421 research outputs found
The Transition to Middle School is Associated with Changes in the Developmental Trajectory of ADHD Symptomatology in Young Adolescents with ADHD
The attention deficit hyperactivity disorder (ADHD) symptom presentation of young adolescents with
ADHD was examined in association with the transition to middle school. This study used data collected in
the Multimodal Treatment Study of ADHD, which included children between 7 and 9 years of age with a
diagnosis of ADHD (n=258) and grade- and sex-matched controls (n=112). The trajectory of ADHD
symptoms before, during, and after the transition to middle school was modeled using hierarchical linear
modeling. A clear developmental reduction in ADHD symptomatology was observed for all three ADHD
symptom domains. For young adolescents with ADHD, the transition to middle school was associated with a
disruption in the developmental decline of inattention, hyperactivity, and impulsivity symptoms as measured
by parent ratings. This effect was also observed for teacher ratings of inattention and hyperactivity. These
results support the assertion that the environmental changes associated with transitioning to middle school
coincide with a transient reversal in ADHD symptom decline among children with ADHD
M. tuberculosis Ser/Thr Protein Kinase D Phosphorylates an Anti-AntiāSigma Factor Homolog
Receptor Ser/Thr protein kinases are candidates for sensors that govern developmental changes and disease processes of Mycobacterium tuberculosis (Mtb), but the functions of these kinases are not established. Here, we show that Mtb protein kinase (Pkn) D overexpression alters transcription of numerous bacterial genes, including Rv0516c, a putative anti-antiāsigma factor, and genes regulated by sigma factor F. The PknD kinase domain directly phosphorylated Rv0516c, but no other sigma factor regulator, in vitro. In contrast, the purified PknB and PknE kinase domains phosphorylated distinct sigma regulators. Rather than modifying a consensus site, PknD phosphorylated Rv0516c in vitro and in vivo on Thr2 in a unique N-terminal extension. This phosphorylation inhibited Rv0516c binding in vitro to a homologous anti-antiāsigma factor, Rv2638. These results support a model in which signals transmitted through PknD alter the transcriptional program of Mtb by stimulating phosphorylation of a sigma factor regulator at an unprecedented control site
Ethnicity as a Moderator of Treatment Effects on Parent-Child Interaction for Children With ADHD
Objective:
To examine ethnic differences in observed parenting and child behavior and the moderating effects
of ethnicity on the relationship between treatment and parent and child behavior.
Method:
Observations of 508 children with ADHD (ages 7ā9) and their caregivers, collected during the
Multimodal Treatment Study of ADHD, were analyzed using univariate and mixed-model ANOVAs.
Results:
Although baseline parenting practices differed by ethnic group, ethnicity did not moderate the
relationship between treatment and either parenting or child behavior.
Conclusion:
Consistent with data from normative samples, parents of children with ADHD differed by ethnicity
in their utilization of certain parenting strategies. However, different ethnic groups did not differ on benefit
received from treatments for ADHD, measured by parent and child behavior. Although ethnicity did not
emerge as a moderator, ethnic minority family engagement in treatment may be increased by recognizing
different parenting strategies and modifying interventions accordingly. (J. of Att. Dis. 2010; 13(6) 592-600
Evidence, Interpretation, and Qualification From Multiple Reports of Long- Term Outcomes in the Multimodal Treatment Study of Children With ADHD (MTA) Part II: Supporting Details
Objective:
To review and provide details about the primary and secondary findings from the Multimodal
Treatment study of ADHD (MTA) published during the past decade as three sets of articles.
Method:
In the second of a two part article, we provide additional background and detail required by the
complexity of the MTA to address confusion and controversy about the findings outlined in part I (the
Executive Summary).
Results:
We present details about the gold standard used to produce scientific evidence, the randomized
clinical trial (RCT), which we applied to evaluate the long-term effects of two well-established unimodal
treatments, Medication Management (MedMGT) and behavior therapy (Beh), the multimodal combination
(Comb), and treatment āas usualā in the community (CC). For each of the first three assessment points
defined by RCT methods and included in intent-to-treat analyses, we discuss our definition of evidence
from the MTA, interpretation of the serial presentations of findings at each assessment point with a
different definition of long-term varying from weeks to years, and qualification of the interim conclusions
about long-term effects of treatments for ADHD based on many exploratory analyses described in
additional published articles.
Conclusions:
Using a question and answer format, we discuss the possible clinical relevance of the MTA and
present some practical suggestions based on current knowledge and uncertainties facing families,
clinicians, and investigators regarding the long-term use of stimulant medication and behavioral therapy in
the treatment of children with ADHD. (J. of Att. Dis. 2008; 12(1) 15-43
Contextualizing the Global Nursing Care Chain: International Migration and the Status of Nursing in Kerala, India
In this article I explore the issue of nursing status in Kerala, India and how over time a colonial discourse of casteābased pollution has given way to a discourse of sexual pollution under expanding migratory opportunities. Based on survey and qualitative research findings, I caution that the improving occupational status of nursing in India is not directly mapped onto social status, and this is particularly evident in the matrimonial market. In the light of these findings I argue that global nursing care chain (GNCC) analysis must assess more than just workplace contexts in order to conceptualize how global care chains (GCCs) interlock, and how they are differentiated from each other
Parent Agreement on Ratings of Children's Attention Deficit/Hyperactivity Disorder and Broadband Externalizing Behaviors
Mothers and fathers often disagree in their ratings of child behavior, as evidenced clinically and as supported
by a substantial literature examining parental agreement on broadband rating scales. The present study
examined mother-father agreement on Diagnostic and Statistical Manual-based symptom-specific ratings
of Attention-Deficit/Hyperactivity Disorder (ADHD), as compared to agreement on broadband ratings of
externalizing behavior. Based on mother and father ratings of 324 children who participated in the
Multimodal Treatment Study of Children with ADHD (MTA), parental agreement was computed and
patterns of disagreement examined. Mother-father ratings were significantly correlated; however, a clear
pattern of higher ratings by mothers was present. Agreement on attention-deficit/hyperactivity disorder
symptom-specific ratings was significantly lower than that for broadband externalizing behaviors and
oppositional defiant disorder symptoms. Of several moderator variables tested, parental stress was the only
one that predicted the discrepancy in ratings. Disagreement between parents is clinically significant and may
pose complications to the diagnostic process
Are mice good models for human neuromuscular disease? Comparing muscle excursions in walking between mice and humans
The mouse is one of the most widely used animal models to study neuromuscular diseases and test new therapeutic strategies. However, findings from successful pre-clinical studies using mouse models frequently fail to translate to humans due to various factors. Differences in muscle function between the two species could be crucial but often have been overlooked. The purpose of this study was to evaluate and compare muscle excursions in walking between mice and humans
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