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This briefing was prepared by Dr. Chris Wilkins and Emily Rose Report Authors Dr. Chris Wilkins, James Reilly, Emily Rose, Debashish Roy, Dr. Megan Pledger, Arier Lee Centre for Social and Health Outcomes Research and Evaluation SHORE ; Massey University Research funding New Zealand Police with money received from the Cross Departmental Research Pool CDRP ; , administered by the Ministry of Research Science and Technology MoRST.
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The knowledge and experience of the law enforcement community must be brought to bear in prevention and education initiatives to help reduce crime rates. Education programs such as D.A.R.E., which emphasize the dangers of drug and alcohol abuse and community education programs such as CrimeStoppers are proven winners that should be available on a broader scale. Texas Tomorrow, Austin, TX: Office of the Governor, 1995.
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Direct-to-Physician Marketing. About half the cost is the free samples they give to your doctor, and that's been valued at retail cost. So that overstates the cost to the pharmacy companies, but still that's the biggest part of their spending on promotion. Another 26 percent of their spending is on other commercial activities directed at physicians. Direct-to-Consumer Advertising DTC ; . Direct consumer advertising is still a fairly small portion. It's about out of every spent on promotion purposes, but it's a rapidly growing portion of the pie, and I think it has a very big impact on spending patterns. Then there's another 5 percent for hospital-based promotions and another 3 percent on medical journal ads. Freebies to Doctors. First of all, we have direct-to-physician marketing or detailing. As I mentioned, two-thirds of that is free samples given to physicians with the intention of getting patients started on that drug. If the physician determines that a certain drug will be beneficial to a patient, he or she can just reach into their closet and grab some free samples of the drug, and that gives a leg up to a particular brand. Or it might even give a leg up to a brand drug over an equivalent generic drug. There are also the perks that doctors receive--free travel, speaking fees at conferences and other gifts. There's some question in my mind about whether that has any effect. Most of the doctors I know just take the money and run and don't really pay much attention to who's providing it. However, some doctors--and particularly some medical students--are trying to get away from all the freebies. There's an article in today's Wall Street Journal about that. A med student at Brown is swearing off of all the freebies from pharmaceutical companies and urging others to do so. Free Info. Then there's the free information that the detailers, the salespeople, provide to doctors. And this is a valuable service, because doctors don't have time to keep up with all the new information that's coming out about new drugs. But while physicians do learn about available drug therapies, they don't really get the cost benefit analysis, because these detailers are there to promote their employer's drugs. So that's just the nature of the business. More on DTC. Now, looking at direct-to-consumer advertising, the total amount has risen dramatically over the past few years. In 1994 it was about 0 million. It's risen to almost .5 billion in 2000. And if you look at print and other advertising, this has leveled off over the past few years. There's been an explosion in TV advertising.
The authors conclude that their findings provide further evidence that "inhaled corticosteroid use is an independent risk factor for fracture". The study has a number of potential limitations, including limited statistical power, the age of the participants, and inability to control for historical precomputerisation of practice records ; oral corticosteroid use. The assumption that all inhaled corticosteroids are equipotent is incorrect, however the great majority of the participants 824, 84% ; were prescribed beclometasone or budesonide for which this assumption is acceptable and atomoxetine.
Lent offenses. Past work has consistently shown that those charged with violent offenses e.g., homicide, criminal sexual assault, robbery ; are the least likely to test positive for an illicit drug but the most likely to have been using alcohol. ; We examined the odds ratios for the three most frequently used drugs by Cook and DuPage County arrestees: marijuana, cocaine, and opiates. The results show that those charged with a drug-related offense, such as possession, were twice as likely to test positive for marijuana, three times as likely to test positive for cocaine, and five times as likely to test positive for opiates compared to those charged with a violent offense and controlling for gender and age. A similar though somewhat less pronounced pattern was found for those charged with a property offense such as theft or burglary and those.
