Ten-year research update review: child sexual abuse

OBJECTIVE To provide clinicians with current information on prevalence, risk factors, outcomes, treatment, and prevention of child sexual abuse (CSA). To examine the best-documented examples of psychopathology attributable to CSA.METHOD Computer literature searches of and for key words. All English-language articles published after 1989 containing empirical data pertaining to CSA were reviewed.RESULTS CSA constitutes approximately 10% of officially substantiated child maltreatment cases, numbering approximately 88,000 in 2000. Adjusted prevalence rates are 16.8% and 7.9% for adult women and men, respectively. Risk factors include gender, age, disabilities, and parental dysfunction. A range of symptoms and disorders has been associated with CSA, but depression in adults and sexualized behaviors in children are the best-documented outcomes. To date, cognitive-behavioral therapy (CBT) of the child and a nonoffending parent is the most effective treatment. Prevention efforts have focused on child education to increase awareness and home visitation to decrease risk factors.CONCLUSIONS CSA is a significant risk factor for psychopathology, especially depression and substance abuse. Preliminary research indicates that CBT is effective for some symptoms, but longitudinal follow-up and large-scale "effectiveness" studies are needed. Prevention programs have promise, but evaluations to date are limited.     

Ten-year follow-up of adolescent-onset anorexia nervosa: physical health and neurodevelopment

To study the development of physical health and some neuromotor functions in anorexia nervosa (AN) 51 individuals (48 females, three males) with a mean AN onset of 14 years, recruited after community screening, were followed prospectively together with 51 age-, sex-, and school-matched individuals without AN (controls). About 10 years after AN onset, all individuals were examined in respect of physical health and neurodevelopment. There were no deaths. Weight and height had normalised, except in three participants with persistent AN. Significantly more participants with AN had a physical complaint/disorder, including hirsutism. This might be a long-term complication in weight restored AN. Dysdiadochokinesis occurred almost exclusively among individuals with former AN in accordance with our previous studies.     

A review of the outcome expectancy construct in physical activity research

Background: Outcome expectancy is a central construct in social cognitive models of health behavior widely used as frameworks for physical activity research.Purpose: This article provides a review of the outcome expectancy construct and its application to research on physical activity.Methods: Theoretical articles describing definitions and placement of outcome expectancy within social cognitive models, as well as empirical research on outcome expectancy and physical activity, were reviewed.Results: Self-efficacy theory, the transtheoretical model, the theory of planned behavior, and protection motivation theory differ in their labeling and conceptualization of outcome expectancy but unanimously include expected outcomes of behavior. Preliminary empirical investigation of the role of outcome expectancy in understanding physical activity has yielded mixed results. Positive outcome expectancy appears to be more predictive of physical activity in older adults than in young to middle-aged adults, and personal barriers appear to be the most predictive subtype of negative outcome expectancy. In addition, a small number of studies indicate relations between outcome expectancy and other theoretical variables, including behavioral intention, stage of change, and self-efficacy.Conclusions: Further research on the role of outcome expectancy is necessary to design effective physical activity interventions. New directions in outcome expectancy research could involve (a) expanding the conceptualization of outcome expectancy to include expected outcomes of sedentary behavior and affective responses to physical activity, (b) further examination of potential moderators of the relation between outcome expectancy and physical activity (such as outcome value and outcome proximity), (c) distinguishing between the role of outcome expectancy in behavior onset versus behavior maintenance, (d) examining outcome expectancy as a mechanism of change in environmental intervention approaches, and (e) further analysis of interrelations between outcome expectancy and other social cognitive variables. (Ann Behav Med 2005,29(1):70-79) Support for this article was partly provided by Grant R01CA79469 from the National Cancer Institute to Richard A. Winett, principal investigator, at Virginia Tech. This research was conducted to complete requirements for David M. Williams's preliminary examination at Virginia Polytechnic Institute and State University. Richard Winett and Eileen Anderson served as co-chairs on the committee. Special thanks to other committee members Lee Cooper, Robert Stephens, and Janet Wojcik.     

Ten-year review of rating scales. VI: scales assessing externalizing behaviors

OBJECTIVE: This is the sixth article in a series of 10-year reviews of rating scales. The current article reviews scales that assess externalizing behaviors such as disruptive behavior disorders and aggression. METHOD: Relevant scales were found by searching popular electronic databases. The search was then broadened by a review of the references in selected articles. Due to the paucity of well-established scales, any such scales with potential utility for elucidating the functioning of youths with externalizing behaviors were selected. RESULTS: None of these scales is diagnosis-based, although some correlate with DSM-IV-defined disruptive behavior disorders. Most scales assessing disruptive behavior disorders have a solid normative base, good psychometric functioning, and high clinical utility. Scales assessing aggression comprise a bimodal group. Several have been adapted from the adult literature and are widely used in clinical practice, while others address theoretical aspects of aggression and are used predominantly in research. Empirical support for all of the scales assessing aggression varies widely, although several show potential for routine clinical practice. CONCLUSIONS: Overall, these scales measure a variety of constructs with considerable utility for assessing youths' externalizing behaviors, predicting outcome, and evaluating treatment effects. Many need further validation with youth.     

