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Article: Caregiver-fabricated illness in a child prescribed long-term opioids and benzodiazepines.

Kattail, Deepa / Niec, Anne

2020 Volume 16, Issue 2, Page(s) 155–159

Abstract: Caregiver-fabricated illness in a child (CFIC) can result in unnecessary, potentially harmful medical investigations and treatment. As pediatric pain has historically been undertreated, the movement for more compassionate treatment has led to an increase ...

Abstract	Caregiver-fabricated illness in a child (CFIC) can result in unnecessary, potentially harmful medical investigations and treatment. As pediatric pain has historically been undertreated, the movement for more compassionate treatment has led to an increase in analgesic prescribing in children and adolescents. Overall, this has been a positive change but this may also lead to unintentional harm, partic-ularly if CFIC is not considered as a possibility in the presentation. We present a case in which CFIC was associated with long-term prescribing of opioids, benzodiazepines, and other central nervous system depressants.
MeSH term(s)	Adolescent ; Analgesics, Opioid/therapeutic use ; Benzodiazepines/therapeutic use ; Caregivers ; Central Nervous System Depressants ; Child ; Humans ; Munchausen Syndrome by Proxy/drug therapy
Chemical Substances	Analgesics, Opioid ; Central Nervous System Depressants ; Benzodiazepines (12794-10-4)
Language	English
Publishing date	2020-04-24
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2397614-7
ISSN	1551-7489
ISSN	1551-7489
DOI	10.5055/jom.2020.0562
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Article: Case conceptualization in child welfare: an underused resource to improve child, family, and provider outcomes.

McTavish, Jill R / McHolm, Angela / Niec, Anne / Pietrantonio, Anna Marie / McKee, Christine / MacMillan, Harriet L

Frontiers in psychiatry

2024 Volume 14, Page(s) 1292690

Abstract: Case conceptualization, formally known as case formulation, is one tool that assists in determining the best course of action for children and families experiencing family violence that has been under-utilized in child welfare. In this article we present ...

Abstract	Case conceptualization, formally known as case formulation, is one tool that assists in determining the best course of action for children and families experiencing family violence that has been under-utilized in child welfare. In this article we present a step-by-step case conceptualization process that considers the child welfare context. We then present a hypothetical case example of a 10-year-old child referred by a child welfare worker to evidence-based treatment for mental health and behavioural concerns. Mental health services are not helpful for the child and further consultation is enlisted. To more effectively guide intervention and treatment planning and ultimately improve outcomes for the child, we present case conceptualization as a process that incorporates relevant aspects of the child and family's history and circumstance. We conclude with a succinct case conceptualization and treatment plan to show how the prognosis of the child can be improved when case conceptualization is employed.
Language	English
Publishing date	2024-01-11
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2023.1292690
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Article ; Online: Understanding the Conceptualization and Operationalization of Trauma-Informed Care Within and Across Systems: A Critical Interpretive Synthesis.

Bargeman, Maria / Abelson, Julia / Mulvale, Gillian / Niec, Anne / Theuer, Ania / Moll, Sandra

The Milbank quarterly

2022 Volume 100, Issue 3, Page(s) 785–853

Abstract: Policy Points In order to achieve successful operationalization of trauma-informed care (TIC), TIC policies must include conceptual clarity regarding the definition of both trauma and TIC. Furthermore, TIC requires clear and cohesive policies that ... ...

