Persistent and Transitory Sexualized Behavior Problems in Children.

The aim of this longitudinal study was to examine the course of sexualized behavior problems (SBP) over 2 years in a sample comprised of 104 children aged 2-12, including 62 children with histories of child sexual abuse (CSA). Parents completed questionnaires assessing SBP, internalizing and externalizing difficulties at baseline, as well as 2 years later. In more than half (56.7%) of children with clinically significant SBP at baseline, sexualized behaviors persisted and remained at a clinically significant level over time. In children with CSA, 48.4% presented persistent SBP, 27.4% presented transitory SBP, while 19.4% did not present clinically significant SBP at either time. CSA increased the relative risk of persistent SBP 3.29 times, and for each one-unit increase in scores of externalizing difficulties, the odds of persistent SBP increased by 21%. The findings suggest that SBP consequent to CSA, especially when it co-occurs with externalizing difficulties, is likely to remain at levels warranting clinical intervention.

Renal tumour suppressor function of the Birt-Hogg-Dubé syndrome gene product folliculin.

BACKGROUND: Renal cell carcinoma (RCC) comprises five major molecular and histological subtypes. The Birt-Hogg-Dubé (BHD) syndrome is a hereditary human cancer syndrome that predisposes affected individuals to develop renal carcinoma of nearly all subtypes, in addition to benign fibrofolliculomas, and pulmonary and renal cysts. BHD is caused by loss-of-function mutations in the folliculin (FLCN) protein. The molecular function of FLCN is still largely unknown; opposite and conflicting evidence of the role of FLCN in mammalian target of rapamycin signalling/phosphorylated ribosomal protein S6 (p-S6) activation had recently been reported. RESULTS AND METHODS: Here, the expression pattern of murine Flcn was described, and it was observed that homozygous disruption of Flcn results in embryonic lethality early during development. Importantly, heterozygous animals manifest early preneoplastic kidney lesions, devoid of Flcn expression, that progress towards malignancy, including cystopapillary adenomas. A bona fide tumour suppressor activity of FLCN was confirmed by nude mouse xenograft assays of two human RCC cell lines with either diminished or re-expressed FLCN. It was observed that loss of FLCN expression leads to context-dependent effects on S6 activation. Indeed, solid tumours and normal kidneys show decreased p-S6 upon diminished FLCN expression. Conversely, p-S6 is found to be elevated or absent in FLCN-negative renal cysts. CONCLUSION: In accordance with clinical data showing distinct renal malignancies arising in BHD patients, in this study FLCN is shown as a general tumour suppressor in the kidney.

The eating disturbed spectrum in relation with coping and interpersonal functioning.

UNLABELLED: Although much has been written with regards to the interpersonal functioning of eating-disordered women, research in the domain of eating disorders (ED) has still overlooked the complex relationships between stressful life events, coping styles, social and marital support while considering the ED spectrum. OBJECTIVE: This study evaluates to what extent stressful life events, coping styles, and social support represent useful concepts for differentiating between four groups of participants with varying severity of eating preoccupations and disturbances. METHOD: One hundred twenty-five participants were divided into four groups: 40 women suffering from ED, 21 women in remission from an ED, 33 women with intense weight and shape preoccupations, and 31 women without eating preoccupations. Each participant completed the Eating Disorder Evaluation, as well as questionnaires concerning stressful life events, coping styles, social support, and couple satisfaction. RESULTS: There were significant differences between the groups in terms of negative impact of stressful events, social support, as well as task-oriented and emotion-oriented coping styles. Significant differences were not found between the groups for couple satisfaction. CONCLUSION: It appears that accurate cognitive appraisal of stressful situations, adaptive coping styles and improvement of the social network represent interesting dimensions to include in prevention and treatment programs for ED. Moreover, for women in remission from an ED, an effective relapse prevention strategy could be to learn to make better use of their social network.

Creutzfeldt-Jakob disease mortality in Canada, 1998 to 2013.

