A systematic review of the behaviours associated with depression in people with severe-profound intellectual disability.

The assessment of depression in people with severe to profound intellectual disability (severe-profound ID) is challenging, primarily due to inability to report internal states such as mood, feelings of worthlessness and suicidal ideation. This group also commonly presents with challenging behaviours (e.g. aggression and self-injury) with debate about whether these behaviours should be considered 'depressive equivalents' or are sensitive for, but not specific to, depression in severe-profound ID. We conducted a systematic review exploring behaviours associated with depression and low mood in individuals with severe-profound ID. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (2009) guidelines. Three electronic databases were searched (Embase, PsycINFO and Ovid MEDLINE), and 13 studies were included and rated for quality. Few studies were rated as having high methodological quality. Behaviours captured by standard diagnostic schemes for depression (e.g. Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases) showed a relationship with depression in severe-profound ID, including the two core symptoms (depressed affect and anhedonia), as well as irritability, sleep disturbance, psychomotor agitation, reduced appetite and fatigue. Challenging behaviours such as aggression, self-injury, temper tantrums, screaming and disruptive behaviour were associated with depression. Challenging behaviours show a robust relationship with depression. Whilst these behaviours may suggest an underlying depression, study limitations warrant caution in labelling them as 'depressive equivalents'. These limitations include not controlling for potential confounds (autism, other affective disorders and pain) and bias associated with comparing depressed/non-depressed groups on the same behavioural criteria used to initially diagnose and separate these groups. Future studies that use depressive measures designed for ID populations, which control for confounds and which explore low mood irrespective of psychiatric diagnosis, are warranted to better delineate the behaviours associated with depression in this population (PROSPERO 2018: CRD42018103244).

Beyond symptom control for attention-deficit hyperactivity disorder (ADHD): what can parents do to improve outcomes?

Attention-deficit hyperactivity disorder (ADHD) and its associated behavioural manifestations develop and progress as the result of complex gene-environment interactions. Parents exert a substantial influence and play a major role in their child's social environment. Despite this, recent evidence has suggested that adapting the child's environment via parenting interventions has minimal effects on child ADHD symptoms when analysing data from informants who are probably blind to treatment allocation. However, adverse parenting and family environments may act as a source of environmental risk for a number of child outcomes beyond ADHD symptoms. This is a narrative review that critically discusses whether parenting interventions are beneficial for alternative functioning outcomes in ADHD including neuropsychological, academic and social functioning and disruptive behaviour and how parenting and familial environments may be associated with these outcomes. In addition, the review explores how parental depression and parenting efficacy impact on capacity for optimal parenting and whether parenting interventions benefit parents too. A review of the evidence suggests that with modification, parenting interventions are beneficial for a number of outcomes other than ADHD symptom reduction. Improving the parent-child relationship may have indirect benefits for disruptive behaviour. Furthermore, parenting behaviours may directly benefit child neuropsychological, academic and social functioning. Parenting interventions can have therapeutic benefits for parents as well as children, which is important as parent and child well-being is likely to have a transactional relationship. Evaluation of the clinical success of parenting interventions should focus on a wider range of outcomes in order to aid understanding of the multifaceted benefits that they may be able to offer. Parenting interventions should not be seen as a redundant adjunct to medication in multi-modal treatment approaches for ADHD; they have the potential to target outcomes that, at present, medication seems less able to improve.

Attention-deficit hyperactivity disorder (ADHD): an updated review of the essential facts.

Attention-deficit hyperactivity disorder (ADHD) is a complex disorder that can affect individuals across the lifespan. It is associated with substantial heterogeneity in terms of aetiology, clinical presentation and treatment outcome and is the subject of extensive research. Because of this, it can be difficult for clinicians to stay up to date with the most relevant findings and know how best to respond to parents' questions and concerns about the disorder and interventions. This is a narrative review that aims to summarize key findings from recent research into ADHD and its treatment that clinicians can share with families in order to increase their knowledge about ADHD and intervention options. ADHD develops as a result of complex interplay between interdependent genetic and non-genetic factors. The disorder is associated with substantial impairments in functioning and poor long-term outcomes. Pharmacological and non-pharmacological treatment options are available for symptom management and to improve function, but functioning outcomes often fail to normalize in children with ADHD. Despite extensive advances in understanding this complex disorder, it is clear that there is still a long way to go. In particular, we address the need for future non-pharmacological interventions to be more specifically targeted for ADHD symptoms and its commonly associated functioning deficits in order to ensure the best long-term outcomes for children with ADHD.

Is evolutionary history repeatedly rewritten in light of new fossil discoveries?

