Miracle-dz/UniFAR-FTUs huggingface dataset:
Differences in Caregiver Self-Efficacy and Satisfaction Related to Sexual Abuse of Offspring

Research suggests parents of sexually abused children may experience negative perceptions of themselves and their parenting abilities following the victimization of their children, which may influence the recovery process in treatment for these families. This study assessed perceived self-efficacy and parenting satisfaction among female caregivers of sexually abused children and female caregivers whose children were not victimized. Results indicated that caregivers of child victims had significantly lower levels of perceived parenting efficacy than their counterparts. There were no significant differences found between groups with regard to parenting satisfaction. The results highlight the importance of evaluating perceived parenting competence in the treatment of nonoffending caregivers in order to facilitate optimal treatment of the child victim and all members of the family system.
Personal goals and prolonged grief disorder symptoms.

Prolonged grief disorder (PGD, previously called complicated grief) is a debilitating condition that can develop following the loss of a loved one. The present study investigated the relationship between different features of personal goals of bereaved individuals and PGD symptom severity. To this end, 160 bereaved people were asked to write down seven important personal goals and to complete self-report measures of PGD and depression symptom severity. With respect to the form of goals, the findings showed that more severe PGD symptomatology was associated with lower specificity of goals, a reduced sense of control over achieving goals and a lower perceived likelihood of achieving goals. With respect to the content of the goals, it was found that mourners with more severe levels of PGD symptoms reported more goals that were associated with loss (compared with goals unrelated to the loss), more goals related to feeling states and less goals related to work/education and close relationships. Implications of these findings are discussed. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • The severity of prolonged grief disorder (PGD) symptoms after bereavement is associated with different features of personal goals, including reduced specificity of goals, lower perceived probability and controllability of achieving goals and an enhanced focus on loss-related goals and goals related to feeling states. • In the treatment of PGD, it could be useful to change the negative beliefs that patients have about the probability and controllability of achieving goals and to help them in finding ways to achieve valued goals. • As recovery from loss hinges (in part) on the person's ability to continue (or restore) activities that are satisfying and meaningful, it could furthermore be fruitful to help patients to reduce their focus on 'inward-directed' goals (associated with their own feelings) and to increase their focus on 'outward-directed' goals (related to social, recreational and occupational activities).
Caregiver Needs Following Disclosure of Child Sexual Abuse

ABSTRACT Caregiver support is vital in improving outcomes for child sexual abuse victims; however, the disclosure can significantly affect caregivers, thus impacting their ability to meet their children’s needs. To maximize the support from caregivers, their own needs following disclosure need to be met. This study investigated the impact of child sexual abuse disclosure and associated needs as identified by caregivers. Sixty needs assessment forms were collected from families who accessed a parenting support pilot program run in New Zealand. These forms were completed by nonoffending caregivers during an assessment session with their counselor and consisted of both open-ended and Likert scale questions focusing on both the needs of the child and the family. Caregivers identified a range of impacts of the disclosure on their children, themselves, and other families members and the related support that may be needed. In particular, caregivers identified that they needed support with child behavior management and with their own coping. The findings suggest that interventions with caregivers following disclosure of child sexual abuse may be a valuable adjunct to therapy provided directly to the child.
Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

ABSTRACT Considering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.
Psychometric properties of the Dutch Inventories of Prolonged Grief for Children and Adolescents.

UNLABELLED A significant minority of bereaved adults develops prolonged grief disorder (PGD), a syndrome encompassing debilitating symptoms of grief distinct from depression and anxiety. Few studies have examined the phenomenology and correlates of PGD among children and adolescents. In part, this is due to the lack of a psychometrically sound questionnaire to assess PGD symptoms in these groups. Based on an adult measure of PGD, we developed two questionnaires of PGD symptoms for children and adolescents named the Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A), respectively. Psychometric properties of these measures were examined in three samples, including mostly parentally bereaved children (aged 8-12 years, total sample n = 169) and adolescents (aged 13-18 years, total sample n = 153). First, findings showed that items of the IPG-C and IPG-A represented one underlying dimension. Second, the internal consistency and temporal stability of both questionnaires were adequate. Third, findings supported the concurrent validity (e.g., significant correlations with measures of depression and post-traumatic stress-disorder [PTSD]), convergent and divergent validity (stronger correlations with similar questionnaires of 'traumatic grief' than with two dissimilar questionnaires of 'ongoing presence' and 'positive memories') and incremental validity (significant correlations with an index of functional impairment, even when controlling for concomitant depression and PTSD) of the IPG-C and IPG-A. This report provides further evidence of the clinical significance of PGD symptoms among children and adolescents and promising psychometric properties of questionnaires that can be used to assess these symptoms. KEY PRACTITIONER MESSAGE The Inventory of Prolonged Grief for Children (IPG-C) and Inventory of Prolonged Grief for Adolescents (IPG-A) were developed to be able to assess symptoms of Prolonged Grief Disorder (PGD) among children and adolescents. In different samples, the internal consistency, temporal stability, and concurrent and construct validity of these questionnaires were found to be adequate. The IPG-C and the IPG-A can be used in research examining causes and consequences of PGD, and the effectiveness of bereavement interventions for children and adolescents. This study provides further evidence of the existence and clinical significance of PGD symptoms among children and adolescents and supports the inclusion of a new category for bereavement-related disorders in DSM-5.
Using plan analysis in psychotherapeutic case formulation of borderline personality disorder.

