WorldWideScience

Sample records for global essential medicines

  1. Improving Access to Essential Medicines: How Health Concerns can be Prioritised in the Global Governance System.

    Science.gov (United States)

    Sridhar, Devi

    2008-07-01

    This paper discusses the politics of access to essential medicines and identifies 'space' in the current system where health concerns can be strengthened relative to trade. This issue is addressed from a global governance perspective focusing on the main actors who can have the greatest impact. These include developing country coalitions and citizens in developed countries though participation in civil society organisations. These actors have combined forces to tackle this issue successfully, resulting in the 2001 Doha Declaration on Public Health. The collaboration has been so powerful due to the assistance of the media as well as the decision to compromise with pharmaceutical companies and their host countries. To improve access to essential medicines, six C's are needed: coalitions, civil society, citizenship, compromise, communication and collaboration.

  2. Psychopharmacological Treatment Options for Global Child and Adolescent Mental Health: The WHO Essential Medicines Lists

    Science.gov (United States)

    Kutcher, Stan; Murphy, Andrea; Gardner, David

    2008-01-01

    The article examines the World Health Organization's Model List of Essential Medicines (EML) and suggests modification for appropriate psychopharmacological treatment of child- and adolescent-onset mental disorders. The EML enlists few of the psychotropic medicines that are useful for the treatment of young people thereby limiting the…

  3. Essential travel medicine

    CERN Document Server

    Zuckerman, Jane N; Leggat, Peter

    2015-01-01

    This 1st edition of Essential Travel Medicine provides an excellent concise introduction to the specialty of Travel Medicine. This core text will enable health care practitioners particularly those new to the clinical practice of Travel Medicine, to gain a fundamental understanding of the diverse and complex issues which can potentially affect the health of the many millions of people who undertake international travel. Jane N Zuckerman is joined by Gary W Brunette from CDC and Peter A Leggat from Australia as Editors. Leading international specialists in their fields have contributed authoritative chapters reflecting current knowledge to facilitate best clinical practice in the different aspects of travel medicine. The aim of Essential Travel Medicine is to provide a comprehensive guide to Travel Medicine as well as a fundamental knowledge base to support international undergraduate and postgraduate specialty training programmes in the discipline of Travel Medicine. The 1st edition of Essential Travel ...

  4. Essential Medicines in National Constitutions

    Science.gov (United States)

    Toebes, Brigit; Hogerzeil, Hans

    2016-01-01

    Abstract A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realization of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential medicines in national constitutions, to identify comprehensive examples of constitutional text on medicines that can be used as a model for other countries, and to evaluate the evolution of constitutional medicines-related rights since 2008. Relevant articles were selected from an inventory of constitutional texts from WHO member states. References to states’ legal obligations under international human rights law were evaluated. Twenty-two constitutions worldwide now oblige governments to protect and/or to fulfill accessibility of, availability of, and/or quality of medicines. Since 2008, state responsibilities to fulfill access to essential medicines have expanded in five constitutions, been maintained in four constitutions, and have regressed in one constitution. Government commitments to essential medicines are an important foundation of health system equity and are included increasingly in state constitutions. PMID:27781006

  5. Essentials of nuclear medicine imaging

    CERN Document Server

    Mettler, Fred A. Jr

    2012-01-01

    Essentials of Nuclear Medicine Imaging, by Drs. Fred A Mettler and Milton J Guiberteau, provides the practical and comprehensive guidance you need to master key nuclear imaging techniques. From physics, instrumentation, quality control, and legal requirements to hot topics such as sodium fluoride, radiopharmaceuticals, and recommended pediatric administered doses and guidelines, this sixth edition covers the fundamentals and recent developments in the practice of nuclear medicine.

  6. Essentials of periodontal medicine in preventive medicine.

    Science.gov (United States)

    Gulati, Minkle; Anand, Vishal; Jain, Nikil; Anand, Bhargavi; Bahuguna, Rohit; Govila, Vivek; Rastogi, Pavitra

    2013-09-01

    Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer's disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. This review article highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.

  7. Essentials of periodontal medicine in preventive medicine

    Directory of Open Access Journals (Sweden)

    Minkle Gulati

    2013-01-01

    Full Text Available Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer′s disease, gastrointestinal disease, prostatitis, renal diseases, which has also been scientifically validated. This side of the oral-systemic link has been termed Periodontal Medicine and is potentially of great public health significance, as periodontal disease is largely preventable and in many instances readily treatable, hence, providing many new opportunities for preventing and improving prognosis of several systemic pathologic conditions. This review article highlights the importance of prevention and treatment of periodontal diseases as an essential part of preventive medicine to circumvent its deleterious effects on general health.

