Clinically apparent adverse reactions to intra-wound vancomycin powder in early onset scoliosis are rare.

PURPOSE: Spine surgeons have increasingly used intraoperative application of topical vancomycin powder (TVP) to prevent surgical site infections (SSIs). The goals of this study were to define the rate of pharmacological adverse reaction to TVP in young patients undergoing posterior spinal surgery and to summarise institutional variation in TVP dosing. METHODS: This retrospective observational study included ten spine centres in the United States and one in Europe. Patients with early onset scoliosis who underwent posterior spine surgery were eligible for inclusion. Age, weight, TVP dose and surgery type were recorded. Surgeries where patient age was > 12 years were excluded. Pharmacological adverse reactions were defined as clinical instances of Red Man Syndrome, rash, nephrotoxicity, proteinuria, hepatotoxicity or ototoxicity. The rate of pharmacological adverse reaction to TVP was calculated. Dosing practices were summarised. RESULTS: Patient age was in the range of seven months to 12 years (median ten years). Of 1398 observations, there was one possible pharmacological adverse reaction. This was in a ten-year-old, 20.4-kg female patient with neuromuscular sco-liosis undergoing growing rod implantation. She was dosed with 1500 mg of TVP and immediately developed a transient rash without systemic symptoms. This abated over minutes without any medical intervention. There were no other adverse reactions in the sample. The population rate of pharmacological adverse reaction was 0.072% (95% confidence interval 0 to 0.4). Significant variability in dosing practices existed between centres. CONCLUSION: Pharmacological adverse reactions to TVP are rare. Future work may establish evidence-based guidelines for TVP dosing based on patient weight and other variables.

Continuity of cannabis use and violent offending over the life course.

BACKGROUND: Although the association between cannabis use and violence has been reported in the literature, the precise nature of this relationship, especially the directionality of the association, is unclear. METHOD: Young males from the Cambridge Study of Delinquent Development (n = 411) were followed up between the ages of 8 and 56 years to prospectively investigate the association between cannabis use and violence. A multi-wave (eight assessments, T1-T8) follow-up design was employed that allowed temporal sequencing of the variables of interest and the analysis of violent outcome measures obtained from two sources: (i) criminal records (violent conviction); and (ii) self-reports. A combination of analytic approaches allowing inferences as to the directionality of associations was employed, including multivariate logistic regression analysis, fixed-effects analysis and cross-lagged modelling. RESULTS: Multivariable logistic regression revealed that compared with never-users, continued exposure to cannabis (use at age 18, 32 and 48 years) was associated with a higher risk of subsequent violent behaviour, as indexed by convictions [odds ratio (OR) 7.1, 95% confidence interval (CI) 2.19-23.59] or self-reports (OR 8.9, 95% CI 2.37-46.21). This effect persisted after controlling for other putative risk factors for violence. In predicting violence, fixed-effects analysis and cross-lagged modelling further indicated that this effect could not be explained by other unobserved time-invariant factors. Furthermore, these analyses uncovered a bi-directional relationship between cannabis use and violence. CONCLUSIONS: Together, these results provide strong indication that cannabis use predicts subsequent violent offending, suggesting a possible causal effect, and provide empirical evidence that may have implications for public policy.

Childhood Predictors and Adult Life Success of Adolescent Delinquency Abstainers.

While much is known about adolescent delinquency, considerably less attention has been given to adolescent delinquency abstention. Understanding how or why some adolescents manage to abstain from delinquency during adolescence is informative for understanding and preventing adolescent (minor) delinquency. Using data from the Cambridge Study in Delinquent Development (N = 411 males) to compare abstainers, self-report delinquents and convicted delinquents we found five childhood factors (ages 8-10) that predicted adolescent abstention (ages 10-18). First, we find that adolescent abstainers possess characteristics opposite to those of convicted delinquents (namely, abstainers are high on honesty, conformity and family income). However, we also found that abstainers also share some childhood characteristics with convicted delinquents (namely, low popularity and low school achievement). A latent class analysis indicated that the mixed factors predicting abstention can be accounted for by two groups of abstainers: an adaptive group characterized by high honesty, and a maladaptive group characterized by low popularity and low school achievement. Further, validation of these two types of abstainers using data collected at age 48 suggested that adaptive abstainers outperform all other adolescents in general life success, whereas maladaptive abstainers only fare better than delinquent adolescents in terms of lower substance use and delinquency later in life.

