Comparison of the effect of pharmacotherapy and neuro-feedback therapy on oral health of children with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a chronic and progressive mental disorder related to the childhood period. This study aims to compare the oral health of two groups of ADHD children: those under pharmacotherapy and those under neuro-feedback therapy. 72 ADHD children (aged 6?12) were divided into two 36 member groups: The pharmacotherapy group and the neuro-feedback therapy group. Unstimulated salivary flow (USF), DMFT, and plaque index were assessed in these children. Statistical analysis was carried out on the data with the independent t-test, which was performed using SPSS 16. The significance level of the study was p<0.05. In this study, the USF of ADHD children who used Ritalin was found to be significantly less than that of the neuro-feedback group (1.25 ± 1.21 vs. 1.91 ± 1.16 ml/min; p=0.002). Also, the plaque index (5.9 ± 3.1 vs. 3.94 ± 1.9; p=0.018) and DMFT scores (39% ± 9% vs. 31% ± 9%; p=0.018) were significantly higher for the pharmacotherapy group. Neuro-feedback therapy is preferable to Ritalin treatment for ADHD children in terms of their oral health status

Investigations of the neural basis of source memory strength

When an attempt is made to recognize something, we can remember different aspects of the original experience. You may have a memory of the individual items you have encountered. We may also have memories of where those items came from, the source of those memories. Source memory includes elements regarding the perceptual or conceptual context of an item, such as the person who said or wrote it, whether the item was seen inside or outside, or your internal state when the memory was encoded. Some cognitive models of source memory suggest that it is a probabilistic threshold process (Yonelinas, 2002), while others predict that it varies along a continuum of memory strength (Mickes, Wais, & Wixted, 2009; Slotnick, 2010). These models have been largely debated as part the discussion of dual-process theories of memory, leaving open cognitive neuroscience questions about brain structures involved in variations in the strength of source memory (Wixted, 2009; but see Vilberg & Rugg, 2009; Yu, Johnson, & Rugg, 2012). The dominant viewpoint in cognitive Neuroscience was that source memory did not vary in strength, leading to a lack of research into the topic. However there is evidence that this may have lead to a misrepresentation of the brain’s role in the strength of source memory (Wais, 2008) . This dissertation presents a series of experiments that explore the links between brain structures and variations in the strength of source memory. Chapter 2 uses fMRI to examine the role of the hippocampus in source memory strength. Previous dual-process oriented research suggests that a process of recollection would be necessary for source memory, but a process of familiarity would be sufficient for memory of an individual item. Brain imaging studies support the idea that that recollection is mediated by the hippocampus and familiarity by surrounding cortex. However, some researchers dispute this distinction, claiming that the hippocampus responds to the overall strength of memory, not source memory specifically (Kirwan, Wixted, & Squire, 2008; Shrager, Kirwan, & Squire, 2008; Wais, 2008). The experiment in Chapter 2 measured memory type (item and source) and the strength of both to examine whether the hippocampus responds differentially to each type of memory strength. The finding was that hippocampal activity increased with the strength of source memory, but not with item memory strength. This suggests that while the hippocampus does preferentially respond to source retrieval, it does so in a graded fashion with strength. The parietal lobes also showed a differential pattern of activity to item and source strength with different subregions involved in processing item and source memory. Dorsal regions are often associated with processing item memory, and ventral regions with source memory. This may reflect differences in bottom-up versus top-down driven attentional mechanisms (Cabeza, Ciaramelli, Olson, & Moscovitch, 2008) or difference in the accumulation of different types of mnemonic information (Vilberg & Rugg, 2008). The left frontal lobe was increasingly active for item memory strength, suggesting it plays a role of increased effortful retrieval (Henson, Shallice, & Dolan, 1999) or monitoring of source information (Mitchell & Johnson, 2009) to high confidence items. This first study left open questions about the circumstances under which other brain regions contribute to source memory strength. Chapter 3 used fMRI to examine the domain specificity of source memory strength, such as which brain regions are more active for source memory in general and which regions differed in their contribution to source strength depending on stimulus content. The retrieval of information leads to the reactivation of the brain regions that were engaged during encoding of the memory (Danker & Anderson, 2010; Rissman & Wagner, 2012; Walker, Low, Cohen, Fabiani, & Gratton, 2014), this reactivation could also contribute to source memory strength. My paradigm used pairings of words with faces or scenes during encoding, and tested memory for the associated picture with words alone. I found that the hippocampus increased its activity in a domain-general way, increasing with source memory strength to words regardless of associated stimulus type (face or place). The parahippocampal place area shows preferential activity when viewing scenes (Epstein & Kanwisher, 1998). This study found the left parahippocampal cortex to be increasingly active with confidence that a word had been previously paired with a place. Bilateral amygdala is active during the processing of face stimuli (Ishai, 2008) This study found the amygdala was increasingly active with confidence that a word was previously paired with a face. These two regions show domain-specificity in their contribution to source memory strength since they only activate to words paired with certain classes of stimuli, faces or places. Thus, while perceptual processing regions of the brain specific to faces and places showed domain-specificity, the hippocampus was involved in successful source retrieval in a domain general manner, suggesting it supports memory for all types of sources. An open question was whether the activations observed in the previous experiment represented the remembering of general categorical information diagnostic of the source question or the remembering of the specific associated stimuli. Chapter 4 examined the difference in the neural response when remembering general categorical source information or memory of specific associative information using Event Related Potentials (ERPs). During encoding, participants were shown words paired with scenes that were either natural or man-made. When shown the words again during the memory test, the participants were asked a source question, whether the associated scene was natural or manmade. Immediately following the categorical source question, they were asked to identify the specific paired scene from an array consisting of the original stimulus and two within-category lures. Thus I was able to examine ERPs reflecting source category memory retrieval separately from remembering specific associated items. Previous ERP studies have found correlations between recollection of source memory and the “LPC” component (for review see Rugg & Curran, 2007). The amplitude of the LPC has also been shown to track confidence in source memory (Woroch & Gonsalves, 2010). ERP amplitudes in the LPC time window were related to confidence in the category source judgment, but not to success at recognizing the specific associated image. Immediately following the scene category decision, subjects were given a forced choice test probing their memory for the specific associated scene. Success in that decision was related to increased amplitude late in the time window. I conclude that remembering specific information involves increases source-monitoring demands indexed by the frontal ERPs. Across all three studies, multiple brain regions and processes were involved in source memory strength, suggesting source memory is a continuous process, not simply an all or none threshold process. The fMRI data suggest the hippocampus and ventral parietal cortex track source memory in a domain-general fashion, suggesting a global binding mechanism (hippocampus), and attention to memory or memory representation (ventral parietal) processes. Domain-specific perceptual processing regions showed reactivation during retrieval that also tracked source strength, suggesting source memory strength is also affected by the richness of the reinstatement of the memory representation. The ERP results suggest that while these domain general processes, such as source retrieval indexed by the LPC, do support general source memory strength, additional executive processes, such as post-retrieval monitoring, may be necessary to support memory for specific associations at retrieval