Abstract	Policy Points In order to achieve successful operationalization of trauma-informed care (TIC), TIC policies must include conceptual clarity regarding the definition of both trauma and TIC. Furthermore, TIC requires clear and cohesive policies that address operational factors such as clearly delineated roles of service providers, protocol for positive trauma screens, necessary financial infrastructure, and mechanisms of intersectoral collaboration. Additionally, policy procedures need to be considered for how TIC is provided at the program and service level as well as what TIC means at the organizational, system, and intersectoral level. Context: Increased recognition of the epidemiology of trauma and its impact on individuals within and across human service delivery systems has contributed to the development of trauma-informed care (TIC). How TIC can be conceptualized and implemented, however, remains unclear. This study seeks to review and analyze the TIC literature from within and across systems of care and to generate a conceptual framework regarding TIC. Methods: Our study followed a critical interpretive synthesis methodology. We searched multiple databases (Campbell Collaboration, Econlit, Health Systems Evidence, Embase, ERIC, HealthSTAR, IPSA, JSTOR, Medline, PsychINFO, Social Sciences Abstracts, Sociological Abstracts and Web of Science),as well as relevant gray literature and information-rich websites. We used a coding tool, adapted to the TIC literature, for data extraction. Findings: Electronic database searches yielded 2,439 results and after inclusion/exclusion criteria were applied, a purposive sample of 98 information-rich articles was generated. Conceptual clarity and definitional understanding of TIC is lacking in the literature, which has led to poor operationalization of TIC. Additionally, infrastructural and ideological barriers, such as insufficient funding and service provider "buy-in," have hindered TIC implementation. The resulting conceptual framework defines trauma and depicts critical elements of vertical TIC, including the bidirectional relationship between the trauma-affected individual and the system, and horizontal TIC, which requires intersectoral collaboration, an established referral network, and standardized TIC language. Conclusions: Successful operationalization of TIC requires policies that address current gaps in systems arrangements, such as the lack of funding structures for TIC, and political factors, such as the role of policy legacies. The emergent conceptual framework acknowledges critical factors affecting operationalization.
MeSH term(s)	Humans ; Concept Formation ; Referral and Consultation ; Research Design ; Surveys and Questionnaires
Language	English
Publishing date	2022-09-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	632829-5
ISSN	1468-0009 ; 0887-378X
ISSN (online)	1468-0009
ISSN	0887-378X
DOI	10.1111/1468-0009.12579
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Article ; Online: Forensic issues in the assessment of sexually assaulted adolescents.

Niec, Anne

Paediatrics & child health

2009 Volume 7, Issue 3, Page(s) 153–159

Abstract: This article provides a general overview of the principles of conducting a forensic evaluation of adolescents who have been exposed to sexual abuse. This problem is common and is associated with a large burden of suffering. There is a strong likelihood ... ...

Abstract	This article provides a general overview of the principles of conducting a forensic evaluation of adolescents who have been exposed to sexual abuse. This problem is common and is associated with a large burden of suffering. There is a strong likelihood that most paediatricians will be called on to perform such evaluations at some point in time. This overview includes a description of the forensic examination, focuses on such issues as consent and contact with child protection services, and provides specific guidelines about interviewing the adolescent. Familiarity with how to conduct a forensic evaluation will hopefully improve the availability of this service for adolescents. Contact with the legal profession can be stressful. At the same time, paediatricians are in a unique position to advocate on behalf of their adolescent patients.
Language	English
Publishing date	2009-12-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2106767-3
ISSN	1918-1485 ; 1205-7088
ISSN (online)	1918-1485
ISSN	1205-7088
DOI	10.1093/pch/7.3.153
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Article ; Online: Sexual and reproductive health and rights of "last mile" adolescents: a scoping review.

Nowshin, Nahela / Kapiriri, Lydia / Davison, Colleen M / Harms, Sheila / Kwagala, Betty / Mutabazi, Miriam G / Niec, Anne

Sexual and reproductive health matters

2022 Volume 30, Issue 1, Page(s) 2077283

Abstract: Globally, significant progress has been made in the realm of adolescent sexual and reproductive health. We conceptualised "last mile" adolescents as having two or more of the following factors of identity: refugee, Indigenous, 2SLGBTQIA+, out of school, ... ...

Abstract	Globally, significant progress has been made in the realm of adolescent sexual and reproductive health. We conceptualised "last mile" adolescents as having two or more of the following factors of identity: refugee, Indigenous, 2SLGBTQIA+, out of school, rurally or remotely located, slum dwelling, incarcerated or previously incarcerated, HIV/AIDS infected, and living with a disability. We conducted a scoping review with an aim to synthesise evidence and identify research gaps in the literature pertaining to the sexual and reproductive health and rights (SRHR) of last mile adolescents. We conducted searches in three databases (Embase, Global Health, and Medline). Fifty-four publications met our inclusion criteria. Our results revealed that the state of evidence on the SRHR of last mile adolescents is poor. Very few studies used qualitative and mixed-method inquiry. The number of studies carried out in North America, Europe, and Oceania were limited. We found insufficient disaggregated data with respect to SRHR-related knowledge, behaviour, and access to services. Adopting an intersectional lens is critical to uncover the multiplicative effects of last mile adolescents' factors of identity on their SRHR. National data systems should be strengthened to enable the collection of quality disaggregated data which can play a vital role in identifying SRHR inequities affecting last mile adolescents. Research priorities should be realigned to generate data globally on the SRHR of last mile adolescents whose lives are marked by intersecting vulnerabilities.
MeSH term(s)	Adolescent ; Humans ; Reproductive Health ; Reproductive Health Services ; Reproductive Rights ; Sexual Behavior ; Sexual Health
Language	English
Publishing date	2022-06-06
Publishing country	England
Document type	Journal Article ; Review
ISSN	2641-0397
ISSN (online)	2641-0397
DOI	10.1080/26410397.2022.2077283
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Article: The Hidden Curriculum: A Good Thing?

