Social Performance Score Research Articles

Impact on carer burden when stable patients with schizophrenia transitioned from 1-monthly to 3-monthly paliperidone palmitate

RationaleReducing the frequency of long-acting injectable antipsychotic medication may reduce carer burden. ObjectivesTo evaluate the impact of reduced frequency of long-acting injectable antipsychotic medication on carer burden in stable patients with schizophrenia. MethodsCarer burden was assessed using the Involvement Evaluation Questionnaire (IEQ) within a 52-week, prospective, single-arm, non-randomised, open-label, international, multicentre study evaluating the impact of transitioning stable patients with schizophrenia to paliperidone palmitate 3-monthly (PP3M) from paliperidone palmitate 1-monthly (PP1M). Results159 carers completed the IEQ (mean [standard deviation, SD] age: 54.8 [12.8] years); 52.2% were the patients' parent and > 50% had >32 h/week of patient contact. At baseline, mean [SD] IEQ total score was in the lower range (23.8 [12.6]), reflecting patient stabilisation. At last observation carried forward (LOCF) endpoint, the IEQ total score decreased by a mean (95% CI) of −4.0 (−5.9, −2.1), indicating a significant overall reduction in carer burden (P < 0.0001). The six IEQ items with the highest carer burden at baseline were within the urging and worrying domains, in which burden was significantly improved at LOCF endpoint (P < 0.0001). Exploratory analyses found that higher carer burden was associated with lower functional remission (Personal and Social Performance score >70) at baseline and LOCF endpoint, and with the patient being part of the carer's household. Shorter disease duration correlated with better general health of carers at LOCF endpoint. ConclusionReducing the frequency of antipsychotic medication administration in stable patients with schizophrenia by switching from PP1M to PP3M may reduce carer burden.

Profile of Schizophrenia Aggressiveness with the Risk of Suicide based on the Personality and Social Performance Score

A B S T R A C TIntroduction. The risk of schizophrenia for suicide is 10%, of which 10% -15% ofpeople with schizophrenia die of suicide at 20 years of follow-up. Aggressiveness is afactor to be watched out. Other factors are hallucinations, suicide, early-onset,history of schizophrenia, surveillance, age, gender, education, genetics, affect ofdepression. This study aimed to describe the sociodemographic profile,aggressiveness, hallucinations of suicide in schizophrenic patients. Methods. Thedesign of this study is descriptive research. The number of samples in this study was49 schizophrenic patients at risk of suicide. The risk of aggressiveness is measuredby the Personality and Social Performance Score. Results. Of the 49 patients, it wasfound that the proportion of male patients was 31 people (63.3%) and 18 women(36.7%). Aggressive behaviour based on PSP score was divided into modestaggressiveness of 22 people (44.9%), severe 20 people (40.8%), very severe two people(4.1%). Suicidal hallucinations were also found in 11 patients (22.4%). Conclusion.There are markedly aggressive behaviour and hallucinations of suicide in the majorityof schizophrenic patients.

Defining "Adequately Treated": A Post Hoc Analysis Examining Characteristics of Patients with Schizophrenia Successfully Transitioned from Once-Monthly Paliperidone Palmitate to Once-Every-3-Months Paliperidone Palmitate.

PurposePaliperidone palmitate once every 3 months (PP3M) is indicated in adults with schizophrenia adequately treated with once-monthly paliperidone palmitate (PP1M) for at least 4 months, in whom the last two consecutive doses are the same. The decision of when to transition to PP3M is based on the patient’s symptom status while receiving PP1M.Patients and MethodsIn a double-blind relapse–prevention study (NCT01529515), patients who met Positive and Negative Syndrome Scale (PANSS) score stabilization criteria after 4 months of PP1M were eligible for transition to PP3M; those who continued to meet stabilization criteria after 12 weeks following an open-label PP3M dose were randomized to receive PP3M or placebo. We compared (post hoc) PANSS, Clinical Global Impression–Severity (CGI-S), and Personal and Social Performance (PSP) scores during the pre-randomization, open-label phase in patients in randomized versus non-randomized groups using analysis of variance or chi-square tests.ResultsOf 506 patients enrolled, 305 were randomized. After 4 months’ PP1M treatment, PANSS and CGI-S scores were significantly lower and PSP scores significantly higher in randomized patients versus non-randomized patients (least squares means [95% CI]: 57.1 [55.7, 58.6] vs 62.2 [60.0, 64.3], 2.9 [2.8, 3.1] vs 3.3 [3.1, 3.4], and 67.0 [65.7, 68.3] vs 64.5 [62.6, 66.4], respectively); changes from baseline between groups differed significantly (all P ≤0.009).ConclusionConfirming adequate stabilization with PP1M prior to transitioning to PP3M is critical in maximizing treatment response; clinicians should consider transitioning patients to PP3M only if patients respond well to PP1M for at least 4 months and their last two consecutive doses are the same.

