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1.
The argument for pharmaceutical policy 总被引:1,自引:0,他引:1
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In this article the authors deal with issues of drug utilisation from a clinical and policy perspective. They address the difficulties of managing drug therapy on a population level, which is known among professionals, as the problem of rational use of medicines. Various definitions and interpretations are presented and compared. This is followed by a presentation of the concerns associated with pharmaceutical marketing from a policy perspective, including the fear that the dominance of information produced by industry may lead to irrational drug use. Next, the authors review the tools for policy making including educational, managerial, and regulatory interventions. The (often overlapping) concepts of medicines management, clinical pharmacy and pharmaceutical care are then discussed to show how professionals, sometimes in collaboration with policymakers, have tackled the problem of nonrational use of medicines. The authors address the question as to whether the rational use of medicines a universal concept, whether it can be and whether it should be? They argue that, as with most concepts, the rational use of medicines must always be viewed in context. They conclude that pharmacy needs to adapt its way of thinking to include the issue of context. They point out that clinical pharmacists today already adapt their decisons to each patient and patient group. Policymakers are encouraged to adopt a similar approach because populations as well as particular market situations vary and therefore policy solutions cannot be considered universal.*This article is the second in a series of articles on this topic that will appear in Pharmacy World & Science during 2005. 相似文献
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Hafdis Helgadottir Birna Thorisdottir Ingibjorg Gunnarsdottir Thorhallur I. Halldorsson Gestur Palsson Inga Thorsdottir 《Nutrients》2022,14(3)
To strengthen the organization of new national dietary surveys and interventions in childhood, our aim was to study macronutrient intake and blood lipid profile at 6 years of age by comparing results from two earlier population-based cohorts. Subjects were n = 131 and n = 162 in the years 2001–2002 and 2011–2012, respectively. Three-day weighed food records were used to estimate diet and calculate nutrient intake. Total cholesterol, HDL-cholesterol and triacylglycerol were measured in serum and LDL-cholesterol was calculated. The average intake of saturated fatty acids (SFA) and trans FA was lower in 2011–2012 than 2001–2002 (13.3E% vs. 14.7E%, p < 0.001, and 0.8E% vs. 1.4E%, p < 0.001, respectively), replaced by a higher intake of unsaturated fatty acids. Total cholesterol and LDL-cholesterol were significantly lower in 2011–2012 than 2001–2002 (4.6 vs. 4.4 mmol/L, p = 0.003 and 2.8 vs. 2.5 mmol/L, p < 0.001, respectively). In a multiple linear regression model, one E% increase in SFA intake was related to a 0.03 mmol/L increase in LDL cholesterol (p = 0.04). A lower intake of saturated and trans fatty acids, replaced by unsaturated fatty acids, may have contributed to an improved lipid profile in a healthy 6-year-old population. Biological data for analysis of blood lipids are important in national dietary surveys in healthy children to monitor important health outcomes of interventions. 相似文献
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Erna Petersen Birna Thorisdottir Inga Thorsdottir Geir Gunnlaugsson Petra Arohonka Iris Erlund Ingibjrg Gunnarsdottir 《Maternal & child nutrition》2020,16(3)
Iodine is an essential nutrient for growth and development during infancy. Data on iodine status of exclusively (EBF) and partially breastfed (PBF) infants as well as breast milk iodine concentration (BMIC) are scarce. We aimed to assess (a) infant iodine nutrition at the age of 5.5 months by measuring urinary iodine concentration (UIC) in EBF (n = 32) and PBF (n = 28) infants and (b) mothers' breast milk iodine concentration (n = 57). Sixty mother–infant pairs from three primary health care centres in Reykjavik and vicinities provided urine and breast milk samples for iodine analysis and information on mothers' habitual diet. The mother–infant pairs were participants of the IceAge2 study, which focuses on factors contributing to infant growth and development, including body composition and breast‐milk energy content. The median (25th–75th percentiles) UIC was 152 (79–239) μg/L, with no significant difference between EBF and PBF infants. The estimated median iodine intake ranged from 52 to 86 μg/day, based on urinary data (assuming an average urine volume of 300–500 ml/day and UIC from the present study). The median (25th–75th percentiles) BMIC was 84 (48–114) μg/L. It is difficult to conclude whether iodine status is adequate in the present study, as no ranges for median UIC reflecting optimal iodine nutrition exist for infants. However, the results add important information to the relatively sparse literature on UIC, BMIC, and iodine intake of breastfed infants. 相似文献
