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Research on the intergenerational transmission of abuse hypothesis often only examined the existence of abuse. The current study utilizes retrospective recalls of incarcerated male defendants (N = 414), using questions formulated from the modified Conflict Tactics Scales. Five logistic regression models are run, representing a different physical abuse measure, including incidence of physical abuse; severity of physical abuse; and three composite measures: total frequency, total severity, and total frequency/severity. Although social desirability is a limitation in any study relying on self-report data, the comparison of the chi-square values of each model may give indication that the simpler abuse measures ('incidence of physical abuse' and 'severity of physical abuse') are more predictive of later abusive behaviors than the more complex, composite measures. [ABSTRACT FROM AUTHOR]

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Neurovascular coupling (NVC) is the perturbation of cerebral blood flow (CBF) to meet varying metabolic demands induced by various levels of neural activity. NVC may be assessed by Transcranial Doppler ultrasonography (TCD), using task activation protocols, but with significant methodological heterogeneity between studies, hindering cross-study comparisons. Therefore, this review aimed to summarise and compare available methods for TCD-based healthy NVC assessments. Medline (Ovid), Scopus, Web of Science, EMBASE (Ovid) and CINAHL were searched using a predefined search strategy (PROSPERO: CRD42019153228), generating 6006 articles. Included studies contained TCD-based assessments of NVC in healthy adults. Study quality was assessed using a checklist, and findings were synthesised narratively. 76 studies (2697 participants) met the review criteria. There was significant heterogeneity in the participant position used (e.g., seated vs supine), in TCD equipment, and vessel insonated (e.g. middle, posterior, and anterior cerebral arteries). Larger, more significant, TCD-based NVC responses typically included a seated position, baseline durations >one-minute, extraneous light control, and implementation of previously validated protocols. In addition, complementary, combined position, vessel insonated and stimulation type protocols were associated with more significant NVC results. Recommendations are detailed here, but further investigation is required in patient populations, for further optimisation of TCD-based NVC assessments., Competing Interests: Data availabilityThis was a systematic review of existing research studies and no primary research was conducted. Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Remote patient monitoring (RPM) beat-to-beat blood pressure (BP) provides an opportunity to measure poststroke BP variability (BPV), which is associated with clinical stroke outcomes. BP sampling interval (SI) influences ambulatory BPV, but RPM BP SI optimisation research is limited. SI and RPM device capabilities require compromises, meaning SI impact requires investigation. Therefore, this study assessed healthy and stroke subtype BPV via optimised BP sampling, aiding sudden BP change identification and potentially assisting cardiovascular event (recurrent stroke) prediction., Methods: Leicester Cerebral Haemodynamic Database ischaemic [acute ischaemic stroke (AIS), n  = 68] and haemorrhagic stroke (intracerebral haemorrhage, n  = 12) patient and healthy control (HC, n  = 40) baseline BP data were analysed. Intrasubject and interpatient SD (SD i /SD p ) represented individual/population variability with synthetically altered SIs. Matched-filter approaches using cross-correlation function detected sudden BP changes., Results: At SIs between 1 and 180 s, SBP and DBP SD i staticised while SD p increased at SI < 30 s. Mean BP and HR SD i and SD p increased at SI < 60s. AIS BPV, normalised to SI1s, increased at SI30s (26%-131%) and SI120s (1%-274%). BPV increased concomitantly with SI. Cross-correlation analysis showed HC and AIS BP sudden change detection accuracy reductions with increasing SI. Positive BP deviation detection fell 48.48% (SI10s) to 78.79% (SI75s) in HC and 67.5% (SI10s) to 100% (SI75s) in AIS. Negative BP deviation detection fell 50% (SI10s) to 82.35% (SI75s) in HC and 52.27% (SI10s) to 95.45% (SI75s) in AIS., Conclusion: Sudden BP change detection and BPV are relatively robust to SI increases within certain limits, but accuracy reductions generate unacceptable estimates, considerable within RPM device design. This research warrants further SI optimisation., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Previous studies report contradicting age-related neurovascular coupling (NVC). Few studies assess postural effects, but less investigate relationships between age and NVC within different postures. Therefore, this study investigated the effect of age on NVC in different postures with varying cognitive stimuli. Beat-to-beat blood pressure, heart rate and end-tidal carbon dioxide were assessed alongside middle and posterior cerebral artery velocities (MCAv and PCAv, respectively) using transcranial Doppler ultrasonography in 78 participants (31 young-, 23 middle- and 24 older-aged) with visuospatial (VST) and attention tasks (AT) in various postures at two timepoints (T2 and T3). Between-group significance testing utilized one-way analysis-of-variance (ANOVA) (Tukey post-hoc). Mixed three-way/one-way ANOVAs explored task, posture, and age interactions. Significant effects of posture on NVC were driven by a 3.8% increase from seated to supine. For AT, mean supine %MCAv increase was greatest in younger (5.44%) versus middle (0.12%) and older-age (0.09%) at T3 (p = 0.005). For VST, mean supine %PCAv increase was greatest at T2 and T3 in middle (10.99%/10.12%) and older-age (17.36%/17.26%) versus younger (9.44%/8.89%) (p = 0.004/p = 0.002). We identified significant age-related NVC effects with VST-induced hyperactivation. This may reflect age-related compensatory processes in supine. Further work is required, using complex stimuli while standing/walking, examining NVC, aging and falls., (© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

