Efficacy of mirtazapine add on therapy to haloperidol in the treatment of the negative symptoms of schizophrenia: a double-blind randomized placebo-controlled study.

The negative symptoms of schizophrenia remain a major clinical challenge. Mirtazapine is an antidepressant with antagonist properties at 5-HT2A, 5-HT3 and alpha 2 receptors as well as indirect 5-HT1a agonist effects. Many of these pharmacological actions have clinical or preclinical evidence of efficacy in schizophrenia. This study was a 6-week randomized placebo-controlled trial of mirtzepine or placebo add on to haloperidol 5 mg in the treatment of 30 patients with DSM-IV schizophrenia. The primary finding of the trial was a 42% reduction in Positive and Negative Syndrome Scale (PANSS) negative symptom scores in the mirtazapine group compared to placebo at the end of 6 weeks (mirtazapine 13.9, SD 1.56; placebo 23.9, SD 1.56; P = 0.000, F = 20.31, d.f. = 1). The PANNS total scores, Clinical Global Impression severity and improvement scales in addition showed superiority of mirtazapine over placebo. There was no difference between the groups on the Hamilton depression scale at endpoint, suggesting that the improvement in negative symptoms was not an artifact of mood improvement. These results suggest a potential role for mirtazapine in the negative symptoms of schizophrenia.

Reboxetine add on therapy to haloperidol in the treatment of schizophrenia: a preliminary double-blind randomized placebo-controlled study.

The negative symptoms of schizophrenia remain a major clinical challenge. Reboxetine is an antidepressant whose major mechanism of action is as a noradrenergic reuptake inhibitor. This study was a 6-week randomized placebo-controlled trial of reboxetine or placebo add on to haloperidol 5 mg in the treatment of 30 patients with DSM-IV schizophrenia. The trial failed to demonstrate any significant difference between the placebo and reboxetine groups on any of the outcome measures. This trial does not suggest that increased noradreneregic drive mediated by reuptake inhibition in patients taking dopamine antagonists is of therapeutic value in schizophrenia.

Development of guidelines for adults on how to communicate with adolescents about mental health problems and other sensitive topics: a Delphi study

There is little evidence-based information available to guide adults in the general community on communicating effectively with adolescents about mental health problems or other sensitive topics. The Delphi methodology was used to develop guidelines to fill this evidence gap. An online questionnaire containing potential guideline statements was developed following a literature search and input from two focus groups. Two expert panels (Youth Mental Health First Aid instructors and young consumer advocates) rated the questionnaire over three rounds, according to whether or not they believed that the statements should be included in the guidelines. Results were analyzed by comparing endorsement rates between the panels. Of the 175 statements presented, 80 were rated as essential or important by ≥90% of both panels and were included in the guidelines. The Delphi process has offered an effective way to achieve consensus between expert panels on useful tips to help adults communicate with adolescents.

Effect of electrospinning parameters and polymer concentrations on mechanical-to-electrical energy conversion of randomly-oriented electrospun poly(vinylidene fluoride) nanofiber mats

Poly(vinylidene fluoride) (PVDF) nanofiber mats prepared by an electrospinning technique were used as an active layer for making mechanical-to-electric energy conversion devices. The effects of PVDF concentration and electrospinning parameters (e.g. applied voltage, spinning distance), as well as nanofiber mat thickness on the fiber diameter, PVDF β crystal phase content, and mechanical-to-electrical energy conversion properties of the electrospun PVDF nanofiber mats were examined. It was interesting to find that finer uniform PVDF fibers showed higher β crystal phase content and hence, the energy harvesting devices had higher electrical outputs, regardless of changing the electrospinning parameters and PVDF concentration. The voltage output always changed in the same trend to the change of current output whatever the change trend was caused by the operating parameters or polymer concentration. Both voltage and current output changes followed a similar trend to the change of the β crystal phase content in the nanofibers. The nanofiber mat thickness influenced the device electrical output, and the maximum output was found on the 70 μm thick nanofiber mat. These results suggest that uniform PVDF nanofibers with smaller diameters and high β crystal phase content facilitate mechanical-to-electric energy conversion. The understanding obtained from this study may benefit the development of novel piezoelectric nanofibrous materials and devices for various energy uses.

Do women have equitable access to quality breast prosthesis services?

Although up to 90% of women who have had a mastectomy use breast prostheses, significant gaps exist around current breast prosthesis services for Australian women. These gaps include the timeliness and quality of information provision, the disparity in financial assistance, and the lack of knowledge regarding the determinants of what constitutes a "quality" breast prosthesis. Revised policy initiatives are central to addressing these gaps to ensure equitable access to quality breast prosthesis services.

