Effect of n-3 supplementation on hyperactivity, oxidative stress and inflammatory mediators in children with attention-deficit-hyperactivity disorder

BACKGROUND

Attention-deficit/hyperactivity disorder (ADHD) is associated with difficulties in learning, behaviour and psychosocial adjustment that persist into adulthood. Decreased omega-3 fatty acids and increased inflammation or oxidative stress may contribute to neuro-developmental and psychiatric disorders such as ADHD. The aim of this study was to determine the effect of n-3 supplementation on hyperactivity, oxidative stress and inflammatory mediators in children with ADHD.

METHODS

In this double blind study, 103 children (6-12 years) with ADHD receiving maintenance therapy were assigned randomly into two groups. The n-3 group received n-3 fatty acids (635 mg eicosapentaenoic acid (EPA), 195 mg docosahexaenoic acid (DHA)), and the placebo group received olive oil capsules which were visually similar to the n-3 capsules. The duration of supplementation was 8 weeks. Plasma C-reactive protein (CRP), interleukin-6 (IL-6) and the activity of glutathione reductase (GR), catalase (CAT) and superoxide dismutase (SOD) were determined before and after the intervention. Likewise the Conners' Abbreviated Questionnaires (ASQ-P) was applied.

RESULTS

After 8-week intervention, a significant reduction was observed in the levels of CRP ( P < 0.05, 95% CI = 0.72-2.02) and IL-6 (P < 0.001, 95% CI = 1.93-24.33) in the n-3 group. There was also a significant increase in activity of SOD and GR (P < 0.001). A significant improvement was seen in the ASQ-P scores in the n-3 group (P < 005).

CONCLUSION

Eight weeks of EPA and DHA supplementation decreased plasma inflammatory mediators and oxidative stress in the children with ADHD. These results suggest that n-3 fatty acid supplementation may offer a safe and efficacious treatment for children with ADHD.

Ophthalmic public health; the way ahead

BACKGROUND

Visual sciences have been progressing quickly in recent decades through globalization phenomenon. An enormous change has taken place in ocular health issues, however, there are various problems facing ophthalmic public health worldwide. In the previous years, the World Health Organization and the International Agency for the Prevention of Blindness in partnership launched the global initiative to eradicate avoidable blindness by the year 2020, VISION 2020 the Right to Sight. It has concentrated on the prevention of blindness disability and recognized a health issue-sight as a human right. In view of challenges ahead of visual sciences, close collaboration between international agencies at the global level to implement new strategies and monitor the progress will be mandatory. In these circumstances non-governmental organizations should not be neglected. World Sight Day 2012 would be a great opportunity to be a focus on importance of visual impairment as an important public health issue and discovering new challenges ahead.

Towards an ontology for data quality in integrated chronic disease management: a realist review of the literature

PURPOSE

Effective use of routine data to support integrated chronic disease management (CDM) and population health is dependent on underlying data quality (DQ) and, for cross system use of data, semantic interoperability. An ontological approach to DQ is a potential solution but research in this area is limited and fragmented.

OBJECTIVE

Identify mechanisms, including ontologies, to manage DQ in integrated CDM and whether improved DQ will better measure health outcomes.

METHODS

A realist review of English language studies (January 2001-March 2011) which addressed data quality, used ontology-based approaches and is relevant to CDM.

RESULTS

We screened 245 papers, excluded 26 duplicates, 135 on abstract review and 31 on full-text review; leaving 61 papers for critical appraisal. Of the 33 papers that examined ontologies in chronic disease management, 13 defined data quality and 15 used ontologies for DQ. Most saw DQ as a multidimensional construct, the most used dimensions being completeness, accuracy, correctness, consistency and timeliness. The majority of studies reported tool design and development (80%), implementation (23%), and descriptive evaluations (15%). Ontological approaches were used to address semantic interoperability, decision support, flexibility of information management and integration/linkage, and complexity of information models.

