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Frontiers in Psychology, ISSN 1664-1078, 05/2017, Volume 8, Issue MAY, p. 721
Literature has documented the role of family in the outcome of chronic schizophrenia. In the light of this, family interventions (FIs) are becoming an integral... 
Community psychiatry | Early psychosis | Pragmatic trial | Relatives | Outcomes | relatives | outcomes | pragmatic trial | early psychosis | community psychiatry
Journal Article
The Herald, 10/1998
This, despite the school bans and fears of yo-yos as a heid-bangin' weapon. As with a catalogue of traditional toys - see under skateboard, hula- hoop, roller... 
Newspaper Article
European Psychiatry, ISSN 0924-9338, 2015, Volume 30, pp. 275 - 275
Introduction Pragmatic abilities play a crucial role in daily functioning and have been suggested to be impaired in schizophrenia. Nevertheless, patterns of... 
Internal Medicine | Psychiatry | Schizophrenia
Journal Article
by Jeffrey T Jensen Leon Speroff Professor and Vice Chair for Research of Obstetrics and Gynecology Health & Science University Dr Jensen reports he is a consultant for and receives grant/research support from HRA Pharma Healthcare Pharm Council and ContraMed and is a consultant for Teva Pharmaceuticals and Microchips Synopsis: the third attempt FDA approved the mixed serotonin agonist/antagonist flibanserin for the treatment of generalized hypoactive sexual desire disorder in premenopausal women Sources: Food and Drug Administration FDA Briefing Document: Joint Meeting of the Bone and Urologic Drugs Advisory Committee (BRUDAC) and the Drug Safety and Risk Management (DSaRM) Advisory Committee Available at wwwfdagov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/DrugSafetyandRiskManagementAdvisoryCommittee/UCM449088pdf Accessed August 24 Katz M al Efficacy of flibanserin in women with hypoactive sexual desire disorder: Results from the BEGONIA trial J Sex Med 2013 and 10:1807-1815 Thorp J al Treatment of hypoactive sexual desire disorder in premenopausal women: Efficacy of flibanserin in the DAISY study J Sex Med 2012 and 9:793-804 On August 18 FDA approved flibanserin to treat acquired hypoactive sexual desire disorder (HSDD) in premenopausal women The dose of flibanserin is 100 mg orally daily taken at bedtime A total of 3548 patients were randomized to treatment (flibanserin n = 2310 and placebo n = 1238) in the combined data from the three pivotal trials submitted in the new drug application (NDA) (the two published trials are referenced above) In the combined evaluation group mean age of participants was 36 years and most (~89%) were white and reported being in a relationship with a mean length of 11 years The overall completion rate was 78% for placebo and 70% for flibanserin (24 weeks of treatment) The two co-primary endpoints in the published studies were: 1) change in the number of satisfying sexual events (SSEs) from baseline (28-day interval) to end of study (28-day interval and 2) change in the eDiary sexual desire score from baseline to end of study (sum of daily sexual desire scores over 28 days) In these studies used a personal handheld electronic device (eDiary) to record on a daily basis information about sexual activity sexual encounters and desire The third (unpublished) study referenced in the NDA did not use the eDiary to capture data for sexual desire Instead Female Sexual Function Index (FSFI) sexual desire domain questions were assessed every 4 weeks at clinic visits and the baseline and final clinical visit data were used for the co-primary efficacy endpoint (the FSFI was a secondary endpoint in the other studies) Key secondary endpoints included: 1) how often subjects reported being bothered by low sexual desire (“never” “rarely” “occasionally” “frequently” or “always” and 2) the number of “satisfying sexual episodes (SSE)” each assessed for the 28-day baseline and end-of-study intervals The FDA review panel concluded that flibanserin’s treatment effects were consistent across the three trials with respect to increasing overall satisfying sexual events (statistically significant P < 005 and median increase of 05 to 10 episodes in 28 days and reducing distress (mean treatment difference [95% confidence interval]: -03 [-04 to -01] -04 [-05 to -02] and 03 [-04 to -01] in the three studies) Although treatment benefit was also consistently demonstrated for sexual desire became statistically significant only when measured using the FSFI-desire domain questions (mean treatment difference [95% CI]: 03 [02-04]4 [02-05] and 03 [02-05]) but not with the eDiary Descriptive data presented suggest that the clinical effect takes about 4 weeks to develop Side effects occurred significantly more frequently in the treatment group twice as many (128% vs 59%) discontinuations for adverse events (AEs) The most common AEs included dizziness (114% vs 22%) (112% vs 31%) (104% vs 37%) (92% vs 5 and insomnia (49% vs 24%) There was no difference with respect to depression In a small substudy where subjects consumed moderate (2-4 drinks) amounts of ethanol with and without flibanserin combination precipitated hypotension and presyncope/syncope in some participants Due to these findings