Nurses\u27 Alumnae Association Bulletin - Volume 17 Number 1

Alumnae Notes Committee Reports Digest of Alumnae Association Meetings Greetings from Miss Childs Greetings from the Educational Director Greetings from the President Graduation Awards - 1951 Jefferson\u27s New Hospital Addition Marriages Necrology Neurosurgery Department New Arrivals New Drugs Notes on the Cause of Leukemia Nursing Staff Saul Among the Prophets Staff Activities, 1951-1952 Students\u27 Corner The Hospital Pharmacy The Student Nurse Association of Pennsylvania White Haven and Barton Memorial Division

A Double-Blind, Placebo-Controlled Withdrawal Trial of Dexmethylphenidate Hydrochloride in Children with Attention Deficit Hyperactivity Disorder

Objectives: d,l-threo-methylphenidate HCl (d,l-MPH) is the most common treatment of attention deficit hyperactivity disorder (ADHD). A previous report showed placebo-controlled efficacy for the purified disomer (dexmethylphenidate hydrochloride, d-MPH, Focalin™) with a 2:1 potency compared to dl, and suggested a 6-hour duration of action. This study complements that report by studying the effect of placebo-controlled discontinuation and retesting the duration of action. Methods: A 6-week, open-label titration of d-MPH (2.5–10 mg twice-a-day) was followed by a doubleblind, placebo-controlled, 2-week withdrawal study of responders. Results: In the open titration, 82% of the 89 enrolled patients achieved a Clinical Global Impression— Improvement (CGI-I) rating of much or very much improved. Only 5 patients discontinued for adverse events. Seventy-five patients continued into the placebo-controlled discontinuation. For the randomly assigned d-MPH (n = 35) and placebo (n = 40) groups, mean ages, respectively, were 10.1 ± 2.9 and 9.9 ± 2.7 years, 86% and 78% were male, and 70.6% and 80.0% took the ceiling dose of 10 mg twice-daily, respectively. Each group had 80% combined-type ADHD and 20% inattentive type. By the end of the 2- week, placebo-masked withdrawal, significantly more placebo patients (24 of 39) than d-MPH continuers (6 of 35) relapsed (61.5% versus 17.1%, p = 0.001). Compared to d-MPH continuers, placebo patients deteriorated significantly more in the 2-week period on teacher ratings of the 18 ADHD symptoms rated 0– 3 (p = 0.028), the 3 p.m. and 6 p.m. parent ADHD symptom ratings (p = 0.0026 and p = 0.0381, respectively), and clinic (2–3 p.m.) and home (6 p.m.) Math Tests (p = 0.024 and p < 0.0001, respectively). The 6 p.m. scores replicated the significant effect at 6 hours reported in the previous study. Conclusions: d-MPH is safe, tolerable, and effective, with a 6-hour duration of effect suggested by the significant difference from placebo at 6 hours on a double-blind discontinuation

Biological processes and links to the physics

Analysis of the temporal and spatial variability of biological processes and identification of the main variables that drive the dynamic regime of marine ecosystems is complex. Correlation between physical variables and long-term changes in ecosystems has routinely been identified, but the specific mechanisms involved remain often unclear. Reasons for this could be various: the ecosystem can be very sensitive to the seasonal timing of the anomalous physical forcing; the ecosystem can be contemporaneously influenced by many physical variables and the ecosystem can generate intrinsic variability on climate time scales. Marine ecosystems are influenced by a variety of physical factors, e.g., light, temperature, transport, turbulence. Temperature has a fundamental forcing function in biology, with direct influences on rate processes of organisms and on the distribution of mobile species that have preferred temperature ranges. Light and transport also affect the physiology and distribution of marine organisms. Small-scale turbulence determines encounter between larval fish and their prey and additionally influences the probability of successful pursuit and ingestion. The impact of physical forcing variations on biological processes is studied through long-term observations, process studies, laboratory experiments, retrospective analysis of existing data sets and modelling. This manuscript reviews the diversity of physical influences on biological processes, marine organisms and ecosystems and their variety of responses to physical forcing with special emphasis on the dynamics of zooplankton and fish stocks

Les premières loges de Palestine et leurs relations avec la Franc-maçonnerie égyptienne

On fait une description des rélations entre la Franc-maçonnerie egyptienne et les loges de Palestine, et entre les frères juifs et arabes, que constituent un exemple singulier de fraternité dans une region soumise á la violence et la haine.A description is made of the relations between Egyptian Freemasonry and the lodges in Palestine, and between Jewish and Arab Masons, which constitute an extraordinary example of fraternity in a region characterized by violence and hatred