Validity of Spirometry for Diagnosis of Cough Variant Asthma

Background Cough variant asthma (CVA) is a chronic or recurrent cough without wheezing accompanied by bronchial hyper-responsiveness and eosinophilic inflammation of the airways. This study aimed to evaluate the validity of spirometry in the diagnosis of CVA, as well as determining the specificity and sensitivity of spirometry parameters in CVA. Materials and Methods This descriptive observational study was conducted from March 2015 to February 2016. The subjects were 73 patients 5 to 15 years of age who referred to the pulmonology clinics of Tabriz Pediatric Center, Tabriz city, Iran. The patients were divided into two groups of classic asthma (n=37), and CVA (n=36). Basic spirometry parameters such as FEV1/FVC and FEF25-75% were measured and the spirometry findings of each individual were measured based on European Respiratory Society (ERS) criteria. After intervention (β2 (beta2) adrenergic receptor agonists as bronchodilator test), in two groups, spirometry was again performed. The FEV1/FVC and FEF 25-75% parameters were examined for intervention. Data analysis was performed using SPSS (version 16.0).   Results Cut-off points for the diagnosis of CVA and classic asthma were obtained using FEV1/FVC and FEF 25-75% spirometry. The cut-off point for FEV1/FVC for the diagnosis of CVA was calculated to be 80%. When the FEV1/FVC ratio was higher than 80%, diagnosis of CVA was possible with a specificity of 94.59%, and sensitivity of 66.67%. These findings suggest a specificity and sensitivity of 94.59%, and 66.67%, respectively, for the diagnosis of classic asthma (with an FEV1/FVC ratio of below 80%). Analysis showed a positive predictive value of 100% for CVA at FEF 25-75% with a negative predictive value of 55.4%. Conclusion Spirometry can be a sensitive method for the diagnosis of CVA at a FEF 25-75% below 65%; however, it lacks the specificity for accurate diagnosis of CVA

The Role of Spirometry in the Diagnosis of Cough Variant Asthma in Children Aged 5 to 15 Years

