Screening for Elder Abuse in Hospitalized Older Adults With Dementia

When older adults with dementia are hospitalized for psychiatric treatment, which elder abuse screen to use is questionable. This article reviews screens to identify desirable characteristics. For clinician completion, the Elder Assessment Instrument and the Brief Abuse Screens for the Elderly are recommended. For the older adult, the brief Hwalek-Sengstock Elder Abuse Screening Test is suitable. The Modified Conflict Tactics Scale, which can be used by both the older adult and the nonprofessional caregiver, has many of the recommended characteristics. Research is necessary in the application of these screens within hospitals to detect elder abuse within this specialized population.     

Development and Utilization of a Practice-Based,Adolescent Intake Questionnaire (Adquest)

Summary

This article describes an intake questionnaire (Adquest) that was designed, tested, and implemented, and later employed in clinical data-mining studies, by practitioners in an adolescent mental health program. The instrument is primarily a practice-based, clinical information-gathering and client engagement device. Consequently, it differs in significant ways from more research-driven Rapid Assessment Instruments (RAIs). Despite these differences, when aggregated and analyzed, Adquest data provides valuable psychosocial information about hundreds of vulnerable urban youth seeking mental health services.     

A Short Form of the Trauma Symptom Checklist for Young Children

A short form of the Trauma Symptom Checklist for Young Children was derived from the original 90 items. An exploratory factor analysis of each factor identified the four items from each of the original factors with the highest eigenvalues. These items were subjected to confirmatory factor analysis. The best fit was obtained for an 8-factor, 32-item model. The short form evidenced good convergent validity with parent ratings obtained from the Child Behavior Checklist, the Child Sexual Behavior Inventory, and the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD RI). Norms (t-scores and percentiles based on raw scores) were calculated by age and by gender. The short form has promise as a screening measure with parents in settings like a child advocacy center.     

Screening for Geriatric Depression in Residential Care Facilities: A Systematic Narrative Review

Studies in residential care facilities suggest that routine screening can assist in the early detection of geriatric depression. However, the effectiveness of screening instruments in residential care in the US and Canada has not been adequately evaluated. We conducted a systematic narrative review of the English-language literature published between 2000 and 2010 on screening instruments used for depression detection in older adults living in residential care facilities. The review yielded nine scales and their modifications tested in residential care, which we evaluated. We provide specific recommendations for the use of effective scales and discuss implications for practice, policy and research.     

孤独症谱系障碍儿童呼名反应和应答性微笑的影响因素研究

呼名反应（Response to name）需要被呼叫的儿童识别并将注意转移到自己的名字这一具有社会意义的刺激上。前人研 究对于孤独症儿童是否存在呼名反应缺陷尚不完全清楚。笔者在本研究中主要采用家庭录像法考察孤独症儿童的呼名反应, 同时考察儿童在呼名反应之后的应答性微笑,共收集46名孤独症儿童的视频资料。结果表明,59.1%的孤独症儿童表现出呼 名反应,但是仅有28.3%的儿童在被呼名后出现应答性微笑。影响呼名反应和应答性微笑的情境因素包括主要活动、交往对 象和互动媒介等。总之,孤独症儿童应答性微笑非常困难。该指标更具有敏感性,可作为孤独症早期的筛查指标之一。     

违约风险、银行信贷筛选与货币政策非对称效应

本文构建一个包含企业违约风险与银行信贷筛选的动态随机一般均衡模型,研究银行信贷筛选对货币政策宏观经济效应产生的影响。在参数校准的基础上,分析了货币政策冲击的长期效应与短期效应。研究结果显示：(1)无论是基于长期还是短期效应的角度,银行信贷筛选均显著抑制了扩张性货币政策对宏观经济产生的积极影响;(2)基于货币政策冲击的短期效应可以发现,银行信贷筛选降低了扩张性货币政策的实际效应,并且放大了货币政策对通胀的影响;(3)通过比较扩张性与紧缩性货币政策的脉冲响应可以发现,银行信贷筛选导致货币政策的宏观经济效应存在非对称性特征。福利分析的结果表明,相比无银行信贷筛选的情形而言,银行信贷筛选导致了整体社会福利的恶化。     

不对称信息下信息技术服务外包合同设计

本文针对客户企业向IT供应商外包信息技术服务这一背景,考虑IT供应商不仅具有开发信息系统能力的私有信息,且其开发过程中的努力行为对于客户企业不可见的情况,研究了客户企业信息技术服务外包合同设计问题。研究发现,不对称信息下,客户企业可以通过设计最优合同菜单来甄别不同能力的IT供应商,但是此时客户企业需要向高能力IT供应商支付信息租金。同时,客户企业可以通过设计最优合同有效规制高能力IT供应商系统开发过程中的努力行为,但是相比于信息对称的情况,不对称信息下低能力IT供应商会存在努力不足的现象。低能力IT供应商努力不足的现象会降低社会福利和客户企业的期望利润;客户企业向高能力IT供应商支付信息租金的行为也会减少客户企业的期望利润。增加系统调试阶段的调试时间或者选择信息系统故障检出率高的IT供应商,可以降低高能力IT供应商的信息租金,并缓解低能力IT供应商努力不足的现象,进而减少信息不对称给客户企业带来的利润损失。     

A boosting inspired personalized threshold method for sepsis screening

Sepsis is one of the biggest risks to patient safety, with a natural mortality rate between 25% and 50%. It is difficult to diagnose, and no validated standard for diagnosis currently exists. A commonly used scoring criteria is the quick sequential organ failure assessment (qSOFA). It demonstrates very low specificity in ICU populations, however. We develop a method to personalize thresholds in qSOFA that incorporates easily to measure patient baseline characteristics. We compare the personalized threshold method to qSOFA, five previously published methods that obtain an optimal constant threshold for a single biomarker, and to the machine learning algorithms based on logistic regression and AdaBoosting using patient data in the MIMIC-III database. The personalized threshold method achieves higher accuracy than qSOFA and the five published methods and has comparable performance to machine learning methods. Personalized thresholds, however, are much easier to adopt in real-life monitoring than machine learning methods as they are computed once for a patient and used in the same way as qSOFA, whereas the machine learning methods are hard to implement and interpret.     

MRI、MRS对鉴别前列腺癌和前列腺增生的诊断价值

目的综合MRI及MRS检查,从形态学和组织代谢双方面诊断、鉴别前列腺癌（PCa）和良性前列腺增生（BPH）,提高磁共振对此两种老年男性易患疾病诊断的准确性。方法回顾性分析经病理证实的30例前列腺癌和35例增生患者的MRI前列腺形态、信号改变及MRS波谱变化,并对其各自诊断结果加以比较。结果30例前列腺癌患者MRI确诊为前列腺癌23例,准确率76.7%;MRI联合MRS确诊为前列腺癌28例,准确率为93.3%。35例BPH患者MRI影像诊断确诊为前列腺增生26例,前列腺癌不除外9例,准确率为74.3%。MRS波谱分析结合MRI影像诊断确诊为前列腺增生31例,前列腺癌不除外4例,准确率为88.6%。结论根据前列腺形态和T2WI上的信号改变,MRI诊断前列腺癌的准确性为75%,敏感性为74.3%,特异性为76.7%。MRI联合MRS诊断前列腺癌的准确性为90.8%,敏感性为88.6%,特异性为93.3%。MRI结合MRS波谱检查可以有效提高前列腺癌诊断的准确性。