Challenges to pharmaceutical policymaking: lessons from Australia’s National Medicines Policy

Objective: National medicines policies (NMPs) provide a means for governments to achieve their objectives in relation to pharmaceuticals and other medicines. This research aimed to identify challenges to implementing the objectives of the Australian NMP from the perspective of key stakeholders. Methods: In 2012 and 2103, we conducted 30 semi-structured interviews with stakeholders involved in the discovery, clinical testing, regulation and funding of medicines in Australia. We asked participants to describe their careers and to give their opinions on specific issues surrounding drug development, clinical research, regulation and subsidisation in Australia. Data were analysed using Morse’s outline of the cognitive basis of qualitative research and Charmaz’s outline of data analysis in grounded theory. The initial phase of “open coding”, revealed findings that could be mapped to three of the four objectives of the NMP. We then conducted “focused coding” for themes relevant to these objectives. Results: Participants identified many issues relevant to the ongoing evolution of the NMP, relating primarily to ongoing tensions between the commercial objective of ensuring a viable medicines industry, and the non-commercial objectives of ensuring that medicines are safe, effective and affordable. There were also a number of other challenges identified to the achievement of both the commercial and non-commercial objectives of the NMP. These included limits to government funding, globalisation, consumer advocacy, changing scientific paradigms and new information technologies. Conclusions: There are many issues that need to be addressed if policymakers are to achieve the best outcomes from the NMP. Tensions between the commercial and non-commercial objectives of the NMP suggest the need to ensure that one stakeholder group’s imperatives do not stifle those of other groups. At the same time, there are a number of emerging issues that are likely to concern all stakeholders equally, and these are both challenges and opportunities for new kinds of collaboration

Zeros of Rydberg-Rydberg Foster Interactions

Rydberg states of atoms are of great current interest for quantum manipulation of mesoscopic samples of atoms. Long-range Rydberg-Rydberg interactions can inhibit multiple excitations of atoms under the appropriate conditions. These interactions are strongest when resonant collisional processes give rise to long-range C_3/R^3 interactions. We show in this paper that even under resonant conditions C_3 often vanishes so that care is required to realize full dipole blockade in micron-sized atom samples.Comment: 10 pages, 4 figures, submitted to J. Phys.

Measuring Health and Broader Well-Being Benefits in the Context of Opiate Dependence: The Psychometric Performance of the ICECAP-A and the EQ-5D-5L

BACKGROUND: Measuring outcomes in economic evaluations of social care interventions is challenging because both health and well-being benefits are evident. The ICEpop CAPability instrument for adults (ICECAP-A) and the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) are measures potentially suitable for the economic evaluation of treatments for substance use disorders. Evidence for their validity in this context is, however, lacking. OBJECTIVES: To assess the construct validity of the ICECAP-A and the EQ-5D-5L in terms of convergent and discriminative validity and sensitivity to change on the basis of standard clinical measures (Clinical Outcomes in Routine Evaluation-Outcome Measure, Treatment Outcomes Profile, Interpersonal Support Evaluation List, Leeds Dependence Questionnaire, and Social Satisfaction Questionnaire). METHODS: A secondary analysis of pilot trial data for heroin users in opiate substitution treatment was conducted. Baseline convergence with clinical measures was assessed using the Pearson correlation coefficient. Discriminative validity was assessed using one-way analysis of variance and stepwise regressions. Sensitivity to changes in clinical indicators was assessed at 3 and 12 months using the standardized response mean statistic and parametric and nonparametric testing. RESULTS: Both measures had the same level of construct validity, except for clinical indicators of well-being, for which the ICECAP-A performed better. The ICECAP-A was sensitive to changes in both health and well-being indicators. The EQ-5D-5L had lower levels of sensitivity to change, and a ceiling effect (27%), particularly evident in the dimensions of self-care (89%), mobility (75%), and usual activities (72%). CONCLUSIONS: The findings support the construct validity of both measures, but the ICECAP-A gives more attention to broader impacts and is more sensitive to change. The ICECAP-A shows promise in evaluating treatments for substance use disorders for which recovery is the desired outcome

Search for supersolidity in 4He in low-frequency sound experiments

We present results of the search for supersolid 4He using low-frequency, low-level mechanical excitation of a solid sample grown and cooled at fixed volume. We have observed low frequency non-linear resonances that constitute anomalous features. These features, which appear below about 0.8 K, are absent in 3He. The frequency, the amplitude at which the nonlinearity sets in, and the upper temperature limit of existence of these resonances depend markedly on the sample history.Comment: Submitted to the Quantum Fluids and Solids Conf. Aug. 2006 Kyot