  8. Monographs for medicines on WHO's Model List of Essential Medicines.

    Science.gov (United States)

    Roth, Lukas; Adler, Melissa; Jain, Tanvi; Bempong, Daniel

    2018-06-01

    To raise awareness about the importance of public pharmaceutical standards, identify if and, if so, where current pharmacopeias are falling short in the development of new and complete monographs and foster collaboration among the various pharmacopeias, to prioritize, develop and make available standards for those key medicines for which no complete monographs exist. In August 2017, we mined eight pharmacopeias to identify which of the 669 medicines in the 20th edition of the World Health Organization's Model List of Essential Medicines were covered by complete or incomplete monographs. The pharmacopeias we included were the Brazilian Pharmacopoeia, the British Pharmacopoeia, the Indian Pharmacopeia Commission, the International Pharmacopoeia, the Japanese Pharmacopoeia, the Mexican Pharmacopoeia, the Pharmacopeia of the People's Republic of China and the United States Pharmacopeia. For 99 (15%) of the medicines on the Model List, no monographs were available in any of the eight pharmacopeias investigated. Only 3% (1/30) of the cardiovascular medicines listed, but 28% (9/32) of the antiretroviral medicines and 23% (6/26) of the antimalarial medicines lacked monographs. There appear to be no public standards for many so-called essential medicines. To address this shortfall, a greater collaboration in the global health community is needed.

  9. Essential Medicines in a High Income Country: Essential to Whom?

    Science.gov (United States)

    Duong, Mai; Moles, Rebekah J; Chaar, Betty; Chen, Timothy F

    2015-01-01

    To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders

  10. Essential Medicines in a High Income Country: Essential to Whom?

    Directory of Open Access Journals (Sweden)

    Mai Duong

    Full Text Available To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML concept functions in a high income country context.In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach.Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain.This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of

  11. Essentials of nuclear medicine physics and instrumentation

    CERN Document Server

    Powsner, Rachel A; Powsner, Edward R

    2013-01-01

    An excellent introduction to the basic concepts of nuclear medicine physics This Third Edition of Essentials of Nuclear Medicine Physics and Instrumentation expands the finely developed illustrated review and introductory guide to nuclear medicine physics and instrumentation. Along with simple, progressive, highly illustrated topics, the authors present nuclear medicine-related physics and engineering concepts clearly and concisely. Included in the text are introductory chapters on relevant atomic structure, methods of radionuclide production, and the interaction of radiation with matter. Fu

  12. Research in Medicine: Essentials for Developing Countries

    Directory of Open Access Journals (Sweden)

    Yusuf YAKUPOGULLARI

    2014-06-01

    Full Text Available (ExtractThe well-being has been the highest topic for humanity throughout the adventure of mankind on the earth. Therefore, extensive efforts have been performed on the science of medicine, and glorious advances have been gained especially in the last two centuries. Research is essential for medicine to develop new therapeutic methods and to monitor the results of the current treatment given to the patient. These are possibly the simplest reasons for investigations in medicine. On the other hand, qualified human resource, research ethics, financial supports, regular data recording and analysis, and publication are important issues for improvement of the medical researches in the developing countries.... 

  13. Attitude and opinion towards essential medicine formulary.

    Science.gov (United States)

    Sharma, Sangeeta; Kh, Reeta; Chaudhury, R Roy

    2010-06-01

    The Delhi State Drug Policy was adopted in 1994 following which the first Essential Medicines List (EML) was developed in 1996. The Delhi State Essential Medicines Formulary was brought out in 1997. A need was felt to revise the formulary to match with the EML as the EML is renewed every 2 years. A survey was undertaken to elicit the opinions of the doctors practicing in the state on the usefulness of the formulary before revising and printing the updated version. The survey covered dispensaries, 10-20 bedded hospitals, 100-bedded hospitals and two tertiary care hospitals. Discussions were focused on questionnaires on attitudes toward adopting Essential Medicines Formulary using a 10-point scale. Of the 200 doctors approached, only 90 doctors completed the questionnaire. Sixty-nine respondents (76.6%) had received the copy of the formulary. Most practitioners welcomed the formulary and were satisfied with the coverage and selection of the medicines. Most respondents (76.9%) agreed that a well-developed formulary would improve the quality of the public health care system, although they had reservations about the authority, relevance and effect on professional autonomy. About 74% of the respondents used the formulary in clinical practice as a source of medicine information, which makes its regular revision necessary.