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| The Association of Faculties of Pharmacy of Canada extends sincere appreciation to the following members of the pharmaceutical industry and pharmacy organizations for their generous contributions to AFPC in the year 2001. Educational Grants for AFPC CCCP Conference 2001 GOLD MERCK FROSST CANADA & CO. PFIZER CANADA INC. DUPONT PHARMA.
On the basis of the preliminary trials a 32 full factorial design was employed to study the effect of independent variables i.e. polymer to drug ratio X1 ; and the stirring speed X2 ; on dependent variables % mucoadhesion, t80, drug entrapment efficiency and swelling index. The results depicted in Table 2 clearly indicate that all the dependent variables are strongly dependent on the selected independent variables as they show a wide variation among the nine batches B1 to B9 ; The fitted equations full models ; relating the responses i.e. % mucoadhesion, t80, drug and azathioprine.
Setting: A collaboration of the International Food Information Council Foundation, International Life Sciences Institute, American Dietetic Association, American Academy of Family Physicians, American College of Sports Medicine, and National Recreation and Park Association developed a multifaceted communications program targeted at children aged 911 and their parents. Interventions: ACTIVATE uses unprecedented, in-depth consumer research--focus group, ethnographic, in-home interviews and quantitative--to track consumer knowledge and perceptions of the overweight problem, define appropriate audiences for messages, and develop customized program elements in order to deliver personalized and achievable advice for healthy living. Outcomes: An interactive and innovative Web site will be.
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Table 5.35 Difference in Public Expectations According to Consumer Experience with Purchasing OTCs from a Convenience Store Consumer Had Purchased OTCs from a Convenience Store YES N 507 Mean of Difference a and imuran.
Sign the resolution for a federal commission on drug policy contents feedback search drcnet home page join drcnet drcnet library schaffer library the drug legalization debate dea statement claim v: there are no compelling medical reasons to prescribe marijuana or heroin to sick people.
SECTION 1 LEARNING OBJECTIVES Target Group: Nurse practitioners, physician assistants, medical and nursing students, practicing clinicians, and health services personnel in training. By the end of this discussion, participants should: 1. 2. Know the major risk factors and principal sites for oral cancer development Provide a thorough oral examination for abnormalities that may be malignant or may need professional attention Know what screening tests may be used as adjuncts to biopsy of suspicious lesions Be able to advise patients on reducing behaviors or factors that raise their risk of oral cancers Understand the importance of providing necessary dental rehabilitative work before a patient undergoes radiation or chemotherapy for oral cancers Know when to refer patients for biopsies of suspicious lesions in their oropharynx Teach patients how to do a self-examination for oral and pharyngeal abnormalities and why they should do so and co-trimoxazole.
69. Neilson JP, Munjanja SP, Whitfield CR. Screening for small for dates fetuses: a controlled trial. BMJ 1984; 289: 11791182 Level II-2 ; 70. Pearce JM, Campbell S. A comparison of symphysis-fundal height and ultrasound as screening tests for light-forgestational age infants. Br J Obstet Gynaecol 1987; 94: 100104 Level II-3 ; 71. Warsof SL, Cooper DJ, Little D, Campbell R. Routine ultrasound screen for antenatal detection of intrauterine growth restriction. Obstet Gynecol 1986; 67: 3339 Level II-2 ; 72. Weiner Z, Farmakides G, Schulman H, Lopresti S, Schneider E. Surveillance of growth-retarded fetuses with computerized fetal heart rate monitoring combined with Doppler velocimetry of the umbilical and uterine arteries. J Reprod Med 1996; 41: 112118 Level III ; 73. Hadlock FP, Deter RL, Harrist RB, Park SK. Estimating fetal age: computer-assisted analysis of multiple fetal growth parameters. Radiology 1984; 152: 497501 Level II-3 ; 74. Shepard MJ, Richards VA, Berkowitz RL, Warsof SL, Hobbins JC. An evaluation of two equations for predicting fetal weight by ultrasound. J Obstet Gynecol 1982; 142: 4754 Level III ; 75. Chamberlain PF, Manning FA, Morrison I, Harman CR, Lange IR. Ultrasound evaluation of amniotic fluid volume. I. The relationship of marginal and decreased amniotic