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Inflammatory cytokines are involved in attention deficit hyperactivity disorder (ADHD), a highly prevalent neurodevelopmental disorder. To quantify the baseline levels of pro- and anti-inflammatory cytokines and their changes after methylphenidate (MPH), a total of 31 prepubertal children with ADHD were recruited and subclassified into only two ADHD presentations—ADHD attention deficit (n = 13) or ADHD combined (n = 18). The children were also screened for oppositional defiant conduct disorder (ODCD) and anxiety disorder. Blood samples were drawn at 09:00 and after 4.63 ± 1.87 months of treatment. Four pro-inflammatory cytokines (interleukin-1beta (IL-1β), IL-5, IL-6, tumor necrosis factor-alpha (TNF-α)) and three anti-inflammatory cytokines (IL-4, IL-10, IL-13) were measured using a Luminex® assay. For statistics, a factorial analysis was performed in Stata 15.1. Overall, there were no statistically significant differences in the interleukin (IL) values induced by treatment. When grouped by presentation, the differences were present almost exclusively in ADHD-AD, usually with a profile opposite to that observed in ADHD-C, and with interactions between comorbid factors, with IL-1β (p = 0.01) and IL-13 (p = 0.006) being the ones reaching the greatest statistical significance. These differences are probably related to the ODCD factor, and they disappear after treatment. In conclusion, the changes observed in cytokine levels in prepubertal children only in the ADHD-AD presentation are probably related to comorbidities (specifically ODCD) and are mitigated after treatment. [ABSTRACT FROM AUTHOR]

Policy PointsThe US health care system faces mounting pressure to reduce greenhouse gas emissions and adapt to the impacts of climate change; motivated institutions and an engaged health care workforce are essential to the development, implementation, and maintenance of a climate‐ready US health care system.Health care workers have numerous profession‐specific and role‐specific opportunities to address the causes and impacts of climate change.Policies must address institutional barriers to change and create incentives aligned with climate readiness goals.Institutions and individuals can support climate readiness by integrating content on the health care implications of climate change into educational curricula. [ABSTRACT FROM AUTHOR]

Unhealthy substance-use behaviors, including a heavy alcohol intake, illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage their disease-related symptoms. This study, based on data from a larger randomized controlled trial of an HIV/AIDS symptom management manual, examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms. The mean age of the sample (n = 775) was 42.8 years and 38.5% of the sample was female. The mean number of years living with HIV was 9.1 years. The specific self-reported unhealthy substance-use behaviors were the use of marijuana, cigarettes, a large amount of alcohol, and illicit drugs. A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance-use behaviors, including amphetamine and injection drug use, heavy alcohol use, cigarette smoking, and marijuana use. The implications for clinical practice include the assessment of self-care behaviors, screening for substance abuse, and education of persons regarding the self-management of HIV.

As part of a larger randomized controlled trial examining the efficacy of an HIV/AIDS symptom management manual (n = 775), this study examined the prevalence of peripheral neuropathy in HIV-infected individuals at 12 sites in the USA, Puerto Rico, and Africa. Neuropathy was reported by 44% of the sample; however, only 29.4% reported initiating self-care behaviors to address the neuropathy symptoms. Antiretroviral therapy was found to increase the frequency of neuropathy symptoms, with an increased mean intensity of 28%. A principal axis factor analysis with Promax rotation was used to assess the relationships in the frequency of use of the 18 self-care activities for neuropathy, revealing three distinct factors: (i) an interactive self-care factor; (ii) a complementary medicine factor; and (iii) a third factor consisting of the negative health items of smoking, alcohol, and street drugs. The study's results suggest that peripheral neuropathy is a common symptom and the presence of neuropathy is associated with self-care behaviors to ameliorate HIV symptoms. The implications for nursing practice include the assessment and evaluation of nursing interventions related to management strategies for neuropathy.

The Florida Department of Health (FDOH) initiated a tobacco prevention program in 1989 when it received federal funding to implement tobacco prevention and control activities. By 1997, the State of Florida successfully settled with the tobacco industry for $11.3 billion to recoup Medicaid costs incurred by smokers. As part of the settlement agreement, the FDOH launched the Tobacco Pilot Program targeting tobacco use among underage youth.The Florida Youth Tobacco Survey (FYTS), which was originally part of the Tobacco Pilot Program, is a statewide, school-based anonymous survey that has been conducted annually since 1998. The FYTS collects information regarding the prevalence of tobacco use, attitudes, and related behaviors among middle and high school students throughout Florida and tracks those behaviors over time. The FYTS has been administered to a state-level sample annually since 1998, with county-level surveys being conducted in 2000, 2002, 2006, and 2008.In 2000, the FDOH worked with other state agencies to coordinate school-based surveys to reduce the burden on schools, teachers, and students. The FYTS became part of a multi-agency joint survey effort that also includes the Florida Youth Substance Abuse Survey (FYSAS), the Youth Physical Activity and Nutrition Survey (YPANS), and the Youth Risk Behavior Survey (YRBS).The 2008 FYTS was based on a two-stage cluster probability sample design. First, a random sample of public middle schools and high schools was selected for participation in the survey. Then, within each selected school, a random sample of classrooms was selected, and all students in that class were invited to participate in the survey. To be able to generalize the data to all of Florida, the survey data were statistically weighted. Weighting is a procedure that adjusts for oversampling and for any discrepancies between the sample and the entire population from which the sample is drawn. The weighted responses of the survey participants that are presented in this report were calculated to reflect the prevalence of tobacco usage and related indicators among all Florida public middle and high school students within each county and for Florida as a whole.The 2008 county-level FYTS was implemented in the spring of 2008. Sixty-six of the 67 Florida counties participated in this survey. The survey was administered to 38,510 middle school students (grades six to eight) and 40,283 high school students (grades nine to twelve) in 744 public schools throughout the state. The survey response rate for middle school students was 79% and the survey response rate for high school students was 73%. Sarasota County did not participate in the 2008 Florida Youth Survey and, therefore, has been omitted from this report. In addition, no middle school students from Gilchrist County participated in the survey so results for Gilchrist County are presented at the high school level only.In this report, county values are presented for key indicators with maps for both middle and high school students, followed by detailed tables listing the prevalence by county. On each map, counties have been split into four groups: (1) counties with rates higher than the state rate and statistically significant; (2) counties with rates higher than the state rate, but not statistically significant; (3) counties with rates lower than the state rate, but not statistically significant; and (4) counties with rates lower than the state rate and statistically significant. Confidence intervals (C.I.s) were used to determine significance. A 95% C.I. is a range in which the “true” rate will fall 95% of the time. The tables in this document show the total percentage for the county, as well as the breakdown by gender for each county, including 95% C.I.s. These maps and tables will allow readers to view their county in comparison to other counties, as well as to the State of Florida. Results were omitted if there were less than 30 respondents for a specific indicator.

In recent years there has been a considerable increase in the publishing of textbooks and monographs covering what was formerly known as random or irregular deterministic motion, now referred to as deterministic chaos. There is still substantial interest in a matter that is included in many graduate and even undergraduate courses on classical mechanics. Based on the Hamiltonian formalism, the main objective of this paper is to provide, from the physicist's point of view, an overall and intuitive review of this broad subject (with some emphasis on the Kolmogorov-Arnold-Moser theorem and the stability of planetary motions) which may be useful to both students and instructors. (Contains 8 footnotes and 10 figures.)