The U.S. Army employs over 470,000 active duty soldiers throughout the world. Although the Army also employs hundreds of public health professionals, public health recommendations are often not framed in ways that are readily actionable to senior Army leaders. This case study shows how public health findings were translated into actionable recommendations using the Army Design Methodology (ADM) and subsequently implemented by installation leadership. Following a perceived increase in suicides at Fort Wainwright, Alaska, in 2019, installation leadership requested that the U.S. Army Public Health Center conduct an epidemiological consultation. A mixed-methods approach was used to gather qualitative and quantitative data. The ADM was used to translate the findings and provide actionable recommendations for senior Army leaders. Many recommendations were implemented within a year of the report's release and included modifications to gym facilities, dining halls, and sleeping areas. Key improvements included the installation of $900,000 worth of new gym equipment in existing physical fitness facilities, increasing the basic daily food allowance by 44% to facilitate the purchase of healthy options, and the installation of blackout blinds in all barracks to ensure more restful sleep during times of peak sunlight. The ADM is well understood by senior Army leaders. Use of the ADM in future military-specific public health studies could ensure a more effective uptake and implementation of public health recommendations., (Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2021. This work is written by (a) US Government employee(s) and is in the public domain in the US.)

Objective: Cocaine use is increasing. Comorbidities and diagnostic sequencing are needed among college students to inform treatment of cocaine use disorder (CUD). Method: Using electronic medical records from the psychiatric clinic at the student health care center of a large, public university from 2005 to 2015, patients diagnosed with CUD were identified. Their top mental health conditions were identified and assessed to see whether the first diagnosis of these conditions was made (1) before, (2) at the same time as, or (3) after the first diagnosis of CUD. Results: Among the 50 CUD patients, their most common mental health comorbidities were alcohol use disorder, anxiety, depression, and cannabis use disorder. Anxiety and depression were likely to be diagnosed before CUD; alcohol and cannabis use disorders were likely to be diagnosed concurrently with CUD. Conclusion : Diagnostic sequencing can be used to inform screening, workup, and treatment for patients with CUD.

Objective: The objective of this study was to examine clinical and epidemiological information collected by Student Health Center (SHC) providers on HIV-positive students, and benchmark this information against Infectious Disease Society of America guidelines. Participants: Students who utilized the SHC and had an ICD-9 code indicating positive HIV status between 2005 and 2015 ( 3  = 7). Methods: In June 2016, we accessed the free-form provider notes of the SHC's electronic medical records to identify specific, recorded epidemiological and clinical information. Results: Seven unique students sought care at the SHC during the study period. Current sexual risk taking and other known behavioral risk factors were absent from all records, along with CD4 count and viral load. ART status was only available for one patient, and he was not on ART. The information collected failed to meet IDSA benchmarks. Conclusion : Clinically- and epidemiologically-relevant information is not systematically collected from HIV-positive students at SHCs.

Purpose: AMD is the leading cause of irreversible blindness in older individuals in the Western world, and there are currently no therapies to halt disease progression. Studies suggest that the commonly prescribed antidiabetic drug, metformin, is associated with decreased risk of several ocular diseases, but no work has investigated the effect of metformin use on development of AMD. Thus, we aim to investigate whether metformin use is associated with decreased risk of developing AMD., Methods: In this retrospective case-control study, we used medical records from patients older than 55 who have visited a University of Florida health clinic. Three controls were matched for every AMD case, defined by International Classification of Diseases, Ninth Revision code, based on the Charlson Comorbidity Index to ensure comparable baseline overall health status. Univariate and conditional multivariable logistic regressions were used to determine the association between a variety of covariates, including metformin use, and AMD diagnosis., Results: Metformin use was associated with decreased odds of developing AMD, independently of the other covariates investigated, with an odds ratio of 0.58 and a 95% confidence interval of 0.43 to 0.79. Other medications assessed were not associated with decreased odds of developing AMD., Conclusions: Patients who had taken metformin had decreased odds of developing AMD, suggesting that metformin may have a therapeutic role in AMD development or progression in those who are at risk. Further work should include clinical trials to investigate prospectively whether metformin has a protective effect in those at risk for developing AMD.

Background: Beginning in December 2013, an epidemic of chikungunya virus (CHIKV) infection spread across the Caribbean and into virtually all countries in the Western hemisphere, with >2.4 million cases reported through the end of 2017., Methods: We monitored a cohort of school children in rural Haiti from May 2014, through February 2015, for occurrence of acute undifferentiated febrile illness, with clinical and laboratory data available for 252 illness episodes., Results: Our findings document passage of the major CHIKV epidemic between May and July 2014, with 82 laboratory-confirmed cases. Subsequent peaks of febrile illness were found to incorporate smaller outbreaks of dengue virus serotypes 1 and 4 and Zika virus, with identification of additional infections with Mayaro virus, enterovirus D68, and coronavirus NL63. CHIKV and dengue virus serotype 1 infections were more common in older children, with a complaint of arthralgia serving as a significant predictor for infection with CHIKV (odds ratio, 16.2; 95% confidence interval, 8.0-34.4; positive predictive value, 66%; negative predictive value, 80%)., Conclusions: Viral/arboviral infections were characterized by a pattern of recurrent outbreaks and case clusters, with the CHIKV epidemic representing just one of several arboviral agents moving through the population. Although clinical presentations of these agents are similar, arthralgias are highly suggestive of CHIKV infection., (© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.)