Synergy of pandemics-social isolation is associated with worsened Parkinson severity and quality of life

Social isolation and its deleterious effects on health increases with age in the general population. People with Parkinson’s Disease (PWP) are no exception. Social isolation is a risk factor for worsened health outcomes and increased mortality. Symptoms such as depression and sleep dysfunction are adversely affected by loneliness. There is a paucity of research on social isolation in Parkinson’s disease (PD), which is all the more critical now in the setting of social distancing due to COVID-19. The goal of this study was to survey individuals with PD to evaluate whether social isolation is associated with PD symptom severity and quality of life. Only individuals reporting a diagnosis of idiopathic PD were included in this analysis. The primary outcome measures were the Patient-Reported Outcomes in PD (PRO-PD) and questions from PROMIS Global related to social health. PRO-PD scores increased as social performance and social satisfaction scores diminished. Individuals who reported being lonely experienced a 55% greater symptom severity than those who were not lonely (P < 0.01). Individuals who documented having a lot of friends had 21% fewer symptoms than those with few or no friends (P < 0.01). Social isolation was associated with greater patient-reported PD severity and lower quality of life, although it is unclear whether this is the cause and/or a consequence of the disease. In essence, the Parkinson pandemic and the pandemic of social isolation have been further compounded by the recent COVID-19 pandemic. The results emphasize the need to keep PWP socially connected and prevent loneliness in this time of social distancing. Proactive use of virtual modalities for support groups and social prescribing should be explored.

Assessing Firms’ Environmental, Social and Governance Performance (ESGP) and Its Effect on Financial Performance: Evidence from Pakistan

In the recent past, the knowledge of Corporate Social Responsibility (CSR) among practitioners, scholars, and researchers has grown tremendously. Scholars have been trying to find out whether the tradeoff among Corporate Social Performance and Corporate Financial Performance is unavoidable or the association remains positive as well as rewarding for the businesses. This study aims to empirically investigate whether Financial Performance (FINP) of firms is associated with their Environmental, Social, and Governance Performance (ESGP) scores in Pakistan. The study has used the overall ESG and its three constituents (Environmental, Social and Governance) disclosure scores for the ESGP measure and to measure financial performance three accounting ratios were considered, one reflects the market position of firm (i.e. Tobin‘s Q) and the other two measure the business profitability in relation to the firm‘s total assets (i.e. Return on Assets) commonly known as ROA and equity (i.e. Return on Equity) commonly known as ROE. Regression analysis is used to analyze the effects of ESG Performance on firms’ Financial Performance, using cross-sectional data, the sample includes listed companies on the PSX100 index for the year 2018 with a sample size of the 95 companies. The data was hand-collected by the annual reports and publications of the firms. Results indicated that ESG has a significant positive effect on ROA, but not on Tobin Q which remained insignificant for ESG and its dimensions. Among its components, GS and SS also seem to have a significant and positive effect. Among, the control variables, Debt has a negative impact, whereas size seems to have a positive effect on ROA. Most of the variables remained insignificant with regards to Tobin Q Hence, the findings indicate a partial significant association between ESGP and Financial Performance.

Quantitative efficacy of three antipsychotic drugs for schizophrenia based on a real-world study in China.

Atypical antipsychotics exert remarkable long-term efficacy on the personal and social functions of schizophrenic patients. However, quantitative information on the social function of schizophrenic patients treated with atypical antipsychotics is scarce in the current clinical guidelines. In this study, we established pharmacodynamic models to quantify the time–efficacy relationship of three antipsychotic drugs based on the data from a real-world study conducted in China. A total of 373 schizophrenic patients who received antipsychotic monotherapy with olanzapine (n = 144), risperidone (n = 160), or aripiprazole (n = 69) were selected from a three-year prospective, multicenter study. The follow-up times were 13, 26, 52, 78, 104, 130, and 156 weeks after baseline. A time–efficacy model was developed with nonlinear mixed effect method based on changes in Personal and Social Performance (PSP) score compared with the baseline level. Crucial pharmacodynamic parameters, including maximum efficacy and drug onset time, were used to distinguish the efficacy of the three drugs. We quantified the time course of PSP improvement in patients after treatment with these three antipsychotics: olanzapine, risperidone, and aripiprazole reached an Emax value of 80.3%, 68.2%, and 23.9% at weeks 56.7, 29.2, and 36.8, respectively. General psychotic symptoms, onset frequency, and illness course were identified as significant factors affecting the efficacy of these drugs. The newly constructed models provide an evidence of the benefit of long-term maintenance therapy with atypical antipsychotics in individualized schizophrenia treatment in China.

