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The purpose of this study was to evaluate the influence of knee joint range of motion (RoM) on the torque–velocity relationship and fatigue in the knee extensor muscles of 7 young (median = 26 y) and 7 older (68 y) adults. Each leg was assigned a RoM (35° or 75°) over which to perform a torque–velocity protocol (maximal isokinetic contractions, 60–300°·s−1) and a fatigue protocol (120 maximal contractions at 120°·s−1, 0.5 Hz). Six older participants were unable to reach 300°·s−1 over 35°. Therefore, the velocity eliciting 75% of peak torque at 60°·s−1 (V75, °·s−1) was calculated for each RoM from a fit of individual torque–velocity curves (60–240°·s−1), and ΔV75 (35°–75°) was determined. Fatigue (final torque/initial torque) was used to calculate Δfatigue (35°–75°). ΔV75 was not different from 0 in young (−28.3°·s−1 [−158.6 to 55.7], median [range], P =.091) or older (−18.5°·s−1 [−95.0 to 23.9], P =.128), with no difference by age (P =.710). In contrast, fatigue was greater for 75° in young (Δfatigue = 25.9% [17.5–30.3], P =.018) and older (17.2% [11.9–52.9], P =.018), with no effect of age (P =.710). These data indicate that, regardless of age, RoM did not alter the torque–velocity relationship between 60 and 240°·s−1, and fatigue was greater with a larger RoM. [ABSTRACT FROM AUTHOR]

Purpose: This study examined preliminary psychometrics of the Adolescent/Young Adult Self‐Management and Independence Self‐Report Scale (AMIS II SR). Methods: Adolescents and adults (N = 159; 13–38 years old) with spina bifida from two clinics and one community sample completed the AMIS II SR. The majority (83%) had myelomeningocele, and about half were female (51.6%). The sample included 44.7% White, 11.3% Black and over one‐third Hispanic/Latino (38.4%) participants. Descriptive analyses and reliability were assessed; a confirmatory factor analysis (CFA) was conducted. Results: Item‐to‐total correlations support the AMIS II SR total scale (r =.38–.79) and its two subscales: condition (r =.49–.67) and independent living (r =.49–.85). Internal consistency reliability was high (α =.91–.96) for the AMIS II SR total scale and subscales. A higher order CFA model that included independent living and condition self‐management as first‐order factors and a second‐order overall self‐management factor had excellent fit (RMSEA = 0.06; CFI = 0.97; TLI = 0.96). Descriptive analyses findings were reported. Conclusions: This study provides psychometric evidence for the use of the AMIS II SR total (overall) scale and subscales (condition and independent living) to assess self‐management and independence. [ABSTRACT FROM AUTHOR]

Background: This longitudinal study examined growth trajectories of academic motivation in youth with and without attention‐deficit/hyperactivity disorder (ADHD) across the important developmental transition from middle school to high school, and associations with academic success. Consistent with self‐determination theory (SDT) of motivation, trajectories of amotivation, extrinsic motivation, and intrinsic motivation were modeled. Methods: The study included a robust multi‐method, multi‐source assessment of academic outcomes, including homework performance ratings; reading and mathematics standardized test scores; and grade point average (GPA) obtained from school records. Participants included 302 adolescents (ages 12–14; Mage = 13.20) in eighth grade who were specifically recruited so that approximately half (n = 162) were diagnosed with ADHD and 140 adolescents comprising a comparison sample without ADHD. The sample was predominantly White (81.80%), with 7.90% identifying as bi/multiracial, 5.30% identifying as Black/African American, 4.60% identifying as Asian, and 0.30% identifying as Indigenous/Alaskan. Results: Adolescents with ADHD had worse academic motivation at all timepoints. Growth curve analyses indicated the academic motivation of adolescents without ADHD decreased at faster rates across the transition to high school compared to adolescents with ADHD. However, for adolescents with ADHD, amotivation, extrinsic motivation, and intrinsic motivation each predicted GPA, with higher extrinsic and intrinsic motivation also predicting better homework performance and different aspects of math performance, whereas for youth without ADHD, only amotivation and extrinsic motivation predicted GPA. Conclusions: Intervention and school policy implications are discussed, including the importance of fostering autonomy and internal motivation, and consideration of whether current ADHD interventions primarily foster extrinsic motivation. [ABSTRACT FROM AUTHOR]