Urinary tract infections (UTIs) are common among college-aged women and often recur. Some antibiotics recommended to treat UTIs trigger dysbiosis of intestinal and vaginal microbiomes - where uropathogens originate, though few studies have investigated associations between these therapies with recurrent infections. We retrospectively analysed the electronic medical records of 6651 college-aged women diagnosed with a UTI at a US university student health centre between 2006 and 2014. Women were followed for 6 months for incidence of a recurrent infection. In a secondary analysis, associations in women whose experienced UTI recurrence within 2 weeks were also considered for potential infection relapse. Logistic regression was used to assess associations between infection recurrence or relapse and antibiotics prescribed, in addition to baseline patient characteristics including age, race/ethnicity, region of origin, year of encounter, presence of symptomology, pyelonephritis, vaginal coinfection and birth control consultation. There were 1051 instances of infection recurrence among the 6620 patients, indicating a prevalence of 16%. In the analysis of patient characteristics, Asian women were statistically more likely to experience infection recurrence whereas African American were less likely. No significant associations were identified between the antibiotic administered at the initial infection and the risk of infection recurrence after multivariable adjustment. Treatment with trimethoprim-sulphamethoxazole and being born outside of the USA were significantly associated with increased odds of infection relapse in the multivariate analysis. The results of the analyses suggest that treatment with trimethoprim-sulphamethoxazole may lead to an increased risk of UTI relapse, warranting further study.

The adenovirus vaccine and benzathine penicillin G (BPG) have been used by the US military to prevent acute respiratory diseases (ARD) in trainees, though these interventions have had documented manufacturing problems. We fit Poisson regression and random forest models (RF) to 26 years of weekly ARD incidence data to explore the impact of the adenovirus vaccine and BPG prophylaxis on respiratory disease burden. Adenovirus vaccine availability was among the most important predictors of ARD in the RF, while BPG was the ninth most important. BPG was a significant protective factor against ARD (incidence rate ratio (IRR) = 0.68; 95% confidence interval (CI) 0.67-0.70), but less so than either the old or new adenovirus vaccine (IRR = 0.39, 95% CI 0.38-0.39 and IRR = 0.11, 95% CI 0.11-0.11), respectively. These results suggest that BPG is moderately predictive of, and significantly protective against ARD, though to a lesser extent than either the old or new adenovirus vaccine.

The goal of this study was to assess morbidity, mortality, and health-seeking behaviours during the 2014 Ebola outbreak in Monrovia, Liberia. This study examined commonly reported symptoms of illness, pre-clinical diagnostic practices, typical healthcare-seeking strategies, and health resources available to populations, in order to identify salient needs and gaps in healthcare that would inform local emergency response efforts. Semi-structured interviews were conducted with household members in four Monrovia neighbourhoods. Researchers used a multi-stage cluster approach to recruit participants. Within 555 households sampled, 505 individuals were reported sick (69%) or recently sick (38%) or deceased (7%). Common self-diagnoses included malaria, hypertension, influenza, typhoid, and Ebola. The most cited health-seeking strategy was to purchase medications from the private sector. Respondents also obtained healthcare from community members known to have medical experience. Findings suggest that non-formal healthcare systems played an important role in managing morbidity during the West African Ebola virus disease (EVD) outbreak. Lay community members engaged in complex assessments of health symptoms and sought biomedical care at rates perhaps higher than anticipated during the response. This study highlights how informal networks of healthcare providers can play an important role in preventing and curbing future emerging disease outbreaks.

Background: The geographic distribution and burden of dengue is increasing globally. This study aims to evaluate dengue outbreaks and to substantiate the need for strengthened surveillance, reporting and control in Eritrea., Methods: Data from two cross-sectional dengue epidemic investigations in 2005 and 2010 were analyzed. Samples were tested for dengue virus-specific IgM and IgG antibodies using capture enzyme-linked immunosorbent assays. Dengue vectors' breeding attributes were characterized and epidemic risk indices determined. National routine surveillance weekly reports from 2005 to the second quarter of 2015 were analyzed for spatiotemporal trends., Results: Dengue outbreaks increased in Eritrea from 2005 to 2015 with clinical presentation varying markedly among patients. The house and container indices for Aedes aegypti were 40 and 39.6 % respectively, with containers having A. aeqypti varying significantly ( P  < 0.04). Serum from 33.3 % ( n  = 15) and 88 % ( n  = 26) of clinical dengue cases in Aroget sub-Zoba (district) of Gash Barka Zoba (region) contained anti-DENV IgM antibody in 2005 and 2006, respectively. The national surveillance data from 2005 to 2015 indicate an overall spatiotemporal increase of dengue fever., Conclusions: The increase in dengue outbreaks has been confirmed in Eritrea and necessitates strengthening of surveillance and health worker and laboratory capacity, as well as targeted vector control interventions.

