Towards a transparent, credible, evidence-based decision-making process of new drug listing on the Hong Kong Hospital Authority Drug Formulary: challenges and suggestions

The aim of this article is to describe the process, evaluation criteria, and possible outcomes of decision-making for new drugs listed in the Hong Kong Hospital Authority Drug Formulary in comparison to the health technology assessment (HTA) policy overseas. Details of decision-making processes including the new drug listing submission, Drug Advisory Committee (DAC) meeting, and procedures prior to and following the meeting, were extracted from the official Hong Kong Hospital Authority drug formulary management website and manual. Publicly-available information related to the new drug decision-making process for five HTA agencies [the National Institute of Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC), the Australia Pharmaceutical Benefits Advisory Committee (PBAC), the Canadian Agency for Drugs and Technologies in Health (CADTH), and the New Zealand Pharmaceutical Management Agency (PHARMAC)] were reviewed and retrieved from official documents from public domains. The DAC is in charge of systemically and critically appraising new drugs before they are listed on the formulary, reviewing submitted applications, and making the decision to list the drug based on scientific evidence to which safety, efficacy, and cost-effectiveness are the primary considerations. When compared with other HTA agencies, transparency of the decision-making process of the DAC, the relevance of clinical and health economic evidence, and the lack of health economic and methodological input of submissions are the major challenges to the new-drug listing policy in Hong Kong. Despite these challenges, this review provides suggestions for the establishment of a more transparent, credible, and evidence-based decision-making process in the Hong Kong Hospital Authority Drug Formulary. Proposals for improvement in the listing of new drugs in the formulary should be a priority of healthcare reforms

Mediaeval concept of the just price

Thesis (M.A.)--Boston University, 1949. This item was digitized by the Internet Archive

The Future of Partisan Symmetry as a Judicial Test for Partisan Gerrymandering after LULAC v. Perry

While the Supreme Court in Bandemer v. Davis found partisan gerrymandering to be justiciable, no challenged redistricting plan in the subsequent 20 years has been held unconstitutional on partisan grounds. Then, in Vieth v. Jubilerer, five justices concluded that some standard might be adopted in a future case, if a manageable rule could be found. When gerrymandering next came before the Court, in LULAC v. Perry, we along with our colleagues filed an Amicus Brief (King et al., 2005), proposing the test be based in part on the partisan symmetry standard. Although the issue was not resolved, our proposal was discussed and positively evaluated in three of the opinions, including the plurality judgment, and for the first time for any proposal the Court gave a clear indication that a future legal test for partisan gerrymandering will likely include partisan symmetry. A majority of Justices now appear to endorse the view that the measurement of partisan symmetry may be used in partisan gerrymandering claims as “a helpful (though certainly not talismanic) tool” (Justice Stevens, joined by Justice Breyer), provided one recognizes that “asymmetry alone is not a reliable measure of unconstitutional partisanship” and possibly that the standard would be applied only after at least one election has been held under the redistricting plan at issue (Justice Kennedy, joined by Justices Souter and Ginsburg). We use this essay to respond to the request of Justices Souter and Ginsburg that “further attention … be devoted to the administrability of such a criterion at all levels of redistricting and its review.” Building on our previous scholarly work, our Amicus Brief, the observations of these five Justices, and a supporting consensus in the academic literature, we offer here a social science perspective on the conceptualization and measurement of partisan gerrymandering and the development of relevant legal rules based on what is effectively the Supreme Court’s open invitation to lower courts to revisit these issues in the light of LULAC v. Perry.Governmen

Electronic polarization in quasilinear chains

Starting with a finite $k$-mesh version of a well-known equation by Blount, we show how various definitions proposed for the polarization of long chains are related. Expressions used for infinite periodic chains in the 'modern theory of polarization' are thereby obtained along with a new single particle formulation. Separate intracellular and intercellular contributions to the polarization are identified and, in application to infinite chains, the traditional sawtooth definition is found to be missing the latter. For a finite open chain the dipole moment depends upon how the chain is terminated, but the intracellular and intercellular polarization do not. All of these results are illustrated through calculations with a simple H\"uckel-like model.Comment: 5 page