Environmental and social life cycle assessment of urban water systems: The case of Mexico City.

Mexico City and its metropolitan area have suffered problems of sustainability in the water system. The main goals of this study were to assess the environmental and social impacts of the water system in Mexico City using Life Cycle Assessment (LCA), identify the significant impacts and their sources, and provide a new perspective for a sustainable water system in the city. The entire water system was considered, including the following stages: water abstraction and treatment, transport, distribution, use, sewage collection and wastewater treatment. Social Life Cycle Assessment was performed considering the UNEP/SETAC Guidelines for the Social-LCA of products and the water system workers. We used five subcategories (working hours, fair wage, health and safety conditions, social security and professional development) and 30 indicators of labor conditions. The results of LCA show that the processes of abstraction, water treatment, transport and distribution combined to produce between 83.9 and 89.6% of the impacts in four of six categories. However, the transportation stage generates the highest environmental impacts due to energy consumption. The wastewater treatment stage avoids environmental impacts in freshwater eutrophication (-69.9%) and non-carcinogenic effects (-86.2%) due to Atotonilco, the new centralized WWTP. The social life cycle assessment results indicated that the transport stage had the best social performance score, with a value of 0.3 on a scale of zero to one. The total system exhibited regular performance in health and safety conditions, with a value of 0.6 in this category. Moving toward a sustainable water system in Mexico City requires analyze future scenarios on the decentralization of potable water services and the implementation of renewable energy technologies in water abstraction and transport to reduce electrical energy consumption and mitigate global warming impacts. Regarding the social dimension, the water system requires stricter policies to monitor the health and safety conditions of workers according to the definition of decent work toward recent sustainable development goals. This study allowed us to identify the stages with high and low environmental impacts with LCA and, with S-LCA, the best and worst social performance in working conditions. The next step is to complete a sustainability assessment that includes the economic dimension, develop a framework to integrate the three dimensions and propose scenarios to improve environmental and social performance.

Development of a social impact assessment method and application to a case study of sugarcane, sugar, and ethanol in Thailand

The implementation of midpoint, endpoint, and single score assessments to support decision-making remains a major challenge for developing a coherent social impact assessment methodology. The simple weighted sum approach and normalization technique for single score assessments have been problematic and the final results do not realistically represent stakeholder perspectives due to mis/over-interpretations. The focus of this study is to develop a weighting scheme for social impact assessment. The developed scheme is then evaluated using a case study on social impact assessment of the sugarcane sector in Thailand. A weighted aggregation method has been developed for assessing different categories and sub-categories of social dimensions. The performance indicators for each sub-category determine the accuracy of the impact results by establishing the rating weight of the importance of social aspects and satisfaction. The developed method is then applied to a case study on sugarcane-based ethanol production in Thailand. The stakeholders involved in the sugarcane sector comprising sugarcane, sugar, and ethanol production include cane growers, cane workers, sugar factory, and ethanol factory workers. The social issues related to stakeholders in sugarcane, sugar, and ethanol production must fit the cause-effect chain, which can help not only in defining the specific social aspects to meet the appropriate sub-categories and performance indicators but also in facilitating the data collection. The characterized/inventory result can be improved by using the weighting factor of importance of social aspects and satisfaction. The results of the social impact performance score reveal that including the weighting of the importance of social aspects and satisfaction affects the result of the impact sub-categories and social categories. The case study revealed that the relevant impact categories of cane growers are (1) land tenure; (2) access to knowledge, facility, and natural resources; (3) employment, wages, and labor conditions; (4) equity; and (5) human health and safety. On the other hand, the impact categories of cane workers, sugar factory workers, and ethanol factory workers are (1) decent livelihood, (2) labor rights, (3) equity, and (4) human health and safety. The social impact assessment method with developed weighting scheme can help the government and private sectors prioritize their efforts in minimizing negative social impacts throughout the life cycle of biofuel systems. However, the data on the importance of social aspects and satisfaction is subjective; uncertainty analysis or sensitivity analysis must therefore be applied to further observe the variation of different options to facilitate decision-making.

