Combined Chronic Oral Methylphenidate and Fluoxetine Treatment During Adolescence: Effects on Behavior.

BACKGROUND: Attention Deficit Hyperactivity Disorder (ADHD) can be comorbid with depression, often leading to the prescription of both methylphenidate (MP) and selective serotonin reuptake inhibitor (SSRI) antidepressants, such as fluoxetine (FLX). Moreover, these drugs are often misused as cognitive enhancers. This study examined the effects of chronic oral co-administration of MP and FLX on depressive- and anxiety-like behaviors. METHODS: Adolescent rats received daily either water (control), MP, FLX, or the combination of MP plus FLX in their drinking water over the course of 4 weeks. RESULTS: Data analysis shows a decrease in food consumption and body weight for rats exposed to FLX or the combination of MP and FLX. Sucrose consumption was significantly greater in FLX or MP+FLX groups compared to controls. FLX-treated rats showed no effect in the elevated plus maze (EPM; open arm time) and forced swim test (FST; latency to immobility). However, rats treated with the combination (MP+FLX) showed significant anxiolytic-like and anti-depressive-like behaviors (as measured by EPM and FST), as well as significant increases in overall activity (distance traveled in open field test). Finally, the combined MP+FLX treatment induced a decrease in anxiety and depressive- like behaviors significantly greater than the response from either of these drugs alone. CONCLUSION: These behavioral results characterize the long-term effects of these drugs (orally administered) that are widely co-administered and co-misused and provide important insight into the potential neurobiological and neurochemical effects. Future research will determine the potential risks of the long-term use of MP and FLX together.

The Diabetes Transition of Hospital Care (DiaTOHC) Pilot Study: A Randomized Controlled Trial of an Intervention Designed to Reduce Readmission Risk of Adults with Diabetes.

Hospital readmission within 30 days of discharge (30-day readmission) is a high-priority quality measure and cost target. The purpose of this study was to explore the feasibility and efficacy of the Diabetes Transition of Hospital Care (DiaTOHC) Program on readmission risk in high-risk adults with diabetes. This was a non-blinded pilot randomized controlled trial (RCT) that compared usual care (UC) to DiaTOHC at a safety-net hospital. The primary outcome was all-cause 30-day readmission. Between 16 October 2017 and 30 May 2019, 93 patients were randomized. In the intention-to-treat (ITT) population, 14 (31.1%) of 45 DiaTOHC subjects and 15 (32.6%) of 46 UC subjects had a 30-day readmission, while 35.6% DiaTOHC and 39.1% UC subjects had a 30-day readmission or ED visit. The Intervention−UC cost ratio was 0.33 (0.13−0.79) 95%CI. At least 93% of subjects were satisfied with key intervention components. Among the 69 subjects with baseline HbA1c >7.0% (53 mmol/mol), 30-day readmission rates were 23.5% (DiaTOHC) and 31.4% (UC) and composite 30-day readmission/ED visit rates were 26.5% (DiaTOHC) and 40.0% (UC). In this subgroup, the Intervention−UC cost ratio was 0.21 (0.08−0.58) 95%CI. The DiaTOHC Program may be feasible and may decrease combined 30-day readmission/ED visit risk as well as healthcare costs among patients with HbA1c levels >7.0% (53 mmol/mol).

Childhood Neglect History, Depressive Symptoms, and Intimate Partner Violence Perpetration by College Students.

College students experience intimate partner violence (IPV) at an alarming rate, and preventing such violence depends on identifying factors that contribute to perpetration. Although there is extensive research that has established a link between childhood neglect and later physical IPV perpetration, less is known about the specific mechanisms through which childhood neglect leads to IPV perpetration. In the present study, we examined potential mediators of the relationship between childhood neglect and IPV perpetration by college students, with special emphasis on the role of depressive symptoms and IPV victimization. A total of 302 college students reported on their experiences of childhood maltreatment, depressive symptoms, and IPV victimization and perpetration. Results indicate that increasing levels of childhood emotional and physical neglect correspond with increasing rates of IPV perpetration, after accounting for the effect of childhood emotional, physical, and sexual abuse. This effect between childhood neglect and IPV perpetration was fully mediated by the combination of IPV victimization and depressive symptoms for the overall sample. However, when examining the model for men and women separately, only the indirect effect through victimization remained statistically significant for men. Our findings suggest that research on the link between childhood neglect and IPV perpetration should also consider the impact of IPV victimization, as neglect may lead to IPV perpetration within the context of a mutually aggressive relationship. Furthermore, these findings indicate that childhood neglect leads to long-term emotional consequences that contribute to later IPV perpetration, and treating depressive symptoms may help prevent IPV perpetration against college students who experienced childhood neglect.

The Importance of Interdisciplinary Research Training and Community Dissemination.

Funding agencies and institutions are creating initiatives to encourage interdisciplinary research that can be more easily translated into community initiatives to enhance health. Therefore, the current research environment calls for interdisciplinary education and skills to create sustained partnerships with community institutions. However, formalized opportunities in both of these areas are limited for students embarking on research careers. The purpose of this paper is to underscore the historical and current importance of providing interdisciplinary training and community dissemination for research students. We also suggest an approach to begin to address the existing gap. Specifically, we suggest embedding a 10-week summer rotation into existing research curricula with the goals of: (1) providing students with a hands-on interdisciplinary research experience, (2) facilitating dialogue between research students and community settings to disseminate science to the public, and (3) sparking collaborations among researchers who seek to create a way to sustain summer program rotations with grant funding.