Risperidone Versus Methylphenidate in Treatment of Preschool Children With Attention-Deficit Hyperactivity Disorder

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis among preschool children. Objectives: The aim of this study was to examine the Risperidone treatment compared to Methylphenidate (MPH) in preschool children with ADHD. Patients and Methods: Thirty three outpatient preschool children, aged 3-6 years, diagnosed with ADHD (The diagnosis of ADHD was established by two child and adolescent psychiatrists according to the DSM-IV-TR criteria), participated in a 6-week, double-blind clinical trial with risperidone (0.5-1.5 mg/d) and methylphenidate (5-20 mg/d), in two divided doses. Treatment outcomes were assessed using the Parent ADHD Rating Scale and Conners Rating Scale. Patients were assessed by a child psychiatrist at baseline, 2, 4 and 6 weeks after the medication started. Side effects were also rated by side effects questionnaire. Results: There were no significant differences between the two protocols on the Parent ADHD Rating Scale scores (P > 0.05) and Parent Conners Rating Scale scores (P > 0.05). Both groups showed a significant improvement in ADHD symptoms over the 6 weeks of treatment for parent ADHD Rating Scale (P < 0.001) and Parent Conners Rating Scale (P < 0.001). The most common adverse effects seen with risperidone were daytime drowsiness and anorexia (20%), and with methylphenidate it was anorexia (55%). Conclusions: Results of this study show that risperidone may be effective and well tolerated for ADHD in preschool children, but more researches are needed to clarify the potential benefits and adverse effects in long term use and comorbid conditions.

Assessing canopy temperature patterns in two grapevine varieties subjected to deficit irrigation: a tool to optimize water management ?

A better understanding of grapevine responses to drought and high air temperatures can help to optimize vineyard management to improve water use efficiency, yield and berry quality. Faster and robust field phenotyping tools are needed in modern precision viticulture, in particular in dry and hot regions such as the Mediterranean. Canopy temperature (Tc) is commonly used to monitor water stress in plants/crops and to characterize stomatal physiology in different woody species including Vitis vinifera. Thermography permits remote determination of leaf surface or canopy temperature in the field and also to assess the range and spatial distribution of temperature from different parts of the canopies. Our hypothesis is that grapevine genotypes may show different Tc patterns along the day due to different stomatal behaviour and heat dissipation strategies. We have monitored the diurnal and seasonal course of Tc in two grapevine genotypes, Aragonez (syn. Tempranillo) and Touriga Nacional subjected to deficit irrigation under typical Mediterranean climate conditions. Temperature measurements were complemented by determination of the diurnal course of leaf water potential (ψleaf) and leaf gas exchange. Measurements were done in two seasons (2013 and 2014) at different phenological stages: i) mid-June (green berry stage), ii) mid-July (veraison), iii) early August (early ripening) and iv) before harvest (late ripening). Correlations between Tc and minimal stomatal conductance will be presented for the two genotypes along the day. Results are discussed over the use of thermal imagery to derive information on genotype physiology in response to changing environmental conditions and to mild water stress induced by deficit irrigation. Strategies to optimize the use of thermal imaging in field conditions are also proposed

The Effect of Stress Management Program Using Cognitive Behavior Approach on Mental Health of the Mothers of the Children With Attention Deficit Hyperactivity Disorder

Background: Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in children. Objectives: The study aimed to evaluate the effectiveness of stress management program using cognitive behavior approach on mental health of the mothers of the children with attention deficit hyperactivity disorder. Patients and Methods: In this interventional study, 90 mothers of the children with attention deficit hyperactivity disorder were randomly allocated into three intervention, placebo, and control groups. The general health questionnaire was used to measure mental health. Besides, stress was assessed through the depression-anxiety-stress scale. The two instruments were completed at baseline, immediately after, and one month after the intervention by the mothers. Afterwards, within group comparisons were made using one-sample repeated measurement ANOVA. One-way ANOVA was used for inter group comparisons. Mothers in the placebo group only participated in meetings to talk and express feelings without receiving any interventions. Results: At the baseline, no significant difference was found among the three groups regarding the means of stress, anxiety, depression, and mental health. However, a significant difference was observed in the mean score of stress immediately after the intervention (P = 0.033). The results also showed a significant difference among the three groups regarding the mean score of mental health (P < 0.001). One month after the intervention, the mean difference of mental health score remained significant only in the intervention group (P < 0.001). Conclusions: The study findings confirmed the effectiveness of stress management program utilizing cognitive behavior approach in mental health of the mothers of the children with attention deficit hyperactivity disorder.