Fortune 500 Türkiye de Yer Alan Lojistik İşletmelerinin Sosyal Medya Kullanımının Analizi ve Değerlendirilmesi - Analysis and Evaluation of the Social Media Usage of the Logistics Companies Listed in Fortune 500 Turkey

Technology, which takes place in every area of life, now mediates many virtual platforms where crowds met. By using social media platforms, which provide the opportunity to reach large audiences and create interactive communication, bring together all business stakeholders. In this study, it is proposed to determine the social media usage level of Turkey's leading logistics companies. In this direction, the official web sites of the companies and their specific social media platforms are examined. For evaluating the social media usage of the companies, we take in to account the Twitter, Facebook, Instagram and YouTube platforms. In this context, a hybrid Multi-Criteria Decision Making method has been proposed in this study. Fuzzy Analytical Hierarchy Process method is used to identify criteria weights and the Grey Relational Analysis method was used to evaluate the social media performance of the alternatives. According to the results obtained by using fuzzy AHP method; Twitter and Official Web pages were found to be the most important criteria affecting the social media performance of enterprises. The least impact in performance appraisal is the activities carried out on Instagram and YouTube social networks. As a result of the calculations made using the hybrid model, Turkish Airlines has the highest social media performance score. It is seen that the enterprises, which are in the top 3 in the ranking, are in the aviation sector.

Adaptation of Medical Students During Clinical Training: Effects of Holistic Preclinical Education on Clerkship Performance

Theory: Taiwan’s medical undergraduate program at a university or medical center is a continuation of 12 years of compulsory citizenship education rooted in holistic philosophies. Students acquire both technical knowledge and nontechnical attributes, which are necessary for success in further work and life. The early clinical learning experiences of medical students are primarily acquired through clerkships. These clerkships require medical students to apply and extend what they learned during their preclinical education; however, previous studies have explored this issue through examining fragmentary factors such as preclinical course grades and traits but not undertaking comprehensive, whole-person investigations. Hypotheses: To account for the potential benefits of a holistic approach in medical students’ learning, we propose three hypotheses: Medical students’ preclinical performance on Taiwan’s technical and nontechnical higher education assessments are positively associated with their clinical competence (Hypothesis 1) and psychological well-being (Hypothesis 2) during clerkships, and medical students’ psychological well-being during clerkships is positively associated with their clinical competence (Hypothesis 3). Method: We studied a cohort of 65 medical students engaged in clerkships from September 2013 to April 2015. Their preclinical technical knowledge scores—formal curricular grades received from course instructors—were obtained from their medical school’s archival dataset. Their nontechnical attributes—moral and social performance scores received from student mentors and physical performance scores received from course instructors—were also obtained from the school’s archival data set. The medical students’ competence in their 2-year clinical clerkships was measured using the objective structured clinical examination scores from the end of both clerkship years. The medical students’ psychological well-being during their 2-year clerkships was measured according to burnout level, which was determined using routine online surveys that employed validated, structured, and self-administered questionnaires at each specialty rotation. Multiple regressions and linear mixed-effects model were employed for statistical analysis. Results: Our study revealed that higher preclinical technical knowledge predicted superior clinical competence and a higher level of burnout during clerkships. By contrast, higher preclinical nontechnical attributes (i.e., higher preclinical moral, social, and physical performance) predicted lower level of burnout. However, no relationship was discovered between clerkship burnout and the clinical competence of the medical students. Conclusions: Our study verified the value of a holistic education that encompasses both technical knowledge and nontechnical attributes during the preclinical learning stage for medical students. Our findings can serve as a reference for medical educators designing preclinical educational programs for medical students.

How not to compare apples and oranges: Generate context-specific performance reference points for a social life cycle assessment model

Abstract In recent years the need to consider the social dimension of sustainability within life cycle thinking has been increasing, catalysing the development of many different social life cycle assessment approaches (sLCA). The demand to assess potential social effects has been strengthened further, due to the implementation of national bioeconomy strategies. The RESPONSA framework (REgional SPecific cONtextualised Social life cycle Assessment) has been developed to assess the social effects associated with wood-based bioeconomy products from Germany (Siebert et al., 2018a; Siebert et al., 2018b). However, a characterisation approach, based on a context-specific benchmark which is easy to understand and interpret, is still missing. In general, characterisation approaches provide meaning to social indicator values (i.e., the inventory data). However, there is no standardised sLCA characterisation method yet. Therefore, the aim of this paper is to outline a characterisation method based on context-specific performance reference points (PRPs), which can effectively reflect the social conditions influencing the various organisations involved in producing a specified product. Such PRPs should also qualify whether the social indicator values collected from the organisations in the production system corresponds to a negative (worse than sector average) or positive performance (better than sector average). Therefore, we considered the classification of economic sector of the assessed organisation and in some cases the size of the organisation as factors influencing the potential social effects related to our particular context. These were then applied to define context-specific PRPs, which relate the social indicators calculated in the inventory phase, to those benchmarks, thus generating relative social performance scores for producers of a wood-based product in Germany.

