Efficacy of newer medications for lower urinary tract symptoms attributed to benign prostatic hyperplasia: a systematic review

We conducted a systematic review to evaluate the efficacy and adverse effects of newer drugs used to treat lower urinary tract symptoms (LUTS). The drugs were either Food and Drug Administration (FDA) approved for benign prostatic hyperplasia (BPH) or not FDA approved for BPH but have been evaluated for treatment of BPH since 2008. We searched bibliographic databases through September 2017. We included randomized controlled trials (RCTs) lasting one month or longer published in English. Outcomes of interest were LUTS assessed by validated measures. Efficacy was interpreted using established thresholds indicating clinical significance that identified the minimal detectable difference. Twenty-three unique, generally short-term, RCTs evaluating over 9000 participants were identified. Alpha-blocker silodosin and phosphodiesterase type 5 inhibitor tadalafil were more effective than placebo in improving LUTS (moderate strength evidence) but these drugs had more adverse effects, including abnormal ejaculation (silodosin). Anticholinergics were only effective versus placebo when combined with an alpha-blocker. Evidence was generally low strength or insufficient for other drugs. Evidence was insufficient to assess long-term efficacy, prevention of symptom progression, need for surgical intervention, or long-term adverse effects. Longer trials are needed to assess the effect of these therapies on response rates using established minimal detectable difference thresholds, disease progression, and harms.     

Psychological Morbidity,Social Intimacy,Physical Symptomatology,and Lifestyle in Adult Children of Divorced Parents

This study assessed the relationships between psychological morbidity, social intimacy, perception of the parental relationship, lifestyle and physical symptomatology as well as the contributors of physical symptomatology, in adult children of divorced parents. Participants answered the Physical Symptom Questionnaire, the Anxiety, Depression and Stress Scale, the Lifestyle Questionnaire, the Social Intimacy Scale and The Perception of the Parental Relationship Scale. Results revealed that older participants showed lower levels of anxiety, depression and stress and that male participants perceived the parental relationship as better when compared to females. There was a negative association between depression and the duration of parental divorce. Adult children with greater physical symptoms and more anxious showed less social intimacy. The latter was associated with a less healthy lifestyle. As expected less physical symptomatology was associated with lower levels of depression, anxiety, and stress. Anxiety was the only variable that contributed to physical symptomatology. Intervention should be gender sensitive and focus early on on the identification of psychological morbidity, social intimacy, healthy behaviors, and physical symptomatology, in adult children whose parents are in the process of divorcing.     

Clinicians' Attributions of Responsibility for Sexual and Physical Child Abuse

Although responsibility attribution is known to influence decisions in clinical practice, factors which influence responsibility attribution for child abuse are not well understood. In the present study, licensed practicing psychologists from two states (n = 328) responded to clinical case vignettes which experimentally manipulated five two-level independent variables. As dependent measures, subjects assigned relative percentages of responsibility for abuse to the father, mother, child/victim, and an older sister. Results indicated that fathers suspected of sexual abuse were held significantly more responsible than those suspected of physical abuse. In addition, adolescent age victims were held significantly more responsible than seven year old victims. All of the sources of responsibility were affected by the child providing a verbal disclosure of abuse to a psychotherapist. Regression analyses also showed that certainty in the occurrence of abuse and responsibility attributed to the child/victim and older sister accounted for 31% of the variance in decisions to report the case as suspected abuse.     

福州地区部分产妇“坐月子”传统习俗的调查

采用定性研究方法对福州市城区和福清农村两地12户正在“坐月子”的家庭进行调查,并召开专题小组讨论会,组织19名卫生工作者参加讨论与分析。结果表明,“坐月子”是一个很重要的惯例,其强调摄入大量的高蛋白食物、提供家庭照顾、多休息并专注于体能的恢复、注意会阴部卫生和悉心照顾孩子等有利于产妇恢复健康;而对产妇采取限制洗澡、谢绝会客、限制活动、不适宜的辅助母乳喂养、给新生儿喂中药汤和不重视牙齿卫生等可能无益,甚至有害。建议提倡有利于产妇恢复健康的习俗与措施,努力克服和避免不利于产妇健康的因素。     

The Parent's Capacity to Treat the Child as a Psychological Agent: Constructs, Measures and Implications for Developmental Psychopathology

