Willingness to Use ADHD Treatments: A Mixed Methods Study of Perceptions by Adolescents, Parents, Health Professionals and Teachers

Little is known about factors that influence willingness to engage in treatment for attention deficit/hyperactivity disorder (ADHD). From 2007 to 2008, in the context of a longitudinal study assessing ADHD detection and service use in the United States, we simultaneously elicited ADHD treatment perceptions from four stakeholder groups: adolescents, parents, health care professionals and teachers. We assessed their willingness to use ADHD interventions and views of potential undesirable effects of two pharmacological (short- and long-acting ADHD medications) and three psychosocial (ADHD education, behavior therapy, and counseling) treatments. In multiple regression analysis, willingness was found to be significantly related to respondent type (lower for adolescents than adults), feeling knowledgeable, and considering treatments acceptable and helpful, but not significantly associated with stigma/embarrassment, respondent race, gender and socioeconomic status. Because conceptual models of undesirable effects are underdeveloped, we used grounded theory method to analyze open-ended survey responses to the question: What other undesirable effects are you concerned about? We identified general negative treatment perceptions (dislike, burden, perceived ineffectiveness) and specific undesirable effect expectations (physiological and psychological side effects, stigma and future dependence on drugs or therapies) for pharmacological and psychosocial treatments. In summary, findings indicate significant discrepancies between teens\u27 and adults\u27 willingness to use common ADHD interventions, with low teen willingness for any treatments. Results highlight the need to develop better treatment engagement practices for adolescents with ADHD. (C) 2011 Elsevier Ltd. All rights reserved

The Prevalence of Fatigue Following Deep Brain Stimulation Surgery in Parkinson's Disease and Association with Quality of Life

Fatigue is a common and disabling nonmotor symptom seen in Parkinson's disease (PD). While deep brain stimulation surgery (DBS) improves motor symptoms, it has also been associated with non-motor side effects. To date no study has utilized standardized instruments to evaluate fatigue following DBS surgery. Our objective was to determine the prevalence of fatigue following DBS surgery in PD its impact on quality of life and explore predictive factors. We recruited 44 PD subjects. At least one year following DBS placement, we administered the Fatigue Severity Scale (FSS), the Parkinson's Disease Questionnaire (PDQ-39), the Beck Depression Inventory, the Beck Anxiety Inventory, the UPDRS, and a neuropsychological battery. Fifty-eight percent of subjects had moderate to severe fatigue. Fatigue was significantly associated with quality of life, depression, and anxiety. Depression preoperatively was the only predictive factor of fatigue. Fatigue is common following DBS surgery and significantly impacts quality of life

Team-Based Learning Instruction for Responsible Conduct of Research Positively Impacts Ethical Decision-Making

https://scholarworks.utrgv.edu/hidalgocoa/1212/thumbnail.jp

Speckle tracking echocardiography-determined measures of global and regional left ventricular function correlate with functional capacity in patients with and without preserved ejection fraction.

BACKGROUND: Standard measures of left ventricular systolic and diastolic function often fail to identify left ventricular dysfunction in patients with heart failure and do not correlate with measures of functional capacity. AIM: To determine if speckle tracking echocardiography (STE)-determined measures of global and regional myocardial contractility have a linear association with functional capacity in patients with and without preserved ejection fraction. METHODS: In 68 adult patients, functional status was estimated with the Duke Activity Status Index (DASI), left ventricular ejection fraction was determined with Simpson\u27s biplane method, and QLAB advanced quantification software (Philips, The Netherlands) was used to determine peak measures of strain. RESULTS: Global and regional measures of longitudinal, circumferential, and radial strain had a strong linear association with the DASI score. Longitudinal strain in the inferolateral segments had the strongest correlation with DASI (r = -0.72, P \u3c 0.001). In patients with an ejection fraction ≥45%, ejection fraction and E/e\u27 had no correlation with DASI, whereas longitudinal strain in the inferolateral segments had significant correlation with DASI (r = -0.53, P = 0.03, n = 16). CONCLUSIONS: STE-determined measures of global and regional left ventricular function have a strong linear association with estimates of functional capacity in patients with and without preserved ejection fraction. STE-determined measures of strain, especially longitudinal strain, are likely to be important targets for therapy and should be considered in future studies aimed at improving our diagnosis of left ventricular inadequacy in patients with heart failure, especially those with preserved ejection fraction

Feasibility of School-Based ADHD Interventions: A Mixed-Methods Study of Perceptions of Adolescents and Adults

Objective: Little is known about perceptions surrounding academic interventions for ADHD that determine intervention feasibility. Method: As part of a longitudinal mixed-methods research project, representative school district samples of 148 adolescents (54.8%), 161 parents (59.4%), 122 teachers (50.0%), 46 health care providers (53.5%), and 92 school health professionals (65.7%) completed a cross-sectional survey. They also answered open-ended questions addressing undesirable intervention effects, which were analyzed using grounded theory methods. Results: Adolescents expressed significantly lower receptivity toward academic interventions than adult respondents. Stigma emerged as a significant threat to ADHD intervention feasibility, as did perceptions that individualized interventions foster inequality. Conclusion: Findings suggest that adolescents\u27 viewpoints must be included in intervention development to enhance feasibility and avoid interventions acceptable to adults, but resisted by adolescents