Management of adult attention deficit hyperactivity disorder in UK primary care: a survey of general practitioners

Background: Compared to existing literature on childhood attention deficit hyperactivity disorder (ADHD), little published adult data are available, particularly outside of the United States. Using General Practitioner (GP) questionnaires from the United Kingdom, this study aimed to examine a number of issues related to ADHD in adults, across three cohorts of patients, adults who received ADHD drug treatment in childhood/adolescence but stopped prior to adulthood; adults who received ADHD drug treatment in childhood/adolescence and continued treatment into adulthood and adults who started ADHD drug treatment in adulthood.Methods: Patients with a diagnosis of ADHD and prescribed methylphenidate, dexamfetamine or atomoxetine were identified using data from The Health Improvement Network (THIN). Dates when these drugs started and stopped were used to classify patients into the three cohorts. From each cohort, 50 patients were randomly selected and questionnaires were sent via THIN to their GPs.GPs returned completed questionnaires to THIN who forwarded anonymised copies to the researchers. Datasets were analysed using descriptive statistics.Results: Overall response rate was 89% (133/150). GPs stated that in 19 cases, the patient did not meet the criteria of that group; the number of valid questionnaires returned was 114 (76%). The following broad trends were observed: 1) GPs were not aware of the reason for treatment cessation in 43% of cases, 2) patient choice was the most common reason for discontinuation (56%), 3) 7% of patients who stopped pharmacological treatment subsequently reported experiencing ADHD symptoms, 4) 58% of patients who started pharmacological treatment for ADHD in adulthood received pharmacological treatment for other mental health conditions prior to the ADHD being diagnosed.Conclusion: This study presents some key findings relating to ADHD; GPs were often not aware of the reason for patients stopping ADHD treatment in childhood or adolescence. Patient choice was identified as the most common reason for treatment cessation. For patients who started pharmacological treatment in adulthood, many patients received pharmacological treatment for comorbidities before a diagnosis of ADHD was made.

A Gap with a Deficit of Large Grains in the Protoplanetary Disk around TW Hya

We report 3 au resolution imaging observations of the protoplanetary disk aroundTW Hya at 145 and 233 GHz with the Atacama Large Millimeter/Submillimeter Array.Our observations revealed two deep gaps (~25-50 %) at 22 and 37 au and shallowergaps (a few %) at 6, 28, and 44 au, as recently reported by Andrews et al. (2016). Thecentral hole with a radius of  3 au was also marginally resolved. The most remarkablefinding is that the spectral index α(R) between bands 4 and 6 peaks at the 22 au gap.The derived power-law index of the dust opacity β(R) is  ~1.7 at the 22 au gap anddecreases toward the disk center to ~0. The most prominent gap at 22 au could becaused by the gravitational interaction between the disk and an unseen planet with amass of ≲1.5 MNeptune although other origins may be possible. The planet-induced gap is supported by the fact that β(R) is enhanced at the 22 au gap, indicating a deficitof mm-sized grains within the gap due to dust filtration by a planet.

Omega-3 Fatty Acids are Related to Abnormal Emotion Processing in Adolescent Boys with Attention Deficit Hyperactivity Disorder

Background In addition to the core symptoms, attention deficit hyperactivity disorder (ADHD) is associated with poor emotion regulation. There is some evidence that children and young adults with ADHD have lower omega-3 levels and that supplementation with omega-3 can improve both ADHD and affective symptoms. We therefore investigated differences between ADHD and non-ADHD children in omega-3/6 fatty acid plasma levels and the relationship between those indices and emotion-elicited event-related potentials (ERPs). Methods Children/adolescents with (n=31) and without ADHD (n=32) were compared in their plasma omega-3/6 indices and corresponding ERPs during an emotion processing task. Results Children with ADHD had lower mean omega-3/6 and ERP abnormalities in emotion processing, independent of emotional valence relative to control children. ERP abnormalities were significantly associated with lower omega-3 levels in the ADHD group. Conclusions The findings reveal for the first time that lower omega-3 fatty acids are associated with impaired emotion processing in ADHD children.

Omega-3 Fatty Acids are Inversely Related to Callous and Unemotional Traits in Adolescent Boys with Attention Deficit Hyperactivity Disorder

A number of research studies have reported abnormal plasma fatty acid profiles in children with ADHD along with some benefit of n−3 to symptoms of ADHD. However, it is currently unclear whether (lower) long chain-polyunsaturated fatty acids (LC-PUFAs) are related to ADHD pathology or to associated behaviours. The aim of this study was to test whether (1) ADHD children have abnormal plasma LC-PUFA levels and (2) ADHD symptoms and associated behaviours are correlated with LC-PUFA levels. Seventy-two, male children with (n=29) and without a clinical diagnosis of ADHD (n=43) were compared in their plasma levels of LC-PUFA. Plasma DHA was higher in the control group prior to statistical correction. Callous–unemotional (CU) traits were found to be significantly negatively related to both eicosapentaenoic acid (EPA), and total omega-3 in the ADHD group. The findings unveil for the first time that CU and anti-social traits in ADHD are associated with lower omega-3 levels.