Background: Zika virus (ZIKV) is an emerging arbovirus transmitted to humans by Aedes mosquitoes, the same vectors that transmit dengue virus and chikungunya. Recent work has suggested that prior infection with dengue could lead to more severe clinical disease in ZIKV patients. Here, we describe the spatial distribution of and clinical symptoms experienced by ZIKV cases in Mexico., Methods: We performed Fisher's Exact test and Pearson's Chi-Square tests on data from Mexico's national surveillance system on the demographic and clinical characteristics of ZIKV patients (N=84), and then a multivariate logistic regression analysis to determine demographic risk factors for patients presenting with at least 9 symptoms. We also mapped the cases to describe the spatial distribution of ZIKV in Mexico., Results: Results from the multivariate logistic regression analysis indicate that, controlling for all covariates, sex (male) is a significant protective factor in reporting a high number of symptoms (OR=0.36, 95% CI: 0.14, 0.92), and that a one-year increase in age is associated with a 4% increase in odds of having at least 9 symptoms (95% CI: 1.00, 1.08). Spatial analysis revealed more than 50% cases reported within 50km of railways., Conclusion: We found that sex and age are both significant risk factors for ZIKV infection severity, using number of reported symptoms as a proxy. The presence of cases along railways indicates that transportation networks within Mexico may be relevant for the national and international spread of the disease., (Copyright © 2016 Elsevier B.V. All rights reserved.)

in groundwaters from 145 wells across central West Bengal, India, those from Pleistocene aquifers at depths >70 m beneath paleo-interfluves contain <10 μg/L As. Pleistocene aquifers beneath deep paleo-channels typically host groundwaters containing 10-100 μg/L As at depths between 120 and 180 m. The depth profiles of As and SO4 and the conservative tracers Cl/Br, δ(18)O, and δ(2)H show that the As in Pleistocene groundwater beneath deep paleo-channels is relict and does not arise from migration downward of As-polluted groundwater in overlying aquifers. We postulate that the As was liberated in situ by reduction of minimal iron oxyhydroxides in the gray Pleistocene sands by organic matter infiltrating from riverbeds during late Pleistocene or earliest Holocene times. Mitigation of the widespread As-pollution in shallow aquifers through exploitation of deep Pleistocene aquifers would improve if guided by an understanding of the distribution of buried paleo-channels and paleo-interfluves and the knowledge that As may be present naturally in groundwater at depths >150 m beneath deep paleo-channels.

Objectives: The purpose of this study was to evaluate neuropsychological test data in school-aged children whose fetal sonograms revealed mild isolated cerebral ventriculomegaly without asymmetry of the lateral ventricles., Methods: Nine of 52 children 6 years and older with sonographic evidence of mild isolated cerebral ventriculomegaly without asymmetry of the lateral ventricles were able to be recruited for follow-up school-aged neuropsychological testing. The children received a half-day battery of neuropsychological tests, including the Wechsler Abbreviated Scales of Intelligence; Beery-Buktenica Developmental Test of Visual Motor Integration, Fifth Edition; Wide Range Achievement Test, Fourth Edition; and Integrated Visual and Auditory Continuous Performance Test. Parents completed the Conners 3 Parent Short Form and the Personality Inventory for Children, Second Edition., Results: In this small group, other risk factors for neurodevelopmental disorders were often present, including preterm birth, perinatal hypoxia, and a family history of psychiatric disease or substance abuse. Within this sample, the proportion of children with a pattern of test results showing poorer nonverbal intelligence than verbal intelligence scores and poorer math than reading performance, as well as meeting criteria for a diagnosis of attention deficit/hyperactivity disorder, was higher than the basal rates of these problems among children in general., Conclusions: Particularly given the complexity of various factors affecting neurodevelopment, follow-up neuropsychological evaluation is warranted in children with sonographic evidence of mild isolated cerebral ventriculomegaly without asymmetry of the lateral ventricle (eg, in the context of poor school performance).

Objective: In this article, the authors investigated the effectiveness of a behavior modification program using global positioning system (GPS) vehicle tracking devices with contingency incentives and disincentives to reduce the speeding behavior of drivers with ADHD., Method: Using an AB multiple-baseline design, six participants drove a 5-mile stable driving route weekly while GPS devices recorded speeds. The dependent variable was percentage of feet speeding. Following an initial baseline period, five participants received treatment. One participant remained at baseline., Results: Visual inspection of individual participant graphs, reductions in mean percentages of speeding from baseline to treatment across participants (M = 82%), C-statistic analyses, and visual graphs with applied binomial formula supported a treatment effect. The between-participant analysis using R n Test of Ranks was significant, R n = 6, p < .01, and complemented a clean multiple-baseline result., Conclusion: Results indicated that this treatment program was effective in reducing speeding by drivers with ADHD and warrants replication.

