Education and training in clinical neuropsychology: Recent developments and documents from the clinical neuropsychology synarchy

The Clinical Neuropsychology Synarchy (CNS) interfaces with the American Psychological Association and affiliated organizations to address issues and advances in specialty training. The past several years have seen the development and dissemination of several initiatives pertinent to specialty training. Among these initiatives was the creation of a taxonomy for education and training in clinical neuropsychology. In additional there has been a movement toward competency-based education that has become codified in the APA’s new Standards for Accreditation. Calls for competency-based education have also influenced the expectations of the APA’s Committee on Recognition of Specialties and Proficiencies in Professional Psychology. As the convener of national clinical neuropsychology organizations, the CNS has overseen the development of relevant documents for our specialty. This paper presents three documents critical to training in our field that were developed through the CNS and approved by its member organizations. The first is the Taxonomy for Education and Training in Clinical Neuropsychology. The second is Entry Level Competencies for Clinical Neuropsychology and the third is a distillation of the entry-level competency document for the purpose of identifying competencies to be addressed at the post-doctoral residency level.     

Sécurisation de la prise en charge médicamenteuse des patients sous antipsychotiques : impact de la collaboration médico-pharmaceutique à la Maison d’Arrêt de Lyon-Corbas

ObjectiveAntipsychotics are the standard treatment for psychosis. However, when combined with other lifestyle factors they are partially responsible for an excessive mortality rate. A clinical and paraclinical monitoring of patients is therefore necessary. In 2011, this element led doctors and pharmacists to improve monitoring and formalize a follow-up adapted to inmate patients. The aim of this study was to assess the impact of medical-pharmaceutical collaboration on monitoring quality of patients treated by antipsychotics.MethodsThis is a retrospective study including all patients treated by antipsychotics for at least 6 months in 2011 and again in 2015. Data were collected from medical files. The indicator assessing the monitoring quality was the compliance percentage, of registred parameters for each patient on the basis of specific guidelines.ResultsIn 2015 compared to 2011, the monitoring quality increased for 9 out of 10 parameters. This improvement was statisticaly significant for 7 of them : Body Mass Index, lipid test, complete blood count, transaminase, ionogram, glycemia, glomerular filtration rate.ConclusionThe actions of improvement collectivelly implemented in 2011 had a concrete impact on patients in the follow-up in 2015.     

一种预测子宫内膜病变患者内膜病理类型的临床模型＊

目的 开发并评估一种用于预测子宫内膜病变患者内膜病理类型的临床模型；方法 选取2019年11月至2021年11月因妇科B超发现子宫内膜病变并于山东中医药大学附属医院行宫腔镜下内膜活检的患者，结合其病史与最小绝对收缩和选择算子法（Least absolute shrinkage and selection operator，LASSO）筛选影响内膜病变的独立危险因素，列线图（nomogram）函数建立列线图模型，采用ROC曲线下方的面积大小（Area Under Curve， AUC）、C指数（C-index）、拟合优度（Hosmer-Lemeshow）检验、自举法（bootstrap）评估及验证模型，依据列线图对纳入患者进行风险赋分，绘制ROC曲线获取风险评分的截断值，从而划分高低风险的人群；结果 阴道流血、绝经、无流产史、并发高血压、B超内膜厚度增厚、内膜回声不正常，中医证型为虚实夹杂证是发生子宫内膜癌及癌前病变的独立危险因素，评估模型所得AUC值与C-index均>0.9，Hosmer-Lemeshow检验显示P>0.05，bootstrap内部验证法所得C-index亦高于0.9，均说明模型准确度、区分度及可信度良好，当患者的风险评分总和≥177分时，属于高风险人群；结论 本模型可以预测B超提示子宫内膜病变患者的内膜病理类型为癌前或恶变型的概率并识别高风险人群。     

Recreational runners with Achilles tendinopathy have clinically detectable impairments: A case-control study

ObjectivesTo confirm what impairments are present in runners with Achilles tendinopathy (AT) and explore the variance of AT severity in an adequately powered study.DesignCase-control study.SettingTwo private physiotherapy clinics in Australia and Spain.ParticipantsForty-four recreational male runners with AT and 44 healthy controls matched by age, height, and weight.Main outcome measuresDemographics, activity (IPAQ-SF), pain and function (VISA-A), pain during hopping (Hop pain VAS), hopping duration, psychological factors (TSK-11, PASS20), and physical tests regarding lower-limb maximal strength and endurance.ResultsBody mass index (BMI), activity, VISA-A, pain, and duration of hopping, TSK-11, PASS20, standing heel raise to failure, seated heel raise and leg extension 6RM, hip extension and abduction isometric torque were significantly different between groups (P < 0.05) with varied effect sizes (V = 0.22, d range = 0.05–4.18). 46% of AT severity variance was explained by higher BMI (β = −0.41; p = 0.001), weaker leg curl 6RM (β = 0.32; p = 0.009), and higher pain during hopping (β = −0.43; p = 0.001).ConclusionRunners with AT had lower activity levels, lower soleus strength, and were less tall. BMI, pain during hopping, and leg curl strength explained condition severity. This information, identified with clinically applicable tools, may guide clinical assessment, and inform intervention development.