Creating a firestorm: a review of children who deliberately light fires

Deliberate firesetting is a significant social problem that causes millions of dollars of property damage each year. Of particular concern is that a high proportion of these arson offences are committed by children and adolescents. Youth firesetters are a unique and diverse group, variant in their motivations, needs and behavior and distinct from their adult counterparts.The study of firesetting has been approached in a number of ways and thus the existing body of research lacks a coherent, consistent and comprehensive set of empirical findings. In synthesizing the literature on child and adolescent firesetting, this review considers the potential relationships between firesetting typologies, risk factors, development and treatment. It considers the extent to which firesetting can be considered within the framework of antisocial behavior and what implications such a relationship may have for clinical practice.The review concludes that despite a number of risk factors being repeatedly identified, an understanding of the etiology behind firesetting behavior and potential developmental trajectories remain theoretically rather than empirically based. Existing typological theories do not take sufficient account of the complexities of firesetting behavior and there is not yet a typology and accompanying assessment that has undergone thorough empirical testing and is of significant clinical utility. Despite indications that the relationship between firesetting and antisocial behavior is of a serious nature, there has been a general lack of attention to this in literature and practice. Attention to this relationship is necessary not just in the area of firesetting research and practice but also amongst those working with youth with behavioral difficulties and conduct problems as for these individuals firesetting is likely to indicate particularly high risk for severity of behavior and future offending. Because of this relationship and the diversity of firesetting populations there is a need for collaborative intervention for firesetters that includes thorough assessment and provides an individualized, and developmentally appropriate approach best suited to the needs of the individual. This review reflects on the methodological limitations as well as clinical implications of existing studies and suggests necessary directions for future research.     

Somatization: a critical review of conceptual and methodological issues

Despite its apparent clinical importance and the extensive research that has been conducted in the past decades, somatization remains a complex concept. Two distinct ways of looking at somatization can be distinguished: somatization as a phenomenon that is secondary to psychological distress (presenting somatization) and somatization as a primary phenomenon characterized by medically unexplained symptoms (functional somatization). The literature was analyzed in terms of this distinction and a selective review was conducted, focusing on a critical analysis of conceptual and methodological issues related to presenting and functional somatization. A number of measurement issues related to somatization in general were also highlighted. On the basis of the available data, the strengths and weaknesses of different concepts are pointed out. Conclusions are formulated regarding which concepts or approaches might be useful both clinically and from a research perspective. Finally, a number of suggestions for future research are offered.     

Substance misuse and substance use disorders in sex offenders: a review

Substance abuse has often been associated with committing sex offenses. In this article, the following will be reviewed: 1) studies that assessed substance abuse in sex offenders; 2) differences in substance abuse among different types of sex offenders; 3) differences in substance abuse between sex offenders and nonsexual offenders and substance abuse in the normal population; 4) sex offenders’ intoxication at the time of the offense; and 5) differences in intoxication at the time of the offense among different types of sex offenders. Studies will be discussed according to the method they used to assess substance abuse, i.e., file research, screening instruments or semi-structured interviews. This review shows that about half of the sex offenders has a history of substance abuse, a quarter to half of the sex offenders has a history of alcohol misuse and that about one fifth to a quarter of the sex offenders has a history of drug misuse. Furthermore, about a quarter to half of the sex offenders appeared to be intoxicated at the time of the offense. The review results in recommendations for future research. Because of the high prevalence of substance abuse in sex offenders it is advisable to routinely screen for substance abuse and, if necessary, to treat substance abuse.     

Internet-based patient education and support interventions: a review of evaluation studies and directions for future research

The Internet provides patients, families, and health providers with unparalleled opportunities to learn, inform, and communicate with one another. This paper is a review of studies that have evaluated the impact of professionally facilitated Internet-based programs for diverse clinical populations on health outcomes, utilization, and user satisfaction. The findings suggest that some outcomes in certain groups can be moderately improved and that user satisfaction has been generally positive. Given the increasing need to provide timely and effective patient-centered care, a stronger evidence base for eHealth applications must be established before broader deployment of such programs will take place.     

Psychoneuroendocrinology of stress and emotions: issues for future research

It is stated that much psychoneuroendocrinological research is carried out that lacks a theoretical framework and therefore adds little to our current knowledge. Therefore, five research issues have been presented which need further exploration: (1) the temporal relation between subjective and biological stress responses; (2) the question of the psychobiological specificity; (3) the relationship between endocrine responses to acute and to chronic stressors; (4) the relationship between endocrine activity and susceptibility to disease, and (5) the mediating and moderating effects of personal factors (coping, personality, and task performance) on psychobiological responses. It is argued that the study of these issues will increase our understanding of the stress phenomenon.     

