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PubMed2005

Development of a school-wide behavior program in a public middle school: an illustration of deployment-focused intervention development, stage 1.

School-wide behavior management systems can improve academic performance and behavior in middle schools, and they should have positive effects on students with ADHD. Unfortunately, evidence-based, school-wide behavior management systems have not been widely adopted because of problems with feasibility, acceptability, and sustainability. The Deployment-Focused Model of Intervention Development and Testing has been proposed as a promising method of bridging the gap between research and practice settings. A key aspect of the model is to involve the persons most likely to deliver the service (e.g., teachers) in the intervention development process from the very beginning. To illustrate this process, the authors describe the planning and implementation of a school-wide program designed to improve behavior in a public middle school.

Adolescent↗
PubMed2006

A randomized, double-blind, placebo-controlled, laboratory classroom assessment of methylphenidate transdermal system in children with ADHD.

OBJECTIVE: This study evaluates the efficacy, duration of action, and tolerability of methylphenidate transdermal system (MTS) in children with ADHD. METHOD: Participants were dose optimized over 5 weeks utilizing patch doses of 10, 16, 20, and 27 mg applied in the morning and worn for 9 hours. Following optimization, 80 participants were randomized to 1 week of MTS or placebo followed by 1 week of the opposite treatment. Laboratory classroom sessions conducted after each randomized week included blinded ratings of attention, behavior, and academic performance. RESULTS: MTS was well tolerated and displayed significant improvement compared with placebo. Improvements were seen at the first postdose time point measured and continued through 12 hours. CONCLUSIONS: Treatment with MTS resulted in statistically significant improvements on all efficacy measures. Time course and therapeutic effects of MTS suggest that this novel methylphenidate delivery system is an efficacious once-daily treatment for ADHD.

Administration, Cutaneous↗
PubMed2006

Internship workplace preferences of final-year medical students at Zagreb University Medical School, Croatia: all roads lead to Zagreb.

BACKGROUND: Human resources management in health often encounters problems related to workforce geographical distribution. The aim of this study was to investigate the internship workplace preferences of final-year medical students and the reasons associated with their choices. METHOD: A total of 204 out of 240 final-year medical students at Zagreb University Medical School, Croatia, were surveyed a few months before graduation. We collected data on each student's background, workplace preference, academic performance and emigration preferences. Logistic regression was used to analyse the factors underlying internship workplace preference, classified into two categories: Zagreb versus other areas. RESULTS: Only 39 respondents (19.1%) wanted to obtain internships outside Zagreb, the Croatian capital. Gender and age were not significantly associated with internship workplace preference. A single predictor variable significantly contributed to the logistic regression model: students who believed they would not get the desired specialty more often chose Zagreb as a preferred internship workplace (odds ratio 0.32, 95% CI 0.12-0.86). CONCLUSION: A strong preference for Zagreb as an internship workplace was recorded. Uncertainty about getting the desired specialty was associated with choosing Zagreb as a workplace, possibly due to more extensive and diverse job opportunities.

Journal Article↗
PubMed2006

Comparing attitudes about legal sanctions and teratogenic effects for cocaine, alcohol, tobacco and caffeine: a randomized, independent samples design.

BACKGROUND: Establishing more sensible measures to treat cocaine-addicted mothers and their children is essential for improving U.S. drug policy. Favorable post-natal environments have moderated potential deleterious prenatal effects. However, since cocaine is an illicit substance having long been demonized, we hypothesized that attitudes toward prenatal cocaine exposure would be more negative than for licit substances, alcohol, nicotine and caffeine. Further, media portrayals about long-term outcomes were hypothesized to influence viewers' attitudes, measured immediately post-viewing. Reducing popular crack baby stigmas could influence future policy decisions by legislators. In Study 1, 336 participants were randomly assigned to 1 of 4 conditions describing hypothetical legal sanction scenarios for pregnant women using cocaine, alcohol, nicotine or caffeine. Participants rated legal sanctions against pregnant women who used one of these substances and risk potential for developing children. In Study 2, 139 participants were randomly assigned to positive, neutral and negative media conditions. Immediately post-viewing, participants rated prenatal cocaine-exposed or non-exposed teens for their academic performance and risk for problems at age 18. RESULTS: Participants in Study 1 imposed significantly greater legal sanctions for cocaine, perceiving prenatal cocaine exposure as more harmful than alcohol, nicotine or caffeine. A one-way ANOVA for independent samples showed significant differences, beyond .0001. Post-hoc Sheffe test illustrated that cocaine was rated differently from other substances. In Study 2, a one-way ANOVA for independent samples was performed on difference scores for the positive, neutral or negative media conditions about prenatal cocaine exposure. Participants in the neutral and negative media conditions estimated significantly lower grade point averages and more problems for the teen with prenatal cocaine exposure than for the non-exposed teen beyond .0001 alpha level. The positive media program closed estimated grade point average differences and risks of later problems to a non-statistically significant margin, p >.05. CONCLUSION: Ratings for prenatal cocaine were more negative than comparable ratings for alcohol, nicotine or caffeine exposure. Stereotypes can be reduced, showing viewers that positive postnatal environments ameliorate potential teratogenic effects of cocaine. Reducing negative stereotypes for crack babies may be a requisite for substantive changes in current policy.

