Comparing patient characteristics and treatment processes in patients receiving physical therapy in the United States, Israel and the Netherlands. Cross sectional analyses of data from three clinical databases

<p>Abstract</p> <p>Background</p> <p>Many assume that outcomes from physical therapy research in one country can be generalized to other countries. However, no well designed studies comparing outcomes among countries have been conducted. In this exploratory study, our goal was to compare patient demographics and treatment processes in outpatient physical therapy practice in the United States, Israel and the Netherlands.</p> <p>Methods</p> <p>Cross-sectional data from three different clinical databases were examined. Data were selected for patients aged 18 years and older and started an episode of outpatient therapy between January 1^st2005 and December 31^st2005. Results are based on data from approximately 63,000 patients from the United States, 100,000 from Israel and 12,000 from the Netherlands.</p> <p>Results</p> <p>Age, gender and the body part treated were similar in the three countries. Differences existed in episode duration of the health problem, with more patients with chronic complaints treated in the United States and Israel compared to the Netherlands. In the United States and Israel, physical agents and mechanical modalities were applied more often than in the Netherlands. The mean number of visits per treatment episode, adjusted for age, gender, and episode duration, varied from 8 in Israel to 11 in the United States and the Netherlands.</p> <p>Conclusion</p> <p>The current study showed that clinical databases can be used for comparing patient demographic characteristics and for identifying similarities and differences among countries in physical therapy practice. However, terminology used to describe treatment processes and classify patients was different among databases. More standardisation is required to enable more detailed comparisons. Nevertheless the differences found in number of treatment visits per episode imply that one has to be careful to generalize outcomes from physical therapy research from one country to another.</p

Sexual Abuse-Current Medico-legal, Forensic and Psychiatric Aspects

Abstract Violence against women and minors is a worldwide problem that has not yet been sufficiently acknowledged. There are many obstacles especially when sexual abuses have to be evaluated. These problems are present both when victims of sexual abuse are evaluated and when sex offenders are dealt with, especially when the offenders are juvenile sex offenders (JSO). These issues give cause for great concern about prognosis, and the resulting psychosocial implications, and call for a special effort from the scientific community in identifying appropriate prevention and treatment methods. This chapter is divided into two parts. The first part deals with the forensic and psychiatric features, such as diagnostic and therapeutic/rehabilitative strategies for JSO, while the second part analyzes the legal–medicine aspects related to rape/sexual assault in a European context

Childhood traumatic experiences and mental health problems in sexually offending and non-sexually offending juveniles

OBJECTIVE: To examine the relationship between a history of childhood abuse and mental health problems in juveniles who sexually offended (JSOs) over and above general offending behavior. METHODS: A sample of 44 JSOs incarcerated in two juvenile detention centers in the Netherlands between May 2008 and March 2014 were examined for childhood abuse history (Childhood Trauma Questionnaire-Short Form) and mental health problems (Massachusetts Youth Screening Instrument-Version 2). Furthermore, the connection between childhood abuse and mental health problems in JSOs was compared to a sample of 44 propensity score matched juveniles who offended non-sexually (non-JSOs). RESULTS: In JSOs, sexual abuse was related to anger problems, suicidal ideation, and thought disturbance. These associations were significantly stronger in JSOs than in non-JSOs. CONCLUSIONS: Our results suggest that the relationship between childhood abuse and both internalizing and externalizing mental health problems is of more salience for understanding sexual offending than non-sexual offending, and should, therefore, be an important focus in the assessment and treatment of JSOs

JUVENILE SEX OFFENDERS: MENTAL HEALTH AND REOFFENDING

New methods for child psychiatric diagnosis and treatment outcome evaluatio

Mental disorders and criminal re-referrals in juveniles who sexually offended

OBJECTIVE: To investigate the prevalence of mental disorders in (subgroups of) juvenile suspects who sexually offended (JSOs), and its relation with criminal re-referrals five to eight years later. METHODS: A sample of 106 JSOs (mean age 15.0 +/- 1.5 years) referred to the Dutch Child Protection Board between May 2003 and December 2006 was classified into JSOs with child victims (N = 19), solo JSOs with adolescents and/or adults victims (N = 29), and group JSOs with adolescents and/or adults victims (N = 58). Mental disorders were assessed at baseline by means of a semi-structured interview (K-SADS-PL), the level of functioning by means of the Children's Global Assessment Scale (CGAS) and re-referrals was ascertained from official judicial registration systems. RESULTS: Three quarters of JSOs met criteria for at least one mental disorder. Comorbidity was found in more than half of the subjects and almost two thirds of the JSOs were functionally impaired. As compared to the other subgroups, JSOs with child victims showed higher rates of affective disorders and had a lower overall level of functioning. Furthermore, JSOs re-referred for another sexual offense were more often diagnosed with an affective disorder, were more often sexually abused and had a lower level of global functioning than JSOs who were not re-referred for another sex offense. CONCLUSIONS: JSOs should receive mental assistance, as more than two thirds are functionally impaired due to mental problems. This may not only be important to safeguard the development of the juvenile offender but might also reduce repeated sexual offending

Self-reported psychopathic traits in sexually offending juveniles compared with generally offending juveniles and general population youth

The aim of the current study is to gain a better insight into the relationship between sexually aggressive behaviour and psychopathy in youths; juveniles who sexually offended (JSOs) were compared with generally offending youths and a general population group. Seventy-one JSOs, 416 detained general offenders, and 331 males from the general population were assessed by means of the Youth Psychopathic traits Inventory (YPI), a self-report instrument. Sexually and generally offending juveniles had significantly lower levels of self-reported psychopathic traits than youths from the general population. Juvenile sexual offenders and generally offending juveniles did not differ in self-reported psychopathic traits. Furthermore, no differences in self-reported psychopathic traits were found between subgroups of JSOs (i.e., child molesters, solo offenders, and group offenders). The finding that self-reported psychopathic traits are less prevalent in offending juveniles than in general population youths raises questions about the usefulness of the YPI when comparing psychopathic traits between clinical samples and general-population samples