CONCLUSION

DQ lacks a consensus conceptual framework and definition. DQ and ontological research is relatively immature with little rigorous evaluation studies published. Ontology-based applications could support automated processes to address DQ and semantic interoperability in repositories of routinely collected data to deliver integrated CDM. We advocate moving to ontology-based design of information systems to enable more reliable use of routine data to measure health mechanisms and impacts.

Lessons learnt from malaria epidemics in the Islamic Republic of Iran

The Islamic Republic of Iran is in the pre-elimination phase of malaria control, but malaria epidemics are still a concern in the south of the country. This retrospective study presents the epidemiological characteristics and predisposing factors of 60 of the malaria epidemics reported in Sistan va Baluchestan province during 2005-09. A zero-truncated negative binomial model was used to investigate the relation between predictor variables and the total number of malaria cases. Malaria epidemics occurred mainly in the southern part of the province, mostly between July and October, peaking in August. Most malaria epidemics were small-scale (68.3% were < 100 cases) and short (51.7% lasted < 1 month). Plasmodium falciparum was present in 46.7% of the epidemics. An increase in the rainfall rate as well as population movements were the most significant predisposing factors. The results may help inform an epidemic investigation and reporting system as the country approaches the malaria elimination phase.

Torque capabilities of self-ligating and conventional brackets under the effect of bracket width and free wire length

OBJECTIVES

To numerically investigate the torque capacity of conventional and self-ligating brackets under the effect of varying bracket width and free wire length.

MATERIAL AND METHODS

Finite element models of three kinds of orthodontic brackets in the 0.022-inch slot size were investigated: Discovery, Damon 3MX, Speed. Additionally, finite element (FE) models of Speed and Damon brackets were generated with the same width as the Discovery. From the left upper incisor to the right upper canine, four brackets each were modelled. The total wire length at the upper right incisor was kept constant at 12 mm for all brackets types. For the Discovery brackets, the wire length was increased from 12 to 16 mm in 2-mm steps. A torque of 20° was applied to the upper right incisor with 0.46 × 0.64 mm(2) (0.018″ × 0.025″) and 0.48 × 0.64 mm(2) (0.019″ × 0.025″) wires. Wires made of stainless steel, titanium molybdenum and nickel titanium were studied. Torque angle/moment characteristics were recorded.

RESULTS

  Wider brackets showed more torque control capability (e.g. Discovery: 10.6 Nmm, Damon: 9.2 Nmm, Speed: 4.0 Nmm for the NiTi wire). Even with the same width as the Discovery bracket, Damon and Speed brackets showed lower torque capability than the Discovery bracket. Increasing the free wire length decreased the torsional stiffness of the wire and thus decreased the torque capability.

CONCLUSION

The results showed that the bracket design has less influence on the torquing moment than other parameters, such as bracket width, free wire length, wire/slot play or misalignment.

Cre transgene results in global attenuation of the cAMP/PKA pathway

Use of the cre transgene in in vivo mouse models to delete a specific 'floxed' allele is a well-accepted method for studying the effects of spatially or temporarily regulated genes. During the course of our investigation into the effect of cyclic adenosine 3',5'-monophosphate-dependent protein kinase A (PKA) expression on cell death, we found that cre expression either in cultured cell lines or in transgenic mice results in global changes in PKA target phosphorylation. This consequently alters gene expression profile and changes in cytokine secretion such as IL-6. These effects are dependent on its recombinase activity and can be attributed to the upregulation of specific inhibitors of PKA (PKI). These results may explain the cytotoxicity often associated with cre expression in many transgenic animals and may also explain many of the phenotypes observed in the context of Cre-mediated gene deletion. Our results may therefore influence the interpretation of data generated using the conventional cre transgenic system.

Pain and health-related quality of life in war veterans with bilateral lower limb amputations

Background

Amputation and pain may have considerable impact on health-related quality of life.

Objectives

The purpose of this study was to assess the impact of pain on health-related quality of life in a population of war related bilateral lower limb amputees.

Materials and Methods

The Veterans and Martyrs Affairs Foundation (VMAF) database documented 578 patients with bilateral lower limb amputation; 335 consented to the study (response rate = 58%). The majority of participants in the sample were males (96.7%). Types of pain were investigated using a questionnaire. Health-related quality of life (HRQOL) was investigated using the sf-36 questionnaire.

