Predicting military readiness using objective and subjective indices of neuropsychological impairment in service members with mild traumatic brain injury.

The military is interested in identifying factors to improve the readiness of service members with traumatic brain injury (TBI). TBI outcome studies have primarily used objective neuropsychological data interpreted using the absolute level of functioning (i.e., high average, average, low average), though research suggests it is also important to consider other objective indices of the relative degree of decline (e.g., mild, moderate, severe) and subjective complaints. The current study determined the predictive ability of objective indices of neuropsychological functioning (i.e., absolute level and the relative degree of decline) and subjective complaints (i.e., Neurobehavioral Symptom Inventory) in terms of military work status (i.e., return to duty, medically disabled, retired) for 113 service members with mild TBI. ANOVAs and post-hoc tests indicated individuals who were able to return to duty had higher absolute indices and lower relative decline scores in working memory and overall intelligence, as well as lower subjective neuropsychological complaints when compared to those who were disabled or retired. Multinomial logistic regression models generally supported these findings, except relative decline scores were not predictive of military work status likely due to issues of collinearity (i.e., relative decline scores are calculated using absolute scores). In conclusion, indices of absolute functioning and subjective neuropsychological impairments appear to be predictors of the ability to return to duty post-TBI in military populations, emphasizing the need to focus on cognitive reserve and emotional resilience as potential interventions.

Identifying ADHD Symptoms Most Associated with Impairment in Early Childhood, Middle Childhood, and Adolescence Using Teacher Report.

The purpose of this study was to examine the relationships between ADHD symptoms and impairment within a sample that includes children in early childhood (n = 250), middle childhood (n = 269) and adolescence (i.e., high school; n = 269). Nested multivariate regression analyses were used to examine the extent to which each ADHD symptom dimension (inattention and hyperactivity/impulsivity) is most associated with impairment in academic, social, and behavioral functioning within and across three developmental levels. Results indicated for academic impairment, inattention is more predictive than hyperactivity/impulsivity at all ages. For social functioning, both with peers and teachers, hyperactivity/impulsivity is more predictive than inattention but only for early childhood students; at the high school level, inattention is a significant predictor of social impairment. For behavioral functioning in the classroom, the pattern is mixed across dimensions and ages with HI decreasing in predictive utility across the three age groups and IA increasing in predictive utility. Forward stepwise regression was used to determine which of the 18 ADHD symptom items are most associated with impairment within and across developmental levels. Findings indicate that the symptoms that were most predictive of impairment varied by age group and by domain of impairment. Implications for assessment are discussed.

Measuring ADHD and ODD symptoms and impairment using high school teachers' ratings.

We analyzed the results of high school teachers' ratings of symptoms of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder, as well as school-related impairment of 875 adolescents. One hundred forty-three teachers at 19 high schools across 4 states each rated 6 students from their first-period classes according to selection criteria that led to ratings for 3 male and 3 female students. Factor analyses were conducted on the symptom measure to test hypotheses pertaining to the divergence of impulsivity and hyperactivity dimensions. Normative values for the Disruptive Behavior Disorder-Teacher Rating Scale and Impairment Rating Scale are reported, as well as important differences related to age, race, and gender. Gender and age contrasts revealed that boys were rated as more symptomatic and impaired than girls and younger adolescents were rated as having more problems than older adolescents in most areas. African American adolescents were rated higher on measures of symptoms and impairment than their Caucasian peers. Large differences in normative levels of hyperactivity/impulsivity and inattention are reported that are consistent with a reduced likelihood of a diagnosis of ADHD-C as children get older. Implications for the interpretation of ratings from high school teachers are discussed.

Community and school mental health professionals' knowledge and use of evidence based substance use prevention programs.

