Short form Conners' Adult ADHD Rating Scales: Factor structure and measurement invariance by sex in emerging adults.

INTRODUCTION: The short version of the Conners' Adult ADHD Rating Scales (CAARS-S:S) is a self-report measure used to identify symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) during adulthood. However, its psychometric properties specifically in emerging adults, or the transitional age group between adolescence and adulthood, remain understudied. This study aimed to validate the factor structure of the CAARS-S:S in a sample of emerging adults. METHOD: The CAARS-S:S measure was completed by adults (n = 591) aged 18 to 29 located in English-speaking countries, including Australia, Canada and the United States. Confirmatory factor analysis was used to test a four-factor model of Inattention/Memory Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability and Problems with Self-Concept, as well as the model's invariance by sex. Sex was also included as a covariate in the model to examine differences in males' and females' scores on each factor. RESULTS: Overall, the four-factor structure fit the data and was invariant across males and females. All factors demonstrated high internal reliability (average ωt and α = .86). It was observed that males tended to score higher on Inattention/Memory Problems while females scored higher on Problems with Self-Concept. CONCLUSION: This research establishes the psychometric properties of the CAARS-S:S, placing greater confidence in using it to screen for ADHD symptoms in emerging adults living in a Westernized cultural context. The detailed findings of this research, implications for the use of the CAARS-S:S in this age group and potential future directions for examining the properties of the measure are discussed.

Scoping review of employment resources for individuals with fetal alcohol spectrum disorder and justice involvement.

OBJECTIVES: Individuals with fetal alcohol spectrum disorder (FASD) are over-represented within the justice system and have significant employment challenges. The primary aim of this scoping review was to ascertain available employment resources for FASD individuals particularly those involved in the justice system. Secondary aims were to determine available evidence-based interventions for the justice workforce and employment providers. METHODS: Eligibility criteria: That the resource was (a) published between 1990 and 2021, (b) in English, (c) available electronically in full text, (d) focused on strategies for improving employment outcomes of individuals with FASD and (f) developed for those aged over 15. Sources of evidence: Electronic searches of the following databases were conducted: EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science and Google Scholar. Grey literature was collected via the databases ProQuest Dissertations & Theses Global, OpenGrey, GreyNet International and Grey Matters. Charting methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews reporting guidelines, a five-stage methodological framework was employed. A quality appraisal of identified resources was conducted. Data were summarised qualitatively using a content analysis method that allowed for analysis of specific terms/themes/concepts/resource elements that resources covered, as well as a quantitative analysis of their frequency. RESULTS: An initial search identified 850 articles, 512 of which were obtained through online database searches, 321 through Google Scholar searches and 17 through google searches. Sixteen resources were identified as meeting inclusion criteria, including four peer-reviewed papers and 12 grey literature resources. Six of the resources extracted were deemed 'good' or 'strong' quality, with the remainder-all grey literature resources-being 'adequate' or 'limited'. None of the resources identified were empirically evaluated or could be implemented synergistically. Content analysis revealed common themes addressing FASD-related employment challenges and required supports. CONCLUSIONS: This review highlights the need for developing evidence-based employment-related resources for justice-involved people with FASD. Most of the 16 identified resources had a psychoeducational and advocacy component and described typical employment challenges with specific supports and accommodations to maximise workforce participation. However, none had been empirically evaluated, underscoring the importance of future research in this area to better inform more responsive and evidence-based employment-related programmes. TRIAL REGISTRATION NUMBER: doi:10.17605/OSF.IO/J5VMB.

Examining the Rate of Self-Reported ADHD-Related Traits and Endorsement of Depression, Anxiety, Stress, and Autistic-Like Traits in Australian University Students.

OBJECTIVE: To investigate the rate of ADHD-related traits among young adults in an Australian university, and to examine whether higher endorsement of ADHD-related symptoms is associated with self-reported symptoms of depression, anxiety, distress, and autistic-like traits. METHOD: In total, 1,002 students aged 17 to 25 years completed the Conners' Adult ADHD Rating Scale (CAARS), the Depression, Anxiety, and Stress Scale (DASS), and the Autism Quotient (AQ). RESULTS: About 17.3% of students reported "at-risk" levels of ADHD-related symptoms. Regression analyses revealed that CAARS scores explained unique variance in self-reported levels of depression, anxiety, stress, and autism-related traits. CONCLUSION: The rate of self-reported ADHD symptoms is higher in Australian undergraduate students than that reported in previous studies using the CAARS to investigate rates of diagnosed students. Problems with self-concept accounted for the most unique variance in DASS subscale scores. Hyperactivity/restlessness and inattention/memory problems accounted for the most unique variance in AQ-Social and AQ-Attention-to-Detail scores, respectively.

Urinary CXCL10: a marker of nephritis in lupus patients.