  14. Attitude and opinion towards essential medicine formulary

    Science.gov (United States)

    Sharma, Sangeeta; Kh, Reeta; Chaudhury, R. Roy

    2010-01-01

    Objective: The Delhi State Drug Policy was adopted in 1994 following which the first Essential Medicines List (EML) was developed in 1996. The Delhi State Essential Medicines Formulary was brought out in 1997. A need was felt to revise the formulary to match with the EML as the EML is renewed every 2 years. Materials and Methods: A survey was undertaken to elicit the opinions of the doctors practicing in the state on the usefulness of the formulary before revising and printing the updated version. The survey covered dispensaries, 10–20 bedded hospitals, 100-bedded hospitals and two tertiary care hospitals. Discussions were focused on questionnaires on attitudes toward adopting Essential Medicines Formulary using a 10-point scale. Results: Of the 200 doctors approached, only 90 doctors completed the questionnaire. Sixty-nine respondents (76.6%) had received the copy of the formulary. Most practitioners welcomed the formulary and were satisfied with the coverage and selection of the medicines. Most respondents (76.9%) agreed that a well-developed formulary would improve the quality of the public health care system, although they had reservations about the authority, relevance and effect on professional autonomy. Conclusion: About 74% of the respondents used the formulary in clinical practice as a source of medicine information, which makes its regular revision necessary. PMID:20871765

  15. Essential Medicines for Children: An Endocrine Perspective

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2014-11-01

    Full Text Available The emergence of endocrine disease has created significant challenges for healthcare policy-makers and payers across the world. Policy-makers have to ensure availability of drugs used for various endocrinopathies. One way in which this is facilitated is through the World Health Organization (WHO List of Essential Medicines (LEM. The LEM aims to cover the basic pharmaceutical needs of the majority of people seeking healthcare (1.

  16. Global Journal of Community Medicine

    African Journals Online (AJOL)

    Global Journal of Community Medicine is aimed at promoting research in all areas of community or public health. It addresses issues of primary and tertiary health care. It deals with problems and solutions of health problems at the grassroots and daily livings. Visit the Global Journal Series website here: ...

  17. Essential Medicines in Nigeria: Foregrounding Access to Affordable ...

    African Journals Online (AJOL)

    Abstract. Within every functional healthcare system, access to quality and affordable essential medicine stands out as one of the building blocks. However ... Keywords: Access to medicines, Essential medicines, Healthcare, Public health facilities, Counterfeit medicines, Traditional medicines, Health systems, Systems theory ...

  18. The Essential Medicinal Chemistry of Curcumin.

    Science.gov (United States)

    Nelson, Kathryn M; Dahlin, Jayme L; Bisson, Jonathan; Graham, James; Pauli, Guido F; Walters, Michael A

    2017-03-09

    Curcumin is a constituent (up to ∼5%) of the traditional medicine known as turmeric. Interest in the therapeutic use of turmeric and the relative ease of isolation of curcuminoids has led to their extensive investigation. Curcumin has recently been classified as both a PAINS (pan-assay interference compounds) and an IMPS (invalid metabolic panaceas) candidate. The likely false activity of curcumin in vitro and in vivo has resulted in >120 clinical trials of curcuminoids against several diseases. No double-blinded, placebo controlled clinical trial of curcumin has been successful. This manuscript reviews the essential medicinal chemistry of curcumin and provides evidence that curcumin is an unstable, reactive, nonbioavailable compound and, therefore, a highly improbable lead. On the basis of this in-depth evaluation, potential new directions for research on curcuminoids are discussed.

  19. Globalization and medicine in Trinidad.

    Science.gov (United States)

    Reznik, David L; Murphy, John W; Belgrave, Linda Liska

    2007-05-01

    In a qualitative study of urban Trinidadians who work in the medical industry, the concept of medical globalization was provisionally analysed. Two research questions were addressed: what is globalization, in the context of mainstream medicine, and how is this process manifested in everyday practices? Four fundamental principles of medical globalization emerged from in-depth interviews and analysis of observational materials: (1) the notion of history as an autonomous force with globalization as the latest stage, (2) the expansion of 'Total Market' philosophy as a driving social force, (3) the fragmentation of society into atomistic, self-interested, and competitive individuals, and (4) the adoption of a 'centralised' set of ideals as the normative core necessary for social order. In this paper, findings from this investigation and their implications are discussed. In particular, medical globalization is linked with major themes in medical sociological theory including dualism and medicalization.