Mass media and popular science journals commonly report that new fossil discoveries have 'rewritten evolutionary history'. Is this merely journalistic hyperbole or is our sampling of systematic diversity so limited that attempts to derive evolutionary history from these datasets are premature? We use two exemplars-catarrhine primates (Old World monkeys and apes) and non-avian dinosaurs-to investigate how the maturity of datasets can be assessed. Both groups have been intensively studied over the past 200 years and so should represent pinnacles in our knowledge of vertebrate systematic diversity. We test the maturity of these datasets by assessing the completeness of their fossil records, their susceptibility to changes in macroevolutionary hypotheses and the balance of their phylogenies through study time. Catarrhines have shown prolonged stability, with discoveries of new species being evenly distributed across the phylogeny, and thus have had little impact on our understanding of their fossil record, diversification and evolution. The reverse is true for dinosaurs, where the addition of new species has been non-random and, consequentially, their fossil record, tree shape and our understanding of their diversification is rapidly changing. The conclusions derived from these analyses are relevant more generally: the maturity of systematic datasets can and should be assessed before they are exploited to derive grand macroevolutionary hypotheses.

Total syntheses of conformationally constrained didemnin B analogues. replacements of N,O-dimethyltyrosine with L-1,2,3,4-tetrahydroisoquinoline and L-1,2,3,4-tetrahydro-7-methoxyisoquinoline.

The design and synthesis of two conformationally constrained analogues of didemnin B are described. The [N,O-Me(2)Tyr(5)]residue of didemnin B was replaced with L-1,2,3,4-tetrahydroisoquinoline-3-carboxylic acid (Tic) and L-1,2,3,4-tetrahydro-7-methoxyisoquinoline-3-carboxylic acid (MeO-Tic), which mimic the N,O-dimethylated tyrosine while constraining the conformation of the molecule. Preliminary results indicate that the conformation of the [N,O-Me(2)Tyr(5)]residue closely matches the conformation imposed by the Tic replacement.

Urbanization in Africa since independence.

PIP: Over 185 million inhabitants were added to the urban areas of Africa between 1950 and 1990. Botswana, Lesotho, Namibia, South Africa, and Swaziland is the most highly urbanized, with 55% in 1990; while less than a quarter of Eastern Africa's population is living in urban centers. By the year 2015 more than half of Africa's population will be living in urban areas. Many parts of Africa have suffered prolonged droughts, overgrazing, locust infestations, and desertification. Millions have become refugees from natural disasters, political oppression, and rural poverty. The large exodus from Africa's rural areas has gone to cities but the large cities have attracted disproportionately large numbers of destitute migrants. Alexandria (1 million), Cairo (2.4 million) and the Witwatersrand in South Africa were the only African urban agglomerations with at least one million inhabitants in 1950. By 1990 the two Egyptian cities together had 12.7 million inhabitants and the Witwatersrand some 5 million, whereas the other 25 urban agglomerations with a million inhabitants each in 1990 had a total population of about 51 million. Lagos, Kinshasa, and Algiers ranged from 3 to 7.7 million. The capitals are the largest cities in at least 54 of the 59 countries and territories. Lagos, Nairobi, and Dar es Salaam are disproportionately larger than the next most populous cities in their countries. The 28 urban agglomerations with at least one million inhabitants had a total population of 70 million in 1990, and are projected to reach 100 million in the year 2000. Overall, Africa's urban population is projected to increase by approximately 135 million in the 1990-2000 decade (from 217 million to 352 million). About 105 million of the growth probably will occur in the smaller urban centers. The total African urban population is likely to reach one billion inhabitants within the next 50 years. It stood at 32 million in 1950. Presently, the United Nations projects 912 million urban residents (57% of the total population) by 2025.^ieng

Modelling the formation of polycentric chromosome aberrations.

Exchange-type chromosome aberrations produced by ionizing radiation or restriction enzymes are believed to result from pairwise interaction of DNA double-strand breaks (dsb). In addition to dicentrics, such aberrations may include higher-order polycentrics (tricentrics, tetracentrics, etc.). We have developed computer programs that calculate the probability of the various polycentrics for a given average number of pairwise interactions. Two models are used. Model I incorporates kinetic competition between restitution, complete exchanges (illegitimate recombination events), and incomplete exchanges. Model II allows unrestituted breaks even if there is no recombination. The models were applied to experimental observations of aberrations produced in G1 Chinese hamster ovary cells after electroporation with the restriction enzyme PvuII, which produces blunt-end dsb. We found, experimentally and theoretically, that there was a maximum in the number and multiplicity of polycentrics per cell: beyond a certain PvuII concentration no additional or higher-order polycentrics were produced. Computer-generated relationships, which were remarkably similar for both models and for all values of the adjustable parameters, were found between dicentrics per cell and higher-order polycentrics per cell. Excellent agreement was found between the experimental observations and the consensus theoretical curve relating tricentrics per cell to dicentrics per cell. The observed number of higher polycentrics per cell for a given number of dicentrics per cell was somewhat larger than the consensus theoretical prediction. The observed number of centric rings per cell was markedly larger than the consensus theoretical value, presumably owing to intrachromosomal localization ('proximity effects'). The computer models also provided estimates for the adjustable parameters; for example, in model I the fraction of incomplete exchanges was found to be about 35%.

