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Systemic sclerosis (SSc) is a progressive, multiorgan disease with limited treatment options. Although a recent proof-of-concept study using romilkimab or SAR156597, a bispecific IL-4/IL-13 antibody, suggests a direct role of these cytokines in the pathophysiology of SSc, their contributions to the balance between inflammation and fibrosis are unclear. Here, we determine the roles of type 2 inflammation in fibrogenesis using FRA2-Tg (Fos-related antigen 2-overexpressing transgenic) mice, which develop spontaneous, age-dependent progressive lung fibrosis. We defined the molecular signatures of inflammation and fibrosis at three key stages in disease progression, corresponding to preonset, inflammatory dominant, and fibrosis dominant biology, and revealed an early increase in cytokine-cytokine receptor interactions and antigen-processing and presentation pathways followed by enhanced Th2- and M2 macrophage-driven type 2 responses. This type 2 inflammation progressed to extensive fibrotic pathology by 14-18 weeks of age, with these gene signatures overlapping significantly with those seen in the lungs of patients with SSc with interstitial lung disease (ILD). These changes were also evident in the histopathology, which showed perivascular and peribronchiolar inflammation with prominent eosinophilia and accumulation of profibrotic M2-like macrophages followed by rapid progression to fibrosis with thickened alveolar walls with multifocal fibrotic bands and signs of interstitial pneumonia. Critically, treatment with a bispecific antibody targeting IL-4 and IL-13 during the inflammatory phase abrogated the Th2 and M2 responses and led to near-complete abrogation of lung fibrosis. These data recapitulate important features of fibrotic progression in the lungs of patients with SSc-ILD and enhance our understanding of the progressive pathobiology of SSc. This study also further establishes FRA2-Tg mice as a valuable tool for testing future therapeutic agents in SSc-ILD. [ABSTRACT FROM AUTHOR]

This study surveyed interns, postdoctoral residents, directors of training, and psychologists in independent practice to assess their support for the Association of State and Provincial Psychology Board's efforts to facilitate license portability across state or provincial boundaries. Results indicate strong support at all career levels and are discussed in terms of psychology remaining competitive in a constantly changing workplace. Additional research to clarify motives for this strong support and to identify possible drawbacks to license portability is also suggested. Keywords: license, credential, portability, mobility, public safety

This study assessed the views of psychology interns, residents, and psychologists regarding various aspects of the American Psychological Association's prescriptive authority initiative, willingness to seek prescriptive authority, and views regarding psychopharmacological training. Results demonstrated continuing support for prescriptive authority legislation and for a training curriculum that begins prior to completion of the doctorate. Personal interest in pursuing training for prescriptive authority decreased markedly as tuition rose above $I0,000 and time to completion extended beyond 2 years. Results are discussed in terms of the costs versus benefits of such training. Keywords: prescriptive authority, training, psychopharmacology

Attention deficit hyperactivity disorder (ADHD) has been long recognized and well established in children, but its continuation into adulthood has only recently been supported by the research. ADHD symptoms and concerns typically appear differently in adults, but treatment options, conceptually at least, are similar to those used for children who have ADHD. This article introduces the issue of Journal of Clinical Psychology: In Session devoted to ADHD in teens and adults. It presents the prevalence and manifestations of the disorder and then reviews the subsequent articles on the comorbidity, evaluation, education, psychopharmacology, and psychosocial treatments of ADHD for teens and adults. The issue concludes with an article on neurobiofeedback, a relatively new treatment option. Keywords: adults with attention deficit hyperactivity disorder (ADHD); teens with attention deficit hyperactivity disorder (ADHD); diagnosis; treatment

This study, which replicated a 1995 survey of intern and training director attitudes toward prescription privileges (R. K. Ax, M. R. Forbes, & D. D. Thompson, 1997), found a slight decline in support for prescription privileges. It also noted that factors such as age, position, degree, type of internship program attended, and nature of internship setting were all predictive of willingness to pursue prescription privileges. Attitudinal factors most predictive of willingness to seek prescriptive authority were also reported. The study suggested that previous survey findings have been influenced by several of these variables, which may account for some of the variability of past surveys. Findings were discussed in terms of career status and options, workplace experiences and demands, and the costs versus benefits of pursuing prescription privileges.

What are the most appropriate empirically supported diagnostic and treatment approaches to children with attention-deficit/hyperactivity disorder (ADHD)? This article summarizes the nomenclature, prevalence and course, comorbidity, etiology, assessment, and federal laws associated with ADHD. The authors then review clinical research and consensus guidelines for the treatment of ADHD, including the largest randomized treatment study completed on ADHD (MTA Cooperative Group, 1999a). The empirical evidence supports either a behavioral--psychosocial or a combined behavioral--psychosocial and medication intervention in the treatment of children with ADHD.

Consultation-liaison has become increasingly important to the diversification of psychological practice. With the advent of national health proposals, the ability to service individuals (including the youth of this nation) in a variety of settings will be critical. This article describes a comprehensive training program in consultation-liaison child and adolescent psychology and encourages its adoption in other training programs. Psychology training programs will need to provide practice experiences in a variety of settings for psychologists to remain viable in an increasingly competitive mental health market place.