FDA approved flibanserin with a risk evaluation and mitigation strategy (REMS) to assure safe use The REMS requires that prescribers and pharmacies complete training and be certified with the REMS Certified prescribers must counsel patients using a Patient-Provider Agreement form about the increased risk of severe hypotension and syncope and about the importance of not drinking alcohol during treatment The labeling for flibanserin (Addyi™) will include a black box warning to highlight the risks of severe hypotension and syncope in patients who drink alcohol during treatment those who use moderate or strong CYP3A4 inhibitors and in those who have liver impairment COMMENTARY What would you pay for a drug that must be taken daily to have (at best) a marginal impact on female sexual desire and is associated with serious side effects particularly when coadministered with moderate amounts of alcohol? How about $1 billion? That’s the amount of money that Valient Pharmaceuticals paid to acquire Sprout Pharmaceuticals company that successfully received FDA approval for flibanserin The approval came on the third round and was controversial1 It took three pivotal studies and a patient advocacy campaign to gain approval The initial NDA was submitted by Boehringer Ingelheim (BI) in 2010 At that time committee voted unanimously that the risks exceeded potential benefits and BI discontinued development of the drug Rights were sold to Sprout Pharmaceuticals company with no other products Sprout filed a second NDA in 2013 and the application was again rejected After the second NDA was denied advocacy group called Even the Score was formed to advocate for what it called “gender equality” in access to treatments for sexual dysfunction The group promoted the claim that there are 26 approved medications for male sexual dysfunction but none for women and however failed to mention that none of these treatments were approved for low sexual desire1 The male products include forms of testosterone and the phosphodiesterase (PDE)-5 inhibitors used to treat erectile dysfunction Although the claim may have been inaccurate advocacy appeared to work and Addyi is now approved Flibanserin is classified as a mixed post-synaptic 5HT1A receptor agonist and 5HT2A receptor antagonist2 It initially was studied for activity as an antidepressant While the drug was no more effective than placebo in treating depression was more effective than placebo in terms of study participants’ responses to the question “How strong is your sex drive?” This led BI to the clinical development program for treatment of sexual desire The Diagnostic and Statistical Manual of Mental Disorders (DSMD) edition HSDD as “persistently or recurrently deficient or absent sexual fantasies and desire for sexual activity” accompanied by “marked distress and interpersonal difficulty” that is not accounted for by a nonsexual mental disorder relationship stress general medical condition In 2013 DSMD edition HSDD with female sexual arousal disorder into female sexual interest/arousal disorder (FSIAD) The FDA has recognized that there are no approved treatments for these disorders3 But is flibanserin the answer? First is not like treating an arousal disorder with a PDE5 inhibitor dosed a few times per month Daily treatment is required and it appears to take about a month to show any benefit at all That with serious side effects like hypotension and syncope in some individuals (particularly with alcohol use) and annoying less serious adverse events like headache and nausea in others’t make this a dream drug Still allure of a drug to treat desire is intoxicating Imagine the conversation that ends with “if you loved me would get that medicine that makes you more interested in sex” While women are generally motivated to improve relationships is important to recognize that the diagnosis of FSIAD requires that the lack of desire is accompanied by “marked distress and interpersonal difficulty” Guilt and desire to please a partner should not be deciding factors The FDA did a good thing requiring that providers receive training to become certified to prescribe flibanserin I hope that goes far enough While it is important not to dismiss a therapeutic opportunity is critical that you make an accurate diagnosis In my practice refer patients with sexual desire disorders to a qualified sexual therapist for counseling and treatment I suspect a minority may benefit from flibanserin However imagine that Valient Pharmaceuticals is banking on widespread over-prescription of this product That’s the $1 billion dollar answer REFERENCES 1 Gellad WF al Evaluation of flibanserin: Science and advocacy at the FDA JAMA 2015 and July 6 [Epub ahead of print] 2 Stahl SM Mechanism of action of flibanserin multifunctional serotonin agonist and antagonist (MSAA) hypoactive sexual desire disorder CNS Spectr 2015 and 20:1-6 3 Nappi RE Why are there no FDA-approved treatments for female sexual dysfunction? Expert Opin Pharmacother 2015 and 16:1735-1738
OB GYN Clinical Alert, ISSN 0743-8354, 10/2015, Volume 32, Issue 6
Leon Speroff Professor and Vice Chair for Research, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland Dr. Jensen reports he... 
