ADHD: Reviewing the Causes and Evaluating Solutions.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder in which patients present inattention, hyperactivity, and impulsivity. The etiology of this condition is diverse, including environmental factors and the presence of variants of some genes. However, a great diversity exists among patients regarding the presence of these ADHD-associated factors. Moreover, there are variations in the reported neurophysiological correlates of ADHD. ADHD is often treated pharmacologically, producing an improvement in symptomatology, albeit there are patients who are refractory to the main pharmacological treatments or present side effects to these drugs, highlighting the importance of developing other therapeutic options. Different non-pharmacological treatments are in this review addressed, finding diverse results regarding efficacy. Altogether, ADHD is associated with different etiologies, all of them producing changes in brain development, leading to the characteristic symptomatology of this condition. Given the heterogeneous etiology of ADHD, discussion is presented about the convenience of personalizing ADHD treatment, whether pharmacological or non-pharmacological, to reach an optimum effect in the majority of patients. Approaches to personalizing both pharmacological therapy and neurofeedback are presented.

Subdivision of modified-release tablets: state-of-the-art and future perspectives.

Tablet splitting is a practice disseminated among health professionals for dose adjustments, swallowing facilitation or even treatment cost reduction. Nevertheless, tablets not designed for this purpose cause imprecise dosage and stability loss with important therapeutic repercussions. Novel technologies of modified drug release tablets have come to market including new materials and innovative production processes, for example, polymeric matrix, orodispersible, 3D printing, MUPs, etc. The heterogeneity and complexity of these tablets go well beyond a traditional gastroresistant coating tablet, making orientations on the practice of tablet subdivision difficult. This editorial aims to provide a critical and up-to-date evaluation of this scenario based on the most recent studies involving the subdivision of modified-release tablets.

When a Calling Goes Unanswered: Exploring the Role of Workplace Personalizations as Calling Enactments.

Individuals are sometimes unable to realize their callings in their formal careers. The literature has highlighted that such unanswered callings produce negative outcomes in the individual's career and personal life and that coping strategies, such as job and leisure crafting, can help them buffer such consequences. We developed a grounded theory regarding how people cope with their unanswered callings through a previously unexplored strategy in the calling literature: workplace personalization. Our study revealed that through this strategy, individuals retain the aspects of an unanswered calling in their self-concept and then reduce the consequences of not realizing the calling. Some participants enjoy some of the benefits of perceiving a calling, even without performing it in a formal work role. This phenomenon occurs because workplace personalization can be used to represent unanswered callings performed in the past and present, or that are intended to be performed in the future. This form of enactment produces interpersonal and intrapersonal processes that help buffer the negative consequences of not realizing a calling.

Categorización de los objetos que forman parte del Extended Self, y sus discursos asociados / Categorization of objects that are part of the extended self, and its associated discourses

Resumen La personalización del espacio se construye con las claves que el propietario distribuye en el espacio. Estas claves, mayoritariamente objetos, forman parte del Extended Self. Para comprobar si existe un discurso diferenciado según la categoría a la que pertenecen los objetos de los dormitorios, se realizaron tres estudios. Tras obtener una lista de los objetos más representativos, en el siguiente estudio los participantes clasificaron bajo su criterio estos objetos. Un análisis de cluster mostró dos categorías: funcional y simbólico. Finalmente, un análisis de contenido de las razones de selección de los objetos mostró discursos diferenciados para cada categoría. Los resultados confirman que los objetos se organizan en funcional y simbólico, en donde se obtienen discursos diferenciados según la categoría a la que pertenecen.

Abstract Personalization of space is constructed through the cues that the owner leaves in the space. These cues, mostly objects, are also a basic part of the extended self. To check if there is a differentiate discourse consistent with the categories in which the objects belong, three studies are carried out. After obtaining a list of the most representative, in the subsequent study the participants short these objects using their own criteria. A Cluster analysis showed two categories, Functional and Symbolic. Finally, a content analysis about the reasons of participants to choose each object showed differentiated discourses for each category. These results confirm the objects are organized into Functional and Symbolic, producing differentiated discourses. depending on the category they belong.