Manejo actual de la escoliosis de aparición precoz / Current management of the early onset scoliosis

En los últimos años, el avance en nuevas técnicas quirúrgicas y no quirúrgicas, y el reconocimiento de la trascendencia de preservar la cavida torácica, h an llevado a que el pronóstico de los niños con escoliosis de aparición preco hay mejorado sustancialmente. Los corsés de yeso pueden indicarse en niños que presentan progresión de la deformidad raquídea y curvas menores de 601, a los que no se ha realizado tratamiento quirúrgico previo. Los tallos de crecimiento han probado su eficacia en el control de las curvas, permitiendo a la vez el crecimiento de la columna vertebral. Los tallos de crecimiento electromagnéticos suponen una opción muy prometedora, al evitar las múltiples cirugías a las que se tiene que someter el paciente con los tallos convencionales. El VEPTR está indicado en aquellos pacientes que presentan una escoliosis congénita con fusiones costales y síndrome de insuficiencia torácica asociado. En el caso de niños no tributarios de elongaciones repetidas por sus comorbilidades se puede optar por una técnica Shilla o trolley de Luque. La modulación del crecimiento utilizando grapas de memoria o tirantes empieza a ser una realidad (AU)

In recent years, advances in surgical and non-surgical techniques and comprehension of the importance of preserving the thoracic space has drastically improved the prognosis of children with early onset scoliosis. Casting can be considered in children with curves <60º and documented progression without previous surical treatment. Growing rods have proven to be effective in curve control, preserving at the same time spine growth. Magnetically driven growing rods have shown promising results, avoiding the multiple surgical procedures associated to conventional growing rods. VEPTR seems to be beneficial for patients with congenital scoliosis and fused ribs and thoracic insufficiency syndrome. Children with medical comorbidities who may not tolerate repeated lengthenings should be considered for Shilla or Luque Trolley technique. Growth modulation using SMA staples or other tethers is gradually becomin reality (AU)

Novedades en displasias óseas / Advances in bone dysplasias

La prevalencia de las displasias óseas se calcula en un caso por cada 1.000 habitantes, lo que evidencia que, en algún momento de la trayectoria profesional de un especialista en cirugía ortopédica, se encontrará ante un paciente afecto por ellas. El objetivo de este trabajo es revisar los aspectos generales de las displasias óseas y centrarnos en las que, por su frecuencia e importancia, hemos considerado más destacadas (acondroplasia, displasia epifisaria múltiple, displasia espondiloepifisaria y osteogénesis imperfecta), revisando sus características fundamentales y los últimos avances terapéuticos. No existe tratamiento curativo para estas enfermedades, por lo que el diagnóstico precoz y el manejo terapéutico adecuado se convierten en la clave para mejorar la calidad de vida de estos pacientes (AU)

The prevalence of bone dysplasias is estimated to be one case per 1,000 inhabitants, which suggests that, at some point in the career of an orthopaedic surgeon, he will face with one of these patients. The aim of this paper is to review the general aspects of bone dysplasias and focus on those, which due to their frequency and importance, we consider most relevant (achondroplasia, multiple epiphyseal dysplasia, spondyloepiphyseal dysplasia, osteogenesis imperfecta), reviewing their fundamental features and the latest therapeutic advances. There is no cure for these diseases, so early diagnosis and appropriate therapeutic management, becomes the key to improving quality of life of these patients (AU)

[Advances in bone dysplasias]. / Novedades en displasias óseas.