Integrity and public sector governance : a democratic deficit?

The Effect of Dietary Tartrazine on Brain Dopamine and the Behavioral Symptoms of Attention Deficit Hyperactivity Disorder

Attention Deficit Hyperactivity Disorder is a neurodevelopmental disorder correlated with a decrease in brain dopamine and an increase in behavioral symptoms of hyperactivity and impulsivity. This experiment explored how tartrazine (Yellow #5) impacts these symptoms. After tartrazine administration to Spontaneously Hypertensive Rats (SHR), dopamine concentrations in regions of brain tissue were measured using Enzyme-Linked Immunosorbent Assay analysis. Behavioral testing with a T-maze and open field test measured impulsivity and hyperactivity, respectively. Results indicate that dietary tartrazine increases hyperactive behaviors in the SHR. However, results do not indicate a relationship between dietary tartrazine and brain dopamine. No conclusions regarding the relationship between dietary tartrazine and impulsivity were drawn.

Gerencia social del recurso hídrico: un enfoque de la organización social

Esta ponencia tiene como finalidad contribuir con un cuerpo de conocimientos y prácticas emergentes que sirvan de apoyo a la intervención de los actores sociales involucrados en la resolución de los problemas de gerenciamiento social del recurso hídrico, que contribuyan al mejoramiento en la calidad de vida costarricense, en el marco de la realidad política, institucional, legal, financiera, participativa y técnico instrumental existente en el país desde una perspectiva socialmente sostenible. El logro en el desarrollo de estas capacidades de gerenciamiento social en los actores públicos y privados en el uso y manejo del recurso hídrico aportará al país un capital cognoscitivo y tecnológico que puede marcar su mejoramiento futuro. Abstract This communication has like purpose of contributing with a body of knowledge and emergent practices that serve as support to the intervention of the involved social actors in the resolution of the problems of legal, financial, participative and technicalinstrumental social managment of the resource hydric, which they contribute to the improvement in the quality of Costa Rican life, within the framework of the political reality, institutional, existing in the country from a socially sustainable perspective. The profit in the development of these capacities of social management in the actors public and deprived in the use and handling of the hydric resource will contribute to the country a cognoscitive and technological capital that can mark its future improvement.

Attention Deficit Hyperactivity Disorder and Executive Function Impairment: An Overview.

As with any cognitive ability, attention is vulnerable to dysfunction. The most common attentional problem is attention deficit hyperactivity disorder (ADHD). This brief overview will highlight the symptoms and deficits associated with ADHD, its prevalence in today’s society, the association between executive function impairment and ADHD using Barkley’s (1997) work, and the personal and societal effects of the disorder.

Moringa oleifera plasticity to face climatic changes

Extreme abiotic factors, such drought combined with heat waves and/or high UVB radiation are predicted to become more frequent in the future. The impact on plant production of these challenges on multipurpose Moringa oleifera L. remains unclear. A susceptibility of this species may lead to increase poverty in endangered regions. M. oleifera is a woody species native from sub-Himalaya regions under high climate stress pressure. The interest on this species is emerging due to its several medicinal properties and its nutritional value. Agropharmaceutical industry is interest in this species too. To understand the impact of increased climate factors, young (2 months old) plants of this species were exposed to water deficit (WD) and UVB (alone or combined). WD and WD+UVB imposition consists of unwater for 4 days. After 1 day withholding water, UVB and WD+UVB were irradiated with 26.3 kJ m-2 distributed per 3 days. Immediately after treatment exposition (1 day) and after 10 days, plant water status, growth, carbon metabolism and oxidative stress were measured. Overall no significant differences were observed in WD, regarding the parameters analysed, except on gas exchanges, MDA and phenols. The plants exposed to UVB showed, in general, more severe effects, as higher pigment content, MDA and membrane permeability, while no changes were observed in the total antioxidant activity. Plants exposed to UVB+WD, despite changes observed, the impact was lower than the one observed in UVB exposed plants, meaning that a protective/adaptive mechanism was developed in the plants under combined stressors. On the other hand, in all treatments the net CO2 assimilation rate decreased. Results suggest that M. oleifera has some tolerance to WD and UVB, and that develops mechanism of adaptation to these two types of stress that often arise in combination under a climate change scenario.

