Relation between therapeutic response and side effects induced by methylphenidate as observed by parents and teachers of children with ADHD

<p>Abstract</p> <p>Background</p> <p>The desired (therapeutic) and undesired (side) effects of methylphenidate might have underlying correlations. The aim of this study was to explore the strength and the possible sources of these correlations.</p> <p>Methods</p> <p>One hundred and fifty-seven children with ADHD (6-12 years) were administered placebo and methylphenidate (0.5 mg/kg in a divided b.i.d. dose), each for a one-week period, in a double-blind, crossover trial. Therapeutic response was assessed using the Conners' Global Index for parents (CGI-Parents) and teachers (CGI-Teachers), while side effects were assessed using the Barkley Side Effects Rating Scale (SERS).</p> <p>Results</p> <p>The side effect profile as assessed by the SERS was similar to that of previous studies with insomnia, decreased appetite, and headaches showing significant treatment effects (p < 0.005). These "somatic/physical" side effects did not correlate with CGI-Parents or CGI-Teachers. However, the side effects of "irritability", "proneness to crying", and "anxiousness" showed significant relationships with CGI-Parents. These "mood/anxiety" side effects showed no significant correlations with the CGI-Teachers.</p> <p>Conclusion</p> <p>The greater "mood/anxiety" side effects on methylphenidate and placebo, the less the parents observe improvement of their children while treated with methylphenidate. This suggests that the correlations between "mood/anxiety" side effects and poor response to treatment may be driven by observer effects rather than biological commonalities between therapeutic and side effects of methylphenidate.</p

Understanding ADHD

The articles presented in this thesis examined issues of identification and perception of Attention Deficit Hyperactivity Disorder (ADHD) in a sample of 38 boys with ADHD and 43 comparison boys without ADHD. The boys were recruited from local schools in the Montreal area as well as through the community. In Article 1, the positive illusory bias was explored in the area of attention using two different tasks in order to improve our understanding of the self-perceptions of boys with ADHD. Some evidence for positive illusions was found in that boys with ADHD estimated performance at the same level as the comparison group despite performing significantly worse. Additionally, on the Conners' Continuous Performance Test-II (C-CPT-II), significantly more boys with ADHD overestimated their performance than comparison boys. However, because the majority of the boys underestimated their performance, it is suggested that in unfamiliar situations boys with ADHD do not exhibit positive illusions to the same extent as in familiar situations. In Article 2, the perceptions of ADHD reported by others were examined in relation to an objective measure of attention. Through this, the validity of the C-CPT-II was also examined. Parent and teacher ratings of boys with ADHD were compared to boys' performance on the C-CPT-II. Parents completed the Conners' Parent Rating Scale-Revised (CPRS-R) and the Child Behavior Checklist (CBCL) and teachers completed the Conners' Teacher Rating Scale-Revised (CTRS-R). While both parent and teacher ratings on the CPRS-R and the CTRS-R respectively showed significant correlations with performance, teachers' ratings had the highest correlations with the errors of the C-CPT-II. Only the externalizing total T score rating on the CBCL was correlated with performance on the C-CPT-II. Additionally, boys with ADHD performed significantly more poorly than comparison boys on the C-CPT-II. However, there was no significant difference between the performance of boys with ADHD and boys with learning disabilities or between boys with learning disabilities and comparison boys. Using discriminate function analysis, the C-CPT-II was able to correctly classify 72% of the participants into either an ADHD or comparison group. The final discussion centres on this research programme's contribution to the field

Strategic Issues, Problems and Challenges in Inductive Theorem Proving

Abstract(Automated) Inductive Theorem Proving (ITP) is a challenging field in automated reasoning and theorem proving. Typically, (Automated) Theorem Proving (TP) refers to methods, techniques and tools for automatically proving general (most often first-order) theorems. Nowadays, the field of TP has reached a certain degree of maturity and powerful TP systems are widely available and used. The situation with ITP is strikingly different, in the sense that proving inductive theorems in an essentially automatic way still is a very challenging task, even for the most advanced existing ITP systems. Both in general TP and in ITP, strategies for guiding the proof search process are of fundamental importance, in automated as well as in interactive or mixed settings. In the paper we will analyze and discuss the most important strategic and proof search issues in ITP, compare ITP with TP, and argue why ITP is in a sense much more challenging. More generally, we will systematically isolate, investigate and classify the main problems and challenges in ITP w.r.t. automation, on different levels and from different points of views. Finally, based on this analysis we will present some theses about the state of the art in the field, possible criteria for what could be considered as substantial progress, and promising lines of research for the future, towards (more) automated ITP

