This book is a tribute to Lois Wilson, bringing together essays by prominent figures who have worked alongside her and who have been influenced by her practical Christianity, progressive values, and ...commitment to ending oppression. The collection acknowledges her inspiring legacy while taking on the important task of continuing her work.
Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed and treated psychiatric disorders in childhood. Typically, children with ADHD find it difficult to pay attention, ...they are hyperactive and impulsive.Methylphenidate is the drug most often prescribed to treat children and adolescents with ADHD but, despite its widespread use, this is the first comprehensive systematic review of its benefits and harms.
To assess the beneficial and harmful effects of methylphenidate for children and adolescents with ADHD.
In February 2015 we searched six databases (CENTRAL, Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, Conference Proceedings Citations Index), and two trials registers. We checked for additional trials in the reference lists of relevant reviews and included trials. We contacted the pharmaceutical companies that manufacture methylphenidate to request published and unpublished data.
We included all randomised controlled trials (RCTs) comparing methylphenidate versus placebo or no intervention in children and adolescents aged 18 years and younger with a diagnosis of ADHD. At least 75% of participants needed to have an intellectual quotient of at least 70 (i.e. normal intellectual functioning). Outcomes assessed included ADHD symptoms, serious adverse events, non-serious adverse events, general behaviour and quality of life.
Seventeen review authors participated in data extraction and risk of bias assessment, and two review authors independently performed all tasks. We used standard methodological procedures expected within Cochrane. Data from parallel-group trials and first period data from cross-over trials formed the basis of our primary analyses; separate analyses were undertaken using post-cross-over data from cross-over trials. We used Trial Sequential Analyses to control for type I (5%) and type II (20%) errors, and we assessed and downgraded evidence according to the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach for high risk of bias, imprecision, indirectness, heterogeneity and publication bias.
The studies.We included 38 parallel-group trials (5111 participants randomised) and 147 cross-over trials (7134 participants randomised). Participants included individuals of both sexes, at a boys-to-girls ratio of 5:1, and participants' ages ranged from 3 to 18 years across most studies (in two studies ages ranged from 3 to 21 years). The average age across all studies was 9.7 years. Most participants were from high-income countries.The duration of methylphenidate treatment ranged from 1 to 425 days, with an average duration of 75 days. Methylphenidate was compared to placebo (175 trials) or no intervention (10 trials). Risk of Bias.All 185 trials were assessed to be at high risk of bias. Primary outcomes. Methylphenidate may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.77, 95% confidence interval (CI) -0.90 to -0.64; 19 trials, 1698 participants; very low-quality evidence). This corresponds to a mean difference (MD) of -9.6 points (95% CI -13.75 to -6.38) on the ADHD Rating Scale (ADHD-RS; range 0 to 72 points; DuPaul 1991a). A change of 6.6 points on the ADHD-RS is considered clinically to represent the minimal relevant difference. There was no evidence that methylphenidate was associated with an increase in serious (e.g. life threatening) adverse events (risk ratio (RR) 0.98, 95% CI 0.44 to 2.22; 9 trials, 1532 participants; very low-quality evidence). The Trial Sequential Analysis-adjusted intervention effect was RR 0.91 (CI 0.02 to 33.2).
Among those prescribed methylphenidate, 526 per 1000 (range 448 to 615) experienced non-serious adverse events, compared with 408 per 1000 in the control group. This equates to a 29% increase in the overall risk of any non-serious adverse events (RR 1.29, 95% CI 1.10 to 1.51; 21 trials, 3132 participants; very low-quality evidence). The Trial Sequential Analysis-adjusted intervention effect was RR 1.29 (CI 1.06 to 1.56). The most common non-serious adverse events were sleep problems and decreased appetite. Children in the methylphenidate group were at 60% greater risk for trouble sleeping/sleep problems (RR 1.60, 95% CI 1.15 to 2.23; 13 trials, 2416 participants), and 266% greater risk for decreased appetite (RR 3.66, 95% CI 2.56 to 5.23; 16 trials, 2962 participants) than children in the control group.Teacher-rated general behaviour seemed to improve with methylphenidate (SMD -0.87, 95% CI -1.04 to -0.71; 5 trials, 668 participants; very low-quality evidence).A change of seven points on the Child Health Questionnaire (CHQ; range 0 to 100 points; Landgraf 1998) has been deemed a minimal clinically relevant difference. The change reported in a meta-analysis of three trials corresponds to a MD of 8.0 points (95% CI 5.49 to 10.46) on the CHQ, which suggests that methylphenidate may improve parent-reported quality of life (SMD 0.61, 95% CI 0.42 to 0.80; 3 trials, 514 participants; very low-quality evidence).
