A prospective open-label treatment trial of olanzapine monotherapy in children and adolescents with bipolar disorder

OBJECTIVE: The goal of this study was to assess the effectiveness and tolerability of olanzapine in the treatment of acute mania in children and adolescents. METHODS: This was an 8-week, open-label, prospective study of olanzapine monotherapy (dose range 2.5-20 mg/day) involving 23 bipolar youths (manic, mixed, or hypomanic; 5-14 years old). Weekly assessments were made using the Young Mania Rating Scale (YMRS), Clinical Global Impressions Severity Scale (CGI-S), Brief Psychiatric Rating Scale, and Children\u27s Depression Rating Scale. Adverse events were assessed through self-reports, vital sign and weight monitoring, laboratory analytes, and extrapyramidal symptom rating scales (Barnes Akathisia Scale, Simpson-Angus Scale, and Abnormal Involuntary Movement Scale). RESULTS: Twenty-two of the 23 youths (96%) completed the study. Olanzapine treatment was associated with significant improvement in mean YMRS score (-19.0 +/- 9.2, p \u3c 0.001). Using predefined criteria for improvement of \u3e or = 30% decline in the YMRS and a CGI-S Mania score of \u3c or = 3 at endpoint, the overall response rate was 61%. Overall, olanzapine was well tolerated, and extrapyramidal symptom measures were not significantly different from baseline. Body weight increased significantly over the study (5.0 +/- 2.3 kg, p \u3c 0.001). CONCLUSIONS: Open-label olanzapine treatment was efficacious and well tolerated in the treatment of acute mania in youths with bipolar disorder. Future placebo-controlled, double-blind studies are warranted

Quetiapine in the treatment of schizophrenia and related disorders

Quetiapine was developed in 1985 by scientists at AstraZeneca (formerly Zeneca) Pharmaceuticals. It received official US Food and Drug Administration approval in September 1997 and approval in Germany in 2000. Since then, quetiapine has been used in the treatment of severe mental illness in approximately 70 countries including Canada, most Western European countries, and Japan. Quetiapine is a dibenzothiazepine derivative with a relatively broad receptor binding profile. It has major affinity to cerebral serotonergic (5HT2A), histaminergic (H1), and dopaminergic D1 and D2 receptors, moderate affinity to α1- und α2-adrenergic receptors, and minor affinity to muscarinergic M1 receptors; it demonstrates a substantial selectivity for the limbic system. This receptor occupancy profile with relatively higher affinity for the 5HT2A receptor compared with the D2 receptor is in part responsible for the antipsychotic characteristics and low incidence of extrapyramidal side-effects of quetiapine. The efficacy of quetiapine in reducing positive and negative symptoms of schizophrenia has been proven in several clinical trials with placebo-controlled comparators. Quetiapine has also demonstrated robust efficacy for treatment of cognitive, anxious-depressive, and aggressive symptoms in schizophrenia. Long-term trials show sustained tolerability for a broad spectrum of symptoms. Quetiapine has also proven efficacy and tolerability in the treatment of moderate to severe manic episodes, and in the treatment of juveniles with oppositional-defiant or conduct disorders, and in the geriatric dementia population. Recent data indicate that quetiapine may also be effective in the treatment of bipolar depressive symptoms without increasing the risk of triggering manic episodes, and in borderline personality disorder. In comparison with other antipsychotics, quetiapine has a favorable side-effect profile. In clinical trials only small insignificant prolongations of the QT interval were observed. Weight-gain liabilities and new-onset metabolic side-effects occupy a middle-ground among newer antipsychotics. As a result of its good efficacy and tolerability profile quetiapine has become well established in the treatment of schizophrenia and manic episodes

Why education in public schools should include religious ideals

This article aims to open a new line of debate about religion in public schools by focusing on religious ideals. The article begins with an elucidation of the concept ‘religious ideals’ and an explanation of the notion of reasonable pluralism, in order to be able to explore the dangers and positive contributions of religious ideals and their pursuit on a liberal democratic society. We draw our examples of religious ideals from Christianity and Islam, because these religions have most adherents in Western liberal democracies that are the focus of this article. The fifth and most important section "Reasonable pluralism and the inclusion of religious ideals in public secondary schools" provides three arguments for our claim that public schools should include religious ideals, namely that they are important to religious people, that they are conducive for the development of pupils into citizens of a liberal democracy, and that the flourishing of pupils as adults is advanced by encountering religious ideals. We also offer a more practical reason: religious ideals can more easily be included within public education than religious dogmas and rules

Trends in Sharia-Compliant

Sharia-compliant financial inclusion represents the confluence of two rapidly growing sectors: microfinance1 and Islamic finance. With an estimated 650 million Muslims living on less than $2 a day (Obaidullah and Tariqullay 2008), finding sustainable Islamic models could be the key to providing financial access to millions of Muslim poor who strive to avoid financial products that do not comply with Sharia (Islamic law). Consequently, Sharia-compliant financial inclusion has recently galvanized considerable interest among regulators, financial service providers, and other financial inclusion stakeholders. However, despite a four-fold increase in recent years in the number of poor clients using Sharia-compliant products (estimated at 1.28 million) and a doubling in the number of providers, the nascent sector continues to struggle to find sustainable business models with a broad array of products that can meet the diverse financial needs of religiously observant poor Muslims. Financial tenets enshrined in Sharia challenge the microfinance sector’s ability to sustainably provide Sharia-compliant financial products at scale. One such tenet is the widely known prohibition on interest, which makes traditional microloan models technically impossible. 2 A lesser known tenet is the encouragement of wealth creation through equity participation in business activities, which requires risk-sharing by financial service providers that does not guarantee returns. CGAP’s 2008 Focus Note on Islamic microfinance explored the state of the sector then and identified key obstacles to its growth (Karim, Tarazi, and Reille 2008). CGAP, in collaboration with the French development agency Agence Française de Développement, conducted a survey in 2011 to better understand the current landscape of Islamic microfinance supply. Based on this survey, the results of which are highlighted herein, we conclude that despite impressive increases in the number of Islamic microfinance providers and clients, the sector is still largely dominated by a few providers in a few countries that rely primarily on only two products. The Islamic microfinance sector needs a concerted, evidence-based effort Box 1. What Makes a Financial Produc

Steady state and transient thermal analyses of GaAs pHEMT devices

GaAs pHEMT thermal reliability test structures are introduced which incorporate on-wafer heating using Thin Film Resistors (TFR) and a DC gate metal temperature measurement method. Results from 3D Finite Element Method (FEM) thermal simulations are compared with measurements and used to investigate the frequency response of device self-heating. Comparisons are made with existing thermal models. The influence of individual device structures on the thermal characteristics of an entire device is investigated and the epitaxial layers are seen to have a large impact on overall performance. Bias dependent self-heating, independent of thermal dissipation is observed and attributed to confinement of the thermal source as the drain voltage is increased.7 page(s