Revising the self-report strengths and difficulties questionnaire for cross-country comparisons of adolescent mental health problems: the SDQ-R.

AIMS: The Strengths and Difficulties Questionnaire (SDQ) has been used in many epidemiological studies to assess adolescent mental health problems, but cross-country comparisons of the self-report SDQ are scarce and so far failed to find a good-fitting, common, invariant measurement model across countries. The present study aims to evaluate and establish a version of the self-report SDQ that allows for a valid cross-country comparison of adolescent self-reported mental health problems. METHODS: Using the Health Behaviour in School-aged Children study, the measurement model and measurement invariance of the 20 items of the self-report SDQ measuring adolescent mental health problems were evaluated. Nationally representative samples of 11-, 13- and 15-year old adolescents (n = 33 233) from seven countries of different regions in Europe (Bulgaria, Germany, Greece, the Netherlands, Poland, Romania, Slovenia) were used. RESULTS: In order to establish a good-fitting and common measurement model, the five reverse worded items of the self-report SDQ had to be removed. Using this revised version of the self-report SDQ, the SDQ-R, partial measurement invariance was established, indicating that latent factor means assessing conduct problems, emotional symptoms, peer relationships problems and hyperactivity-inattention problems could be validly compared across the countries in this study. Results showed that adolescents in Greece scored relatively low on almost all problem subscales, whereas adolescents in Poland scored relatively high on almost all problem subscales. Adolescents in the Netherlands reported the most divergent profile of mental health problems with the lowest levels of conduct problems, low levels of emotional symptoms and peer relationship problems, but the highest levels of hyperactivity-inattention problems. CONCLUSIONS: With six factor loadings being non-invariant, partial measurement invariance was established, indicating that the 15-item SDQ-R could be used in our cross-country comparison of adolescent mental health problems. To move the field of internationally comparative research on adolescent mental health forward, studies should test the applicability of the SDQ-R in other countries in- and outside Europe, continue to develop the SDQ-R as a cross-country invariant measure of adolescent mental health, and examine explanations for the found country differences in adolescent mental health problems.

[Ultrasound diagnosis in blunt thoracic trauma]. / Ultraschalldiagnostik beim stumpfem Thoraxtrauma.

AIM: Aim of the study was to determine the rate of injuries detectable by ultrasonography in patients suffering from blunt thoracic trauma. PATIENTS AND METHODS: Ultrasonography of the thorax was prospectively performed in patients with blunt chest trauma additionally to the routine radiological diagnostic procedures. A comparison between ultrasonography and chest x-ray findings referring to the rate of detection of fractures and pleural effusions was performed. RESULTS: 100 patients were enrolled in the study. 23 of them were examined within 24 hours after the trauma, the remaining 77 were examined with a delay of more than 24 hours. The findings detectable by ultrasonography were the following: fractured rib 65%, fracture of sternum 7%, fracture of clavicle 1%, rib fracture with callus 3%, haematoma of the chest wall 11%, pleural effusion 37%, pneumothorax 1%, atelectasis 8%, pneumonia 1%, lung contusion 18%, splenic rupture 3%. Rib fractures were detected in 36% of the patients and pleural effusions were detected in 11%, respectively, by chest x-ray. CONCLUSION: Rib fractures and pleural effusions are commonly diagnosed by ultrasonography in patients with blunt thoracic trauma. Concerning the diagnosis of rib fractures (65% versus 36%) and pleural effusions (37% versus 11%), ultrasonography is superior to chest-x-ray. A new and remarkable result is that subpleural infiltrates which are supposed to be lung contusions are also detectable by ultrasonography.

Tipos de formaciones venosas en la fosa cubital en jóvenes chilenos / Types of vein formations in the cubital fossa of young chileans

Estudiamos las venas superficiales de la fosa cubital en 400 antebrazos; 200 derechos y 200 izquierdos, de jóvenes de ambos sexos: 57 por ciento masculinos y 43 por ciento femeninos, chilenos, de diferentes grupos étnicos, entre 17 y 24 años, todos estudiantes de la Facultad de Medicina de la Universidad de la Frontera; con la finalidad de contribuir para el conocimiento anatómico, clínico y médico-quirúrgico. Basados en los datos obtenidos, clasificamos las formaciones venosas en cinco tipos: tipo I: 145 casos 36,25 por ciento , la vena cafálica VC se divide en vena intermedia basílica VIB y vena intermedia cefálica VIC, uniéndose a la vena basílica VB y vena cefálica accesoria VCA, respectivamente; la vena intermedia del antebrazo VIA drena generalmente en la VIB o en la VB; tipo II: 115 casos 28,75 por ciento , la VC origina la vena intermedia del codo VICo que se une a la VB, no existe VCA; tipo III: 69 casos 17,25 por ciento , no existe comunicación entre la VB y la VC a nivel de la fosa cubital; tipo IV: 59 casos 14,75 por ciento , la VC drena en la VB; tipo V: 12 casos 3 por ciento , con otras disposiciones. La VIB se presentó más voluminosa en el tipo II. Para la punción venosa en la fosa cubital recomendamos utilizar, preferencialmente, la VIB o VICo recordando su estrecha relación con el nervio cutáneo medial del antebrazo y con la arteria braquial