Self-evaluated burden in adults with attention-deficit hyperactivity disorder (ADHD): a pilot study

OBJECTIVES: To investigate feasibility and easiness of administration of a brief and simple instrument addressing impairment associated with adult attention deficit hyperactivity disorder (ADHD) and if ADHD subtypes were correlated to specific profiles of self-reported impairment. METHODS: Thirty-five adults (19 men and 16 women; mean age of 31.74 years) diagnosed with ADHD according to DSM-IV with a semi-structured interview (K-SADS PL) were asked to fill out a Likert scale covering six different functional areas (academic, professional, marital, familiar, social and daily activities). Clinicians questioned patients about their understanding of the questionnaire and investigated their answers in more details to check consistency of their answers. RESULTS: No patient reported difficulties in understanding the questionnaire. Further questioning of patients' answers confirmed their choices in the six areas. Academic burden had the highest average score in the whole sample, followed by professional burden. Social area had the lowest average score in this sample.

Improving Post-Discharge Medication Adherence in Patients with CVD: A Pilot Randomized Trial

Background:Effective interventions to improve medication adherence are usually complex and expensive.Objective:To assess the impact of a low-cost intervention designed to improve medication adherence and clinical outcomes in post-discharge patients with CVD.Method:A pilot RCT was conducted at a teaching hospital. Intervention was based on the four-item Morisky Medication Adherence Scale (MMAS-4). The primary outcome measure was medication adherence assessed using the eight-item MMAS at baseline, at 1 month post hospital discharge and re-assessed 1 year after hospital discharge. Other outcomes included readmission and mortality rates.Results:61 patients were randomized to intervention (n = 30) and control (n = 31) groups. The mean age of the patients was 61 years (SD 12.73), 52.5% were males, and 57.4% were married or living with a partner. Mean number of prescribed medications per patient was 4.5 (SD 3.3). Medication adherence was correlated to intervention (p = 0.04) and after 1 month, 48.4% of patients in the control group and 83.3% in the intervention group were considered adherent. However, this difference decreased after 1 year, when adherence was 34.8% and 60.9%, respectively. Readmission and mortality rates were related to low adherence in both groups.Conclusion:The intervention based on a validated patient self-report instrument for assessing adherence is a potentially effective method to improve adherent behavior and can be successfully used as a tool to guide adherence counseling in the clinical visit. However, a larger study is required to assess the real impact of intervention on these outcomes.

Functional Class in Children with Idiopathic Dilated Cardiomyopathy. A pilot Study

Abstract Background: Idiopathic dilated cardiomyopathy (IDCM), most common cardiac cause of pediatric deaths, mortality descriptor: a low left ventricular ejection fraction (LVEF) and low functional capacity (FC). FC is never self reported by children. Objective: The aims of this study were (i) To evaluate whether functional classifications according to the children, parents and medical staff were associated. (iv) To evaluate whether there was correlation between VO2 max and Weber's classification. Method: Prepubertal children with IDCM and HF (by previous IDCM and preserved LVEF) were selected, evaluated and compared. All children were assessed by testing, CPET and functional class classification. Results: Chi-square test showed association between a CFm and CFp (1, n = 31) = 20.6; p = 0.002. There was no significant association between CFp and CFc (1, n = 31) = 6.7; p = 0.4. CFm and CFc were not associated as well (1, n = 31) = 1.7; p = 0.8. Weber's classification was associated to CFm (1, n = 19) = 11.8; p = 0.003, to CFp (1, n = 19) = 20.4; p = 0.0001and CFc (1, n = 19) = 6.4; p = 0.04). Conclusion: Drawing were helpful for children's self NYHA classification, which were associated to Weber's stratification.

