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Objectives: Health care guidelines recommend psychological interventions for childhood unusual experiences that are associated with distress or adverse functional impact (UEDs), based on adult, rather than child-specific, evidence. We report the first randomized controlled evaluation of the acceptability and potential clinical utility of cognitive behavioural therapy for childhood UEDs (CBT-UED)., Design: Pilot randomized controlled trial., Methods: Participants aged 8-14 years were recruited from referrals to community services for children with emotional/behavioural problems and screened for self-reported UEDs., Results: Of around 1,000 referrals over 36 months, 304 (30%) were identified to the research team, 174 (57%) were successfully contacted, 110 (63%) consented to screening, 96 (87%) attended a screening assessment, and 51 (53%) reported UEDs. Forty-nine (96%) consented to randomization to either CBT-UED (9-12 weekly sessions of 40-50 min, adjunctive to usual care, n = 24) or treatment-as-usual/waitlist control (TAU/WL, n = 25). Childhood internalizing emotional symptoms (e.g., feeling 'nervous'/'scared'/'tearful'/'worried'/'sick'; proposed primary outcome), UEDs, depression, anxiety, and childhood psychopathology (secondary outcomes) were measured at baseline, at 12 weeks, and, where therapy was ongoing but incomplete (<12 sessions) at 12 weeks, at end-of-treatment (EOT). Twenty-two CBT-UED participants (92%) attended ≥5 sessions. Forty-four participants (90%) completed 12-week assessments (CBT-UED, n = 21/24, 88%; TAU/WL, n = 23/25, 92%). Preliminary findings were encouraging for emotional symptoms and UEDs, but otherwise mixed., Conclusions: Retention, screening, and consent rates were as anticipated; recruitment took longer than planned. Trial procedures were acceptable to young people, their families, and clinicians. Therapy exceeded 12 weeks, but was well-received, with no serious adverse events attributed to participation. Further evaluation is needed., Practitioner Points: Around half of 8- to 14-year-olds in Child and Adolescent Mental Health Services reported distressing unusual experiences. An age-adapted cognitive behavioural intervention appears feasible, and safe to deliver, with the potential to augment standard care. This is a pilot study, and further evaluation is needed. Longer term outcomes should be a focus of future evaluation., (© 2018 The British Psychological Society.)

Mirror self-recognition is often considered as an index of self-awareness. Neuroimaging studies have identified a neural circuit specialised for the recognition of one's own current facial appearance. However, faces change considerably over a lifespan, highlighting the necessity for representations of one's face to continually be updated. We used fMRI to investigate the different neural circuits involved in the recognition of the childhood and current, adult, faces of one's self. Participants viewed images of either their own face as it currently looks morphed with the face of a familiar other or their childhood face morphed with the childhood face of the familiar other. Activity in areas which have a generalised selectivity for faces, including the inferior occipital gyrus, the superior parietal lobule and the inferior temporal gyrus, varied with the amount of current self in an image. Activity in areas involved in memory encoding and retrieval, including the hippocampus and the posterior cingulate gyrus, and areas involved in creating a sense of body ownership, including the temporo-parietal junction and the inferior parietal lobule, varied with the amount of childhood self in an image. We suggest that the recognition of one's own past or present face is underpinned by different cognitive processes in distinct neural circuits. Current self-recognition engages areas involved in perceptual face processing, whereas childhood self-recognition recruits networks involved in body ownership and memory processing., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Range of motion of the hip joint is a major contributor to dislocation post total hip replacement. Impingement is often treated as a surrogate for dislocation and occurs--prosthetically--when the neck of the femoral component contacts with the rim of the pelvic acetabular cup. This impingement is caused by movement of the leg during activities of daily living. This article analyses hip joint range of motion and its implication for impingement. A systematic literature review was undertaken with the purpose of establishing a range of motion benchmark for total hip replacement. This paper proposes a method by which a three-dimensional range of motion boundary established from the literature can be presented. The nominal boundary is also validated experimentally using a number of configurations of a neutral hip joint coordinate frame.

Background: Episodic collapse in horses has equine welfare and human safety implications. There are, however, no published case series describing this syndrome., Objectives: To characterize the cause and outcomes for horses referred for investigation of episodic collapse., Animals: Twenty-five horses referred for investigation of single or multiple episodes of collapse., Methods: Retrospective study. Clinical records from the Dick Vet Equine Hospital, University of Edinburgh from November 1995 to July 2009 were searched using the following keywords: collapse, collapsing, fall, syncope. Collapse was defined as an incident in which the horse lost postural tone with or without progression to recumbency and with or without loss of consciousness. Long-term follow-up information was obtained by telephone conversation with the owner., Results: A final diagnosis was reached in 11 cases, namely cardiac arrhythmia (4), right-sided heart failure (1), hypoglycemia (2), generalized seizures (2), and sleep disorder (2). A presumptive diagnosis was reached in 8 cases, namely neurocardiogenic syncope (5), exercise-induced pulmonary hemorrhage (2), and generalized seizures (1). No diagnosis was reached in 6 cases despite comprehensive investigations. Three horses were euthanized at presentation. Treatment was attempted in 9 horses with 6 cases having successful outcome before discharge. Follow-up information was available for 14 of 19 horses discharged from the hospital. Only 1 of these horses was observed to collapse after discharge., Conclusions and Clinical Importance: Definitive diagnosis was more likely to be reached in cases with multiple episodes of collapse. Horses in which 1 episode of collapse occurred did not necessarily collapse again., (Copyright © 2010 by the American College of Veterinary Internal Medicine.)

Segmental limb blood pressures (BPs) measured by Doppler ultrasound and digit photoplethysmography were used to define hemodynamic correlates of wound healing in 122 lower-extremity amputations for ischemia. Healing of digit or transmetatarsal amputations were influenced by the presence of diabetes and correlated better with digit pulsation and BP than with ankle pressure. Healing of below-knee amputation did not correlate with segmental limb BPs. In the absence of an absolute threshold to predict wound healing or failure, caution is urged in using hemodynamic indices to select the level of amputation of arterial insufficiency.

Quantifying the hemodynamic results of elastic compression requires invasive and cumbersome techniques. Twenty lower extremities (normal, primary, acute and chronic post-thrombotic varicosities) were evaluated with quantitative photoplethysmography (PPG) prior and subsequent to initiating graded compression. The PPG transducer is placed against the stockings and the in vivo method of calibration is used to predict the results of compressive therapy on ambulatory venous pressure (AVP). (table see text) Noninvasive evaluation of patients with quantitative PPG techniques following compressive therapy may provide a better understanding of venous hemodynamics and a rational approach to selection of therapy.