The Development of a Depression Preventive Intervention for Adolescents with Attention-Deficit/Hyperactivity Disorder

Despite the considerable progress made identifying attention-deficit/hyperactivity disorder (ADHD) as a risk for depressive outcomes in adolescence and adulthood as well as potential explanations for the co-occurrence of ADHD and unipolar depression (i.e., emotion regulation, family support, and reward responsivity), targeted depression prevention efforts have not yet been implemented for adolescents with ADHD. Thus, the specific aims were as follows: (1) develop a behaviorally oriented, tailored, depression preventive intervention for adolescents with ADHD targeting variables empirically supported to account for the covariation between ADHD and depression (Behaviorally Enhancing Adolescents’ Mood; BEAM), (2) pilot BEAM in a small sample of adolescents with ADHD and their parents, (3) evaluate the feasibility and acceptability of BEAM, and (4) examine preliminary results regarding changes in depressive symptoms, emotion regulation, reward responsivity, and family support after BEAM. The sample consisted of 8 parent-adolescent dyads with adolescents ranging in age from 12 to 16 years old. Research questions were tested using both quantitative and qualitative methods. Outcome trends were evaluated using paired samples t-tests and reliable change indices. Semi-structured interviews were coded and analyzed qualitatively using NVivo10. Group-level analyses indicated that there were significant differences in depressive symptoms, emotion regulation, and reward responsivity after BEAM. Findings on family support after BEAM were equivocal. According to reliable change indices used to analyze individual results, majority of participants saw improvements in depressive symptoms and emotion regulation. In addition to improvements in outcome variables, both parents and adolescents were highly satisfied with the BEAM program and used BEAM skills following the completion of the program. Though staff supervision notes suggested that several barriers for delivery of the program arose, the BEAM program was easy to implement and was done so with high integrity. The study’s main findings and their clinical implications are further discussed, including suggested revisions to the BEAM program. Future directions for research are presented with a focus on moving towards a large, randomized control trial

Effectiveness of a Pharmacist-Directed Tdap Immunization Program for a University Campus

Background/Objectives: Despite a slight increase in Tdap immunization rates, the total numbers are still low among adults. The purpose of this study is to determine the impact of a pharmacist-directed immunization program. The primary objective was to assess the increase in vaccination rates among the subjects indicated to receive the Tdap vaccine. The secondary objective was to assess changes in pre and post vaccine knowledge scores.Methods: Employees enrolled in the pharmacist-directed employee wellness clinic on a university campus in Ohio were screened forTdap vaccination at the annual employee health fair during Fall of 2016. Results were cross-referenced with the state vaccination database. Subjects were recruited via email to an educational program. Indicated patients were asked to schedule an appointment with a pharmacist. Assessment data on the educational program was collected before the presentation and after the appointment when the vaccine was administered. The efficacy endpoint for the primary objective was a 20% increase in baseline vaccination rates.Results: Of the 198 subjects recruited, a total of 54 received Tdap vaccination. The baseline vaccination rate of the study populationwas 37.4% and increased by 27.2% after the intervention to a total vaccination rate of 64.6% (p< 0.001). Six knowledge assessmentswere utilized for the secondary objective; however, these results did not show significance.Conclusions: A pharmacist-directed Tdap immunization program is effective at increasing vaccination rates. Even though the changein education assessment data proved more observational, the education provided will empower subjects to make informed healthcaredecisions

Cue-Dependent Inhibition in Posttraumatic Stress Disorder and Attention- Deficit/Hyperactivity Disorder

Objective Attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are common among military veterans, but the comorbidity of these two psychiatric disorders remains largely unstudied. Evaluating response inhibition and cue-dependent learning as behavioral and neurocognitive mechanisms underlying ADHD/PTSD can inform etiological models and development of tailored interventions. Method A cued go/no-go task evaluated response inhibition in 160 adult males. Participants were recruited from the community and a Veterans Administration medical center. Four diagnostic groups were identified: ADHD-only, PTSD-only, ADHD + PTSD, controls. Results Group differences were observed across most indices of inhibitory functioning, reaction time, and reaction time variability, whereby PTSD-only and ADHD + PTSD participants demonstrated deficits relative to controls. No cue dependency effects were observed. Conclusion Finding complement prior work on neurocognitive mechanisms underlying ADHD, PTSD, and ADHD + PTSD. Lack of expected group differences for the ADHD-only group may be due to limited power. Additional work is needed to better characterize distinctions among clinical groups, as well as to test effects among women and youth

Imaging short- and long-term training success in chronic aphasia

<p>Abstract</p> <p>Background</p> <p>To date, functional imaging studies of treatment-induced recovery from chronic aphasia only assessed short-term treatment effects after intensive language training. In the present study, we show with functional magnetic resonance imaging (fMRI), that different brain regions may be involved in immediate versus long-term success of intensive language training in chronic post-stroke aphasia patients.</p> <p>Results</p> <p>Eight patients were trained daily for three hours over a period of two weeks in naming of concrete objects. Prior to, immediately after, and eight months after training, patients overtly named trained and untrained objects during event-related fMRI. On average the patients improved from zero (at baseline) to 64.4% correct naming responses immediately after training, and treatment success remained highly stable at follow-up. Regression analyses showed that the degree of short-term treatment success was predicted by increased activity (compared to the pretraining scan) bilaterally in the hippocampal formation, the right precuneus and cingulate gyrus, and bilaterally in the fusiform gyri. A different picture emerged for long-term training success, which was best predicted by activity increases in the right-sided Wernicke's homologue and to a lesser degree in perilesional temporal areas.</p> <p>Conclusion</p> <p>The results show for the first time that treatment-induced language recovery in the chronic stage after stroke is a dynamic process. Initially, brain regions involved in memory encoding, attention, and multimodal integration mediated treatment success. In contrast, long-term treatment success was predicted mainly by activity increases in the so-called 'classical' language regions. The results suggest that besides perilesional and homologue language-associated regions, functional integrity of domain-unspecific memory structures may be a prerequisite for successful (intensive) language interventions.</p

