Clinical Sciences

The present review discusses validity aspects of the Beck Depression Inventory (BDI) on the basis of meta-analyses of studies on the psychometric properties. Shortcomings of the BDI are its high item difficulty, lack of representative norms, and thus doubtful objectivity of interpretation, controversial factorial validity, instability of scores over short time intervals (over the course of 1 day), and poor discriminant validity against anxiety. Advantages of the inventory are its high internal consistency, high content validity, validity in differentiating between depressed and nondepressed subjects, sensitivity to change, and international propagation. The present paper outlines agreements and contradictions between the various studies on the BDI and discusses the potential factors (composition of the subject sample, statistical procedures, point in time of measurement) accounting for the variance in their results.

Step Test (ESST), and Illinois Agility Test (IAT) have been used to assess agility in athletes and nonathletes; however, the reliability and validity of these tests have not been established. The purpose of this study was to establish the reliability and convergent construct validity of the ESST, T-Test, and IAT in young, nondisabled, physically active male servicemembers (SMs). Ninety-seven male Active Duty U.S. Army SMs completed the study. Statistically significant differences were not found between the ESST (p = 0.10), T-Test (p = 0.09), and IAT (p = 0.23) when administered twice within a 24 to 48 h period. These tests were found to have excellent interrater reliability and moderate to good test-retest reliability. A good positive relationship exists between the IAT and T-Test (r = 0.76, p < 0.001) and a moderate negative relationship exists between the ESST and both the T-Test (r = 0.69, p < 0.001) and IAT (r = 0.65, p < 0.001). The results suggest that these tests are valid measures of agility that uniquely assess movement in different planes, thus providing a comprehensive assessment of high-level mobility.

With the recent resurgence in popularity of trait theories of leadership, it is timely to consider the genetic determination of the multiple factors comprising the leadership construct. Individual differences in personality traits have been found to be moderately to highly heritable, and so it follows that if there are reliable personality trait differences between leaders and non-leaders, then there may be a heritable component to these individual differences. Despite this connection between leadership and personality traits, however, there are no studies of the genetic basis of leadership using modern behavior genetic methodology. The present study proposes to address the lack of research in this area by examining the heritability of leadership style, as measured by selfreport psychometric inventories. The Multifactor Leadership Questionnaire (MLQ), the Leadership Ability Evaluation, and the Adjective Checklist were completed by 247 adult twin pairs (183 monozygotic and 64 same-sex dizygotic). Results indicated that most of the leadership dimensions examined in this study are heritable, as are two higher level factors (resembling transactional and transformational leadership) derived from an obliquely rotated principal components factors analysis of the MLQ. Univariate analyses suggested that 48% of the variance in transactional leadership may be explained by additive heritability, and 59% of the variance in transformational leadership may be explained by non-additive (dominance) heritability. Multivariate analyses indicated that most of the variables studied shared substantial genetic covariance, suggesting a large overlap in the underlying genes responsible for the leadership dimensions.

Low back pain is an extremely common problem that most people experience at some point in their life. While substantial heterogeneity exists among low back pain epidemiological studies limiting the ability to compare and pool data, estimates of the 1 year incidence of a first-ever episode of low back pain range between 6.3% and 15.4%, while estimates of the 1 year incidence of any episode of low back pain range between 1.5% and 36%. In health facility-or clinic-based studies, episode remission at 1 year ranges from 54% to 90%; however, most studies do not indicate whether the episode was continuous between the baseline and follow-up time point(s). Most people who experience activitylimiting low back pain go on to have recurrent episodes. Estimates of recurrence at 1 year range from 24% to 80%. Given the variation in definitions of remission and recurrence, further populationbased research is needed to assess the daily patterns of low back pain episodes over 1 year and longer. There is substantial information on low back pain prevalence and estimates of the point prevalence range from 1.0% to 58.1% (mean: 18.1%; median: 15.0%), and 1 year prevalence from 0.8% to 82.5% (mean: 38.1%; median: 37.4%). Due to the heterogeneity of the data, mean estimates need to be interpreted with caution. Many environmental and personal factors influence the onset and course of low back pain. Studies have found the incidence of low back pain is highest in the third decade, and overall prevalence increases with age until the 60-65 year age group and then gradually declines. Other commonly reported risk factors include low educational status, stress, anxiety, depression, job dissatisfaction, low levels of social support in the workplace and whole-body vibration. Low back pain has an enormous impact on individuals, families, communities,