Recent studies of the relationship between parenting and child development have included a focus on the parent's capacity to treat the child as a psychological agent. Several constructs have been developed to refer to this capacity, for example maternal mind-mindedness, reflective functioning, and parental mentalizing. In this review article, we compare and contrast different constructs from diverse theoretical backgrounds that have been developed to operationalize parental mentalizing. We examine the empirical evidence to date in support of each of the constructs and review the relevant measures associated with each construct. Next, we discuss the possibility that these apparently diverse constructs may tap into the same underlying neurobiological socio-cognitive system. We conclude by proposing a testable model for describing the links between parental mentalization, the development of mentalizing in children, and child psychopathology.     

秦国早期婚姻习俗及其对后世政治势力和政治变革的影响

秦国早期的母系氏族残余及其婚姻状况对其后世政治势力演变和商鞅变法都有较大的影响。秦国的母系氏族残余、婚姻关系混乱,形成了独特的母系贵族势力强大的局面。这与六国一脉相承的公族势力恰好相反,母系贵族势力往往一朝而衰,形不成能动摇君权的顽固势力,因此变法顺利实现,中央集权制度得以建立,秦国逐步走向强盛,继而实现统一。     

Broadening the Study of Infant Security of Attachment: Maternal Autonomy‐support in the Context of Infant Exploration

Although security of attachment is conceptualised as a balance between infants' attachment and exploratory behaviours, parental behaviours pertaining to infant exploration have received relatively little empirical attention. Drawing from self‐determination theory, this study seeks to improve the prediction of infant attachment by assessing maternal autonomy‐support during infant exploration, in addition to maternal sensitivity. Seventy‐one dyads participated in two home visits. Maternal sensitivity was assessed when the infants were 12 months old, whereas maternal autonomy‐support and infant attachment were assessed at 15 months. The results revealed that autonomy‐support explained an additional portion of the variance in attachment when maternal socioeconomic status and sensitivity were controlled. These results speak to the relevance of a theory‐driven approach to examining maternal behaviours in the context of child exploration.     

Poster Abstracts

Objectives. To analyse the relation between results of the Aging Males' Symptoms (AMS) questionnaire for aging males, and of quality of life (QOL) questionnaire SF-12 and cardiovascular risk factors.

Methods. 1,927 men aged 55–85 years were interviewed by 56 general practitioners. During the interview the men were asked to fill in the AMS scale and the QOL questionnaire SF-12.

Results. Of 1,927 men 1,806 men filled correctly the AMS questionnaire. The mean SF-12 mental index was respectively 55.9 in men with a total AMS score indicating no impairment, 50.9 mild, 42.8 moderate, and 32.8 severe impairment. The corresponding values for the physical index were 51.2, 46.7, 40.8 and 32.3.

A history of diabetes was associated with an increased risk of reporting moderate/severe impairment: in relation to the total AMS score the odds ratio, (OR), of moderate/severe impairment in comparison with no impairment was 1.6 (95%CI 1.2–2.1). A history of myocardial infarction and hypertension increased the risk (respectively OR 1.4 (95%CI 1.1–18) and 1.7 (95%CI 1.2–2.4)).

Conclusions. This study shows that higher AMS scores are associated with lower SF-12 indices and suggests that elevated values of the AMS score are associated with cardiovascular risk factors or diseases.     

Security of Attachment as a Predictor of Symbolic and Mentalising Abilities: A Longitudinal Study

The development of symbolic and mentalising abilities was examined in 33 children whose security of attachment had been assessed in infancy. It was found that securely attached children: (i) were better able to incorporate an experimenter's play suggestions into their sequences of symbolic play at 31 months; and (ii) performed better on a version of Wimmer and Perner's (1983) unexpected transfer task at age 4. There was also evidence of superior mentalising abilities among the secure group at age 5, despite no group differences being found in general cognitive ability. We suggest that these security-related differences might be related to mothers' propensity to treat their securely attached children as individuals with minds. In support of this hypothesis, mothers in the secure group adopted more sensitive tutoring strategies, and were more likely to describe their children in terms of their mental characteristics. Possible developmental pathways linking security of attachment in infancy with subsequent development were investigated using path analyses.