Progress control in iterated local search for nurse rostering

This paper describes an approach in which a local search technique is alternated with a process which ‘jumps’ to another point in the search space. After each ‘jump’ a (time-intensive) local search is used to obtain a new local optimum. The focus of the paper is in monitoring the progress of this technique on a set of real world nurse rostering problems. We propose a model for estimating the quality of this new local optimum. We can then decide whether to end the local search based on the predicted quality. The fact that we avoid searching these bad neighbourhoods enables us to reach better solutions in the same amount of time. We evaluate the approach on five highly constrained problems in nurse rostering. These problems represent complex and challenging real world rostering situations and the approach described here has been developed during a commercial implementation project by ORTEC bv

Electroconvulsive therapy in treatment-resistant mania: case reports A Eletroconvulsoterapia no tratamento da mania resistente: relatos de casos

Electroconvulsive therapy is known to be effective in the treatment of mood disorders, more specifically for depression and mania. Although a large body of evidence confirms the efficacy of electroconvulsive therapy in the treatment of mania, few prospective studies have been done to assess its effectiveness in treatment-resistant manic episodes. These case reports describe the initial results of a study that is being conducted to evaluate the efficacy of Electroconvulsive therapy among treatment-resistant bipolar patients. METHODS: Three manic patients (according to DSM-IV criteria) who were considered treatment-resistant underwent a series of 12 bilateral Electroconvulsive therapy sessions. Before the treatment and then weekly, they were evaluated with the following rating scales: Young Mania Rating Scale, Hamilton Rating Scale for Depression, Brief Psychiatric Rating Scale, and Clinical Global Impressions-Bipolar Version. RESULTS: The 3 patients showed a satisfactory response to Electroconvulsive therapy, although some differences in the course of response were observed. CONCLUSION: These case reports suggest that Electroconvulsive therapy needs further evaluation for the treatment of resistant bipolar patients.<br>A Eletroconvulsoterapia é uma alternativa reconhecidamente eficaz no tratamento dos transtornos do humor. Embora vários estudos tenham confirmado a eficácia desta modalidade terapêutica no tratamento da mania aguda, poucos estudos foram realizados em pacientes maníacos resistentes à farmacoterapia. Esses relatos de casos descrevem resultados preliminares de um projeto de pesquisa que tem por objetivo avaliar a eficácia da Eletroconvulsoterapia no tratamento de transtornos bipolares resistentes. MÉTODOS: Três pacientes com diagnóstico de mania (de acordo com os critérios do DSM-IV), considerados resistentes ao tratamento medicamentoso, foram submetidos a 12 aplicações bilaterais de Eletroconvulsoterapia. Antes do tratamento e semanalmente, até o final da série, foram avaliados com as escalas: Young Mania Rating Scale, Hamilton Rating Scale for Depression, Brief Psychiatric Rating Scale e Clinical Global Impressions-Bipolar Version. RESULTADOS: Os três casos aqui relatados apresentaram resposta satisfatória à Eletroconvulsoterapia, e aspectos individuais são discutidos. CONCLUSÕES: Os resultados iniciais sugerem que a eficácia da Eletroconvulsoterapia no tratamento de pacientes bipolares resistentes deve ser melhor estudada

Tratamento de depressão em indivíduos infectados pelo HIV Treatment of depression in HIV-infected individuals

A infecção pelo HIV/Aids é freqüentemente associada a transtornos psiquiátricos. Dentre eles, a depressão é o mais comum. O diagnóstico e o tratamento dos transtornos depressivos são fundamentais para melhorar a qualidade de vida desses pacientes. Esta revisão tem como objetivo sintetizar e discutir os resultados mais importantes da literatura a respeito das particularidades do tratamento dos transtornos depressivos em indivíduos infectados pelo HIV. São discutidos a epidemiologia, o quadro clínico, a influência da depressão na evolução da infecção, o tratamento farmacológico com antidepressivos, testosterona e psicoestimulantes e a interação farmacológica entre os antidepressivos e benzodiazepínicos e as drogas antivirais. Conclui-se que o tratamento antidepressivo nessa população é eficaz, seguro e não promove imunossupressão nos indivíduos afetados.<br>HIV/AIDS infection is frequently associated with psychiatric disorders, especially depression. The diagnosis and treatment of depression are essential to improve quality of life in these individuals. This review intends to summarize and discuss the most important results in the literature about the treatment of depression in HIV-infected individuals. The epidemiology, clinical presentation, contribution of depression on HIV infection, pharmacological treatment with antidepressants, testosterone, and psychostimulant drugs, and pharmacological interactions between antidepressants, benzodiazepines, and antiviral medications are discussed. The conclusion drawn from this study is that the treatment of depression in this population is effective, safe and does not promote immunosupression