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Two studies examine the convergence between measures of friendship and measures of liking in the assessment of friendship and peer acceptance. In the first study, 551 (301 boys and 250 girls) Canadian primary school children (ages 8–11) nominated friends and liked-most classmates. In the second study, 282 (127 boys and 155 girls) US primary school children (ages 9–11) nominated friends and rated classmates on a sociometric preference scale. The results revealed considerable convergence in the assessment of friendship. Most first, second, and third ranked friends were also nominated and rated as liked-peers, suggesting that when measures of liking are used to identify friends, few top-ranked friendships are overlooked. There was less convergence in assessments of peer acceptance. Peer acceptance scores derived from friend nominations were more strongly correlated with peer acceptance scores derived from liking nominations than with those derived from sociometric preference ratings. We conclude that liking nominations accurately capture friendships, particularly best friendships. Friend nominations may be a suitable substitute for assessments of liking, but they are a poor substitute for assessments of sociometric preference.

This study described the development of the Social Skills Improvement System Social Emotional Learning Edition Rating Forms (SSIS SEL RF) for teachers, parents, and students. This new multirater assessment is a reconfiguration of the SSIS Rating Scales items inspired by the CASEL Social Emotional Competency framework. The internal structure and score reliability estimates were examined across three raters for a common sample of more than 200 individual children ages 3 to 18 years. Confirmatory factor analyses tested against the CASEL five-dimensional SEL theoretical model demonstrated adequate fit for the SSIS SEL Parent and Student RFs and mediocre fit of the Teacher RF. Internal consistency, test-retest, and interrater reliability estimates for scores on each of the SSIS SEL RFs all met or exceeded acceptable criteria. Thus, researchers and practitioners interested in measuring the social–emotional behavior of children ages 3 to 18 can expect reliable scores and structurally meaningful behavior content within the Collaborative on Academic Social Emotional Learning (CASEL) SEL competency framework. Limitations to the present findings and suggestions for future research conclude the report.

Objective: Epidemiologic studies consistently link caffeine, a nonselective adenosine antagonist, to lower risk of Parkinson disease (PD). However, the symptomatic effects of caffeine in PD have not been adequately evaluated. Methods: We conducted a 6-week randomized controlled trial of caffeine in PD to assess effects upon daytime somnolence, motor severity, and other nonmotor features. Patients with PD with daytime somnolence (Epworth >10) were given caffeine 100 mg twice daily ×3 weeks, then 200 mg twice daily ×3 weeks, or matching placebo. The primary outcome was the Epworth Sleepiness Scale score. Secondary outcomes included motor severity, sleep markers, fatigue, depression, and quality of life. Effects of caffeine were analyzed with Bayesian hierarchical models, adjusting for study site, baseline scores, age, and sex. Results: Of 61 patients, 31 were randomized to placebo and 30 to caffeine. On the primary intention-to-treat analysis, caffeine resulted in a nonsignificant reduction in Epworth Sleepiness Scale score (−1.71 points; 95% confidence interval [CI] −3.57, 0.13). However, somnolence improved on the Clinical Global Impression of Change (+0.64; 0.16, 1.13, intention-to-treat), with significant reduction in Epworth Sleepiness Scale score on per-protocol analysis (−1.97; −3.87, −0.05). Caffeine reduced the total Unified Parkinson9s Disease Rating Scale score (−4.69 points; −7.7, −1.6) and the objective motor component (−3.15 points; −5.50, −0.83). Other than modest improvement in global health measures, there were no changes in quality of life, depression, or sleep quality. Adverse events were comparable in caffeine and placebo groups. Conclusions: Caffeine provided only equivocal borderline improvement in excessive somnolence in PD, but improved objective motor measures. These potential motor benefits suggest that a larger long-term trial of caffeine is warranted. Classification of evidence: This study provides Class I evidence that caffeine, up to 200 mg BID for 6 weeks, had no significant benefit on excessive daytime sleepiness in patients with PD.

Background Although non-motor manifestations of Parkinson’s disease are common and can cause severe disability, they are often under-recognized, leading to missed treatment opportunities. Screening tools for non-motor symptoms are urgently needed. Recently a 30–item screening Non Motor Symptoms Questionnaire was developed. Although some psychometric properties have been evaluated, sensitivity and specificity of the questionnaire have not been systematically assessed. Methods Parkinson patients completed Non Motor Symptoms Questionnaire, then underwent a gold-standard clinical evaluation of non-motor symptoms and signs that included extensive standardized questionnaires, cognitive/behavioural assessment, and neurological examination to determine whether each manifestation was present or absent. The sensitivity and specificity of each non-motor symptom, in relation to the gold-standard were estimated. Results For the 70 participants, the mean age was 66.7+/−9.3, 64% were men, and disease duration was 3.8+/−2.8 years. From the gold-standard evaluation, the prevalence of non-motor manifestations ranged from 8.7% (hallucinations) to 78.3% (nocturia). The mean sensitivity of all Non Motor Symptoms was 63.4%. This varied considerably among different manifestations, ranging from 24% (sleepiness, hyposmia) to 100% (diplopia). By restricting analysis to clinically significant non-motor problems (i.e. those serious enough to warrant treatment), the mean sensitivity increased to 71.8%. The specificity for most items was high, with an overall mean specificity of 88.5%. Conclusions For many non-motor manifestations Non Motor Symptoms Questionnaire is an effective screen; however, for manifestations such as somnolence, olfactory loss and apathy, sensitivity is suboptimal. Overall, this questionnaire can be a useful clinical tool for screening non-motor problems in an office setting.