Results

About two third of amputees reported phantom pain 66.7% (n = 223) and vertebral column pain 60.9% (n = 204). The most common type of pain was lumbosacral pain 52.8 % (n = 177) followed by neck 18.2 % (n = 61) and thoracic pain 9.6% (n = 32). Back pain affected on vitality, social function, mental health and mental component scale in our cases (P < 0.05). Neck pain affected all components of health-related quality of life (P < 0.05). Thoracic pain affected quality of life significantly (P < 0.05). The results obtained from logistic regression analysis indicated that none of the three spinal column pains including neck, thoracic and lumbosacral pain resulted in poor physical or mental component scales.

Conclusions

This study revealed that bilateral lower limb amputees suffer from different types of pain and poor health-related quality of life. Therefore, the assessment and management of all types of pain are necessary to improve quality of life in veterans.

Development of a valid and reliable diabetes empowerment scale: an Iranian version

BACKGROUND

Patient empowerment can enhance the outcomes of care such as metabolic control as well as quality of their life. This study evaluates the Iranian version for development of a valid and reliable diabetes empowerment scale.

METHODS

Validity and reliability of Iranian version of Diabetes Empowerment Scale (DES-LF) were measured through a cross-sectional study. DES-LF was evaluated through a qualitative and quantitative study by 160 type 2 diabetic patients.

RESULTS

Reliability and validity of the scale and its 3 subscales, namely, managing the psychosocial aspects of diabetes (α=0.94), assessing dissatisfaction and readiness to change (α=0.96), and setting and achieving diabetes goals (α=0.96) were approved by a psychometric analysis.

CONCLUSION

Findings approved the reliability and validity of the Iranian version of DES-LF for patient education and psychosocial interventions among Iranian people with type 2 diabetes.

An innovative educational model in intraocular pressure measurement

Tactile palpation is a simple technique that can prove useful for estimating intraocular pressure (IOP) in primary healthcare settings, mainly in the absence of equipment, for very young children, patients who are intellectually challenged, those with eyes with extremely irregular corneas, and patients with corneal prostheses. Accordingly, this technique can also aid in the diagnosis of high IOP in primary and emergency care settings. To the best of our knowledge, there is no instrument that can quantify the estimation of IOP and teach tactile examiners. This group has developed a digital instrument called the MEHDI-IOP Measurement Model to train primary healthcare workers as well as blind individuals in the estimation of IOP. In this simple instrument, elastic spheres with a specific inner pressure can be touched and the responses of candidates with regard to the estimated pressure can be graded accordingly.

The University of NSW electronic practice based research network: disease registers, data quality and utility

INTRODUCTION

Accurate well-maintained registers are a prerequisite to co-ordinated care of patients with chronic diseases. Their effectiveness in enabling improved management is dependent on the quality of the information captured. This paper provides an overview into the methodology and data quality of the electronic Practice Based Research Network.

METHODS

Clinical records with no identifying information are routinely extracted from four general practices. The data are linked in the data warehouse. Data quality is assessed for completeness, correctness and consistency. Reports on data quality are given back to practices and semi-structured interviews provide information to interpret the results and discuss how data quality could be improved.

FINDINGS

Data quality is mostly complete for sex and date of birth but indigenous status, smoking and weight were incomplete. There are generally high levels of correctness and internal consistency. Completeness of records in assisting the management of diabetes patients using the annual cycle of care was poor. GPs often use the progress notes to enter information during the consultation and coding diagnoses was considered onerous.

DISCUSSION

The routine capture of electronic clinical health records from primary health care and health services can be used to monitor performance and improve the quality of clinical records. There is a need for accurate and comprehensive clinical records to ensure the safety and quality of clinical practice. Understanding the true reasons for poor data quality is complex. Having a community-based research network may assist in answering some of these questions.

CONCLUSION

Electronic health records are increasingly being used for secondary research and evaluation, beyond the primary purpose of supporting clinical care. The data must be of sufficient quality to support these purposes.