The prevalence of bone dysplasias is estimated to be one case per 1,000 inhabitants, which suggests that, at some point in the career of an orthopaedic surgeon, he will face with one of these patients. The aim of this paper is to review the general aspects of bone dysplasias and focus on those, which due to their frequency and importance, we consider most relevant (achondroplasia, multiple epiphyseal dysplasia, spondyloepiphyseal dysplasia, osteogenesis imperfecta), reviewing their fundamental features and the latest therapeutic advances. There is no cure for these diseases, so early diagnosis and appropriate therapeutic management, becomes the key to improving quality of life of these patients.

Escoliosis de aparición precoz. ¿Qué opciones tengo? / Early onset scoliosis. What are the options?

El pronóstico de los ni˜nos con escoliosis de aparición precoz progresiva ha mejorado considerablemente gracias a los recientes avances en las técnicas quirúrgicas y no quirúrgicas, y al reconocimiento de la trascendencia de preservar la cavidad torácica. La mejora de técnicas ya existentes y el desarrollo de otras nuevas han modificado sustancialmente el tratamiento de esta entidad. Los yesos derrotatorios pueden indicarse en ni˜nos con curvas < 60◦ y progresión constatada, a los que no se ha realizado tratamiento quirúrgico previo. Tanto los tallos de crecimiento únicos como dobles son eficaces, aunque los últimos parecen ofrecer un mejor resultado. Los sistemas híbridos se plantean como mejor opción en ni˜nos que requieren un anclaje proximal con un perfil bajo. El vertical expandable prosthetic titanium rib (VEPTR®) puede ser útil en pacientes que presentan escoliosis congénita con fusiones costales y síndrome de insuficiencia torácica asociado. Los ni˜nos no tributarios de elongaciones repetidas por sus comorbilidades pueden ser candidatos a una técnica de Shilla o trolley de Luque. La modulación del crecimiento utilizando grapas de memoria o tirantes resulta prometedora en curvas menores, aunque se requieren más trabajos para definir su indicación precisa (AU)

The prognosis of children with progressive early onset scoliosis has improved considerably due to recent advances in surgical and non-surgical techniques and the understanding of the importance of preserving the thoracic space. Improvements in existing techniques and development of new methods have considerably improved the management of this condition. Derotational casting can be considered in children with documented progression of a < 60◦ curve without previous surgical treatment. Both single and dual growing rods are effective, but the latter seem to offer better results. Hybrid constructs may be a better option in children who require a low-profile proximal anchor. The vertical expandable prosthetic titanium rib (VEPTR®) appears to be beneficial for patients with congenital scoliosis and fused ribs, and thoracic Insufficiency Syndrome. Children with medical comorbidities who may not tolerate repeated lengthenings should be considered for Shilla or Luque Trolley technique. Growth modulation using shape memory alloy staples or other tethers seem promising for mild curves, although more research is required to define their precise indications (AU)

[Early onset scoliosis. What are the options?]. / Escoliosis de aparición precoz. ¿Qué opciones tengo?

The prognosis of children with progressive early onset scoliosis has improved considerably due to recent advances in surgical and non-surgical techniques and the understanding of the importance of preserving the thoracic space. Improvements in existing techniques and development of new methods have considerably improved the management of this condition. Derotational casting can be considered in children with documented progression of a <60° curve without previous surgical treatment. Both single and dual growing rods are effective, but the latter seem to offer better results. Hybrid constructs may be a better option in children who require a low-profile proximal anchor. The vertical expandable prosthetic titanium rib (VEPTR(®)) appears to be beneficial for patients with congenital scoliosis and fused ribs, and thoracic Insufficiency Syndrome. Children with medical comorbidities who may not tolerate repeated lengthenings should be considered for Shilla or Luque Trolley technique. Growth modulation using shape memory alloy staples or other tethers seem promising for mild curves, although more research is required to define their precise indications.

RNA splicing and editing modulation of 5-HT(2C) receptor function: relevance to anxiety and aggression in VGV mice.

