The Intertwining of Language Impairment and Autism Spectrum Disorders — Highlighting the Need of Long Term Interdisciplinary Collaboration

This chapter highlights the importance of adopting a broader as well as longer perspective in screening for problems of language and communication in children prospectively as well as in adults retrospectively. As coauthors we represent a wide range of professional experience covering different disciplines: speech and language pathology, pediatrics, child psychiatry and adult psychiatry. We have several years of experience of working in teams for assessment and diagnostics as well as of performing interventions for children, youth and adults with complex developmental disorders

Efficacy and safety of atomoxetine as add-on to psychoeducation in the treatment of attention deficit/ hyperactivity disorder

Objective: The primary objective of this study was to assess the impact of atomoxetine in combination with psychoeducation, compared with placebo and psychoeducation, on health-related quality of life (HRQL) in Swedish stimulant-naïve pediatric patients with attention deficit/ hyperactivity disorder (ADHD). HRQL results will be presented elsewhere. Here, psychoeducation as well as efficacy and safety of the treatment are described. Patients and methods: A total of 99 pediatric ADHD patients were randomized to a 10-week double-blind treatment with atomoxetine (49 patients) or placebo (50 patients). Parents of all patients received four sessions of psychoeducation. Atomoxetine was dosed up to approximately 1.2 mg/kg day (≤70 kg) or 80 mg/day (>70 kg). Improvement of ADHD symptoms was evaluated using the ADHD rating scale (ADHD-RS) and clinical global impression (CGI) rating scales. Safety was assessed based on adverse events (AEs). Results: The study population was predominantly male (80.8%) and diagnosed with the combined ADHD subtype (77.8%). The least square mean (lsmean) change from baseline to endpoint in total ADHD-RS score was −19.0 for atomoxetine patients and −6.3 for placebo patients, resulting in an effect size (ES) of 1.3 at endpoint. Treatment response (reduction in ADHD-RS score of ≥25 or ≥40%) was achieved in 71.4 or 63.3% of atomoxetine patients and 28.6 or 14.3% of placebo patients. The lsmean change from baseline to endpoint in CGI-Severity was −1.8 in the atomoxetine group compared with −0.3 in the placebo group. The difference between treatments in CGI-Improvement at endpoint was −1.4 in favor of atomoxetine. No serious AEs occurred. The safety profile of atomoxetine was in line with the current label. Conclusions: Atomoxetine combined with psychoeducation was superior to placebo and psychoeducation in ADHD core symptoms improvement. The large ES might be a result of including stimulant-naïve patients only, but also may indicate a positive interaction between atomoxetine treatment and psychoeducation, possibly by increased compliance

Evaluation of Stress in Korean Patients with Diabetes Mellitus Using the Problem Areas in Diabetes-Korea Questionnaire

BackgroundIt is known that diabetes and stress are directly or indirectly related, and that it is important to evaluate stress in patients with diabetes. The relationship between Korean diabetics and diabetes-related stress has never been reported. The objective of this study was to develop a stress questionnaire suitable for use with Korean diabetics and to evaluate its utility.MethodsThis study subjects were 307 Korean diabetics, aged 40 to 74 years old, who visited the Department of Endocrinology and Metabolism at Gachon University Gil Hospital, Yeungnam University Medical Center, and Inha University Hospital in Korea between March 2006 and February 2008. We developed a Korean version of Polonsky's Problem Areas in Diabetes (PAID) stress questionnaire (PAID-K) and used it to assess degrees of stress in our sample of Korean patients. We evaluated the utility of the questionnaire and analyzed the relationships between clinical characteristics of the study subjects and degrees of stress.ResultsCronbach's alpha for PAID-K was 0.95, and PAID-K scores were significantly correlated with Hypoglycemia Fear Survey scores (r=0.44, P<0.05) and State Trait Anxiety Inventory-6 scores (r=0.21, P<0.05). PAID-K scores were significantly higher in patients with longer durations of diabetes, patients using insulin, and female patients (P=0.02, P=0.038, and P=0.001, respectively). The score also tended to increase as HbA1c levels increased, except for very high HbA1c levels (above 11%) (P for trend<0.05).ConclusionWe developed the PAID-K questionnaire and demonstrated its utility to evaluate levels of stress in diabetic patients in Korea

Atomoxetine improves patient and family coping in attention deficit/hyperactivity disorder: a randomized, double-blind, placebo-controlled study in Swedish children and adolescents

