Attention deficit hyperactivity disorder and comorbidity: A review of literature

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with onset in early childhood.It is a clinically heterogenous condition with comorbidity posing a distinct challenge to diagnosing and managing these children and adolescents.This review aims to provide an overview of comorbidity with ADHD including other neurodevelopmental disorders,learning disorders,externalising and internalising disorders.Challenges in screening for,diagnosing and managing comorbidity with ADHD are summarised.Also,methodological challenges and future directions in research in this interesting field are highlighted.

Audit of physical health monitoring in children and adolescents receiving antipsychotics in neurodevelopmental clinics in Northumberland

AIM To ascertain performance against the standards set by National Institute for Clinical Excellence (NICE) guidelines on physical health monitoring of thirty children and adolescents prescribed antipsychotics in neurodevelopmental clinics in Northumberland and identifying areas for improvement in practice. METHODS The audit involved a review of recorded documentation pertaining to physical health monitoring in patient electronic records pertaining to children and adolescents attending neurodevelopmental clinics in Northumberland prescribed antipsychotics. Clients were also contacted by telephone if relevant documentation could not be identified or retrieved to confirm the details. 32 case notes were perused of which 2 were excluded as they had refused to have venepuncture which was documented in the electronic records. RESULTS The overall audit results demonstrated partial compliance with NICE guidelines on physical health monitoring in children and adolescents prescribed antipsychotics. Bi-annual recording of height, weight, blood pressure, pulse rate and review of side effects was completed in 100% of subjects. However, annual monitoring for blood tests including liver function, renal function full blood count as well as biannual monitoring of serum prolactin, serum lipid profile was completed only in 56% of subjects. Comparative baseline characteristics between the two groups (compliant and non-compliant with guidelines) found no differences based on any socio-demographic or clinical variables. However, the proportion of patients in the group compliant to guidelines was higher in the age group of 12-17 years as compared to < 12 years (70.58% vs 38.46%), though not statistically significant (χ~2 = 1.236; P = 0.24). CONCLUSION Development of tailored and specific guidelines for physical health monitoring in children and adolescents prescribed antipsychotics taking into consideration clinical effectiveness and safety profile is likely to improve adherence rates.

Optimal Islanding for Restoration of Power Distribution Systems Using Prim’s MST Algorithm

Power systems can suffer outages,causing complete or partial disconnection of their power supply to load centers within the distribution networks.Distributed Generation(DG)plays an essential role in power systems.DG can be used as a back-up power source to enhance the resiliency and reliability of a power system.Island mode operations after outages in an active distributing network(ADN)is an effective way to maintain continuity of the power supply to significant loads.It is a quite complicated task for power system operators to find the power flow path.Previous studies have primarily used pre-defined guidelines to find feasible power flow paths,and have focused on multiple islands for restoration.In these studies,possible restoration pathfinding with DG was the fundamental weakness,and furthermore,the power of DG was limited to pre-defined boundaries in the form of islands.Therefore,in this study,a new algorithm has been proposed,which uses the minimum spanning tree(MST)method to find the most feasible path.The proposed algorithm starts at any random node(in this case,DG),and progresses by selecting the next node with the least cost(weight),thus considering all the nodes through which power will flow.The proposed model is formulated as a multiobjective program considering the priority of loads and minimum power loss.The effectiveness of the proposed model is tested on a modified IEEE69-bus distribution system with the penetration of multiple distributed generation sources at different nodes.Results were compared with the strategies found in literature,and the proposed method was found to be feasible and efficient.