Background Microbiologic diagnosis of childhood tuberculosis may be difficult. Oral swab specimens are a potential noninvasive alternative to sputum specimens for diagnosis. Methods This was a prospective diagnostic accuracy study of oral swab specimens (buccal and tongue) for pulmonary tuberculosis diagnosis in children (aged ≤ 15 years) in 2 South African hospital sites. Children with cough of any duration as well as a positive tuberculin skin test result, tuberculosis contact, loss of weight, or chest radiograph suggestive of pulmonary tuberculosis were enrolled. Two induced sputum specimens were tested with Xpert MTB/RIF (or Xpert MTB/RIF Ultra) assay and liquid culture. Oral swab specimens were obtained before sputum specimens, frozen, and later tested with Xpert MTB/RIF Ultra. Children were classified as microbiologically confirmed tuberculosis, unconfirmed tuberculosis (receipt of tuberculosis treatment), or unlikely tuberculosis according to National Institutes of Health consensus definitions based on sputum microbiologic results. Results Among 291 participants (median age [interquartile range], 32 [14–73] months), 57 (20%) had human immunodeficiency virus (HIV), and 87 (30%) were malnourished; 90 (31%) had confirmed pulmonary tuberculosis (rifampicin resistant in 6 [7%]), 157 (54%), unconfirmed pulmonary tuberculosis, and 44 (15%), unlikely tuberculosis. A single oral swab specimen was obtained from 126 (43%) of the participants (tongue in 96 and buccal in 30) and 2 swab specimens from 165 (57%) (tongue in 110 and buccal in 55). Sensitivity was low (22% [95% confidence interval, 15%–32%]) for all swab specimens combined (with confirmed pulmonary tuberculosis as reference), but specificity was high (100% [91%–100%]). The highest sensitivity was 33% (95% confidence interval, 15%–58%) among participants with HIV. The overall yield was 6.9% with 1 oral swab specimen and 7.2% with 2. Conclusions Use of the Xpert MTB/RIF Ultra assay with oral swab specimens provides poor yield for microbiologic pulmonary tuberculosis confirmation in children. [ABSTRACT FROM AUTHOR]

This study explored the experiences of Head Start parents who were becoming involved in their pre-school–age children's Individualized Education Program (IEP) process. Seven participants from the rural Midwest engaged in focus group (n = 2) or interview (n = 1) format discussions regarding barriers to involvement in the IEP process and recommendations to alleviate these barriers. Qualitative analysis with thematic coding was used to interpret the data. Results indicated that parents believed they lacked necessary information that could increase their advocacy for their children and reported the wording of the IEP was too difficult to understand. In addition, parents felt that their negative emotions barred them from being active members at IEP meetings. Parents noted that Head Start's encouragement and positive parent–teacher communication helped alleviate some barriers but believed that a yearly class on IEPs and more frequent one-on-one meetings would help them become better advocates for their young children. [ABSTRACT FROM AUTHOR]

Background: Sluggish cognitive tempo (SCT) is a construct that includes symptoms of slowness, excessive daydreaming, and drowsiness. SCT is often comorbid with attention‐deficit/hyperactivity disorder (ADHD), and SCT symptoms are associated with significant academic impairment above the influence of ADHD. Despite the overlap between ADHD and SCT and associated impairments, no studies have evaluated how evidence‐based psychosocial interventions for adolescents with ADHD impact symptoms of SCT. Methods: This study examined whether SCT symptoms improved in a sample of 274 young adolescents with ADHD who were randomly assigned to an organizational skills intervention, homework completion intervention, or to a waitlist control. SCT intervention response was evaluated broadly in all participants and, specifically, for participants in the clinical range for SCT symptom severity at baseline. Change in ADHD symptoms of inattention, executive functioning, and motivation were examined as potential predictors of improvement in SCT. Results: The two intervention groups were collapsed together for analyses because there were no significant differences in change in SCT symptoms. Multilevel modeling results indicate that parent‐reported SCT symptoms significantly decreased when comparing the intervention group to waitlist control (d =.410). For adolescents with parent‐reported clinical levels of SCT, the decrease in symptoms was more pronounced (d =.517). Self‐reported SCT symptoms produced null results, though effect size calculations showed small improvement for the full sample (d =.313) and for the high‐SCT group (d =.384). Change in behavior regulation executive functioning (d =.247), metacognitive executive functioning (d =.346), and inattention (d =.230) predicted change in parent‐reported SCT symptoms. Conclusions: Although not specifically designed to decrease SCT symptoms, the ADHD interventions evaluated in this study resulted in significant improvements in parent‐reported SCT with small to moderate effect sizes. Clinical implications and future directions are discussed, including development of interventions for adolescents with high levels of SCT. [ABSTRACT FROM AUTHOR]