This 10-week study assessed the efficacy of atomoxetine in combination with psychoeducation compared to placebo and psychoeducation in the improvement of Quality of Life in Swedish stimulant-naive children and adolescents with attention deficit/hyperactivity disorder. A total of 99 patients were treated with atomoxetine (49 patients) or placebo (50 patients) for 10 weeks and assessed regarding broader areas of functioning using the Quality of Life measures Child Health and Illness Profile-Child Edition (CHIP-CE), Family Strain Index [FSI; equivalent to the Family Burden of Illness Module used in the study], Appraisal of Stress in Child-Rearing (ASCR), Five to fifteen (FTF), “I think I am” (“Jag tycker jag är”), and Children’s Depression Rating Scale-Revised (CDRS-R) before and after the active treatment phase. Simultaneously, the patients’ parents participated in a 4-session psychoeducation program. A statistically significant difference in favor of atomoxetine was seen in the improvement from baseline to study endpoint for the CHIP-CE domains “Achievement” and “Risk avoidance”, for the FSI total score, for the ASCR section (I) domain “Child as a burden”, for all FTF domains except for “Language and Speech”, and for the CDRS-R total score. No difference between treatment groups was observed in the patient-assessed evaluation of self-esteem using the “I think I am” scale. Atomoxetine combined with psychoeducation had a positive effect on various everyday coping abilities of the patients as well as their families during 10 weeks of treatment, whereas the patients’ self-image and the parents’ image of the climate in the family were not significantly improved

Täthet och häckningsframgång för törnskata Lanius collurio på Lovön nära Stockholm

The density of Red-backed Shrikes Lanius collurio was determined in 2004 and 2005 at Lovön, a 20 km2 island. In spite of its proximity to Stockholm, the island has retained much of the older rural landscape with components favored by the shrikes. There were about 40 sites that were judged suitable for breeding, and all these sites were examined both years. Each year 20 sites were occupied, and in both years together, 30 sites were used. The density of one pair per km2 is at par with that of another study of a mixed landscape in the same province (Uppland) but about two times higher than the estimated density of the whole province. Breeding success was high in both years. The exact number of fledglings could not be determined, but at least 75% (2004) and 90% (2005) of the pairs produced at least one fledgling. 2005 was a successful year in spite of unfavorable weather about arrival time (the first bird was recorded on 22 May versus 9 may in 2004).</jats:p

A Biopsychosocial Approach to the Onset of Childhood Diabetes

This thesis is a part of a prospective multi-centre study concerning psychosocial aspects of importance for the onset and course of insulin-dependent diabetes mellitus (IDDM). The investigated population was all children with onset of IDDM in the participating clinics during 1988 and 1989. Of 79 diseased children, 67 participated in the study. To each child a healthy control child was chosen, 61 accepted to participate. Data was collected by interviews and self-report questionnaires at the first hospital admission, two months after onset, and at the end of the first year. Many of the instruments were designed and/or tested for reliability and validity, as the network map and the crisis questionnaires. The children with diabetes had experienced a higher life stress than the control children, especially during their first two years of life. Some more case children had shown behaviour symptoms before onset than the control children. These facts support the hypothesis that stress might interact with autoimmune mechanisms during the development of the disease. There were insignificant differences between the cases and controls regarding social support and family function. The children did not differ from a normal population by psychological assessment. Most parents reacted with strong to moderate distress at the onset. The children showed lesser reactions than the parents. During the first year, most families adapted well to the disease. A pattern with injection anxiety but low general distress at onset for children and mothers was associated with a better metabolic control during the first two years

Dracula vs. the Beetle : How Science is Used as a Rhetorical Tool to Bring the Monsters to Life

This essay is a cultural/historical analysis of the role of science in the books Dracula by Bram Stoker and The Beetle by Richard Marsh. The aim is to investigate how science is used to lessen the amount of critical judgment the reader has to suspend while reading these two Gothic stories, as well as identifying what contexts science is part of. Initially, there is an introduction of the late nineteenth century Britain and the social and scientific events of that era, focusing on Darwinian ideologies, imperialism, and fear of degeneration. The conclusion reached is that science is used to inspire realism by increasing the feeling of authenticity, by erasing the boundaries of facts and beliefs with a juxtaposition of science and superstition, and by creating and upholding an uncanny effect

Dracula vs. the Beetle : How Science is Used as a Rhetorical Tool to Bring the Monsters to Life

This essay is a cultural/historical analysis of the role of science in the books Dracula by Bram Stoker and The Beetle by Richard Marsh. The aim is to investigate how science is used to lessen the amount of critical judgment the reader has to suspend while reading these two Gothic stories, as well as identifying what contexts science is part of. Initially, there is an introduction of the late nineteenth century Britain and the social and scientific events of that era, focusing on Darwinian ideologies, imperialism, and fear of degeneration. The conclusion reached is that science is used to inspire realism by increasing the feeling of authenticity, by erasing the boundaries of facts and beliefs with a juxtaposition of science and superstition, and by creating and upholding an uncanny effect