Degradació en planta pilot de colorants reactius mitjançant el procés de foto-Fenton assistit amb llum solar: aplicació del procés com a pre-tractament d'un procés biològic

Estudi elaborat a partir d’una estada a la Plataforma Solar de Almería entre desembre del 2006 i gener del 2007. S’ha dut a terme la degradació en planta pilot dels colorants reactius Procion Red H-E7B i Cibacron Red FN-R mitjançant el procés de foto-Fenton aplicat com a tractament únic i com a pretractament d’un procés biològic. El procés de foto-Fenton, assistit amb llum solar, es va realitzar en un fotoreactor solar tipus Col•lector Parabòlic Compost (CPC) i el tractament biològic en un Reactor de Biomassa Immobilitzada (RBI). Com a punt de partida, i amb l’objectiu d’estudiar la reproductibilitat del sistema, es van prendre resultats obtinguts d’experiments realitzats prèviament a escala de laboratori i amb llum artificial. El paràmetre Carboni Orgànic Total (COT) es va emprar com a indicador de l’eliminació dels colorants i dels seus intermedis. En aplicar únicament el procés de foto-Fenton com a tractament, concentracions de 10 mg•l-1 de Fe (II) i 250 mg•l-1 de H2O2 per degradar 250 mg•l-1 Procion Red H-E7B, i de 20 mg•l-1 de Fe (II) i 500 mg•l-1 de H2O2 per degradar 250 mg•l-1 Cibacron Red FN-R, van reproduir els resultants obtinguts al laboratori, amb uns nivells d’eliminació de COT del 82 i 86%, respectivament. A més, l’ús beneficiós de la llum solar en el procés de foto-Fenton, juntament amb la configuració del CPC, van incrementar la velocitat de degradació respecte als resultats previs, permetent la reducció de la concentració de Fe (II) de 10 a 2 mg•l-1 (Procion Red H-E7B) i de 20 a 5 mg•l-1 (Cibacron Red FN-R) sense pèrdues d’efectivitat. D’altre banda, el sistema combinat foto-Fenton/tractament biològic en planta pilot, unes concentracions d’oxidant de 225 mg•l-1 H2O2 per Cibacron Red FN-R i 65 mg•l-1 H2O2 per Procion Red H-E7B van ser suficients per generar solucions intermèdies biodegradables i alimentar així el RBI, millorant inclús els resultats obtinguts prèviament al laboratori.

Pilot (Diptych)

Combined media on photographic paper. 74¾” x 84”

Anàlisi socio-ambiental dels usos tradicionals, actuals i futurs de les bordes : prova pilot a la zona del Bosc de Virós (Pallars Sobirà)

El present projecte ha estat desenvolupat entre l’octubre de 2006 i el febrer de 2007 per un equip de llicenciades en Ciències Ambientals per la Universitat Autònoma de Barcelona. L’objecte d’estudi han estat les bordes, construccions agro-ramaderes utilitzades tradicionalment per a emmagatzemar l’herba i estabular-hi el bestiar. L’àmbit d’estudi seleccionat ha estat el Bosc de Virós, contingut dins el municipi d’Alins, a la comarca del Pallars Sobirà, Catalunya. Part de la superfície estudiada es troba sota la protecció del Parc Natural de l’Alt Pirineu. Per a dur a terme aquest estudi, s’ha desenvolupat una metodologia d’estudi de bordes amb dues vessants diferenciades que requereixen de tècniques metodològiques específiques. La vessant tècnica d’aquestes construccions s’ha materialitzat en un inventari de bordes, desenvolupat a partir de dades obtingudes durant l’observació al camp. La vessant etnològica s’ha obtingut a través de la realització d’entrevistes als propietaris, usuaris i gestors de la zona. A partir de l’anàlisi dels resultats, s’ha detectat una pèrdua de la funció tradicional d’aquestes construccions, derivant a una diversificació dels usos i un elevat grau d’abandonament d’aquestes. La diagnosi de l’estat d’aquests edificis i la seva influència sobre l’entorn és que els nous usos desenvolupats generen pressions sobre el medi i que el desús implica la degradació de l’estructura, amb la conseqüent pèrdua de patrimoni.