Changes in serotonin(2C) receptor (5-HTR2c) editing, splicing and density were found in conditions such as depression and suicide, but mechanisms explaining the changes in 5-HTR2c function are unknown. Thus, mice expressing only the fully edited VGV isoform of 5-HTR2c, in which clinically relevant behavioral changes are associated with alterations in splicing and receptor density, were studied. VGV mice displayed enhanced anxiety-like behavior in response to a preferential 5-HTR2c agonist in the social interaction test. Nearly half of interactions between pairs of VGV congeners consisted of fighting behaviors, whereas no fighting occurred in wild-type (WT) mice. VGV mice also exhibited a striking increase in freezing behaviors in reaction to an innately aversive ultrasonic stimulus. This behavioral phenotype occurred in conjunction with decreased brain 5-HT turnover during stress. These functional data were put in relation with the 5-HTR2c mRNA splicing process generating a truncated protein (5-HTR2c-Tr) in addition to the full-length receptor (5-HTR2c-Fl). 5-HTR2c-Tr mRNA was less abundant in many brain regions of VGV mice, which concomitantly had more 5-HTR2c than WT mice. Fluorescence resonance energy transfer and bioluminescence resonance energy transfer studies in transfected living HEK293T cells showed that 5-HTR2c-Tr interacts with 5-HTR2c-Fl. The 5-HTR2c-Tr was localized in the endoplasmic reticulum where it retained 5-HTR2c-Fl, preventing the latter to reach the plasma membrane. Consequently, 5-HTR2c-Tr decreased (3)H-mesulergine binding to 5-HTR2c-Fl at the plasma membrane in a concentration-dependent manner and more strongly with edited 5-HTR2c-Fl. These results suggest that 5-HTR2c pre-mRNA editing and splicing are entwined processes determining increased 5-HTR2c levels in pathological conditions through a deficit in 5-HTR2c-Tr.

[Bone mineral density in a population with severe infantile cerebral palsy]. / Densidad mineral ósea en la población con afectación severa por parálisis cerebral infantil.

OBJECTIVE: To determine the bone mineral density (BMD) values in children and adolescents with moderate and severe infantile cerebral palsy (ICP) in our catchment area, and compare these values with a healthy population. MATERIAL AND METHOD: A prognostic study of cases and controls for the assessment of BMD in patients from 2 to 18 years old with infantile cerebral palsy belonging to the Gross Motor Function Classification System (GMFCS) Groups IV and V. The BMD measurements were performed at distal femur level, dividing this region into 3 areas following the forearm protocol. RESULTS: The BMD for each of the three areas studied results in the final sample of 69 patients were much lower than the reference levels. There was a statistically significant difference (P<.05) between the BMD values in the two sub-groups studied. DISCUSSION: The greater the involvement, from a neurological point of view, in patients classified as Group V shows a very low BMD compared to patients of similar sex and age. The acquisition of bone capital in patients with ICP does not follow the normal pattern of the healthy population.

Cohort differences in the progression of developmental pathways: evidence for period effects on secular trends of violence in males.

BACKGROUND: Rates of violence in the USA have fluctuated widely over the past few decades. Theorists have examined period and cohort effects, but there appear to be no studies examining these effects on progression in developmental pathways towards violence. OBJECTIVE: To assess whether differences in progression among individuals in the Pittsburgh Youth Study are consistent with period or cohort effects. DESIGN: Multivariate logistic regression was conducted to examine differences between cohorts in the odds of progressing through the developmental pathway towards violence. Adjusted and unadjusted odds ratios (ORs) and corresponding 95% CI are reported. SETTING: Pittsburgh Pennsylvania, from 1987 to 2000. SUBJECTS: Two cohorts of male adolescents from the Pittsburgh Youth Study. The youngest cohort (n = 503) was followed from median ages 7 to 20, and the oldest cohort (n = 506) was followed up from median ages 13 to 25. MAIN OUTCOME MEASURE: The odds of progression along a developmental pathway towards violence. RESULTS: There was no statistically significant difference between the cohorts in progression from minor aggression to physical fighting (OR = 1.13, 95% CI 0.77 to 1.65). However, after adjustment for major risk factors, the oldest cohort was significantly more likely to progress from physical fighting to violence (OR = 2.34, 95% CI 1.39 to 3.92). CONCLUSIONS: These results provide initial evidence that cohort effects, which would be present early in development, do not contribute significantly to later differences in reported violence and raises the possibility of whether period effects can explain these differences.