Coagulopathy, Bleeding Events, and Outcome According to Rotational Thromboelastometry in Patients With Acute Liver Injury/Failure

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/169284/1/hep31767_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/169284/2/hep31767-sup-0001-Supinfo.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/169284/3/hep31767.pd

Linking nonstructural carbohydrate dynamics to gas exchange and leaf hydraulic behavior in Pinus edulis and Juniperus monosperma

Leaf hydraulics, gas exchange and carbon storage in Pinus edulis and Juniperus monosperma, two tree species on opposite ends of the isohydry–anisohydry spectrum, were analyzed to examine relationships between hydraulic function and carbohydrate dynamics. Leaf hydraulic vulnerability, leaf water potential (Wl), leaf hydraulic conductance (Kleaf), photosynthesis (A), stomatal conductance (gs) and nonstructural carbohydrate (NSC) content were analyzed throughout the growing season. Leaf hydraulic vulnerability was significantly lower in the relatively anisohydric J. monosperma than in the more isohydric P. edulis. In P. edulis, ψ₁ dropped and stayed below 50% loss of leaf hydraulic conductance (P₅₀) early in the day during May, August and around midday in September, leading to sustained reductions in K[subscript leaf]. In J. monosperma, ψ₁ dropped below P₅₀ only during August, resulting in the maintenance of K[subscript leaf] during much of the growing season. Mean A and g[subscript s] during September were significantly lower in P. edulis than in J. monosperma. Foliar total NSC was two to three times greater in J. monosperma than in P. edulis in June, August and September. Consistently lower levels of total NSC in P. edulis suggest that its isohydric strategy pushes it towards the exhaustion of carbon reserves during much of the growing season.Keywords: Juniperus monosperma, Carbon storage, Leaf hydraulics, Pinus edulis, Carbon starvation, Growth limitation, Nonstructural carbohydrate (NSC), Drough

Spring temperature responses of oaks are synchronous with North Atlantic conditions during the last deglaciation

Paleoclimate proxies based on the measurement of xylem cell anatomy have rarely been developed across the temperature range of a species or applied to wood predating the most recent millennium. Here we describe wood anatomy-based proxies for spring temperatures in central North America from modern bur oaks (Quercus macrocarpa Michx.). The strong coherence of temperature signals across the species range supports the use of these proxies across thousands of years of climatic change. We also used 79 subfossil oak log cross sections from northern Missouri, ¹⁴C-dated to 9.9-13.63 ka (ka is 1000 cal yr BP), to assess the frequency of oak deposition into alluvial sediments and a subset of these oaks for a wood anatomy-based reconstruction of spring paleotemperatures. Temperatures during the Younger Dryas cold period (YD) were up to 3.5 degrees C lower than modern temperatures for that region, equivalent to or lower than those experienced at the northern edge of the modern species range. Compared to extant oaks growing at much higher [CO₂], subfossil oaks had greater vessel frequencies. Besides very low theoretical (or estimated) xylem conductivity near the beginning of the oak record near 13.6 ka, vessel frequencies greater than modern trees compensated for reduced vessel dimensions so that theoretical xylem conductivity was consistently above that of modern trees at the cold northern sites. Significant correlations were found between the frequency of ¹⁴C-dated oaks and either delta δ¹⁸O from the NGRIP (North Greenland Ice Core Project) ice core or from the Cariaco grayscale marine-sediment record from the southern Caribbean sea. Oak deposition into alluvial sediments during the YD was significantly lower than expected given the average sample depth of oaks from 9.9 to 13.6 ka. Reduced oak deposition during the YD suggests that an abrupt shift in climate reduced oak populations across the region and/or changed the rates of channel movement across drainages.Keywords: Pleistocene, Quercus macrocarpa, Holocene, Pre-Boreal, Younger Dryas, Radiocarbon, Wood anatomy, Great Plains\, USA, Phenology, Bolling-Allerod, Xylem, Bur oa

Nod2 Mediates Susceptibility to Yersinia pseudotuberculosis in Mice

Nucleotide oligomerisation domain 2 (NOD2) is a component of the innate immunity known to be involved in the homeostasis of Peyer patches (PPs) in mice. However, little is known about its role during gut infection in vivo. Yersinia pseudotuberculosis is an enteropathogen causing gastroenteritis, adenolymphitis and septicaemia which is able to invade its host through PPs. We investigated the role of Nod2 during Y. pseudotuberculosis infection. Death was delayed in Nod2 deleted and Crohn's disease associated Nod2 mutated mice orogastrically inoculated with Y. pseudotuberculosis. In PPs, the local immune response was characterized by a higher KC level and a more intense infiltration by neutrophils and macrophages. The apoptotic and bacterial cell counts were decreased. Finally, Nod2 deleted mice had a lower systemic bacterial dissemination and less damage of the haematopoeitic organs. This resistance phenotype was lost in case of intraperitoneal infection. We concluded that Nod2 contributes to the susceptibility to Y. pseudotuberculosis in mice