Generic drug policy in Australia: a community pharmacy perspective

This article provides a commentary, from a community pharmacy perspective, on the policy environment for the pharmacy sector in Australia, with a particular focus on present challenges arising from proposals to achieve substantial PBS cost savings from an anticipated surge of new generic drugs. Some $2 billion of medicines currently on the PBS will come off patent in the next 4 years. This growth comes from a low base where generics currently account for only 15% of the total PBS budget. Remuneration for PBS dispensing is fixed through five year agreements with the government, so trading terms on generics are important for the cross-subsidy of other dispensing activities and professional services. These trading terms (discounts provided by generics suppliers) have become part of the overall cost and revenue structure of pharmacies. Despite these arrangements, generic substitution rates in Australia are lower than in most comparable countries, which the government views as an opportunity to promote generic use. The future of generic drug supply via the PBS is important to allow consumers access to medications at the lowest possible price and to provide space for PBS listing of new and expensive drugs. But considerations of PBS reform need to take account of the role and viability of community pharmacy sector as provider of pharmaceuticals in a timely and efficient manner to Australian residents

Information Model: From Abstraction to Application

ion to Application Jean SCLAVOS - Noëmie SIMONI - Simon ZNATY TELECOM Paris, Département Réseaux 46 rue Barrault, 75634 Paris Cedex 13, FRANCE E-mail: [email protected] Fax: 33 1 45 89 16 64 Topics: Integrated Management, Models and Architectures. For presentation at the symposium. Keywords: Information Model, SMT. Abstract Today's telecommunication structures, already widespread, are based on heterogeneous systems. In fact, in most networks, there are products and services from multiple vendors, and these products incorporate multiple technologies. So how can we manage networks which coexist, cooperate and internetwork in heterogeneous environment? As a matter of fact, we can say that management of network needs to have information on the whole behavior of all network elements. Thus, an information model must be provided, describing the way in which information is structured. We know that this information model is a critical component of a network management framework. Which are..

FDDI Integrated Network Management: A Viewpoint Approach

This paper defines viewpoints in order to deal with the integrated network management complexity. A viewpoint leads to the representation of a system with emphasis on a specific concern. Five viewpoints are identified, namely information, functional, communication, architectural and organizational, and then integrated. The network management standards provisions and lacks for every viewpoint are enhanced and some elements of solutions are presented. To perform FDDI (Fibre Distributed Data Interface) integrated network management, these viewpoints are applied to every management level of an FDDI subnetwork considered as a component of a high speed multi-network . I. Introduction To cope with integrated network management complexity, modeling according to different network management viewpoints or models is required. A viewpoint leads to the representation of a system with emphasis on a specific concern. Such an approach enables us to focus on every particular view of a network managem..

Micromorphologic features of dentin in vitamin D-resistant rickets: correlation with clinical grading of severity

This study was a histological analysis of 20 primary teeth from 5 patients with 3 clinical grades of vitamin D-resistant rickets (VDRR). The results showed that the degree of globular dentin formation in the histological sections may be graded into Grades I-III in increasing order of severity. In Grade I, the amount of globular dentin was less than 50% of the total dentin thickness, and the interglobular spaces were small. By contrast, in Grade III severity, globular dentin extended throughout the entire thickness of dentin, and the interglobular spaces were large. In Grade II severity, the amount of globular dentin was more than half but did not involve the entire dentin thickness. These histologic grades of severity correlated directly with the clinical grades of the patients. In addition, the study found that lack of medical treatment in affected mothers might lead to globular dentin formation in the fetus in-utero. Conversely, adequate phosphate supplementation in a hypophosphatemic mother might prevent the formation of globular dentin in the fetus

[De l'adoption] : droit romain ; [De l'adoption et de la tutelle officieuse, C. N. liv. I, tit. VIII, art. 343 à 370] : droit français / par Spiridion G. Sclavos,... ; Faculté de droit de Paris

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Managing FDDI in a High Speed MultiNetwork: the QoS Application.

. In this paper a set of Quality of Service criteria is proposed that enables the monitoring of any network element. For QoS computation the service management information model is instantiated with these QoS criteria. Emphasis lies on the FDDI network management considered as a component of a high speed multi-network. The lacks of the current FDDI management architecture for providing the necessary information for QoS computation are enhanced and some elements of solution are proposed. A set of diagnoses is also presented for QoS management. 1. Introduction As interest increases in multimedia networks, ever higher speeds and greater bandwidth must be made available. Moreover, the interconnection of existing local area networks (LANs), especially those within a limited geographic area, will require high speed bridging. To meet these requirements, a possible solution is to consider the Fiber Distributed Data Interface (FDDI) standardized by ANSI [1-3]. When FDDI is chosen as a backbone..

Three-Dimensional Gait Analysis in Children Undergoing Gastrocsoleus Lengthening for Equinus Secondary to Cerebral Palsy

Background and Objectives: Equinus is the most common deformity in children with cerebral palsy, and surgical lengthening of the gastrocsoleus muscle-tendon unit is the most commonly performed operation for children with cerebral palsy. Treatment outcomes of orthopaedic surgery can be measured objectively with three-dimensional gait analysis. This study examined the quality of evidence for gastrocsoleus lengthening surgery based on objective measures. Materials and Methods: A search was performed with Medline, Embase and PubMed from 1990 to 25 August 2020 using the keywords "cerebral palsy", "equinus", "surgery" and "gait analysis". Only studies of gastrocsoleus lengthening surgery using three-dimensional gait analysis were included, yielding 34 studies. Results: Fourteen studies reported swing phase kinematics and all studies reported a significant improvement. Rates of recurrent equinus and calcaneus were reported in 21 studies and varied widely based on follow-up period and surgical technique. Conclusions: Poor study quality and marked variability in study samples and interventions made comparison difficult. Future studies should consider prospective design, controls or comparison groups and more detailed breakdowns of outcomes by cerebral palsy subtype, sagittal gait pattern, and equinus type in order to allow more rigorous treatment recommendations to be made