Who Cares? The Views of Sexual Offenders About the Group Treatment They Receive

This paper describes one of the first systematic focused attempts to elicit the views of sexual offenders about the treatment that they have received. The paucity of previous research in this area is suggested to be the result of negative societal attitudes towards sexual offenders, as exemplified by recent tabloid newspaper coverage of this population. It is suggested that these attitudes may have a negative impact upon the attitudes of clinicians and researchers, and thus upon the treatment offered to this client group. Therefore, it is argued that seeking the views of the clients is essential in order to ensure that treatment is relevant and reflexive, and promotes relapse prevention. A questionnaire was distributed to participants who had completed treatment groups run by the Psychology Service at a Regional Secure Unit and at a Probation Service Sexual Offender Unit. The questionnaire aimed to elicit their views of the group experience, including issues to do with programme structure and content, group process, and therapeutic style of group facilitators. The results (including a pilot study) indicated that, on the whole, participants' experiences of the group were positive, for example aspects of the group process, understanding and preventing reoffending. Some suggestions for the modification and development of future sexual offender treatment are outlined, based on the feedback from subjects, for example, consideration of alternative treatment modalities, enhancing the content of group sessions, improving the organization of groups and modifying the training of groups leaders.     

A Rasch Analysis Validation of the Maslach Burnout Inventory–Student Survey with Preclinical Medical Students

Construct: Burnout is a psychological construct characterized by emotional exhaustion that arises from an excess of physical, emotional, and social demands over an extended period. Symptoms of burnout include withdrawal or disengagement from work. Burnout has become an important public health concern due to its association with severe negative consequences across numerous professions. Background: The most widely used instrument for measuring burnout is the Maslach Burnout Inventory (MBI). An adaptation of the MBI, the MBI–Student Survey (MBI-SS), was developed for college students. The MBI-SS consists of 15 items covering 3 domains of burnout: exhaustion, cynicism (CY), and professional efficacy (PE). Although studies have confirmed the validity of the MBI-SS for college student populations, studies of its use with medical students are limited. The purpose of this study was to employ the Rasch model to examine the psychometric properties of the MBI-SS when used with a population of preclinical medical students. Approach: Data were collected from 787 medical students who answered the MBI-SS at the conclusion of their 1st year. A maximum likelihood exploratory factor analysis for ordinal data confirmed the hypothesized three factor structure of the MBI-SS. Subsequently, a Rasch analysis was employed to further evaluate the measurement properties of MBI-SS. We used the Rasch Rating Scale model to investigate the extent to which the three MBI subscales conformed to proper measurement characteristics, including comprehensive coverage of person ability and item difficulty along the latent continuum. Results: Most of the 15 items on the MBI-SS effectively fit the Rasch Rating Scale Model, with minimal measurement error. Respondents effectively used the full range of the rating scale for all 15 items. Two subscales (PE and CY) contained items that were difficult for respondents to endorse, resulting in significant gaps along the measurement continuum. The CY subscale exhibited a slight floor effect. The 3 subscales showed good person reliability, good real-item reliability, and good person separation. Conclusions: The Rasch analysis confirmed that the MBI-SS works well for measuring burnout among preclinical medical students. However, the Rasch analysis was able to identify that additional items are needed to improve the performance of MBI-SS. New items would be targeted at reducing the floor effect for the CY subscale and filling the other gaps in measurement along the latent continuum for the PE and CY subscales.     

Recovering Memories of the Offense in “Amnesic’’ Sexual Offenders

This paper describes a technique designed to assist sexual offenders to recover memories of their offense. We have consistently observed that some sexual offenders present as having no recall of their offense although they are able to remember other events of the day of the offense. This failure to recall offense details prevents the offenders from making an appropriate disclosure which, in turn, blocks attempts to identify their offense pathways and develop relapse prevention plans. The memory recovery technique we describe is based on experimental literature on memory and we outline its use with 22 clients, 20 of whom showed satisfactory recovery of their memories.     

What Happens in Therapy with Sexual Offenders? A Model of Process Research

This paper presents two studies (one single case and one comparative study) examining change processes within individual therapy sessions as well as during the course of treatment. The Therapeutic Cycle Model (TCM), developed for general psychotherapy to objectify change events in the course of psychotherapies, is applied to transcribed tape recordings of therapy sessions with sexual offenders. The TCM focuses on emotional experience and cognitive mastery and uses computer assisted text analysis. In addition to the TCM approach clinical ratings are used as independent criteria. The predicted relationship between the phases of the TCM and scores on the respective scales of the clinical ratings were supported.     

