Carbamazepine augmentation for schizophrenia: How good is the evidence?

Background: Augmentation strategies in schizophrenia treatment remain an important issue because despite the introduction of several new antipsychotics, many patients remain treatment resistant. The aim of this study was to undertake a systematic review and meta-analysis of the safety and efficacy of one frequently used adjunctive compound: carbamazepine. Data sources and study selection: Randomized controlled trials comparing carbamazopine (as a sole or as an adjunctive compound) with placebo or no intervention in participants with schizophrenia or schizoaffective disorder were searched for by accessing 7 electronic databases, cross-referencing publications cited in pertinent studies, and contacting drug companies that manufacture carbamazepine. Method: The identified studies were independently inspected and their quality assessed by 2 reviewers, Because the study results were generally incompletely reported, original patient data were requested from the authors; data were received for 8 of the 10 randomized controlled trials included in the present analysis, allowing for a reanalysis of the primary data. Dichotomous variables were analyzed using the Mantel-Haenszel odds ratio and continuous data were analyzed using standardized mean differences, both specified with 95% confidence intervals. Results: Ten studies (total N = 283 subjects) were included. Carbamazepine was not effective in preventing relapse in the only randomized controlled trial that compared carbamazepine monotherapy with placebo. Carbamazepine tended to be less effective than perphenazine in the only trial comparing carbamazepine with an antipsychotic. Although there was a trend indicating a benefit from carbamazepine as an adjunct to antipsychotics, this trend did not reach statistical significance. Conclusion: At present, this augmentation strategy cannot be recommended for routine use. The most promising targets for future trials are patients with excitement, aggression, and schizoaffective disorder bipolar type.

Exploring complex fitness surfaces: Multiple ornamentation and polymorphism in male guppies

The sexual ornamentation used by male guppies to attract females comprises many components, each of which varies considerably among males. Although natural and sexual selection have been shown to contribute to divergence among populations in male sexual ornaments, the role of sexual selection in maintaining polymorphism within populations is less clear. We used both parametric quadratic regression and nonparametric projection pursuit regression techniques to reveal the major axes of non-linear sexual selection on male ornaments. We visualized the fitness surfaces defined by these axes using thin-plate splines to allow a direct comparison of the two methodologies. Identification of the major axes of selection and their visualization was critical in determining the form and strength of nonlinear selection. Both types of analysis revealed fitness surfaces comprising three peaks, suggesting that there is more than one way to make an attractive guppy. Disruptive selection may be an important process underlying the presence of multiple sexual ornaments and may contribute to the maintenance of the high levels of polymorphism in male sexual ornaments found in guppy populations.

Medical marijuana initiatives - Are they justified? How successful are they likely to be?

The principal constituent of cannabis, Delta(9)-tetrahydrocannabinol (THC), is moderately effective in treating nausea and vomiting, appetite loss, and acute and chronic pain. Oral THC (dronabinol) and the synthetic cannabinoid, nabilone, have been registered for medical use in the US and UK, but they have not been widely used because patients find it difficult to titrate doses of these drugs. Advocates for the medical use of cannabis argue that patients should be allowed to smoke cannabis to relieve these above-mentioned symptoms. Some US state governments have legislated to allow the medical prescription of cannabis, but the US federal government has tried to prevent patients from obtaining cannabis and threatened physicians who prescribe it with criminal prosecution or loss of their licence to practise. In the UK and Australia, committees of inquiry have recommended medical prescription (UK) and exemption from criminal prosecution (New South Wales, Australia), but governments have not accepted these recommendations. The Canadian government allows an exemption from criminal prosecution to patients with specified medical conditions. It has recently legislated to provide cannabis on medical prescription to registered patients, but this scheme so far has not been implemented. Some advocates argue that legalising cannabis is the only way to ensure that patients can use it for medical purposes. However, this would be contrary to international drug control treaties and is electorally unpopular. The best prospects for the medical use of cannabinoids lie in finding ways to deliver THC that do not involve smoking and in developing synthetic cannabinoids that produce therapeutic effects with a minimum of psychoactive effects. While awaiting these developments, patients with specified medical conditions could be given exemptions from criminal prosecution to grow cannabis for their own use, at their own risk.

