Long-acting injectable risperidone: an emerging tool in schizophrenia treatment

Long-term treatment of patients with schizophrenia remains challenging. Functional and cognitive declines associated with schizophrenia compromise patients' ability to adhere to therapy. While medications can improve outcomes, partial adherence limits effectiveness and is associated with relapse and rehospitalization. Partial adherence has been shown to be high with both oral conventional and oral atypical antipsychotic agents. While long-acting conventional antipsychotic agents provide ensured medication delivery and reduce relapse rates, they carry a substantial risk of movement disorders. A new long-acting formulation of the atypical agent risperidone has shown improved efficacy with decreased risk of adverse events. Its use, along with psychosocial approaches focused on adherence, may help, if initiated during inpatient treatment, by promoting adherence immediately postdischarge and improving long-term treatment outcomes.     

Infants Use Statistical Sampling to Understand the Psychological World

Preverbal infants engage in statistical and probabilistic inference to learn about their linguistic and physical worlds. Do they also employ probabilistic information to understand their social world? Do they infer underlying causal mechanisms from statistical data? Here, we show, with looking‐time methods, that 10‐month‐olds attend to statistical information to understand their social–psychological world and plausibly infer underlying causal mechanisms from violations of physical probabilities.     

Exploring the experiences and dynamics of an unconditional cash transfer for low-income mothers: A mixed-methods study

ABSTRACT

Little is understood about how an unconditional cash transfer might operate and affect behavior among low-income parents of infants in the United States. We investigate these questions using data from a random-assignment pilot study (N?=?30) in which unconditional cash transfers were distributed monthly on debit cards to two groups of low-income parents in New York City during the first 12 months of their newborns’ lives. Mothers were randomized to receive either $100 per month or $20 per month. Mothers distinguished spending the cash transfer on essentials vs. extras, such as going out to dinner with family. The monthly cash transfer “tided them over,” even at the lower amount of $20, especially when income from other sources ran short at the end of the month. Some mothers reported saving money for unexpected expenses.     

Preeradication Vaccine Policy Options for Poliovirus Infection and Disease Control

With the circulation of wild poliovirus (WPV) types 1 and 3 continuing more than a decade after the original goal of eradicating all three types of WPVs by 2000, policymakers consider many immunization options as they strive to stop transmission in the remaining endemic and outbreak areas and prevent reintroductions of live polioviruses into nonendemic areas. While polio vaccination choices may appear simple, our analysis of current options shows remarkable complexity. We offer important context for current and future polio vaccine decisions and policy analyses by developing decision trees that clearly identify potential options currently used by countries as they evaluate national polio vaccine choices. Based on a comprehensive review of the literature we (1) identify the current vaccination options that national health leaders consider for polio vaccination, (2) characterize current practices and factors that appear to influence national and international choices, and (3) assess the evidence of vaccine effectiveness considering sources of variability between countries and uncertainties associated with limitations of the data. With low numbers of cases occurring globally, the management of polio risks might seem like a relatively low priority, but stopping live poliovirus circulation requires making proactive and intentional choices to manage population immunity in the remaining endemic areas and to prevent reestablishment in nonendemic areas. Our analysis shows remarkable variability in the current national polio vaccine product choices and schedules, with combination vaccine options containing inactivated poliovirus vaccine and different formulations of oral poliovirus vaccine making choices increasingly difficult for national health leaders.     

Interactions and outcomes using the Social Relations Model in a healthcare group

Health care today necessitates a group effort, in part, due to the availability of complex interventions. Often measures of central tendency are used to examine groups which can result in misleading interpretations. Interactions within groups can influence outcomes so a multi-level approach to examining individual and dyad contributions is helpful to determine where interventions may be needed. The Social Relations Model (SRM) (Cook & Kenny, 2004) is a mathematical technique used for estimating the variances due to interaction effects from individuals and dyads within the group. This exploratory research used the SRM to examine 43 triads, composed of a patient, telehealth nurse and home helper, from three western U.S. Veterans Health Administration systems. The purpose of this research is to utilize the SRM to examine communication and information integration among individuals and dyads within groups that may influence outcomes in a health care example. Three triads with identical communication and information integration group scores were compared for Perceiver, Target and Relational Effect scores. Results identified individual and relational variances within the groups that may influence satisfaction and self-care outcomes. SRM techniques are beneficial not only to examine existing group interactions but to prevent potential group combinations that may inhibit desirable outcomes in a complex health care environment.     

Review and Assessment of Poliovirus Immunity and Transmission: Synthesis of Knowledge Gaps and Identification of Research Needs

With the intensifying global efforts to eradicate wild polioviruses, policymakers face complex decisions related to achieving eradication and managing posteradication risks. These decisions and the expanding use of inactivated poliovirus vaccine (IPV) trigger renewed interest in poliovirus immunity, particularly the role of mucosal immunity in the transmission of polioviruses. Sustained high population immunity to poliovirus transmission represents a key prerequisite to eradication, but poliovirus immunity and transmission remain poorly understood despite decades of studies. In April 2010, the U.S. Centers for Disease Control and Prevention convened an international group of experts on poliovirus immunology and virology to review the literature relevant for modeling poliovirus transmission, develop a consensus about related uncertainties, and identify research needs. This article synthesizes the quantitative assessments and research needs identified during the process. Limitations in the evidence from oral poliovirus vaccine (OPV) challenge studies and other relevant data led to differences in expert assessments, indicating the need for additional data, particularly in several priority areas for research: (1) the ability of IPV‐induced immunity to prevent or reduce excretion and affect transmission, (2) the impact of waning immunity on the probability and extent of poliovirus excretion, (3) the relationship between the concentration of poliovirus excreted and infectiousness to others in different settings, and (4) the relative role of fecal‐oral versus oropharyngeal transmission. This assessment of current knowledge supports the immediate conduct of additional studies to address the gaps.     

Modeling Population Immunity to Support Efforts to End the Transmission of Live Polioviruses

Eradication of wild poliovirus (WPV) types 1 and 3, prevention and cessation of circulating vaccine‐derived polioviruses, and achievement and maintenance of a world free of paralytic polio cases requires active risk management by focusing on population immunity and coordinated cessation of oral poliovirus vaccine (OPV). We suggest the need for a complementary and different conceptual approach to achieve eradication compared to the current case‐based approach using surveillance for acute flaccid paralysis (AFP) to identify symptomatic poliovirus infections. Specifically, we describe a modeling approach to characterize overall population immunity to poliovirus transmission. The approach deals with the realities that exposure to live polioviruses (e.g., WPV, OPV) and/or vaccination with inactivated poliovirus vaccine provides protection from paralytic polio (i.e., disease), but does not eliminate the potential for reinfection or asymptomatic participation in poliovirus transmission, which may increase with time because of waning immunity. The AFP surveillance system provides evidence of symptomatic poliovirus infections detected, which indicate immunity gaps after outbreaks occur, and this system represents an appropriate focus for controlling disease outbreaks. We describe a conceptual dynamic model to characterize population immunity to poliovirus transmission that helps identify risks created by immunity gaps before outbreaks occur, which provides an opportunity for national and global policymakers to manage the risk of poliovirus and prevent outbreaks before they occur. We suggest that dynamically modeling risk represents an essential tool as the number of cases approaches zero.