Attention Deficit Hyperactivity Disorder in a Patient With Congenital Mirror Movement Disorder and Colpocephaly

Introduction: Congenital mirror movement disorder designates involuntary movements on one side of the body that occur as mirror of the intentional movements on the contralateral side. Colpocephaly is described as persistence of fetal configuration of lateral ventricles. Case Presentation: A two-month old male infant was brought to the hospital due to bilateral identical movements of the hands. Except for bilateral involuntary synkinetic imitative movements in hands, neurological and physical examination was normal. Cranial MRI showed corpus callosum dysgenesis, hypogenesis and dilation of bilateral lateral ventricular posterior horns (colpocephaly). At the age of 7 years, he was started to use metylphenydate to mitigate attention deficit and hyperactivity disorder. The mirror movements were decreasing in amplitude by years and were not so serious to affect normal life activities. Conclusions: Mirror movements, diagnosed usually during childhood, may be congenital or secondary to neurological diseases. Although they generally do not affect normal life activities, in some cases severity of mirror movements causes a real debilitating disease. In our case the patient was diagnosed at the age of 2 months and on follow-up no debilitating problems were observed. This is the first case to describe the association of colpocephaly and mirror movements. The exact mechanism of this association is not known. Although it is known that mirror movements may be in relation with some pychiatric pathologies, this is the first report of attention deficit and hyperactivity disorder in conjunction with mirror movements and/or colpocephaly. Managing comorbidities, either physical or psyhchological, will help the patient to live in good health without trying to cope with other pathological diseases.

Critical energy deficit and mortality in critically ill patients

Objective: We investigate the influence of caloric and protein deficit on mortality and length of hospital stay of critically ill patients. Methods: A cohort prospective study including 100 consecutive patients in a tertiary intensive care unit (ICU) receiving enteral or parenteral nutrition. The daily caloric and protein deficit were collected each day for a maximum of 30 days. Energy deficits were divided into critical caloric deficit (≥ 480 kcal/day) and non-critical caloric deficit (≤ 480 kcal/day); and in critical protein deficit (≥ 20 g/day) and non-critical protein deficit (≤ 20 g/day). The findings were correlated with hospital stay and mortality. Results: The mortality rate was 33%. Overall, the patients received 65.4% and 67.7% of the caloric and protein needs. Critical caloric deficit was found in 72% of cases and critical protein deficit in 70% of them. There was a significant correlation between length of stay and accumulated caloric deficit (R = 0.37; p < 0.001) and protein deficit (R = 0.28; p < 0.001). The survival analysis showed that mortality was greater in patients with both critical caloric (p < 0.001) and critical protein deficits (p < 0.01). The Cox regression analysis showed that critical protein deficit was associated with higher mortality (HR 0.25, 95% CI 0.07-0.93, p = 0.03). Conclusions: The incidence of caloric and protein deficit in the ICU is high. Both caloric and protein deficits increase the length of hospital stay, and protein deficit greater than 20 g/day is an independent factor for mortality in critical care unit.

The Effect of a Multi-Component Consultation Intervention on the Pragmatic Language Skills of Students with Symptoms of Attention Deficit Hyperactivity Disorder

The purpose of this research was to determine if a multi-component consultation intervention was effective in improving pragmatic performance in students with ADHD. Participants for this study consisted of 7 children for whom 3 data points were obtained by a parent or 2 data points by a teacher. Changes in pragmatic performance were measured by comparing reports provided by parents or teachers pre- and post- intervention. Descriptive analysis procedures were completed to summarize changes in pragmatic behavior. Results revealed the mean overall change in pragmatic behavior for children in the MCC condition (Χ=1.133) was greater than the change seen in the CAU condition (.334) after 2 months of intervention as per parent reported data. Data indicated improvement in each behavior but incongruence between teachers and parents was found. Results support the hypothesis that the multi-component consultation intervention is effective in improving the pragmatic language performance of children with ADHD.

Deficit of quantal release of GABA in experimental models of temporal lobe epilepsy

Because GABA (gamma-aminobutyric acid) receptor-mediated inhibition controls the excitability of principal neurons in the brain, deficits in GABAergic inhibition have long been favored to explain seizures. In an experimental model of temporal lobe epilepsy, we have identified a deficit of inhibition in presynaptic GABAergic terminals characterized by decreased GABA quantal activity associated with reduced synaptic vesicle density. This decrease in vesicle number primarily seems to affect the reserve pool, rather than the docked or the readily releasable pool.

Bilateral force deficit in patients with haemophilic arthropathy of lower limbs: cross-sectional study

SIN FINANCIACIÓN

Self-care in older people with functional deficit: needs of long-term care.

The group of 65-year-olds is becoming more numerous and with greater needs for health care. So, is necessary the reflection about new models of provision, organization, and allocation of health resources. According to the United Nations Organization, 2015, in 2050 elderly people will reach two million people (20% of the world’s population), what mean that the number of people over 60 years old will exceed a population of young people under 15 years. Parallel to aging, less healthy lifestyles have contributed to the prevalence of chronic diseases, especially cerebrovascular diseases. Hypertension and diabetes mellitus are risk factors and increase predisposition to other diseases. With aging, there is an increased risk for developing chronic, oncological and degenerative diseases, which account for more than 50% of the burden of diseases, with profound implications on independency, use of health care and services.

Different levels of water deficit induces changes in growth pattern but not in chlorophyll fluorescence and water relations of Hancornia speciosa Gomes seedlings.