Statement of Problem: Although pure titanium is known to have good biocompatibility, a titanium alloy with better strength is needed for fabricating clinically acceptable, partial removable dental prosthesis (RDP) frameworks., Purpose: The mechanical properties of an experimental Ti-5Al-5Cu alloy cast with a 2-step investment technique were examined for RDP framework applications., Material and Methods: Patterns for tests for various properties and denture frameworks for a preliminary trial casting were invested with a 2-step coating method using 2 types of mold materials: a less reactive spinel compound (Al(2)O(3)·MgO) and a less expensive SiO(2)-based material. The yield and tensile strength (n=5), modulus of elasticity (n=5), elongation (n=5), and hardness (n=8) of the cast Ti-5Al-5Cu alloy were determined. The external appearance and internal porosities of the preliminary trial castings of denture frameworks (n=2) were examined with a conventional dental radiographic unit. Cast Ti-6Al-4V alloy and commercially pure titanium (CP Ti) were used as controls. The data for the mechanical properties were statistically analyzed with 1-way ANOVA (α=.05)., Results: The yield strength of the cast Ti-5Al-5Cu alloy was 851 MPa and the hardness was 356 HV. These properties were comparable to those of the cast Ti-6Al-4V and were higher than those of CP Ti (P<.05). One of the acrylic resin-retention areas of the Ti-5Al-5Cu frameworks was found to have been incompletely cast., Conclusions: The cast biocompatible experimental Ti-5Al-5Cu alloy exhibited high strength when cast with a 2-step coating method. With a dedicated study to determine the effect of sprue design on the quality of castings, biocompatible Ti-5Al-5Cu RDP frameworks for a clinical trial can be produced., (Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.)

This study uses the National Longitudinal Study of Adolescents (Add Health) data, a nationally representative sample of adolescents, to disentangle the relationship between child maltreatment and violent delinquency. Also examined are potential moderating effects of gender, socioeconomic status (SES), and religiosity on the association between child maltreatment and violent delinquency. Contrary to prior research findings, the current analyses reveal that physical abuse is not associated with future violent delinquency, whereas sexual abuse and neglect predict violent delinquency significantly. The current study also did not reveal any moderating effects of gender, SES, and religiosity on the association between maltreatment and violent delinquency. Interpretations of these findings are presented, drawing on the properties of the national probability sample compared to the findings of most prior studies that used localized samples.

This paper is based on an invited address for the Association of Psychologists in Academic Health Centers (APAHC) at the 2010 American Psychological Association (APA) Convention in San Diego, California. It is in response to the Ivan Mensh Award for Distinguished Achievement in Teaching presented to the author at the 2009 APA Convention. This article addresses two key themes in the instruction and professional development of clinical psychologists: internalization and management matters. The author asserts that these process and content topics characterize critical training ingredients in preparing students for the future practice of clinical psychology within modern academic health care settings.

While the application of normative standards is vital to the practice of clinical neuropsychology, data regarding normative change remains scarce despite the frequency of serial assessments. Based on 285 normal individuals, we provide co-normed baseline data with demographic adjustments and test-retest standardized regression based (SRB) models for three time points for several measures. These models delineate normal, expected change across time, and yield standardized z-scores that are comparable across tests. Using a new approach, performance on any previous trial was accounted for in the subsequent models of change, yielding serial normative formulas that model change trajectories rather than simple change from point to point. These equations provide indices of deviation from expected baseline and change for use in clinical or research settings.

Various Barona formulae, a WTAR algorithm based on demographic data, and WRAT-3 oral reading methods of estimating premorbid ability were compared in a diverse research sample of 119 subjects. These methods were correlated with one another and with a modified version of the Raven Standard Progressive Matrices. Descriptive data are provided to illustrate advantages and disadvantages of various methods of estimating premorbid ability when no formal intellectual testing is available. While predicting premorbid ability for individual subjects involves varying degrees of error, we found that the revised Barona formula was superior to the original formula for subjects at the upper end of ability level. When researchers have screened out learning disability and have subject samples with few individuals likely to be of superior premorbid intelligence, oral reading scores are a reasonable measure of premorbid ability. Otherwise, researchers are advised to use both demographic and oral reading methods to estimate premorbid ability.

Little research has evaluated the validity of the Coping Deficit Index (CDI) of the Rorschach Comprehensive System (CS). Because the CS Depression Index (DEPI) has frequently been found to yield false negatives, the CDI has been proposed as an alternative means of assessing social coping skills that may relate to depression. This study examined potential correlates of the CDI using the Personality Inventory for Children-Second Edition (PIC-2). Sixty-five children and adolescents were assessed with the Rorschach CS and the PIC-2. None of the PIC-2 clinical scales or subscales measuring withdrawal or social skills predicted a positive CDI, and none of the depression-related PIC-2 scales predicted a positive CDI or DEPI. The only significant relationship found was a negative relationship between the CDI and a PIC-2 subscale measuring sleep problems and preoccupation with death. Implications of these findings for clinicians and further research are discussed.