Female↗
PubMed1988

Age disorientation in chronic schizophrenia is not associated with pre-morbid intellectual impairment or past physical treatment.

Forty-two long-stay hospital patients with chronic schizophrenia were divided into age and sex-matched groups with and without temporal disorientation, and assessed for premorbid academic performance and past physical treatment. The schooling of schizophrenic patients who had cognitive impairment, as identified by gross temporal disorientation, did not differ from those who were cognitively intact. The groups did not differ in past history of ECT, insulin coma, neuroleptic treatment, or psychosurgery. Patients with age disorientation were on lower mean doses of neuroleptic or anticholinergic medication. Gross cognitive impairment thus appears to occur in the course of the disease and is not due to physical treatment.

Adolescent↗
PubMed2005

Predictors of schizophrenia: evidence from the Northern Finland 1966 Birth Cohort and other sources.

BACKGROUND: Subtle motor, emotional, cognitive and behavioural abnormalities are often present in apparently healthy individuals who later develop schizophrenia, suggesting that some aspects of causation are established before overt psychosis. AIMS: To outline the development of schizophrenia. METHOD: We drew on evidence from The Northern Finland 1966 Birth Cohort supplemented by selected findings from other relevant literature. RESULTS: The main known risk factors in development of schizophrenia are genetic causes, pregnancy and delivery complications, slow neuromotor development, and deviant cognitive and academic performance. However, their effect size and predictive power are small. CONCLUSIONS: No powerful risk factor, premorbid sign or risk indicator has been identified that is useful for the prediction of schizophrenia in the general population.

Adult↗
PubMed2003

Neural substrates underlying impulsivity.

Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder whose three main symptoms are impulsiveness, inattention, and hyperactivity. Although ADHD is an early developmental disorder, it may persist into adulthood, resulting in deficits associated with poor academic performance, frequent job changes, poor and unstable marriages, and increases in motor vehicle accidents. Of the three primary symptoms of ADHD, deficits in impulse control are the most challenging to the social network and the judicial system. While the etiology of ADHD remains unknown, recent work suggests that the central deficits in ADHD may be due to poor response inhibition that is linked to monoamine and prefrontal lobe deficiencies. In the past, preclinical studies designed to understand the lack of impulse control have generally been relegated to studies linked to aggression and drug abuse. With the use of innovative noninvasive techniques, like anatomical and functional magnetic resonance imaging, selective neurochemical and behavioral paradigms have converged with preclinical reports and lend support to the premise that monoaminergic neurotransmitter systems and the cortico-striatal circuitry are essential to impulse control. Furthermore, new emerging data on neural substrates underlying impulsivity have incorporated brain regions involved in reinforcement, reward, and decision making such as the nucleus accumbens, cerebellum, and amygdala. As noninvasive brain imaging, neurochemical, and behavioral approaches are combined, our knowledge of the neural networks underlying impulsivity will hopefully give rise to therapeutic approaches aimed at alleviating this disorder.

Animals↗
PubMed2004

Regulation of adolescent sleep: implications for behavior.

