Adverse Side Effects of Psychotropic Medication and Challenging Behavior: Pilot Work Assessing Impact

Psychotropic medications are often prescribed to reduce challenging behavior in individuals with intellectual and developmental disabilities (IDD). Functional analyses (FAs) have demonstrated utility in assessing medication impact on behavior; however, the impact of adverse side effects (ASE) on challenging behavior is under-assessed. The purpose of this study was to develop a methodology, similar to FAs, to explore potential medication ASE impact on challenging behavior in seven individuals with IDD. Results revealed response rate differences in designed ASE conditions for most participants. Outcomes support further development and use of this methodology to assess the presence and impact of ASEs.     

Understanding and using time series analyses in addiction research

Time series analyses are statistical methods used to assess trends in repeated measurements taken at regular intervals and their associations with other trends or events, taking account of the temporal structure of such data. Addiction research often involves assessing associations between trends in target variables (e.g. population cigarette smoking prevalence) and predictor variables (e.g. average price of a cigarette), known as a multiple time series design, or interventions or events (e.g. introduction of an indoor smoking ban), known as an interrupted time series design. There are many analytical tools available, each with its own strengths and limitations. This paper provides addiction researchers with an overview of many of the methods available (GLM, GLMM, GLS, GAMM, ARIMA, ARIMAX, VAR, SVAR, VECM) and guidance on when and how they should be used, sample size det ermination, reporting and interpretation. The aim is to provide increased clarity for researchers proposing to undertake these analyses concerning what is likely to be acceptable for publication in journals such as Addiction. Given the large number of choices that need to be made when setting up time series models, the guidance emphasizes the importance of pre‐registering hypotheses and analysis plans before the analyses are undertaken.     

Speech,language and communication: a public health issue across the lifecourse

Speech and Language skill is an essential component of normal child development. Speech, language and communication needs are widespread and are an important determinant of outcomes over the life course. This article discusses the evidence for this relationship and what can be done to improve speech, language and communication capacity for children today.     

Vitamin D and the anti-viral state

Vitamin D has long been recognized as essential to the skeletal system. Newer evidence suggests that it also plays a major role regulating the immune system, perhaps including immune responses to viral infection. Interventional and observational epidemiological studies provide evidence that vitamin D deficiency may confer increased risk of influenza and respiratory tract infection. Vitamin D deficiency is also prevalent among patients with HIV infection. Cell culture experiments support the thesis that vitamin D has direct anti-viral effects particularly against enveloped viruses. Though vitamin D's anti-viral mechanism has not been fully established, it may be linked to vitamin D's ability to up-regulate the anti-microbial peptides LL-37 and human beta defensin 2. Additional studies are necessary to fully elucidate the efficacy and mechanism of vitamin D as an anti-viral agent.     

Effects of brief stress exposure during early postnatal development in balb/CByJ mice: I. Behavioral characterization

Early life stress has been linked to the etiology of mental health disorders. Rodent models of neonatal maternal separation stress frequently have been used to explore the long‐term effects of early stress on changes in affective and cognitive behaviors. However, most current paradigms risk metabolic deprivation, due to prolonged periods of pup removal from the dam. We have developed a new paradigm in Balb/CByJ mice, that combines very brief periods of maternal separation with temperature stress to avoid the confound of nutritional deficiencies. We have also included a within‐litter control group of pups that are not removed from the dam. The present experiments provide an initial behavioral characterization of this new model. We show that neonatally stressed mice display increased anxiety and aggression along with increased locomotion but decreased exploratory behavior. In contrast, littermate controls show increased exploration of novelty, compared to age‐matched, colony‐reared controls. Behavioral changes in our briefly stressed mice substantially concur with the existing literature, except that we were unable to observe any cognitive deficits in our paradigm. However, we show that within litter control pups also sustain behavioral changes suggesting complex and long‐lasting interactions between different environmental factors in early postnatal life. © 2012 Wiley Periodicals, Inc. Dev Psychobiol 55: 283–293, 2013     

Effects of a student response system on preclass preparation,learning, and class participation in a diverse classroom

As classrooms grow in diversity, educators may find it more challenging to create learning environments that meet the needs of all students. Pedagogical practices that facilitate discussion should be used to enhance learning for all students. However, engaging students in conversation becomes a daunting task if students have not completed preclass assignments. This study examines whether the student response system could promote learning, encourage participation, and motivate diverse students to prepare for class.     

What is the best clinical test for Achilles tendinopathy?

BackgroundDifferential diagnosis of Achilles pathology is demanding. This study evaluates the diagnostic accuracy of clinical tests identified for a chronic mid body Achilles tendinopathy. Ultrasound scanning provides the reference standard.MethodsTwenty-one participants with, and without, an Achilles tendinopathy, had an ultrasound scan followed immediately by the application of ten clinical tests. The accuracy and reproducibility of each test was determined.ResultsThe most valid tests are; pain on palpation of the tendon (sensitivity 84%, specificity 73%, kappa 0.74–0.96) and the subjective reporting of pain 2–6 cm above the insertion into the calcaneum (sensitivity 78%, specificity 77%, kappa 0.75–0.81).ConclusionOnly location of pain and pain on palpation were found to be sufficiently reliable and accurate, to be recommended for use.     

Methaemoglobin and erythrocyte reducing systems in high-altitude natives

The stress of chronic hypobaric hypoxia present at high altitudes induces a series of adaptive changes in the intermediate metabolism in erythrocytes of high-altitude natives. Aymaras of the high Andean Plateau are shown to have within erythrocytes: (a) increased activity of NADH₂ (GAPDH) generating stages, (b) decreased activity of NADH₂ (LDH) consuming steps, (c) significantly increased methaemoglobin content, and (d) a large increase in the level of reduced glutathione. These alterations occur also in persons of the same ethnic group residing at low altitude. There is, however, only a moderate elevation of classic haematological parameters (erythrocyte count, haemoglobin and haematocrit) in highland natives. The functional implications of these metabolic changes are discussed with respect to regulation of erythrocyte metabolism.     

Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989.

No reports of the incidence rates for primary systemic amyloidosis (AL) have come to our attention. Records of all residents of Olmstead County, Minnesota, with a diagnosis of amyloidosis were obtained from the Mayo Clinic and its affiliated hospitals, as well as other medical groups that might have seen local patients for the period January 1, 1950 to December 31, 1989. Twenty-one patients fulfilled the criteria for the diagnosis of AL. The median age was 73.5 years, and 62% were men. In all but one patient the diagnosis was made ante mortem. The clinical data of the 21 patients were similar to those referral patients with AL seen at Mayo Clinic. Immunohistochemical stains were positive for monoclonal light chains in the amyloid deposits in 15 of the 21 cases. In six cases, tissue was not available for immunohistochemical studies. Three of the six patients without immunohistochemical stains had a free monoclonal lambda light chain in the urine, and the other three had a monoclonal serum protein. Immunoelectrophoresis/immunofixation detected a monoclonal (M)-protein in the serum of 16 of 17 patients tested. A monoclonal light chain was found in the urine of 10 of 15 patients. The overall sex- and age-adjusted rate per million person-years was 6.1 from 1950 to 1969 and 10.5 from 1970 to 1989. The similarity of these rates suggests no significant increase over time.