fluid volumes to perinatal outcome. J Obstet Gynecol 1984: 150: 245249 Level II-3 ; 76. Varma TR. Bateman S, Patel RH, Chamberlain GV, Pillai U. Ultrasound evaluation of amniotic fluid: outcome of pregnancies with severe oligohydramnios. Int J Gynaecol Obstet 1988; 27: 185192 Level II-2 ; 77. Philipson EH, Sokol RJ, Williams T. Oligohydraminios: clinical associations and predictive value for intrauterine growth retardation. J Obstet Gynecol 1983; 146: 271278 Level II-2 ; 78. Davies JA, Gallivan S, Spencer JA. Randomised controlled trial of Doppler ultrasound screening of placental perfusion during pregnancy. Lancet 1992; 340: 12991303 Level I ; 79. Low JA. The current status of maternal and fetal blood flow velocimetry. J Obstet Gynecol 1991; 164: 10491063 Level III ; 80. Wladimiroff JW, v.d.Wijngaard JA, Degani S, Noordam MJ, van Eyck J, Tonge HM. Cerebral and umbilical arterial blood flow velocity waveforms in normal and growthretarded pregnancies. Obstet Gynecol 1987; 69: 705709 Level II-2 ; 81. Alfirevic Z, Neilson JP. Doppler ultrasonography in highrisk pregnancies: systemic review with meta-analysis. J Obstet Gynecol 1995; 172: 13791387 Meta-analysis ; 82. Leeson S, Aziz N. Customised fetal growth assessment. Br J Obstet Gynaecol 1997; 104: 648651 Level III ; 83. Ewigman BG, Crane JP, Frigoletto FD, LeFevre ML, Bain RP, McNellis D. Effect of prenatal ultrasound screening on perinatal outcome. RADIUS Study Group. N Engl J Med 1993; 329: 821827 Level I.
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Ms. Houck is statistician, Dr. Mulsant is associate professor, Dr. Pollock is professor, Dr. Dew is professor, and Dr. Reynolds is professor in the Department of Psychiatry, University of Pittsburgh in Pennsylvania. Dr. Mazumdar is professor in the Department of Biostatistics, Univeristy of Pittsburgh. To whom correspondence should be addressed: Patricia R. Houck, MSH, Western Psychiatric Institute and Clinic, UPMC Health System, Thomas Detre Hall, E-1128, 3811 O'Hara Street, Pittsburgh, PA 15213-2593; Tel: 412-624-2246 x0947; Fax: 412-624-2841; E-mail: houckpr msx.upmc.
BBC TV programme 'See Hear', who think that research scientists simply seek out sick animals and try out cures on them! Charities should be legally required to reveal in their publicity materials whether donations may be used to fund animal experimentation, so that people who object to such practices can choose which charities to support. Debate Discussions on the TV and radio tend to involve tedious repetitions of stock arguments in favour of animal research, and some such programmes have seriously unbalanced panels. For example, the BBC Radio 4 programme 'The Moral Maze' on 8th December 2002 about animal experimentation featured four panellists, none of whom had a fundamental objection to animal experiments! Other science programmes tend to refer to animal research casually as though it were not in any way questionable or controversial. I want to see biologically-qualified people debating the issues in a calm, civilised and open manner, covering animal and non-animal methods in detail and assessing them honestly, in well-chaired TV and radio discussion programmes which also present reliable statistics. They should address the validation issue: "All of the traditional animal-based safety tests were never validated and would be unlikely to pass the level of proof required of new in vitro methods."1 My favoured model would be some of the better TV programmes on the Hutton Enquiry. Animal experimenters fearful of animal rights extremists could have their identities concealed if necessary. Trust With regard to the provision of balanced information about research involving animals, I would not trust the words of representatives of, or shareholders in, companies which carry out, fund or promote research. In order for me to trust scientists, doctors or other experts I would require them to declare all interests such as sources of past, present and potential future funding for their work. I do not generally trust politicians on this issue or many others! ; , largely because pharmaceutical companies contribute to party funding. As a science graduate and postgraduate student in medical science, I cultivate a healthy cynicism in all matters, so my trust or lack of trust for particular sectors of society is relative and conditional, the latter quality depending on what I already know and subsequently learn, and the former depending on previous experience of the sector or individual. I prefer to hear both sides of a debate before making up my own mind. 15.