Development and validation of a phosphorylated SMAD ex vivo stimulation assay.

Assessing the pharmacodynamics (PD) of a potential therapeutic through the use of a downstream biomarker is essential. This is traditionally performed in the target tissue but limited volume and invasiveness of sampling pose challenges with solid tumours. Currently, there are several small molecule receptor kinase inhibitors and large molecule therapeutic antibodies in clinical trials that interfere with TGFbeta signalling to treat various forms of cancer. With the advent of these new therapies, there is a need for a surrogate tissue that is easily accessible and indicative of tumour response. We propose the use of an ex vivo TGFbeta1 stimulation of peripheral blood mononuclear cells (PBMCs) coupled with the measurement of phosphorylated SMAD2 (Sma/Mothers Against dpp, a downstream transcriptional activator) using a sandwich ELISA. TGFbeta is involved in many different cellular responses, such as proliferation, angiogenesis, migration, invasion and immunomodulation. SMAD2 and SMAD3 are phosphorylated as a result of the canonical cascade through ligand binding and receptor kinase activation. These phosphorylated SMADs (pSMAD) associate with SMAD4, a co-SMAD, and transcriptionally activate TGFbeta-mediated genes. This paper describes the novel method for measuring the downstream effects of inhibiting canonical TGFbeta signalling using ex vivo stimulation of surrogate tissue to predict tumour response. In addition, we present the assay validation rationale and data. This novel, validated assay can be used to gain insight into clinical trials regarding TGFbeta signal modulation by multiple inhibitor platforms for both large and small molecules.

Effects of light level, time of harvest and position within field on the variability of tissue nitrate concentration in commercial crops of lettuce (Lactuca sativa) and endive (Cichorium endiva).

Seven commercial crops of lettuce and one crop of endive were sampled in order to study the variability in plant tissue nitrate concentration (TNC). Assuming that an appropriate sampling pattern was employed, ten plants were sufficient to give an acceptable estimate of the mean TNC. Short-term shading (24-48 h) had no significant effects on mean TNC, unlike the increase in TNC known to occur following dull periods 10-14 days before harvest. The effect on TNC of time of day harvested was significant, but there was no obvious pattern of diurnal variation. Averaged over all experiments, the coefficient of variation for TNC was in the order of 35%. Increasing the sample size from ten to 40 plants would only be expected to decrease the standard error of measurement of TNC from 16 to 12% of the mean because of the underlying analytical error, which would remain constant.

Mercury in UK imported fish and shellfish and UK-farmed fish and their products.

Total mercury concentrations were measured in fish and shellfish and their products imported into the UK and also in UK-produced farmed salmon and trout. Three hundred and thirty-six samples were collected using a two-stage sampling plan. The sample plan was weighted to reflect consumption, but with some bias towards fish that might accumulate higher levels of mercury, such as large predatory fish at the top of the food chain. The highest levels of total mercury were found in billfish (swordfish and marlin) and shark. Mercury concentrations in the five samples of fresh/frozen shark ranged from 1.006 to 2.200 mg kg(-1), all above the European Commission limit for the species, and concentrations in 20 samples of fresh/frozen billfish ranged from 0.153 to 2.706 mg kg(-1) with 13 samples above the 1.0 mg kg(-1) limit for the species. One sample of Antarctic ice fish was collected and had a mercury concentration of 0.664 mg kg(-1). The limit for this species was 0.5 mg kg(-1). One sample of fresh/frozen tuna out of the 20 collected had a mercury concentration above the limit of 1.0 mg kg(-1) (1.5 mg kg(-1)), but all other fresh tuna samples were well within the regulatory limit (average 0.4 mg kg(-1)). Mercury concentrations in canned tuna were lower with concentrations on average half that measured in fresh/frozen tuna. Mercury concentrations in UK-farmed salmon and trout were relatively low. The maximum concentration found in 46 samples of fresh/frozen or smoked trout and salmon was 0.103 mg kg(-1).