  20. Monographs for medicines on WHO’s Model List of Essential Medicines

    Science.gov (United States)

    Adler, Melissa; Jain, Tanvi; Bempong, Daniel

    2018-01-01

    Abstract Objective To raise awareness about the importance of public pharmaceutical standards, identify if and, if so, where current pharmacopeias are falling short in the development of new and complete monographs and foster collaboration among the various pharmacopeias, to prioritize, develop and make available standards for those key medicines for which no complete monographs exist. Methods In August 2017, we mined eight pharmacopeias to identify which of the 669 medicines in the 20th edition of the World Health Organization’s Model List of Essential Medicines were covered by complete or incomplete monographs. The pharmacopeias we included were the Brazilian Pharmacopoeia, the British Pharmacopoeia, the Indian Pharmacopeia Commission, the International Pharmacopoeia, the Japanese Pharmacopoeia, the Mexican Pharmacopoeia, the Pharmacopeia of the People’s Republic of China and the United States Pharmacopeia. Findings For 99 (15%) of the medicines on the Model List, no monographs were available in any of the eight pharmacopeias investigated. Only 3% (1/30) of the cardiovascular medicines listed, but 28% (9/32) of the antiretroviral medicines and 23% (6/26) of the antimalarial medicines lacked monographs. Conclusion There appear to be no public standards for many so-called essential medicines. To address this shortfall, a greater collaboration in the global health community is needed.

  1. Pharmaceutical patents and access to essential medicines in sub ...

    African Journals Online (AJOL)

    The World Trade Organisation (WTO) agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) has reawakened old arguments over the impact of the intellectual property (IP) system on public access to essential medicines. As used here, essential medicines are those needed in symptom management, ...

  2. [Reduction of ADRs of essential traditional Chinese medicines].

    Science.gov (United States)

    Nie, Qing; Liu, Yan; Chen, Jing

    2016-01-01

    The essential traditional Chinese medicines (ETCM) are the characteristics of our National Essential Medicine List (NEML) and we should give full play to its unique advantage. The essential medicines of ETCM are specific, but also have dual characters, namely efficacy and ADRs. Although ADRs cannot be avoided, we can make efforts to control some conditions to minimize the possibility of ADRs. It is significant to give suggestions to reduce ADRs of ETCM under the ETCM system by analyzing the possibility of ADRs during ETCM selection, production distribution and use. This research focuses on ETCM, and the conclusion is also applicable to common traditional Chinese medicines. Copyright© by the Chinese Pharmaceutical Association.

  3. Essential Medicines in Nigeria: Foregrounding Access to Affordable ...

    African Journals Online (AJOL)

    (EM) given the fact that it established the criterion for medicines classification as well ... AIDS, malaria, tuberculosis, and access to essential medicines. Lancet .... Vaccines, and Health Commodities: Report of the WHO-MSH Consultative Meeting, ... Prepared for the Strategies for Enhancing Access to Medicines Program.

  4. Are essential medicines in Malaysia accessible, affordable and available?

    Science.gov (United States)

    Saleh, Kamaruzaman; Ibrahim, Mohamed I M

    2005-12-01

    To assess the pharmaceutical sector to know whether people have access to essential medicines. The study was conducted in 20 public health clinics, five public district drug stores and 20 private retail pharmacies selected randomly in five different areas randomly selected (four states and a federal territory). The methodology used was adopted from the World Health Organization study protocol. The degree of attainment of the strategic pharmaceutical objectives of improved access is measured by a list of tested indicators. Access is measured in terms of the availability and affordability of essential medicines, especially to the poor and in the public sector. The first survey in the public health clinics and public district drug stores gathered information about current availability of essential medicines, prevalence of stock-outs and affordability of treatment (except drug stores). The second survey assessed affordability of treatment in public health clinics and private retail pharmacies. Availability, stock-out duration, percent of medicines dispensed, accessibility and affordability of key medicines. The average availability of key medicines in the public health clinics for the country was 95.4%. The average stock-out duration of key medicines was 6.5 days. However, average availability of key medicines in the public district drug stores was 89.2%; with an average stock-out duration of 32.4 days. Medicines prescribed were 100% dispensed to the patients. Average affordability for public health clinics was 1.5 weeks salary and for the private pharmacies, 3.7 weeks salary. The present pharmaceutical situation in the context of essential medicines list implementation reflected that the majority of the population in Malaysia had access to affordable essential medicines. If medicines need to be obtained from the private sector, they are hardly affordable. Although the average availability of essential medicines in Malaysia was high being more than 95.0%, in certain