April 2003: Collection Provides Free Public Access to Government Documents

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October 2006: Greater Access to US Goverment Documents

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The development agenda for WIPO: another stillbirth?: A batttle between access to knowledge and enclousure

This paper has been produced as part of the examination in order to obtain a Master degree in Law (LLM), in Intellectual Property, at Queen Mary & Westfield College, University of London.

The access to demand

In this paper I argue that, in developing countries, sufficient aggregate demand is not enough to motivate investment and achieve full employment. Besides, according to the Keynesian developmental macroeconomics under construction, competent business enterprises must have access to that demand –access which is denied to most of them because developing countries face the tendency to the cyclical and chronic overvaluation of the exchange rate

An exploratory study on how to improve the economy of American Samoa

Deep in the South Pacific region about 2,300 miles southwest of the Hawaiian islands1 lies a United States territory that many Americans have never heard of nor known anything about. However, some famous Americans such as Troy Polamalu of the Pittsburgh Steelers, semi retired professional wrestler Dwayne “The Rock” Johnson, and Hawaii Congresswoman Tulsi Gabbard have genealogical roots there. More importantly, many of the Territory’s sons and daughters have served and lost their lives for the United States flag and the cause of freedom around the world. This place is called American Samoa, a collection of seven islands that if glued together would have a total landmass of approximately 76 square miles, just a tad bigger than the capital city of the United States. According to the United States Census Bureau, there were 55,519 residents of American Samoa in 2010.1 The majority of them are ethnic Samoans, a Polynesian sect that traces its history back to early migrants from Southeast Asia who settled the islands around 1500 B.C.2 3 The climate is warm all year long and the forests along the mountains are ripe with vegetation. The main island is Tutuila with its beautiful and coveted landlocked harbor that was used as a coaling station by the United States naval ships during World War II. In fact, it was the Pago Pago Harbor that diminished the impact of the 2009 Tsunami that devastated the Samoan islands by channeling the waters of the Pacific Ocean towards the end of the harbor instead of flooding many other villages surrounding the Pago Pago Bay area. Lives and property were destroyed near the end of the Harbor but it could have been worse for the entire Bay area. Locally grown foods include coconut, taro, banana, guava, sugar cane, papaya, yam, pineapple, and breadfruit. It is completely surrounded by the Pacific Ocean from which the locals obtain a variety of seafood. There is a popular saying in Samoa that goes, “In Samoa, it is impossible to starve 1 American Samoa Department of Commerce, 2012 Statistical Yearbook, http://www.doc.as/wpcontent/uploads/2011/06/2012-Statistical-Yearbook-1.pdf 2 U.S. Census Bureau News, U.S. Census Bureau Releases 2010 Census Population Counts for American Samoa, http://www.census.gov/2010census/news/releases/operations/cb11-cn177.html (Aug. 24, 2011). 3 3 J. Robert Shaffer, American Samoa: 100 Years Under the United States Flag (Honolulu, Hawaii: Island Heritage Publishing, 2000), 34. 4 because people live off of the land’s and the ocean’s abundant resources.” To the west of American Samoa lies a larger group of four islands that make up the Sovereign State of Samoa, which became independent from New Zealand in 1962. Samoa and American Samoa share the same language, culture, and religion but are divided by government and political systems. The focus of this study will be on American Samoa, which became a United States territory in 1900 when the principal chiefs of Tutuila (the largest island in American Samoa) ceded the islands to the United States.

The influence of temperature of three adhesive systems on bonding to ground enamel

This study evaluated the microtensile bond strength test (mu T), micromorphology of resin-enamel interface (RET) and etching patterns (EP) promoted by the etch-and-rinse adhesive, Prime&Bond NT (PB), and two self-etching adhesives, Clearfil SE Bond (SE) and Adper Prompt L-Pop (APR), to ground bovine enamel surfaces' when applied at temperatures of 5 degrees C (C), 40 degrees C (H) and 20 degrees C (R). Materials and Methods. Sixty-three bovine incisors were randomly divided into nine experimental groups (n=7) according to adhesive systems and temperatures. The buccal enamel surfaces were flattened with 600-grit SiC paper and abraded with a diamond bur under water-cooling. The adhesive systems were applied according to the manufacturer's instructions. After the restorative procedures, the specimens were sectioned into five slabs. Four slabs were prepared for mu T and one for interface analysis. For etching pattern analysis, the remaining 16 bovine enamel fragments were used (n=2). The adhesives were applied and the surfaces were rinsed with organic solvents after application. The specimens for RET and EP analysis were prepared for SEM analysis. Results. No significant differences among the adhesives were found at R temperature. However, at 5 degrees C, PB and APR presented lower bond strength than SE. At H temperature, higher bond strength was observed for PB than for APR and SE. At C and H temperature, formation of the interdiffusion zone was impaired and the treated enamel surfaces presented an undefined EP.