Ten-year review of rating scales, VII: scales assessing functional impairment

OBJECTIVE: This is the seventh in a series of 10-year reviews of rating scales. Here the authors present scales measuring functional impairment, a sequela of mental illness. The measurement of functional impairment has assumed importance with the recognition that symptom resolution does not necessarily correlate with functional improvement. METHOD: The authors reviewed functional impairment from multiple sources over the past 20 years. Thus, this article includes a variety of scales ranging from those that have been subject to critical review with strong psychometric support to those that have not been critically reviewed but are in widespread use to those that are still finding their niche. RESULTS: These scales represent a continuum of constructs from symptoms to functional impairment to contextual factors that affect youths' functioning. Most older scales have focused on developmentally delayed youths. Newer scales strive to measure functional impairment separate from symptomatology. Some newer scales are also keyed to determination of level of service need. CONCLUSIONS: Scales measuring functional impairment can elucidate the impact of illness on youths, identify targets for treatment, determine service needs, and monitor treatment effectiveness. These scales are widely used in community mental health and health service delivery. They can assist in providing evidence-based treatment.     

Ten-year review of rating scales. II: Scales for internalizing disorders

OBJECTIVE: This article, the second in the Journal's series of 10-year updates on rating scales, summarizes scales assessing internalizing disorders. METHOD: The authors sampled articles on mood and anxiety disorders over the past 25 years, selected scales with multiple citations over many years, and reviewed their properties. Those with adequate psychometric properties, plus continued wide literature citations or a current special niche, are presented here. RESULTS: Rating scales for depression were developed and/or examined in the 1980s. Despite generally strong properties, they lack clear construct validity. Most have parent-report forms that broaden their suitability with youths. Anxiety scales were developed bimodally. Those developed in the 1960s to 1970s were downward modifications of adult scales. They have been criticized for unclear constructs and unsuitability for youths. Newer scales developed in the 1990s have addressed these problems and have parent-report forms. However, their utility is still being determined. CONCLUSIONS: Rating scales can reliably, validly, and efficiently measure youths' internalizing psychopathology. They have great utility in research, treatment planning, and accountability in practice. However, the user must define the goals of measurement, consider the construct the scale measures, and use the scale within its defined capabilities. The use of more than one scale for a task is recommended.     

Ten-year review of extradural spinal abscesses in a New Zealand tertiary referral centre

Despite being a well-understood pathology, patients with an extradural spinal abscess (ESA) still experience delays in diagnosis, with associated morbidity and mortality. This 10-year retrospective audit aimed to define the presentation, findings and prognosis of ESA in a New Zealand tertiary referral centre. Forty-two patients were diagnosed and treated between 1 May 1997 and 30 June 2007. The mean age was 55 years, with a male predominance of 1.6:1. Staphylococcus aureus was identified in 67% of patients. On presentation, 27/38 patients with back pain were afebrile and 2/37 patients had a normal C-reactive protein (CRP) level in the first 24 hours. Ten patients were discharged with neurological dysfunction and one died. One reason for the delays in diagnosis and appropriate referral could be the lack of “red flag” symptoms at the time of presentation. Attention needs to be paid to the history and nature of a patient’s back pain. We recommend routine CRP and full blood count to help raise clinical suspicion.     

A review of research on physical exercise with people with severe and profound developmental disabilities

During the last two decades, a significant amount of research has examined physical exercise with people with severe and profound developmental disabilities. The research has followed three main objectives: 1) finding strategies for allowing the people to engage in physical exercise fairly independent; 2) improving the people’s physical fitness; and 3) reducing the people’s deviant behavior. This paper reviews the studies related to the aforementioned objectives and comments on the main findings and on the practicality and acceptability of physical exercise.     