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A modification of the haemolysis-in-gel test for rubella is described. This involves using, instead of sera, whole blood samples taken from the earlobe and placed directly onto the test plates without any pretreatment. A comparison was made between this method and the HI test. Samples from 461 individuals were tested by both methods. The results of these two tests were in good agreement. No false negatives or false positives were observed by the direct HIG test. The direct HIG test is particularly well suited for screening large groups for rubella antibodies in connection with a vaccination program. 相似文献
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There has been an upsurge of academic interest in using focus groups (FGs) as a main or stand-alone qualitative method. In this article, the authors introduce a recently developed ancillary method to FGs called interviewing the moderator. The method is employed immediately after an FG and consists of a one-on-one interview with the FG moderator by another member of the research team. The authors argue, with reference to a specific study, that interviewing the moderator adds a new and valuable dimension to group interviews used in research. They describe how this method came about and provide a concrete example of its use in a recently completed research project. They discuss several advantages of the interview, among them that it provides information about group interaction and participant behavior, and furnishes additional data on what is discussed when the tape recorder is turned off. 相似文献
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Almost every national and supranational health policy document accords high importance to the need to listen to and ‘empower’
patients. The relationship between pharmaceutical policy and the lay public is not direct but mediated by several actors,
including health care workers, patient organisations, industry and, most recently, the media. Although the overall aim of
health and pharmaceutical policy is to address the needs of all citizens, there are only a few, well organised groups who
are actually consulted and involved in the policymaking process, often with the support of the industry. The reasons for this
lack of citizen involvement in health and pharmaceutical policymaking are many, for example: there is no consensus about what
public involvement means; there is a predominance of special interest groups with narrow, specific agendas; not all decision
makers welcome lay participation; patients and professionals have different rationalities with regard to their views on medicine.
Because the lay public and medicine users are not one entity, one of the many challenges facing policy makers today is to
identify, incorporate and prioritise the many diverse needs. The authors recommend research which includes studies that look
at: lay attitudes towards pharmaceutical policy; lay experiences of drug therapy and how it affects their daily lives; the
problem of identifying lay representatives; the relationship between industry and the consumers; the effect of the media on
medicine users and on pharmaceutical policy itself. The authors acknowledge that although lay involvement in policy is still
in its infancy, some patient organisations have been successful and there are developments towards increased lay involvement
in pharmaceutical policymaking.
This article is the fourth in a series of articles on this topic that will appear in Pharmacy World & Science during 2005. 相似文献
10.
Jrgen Steen Jensen Annette Sylvest Birna Trap Jrn C. Jensen 《Basic & clinical pharmacology & toxicology》1991,69(5):386-389
Abstract: The genotoxicity of conventional polymethylmethacrylate (PMMA) and a new formulation of bone cement: methylmethacrylate/n-decylmethacrylate/isobornylmethacrylate (MMA/DMA/IBMA) were tested by micronucleus test and reverse mutation assays of Salmonella typhimurium (Ames test). In extracts from cement pellets (37°, 72 hr) with water and water/ethanol the concentration of MMA was reduced by 13–1. times with the new formulation and the concentrations of accelerators were reduced by 4-5 times. New chemical constituents (DMA, IBMA, dihydroxy- propyl-p-toluidine) were found in negligible concentrations. In the micronucleus test all three cement brands were found non-mutagenic and in the Ames test scattered increased revertant ratios were found without differences between the three brands. The new formulation does not possess any increased risk of genotoxicity. 相似文献