It has recently been suggested that peripheral nerve or plexus blocks performed with the use of a nerve stimulator at low currents (

Simulation-based training is becoming an accepted tool for educating physicians before direct patient care. As ultrasound-guided regional anesthesia (UGRA) becomes a popular method for performing regional blocks, there is a need for learning the technical skills associated with the technique. Although simulator models do exist for learning UGRA, they either contain food and are therefore perishable or are not anatomically based. We developed 3 sonoanatomically based partial-task simulators for learning UGRA: an upper body torso for learning UGRA interscalene and infraclavicular nerve blocks, a femoral manikin for learning UGRA femoral nerve blocks, and a leg model for learning UGRA sciatic nerve blocks in the subgluteal and popliteal areas.

Introduction: Epidemiologic studies consistently find an inverse association between caffeine use and PD. Numerous explanations exist, but are difficult to evaluate as caffeine's symptomatic effect and tolerability in PD are unknown. Patients and Methods: We designed an open-label, 6-week dose-escalation study of caffeine to establish dose tolerability and evaluate potential motor/nonmotor benefits. Caffeine was started at 200 mg daily and was increased to a maximum of 1,000 mg. Results: Of 25 subjects, 20 tolerated 200 mg, 17 tolerated 400 mg, 7 tolerated 800 mg, and 3 tolerated 1,000 mg. The most common adverse events were gastrointestinal discomfort, anxiety, and worsening/emerging tremor. At 400 mg daily, we found potential improvements in motor manifestations and somnolence (UPDRS III: −4.5 ± 4.6, P = 0.003; Epworth: −2.0 ± 3.0, P = 0.015). Conclusion: Maximum dose tolerability for caffeine in PD appears to be 100 to 200 mg BID. We found pilot preliminary evidence that caffeine may improve some motor and nonmotor aspects of PD, which must be confirmed in longer term, placebo-controlled, clinical trials. © 2011 Movement Disorder Society

Purpose To evaluate the utility of femoral nerve blocks in postoperative pain control after hip arthroscopy. Methods Forty consecutive patients scheduled for hip arthroscopy were randomized into 2 groups for postoperative pain control. Half were to receive routine intravenous narcotics for pain scores of 7 or above in the postanesthesia care unit (PACU), and the other half were to receive a femoral nerve block in the PACU for the same pain scores. Data were compared with respect to patient sex, patient age, traction times, type of procedure, nausea, overall patient satisfaction with analgesia, and duration of time in the PACU. Results Thirty-six patients had initial pain scores of 7 of 10 or greater on a visual analog scale. Of these patients, 16 were randomized to receive postoperative morphine and 20 to receive a femoral nerve block. There were no significant differences between the 2 groups with respect to sex, age, traction times, or type of procedure performed. Patients who received morphine had a significantly longer time to discharge from the PACU (216 minutes) than the femoral nerve block group (177 minutes). The morphine group was also significantly more likely to report postoperative nausea (75%) than the femoral nerve block group (10%). Patients receiving femoral nerve blocks were significantly more likely to be satisfied with their postoperative pain control (90%) than those who had received morphine (25%). All of the patients receiving a femoral nerve block stated that they would undergo the block again if they needed another hip arthroscopy. Conclusions On the basis of all criteria studied (quality of pain relief, length of stay in the PACU, side effects, and patient satisfaction), a femoral nerve block is an excellent alternative to routine narcotic pain medication in patients undergoing hip arthroscopy. Level of Evidence Level II, randomized controlled trial.

It has recently been suggested that peripheral nerve or plexus blocks performed with the use of a nerve stimulator at low currents (0.5 mA) may result in neurologic damage. We studied the infraclavicular nerve block, performed with the use of a nerve stimulator and an insulated needle, in a prospective evaluation of efficacy and safety. During a one-year period, 248 patients undergoing infraclavicular nerve block were evaluated for block success rate and incidence of neurologic complication. All blocks were performed with the use of a nerve stimulator and an insulated needle ator =0.3 mA. Success rate was 94%, which increased to 96% with surgical infiltration of local anesthetic. There were no intraoperative or immediate postoperative complications noted. After one week, only one patient had a neurologic complaint, and this was surgically related, referable to surgery performed on the radial nerve. We conclude that infraclavicular nerve blocks performed at low currents (or =0.3 mA) are safe and effective.

Cetirizine, an oxidative metabolite of hydroxyzine, is a cyclizine class H1-receptor antagonist with diminished CNS activity currently under investigation. It has a novel pharmacokinetic profile with a 9-hour half-life, lower volume of distribution and total body clearance, minimal metabolism and essentially renal excretion. Minimal binding to CNS receptors has been demonstrated in animal models. In contrast to its parent compound and diphenhydramine, cetirizine has an effect comparable to placebo on psychomotor function and multiple sleep latency tests. Inhibition of histamine-induced bronchospasm and mild bronchodilation has also been demonstrated. U.S. and European clinical trials have affirmed its safety and efficacy in histamine-associated disorders.

Multiple injections of ovomucoid were given to mice with ongoing prolonged IgE antibody production to that antigen. Two inbred strains and antigen doses ranging from 0.05 to 5 μg each injection, given intradermally and subcutaneously, were used. Mice treated in this manner showed a marked diminution of the IgE antibody booster response as compared to controls. This decrease in booster response was antigen-specific. In addition, a protective effect from anaphylaxis was indicated. The mouse model continues to be a valuable tool for studies of certain IgE-mediated diseases.