Comparing the CASI-4R and the PGBI-10 M for Differentiating Bipolar Spectrum Disorders from Other Outpatient Diagnoses in Youth

We compared 2 rating scales with different manic symptom items on diagnostic accuracy for detecting pediatric bipolar spectrum disorder (BPSDs) in outpatient mental health clinics. Participants were 681 parents/guardians of eligible children (465 male, mean age = 9.34) who completed the Parent General Behavior Inventory-10-item Mania (PGBI-10 M) and mania subscale of the Child and Adolescent Symptom Inventory-Revised (CASI-4R). Diagnoses were based on KSADS interviews with parent and youth. Receiver operating characteristic (ROC) analyses and diagnostic likelihood ratios (DLRs) determined discriminative validity and provided clinical utility, respectively. Logistic regressions tested for incremental validity in the CASI-4R mania subscale and PGBI-10 M in predicting youth BPSD status above and beyond demographic and common diagnostic comorbidities. Both CASI-4R and PGBI-10 M scales significantly distinguished BPSD (N = 160) from other disorders (CASI-4R: Area under curve (AUC) = .80, p < 0.0005; PGBI-10 M: AUC = 0.79, p < 0.0005) even though scale items differed. Both scales performed equally well in differentiating BPSDs (Venkatraman test p > 0.05). Diagnostic likelihood ratios indicated low scores on either scale (CASI: 0–5; PGBI-10 M: 0–6) cut BPSD odds to 1/5 of those with high scores (CASI DLR- = 0.17; PGBI-10 M DLR- = 0.18). High scores on either scale (CASI: 14+; PGBI-10 M: 20+) increased BPSD odds about fourfold (CASI DLR+ = 4.53; PGBI-10 M DLR+ = 3.97). Logistic regressions indicated the CASI-4R mania subscale and PGBI-10 M each provided incremental validity in predicting youth BPSD status. The CASI-4R is at least as valid as the PGBI-10 M to help identify BPSDs, and can be considered as part of an assessment battery to screen for pediatric BPSDs.     

Maternal Childhood Sexual Trauma and Early Parenting: Prenatal and Postnatal Associations

Existing research suggests that approximately 19% of females experience childhood sexual trauma (CST). Little is known, however, about the parenting behaviour of mothers who have experienced CST. Using propensity‐matched controls, the present study examines prenatal psychosocial distress, postnatal depressive symptomatology, and caregiving behaviours of women reporting CST at or before the age of 14. Data for these analyses were obtained from mother reports and from observational protocols from a longitudinal study of low‐income, rural families. Propensity score methodology was used to create a contrast group matched on family of origin variables in an effort to isolate and examine the long‐term associations of CST beyond the effects of other childhood adversities such as poverty. Study findings provide evidence that women with CST histories report greater prenatal psychosocial distress compared to women without trauma histories. Findings further provide evidence for a spillover process from prenatal distress to the broader caregiving system including less sensitive parenting through postnatal depressive symptoms for women with CST histories. These results highlight the importance of screening for CST and psychosocial distress and depression prenatally. Interventions for women with CST histories and directions for future study are proposed. Copyright © 2016 John Wiley & Sons, Ltd.     

德鲁克医院管理思想研究

德鲁克医院管理思想主要有:医院管理与企业管理没有多大差异;医疗保健是21世纪增长最快、最需要管理的部门;医疗服务需要合理组织及团队精神;评价医疗服务质量的标准是"最佳";医院要实施目标管理并不断致力于变革,通过"专业化"提高效率和效益;医院管理者与员工之间是伙伴关系;信息技术对医疗服务有深刻的影响;医院应实行"职业化"管理.     

DNA-sequence patenting: National Society of Genetic Counselors (NSGC) position paper

In November 2000, the Genetic Services Committee of the National Society of Genetic Counselors (NSGC) convened a working group to draft a position paper on patenting of DNA-sequences. The mandate of the group was to produce general position statements that support the perspective and needs of consumers of DNA-based genetic tests and therapies (our patients and their families) and participants in DNA-based genetic research. After review and discussion of the literature on DNA-sequence patenting issues, the working group drafted position statement points that support current United States Patent and Trademark Office (USPTO) guidelines; broad licensing of DNA-sequence patents; nonenforcement of DNA-sequence patents in noncommercial research; reasonable royalty rates; an informed consent process for research participants that discloses whether they can share in any financial rewards relating to the project; the development of guidelines for licensing of DNA-sequence patents; and the establishment of oversight organizations to monitor licensing of DNA-sequence patents. These position statements were approved by the NSGC Board of Directors in the fall of 2001.     

Measures of self-concept, attitudes, and achievement motivation of primary grade children

Semi-projective measures (suitable for small group testing) of Self-Concept and Attitutes toward School, Home, Peers, and Society along with a teachers' rating instrument of Achievement Motivation have been developed for preschool and primary grade children. National norms for disadvantaged children are reported along with correlations of these measures with standardized achievement tests.     

High school psychology in the rocky mountain region

Over 40% of the high schools in a five-state Rocky Mountain region reported offering courses in psychology. A significant portion of students entering college classes have had such courses. With but 15% of teachers claiming a major in psychology and the rest scattered through 20-some other subjects, adequacy of teacher preparation is questioned. Areas for effort are suggested to enhance teacher preparation and to develop high school courses whivh might be appropriatet to advanced placement or enriched introductory study at the college level. These developments should have added benefits for psychology's recruitment efforts and the spread of public knowledge about psychology.     

Doctor can I buy a new kidney? I've heard it isn't forbidden: what is the role of the nephrologist when dealing with a patient who wants to buy a kidney?

Organ trafficking is officially banned in several countries and by the main Nephrology Societies. However, this practice is widespread and is allowed or tolerated in many countries, hence, in the absence of a universal law, the caregiver may be asked for advice, placing him/her in a difficult balance between legal aspects, moral principles and ethical judgments.In spite of the Istanbul declaration, which is a widely shared position statement against organ trafficking, the controversy on mercenary organ donation is still open and some experts argue against taking a negative stance. In the absence of clear evidence showing the clinical disadvantages of mercenary transplantation compared to chronic dialysis, self-determination of the patient (and, with several caveats, of the donor) may conflict with other ethical principles, first of all non-maleficence. The present paper was drawn up with the participation of the students, as part of the ethics course at our medical school. It discusses the situation in which the physician acts as a counselor for the patient in the way of a sort of “reverse” informed consent, in which the patient asks advice regarding a complex personal decision, and includes a peculiar application of the four principles (beneficence, non-maleficence, justice and autonomy) to the donor and recipient parties.     

对塔斯基“真”理论的辩护——与陈晓平教授商榷

陈晓平教授对塔斯基的"真"理论提出四点批评,并给出了使用"T′模式"作为真之定义的建议。但"T′模式"并不具有"内容恰当性"和"形式正确性",其引入的对"p"的摹状词解释比塔斯基的方案更复杂,对"真"进行递归定义在现有逻辑学内是不可能的。陈晓平教授对塔斯基"真"理论的批评和建议的失误之处在于误解塔斯基的原意、引入形而上学词项、需要新建形式逻辑。总之,其作为真之定义的"T′模式"是"不能允许地冗长"。