Medicating mood with maintenance in mind : bipolar depression pharmacotherapy

Objectives:  Bipolar depression is a core feature of bipolar disorder, a phase in which many patients spend the majority of time and one that confers a significant degree of burden and risk. The purpose of this paper is to briefly review the evidence base for the pharmacotherapy of bipolar depression and to discuss the recommendations for its optimal management.Methods:  A detailed literature review was undertaken with a particular emphasis on pharmacological treatment strategies for bipolar depression across the acute and maintenance phases of the illness. Electronic library and Web-based searches were performed using recognised tools (MEDLINE, PubMED, EMBASE and PsychINFO) to identify the pertinent literature. A summary of the evidence base is outlined and then distilled into broad clinical recommendations to guide the pharmacological management of bipolar depression.Results:  Partitioning treatment into acute and maintenance therapy is difficult based on the paucity of current evidence. The evidence from treatment trials favours the use of lithium and lamotrigine as first-line treatment in preference to valproate, and indicates that, for acute episodes, quetiapine and olanzapine have perhaps achieved equivalence at least in terms of efficacy. However, the effectiveness of the atypical antipsychotics in maintenance therapy is constrained by the potential for significant side effects of individual agents and the lack of both long-term research data and clinical experience in treating bipolar disorder as compared to other agents. Conversely, lithium and the anticonvulsants are generally slower to effect symptomatic change, and this limits their usefulness.Conclusions:  There has been a tendency for research trials of bipolar depression to differentiate the illness cross-sectionally into the acute and maintenance phases of bipolar depression; however, in clinical terms, bipolar depression invariably follows a longitudinal course in which the phases of illness are inextricably linked, and useful acute treatments are typically continued in maintenance. Therefore, when medicating mood in acute bipolar depression it is imperative to keep maintenance in mind as it is this aspect of treatment that determines long-term success.

Influence of energy and polymer-escapsulated methionine supplements on mohair growth and fibre diameter of Angora goats fed at maintenance

We studied the fleece production of Angora wether goats provided with energy, to maintain liveweight, and polymer-encapsulated methionine while they were fed on poor quality roughage rations in early summer. Forty goats (mean fleece-free liveweight 28.5 kg) were randomly allotted to 5 treatments and housed individually for 12 weeks. The treatments were: control, fed to lose 5 kg liveweight; M, fed to maintain liveweight; and 3 maintenance rations with either 0.5, 1 or 2 g day-1 of polymer-encapsulated methionine. The basal ration was oaten chaff (56.8% digestible dry matter) and all maintenance- fed goats received a supplement of 150 g day- 1 gristed barley. Goats required an estimated 267 kJ ME kg-0.75 day-1 to maintain liveweight. Goats fed the control diet grew less mohair (P<0.05) with reduced mean fibre diameter (P< 0.05) than maintenance-fed goats (4.9 g day-1, 30.0 pm compared with 5.8 g day-1, 31.9 pm). For maintenance-fed animals, the addition of 1 g day- methionine (0.15% of dry matter intake) increased mohair growth by 0.8g day-1 (P<0.075). Feeding barley to prevent liveweight loss and feeding polymer-encapsulated methionine at maintenance is unlikely to result in economic responses in mohair production of goats grazing low quality summer pastures

Price dynamics, foreign exchange and anticipated shocks in a tourism economy

Using a dynamic model of an open monetary economy, this paper examines the effects of tourism-related anticipated shocks on goods prices and foreign exchange reserves. Foreign tourists consume mainly non-traded goods in holiday destinations, converting them into exportable goods. This gives rise to a tourism terms-of-trade effect that affects the accumulation of foreign exchange. Announcements of anticipated events bring tourist visits forward, resulting in an initial underadjustment or an over-adjustment in the prices of the non-traded goods when the tourism termsof-trade effect is positive or negative. This leads to an increase or a decrease in foreign reserves in the long run.