Lifetime migration to the major cities of the United States, Asia, and Africa.

"The purpose of this paper is to compare and contrast the lifetime migration patterns into the major cities of selected developed and developing countries. This study was confined to cities in...the United States and certain Asian and African countries with relevant published data.... This paper has shown that some lifetime population movements were exceptionally high. Two-thirds of the residents of the major U.S. cities in 1970 were born elsewhere. The major cities in sub-Saharan Africa were second highest with 60 percent. Asian cities followed with 48 percent of their residents being lifetime migrants and the cities of North Africa were lowest with less than a third. Finally, the native population born and reared in most urban agglomerations will probably comprise a larger percentage of the total population in those areas in the future." (SUMMARY IN FRE AND ITA)

The future population of Botswana.

PIP: Population projections by age and sex are presented for Botswana up to the year 2001, as are estimates for 1991. The data are from the 1981 census.^ieng

Rural-urban migration in a developing country: Botswana, Africa.

PIP: Trends in internal migration in Botswana are analyzed, with a focus on rural-urban migration. Data are from the 1981 census and from a survey carried out in 1979. The authors note that even though the predominance of subsistence agriculture acts as a deterrent to rural-urban migration, it is probable that the total and percentage of people living in urban areas will increase. However, the magnitude and pattern of future migration will fluctuate over time as social and economic conditions change.^ieng

Republic of Botswana. Country profile.

PIP: A summary of Botswana's population characteristics, population distribution, labor force characteristics, health situation, and transportation and communication facilities is provided. 87% of the country's 941,027 inhabitants live in the catchment area of the Limpopo River in the eastern region of the country. Much of the remaining area is covered by the Kalahari Desert. The population is growing at an annual rate of 3.6%, the birth rate is 50 and the total fertility rate is 6.6. The government has no official population policy. Major ethnic groups are the cattle raising Tswanas, which make up 50% of the population, the Herero, and the Basarwa, or Bushmen, of the Kalahri Desert. Urban areas are officially defined as population centers which contain 5000 or more residents and in which at least 75% of the inhabitants are engaged in nonagricultural work. According to this classification, 84% of the population is rural; however, most rural inhabitants live in agrotowns and temporarily move to outlying cattle and land posts during part of the year. Some of the agrotowns have almost 25,000 inhabitants. Major urban centers include 1) Gaborone, the capital and major administrative center, with a popualtion of 59,657; 2) Francistown, a large commercial center, with a population of 31,065; 3) Selebi-Phikwe, a mining center, populated by 29,469; and 4) Lobatse, a livestock marketing and processing center, with 19,034 residents. The urban population increased from 54,416 to 150,021 between 1971-81. The population has a young age structure. A large number of working aged males migrate temporarily to the Republic of South Africa to work in the gold mines. 37% of the economically active population is engaged in government services, 26% in mining, manufacturing, and construction, 21% in trade and finance, 6% in transportation, utilities, and communication, and 4.5% in agriculture. Only 1.3% of the land is cultivatable. The working age population is expected to double by the end of the 20th century. Per capita income is US$392 (1982). English is the official language, but Setswana is the national language. 35% of the population, 10 years of age or older, is literate. Education is not compulsory, and 40% of those 5 years of age or older have no schooling. Recently, school enrollments increased, and 1/2 of those aged 5-19 years are currently enrolled in school. There are 170,000 housing units. In urban areas, most housing units have piped water, 1/3 have flush toilets, and 27% have either electircity or gas for lighting and cooking. In 1983, there were 15 hospitals, 7 health centers, 127 clinics, 684 health posts or mobile units, 146 doctors, 9 dentists, and 1440 nurses. The infant mortality rate declined from 102-79 between 1971-84, and life expectancy increased from 53-56 between 1971-81. The government places a high priority on improving the health status of the population, and hospital facilities are being expanded. Botswana has 13,500 kilometers of roads, of which 23% are paved. There is 1 daily newspaper with a circulation of 25,000 and a weekly newspaper with a circulation of 14,000. In 1983, the country imported 38,000 radios and televisions. There are 6,800 telephone subscribers in the country. Government sources of statistical information on Botswana are listed and an age and sex distribution pyramid is provided.^ieng

Migration of the population of Botswana.

PIP: The contribution of migration to population changes in Botswana is analyzed. Consideration is given to international migration, internal migration, rural-urban migration, and the socioeconomic characteristics of migrants. The data are primarily for the years 1980-1981 and are from the 1981 census.^ieng