What we know: The disorder named AD/HD [online].

Attention can be defined as the concentration of mental powers upon an object (e.g. a close or careful observing or listening). Everyone is inattentive sometimes. However, for some people inattention becomes a serious condition that leads to significant problems in school or work. Once, inattention was thought of as a problem only experienced by children. Now there is growing evidence that significant inattention effects many people of all ages. Symptoms There are many symptoms of inattention, some very obvious and some subtler. The symptoms of inattention include: Making careless mistakes in work or schoolwork Difficulty sustaining attention during a task or when playing Seems to not listen when spoken to directly Doesn’t follow through on instructions and doesn’t finish work or schoolwork Difficulty organising complex tasks Forgetfulness Loses important items Avoids or dislikes activities that require long periods of concentration (e.g. homework) Children  Some examples of inattention in children include: Trouble keeping focussed during games Avoid school projects (which involve a long periods of concentration) Losing school supplies Difficulties completing household chores Easily distractible Adults  Some examples in adults include: Difficulty concentrating in long conversations Trouble organising themselves at work Easily distracted by activity or noise Trouble remembering appointments or often being late Common causes There are many possible causes of inattention. The most common causes are: Attention deficit hyperactivity disorder (ADHD), especially inattentive type ADHD Learning disabilities Oppositional defiant disorder (often co-exists with ADHD) Autism Depression and anxiety: There is no strong evidence that these conditions change attention. Drug abuse (e.g. alcohol or cocaine) Other mental health disorders (e.g. personality disorder) Foetal alcohol syndrome Sleep apnoea (brief periods of time when a sleeping person will stop breathing) There are also non-medical causes of inattention. Poor attention spans can be a result of: Being tired Sleep deprivation Hunger  Being unfit How common is inattention? It is difficult to assess the true incidence of inattention.

The rates of ADHD are thought to be 3-7% of school children, although they could be as high as 18%. Up to a quarter of preschool aged children will show some symptoms of inattentive type ADHD. The rates in adults are not well known, but it is thought that 1-5% of adults have inattentive type ADHD, with males more effected than females. Severe sleep apnoea, which can lead to sleep deprivation and inattention, affects about 7.5% of the population. Autism affects around 10-20 children per 10,000. Males are affected 4 times more commonly than females.reduslim truffa     When to approach your health care professional Many people, especially children, will be inattentive at times, and this can be due to something as simple as being tired. However, it is also important not to dismiss inattention, as this can have long-term consequences. It is important to see a health care professional if the inattention is having a serious effect on the person’s life. Examples include a child that is misbehaving at school and falling behind in their schoolwork, or an adult who is forgetting about important meetings.

It is also important to see a health care professional if the person is experiencing other behavioural or emotional problems, such as low self-esteem, being constantly upset or angry, or relationship problems. What will the health care professional do? There are several tests that a health care professional can do to assess inattention. To begin with, the health care professional will take a full history about the symptoms, when they occur, and what else may be associated with them. Then the health care professional will ask more general questions about any ongoing medical conditions and any significant recent stresses or emotional problems. For a child, the health care professional will also ask about the development of the child. Teachers or colleagues will also be ask to fill in some questionnaires about the person’s behaviour.

After this, there are a series of specific tests to assess attention span. These include the Gordon Diagnostic System and the Wechsler Intelligence Scale for Children (WISC) tests. Both these tests are specifically designed to assess attention and have been validated by numerous studies. Below is a brief outline of what each test involves. It is important to realise that making a diagnosis of someone with inattention is not as simple as looking at any particular test result. History, collateral history from teachers or colleagues, emotional health, and any ongoing issues or recent stresses need to be considered along with formal tests before a diagnosis is made. The Gordon Diagnostic System The Gordon Diagnostic System is a series of game-like tests that assess both attention and impulsivity. The system includes a “vigilance task”, which shows the child a series of digits, one at a time. The child must identify every time a particular sequence of numbers appear (e.g. a 1 followed by a 9).

This test is performed once visually, and once with the child listening to the numbers. There is also a test to check for impulsivity. The Gordon Diagnostic System has been validated for children between the ages of 4 and 16. WISC The Wechsler Intelligence Scale for Children is a large series of tests that where originally developed in 1949 and are now in their 4th edition (WISC-IV). These tests look at the areas of verbal comprehension, reasoning, speed and working memory. To test for attention, the most important part of the WISC is the subtest for working memory.

