Survivors of meningitis often complain about neurological and neuropsychological consequences. In this study, the extent of these sequelae was quantified and correlated to MRI findings. Neurological, neuropsychological and neuroradiological examinations were performed with adult patients younger than 70 years, 1-12 years after recovery from bacterial meningitis (BM; n = 59), or from viral meningitis (VM; n = 59). Patients with other potential causes for neuropsychological deficits (e.g. alcoholism) were carefully excluded. Patients were compared to 30 healthy subjects adjusted for age, gender and length of school education. With the exception of attention functions, both patient groups showed more frequently pathological results than the control group for all domains examined. Applying an overall cognitive sum score, patients after BM did not differ significantly in their performance from patients after VM. Separate analyses of various cognitive domains, however, revealed a higher rate of persistent disturbances in short-term and working memory after BM than after VM. Moreover, patients after BM exhibited greater impairment of executive functions. Associative learning of verbal material was also reduced. These deficits could not be ascribed to impaired alertness functions or decreased motivation in BM patients. Applying a logistic regression model, the neuropsychological outcome was related to the neurological outcome. Patients with a Glasgow Outcome Scale (GOS) of <5 had more frequently impaired test results for non-verbal learning and memory. GOS was also correlated with performance in executive functions. Brain volume was lower and ventricular volume was higher in the bacterial than in the VM group, and cerebral volume and the amount of white matter lesions of patients after BM were negatively correlated with short-term and working memory. In conclusion, patients after both BM and VM with favourable outcome showed affected learning and memory functions. More patients after BM than after VM displayed pathological short-term and working memory. BM resulted in poorer performance in executive functions, language, short-term memory and verbal learning/memory tests. As a result of neurological and neuropsychological sequelae, BM with a GOS > or = 4 led to decreased activities of daily living but only a minority of patients were disabled in a way that social functions were affected. The extent of neuropsychological sequelae of BM might have been overestimated in earlier studies which often had not been controlled for comorbidity factors such as alcoholism.
The goal of the present study was to replicate and extend published preliminary evidence demonstrating that a relatively new treatment (Achieving Change through Value-Based Behavior [ACTV]) for men convicted of domestic violence significantly reduces recidivism compared to the standard treatment offered across the United States (the Duluth Model and/or cognitive-behavioral approaches). Method: Men convicted of domestic assault (DA) and court-mandated to a Batterers Intervention Program [N = 725; M age = 34.9 years (SD age = 10.37 years)] were assigned to attend ACTV or treatment-as-usual (TAU). Participants were predominantly Black (63.3%). Recidivism, defined as any new convictions, any violent convictions, and any DA convictions, was examined up to 5 years posttreatment. Only men classified as medium or high risk were included. Results: Men in TAU were more likely to receive any conviction (95% CI [1.61, 4.40]), a violent conviction (95% CI [1.67, 9.60]), and a DA conviction (95% CI [1.36, 4.90]) compared to men in ACTV. Time to new conviction posttreatment was shorter for men in TAU versus ACTV (95% CI [2.16, 4.11]). Finally, the risk of receiving any new conviction (95% CI [1.46, 7.11]) was more strongly associated with noncompletion for TAU than ACTV participants. Conclusions: ACTV shows great promise for reducing recidivism compared to TAU. The present study represents the first time this intervention has been implemented in a state other than where it was developed and provides initial evidence for its generalizability and robustness.What is the public health significance of this article? Intimate partner violence (IPV) is highly prevalent in U.S. families and yields financial costs exceeding $5.8 billion each year. Even mild and infrequent forms of physical IPV have serious consequences for individuals, couples, and children exposed to violence. Interventions that reduce the prevalence of psychological and physical IPV among men who have engaged in IPV previously would have benefits for victims, children, and society.
The COVID-19 pandemic has profoundly altered life in the United States, especially for ethnic and racial minority communities who are disproportionately affected by the virus. In this descriptive study, we sought to understand how mixed-gender Latine couples in the U.S. are functioning both dyadically and individually, in addition to identifying aspects of their unique experience during the early stages of the pandemic. We administered an online survey to 146 participants (67 mixed-sex dyads and 12 individual partners), already enrolled in a longitudinal study on marital functioning, in which at least one partner self-identified as Latine. Results from the study revealed couples overwhelmingly reported positive relationship functioning, although individual stress and negative affect were both elevated, suggesting that individual—but not relational—distress is prevalent among Latine couples during the COVID-19 pandemic. We recommend that clinicians working with Latine couples focus on helping them adapt to COVID-related stressors rather than addressing novel relationship problems and to approach their relationships as fundamentally protective. This study lays important groundwork for how Latine couples are experiencing the pandemic and demonstrates profound resilience against the potentially negative impacts of stress on relationships.
A 74-year-old man presented in a pulmonary clinic with symmetrically ascending tetraparesis. Physical and neurophysiological examinations suggested Guillain-Barré syndrome. The patient was treated with an initial course of 7s immunoglobulins without success. His state worsened until he was unable to walk. Severe eosinophilia (41%) was later noted in the differential white blood cell count. Combined with the onset of asthma-like symptoms, this prompted us to suspect Churg-Strauss syndrome. Despite treatment with high-dose corticoids, the palsy did not improve. It was only after immunosuppression with cyclophosphamide that the patient began to recover. The subgroup of necrotising vasculitides must be considered as differential diagnosis of rapidly progressive, symmetrical neuropathy with ascending course. Early identification and treatment are essential, since early immunosuppressive therapy is often successful, whereas delayed initiation of treatment may lead to a fatal outcome.
Homicide injury severity (HIS), the degree of physical injury inflicted on a victim during a homicide, has emerged as a relevant criminological variable. However, little is known regarding the offender characteristics and criminological variables that may be associated with greater HIS. Data (demographic, cognitive, and criminological variables) from forensic neuropsychological evaluations of N = 101 offenders convicted of murder, were explored in relation to the Homicide Injury Scale. Numerous factors were related to HIS. Results partially replicate prior findings of factors associated with violent offending and provide preliminary evidence for distinct risk factors for inflicting severe injury during a homicide.
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