Prevention of depression in youth: a qualitative review and future suggestions

Since 1990, significant efforts have been made towards developing interventions to prevent depression in youth. Meta-analyses of preventive interventions have consistently yielded small but significant effect sizes in the short-term prevention of depression. However, the maintenance of intervention effects over extended follow-ups ranging from 6 months to 3 years has not been consistently demonstrated. In this qualitative review, significant methodological issues that continue to be of concern are discussed. Illustrative studies are described to highlight the accomplishments and limitations of interventions to date. Particular areas in need of attention include the implementation of booster sessions, use of appropriate statistical analyses, examination of multiple outcome variables, augmentation of protective factors, and exploration of mediators and moderators of intervention effects. Future directions for the field of depression prevention are outlined.     

The effectiveness of hypnosis for reducing procedure-related pain in children and adolescents: a comprehensive methodological review

A comprehensive, methodologically informed review of studies of the effectiveness of hypnosis for reducing procedure-related pain in children and adolescents is provided. To be included in the review, studies were required to use a between-subjects or mixed model design in which hypnosis was compared with a control condition or an alternative intervention in reducing the procedure-related pain of patients younger than age 19. An exhaustive search identified 13 studies satisfying these criteria. Hypnosis was consistently found to be more effective than control conditions in alleviating discomfort associated with bone marrow aspirations, lumbar punctures, voiding cystourethograms, the Nuss procedure, and post-surgical pain. Furthermore, hypnosis was as at least as effective as distraction. Three hypnotic interventions met criteria as a possibly efficacious empirically supported therapy for reducing post-surgical or lumbar puncture pain. Several other hypnotic interventions would have achieved the status of a possibly efficacious therapy had studies used a treatment manual.     

The efficacy of hypnosis as an intervention for labor and delivery pain: A comprehensive methodological review

This paper presents a comprehensive methodological review of research on the efficacy of hypnosis for reducing labor and delivery pain. To be included, studies were required to use a between-subjects or mixed model design in which hypnosis was compared with a control condition or alternative intervention in reducing labor pain. An exhaustive search of the PsycINFO and PubMed databases produced 13 studies satisfying these criteria. Hetero-hypnosis and self-hypnosis were consistently shown to be more effective than standard medical care, supportive counseling, and childbirth education classes in reducing pain. Other benefits included better infant Apgar scores and shorter Stage 1 labor. Common methodological limitations of the literature include a failure to use random assignment, to specify the demographic characteristics of samples, and to use a treatment manual.     

Internet-based interventions for traumatic stress-related mental health problems: A review and suggestion for future research

Exposure to potentially traumatic events is a common occurrence. Most individuals exposed to such an event are resilient or recover rapidly, although some individuals develop psychological problems that warrant treatment. However, a small percentage of individuals seek traditional treatment, thereby calling for novel approaches or methodologies of treatment. The present paper provides a comprehensive and critical review of the extant literature on computerized and internet-based interventions (IBIs) for traumatic stress-related conditions (i.e., panic disorder, posttraumatic stress disorder/complicated grief, depression, comorbid anxiety and depression, alcohol abuse, smoking cessation). Generally, computerized or IBIs for depression and anxiety are yielding effect sizes that are comparable to traditional psychosocial treatment. Interventions aimed at alcohol and smoking cessation generally have lower effect sizes than do IBIs for anxiety and depression. Most interventions reviewed in this paper included common components (e.g., were developed through a cognitive behavioral framework and included psychoeducation, cognitive restructuring, goal setting, exposure). Therefore, it is possible that these shared features may in part account for symptom reduction. Little is known regarding mechanisms of change. Future directions for novel web-based approaches to treatment are provided.     

The prevalence of anxiety in older adults: methodological issues and a review of the literature

BACKGROUND: Despite the relative neglect of anxiety in older adults, the growing literature on its prevalence suggests that anxiety is highly prevalent and associated with considerable distress and morbidity in this age group. This review provides a comprehensive overview of this literature and discusses some unresolved controversies in the field. METHODS: A systematic search of articles published from 1980-2007 was performed. Articles were included for review if they reported the prevalence of anxiety symptoms, anxiety disorder or specified anxiety disorders in adults aged >60 in either community or clinical settings. RESULTS: The prevalence of anxiety in community samples ranges from 1.2% to 15%, and in clinical settings from 1% to 28%. The prevalence of anxiety symptoms is much higher, ranging from 15% to 52.3% in community samples, and 15% to 56% in clinical samples. These discrepancies are partly attributable to the conceptual and methodological inconsistencies that characterise this literature. Generalised Anxiety Disorder is the commonest anxiety disorder in older adults. LIMITATIONS: The methodologies used in the studies are so variable as to make comparisons difficult. CONCLUSIONS: Although anxiety disorder, particularly Generalised Anxiety Disorder is common, issues in relation to comorbidity and the nature of anxiety in old age remain unresolved. This hampers the design of intervention programmes, and highlights the need for further research with a primary focus on anxiety.     

