Biomedical subjects

J Costin

Publications and source records attributed to J Costin.

5 recordsLinked to original sources

PubMed2002

Attention deficit hyperactivity disorder, combined type (ADHD-CT): differences in blood pressure (BP) due to posture and the child report of anxiety.

AIM: ADHD-CT and anxiety has been associated with increased diastolic BP in controlled trials of single dosage studies of methylphenidate, although parent and child reports of anxiety have not been considered separately. Therefore, we tested the hypothesis that primary school-age children with ADHD-CT and anxiety have increased diastolic BP from a sitting to a standing position compared to children with ADHD-CT without anxiety, whether defined from a parent or child perspective. METHOD: Thirty-eight medication naive children with ADHD-CT were studied. Four groups were formed from parent and child reports of anxiety, using categorical and continuous measures of anxiety. The groups were compared using one-way ANOVA. Where omnibus F was significant, the post hoc SNK procedure (p < 0.05) was used to determine the source of this significance. RESULTS: Primary school-age children with ADHD-CT and anxiety, defined from the child's report alone, had significantly increased diastolic BP from a sitting to a standing position than children with ADHD-CT without anxiety. CONCLUSIONS: The recognition of anxiety and its management in primary school-age children with ADHD-CT is generally poorly understood. In this particular group of children, only the child's report of anxiety was associated with significantly increased diastolic BP from a sitting to a standing position. Therefore, careful and thorough assessment of the child's perspective is required. The characteristics of this anxiety and its association with postural BP require further careful longitudinal study. Biological implications are noted.

Analysis of Variance↗

PubMed2001

Abnormal executive function in attention deficit hyperactivity disorder: the effect of stimulant medication and age on spatial working memory.

OBJECTIVE: This study sought to examine the factors associated with spatial working memory and the use of strategies to impairments in spatial working memory in children with attention deficit hyperactivity disorder (ADHD). The developmental trajectories for spatial working memory in medicated and medication naïve children with ADHD were investigated. In addition, the effect of psychostimulant medication on deficits in spatial working memory was examined. METHOD: A cross-sectional study compared performance between 21 psychostimulant medicated children with ADHD, 27 medication naïve children with ADHD and 26 matched control subjects on computerized tests of spatial memory and spatial working memory. RESULTS: Compared with the controls, performance in medication naïve children with ADHD was significantly worse on the spatial working memory task. There was no difference in performance between the medicated children with ADHD and the control subjects on this same task, despite the ongoing symptoms of ADHD in the former group. The pattern of normal and abnormal performance in the ADHD groups was age-independent. CONCLUSIONS: Deficits in executive functions related to spatial working memory do occur in children with ADHD, although the magnitude of these deficits is not related to the child's age or the level of ADHD symptoms. These deficits were not present in the current sample of children who were receiving psychostimulant medication.

Age Factors↗

PubMed1999

Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children.

BACKGROUND: Executive function deficits have been reported repeatedly in children with Attention Deficit Hyperactivity Disorder (ADHD). Stimulant medication has been shown to be effective in improving cognitive performance on most executive function tasks, but neuropsychological tests of executive function in this population have yielded inconsistent results. Methodological limitations may explain these inconsistencies. This study aimed to measure executive function in medicated and non-medicated children with ADHD by using a computerized battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), which is sensitive to executive function deficits in older patients with frontostriatal neurological impairments. METHODS: Executive function was assessed in 30 children with ADHD: 15 were stimulant medication naive and 15 were treated with stimulant medication. These two groups were compared to 15 age, sex and IQ matched controls. RESULTS: The unmedicated children with ADHD displayed specific cognitive impairments on executive function tasks of spatial short-term memory, spatial working memory, set-shifting ability and planning ability. Impairments were also seen on spatial recognition memory and delayed matching to sample, while pattern recognition memory remained intact. The medicated children with ADHD were not impaired on any of the above executive function tasks except for deficits in spatial recognition memory. CONCLUSIONS: ADHD is associated with deficits in executive function. Stimulant medication is associated with better executive function performance. Prospective follow-up studies are required to examine these effects.

Adolescent↗

PubMed1999

Attention deficit hyperactivity disorder: anxiety phenomena in children treated with psychostimulant medication for 6 months or more.

OBJECTIVE: The intermediate- to long-term use of psychostimulant medication has unclear benefits on the core symptoms of attention deficit hyperactivity disorder (ADHD) and delayed onset affective symptom side effects which can mimic these core ADHD symptoms. 'ADHD and anxiety' has also been associated with a poor response to short-term psychostimulant medication treatment. In addition, it is unclear whether 'ADHD and anxiety' should be defined from the child's and/or the parent's perspective. We propose that anxiety will be increased in children with ADHD who are treated with psychostimulant medication in the intermediate- to long-term who are identified by clinicians as poor responders. METHOD: Twenty children with ADHD who were medicated for 6 months or more and who had ongoing core symptoms of ADHD were compared to 20 age- and IQ-matched children with ADHD who were medication-naïve. Chi-squared tests were performed on the categorical dependent variables and independent t-tests on the dependent continuous variables. RESULTS: Anxiety is significantly increased in children with ADHD treated with psychostimulant medication in the intermediate- to long-term who are noted by clinicians to have ongoing core symptoms of ADHD. This statistically significant finding is evident with both categorical and dimensional measures of anxiety from the child's perspective. CONCLUSIONS: The recognition of anxiety and its management in children with ADHD is generally poorly understood. In this particular group of children with ADHD, anxiety may be a side effect of intermediate- to long-term psychostimulant medication and/or a potential marker for a poor response to intermediate- to long-term psychostimulant medication treatment.

Anxiety↗

PubMed1985

Investigative auditing.

The use of traditional audit approaches, such as those employed by the accounting profession, frequently fail to uncover losses or the causes of such losses in an operation such as hospital linen. In this article, the authors describe a different type of audit, called Investigative Auditing, and relate how it was used at one institution to uncover a serious theft problem and recommend better techniques.

Bedding and Linens↗