Caught in the eye of the storm: a qualitative study of views and experiences of planned drug holidays from methylphenidate in child and adolescent ADHD treatment

Background: Attention deficit hyperactivity disorder (ADHD) can be treated with stimulant medication such as methylphenidate. Although effective, methylphenidate can cause serious side-effects, including suppressed appetite, growth retardation and sleep problems. A drug holiday is a deliberate interruption of pharmacotherapy for a defined period of time and for a specific clinical purpose, for example for appeasing side-effects. Whilst some international guidelines recommend introducing drug holidays in ADHD treatment, this is not practised routinely. Our aim was to examine the views and experiences of planned drug holidays from methylphenidate with adults who have responsibility for treatment decisions in children and adolescents with ADHD. Method: In-depth interviews were carried out. Child and Adolescent Mental Health Services (CAMHS) practitioners (n=8), General Practitioners (n=8), teachers (n=5), and mothers of children with ADHD (n=4) were interviewed in a UK setting. Interview transcripts were analysed using grounded theory. Results: Methylphenidate eases the experience of the child amid problems at home and at school and once started is mostly continued long-term. Some families do practise short-term drug holidays at weekends and longer-term ones during school holidays. The decision to introduce drug holidays is influenced by the child’s academic progress, the parents’ ability to cope with the child, as well as medication beliefs. Trialling a drug holiday is thought to allow older children to self-assess their ability to manage without medication when they show signs of wanting to discontinue treatment prematurely. Conclusions: Planned drug holidays could address premature treatment cessation by enabling adolescents to assess repercussions under medical supervision.

Digital visualisation in Classics teaching and beyond

For the last few years, I have been working on an extensive digital model of ancient Rome as it appeared in the early 4th Century AD. This sort of visualisation lends itself to many applications in diverse fields: I am currently using it for research work into illumination and sightlines in the ancient city, have licensed it for broadcast in TV documentaries and publication in magazines, and am working with a computer games studio to turn it into an online game where players will be able to walk round the streets and buildings of the entire city (when not engaged in trading with or assassinating one another). Later this year I will be making a free online course, or MOOC, about the architecture of ancient Rome, which will largely be illustrated by this model.

Reading That Matters : A Literature Review on Meaningful Reading Experiences in the EFL Classroom

This thesis is a literature review on literature reading in the English as a Foreign Language (EFL) and the English as a Second Language (ESL) classroom, of mainly upper secondary schools. The underlying objective for this work is that meaningful reading experiences can have a positive impact on a developing young individual on his or her way into adulthood. The aim of this thesis is to explore what theories and methods are used when trying to create prerequisites for meaningful reading experiences, and how these experiences actually are realized. Qualitative methods are mainly used, except for a small section of the methodology of finding the sources, which is quantitative in nature. Since very little previous research has been done in the field, the six sources used in this review are internationally spread over five continents. They are mainly analyzed from a theoretical background of reader response and critical literacy perspectives. The main findings show that a number of theoretical approaches and methodologies can be useful in creating meaningful reading experiences. What may have proven most effective was addressing actual problems in the students’ everyday lives through applied critical literacy.

MLCMS actual use, perceived use, and experiences of use

Mobile learning involves use of mobile devices to participate in learning activities. Most elearning activities are available to participants through learning systems such as learning content management systems (LCMS). Due to certain challenges, LCMS are not equally accessible on all mobile devices. This study investigates actual use, perceived usefulness and user experiences of LCMS use on mobile phones at Makerere University in Uganda. The study identifies challenges pertaining to use and discusses how to improve LCMS use on mobile phones. Such solutions are a cornerstone in enabling and improving mobile learning. Data was collected by means of focus group discussions, an online survey designed based on the Technology Acceptance Model (TAM), and LCMS log files of user activities. Data was collected from two courses where Moodle was used as a learning platform. The results indicate positive attitudes towards use of LCMS on phones but also huge challenges whichare content related and technical in nature.