BACKGROUND: Human prion diseases, known collectively as Creutzfeldt-Jakob disease (CJD), are fatal, infectious neurodegenerative disorders that occur in all human populations. OBJECTIVE: To summarize national surveillance data for CJD in Canada between January 1, 1998, and December 31, 2013. METHODS: Detailed investigations were conducted of individual suspected CJD cases, with collaboration between Canadian health professionals and investigators affiliated with a central CJD surveillance registry operated by the Public Health Agency of Canada. Data were collected on the clinical profile, family history, and results of paraclinical and laboratory investigations, including post-mortem neuropathological examination. RESULTS: A total of 662 deaths from definite and probable CJD were identified in Canadian residents during the study period, comprising 613 cases of sporadic CJD (92.6%), 43 cases of genetic prion disease (6.5%), 4 cases of iatrogenic CJD (0.6%), and 2 cases of variant CJD disease (0.3%). The overall crude mortality rate for sporadic CJD was 1.18 per million per year [95% confidence interval (CI): 1.08,1.27]. Age-specific rates ranged from 0.05 [95% CI: 0.03,0.08] in persons under 50 years of age to 7.11 [95% CI: 6.20,8.11] in those aged 70 to 79. A significant net upward trend in age-adjusted rates was observed over the study period. Standardized mortality ratios, calculated for 10 individual Canadian provinces with reference to national average mortality rates, did not differ significantly from 1.0. CONCLUSION: Creutzfeldt-Jakob disease remains rare in Canada, although mortality rates vary by two orders of magnitude between older and younger age groups. The upward trend in age-standardized sporadic CJD mortality rate over the study period can be better accounted for by gradually improving case ascertainment than by a real increase in incidence.

Are consumers of modern fertility treatments satisfied?

OBJECTIVE: To determine the extent of patients satisfaction with fertility treatments, its antecedents, and its correlates. DESIGN: This is a two-wave correlational panel study in which consumer satisfaction was assessed 6 and 12 months after admission to the clinic. PATIENTS: The sample consisted of 385 couples who consulted the fertility clinic of a large metropolitan hospital. MEASURES: After their admission, patients completed scales measuring psychosocial disturbances. These variables were reassessed 6 and 12 months later along with a consumer satisfaction questionnaire. RESULTS: Patients were generally satisfied with modern fertility treatments. Approximately 10% of the sample expressed dissatisfaction with received services. Analyses revealed that consumer satisfaction was significantly related to poor psychosocial functioning at intake and after 6 months. CONCLUSIONS: Our results suggest that consumers of fertility treatments are generally satisfied with the quality and quantity of service they received at the clinic. The more patients exhibited personal, marital, and social symptoms of distress when they were admitted to the clinic, the more they were likely to be later dissatisfied with fertility treatments.

Psychosocial distress and infertility: men and women respond differently.

The purpose of this study was to evaluate gender differences in psychosocial responses of 449 consecutive first-admission couples in a fertility clinic. Consistent with previous research, infertile women showed higher distress than their partners on a global measure of psychiatric symptoms and subscales of anxiety, depression, hostility, and cognitive disturbances, as well as on measures of stress and self-esteem. When compared with same-sexed population norms on the measure of psychiatric symptoms, both male and female infertile patients were significantly more distressed than average. No evidence was found for unusually high levels of marital or sexual distress at intake. Implications of results for clinical management are explored.

Predictive validity of therapeutic alliance in group marital therapy.

The relation between marital distress, therapeutic alliance formation, and treatment outcome was investigated in a group marital skills training program in which 63 couples met for 9 weekly 3-hr sessions. Treatment outcome was assessed before and after completion of treatment through a series of self-report measures. The quality of the therapeutic alliance as viewed by the couples and the therapists was monitored at the 3rd session. Results indicate that levels of marital distress neither impaired nor facilitated alliance formation. In addition, it was demonstrated that patients' and therapists' ratings of the strength of the therapeutic alliance constitute a determinant of successful treatment. It appears, however, that the strength of the alliance is a more powerful predictor of therapeutic success among men than among women.

Macroscopic marital interaction coding systems: are they interchangeable?

The present study sought to determine the convergent validity of two macroscopic marital interaction coding systems: the Marital Interaction Coding System-Global and the Global Couple Interaction Coding System. The sample consisted of 40 couples who completed the Dyadic Adjustment Scale, the Potential Problem Checklist and a 30-min problem solving interactional task. Filmed interactions were coded by separate teams of observers using the Marital Interaction Coding System-Global and the Global Couple Interaction Coding System. Results showed that interobserver agreement, as assessed through intraclass correlations, was satisfactory for both coding systems. Between-system comparisons revealed that convergent validity coefficients were moderate; thus, it seems premature to conclude that macroscopic coding systems are interchangeable. Finally, multiple regression analyses indicated that both systems contained significant non-redundant behavioral predictors of marital adjustment. Implications of these results are discussed.

