Treatment of depression in older adults beyond fluoxetine

This review aimed to discuss the importance of the comprehensive treatment of depression among older adults in Brazil. The abuse of selective serotonin reuptake inhibitors, including fluoxetine hydrochloride, as antidepressants has been considered a serious public health problem, particularly among older adults. Despite the consensus on the need for a comprehensive treatment of depression in this population, Brazil is still unprepared. The interface between pharmacotherapy and psychotherapy is limited due to the lack of healthcare services, specialized professionals, and effective healthcare planning. Fluoxetine has been used among older adults as an all-purpose drug for the treatment of depressive disorders because of psychosocial adversities, lack of social support, and limited access to adequate healthcare services for the treatment of this disorder. Preparing health professionals is a sine qua non for the reversal of the age pyramid, but this is not happening yet

Clinical and functional outcome of assertive outreach for patients with schizophrenic disorder: Results of a quasi-experimental controlled trial

BACKGROUND: The majority of studies support modern assertive health service models. However, the evidence is limited for parts of continental Europe, as well as for the pharmacological adherence outcome parameter. METHOD: We conducted a quasi-experimental controlled trial including adult patients with a schizophreniform disorder and a maximum of 60 points on the Global Assessment of Functioning Scale (GAF). Interventions (n=176) and controls (TAU, n=142) were assessed every six-month within one year in 17 study practices in rural areas. Mental and functional state were rated using the Brief Psychiatric Rating Scale (BPRS) and the GAF. Functional limitations and pharmacological adherence were patient-rated using the WHO-Disability Assessment Schedule II (WHODAS-II) and the Medication Adherence Report Scale (MARS). We computed multilevel mixed models. RESULTS: The GAF and BPRS of both groups improved significantly, yet the increase in the intervention group was significantly higher. In contrast, patient-rated variables - WHODAS-II and MARS - neither showed a stable temporal improvement nor a difference between groups. CONCLUSION: Our findings only partly support the investigated AO intervention, because of conflicting results between clinician- and patient-ratings. Accordingly, the benefits of AO need to be further evaluated

The luminescent concentrator illuminated

Luminescent concentrator (LC) plates with different dyes were combined with standard multicrystalline silicon solar cells. External quantum efficiency measurements were performed, showing an increase in electrical current of the silicon cell (under AM1.5, 1 sun conditions, at normal incidence) compared to a bare cell. The influence of dye concentration and plate dimensions are addressed. The best results show a 1.7 times increase in the current from the LC/silicon cell compared to the silicon cell alone. To broaden the absorption spectrum of the LC, a second dye was incorporated in the LC plates. This results in a relative increase in current of 5-8% with respect to the one dye LC, giving. Using a ray-tracing model, transmission, reflection and external quantum efficiency spectra were simulated and compared with the measured spectra. The simulations deliver the luminescent quantum efficiencies of the two dyes as well as the background absorption by the polymer host. It is found that the luminescent quantum efficiency of the red emitting dye is 87%, which is one of the major loss factors in the measured LC. Using ray-tracing simulations it is predicted that increasing the luminescent quantum efficiency to 98% would substantially reduce this loss, resulting in an increase in overall power conversion efficiency of the LC from 1.8 to 2.6%