Summary of the practice parameter for the use of stimulant medications in the treatment of children, adolescents, and adults.

This practice parameter describes treatment with stimulant medication. It uses an evidence-based medicine approach derived from a detailed literature review and expert consultation. Stimulant medications in clinical use include methylphenidate, dextroamphetamine, mixed salts of amphetamine, and pemoline. They carry U.S. Food and Drug Administration indications for the treatment of attention-deficit hyperactivity disorder.

Summary of the practice parameter for the prevention and management of aggressive behavior in child and adolescent psychiatric institutions with special reference to seclusion and restraint.

This parameter reviews the current state of the prevention and management of child and adolescent aggressive behavior in psychiatric institutions, with particular reference to the indications and use of seclusion and restraint. It also presents guidelines that have been developed in response to professional, regulatory, and public concern about the use of restrictive interventions with aggressive patients with regard to personal safety and patient rights. The literature on the use of seclusion, physical restraint, mechanical restraint, and chemical restraint is reviewed, and procedures for carrying out each of these interventions are described. Clinical and regulatory agency perspectives on these interventions are presented. Effectiveness, indications, contraindications, complications, and adverse effects of seclusion and restraint procedures are addressed. Interventions are presented to provide more opportunities to promote patient independence and satisfaction with treatment while diminishing the necessity of using restrictive procedures.

Implant and copper oxide needles for steers grazing Acremonium coenophialum-infected tall fescue pastures: effects on grazing and subsequent feedlot performance and serum constituents.

Two experiments were conducted to compare the effects of a progesterone-estradiol implant (PEI) with no implant (NI) and 20 g of copper oxide needles (CuON) with no CuON on grazing, subsequent feedlot performance, and selected serum constituents of steers. In Exp. 1, 114 Limousin crossbred yearling steers (317 kg average initial BW) were stocked continuously on Acremonium coenophialum-infected tall fescue (Festuca arundinacea Schreb.)-ladino clover (Trifolium repens L.) pastures (C) or were rotated to bermuda grass (Cynodon dactylon [L.] Pers.) during summer months (R) of two consecutive years. Implant and copper treatments were applied within pasture. Blood samples were collected four times during each grazing season. Continuously stocked steers had greater (P less than .05) grazing gain, less (P less than .10) feedlot gain, and heavier (P less than .05) carcass weights than R steers did. Implanted steers had greater (P less than .05) pasture but lesser (P less than .05) feedlot gains than did NI steers. Prolactin concentrations were greater (P less than .05) from R than from C steers in late summer 1988. Ceruloplasmin was greater (P less than .01) with CuON than without on the last three and last two sampling dates in 1988 and 1989, respectively. In Exp. 2, blood samples were collected twice from 40 mixed-breed steers (283 kg average initial BW) receiving the same implant and copper treatments as in Exp. 1 and grazing infected fescue for one season. Serum ceruloplasmin and copper concentrations were increased (P less than .01) by CuON, but other measurements did not differ among treatments. Summer grazing of bermuda grass increased serum copper, ceruloplasmin, and prolactin but decreased grazing performance. Implanting increased grazing performance. Copper oxide needles increased serum ceruloplasmin and copper concentrations but did not affect steer performance.

Salivary testosterone measurements among women: relative magnitude of circadian and menstrual cycles.

Measures of testosterone among women are potentially useful in behavioral research, but information is needed on how much error is introduced by variability across the menstrual cycle. Morning and evening salivary testosterone concentrations were measured at weekly intervals across one menstrual cycle in each of 22 women, using the luteinizing hormone surge to mark midcycle. Menstrual cycles were statistically significant but smaller than daily cycles or individual differences. Menstrual cycle effects can be ignored in most research relating psychological and behavioral variables to individual differences in testosterone.