S227. A PROPOSED ALTERNATIVE BETWEEN DISCONTINUATION AND MAINTENANCE OF ANTIPSYCHOTICS: A GUIDED DOSE REDUCTION TRIAL FOR PATIENTS WITH REMITTED PSYCHOSIS

BackgroundEarly intervention at the beginning of schizophrenia and related psychotic disorders can get better treatment response. Once symptoms subsided, the majority of patients wish to discontinue medications, yet currently the mainstream opinions still recommend maintenance antipsychotic therapy because non-adherence to medication is the most significant risk factor to predict a relapse. However, recent longitudinal studies assessing patients in community for a longer term found that discontinuation of antipsychotics might not necessarily be parallel to poorer functioning. Also there are studies suggesting a lower percentage of dopamine occupancy by antipsychotic is acceptable in stable patients with psychosis. To elucidate such discrepancies, a hypothetical compromised approach “guided dose reduction, but not aiming at discontinuation” was proposed and an observational clinical trial was initiated since July 2017.MethodsOutpatients with schizophrenia-related psychotic disorders under remitted states will be recruited and randomized into guided dose reduction group (GDR, target n = 80) and maintenance treatment group (MTG1, target n = 40), and those who eligible to dose reduction yet willing to continue medication will serve as a naturalistic observation group (MTG2, target n = 40). Patients in the GDR will reduce no more than 25% of their current dose of antipsychotics and closely monitored every 4 weeks for at least 24 weeks before next dose reduction adjustment. Patients of both MTGs receive treatment as usual. All patients will be followed up for at least 2 years. The main outcomes of interests are differences in relapse rates, personal social performance, quality of life, drug-related adverse reactions, medication satisfaction, and neurocognitive functioning between groups. Patient’s actual medication status will be monitored by keeping a log and therapeutic drug monitoring on selective antipsychotics. Patient’s demographics and clinical variables will be taken to test whether these variables are related to outcomes during follow-up.ResultsCurrently 26 patients have participated in this study, including 10 males and 16 females, with a Mean (SD) age 31.8(7) years old. Eleven of them were in GDR group, 10 in MTG1, and 5 in MTG2. Their baseline PANSS scores were 36.9(5.7), 37.4(7.9), 49.2(7.4), CGI-S scores were 1.7(0.6), 1.5(0.7), 2(0), and Personal Social Performance (PSP) scores were 82.2(7.9), 83.9(6.8), 77.8(2.3) in GDR, MTG1, and MTG2, respectively. So far one patient in the GDR group has resumed her original dose due to suspected early signs of relapse and no further worsening of symptoms noticed, while one patient of the MTG1 withdrew consent due to feeling unnecessary to receive comprehensive follow-up assessments. Most of patients endorsed no significant difference between ordinary dose and reduced dose at present time.DiscussionDuring the first 4 months of this trial, we have not seen any unexpected happening yet. We will continue case recruitment and follow-up to test if the metaphor derived from Cantor’s Set and Sierpinski Triangle can serve a valid model for our dose reduction trial and see if such a slow-paced guided dose reduction approach a feasible solution for the debates between medication discontinuation and maintenance.

Factors related to improvement of symptoms, function, and caregiver burden in Chinese patients with schizophrenia after switching to paliperidone palmitate once-monthly from oral antipsychotics.

