The Detection of ADHD and Malingering in Young Adults

Over the past 20 years, an increasing number of adults and college students have self-referred for ADHD evaluations. With the rise in adult ADHD evaluations, there has been increased concern that a proportion of these adults may be malingering the symptoms of ADHD to receive external incentives such as academic accommodations and stimulant medications. Research supports the use of well-validated measures to classify malingering in non-ADHD populations, yet all available validity tests have insufficient research to support their usage to detect this population. The present study investigated the ability of the Multidimensional ADHD Rating Scale (MARS) and two published validity tests (Word Memory Test and CAT-A Infrequency scale) to detect a group of non-ADHD college students instructed to feign ADHD, and to differentiate ADHD from non-ADHD cases. Results found that the MARS Symptom Validity Index demonstrated higher sensitivity rates for simulated malingering (75.4%) at close to optimal specificity (86.8%) compared to two published tests (sensitivity \u3c 50%). The MARS Total Symptom index differentiated ADHD from non-ADHD cases with high sensitivity (87.1%). The study provides additional support for the effectiveness of the MARS symptom, impairment, and symptom validity indices to detect simulated cases of malingering, and to differentiate ADHD from non-ADHD cases

The Construction of a Multidimensional ADHD Self-Report Measure: A Pilot Study

Recent research on adult onset Attention Deficit/Hyperactivity Disorder (ADHD) has led to an increase in evaluations of college students and adults suspected of the disorder, as well as increased concern that some may feign or malinger ADHD characteristics in order to obtain a diagnosis and associated incentives (e.g., stimulant medications and academic accommodations). Faking ADHD is especially easy when the diagnosis is based on self-report, symptoms-only rating scales. Diagnostic accuracy improves with the assessment of symptoms, impairment, and symptom validity, but this type of comprehensive self-report measure is currently not available. The aim of this study was to examine the effectiveness of a newly constructed Multidimensional ADHD Rating Scale (MARS) comprised of ADHD symptom, functional impairment, and symptom validity indexes. The MARS self-report items were completed by three groups of college-aged students. Participants with ADHD (n=39) and non-ADHD controls (n=62) completed the MARS honestly. A group of non-ADHD participants (n=56) were instructed to malinger ADHD. Results indicated that malingerers reported more symptoms and impairment than ADHD participants, and both groups reported more symptoms and impairment than controls. The symptom validity index was able to differentiate malingerers from ADHD participants with high sensitivity and specificity. These preliminary results suggest that measures that combine symptoms, impairment, and symptom validity could be useful additions to ADHD rating scales

Project SustAIn: Sustainable Agriculture Initiative

In partnership with Outside In, Pacific University School of Occupational Therapy and two students as a part of their Innovative Practice Project (IPP) began Project SustAIn a program in 2008. Project SustAIn was a renewed effort to continue a gardening program initiated at Outside In’s Education Resource Center by one of the Urban Education teachers (see Figure 1 for an illustration of Project SustAIn: Program Development and Partnership). Project SustAIn was initially designed to create vocational job opportunities and attain educational credits for the homeless youth while collaborating with occupational therapy to develop work and vocational skills through the therapeutic process of gardening; these skills included personal goal development and planning, time management, professional behavior and interview skills training. Through continued partnership on the behalf of the original 2008 occupational therapy students (currently practicing occupational therapists), Pacific University, and Outside In’s Urban Ed program, Project SustAIn was expanded in the Winter of 2010 by two additional occupational therapy students as a part of their IPP to encompass a new tract for independent living and transitional skill development as well as grow in areas of professional and organizational collaboration to more fully meet the needs of Portland’s homeless youth population. This document describes the expansion and growth of Project SustAIn including: a background and literature search of adolescent development in addition to theory and the implications for transition into adulthood for the homeless youth at Outside In; an account of actions and methodologies of Project SustAIn 2010; and a discussion and summary of outcomes, perceived benefits and suggestions for future program development and collaboration

Decolonizing & Indigenizing LIS

What does it mean to Indigenize and decolonize a Master of Library and Information Science (MLIS) program? This paper outlines the process by which one Canadian MLIS program responded to the reports from the Truth and Reconciliation Commission of Canada and the Canadian Federation of Library Association Indigenous Matters Committee that specify the implications and provide guidelines for best practices for librarianship and the information professions across Canada. In outlining the challenges of re-engineering our standard procedures, practices, and pedagogies, this paper provides a path forward for other MLIS programs looking to critically evaluate and develop their own programs

Ladies that UX Leadership and Organization Report

Ladies that UX (LTUX) is an international organization focused on mentoring women in the software industry. In order to explore both the mission and the focus of the international organization and smaller, localized chapters of LTUX, we conducted a series of surveys and interviews. These surveys focused on how local groups of LTUX were formed and structured, what leaders see as the goals and needs of their chapters, and how members interact with both each other and with the broader international organization. Our research goal was to gain some insight into means of formation, communication, and structure of these local chapters and to understand and anticipate what chapter needs are, in order to better grow LTUX as an organization

Multi-Disciplinary Experts Supporting Graduate Medical Education through Participation in COMPLETE Chart Rounds