A mass-casualty respiratory failure event where patients exceed available ventilators has spurred several proposed solutions. One proposal is use of a single ventilator to support 4 patients. A ventilator was modified to allow attachment of 4 circuits. Each circuit was connected to one chamber of 2 dual-chambered, test lungs. The ventilator was set at a tidal volume (V(T)) of 2.0 L, respiratory frequency of 10 breaths/min, and PEEP of 5 cm H(2)O. Tests were repeated with pressure targeted breaths at 15 cm H(2)O. Airway pressure, volume, and flow were measured at each chamber. The test lungs were set to simulate 4 patients using combinations of resistance (R) and compliance (C). These included equivalent C and R, constant R and variable C, constant C and variable R, and variable C and variable R. When R and C were equivalent the V(T) distributed to each chamber of the test lung was similar during both volume (range 428-442 mL) and pressure (range 528-544 mL) breaths. Changing C while R was constant resulted in large variations in delivered V(T) (volume range 257-621 mL, pressure range 320-762 mL). Changing R while C was constant resulted in a smaller variation in V(T) (volume range 418-460 mL, pressure range 502-554 mL) compared to only C changes. When R and C were both varied, the range of delivered V(T) in both volume (336-517 mL) and pressure (417-676 mL) breaths was greater, compared to only R changes. Using a single ventilator to support 4 patients is an attractive concept; however, the V(T) cannot be controlled for each subject and V(T) disparity is proportional to the variability in compliance. Along with other practical limitations, these findings cannot support the use of this concept for mass-casualty respiratory failure.

Study Design. The Oswestry Disability Index (ODI) has become one of the principal condition-specific outcome measures used in the management of spinal disorders. This review is based on publications using the ODI identified from the authors' personal databases, the Science Citation Index, and hand searches of Spine and current textbooks of spinal disorders.

Diagnosing attention deficit/hyperactivity disorder (ADHD) in patients with substance use disorder (SUD) is a complicated process in which a screening tool may be useful. We analyzed the ASRS-v1.1 validity in patients with SUD, considering the addiction severity and co-morbidity with depressive disorders, antisocial and borderline personality. Eighty outpatients with SUD were evaluated with the following instruments: ASRS-v1.1, CAAD-II, EuropASI, SCID-I, SCID-II. A factor analysis was performed with Varimax rotation to determine the structure of the intercorrelations among the items. Accuracy of ASRS-v1.1 was also analyzed. The diagnostic interview CAADID used as a gold standard indicated that 20% (95% confidence interval [CI]: 11-29) meet the criteria for ADHD. The ASRSv1.1 factor structure is marked by two factors related to inattention and hyperactivity / impulsivity that account for 67.7% of the variance. ASRS-v1.1, with a 4 cut-off, showed an 87.5% sensitivity and 68.6% specifi...

In recent years, deficits in emotion regulation have been studied as a putative maintaining factor and promising treatment target in a broad range of mental disorders. This article aims to provide an integrative review of the latest theoretical and empirical developments in this rapidly growing field of research.

Understanding violence against women is as complex as its process. As a perusal of literature shows that most of the explanations were contextually and culturally based, this review attempts to analyze the issue of violence against women using theories applicable within the Pakistani context. Literature examining the issue of violence against women and its various theories was reviewed. A framework using the determinants of violence against women as proposed, include intrinsic and extrinsic factors within the people, the socio-economic-political and cultural system of Pakistan and the influences of surrounding countries. The Pakistani scenario has been described and the theoretical bases were presented. Each determinant has been discussed with supporting literature. Further studies are needed to strengthen the framework; however, it provided a modest view of violence against women in Pakistan. The framework would help the policy and decision makers to understand the dynamics of violence against women and may move them to action to bring about improvements in women's' lives.