BackgroundPaliperidone palmitate once-monthly (PP1M) demonstrated symptomatic and functional remission in patients with schizophrenia. This post hoc analysis aimed to identify factors associated with improved clinical outcomes in patients switching to PP1M (75–150 mg eq.).MethodsThe improved patient outcomes were observed as Positive and Negative Symptom Scale (PANSS, symptoms) score <70:66.7% (407/610), Personal and Social Performance (PSP, function) score >70:34.3% (199/581), and Involvement Evaluation Questionnaire (IEQ, caregiver burden) reduction ≥6:50.2% (270/538). Independent variables including demographics, disease duration, employment status, and clinical scores were screened individually using a univariate analysis and subsequently, variables (cutoff p<0.15) were analyzed using a multivariate regression analysis for association with better clinical outcomes at week 13.ResultsThe factors significantly associated with favorable clinical outcomes were reduction in PANSS at week 5 (odds ratio [OR]=1.14, 95% CI=1.11–1.17) with symptom reduction; baseline PSP total score (OR=1.07, 95% CI=1.05–1.10), PSP change at week 5 (OR=1.07, 95% CI=1.05–1.10), PANSS reduction at week 5 (OR=1.06, 95% CI=1.03–1.08) with functional improvement, reduction in PANSS at week 5 (OR=1.02, 95% CI=1.01–1.03), and total IEQ score at baseline (OR=1.09, 95% CI=1.07–1.11) with caregiver burden reduction.ConclusionThus, symptom and functional improvements with caregiver burden reduction were observed in patients, and PANSS reduction at week 5 was commonly associated with favorable outcomes.

Socially responsible investment portfolios: Does the optimization process matter?

This study investigates the impact of the choice of optimization technique when constructing Socially Responsible Investment (SRI) portfolios. Corporate Social Performance (CSP) scores are price sensitive information that is subject to considerable estimation risk. Therefore, uncertainty in the input parameters is greater for SRI portfolios than conventional portfolios, and this affects the selection of the appropriate optimization method. We form SRI portfolios based on six different approaches and compare their performance along the dimensions of risk, risk-return trade-off, diversification and stability. Our results for SRI portfolios contradict those of the conventional portfolio optimization literature. We find that the more “formal” optimization approaches (Black-Litterman, Markowitz and robust estimation) lead to SRI portfolios that are both less risky and have superior risk-return trade-offs than do more simplistic approaches; although they also have more unstable asset allocations and lower diversification. Our conclusions are robust to a series of tests, including the use of different estimation windows and stricter screening criteria.

Safety and efficacy of paliperidone palmitate 1-month formulation in Chinese patients with schizophrenia: a 25-week, open-label, multicenter, Phase IV study.

RationaleLong-acting injectable (LAI) paliperidone palmitate 1-month formulation (PP1M) has demonstrated acceptable tolerability and favorable clinical outcomes in Western and Asian patients with schizophrenia. Hence, analysis of the outcomes of long-term PP1M treatment specifically in Chinese patients is of interest.ObjectiveThe aim of this study is to evaluate the long-term safety and efficacy of PP1M treatment in Chinese patients with schizophrenia.MethodsIn this 25-week, open-label, Phase IV study, patients (18–65 years) diagnosed with schizophrenia and having a baseline Positive and Negative Syndrome Scale (PANSS) total score of 60–120 (inclusive) were enrolled. All patients received injections of PP1M 150 mg eq. (day 1) and 100 mg eq. (day 8), followed by a flexible once-monthly maintenance dosing (75, 100, or 150 mg eq.).ResultsOf the 353 patients, 234 (66.3%) completed the study treatment (mean age, 31.1 years; 52.7% men). The PANSS total score (primary end point) improved significantly over the 6-month treatment period (mean [standard deviation] change from baseline to end of treatment, −27.2 [18.30]; P<0.0001). The Clinical Global Impressions-Severity and Personal and Social Performance scores (secondary end points) also improved significantly (P<0.0001). At 6 months, PP1M had a positive impact on medication satisfaction, adherence, and increased preference for LAIs. Treatment-emergent adverse events (TEAEs) were reported by 181 (51.3%) patients (TEAEs ≥5%: extrapyramidal disorder [15.3%], akathisia [10.5%], blood prolactin increase [8.8%], insomnia [5.4%]). A total of 8 deaths were reported, including 4 completed suicides.ConclusionLong-term treatment with PP1M was efficacious, and no new safety concerns were identified in Chinese patients with schizophrenia. Overall, the results were comparable with observations from previous studies.

Efficacy and safety of paliperidone palmitate three-monthly formulation in East Asian patients with schizophrenia: subgroup analysis of a global, randomized, double-blind, Phase III, noninferiority study.