Consequences associated with work-to-family conflict: a review and agenda for future research

A comprehensive review of the outcomes associated with work-to-family conflict was conducted and effect sizes were estimated. Atypology was presented that grouped outcomes into 3 categories: work related, nonwork related, and stress related. Issues concerning the measurement of work-family conflict were also discussed. The results demonstrate the widespread and serious consequences associated with work-to-family conflict. On the basis of the results of the review, an agenda for future research was provided.     

Financial efficacy of clinical assessment: rational guidelines and issues for future research

Whereas the financial efficacy of assessment has been well documented in industrial/organizational settings, there is no comparable literature within the field of clinical assessment. This has become a significant issue due to the increasing cost-consciousness of managed health care organizations. A rational means of increasing the financial efficacy of assessment is outlined, which includes the following: (a) focus on domains most relevant to treatment planning and outcome; (b) use formal assessment for risk management; (c) target problems most likely to result in cost savings (i.e., dissociation, somatization, panic); (d) increase the use of computer-assisted assessment; (e) use time-efficient instruments; (f) more closely link assessment, feedback, and therapy; and (g) integrate treatment planning, monitoring progress, and evaluating outcome. Issues and strategies for developing a research program include clearly defining what should be considered a cost, enumerating possible outcome variables, optimal follow-up time frame, selection of instruments, and the function of assessment.     

Neuroimaging studies of psychological interventions for mood and anxiety disorders: empirical and methodological review

This article reviews the methods and results of published neuroimaging studies of the effects of structured psychological interventions for mood and anxiety disorders. The results are consistent with neural models of improved affective- and self-regulation, as evidenced by psychotherapeutic modulation of brain metabolic activity within the dorsolateral, ventrolateral, and medial prefrontal cortices, the anterior cingulate, the posterior cingulate/precuneus, and the insular cortices. Specific recommendations for future studies are outlined, and the clinical and theoretical significance of this research is discussed.     

Current applications and future directions for the CDISC Operational Data Model standard: A methodological review

IntroductionIn order to further advance research and development on the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) standard, the existing research must be well understood. This paper presents a methodological review of the ODM literature. Specifically, it develops a classification schema to categorize the ODM literature according to how the standard has been applied within the clinical research data lifecycle. This paper suggests areas for future research and development that address ODM’s limitations and capitalize on its strengths to support new trends in clinical research informatics.MethodsA systematic scan of the following databases was performed: (1) ABI/Inform, (2) ACM Digital, (3) AIS eLibrary, (4) Europe Central PubMed, (5) Google Scholar, (5) IEEE Xplore, (7) PubMed, and (8) ScienceDirect. A Web of Science citation analysis was also performed. The search term used on all databases was “CDISC ODM.” The two primary inclusion criteria were: (1) the research must examine the use of ODM as an information system solution component, or (2) the research must critically evaluate ODM against a stated solution usage scenario. Out of 2686 articles identified, 266 were included in a title level review, resulting in 183 articles. An abstract review followed, resulting in 121 remaining articles; and after a full text scan 69 articles met the inclusion criteria.ResultsAs the demand for interoperability has increased, ODM has shown remarkable flexibility and has been extended to cover a broad range of data and metadata requirements that reach well beyond ODM’s original use cases. This flexibility has yielded research literature that covers a diverse array of topic areas. A classification schema reflecting the use of ODM within the clinical research data lifecycle was created to provide a categorized and consolidated view of the ODM literature. The elements of the framework include: (1) EDC (Electronic Data Capture) and EHR (Electronic Health Record) infrastructure; (2) planning; (3) data collection; (4) data tabulations and analysis; and (5) study archival. The analysis reviews the strengths and limitations of ODM as a solution component within each section of the classification schema. This paper also identifies opportunities for future ODM research and development, including improved mechanisms for semantic alignment with external terminologies, better representation of the CDISC standards used end-to-end across the clinical research data lifecycle, improved support for real-time data exchange, the use of EHRs for research, and the inclusion of a complete study design.ConclusionsODM is being used in ways not originally anticipated, and covers a diverse array of use cases across the clinical research data lifecycle. ODM has been used as much as a study metadata standard as it has for data exchange. A significant portion of the literature addresses integrating EHR and clinical research data. The simplicity and readability of ODM has likely contributed to its success and broad implementation as a data and metadata standard. Keeping the core ODM model focused on the most fundamental use cases, while using extensions to handle edge cases, has kept the standard easy for developers to learn and use.     