The findings and conclusions represent the consensus views of its 15 authors, none of whom received either direct or indirect support for their participation from the sponsoring organizations or any other organization that might represent a conflict of interest.

of the target gene relative to some reference group The two most commonly used methods to analyze data from such as an untreated control or a sample at time zero real-time, quantitative PCR experiments are absolute quantificain a time-course study.

We have two ways of knowing. Our mind knows forms, things, both subtle and gross. Faces, hands, buildings, trees, math formulas, mind knows subject and the mind knows otherness. The mind knows dualities, the mind knows me and you, us and them, and this and that. Mind knows time, mind knows the past, the present and the sense of the future. The mind knows things and entities, the mind knows beings, infinite numbers of beings and things. The mind knows difference. The mind thinks conceptually, feels affectively, imagines through imagery, the mind has sense and the mind has memory. The mind knows dualistically.

Problematic Internet use or excessive Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behaviors regarding computer use, and Internet access that leads to impairment or distress. Cross-sectional studies on samples of patients reported high comorbidity of Internet addiction with psychiatric disorders, especially affective disorders (including depression), anxiety disorders (generalized anxiety disorder, social anxiety disorder), and attention-deficit/hyperactivity disorder. We have investigated the association between Internet addiction and social anxiety in 2 samples of 120 university students (60 males and 60 females in each sample). We found a correlation between Internet addiction and social anxiety in the 2 samples (r = 0.411, P &lt; .001; r = 0.342, P &lt; .01) respectively. Secondly, we found no difference between males and females on the level of Internet addiction. Thirdly, we did not find a preference for social networks among partic...

Symmetry is believed to be a hallmark of appealing faces. However, this does not imply that the most aesthetically pleasing proportions are necessary those that arise from the simple division of the face into thirds or fifths. Based on the etymology of the word symmetry, as well as on specific examples and theories of beauty, we conclude that &#966;-value, a ratio also known as the golden ratio or the divine proportion, can also characterize symmetrical forms. Therefore, we propose the utilization of this ratio in facial aesthetics.

A new family of rehabilitation techniques, termed Constraint-Induced Movement Therapy or CI Therapy, has been developed that controlled experiments have shown is effective in producing large improvements in limb use in the real-world environment after cerebrovascular accident (CVA). The signature therapy involves constraining movements of the less-affected arm with a sling for 90% of waking hours for 2 weeks, while intensively training use of the moreaffected arm. The common therapeutic factor in all CI Therapy techniques would appear to be inducing concentrated, repetitive practice of use of the more-affected limb. A number of neuroimaging and transcranial magnetic stimulation studies have shown that the massed practice of CI Therapy produces a massive use-dependent cortical reorganization that increases the area of cortex involved in the innervation of movement of the more-affected limb. The CI Therapy approach has been used successfully to date for the upper limb of patients with chronic and subacute CVA and patients with chronic traumatic brain injury and for the lower limb of patients with CVA, incomplete spinal cord injury, and fractured hip. The approach has recently been extended to focal hand dystonia of musicians and possibly phantom limb pain.

Oral-facial-digital type I (OFDI) syndrome is a male-lethal X-linked dominant developmental disorder belonging to the heterogeneous group of oral-facial-digital syndromes (OFDS). OFDI is characterized by malformations of the face, oral cavity, and digits. Central nervous system (CNS) abnormalities and cystic kidney disease can also be part of this condition. This rare genetic disorder is due to mutations in the OFD1 gene that encodes a centrosome/basal body protein necessary for primary cilium assembly and for left-right axis determination, thus ascribing OFDI to the growing number of disorders associated to ciliary dysfunction. We now report a mutation analysis study in a cohort of 100 unrelated affected individuals collected worldwide. Putative disease-causing mutations were identified in 81 patients (81%). We describe 67 different mutations, 64 of which represent novel mutations, including 36 frameshift, nine missense, 11 splice-site, and 11 nonsense mutations. Most of them concentrate in exons 3, 8, 9, 12, 13, and 16, suggesting that these exons may represent mutational hotspots. Phenotypic characterization of the patients provided a better definition of the clinical features of OFDI syndrome. Our results indicate that renal cystic disease is present in 60% of cases >18 years of age. Genotype-phenotype correlation did not reveal significant associations apart for the high-arched/cleft palate most frequently associated to missense and splice-site mutations. Our results contribute to further expand our knowledge on the molecular basis of OFDI syndrome. Hum Mutat 0, 1–10, 2008. © 2008 Wiley-Liss, Inc.

