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dietary modifications may be of benefit to some children with adhd a 2013 meta @@ analysis found less than a third of children with adhd see some improvement in symptoms with free fatty acid supplementation or decreased eating of artificial food coloring these benefits may be limited to children with food sensitivities or those who are simultaneously being treated with adhd medications this review also found that evidence does not support removing other foods from the diet to treat adhd a 2014 review found that an elimination diet results in a small overall benefit a 2016 review did not support a clear link between celiac disease and adhd and stated that routine screening for celiac disease in people with adhd and the use of a gluten @@ free diet as standard adhd treatment are discouraged iron magnesium and iodine may also have an effect on adhd symptoms there is a small amount of evidence that lower tissue zinc levels may be associated with adhd in the absence of a demonstrated zinc deficiency ( which is rare outside of developing countries ) zinc supplementation is not recommended as treatment for adhd there is evidence of a modest benefit of omega 3 fatty acid supplementation but it is not recommended in place of traditional medication
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= = prognosis = =
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an 8 @@ year follow up of children diagnosed with adhd ( combined type ) found that they often have difficulties in adolescence regardless of treatment or lack thereof in the us fewer than 5 of individuals with adhd get a college degree compared to 28 of the general population aged 25 years and older the proportion of children meeting criteria for adhd drops by about half in the three years following the diagnosis and this occurs regardless of treatments used adhd persists into adulthood in about 30 50 of cases those affected are likely to develop coping mechanisms as they mature thus compensating for their previous symptoms
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= = epidemiology = =
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adhd is estimated to affect about 6 7 of people aged 18 and under when diagnosed via the dsm @@ iv criteria when diagnosed via the icd @@ 10 criteria rates in this age group are estimated at 1 2 children in north america appear to have a higher rate of adhd than children in africa and the middle east this is believed to be due to differing methods of diagnosis rather than a difference in underlying frequency if the same diagnostic methods are used the rates are more or less the same between countries it is diagnosed approximately three times more often in boys than in girls this difference between sexes may reflect either a difference in susceptibility or that females with adhd are less likely to be diagnosed than males
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rates of diagnosis and treatment have increased in both the united kingdom and the united states since the 1970s this is believed to be primarily due to changes in how the condition is diagnosed and how readily people are willing to treat it with medications rather than a true change in how common the condition is it is believed that changes to the diagnostic criteria in 2013 with the release of the dsm @@ 5 will increase the percentage of people diagnosed with adhd especially among adults
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= = history = =
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hyperactivity has long been part of the human condition sir alexander crichton describes mental restlessness in his book an inquiry into the nature and origin of mental derangement written in 1798 adhd was first clearly described by george still in 1902
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the terminology used to describe the condition has changed over time and has included in the dsm @@ i ( 1952 ) minimal brain dysfunction in the dsm @@ ii ( 1968 ) hyperkinetic reaction of childhood in the dsm @@ iii ( 1980 ) attention @@ deficit disorder ( add ) with or without hyperactivity in 1987 this was changed to adhd in the dsm @@ iii @@ r and the dsm @@ iv in 1994 split the diagnosis into three subtypes adhd inattentive type adhd hyperactive @@ impulsive type and adhd combined type these terms were kept in the dsm @@ 5 in 2013 other terms have included minimal brain damage used in the 1930s
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the use of stimulants to treat adhd was first described in 1937 in 1934 benzedrine became the first amphetamine medication approved for use in the united states methylphenidate was introduced in the 1950s and <unk> dextroamphetamine in the 1970s
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= = society and culture = =
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= = = controversies = = =
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adhd its diagnosis and its treatment have been controversial since the 1970s the controversies involve clinicians teachers policymakers parents and the media positions range from the view that adhd is within the normal range of behavior to the hypothesis that adhd is a genetic condition other areas of controversy include the use of stimulant medications in children the method of diagnosis and the possibility of overdiagnosis in 2012 the national institute for health and care excellence while acknowledging the controversy states that the current treatments and methods of diagnosis are based on the dominant view of the academic literature in 2014 keith conners one of the early advocates for recognition of the disorder spoke out against overdiagnosis in a new york times article in contrast a 2014 peer @@ reviewed medical literature review indicated that adhd is underdiagnosed in adults
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with widely differing rates of diagnosis across countries states within countries races and ethnicities some suspect factors other than the presence of the symptoms of adhd are playing a role in diagnosis some sociologists consider adhd to be an example of the medicalization of deviant behavior that is the turning of the previously non @@ medical issue of school performance into a medical one most healthcare providers accept adhd as a genuine disorder at least in the small number of people with severe symptoms among healthcare providers the debate mainly centers on diagnosis and treatment in the much larger number of people with less severe symptoms