High temperature and vapor pressure deficit aggravate architectural effects but ameliorate non-architectural effects of salinity on dry mass production of tomato

Tomato (Solanum lycopersicum L.) is an important vegetable crop and often cultivated in regions exposed to salinity and high temperatures (HT) which change plant architecture, decrease canopy light interception and disturb physiological functions. However, the long-term effects of salinity and HT combination (S+HT) on plant growth are still unclear. A dynamic functional-structural plant model (FSPM) of tomato was parameterized and evaluated for different levels of S+HT combinations. The evaluated model was used to quantify the contributions of morphological changes (architectural effects) and physiological disturbances (non-architectural effects) on the reduction of shoot dry mass under S+HT. The model predicted architectural variables with high accuracy (>85%), which ensured the reliability of the model analyses. HT enhanced architectural effects but reduced non-architectural effects of salinity on dry mass production. The stronger architectural effects of salinity under HT could not be counterbalanced by the smaller non-architectural effects. Therefore, long-term influences of HT on shoot dry mass under salinity were negative at the whole plant level. Our model analysis highlights the importance of plant architecture at canopy level in studying the plant responses to the environments and shows the merits of dynamic FSPMs as heuristic tools.

Seeing it my way: a case of a selective deficit in inhibiting self-perspective

Little is known about the functional and neural architecture of social reasoning, one major obstacle being that we crucially lack the relevant tools to test potentially different social reasoning components. In the case of belief reasoning, previous studies tried to separate the processes involved in belief reasoning per se from those involved in the processing of the high incidental demands such as the working memory demands of typical belief tasks (e.g., Stone et al., 1998; Samson et al., 2004). In this study, we developed new belief tasks in order to disentangle, for the first time, two perspective taking components involved in belief reasoning: (1) the ability to inhibit one’s own perspective (self-perspective inhibition) and (2) the ability to infer someone else’s perspective as such (other-perspective taking). The two tasks had similar demands in other-perspective taking as they both required the participant to infer that a character has a false belief about an object’s location. However, the tasks varied in the self-perspective inhibition demands. In the task with the lowest self-perspective inhibition demands, at the time the participant had to infer the character’s false belief, he or she had no idea what the new object’s location was. In contrast, in the task with the highest self-perspective inhibition demands, at the time the participant had to infer the character’s false belief, he or she knew where the object was actually located (and this knowledge had thus to be inhibited). The two tasks were presented to a stroke patient, WBA, with right prefrontal and temporal damage. WBA performed well in the low-inhibition false belief task but showed striking difficulty in the task placing high self-perspective inhibition demands, showing a selective deficit in inhibiting self-perspective. WBA also made egocentric errors in other social and visual perspective taking tasks, indicating a difficulty with belief attribution extending to the attribution of emotions, desires and visual experiences to other people. The case of WBA, together with the recent report of three patients impaired in belief reasoning even when self-perspective inhibition demands were reduced (Samson et al., 2004), provide the first neuropsychological evidence that (a) the inhibition of one’s own point of view and (b) the ability to infer someone else’ s point of view, rely on distinct neural and functional processes.

Perspectivas de desarrollo local para la sustentabilidad del recurso hídrico en el municipio de Acacias, Meta 2001- 2015

Bogotá (Colombia): Universidad de La Salle, Facultad de Ciencias Económicas y Sociales. Maestría en Estudios y Gestión del Desarrollo

Efeito do deficit de agua no solo sobre o ataque de macrophomina phaseolina em feijao.

Sob condicoes de campo, e adotando-se um delineamento estatistico de blocos ao acaso, com sete tratamentos e quatro repeticoes, estudou-se o efeito do deficit de agua no solo sobre a incidencia de "podridao-cinzenta-do-caule" causada pelo fungo Macrophomina phaseolina (Tassi) Goid. em feijao. Os tratamentos de 1 a 7 constaram, respectivamente, de 0, 6, 9, 11, 13, 16 e 18 dias sem irrigacao, a partir do inicio da floracao. O solo, antes e apos cada periodo de deficit, foi mantido em condicoes otimas de umidade. As contagens de plantas mortas forma feitas aos 49 dias (final do periodo de deficit do tratamento 7), 63 e 84 dias apos o plantio. No que se refere a mortandade de plantas, causada pelo ataque do fungo, os tratamentos diferiram significativamente ao nivel de 1% de probabilidade. O ataque foi intensificado, a medida que se prolongou o deficit de agua, resultando em 63,9% de plantas mortas apos 18 dias de deficit, e somente 8,6%, nos solos em condicoes otimas de umidade.