A comprehensive understanding of the patient's problems is essential for a constructive therapeutic behaviour, especially in borderline personality disorder (BPD) where difficult interpersonal patterns are persistent. In these circumstances, the use of an integrative case formulation approach such as Plan Analysis, developed by K. Grawe and F. Caspar, can be of help for therapy planning. The focus here is on instrumental relations between behaviours and the hypothetical Plans and motives 'behind' those behaviours. The present qualitative study aimed at setting a prototypical Plan structure for n = 15 patients presenting a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of BPD using Plan Analysis. The first psychotherapeutic session of every outpatient was video-taped and evaluated according to the Plan Analysis procedure. Inter-rater reliability was established between two independent raters and was considered sufficient. The detailed prototypical Plan structure of BPD showed two main tendencies: first, the important presence of support-seeking among these patients and second, the will to be in control and to protect oneself. This study confirms the existence of several core similarities in the functioning of patients with BPD. These findings are in line with earlier studies and expand the latter with the aim of contributing to the understanding of BPD psychopathology. Clinical implications are discussed.
Improving Care Transitions Across Healthcare Settings Through a Human Factors Approach

Abstract:After more than two decades of research focused on care transition improvement and intervention development, unfavorable outcome measures associated with care transitions across healthcare settings persist. Readmissions rates remain an important outcome to target for intervention, adverse events associated with care transitions continue to be an issue, and patients are often dissatisfied with the quality of their care. Currently, interventions to improve care transitions are disease specific, require substantial financial investments in training allied healthcare professionals, or focus primarily on hospital-based discharge planning with mixed results. This complex situation requires a method of evaluation that can provide a comprehensive, in-depth, and context-driven investigation of potential risks to safe care transitions across healthcare settings, which can lead to the creation of effective, usable, and sustainable interventions. A systems' approach known as Human Factors and Ergonomics (HFE) evaluates the factors in a system that affect human performance. This article describes how HFE can complement and further strengthen efforts to improve care transitions.
Twice Silenced: The Underreporting of Child Sexual Abuse in Orthodox Jewish Communities

ABSTRACT Child sexual abuse remains an underreported crime throughout the world, despite extensive research and resources dedicated both to improving investigative techniques and helping children disclose their experiences. The discovery of rampant cover-ups within the Catholic Church has exposed some of the ways religious and cultural issues can impede reporting to authorities. This article examines specific factors that contribute to the underreporting of child sexual abuse within Orthodox Jewish communities. It also explores ways in which these communities have handled child sexual abuse reporting in the past and describes recent progress. Implications are offered for CSA prevention, detection, and recovery in Orthodox Jewish communities as well as other minority religious groups.
Reactivity in Pain‐Free Subjects and a Clinical Pain Population: Evaluation of the Kohn Reactivity Scale‐Dutch Version

Patients with pain are more reactive to various types of sensations, not limited to pain alone. A potential useful instrument to assess reactivity is the Kohn Reactivity Scale (KRS). This study examines the psychometric characteristics of the KRS‐Dutch version and its ability to differentiate between subjects with and without pain.
Clinical Trials Simulation: A Statistical Approach

A generic template for clinical trials simulations that are typically required by statisticians is developed. Realistic clinical trials data sets are created using a unifying model that allows general correlation structures for endpoint*timepoint data and nonnormal distributions (including time-to-event), and computationally efficient algorithms are presented. The model allows for patient dropout and noncompliance. A grid-enabled SAS-based system has been developed to implement this model; details are presented summarizing the system development. An example illustrating use of the system is given.
A Bayesian Meta-Analysis on Published Sample Mean and Variance Pharmacokinetic Data with Application to Drug–Drug Interaction Prediction

