RESUMEN
OBJECTIVE: The aim of this study was to determine whether implementation of a collaborative problem-solving approach would be associated with a decrease in seclusion and restraint in a child and adolescent inpatient unit. METHOD: A collaborative problem-solving (CPS) approach was implemented. Seclusion and restraint, length of treatment, clinician- and patient/parent-rated outcomes and staff utility and acceptability were surveyed pre and post implementation. RESULTS: The number of restrictive events significantly decreased, including full restraint, partial restraint and seclusion. Length of treatment and routine clinician-rated outcome measures remained consistent. Patient or parent-rated outcomes showed greater reduction post implementation. Despite some initial scepticism, the staff found this approach useful. CONCLUSIONS: A CPS approach was successfully implemented, and in this naturalistic study was associated with a significant decrease in seclusions and restraints.
Asunto(s)
Conducta Cooperativa , Pacientes Internos , Aislamiento de Pacientes/estadística & datos numéricos , Solución de Problemas , Restricción Física/estadística & datos numéricos , Adolescente , Niño , Hospitales Psiquiátricos/organización & administración , Humanos , Nueva Zelanda , Medición de Resultados Informados por el PacienteRESUMEN
This technical report describes the methods undertaken by a US-based Digital Health company (X2AI or X2 for short) to develop an ethical code for startup environments and other organizations delivering emotional artificial intelligence (AI) services, especially for mental health support. With a growing demand worldwide for scalable, affordable, and accessible health care solutions, the use of AI offers tremendous potential to improve emotional well-being. To realize this potential, it is imperative that AI service providers prioritize clear and consistent ethical guidelines that align with global considerations regarding user safety and privacy. This report offers a template for an ethical code that can be implemented by other emotional AI services and their affiliates. It includes practical guidelines for integrating support from clients, collaborators, and research partners. It also shows how existing ethical systems can inform the development of AI ethics.
RESUMEN
The objective of this study was to evaluate the efficacy and tolerability of quetiapine in the treatment of first onset psychosis in older adolescents using risperidone as a comparator. Twenty-two patients with first onset psychosis were randomized to receive quetiapine (up to 800 mg/day) or risperidone (up to 6 mg/day) for 6 weeks. Raters blind to treatment assignment performed outcome symptom ratings. No statistical differences emerged in terms of efficacy or tolerability between the two drugs. However, there were some clinically notable differences that seem to favour the efficacy of risperidone over quetiapine. Patients taking quetiapine, although improved, showed less clinical improvement on scores for total positive and negative symptoms, clinical global severity and depression at 6 weeks than patients taking risperidone. Although both treatments were associated with weight gain and sedation, more patients on quetiapine experienced over 10% weight gain. However, fewer patients who were taking quetiapine required anticholinergic medication or experienced extrapyramidal side effects than patients taking risperidone. Risperidone was significantly more likely to be associated with elevation in serum prolactin levels in this population. In conclusion, the results in this small trial show that adolescent patients may benefit more from treatment with risperidone than quetiapine. However, those susceptible to side effects, particularly hyperprolactinaemia, may be more suitable for treatment with quetiapine.