Hancornia speciosa Gomes é uma espécie conhecida popularmente no Brasil como mangabeira, cujo fruto apresenta alto valor nutricional. O conhecimento sobre a sua fisiologia é ainda escasso, principalmente no que se refere ao desenvolvimento inicial. Dessa forma, o objetivo do presente trabalho foi avaliar os efeitos de diferentes níveis de déficit hídrico sobre o padrão de crescimento, fluorescência de clorofila e relações hídricas em mudas de mangabeira. Foi utilizado um esquema fatorial (tratamentos x época de avaliação) com quatro tratamentos hídricos com base na capacidade de campo (CC) (80%, 60%, 40% e 20%), com cinco repetições. Foram avaliados a altura das plantas, número de folhas, diâmetro do caule, produção e partição de biomassa, eficiência quântica do fotossistema II (PSII), potencial hídrico (?w), teor relativo de água (TRA) e teor de carboidratos, proteínas e prolina. O déficit hídrico severo (20% CC) levou a uma redução no crescimento e alterou o padrão de partição de biomassa nas mudas. No entanto, as relações hídricas não foram significativamente afetadas, pois as mudas mantiveram altos valores de ?w e TRA, sem acúmulos significativos nos teores de solutos orgânicos quando cultivadas com 20%CC. Além do mais, a eficiência quântica do PSII não foi afetada pelos diferentes regimes hídricos, sugerindo que não houve fotoinibição devido ao estresse hídrico. A mudança no padrão de crescimento, com um incremento no aprofundamento das raízes e redução no crescimento da parte aérea parece ser a principal estratégia das mudas de H. speciosa para a manutenção da hidratação dos tecidos durante períodos de déficit hídrico.

Estimation of climatological water deficit in an experimental watershed in the brazilian cerrado.

ABSTRACT: This study aimed to estimate the probability of climatological water deficit in an experimental watershed in the Cerrado biome, located in the central plateau of Brazil. For that, it was used a time series of 31 years (1982?2012). The probable climatological water deficit was calculated by the difference between rainfall and probable reference evapotranspiration, on a decennial scale. The reference evapotranspiration (ET0) was estimated by the standard FAO-56 Penman-Monteith method. To estimate water deficit, it was used gamma distribution, time series of rainfall and reference evapotranspiration. The adherence of the estimated probabilities to the observed data was verified by the Kolmogorov-Smirnov nonparametric test, with significance level (a-0.05), which presented a good adjustment to the distribution models. It was observed a climatological water deficit, in greater or lesser intensity, between the annual decennials 2 and 32.

Identificação e avaliação da expressão de genes pertencentes a família CCCH zinc finger em duas cultivares de soja sob deficit hídrico.

2016

Respostas ecofisiológicas de acessos de mandioca (Manihot esculenta Crantz) sob deficit hídrico.

A mandioca é um alimentar tipicamente brasileiro, cultivada em várias regiões do País. Apesar de ser considerada uma planta tolerante ao deficit hídrico, sua produtividade é baixa sob certas condições edáficas e pluviométricas do Semiárido nordestino, onde é amplamente consumida na alimentação humana e animal. O objetivo deste estudo foi avaliar o crescimento inicial e a capacidade fotossintética sob déficit hídrico de dez acessos de Manihot esculenta do Banco Ativo de Germoplasma de Mandioca da Embrapa, para a identificação de materiais mais tolerantes à seca. O delineamento experimental foi realizado em blocos ao acaso, com quatro blocos por tratamento em esquema fatorial 2 (disponibilidade hídrica) x 10 (acessos), com espaçamento 0,9 m entrelinhas e 0,85 m entre plantas. O crescimento em altura foi avaliado aos 60 dias do plantio. O deficit hídrico foi induzido aos 120 dias do plantio com a suspensão da irrigação. A taxa fotossintética foi monitorada entre 90 e 111 dias após o início do deficit hídrico. Os genótipos GCP 01, 9624-09, 89, 279, Dourada, 785, 815, e cacau mostraram-se como os mais tolerantes à seca com base na menor diminuição da taxa fotossintética aos 90 dias de suspensão da irrigação, sendo os dois primeiros mais tolerantes que os acessos 163 e Formosa.

Identifying the knowledge management structures in enterprise systems projects

Enterprise System (ES) implementation and management are knowledge intensive tasks that inevitably draw upon the experience of a wide range of people with diverse knowledge capabilities. Knowledge Management (KM) has been identified as a critical success factor in ES projects. Despite the recognized importance of managing knowledge for ES benefits realization, systematic attempts to conceptualize KM-structures have been few. Where the adequacy of KM-structures is assessed, the process and measures are typically idiosyncratic and lack credibility. Using the ‘KM-process’, itself based in sociology of knowledge, this paper conceptualizes four main constructs to measure the adequacy of KM-structures. The SEM model is tested using 310 responses gathered from 27 ES installations that had implemented SAP R/3. The findings reveal six constructs for KM-structure. Furthermore, the paper demonstrates the application of KM-structures in the context of ES using the Adaptive Structuration Theory. The results demonstrate that having adequate KM-structures in place, while necessary, is not sufficient. These rules and resources must be appropriated to have greater positive influence on the Enterprise System. Furthermore, the study provides empirical support for knowledge-based theory by illustrating the importance of knowledge use/re-use (vs. knowledge creation) as the most important driver in the process of KM.