Com os pés no chão: sobre como se pode sonhar a conquista de um corpo próprio num processo de análise / Keeping both feet on the ground: about how one may dream of conquering one's own body in a process of analysis / Con los pies en la tierra: sobre cómo se puede soñar la conquista de un cuerpo propio en un proceso de análisis / En ayant les pieds sur terre: à propos de comment on peut rêver sur la conquête un corps propre, dans un processus d'analyse

Neste artigo, descreve-se o caso clínico de um paciente borderline, cujo self era inicialmente formado por uma hipertrofia da área intelectual e que, ao longo da análise, veio a conquistar um corpo próprio e, com isso, uma unidade psicos-somática. Essa descrição tem a finalidade de mostrar que, na perspectiva winnicot-tiana, existem outras possibilidades de interpretar os sonhos em casos de patologia borderline, possibilidades que escapam à teoria dos sonhos proposta por Freud. Não se pretende fazer uma revisão da teoria freudiana, o que exigiria um estudo à parte. Conclui-se que, na perspectiva winnicottiana, o sonho geralmente traduz características do estágio de amadurecimento em que o paciente se encontra.

The author describes a clinical case of a borderline patient, whose self was first formed by a hypertrophy of intellectual area. Throughout the process of analysis, this self has achieved an own body and therefore a psychosomatic unity. The purpose of this description is to show, from a Winnicottian perspective, the existence of other ways of interpreting dreams in cases of borderline disorder. These possible ways were not considered by Freud in his theory of dreams. This paper is not an attempt of reviewing Freud's theory; it would require at least a separate study because of its complexity. From a Winnicottian perspective, in cases of borderline pathology, the dream usuallly does not express an unconscious sexual desire, but rather translates aspects of the maturational stage of the patient, the author concludes.

Este artículo describe el caso clínico de un paciente cuyo self estaba formado por una hipertrofia del área intelectual y que, durante el análisis, conquistó un cuerpo proprio y, con esto, una unidad psicosomática. La descripción tiene el objetivo de mostrar que, en la perspectiva de Winnicott, existen otras posibilidades de interpretar los sueños en casos de patología borderline, posibilidades que escapan en la teoría de los sueños propuesta por Freud. No se pretende aquí una revisión de la teoría de Freud, pues esto es una tarea compleja, que exigiría otro estudio. Se concluye que, en la perspectiva winnicottiana, el sueño generalmente traduce características de la etapa de madurez en la que se encuentra el paciente.

Dans cet article, on décrit le cas clinique d'un patient borderline, dont le self était d'abord formé par une hypertrophie du champ intellectuel, et qui, tout au long de l'analyse, parvient à la conquête d'un corps qui lui est propre et, par conséquent, d'une unité psychosomatique. Cette description a pour but montrer que, dans la perspective Winicottienne, il y a d'autres possibilités d'interpréter les rêves, dans des cas de pathologie borderline, des possibilités qui ne sont pas comprises dans la théorie des rêves proposé par Freud. On n'a pas l'intention de faire une révision de la théorie Freudienne, ce qui exigerait une étude particulière. On conclut que, dans la perspective Winicottienne, le rêve généralement traduit des caractéristiques du stage de maturité où se trouve le patient.