Molecular evidence for gender differences in the migratory behaviour of a small seabird

Molecular sexing revealed an unexpectedly strong female bias in the sex ratio of pre-breeding European Storm Petrels (Hydrobates pelagicus), attracted to playback of conspecific calls during their northwards migration past SW Europe. This bias was consistent across seven years, ranging from 80.8% to 89.7% female (mean annual sex ratio ± SD = 85.5% female ±4.1%). The sex ratio did not differ significantly from unity (i.e., 50% female) among (i) Storm Petrel chicks at a breeding colony in NW France, (ii) adults found dead on beaches in Southern Portugal, (iii) breeding birds attending nest burrows in the UK, captured by hand, and (iv) adults captured near a breeding colony in the UK using copies of the same sound recordings as used in Southern Europe, indicating that females are not inherently more strongly attracted to playback calls than males. A morphological discriminant function analysis failed to provide a good separation of the sexes, showing the importance of molecular sexing for this species. We found no sex difference in the seasonal or nocturnal timing of migration past Southern Europe, but there was a significant tendency for birds to be caught in sex-specific aggregations. The preponderance of females captured in Southern Europe suggests that the sexes may differ in migration route or in their colony-prospecting behaviour during migration, at sites far away from their natal colonies. Such differences in migration behaviour between males and females are poorly understood but have implications for the vulnerability of seabirds to pollution and environmental change at sea during the non-breeding season

Astronomical Handbooks and Tables from the Islamic World (750-1900): an Interim Report

The purpose of this paper is to present an overview of the current state of research on the medieval Islamic astronomical handbook known as zijes in particular, and astronomical tables in general

Does Involvement in Healthy Eating Among University Students Differ Based on Exercise Status and Reasons for Exercise?

Background. Unhealthy nutritional habits are a major cause of morbidity and mortality in the US. Research indicates that regular physical activity can influence dietary habits of adults. Purpose. The purpose of this study was to examine whether university students’ involvement in healthy eating differed based on current exercise status and reported reasons for exercising. Methods. A sample of 204 university students completed a 22-item survey on healthy eating and physical activity. Results. Less than 10% met all Food Guide recommendations. The leading barriers to healthy eating were time, convenience and healthy food availability. Less than half exercised on four or more days each week. The leading reasons for exercising were to improve appearance, improve health and lose weight. Being physically active did not have a significant effect on healthy eating, nor did specific reason for exercising. Discussion. Most students did not eat healthy and their physical activity levels did not significantly affect their nutritional habits. Increased awareness campaigns are warranted. Conclusions. Strategies other than physical activity promotion are needed to positively impact students’ healthy eating behaviors. Students should continue to be educated about healthy nutrition and ways to reduce perceived barriers to healthy eating

Vacuum Alignment in "Composite Technicolor" Models

We consider the question of vacuum alignment in the recently proposed "composite technicolor" (CTC) models. In order for these models to work, an "ultrafermion" condensate must align in a particular way, driven by the competition between ultrafermion masses and "flavor" gauge boson exchange. We show that for ultrafermion masses large enough to explain the top quark mass, order-of-magnitude estimates are sufficient to establish that the required vacuum alignment cannot occur for perturbative values of the flavor gauge couplings. If the top quark gets its mass from some other mechanism, a detailed calculation is required. Using spectral function sum rules and a vector-meson saturation approximation which is known to work well in QCD, we determine the correct vacuum for this case in a limit where the flavor gauge bosons are weakly coupled and the number of ultracolors $N$ is large. We again find that the vacuum required by CTC models does not occur for perturbative values of the flavor gauge couplings. We conclude that there is no evidence that the vacuum aligns as required in CTC models.Comment: 10 pages, 1 figure (not included) [This revision corrects an erroneous estimate of 1/N corrections and treats influence of the top quark.