The results of meta-analyses suggest that methylphenidate may improve teacher-reported ADHD symptoms, teacher-reported general behaviour, and parent-reported quality of life among children and adolescents diagnosed with ADHD. However, the low quality of the underpinning evidence means that we cannot be certain of the magnitude of the effects. Within the short follow-up periods typical of the included trials, there is some evidence that methylphenidate is associated with increased risk of non-serious adverse events, such as sleep problems and decreased appetite, but no evidence that it increases risk of serious adverse events.Better designed trials are needed to assess the benefits of methylphenidate. Given the frequency of non-serious adverse events associated with methylphenidate, the particular difficulties for blinding of participants and outcome assessors point to the advantage of large, 'nocebo tablet' controlled trials. These use a placebo-like substance that causes adverse events in the control arm that are comparable to those associated with methylphenidate. However, for ethical reasons, such trials should first be conducted with adults, who can give their informed consent.Future trials should publish depersonalised individual participant data and report all outcomes, including adverse events. This will enable researchers conducting systematic reviews to assess differences between intervention effects according to age, sex, comorbidity, type of ADHD and dose. Finally, the findings highlight the urgent need for large RCTs of non-pharmacological treatments.
Empirical evidence underscores an association between parental stress and emotional and behavioral problems in offspring. However, a comprehensive systematic review or meta-analysis on this topic is ...lacking. Thus, this study aims to address the scientific inquiry: Is there a relationship between parental stress and emotional/behavioral problems in children?
This systematic review with a meta-analysis surveyed PubMed, PsycINFO, and the Biblioteca Virtual em Saúde between August and September 2021. The present search combined terms (school-age children) AND (parental stress OR parenting stress OR family stress) AND (emotional and behavioral problems OR internalizing and externalizing problems). Eligibility criteria encompassed cross-sectional, cohort, and case-control studies published within the last five years, exploring the association between parental stress (stressful life events and parenthood-related stress disorders) and emotional/behavioral problems in school-age children. PROSPERO ID CRD42022274034.
Of the 24 studies meeting all inclusion criteria (n = 31,183) for the systematic review, nine were eligible for inclusion in the meta-analysis. The meta-analysis revealed an association between parental stress and emotional problems (COR: 0.46 95 % CI: 0.27 - 0.61, p < 0.001, Heterogeneity = 89 %) as well as behavioral problems (COR: 0.37 95 % CI: 0.27 - 0.46, p < 0.001, Heterogeneity = 76 %).
These findings indicate that parental stress predicts emotional/behavioral problems in school-age children. Since these problems are related to long-term negative effects in adulthood, these results are crucial for preventing mental health problems in offspring and for screening and managing parental stress.
In this survey paper, we start with a discussion of the general fractional derivative (GFD) introduced by A. Kochubei in his recent publications. In particular, a connection of this derivative to the ...corresponding fractional integral and the Sonine relation for their kernels are presented. Then we consider some fractional ordinary differential equations (ODEs) with the GFD including the relaxation equation and the growth equation. The main part of the paper is devoted to the fractional partial differential equations (PDEs) with the GFD. We discuss both the Cauchy problems and the initial-boundary-value problems for the time-fractional diffusion equations with the GFD. In the final part of the paper, some results regarding the inverse problems for the differential equations with the GFD are presented.
Assessing problem-solving remains a challenge for both teachers and researchers. With the aim of contributing to the understanding of this complex process, this paper presents an exploratory study of ...peer assessment in mathematical problem-solving activities. The research was conducted with a group of future Secondary mathematics teachers who first were asked to individually solve an open-ended problem and then, to assess a classmate’s answer in pairs. We present a study of two cases involving two pairs of students, each of whom assessed the solution of a third classmate. The analysis was carried out in two interrelated phases: (a) individual solutions to the mathematical problem and (b) the peer assessment process. The results show that, in both cases, the assessors were strongly attached to their own solutions, which directly influenced the assessment process, focused on aspects that involve the general problem-solving process and the results. The main difference between the evaluation processes followed by the two pairs lies in the concept of assessment. While the first pair focuses on assessing the resolution process and errors, the other focuses its discussion on giving a numerical grade.