¿Cómo llenar un continente no diferenciado con un determinado contenido? Abordaje psicodinámico de un síntoma alimentario / How to fill an undifferentiated continent with a determined content? Psychodynamic approach of an eating symptom

Resumen El objetivo del presente trabajo fue establecer, a través del análisis de un caso clínico, que la falta de distinción entre el adentro y el afuera de la paciente era uno de los factores centrales de su síntoma alimentario: los «atracones¼ con lechuga. Para tal fin se presentan viñetas del proceso terapéutico que, bajo un enfoque psicodinámico y un dispositivo bifocal, fue llevado a cabo con Rosa a lo largo de 10 años, con énfasis en la relación transferencia-contratransferencia. Viñetas y aspectos evocados del caso se teorizan a partir de los planteamientos de diversos autores. El proceso terapéutico permitió construir-reconstruir lo que falló en el desarrollo temprano de Rosa, a través del cual fue edificando una imagen corporal y psíquica de sí misma, enriqueciendo su Self y sus relaciones interpersonales. Esta experiencia clínica invita a pensar que las fallas tempranas se presentan a través de múltiples expresiones -con predominio en cuerpo o en psique- y su tratamiento requirió el abordaje de múltiples aspectos y, en ello, el dispositivo bifocal usado mostró ser una opción pertinente.

Abstract The aim of this study was to establish that the lack of distinction between inside and outside of the patient presented was one of the nuclear factors in Rosa's eating symptom. For this purpose we present the clinical materials issued from the psychotherapeutic process carried on with Rosa during 10 years -one of the two components of the bifocal therapy-emphasizing the transference-countertransference relation. The comprehension achieved from clinical materials is enriched by means of discussing approaches of several authors on relevant concepts. Results showed that what had failed during Rosa's early development was built-rebuilt throughout therapy. She worked on building a bodily and mental image, enriched her self and her relationships with others. This clinical experience is an invitation to think about the great variety of expressions -sometimes by means of the body and sometimes of the psyche- of early failures and also, that treatments must include various aspects, with bifocal therapy being an option.

Experiencia en la adaptación de actividades a los estilos de aprendizaje desde la educación de posgrado a distancia / Experience in adapting activities to the learning styles of postgraduate distance learning

Introducción: de una Universidad Innovadora emergen modelos para facilitar el aprendizaje. Un elemento a tener en cuenta para su personalización es la determinación de los estilos con que aprenden los estudiantes. Objetivo: socializar los resultados de una experiencia en el ajuste instructivo de un curso de postgrado a distancia a los estilos de aprendizaje de los estudiantes. Métodos: la experiencia se realizó desde octubre de 2015 hasta febrero de 2016. Se utilizó el Aula Virtual de Salud (UVS) cubana, ubicada en la dirección http://aulavirtual.sld.cu/. Se determinó los estilos de aprendizaje mediante el cuestionario Honey-Alonso. Se distribuyeron los estudiantes en dos subgrupos: activos y pragmáticos, y reflexivos y teóricos. Se adaptaron las actividades de aprendizaje a los estilos de los estudiantes. Se observaron sistemáticamente los procesos y las interacciones que tienen lugar en el curso y se aplicó encuesta de satisfacción. Entre los métodos matemáticos - estadísticos se emplearon: los de estadística descriptiva, Alfa de Crombach, prueba T, Chi-cuadrado y análisis de correlación de Pearson. Resultados: los estilos de aprendizaje activo, reflexivo, y pragmático se encuentra en el estándar de preferencia moderada, en los estudiantes y para el estilo teórico, en el estándar de preferencia Alta; no existieron diferencias entre géneros. Los estudiantes de ambos subgrupos aprobaron todas las actividades de aprendizaje. Los estudiantes mostraron satisfacción con los elementos evaluados del curso, no existiendo diferencias entre los subgrupos/estilos(AU)