Learning Objective: As a result of this presentation, attendees will learn skills that they can use to implement collaborative graduate medical education learning experiences using a community of multi-disciplinary professionals within their own institutions. Background: Inter-professional Chart Rounds were implemented to provide residents an opportunity to review and present patient cases utilizing “COMPLETE” guidelines developed by residency leadership as the result of a “Regional Medicine – Public Health Education Centers” grant. COMPLETE guidelines explicitly direct residents to include consideration of: - Context – Culture of context – who is the patient? - Outside Visitors/Resources – incorporate visitors/experts such as librarians, pharmacists and psychologists and utilize their resources - Mental Health – assess behavioral health aspects of the case - Population Perspective – address prevalence of the condition in the community - Learn From Others – consider specialists, home care, and complementary therapies - Expectations – clear goals set between physician and patient - Time – Start on time, end on time. Respect everyone’s time. - End with “Culture of Continuity” – what are the key lessons? Is there a follow-up plan? Through the attendance of librarians, psychologists, pharmacologists, medical students and other faculty, discussion ensues which leads to continued resident education and support. Methods: Chart Rounds are held daily at each residency practice site. Residents are required to attend along with medical and pharmacy students rotating at the centers. The preceptor leads Chart Rounds and other faculty physicians join as they are able. Residents present cases while maintaining patient confidentiality. The preceptor leads the group discussion of the case. Faculty members discuss clinical and administrative implications, the psychologist addresses potential behavioral aspects of the case, the librarian searches for Evidence-Based information to support decisions and the pharmacologist advises on medication management. The group also discusses how individual patient care reflects the public health needs and profile of the community. Residents (n=32) were invited to complete a survey asking them to evaluate their experience with multi-disciplinary COMPLETE Chart Rounds. Results: Survey results as well as observational analysis will be used to improve the resident’s experience at Chart Rounds with the goal of making this experience an even more rewarding collaborative educational experience. Some sample findings include: - 66% of residents report satisfaction of Chart Rounds challenging the academic aspects of their work - 100% of residents in the early portion of their program report that Chart Rounds assists them in building collaborative relationships with faculty and other providers/experts - Residents report the greatest satisfaction (92% overall) with pharmacist participation in Chart Rounds across all Post Graduate Years - Satisfaction with librarian participation increases through each year (from only 10% in PGY1 to over 60% in PGY3) , possibly due to limited exposure early in the program Although these guidelines were developed for use in a Family Medicine Graduate Medical Education program and fit well into this practice model, the findings can be utilized in other resident training programs. Presented at the Patients and Populations: Public Health in Medical Education conference sponsored by the Association of American Medical Colleges (AAMC) and the Centers for Disease Control and Prevention (CDC), held September 14-15, 2010, in Cleveland, OH

Implementation of electronic patient clinical records in ambulances in the UK: a national survey.

Background: The roll-out of electronic Patient Clinical Records (ePCR) across UK ambulance services has been an important aspect of modernisation. Electronic Records in Ambulances (ERA) is a two-year study which aims to describe the opportunities and challenges of implementing ePCR and associated technology in emergency ambulances. Our study includes a baseline survey of progress implementing ePCR in all UK ambulance services providing a snapshot of current usage. Methods: We carried out semi-structured telephone interviews with information managers in each ambulance service in the UK. We asked them about the systems in use, the process and current stage of implementation and explored the perceived value of using ePCR. If services did not use ePCR we asked about plans for future introduction. The interviews were transcribed and thematically analysed, by three members of the research team. Results: We completed interviews with 22 managers from 13 services. Implementation varied across the UK. Seven services were using electronic records. Four services had adopted electronic records but, at the time of interview, had reverted to paper with the intention of implementing a new ePCR. Two services still used paper but hoped to move to ePCR in the future. Those who had fully implemented ePCR reported mixed success in terms of staff compliance, and in realising the potential benefits offered by ePCR to link with primary and secondary care

The Grizzly, April 4, 2002

Ursinus Students Seek an International Perspective During Model U.N. • Airband: When Your Lip-syncing Actually Helps Save a Life • Binge Drinking: When College Becomes Equivalent to the Neighborhood Bar • The Class of 2002 gets Ready for the Senior Class Gift Drive • Opinions: Want Easter Vacation? Some Schools Have it • Performer Gives Life to Short Stories of the South • Softball Turning Around for Some Wins • Comparative Pricing Report: Pedicureshttps://digitalcommons.ursinus.edu/grizzlynews/1512/thumbnail.jp

The Grizzly, February 2, 1999

Wash Your Worries Away • February is Black History Month • Centralization of Academic Computing • The Class of 1999 Leaves Behind a Comfortable Legacy • Post-Graduation Opportunities • Ursinusites Named to Who\u27s Who • Opinion: Tom Daschle and Partisanship Redefined; Follow, Lead or Get Out of the Way: Conformity as a Social Disease • Artful Lives: Living Portraits of Women Artists • Reginald Pindell to Perform • Swimming Suffers Loss to F&M • UC Men\u27s Basketball First in Conference • Women\u27s Basketball Snaps Losing Streak • UC Wrestlers Win Two Out of Three • UC Gymnastics Overcomes Navyhttps://digitalcommons.ursinus.edu/grizzlynews/1432/thumbnail.jp

Cross-Reactivity and Expansion of Dengue-Specific T cells During Acute Primary and Secondary Infections in Humans

Serotype-cross-reactive memory T cells responding to secondary dengue virus (DENV) infection are thought to contribute to disease. However, epitope-specific T cell responses have not been thoroughly compared between subjects with primary versus secondary DENV infection. We studied CD8+ T cells specific for the HLA-A*1101-restricted NS3133 epitope in a cohort of A11+ DENV-infected patients throughout acute illness and convalescence. We compared the expansion, serotype-cross-reactivity, and activation of these cells in PBMC from patients experiencing primary or secondary infection and mild or severe disease by flow cytometry. Our results show expansion and activation of DENV-specific CD8+ T cells during acute infection, which are predominantly serotype-cross-reactive regardless of DENV infection history. These data confirm marked T cell activation and serotype-cross-reactivity during the febrile phase of dengue; however, A11-NS3133-specific responses did not correlate with prior antigenic exposure or current disease severity