Background Cough variant Asthma (CVA) is defined as chronic cough without wheezing, and may be precursor of typical asthma. Thus, the diagnosis of CVA and early intervention can partly inhibit asthma progression.This study aimed to evaluate the role of spirometry in diagniosis of Cough variant Asthma in Iranian Children. Materials and Methods This descriptive observational study included a total of 73 patients, who were referred to the specialized lung clinic of Tabriz Pediatric Center, Tabriz city, Iran. Patients were divided into two groups with classic asthma (n=37) and cough variant asthma (n=36) and basic spirometry parameters such as FEV1, FVC, FEV1/FVC, FEF 25-75% and PEF were measured, and the spirometry findings of each individual were measured based on the European Respiratory Society (ERS) criteria. Results The mean of FEV1 and FVC in the classic asthma group were 83.45 ± 20.49% and 86.45 ± 21.57%, respectively; and in the cough variant asthma group were 87.44 ± 13.99% and 86.8 ± 14.71%, respectively. There was no significant difference between the two groups for the basic spirometry parameters of FEV1 and FVC (p=0.343, P=0.916; respectively). The average FEV1/FVC parameter in the cough variant asthma group was 89.44±13.07, but it was 72.35±8.47 in the classic asthma group, with a significant difference between the two groups (

Wpływ postrzegania zrównoważonych polityk marketingowych na zadowolenie klienta przyjaznego środowisku

Sustainability and sustainable marketing have obviously become very crucial, and strategies that are in control of the environment can give several businesses a competitive edge. Moreover, as a result of the rapid development and changes in Iran, sustainability is more important than ever, and deep change is needed to bring Persian people and companies into sustainable orientation. The purpose of this article is to study the relationship between customers’ green satisfaction and perceived sustainable marketing policies in Iran. The study is based on the designed questionnaire, which considers different cultural issues. The data analysis has been done based on the Pearson correlation coefficient and linear regression analyses by using SPSS 21. The results show that the correlation between the perceived sustainable marketing policies and green customer satisfaction is greater than 0.6. Moreover, the regression analysis proves that the perceived sustainable marketing policies have a positive impact on green customer satisfaction. Therefore, sustainability is a crucial factor for companies in order to make their customers satisfied and consequently having a competitive advantage comparing their competitors.Zrównoważony rozwój i zrównoważony marketing stały się bardzo istotne, a strategie ujmujące wymogi środowiskowe mogą zapewnić firmom przewagę konkurencyjną. Ponadto, w wyniku szybkiego rozwoju i zmian w Iranie, zrównoważony rozwój jest ważniejszy niż kiedykolwiek dotąd, a głębokie zmiany są konieczne, aby doprowadzić mieszkańców i firmy do zrównoważonej orientacji. Celem tego artykułu jest zbadanie związku między ekologiczną satysfakcją klientów a postrzeganą polityką zrównoważonego marketingu w Iranie. Badanie opiera się na zaprojektowanym kwestionariuszu, który uwzględnia różne zagadnienia kulturowe. Analiza danych została przeprowadzona na podstawie współczynnika korelacji Pearsona i analizy regresji liniowej przy użyciu SPSS 21. Wyniki pokazują, że korelacja między postrzeganą zrównoważoną polityką marketingową a satysfakcją klientów przyjaznych środowisku jest większa niż 0,6. Co więcej, analiza regresji dowodzi, że postrzegana zrównoważona polityka marketingowa ma pozytywny wpływ na zadowolenie klientów przyjaznych środowisku. Dlatego zrównoważony rozwój jest kluczowym czynnikiem dla firm, aby ich klienci byli zadowoleni, a co za tym idzie, firmy mogły osiągnąć przewagę konkurencyjną w porównaniu z konkurencją

Study of the Determinant Factors in Seizure Following Gastroenteritis in Children Admitted in Tabriz Children's Hospital during 2001 to 2016

Background: One of the common side effects of gastroenteritis in children is seizure, which is one of the causes of fever, electrolyte disturbances, and meningitis. This study was aimed to investigate the determinant factors in seizure in children with gastroenteritis and seizure admitted in Tabriz Children's Hospital from 2001 to 2016. Materials and Methods: This is a descriptive study. The study population included all children admitted with diagnosis of gastroenteritis and seizure in Tabriz Children's Hospital during the years 2001 to 2016. The data of admitted patients including electrolyte disturbances, age, gender, blood-venous analysis, Blood urine nitrogen (BUN), and creatinine tests were extracted from hospital records by a resident and intern of this hospital using a questionnaire designed for this research. Results: A total of 84 patients were included in the study. The patients included 44 males (52.4%) and 40 females (47.6%). The mean age of the patients was 9.31 ± 7.13 years. Forty-six (55.42%) patients suffered from electrolyte impairment, 24 of which (52.2%) were male and 22 (47.8%) were female; and hyponatremia was the most common disorder (24.10%). Accordingly, only BUN of has proven to be a strong predictor of the likelihood of seizure; also despite of non-significant p-value of PH, it had a potentially strong association with seizure. Conclusion According to the results of this study, electrolyte impairment is fairly common in children with acute gastroenteritis. Education about the management of children with seizure to is an important factor in this regard