Introduction: Models to facilitate learning emerge from an innovative university. One element to take into account for their personalization is to determine the styles with which the students learn. Objective: To socialize the results of an experience in the instructive adjustment of a distance postgraduate course to the learning styles of the students. Methods: The experiment was carried out from October 2015 to February 2016. The Virtual Health Classroom (VHC) was used in Cuba, located at http://aulavirtual.sld.cu/. Learning styles were determined using the Honey-Alonso questionnaire. The students were divided into two subgroups: one active and pragmatic, and the other reflective and theoretical. The learning activities were adapted to the styles of the students. The processes and interactions that took place in the course were systematically observed and a satisfaction survey was applied. Mathematical-statistical methods were used: descriptive statistics, Crombach's Alpha, T-test, Chi-square, and Pearson's correlation analysis. Results: Active, reflective, and pragmatic learning styles are found in the standard of moderate preference, in students and for the theoretical style, in the standard of preference as high; there were no gender differences. Students in both subgroups approved all learning activities. The students showed satisfaction with the evaluated elements of the course, with no differences between subgroups or styles(AU)

Experiencia en la adaptación de actividades a los estilos de aprendizaje desde la educación de posgrado a distancia / Experience in adapting activities to the learning styles of postgraduate distance learning

Introducción: de una Universidad Innovadora emergen modelos para facilitar el aprendizaje. Un elemento a tener en cuenta para su personalización es la determinación de los estilos con que aprenden los estudiantes. Objetivo: socializar los resultados de una experiencia en el ajuste instructivo de un curso de postgrado a distancia a los estilos de aprendizaje de los estudiantes. Métodos: la experiencia se realizó desde octubre de 2015 hasta febrero de 2016. Se utilizó el Aula Virtual de Salud (UVS) cubana, ubicada en la dirección http://aulavirtual.sld.cu/. Se determinó los estilos de aprendizaje mediante el cuestionario Honey-Alonso. Se distribuyeron los estudiantes en dos subgrupos: activos y pragmáticos, y reflexivos y teóricos. Se adaptaron las actividades de aprendizaje a los estilos de los estudiantes. Se observaron sistemáticamente los procesos y las interacciones que tienen lugar en el curso y se aplicó encuesta de satisfacción. Entre los métodos matemáticos - estadísticos se emplearon: los de estadística descriptiva, Alfa de Crombach, prueba T, Chi-cuadrado y análisis de correlación de Pearson. Resultados: los estilos de aprendizaje activo, reflexivo, y pragmático se encuentra en el estándar de preferencia moderada, en los estudiantes y para el estilo teórico, en el estándar de preferencia Alta; no existieron diferencias entre géneros. Los estudiantes de ambos subgrupos aprobaron todas las actividades de aprendizaje. Los estudiantes mostraron satisfacción con los elementos evaluados del curso, no existiendo diferencias entre los subgrupos/estilos(AU)

Introduction: Models to facilitate learning emerge from an innovative university. One element to take into account for their personalization is to determine the styles with which the students learn. Objective: To socialize the results of an experience in the instructive adjustment of a distance postgraduate course to the learning styles of the students. Methods: The experiment was carried out from October 2015 to February 2016. The Virtual Health Classroom (VHC) was used in Cuba, located at http://aulavirtual.sld.cu/. Learning styles were determined using the Honey-Alonso questionnaire. The students were divided into two subgroups: one active and pragmatic, and the other reflective and theoretical. The learning activities were adapted to the styles of the students. The processes and interactions that took place in the course were systematically observed and a satisfaction survey was applied. Mathematical-statistical methods were used: descriptive statistics, Crombach's Alpha, T-test, Chi-square, and Pearson's correlation analysis. Results: Active, reflective, and pragmatic learning styles are found in the standard of moderate preference, in students and for the theoretical style, in the standard of preference as high; there were no gender differences. Students in both subgroups approved all learning activities. The students showed satisfaction with the evaluated elements of the course, with no differences between subgroups or styles(AU)

Activity Recognition Using Community Data to Complement Small Amounts of Labeled Instances.