In drug-drug interaction (DDI) research, a two-drug interaction is usually predicted by individual drug pharmacokinetics (PK). Although subject-specific drug concentration data from clinical PK studies on inhibitor or inducer and substrate PK are not usually published, sample mean plasma drug concentrations and their standard deviations have been routinely reported. Hence there is a great need for meta-analysis and DDI prediction using such summarized PK data. In this study, an innovative DDI prediction method based on a three-level hierarchical Bayesian meta-analysis model is developed. The three levels model sample means and variances, between-study variances, and prior distributions. Through a ketoconazle-midazolam example and simulations, we demonstrate that our meta-analysis model can not only estimate PK parameters with small bias but also recover their between-study and between-subject variances well. More importantly, the posterior distributions of PK parameters and their variance components allow us to predict DDI at both population-average and study-specific levels. We are also able to predict the DDI between-subject/study variance. These statistical predictions have never been investigated in DDI research. Our simulation studies show that our meta-analysis approach has small bias in PK parameter estimates and DDI predictions. Sensitivity analysis was conducted to investigate the influences of interaction PK parameters, such as the inhibition constant Ki, on the DDI prediction.
Equivalence Testing for Parallelism in the Four-Parameter Logistic Model

For assay or dose-response data in drug discovery, it is often important to test for parallelism of the response curves for two preparations, such as a test drug and a standard drug, in order to determine the potency of the test preparation relative to the standard preparation. A typical approach is to perform a three-degree of freedom approximate F test of the null hypothesis that the relevant parameters are equal for the two preparations. We argue that this problem may be more appropriately viewed as a practical equivalence testing problem, and present an alternative method for testing parallelism in the four-parameter logistic response curve, based on the theory of intersection–union tests. The approach is intuitively appealing and simple to implement using commonly available software, and may provide more appropriate inference for the problem of interest. Two examples are discussed to illustrate the testing approach outlined in this article, and to compare it with the typical approach to testing parallelism. A simulation study is also presented to compare the empirical properties of the two different testing approaches for a set of cases based approximately on one of the examples.
ITC Commentary on Metformin Clinical Drug–Drug Interaction Study Design That Enables an Efficacy‐ and Safety‐Based Dose Adjustment Decision

Metformin drug-drug interaction (DDI) studies are conducted during development of drugs that inhibit organic cation transporters and/or multidrug and toxin extrusion proteins (OCTs/MATEs). Monitoring solely changes in systemic exposure, the typical DDI study endpoint appears inadequate for metformin, which is metabolically stable, has poor passive membrane permeability, and undergoes transporter-mediated tissue distribution and clearance. Evaluation of renal clearance, antihyperglycemic effects, and potentially lactate as an exploratory safety marker, can support rational metformin dose adjustment. The proposed DDI study design aims to adequately inform metformin dosing during comedication.
Epilepsy Care in Developing Countries: Part I of II

Although 80% of people with epilepsy reside in resource poor, developing countries, epilepsy care in these regions remains limited and the majority of epilepsy patients go untreated. Cost-effective, sustainable epilepsy care services, delivering first-line antiepileptic drugs through established primary health care facilities, are needed to decrease these treatment gaps. Neurologists with local experience and knowledge of the culture, who are willing to serve as educators, policy advisors, and advocates, can make a difference. This is Part I of a two-part article. Part I reviews the burden of epilepsy and the current state of resources for treatment in developing countries, while Part II (to be published in Epilepsy Currents issue 10.5) will provide an “Overview of Care” in these countries.
Risks of congenital malformations in offspring exposed to valproic acid in utero: A systematic review and cumulative meta‐analysis

Despite extensive research efforts over decades, the teratogenic profile of valproic acid (VPA) remains obscure. We performed cumulative and conventional meta‐analyses of cohort studies to determine the time profiles of signal emergence of VPA‐associated congenital malformations (CMs) and to define risk estimates of each of the CMs. Fifty‐nine studies were identified and analyzed. We found that the significant risk signals began to emerge over the last 10–20 years even before large‐scale studies were performed: neural tube defect (the significant risk signal emerged in 1992); genitourinary and musculoskeletal anomalies (2004); cleft lip and/or palate (2005); and congenital heart defects (2006). At present, the risks of VPA‐associated CMs are 2–7‐fold higher than other common antiepileptic drugs. VPA should not be used as a first‐line therapy in women of childbearing age unless it is the only option for the patient.
Surgical treatment of the congenital dislocation of the hip after walking age: open reduction and Salter's osteotomy