Multimodal multiobjective optimization problems (MMOPs) are commonly seen in real-world applications. Many evolutionary algorithms have been proposed to solve continuous MMOPs. However, little effort ...has been made to solve combinatorial (or discrete) MMOPs. Searching for equivalent Pareto-optimal solutions in the discrete decision space is challenging. Moreover, the true Pareto-optimal solutions of a combinatorial MMOP are usually difficult to know, which has limited the development of its optimizer. In this article, we first propose a test problem generator for multimodal multiobjective traveling salesman problems (MMTSPs). It can readily generate MMTSPs with known Pareto-optimal solutions. Then, we propose a novel evolutionary algorithm to solve MMTSPs. In our proposed algorithm, we develop two new edge assembly crossover operators, which are specialized in searching for superior solutions to MMTSPs. Moreover, the proposed algorithm uses a new environmental selection operator to maintain a good balance between the objective space diversity and decision space diversity. We compare our algorithm with five state-of-the-art designs. Experimental results convincingly show that our algorithm is powerful in solving MMTSPs.
•Systems thinking is a critical skill needed to work on problems facing society.•A framework is presented for an interdisciplinary development of systems thinking competency.•A scenario and scoring ...rubric for measuring systems thinking competency is shared.
An increasingly important aim of higher education is to develop graduates capable of addressing complex, interdependent problems. Systems thinking is a critical interdisciplinary skill that describes the cognitive flexibility needed to collaboratively work on problems facing society. Although institutions of higher education are asked to develop systems thinkers and many programs strive towards such an aim, mechanisms to assess this competency are lacking. This paper (1) presents a framework for operationalizing systems thinking competency, and (2) shares a novel scenario-based assessment tool based on the framework. The paper describes the iterative development of the community-level problem scenario and associated scoring rubric based on a set of 93 student responses. Appendices contain the full tool consisting of the problem scenario, scoring rubric, and other guiding documents to enable others to adopt the tool for research purposes or to assess student outcomes from university programs.
The Cauchy problem for the Helmholtz equation appears in various applications. The problem is severely ill-posed and regularization is needed to obtain accurate solutions. We start from a formulation ...of this problem as an operator equation on the boundary of the domain and consider the equation in (H1/2)∗ spaces. By introducing an artificial boundary in the interior of the domain we obtain an inner product for this Hilbert space in terms of a quadratic form associated with the Helmholtz equation; perturbed by an integral over the artificial boundary. The perturbation guarantees positivity property of the quadratic form. This inner product allows an efficient evaluation of the adjoint operator in terms of solution of a well-posed boundary value problem for the Helmholtz equation with transmission boundary conditions on the artificial boundary.
In an earlier paper we showed how to take advantage of this framework to implement the conjugate gradient method for solving the Cauchy problem. In this work we instead use the Conjugate gradient method for minimizing a Tikhonov functional. The added penalty term regularizes the problem and gives us a regularization parameter that can be used to easily control the stability of the numerical solution with respect to measurement errors in the data. Numerical tests show that the proposed algorithm works well.
An inverse problem of finding an unknown heat source for a class of linear parabolic equations is considered. Such problems can typically be converted to a direct problem with non-local conditions in ...time instead of an initial value problem. Standard ways of solving these non-local problems include direct temporal and spatial discretization as well as the shooting method, which may be computationally expensive in higher dimensions. In the present article, we present approaches based on low-rank approximation via Arnoldi algorithm to bypass the computational limitations of the mentioned classical methods. Regardless of the dimension of the problem, we prove that the Arnoldi approach can be effectively used to turn the inverse problem into a simple initial value problem at the cost of only computing one-dimensional matrix functions while still retaining the same accuracy as the classical approaches. Numerical results in dimensions d=1,2,3 are provided to validate the theoretical findings and to demonstrate the efficiency of the method for growing dimensions.
PDF