This includes the Digit Span (the child is asked to repeat ever longer series of numbers) and Letter Number Sequencing tests (the child is asked to repeat sequences of letters and numbers). What can be done to help with inattention? Some causes of inattention (e.g. sleep apnoea, depression) can be corrected, and there will be improvements in attention. However, most of the causes of inattention (e.g. ADHD) do not have an easy cure. It is important to manage inattention to ensure that the person lives as well as possible. This requires a broad approach that must include the parents/family of the person, as well as teachers or colleagues.

Important aspects of therapy are: Behavioural therapy: The goals of cognitive behavioural therapy are to improve problem solving abilities and social skills. Anger management training: To increase the ability to cope and solve problems without anger. Parent skills training: Parent training includes teaching appropriate rewards and punishments (e.g. using a ‘time-out corner’ where a child is sent for misbehaviour) Family therapy: Family therapy focusses on problemsolving and improving communication and relationships within the family. Education: Involves the school and provides information to teachers on how best to engage the child. Suport groups Useful information For information on childhood ADHD and its symptoms and treatments, as well as some useful tools and animations, see Childhood ADHD. For information on ADHD in adults and its treatments, as well as some useful tools and animations, see Adult ADHD. References Springerhouse.

  Professional Guide to Diseases. 8th Ed. Lippincott Williams & Wilkins; 2005. Mayes S, Callhoun S. Learning, attention, writing and processing speed in typical children and children with ADHD, autism, anxiety, depression, and oppositional-defiant disorder. Child Neuropsychology. 2007; 13(6): 469-93. Super S, Optom D. Medical and nonmedical causes for inattention and attention deficits [online]. Professor Selwyn Super. [cited 26 February 2008]. Available from URL: http://www.professorselwynsuper.com/ pdf/ researcher/ MEDICAL%20AND%20NONMEDICAL%20adhd.pdf. Arman A, Ersu R, Save D, Karadag B, Karabekiroglu K, Karakoc F, et al.

Symptoms of inattention and hyperactivity in children with habitual snoring: Evidence for a community-based study in Instanbul. Child: Care, Health & Development. 2005; 31(6): 707-17. Children and Adults with Attention-Deficit/Hyperactivity Disorder. What we know: The disorder named AD/HD [online]. National Resource Centre on ADHD. 2004 [cited 26 February 2008]. Available from URL: http://www.help4adhd.org/ documents/ WWK1.pdf Smidts D, Oosterlaan. How common are symptoms of ADHD in typically developing preschoolers? A study on prevelence rates and prenatal/demographic risk factors. Cortex.

2007; 43: 710-7. Newschaffer CJ, Croen LA, Daniles J, Giarelli E, et al. The epidemiology of autism spectrum disorders. Annu Rev Public Health. 2007; 28: 235-58. Tishler P, Larkin E, Schluchter M, Redline S. Incidence of sleep-disordered breathing in an urban adult population. JAMA. 2003; 289: 2230-7. Warner-Rogers J, Taylor A, Taylor E, Sandberg S. Inattentive behaviour in childhood: Epidemiology and implications for development.

J Learning Disabilities. 2000; 33(6): 520-37. Watkins M, Kush J, Glutting J. Discriminant and predictive validity of the WISC-III ACID profile among children with learning disabilities. Psychology in the Schools. 1997; 34(4): 309-19. National Health and Medical Research Council (NHMRC). Attention deficit hyperactivity disorder (ADHD). Publication ID. no. 1938. Comonwealth Department of Health and Family Services.

1997. National Institute of Mental Health (NIMH). Attention deficit hyperactivity disorder (ADHD). NIH Publication No. 3572. National Institutes of Health 2006. NSW Health. Attention deficit hyperactivity disorder (ADHD) [online]. Australian Psychological Society 2007 [cited 28 February 2008].

