In order to effectively study the population experiencing insomnia, it is important to identify reliable and valid tools to measure sleep that can be administered in the home setting. The purpose of this study was to assess psychometric properties for the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in community-dwelling adults with primary insomnia. The CPSQI had an overall reliability coefficient of 0.82 -0.83 for all subjects. "Subjective sleep quality" was the component most highly correlated with the global score. Overall, the CPSQI showed acceptable test-retest reliability over a 14- to 21-day interval with a coefficient of 0.85 for all subjects and 0.77 for primary insomniacs. The two contrasting groups had significantly different global and component scores. A CPSQI of greater than 5 yielded a sensitivity and specificity of 98 and 55% in primary insomniacs vs. controls. A CPSQI of greater than 6 resulted in a sensitivity and specificity of 90 and 67%. Results suggest that the CPSQI is a psychometrically sound measure of sleep quality and disturbance for patients with primary insomnia. It may not be an effective screening tool because of its low specificity, but it can be a sensitive, reliable, and valid outcome assessment tool for use in community-based studies of primary insomnia.

Title. The efficacy of reflexology: systematic review. Aim. This paper is a report of a systematic review to evaluate the efficacy of reflexology in any condition. Background. Anecdotal evidence has shown potential benefits of reflexology in a variety of health conditions. However, the efficacy of reflexology has yet to be determined. Data sources. Cochrane library, PubMed, MEDLINE, EBM review, ProQuest Medical Bundle and SCOPUS databases were searched using the following medical subject headings or key words: reflexology, foot reflexotherapy, reflexological treatment, foot massage and zone therapy. Chinese articles were searched through the Chinese electronic periodical services and Wangfane database. The publication date was limited from 1996 to 2007. Review methods. Studies were selected if they were written in English or Chinese, used a controlled clinical trial design, used reflexology as a stand-alone modality, and reported such outcomes as symptoms relief, quality of life and patients' perceptions of reflexology. Study quality was reviewed based on the evidence rating system of the United States Preventive Services Task Force, and studies with the evidence rating of II-2 fair or above were included in this review. Results. Among the five studies suitable for review, there was only one report of a statistically significant treatment effect. Among the 12 outcome variables examined, the treatment effect size for urinary symptoms was large, whereas the effect size for other conditions was negligible.Conclusion. There is no evidence for any specific effect of reflexology in any conditions, with the exception of urinary symptoms associated with multiple sclerosis. Routine provision of reflexology is therefore not recommended.

CONTEXT: The Child Behavior Checklist-Attention Problem (CBCL-AP) scale and Conners Rating Scale-Revised (CRS-R) are commonly used behavioral rating scales for diagnosing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. OBJECTIVE:To evaluate and compare the diagnostic performance of CBCL-AP and CRS-R in diagnosing ADHD in children and adolescents.DATA SOURCES: PubMed, Ovid Medline, and other relevant electronic databases were searched for articles published up to May 2015. STUDY SELECTION:We included studies evaluating the diagnostic performance of either CBCL-AP scale or CRS-R for diagnosing ADHD in pediatric populations in comparison with a defined reference standard. DATA EXTRACTION:Bivariate random effects models were used for pooling and comparing diagnostic performance. RESULTS:We identified and evaluated 14 and 11 articles on CBCL-AP and CRS-R, respectively. The results revealed pooled sensitivities of 0.77, 0.75, 0.72, and 0.83 and pooled specificities of 0.73, 0.75, 0.84, and 0.84 for CBCL-AP, Conners Parent Rating Scale-Revised, Conners Teacher Rating Scale-Revised, and Conners Abbreviated Symptom Questionnaire (ASQ), respectively. No difference was observed in the diagnostic performance of the various scales. Study location, age of participants, and percentage of female participants explained the heterogeneity in the specificity of the CBCL-AP.CONCLUSIONS: CBCL-AP and CRS-R both yielded moderate sensitivity and specificity in diagnosing ADHD. According to the comparable diagnostic performance of all examined scales, ASQ may be the most effective diagnostic tool in assessing ADHD because of its brevity and high diagnostic accuracy. CBCL is recommended for more comprehensive assessments.a School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; and b Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan Dr Chang conceptualized and designed the study, performed the analyses, and drafted the initial manuscript; Professor Wang participated in the study selection and data extraction process, conducted the quality assessment of the study, and reviewed and revised the manuscript; Professor Tsai participated in the study design, coordinated and supervised data collection, and critically reviewed and revised the manuscript; and all authors approved the fi nal manuscript and are accountable for all aspects of the study. 7,8 Therefore, it is crucial to identify children and adolescents with ADHD so that appropriate treatments and interventions can be applied for preventing the adverse consequences associated with this disorder. DOIDiagnostic criteria for identifying ADHD are based on behavioral symptoms, because of the lack of reliable biological markers for diagnosing ADHD. 9 Behavior rating scales, which comprise checklists that examine various behaviors and symptoms, are the most common ADHD assessment tools in schools and communities because of their uncomplicated administration and high ti...

Taiwanese adults had a high prevalence of insomnia. Insomnia contributed at least partially to an individual's psychological well-being.

These randomized controlled trial studies demonstrated that CBT was superior to any single-component treatment such as stimulus control, relaxation training, educational programmes, or other control conditions. However, heterogeneity in patient assessment, CBT protocols, and outcome indicators made determination of the relative efficacy and clinical utility of the therapy difficult. Therefore, the standard components of CBT need to be clearly defined. In addition, a comprehensive assessment of patients is essential for future studies.