Trajectories of psychiatric diagnoses and medication usage in youth with 22q11.2 deletion syndrome: a 9-year longitudinal study.

BACKGROUND: Chromosome 22q11.2 deletion syndrome (22q11DS) is associated with high rates of psychiatric disorders, including schizophrenia in up to 30% of individuals with the syndrome. Despite this, we know relatively little about trajectories and predictors of persistence of psychiatric disorders from middle childhood to early adulthood. Accordingly, we followed youth over four timepoints, every 3 years, to assess long-term trajectories of attention-deficit hyperactivity disorder (ADHD), anxiety, mood, and psychosis-spectrum disorders (PSDs), as well as medication usage. METHODS: Eighty-seven youth with 22q11DS and 65 controls between the ages of 9 and 15 years at the first timepoint (T1; mean age 11.88 ± 2.1) were followed for 9 years (mean age of 21.22 ± 2.01 years at T4). Baseline cognitive, clinical, and familial predictors of persistence were identified for each class of psychiatric disorders. RESULTS: Baseline age and parent-rated hyperactivity scores predicted ADHD persistence [area under curve (AUC) = 0.81]. The presence of family conflict predicted persistence of anxiety disorders (ADs) whereas parent ratings of child internalizing symptoms predicted persistence of both anxiety and mood disorders (MDs) (AUC = 0.84 and 0.83, respectively). Baseline prodromal symptoms predicted persistent and emergent PSDs (AUC = 0.83). Parent-reported use of anti-depressants/anxiolytics increased significantly from T1 to T4. CONCLUSIONS: Psychiatric, behavioral, and cognitive functioning during late childhood and early adolescence successfully predicted children with 22q11DS who were at highest risk for persistent psychiatric illness in young adulthood. These findings emphasize the critical importance of early assessments and interventions in youth with 22q11DS.

Beyond water, beyond boundaries: spaces of water management in the Krishna river basin, South India.

As demand and competition for water resources increase, the river basin has become the primary unit for water management and planning. While appealing in principle, practical implementation of river basin management and allocation has often been problematic. This paper examines the case of the Krishna basin in South India. It highlights that conflicts over basin water are embedded in a broad reality of planning and development where multiple scales of decisionmaking and non-water issues are at play. While this defines the river basin as a disputed "space of dependence", the river basin has yet to acquire a social reality. It is not yet a "space of engagement" in and for which multiple actors take actions. This explains the endurance of an interstate dispute over the sharing of the Krishna waters and sets limits to what can be achieved through further basin water allocation and adjudication mechanisms ­ tribunals ­ that are too narrowly defined. There is a need to extend the domain of negotiation from that of a single river basin to multiple scales and to non-water sectors. Institutional arrangements for basin management need to internalise the political spaces of the Indian polity: the states and the panchayats. This re-scaling process is more likely to shape the river basin as a space of engagement in which partial agreements can be iteratively renegotiated, and constitute a promising alternative to the current interstate stalemate.

International borders, ground water flow, and hydroschizophrenia.

A substantial body of research has been conducted on transboundary water, transboundary water law, and the mitigation of transboundary water conflict. However, most of this work has focused primarily on surface water supplies. While it is well understood that aquifers cross international boundaries and that the base flow of international river systems is often derived in part from ground water, transboundary ground water and surface water systems are usually managed under different regimes, resulting in what has been described as "hydroschizophrenia." Adding to the problem, the hydrologic relationships between surface and ground water supplies are only known at a reconnaissance level in even the most studied international basins, and thus even basic questions regarding the territorial sovereignty of ground water resources often remain unaddressed or even unasked. Despite the tensions inherent in the international setting, riparian nations have shown tremendous creativity in approaching regional development, often through preventive diplomacy, and the creation of "baskets of benefits," which allow for positive-sum, integrative allocations of joint gains. In contrast to the notion of imminent water wars, the history of hydropolitical relations worldwide has been overwhelmingly cooperative. Limited ground water management in the international arena, coupled with the fact that few states or countries regulate the use of ground water, begs the question: will international borders serve as boundaries for increased "flows" of hydrologic information and communication to maintain strategic aquifers, or will increased competition for shared ground water resources lead to the potential loss of strategic aquifers and "no flows" for both ground water users?

Normal hematologic and biochemical values for prelaying greater sage grouse (Centrocercus urophasianus) and their influence on chick survival.

Declines in greater sage grouse (Centrocercus urophasianus) productivity and population numbers throughout their range demand a better understanding of how nutrition influences sage grouse populations. During March and April 1999-2001, blood samples were collected from 158 female (73 adult, 85 yearling), free-ranging, prelaying, greater sage grouse from an area in northwestern Nevada, USA, and southeastern Oregon, USA. These blood samples were evaluated to establish normal blood values for sage grouse and ascertain if certain blood parameters, as indices of nutrition, are useful for predicting if sage grouse hens would raise at least one chick to 1 August. Results of logistic regression indicated that three of six blood parameters analyzed--glucose, total plasma protein, and calcium: phosphorus ratio-affected the probability of a female sage grouse raising at least one chick to late summer. Ranking of the standardized estimates revealed that glucose and total plasma protein had the greatest impact on the likelihood of a female successfully raising chicks. Odds ratios indicated that a 1-unit increase in glucose (1 mg/dl) and plasma protein (0.1 g/dl) would result in a 4% and 113% positive increase, respectively, in the predicted odds of at least one chick surviving until 1 August. Odds ratios for calcium : phosphorus ratio revealed a 70% decline in the predicted odds of at least one chick surviving until 1 August if the level of this parameter increased one unit (e.g., 3:1 to 4:1). Based on these analyses, values of some blood parameters used as indices of nutrition, especially glucose, total plasma protein, and calcium : phosphorus ratio, can be successfully used to predict reproductive success of sage grouse. These parameters are not only indicative of the nutritional status of prelaying hens but may be associated with nutritional quality of the habitat and therefore have important management significance.

Blood parasites in sage-grouse from Nevada and Oregon.

Peripheral blood smears from 196 adult and yearling female greater sage-grouse (Centrocercus urophasianus) were examined for blood parasites (167 from the breeding and 29 from the brood-rearing season) to determine prevalence of blood parasites, to attempt to correlate infection with chick survival, and to establish base-line values of prevalence in sage-grouse from Nevada and Oregon (USA). Birds were captured and released on two study areas during 1999-2001; Sheldon National Wildlife Refuge (SNWR) in northwestern Nevada, and Hart Mountain National Antelope Refuge (HMNAR) in southeastern Oregon. Birds from a third study area, Beaty's Butte grazing allotment (BB) in southeastern Oregon, were sampled in 2000 and 2001. Overall, 19 birds (10%) were positive for Leucocytozoon lovati (= L. bonasae), 1 (0.5%) for Plasmodium pedioecetii, and 2 (1%) for microfilariae. Although prevalence of L. lovati on HMNAR was 39% during the breeding season in 1999 and 100% during the brood-rearing season in 2000, statistically, prevalence of L. lovati among study areas and years was not different. However, there were statistical differences between capture periods. Overall, 31% of the hens were positive for L. lovati during the brood-rearing season compared to 6% during the breeding season. There was no difference in packed cell volume between infected and non-infected birds and no difference between age-classes. However, mean sage-grouse productivity on HMNAR was higher (1.6 chicks/hen) for non-infected (n = 10) compared to infected hens (0.7 chicks/hen; n = 7), during 1999. Based on these limited observations on HMNAR in 1999, the possible effects that L. lovati may have on young sage-grouse could be detrimental to sage-grouse populations in Nevada and Oregon.