Studies | Advocacy | Mental disorders | Committees | Alcohol | FDA approval | Patients | Pharmaceuticals
Journal Article
Chicago Tribune (1963-1996), ISSN 1085-6706, 09/1988, p. F2
Brandi paid $5.23 for 3.6 pounds of chicken. At this rate, how much is she paying for each pound? Express your answer to the nearest penny. 
Newspaper Article
by Bartlett, Teams and Aurora, East and Elgin and East, Glenbard and South, Glenbard and Larkin and Elgin, South and Streamwood and Aurora, West and Chicago, West Chicago. Key Games: Larkin At West and East, Sept. 14; West Aurora At Glenbard and Aurora, Sept. 14; Glenbard South At West and Larkin, Sept. 28; Elgin At and South, Oct. 12; Glenbard East At Glenbard and Elgin, Oct. 12; Bartlett At South and Aurora, Oct. 13; South Elgin At West and Aubrey, Oct. 19. Top Players: Jaxon and Qb and Beach, Larkin; Elijah and Dl and Bonds, Streamwood; Xavier and Wr-Db and Buchanan, Elgin; JaQuan and Rb-Lb and Bushka, West Aurora; Bret and Gibson, Glenbard East; Noah and Lb and Grant, Glenbard South; Jeremy and Guo, West Chicago; Eric and Johnson, Elgin; Jeremy and Wr and Keith, Glenbard East; Tavion and Konstanzer, Glenbard South; Spencer and Madison, Bartlett; John and Ol-Dl and Mooney, Glenbard South; Ian and Ol and Noworol, West Aurora; Pat and Rios, South Elgin; Isai and Salinas, Larkin; Azxavier and Qb-Wr-db and Salter, South Elgin; Hezekiah and Rb and Shockey, West Aurora; Anthony and Shuberth, Glenbard East; Jason and Stubbs, Bartlett; Jahari and Tittle, Larkin; Trevon and Warren, West Aurora; Denver and Batavia, West Aurora. Outlook: This Is An Athletic Director'S Dream. Since and Geneva and East, St. Charles and Conference, St. charles North Left The Uec River Division To Help Inaugurate The Dukane and Suburban, Glenbard South Came In From The Metro and Teams, The Uec Is Now One Group Of 10 and Coaches, No Nonconference Football Scheduling Required. Five Teams Have New and Rustman, Including West Chicago'S Jack and Aurora, Naperville Central Graduate Nick Kukuc At East and Teonic, South Elgin'S Dragan and Champion, Who Switched From Larkin To Lead The Defending Valley Division and Erlenbaugh, Bartlett'S Matt and Aurora, Larkin'S Zeus Gonzalez. All Will Be Looking Up To Prohibitive Favorite West and Skein, As Blackhawks Coach Nate Eimer Has Orchestrated One Of The State'S Most Remarkable Turnarounds. Suddenly On A Three-Year Playoff and Ball, From A 7-3 Squad West Aurora Returns Eight Starters On Both Sides Of The and 6-Foot-3, Including and Warren, 300-Pound Defensive Tackle Denver and Tammaru, A Michigan Commit As A Junior. We Could Easily Cite More Blackhawks In The "Top Players" List With The Likes Of Returning All-Conference Quarterback Will and 1, A Junior Who Passed For and Young, 142 Yards As A Sophomore. After That Predictions Get Dicey. Usual Suspect South Elgin Is and Quarterback, Larkin Has Joliet West Transfer Jaxon Aubrey At and Spot, Glenbard South Will Face Many Of These Teams For The First Time. All This Flux Could Result In Glenbard East Earning Only Its Second Playoff and Bushka, First Since 1999. The Rams Boast Several Three-Year Starters Including Quarterback Bret and Shockey, Linebacker Anthony and Johnson, All-Conference Receiver Jeremy and Population, As Well As Four Returning Starters To The Offensive Line. Quotable: "We'Re Significantly Smaller In (School) and Teams, But We Wouldn'T Have Made The Move To The Upstate Eight Conference If We Didn'T Feel We Compete With The Top and Crissey., " Said Glenbard South Coach Ryan
Daily Herald (Arlington Heights, IL), 08/2018, p. 5
Newspaper Article