Therapeutic Recreation Education in Canada: A Review of the Current Curriculum

Abstract This descriptive study sought to identify the similarities and differences between the various educational institutions offering therapeutic recreation curriculum across Canada. The study utilized mixed methods, including open and closed-ended questions on a survey and document analysis. The research participants were from 14 educational institutions located across the nation. Results from this study identify similarities and differences in the curriculum used to prepare students pursuing a career in the TR field. Core competencies and standards of practice for the field of therapeutic recreation were defined and discussed. Accreditation and the accrediting bodies in the field of TR are reviewed because of their significant impact on curriculum. Implications regarding certification and regulation pertaining to the education for therapeutic recreation practitioners were discussed along with suggestions for future research

Debtor Assistance and Debt Advice: The Role of the Canadian Credit Counselling Industry

A continuing theme of our work, and that of others, has been the failure of insolvency law to keep pace with the new problems faced by low-income debtors. Researchers have suggested that the cost of personal bankruptcy puts it beyond the reach of many of those in need of it, though it has proven difficult to demonstrate conclusively that large numbers of low income debtors would take advantage of bankruptcy if the price was lower. In this paper, we analyze another industry — the not-for-profit credit counselling industry — that has grown rapidly in recent years and that offers a different sort of remedy for financial distress. We begin in Section II with a brief history of the credit counseling industry in Canada and in the US. We show how the industry has evolved from a small set of government-subsidized and community-based not-for-profit groups into an industry that is heavily subsidized by credit suppliers and, for the most part, lacking any significant community connection. In Section III, we briefly set out the regulatory framework that seems to encompass credit counselling agencies (“CCA”), both for-profit and not-for-profit. We do not, however, reach any conclusions on the application of this framework to Canadian CCA. Instead, we describe the concepts underlying the framework in a coordinated way. In Section IV, based on a set of mystery calls to the largest CCA, we show that most simply have nothing to offer low-income debtors and that most do not do a good job of providing information concerning the alternatives available to them. Rather than introducing substantive legislative or legal rules to help low-income debtors, the Canadian federal government has chosen instead to promote financial education with its 2010 Task Force on Financial Literacy. In Section V, we briefly analyze the Task Force process, suggesting that it largely overlooked the needs of the poor

You Can’t Save Dead People: The Emerging Battles over Supervised Consumption Sites

The United States is experiencing a drug overdose epidemic of historic proportions. As fatal overdose rates continue to increase, some jurisdictions have sought evidence-based solutions to this public health issue. This Comment concerns one proposed remedy in particular: supervised consumption sites. In a supervised consumption site, drug users are encouraged to consume their own drugs at the facility. Facility staff give drug users clean equipment, teach safe injection techniques, and, most importantly, monitor drug users for symptoms of overdose. If a staff member witnesses an overdose, they act to prevent the overdose from becoming fatal. Research conducted on supervised consumption sites outside the United States has generally concluded that the sites are effective at saving lives, preventing the spread of disease, and eventually leading drug users towards treatment. As of this writing, no supervised consumption sites operate legally in the United States. U.S. jurisdictions that have considered establishing supervised consumption sites face a number of legal hurdles, including the threat of federal prosecution. However, these jurisdictions can take steps to put their proposed supervised consumption sites, and those who will utilize and staff them, in the best possible legal position under their own laws. This Comment focuses on the emerging issue of supervised consumption sites by examining research on supervised consumption sites and its implications for the sites as a public health measure. Specifically, this Comment looks at King County, Washington, which, jointly with the City of Seattle and other entities and organizations, created a detailed plan to establish supervised consumption sites that has faced legal and political challenges. This Comment contrasts King County’s legal hurdles with those faced by San Francisco, California, which also seeks to implement the sites. This Comment makes three recommendations to any jurisdiction seeking to implement the sites: (1) empower public health boards to make decisions in the public interest that are protected from direct referendum, (2) allow public health boards to make decisions in the name of public health unconstrained by criminal law, and (3) if necessary, enact legislation at the state level to exempt supervised consumption sites from state drug laws. Finally, this Comment calls for a change in federal law to allow jurisdictions to legally establish supervised consumption sites

Law in the Age of Exabytes: Some further Thoughts on ‘Information Inflation’ and Current Issues in E-Discovery Search

In 2007, in the pages of this Journal, George L. Paul and I posed a question to the legal profession at large, to wit: can the legal system adapt to the new reality of an era of rapid inflation in the amount of electronically stored information (ESI) at issue in civil litigation? After surveying the history of technological innovation that led to an explosion of new data, we proceeded to discuss various legal strategies for success in our current inflationary epoch. These strategies included: consideration of new and emerging ways in which to think about search and information retrieval in light of the limitations of traditional keyword searching the legal profession had come to rely upon; greater use of sampling and iteration so as to ensure greater quality; the use of multiple meet-and- confers to produce a “virtuous feedback cycle” of cooperation amongst counsel; predicting congressional enactment of Federal Rule of Evidence 502, enabling parties to leverage resources by providing large amounts of data in open discovery; and finally, making tentative predictions about the future of artificial intelligence as applied to information law problems