The concentration of offenders in families, and family criminality in the prediction of boys' delinquency.

The main aims of this study were to investigate inter-relationships among offending by three generations of relatives (fathers, mothers, sons, daughters, uncles, aunts, grandfathers and grandmothers) and the concentration of offending in families. This study also investigates how far criminal relatives predict a boy's delinquency. The parents of 1395 Pittsburgh boys aged 8, 11 or 14 reported arrests by all relatives. Parent reports of boys' arrests predicted their later referrals to juvenile court, demonstrating predictive validity. Offenders were highly concentrated in families; if one relative had been arrested, there was a high likelihood that another relative had also been arrested. Arrests of relatives were compared with arrests of the boy, court petitions of the boy, and the boy's reported delinquency (according to the parent, boy and teacher). Arrests of brothers, sisters, fathers, mothers, uncles, aunts, grandfathers and grandmothers all predicted the boy's delinquency. The most important relative was the father; arrests of the father predicted the boy's delinquency independently of all other arrested relatives. Studies of explanatory variables suggested that having a young mother, living in a bad neighbourhood, and low guilt of the boy may be links in the causal chain between arrested fathers and delinquent boys.

Slipped capital femoral epiphysis associated with peripheral osteoarticular tuberculosis.

We report a case of slipped capital femoral epiphysis that developed associated with a peripheral osteoarticular tuberculosis lesion located at the proximal metaphysis of the femur in contact with the growth plate in a 12-year-old boy. Multiple factors have been involved in slipped capital femoral epiphysis pathogenesis, but we believe an osteoarticular tuberculosis lesion is not a common finding as a possible etiological factor causing weakness of the growth plate and, therefore, the femoral head displacement.

Male mental health problems, psychopathy, and personality traits: key findings from the first 14 years of the Pittsburgh Youth Study.

This paper reviews key findings on juvenile mental health problems in boys, psychopathy, and personality traits, obtained in the first 14 years of studies using data from the Pittsburgh Youth Study. This is a study of 3 samples, each of about 500 boys initially randomly drawn from boys in the 1st, 4th, and 7th grades of public schools in Pittsburgh. The boys have been followed regularly, initially each half year, and later at yearly intervals. Currently, the oldest boys are about 25 years old, whereas the youngest boys are about 19. Findings are presented on the prevalence and interrelation of disruptive behaviors, ADHD, and depressed mood. Results concerning risk factors for these outcomes are reviewed. Psychological factors such as psychopathy, impulsivity, and personality are described. The paper closes with findings on service delivery of boys with mental health problems.

Psychosocial predictors of adult antisocial personality and adult convictions.

In the Cambridge Study in Delinquent Development, 411 South London males have been followed up since age 8. This article investigates the ability of psychosocial risk factors measured at age 8 - 10 to predict antisocial personality measures at ages 18 and 32 and convictions between ages 21 and 40. The most important childhood predictors were a convicted parent, large family size, low intelligence or attainment, and child-rearing factors, including a young mother and a disrupted family. The accuracy of prediction of antisocial personality at age 32 on the basis of childhood risk factors measured more than 20 years before was surprising: nearly half of boys with a convicted parent at age 10 were antisocial at age 32, compared with one in six of the remainder. Over 60% of boys very high risk at age 8 - 10 became antisocial at age 32. While the present research shows how far adult antisocial and criminal behavior can be predicted in childhood, more research is needed to establish the precise causal mechanisms involved.