Human Activity Recognition (HAR) is an important part of ambient intelligence systems since it can provide user-context information, thus allowing a greater personalization of services. One of the problems with HAR systems is that the labeling process for the training data is costly, which has hindered its practical application. A common approach is to train a general model with the aggregated data from all users. The problem is that for a new target user, this model can perform poorly because it is biased towards the majority type of users and does not take into account the particular characteristics of the target user. To overcome this limitation, a user-dependent model can be trained with data only from the target user that will be optimal for this particular user; however, this requires a considerable amount of labeled data, which is cumbersome to obtain. In this work, we propose a method to build a personalized model for a given target user that does not require large amounts of labeled data. Our method uses data already labeled by a community of users to complement the scarce labeled data of the target user. Our results showed that the personalized model outperformed the general and the user-dependent models when labeled data is scarce.

La reactividad constitucional del sujeto: una piedra de rosetta interdisciplinaria / A reatividade constitucional do sujeito. Uma pedra de roseta interdisciplinar / Subject’s constitutional reactivitya: interdisciplinary rosetta stone

Aprender a identificar de manera integral, mixta y dinámica la constitución de un sujeto significa, por un lado, ayudarlo a autoconocerse en su manera de reaccionar (por eso se habla de reactividad constitucional y no más de biotipos o rasgos), de desarrollarse (madurar o destruirse), de relacionarse y aceptar a los demás tal como son; por otro lado, sirve para personalizar diagnóstico, terapia y pronóstico. La historia del constitucionalismo y un esquema sinóptico interdisciplinario (filosofía griega, teología, medicina hipocrática, galénica, homeopática, china, ayurvédica y holística, biología, embriología, bioquímica, fisiopatología, neurología, endocrinología, psicología y espiritualidad) muestra una precisa correspondencia y un denominador común sobre la base de la teoría constitucional embriológica que habla de endoblasto, mesoblasto y ectoblasto. Una coherencia que dura por más de 24 siglos en occidente y pasa también las barreras culturales (oriente y occidente) y paradigmáticas (biomedicina y homeopatía), no puede ser casual.

To learn to identify in an integral, mixed and dynamic way the subject’s constitution means, on one hand, to help him to a self-knowledgement of his reactive way (for this, we speak of constitutional reactivity and no more of biotipe or trait), to develop himself (to mature or to destroy), to join and accept the others like they are; on the other way, it serve to personalize diagnosis, therapy and prognosis. The constitution history and a synoptic interdisciplinary diagram (Greek philosophy, theology, hippocratic, galenic, homeopatic, chinese, ayurvedic and holistic medicines, biology, embriology, biochemistry, physiopathology, neurology, endocrinology, psychology and spirituality) shows a precise link and a common denominator according to an embriologic constitutional theory, that speaks about endoblast, mesoblast and ectoblast. A coherence thas lasts for more than 24 centuries in occident and goes through even the cultural borders (eastern and western world) and paradigmatic logics (biomedicine and homeopaty) cannot be casual.

Aprender a identificar de maneira integral, mista e dinâmica a constituição de um sujeito significa, por um lado, ajudá-lo a se autoconhecer na sua maneira de reagir (por isso se fala de reatividade constitucional e não mais de biotipos ou traços), de desenvolver-se (amadurecer ou destruir-se), de relacionar-se e aceitar os demais taisl como são; por outro lado, serve para personalizar diagnóstico, terapia e prognóstico. A história do constitucionalismo e um esquema sinóptico interdisciplinar (filosofia grega, teologia, medicina hipocrática, galênica, homeopática, chinesa, ayurvédica e holística, biologia, embriologia, bioquímica, fisiopatologia, neurologia, endocrinologia, psicologia e espiritualidade) mostra uma precisa correspondência e um denominador comum sobre a base da teoria constitucional embriológica que fala de endoblasto, mesoblasto e ectoblasto. Uma coerência que dura por mais de 24 séculos no ocidente e ultrapassa também as barreiras culturais (oriente e ocidente) e paradigmáticas (biomedicina e homeopatia), não pode ser casual.