Adolescent development is accompanied by profound changes in the timing and amounts of sleep and wakefulness. Many aspects of these changes result from altered psychosocial and life-style circumstances that accompany adolescence. The maturation of biological processes regulating sleep/wake systems, however, may be strongly related to the sleep timing and amount during adolescence-either as "compelling" or "permissive" factors. The two-process model of sleep regulation posits a fundamental sleep-wake homeostatic process (process S) working in concert with the circadian biological timing system (process C) as the primary intrinsic regulatory factors. How do these systems change during adolescence? We present data from adolescent participants examining EEG markers of sleep homeostasis to evaluate whether process S shows maturational changes permissive of altered sleep patterns across puberty. Our data indicate that certain aspects of the homeostatic system are unchanged from late childhood to young adulthood, while other features change in a manner that is permissive of later bedtimes in older adolescents. We also show alterations of the circadian timing system indicating a possible circadian substrate for later adolescent sleep timing. The circadian parameters we have assessed include phase, period, melatonin secretory pattern, light sensitivity, and phase relationships, all of which show evidence of changes during pubertal development with potential to alter sleep patterns substantially. However the changes are mediated-whether through process S, process C, or by a combination-many adolescents have too little sleep at the wrong circadian phase. This pattern is associated with increased risks for excessive sleepiness, difficulty with mood regulation, impaired academic performance, learning difficulties, school tardiness and absenteeism, and accidents and injuries.

Adolescent↗
PubMed1985

Central nervous system morbidity following an initial isolated central nervous system relapse and its subsequent therapy in childhood acute lymphoblastic leukemia.

The frequency and types of major CNS toxicity and morbidity were analyzed in 107 children with acute lymphoblastic leukemia (ALL) following an isolated primary CNS relapse. Seventy-nine (73%) have had multiple subsequent marrow or CNS relapses requiring intensive and prolonged therapy to the CNS. Median survival time is two years. Of these 79 patients, two thirds have had one or more types of major CNS toxicity, including epileptiform seizures (35), moderate to severe structural abnormalities (24 of 27 evaluated), major motor disabilities (9), blindness (2), CNS infection (6), cranial nerve palsies (2), and intracranial lymphoma (2). The remaining 28 patients (26%) have had no or one additional CNS relapse and have received therapy for a median of eight years. One half of this surviving group of patients have had major CNS toxicity, including seizures (9), major motor disability (2), and intracranial calcifications (12/19). When neuropsychologic evaluations were compared between the 28 survivors and 50 of their contemporaries who had been in initial continuous complete remission, the CNS survivors had significantly lower Full Scale IQ scores (83 +/- 16 v 99 +/- 14, P = less than .001) with similarly lower measures of academic performance. The relative contributions of meningeal leukemia itself and intrathecal or radiation therapy to these effects cannot be determined. Since major CNS sequelae occurred in the majority of patients who had a primary isolated CNS relapse, and the frequency of CNS relapse is dependent on the efficacy of the method of CNS prophylaxis, the best method of avoiding major CNS sequelae is the most effective form of CNS prophylaxis.

Acute Disease↗
PubMed2000

School-age consequences of birth weight less than 750 g: a review and update.

Recent advances in perinatal care have led to the survival of increasing numbers of children born at the lower limits of viability. Children with very low birth weight (LBW; less than 1,500 g, 3 lb 5 oz) have been studied extensively. Findings document poorer outcomes relative to normal birth weight term-born controls in neurologic and health status, cognitive-neuropsychological skills, school performance, academic achievement, and behavior. This report reviews current knowledge regarding LBW children, with special emphasis on outcomes for children with birth weight less than 750 g (1 lb 10 oz). Results from an ongoing longitudinal study suggest a gradient of sequelae, with poorer outcomes in less than 750 g birth weight children compared to both 750 g to 1,499 g birth weight children and term-born controls. Children with less than 750 g birth weight fail to catch up with their peers over time and may even be at risk for age-related increases in sequelae. Outcomes are highly variable but related to neonatal medical complications of prematurity and social risk factors. Further research is needed to understand the etiology and neuropathological basis of sequelae, the long-term developmental implications of LBW, and treatment needs.

Child↗
PubMed1978

The power motive, n power, and fear of weakness.

Among 85 male undergraduates, high need for power as measured by the 1968 Winter scoring system is shown to relate to high drinking frequency (p less than .01), high alcohol consumption (p less than .05), and taking the first drink at age 16 or less (p less than .05); to the Disinhibition ("Swinger") factor on Zuckerman's Sensation Seeking Scale (p less than .05) to poor academic performance (p less than .05); and to generate a regression equation with the California Psychological Inventory that suggests qualities of personal disorderliness and intellectual aggression. These findings, considered in terms of power motive theory, are seen as replicating earlier evidence that high n Power is maladaptie, voyeuristic and power avoidant.

