Clinical consequences of switching from olanzapine to risperidone and vice versa in outpatients with schizophrenia: 36-month results from the worldwide schizophrenia outpatients health outcomes (W-SOHO) study

BACKGROUND: With many atypical antipsychotics now available in the market, it has become a common clinical practice to switch between atypical agents as a means of achieving the best clinical outcomes. This study aimed to examine the impact of switching from olanzapine to risperidone and vice versa on clinical status and tolerability outcomes in outpatients with schizophrenia in a naturalistic setting. METHODS: W-SOHO was a 3-year observational study that involved over 17,000 outpatients with schizophrenia from 37 countries worldwide. The present post hoc study focused on the subgroup of patients who started taking olanzapine at baseline and subsequently made the first switch to risperidone (n=162) and vice versa (n=136). Clinical status was assessed at the visit when the first switch was made (i.e. before switching) and after switching. Logistic regression models examined the impact of medication switch on tolerability outcomes, and linear regression models assessed the association between medication switch and change in the Clinical Global Impression-Schizophrenia (CGI-SCH) overall score or change in weight. In addition, Kaplan-Meier survival curves and Cox-proportional hazards models were used to analyze the time to medication switch as well as time to relapse (symptom worsening as assessed by the CGI-SCH scale or hospitalization). RESULTS: 48% and 39% of patients switching to olanzapine and risperidone, respectively, remained on the medication without further switches (p=0.019). Patients switching to olanzapine were significantly less likely to experience relapse (hazard ratio: 3.43, 95% CI: 1.43, 8.26), extrapyramidal symptoms (odds ratio [OR]: 4.02, 95% CI: 1.49, 10.89) and amenorrhea/galactorrhea (OR: 8.99, 95% CI: 2.30, 35.13). No significant difference in weight change was, however, found between the two groups. While the CGI-SCH overall score improved in both groups after switching, there was a significantly greater change in those who switched to olanzapine (difference of 0.29 points, p=0.013). CONCLUSION: Our study showed that patients who switched from risperidone to olanzapine were likely to experience a more favorable treatment course than those who switched from olanzapine to risperidone. Given the nature of observational study design and small sample size, additional studies are warranted.

Optical and microstructural properties of MgF2 UV coatings grown by ion beam sputtering process

The optical, mechanical, and microstructural properties of MgF2 single layers grown by ion beam sputtering have been investigated by spectrophotometric measurements, film stress characterization, x-ray photoelectron spectroscopy (XPS), x-ray diffraction, and transmission electron microscopy. The deposition conditions, using fluorine reactive gas or not, have been found to greatly influence the optical absorption and the stress of the films as well as their microstructure. The layers grown with fluorine compensation exhibit a regular columnar microstructure and an UV-optical absorption which can be very low, either as deposited or after thermal annealings at very low temperatures. On the contrary, layers grown without fluorine compensation exhibit a less regular microstructure and a high ultraviolet absorption which is particularly hard to cure. On the basis of calculations, it is shown that F centers are responsible for this absorption, whereas all the films were found to be stoichiometric, in the limit of the XPS sensitivity. On the basis of external data taken from literature, our experimental curves are analyzed, so we propose possible diffusion mechanisms which could explain the behaviors of the coatings.

The process of basic training, applied training, maintaining the performance of an observer

In the field of observational methodology the observer is obviously a central figure, and close attention should be paid to the process through which he or she acquires, applies, and maintains the skills required. Basic training in how to apply the operational definitions of categories and the rules for coding, coupled with the opportunity to use the observation instrument in real-life situations, can have a positive effect in terms of the degree of agreement achieved when one evaluates intra- and inter-observer reliability. Several authors, including Arias, Argudo, & Alonso (2009) and Medina and Delgado (1999), have put forward proposals for the process of basic and applied training in this context. Reid y De Master (1982) focuses on the observer's performance and how to maintain the acquired skills, it being argued that periodic checks are needed after initial training because an observer may, over time, become less reliable due to the inherent complexity of category systems. The purpose of this subsequent training is to maintain acceptable levels of observer reliability. Various strategies can be used to this end, including providing feedback about those categories associated with a good reliability index, or offering re-training in how to apply those that yield lower indices. The aim of this study is to develop a performance-based index that is capable of assessing an observer's ability to produce reliable observations in conjunction with other observers.

A Fair and Secure Cluster Formation Process for Ad Hoc Networks

An efficient approach for organizing large ad hoc networks is to divide the nodesinto multiple clusters and designate, for each cluster, a clusterhead which is responsible forholding intercluster control information. The role of a clusterhead entails rights and duties.On the one hand, it has a dominant position in front of the others because it manages theconnectivity and has access to other node¿s sensitive information. But on the other hand, theclusterhead role also has some associated costs. Hence, in order to prevent malicious nodesfrom taking control of the group in a fraudulent way and avoid selfish attacks from suitablenodes, the clusterhead needs to be elected in a secure way. In this paper we present a novelsolution that guarantees the clusterhead is elected in a cheat-proof manner.

El Papel de la motivación de los asesores y profesores en el proceso de asesoramiento = The figure of the motivation of the advisers and professors in the advice process

El escenario de asesoramiento colaborativo es un espacio sociocultural donde lo que se hace y se dice condiciona el tipo de interacción que se va a dar entre las personas que participan así como la actividad que llevan a cabo de manera conjunta. En este artículo vamos a reflexionar sobre el papel de la motivación de los profesores y asesores para mantener el asesoramiento así como en las posibilidades que tiene el asesor para crear y mantener un contexto que resulte motivante para asesor y asesorados