What Do We Know About the Effect of Aging on Recidivism Risk for Sexual Offenders?

Meta-analytic and multiple sample study findings indicate there is an overall inverse relationship between sexual offenders’ age at the time of their release from incarceration and their sexual recidivism risk (Hanson, 2002; Hanson & Bussière, 1998). Very recent studies, however, document limits to the generalizability of that finding. This article attempts to integrate the new empirical results into a coherent picture concerning the relationship between aging and recidivism risk for sexual offenders. The purpose is to determine the extent to which empirically-based conclusions can be drawn about how to incorporate the issue of offender age in sexual recidivism risk assessments. Overall, instead of finding straightforward conclusions of a practical nature, a series of study-specific conclusions were found that were often mutually exclusive. Further analyses of existing data were conducted in an attempt to tease out meaningful hypotheses concerning the relationship between offender age and sexual recidivism. Numerous potentially interacting variables were uncovered including participation in treatment, type of risk measure used, type of sexual offender, jurisdiction, and even a different measure of offender age. Implications of these findings are discussed.

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Adaptation and Initial Validation of the Premature Infant Pain Profile–Revised (PIPP-R) in Brazil

BackgroundThe use of reliable pain assessment measures is essential for scoring and managing pain in infants. The Premature Infant Pain Profile (PIPP) is reliable and valid and has been recently revised. To adapt and validate the PIPP-R into Portuguese and to evaluate its psychometric properties are required to ensure maintenance of meaning and content.AimsThe aim of this study was to culturally adapt to Brazilian Portuguese and explore content validity and construct validity of the Premature Infant Pain Profile–Revised.DesignThis is a methodological study.Participants/SettingsTwo existing data sets of randomized clinical trials previously conducted were used to examine initial construct validity of the prefinal version of the Premature Infant Pain Profile–Revised.MethodsCross-cultural adaptation and validation occurred in four steps. Independent versions of the Premature Infant Pain Profile–Revised were produced, followed by the preparation of a synthetic version. Two back-translated versions were realized by professional translators. An expert committee evaluated idiomatic and semantic equivalence and clarity and relevance of the items. A content validity index was calculated. Finally, a consolidated prefinal version in Portuguese was then produced.ResultsNo difficulties in producing the material were reported. Semantic and idiomatic aspects were considered adequate, and content validity index was 1.0. Premature Infant Pain Profile and Premature Infant Pain Profile–Revised scores were highly correlated for pain after heel lancing and venipuncture (R² = 0.986, p < .001) and for pain associated with analgesic strategies (R² = 0.966-1.00, p < .001).ConclusionsThe Premature Infant Pain Profile–Revised was culturally adapted into Brazilian Portuguese. Appropriate content validity index was determined. Evidence of construct validity was also found. Future studies are warranted to explore the feasibility and other psychometric properties of using the Premature Infant Pain Profile–Revised translated and adapted into Brazilian Portuguese in the clinical setting.     

Psychometric and Clinical Assessment of the 10-Item Reduced Version of the Fatigue Scale—Child Instrument

Fatigue is one of the most debilitating conditions associated with cancer and anticancer therapy. The lack of reliable and valid self-report instruments has prevented accurate assessment of fatigue in pediatric oncology patients. The purpose of this study was to identify the most sensitive and specific score, that is, the “cut score,” on the Fatigue Scale-Child (FS-C) to identify those children with high cancer-related fatigue in need of clinical intervention. We first used Rasch methods to identify the items on the FS-C that distinguished children with high cancer-related fatigue from other children; our findings indicated that the FS-C needed to be reduced from 14 items to 10 items. We then assessed the 10-item FS-C for its psychometric properties and applied the receiver operating characteristics curve analysis to the FS-C responses from 221 children (aged 7–12 years) receiving anticancer treatment. The cut score identified with 75% sensitivity and 73.5% specificity was 12; 73 (33%) patients scored 12 or higher. Findings from this validated instrument provide a needed guide for clinicians to interpret fatigue scores and provide clinical interventions for this debilitating condition to their pediatric patients with cancer.     