What is important for you? A qualitative interview study of living with diabetes and experiences of diabetes care to establish a basis for a tailored Patient-Reported Outcome Measure for the Swedish National Diabetes Register

OBJECTIVES: There is a growing emphasis on the perspective of individuals living with diabetes and the need for a more person-centred diabetes care. At present, the Swedish National Diabetes Register (NDR) lacks patient-reported outcome measures (PROMs) based on the perspective of the patient. As a basis for a new PROM, the aim of this study was to describe important aspects in life for adult individuals with diabetes. DESIGN: Semistructured qualitative interviews analysed using content analysis. SETTING: Hospital-based outpatient clinics and primary healthcare clinics in Sweden. PARTICIPANTS: 29 adults with type 1 diabetes mellitus (DM) (n=15) and type 2 DM (n=14). INCLUSION CRITERIA: Swedish adults (≥18 years) living with type 1 DM or type 2 DM (duration ≥5 years) able to describe their situation in Swedish. Purposive sampling generated heterogeneous characteristics. RESULTS: To live a good life with diabetes is demanding for the individual, but experienced barriers can be eased by support from others in the personal sphere, and by professional support from diabetes care. Diabetes care was a crucial resource to nurture the individual's ability and knowledge to manage diabetes, and to facilitate life with diabetes by supplying support, guidance, medical treatment and technical devices tailored to individual needs. The analysis resulted in the overarching theme 'To live a good life with diabetes' constituting the two main categories 'How I feel and how things are going with my diabetes' and 'Support from diabetes care in managing diabetes' including five different categories. CONCLUSIONS: Common aspects were identified including the experience of living with diabetes and support from diabetes care. These will be used to establish a basis for a tailored PROM for the NDR.

Development of site-specific sediment quality guidelines for North and South Atlantic littoral zones: Comparison against national and international sediment quality benchmarks

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

An experimental assessment of landscape configuration effects on frog and toad abundance and diversity in tropical agro-savannah landscapes of southeastern Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of sedation on morbidity and mortality in the intensive care unit

CONTEXTO: Embora cerca de 30% a 50% dos pacientes hospitalizados em unidades de terapia intensiva (UTI) recebam algum tipo de sedativo, existe escassez de informações sobre efeitos adversos desta prática, especialmente no Brasil. Estes efeitos podem ser significantes e o uso de sedativos é associado a elevação de infecção e mortalidade, mesmo sendo difícil avaliar o impacto clínico deste procedimento. OBJETIVO: Avaliar o impacto da sedação sobre incidência de complicações e mortalidade em doentes graves durante internação em unidade de terapia intensiva. TIPO DE ESTUDO: Estudo prospectivo. LOCAL: Unidade de Terapia Intensiva Cirúrgica da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina. PARTICIPANTES: Após excluídos pacientes que permaneceram menos de 24 horas ou sem exames indispensáveis para o cálculo do índice de gravidade (APACHE II), restaram 307 pacientes. Estes foram divididos em dois grupos: Grupo Sedado e Grupo Não Sedado. Constatada heterogeneidade com relação ao APACHE II, foram pareados 97 sedados e 97 não sedados com idênticos índices de gravidade. VARIÁVEIS ESTUDADAS: Impacto da sedação e das técnicas sobre a mortalidade, tempo de internação, além da incidência de escara de decúbito ou pressão, trombose venosa profunda e infecção. RESULTADOS: Não houve diferença na incidência de trombose venosa profunda, entre os grupos Sedado e Não Sedado, enquanto que escara de decúbito foi significativamente maior nos sedados (p = 0,03). Infecção foi detectada em 45,4% dos pacientes com sedação e em 21,6% dos pacientes sem sedação (p = 0,006). A mortalidade para os pacientes que não receberam qualquer tipo de sedativo foi de 20,6% e, para aqueles que foram sedados durante a internação, foi de 52,6% (p < 0,0001). CONCLUSÕES: Conclui-se que a sedação está associada a maior duração da internação, morbidade e mortalidade significativas. Apesar da intensidade das associações encontradas, não é possível estabelecer relação causal entre sedação e mortalidade.