Youth with learning and behavioral problems are at elevated risk for substance use during adolescence. Although evidence-based substance use prevention and screening practices are described in the literature, the extent with which these are provided to these youth is unclear. Mental health professionals in schools and community mental health centers are in an ideal position to conduct substance use screening and prevention practices since they have frequent contact with this high risk group. In order to determine whether these mental health professionals were using evidence based substance use screening and prevention programs with these youth, we analyzed 345 completed surveys from mental health professionals in schools and community clinics throughout a mid-Atlantic state. Results indicated that a large portion of the respondents were unfamiliar with evidence based practices and they were infrequently used. Implications for the division of labor at schools and community mental health centers are discussed in relation to time allotment and priority for these procedures.

Polycystic ovary syndrome and its impact on women's quality of life: More than just an endocrine disorder.

In the past, polycystic ovary syndrome has been looked at primarily as an endocrine disorder. Studies now show that polycystic ovary syndrome is a metabolic, hormonal, and psychosocial disorder that impacts a patient's quality of life. It is extremely important to holistically treat these patients early on to help them deal with the emotional stress that is often overlooked with polycystic ovary syndrome. Early diagnosis and long term management can help control polycystic ovary syndrome so that women can still live a healthy active life and avoid long-term complications such as metabolic syndrome and cardiovascular diseases.

Development of potential manufacturing routes for substituted thiophenes--preparation of halogenated 2-thiophenecarboxylic acid derivatives as building blocks for a new family of 2,6-dihaloaryl 1,2,4-triazole insecticides.

BACKGROUND: Dow AgroSciences has been investigating a new family of functionalized 2,6-dihaloaryl 1,2,4-triazole insecticides featuring specifically targeted insecticidal activities coupled with low mammalian toxicity. With broad spectrum control of both chewing and sap-feeding pests in mind, this family of compounds has been under investigation for aphid, mite, and whitefly control in food crop protection as well as ornamental applications. Two specific targets for development have been the 2,6-dihalo 1,2,4-triazoles XR-693 and XR-906, which require a supply of the halogenated 2-thiophenecarboxylic acid derivatives 1, 2, and 3 for assembly of the C-ring portion of the triazole products. RESULTS: Potential manufacturing routes to three halogenated 2-thiophenecarboxylic acid derivatives 4-bromo-3-methyl-2-thiophenecarbonyl chloride 1, 3,4,5-trichloro-2-thiophenecarbonyl chloride 2, and 3,4,5-trichloro-2-thiophenecarbonitrile 3 from commercially available thiophene raw materials have been developed and demonstrated on a laboratory scale. A one-pot bromination/debromination procedure developed for 3-methylthiophene gave 2,4-dibromo-3-methylthiophene. Carboxylic acid functionality was then introduced either by a Grignard metallation followed by carbonation with CO2, or by a palladium catalyzed carbonylation procedure under CO pressure. The vapor phase chlorination of 2-thiophenecarbonitrile with chlorine gas at 500 degrees C with an average residence time of 6 seconds gave 3,4,5-trichloro-2-thiophenenitrile 3 in a 69% distilled yield, a process that was carried out on a multi-kilogram scale in the laboratory. Finally, a route for the preparation of 3,4,5-trichloro-2-thiophenecarbonyl chloride 2 was developed from tetrachlorothiophene via either a lithiation reaction with n-butyllithium in MTBE solvent, or by a previously reported Grignard method using 1,2-dibromoethane as activator, followed by carbonation of the anion with CO2 to give the trichloro-2-thiophenecarboxylic acid, which was readily converted to the acid chloride 2 with SOCl2. CONCLUSION: The successful development of efficient synthetic routes to the halogenated thiophene building blocks 4-bromo-3-methyl-2-thiophenecarbonyl chloride 1, 3,4,5-trichloro-2-thiophenecarbonyl chloride 2, and 3,4,5-trichloro-2-thiophenecarbonitrile 3 paved the way for the development of viable commercial processes for XR-693 and XR-906, members of a new class of 2,6-dihaloaryl 1,2,4-triazole insecticides that exhibit selective activity against aphids, mites, and whiteflies coupled with low mammalian toxicity. The process development work for the experimental insecticide target molecules XR-693 and XR-906 will be the topic of a forthcoming paper.