Systemic lupus erythematosus (SLE) is a connective tissue disease characterized by the formation of autoantibodies and immune complexes. Lupus nephritis is one of the hallmark features of SLE. CXCL10 is a chemokine secreted by IFNg- stimulated endothelial cells and has been shown to be involved in the pathological processes of autoimmune diseases. The objective was to measure urinary CXCL10 in SLE patients, to compare levels between nephritis and non-nephritis groups and to study its correlation with other variables. Sixty lupus patients were enrolled in our trial. Thirty patients had lupus nephritis and the other 30 were without evidence of lupus nephritis. Thirty healthy subjects were willing to participate as a healthy control group. Renal biopsy was performed for lupus nephritis group. Urinary CXCL10 was measured using the ELISA technique. Serum creatinine, C3, C4 and 24 h urinary proteins were measured. Lupus activity was assessed using systemic lupus erythematosus disease activity index (SLEDAI) scoring system. Renal activity was measured using renal activity scoring system. CXCL10 was significantly higher in lupus nephritis patients than in lupus patients without nephritis. CXCL10 was significantly correlated with renal activity score, 24 hours urinary proteins and the SLEDAI score. It is highly valid predictor of SLE nephritis with high sensitivity and specificity. CXCL 10 a highly sensitive and specific non-invasive diagnostic tool for lupus nephritis patients.

Evidências sobre efeitos da atividade física no controle glicêmico: importância da adesão a programas de atenção em diabetes / Evidence of physical activity effects on glycemic control: importance of adherence to diabetes care programs

O Diabetes Mellitus (DM) tipo 2 (DM2) é um problema de saúde pública que requer cuidados contínuos e multidisciplinares. A presente revisão tem por objetivo destacar a importância da inclusão de atividades físicas em programas de atenção em DM2, salientando seu efeito no controle glicêmico e aspectos que influenciam a adesão de usuários, bem como associar a temática às atuais políticas públicas de atenção básica em saúde no Brasil. Artigos originais, revisões sistemáticas e de meta-análise que continham os termos DM2, adesão, exercício físico, atividade física e programa de educação em DM (em português e inglês) encontrados nos bancos de dados PubMed, Scopus e BioMed Central foram incluídos. Políticas públicas e diretrizes (guidelines) também foram utilizadas para contextualização e discussão. Evidências indicam que a participação em programas de atenção à DM2 se associa a um melhor prognóstico da doença; indivíduos mais aderentes apresentam melhores resultados no controle glicêmico e redução da massa corporal que os menos aderentes. Fatores como supervisão profissional, envolvimento em grupos, apoio familiar, tipo de exercício e frequência de encontros podem influenciar diretamente a adesão a esses programas. Educação em DM, atividades físicas e terapia nutricional são importantes no tratamento da DM2, porém, há escassez de programas públicos de saúde que, de forma multidisciplinar e contínua, contemplem estas ações terapêuticas.

Type 2 Diabetes Mellitus (DM2) is a public health issue that requires continuous and multidisciplinary care. This review aims to present the importance of including physical activities in DM2 care programs, highlighting the effect on glycemic control and the aspects that influence user?s adherence, as well as linking this issue to current public policies on primary health care in Brazil. Original articles, systematic reviews and meta-analyzes that contained the words DM2, adherence, exercise, physical activity and diabetic education program (in Portuguese and English) found on PubMed, Scopus and BioMed Central databases were included. Public policies and guidelines were also used for contextualization and discussion. Evidences indicate that attending a DM2 care program is associated with a better prognosis; individuals with greater adherence have better results on glycemic control and weight reduction then the lesser adherents. Factors like professional supervision, group involvement, family support, type of physical activity and frequency of meetings may directly influence the adherence to the programs. DM education, physical activities and nutritional therapy are important to the DM2 treatment; however, there is a lack of programs that support these therapeutic actions in a multidisciplinary and continuous way.

Medicamentos não aprovados para crianças em prescrições de 332 pacientes pediátricos hospitalizados / Unapproved drugs for children in prescriptions for 332 pediatric inpatients

Introdução: É importante avaliar a prescrição de medicamentos para pacientes pediátricos, uma vez que eles são excluídos dos ensaios clínicos no desenvolvimento de novas drogas. Este estudo avaliou a prescrição de medicamentos não aprovados e não indicados para crianças, para uso em pacientes pediátricos hospitalizados, e propõe uma prática racional para prescrição. Método: Foram analisados prescrições de 332 pacientes, cujos dados foram obtidos em quatro dias de coleta. O farmacêutico hospitalar determinou a prevalência de prescrição de medicamentos em cinco enfermarias pediátricas. A analisé foi realizada com dados reunidos em quatro coletas nos meses de março a junho de 1999. Foram registrados todos os medicamentos prescritos para todas as crianças internadas nas enfermarias nos dias de estudo. Foi realizada avaliação dos medicamentos não aprovados e não indicados para a utilização em crianças. Os medicamentos foram classificados pela anatomic therapeutic classification (ATC) recomendada pela Organização Mundial de Saúde. Resultados: Os diagnósticos mais frequêntes foram pneumonia (40,4 por cento), meningite e meningococcemia (6 por cento), diarréia e desidratação (6 por cento). As três classes terapêuticas mais prescritas foram as de atuação no sistema nervoso (N) (109 por cento), as de antiinfecciosos de uso sistêmico (J) (81,9 por cento) e as de atuação no sistema respiratório (R) (69 por cento). Os três medicamentos mais prescritos foram dipirona (88,3 por cento), fenoterol (30,7 por cento) e penicilina G (25,0 por cento). O trabalho mostra o resultado da integração do farmacêutico hospitalar na equipe multiprofissional de assistência ao doente. Conclusão: Medidas simples, como a adoção de apresentações mais adequadas ao uso em crianças e de informações mais detalhadas e precisas sobre os medicamentos, podem acrescentar qualidade ao atendimento de crianças hospitalizadas.