The case for emotional intelligence in organizational research

Since its popularization by Goleman (1995), the concept of emotional intelligence has been the subject of ongoing controversy, so it is understandable that the model we proposed, which includes emotional intelligence as a moderator variable, would attract its share of criticism.

A gest??o de pessoas como um recurso estrat??gico

O texto examina as estrat??gias e os sistemas que devem ser considerados para se alcan??ar a melhor gest??o de recursos humanos no setor p??blico. Inicialmente, baseado em tr??s modelos tradicionais de administra????o p??blica, sugere uma abordagem hol??stica para aumentar a efetividade da gest??o. Em seguida, defende a id??ia de um ??rg??o ???guardi??o??? central, que considere o princ??pio do m??rito e que divida com os ??rg??os de linha a responsabilidade sobre a GRH. Mostra, ainda, a import??ncia de institucionalizar os valores da imparcialidade, do profissionalismo e da responsividade. Ao tratar da profissionaliza????o da GRH, ressalta a necessidade de uma pol??tica que defina como a gest??o de pessoas contribuir?? para o alcance de objetivos governamentais. Para isso, prop??e a aplica????o de um modelo integrado baseado em compet??ncias e o desenvolvimento de uma pol??tica salarial que permita a atra????o e reten????o de talentos no setor p??blico. Ao final, o texto apresenta os pr??s e contras da gest??o por desempenho, bem como os desafios de um redimensionamento organizacional no servi??o p??blico.

Trajetória do crescimento da cidade de Colatina

It approaches the growth of the city of Colatina-ES, the county seat that has urban economy and urban population, and territory with most of the rural area. Rural areas, however, contribute little to the city s economy and are largely environmentally degraded, idle and waiting for recovery. The objective is to understand the growth of the city of Colatina, and the factors and consequences of this growth. Land division projects, investments and interventions in urban and rural areas were collected for the analysis. As a median-sized city characterized by central and regional polarity, but outside of the main investments in the state, Colatina seeks to take advantage of its situation of commercial warehouse city and road junction to stay alive in the regional economy. The citys economy is based on trade and services, but seeks to attract investment to the industry and logistics. The expansion of the city since the early formation follows the road system, which creates a dispersed spatiality. The characteristics of the urban growth of Colatina are the result of economic development strategies, interests in the property market and a government that abstains from urban control. These factors lead a sprawl urbanization that presents itself costly and not sustainable for urban and rural areas because it creates segregation, higher infrastructure costs, low-density and monofunctional urban spaces, pollution, and worsening of environmental depletion. The challenges for sustainable growth of the city of Colatina depends on a municipal and regional planning, which qualifies and diversifies its urban areas, avoids unnecessary expansion of the urban perimeter, retrieves its environmental degraded areas and leverages the agricultural activities in a productive and less aggressive way to the environment

Ambient assisted living technology: comparative perspectives of users and caregivers

Developed societies are currently facing severe demographic changes: the world population is ageing at an unprecedented rate. This demographic trend will be also followed by an increase of people with physical limitations. New challenges are being raised to the traditional health care systems, not only in Portugal, but also in all other European states. There is an urgent need to find solutions that allow extending the time people can live in their preferred environment by increasing their autonomy, self-confidence and mobility. AAL4ALL is a project currently being developed in cooperation with 34 Portuguese interdisciplinary partners, from industry to academia, R&D and social disciplines, which employs a novel conceptual approach through the development of an ecosystem of products and services for Ambient Assisted Living (AAL) associated to a business model and validated through large scale trial. This paper presents a comparative perspective of the needs and attitudes towards technology of the AAL users and caregivers identified in the analysis of a set of three different surveys: a users survey targeted at the Portuguese seniors and pre-seniors; an informal caregivers survey targeted at the family, friends and neighbours who provide care without any financial compensation; and a formal caregivers survey targeted at physicians, nurses,psychologists, social workers, and direct-care workers providing care to elders. The first results indicate that AAL solutions must be affordable,user friendly and have a true perceived benefit to their users.

Does corruption inhibit foreign direct investment?

Globalization creates new opportunities for firms to invest abroad and many economies are making active efforts to attract Foreign Direct Investment (FDI) in order to promote economic growth. Decisions to invest abroad depend on a complex set of factors, but the least corrupt countries may attract more foreign direct investment because they provide a more favorable climate for investors. In this paper we investigate the impact of corruption on FDI inflows in 73 countries, over the period 1998-2008. Our results suggest that countries where corruption is lower, the FDI inflows are greater, and so controlling corruption may be an important strategy for increase FDI inflows.

