RESULTS OF THE COLLABORATIVE STUDY ON NEUROFIBROMATOSIS TYPE-1 (NF1) IN ITALY

The results of a collaborative Italian study on Neurofibromatosis type 1 (NF1) among the Pediatric Institute of Siena and 63 Italian Pediatric Institutions are reported. Data regarding 375 NF1 cases have been obtained from the Italian Registry of Neurocutaneous Syndromes established in 1987. The study allowed us to obtain data about the frequency of the main findings of the disease. Some of these findings, such as macrocephaly and multiple areas of increased signal intensity on T2-weighted images at brain MRI (Unidentified Bright Objects or UBOs) are not included in the diagnostic criteria; however they appear to be important from the diagnostic point of view because of their high incidence. UBOs have been observed in 56% of cases in which MRI was performed and, since they did not show an invasive nature, it is important that these images are well known in order to avoid a misdiagnosis of cerebral tumors. DNA linkage analysis, using probes linked to NF1 locus in 9 families with 2 or 3 generations of NF1-patients, indicated that 6 of these families resulted informative and a prenatal diagnosis would be possible whenever requested. The same molecular study allowed us to exclude the disease in 3 at risk individuals coming from 3 different families. Two recent international Seminars and the istitution of the Italian Association of Neuro Ectodermosis (A.I.N.E.) have greatly contribute to improve the knowledge about the genetic and clinic implications of the disease among physicians and general population. We think useful to obtain a widespread collaboration among all physicians who take care of NFI-patients and to operate in order to obtain from the politic authorities an adequate assistence to these patients and their families

Development and psychometric properties of the “Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales” in adolescents

Suicidality in the child and adolescent population is a major public health concern. There is, however, a lack of developmentally sensitive valid and reliable instruments that can capture data on risk, and clinical and psychosocial mediators of suicidality in young people. In this study, we aimed to develop and assess the validity of instruments evaluating the psychosocial risk and protective factors for suicidal behaviours in the adolescent population. In Phase 1, based on a systematic literature review of suicidality, focus groups, and expert panel advice, the risk factors and protective factors (resilience factors) were identified and the adolescent, parent, and clinician versions of the STOP-Suicidality Risk Factors Scale (STOP-SRiFS) and the Resilience Factors Scale (STOP-SReFS) were developed. Phase 2 involved instrument validation and comprised of two samples (Sample 1 and 2). Sample 1 consisted of 87 adolescents, their parents/carers, and clinicians from the various participating centres, and Sample 2 consisted of three sub-samples: adolescents (n = 259) who completed STOP-SRiFS and/or the STOP-SReFS scales, parents (n = 213) who completed one or both of the scales, and the clinicians who completed the scales (n = 254). The STOP-SRiFS demonstrated a good construct validity—the Cronbach Alpha for the adolescent (α = 0.864), parent (α = 0.842), and clinician (α = 0.722) versions of the scale. Test–retest reliability, inter-rater reliability, and content validity were good for all three versions of the STOP-SRiFS. The sub-scales generated using Exploratory Factor Analysis (EFA) were the (1) anxiety and depression risk, (2) substance misuse risk, (3) interpersonal risk, (4) chronic risk, and (5) risk due to life events. For the STOP-SRiFS, statistically significant correlations were found between the Columbia-Suicide Severity Rating Scale (C-SSRS) total score and the adolescent, parent, and clinical versions of the STOP-SRiFS sub-scale scores. The STOP-SRiFS showed good psychometric properties. This study demonstrated a good construct validity for the STOP-SReFS—the Cronbach Alpha for the three versions were good (adolescent: α = 0.775; parent: α = 0.808; α = clinician: 0.808). EFA for the adolescent version of the STOP-SReFS, which consists of 9 resilience factors domains, generated two factors (1) interpersonal resilience and (2) cognitive resilience. The STOP-SReFS Cognitive Resilience sub-scale for the adolescent was negatively correlated (r = − 0.275) with the C-SSRS total score, showing that there was lower suicidality in those with greater Cognitive Resilience. The STOP-SReFS Interpersonal resilience sub-scale correlations were all negative, but none of them were significantly different to the C-SSRS total scores for either the adolescent, parent, or clinician versions of the scales. This is not surprising, because the items in this sub-scale capture a much larger time-scale, compared to the C-SSRS rating period. The STOP-SReFS showed good psychometric properties. The STOP-SRiFS and STOP-SReFS are instruments that can be used in future studies about suicidality in children and adolescents

Kreislaufstillstand in besonderen Situationen

Truhlář A, Deakin CD, Soar J, et al. Kreislaufstillstand in besonderen Situationen. Notfall + Rettungsmedizin. 2015;18(8):833-903