Differentiated effects of the multimodal antidepressant vortioxetine on sleep architecture: Part 1, a pharmacokinetic/pharmacodynamic comparison with paroxetine in healthy men

We compared the effect of vortioxetine, paroxetine and placebo after three days of dosing on sleep architecture. This was a randomised, double-blind, four-way crossover, placebo-controlled, multiple-dose study in 24 healthy young men. Subjects received 20mg vortioxetine, 40mg vortioxetine, 20mg paroxetine or placebo for three consecutive days in four different periods with at least three weeks between them. Polysomnography and blood sampling for pharmacokinetic analysis were performed on the pre-dose night and nights 1 and 3 of dosing in each period. Plasma concentrations of vortioxetine and paroxetine during the polysomnography measurement were used to estimate SERT occupancies using published relationships in healthy subjects. All three active treatments significantly increased REM onset latency and decreased time spent in REM sleep. In the pharmacokinetic/pharmacodynamics analysis significant relationships were found between REM onset latency and time spent in REM sleep and vortioxetine/paroxetine exposure. The relation between REM suppression parameters and SERT occupancy was significantly different between vortioxetine and paroxetine, despite the same SERT occupancy. This indicates that vortioxetine has a different clinical pharmacological profile from paroxetine, which may explain the differences in adverse effect profile of the two drugs, for instance the lower incidence of nausea, weight gain and sexual dysfunction with vortioxetine

Sexuality and Health: A Study of Tanzanian Men\'s Experiences of Living with HIV/AIDS

The aim of this study was to explore Tanzanian men\'s experiences regarding their health and sex life after they had been diagnosed with HIV. In-depth interviews were performed with a purposive sample of ten men living in an urban area in Tanzania and who had been HIV positive for more than one year. A phenomenological-hermeneutic approach was used for analyzing the transcribed interviews. Three themes emerged from the texts; “awareness of HIV infection”, “perceived and ideal health”, and “sex life a source of happiness and caring”. Living with HIV meant profound adjustments to daily life activities for the participants. HIV forced them to learn new ways of having sexual intercourse and new ways of acting as a man. The meaning of being a “real man” had changed from being a man with great sexual prowess to being a “caring man” within one elationship.Keywords: HIV; sex life; phenomenological-hermeneutic method; interviewsAfrican Journal of Reproductive Health Vol. 12 (1) 2008: pp. 35-4

Gastrointestinal decontamination in the acutely poisoned patient

ObjectiveTo define the role of gastrointestinal (GI) decontamination of the poisoned patient.Data sourcesA computer-based PubMed/MEDLINE search of the literature on GI decontamination in the poisoned patient with cross referencing of sources.Study selection and data extractionClinical, animal and in vitro studies were reviewed for clinical relevance to GI decontamination of the poisoned patient.Data synthesisThe literature suggests that previously, widely used, aggressive approaches including the use of ipecac syrup, gastric lavage, and cathartics are now rarely recommended. Whole bowel irrigation is still often recommended for slow-release drugs, metals, and patients who "pack" or "stuff" foreign bodies filled with drugs of abuse, but with little quality data to support it. Activated charcoal (AC), single or multiple doses, was also a previous mainstay of GI decontamination, but the utility of AC is now recognized to be limited and more time dependent than previously practiced. These recommendations have resulted in several treatment guidelines that are mostly based on retrospective analysis, animal studies or small case series, and rarely based on randomized clinical trials.ConclusionsThe current literature supports limited use of GI decontamination of the poisoned patient

Post-humanitarianism: humanitarian communication beyond a politics of pity

This article offers a trajectory of humanitarian communication, which suggests a clear, though not linear, move from emotion-oriented to post-emotional styles of appealing. Drawing on empirical examples, the article demonstrates that the humanitarian sensibility that arises out of these emerging styles breaks with pity and privileges a short-term and low-intensity form of agency, which is no longer inspired by an intellectual agenda but momentarily engages us in practices of playful consumerism. Whereas this move to the post-emotional should be seen as a reaction to a much-criticized articulation between politics and humanitarianism, which relied on ‘universal’ morality and grand emotion, it is also a response to the intensely mediatized global market in which humanitarian agencies operate today. The article concludes by reflecting on the political and ethical ambivalence at the heart of this new style of humanitarian communication, which offers both the tentative promise of new practices of altruism and the threat of cultural narcissism

Community forest enterprise markets in Mexico and Brazil: new opportunities and challenges for legal access to the forest

A significant shift has taken place in global forest tenure, with a doubling of the forest area under community ownership (or administration over the past 15 years). There is every indication that communal tenure will double again over the next 15 years. Recognition of traditional and indigenous peoples' collective rights over forest lands has important implications for forest-rich countries—both developed and developing. Combined with dramatic changes in the structure of the forest industry and globalizing markets, this shift creates new opportunities and challenges for low-income forest producers and community enterprises to leave poverty and diversify livelihoods. The challenge for policy makers and governments is to reform outdated regulatory and incentive frameworks to support these enterprises. This article presents findings on three types of responses from communities to the new opportunities created by the tenure shift and looks specifically at community timber enterprise cases from Mexico and Brazil; recommending actions by communities, policy makers, and private sector. Changes in international and domestic forest product demand, consolidation of commodity wood sectors, new corporate responsibility commitments, and the emergence of ecosystem service markets all affect community markets. One response has been the emergence of socially-integrated, timber and non-timber based enterprises. Another has been the expansion of self-financed community conservation. A third response has been new models of collaboration between companies and communities