Mackin, Robin / Baptiste, Sue / Niec, Anne / Kam, April J

Cureus

2019 Volume 11, Issue 12, Page(s) e6305

Abstract: Introduction The hidden curriculum is defined as a set of influences that function at the level of the organizational structure and culture to impact learning. Literature supports the significant impact of the hidden curriculum on all levels of learners ... ...

Abstract	Introduction The hidden curriculum is defined as a set of influences that function at the level of the organizational structure and culture to impact learning. Literature supports the significant impact of the hidden curriculum on all levels of learners in medical education. Our project aims to capture the messages being delivered to healthcare providers at our local facility. Methods Multiple one-time educational sessions on the hidden curriculum were provided over a five-year period to healthcare professionals. Participants were asked to share personal examples of their lived experiences with the hidden curriculum. A thematic analysis of the responses was completed and coded by two independent reviewers. Results Participants consisted of medical students, residents, faculty physicians, and allied health professionals. Their experience of the hidden curriculum emerged in six main themes: Vulnerability, Hierarchy, Privilege, Navigation & Negotiation, Positivity, and Dehumanizing. Conclusion A minority of responses demonstrated the positive impact that the hidden curriculum can have on professional development. This project highlights the importance of formally addressing the hidden curriculum to capitalize on its impact on medical trainees. The results have inspired a project focusing on residents as the population of interest in their unique role as learners and preceptors.
Language	English
Publishing date	2019-12-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.6305
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Article: Burn injury from car seat in an 11-month-old infant.

Moharir, Madhavi / Niec, Anne / Wekerle, Christine

Paediatrics & child health

2013 Volume 17, Issue 9, Page(s) 495–497

Abstract: Burns in young infants have long been recognized as a potential cause of nonaccidental injury. Accidental exposure to hot car seat parts resulting in significant burn injury is an unusual mimicker of child abuse. A case involving an 11-month-old child ... ...

Abstract	Burns in young infants have long been recognized as a potential cause of nonaccidental injury. Accidental exposure to hot car seat parts resulting in significant burn injury is an unusual mimicker of child abuse. A case involving an 11-month-old child who presented with a significant contact burn injury related to the noncovered, heated, plastic part of a car seat, is described. The present case encourages physicians to maintain an unbiased approach to each referred case and to explore the differential diagnosis by detailed history and physical examination. It also serves as a reminder in caregiver education about the precautions to be taken during long-distance travel with young children and infants.
Language	English
Publishing date	2013-10-09
Publishing country	England
Document type	Case Reports
ZDB-ID	2106767-3
ISSN	1918-1485 ; 1205-7088
ISSN (online)	1918-1485
ISSN	1205-7088
DOI	10.1093/pch/17.9.495
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Article: The medical assessment of bruising in suspected child maltreatment cases: A clinical perspective.

Ward, Michelle Gk / Ornstein, Amy / Niec, Anne / Murray, C Louise

Paediatrics & child health

2013 Volume 18, Issue 8, Page(s) 433–442

Abstract: Bruises commonly occur in children and are most often the result of a minor accidental injury. However, bruises can also signal an underlying medical illness or an inflicted injury (maltreatment). Although bruising is the most common manifestation of ... ...

Abstract	Bruises commonly occur in children and are most often the result of a minor accidental injury. However, bruises can also signal an underlying medical illness or an inflicted injury (maltreatment). Although bruising is the most common manifestation of child physical maltreatment, knowing when to be concerned about maltreatment and how to assess bruises in this context can be challenging for clinicians. Based on current literature and published recommendations, this practice point will help clinicians to distinguish between accidental and inflicted bruises, to evaluate and manage bruising in the context of suspected child maltreatment, and to evaluate for an underlying medical predisposition to bruising.
Language	French
Publishing date	2013-07-03
Publishing country	England
Document type	Journal Article
ZDB-ID	2106767-3
ISSN	1918-1485 ; 1205-7088
ISSN (online)	1918-1485
ISSN	1205-7088
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Article ; Online: Mandatory reporting of child abuse and neglect: crafting a positive process for health professionals and caregivers.