ObjectiveTo demonstrate the efficacy and safety of paliperidone palmitate three-monthly (PP3M) formulation in an East Asian population with schizophrenia by subgroup analysis of a double-blind (DB), multicenter, noninferiority study.Patients and methodsOf 1,429 patients who entered the open-label (OL) phase, 510 were East Asian (China: 296 [58%], Japan: 175 [34%], South Korea: 19 [4%] and Taiwan: 20 [4%]). In the 17-week OL phase, patients received paliperidone palmitate once-monthly (PP1M) formulation on day 1 (150 mg eq.), day 8 (100 mg eq.) and once-monthly thereafter (50–150 mg eq., flexible). Following the OL phase, patients (n=344 East Asian) entered DB phase and were randomized (1:1) to PP1M (n=174) or PP3M (n=170). Primary efficacy endpoint was the percentage of patients who remained relapse free at the end of the 48-week DB phase, using Kaplan–Meier cumulative survival estimate. Secondary efficacy endpoints included change from DB baseline to endpoint in Positive and Negative Syndrome Scale, Clinical Global Impression Severity, Personal and Social Performance scores and symptomatic remission. Additional assessments included caregiver burden and safety.ResultsA total of 285/344 (83%) randomized East Asian patients completed the DB phase. The percentage of patients who had a relapse event was similar on comparing PP3M (17 [10.2%]) to PP1M (20 [11.8%]), and also for Japan (PP3M: 9 [17.6%], PP1M: 13 [23.2%]) and China (PP3M: 6 [5.9%], PP1M: 7 [6.9%]). Mean change from baseline in secondary efficacy parameters was similar to the global population, regardless of treatment. Symptomatic remission was attained by 50% of the treated patients. Caregiver burden was significantly reduced (P<0.001) following treatment with PP3M/PP1M. Frequency of treatment-emergent adverse events in PP3M group during DB phase was greater in the East Asian subgroup (81%) than the global population (68%) and was higher in Japan (92%) than China (75%).ConclusionResults suggest that PP3M is efficacious in the East Asian subgroup. Although treatment-emergent adverse events were slightly higher in the East Asian subgroup versus the global population, no new safety signals were identified.

SA83. Brain Glutamate Levels and Antipsychotic Response in Schizophrenia

Background: There is considerable interest in identifying biomarkers of antipsychotic response in schizophrenia, and brain glutamate is one key candidate. Methods: In a series of 1H-MRS studies, we have investigated the relationship between brain glutamate and antipsychotic response. This includes cross-sectional studies in patients with early psychosis,1 and chronic schizophrenia.2,3 Longitudinally, within the OPTiMiSE consortium, we examined whether glutamate levels in first-episode psychosis (FEP; n = 72, <2 weeks antipsychotic medication) predict psychopathology after subsequent administration of oral amisulpride for 4 weeks. Finally, in an ongoing study in treatment-resistant schizophrenia, we investigate whether glutamate levels prior to clozapine initiation predict the degree of symptomatic response after 12 weeks of clozapine treatment. Results: The cross-sectional study in early psychosis1 found elevated glutamate in the anterior cingulate cortex (ACC) in patients who had reached remission compared to those who had not (T(30) = 3.02; P = .005). ACC glutamate level was positively associated with the severity of negative symptoms (r = .42; P = .017) and negatively associated with of global functioning (r = .47; P = .007). Our first cross-sectional study in chronic schizophrenia2 detected an elevation in ACC glutamate in treatment-resistant schizophrenia (TRS) compared to healthy volunteers (T(14) = 2.80, P = 0.01), which was not apparent in treatment responders (T(16) = 0.29, P = .77). The subsequent larger study3 found higher ACC glutamate levels in TRS than in treatment-responsive patients (T(35) = 2.34, P = .025). In the OPTiMiSE FEP cohort at baseline (prior to amisulpride treatment), ACC glutamate was positively correlated with the PANSS general score (r = .26; P = .03) and negatively correlated with the personal and social performance (PSP) score, (r = −.34; P = .006). Baseline glutamate in the ACC (r = −.38; P = .004) and thalamus (r = −.42; P = .003) were negatively correlated with PSP score after 4 weeks amisulpride. Baseline thalamic glutamate negatively correlated with the longitudinal reduction in the PANSS positive (r = −.35; P = .009) and total (r = −.28; P = .04) scores after 4 weeks amisulpride. An interim update on the ongoing clozapine study will also be provided. Conclusion: This series of studies has returned consistent findings that elevated ACC glutamate is associated with poor response to antipsychotics, more severe symptoms, and social dysfunction. Brain glutamate may relate to the magnitude of response to subsequent antipsychotic treatment.