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as of 2009 8 of all united states major league baseball players had been diagnosed with adhd making the disorder common among this population the increase coincided with the league 's 2006 ban on stimulants which has raised concern that some players are mimicking or falsifying the symptoms or history of adhd to get around the ban on the use of stimulants in sport
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= = = media commentary = = =
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a number of public figures have given controversial statements regarding adhd tom cruise has described the medications ritalin ( methylphenidate ) and adderall ( a mixed @@ salt amphetamine formulation ) as street drugs <unk> s neill criticized this view stating that the doses of stimulants used in the treatment of adhd do not cause addiction and that there is some evidence of a reduced risk of later substance addiction in children treated with stimulants in the uk susan greenfield spoke out publicly in 2007 in the house of lords about the need for a wide @@ ranging inquiry into the dramatic increase in the diagnosis of adhd and possible causes her comments followed a bbc panorama program that highlighted research that suggested medications are no better than other forms of therapy in the long term in 2010 the bbc trust criticized the 2007 panorama program for summarizing the research as showing no demonstrable improvement in children 's behaviour after staying on adhd medication for three years when in actuality the study found that medication did offer a significant improvement over time although the long @@ term benefits of medication were found to be no better than children who were treated with behavior therapy
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= = special populations = =
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= = = adults = = =
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it is estimated that between 2 5 of adults have adhd around 25 @@ 50 of children with adhd continue to experience adhd symptoms into adulthood while the rest experiences fewer or no symptoms most adults remain untreated many have a disorganized life and use non @@ prescribed drugs or alcohol as a coping mechanism other problems may include relationship and job difficulties and an increased risk of criminal activities associated mental health problems include depression anxiety disorder and learning disabilities
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some adhd symptoms in adults differ from those seen in children while children with adhd may climb and run about excessively adults may experience an inability to relax or they talk excessively in social situations adults with adhd may start relationships impulsively display sensation @@ seeking behavior and be short @@ tempered addictive behavior such as substance abuse and gambling are common the dsm @@ iv criteria have been criticized for not being appropriate for adults those who present differently may lead to the claim that they outgrew the diagnosis
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= chimes at midnight =
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chimes at midnight ( uk release falstaff ( chimes at midnight ) spanish release <unk> a <unk> ) is a 1966 english @@ language spanish @@ swiss co @@ produced film directed by and starring orson welles the film 's plot centres on william shakespeare 's recurring character sir john falstaff and the father @@ son relationship he has with prince hal who must choose between loyalty to falstaff or to his father king henry iv
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welles said that the core of the film 's story was the betrayal of friendship it stars welles as falstaff keith baxter as prince hal john gielgud as henry iv jeanne moreau as doll <unk> and margaret rutherford as mistress quickly the script contains text from five of shakespeare 's plays primarily henry iv part 1 and henry iv part 2 but also richard ii henry v and uses some dialogue from the merry wives of windsor ralph richardson 's narration is taken from the works of chronicler raphael holinshed
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welles had previously produced a broadway stage adaptation of nine shakespeare plays called five kings in 1939 in 1960 he revived this project in ireland as chimes at midnight which was his final on @@ stage performance neither of these plays was successful but welles considered portraying falstaff to be his life 's ambition and turned the project into a film throughout its production welles struggled to find financing and at one point to get money he lied to producer emiliano piedra about intending to make a version of treasure island welles shot chimes at midnight throughout spain between 1964 and 1965 and premiered it at the 1966 cannes film festival where it won two awards
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initially dismissed by most film critics chimes at midnight is now regarded as one of welles ' highest achievements and welles himself called it his best work welles felt a strong connection to the character of falstaff and called him shakespeare 's greatest creation some film scholars and welles 's collaborators have made comparisons between falstaff and welles while others see a resemblance between falstaff and welles 's father disputes over the ownership of chimes at midnight made it difficult to view the film legally until recently it was released in the uk on dvd and blu @@ ray in 2015 a new restoration by janus films and the criterion collection was screened at the film forum in new york january 1 12 2016 the criterion collection will release the film on blu @@ ray and dvd on august 30 2016
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= = plot = =
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the film opens with sir john falstaff and justice shallow walking through the snow then to a warm fire inside the boar 's head tavern as the two reminisce after a main credit sequence the narrator explains that king henry iv of england has succeeded richard ii whom he had killed richard ii 's true heir edmund mortimer is a prisoner in wales and mortimer 's cousins northumberland worcester and northumberland 's son hotspur demand that henry rescue mortimer henry refuses and northumberland worcester and hotspur begin to plot his overthrow
