The Retrospective Diagnosis of Attention-Deficit/Hyperactivity Disorder in Adolescents: Family Physicians\u27 Challenges

The primary purpose of the study was to identify current retrospective practices used by family physicians in the diagnosis of Attention-Deficit-Hyperactivity Disorder (ADHD) in adolescents and young adults. In other words, do physicians adhere to best practices and examine information from childhood in order to diagnose ADHD in adolescents and young adults? In addition, this study aimed to examine the information physicians request for ADHD diagnosis, types of treatments they recommend, the type of information they use to assess treatment outcomes, and professional attitudes regarding the nature of ADHD. Participants completed a questionnaire designed to answer the research questions. Participants included a random sample of members of the American Academy of Family Physicians (AAFP, N = 143) and a convenience sample (N = 84). Results indicated discrepancies between participating physicians\u27 current practices and best diagnostic practices, while these physicians generally reported treatment recommendations consistent with evidence-based practice. Reports of adherence to retrospective diagnostic practices and treatment outcome evaluation were limited, suggesting the need for training as well as collaboration with school professionals. Limitations of the current study and implications for future research are discussed

A statistical test to show negligible trend

The usual statistical tests of trend are inappropriate for demonstrating the absence of trend. This is because failure to reject the null hypothesis of no trend does not prove that null hypothesis. The appropriate statistical method is based on an equivalence test. The null hypothesis is that the trend is not zero, i.e., outside an a priori specified equivalence region defining trends that are considered to be negligible. This null hypothesis can be tested with two one-sided tests. A proposed equivalence region for trends in population size is a log-linear regression slope of (−0.0346, 0.0346). This corresponds to a half-life or doubling time of 20 years for population size. A less conservative region is (−0.0693, 0.0693), which corresponds to a halving or doubling time of 10 years. The approach is illustrated with data on four amphibian populations; one provides significant evidence of no trend

A statistical test to show negligible trend: Reply

Camp et al. (2008) extend the ideas discussed in Dixon and Pechmann (2005). Our paper used equivalence regions to test for negligible trends (null hypothesis that trends are not negligible). Their paper suggests also using equivalence regions to test an alternative hypothesis of “ecologically meaningful” trends (null hypothesis that trends are negligible but not zero)

College Students’ Responses to Antismoking Messages: Denial, Defiance, and Other Boomerang Effects

Despite the success of antismoking campaigns that aim to prevent young teens from smoking, this qualitative study provides strong evidence that different initiatives are needed for college students, particularly those who already smoke. When asked for responses to current antismoking messages, nonsmokers generally championed the cause; however, smokers often responded with anger, defiance, denial, and other negative responses. Consumers who respond in this manner are not well served by existing strategies, and money used for such campaigns could be better spent. New strategies are offered in hopes that antismoking campaigns can communicate more effectively with one high-risk group—college student smokers

Physicochemical principles that regulate the competition between functional and dysfunctional association of proteins

To maintain protein homeostasis, a variety of quality control mechanisms, such as the unfolded protein response and the heat shock response, enable proteins to fold and to assemble into functional complexes while avoiding the formation of aberrant and potentially harmful aggregates. We show here that a complementary contribution to the regulation of the interactions between proteins is provided by the physicochemical properties of their amino acid sequences. The results of a systematic analysis of the protein-protein complexes in the Protein Data Bank (PDB) show that interface regions are more prone to aggregate than other surface regions, indicating that many of the interactions that promote the formation of functional complexes, including hydrophobic and electrostatic forces, can potentially also cause abnormal intermolecular association. We also show, however, that aggregation-prone interfaces are prevented from triggering uncontrolled assembly by being stabilized into their functional conformations by disulfide bonds and salt bridges. These results indicate that functional and dysfunctional association of proteins are promoted by similar forces but also that they are closely regulated by the presence of specific interactions that stabilize native states

Measurements of the group delay and the group delay dispersion with resonance scanning interferometer

We developed a method for group delay and group delay dispersion measurements, based on location of interference resonance peaks. Such resonance peaks can be observed in transmittance or in reflectance when two mirrors are placed parallel to each other and separated by a thin air spacer. By using a novel approach, based on simultaneous processing of the data acquired for different spacer distances we obtained reliable results with high resolution. Measurements were performed both in transmittance and reflectance layouts depending on the reflectivity of the mirror to be measured. The developed method allows dispersion measurements of ultraviolet mirrors and ultra-broadband mirrors spanning more than one optical octave to be performed