Evaluation of Relationship Between Mental Health and Marital Satisfaction in Male Married Students

Background: Marital satisfaction is a multidimensional concept and depends on many factors including general health. As educated males have an effective role in the productive activities, it is essential to present some appropriate perspectives in the field of their mental health and marital satisfaction. Objectives: The current study aimed at investigating the association between mental health and marital satisfaction in married male students of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. Methods: The study sample consisted of 100 married male students of Ahvaz Jundishapur University of Medical Sciences selected through the convenience sampling method. The data were gathered using the ENRICH marital satisfaction inventory and the general health questionnaire, and analyzed through Pearson correlation coefficient by SPSS version 16. Results: In 25% of the subjects, scores of physical function was higher than the cutoff point.The anxiety, social function, depression, and general health scores of 30%, 45%, 19%, and 44% of the subjects were higher than the cutoff point, respectively. There was significant association between marital satisfaction of the students and physical symptoms (r = -0.51), anxiety (r = -0.49), social performance (r = -0.34), depression (r = -0.33), and total score of mental health (r = -0.53). Conclusions: Prevention and intervention efforts can focus on how mental health problems can trigger interpersonal relationship and vice versa.

Empirical study on relationship between corporate social responsibility and financial performance in Korea

There have been numerous studies on corporate social responsibility (CSR) and its relation to corporate performance. Recently, studies in this field have paid particular attention to the method of measurement in order to identify the CSR activities. One of the widely recognized measures to proxy CSR is the Environmental, Social, and Governance (ESG) score. This paper examines the relationship between Corporate Social Responsibility (CSR) and corporate profit by testing the ESG performance score on the firm’s Financial Performance (FP), specifically for Korea Stock Market (KOSPI) listed firms in the period of 2008 ~ 2014. We use three separate individual Environmental, Social and Corporate Governance (ESG) disclosure scores from Bloomberg for the CRS proxy measure, as well as the Return on Equity (ROE), Market-to-Book Ratio (MBR) and Stock Return for the FP measures. We found that the ESG disclosure scores (the measures of environmental, social, and governance responsibility performance) in the Korean corporations shows diversified results. Particularly, the environmental responsibility performance score presents a negative (or U curve) relationship with FP, whereas the governance responsibility performance score presents a positive (or inverse U curve) relationship with FP. On the other hand, we did not find any statistically significant evidence of a relationship between the social responsibility performance score and FP.

Switching from oral atypical antipsychotic monotherapy to paliperidone palmitate once-monthly in non-acute patients with schizophrenia: A prospective, open-label, interventional study

RationaleLong-acting injectable antipsychotic therapies may offer benefits over oral antipsychotics in patients with schizophrenia.ObjectiveThis study aimed to explore the safety, tolerability, and treatment response of paliperidone palmitate once-monthly in non-acute but symptomatic adult patients switched from previously unsuccessful monotherapy with frequently used oral atypical antipsychotics.MethodsThis was a post hoc analysis of a prospective, interventional, single-arm, international, multicenter, open-label, 6-month study.ResultsThe patients (N = 472) were switched to paliperidone palmitate once-monthly (PP1M) from daily oral treatment with either aripiprazole (n = 46), olanzapine (n = 87), paliperidone extended-release (n = 104), quetiapine (n = 44), or risperidone (n = 191). In all groups, mean Positive and Negative Syndrome Scale total (p < 0.0001) and Clinical Global Impression-Severity scores improved significantly (p = 0.0004 to p < 0.0001). An improvement of ≥50 % in the Positive and Negative Syndrome Scale total score was observed in 21.7 % (aripiprazole), 29.9 % (olanzapine), 29.8 % (paliperidone extended-release), 27.3 % (quetiapine), and 37.2 % (risperidone) of patients. The patients showed significant improvements in the Personal and Social Performance score (aripiprazole p = 0.0409, all others p ≤ 0.0015); Mini International Classification of Functionality, Disability and Health Rating for Activity and Participation Disorders in Psychological Illnesses total scores (all p < 0.01); and Treatment Satisfaction Questionnaire for Medication Global Satisfaction score (olanzapine and risperidone p < 0.0001, quetiapine p = 0.0465, paliperidone extended-release p = 0.0571, aripiprazole p = NS). Paliperidone palmitate once-monthly was well tolerated, presenting no new safety signals.ConclusionsThese data illustrate that stable, non-acute but symptomatic patients on oral antipsychotic monotherapy may show clinically meaningful improvement of symptoms, functioning, and treatment satisfaction after direct transition to PP1M. The findings are limited by the naturalistic study design; thus, further studies are required to confirm the current findings.