The treatment of bruxism: A review and proposal for future research

The epidemiology, etiology, and psychological treatment of bruxism are reviewed. A methodological critique of treatment studies is also presented. Lastly, suggestions for future research are discussed.     

Methicillin-resistant food-related Staphylococcus aureus: a review of current knowledge and biofilm formation for future studies and applications

There is increasing concern about the public health impact of methicillin-resistant Staphylococcus aureus. Food and animal are vectors of transmission, but the contribution of a contaminated environment is not well characterized. With regard to this, staphylococcal biofilms serve as a virulence factor, allowing MRSA strains to adhere to surfaces and other materials used in the food industry.Methicillin resistance and biofilm-forming capacity may contribute to the success of S. aureus as a human pathogen in both health care and community settings and the food production chain. This review summarizes current knowledge about the significance of food- and animal-derived MRSA strains and provides data on attachment and biofilm formation of MRSA. In addition, the impact of quorum sensing on MRSA gene expression and biofilm formation is examined.     

Current status and future prospects for biologic treatments of psoriasis

Introduction: Biological agents have transformed psoriasis treatment by selectively targeting immune signaling molecules involved in psoriasis pathogenesis. While biologics offer the most effective treatment of moderate to severe psoriasis, they are not without complications. Some patients treated with biologics have poor clinical responses, form anti-drug antibodies, or develop adverse events. Additionally, there is growing need for head-to-head studies comparing biologic treatment regimens, efficacy, and safety.

Areas covered: Here we review the literature surrounding biologics already in clinical use and those undergoing development and clinical trials. We also investigate the development and approval of small molecules inhibitors and biosimilars used to treat psoriasis.

Expert commentary: As the psoriasis treatment armamentarium continues to expand, it is important to follow the safety profile of these drugs both in clinical trials and in post-marketing registries to ensure their long-term safety. Physicians must be aware of the limitations of existing safety data of a drug and the potential risk for rare adverse events when selecting appropriate treatments and monitoring patient outcomes.     

Mood disorders and fertility in women: a critical review of the literature and implications for future research

A medline literature review of fertility and mood disorder articles published since 1980 was performed in order to critically review the literature regarding a relationship between mood disorders, fertility and infertility treatment. Previous studies suggests that mood disorders, both in the bipolar and unipolar spectrum, may be associated with decreased fertility rates. Most studies report that women seeking treatment for infertility have an increased rate of depressive symptoms and possibly major depression (none showed evaluated mood elevations). Many, but not all, studies found that depressive symptoms may decrease the success rate of fertility treatment. Treatments for infertility may independently influence mood through their effects on estrogen and progesterone, which have been shown to influence mood through their actions on serotonin. Studies are limited in scope and confounding variables are many, limiting the strength of the results. In conclusion, a range of existing studies suggests that fertility and mood disorders are related in a complex way. Future studies should use clinical interviews and standardized and validated measures to confirm the diagnosis of mood disorders and control for the variables of medication treatment, desire for children, frequency of sexual intercourse, age, FSH levels, menstrual cycle regularity in assessing an interrelationship between mood disorders and fertility.     

Recommendations for future studies: a systematic review of educational interventions in primary care settings.

Systematic reviews are an important part of the current move towards evidence-based practice. Independent reviewers use a variety of search strategies to identify and assess relevant articles in the field of concern. Criteria for quality must be agreed and articles evaluated accordingly. This study systematically reviewed educational interventions targeting physicians in primary care (excluding hospital clinic and academic settings) to determine their effectiveness in changing behaviour and to investigate whether studies gave information about the resource implications of the interventions described and their rationale for choosing a particular target group. Studies in English, French, or German language journals were included. The review applied the criteria of the Cochrane Collaboration for methodological quality of studies (but was not conducted under the auspices of the Cochrane Collaboration). The results showed that relatively few studies had occurred in primary care compared with academic and hospital clinic settings. Many articles did not fit the criteria for rigour of method, and those that did were very heterogeneous in method and target group. Only two studies assessed resource implications, and one study also calculated economic benefits. The review suggests that future studies should either target geographical areas or doctors with an identifiable learning need associated with patient outcome, and that studies should be evaluated on their 'intention to educate'. Evaluations of educational initiatives need to describe the resource implications versus measurable benefits of the intervention to make their studies useful to policymakers and planners of educational provision.