Ten-year review of rating scales. IV: scales assessing trauma and its effects

OBJECTIVE: This article summarizes scales assessing trauma and its effects on youths. METHOD: We sampled trauma-related articles published over the past 25 years, with an emphasis on the past decade, selected scales with at least several publications, and reviewed their properties. Those with minimally adequate psychometric properties and continued literature citations or a special niche are presented. RESULTS: Most of trauma-related scales are relatively new, reflecting the evolving interest in juvenile trauma. Therefore, they do not have the depth of psychometric examination nor the breadth of applications described for previously reviewed scales. However, they have been applied to various traumatic situations. These scales assess a range of trauma-related symptoms and behaviors, including posttraumatic stress disorder, symptoms related to posttraumatic stress disorder, and dissociation. Additionally, several scales assess the trauma itself. CONCLUSIONS: Trauma-related scales show promise for research and clinical use in understanding youths' responses to trauma. However, their utility for treatment planning and for accountability in practice is generally not as clear. The potential user must clearly define the goals of measurement and use these scales within their limited roles. With these caveats, trauma-related scales may assist our work with traumatized youths.     

神经影像学十年进展

最近10年,随着计算机硬件与软件技术的发展,神经影像学取得了极大的发展,主要表现在以下方面. 一、成像技术 1998年,多层螺旋CT(MSCT)问世.X线管球每旋转一周,多层探测器同时接收穿过人体组织的X射线可获得4层以上的影像数据;至2005年初,探测器数量已经达到64层,同时X线管球旋转一周的速度从秒级缩短为毫秒级,目前,最快者已经达到0.27 s.多层螺旋CT在1秒钟之内即可完成头颅平扫,5秒获得整个人体的图像数据.     

Ten-year review of rating scales. V: scales assessing attention-deficit/hyperactivity disorder

OBJECTIVE: This article summarizes information on scales assessing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. METHOD: The authors sampled articles on ADHD over the past decade. Several popular older ADHD measures have recently been revised, and new ADHD scales have been developed. The authors selected primarily ADHD scales based on the DSM-IV construct of ADHD that also have multiple literature citations. They then reviewed their psychometric properties. Those with adequate psychometric functioning plus considerable literature citations, known wide usage in clinical practice, or a current niche are presented here. RESULTS: Several rating scales consistent with the DSM-IV conceptualization of ADHD are now available for use in both home and school settings. Many of the instruments demonstrate solid psychometric properties and a strong normative base. However, some popular scales have not been adequately investigated. Some measures are restricted to the comprehensive assessment of ADHD, whereas others also include symptoms of other disorders. The potential applications for these scales with youths diagnosed with ADHD are broad. CONCLUSIONS: Rating scales can reliably, validly, and efficiently measure DSM-IV-based ADHD symptoms in youths. They have great utility in research and clinical work, assist treatment planning, and help to ensure accountability in practice.     

Medical risks in epilepsy: a review with focus on physical injuries, mortality, traffic accidents and their prevention

The present review aims at highlighting selective aspects of the medical risks in epilepsy and their prevention. Emphasis is put on accidents and physical injuries, including risk factors and effectiveness of prevention; mortality, its causes, risk factors and prevention of seizure-related deaths, as well as traffic accidents, their risk factors and the effectiveness of prevention. Accidents and injuries are slightly more frequent among people with epilepsy than in the general population. This increased risk is probably most prevalent in patients with symptomatic epilepsy and frequent seizures, most often in combination with associated handicaps. The majority of accidents are trivial and occur at home. The most frequent injuries among patients with epilepsy are contusions, wounds, fractures, abrasions and brain concussions. The standardised mortality ratio (SMR; the ratio of observed number of deaths in a population with epilepsy to that expected, based on age and sex-specific mortality rates in a reference population) in population-based studies of epilepsy is 2-3 compared to the general population. This increased mortality is largely related to the etiology of the epilepsy and is probably not influenced by the treatment of the epilepsy. On the other hand, most fatalities in patients with chronic, therapy resistant epilepsy seem to be seizure-related and often sudden unexpected deaths (SUDEP). The frequency of such seizure-related deaths is most likely to be reduced by intensified treatment aiming at early seizure control, although appropriate studies for definitive evidence are still lacking. Apparently, there is an increased rate of traffic accidents in drivers with epilepsy, even if population-based prospective data are lacking. Many of these accidents are seizure-related. Probably, the extent to which physicians report their patients with uncontrolled epilepsy to the authorities is too low, but this has not yet been explored. Moreover, the preventive measures in legislation may be ignored by many people with epilepsy.     

功能神经外科发展十年

功能神经外科是神经外科的一个重要分支,它是运用各种外科手术技术改善中枢神经系统的功能失调,通过对中枢神经系统的某些结构进行刺激、破坏或重建,实现新的各系统之间的平衡,达到缓解症状、恢复神经功能的目的[1].功能神经外科治疗的常见疾病包括癫痫、运动障碍性疾病(帕金森病、肌张力障碍等)、疼痛(三叉神经痛、幻肢痛、癌性疼痛等)、脑神经疾病(面肌抽搐等)、精神疾病(强迫症、重度抑郁症、抽动秽语综合征、药物依赖等)以及脑瘫等.     