The social validity of Social Stories™ for supporting the behavioural and communicative functioning of children with autism spectrum disorder

Abstract

This study examines the social validity of a family-centred collaborative approach to developing Social Stories? to support the behavioural and communicative functioning of children with autism spectrum disorder (ASD). Twenty children with Pervasive Developmental Disorder (PDD)/Autism, PDD-Not Otherwise Specified, or Asperger's Disorder (aged 4–12 years) participated in a multiple baseline design across behaviours with a 6-week follow-up. The effects of behaviour stories (to reduce problem behaviours) and communication stories (to facilitate communication) as assessed by parental subjective perceptions of child functioning were evaluated and compared. Using daily parental ratings, behaviour stories were deemed effective for 11 of 17 stories (64.7%), whereas communication stories were deemed effective for 10 of 19 stories (52.6%), with great variability in effect size for both. Results also indicated variability in performance across specific story targets, although parents’ perceived effects of Social Stories? were not linked to any known child characteristics. This study argues that intervention using Social Stories? to address behavioural and communicative functioning can yield socially valid outcomes across a range of child characteristics and intervention targets. Implications for clinical practice and how present methodological limitations can be addressed in future research are considered.     

The Czech version of the life satisfaction index for the third age—short form (LSITA-SF12): Psychometric properties

Background

Evaluation of life satisfaction of older people using standardised tools can play a crucial role in evaluating the effectiveness of policy measures aimed at mitigating the effects of population aging.

Objectives

The aim of the study was to verify the psychometric properties of the Czech version of a 12-item scale (the Life Satisfaction Index for the Third Age) for older people living in the community.

Methods

The research involved 1113 older people from the Moravian–Silesian Region over 60 years of age living in a home environment. For the newly created Czech version of LSITA-SF12, we tested validity (construct validity and convergent validity) and reliability (internal consistency).

Results

We confirmed a single-factor model for the LSITA-SF12 scale (χ² = 71.33, p < .001, CFI = 0.995, TLI = 0.994, RMSEA = 0.065, SRMR = 0.056, GFI = 0.999) by confirmatory factor analysis and load factor analysis (values of explorations ≥0.45). The internal consistency of the scale was satisfactory (α = 0.878). Furthermore, there was a medium correlation rate (r = 0.592; p < .001) between the overall score of the LSITA-SF and quality-of-life score (OPQoL-Brief).

Conclusions

We found the Czech version of the LSITA-SF12 questionnaire to have satisfactory psychometric properties. The questionnaire is suitable for use in research and clinical practice to evaluate the effectiveness of preventive measures. Clinical Trial Registration: ClinicalTrials.gov. PRS Protocol Registration and Results System; NCT05637177.

Implication for practice

The LSITA_SF12 questionnaire can beadministered by a community gerontological nurse and can be used in clinicalpractice and research.     

Psychometric validation of the functional assessment of cancer therapy—brain (FACT-Br) for assessing quality of life in patients with brain metastases

Objective

This study aimed to test the reliability, psychometric, and clinical validity of the use of the Functional Assessment of Cancer Therapy—Brain (FACT-Br) in patients with brain metastases.

Methods

Patients with brain metastases were interviewed using the FACT-Br (including the FACT-general) 1 week prior to treatment. All patients completed a follow-up assessment 1 month post-treatment. Patients with a good performance status and receiving stereotactic radiosurgery completed an additional 1 week follow-up assessment after the initial baseline interview to assess test–retest reliability.

Results

Forty patients had complete 1 month follow-up data. Ten of these patients also completed the 1 week follow-up assessment from baseline. The median Karnofsky performance status of patients was 80 and the median age was 64 years. All subscales of the FACT-Br were found to be conceptually related (except for two correlations) using the following subscales: physical well-being (PWB), social/family well-being (SWB), emotional well-being (EWB), functional well-being (FWB), FACT-G total score, brain cancer subscale (BrC), and the FACT-Br total score. All FACT-Br scores demonstrated excellent reliability, except for the SWB scale which revealed good reliability. The FACT-Br scores showed no significant change in the quality of life (QoL) of patients from baseline to 1 month follow-up.

Conclusion

The use of the combined FACT-G and FACT-Br Subscale to assess QoL specifically in patients with brain metastases has successfully undergone psychometric validation. Future clinical trials should use the FACT-G and FACT-Br Subscale to assess QoL in this patient population.     

Is Panton-Valentine leucocidin associated with the pathogenesis of Staphylococcus aureus bacteraemia in the UK?