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to henry 's great dissatisfaction his son prince hal spends most of his time at the boar 's head tavern drinking and carousing with prostitutes thieves and other criminals under john falstaff 's patriarchal influence falstaff insists that he and hal should think of themselves as gentlemen but hal warns falstaff that one day he will reject both this lifestyle and falstaff the next morning hal falstaff bardolph peto and poins disguise themselves in <unk> to prepare to rob a group of traveling pilgrims after falstaff bardolph and peto rob the pilgrims hal and poins jump out in disguises and take the stolen treasure from falstaff as a joke
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back at the boar 's head tavern falstaff begins to tell hal and poins with increasing exaggeration the story of how the money was stolen from him hal and poins poke holes in falstaff 's tale until they reveal their joke to the entire group in celebration of the newly recovered stolen treasure falstaff and hal take turns impersonating henry with a cooking pot crown and vocal impressions falstaff 's henry chastises hal for spending his time with common criminals but names sir john falstaff as his one virtuous friend hal 's henry calls falstaff a <unk> of youth
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hal visits the king at the castle and henry scolds him for his criminal and unethical lifestyle henry warns hal about hotspur 's growing army and its threat to his crown hal passionately vows to his unimpressed father that he will defend henry and redeem his good name the king 's army including falstaff parades through the streets and off to war before the battle henry meets with worcester and offers to forgive all of hotspur 's men of treason if they surrender immediately hal vows to personally kill hotspur worcester returns to his camp and lies to hotspur telling him that henry intends to execute all traitors
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the two armies meet in the battle of shrewsbury but falstaff hides in shrubs for most of the conflict after a long and bloody fight the king 's men win the battle after which hotspur and hal meet alone and duel falstaff watches as hal kills hotspur henry sentences worcester to death and takes his men as prisoners falstaff brings hotspur 's body to henry claiming that he killed hotspur henry does not believe falstaff but looks disapprovingly at hal and the ignoble company that he chooses to keep
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the narrator explains that all of henry iv 's rebellious enemies had been killed by 1408 but that henry 's health has begun to deteriorate at the castle henry becomes upset when told that hal is once again spending time with falstaff and collapses hal visits the castle and discovers that henry is sicker than he had realized hal vows to henry to be a good and noble king henry finally has faith in hal and advises him on how to be a king henry dies and hal tells his men that he is now king henry v
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falstaff shallow and silence sit in front of a warm fire continuing from the first scene of the film they receive news of henry iv 's death and that hal 's coronation will be held that morning falstaff becomes ecstatic and goes directly to the castle thinking that he will become a great and powerful nobleman under king henry v at the coronation falstaff cannot contain his excitement and interrupts the entire ceremony announcing himself to hal hal turns his back on falstaff and proclaims that he is now finished with his former lifestyle as falstaff looks up at hal with a mixture of pride and despair the new king banishes falstaff the coronation continues into the castle as falstaff walks away stating that he will be sent for that evening that night falstaff dies at the boar 's head tavern and his friends mourn him saying that he died of a broken heart the narrator explains that hal went on to become a good and noble king
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= = cast = =
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orson welles as sir john falstaff a knight and father @@ figure to prince hal
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keith baxter as prince hal the prince of wales and the heir to the throne of england
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john gielgud as king henry iv the king of england
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jeanne moreau as doll <unk> a prostitute
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margaret rutherford as mistress quickly hostess of the boar 's head tavern
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norman <unk> as henry percy called hotspur northumberland 's son and second cousin of edmund mortimer
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fernando rey as earl of worcester leader of the rebels northumberland 's brother and cousin of edmund mortimer
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marina vlady as kate percy hotspur 's wife
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alan webb as justice shallow a country justice and old friend of falstaff
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walter chiari as justice silence a country justice
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michael aldridge as pistol a friend of falstaff
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tony beckley as ned poins a friend of falstaff and hal
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andrew faulds as earl of westmorland an earl loyal to the king
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josé nieto as earl of northumberland an earl rebellious of the king and cousin of edmund mortimer
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jeremy rowe as prince john henry iv 's second son
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beatrice welles as falstaff 's page a servant
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patrick bedford as bardolph a friend of falstaff and hal
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charles farrell
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fernando <unk>
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andrés <unk>
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julio peña
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keith pyott
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ralph richardson as the narrator ( voice )
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= = original stage productions = =