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As mentioned earlier, pharmaceuticals, biologics, and medical devices are subject to different regulatory requirements that govern pre-market applications, manufacturing practices, and post-market reporting of adverse events. Combination products present a difficult regulatory challenge: which regulations should apply? In the United States, each of the product types is regulated by a different office within the Food and Drug Administration FDA ; . A separate Office of Combination Products OCP ; was established in 2002 to develop regulatory guidelines and compliance systems for products that combine two or more product types. Because a "one-size-fits-all" approach would not accommodate the diversity of product combinations, a specific application for combination products has not been developed50. Instead, the OCP reviews combination product applications and assigns them either to the Center for Drug Evaluation and Research CDER ; , the Center for Biologics Evaluation and Research CBER ; , or the Center for Devices and Radiological Health CDRH ; for review, depending upon the combination product's `primary mode of action.' Although the pre-market review is led by one center, consultation with another center is not uncommon.51 Whether a single application or multiple applications are submitted to the FDA depends on the nature of the combination product, the OCP's determination, and the companies' business strategy. For most combination products, a single application is appropriate for seeking market approval. In some cases, however, the OCP may require multiple applications or the companies involved may choose to submit separate applications in order to obtain the benefits of new product exclusivity, proprietary data protection, or approval under a particular type of product designation, such as an orphan drug designation52. Similarly, among countries in the European Union EU ; , the method by which the principal intended action is achieved determines which set of regulations is applied to the combination product53. For most combination products, however, the principal intended action is achieved through a synergistic effect that neither component could create alone. Manufacturers must choose which component is most responsible for the effect and present clinical evidence and scientific reasoning to regulatory agencies in defense of the choice. When potentially equally strong cases can be made for applying different regulatory requirements, manufacturers can sometimes make adjustments to the intended use, patient population, or labeling of the combination product to strengthen the argument that one regulatory process should be applied instead of another54. Even then, countries within the EU may vary in their views of which regulations should apply for borderline cases. When a drug is involved, manufacturers can seek approval through separate applications to national authorities or through a single application to the European Medicines Agency EMEA ; . While the latter provides the advantages of a centralized process, it can be the longer, more expensive option55. In general, devices typically offer incremental improvements over existing products, so they often qualify for an expedited review that does not require new clinical trials. Pharmaceuticals and biologics that offer incremental improvement over existing therapeutics may also be put on a fast track, but most are submitted as new products that necessitate extensive clinical trials and a lengthy review. When devices are combined with drugs, the generally shorter, less costly regulatory path that many devices follow may no longer apply. Given the challenges and uncertainties involved in regulating combination products, conferring with regulatory agencies early in the product development process is clearly important, if not essential, for avoiding extra costs and delays. A firm's typical testing and validation approach may not be the most appropriate approach for a converged product. By engaging regulators in devising the testing and validation strategy, companies can reduce the likelihood of pursuing an approach that has been dismissed by precedent or that requires unexpected supplemental studies at a late stage. Moreover, frequent consultation with regulators can ensure that regulatory changes are not missed and adjustments are made at the earliest possible stage. Regulatory experience with combination products is relatively new. As innovative product combinations continue to challenge existing approaches and experience accumulates, regulatory requirements are likely to undergo further modification.
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