BACKGROUND: The morbidity and mortality associated with Panton-Valentine leucocidin (PVL)-positive Staphylococcus aureus suggest that this toxin is a key marker of disease severity. Nevertheless, the importance of PVL in the pathogenesis of primary bacteraemia caused by S. aureus is uncertain. We have determined the prevalence of PVL-encoding genes among isolates of S. aureus from bacteraemic patients. METHODS: Consecutive bacteraemia isolates of S. aureus (n=244) from patients hospitalized in 25 centres in the UK and Ireland during 2005 were screened for PVL and mecA genes. PVL-positive isolates were characterized by toxin gene profiling, PFGE, spa-typing and MIC determinations for a range of antimicrobials. RESULTS: Four out of 244 isolates (1.6%) were PVL-positive and susceptible to oxacillin [methicillin-susceptible S. aureus (MSSA)]. Eighty-eight out of 244 (36%) were oxacillin-resistant (methicillin-resistant S. aureus), but none was PVL-positive. The four patients (two males: 30 and 33 years; two females: 62 and 80 years) had infection foci of: skin and soft tissue, unknown, indwelling line, and surgical site, and were located at one centre in Wales, one in England and two in Ireland. One of four PVL-positive isolates was resistant to penicillin and fusidic acid, the remainder were susceptible to all antibiotics tested. Genotypic analyses showed that the four isolates represented three distinct strains; the two isolates from Ireland were related. CONCLUSIONS: We found that 1.6% of S. aureus (all MSSA) from bacteraemic patients were PVL-positive. This low incidence suggests that PVL-positive S. aureus are of no particular significance as causative agents of S. aureus bacteraemia.     

Sexual Safety for In-Patient Mental Health Care—The Democratic Diagnosis of Change

This article discusses a co-produced qualitative understanding aimed at reducing the risk of sexual violence within mental health in-patient settings. It describes the first stages of testing a new approach which democratises organisational change as, people who use mental health services take the lead in partnership working with those who provide services. The article sets out ‘TODAYICAN’ (and its second-generation iteration, ‘TODAYWECAN’) as emerging approaches towards change. In particular, the article focusses upon the ‘diagnose’ component of the approach and reports findings from a mixed methods qualitative methodology. In doing so the article offers a conceptualisation of in-patient sexual safety in a mental health context drawn from the perspectives of people who use or provide in-patient services. The article also outlines where the consensus rests on what needs to change to make sexual safety an ‘always event’ whilst, critically analysing where the two groups differed in their views.     

Development of the Guernsey community participation and leisure assessment—Revised (GCPLA-R)

A sufficiently psychometrically robust measure of community and leisure participation of adults with intellectual disabilities was not in existence, despite research identifying this as an important outcome and a key contributor to quality of life. The current study aimed to update the Guernsey Community Participation and Leisure Assessment (GCPLA). Adults with intellectual disabilities, carers and experts were consulted in creating a revised pool of 46 items. These were then tested and data from 326 adults with intellectual disabilities were analysed for their component structure and psychometric properties. Principal component analysis discovered a stable set of components describing seven different clusters. This revised measure (the GCPLA-R) was demonstrated to have satisfactory reliability, and scores were related to challenging behaviour and adaptive behaviour in theoretically consistent ways and were correlated with scores on comparable measures.     

The therapy with the large dosage of methylprednisolone for the Bell palsy

Background：ThemainpathologicalimpairmentsincludeedemaoffacialnerveanddifferentleveldegenerationofmyelinsheathoraxiscylinderinBell＇spalsy．Theprognosisofthedis－easeresultsfromseveredegreeofthediseaseandwhethertreat－mentsaretimelyornot．ThetherapywithlargedosagesofMethylprednisolone（MPS）inveinforBell＇spalsy，canrelievelocaledema，improvenerveconduction，avoidprogressiveimpair－mentsofmyelinesheathandaxiscylinderandpromoterepairsofmyelinesheath．Objective：Todiscusstheeffectsoflargedosa…     

The early days of orthopaedic nursing in the UK – Agnes Hunt and Baschurch

On 1 October 2000, the Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, UK celebrates the centenary of its foundation. From humble beginnings in the small Shropshire village of Baschurch, it has developed into a world-famous centre of excellence in the treatment of orthopaedic conditions. This article outlines the early days of the hospital’s founder, Dame Agnes Hunt, and the development of orthopaedic nursing at Baschurch from 1900 to 1920.