  5. International assistance and cooperation for access to essential medicines.

    Science.gov (United States)

    Mok, Emily A

    2010-06-15

    Access to essential medicines is a critical problem that plagues many developing countries. With a daunting number of domestic constraints - technologically, economically, and otherwise - developing countries are faced with a steep uphill battle to meet the human rights obligation of providing essential medicines immediately. To meet these challenges, the international human rights obligations of international assistance and cooperation can play a key role to help developing countries fulfill the need for access to essential medicines. This article seeks to highlight and expand upon the current understanding of international assistance and cooperation for access to essential medicines through a review of obligations identified in international human rights law and a synthesis of official guidance provided on the matter.

  6. Basic science of nuclear medicine the bare bone essentials

    CERN Document Server

    Lee, Kai H

    2015-01-01

    Through concise, straightforward explanations and supporting graphics that bring abstract concepts to life, the new Basic Science of Nuclear Medicine—the Bare Bone Essentials is an ideal tool for nuclear medicine technologist students and nuclear cardiology fellows looking for an introduction to the fundamentals of the physics and technologies of modern day nuclear medicine.

  7. Essential Medicines in National Constitutions : Progress since 2008

    NARCIS (Netherlands)

    Perehudoff, S. Katrina; Toebes, Brigit; Hogerzeil, Hans

    A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realization of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential

  8. Essential Medicines in National Constitutions: Progress Since 2008.

    Science.gov (United States)

    Katrina Perehudoff, S; Toebes, Brigit; Hogerzeil, Hans

    2016-06-01

    A constitutional guarantee of access to essential medicines has been identified as an important indicator of government commitment to the progressive realization of the right to the highest attainable standard of health. The objective of this study was to evaluate provisions on access to essential medicines in national constitutions, to identify comprehensive examples of constitutional text on medicines that can be used as a model for other countries, and to evaluate the evolution of constitutional medicines-related rights since 2008. Relevant articles were selected from an inventory of constitutional texts from WHO member states. References to states' legal obligations under international human rights law were evaluated. Twenty-two constitutions worldwide now oblige governments to protect and/or to fulfill accessibility of, availability of, and/or quality of medicines. Since 2008, state responsibilities to fulfill access to essential medicines have expanded in five constitutions, been maintained in four constitutions, and have regressed in one constitution. Government commitments to essential medicines are an important foundation of health system equity and are included increasingly in state constitutions.

  9. Availability, prices and affordability of essential medicines in Haiti.

    Science.gov (United States)

    Chahal, Harinder Singh; St Fort, Nazaire; Bero, Lisa

    2013-12-01

    Haiti is the poorest country in the Western Hemisphere and faces numerous challenges, including inadequate medication access for its residents. The objective of this study was to determine the availability, prices, and affordability of essential medicines in Haiti and compare these findings to other countries. We conducted a cross-sectional nationwide survey in 2011 of availability and consumer prices of 60 essential medicines in Haiti using a standardized methodology developed by the World Health Organization and Health Action International. The survey was conducted in 163 medicine outlets in four health care sectors (public, retail, nonprofit and mixed sectors). Medicine prices were expressed as ratios relative to the International Reference Price. Affordability was calculated by comparing the costs of treatment for common conditions with the salary of the lowest paid government worker and was compared to available data from four Latin American countries. For generic medicines, the availability in public, retail, nonprofit and mixed sectors was 20%, 37%, 24% and 23% of medications, respectively. Most of the available medicines were priced higher than the International Reference Price. The lowest paid government worker would need 2.5 days' wages to treat an adult respiratory infection with generic medicines from the public sector. For treatment of common conditions with originator brands (OB) purchased from a retail pharmacy, costs were between 1.4 (anaerobic bacterial infection) and 13.7 (hyperlipidemia) days' wages, respectively. Treatment of pediatric bacterial infections with the OB of ceftriaxone from a retail pharmacy would cost 24.6 days' wages. Prices in Bolivia, Colombia, Mexico and Nicaragua were frequently lower for comparable medications. The availability of essential medicines was low and prices varied widely across all four sectors. Over 75% of Haitians live on less than US$ 2.00 /day; therefore, most medication regimens are largely unaffordable

  10. Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines.

    Science.gov (United States)

    Mackintosh, Maureen; Chaudhuri, Sudip; Mujinja, Phares Gm

    2011-02-28

    Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action.

