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.

Increased water charges improve efficiency and equity in an irrigation system

Conventional wisdom in many agricultural systems across the world is that farmers cannot, will not, or should not pay the full costs associated with surface water delivery. Across Organisation for Economic Co-operation and Development (OECD) countries, only a handful can claim complete recovery of operation, maintenance, and capital costs; across Central and South Asia, fees are lower still, with farmers in Nepal, India, and Kazakhstan paying fractions of a U.S. penny for a cubic meter of water. In Pakistan, fees amount to roughly USD 1-2 per acre per season. However, farmers in Pakistan spend orders of magnitude more for diesel fuel to pump groundwater each season, suggesting a latent willingness to spend for water that, under the right conditions, could potentially be directed toward water-use fees for surface water supply. Although overall performance could be expected to improve with greater cost recovery, asymmetric access to water in canal irrigation systems leaves the question open as to whether those benefits would be equitably shared among all farmers in the system. We develop an agent-based model (ABM) of a small irrigation command to examine efficiency and equity outcomes across a range of different cost structures for the maintenance of the system, levels of market development, and assessed water charges. We find that, robust to a range of different cost and structural conditions, increased water charges lead to gains in both efficiency and concomitant improvements in equity as investments in canal infrastructure and system maintenance improve the conveyance of water resources further down watercourses. This suggests that, under conditions in which (1) farmers are currently spending money to pump groundwater to compensate for a failing surface water system, and (2) there is the possibility that through initial investment to provide perceptibly better water supply, genuine win-win solutions can be attained through higher water-use fees to beneficiary farmers.

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.

BIORETENTION/CISTERN/IRRIGATION TO ELIMINATE STORMWATER RUNOFF AT THE UNIVERSITY OF MARYLAND

Water quality of parking lot (~1,858 m2) stormwater runoff and its treated effluent flow were analyzed for total phosphorus (TP), total nitrogen (TN), total suspended solids (TSS), electrical conductivity (EC), copper, lead and zinc. The novel system under investigation, located at the University of Maryland, College Park, Maryland, includes a standard bioretention facility, underdrained to a cistern to store treated stormwater, and pumped to a vegetable garden for irrigation. The site abstraction, the average bioretention abstraction, and bowl volumes were estimated to be 8500, 4378, and 895 L, respectively; this indicates that rain events of more than 0.45 cm are necessary to produce runoff and more than 0.75 cm will produce system overflow. The cistern water quality indicates good-to-excellent treatment by the system. Compared to local tap water, cistern water has lower concentrations of TP, TN, EC (non-winter), copper, and zinc, indicating a good water source for irrigation.

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.

Caracterização fisio-molecular de cultivares de feijão (Phaseolus vulgaris L.) em resposta à deficiência hídrica

The identification of genotypes for drought tolerance has a great importance in breeding programs. The aim of this study was to characterize genotypes of beans in response to drought tolerance in different reproductive stages through physiologic, agronomic and molecular analysis. The experiment was conducted in greenhouse, using a randomized block design with four replicates; 10 cultivars: ANFC 9, ANFP 110, BRS Esplendor, BRSMG Realce, IPR Siriri, IPR Tangará, IPR Tuiuiu, IPR Uirapuru, IAC Imperador and IAC Milênio under two conditions of irrigation: plants irrigated during their entire life cycle, and plants under irrigation suppression in the reproductive stage (R7) until 16% of field capacity, when the irrigation was restored. In the last four days of stress, the gas exchanges were analyzed, and in the last day of stress was analyzed the percentage of closed stomata in the abaxial surface of the leaves, collected in different times of the day (9h, 12h, 15h and 18h). Additionally, plant samples were collected for the following analysis: fresh and dry mass of leaves, stems and legumes, and proline content in leaves and roots. The plants were harvested at the physiological maturity and the yield components and grain yield were determined. In addition, in order to identify polymorphisms in the sequences of promoters and genes related to drought, seven pairs of primers were tested on the group of genotypes. The drought susceptibility indexes (ISS) ranged from 0.65 to 1.10 in the group of genotypes, which the lowest values observed were for IAC Imperador (0.65) and BRS Esplendor (0.87), indicating the ability of these two genotypes to maintain grain yield under water stress condition. All genotypes showed reduction in yield components under water stress. IAC Imperador (43.4%) and BRS Esplendor (60.6%) had the lowest reductions in productivity and kept about 50% of the stomata closed during all the different times evaluated at last day of irrigation suppression. IAC Imperador showed greater water use efficiency and CO2 assimilation rate under drought stress. IPR Tuiuiú, IPR Tangará and IAC Imperador had the highest proline concentrations in the roots. Under water stress condition, there was a strong positive correlation (0.696) between the percentage of stomata closed with the number of grains per plant (0.696) and the fresh mass of leaves (0.731), the maximum percentage of stomata closed 73.71% in water stress. The accumulation of proline in the root was the character that most contributed to the divergence between the genotypes under water deficit, but not always the genotypes that have accumulated more proline were the most tolerant. The polymorphisms in DNA of coding and promoting sequences of transcription factors studied in this experiment did not discriminate tolerant genotypes from the sensitive ones to water stress.