Patients' requests and satisfaction with services in an outpatient psychiatric setting.

OBJECTIVE: Patients in four major diagnostic categories were compared to determine if their satisfaction with outpatient services varied. Both overall satisfaction and the degree to which clients and therapists agreed on the importance of 16 aspects of treatment were examined. METHODS: The Patient Request Form (PRF) and the Client Satisfaction Questionnaire were used to interview 464 outpatients. The professional who was the primary contact for each patient filled out a therapist version of the PRF. Diagnoses were grouped into four major categories: anxiety disorders, affective disorders, schizophrenia, and other psychotic disorders. RESULTS: The diagnostic groups differed in overall satisfaction with treatment, treatment characteristics, patients' reasons for coming to the clinic, therapists' descriptions of treatment, and patient-therapist agreement on the importance of different aspects of treatment. Agreement between patients and providers was associated with higher levels of patients' satisfaction. Patients with schizophrenia or with other psychotic disorders had the lowest level of agreement with their therapists and also were the least satisfied. In all patient categories, therapists underestimated the importance to patients of having a reliable source of help. CONCLUSIONS: The greater dissatisfaction expressed by patients with schizophrenia and other psychotic disorders may be related to their therapists' undervaluing the nonbiological aspects of treatment such as social support. Combining medication with psychosocial approaches that have been adapted for patients with psychotic disorders is likely to improve the patients' satisfaction and compliance and increase the overall effectiveness of treatment.

The evaluation of Franco-Quebec victims of child sexual abuse and their mothers: the implementation of a standard assessment protocol.

OBJECTIVE: There were two aims: first, to evaluate the feasibility of applying a standard assessment protocol to Franco-Quebec victims of child sexual abuse and nonoffending mothers; and second, to compare results from an initial sample with available data from English-speaking samples. METHOD: A standard individual case study design was used for victims and mothers; and the satisfaction of the nine participating youth workers was assessed. Four self-report instruments for victims and five for mothers were chosen on the bases of workers' priorities, sensitivity to the impact of CSA, and the availability of published norms on English-speaking samples. Results are reported on 48 confirmed victims and 40 nonoffending mothers. RESULTS: The protocol was favorably received by the CPS workers, supervisors and all mothers and victims. Percentages of clinically distressed victims varied from highs of 68% on the externalization difficulties of the Child Behavior Checklist and 67% for 2- to 6-year-olds on the Child Sexual Behavior Inventory, to lows of 10% on hostility symptoms and 13% on the Dissociation Scale of the Trauma Symptom Check for Children. The rate of symptom-free children was lower (19%) and that of revictimization higher (30%) than most published estimates (Kendall-Tackett, Williams, & Finkelhor, 1993). Most mothers reported elevated emotional distress (depression, 59%) and symptoms of post-traumatic stress (intrusiveness, 67%). Although 87% of mothers believed the allegations, only 45% offered adequate emotional support. CONCLUSION: The implementation phase of this research was successful, given the positive reactions of workers and clients. Results on standard instruments from this French-speaking sample were similar to profiles of English-speaking victims and their mothers but firm conclusions on appropriate norms will require larger samples, cross cultural contrasts, and the evaluation of additional variables.

Information as a distinct dimension for satisfaction assessment of outpatient psychiatric services.

The purpose of this study is to verify whether information on services would appear as a distinct dimension of satisfaction in a multidimensional scale. Data collection was performed in two phases: 263 patients received the original version of the questionnaire and 200 received an adapted version of the scale. The findings suggest that not only is it important to consider information as a distinct dimension of satisfaction but it is equally important to examine three categories, consisting of satisfaction with information on; patients' problems/illness; distinct treatment components such as medication and psychotherapy; and patients' treatment progress.

[The psychosocial profile of couples consulting a fertility clinic]. / Le profil psychosocial de couples consultant à une clinique de fertilité.

The objective of this study is to draw the psychosocial profile of couples who consult fertility clinics. More specifically, it consists of a) comparing the psychosocial status of subjects who seek fertility consultation with that of normal subjects or individuals at grips with psychological problems; b) determining whether there are profile differences between men and women who seek fertility consultation; and c) assessing whether it is possible to predict the nature of the psychosocial profile of the subjects from various sociodemographic and medical characteristics. The sampling includes 30 couples who are consulting a specialist in a fertility clinic belonging to a Montréal-area hospital. Analysis of results shows that the psychosocial profile of subjects consulting a fertility clinic is midway between that or normal subjects and that of individuals suffering of psychological problems. The psychological status of men and women consulting a fertility clinic is different according to three variables: depression, self-esteem and stress. Finally, multiple regression analysis has allowed the author to identify several medical characteristics linked to the extent of the psychosocial difficulties experienced by the infertile subjects.

