Attitudes and reported practice of paediatricians and child psychiatrists regarding the assessment and treatment of ADHD in Ireland

Objectives. This mixed-method national survey has obtained original data on attention deficit hyperactivity disorder (ADHD) attitudes, assessment and treatment regimes reported by paediatricians and child psychiatrists; and has compared their clinics. It has examined the extent of involvement of Irish paediatricians in the management of ADHD. Methods. A questionnaire was designed, based on a review of literature and ADHD guidelines, and piloted by expert clinicians. Universal recruitment was conducted among Child and Adolescent Mental Health Services (CAMHS) consultants (n = 71) and community/general paediatric consultants (n = 72). Quantitative and qualitative data was collected and analysed. Results. There was an overall response rate of 43%. A dedicated ADHD clinic is offered in 79% of CAMHS services, but only in one paediatric service. Participants reported that the assessment of ADHD involves multidisciplinary work and this was only established in CAMHS clinics. Medication is initiated by 82% of child psychiatrists and only 22% of paediatricians. Conclusions. This first national study of ADHD attitudes and practices presents comprehensive data regarding the management of children with ADHD in CAMHS and paediatric settings in Ireland. Paediatricians reported a minor role in managing ADHD. Study limitations are related to subjective reporting rather than case note audit, and a moderate response rate for the paediatricians’ participants

Contribution of cod liver oil-related nutrients (vitamins A, D, E and eicosapentaenoic acid and docosahexaenoic acid) to daily nutrient intake and their associations with plasma concentrations in the EPIC-Norfolk cohort

Total nutrient intake (TNI) is intake from food and supplements. This provides an assessment of nutrient adequacy and the prevalence of excessive intake, as well as the response with respect to biomarkers. Cod liver oil (CLO) is the most frequently consumed supplement in the UK, containing nutrients that might have varying influences on health. We calculated TNI for vitamins A, D and E, as well as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and assessed associations with the respective blood concentrations

Children's development of structure in early mathematics

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Multipoint, high time resolution galactic cosmic ray observations associated with two interplanetary coronal mass ejections

[1] Galactic cosmic rays (GCRs) play an important role in our understanding of the interplanetary medium (IPM). The causes of their short timescale variations, however, remain largely unexplored. In this paper, we compare high time resolution, multipoint space-based GCR data to explore structures in the IPM that cause these variations. To ensure that features we see in these data actually relate to conditions in the IPM, we look for correlations between the GCR time series from two instruments onboard the Polar and INTEGRAL (International Gamma Ray Astrophysical Laboratory) satellites, respectively inside and outside Earth\u27s magnetosphere. We analyze the period of 18–24 August 2006 during which two interplanetary coronal mass ejections (ICMEs) passed Earth and produced a Forbush decrease (Fd) in the GCR flux. We find two periods, for a total of 10 h, of clear correlation between small-scale variations in the two GCR time series during these 7 days, thus demonstrating that such variations are observable using space-based instruments. The first period of correlation lasted 6 h and began 2 h before the shock of the first ICME passed the two spacecraft. The second period occurred during the initial decrease of the Fd, an event that did not conform to the typical one- or two-step classification of Fds. We propose that two planar magnetic structures preceding the first ICME played a role in both periods: one structure in driving the first correlation and the other in initiating the Fd

Developing a gender-based approach to chronic conditions and women's health: A qualitative investigation of communitydwelling women and service provider perspectives

© 2015 DiGiacomo et al. Background: Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. Methods: Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. Results: Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. Conclusions: This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention

The role of climatic and terrain attributes in estimating baseflow recession in tropical catchments

The understanding of low flows in rivers is paramount more than ever as demand for water increases on a global scale. At the same time, limited streamflow data to investigate this phenomenon, particularly in the tropics, makes the provision of accurate estimations in ungauged areas an ongoing research need. This paper analysed the potential of climatic and terrain attributes of 167 tropical and sub-tropical unregulated catchments to predict baseflow recession rates. Daily streamflow data (m<sup>3</sup> s<sup>–1</sup>) from the Global River Discharge Center (GRDC) and a linear reservoir model were used to obtain baseflow recession coefficients (<i>k</i><sub>bf</sub>) for these catchments. Climatic attributes included annual and seasonal indicators of rainfall and potential evapotranspiration. Terrain attributes included indicators of catchment shape, morphology, land cover, soils and geology. Stepwise regression was used to identify the best predictors for baseflow recession coefficients. Mean annual rainfall (MAR) and aridity index (AI) were found to explain 49% of the spatial variation of <i>k</i><sub>bf</sub>. The rest of climatic indices and the terrain indices average catchment slope (SLO) and tree cover were also good predictors, but co-correlated with MAR. Catchment elongation (CE), a measure of catchment shape, was also found to be statistically significant, although weakly correlated. An analysis of clusters of catchments of smaller size, showed that in these areas, presumably with some similarity of soils and geology due to proximity, residuals of the regression could be explained by SLO and CE. The approach used provides a potential alternative for <i>k</i><sub>bf</sub> parameterisation in ungauged catchments