Pietrantonio, Anna Marie / Wright, Elise / Gibson, Kathleen N / Alldred, Tracy / Jacobson, Dustin / Niec, Anne

Child abuse & neglect

2013 Volume 37, Issue 2-3, Page(s) 102–109

Abstract: Health professionals working with children and their families are often required by law to report to governmental authorities any reasonable suspicion of child abuse and/or neglect. Extant research has pointed toward various barriers to reporting, with ... ...

Abstract	Health professionals working with children and their families are often required by law to report to governmental authorities any reasonable suspicion of child abuse and/or neglect. Extant research has pointed toward various barriers to reporting, with scant attention to positive processes to support the reporting process. This paper focuses on the context for mandatory reporting and evidence-informed practice for supporting a more structured and purposeful process of mandatory reporting. These practical strategies discusses: (1) the factors that positively influence the relationship between a child's caregivers and the mandated health professional reporter; (2) a framework and specific skills for discussing concerns about maltreatment and reporting to child protective services with the caregiver(s); and (3) the need for further training and education of health professionals.
MeSH term(s)	Caregivers/psychology ; Child ; Child Abuse/legislation & jurisprudence ; Child Abuse/prevention & control ; Child, Preschool ; Cooperative Behavior ; Health Personnel/education ; Health Personnel/psychology ; Humans ; Infant ; Mandatory Reporting ; United Nations/legislation & jurisprudence
Language	English
Publishing date	2013-02
Publishing country	England
Document type	Journal Article
ZDB-ID	799143-5
ISSN	1873-7757 ; 0145-2134
ISSN (online)	1873-7757
ISSN	0145-2134
DOI	10.1016/j.chiabu.2012.12.007
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Article: Does mental illness stigma contribute to adolescent standardized patients' discomfort with simulations of mental illness and adverse psychosocial experiences?

Hanson, Mark D / Johnson, Samantha / Niec, Anne / Pietrantonio, Anna Marie / High, Bradley / MacMillan, Harriet / Eva, Kevin W

Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry

2008 Volume 32, Issue 2, Page(s) 98–103

Abstract: Objective: Adolescent mental illness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may ... ...

Abstract	Objective: Adolescent mental illness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may provide a stigma-reduction strategy. This article reports an investigation of this hypothetical association between simulation discomfort and mental illness stigma. Methods: ASPs were randomly assigned to one of two simulation conditions: one was associated with mental illness stigma and one was not. ASP training methods included carefully written case simulations, educational materials, and active teaching methods. After training, ASPs completed the adapted Project Role Questionnaire to rate anticipated role discomfort with hypothetical adolescent psychiatric conditions/adverse psychosocial experiences and to respond to open-ended questions regarding this discomfort. A mixed design ANOVA was used to compare comfort levels across simulation conditions. Narrative responses to an open-ended question were reviewed for relevant themes. Results: Twenty-four ASPs participated. A significant effect of simulation was observed, indicating that ASPs participating in the simulation associated with mental illness stigma anticipated greater comfort with portraying subsequent stigma-associated roles than did ASPs in the simulation not associated with stigma. ASPs' narrative responses regarding their reasons for anticipating discomfort focused upon the role of knowledge-related factors. Conclusion: ASPs' work with a psychiatric case simulation was associated with greater anticipated comfort with hypothetical simulations of psychiatric/adverse psychosocial conditions in comparison to ASPs lacking a similar work experience. The ASPs provided explanations for this anticipated discomfort that were suggestive of stigma-related knowledge factors. This preliminary research suggests an association between ASP anticipated role discomfort and mental illness stigma, and that ASP work may contribute to stigma reduction.
MeSH term(s)	Adaptation, Psychological ; Adolescent ; Adolescent Psychiatry/education ; Child ; Cough/psychology ; Depressive Disorder/psychology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Patient Simulation ; Prejudice ; Psychology, Adolescent ; Suicide/psychology
Language	English
Publishing date	2008-03
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	1045331-3
ISSN	1545-7230 ; 1042-9670
ISSN (online)	1545-7230
ISSN	1042-9670
DOI	10.1176/appi.ap.32.2.98
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