A systematic review of the persistence of childhood mental health problems into adulthood.

Many adult mental disorders have their origins in childhood yet our knowledge about this largely comes from studies assessing adults utilising retrospective recall of age of onset. In this systematic review we evaluate the current state of knowledge of how childhood exposure to mental health problems is associated with adult mental disorders using data from prospective longitudinal studies. We identified 40 studies that assessed mental health in childhood or adolescence and reassessed adults for mental disorders. Although there was substantial heterogeneity across studies in terms of methodology and findings, there was a clear pattern that experiencing mental health problems prior to 14 years of age increases risk of adult mental disorder. Importantly, elevated symptoms rather than diagnosis in childhood were generally more strongly associated with adult disorder. These findings provide strong support for the argument that prevention needs to be targeted to children in the primary school years and early intervention efforts to those who are beginning to experience elevated symptoms rather than waiting until a diagnosable disorder is evident.

Online End-of-Life Nursing Education Consortium Core Curriculum for Staff Nurses: An Education Strategy to Improve Clinical Practice.

Because of the growing population of patients with serious illness, the demand for specialty palliative care exceeds the resources available. Nurses must be prepared to provide primary palliative care to fill the gap in the availability of specialized palliative care providers. However, meeting the educational needs of a vast number of practicing nurses poses a significant challenge. Often, institutions are limited in the financial and staffing support that they can contribute for continuing nursing education, especially when the training requires staff to spend substantial time away from work. In order to address this issue, one large medical center conducted a study to examine the educational and clinical practice outcomes of offering an online version of the End-of-Life Nursing Education Consortium Core Curriculum to nearly 100 nurses. The participants were divided into 2 groups. Group 1 received online education only, whereas the other group received the online education plus a 3-hour face-to-face training session. Both groups reported statistically significant improvements in symptom management and communication skills, with no significant difference between the pedagogical approaches. Most importantly, the education resulted in a statistically significant impact on the nurses' clinical practice. The results of this study demonstrate that online education can be used as an effective and efficient strategy to provide primary palliative care education to a large number of nurses.

An examination of the association between anxiety and social functioning in youth with ADHD: A systematic review.

Although up to 50% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) meet criteria for an anxiety disorder, it is unclear how comorbid anxiety influences social functioning for this population. Understanding the factors associated with social functioning in ADHD is important given the limited efficacy of existing social skills interventions for this population. This systematic review aimed to determine the association between anxiety and social functioning (social problems, peer status, and social skills/ competence) in children and adolescents with ADHD. A standardised search protocol was used, identifying 4807 articles for screening with 31 included in the final review. Anxiety symptom severity was associated with lower levels of social skills and higher levels of social problems in young people with ADHD. However, few differences emerged when defining anxiety based on diagnostic measures. Although the results varied considerably amongst studies, a number of key variables emerged that influenced the associations between anxiety and social functioning including the type of reporter and sample characteristics such as age, sex, ADHD subtype and other mental health comorbidities. These findings have implications for social functioning interventions in ADHD given the role of anxiety symptoms in predicting poorer social functioning.

Associations between alcohol consumption patterns and attitudes towards alcohol interlocks.

BACKGROUND: Drink-driving and alcohol-related crashes are a significant problem globally. Alcohol interlocks are used to prevent drivers with a blood alcohol concentration above a pre-determined level from starting their vehicle, making the technology highly effective in preventing drink-drive episodes. While alcohol interlocks are commonly used in drink-drive offender groups, their broader use as a preventative road safety strategy is considered increasingly feasible. In this context it is important to understand attitudes towards the technology, and to investigate whether these attitudes vary according to alcohol consumption patterns as this influences the acceptability of a broad-based preventative alcohol interlock program. METHODS: A representative sample of 2994 Australian drivers participated in an online cross-sectional survey. Participants reported their alcohol consumption, drink-drive behaviour and attitudes towards the use of alcohol interlocks for personal use and for drink-drive offenders. RESULTS: Half of the sample stated that alcohol interlocks would be of use personally. Seventy-four percent of high-risk drinkers (defined by an AUDIT score ≥20) stated they would find the technology personally useful when compared to 49% of low-risk drinkers (AUDIT ≤7). Overwhelmingly, more than 80% of participants agreed with the mandatory instalment of alcohol interlocks and compulsory clinical interventions for drink-drive offenders, with more low-risk drinkers supporting this than the high-risk drinkers. CONCLUSIONS: While there were mixed opinions regarding the perceived personal usefulness of alcohol interlocks, higher-risk drinkers were most likely to perceive interlocks as being of use for themselves. This high-risk group however, was less likely to provide support for clinical interventions and additional re-licensing requirements aimed at eliciting changes in drinking behaviour. These findings have important implications for drink-drive offender relicensing and the likely success of drink-driver education, and interventions aimed at curbing risky alcohol consumption.