  11. Access to essential medicines in Pakistan: policy and health systems research concerns.

    Directory of Open Access Journals (Sweden)

    Shehla Zaidi

    Full Text Available INTRODUCTION: Inadequate access to essential medicines is a common issue within developing countries. Policy response is constrained, amongst other factors, by a dearth of in-depth country level evidence. We share here i gaps related to access to essential medicine in Pakistan; and ii prioritization of emerging policy and research concerns. METHODS: An exploratory research was carried out using a health systems perspective and applying the WHO Framework for Equitable Access to Essential Medicine. Methods involved key informant interviews with policy makers, providers, industry, NGOs, experts and development partners, review of published and grey literature, and consultative prioritization in stakeholder's Roundtable. FINDINGS: A synthesis of evidence found major gaps in essential medicine access in Pakistan driven by weaknesses in the health care system as well as weak pharmaceutical regulation. 7 major policy concerns and 11 emerging research concerns were identified through consultative Roundtable. These related to weaknesses in medicine registration and quality assurance systems, unclear and counterproductive pricing policies, irrational prescribing and sub-optimal drug availability. Available research, both locally and globally, fails to target most of the identified policy concerns, tending to concentrate on irrational prescriptions. It overlooks trans-disciplinary areas of policy effectiveness surveillance, consumer behavior, operational pilots and pricing interventions review. CONCLUSION: Experience from Pakistan shows that policy concerns related to essential medicine access need integrated responses across various components of the health systems, are poorly addressed by existing evidence, and require an expanded health systems research agenda.

  12. Patent and exclusivity status of essential medicines for non-communicable disease.

    Directory of Open Access Journals (Sweden)

    Tim K Mackey

    Full Text Available OBJECTIVE: The threat of non-communicable diseases ("NCDs" is increasingly becoming a global health crisis and are pervasive in high, middle, and low-income populations resulting in an estimated 36 million deaths per year. There is a need to assess intellectual property rights ("IPRs" that may impede generic production and availability and affordability to essential NCD medicines. METHODS: Using the data sources listed below, the study design systematically eliminated NCD drugs that had no patent/exclusivity provisions on API, dosage, or administration route. The first step identified essential medicines that treat certain high disease burden NCDs. A second step examined the patent and exclusivity status of active ingredient, dosage and listed route of administration using exclusion criteria outlined in this study. MATERIALS: We examined the patent and exclusivity status of medicines listed in the World Health Organization's ("WHO" Model List of Essential Drugs (Medicines ("MLEM" and other WHO sources for drugs treating certain NCDs. i.e., cardiovascular and respiratory disease, cancers, and diabetes. We utilized the USA Food and Drug Administration Orange Book and the USA Patent and Trademark Office databases as references given the predominant number of medicines registered in the USA. RESULTS: Of the 359 MLEM medicines identified, 22% (79/359 address targeted NCDs. Of these 79, only eight required in-depth patent or exclusivity assessment. Upon further review, no NCD MLEM medicines had study patent or exclusivity protection for reviewed criteria. CONCLUSIONS: We find that ensuring availability and affordability of potential generic formulations of NCD MLEM medicines appears to be more complex than the presence of IPRs with API, dosage, or administration patent or exclusivity protection. Hence, more sophisticated analysis of NCD barriers to generic availability and affordability should be conducted in order to ensure equitable access to global

  13. Availability and Expiry of Essential Medicines and Supplies During the

    African Journals Online (AJOL)

    Erah

    Pharmacotherapy Group,. Faculty of Pharmacy, University of Benin,. Benin City, 300001 Nigeria. All rights reserved. Available online at http://www.tjpr.org. Research Article. Availability and Expiry of Essential Medicines and. Supplies During the 'Pull' and 'Push' Drug Acquisition. Systems in a Rural Ugandan Hospital.

  14. [Study on essential oils of medicinal plants in insect repellent].

    Science.gov (United States)

    Zhao, Hong-Zheng; Luo, Jiao-Yang; Liu, Qiu-Tao; Lv, Ze-Liang; Yang, Shi-Hai; Yang, Mei-Hua

    2016-01-01

    Mosquitoes are seriously harmful to human health for transmitting some mortal diseases. Among the methods of mosquito control, synthetical insecticides are the most popular. However, as a result of longterm use of these insecticides, high resistant mosquitos and heavy environmental pollution appear. Thus, eco-friendly prevention measures are taken into the agenda. Essential oils extracted from medicinal plants have repellent and smoked killing effects on mosquitoes. With abundant medical plants resources and low toxicity, they have the potential of being developed as a new type of mosquito and insect repellent agent. The recent application advances of essential oils of medicinal plants in insect repellent and its application limitations are overviewed. This review will provide references for the future development and in-depth study of essential oils. Copyright© by the Chinese Pharmaceutical Association.