Purpose: We present a comprehensive account of clitoral anatomy, including its component structures, neurovascular supply, relationship to adjacent structures (the urethra, vagina and vestibular glands, and connective tissue supports), histology and immunohistochemistry. We related recent anatomical findings to the historical literature to determine when data on accurate anatomy became available.

Self-efficacy beliefs in people with chronic pain have been assessed either by reference to confidence in ability to perform specific tasks or to confidence in performing more generalised constructs like coping with pain. Both approaches reflect aspects of the original conceptualisations of self-efficacy and both have proved useful, but it is noteworthy that confidence in performing activities in the context of pain is rarely addressed. An important element in the original formulations of self-efficacy referred to persistence in the face of obstacles and aversive experiences. In this context, self-efficacy beliefs for people experiencing chronic pain might be expected to incorporate not just the expectation that a person could perform a particular behaviour or task, but also their confidence in being able to do it despite their pain. This aspect of the self-efficacy construct has been included in a measure for people with chronic pain, the Pain Self-Efficacy Questionnaire (PSEQ). The accumulated evidence from a number of published studies and a confirmatory analysis with a large cohort of heterogeneous chronic pain patients attending a pain management program provide support for the PSEQ's original psychometric properties developed with a sample of chronic low back pain patients. The importance of taking the context of pain into account in the assessment of self-efficacy beliefs in pain populations and the ways in which this measure can be used to improve the assessment of people experiencing chronic pain, before and after treatment, are examined.

Stretching is usually performed before exercise in an attempt to enhance performance and reduce the risk of injury. Most stretching techniques (static, ballistic, and proprioceptive neuromuscular facilitation) are effective in increasing static flexibility as measured by joint range of motion, but the results for dynamic flexibility as measured by active and passive stiffness, are inconclusive. The mechanisms of various stretching techniques in terms of biomechanics and neurology, the effectiveness of the combination of stretching with other therapies such as heat and cold, and the effectiveness of stretching for performance and injury prevention are reviewed. The possible mechanisms responsible for the detrimental effects of stretching on performance and the minimal effects on injury prevention are considered, with the emphasis on muscle dynamic flexibility. Further research is recommended to explore the mechanisms and effects of alternative stretching techniques on dynamic flexibility, muscle soreness, sport performance, and rate of injury.

"Introduction:
Occupation is the core concept of the occupational therapy profession and its underlying philosophy, and has
long been the primary topic of concern for occupational
scientists. As a result, occupation has been continuously
defined and discussed by occupational therapists and
scientists, with our understanding of what constitutes
occupation ever-evolving. The focus of occupational
therapy and science literature has been upon occupation
and its link to good health and wellbeing. Occupation
has therefore largely been understood as something
positive and productive for the individual, groups and
communities. Only recently has this belief begun to be
challenged (Kiepek & Magalhaes, 2011). This article presents
the assertion that occupation must be viewed as
many-sided, multifaceted and that, of these many
‘sides’, there is a dark side to occupation (Twinley &
Addidle, 2012). The dark side is understood to include
various dimensions of occupation that have not, traditionally,
been examined by occupational therapy theorists,
researchers and practitioners and occupational
scientists, and which may not lead to good health and/
or wellbeing. Reference is made to an online discussion
forum in which a talk about the dark side of occupation
was facilitated; contributions from this discussion are
included as examples of some people’s current opinions
regarding the dark side of occupation. The article concludes
with recommendations for how to implement a
consideration of the dark side into research, theory,
education and practice."