Stress, sexual satisfaction, and marital adjustment in infertile couples.

A longitudinal study was designed to assess the effects of infertility as well as the influence of the subsequent medical investigation on marital functioning. During their initial visit at a fertility clinic, 165 couples underwent psychological assessment. Questionnaires were completed to assess stress, sexual satisfaction, and marital adjustment. Participants were categorized into those who became pregnant during the 12 months of the study (n = 48 couples) and those for whom treatment was not successful (n = 117 couples). Significant increases in stress and decreases in marital functioning were experienced by subjects as the treatment investigation progressed. Furthermore, greater levels of marital distress were observed in couples that did not conceive. Significant gender differences were observed.

[Hematological and biochemical normogram and daily variations of the base parameters in the normal dog]. / Normogramme hématologique et biochimique et variations quotidiennes des paramètres de base chez le chien normal

These experiments were designed in order to determine normal hematological and biochemical values of normal dogs living in a laboratory environment. The findings were conclusive. Serial studies of some of the basic parameters have been done in a second group of animals. After a short period of conditioning, daily changes in weight, temperature, hematocrit and hemoglobin are minimal if the methods of analysis are standardized and reproducible.

Psychosocial distress and infertility: a review of controlled research.

Three hypotheses have been most often cited on the link between infertility and psychosocial distress: (1) psychosocial problems trigger infertility; (2) infertility triggers psychosocial distress; and (3) there is an interactive causal relationship between infertility and psychosocial distress. The controlled research on these three hypotheses was reviewed. The thirty publications that met inclusion criteria provide convincing evidence that, taken as a whole, patients diagnosed and treated in infertility clinics show significantly higher levels of psychosocial distress than do control groups. As well, in general, female patients score higher on psychosocial distress measures than males. However, the authors conclude that research designs to date have failed to control crucial variables that permit conclusive empirical tests of the three hypotheses. The paper closes with recommendations for future research that would accelerate the evaluation of scientific data available on the subject.

[Psychometric characteristics of the French Canadian version of a satisfaction scale for hospitalized psychiatric patients]. / Caractéristiques psychométriques de la version canadienne-française d'une échelle de satisfaction pour patients hospitalisés en psychiatrie.

This paper presents the results of a content and convergent validity study of the French-Canadian version of a standardized satisfaction scale for hospitalized psychiatric patients. One hundred and twenty-two patients underwent an interview during which they completed the translated version of the Client Satisfaction Questionnaire, developed by Distephano et al, and answered open-ended questions on their satisfaction with the services they received. The results revealed strong correlations between these measures of satisfaction and a high level of internal consistency for the Distefano scale, suggesting satisfactory psychometric characteristics for this French version. As for the original questionnaire, the factorial structure yielded at least two distinct satisfaction dimensions. These results, and those of the content analysis, based on answers from the open-ended questions, helped to identify aspects mentioned by the patients but not covered by the items included in the satisfaction scales. The units' cleanliness, therapists' work and attitudes and privacy on the units are examples of these dimensions.

Masculinity, femininity, and marital satisfaction: an examination of theoretical models.

This study sought to investigate the relationship between masculinity, femininity, and marital satisfaction. A number of polynomial multiple regression analyses were performed in an effort to determine the validity of six theoretical models linking sex roles to marital satisfaction. These are the femininity model, masculinity model, sex-typed model, additive androgynous model, interactive androgynous model, and curvilinear model. The sample was composed of 117 couples who completed the Bem Sex-Role Inventory (Bem, 1974) and the Dyadic Adjustment Scale (Spanier, 1976). For men, the results showed that marital satisfaction was related to (a) their self-described levels of femininity and masculinity, (b) the level of self-described femininity of their wives, and (c) the presence of feminine qualities as well as a limited optimal level of masculine qualities which they perceived in their wives. For women, marital satisfaction was associated with (a) the number of self-described feminine qualities and (b) the level of masculinity, as well as an optimal level of femininity, which they perceived in their husbands. Furthermore, small actual-ideal discrepancies in levels of masculinity and femininity ascribed to partners constituted reliable predictors of marital satisfaction for both men and women.