  15. Access to essential medicines: a Hobbesian social contract approach.

    Science.gov (United States)

    Ashcroft, Richard E

    2005-05-01

    Medicines that are vital for the saving and preserving of life in conditions of public health emergency or endemic serious disease are known as essential medicines. In many developing world settings such medicines may be unavailable, or unaffordably expensive for the majority of those in need of them. Furthermore, for many serious diseases (such as HIV/AIDS and tuberculosis) these essential medicines are protected by patents that permit the patent-holder to operate a monopoly on their manufacture and supply, and to price these medicines well above marginal cost. Recent international legal doctrine has placed great stress on the need to globalise intellectual property rights protections, and on the rights of intellectual property rights holders to have their property rights enforced. Although international intellectual property rights law does permit compulsory licensing of protected inventions in the interests of public health, the use of this right by sovereign states has proved highly controversial. In this paper I give an argument in support of states' sovereign right to expropriate private intellectual property in conditions of public health emergency. This argument turns on a social contract argument for the legitimacy of states. The argument shows, further, that under some circumstances states are not merely permitted compulsory to license inventions, but are actually obliged to do so, on pain of failure of their legitimacy as sovereign states. The argument draws freely on a loose interpretation of Thomas Hobbes's arguments in his Leviathan, and on an analogy between his state of War and the situation of public health disasters.

  16. In vitro screening of selected essential oils from medicinal plants ...

    African Journals Online (AJOL)

    Enteric methane production lowers the efficiency of feed utilization in ruminants and contributes to greenhouse gas emissions which are responsible for global climate change. This study examined the effects of nine essential oils (EO) from Citrus aurantifolia, Cymbopogon citratus, Eucalyptus citriodora, Laurus nobilis, ...

  17. Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines

    Directory of Open Access Journals (Sweden)

    Chaudhuri Sudip

    2011-02-01

    Full Text Available Abstract Background Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. Methods The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Results Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. Conclusions We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action.

  18. Can NGOs regulate medicines markets? Social enterprise in wholesaling, and access to essential medicines

    Science.gov (United States)

    2011-01-01

    Background Citizens of high income countries rely on highly regulated medicines markets. However low income countries' impoverished populations generally struggle for access to essential medicines through out-of-pocket purchase on poorly regulated markets; results include ill health, drug resistance and further impoverishment. While the role of health facilities owned by non-governmental organisations (NGOs) in low income countries is well documented, national and international wholesaling of essential medicines by NGOs is largely unstudied. This article describes and assesses the activity of NGOs and social enterprise in essential medicines wholesaling. Methods The article is based on a set of interviews conducted in 2006-8 with trading NGOs and social enterprises operating in Europe, India and Tanzania. The analysis applies socio-legal and economic perspectives on social enterprise and market regulation. Results Trading NGOs can resist the perverse incentives inherent in medicines wholesaling and improve access to essential medicines; they can also, in definable circumstances, exercise a broader regulatory influence over their markets by influencing the behaviour of competitors. We explore reasons for success and failure of social enterprise in essential medicines wholesaling, including commercial manufacturers' market response; social enterprise traders' own market strategies; and patterns of market advantage, market segmentation and subsidy generated by donors. Conclusions We conclude that, in the absence of effective governmental activity and regulation, social enterprise wholesaling can improve access to good quality essential medicines. This role should be valued and where appropriate supported in international health policy design. NGO regulatory impact can complement but should not replace state action. PMID:21356076

  19. Validity Evidence for the Interpretation and Use of Essential Elements of Communication Global Rating Scale Scores

    Science.gov (United States)

    Schneider, Nancy Rhoda

    2015-01-01

    Purpose. Clinical communication influences health outcomes, so medical schools are charged to prepare future physicians with the skills they need to interact effectively with patients. Communication leaders at The University of New Mexico School of Medicine (UNMSOM) developed The Essential Elements of Communication-Global Rating Scale (EEC-GRS) to…

  20. Essential oils as natural medicinal substances: review article

    Directory of Open Access Journals (Sweden)