A Synchrotron-Based Study of the Mary Rose Iron Cannonballs

Post‐excavation iron corrosion may be accelerated by the presence of Cl^{-} , leading to conservation methods designed to remove Cl. This study exploits a unique opportunity to assess 35 years of conservation applied to cast‐iron cannon shot excavated from the Mary Rose. A combination of synchrotron X‐ray powder diffraction (SXPD), absorption spectroscopy (XAS), and fluorescence (XRF) mapping have been used to characterise the impact of conservation on the crystalline corrosion products, chlorine distribution, and speciation. The chlorinated phase akaganeite, β‐FeO(OH,Cl), was found on shot washed in corrosion inhibitor Hostacor IT with or without an additional reduction stage. No chlorinated phases were observed on the surface of shot stored in sodium sesquicarbonate (Na_{2}CO_{3}/NaHCO_{3}); however, hibbingite, β‐Fe_{2}(OH)_{3}Cl, was present in metal pores. It is proposed that surface β‐FeO(OH,Cl) formed in the early stages of active conservation owing to oxidation of β‐Fe_{2}(OH)_{3}Cl at near‐neutral pH

Influence of Spin Orbit Coupling in the Iron-Based Superconductors

We report on the influence of spin-orbit coupling (SOC) in the Fe-based superconductors (FeSCs) via application of circularly-polarized spin and angle-resolved photoemission spectroscopy. We combine this technique in representative members of both the Fe-pnictides and Fe-chalcogenides with ab initio density functional theory and tight-binding calculations to establish an ubiquitous modification of the electronic structure in these materials imbued by SOC. The influence of SOC is found to be concentrated on the hole pockets where the superconducting gap is generally found to be largest. This result contests descriptions of superconductivity in these materials in terms of pure spin-singlet eigenstates, raising questions regarding the possible pairing mechanisms and role of SOC therein.Comment: For supplementary information, see http://qmlab.ubc.ca/ARPES/PUBLICATIONS/articles.htm

Point-of-care measurement of blood lactate in children admitted with febrile illness to an African District Hospital.

BACKGROUND: Lactic acidosis is a consistent predictor of mortality owing to severe infectious disease, but its detection in low-income settings is limited to the clinical sign of "deep breathing" because of the lack of accessible technology for its measurement. We evaluated the use of a point-of-care (POC) diagnostic device for blood lactate measurement to assess the severity of illness in children admitted to a district hospital in Tanzania. METHODS: Children between the ages of 2 months and 13 years with a history of fever were enrolled in the study during a period of 1 year. A full clinical history and examination were undertaken, and blood was collected for culture, microscopy, complete blood cell count, and POC measurement of blood lactate and glucose. RESULTS: The study included 3248 children, of whom 164 (5.0%) died; 45 (27.4%) of these had raised levels of blood lactate (>5 mmol/L) but no deep breathing. Compared with mortality in children with lactate levels of ≤ 3 mmol/L, the unadjusted odds of dying were 1.6 (95% confidence interval [CI].8-3.0), 3.4 (95% CI, 1.5-7.5), and 8.9 (95% CI, 4.7-16.8) in children with blood lactate levels of 3.1-5.0, 5.1-8.0, or >8.0 mmol/L, respectively. The prevalence of raised lactate levels (>5 mmol/L) was greater in children with malaria than in children with nonmalarial febrile illness (P < .001) although the associated mortality was greater in slide-negative children. CONCLUSIONS: POC lactate measurement can contribute to the assessment of children admitted to hospital with febrile illness and can also create an opportunity for more hospitals in resource-poor settings to participate in clinical trials of interventions to reduce mortality associated with hyperlactatemia

Ground state of N=Z doubly closed shell nuclei in CBF theory

The ground state properties of N=Z doubly closed shell nuclei are studied within correlated basis function theory. A truncated version of the Urbana v14 realistic potential, with spin, isospin and tensor components, is adopted, together with state dependent correlations. Fermi hypernetted chain integral equation and single operator chain approximation are used to evaluate density, distribution function and ground state energy of 16O and 40Ca. The results favourably compare with the available, variational MonteCarlo estimates and provide a first substantial check of the accuracy of the cluster summation method for state dependent correlations. We achieve in finite nuclei at least the same level of accuracy in the treatment of non central interactions and correlations as in nuclear matter. This opens the way for a microscopic study of medium heavy nuclei ground state using present days realistic hamiltonians.Comment: 35 pages (LateX) + 3 figures. Phys.Rev.C, in pres

The CMS Tracker Readout Front End Driver

The Front End Driver, FED, is a 9U 400mm VME64x card designed for reading out the Compact Muon Solenoid, CMS, silicon tracker signals transmitted by the APV25 analogue pipeline Application Specific Integrated Circuits. The FED receives the signals via 96 optical fibers at a total input rate of 3.4 GB/sec. The signals are digitized and processed by applying algorithms for pedestal and common mode noise subtraction. Algorithms that search for clusters of hits are used to further reduce the input rate. Only the cluster data along with trigger information of the event are transmitted to the CMS data acquisition system using the S-LINK64 protocol at a maximum rate of 400 MB/sec. All data processing algorithms on the FED are executed in large on-board Field Programmable Gate Arrays. Results on the design, performance, testing and quality control of the FED are presented and discussed