Pediatric cervical spine injuries: a comprehensive review

Introduction  

Cervical spine injuries can be life-altering issues in the pediatric population. The aim of the present paper was to review this literature.     

A case control study of Creutzfeldt-Jakob disease: Association with physical injuries

Sixty cases of Creutzfeldt-Jakob disease reported from 902 neurological clinics throughout Japan between 1975 and 1977 were examined in a retrospective case control study. Histories were obtained from patients, sex-matched neighbors, and spouses. No association was observed in either sex with five socioeconomic variables; exposures to eight species of animals; ingestion of raw meat or quadruped brains; eighteen diseases, allergies, or immunizations; tooth extraction; blood transfusion; or lumbar puncture. Surgical operations within five years before disease onset were reported for 25.9% and 7.8% of male patients and pooled controls and for 24.2% and 9.6% of female patients and controls. Mechanical injuries were observed for the same period in 33.3% and 9.8% of male patients and controls and in 18.2% and 13.5% of female patients and controls. The operations and mechanical injuries varied in all groups as to body parts affected and nature of the lesions. Physical injuries including operations may be a predisposing factor to the development of Creutzfeldt-Jakob disease.     

Accelerometer use during field-based physical activity research in children and adolescents with intellectual disabilities: A systematic review

Many methodological questions and issues surround the use of accelerometers as a measure of physical activity during field-based research. To ensure overall research quality and the accuracy of results, methodological decisions should be based on study research questions. This paper aims to systematically review accelerometer use during field-based research in children and adolescents with intellectual disabilities. Medline, Embase, Cochrane Library, Web of Knowledge, PsycINFO, PubMed, and a thesis database (up to May 2013) were searched to identify relevant articles. Articles which used accelerometry-based monitors, quantified activity levels, and included ambulatory children and adolescents (≤18 years) with intellectual disabilities were included. Based on best practice guidelines, a form was developed to extract data based on 17 research components of accelerometer use. The search identified 429 articles. Ten full-text articles met the criteria and were included in the review. Many shortcomings in accelerometer use were identified, with the percentage of review criteria met ranging from 12% to 47%. Various methods of accelerometer use were reported, with most use decisions not based on population-specific research. However, a lack of measurement research, e.g., calibration/validation, for children and adolescents with intellectual disabilities is limiting the ability of field-based researchers to make to the most appropriate accelerometer use decisions. The methods of accelerometer use employed can have significant effects on the quality and validity of results produced, which researchers should be more aware of. To allow informed use decisions, there should be a greater focus on measurement research related to children and adolescents with intellectual disabilities.     

神经外科身体约束管理的系统评价

目的 系统评价神经外科身体约束相关文献,为神经外科医务人员规范化身体约束提供参考。方法 计算机检索Cochrane Library、PubMed、Web of Science、CINAHL、WANFANG、CNKI、CBM等中英文数据库,收集关于神经外科身体约束的原始研究。采用2017版JBI相关原始研究质量评价标准进行文献质量评价,进行描述性汇总分析。结果 纳入16篇文献:5篇随机对照试验,4篇类实验研究,5篇现况调查,1篇队列研究,1篇质性研究。分析结果显示,神经外科身体约束率高（19.7%~76.5%）,身体约束评估工具有待统一,身体约束对病人造成身心不良影响,护士巡视、记录的意识需加强,神经外科护士和病人的身体约束知信行有待提高。结论 神经外科身体约束的管理有待加强,需根据循证证据结合临床具体情况完善身体约束相关制度,提高神经外科身体约束护理质量,改善患者结局。     

Ten-year review of rating scales. III: scales assessing suicidality,cognitive style,and self-esteem

OBJECTIVE: This is the third article in a series of 10-year reviews of rating scales. Here, the authors review scales that are useful in tapping the affective disturbances experienced with various psychiatric disorders, including suicidality, cognitive style, and self-esteem. METHOD: The authors sampled articles incorporating these constructs over the past 25 years and selected scales with established uses or new development. Those presented here have adequate psychometric properties and high utility for efficiently elucidating youths' functioning, plus either wide literature citations or a special niche. RESULTS: These scales were developed bimodally. Many were developed in the 1980s when internalizing disorders were elucidated, but there has been a resurgence of interest in these constructs. Scales assessing suicidality have clear constructs, whereas scales of cognitive style demonstrate deficits in developmental relevance, and scales of self-esteem suffer from lax constructs. CONCLUSIONS: The constructs underlying these scales tap core symptoms of internalizing disorders, mediate the expression of affective disturbances associated with various disorders, and depict the impairments resulting from these disorders. Overall, the psychometrics of these scales are adequate. These scales provide a broader representation of youths' functioning than that conveyed with diagnostic scales alone.