Torticollis and Fever in a Young Boy: A Unique Presentation of Cat-Scratch Disease With Vertebral Osteomyelitis and Epidural Phlegmon [Case Report]
Cat-scratch disease-associated vertebral osteomyelitis and epidural involvement are rare and may manifest with nonspecific chronic symptoms in children, such as fever or torticollis. We present only the fourth case in the literature describing epidural involvement in an immunocompetent boy presenting with fever, torticollis, and indiscriminate left upper back tenderness. Bartonella henselae serologies are important to consider because such atypical complications often are responsive to conservative management with antibiotics.
Description of a collaborative community approach to impacting juvenile arrests
Although the burden of mental health disorders among youth involved with the juvenile justice system is high, few communities have effectively integrated mental health resources with law enforcement (Myers & Farrell, 2008). The city of Cambridge, Massachusetts has developed the Safety Net Collaborative, which is a multiagency integrated model of preventive services for at-risk youth involving mental health providers, police officers, schools, and the department of youth and families. There are 6,000 youth in the city's public schools under the local police jurisdiction. Youth are referred to this program by schools, courts, and parents. There are approximately 30 active cases each year. Initial outcome measures were tracked, including number of arrests, diversions, and mental health referrals. Rate of decline in arrests was compared pre and post implementation. Community arrests have decreased by more than 50% since implementing this model. Contracting with mental health services has led to an average 94 outpatient mental health provider referral per year. The results show positive trends in arrest rates after implementation of this collaborative model of preventive services. These findings support greater research and utilization of integrated, preventive service models for at-risk youth. (PsycINFO Database Record
Economic grand rounds: Parity from the consumer perspective: implications for federal implementation from New York's parity evaluation
This column reports results from a qualitative study of employees' knowledge of and access to mental health benefits after implementation of New York State's parity law in 2007. Fifty-four employed individuals with insurance coverage were interviewed by telephone (32 adults with mental illness and 22 parents of children with mental illness). Contrary to findings of previous studies, most had been informed of their coverage limits before the parity law but were unaware of their extended parity benefits. They cited their lack of knowledge and inadequate communication from their health plan as barriers to accessing benefits. They also reported barriers to accessing high-quality services. The findings indicate an urgent need for benefits education and monitoring of health plan communications on a federal level.