The Construction and Development of Theory in the Sexual Offending Area: A Metatheoretical Framework

A major problem in the sexual offending area is the absence of an integrated approach to theory building. The lack of a framework to guide empirical and theoretical research has resulted in the ad hoc proliferation of theories that often overlap, and essentially neglect each others' existence. In this paper we outline a metatheoretical framework that will hopefully address these problems. This framework takes into account a number of different theory construction principles and ideas. It differentiates between different levels of theory, such as comprehensive, middle, and micro-levels, and stresses the importance of distinguishing between distal and proximal causal factors. After briefly describing this metatheory we illustrate its utility and demonstrate how different theories of sexual offending can be meaningfully integrated within this framework. We finish with some recommendations for theoretical development in the sexual offending domain.     

Effect of activation of central nervous system serotonin 1A receptors on cardiorespiratory function

Previous studies indicate that the new antihypertensive drug, urapidil, acts at the ventral surface of the medulla in cats to produce a fall in blood pressure. In addition, urapidil was found in receptor binding studies to have a relatively high affinity for the serotonin 1A receptor. These results suggest that drugs which bind to the serotonin 1A receptor might exert hypotensive effects at the ventral surface of the medulla (VSM). To test this hypothesis, the effects of 8-hydroxy-2-(di-N-propylamino)tetralin (8-OH-DPAT), the prototype drug for activating serotonin 1A receptors, were evaluated for cardiovascular activity after local application to the VSM. 8-OH-DPAT applied bilaterally to the intermediate area of the VSM in a dose of 1 micrograms/side produced a decrease in mean blood pressure of 60 +/- 7 mm Hg (P less than .05) and a decrease in heart rate of 26 +/- 4 beats/min (P less than .05) (n = 8). Increases in respiratory rate (8 +/- 1 breaths/1 min) and decreases in tidal volume (13 +/- 4 ml) also occurred. These changes were associated with a significant increase in respiratory minute volume (130 +/- 41 ml, P less than .05). Similar cardiorespiratory changes were produced by application of another drug with high affinity for the serotonin 1A receptor, namely B695-40, to the intermediate area of the VSM. Intravenous administration of 8-OH-DPAT in a dose of 100 micrograms/kg mimicked the cardiorespiratory effects of ventral surface application of this agent.(ABSTRACT TRUNCATED AT 250 WORDS)     

Assessment of trunk function in single and multi-level spinal stenosis: a prospective clinical trial

OBJECTIVE: To clarify the biomechanical indicators of single- and multi-level stenosis and to determine the biomechanical outcome of selective conservative decompression. DESIGN: This study is a prospective clinical trial examining trunk function in spinal stenosis patients operated using a conservative procedure in an orthopaedic clinic. BACKGROUND: Although several clinical studies have examined the instability and motion characteristics of operated lumbar spinal canal stenosis, few if any studies have prospectively examined the biomechanical outcome of lumbar spinal canal stenosis surgery. METHODS: Comprehensive pre- and post-operative trunk dynamometer strength and motion analysis tests were performed on 36 patients operated for lumbar canal stenosis. Surgical treatment efficacy was evaluated within a three variable crossed factorial design considering stenosis classification, number of operative levels, and changes in several trunk biomechanical outcomes from pre- to post-operative assessment. Patients were evaluated after a minimum one-year follow-up. RESULTS: Pre-operatively there were no differential effects associated with stenosis classification or number of operated levels. There was a significant post-operative increase in isometric trunk extension torque and flexion-extension power and a return to a more normal trunk extension-flexion torque ratio. Patients with mixed, single level stenosis demonstrated greater trunk extension power both pre- and post-operatively compared to other patients. CONCLUSIONS: Conservative surgical treatment of lumbar spinal stenosis produced a marked improvement in the functional mechanical status of the low back. RELEVANCE: This study assists clinicians and researchers to understand trunk function following conservative surgical treatment of lumbar spinal stenosis.     

Practices and views of occupational therapists in Nova Scotia regarding wheelchair-skills training for clients and their caregivers: an online survey

Abstract

Purpose: To determine the extent to which Occupational Therapists (OTs) in Nova Scotia (NS) conduct wheelchair skills training, the nature of training and the OTs’ perceptions on training.

Materials and methods: Anonymous online survey.