Epidemiology of juvenile violence.

It is difficult to review the epidemiology of juvenile violence because few studies focus specifically on this topic as opposed to childhood aggression or delinquency in general. More research is needed specifically on juvenile violence, which is generally measured using official records or self-reports. Self-report research shows that a substantial fraction of the male juvenile population commits violence, and that very few violent acts are followed by arrests or convictions. Racial differences in violence may be explainable by reference to racial differences in community contexts. There is a great deal of versatility in juvenile violence. Juveniles who commit one type of violent offense also tend to commit other types and nonviolent offenses. Violent offenders tend to be persistent or frequent offenders, and there is little difference between violent offenders and nonviolent but equally frequent offenders. Nevertheless, there is some degree of specialization in violence. More research is needed to investigate whether risk factors exist for violence that are not risk factors for serious nonviolent delinquency (e.g., biologic factors). Violent juveniles tend to have co-occurring problems such as victimization, substance abuse, and school failure. Often, they might be described as multiple-problem youth. There is considerable continuity from childhood aggression to juvenile violence. An early age of onset of violence predicts a large number of violent offenses. The major long-term risk factors for juvenile violence are individual (high impulsiveness and low intelligence, possibly linked to the executive functions of the brain), family (poor supervision, harsh discipline, child physical abuse, a violent parent, large family size, poverty, a broken family), peer delinquency, gang membership, urban residence, and living in a high-crime neighborhood (characterized by gangs, guns, and drugs in the United States). More research is needed on interactions among risk factors, and especially on interactions between biologic and psychosocial risk factors. Important short-term situational factors include motives of potential offenders (e.g., anger, a desire to hurt), alcohol consumption, and actions leading to violent events (e.g., the escalation of a trivial altercation). More specific research is needed on protective factors against youth violence, for example, by investigating why aggressive children do not become violent juveniles. More research is also needed on the development and validation of risk assessment instruments. To investigate developmental and risk factors for juvenile violence, longitudinal studies are needed. Such studies should include multiple cohorts, to draw conclusions about different age groups, and should include both boys and girls and the major racial and ethnic groups. They should measure a wide range of risk and especially protective factors. They should be based on large, high-risk samples, especially in inner-city areas, incorporating screening methods to maximize the yield of violent offenders while simultaneously making it possible to draw conclusions about the total population. They should include long-term follow-up studies to permit conclusions about developmental pathways. They should make a special effort to study careers of violence and to link developmental and situational data. It will not be easy to mount new longitudinal studies focusing specifically on juvenile violence, but such studies are needed to advance knowledge about the epidemiology of juvenile violence, including risk factors and developmental pathways.

The OADP-CDS: a brief screener for adolescent conduct disorder.

OBJECTIVES: To examine the ability of a very brief (6-item) self-report screener, the Oregon Adolescent Depression Project Conduct Disorder Screener (OADP-CDS), to identify adolescents with a lifetime diagnosis of conduct disorder and to examine its ability to predict antisocial personality disorder by age 24. Relevant scales from the Yough Self-Report and the Child Behavior Checklist were examined for comparison purposes. METHOD: A total of 1,709 high school students completed an initial questionnaire and diagnostic interview assessment (T1); 1,507 participants returned approximately 1 year later for a second assessment (T2). A third (T3) assessment was conducted with selected T2 participants (n = 940) after they had turned 24 years of age. RESULTS: The OADP-CDS had good internal consistency, test-retest stability, and screening properties. Differences in the screening ability of the OADP-CDS as a function of gender and social desirability were nonsignificant. The efficacy of the measure as a screener did not differ significantly from that of longer adolescent- and parent-report measures. Perhaps most importantly, the OADP-CDS was able to identify future cases of antisocial personality disorder in young adulthood. CONCLUSIONS: Results suggest that self-report screening for conduct disorder with older adolescents is possible and should be explored further.