Purpose: The primary purposes of this study were: (1) to describe the number and types of complications patients had before and after insertion of a removable prosthesis (i.e., denture) following radiation therapy to the head and neck and (2) to investigate whether the time between radiation therapy and denture insertion might contribute to those complications., Materials and Methods: This research evaluated edentulous patients and those who were rendered edentulous as a result of their cancer treatment. After obtaining institutional approval following HIPAA regulations, a total of 349 charts were identified: 152 patients from Houston Veterans Administration Medical Center (HVAMC) and 197 patients from M. D. Anderson Cancer Center (MDACC). A total of 190 patients met the inclusion criteria with data available for review., Results: No significant differences were found in any of the comparisons made, except when comparing complications that occurred after the dentures were inserted and the amount of time it took for prosthetic rehabilitation. The majority of patients had no complications. The patients who received their dentures in 180 days or less had the same number of complications when compared with those patients who received their dentures in 181 to 365 days and those who had to wait longer than a year for prosthetic rehabilitation. Patients with more pre-insertion complications tended to have delayed prosthetic rehabilitation. Those patients who had complications both before and after denture insertion tended to have bilateral dosing of their radiation treatment. Patients who had received radiation therapy were 1.7 times more likely to have post-prosthesis insertion complications. The majority of patients who experienced complications before and after denture insertion had greater than 5000 cGy., Conclusions: The numbers of complications reviewed in this retrospective analysis were considerably fewer than the number expected. There appears to be no difference in the number of pre- and post-insertion complications as a function of the time delay from oral surgical procedure to start of radiation treatment (10 to 21 days vs. 22 days or more)., (Copyright (c) 2005 by The American College of Prosthodontists.)

The present study evaluated an alternative method of neuropsychological test interpretation for the classification of Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. Specifically, an intra-individual discrepancy analysis was implemented in which differences between intellectual functioning and performance on a battery of six frontal/executive tests were examined within a homogeneous group of ADHD adults and matched normal controls. Significant group differences were identified between the ADHD adults and control sample on each of the dependent measures, with moderate diagnostic efficiency rates for the individual measures and a Discrepancy Impairment Index (DII). The discrepancy analysis approach generated significantly greater sensitivity in detecting the presence of ADHD as compared to a level of performance interpretive approach. Overall, these results provide support for the consideration of discrepancies between intellectual ability and frontal/executive functioning for the assessment of adult ADHD.

64 normal adult controls (53 men, 11 women; M age 45.2 yr.) in a study of an estuary-associated syndrome were administered the MMPI-2-180 and the Neuroticism scale from the NEO-Personality Inventory. Pearson product-moment correlations between MMPI-2 scales and the Neuroticism scale were similar to those reviously reported using the full-length MMPI. Correlations between MMPI-2 scales, D, Pt, Sc, and Si, and NEO-PI Neuroticism (range .44 to .52) suggest that many psychiatric conditions are associated with psychological distress of the type individuals high in trait neuroticism are prone to experience.

The role of neuropsychological evaluation in the diagnosis of adults with Attention-Deficit/Hyperactivity Disorder (ADHD) is a growing area of research and clinical interest. Our review of the literature indicates that adults with ADHD demonstrate subtle impairments on select measures of attention and executive functions, auditory-verbal list learning, and complex information processing speed relative to normal controls. The validity of these findings is nonetheless hampered by several limitations, including methodological and sample variability, a restricted range of interpretive techniques, and uncertain discriminant validity. Recommendations are offered to advance the cognitive and neurobehavioral understanding of this disorder and to enhance the utility of neuropsychological methods for diagnosis and management of adults with ADHD.

A variety of human symptoms have been associated with exposure to the dinoflagellate Pfiesteria and have been grouped together into a syndrome termed "possible estuary-associated syndrome." Prospective cohort studies of health effects associated with exposure to estuarine waters that may contain Pfiesteria spp. and related organisms are in progress in North Carolina, Virginia, and Maryland. The three studies recruited cohorts of 118-238 subjects who work or engaged in recreation in estuary waters. Baseline health and neuropsychological evaluations are conducted, and study subjects are followed prospectively for 2-5 years with periodic assessments of health and performance on a battery of neuropsychological tests. Health symptoms and estuary water exposure are recorded by telephone interviews or diaries every 1-2 weeks. Water quality information, including measurements of Pfiesteria spp., is collected in the areas where the subjects are working. Because it is not possible to measure individual exposure to Pfiesteria or a toxin produced by this organism, these studies examine surrogate exposure measures (e.g., time spent in estuary waters, in a fish kill area, or in waters where Pfiesteria DNA was detected by molecular amplification). Preliminary analyses of the first 2 years (1998-2000) of data indicate that none of the three ongoing cohorts have detected adverse health effects. However, there have not been any reported fish kills associated with Pfiesteria since the studies began, so it is possible that none of the study subjects have been exposed to toxin-producing Pfiesteria spp.

This paper discusses the implications of Periventricular Leukomalacia (PVL) lesions for the development of Nonverbal Learning Disabilities (NLD) as illustrated through an identical twin case study. PVL lesions were identified in an 8-year-old child, but were not detected in his identical twin brother who served as a matched comparison. While the nonclinical twin displayed a largely unremarkable neuropsychological profile, the clinical twin evidenced a distinct pattern of social, intellectual, academic, and neuropsychological test results often identified among children with PVL and those with the NLD syndrome. The clinical and theoretical implications for this case study are discussed.