Occupational therapists believe that there is a relationship between occupation, health and well-being but there is little evidence in the occupational therapy literature to support this belief. This paper describes the results of a critical review of research examining the relationship between occupation and health and well-being. Twentytwo studies from the health and social sciences literature were reviewed using specific methodological review criteria. The findings of these studies provide moderate to strong evidence that occupation has an important influence on health and well-being. Because most of this research has been completed with persons without disabilities, further research is required to explain the nature of the relationship between occupation and health and well-being for persons who experience a disability which affects their daily occupations RÉSUMÉ Bien que les ergothérapeutes croient qu'il existe un rapport entre l'occupation, la santé et le bien-être, on retrouve peu d'éléments probants dans la littérature en ergothérapie pour appuyer cette croyance. Cet article décrit les résultats d'une analyse critique examinant le rapport entre l'occupation, la santé et le bien-être. Vingt-deux études effectuées dans le domaine de la santé et des sciences sociales ont été examinées à l'aide de critères d'analyse méthodologiques spécifiques. Les résultats de ces études témoignent de façon modérée, ou avec force, de l'influence de l'occupation sur la santé et le bien-être. Comme la plus grande partie de cette recherche a été effectuée auprès de personnes ne présentant aucune déficience, il est indispensable de poursuivre les recherches afin de préciser la nature du rapport entre l'occupation, la santé et le bien-être chez les personnes présentant une déficience qui perturbe leurs occupations quotidiennes.

P ostural misalignment of head on trunk (e.g., forward head posture) is associated with complaints of pain in the neck and shoulder region 1-5 and temporomandibular joint dysfunction 6,7 , but is also observed in asymptomatic individuals 8-10 . Attempts to correct this misalignment towards an ideal posture using a combination of strengthening, stretching, and behavioral/biofeedback training represent a significant component of the physical intervention provided to clients with painful neck and/or Abstract: Forward head posture (FHP) is most often described as excessive anterior positioning of the head in relation to a vertical reference line, involving increased cervical spine lordosis (head forward, middle cervical spine extended, lower cervical spine flexed) and rounded shoulders with thoracic kyphosis. Although exercise is routinely used to improve FHP, relatively little data exists on efficacy. The present study was designed to examine the impact of a 10-week targeted and progressive home exercise program on improving FHP. As improvement through exercise of postural alignment depends upon participants adhering to the program, we also looked at issues related to exercise compliance. Seventeen control (C) and 23 exercise (E) participants with a FHP deviation were part of this program. Pre-and post-exercise postural measurements of FHP were obtained from the sagittal plane using the Biotonix TM Postural Analysis System; in addition neck flexion range of motion was measured. Participants were randomly assigned to C or E groups. The E group performed neck extensor and pectoralis major stretches and deep neck flexor and shoulder retractor strengthening exercises for the 10-week period. Two-factor (group, pre-test/post-test) analysis of variance models were used to test main effects and interactions. There were no significant differences (p>0.05) between groups on any pre-test measure. For the E group, there were significant differences and interactions (p<0.05) between pre-and post-tests and also between the E and C groups at post-test for range of motion and one postural measurement. The results demonstrate that a short, home-based targeted exercise program can improve postural alignment related to FHP. These results provide a foundation for further development of postural improvement programs that include an exercise component.

Twenty Parkinson’s disease (PD) patients (mean age 69.9 years) and 24 normal individuals’ (mean age 63.8) both ears were investigated by brainstem auditory evoked potentials (BAEPs) and pure tone audiometry (PTA). There were no statistically significant age differences between the patients and control subjects. PTA results were significantly elevated for PD patients in 4,000 and 8,000 Hz (P < 0.05). Parkinsonian patients showed significantly increased latencies in wave V and I–V interpeak latencies (P < 0.05). The results of this study suggest that PTA and BAEPs could be affected in parkinson disease.

The purpose of this exploratory study is to better understand the current dynamics of the Malaysian market for smartphone and the usage behaviors of consumers. This paper presents the result of a survey on the trend of smartphone from the perspective of end consumers. The data was collected from 1814 respondents across major cities in Malaysia. This study has looked into the familiarity of users towards smartphones, choices of smartphone brand and service providers, and most importantly the determinants that influence their purchasing decision. Additionally, the consumers' preferences on smartphone specifications such as design, computing power, operating platform, and price were investigated. Furthermore, consumers' usage behaviors such as using smartphone for email, web browsing, gaming, and document reading were examined. The statistics presented provides fundamental information regarding the trends in the smartphone market and usage behaviors in Malaysia. Such information are useful for academics for the development of future works in the field, whereas for smartphone manufacturers, application developers and other stakeholders, they are able to plan their direction in the Malaysian smartphone market.