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A meta-analysis of the published literature was performed in order to quantify the efficacy of low-dose neuroleptic therapy in reducing extrapyramidal side effects in schizophrenic patients. A low-dose regimen between 50–100 mg equivalents of chlorpromazine, in comparison to a standard-dose regimen between 200–500 mg reduced extrapyramidal side effects by a 0.30 (±0.12) standard deviation, which is only a limited effect.
We assessed the relative efficacy and effectiveness of low-versus standard-dose neuroleptic therapy in reducing relapse rate in schizophrenic patients. Six long-term randomized controlled trials were retrieved through a MEDLINE search. A dose regimen between 50 and 100 mg equivalent of chlorpromazine, compared to a conventional one between 200 and 500 mg, was found to increase the likelihood of relapse in chronic schizophrenic patients. Differences, however, were statistically significant at 12 but not at 24 months of treatment.
Molecular line intensity calculations are not a straightforward task. We present a description of the basics for including molecular lines in synthetic spectra and of the input data needed. We aim both at describing ways in which molecular lines are computed in the context of photospheres of F–G–K stars, and to present a new online available version of our code for spectrum synthesis of cool stars. We apply calculations to molecular bands in the ultraviolet, visible, and near-infrared main features, and comparisons with spectra of reference stars are shown. We provide user-friendly tools for the free use of the code Pfant. The code is available at http://trevisanj.github.io/PFANT.
We present orbit analysis for a sample of eight inner bulge globular clusters, together with one reference halo object. We used proper motion values derived from long time base CCD data. Orbits are integrated in both an axisymmetric model and a model including the Galactic bar potential. The inclusion of the bar proved to be essential for the description of the dynamical behaviour of the clusters. We use the Monte Carlo scheme to construct the initial conditions for each cluster, taking into account the uncertainties in the kinematical data and distances. The sample clusters show typically maximum height to the Galactic plane below 1.5 kpc, and develop rather eccentric orbits. Seven of the bulge sample clusters share the orbital properties of the bar/bulge, having perigalactic and apogalatic distances, and maximum vertical excursion from the Galactic plane inside the bar region. NGC 6540 instead shows a completely different orbital behaviour, having a dynamical signature of the thick disc. Both prograde and prograde–retrograde orbits with respect to the direction of the Galactic rotation were revealed, which might characterise a chaotic behaviour.
Research evidence guiding the identification of pragmatic and effective actions aimed at improving the selection, availability, affordability and rational prescribing of medicines for mental disorders is sparse and inconsistent. In order to boost the development of new research, in this commentary we suggest to organise and classify all the activities in this area under a common theoretical framework and nomenclature, adopting the term ‘public health psychopharmacology’. Public health psychopharmacology is proposed as a research discipline, based on contributions from the fields of regulatory science, health services research and implementation science. Implementing the term public health psychopharmacology may offer advantages, as the scientific community would be more focused on common goals and objectives, with, likely, an increasing body of research evidence of practical use.
In recent years a number of intergovernmental initiatives have been activated in order to enhance the capacity of countries to improve access to essential medicines, particularly for mental disorders. In May 2013 the 66th World Health Assembly adopted the World Health Organization (WHO) Comprehensive Mental Health Action Plan 2013–2020, which builds upon the work of WHO's Mental Health Gap Action Programme. Within this programme, evidence-based guidelines for mental disorders were developed, including recommendations on appropriate use of medicines. Subsequently, the 67th World Health Assembly adopted a resolution on access to essential medicines, which urged Member States to improve national policies for the selection of essential medicines and to promote their availability, affordability and appropriate use.
Following the precedent set by these important initiatives, this article presents eleven actions for improving access and appropriate use of psychotropic medicines.
A 4 × 4 framework mapping actions as a function of the four components of access – selection, availability, affordability and appropriate use – and across four different health care levels, three of which belong to the supply side and one to the demand side, was developed. The actions are: developing a medicine selection process; promoting information and education activities for staff and end-users; developing a medicine regulation process; implementing a reliable supply system; implementing a reliable quality-control system; developing a community-based system of mental health care and promoting help-seeking behaviours; developing international agreements on medicine affordability; developing pricing policies and a sustainable financing system; developing or adopting evidence-based guidelines; monitoring the use of psychotropic medicines; promoting training initiatives for staff and end-users on critical appraisal of scientific evidence and appropriate use of psychotropic medicines.
Activating these actions offers an unique opportunity to address the broader issue of increasing access to treatments and care for mental disorders, as current lack of attention to mental disorders is a central barrier across all domains of the 4 × 4 access framework.
The Galactic bulge is the least studied component of our Galaxy. Yet, its formation and evolution are key to understand the formation of the Galaxy itself. Studies on the Galactic bulge have increased significantly in the last years, but still there are many points of controversy. This volume contains several contributions from experts in different aspects of the bulge. Issues discussed include the following: the presence of an old spheroidal bulge, or identification of its old stellar population with the thick disk or halo; fraction of stars younger than 10 Gyr is estimated to be of < 5 to 22% depending on method and authors; multiple populations or only a metal-poor and a metal-rich ones; spheroidal or ellipsoidal distribution of RR Lyrae; formation of the bulge from early mergers or from secular evolution of the bar; different methods of mapping extinction; selection and identification of bulge globular clusters.
A view of the Galactic bulge by means of their globular clusters is fundamental for a deep understanding of its formation and evolution. Connections between the globular cluster and field star properties in terms of kinematics, orbits, chemical abundances, and ages should shed light on different stellar population components. Based on spatial distribution and metallicity, we define a probable best list of bulge clusters, containing 43 entries. Future work on newly discovered objects, mostly from the VVV survey, is suggested. These candidates might alleviate the issue of missing clusters on the far side of the bulge. We discuss the reddening law affecting the cluster distances towards the centre of the Galaxy, and conclude that the most suitable total-to-selective absorption value appears to be RV=3.2, in agreement with recent analyses. An update of elemental abundances for bulge clusters is provided.
We analyze a sample of 21 super-metal-rich (SMR) stars, using high-resolution échelle spectra obtained with the FEROS Spectrograph at the 1.5m ESO telescope. The metallicities are in the range 0.15 < [Fe/H] < 0.5, 3 of them in common with Pompéia et al. (2002). Geneva photometry, astrometric data from Hipparcos, and radial velocities from CORAVEL are available for these stars. The peculiar kinematics suggests the thin disk close to the bulge as the probable birthplace of these stars (Grenon 1999). From Hipparcos data, it appears that the turnoff of this population indicates an age of 10-11 Gyr (Grenon 1999). Detailed analysis of the sample stars is carried out. Lithium abundances of these stars were derived, and their behaviour with effective temperature is shown.