicated that higher levels of sexual identity exploration and commitment predicted sexual well-being. However, other aspects of sexual identity, such as synthesis and sexual orientation identity, were not predictive of sexual well-being. The implications of using an identity framework for measuring sexual identity are discussed.

Discharge planning from hospital to home for elderly patients: a meta-analysis.

In the present healthcare environment, budget cuts, staff shortages, and resource limitations are grave concerns. The elderly in particular consume a considerable proportion of hospital resources. Thus, the discharge planner's role, particularly with respect to elderly patients, is extremely important. In this systematic review recent (within the last 10 years) randomized, controlled or quasi-experimental trials of discharge planning (DP) from hospital to home of patients age 65 years or older were examined. The most important finding was the paucity of investigations by social work professionals. A second important finding was the lack of appropriate reporting of methods and results. Where data were provided, an effect size was computed for statistically significant results (overall mean d = 0.51, SD 0.35). Large effects were noted for patient satisfaction, while moderate effects were evident for patients' quality of life and readmission rates. The integration and evaluation of current knowledge in this field may inform further research and may lead to the advancement of clinical practice and new policy development, with the ultimate goal of improving the quality of patient care and the quality of patient outcomes. The implications for social work clinicians and researchers are discussed.