Available from: www.health.nsw.gov.au/ public-health/ adhd/ treatment Other symptoms related to Inattention: Hyperactivity Impulsivity Bronchioles are described as the smallest airways within the lungs. Bronchioles extend from the bronchi to the alveoli. Myoclonus-dystonia is the combination of myoclonic jerks and dystonia. In most cases the myoclonus is the most disabling feature in the condition. For more information, see Myoclonus. . Cardiology A cardiologist is a doctor who specialises in diseases affecting the heart. Medical Conditions Ischaemic heart disease (angina, heart attack, myocardial infarction, acute coronary syndrome) – narrowing of the vessels that supply blood and oxygen to the heart can cause chest pain, shortness of breath and collapse. Reversible chest pain on exertion caused by vessel narrowing is called angina. A heart attack generally occurs where a vessel is completely blocked and heart muscle is damaged. Arrhythmias (like atrial fibrillation (AF), atrial flutter, supraventricular tachycardia (SVT) & ventricular tachycardia (VT)) – The heart normally beats regularly and reliably.

Any disturbance to this function is called an arrhythmia. The heart may be going too fast (a tachyarrhythmia) or too slow (a bradyarrhythmia). Heart failure – many different conditions can make the heart not pump as well as it should. This is called heart failure and can cause shortness of breath, lethargy, swelling of ankles and dizziness. Valvular heart disease – there are four major valves in the heart. These may become narrowed meaning forward flow of blood through them is impeded, or they may become leaky meaning the heart pump is less efficient. Book your health appointments online Find and instantly book your next health appointment with HealthEngine Find health practitioners Specialty Areas of Interest Interventional cardiology – angioplasty and stenting Arrhythmia management and electrophysiological studies and ablation Heart failure Associated Tests Electrocardiogram (ECG) Echocardiogram (Echo) Angiogram Perfusion study Electrophysiological study (EPS) Procedures Percutaneous Coronary Intervention (PCI) Angioplasty and stenting Pacemaker insertion Ablation therapy What to expect History Your cardiologist will ask you about your current presentation, particularly any chest pain, shortness of breath, dizziness or collapses you may have suffered. They will ask about risk factors for ischaemic heart disease including smoking, diabetes, high blood pressure, high cholesterol levels and a family history of heart problems. It is also important they know what medications you are currently taking. Examination Your cardiologist will check your pulse and blood pressure, then proceed to examine your heart, lungs and other pulses. The history combined with the examination findings will guide your cardiologist to decide on further appropriate investigations.

Training and Qualifications Basic medical training Internship Residency Specialty Training Links Find a Cardiologist Cardiac Society of Australia and New Zealand International Academy of Cardiology European Society of Cardiology American College of Cardiology Wikipedia – Cardiology   Q: Where can I find GP clinics? A: Use HealthEngine to find and book your next GP appointment. Click on the following locations to find a GP clinic in your state or territory. GP Clinics in ACT GP Clinics in NSW GP Clinics in NT GP Clinics in QLD GP Clinics in SA GP Clinics in TAS GP Clinics in VIC GP Clinics in WA   This article is for informational purposes only and should not be taken as medical advice. If in doubt, HealthEngine recommends consulting with a registered health practitioner. What is a scar? When do scars occur?

What types of scars occur? Acne scars Hypertrophic scars Keloid scars Stretch marks (striae)   What factors affect scarring? How do scars change over time? What is a scar? In humans, injured skin cannot regenerate, or ‘grow back’. Instead, the damaged tissue is replaced with scar tissue. A scar (also known as a cicatrix) is fibrous tissue that is visible following healing of a wound. The formation of scars is a normal part of the healing process.They occur when a skin wound extends deeper than the outer layer of skin (epidermis) into the deeper layer of skin (dermis). Collagen is the substance the body uses to heal areas of damage in the body. It forms a dense, fibrous connective tissue.

Scars occur because collagen is not the same texture or colour, and does not have the same properties, as the skin that it is replacing. The epidermis regrows over the top, but the normal ridges (that form fingerprints) are not replaced.Extra structures in the skin such as sweat glands and hair follicles are also not present in scar tissue. Scar tissue is less strong and less functional than the tissue it is replacing, and may result in functional, psychological and cosmetic problems. The collagen in scar tissue is laid down in a disorganised fashion, so scars only reach a maximum of 70% of the strength of normal skin. In some people, scarring may be excessive to that required to heal a wound, and this is known as hypertrophic or keloid scarring. When do scars occur? Scars can occur following any event that damages the skin tissue.

Such events include: Injuries such as cuts and scrapes (abrasions); Burns (sunburn, thermal burns etc); Sores (lesions) such as diabetic or pressure ulcers, insect bites etc; Surgery; Infections (eg chickenpox); and Skin conditions (acne, psoriasis etc).