Achievement↗
PubMed1997

Neuropsychological features and differential diagnosis of sleep apnea syndrome in children.

Recognizing the signs and effects of pediatric apnea is essential for accurate diagnosis and treatment of children with psychological difficulties. Sleep apnea can have serious deleterious effects on children's cognitive, behavioral, and physiological functioning. Diurnal effects include inattention, decreased academic performance, oppositionality, and restlessness, stemming from frequent nocturnal arousals, excessive daytime sleepiness, and hypoxia. Clinically, the effects of pediatric apnea appear similar to characteristics of other childhood disorders, most notably attention deficit hyperactivity disorder. Efforts to screen for sleep apnea should be regularly employed, especially for children who present with the symptoms discussed. Additional study of pediatric apnea is needed to heighten clinicians' awareness and improve diagnostic accuracy.

Achievement↗
PubMed2005

Sleep and risk-taking behavior in adolescents.

The primary purpose of this study was to examine the relationship between adolescents' sleep-wake patterns and risk-taking behavior. A second goal was to replicate the results obtained by Wolfson and Carskadon (1998) regarding adolescents' sleep habits. Three hundred eighty-eight adolescents (217 males, 171 females) completed the Sleep Habits Survey and the Youth Risk Behavior Survey. The results indicated that adolescents who reported longer weekend delay and higher levels of sleep problems also reported significantly higher levels of risk-taking behaviors, and students' weekend delay was also related to their academic performance in this sample. As in the sample studied by Wolfson and Carskadon (1998), the adolescents in this study exhibited changes in both weekday and weekend sleep habits across grade/age. However in the present study, only school-night total sleep time and weekend delay were related to adolescents' daytime functioning, with no significant relationships being found between weekend oversleep and daytime functioning. This provides partial support for the findings of Wolfson and Carskadon (1998). Overall, sleep-wake patterns were found to relate to risk-taking behavior during adolescence in this study.

Adolescent↗
PubMed2004

Intelligence and psychosocial functioning during long-term growth hormone therapy in children born small for gestational age.

Short stature is not the only problem faced by small for gestational age (SGA) children. Being born SGA has also been associated with lowered intelligence, poor academic performance, low social competence, and behavioral problems. Although GH treatment in short children born SGA can result in a normalization of height during childhood, the effect of GH treatment on intelligence and psychosocial functioning remains to be investigated. We show the longitudinal results of a randomized, double-blind, GH-dose response study initiated in 1991 to follow growth, intelligence quotient (IQ), and psychosocial functioning in SGA children during long-term GH treatment. Patients were assigned to one of two treatment groups (1 or 2 mg GH/m(2) body surface.d, or approximately 0.035 or 0.07 mg/kg.d). Intelligence and psychosocial functioning were evaluated at start of GH treatment (n = 74), after 2 yr of GH treatment (n = 76), and in 2001 (n = 53). IQ was assessed by a short-form Wechsler Intelligence Scale for Children-Revised or Wechsler Adult Intelligence Scale (Block-design and Vocabulary subtests). Behavioral problems were measured by the Achenbach Child Behavior Checklist or Young Adult Behavior Checklist, and self-perception was measured by the Harter Self-Perception Profile. Mean (sem) birth length sd score was -3.6 (0.2), mean age and height at start was 7.4 (0.2) yr and -3.0 (0.1) sd score, respectively, mean duration of GH treatment was 8.0 (0.2) yr, and mean age in 2001 was 16.5 (0.3) yr. After 2 yr of GH treatment, 96% of both GH groups showed a height gain sd score of 1 sd from the start of treatment or more, resulting in a normal height (i.e. height >/= -2.0 sd for age and sex) in 70% of the children. In 2001, 48 (91%) of the 53 children participating in this study had reached a normal height. Block-design s-score and the estimated total IQ significantly increased (P < 0.001 and P < 0.001, respectively) from scores significantly lower than Dutch peers at start (P < 0.001 and P < 0.001, respectively) to comparable scores in 2001. The increase over time for the Vocabulary s-score was not significant. Internalizing Behavior sd scores remained comparable to Dutch peers, whereas Externalizing Behavior sd scores and Total Problem Behavior sd scores improved significantly during GH therapy (P < 0.01 and P < 0.05, respectively) to scores comparable to Dutch peers. Self-perception sd scores improved from start of GH treatment until 2001 (P < 0.001) to scores significantly higher than Dutch peers (P < 0.05). No significant differences between the two GH dosage groups were found. Improvement in Externalizing and Total Problem Behavior sd scores over time was significantly related to change in height sd score (P < 0.05 and P < 0.01, respectively), whereas scores over time for Vocabulary, Block-design, Internalizing, or total Harter Self-Perception score were not related to change in height sd scores. In conclusion, parallel to a GH-induced catch-up growth in adolescents born SGA, IQ, behavior, and self-perception showed a significant improvement over time from scores below average to scores comparable to Dutch peers. In addition, children whose height over time became closer to that of their peers showed less problem behavior.