Nuestro recorrido hacia el verdadero self de Miguel / Our journey to the true self of Miguel

Objetivo: Mostrar el proceso analítico de Miguel, un hombre joven que nace con defectos congénitos en su cuerpo y funciones corporales que teñirán de forma particular la construcción de su self y de sus relaciones de objeto tempranas. Método: Estudiar los materiales clínicos del proceso psicoanalítico que llevaba dos años al momento de escribir este trabajo, con énfasis en la relación transferencia – contratransferencia. El tratamiento se llevó a cabo a razón de cuatro sesiones semanales. Resultados y Conclusiones: El trabajo analítico con Miguel permitió mostrar su camino desde un falso self defensivo, tendiendo hacia la emergencia de su self verdadero, logrando una existencia psico- somática, que le permitió asumir su cuerpo defectuoso, su funcionamiento mental y sus afectos de un modo integrado. Esta experiencia nos invita a pensar en el tratamiento psicoanalítico como una opción a proponer a pacientes cuyo sufrimiento se origina en haber nacido con defectos en su cuerpo.

Objective: To give an account of Miguel’s psychoanalytical process. He is a young man with various birth defects and impaired bodily functions which distorted the structuring of his self and early relationships. Method: The study of the clinical material of the first years of Miguel’s psychoanalytical process, time at which this paper was written, emphasizing the transference- countertransference relation. The treatment was conducted four times weekly. Results and Conclusions: Miguel’s psychoanalytical process enabled the passage from a defensive false self towards the emergence of this true self, achieving a psycho- somatic unity which enabled him to assume his defective body, his mind and his feelings in an integrated way. This experience invites us to consider psychoanalysis as a therapeutic option to be proposed to patients whose suffering originated in being born with body defects.

Sobre a importância do corpo para a continuidade do ser / On the importance of the body to the continuity of being

Da forma como Donald Winnicott o entendia, o corpo seria essencial para a psique, na medida em que ela era vista, antes de tudo, como uma organização específica, proveniente da elaboração imaginativa das funções corporais. Contudo, do ponto de vista do indivíduo em processo de amadurecimento emocional, o autor não considerava que o self e o corpo seriam inerentemente superpostos. Ainda assim, para que houvesse saúde, seria necessário que essa superposição se tornasse um fato. Gradualmente, a psique chegaria a um acordo com o corpo, de tal forma que, na saúde, deveria existir um estado no qual as fronteiras corporais seriam também as fronteiras da psique. Levando em conta estas considerações, o objetivo principal do presente artigo é delimitar o lugar do corpo na obra do psicanalista inglês, procurando articular esse conceito com a experiência de continuidade do ser. Para isso, percorremos os seus principais artigos sobre o tema, desde os anos trinta até o início da década de setenta, supondo que desta maneira é possível detectar, de forma mais rigorosa, as principais transformações pelas quais passaram as relações entre corpo e ser. No decorrer deste percurso, são discutidas ainda outras noções e conceitos fundamentais formulados pelo autor, tais como os de integração, personalização, holding e handling, assim como a sua abordagem dos distúrbios psicossomáticos.

As Donald Winnicott understood it, the body would be essential for the psique while it was seen, first of all, as a specific organization, proceeding from the imaginative elaboration of the corporal functions. However, from the point of view of the individual in process of emotional maturation, the author did not consider that the self and the body would be inherently superposed. Nevertheless, in health, it would be necessary that this superposition becomes a fact. Gradually, the psique would arrive at an agreement with the body, in such a way that, in health, there should be a state in which the corporal borders would also be the borders of the psique. Taking in account these considerations, the main objective of the present article is to delimit the place of the body in the work of the English psychoanalyst, trying to articulate this concept with the experience of continuity of the being. For this, we traverse its main articles on the subject, since the Thirties until the beginning of the decade of seventy, assuming that in this way it is possible to detect in a more rigorous way the main transformations in the relations between body and being. During this course, we still discuss other fundamental concepts and notions formulated by the author, such as integration, personalization, holding and handling, as well as his approach of psychosomatic disturbance.