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welles 's inspiration for chimes at midnight began in 1930 when he was a student at the todd school for boys in woodstock illinois welles tried to stage a three @@ and @@ a @@ half @@ hour combination of several of shakespeare 's historical plays called the winter of our discontent in which he played richard iii school officials forced him to make cuts to the production chimes at midnight originated in 1939 as a stage play called five kings which welles wrote and partially staged it was an ambitious adaptation of several shakespeare plays that chronicled the stories of richard ii henry iv henry v henry vi and richard iii its sources were richard ii henry iv part 1 henry iv part 2 henry v the merry wives of windsor henry vi part 1 henry vi part 2 henry vi part 3 and richard iii sometimes collectively called the war of the roses cycle the grouping of henry iv part 1 henry iv part 2 and henry v are often referred to as the <unk>
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= = = five kings ( 1939 ) = = =
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five kings was announced as part of the newly revived mercury theatre 's second season in 1938 john houseman had secured a partnership with the prestigious theatre guild to produce the play for us $ 40 @@ 000 with an initial tour of baltimore boston washington dc and philadelphia before debuting on broadway welles 's intended to stage only the first part of the play which was primarily taken from henry iv parts 1 and 2 and henry v during the tour while simultaneously rehearsing part two and finally debuting the full production on broadway houseman stated that the play 's aim was to combine the immediate quality of the elizabethan with all the devices and techniques possible in the modern theatre the cast included welles as falstaff burgess meredith as prince hal john emery as hotspur morris <unk> as henry iv and robert <unk> as the narrator the play 's music was composed by aaron copland welles commissioned an elaborate revolving set to be built but it was not completed during the five weeks allotted to rehearsals
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welles avoided attending the rehearsals or finishing the play 's final script and instead often went out drinking and socializing with co @@ star meredith with the result that only specific scenes or fragments of the play were ever rehearsed the baltimore performance was eventually dropped and at the first dress rehearsal in boston it was discovered that the play was over five and a half hours long and contained 46 scenes welles cut 14 scenes and shortened others which caused the built @@ in timer for the revolving set to move out of synchronization five kings part 1 premiered at the colonial theatre in boston on february 27 1939 and was a disaster critics were either scathing or apologetic and only the play 's battle scenes received praise by the end of the boston run the theatre guild was on the verge of dropping the production and canceled the dc engagement welles then edited the show to three and a half hours the play closed after only a few performances in philadelphia and the theatre guild terminated its contract with the mercury theater photographs of the play 's rehearsals show similarities to chimes at midnight including the boar 's head tavern set and the character blocking of the chimes at midnight scene with falstaff shallow and silence
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= = = chimes at midnight ( 1960 ) = = =
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welles returned to the project in 1960 with performances in belfast and dublin this version now retitled chimes at midnight was produced by welles 's old friend hilton edwards through his dublin @@ based company gate theatre the cast included welles as falstaff keith baxter as prince hal hilton edwards as the narrator reginald jarman as henry iv and alexis kanner as hotspur at one point welles and edwards wanted micheál mac <unk> to replace jarman as henry iv but mac <unk> would only accept the role of prince hal hilton edwards was officially credited as director but welles is usually acknowledged as the actual director and was often the director throughout rehearsals welles 's alleged biological son michael lindsay @@ hogg also worked on the play as an actor and as edwards 's personal assistant welles 's opinion of falstaff had intensified since first playing the part and his new version of the play focused more upon the relationship between falstaff and prince hal than on the historical story of hal 's defeat of hotspur most of the scenes from henry v used in the first version before were removed welles intended to perform the play in belfast dublin and london before filming it in yugoslavia
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rehearsals began in russell square london with a read through after a week of rehearsing welles left to secure further funding and edwards directed the play working on blocking and lighting welles returned two days before the premiere and the cast had their first dress rehearsal which lasted until 3 am after premiering at the grand opera house in belfast on february 13 1960 and receiving a good review from a variety correspondent the play closed after five performances because of low attendances it moved to the gaiety theatre in dublin where it fared no better by the end of the second week welles had resorted to reading portions of the works of irish author j m synge and from riders to the sea to attract an audience eventually the play simply became a version of an evening with orson welles which would often include a question and answer section with the audience and welles 's solo performance of moby dick <unk> or the works of isak dinesen
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welles continued to adjust the play throughout its short production and at one point moved mistress quickly 's speech about falstaff 's death to the very beginning of the play welles finally abandoned the entire project in late march 1960 when his friend laurence olivier offered him the chance to direct him in eugène ionesco 's play rhinoceros on london 's west end according to keith baxter welles ended the play 's run because he was bored with it and at one point told baxter this is only a rehearsal for the movie keith and i 'll never make it unless you play hal in that too five years later baxter was the only cast member from the play to appear in the film chimes at midnight was welles 's final performance in a theatrical play
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= = production = =
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