A luxacao congenita do quadril (LCQ), apos a marcha, requer o tratamento cirurgico, sendo uma das opcoes a reducao aberta associada a osteotomia do osso inominado (tipo Salter). Neste estudo foram avaliados 18 pacientes, 22 quadris, que apresentavam LCQ tratados cirurgicamente, entre 1989 e 1995, utilizando a osteotomia do osso inominado, pela tecnica de Salter, pos reducao aberta. A idade dos pacientes, na epoca da cirurgia, variou de 12 a 30 meses, com media de 19 meses, sendo 15 do sexo feminino e 3 do masculino, 4 pacientes tinham acometimento bilateral, sendo que nos demais, 8 tinham o quadril esquerdo acometido e 6 o lado direito. Os resultados foram avaliados segundo criterios clinicos de Dutoit et al.(3) e radiograficos de Severin(12), apos um seguimento medio de 48 meses. Clinicamente foram obtidos 18% de resultados excelentes (4); 54% resultados bons (12); 14% regulares (3); e 14% ruins (3). Quanto aos criterios radiograficos, encontramos 36% dos quadris classificados como excelentes (8); 45% bons (10); 5% regulares (1); e 14% ruins(3). Como complicacoes foram constatados 3 casos de reluxacao, tratados com outra tecnica cirurgica. Nao foi observado nenhum caso de infeccao, fratura do enxerto e lesao vascular ou nervosa.
Lower urinary tract disorders of small animals

IN small animals most lower urinary tract disorders (LUTDs) cause a limited number of non-specific clinical signs, including dysuria, altered frequency of urination and, or, incontinence and, often, overt haematuria. The diagnostic aids of greatest value in their investigation are radiography and laboratory procedures. Other techniques such as endoscopy, ultrasonography and pressure profilometry may contribute to the diagnosis of particular conditions, but they are not widely available.
Ibrutinib Dosing Strategies Based on Interaction Potential of CYP3A4 Perpetrators Using Physiologically Based Pharmacokinetic Modeling

Based on ibrutinib pharmacokinetics and potential sensitivity towards CYP3A4‐mediated drug–drug interactions (DDIs), a physiologically based pharmacokinetic approach was developed to mechanistically describe DDI with various CYP3A4 perpetrators in healthy men under fasting conditions. These models were verified using clinical data for ketoconazole (strong CYP3A4 inhibitor) and used to prospectively predict and confirm the inducing effect of rifampin (strong CYP3A4 inducer); DDIs with mild (fluvoxamine, azithromycin) and moderate inhibitors (diltiazem, voriconazole, clarithromycin, itraconazole, erythromycin), and moderate (efavirenz) and strong CYP3A4 inducers (carbamazepine), were also predicted. Ketoconazole increased ibrutinib area under the curve (AUC) by 24‐fold, while rifampin decreased ibrutinib AUC by 10‐fold; coadministration of ibrutinib with strong inhibitors or inducers should be avoided. The ibrutinib dose should be reduced to 140 mg (quarter of maximal prescribed dose) when coadministered with moderate CYP3A4 inhibitors so that exposures remain within observed ranges at therapeutic doses. Thus, dose recommendations for CYP3A4 perpetrator use during ibrutinib treatment were developed and approved for labeling.
Multivariate Recurrent Events in the Presence of Multivariate Informative Censoring with Applications to Bleeding and Transfusion Events in Myelodysplastic Syndrome

We propose a general novel class of joint models to analyze recurrent events that has a wide variety of applications. The focus in this article is to model the bleeding and transfusion events in myelodysplastic syndrome (MDS) studies, where patients may die or withdraw from the study early due to adverse events or other reasons, such as consent withdrawal or required alternative therapy during the study. The proposed model accommodates multiple recurrent events and multivariate informative censoring through a shared random-effects model. The random-effects model captures both within-subject and within-event dependence simultaneously. We construct the likelihood function for the semiparametric joint model and develop an expectation–maximization (EM) algorithm for inference. The computational burden does not increase with the number of types of recurrent events. We utilize the MDS clinical trial data to illustrate our proposed methodology. We also conduct a number of simulations to examine the performance of the proposed model.