Indicadors de pressió ambiental a les platges de Menorca: prova pilot (IPAPM'pp)

L’augment del turisme experimentat des de principis dels anys 70 a l’illa de Menorca (Illes Balears, Espanya) ha provocat un impacte sobre les seves platges, el seu principal atractiu turístic. Molts d’aquests impactes s’incrementen durant la temporada alta, compresa entre els mesos de maig a octubre. L’objectiu principal d’aquest projecte és l’elaboració d’un sistema d’indicadors de pressió ambiental útils per a l’anàlisi de les platges. La zona objecte d’estudi de la prova-pilot, correspon a les platges del sud-oest de Menorca, aquestes cales són les que actualment es troben sotmeses a una major pressió. Es tracta de catorze platges tipificades en tres categories (A, B, C) segons les característiques del tipus d’espai on es troben situades. Són les platges de: Cala Degollador, Cala Blanca, Cala’n Bosch, Son Xoriguer, Son Saura-Es Banyul, Son Saura-Bellavista, Es Talaier, Cala Turqueta, Cala Macarelleta, Cala Macarella, Cala Galdana, Cala Mitjana, Cala Trebalúger i Cala Escorxada. Partint d’un treball bibliogràfic, s’ha realitzat una selecció de mig centenar d’indicadors potencials dels quals catorze han format part dels IPAPM’pp, mitjançant l’elaboració d’una anàlisi multicriteri. Per a cada un dels IPAPM’pp s’ha desenvolupat una metodologia amb les corresponents fitxes individuals descriptives per al seu seguiment temporal. En aquest primer estudi, l’indicador que presenta un nombre de valors no acceptables en una major proporció de platges, és l’indicador 3. Índex de valoració de les mesures de conservació del sistema natural, seguit de l’indicador 6. Superfície subsistema sorra per usuari. El 2006, les platges de tipologia A, presenten un major percentatge positiu de les variables dels indicadors. Les platges de tipologia B i C presenten un percentatge menor d’acceptabilitat dels valors dels indicadors.

A pilot study to control Lutzomyia umbratilis (Diptera: Psychodidae), the major vector of Leishmania brazileiensis guyanensis, in a peri-urban rainforest of Manaus, Amazonas State, Brazil

In the second half of 1980, 112 (or ca. 16%) of the inhabitants of the new settlement of São José, city of Manaus, contracted cutaneous leishmaniasis whilst clearing their properties of terra firme rainforest. With the aid of SUCAM, the authors carried out a pilot study to investigate the feasibility of reducing populations of Lutzomyia umbratilis, the local silvatic vector of Leishmania braziliensis guyanensis, by spraying insecticide on its favoured diurnal resting sites, the bases of the larger forest trees. Most manvector contact is at these resting sites and, therefore, it was encouraging to record a marked reduction of the tree-base populations of L. umbratilis for 21 days following just one application of D.D.T. emulsion in an area 200m square. Most of the treated trunks were not occupied by L. umbratilis for at least eleven months. Suggestions for extending the pilot study are made, and the need for collaboration with a clinical team is emphasized. Leishmania b. guyanensis is the aetiological agent of [quot ]pain bois[quot ], which is hyperendemic from French Guiana to central Amazônia. In the absence of proven vaccines or methods of vector control, some simple methods for limiting transmission of Le. b. guyanensis to man are listed.

Indicadors de pressió ambiental a les platges de Menorca: prova pilot (IPAPM'pp 2007)

Al llarg dels estius de 2006 i 2007 s'estudiaren 44 platges de tot el litoral de l'illa de Menorca, classificades en tres tipologies: A (platges urbanes), B (platges semi-urbanes) i C (platges verges). En cadascuna s'aplicà un sistema de 15 indicadors per tal de veure el nivell de pressió ambiental a què estaven sotmeses, i així valorar el seu grau de qualitat. En aquest treball es presenten els resultats de dos dels indicadors: índex d'impacte visual d'infraestructures i qualitat de flora terrestre. Els resultats preliminars sobre la situació de les platges de Menorca a partir d'aquests dos indicadors mostren conclusions prou significatives. A tall d’exemple, únicament un 9% de les platges estudiades no presentaven cap impacte visual d'alguna infraestructura; però, d'altra banda, un 80% de les platges estudiades compten amb presència d’espècies psammòfiles indicadores de qualitat.