Self-healing behavior of a polyelectrolyte-based lubricant additive for aqueous lubrication of oxide materials

We report on the self-healing behavior of a polyelectrolyte-based aqueous lubricant additive, poly(l-lysine)-graft-poly(ethylene glycol) (PLL-g-PEG), during aqueous lubrication of an oxide-based tribosystem. Combined pin-on-disk tribometry and fluorescence microscopy experiments have shown that stable lubricating performance was enabled by means of rapid healing of the worn tribopair surface by polymers dissolved in the adjoining bulk lubricant. This rapid ‘self-healing' of PLL-g-PEG is attributed to electrostatic interactions between the polycationic poly(l-lysine) (PLL) backbone of the polymer and negatively charged oxide surface. In contrast, a similar healing effect was not readily achievable in the case of methoxy-poly(ethylene glycol)-trimethylsilylether (Sil-PEG), a lubricant additive that is covalently bonded to the surface prior to tribological stres

Tiotropium Respimat efficacy and safety in asthma:Relationship to age

Background: Data are limited on the differential response to long-acting bronchodilators in older versus younger adults with asthma. Objective: To determine whether the response to tiotropium Respimat differed in older versus younger patients with asthma. Methods: Post hoc analyses of 4 randomized, double-blind, placebo-controlled studies in adults with asthma were carried out. Two studies compared tiotropium Respimat 5 μg once daily with placebo, both added to high-dose inhaled corticosteroid (ICS) plus long-acting β2-agonist (ie, severe asthma). The other 2 evaluated tiotropium Respimat 2.5 or 5 μg once daily, salmeterol 50 μg twice daily, or placebo, all added to medium-dose ICS (moderate asthma). Data were analyzed in 2 pools: (1) severe and (2) moderate asthma. Efficacy end points: trough and peak FEV1; trough forced vital capacity; Asthma Control Questionnaire total score and responder percentage, all at week 24. One set of analyses was performed with age as a continuous covariate; the second was conducted in categories less than 40, 40 to 60, and more than 60 years, with treatment-by-age subgroup interaction P values obtained. Safety was analyzed in age categories. Results: Across the age categories, treatment-by-age subgroup interaction P values for trough FEV1 were.13 and.77 for patients with severe and moderate asthma, respectively, not indicating significant impact of age on overall treatment effect, with this observation replicated in the 2 continuum analyses. The other end points (including safety) were also not impacted by age. Conclusions: Once-daily tiotropium Respimat add-on to ICS or ICS/long-acting β2-agonist therapy was effective and well tolerated in patients with asthma independent of age

Tiotropium Respimat® add-on therapy to inhaled corticosteroids in patients with symptomatic asthma improves clinical outcomes regardless of baseline characteristics

BACKGROUND: Despite currently available therapies and detailed treatment guidelines, many patients with asthma remain symptomatic. Tiotropium delivered by the soft mist inhaler Respimat®, as add-on therapy to medium-dose inhaled corticosteroids (ICS), has been shown to improve lung function and asthma control in patients with symptomatic moderate asthma. OBJECTIVE: To determine whether the efficacy of tiotropium Respimat® in asthma differs by patients' study baseline characteristics. METHODS: Two replicate Phase III, randomized, double-blind, placebo-controlled, parallel-group studies (MezzoTinA-asthma®; NCT01172808 and NCT01172821) of once-daily tiotropium Respimat 5 μg and 2.5 μg add-on to ICS were conducted in patients with symptomatic asthma despite treatment with medium-dose ICS with or without additional controllers. Subgroup analyses of peak forced expiratory volume in 1 s (FEV1), trough FEV1, risk of severe asthma exacerbation and Asthma Control Questionnaire responder rate were performed to determine whether results were influenced by patients' baseline characteristics. RESULTS: In this analysis, 523 patients received placebo while 517 and 519 patients received the 5 μg and 2.5 μg dose of tiotropium Respimat, respectively. The magnitude of the improvements in lung function and asthma control, as well as the reduced risk of severe exacerbation with both doses of tiotropium Respimat versus placebo, was independent of a broad range of baseline characteristics. CONCLUSIONS: Once-daily tiotropium Respimat as add-on to ICS is a beneficial treatment option for patients with asthma who remain symptomatic despite at least medium-dose ICS, regardless of baseline characteristics