ADHD adults (N = 26) were compared to normal controls (N = 26) on 6 neuropsychological measures believed sensitive to frontal lobe-executive functioning. MANOVA analyses and subsequent univariate tests indicated that most of the neuropsychological measures discriminated between the two groups. To address clinical significance diagnostic classification rates were also generated for each measure individually, and for the battery as a whole. Levels of positive predictive power (PPP) for each of the 6 measures (83-100%) indicated that abnormal scores on these tests were good predictors of ADHD. However, estimates of negative predictive power (NPP) suggested that normal scores poorly predicted the absence of ADHD. When classification rates were calculated for the overall battery classification accuracy improved substantially. Thus, neuropsychological tests can differentiate adults suffering from ADHD from adults without ADHD, while also providing good classification accuracy. Finally, the pattern of neurobehavioral impairments exemplified through the Summary Index scores was interpreted as consistent with conceptualizations of ADHD depicting mild neurologic dysfunction in networks associated with the frontal lobes.

Certain 4- and 5-oxoacids may exist in their cyclic lactol (or pseudoacid) forms. These commonly occur in compounds with proximate carboxylic acid and carbonyl (aldehyde or ketone) functions for the formation of five- or six-membered rings. Examples include trans-2,3-disubstituted aliphatic, (Z)-2,3-olefinic and o-disubstituted aromatic acids. Crystal structures of compounds in these categories are reported: trans-4-methyl-3-oxo-6-hydroxytetrahydropyran-3-carboxylic acid (6), monoclinic, C2/c, a = 25.412 (5), b = 6.291 (1), c = 10.757 (2) A, beta = 104.84 (3) degrees; penicillic acid (7), 4-methoxy-5-hydroxy-5-(2'-propenyl)dihydrofuran-2-one, tetragonal, P4(2)/n, a = b = 15.83 (2), c = 7.016 (11) A; mucochloric acid (8), (Z)-3,4-dichloro-5-hydroxydihydrofuran-2-one, triclinic, P1, a = 6.227 (5), b = 8.085 (5), c = 12.369 (9) A, alpha = 99.50 (5), beta = 102.38 (6), gamma = 90.29 (6) degrees; 2-methanoylbenzoic acid (9), 3-hydroxy-1-(3H)-isobenzofuranone, monoclinic, P2(1), a = 4.006 (1), b = 11.489 (2), c = 7.347 (1) A, beta = 97.50 (3) degrees; 2-ethanoylbenzoic acid (10), 3-hydroxy-3-methyl-1-(3H)-isobenzofuranone, orthorhombic, P2(1)2(1)2(1), a = 5.199 (6), b = 9.651 (14), c = 15.950 (17) A; 2-(2'-oxoethyl)benzoic acid (11), 3-hydroxy-3,4-dihydroisobenzopyran-1-one, monoclinic, P2(1)/n, a = 4.651 (3), b = 11.886 (7), c = 14.312 (11) A, beta = 90.86 (6) degrees. These compounds also exist in the cyclic forms in chloroform solution. A trimeric cyclic trioxane structure, analogous to paracetaldehyde, is confirmed as the solid form of 5-oxopentanoic acid (1), triclinic, P1, a = 5.640 (4), b = 8.571 (8), c = 18.962 (13) A, alpha = 78.68 (6), beta = 84.34 (5), gamma = 80.38 (6) degrees. In solution (NMR), mixtures of the open aldoacid, trimeric acid and cyclic pseudoacid exist. In both furanoid and pyranoid pseudoacids, endocyclic lactol C-O bond lengths are lengthened (1.46-1.48 A), while the exocyclic C-O(H) bonds are shortened (1.38 A). Pseudoacids commonly form hydrogen-bonded chains linking the lactol hydroxy and carbonyl groups, but 3-hydroxy-3,4-dihydroisobenzopyran-1-one forms distinctive hydrogen-bonded dimers.

Surveyed parents of children with and without ADHD for their perceptions of their children's sleep patterns. All children had been referred for learning or behavior problems to an outpatient assessment center. Diagnoses of ADHD were based on DSM-III-R, rather than DSM-III criteria, avoiding a possible confound from diagnostic criteria that formerly included sleep disturbance as a defining characteristic of ADHD. Data replicated past findings showing that parents perceive children with ADHD to have greater sleep difficulty than normally developing children. Parents perceived few differences between sleep patterns of children with ADHD who were taking or not taking stimulant medication. Implications of these findings are discussed in the context of past literature and present clinical practice.

One hundred and two mothers of adolescents and young adults with traumatic brain injury completed a modified Grief Experience Inventory (GEI) (Sanders, Mauger, & Strong, 1985) and rated their child's functioning on a modified Neurobehavioral Rating Scale (NRS) (Levin et al., 1987). More severe grief was reported by mothers who rated their children as having poor neurobehavioral functioning and by mothers of young adult rather than adolescent patients. The guilt component of grief varied significantly across the 3-year post-injury period measured in the study. Historical comparisons of these respondents with other bereaved populations showed that mothers of adolescent and young adults with head injury reported more intense grief than parents who had experienced other significant non-death losses.

Surveys regarding practitioner perceptions of time requirements for psychological testing were mailed to a national sample of clinical psychologists. There were 228 (36%) returns from 630 mailings actually received. On the basis of 151 usable returns from respondents who conduct psychological testing services, data are presented separately for time requirements associated with administering, scoring, and interpreting the 24 most commonly used tests. Data are also presented regarding the composition of typical test batteries and practitioner usage of technician and/or computer assistance in psychological testing. The implications of these data for research and practice are discussed.