Estudi pilot del progrés de la restauració a les activitats extractives de Catalunya

L’objecte d’aquest estudi és determinar el ritme restaurador i caracteritzar la tipologia de les restauracions d’algunes activitats extractives de Catalunya. S’ha analitzat l’evolució dels treballs de restauració en una selecció d’activitats extractives de Catalunya i s’ha estimat la qualitat de les restauracions efectuades en base a la observació de la vegetació desenvolupada, el control de l’erosió i la integració paisatgística. Per dur a terme aquest estudi s’ha creat una base de dades en format de qüestionari, combinada amb un sistema d’informació geogràfica, que s’ha assajat en un treball de camp amb una mostra limitada d’activitats extractives. A partir de la interpretació dels resultats, es determina que actualment la gestió incorpora la necessitat de restaurar, però com a element subordinat a la producció. Això produeix una manca de planificació que incideix directament en la qualitat de les restauracions dutes a terme. La gestió de les pedreres encara ha de situar el concepte de restauració integrada com a eix central del desenvolupament i planificació de l’activitat extractiva.

Outcome and Experience from the Swiss Mammography Screening Pilot Programmes

BACKGROUND:The Swiss breast cancer screening pilot programme was conducted in 3 districts of theFrench-speaking canton of Vaud (ca. 300,000 resident women) between October 1993 and January 1999.Women aged 50 to 69 were invited by mail every 2 years for a free of charge screening mammography (doubleview, multiple reading). This first ever-organised cancer screening programme in Switzerland showed thefeasibility and acceptability of this kind of public health intervention in the liberal Swiss healthcare system, whichwas the main objective of the pilot programme. This mammographic screening programme was extended to thewhole canton in 1999, and contributed to the implementation of similar programmes in 2 neighbouring cantons. OBJECTIVE:To appraise the use, the quality and the effectiveness of the Swiss screening pilot programme. METHODS:About 15,000 women (aged 50-69) were enrolled. Logistic regression analyses were performedseparately to identify determinants of initial and subsequent attendance. Standard indicators of quality,effectiveness and impact of the programme were assessed and compared with European recommendations. Tothis intent, linkage with data from the Vaud Cancer Registry was performed. RESULTS:About half the target population was screened at least once during the pilot trial. Participation washigher among Swiss than foreigners, among widowed or married women than among single, divorced or separatedones. Attendance also increased with age and decreasing distance between residence and the dedicatedscreening centre. Apart from Swiss citizenship, socio-demographic factors were not associated with reattendance.Intensity of prior recruitment, outcome of previous screening test (positive vs. negative) and indicators of women'shealth behaviour (time of last mammography prior to initial screen, smoking status) were the main determinants ofreattendance. Programme performance and quality indicators were, overall, in line with European Guidelines. Theywere overall more favourable among 60-69 than 50-59 year-olds and improved over time. CONCLUSION:The objectives of the pilot programme were met. Even if participation should increase in order toreach European standards, performance indicators overall met quality requirements. Ways to improve screeninguse, quality and effectiveness were devised and taken into account for the generalisation of the programme.

Avaluació de l'experiència pilot dels tallers d'estudi assistit de la UVic dins dels plans educatius d'entorn de Manlleu, Roda de Ter i Vic (curs 2006-2007)

Aquest treball de recerca ha consistit en realitzar el seguiment dels Tallers d'Estudi Assistit (TEA) de diferents poblacions de la comarca d'Osona, per tal de conèixer-los i avaluar-los. Els TEA consisteixen en una activitat extraescolar d'acompanyament en l'etapa educativa d'alumnes de cicle mitjà, cicle superior i secundària que no disposen d'un entorn favorabale per fer una correcte escolarització. La recerca estudia dues dimensions: per una banda analitzar com la Uvic assumeix la responsabilitat de la formació i seguiment dels estudiants que participen com a monitors en els TEA, i per l'altra, contextualitzar els Tallers d'Estudi Assistit com una eina dels Plans Educatius d'Entorn, per la igualtat d'oportunitats; així com valorar el treball en xarxa que els tallers representen. Amb l'objectiu d'avaluar el funcionament dels TEA, la formació dels monitors (estudiants de la UVic) i la implicació dels agents implicats en el projecte; així com també plantejar propostes de millora per a properes edicions dels TEA.

Ear acupuncture and fMRI: a pilot study for assessing the specificity of auricular points.