by Bartlett, Teams and Aurora, East and Elgin and East, Glenbard and South, Glenbard and Larkin and Elgin, South and Streamwood and Aurora, West and Chicago, West Chicago. Key Games: Larkin At West and East, Sept. 14; West Aurora At Glenbard and Aurora, Sept. 14; Glenbard South At West and Larkin, Sept. 28; Elgin At and South, Oct. 12; Glenbard East At Glenbard and Elgin, Oct. 12; Bartlett At South and Aurora, Oct. 13; South Elgin At West and Aubrey, Oct. 19. Top Players: Jaxon and Qb and Beach, Larkin; Elijah and Dl and Bonds, Streamwood; Xavier and Wr-Db and Buchanan, Elgin; JaQuan and Rb-Lb and Bushka, West Aurora; Bret and Gibson, Glenbard East; Noah and Lb and Grant, Glenbard South; Jeremy and Guo, West Chicago; Eric and Johnson, Elgin; Jeremy and Wr and Keith, Glenbard East; Tavion and Konstanzer, Glenbard South; Spencer and Madison, Bartlett; John and Ol-Dl and Mooney, Glenbard South; Ian and Ol and Noworol, West Aurora; Pat and Rios, South Elgin; Isai and Salinas, Larkin; Azxavier and Qb-Wr-db and Salter, South Elgin; Hezekiah and Rb and Shockey, West Aurora; Anthony and Shuberth, Glenbard East; Jason and Stubbs, Bartlett; Jahari and Tittle, Larkin; Trevon and Warren, West Aurora; Denver and Batavia, West Aurora. Outlook: This Is An Athletic Director'S Dream. Since and Geneva and East, St. Charles and Conference, St. charles North Left The Uec River Division To Help Inaugurate The Dukane and Suburban, Glenbard South Came In From The Metro and Teams, The Uec Is Now One Group Of 10 and Coaches, No Nonconference Football Scheduling Required. Five Teams Have New and Rustman, Including West Chicago'S Jack and Aurora, Naperville Central Graduate Nick Kukuc At East and Teonic, South Elgin'S Dragan and Champion, Who Switched From Larkin To Lead The Defending Valley Division and Erlenbaugh, Bartlett'S Matt and Aurora, Larkin'S Zeus Gonzalez. All Will Be Looking Up To Prohibitive Favorite West and Skein, As Blackhawks Coach Nate Eimer Has Orchestrated One Of The State'S Most Remarkable Turnarounds. Suddenly On A Three-Year Playoff and Ball, From A 7-3 Squad West Aurora Returns Eight Starters On Both Sides Of The and 6-Foot-3, Including and Warren, 300-Pound Defensive Tackle Denver and Tammaru, A Michigan Commit As A Junior. We Could Easily Cite More Blackhawks In The "Top Players" List With The Likes Of Returning All-Conference Quarterback Will and 1, A Junior Who Passed For and Young, 142 Yards As A Sophomore. After That Predictions Get Dicey. Usual Suspect South Elgin Is and Quarterback, Larkin Has Joliet West Transfer Jaxon Aubrey At and Spot, Glenbard South Will Face Many Of These Teams For The First Time. All This Flux Could Result In Glenbard East Earning Only Its Second Playoff and Bushka, First Since 1999. The Rams Boast Several Three-Year Starters Including Quarterback Bret and Shockey, Linebacker Anthony and Johnson, All-Conference Receiver Jeremy and Population, As Well As Four Returning Starters To The Offensive Line. Quotable: "We'Re Significantly Smaller In (School) and Teams, But We Wouldn'T Have Made The Move To The Upstate Eight Conference If We Didn'T Feel We Compete With The Top and Crissey., " Said Glenbard South Coach Ryan
Daily Herald (Arlington Heights, IL), 08/2018, p. 5
Newspaper Article
Newsday, 09/2004
  For instance, the percentage of African-American men ages 20 to 24 who were employed in 1966, two years after passage of the Civil Rights Act, was 82.8... 
Newspaper Article
Scotland on Sunday, ISSN 0955-8756, 05/1999
More than three decades later, [Charan] Gill, head of Britain's largest chain of Indian restaurants, can smile at the memory but says it typifies the resilient... 
Newspaper Article
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