Results: We received 110 responses from OTs living in NS and involved in direct patient care, 96 (93%) of whom reported helping clients obtain manual wheelchairs. Of the OTs who responded to the question “…do you typically provide wheelchair-skills training…?”, 40 (43.5%) answered “Yes, usually” for clients and 40 (46.0%) for caregivers. The median duration of training sessions for clients and caregivers was 30 and 20?min; the median number of sessions was 2 and 1. Regarding the importance of training, 65 (73.9%) OTs answered “Very important” and 22 (25%) “Somewhat important” for clients and 55 (64.0%) answered “Very important” and 29 (33.7%) “Somewhat important” for caregivers. About one-third of OTs considered themselves adequately prepared for the trainer role. A variety of barriers and facilitators to training were identified. Trainers were significantly more likely than non-trainers to consider wheelchair skills training as important (p?=?.0003 for clients and p?=?.0039 for caregivers) and to consider themselves adequately prepared for the trainer role (p?=?.002 for clients and .003 for caregivers).

Conclusions: Only a minority of NS OTs usually provide wheelchair-skills training for clients or their caregivers and the training provided is minimal, despite a majority who consider such training to be important. Only about one-third of OTs feel prepared for the training role.

• Implications for rehabilitation

• Only a minority of Occupational Therapists (OTs) in Nova Scotia, Canada usually provide wheelchair-skills training for clients or their caregivers.

• The training that is provided is minimal.

• A majority of OTs consider such training to be important.

• Only about one-third of OTs feel prepared for the training role.

     

Theory of Mind and Social Competence in Individuals with a Mental Handicap

This study investigated the association between performance on laboratory measures of theory of mind (standard false belief tasks) and teacher-rated measures of social competence in a sample of children and adolescents with a mental handicap. Performance on the theory of mind tasks was not significantly correlated with any aspect of teacher-rated social competence but was correlated with verbal mental age. The findings replicate those of Frith et al. (1994, Soc. Dev. 3: 107–124) who also found no correlation between social competence ratings and false belief task performance for individuals with a mental handicap. Possible reasons for this lack of association in individuals with a mental handicap are explored.     

Galanin acts at GalR1 receptors in spinal antinociception: synergy with morphine and AP-5

The neuropeptide galanin (Gal) and its receptors (GalR1, GalR2, and GalR3) are expressed in spinal cord. We have characterized the pharmacology of the antinociceptive effects of intrathecally (i.t.) administered galanin and its analogs in the formalin test in rats, using an automated flinch detection system. Intrathecal injection of rat galanin (Gal(1-29)) or human galanin (Gal(1-30)) produced a dose-dependent inhibition of formalin-evoked flinching in phase 2, but not in phase 1. Relative potency of galanin homologs is Gal(1-29) >or= Gal(1-30) > galanin-like peptide(1-24) >or= Gal(2-11) = Gal (3-29) (an inactive analog). Galanin(1-29) and Gal(1-30) are both high-affinity agonists to GalR1/R2, whereas Gal(2-11) is a GalR2 receptor agonist. Our data suggest that i.t. galanin-produced antinociception is mediated by activation of GalR1 receptors. When comparing antinociceptive effects of i.t. Gal(1-29) to morphine and to 2-amino-5-phosphonopentanoic acid (AP-5, an N-methyl-d-aspartate antagonist), Gal(1-29) is of intermediate potency between these two analgesic agents based on the ED(50) values. An isobolographic analysis showed synergy between Gal(1-29) and morphine and between Gal(1-29) and AP-5 on the second phase. Fixed ratio dose combinations of morphine and Gal(1-29), or AP-5 and Gal(1-29) produced significantly greater antinociception than predicted from simple additivity. In summary, the present findings reveal that 1) spinal galanin produces a reliable inhibition of formalin-induced facilitated nociceptive processing, an effect possibly mediated by GalR1 receptors; and 2) galanin potentiates i.t. morphine and AP-5-induced antinociception.     