Dynamic price discrimination with customer recognition

This paper studies a general two-period model of product line pricing with customer recognition. Specifically, we consider a monopolist who can sell vertically differentiated products over two periods to heterogeneous consumers. Each consumer demands one unit of the product in each period. In the second period, the monopolist can condition the price-quality offers on the observed purchasing behavior in the first period. In this setup, the monopolist can price discriminate consumers in two dimensions: by quality as well as by purchase history. We fully characterize the monopolist's optimal pricing strategy when there are two types of consumers. When the type space is a continuum, we show that there is no fully separating equilibrium, and some properties of the optimal contracts (price-quality pairs) are characterized within the class of partitional perfect Bayesian equilibria.

Does oil price volatility matter for Asian emerging economies?

This article investigates the impact of oil price volatility on six major emerging economies in Asia using time-series cross-section and time-series econometric techniques. To assess the robustness of the findings, we further implement such heterogeneous panel data estimation methods as Mean Group (MG), Common Correlated Effects Mean Group (CCEMG) and Augmented Mean Group (AMG) estimators to allow for cross-sectional dependence. The empirical results reveal that oil price volatility has a detrimental effect on these emerging economies. In the short run, oil price volatility influenced output growth in China and affected both GDP growth and inflation in India. In the Philippines, oil price volatility impacted on inflation, but in Indonesia, it impacted on both GDP growth and inflation before and after the Asian financial crisis. In Malaysia, oil price volatility impacted on GDP growth, although there is notably little feedback from the opposite side. For Thailand, oil price volatility influenced output growth prior to the Asian financial crisis, but the impact disappeared after the crisis. It appears that oil subsidization by the Thai Government via introduction of the oil fund played a significant role in improving the economic performance by lessening the adverse effects of oil price volatility on macroeconomic indicators.

A spatial decomposition approach for investigating house price convergences

 Convergence of house prices indicates how prices are reaching an aggregate equilibrium in a long-run perspective. Identifying the convergence is important for cross-region housing development and investment. Few studies have identified house price convergences at different levels, with spatial effects on house prices predominantly ignored. The research presented here developed a spatial panel regression approach to investigate the convergences of house prices in Australian capital cities. Three hypotheses were tested to identify the level of house price convergence. The results demonstrate that a steady state in a system of regional house prices and spatial effects contribute to the convergence continuing.

Neighborhood environmental attributes and adults' maintenance of regular walking

Environmental initiatives to support walking are keys to non-communicable disease prevention, but the relevant evidence comes mainly from cross-sectional studies. We examined neighborhood environmental attributes associated cross-sectionally with walking and those associated prospectively with walking maintenance.

The maintenance of Central Thai cultural identity through hybrid music genres

Thailand has experienced rapid industrialisation, modernisation and cultural changesince the mid-nineteenth century. Many Western cultural forms have been adopted intoThai life, including Western popular music. An external view of these processes andtheir results might suggest that Thailand has become quite ‘Western’. However, closeranalysis reveals that elements of foreign cultures have long been adopted and adaptedinto Thai culture, and used as social capital to build an image of modernity andcosmopolitan sophistication.One of the adaptations made has been the fusion of Western genres with Thaiones, to form new hybrid styles of music. One hybrid genre that has developed largelyover the past half century is Dontri Thai Prayuk (‘modernised Thai music’), whichfuses aspects of Western pop with elements of Central Thai classical music. As thispaper demonstrates, clear patterns emerge in the way Thai musicians have maintainedmarkers of Thai identity and fused them with Western elements that signifymodernisation.Motivations behind this deliberate fusion of Thai and Western elements areexplained by the theories of ‘musical accommodation’ and ‘acts of identity’ – thatmusicians will converge with or diverge from other music-cultures in order to gainapproval or assert a separate identity, in ways that deliberately change the underlyingrules of the source musics to form a new identity. Analysis of Dontri Thai Prayukfusion music shows that it has changed the underlying rules of Thai classical andWestern popular music to display a music-cultural identity that is Thai, yet modern.