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Charach A.,Research Institute The Hospital for Sick Children | Charach A.,University of Toronto | Yeung E.,University of Victoria | Volpe T.,Community Health Systems Resource Group | And 2 more authors.
BMC Psychiatry

Background: Young adolescents' and their parents' experiences with Attention-Deficit/Hyperactivity Disorder (ADHD) and its treatment were explored to investigate beliefs and attitudes regarding use of stimulant medication, and their influence on treatment decisions.Methods: Using in-depth qualitative interviews, 12 adolescents with ADHD aged 12 - 15 years, and their parents described their experiences of ADHD and its treatment. Twenty four interviews, 12 with adolescents and 12 with their parents elicited detailed descriptions of beliefs about ADHD, attitudes about stimulant use and the circumstances surrounding treatment decisions. Verbatim transcripts were iteratively analyzed by a team of researchers following an interpretive interactionist framework.Results: Young people offered three themes describing ADHD: 1) personality trait, 2) physical condition or disorder, and 3) minor issue or concern. Regarding medication use, youth described 1) benefits, 2) changes in sense of self, 3) adverse effects, and 4) desire to discontinue use. Parents' beliefs were more homogeneous than youth beliefs, describing ADHD as a disorder requiring treatment. Most parents noted benefits from stimulant use. Themes were 1) medication as a last resort, 2) allowing the child to reach his or her potential; and 3) concerns about adverse and long-term effects. Families described how responsibility for treatment decisions is transferred from parent to adolescent over time.Conclusions: Young adolescents can have different beliefs about ADHD and attitudes about medication use from their parents. These beliefs and attitudes influence treatment adherence. Incorporating input from young adolescents when making clinical decisions could potentially improve continuity of treatment for youth with ADHD. © 2014 Charach et al.; licensee BioMed Central Ltd. Source

Gray S.A.,Neurosciences and Mental Health Research Program | Gray S.A.,Ontario Institute for Studies in Education | Chaban P.,Community Health Systems Resource Group | Martinussen R.,Ontario Institute for Studies in Education | And 6 more authors.
Journal of Child Psychology and Psychiatry and Allied Disciplines

Background: Youths with coexisting learning disabilities (LD) and attention deficit hyperactivity disorder (ADHD) are at risk for poor academic and social outcomes. The underlying cognitive deficits, such as poor working memory (WM), are not well targeted by current treatments for either LD or ADHD. Emerging evidence suggests that WM might be improved by intensive and adaptive computerized training, but it remains unclear whether this intervention would be effective for adolescents with severe LD and comorbid ADHD. Methods: A total of sixty 12- to 17-year olds with LD/ADHD (52 male, 8 female, IQ > 80) were randomized to one of two computerized intervention programs: working memory training (Cogmed RM) or math training (Academy of Math) and evaluated before and 3 weeks after completion. The criterion measures of WM included auditory-verbal and visual-spatial tasks. Near and far transfer measures included indices of cognitive and behavioral attention and academic achievement. Results: Adolescents in the WM training group showed greater improvements in a subset of WM criterion measures compared with those in the math-training group, but no training effects were observed on the near or far measures. Those who showed the most improvement on the WM training tasks at school were rated as less inattentive/hyperactive at home by parents. Conclusions: Results suggest that WM training may enhance some aspects of WM in youths with LD/ADHD, but further development of the training program is required to promote transfer effects to other domains of function. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health. Source

Ruiz-Casares M.,McGill University | Rousseau C.,McGill University | Laurin-Lamothe A.,McGill University | Laurin-Lamothe A.,University of Quebec at Montreal | And 5 more authors.
Maternal and Child Health Journal

Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services. © 2012 Springer Science+Business Media, LLC. Source

Pullenayegum E.M.,Child Health Evaluative science | Pullenayegum E.M.,University of Toronto | Platt R.W.,McGill University | Barwick M.,Community Health Systems Resource Group | And 4 more authors.
Statistics in Medicine

Background:The use of standard statistical methods in the medical literature has been studied extensively; however, the adoption of new methods has received less attention. We sought to understand (i) whether there is a perception that new methods are underused, (ii) what the barriers to use of new methods are, (iii) what dissemination activities are used, and (iv) user preferences for learning about new methods. Methods:We conducted a cross-sectional survey of members of the Statistical Society of Canada (SSC) and of principal investigators (knowledge-users) funded by the Canadian Institutes of Health Research (CIHR). Results: There were 157 CIHR respondents (14% response rate), and 39 respondents were statisticians from the Statistical Society of Canada. Seventy percent of CIHR respondents and 82% of statisticians felt that new developments were under-used. Barriers to use of new methods included lack of access to the necessary expertise (selected by over 90% of respondents), lack of suitable software (selected by 81% of statisticians), and lack of time to implement new methods (selected by 78% of statisticians). Greater access to statistical colleagues with an interest in collaboration and availability of software to implement new methods were the top-rated preferences among knowledge-users. Conclusions: There was a clear perception among all respondents that new statistical methods are underused. Encouraging statistical methodologists to develop a knowledge translation plan for improved dissemination and uptake, placing greater value on the role of the statistical collaborator in research, and providing software alongside new methods may improve the use of newly developed statistical methods. © 2016 John Wiley & Sons, Ltd. Source

Boydell K.M.,Child Health Evaluative science Research Institute | Boydell K.M.,University of Toronto | Hodgins M.,Community Health Systems Resource Group | Pignatiello A.,University of Toronto | And 4 more authors.
Journal of the Canadian Academy of Child and Adolescent Psychiatry

Objective: To conduct a scoping review on the use of technology to deliver mental health services to children and youth in order to identify the breadth of peer-reviewed literature, summarize findings and identify gaps. Method: A literature database search identified 126 original studies meeting criteria for review. Descriptive numerical summary and thematic analyses were conducted. Two reviewers independently extracted data. Results: Studies were characterized by diverse technologies including videoconferencing, telephone and mobile phone applications and Internet-based applications such as email, web sites and CD-ROMs. Conclusion: The use of technologies plays a major role in the delivery of mental health services and supports to children and youth in providing prevention, assessment, diagnosis, counseling and treatment programs. Strategies are growing exponentially on a global basis, thus it is critical to study the impact of these technologies on child and youth mental health service delivery. An in-depth review and synthesis of the quality of fndings of studies on effectiveness of the use of technologies in service delivery are also warranted. A full systematic review would provide that opportunity. © Canadian Academy of Child and Adolescent Psychiatry. Source

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