In recent years research explored different acupuncture stimulation techniques but interest has focused primarily on somatic acupuncture and on a limited number of acupoints. As regards ear Acupuncture (EA) there is still some criticism about the clinical specificity of auricular points/areas representing organs or structures of the body. The aim of this study was to verify through (Functional magnetic resonance imaging) fMRI the hypothesis of EA point specificity using two auricular points having different topographical locations and clinical significance. Six healthy volunteers underwent two experimental fMRI sessions: the first was dedicated to the stimulation of Thumb Auricular Acupoint (TAA) and the second to the stimulation of Brain Stem Auricular Acupoint (BSAA). The stimulation of the needle placed in the TAA of the left ear produced an increase in activation bilaterally in the parietal operculum, region of the secondary somatosensory area SII. Stimulation of the needle placed in the BSAA of the left ear showed a pattern that largely overlapped regions belonging to the pain matrix, as shown to be involved in previous somatic acupuncture studies but with local differences in the left amygdala, anterior cingulate cortex, and cerebellum. The differences in activation patterns between TAA and BSAA stimulation support the specificity of the two acupoints. Moreover, the peculiarity of the regions involved in BSAA stimulation compared to those involved in the pain matrix, is in accordance with the therapeutic indications of this acupoint that include head pain, dizziness and vertigo. Our results provide preliminary evidence on the specificity of two auricular acupoints; further research is warranted by means of fMRI both in healthy volunteers and in patients carrying neurological/psychiatric syndromes.

Can a targeted psychological intervention be effective for young people following a first manic episode? Results from an 18-month pilot study.

Aim: There is a scarce literature describing psychological interventions for a young, first-episode cohort who have experienced psychotic mania. This study aimed to assess whether a manualized psychological intervention could be effective in reducing symptomatology and relapse, and improve functional outcome in this population. Methods: The study was an open-label design, drawn from a larger pharmacotherapy trial. All participants in the pharmacotherapy trial were offered a manualized psychological intervention in addition to case management. Inclusion in the psychotherapy group was based on participant's choice, and on completion of four or more of the eight modules offered. All clinical files were audited to ensure accuracy of group allocation. Forty young people aged 15 to 25 years old who had experienced a manic episode with psychotic features were recruited into the study, with 20 people in the combined treatment as usual plus psychotherapy group (P+TAU), and an equal number of matched control participants who received treatment as usual (TAU) within the same service. All participants were prescribed antipsychotic and mood-stabilizing medication. Symptomatic, functional and relapse measures were taken both at baseline and at 18-month follow-up. Results: Manic symptoms improved significantly for both groups, with no differences between groups. Depression scores and overall symptom severity were significantly lower in the P + TAU group. No differences were evident between groups with regard to numbers or type of relapse. The P + TAU group had significantly better social and occupational functioning after 18 months. Conclusion: This study suggests that a manualized psychological intervention targeted to a first-episode population can be effective in reducing depression and overall symptom severity, and can improve functional outcome following a first episode of psychotic mania.

The effect of the N-methyl-D-aspartate receptor antagonist dextromethorphan on perioperative brain injury in children undergoing cardiac surgery with cardiopulmonary bypass: results of a pilot study.

Experimental evidence indicates a role of the N-methyl-D-aspartate receptor in the pathogenesis of brain injury occurring during cardiac surgery with cardiopulmonary bypass (CPB). Dextromethorphan is a noncompetitive antagonist of this receptor with a favorable safety profile. Thirteen children age 3-36 months undergoing cardiac surgery with expected CPB of 60 minutes or more were randomly assigned to treatment with dextromethorphan (36-38 mg/kg/day) or placebo administered by naso-gastric tube. Dextromethorphan was absorbed well and reached putative therapeutic levels in blood and cerebrospinal fluid. Adverse effects were not observed. Mild hemiparesis developed after operation in one child of each group, and severe encephalopathy in one of the placebo group. Sharp waves were recorded in postoperative continuous electroencephalography in all placebo (n = 7) but only in 2/6 dextromethorphan treated children (p = 0.02). Pre- and postoperative cranial magnetic resonance imaging (MRI) revealed less pronounced ventricular enlargement in the dextromethorphan group (not significant). An increase of periventricular white matter lesions was visible in two placebo-treated children only. No elevations of cerebrospinal fluid enzymes were observed in either group. Although children with dextromethorphan showed less abnormalities in electroencephalography and MRI, dissimilarities of the treatment groups by chance diminished conclusions to possible protective effects of dextromethorphan at this time.