A mobile health care rule-based system

The relation between patient and physician in most modern Health Care Sys- tems is sparse, limited in time and very in exible. On the other hand, and in contradiction with several recent studies, most physicians do not rely their patient diagnostics evaluations on intertwined psychological and social nature factors. Facing these problems and trying to improve the patient/physician relation we present a mobile health care solution to im- prove the interaction between the physician and his patients. The solution serves not only as a privileged mean of communication between physicians and patients but also as an evolutionary intelligent platform delivering a mobile rule based system.

Medicis: a personal health care assistant

The relation between patient and physician in most modern Health Care Systems is sparse, limited in time and very inflexible. On the other hand, and in contradiction with several recent studies, most physicians do not rely their patient diagnostics evaluations on intertwined psychological and social nature factors. Facing these problems and trying to improve the patient/physician relation we present a mobile health care solution to improve the interaction between the physician and his patients. The solution serves not only as a privileged mean of communication between physicians and patients but also as an evolutionary intelligent platform delivering a mobile rule based system.

Planning Considerations for Tourism in the Minho-Lima Region (Northwest Portugal)

In administering their territories, most local municipalities aim to preserve their natural, historical and ethnographical resources while simultaneously using them to increase revenue and employment. In order to efficiently promote the products and services available and attract tourists, decision makers, private and public, need to know and incorporate tourists’ preferences in their marketing strategies. In this chapter we illustrate the use of stated preferences as an instrument to identify national and foreign tourists’ preferences regarding the products and services that the touristic destination of the Minho-Lima region (Northwest Portugal) should offer. As a starting point, we have taken the three general groups of touristic resources mentioned above as attributes. We take Ponte de Lima, a municipality in this region that has a strong cultural tourism potential as an example to identify possible future tourism scenarios for this territory. We believe the previously identified methodology can be a valuable instrument in the identification of the strengths and weaknesses of the selected territory and, thus, support the decision making process behind its future tourist development and marketing strategies.

The role of cultural mega events in the enhancement of city’s image attributes: differences between engaged and attendee participants

In a time of fierce competition between regions, an image serve as a basis to develop a strong sense of community, which fosters trust and cooperation that can be mobilized for regional growth. A positive image and reputation could be used in the promotional activities of the region benefiting all the stakeholders as a whole. Mega cultural events are frequently used to attract tourists and investments to a region, but also to enhance the city’s image. This study adopts a marketing/communication perspective of city’s image, and intends to explain how the image of the city is perceived by their residents. Specifically, we intend to compare the perceptions of residents that effectively participated in the Guimarães European Capital of Culture (ECOC) 2012 (engaged residents), and the residents that only assisted to the event (attendees). Several significant findings are reported and their implications for event managers and public policy administrators presented, along with the limitations of the study.

Cultural mega-events and the enhancement of a city's image: differences between engaged participants and attendees

A city’s image can serve as the basis upon which to develop a strong sense of community. This, in turn, fosters trust and cooperation which may attract tourists and investment, and drive regional economic growth. One strategy to enhance a city’s image is to host cultural mega-events. This study focuses on Guimarães, one of the European Capitals of Culture of 2012, and adopts a marketing communication perspective to explore issues of city image. The objective of the study reported was to understand whether images of Guimarães improved after it hosted the cultural mega-event. To attain this goal, we compare the perceptions of residents who participated in the event (engaged participants) and attendees. Several significant findings are reported and their implications for event managers and public policy administrators are presented, along with the limitations of the study.

Innovation for sustainable urban tourism: some thoughts on best practice

This paper examines a series of strategic initiatives that have been undertaken by Tourism Queensland (TQ), a State Tourism Organization in Australia, to develop tourism and in particular to develop networks in tourism destinations. This paper firstly examines the nature of sustainable urban tourism (SUT) and discusses approaches to defining it. It suggests that developing SUT requires a generic approach to improving sustainable tourism operations amongst all suppliers in an urban area. Further, this approach suggests that best practice in marketing and policy development can be adopted to attract tourists to a SUT destination and examples of this approach are provided.