Predicting Use of Medications for Children with ADHD: The Contribution of Parent Social Cognitions.

OBJECTIVE: To explore how well parental social cognitions, guided by the Theory of Reasoned Action (TRA), contribute to the uptake and continuation of stimulant medication for children with ADHD. No previous study has explored this model in predicting medication use in a clinical sample. METHOD: Sixty-nine parents of children aged 6-13 years presenting to a tertiary ADHD clinic completed questionnaires, and a clinician documented their medication usage. RESULTS: When controlling for medication status at baseline, both of the components of the TRA (i.e., attitudes and norms) predicted medication status following initial visit. Logistic regressions indicated that parents were more likely to enroll in or continue stimulant medication if they had lower stigma related to ADHD, a higher opinion of ADHD medications, and a greater knowledge of ADHD; this model classified 72.5% of the patients who started or continued stimulant medications. CONCLUSIONS: Findings suggest that the parents' knowledge about ADHD, opinion about treatment, and ADHD-related stigma are key factors to target in order to increase the uptake and continued use of evidence-based pharmacological interventions for children with ADHD.

OBJECTIF: Explorer à quel point les cognitions sociales parentales, guidées par la théorie de l'action raisonnée (TAR), contribuent à l'utilisation et à la continuation de médicaments stimulants pour les enfants souffrant du TDAH. Aucune étude précédente n'a exploré ce modèle pour prédire l'utilisation de médicaments dans un échantillon clinique. MÉTHODE: Soixante-neuf parents d'enfants de 6 à 13 ans qui se sont présentés à une clinique tertiaire du TDAH ont rempli des questionnaires, et un clinicien a documenté leur utilisation de médicaments. RÉSULTATS: Après contrôle de l'état des médicaments au départ, les deux composantes de la TAR (c.-à-d., les attitudes et les normes) prédisaient l'état des médicaments par suite de la première visite. Les régressions logistiques indiquaient que les parents étaient plus susceptibles de commencer ou de continuer les médicaments stimulants s'ils avaient moins de stigmates liés au TDAH, une meilleure opinion des médicaments du TDAH, et une meilleure connaissance du TDAH; ce modèle a classifié 72,5 % des patients qui ont commencé ou continué les médicaments stimulants. CONCLUSIONS: Les résultats suggèrent que les connaissances des parents au sujet du TDAH, leur opinion sur le traitement et les stigmates liés au TDAH sont des facteurs clés à cibler afin d'accroître l'utilisation nouvelle et continue des interventions pharmacologiques fondées sur des données probantes pour les enfants souffrant du TDAH.

Mixed methods study exploring parent engagement in child health research in British Columbia.

OBJECTIVES: The objective of this study was to explore parent perspectives of and interest in an interactive knowledge translation platform called Child-Sized KT that proposes to catalyse the collaboration of patients, families, practitioners and researchers in patient-oriented research at British Columbia Children's Hospital (BCCH). METHODS: An explanatory sequential mixed methods design was used over 1 year. Over 500 parents across BC completed an online survey, including a subsample of 102 parents who had accessed care at BCCH within the past 2 years. The survey explored parent perspectives about the value of their engagement at all stages of the research process and their interest in and concerns with using an online platform. Following the online survey, two focus groups were held with parents in the Vancouver area to explore themes emerging from the survey. RESULTS: Parents expressed keen interest in engaging in research at BCCH. Parents perceived benefit from their input at all stages of the research process; however, they were most interested in helping to identify the problem, develop the research question and share the results. Although parents preferred online participation, they had concerns about protecting the privacy of their child's information. CONCLUSIONS: Parents see value in their involvement in all stages of child health research at BCCH. Their input suggests that Child-Sized KT, a hypothetical online platform, would facilitate meaningful stakeholder engagement in child health research, but should offer a customised experience and ensure the highest standard of data privacy and protection.

A novel working memory task for preschoolers: sensitivity to age differences from 3-5 years.

Working memory (WM) plays an important role in children's learning and is linked to later academic and occupational success. Understanding the early development of WM can provide critical clues regarding the underlying structure of executive functions and how they change over the life span. The main objectives of the present study were to (1) investigate age differences in the development of three components of WM (retrieval, substitution, transformation) on a novel preschool WM measure and (2) explore whether findings are consistent with the hierarchical model of WM development by examining perseverative and non-perseverative WM errors. Perseverative errors were hypothesized to be more strongly associated with problems substituting and transforming a representation held in mind, whereas non-perseverative errors were hypothesized to be associated with problems maintaining a representation in mind. Participants were 64 children ranging in age from 3.0 to 5.6 years. The results provide evidence for the sensitivity of the WM task to age differences from 3 to 5 years and support for the hierarchical model of WM development.

A comparison of 3 anesthetic protocols for 24 hours of mechanical ventilation in cats.

OBJECTIVE: To compare the recovery times, recovery quality, and cardiovascular (CV) effects of 3 anesthetic protocols during 24 hours of mechanical ventilation (MV) in healthy cats. DESIGN: Prospective, randomized, crossover study. SETTING: Research laboratory at a veterinary teaching hospital. ANIMALS: Six healthy intact male purpose-bred cats. INTERVENTIONS: Each cat was randomly assigned to receive 3 anesthetic protocols for 24 hours of MV; Protocol K consisted of ketamine, Protocol P, propofol; and Protocol PK, propofol plus fixed-rate low-dose ketamine. Each infusion drug dose was adjusted using a sedation scoring system. All protocols included fixed doses of fentanyl (10 µg/kg/h) and midazolam (0.5 mg/kg/h). MEASUREMENTS AND MAIN RESULTS: Drug doses and recovery times were recorded. Recovery quality was scored. Blood gas results, CV parameters, and frequency of bradycardia or hypotension requiring interventions were recorded. The mean d dose ± standard error of K was 81.3 ± 3.3 µg/kg/m. The median dose (95% cardiac index) of propofol (µg/kg/m) in PK was 16.0 (13.1, 19.6) and in P was 48.1 (39.3, 58.9). P necessitated significantly more propofol than PK (P < 0.05). Protocol K (35.6 ± 3.2 hours) had significantly longer times to full recovery compared to P (18.2 ± 3.2 hours). Protocol K had significantly longer times to head up, crawling, and standing compared to P and PK. Cats sedated with PK (2.33 ± 0.47) required significantly more interventions for hypotension than K (0.50 ± 0.47). Protocol P (3.2 ± 0.4) and PK (1.4 ± 0.3) required significantly more interventions for bradycardia compared to K (0.8 ± 0.3). When comparing protocol K to P and PK, significant differences in blood pressure, lactate, oxygen delivery, and oxygen consumption were noted. CONCLUSIONS: Cats anesthetized with P had shorter times to full recovery compared to K. Cats anesthetized with K required fewer interventions for bradycardia or hypotension but had longer recovery times compared to P or PK. Protocol PK reduced the propofol dose required to maintain optimal anesthesia.