The role of the district nurse in bereavement support

BACKGROUND: District nurses are frequently involved in the care of patients immediately prior to death and could therefore provide support to bereaved relatives. However, little is known about nurses' views on bereavement support or their actual involvement. AIMS OF THE STUDY: To survey a representative sample of district nurses to ascertain their current practice and perceived role in supporting bereaved people and to identify factors that influence their practice. DESIGN AND METHOD: A self-completed postal questionnaire was distributed anonymously to 522 district nurses in the central southern coastal area of Britain. It comprised five sections: interest in and education about bereavement; a Likert scale to measure nurses' views about bereavement care; information about the practice with which the nurse had links; bereavement care provided by the practice; and demographics. RESULTS: A 62% response rate was achieved following two reminders. Sixty-nine per cent reported having an interest in bereavement support. Logistic regression modelling identified older age of the nurse and district of employment as the best predictors of interest in bereavement, and older age of the nurse, district of employment and higher level of academic qualification (having a diploma or degree) as the best predictors of active follow-up bereavement visiting. Ninety five percent of district nurses believed their role should involve visiting bereaved relatives/carers of patients they have nursed, but only 19% believed they should visit bereaved people when the deceased was not their patient. CONCLUSIONS: Older age, higher qualifications and district of employment among district nurses were associated with greater interest in bereavement and more proactive care of bereaved people. The findings of this survey have important implications for the training, continued education and the extended role of the nurse in bereavement support.     

Anti-allodynic efficacy of the chi-conopeptide, Xen2174, in rats with neuropathic pain

Xen2174 is a structural analogue of Mr1A, a chi-conopeptide recently isolated from the venom of the marine cone snail, Conus marmoreus. Although both chi-conopeptides are highly selective inhibitors of the norepinephrine transporter (NET), Xen2174 has superior chemical stability relative to Mr1A. It is well-known that tricyclic antidepressants (TCAs) are also potent NET inhibitors, but their poor selectivity relative to other monoamine transporters and various G-protein-coupled receptors, results in dose-limiting side-effects in vivo. As TCAs and the alpha(2)-adrenoceptor agonist, clonidine, have established efficacy for the relief of neuropathic pain, this study examined whether intrathecal (i.t.) Xen2174 alleviated mechanical allodynia in rats with either a chronic constriction injury of the sciatic nerve (CCI-rats) or an L5/L6 spinal-nerve injury. The anti-allodynic responses of i.t. Mr1A and i.t. morphine were also investigated in CCI-rats. Paw withdrawal thresholds were assessed using calibrated von Frey filaments. Bolus doses of i.t. Xen2174 produced dose-dependent relief of mechanical allodynia in CCI-rats and in spinal nerve-ligated rats. Dose-dependent anti-allodynic effects were also produced by i.t. bolus doses of Mr1A and morphine in CCI-rats, but a pronounced 'ceiling' effect was observed for i.t. morphine. The side-effect profiles were mild for both chi-conopeptides with an absence of sedation. Confirming the noradrenergic mechanism of action, i.t. co-administration of yohimbine (100 nmol) with Xen2174 (10 nmol) abolished Xen2174s anti-allodynic actions. Xen2174 appears to be a promising candidate for development as a novel therapeutic for i.t. administration to patients with persistent neuropathic pain.     

A higher rare CNV burden in the genetic background potentially contributes to intellectual disability phenotypes in 22q11.2 deletion syndrome

The 22q11.2 deletion syndrome (22q11DS), the most common survivable human genetic deletion disorder, is caused by a hemizygous deletion of 30–40 contiguous genes on chromosome 22, many of which have not been well characterized. Clinical features seen in patients with this deletion, including intellectual disability, are not completely penetrant and vary in severity between patients, suggesting the involvement of variants elsewhere in the genome in the manifestation of the phenotype. Given that it is a relatively rare disorder (1/2000-6000 in humans), limited research has shed light into the contribution of these second-site variants to the developmental pathogenesis that underlies 22q11DS. As CNVs throughout the genome might constitute such a genetic risk factor for variability in the 22q11DS phenotypes such as intellectual disability, we sought to determine if the overall burden of rare CNVs in the genetic background influenced the phenotypic variability. We analyzed CNV and clinical data from 66 individuals with 22q11DS, and found that 77% (51/66) of individuals with the 22q11DS also carry additional rare CNVs (<0.1% frequency). We observed several trends between CNV burden and phenotype, including that the burden of large rare CNVs (>200 Kb in size) was significantly higher in 22q11DS individuals with intellectual disability than with normal IQ. Our analysis shows that rare CNVs may contribute to intellectual disability 22q11DS, and further analysis on larger 22q11DS cohorts should be performed to confirm this correlation.