For more than two decades, conventional radionuclide techniques have been employed for the noninvasive evaluation of cardiac function. Standardized techniques have been developed and are widely available. Extensive clinical experience has confirmed the reliability of these techniques and has established important roles in providing diagnostic and prognostic information. Conventional radionuclide cardiac imaging currently emphasizes the demonstration of abnormalities in myocardial perfusion and ventricular function. Myocardial and radionuclide studies are infrequently employed but can offer helpful information in specific clinical situations.

Exner (1983, 1986) developed and recently revised (1990b) a Rorschach Depression Index based on scores from variables in the Comprehensive System. This study evaluated both the original and the revised DEPIs for child and adolescent outpatient (n = 67) and inpatient (n = 99) samples in order to assess the diagnostic utility of these indices. There were no significant relationships between the original form and the revised form of the DEPI and clinical elevations on the Depression scale of the Personality Inventory for Children in the outpatient sample or treatment team diagnostic judgments in the inpatient sample. These findings sound a strong cautionary note for using only Rorschach Depression indices to diagnose depression in children and adolescents.

This article presents a Meta-Analysis of previous HIV-related neuropsychological research and new data from a study with methodological improvements over early investigations. In this study, the authors compared neuropsychological testing for three groups of adult male homosexuals: (a) HIV seronegative controls (n = 30), (b) HIV seropositive non-AIDS subjects (n = 27), and (c) diagnosed AIDS patients (n = 26). Groups were matched for age, education, and handedness, and subjects with other neurobehavioral risk factors were excluded. Subjects with AIDS performed worse than other groups on all tests, with 80% showing clinical impairment. HIV seropositive non-AIDS subjects differed from controls on 3 of 14 tests, with 33% showing clinical impairment. Group differences remained significant even after covarying for psychological distress, using the General Severity Index (GSI) of the Symptom Checklist-90-Revised as the covariate. These results are discussed in reference to findings from the Meta-Analysis of previous research and implications for future research.

One hundred seventy-nine psychiatric inpatients were administered the WAIS-R and several neuropsychological and academic achievement tests. All subjects were assigned to three groups based on their WAIS-R's VIQ-PIQ discrepancy scores: (i) Low Verbal (Verbal IQ < Performance IQ. by at least 13 points); (ii) Low Performance (Performance IQ < Verbal IQ by at least 13 points); and (iii) Equal (Verbal IQ-Performance IQ within 13 points). The Low Verbal group made significantly more errors on the Speech Sounds Perception Test, demonstrated lower spelling scores, evinced more aphasic signs, and had had more special education placements than did the Equal or Low Performance groups. The Low Performance subjects demonstrated significantly more signs of constructional dyspraxia and performed more poorly on the Grooved Pegboard test. The neuropsychiatric patients who had Verbal-Performance IQ discrepancies of at least one standard deviation may be at risk for specific, subtle neuropsychological deficits.

This study compared Tc-99m pyrophosphate (PPi) and Tc-99m methylene diphosphonate (MDP) for myocardial infarct imaging in 24 patients with diagnosed acute myocardial infarction. The radiopharmaceuticals were administered randomly and interpreted without knowledge of the sequence used. Twenty-three patients (96%) had positive Tc-99m PPi scintigrams, but only 17 (71%) had a positive Tc-99m MDP study (P less than 0.05). In addition, a comparison of the relative intensity with each agent revealed greater intensity with Tc-99m in 21 cases, equal intensity in two cases, and less intensity in only one case (p less than 0.001). These findings support the superiority of Tc-99m PPi as the agent of choice for myocardial scintigraphy in acute infarction.

This study investigated MMPI characteristics of male and female adolescent inpatients with diagnoses of borderline personality disorder (n = 28) in contrast to adolescent inpatients receiving principal diagnoses of conduct disorder (n = 21), dysthymic disorder (n = 50), other personality disorders (n = 17), and other diagnoses (n = 30). The borderline group has significantly higher elevations than comparison groups on MMPI scales F, Hs, D, Pd, Pa, Pt, Sc, and Ma. A stepwise discriminant analysis resulted in 82.1% accuracy in correctly classifying borderline patients and 78.0% accuracy in identifying nonborderline patients. Findings are discussed in terms of potential uses and limitations in identifying borderline personality disorder with the MMPI.

A clinical comparison between a new bone seeking radiopharmaceutical, Tc-99m hydroxymethylene diphosphonate (TcHMDP) and the standard agent, Tc-99m pyrophosphate (TcPPi), was performed in 18 patients with acute myocardial infarction. Each patient was imaged initially with either TcHMDP or TcPPi, and imaged 24 hr later with the other tracer. All 18 patients had images positive for acute myocardial infarction with TcPPi, whereas 16 of 18 patients (89%) had positive studies with TcHMDP. The TcPPi images were graded significantly superior to those obtained with TcHMDP in 61% of the patients, and they were equal in 33%. In only one patient (6%) was TcHMDP better. The results indicate that compared with TcHMDP, TcPPi not only has a superior sensitivity for acute myocardial infarction but also has a significantly increased intensity of uptake in positive areas. TcPPi remains the agent of choice for myocardial infarct imaging.