The increasing prevalence of obesity has become one of the most challenging problems facing healthcare providers. Despite recommendations from the U.S. Preventive Services Task Force many health professionals fail to discuss obesity with their patients. This study sought to identify terms that individuals with obesity and being treated in primary care find the most and least acceptable for describing their excess weight. Three-hundred ninety obese adult primary care patients in the Philadelphia area were administered the Weight Preferences Questionnaire from January 2008 through February 2009. Ratings of 11 terms used to describe excess weight were transformed to a five-point scale, ranging from “very desirable” (+2) to neutral (0) to “very undesirable” (-2). The term “fatness” (mean score -1.1 ± 1.3) was rated as significantly more undesirable than all other descriptors (p < 0.001). The terms “excess fat” (-0.6 ± 1.3), “large size” (-0.6 ± 1.3), “obesity” (-0.5 ± 1.4), and “heaviness” (-0.4 ± 1.2) were rated as significantly more undesirable then the remaining terms, which included weight problem, body mass index (BMI), and excess weight (p<0.001). In contrast, the term “weight” was viewed as the most desirable term for characterizing excess weight. Patients' preferences for terms were not significantly influenced by gender, race/ethnicity, or a BMI ≥ 40 kg/m2. Practitioners who treat obesity are encouraged to avoid undesirable terms when discussing this condition with their patients. Instead practitioners may want to consider broaching the topic using more patient-friendly term such as “weight,” “BMI,” “weight problem,” or excess weight.”

IntroductionMany adults with current impairing symptoms of attention-deficit/hyperactivity disorder (ADHD) do not report an age at onset before 7 years of age and cannot, therefore, be assigned the full Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnosis of ADHD. We hypothesized that treatment with oral-release osmotic system (OROS) methylphenidate (MPH) will be safe and efficacious for the treatment of adults with late-onset ADHD.MethodThis was a 6-week, open-label, prospective treatment study of OROS MPH monotherapy in 36 adult patients with late-onset ADHD (onset later than the required 7 years of age) using standardized instruments for diagnosis and a robust oral daily dose of up to 1.3 mg/kg/day. Symptom severity was assessed with the Adult ADHD Investigator Symptom Report Scale (AISRS) and the Clinical Global Impression (CGI) scale.ResultsSubjects reported robust current symptoms of ADHD at pre-treatment baseline (11.1±2.8 DSM-IV symptoms), but had an atypical mean age at onset of 14.2±8.6 years. Treatment with OROS MPH at an average daily dose of 78.2±29.4 mg was associated with a statistically and clinically significant reduction in ADHD symptoms relative to baseline as assessed through the AISRS (−16.4±10.5; P<.001). Using a categorical definition of response (CGI-I much or very much improved), a majority (n=26; 72%) of subjects were rated as improved at endpoint.ConclusionThese results extend previous findings in adults with full ADHD to adults meeting criteria for late-onset ADHD and support the need for further controlled clinical trials in this population.

Although possible to recall in both forward and backward order, recall proceeds most naturally in the order of encoding. Prior studies ask whether and how forward and backward recall differ. We reexamine this classic question by studying recall dynamics while varying the predictability and timing of forward and backward cues. Although overall accuracy did not differ by recall direction, recall dynamics highlight key distinctions. Forward recall exhibits a modest advantage for correct transitions following errors, independent of cueing predictability and list length. Without consistent directional cueing, participants initiate backward recall more accurately, but this effect reverses with predictable directional cues. Following omissions, participants commit more fill-in errors in backward recall. Our findings implicate an asymmetric, cue-dependent retrieval process underlying forward and backward recall, with relative contributions of primacy and recency depending on directional predictability.

We investigated memory encoding and retrieval during a hybrid spatial- episodic memory task in which subjects delivered items to landmarks in a virtual environment and later recalled the delivered items. Conditional probabilities of recall transitions revealed spatial and temporal organization of studied items. We asked whether neural signatures of successful encoding and retrieval uncovered in traditional word-list paradigms also appear when learning occurs within a spatiotemporal context under conditions that interpose a navigation task between each item encoding event. We found that increased theta (+T) and decreased alpha/beta (-A) accompanied successful encoding events, with the addition of increased gamma (+G) for retrieval events. Logistic-regression classifiers trained on these spectral features reliably predicted encoding and retrieval success in "hold out" sessions. Both univariate and multivariate analyses of EEG data revealed a similar spectral T+A−G+ of successful encoding and retrieval.