New guidelines for diagnosis and treatment of insomnia

The Brazilian Sleep Association brought together specialists in sleep medicine, in order to develop new guidelines on the diagnosis and treatment of insomnias. The following subjects were discussed: concepts, clinical and psychosocial evaluations, recommendations for polysomnography, pharmacological treatment, behavioral and cognitive therapy, comorbidities and insomnia in children. Four levels of evidence were envisaged: standard, recommended, optional and not recommended. For diagnosing of insomnia, psychosocial and polysomnographic investigation were recommended. For non-pharmacological treatment, cognitive behavioral treatment was considered to be standard, while for pharmacological treatment, zolpidem was indicated as the standard drug because of its hypnotic profile, while zopiclone, trazodone and doxepin were recommended.

Environment for teaching and development of mobile robot systems

Using robots for teaching is one approach that has gathered good results on Middle-School, High-School and Universities. Robotics gives chance to experiment concepts of a broad range of disciplines, principally those from Engineering courses and Computer Science. However, there are not many kits that enables the use of robotics in classroom. This article describes the methodologies to implement tools which serves as test beds for the use of robotics to teach Computer Science and Engineering. Therefore, it proposes the development of a flexible, low cost hardware to integrate sensors and control actuators commonly found on mobile robots, the development of a mobile robot device whose sensors and actuators allows the experimentation of different concepts, and an environment for the implementation of control algorithms through a computer network. This paper describes each one of these tools and discusses the implementation issues and future works. © 2010 IEEE.

Mechanisms of follow-up to the Programme of Action on Population and Development in the countries of Latin America and the Caribbean

Includes bibliography

Teaching and learning data structures supported by computers: An experiment using CADILAG tool

This paper aims to present the use of a learning object (CADILAG), developed to facilitate understanding data structure operations by using visual presentations and animations. The CADILAG allows visualizing the behavior of algorithms usually discussed during Computer Science and Information System courses. For each data structure it is possible visualizing its content and its operation dynamically. Its use was evaluated an the results are presented. © 2012 AISTI.

Draft operational guide for implementation and follow-up of the Montevideo Consensus on Population and Development: second draft

Introduction .-- I. Background .-- II. Frameworks for implementing the regional agenda on population and development .-- III. Making operational the priority measures of the Montevideo Consensus on Population and Development: A. Full integration of population dynamics into sustainable development with gender equality and respect for human rights. B. Rights, needs, responsibilities and the demands of girls, boys, adolescents and youth. C. Ageing, social protection and socioeconomic challenges. D. Universal access to sexual and reproductive health services. E. Gender equality. F. International migration and protection of the human rights of all migrants. G. Territorial inequality, spatial mobility and vulnerability. H. Indigenous peoples: interculturalism and rights. I. Afro-descendants: rights and combating racial discrimination.

Operational guide for implementation and follow-up of the Montevideo Consensus on Population and Development

This document is the contribution of the Presiding Officers of the Regional Conference on Population and Development in Latin America and the Caribbean to the second session of the Regional Conference, to be held in Mexico City, on 6-9 October 2015. It is a technical tool intended to provide the countries of the region with specific guidelines for implementing the priority measures set forth in the Montevideo Consensus on Population and Development, and offers relevant inputs for monitoring that implementation at the national and regional levels.

The Unique Challenges and Experiences of African¬-American Women Academicians at Predominantly White Institutions

This session addresses the unique challenges of African-American women academicians at predominantly white institutions. After assessing scholarly literature in this area, most research has and continues, to ignore the interrelationship between race, class and gender. This paper builds on existing literature by offering a discourse that addresses various challenges facing these women.