Both drugs had similar cycle control parameters with a tendency towards reduced bleeding with continued use. More subjects in the DRSP 3 mg/EE 30 microg group reported improved physical well-being (60% vs 46%; p = 0.035; chi-squared [chi2] test). Emotional well-being was reported improved in 61% and 51% of DRSP 3 mg/EE 30 microg and LNG 150 microg/EE 30 microg users, respectively (p = 0.1190; chi2 test). Adverse events were typical of oral contraceptive use and did not give rise to any safety concerns. Both products had similar beneficial effects on symptoms of water retention and impaired concentration, but DRSP 3 mg/EE 30 microg was significantly better in alleviating negative affect symptoms during the menstrual phase. The proportion of subjects with acne decreased in the DRSP 3 mg/EE 30 microg group but not in the LNG 150 microg/EE 30 microg group. More subjects in the DRSP 3 mg/EE 30 microg group reported improved physical well-being compared with the LNG 150 microg/EE 30 microg group.

Sexual dysfunction is common during acute and continuation treatment of depressed patients with selective serotonin (5-hydroxytryptamine, 5-HT) re-uptake inhibitors (ssRIs), but there is no consensus on clinical management. Compounds with 5-HT(1A) agonist properties have been proposed as adjuvant agents in patients continuing with ssRIs. Randomized double-blind placebo-controlled parallel-group fixed-dose 4-week treatment study. Previously depressed male or female patients in symptomatic remission receiving stable doses of fluoxetine or paroxetine but experiencing treatment-emergent sexual dysfunction were randomised to double-blind treatment with placebo or VML-670 (a 5-HT(1A) and 5-HT(1D) agonist). sexual dysfunction was assessed by the Arizona sexual Experiences scale (ASEX). Two-hundred and eighty-eight patients (204 women, 84 men; mean age 44.2 years) received VML-670 (n = 149; 107 women, 42 men) or placebo (n = 139; 97 women, 42 men). In the intention-to-treat, last-observation carried forward analysis (n = 282), proportionately more patients became free of sexual dysfunction with VML-670 (34.3% versus 27.9% with placebo) but this difference was not statistically significant. Male patients treated with VML-670 showed a significantly greater (p =0.01) improvement in ability to achieve and maintain penile erection (a secondary outcome measure). A similar proportion of patients reported on-treatment, treatment-emergent adverse events with VML-670 (71.1%) and placebo (68.3%), and a similar proportion experienced at least one treatment-related adverse event (36.9% versus 35.3%). Double-blind treatment with VML-670 offered no significant advantage over placebo on the primary outcome measure in the overall sample. Further studies may be warranted in larger groups of male patients with sexual dysfunction.

No abstract

Living standards in the UK and the US are in danger of falling. In the past change has brought disruption with the offsetting reward of higher living standards from growth. Today we have disruption without reward. The resulting voter dissatisfaction encourages populist policies which threaten even worse outcomes. The decline in growth has weakened the standing of liberal democracy both at home and internationally. The decline is entirely due to poor productivity combined with an unfavourable change in demography. The UK and the US have changed from having a demographic surplus in which the working population grew faster than the total population to a demographic deficit. Before living standards grew faster than productivity they now grow more slowly. Faster immigration could change demography, but voters are likely to press for less. To avoid falling living standards we must increase the rate at which productivity improves. Faster productivity does not only depend on technology. We can improve it by encouraging more investment. Growth depends on Total Factor Productivity (“TFP”), for which current consensus estimates are based on a faulty model which has induced pessimism about our ability to encourage more growth. The book sets out a revised and superior model of TFP which demonstrates that the weakness in productivity is the result of the bonus culture and suggests ways by which this can be changed so that investment is encouraged and growth returns.

Prior to the financial crisis most economists, though happily not all, believed in a version of the Efficient Market Hypothesis (“EMH”) which held that financial markets were efficiently and thus always correctly priced. The financial crisis resulted in the EMH being discredited as, despite many warnings, it led central bankers to ignore the threat posed by excess debt and overpriced assets, which believers in the EMH held to be impossible. The original, random walk, form of this hypothesis had been shown to be wrong by the stationarity of stock market returns, but many economists continued to adhere to some version of the EMH. The difficulty in persuading them to discard it was due to a significant degree to the fact that it was seldom enunciated as a well-defined and refutable hypothesis. But value, as generally understood, depends on relative returns and on this basis the EMH, when defined as holding that price and value are the same, is demonstrably wrong. While the EMH was generally understood to be making this claim the imprecision with which it was defined meant that other interpretations were possible, and some economists remain reluctant to drop the idea of efficiency. Continued claims that the market is efficient have produced no hypotheses which are sufficiently well defined to be refutable and they therefore fall on the wrong side of Karl Popper’s famous demarcation between science and nonscience.