Body Height↗
PubMed1990

Effects of childhood chronic illness on families.

This study examined the intellectual ability, academic performance, behavior, and social perceptions of children with a seizure disorder and their nonafflicted siblings. These data suggest the children are at risk for developmental lag and related problems. Impact of the illness on the family differentiated the sibling pair on many tasks and on parents' feelings towards their children. Although parents reported providing a normal environment for their children, the children reported their perceptions of the home environment to be further from the (population norm) than their parents. These results provide evidence for the whole family being affected by the chronic illness thus supporting social work's inherent holistic view. It also underscores the need for a secondary preventive approach with all families containing a child with a handicapping condition.

Child↗
PubMedDate not supplied

How does menstruation affect cognitive competence and psychophysiological response?

Studies of the effect of the menstrual cycle on standardized cognitive tasks, work and academic performance, perceptual-motor performance, and psychophysiological measures are reviewed. The weight of the evidence argues against a menstrual cycle effect on behavior. Studies of self report and of behaviors reflecting self confidence suggest that beliefs of menstrual debilitation remain in the population. Studies of atypical and deviant groups indicate a possible connection between behavior and the menstrual cycle.

Achievement↗
PubMed1996

Heroin use among Miami's public school students, 1992: peers and the "drug subculture" overwhelm parents, religion and schools.

This analysis examines the use of heroin by 481 adolescents in Dade County, Florida public schools during 1992. Statistically significant factors which tend to increase the probability of heroin use by adolescents include: peer use of heroin and students' involvement in school clubs. Not significantly related to heroin use is their access to the drug, their ethnic background or race, and their gender. Although not statistically significant, adolescents were more likely to use heroin if they knew of the risks associated with heroin use. There are no statistically significant variables which inhibit the rise of heroin by Miami adolescents. When religion was an important part of their lives, they were at lower risk for heroin use, but this was not significant. Also not significantly related to heroin use are a number of other variables, including family-related variables (whether adolescents live with their mothers, fathers, or alone: and whether someone in the family has a problem with drugs or alcohol). Similarly, early cigarette smoking and alcohol rise did not serve as gateways to later heroin use. Academic performance, and extracurricular school activities (athletics, music, and other activities) were all unrelated to the use of heroin by adolescents, with the exception of involvement in school clubs which substantially increased the risk of heroin use.

Adolescent↗
PubMed2001

Risk factors for depression among adolescents living in group homes in South Carolina.

Few data are available concerning the risk factors for depression among adolescents living in group homes. Two hundred fifty-nine adolescents ranging in age from 10 years to 20 years (median age of 15 years) residing in South Carolina group homes were interviewed for symptoms of depression and characteristics including demographics, personal history, family dynamics, academic performance, and social network. Of the study population, 47 percent are female. Population ethnicity is 64.9 percent Anglo-American and 29.1 percent African-American. Among these adolescents, 74.5 percent had clinical depression defined as a total Center for Epidemiologic Studies Depression Scale (CES-D) score of 16 or more which is much greater than population-based estimates of 0.4 to 8.3 percent. Using a total CES-D score of 23 or more, 42.9 percent of the adolescents had severe depression. Among adolescents who were clinically depressed, gender had an adjusted odds ratio (AOR) of 4.24 with a 95 percent confidence interval (CI) of 1.44 and 12.51. History of suicide attempts had an OR of 4.97 with a 95 percent CI of 1.04 and 23.75. However, among severely depressed adolescents, only gender was a significant risk factor (AOR = 6.92, 95 percent CI = 2.91, 16.42). Careful screening of all depressed adolescents in group homes for suicide attempts is indicated, especially among females, and when identified, the adolescent should receive suicide prevention counseling.

Adolescent↗