Cortisol Response to Stress in Adults with Attention Deficit Hyperactivity Disorder.

BACKGROUND: Differences in the cortisol response have been reported between children exhibiting the inattentive and hyperactive/impulsive subtypes of attention deficit hyperactivity disorder. However, there is no such information about adults. The aim of the present study was to determine the possible differences between the combined and inattentive subtypes in the cortisol response to stress. METHODS: Ninety-six adults with attention deficit hyperactivity disorder, 38 inattentive and 58 combined, without any medical or psychiatric comorbidities and 25 healthy controls were included. The Trier Social Stress Test was used to assess physiological stress responses. Clinical data and subjective stress levels, including the Perceived Stress Scale, were also recorded. RESULTS: No significant differences in the cortisol response to the Trier Social Stress Test were found between patients and controls. However, albeit there were no basal differences, lower cortisol levels at 15 (P=.015), 30 (P=.015), and 45 minutes (P=.045) were observed in the combined compared with the inattentive subtype after the stress induction; these differences disappeared 60 minutes after the stress. In contrast, the subjective stress responses showed significant differences between attention deficit hyperactivity disorder patients and controls (P<.001), but no differences were seen between attention deficit hyperactivity disorder subtypes. In turn, subjective stress measures, such as the Perceived Stress Scale, positively correlated with the whole cortisol stress response (P<.027). CONCLUSIONS: Both the combined and inattentive attention deficit hyperactivity disorder adults exhibited a normal cortisol response to stress when challenged. Nevertheless, the inattentive patients displayed a higher level of cortisol after stress compared with the combined patients. Despite the differences in the cortisol response, adults with attention deficit hyperactivity disorder reported high levels of subjective stress in their every-day life.

Use of automated artificial intelligence to predict the need for orthodontic extractions.

Objective: To develop and explore the usefulness of an artificial intelligence system for the prediction of the need for dental extractions during orthodontic treatments based on gender, model variables, and cephalometric records. Methods: The gender, model variables, and radiographic records of 214 patients were obtained from an anonymized data bank containing 314 cases treated by two experienced orthodontists. The data were processed using an automated machine learning software (Auto-WEKA) and used to predict the need for extractions. Results: By generating and comparing several prediction models, an accuracy of 93.9% was achieved for determining whether extraction is required or not based on the model and radiographic data. When only model variables were used, an accuracy of 87.4% was attained, whereas a 72.7% accuracy was achieved if only cephalometric information was used. Conclusions: The use of an automated machine learning system allows the generation of orthodontic extraction prediction models. The accuracy of the optimal extraction prediction models increases with the combination of model and cephalometric data for the analytical process.

Impact of Faculty Development Workshops in Student-Centered Teaching Methodologies on Faculty Members' Teaching and Their Students' Perceptions.

The aim of this study was to assess, after one year, the impact of faculty development in teaching and learning skills focused on a learner-centered approach on faculty members' perceptions of and approaches to teaching and on their students' learning experiences and approaches. Before training (2014), all 176 faculty members at a dental school in Chile were invited to complete the Approaches to Teaching Inventory (ATI) to assess their teaching approaches (student- vs. teacher-focused). In 2015, all 496 students were invited to complete the Study Process Questionnaire (R-SPQ-2F) to assess their learning approaches (deep or surface) and the Course Experience Questionnaire (CEQ) to measure their teaching quality perceptions. Subsequently, faculty development workshops on student-centered teaching methodologies were delivered, followed by peer observation. In March 2016, all 176 faculty members and 491 students were invited to complete a second ATI (faculty) and R-SPQ-2 and CEQ (students). Before (2014) and after (2016) the training, 114 (65%) and 116 (66%) faculty members completed the ATI, respectively, and 89 (49%) of the then-181 faculty members completed the perceptions of skills development questionnaire in September 2016. In 2015, 373 students (75%) completed the R-SPQ-2F and CEQ; 412 (83%) completed both questionnaires in 2016. In 2014, the faculty results showed that student-focused teaching was significantly higher in preclinical and clinical courses than in the basic sciences. In 2016, teacher-focused teaching fell significantly; basic science teaching improved the most. Students in both the 2015 and 2016 cohorts had lower mean scores for deep learning approaches from year 1 on, while they increased their scores for surface learning. The students' perceptions of faculty members' good teaching, appropriate assessment, clear goals, and e-learning improved significantly, but perception of appropriate workload did not. Teaching and learning skills development produced significant gains in student-centered teaching for these faculty members and in some students' perceptions of teaching quality. However, student workload needs to be considered to support deep learning.

Criterion and concurrent validity of Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID) Spanish version.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in adulthood. Its diagnosis requires a retrospective evaluation of ADHD symptoms in childhood, the continuity of these symptoms in adulthood, and a differential diagnosis. For these reasons, diagnosis of ADHD in adults is a complex process which needs effective diagnostic tools. AIM: To analyse the criterion validity of the CAADID semi-structured interview, Spanish version, and the concurrent validity compared with other ADHD severity scales. METHODS: An observational case-control study was conducted on 691 patients with ADHD. They were out-patients treated in a program for adults with ADHD in a hospital. RESULTS: A sensitivity of 98.86%, specificity 67.68%, positive predictive value 90.77% and a negative predictive value 94.87% were observed. Diagnostic precision was 91.46%. The kappa index concordance between the clinical diagnostic interview and the CAADID was 0.88. Good concurrent validity was obtained, the CAADID correlated significantly with WURS scale (r=0.522, P<.01), ADHD Rating Scale (r=0.670, P<.0.1) and CAARS (self-rating version; r=0.656, P<.01 and observer-report r=0.514, P<.01). CONCLUSION: CAADID is a valid and useful tool for the diagnosis of ADHD in adults for clinical, as well as for research purposes.