Papaya seedlings irrigation with saline water in soil with bovine biofertilizer

Water used for irrigation in semiarid regions of the world is not always of good quality, and may contain salts levels that inhibit plants growth. This study was conducted to evaluate the growth of papaya ( Carica papaya L.) ‘Golden’ seedlings irrigated with saline water in soil with and without bovine biofertilizer produced by anaerobic fermentation of a mixture of fresh bovine manure and water. The experiment was carried out in Areia County, Paraiba State, Brazil. Treatments were distributed in randomized blocks using a factorial design 5 × 2 relative to five salinity levels in irrigation water of 0.5, 1.0, 2.0, 3.0 and 4.0 dS m-1 in soil with and without bovine biofertilizer, corresponding to 10% of the substrate volume. At 90 d after emergence (DAE), both the electrical conductivity (EC) in soil saturation extract, biometric growth and DM production of papaya seedlings were evaluated. Increased salinity from 0.5 to 4.0 dS m-1 raised, within 90 DAE, soil EC of saturation extract (ECse) from 1.19 to 3.95 dS m-1 and from 1.23 to 3.63 dS m-1 in treatments with and without bovine biofertilizer, respectively. Also, the increase in water salinity from 0.5 dS m-1 to the estimated maximum values ranging from 1.46 to 2.13 dS m-1 stimulated seedling height to 11.42 and 18.72 cm in soil with and without bovine biofertilizer, respectively. Higher salinity levels in irrigation water increased soil salinity levels to values that inhibited both growth and quality of papaya seedlings, but with less severity when treated with bovine biofertilizer.

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.

Analysis of root canal organic tissue dissolution capacity according to the type of irrigation solution and agitation technique

Aim: To analyze the root canal organic tissue dissolution capacity promoted by irrigating solutions, with or without the use of different agitation techniques. Methods: Bovine pulp tissue fragments were initially weighed. The following irrigating solutions were tested: 2.5% sodium hypochlorite, 2% chlorhexidine digluconate solution, and distilled water. The irrigating protocols were: immersion, mechanical agitation with endodontic files, and ultrasonic or sonic systems (Endoactivactor® and Easy Clean®). At the end of the protocols, the pulps were weighed to determine their final weight. For comparison, the average percentage of tissue dissolution in relation to the groups was analyzed using the Kruskal-Wallis nonparametric test complemented by multiple comparisons test. The significance level was set at 5%. Results: Among the irrigation solutions, 2.5% sodium hypochlorite showed a higher dissolving power than 2% chlorhexidine digluconate and distilled water. Furthermore, ultrasonic and sonic systems were more effective irrigating protocols than immersion and mechanical agitation with endodontic files. Conclusions: The combination of sodium hypochlorite with an agitation system promotes a greater degree of tissue degradation.