    Ehsan Aali

    2017-10-01

    Full Text Available Herbal essential oils are volatile, natural, complex compounds formed by medicinal plants as secondary metabolites. As reported by international organization for standardization (ISO, the term "essential oils" (EOs is defined for a product obtained from vegetable raw materials or fruit using distillation with water or steam. The EOs are generally complex mixtures of volatile organic compounds include hydrocarbons (terpenes and sesquiterpenes and oxygenated compounds (alcohols, esters, ethers, aldehydes, ketones, lactones, phenols, and phenol ethers compounds. In medicinal plants, the EOs chemical profile usually very varies because of both intrinsic (sexual, seasonal, ontogenetic, and genetic variations and extrinsic (ecological and environmental aspects factors, also the EOs composition differs not only in the number and type of molecules but also in their stereochemical structures, and can be very different according to the extraction method. EOs represents a “green” alternative in the nutritional and pharmaceutical fields due to reported antimicrobial, antioxidant, anti-inflammatory and anticancer properties thus, in recent times; EOs has gained great popularity as consumers have developed a particular ever-growing awareness toward the use of natural ingredients, especially in food and household. Therefore, the present review provides a comprehensive summary on the method of preparation of EOs from medicinal plants, chemical composition analysis, their biological and pharmacological effects and their potential benefits on health level. Present information was compiled using keywords “Essential oil, Medicinal Plants and Natural additive in scientific database as Science Direct, Elsevier, PubMed, Google scholar and SID, until 2005 to 2015. EOs have great antimicrobial activity and mostly destroy bacteria, fungi and viruses without harmful effects on consumer’s health. Finding of this study showed that the Thymol, α-Pinene,

  1. Skin diseases highlighting essential global public health priorities.

    Science.gov (United States)

    Morrone, Aldo; Toma, Luigi; Franco, Gennaro

    2005-05-01

    Which are the essential global public health activities that should be carried out in order to attain the largest impact on poverty reduction and health improvement in the world? Since its foundation in 2001 the Human Mobile Population Committee (HMPC) has continued to devote its efforts to finding answers to this question, with a particular focus on the skin diseases of the Human Mobile Population (HMP) and other groups of disadvantaged people. In this article we present the model of socio-sanitary activity in the field of Migration, Poverty and Health of the Department of Preventive Medicine of Migration, Tourism and Tropical Dermatology (Dept.) at San Gallicano Institute--Research Institute for Hospitalization and Treatment (IRCCS)--in Rome (Italy). The activities of this dermatological centre are in the spirit of the HMPC's aims and we are of the opinion that this model is not only ethically valid, but also practically and economically convenient, and that there is evidence that our experience is worth repeating, in as many situations as possible, in the interest of public health.

  2. Essential medicine policy in China: pros and cons.

    Science.gov (United States)

    Hu, Shanlian

    2013-01-01

    To analyze the achievements, issues and policy recommendations for implementing essential medicine system in China after a 3-year effort. Policy documents analysis and Literature reviews are conducted. From 2009-2011, a series of national essential medicine (EM) policies has been established which contain EM list, organizing production, quality assurance, pricing, tendering and procurement, distribution, rational use, monitoring and evaluation, etc. About 98.8% government-run primary healthcare institutions and 41.5% village health posts are conducting zero-mark-up policy while buying EMs. The average cost per visit, per admission, and per description in outpatient and inpatient departments has declined. The issues with the national EM list cannot meet the requirements of clinical practice at the local level, all provinces have to increase additional 64-455 EMs in their local supplementary list; the limitation of EML in primary healthcare institutions causes patients to transfer directly to secondary or tertiary hospitals to search appropriate treatment; there is no defined regulation or legislation regarding the responsibility and accountability of government to compensate for the financial loss after implementing a zero mark-up policy in primary healthcare institutions. In the future, some innovative reform should be taken into account, such as revising EML, quality assurance, control margins within the distribution system, differential pricing and internal reference-based pricing, waive taxes and import duties of EMs, and separation between prescribing and dispensing in public hospital reform. Establishing a national essential medicine system is a difficult task to accomplish. The role of the zero-mark-up policy of EMs is to cut off the economic profit chain among different stakeholders. Using pharmaceutical profit to subsidize hospital revenue will be gradually eliminated in China.

  3. Essential and toxic trace elements in the chinese medicine

    International Nuclear Information System (INIS)

    Wang, C.F.; Jenq Yann Yang; Ming-Jenq Duo; Chang, E.E.

    1996-01-01

    The concentration of certain toxic and essential elements in various raw materials of Chinese herbs and 'scientific Chinese medicine' were determined by atomic absorption spectrometry (AAS) and instrumental neutron activation analysis (INAA). Correlation of these elements as they exist in the raw materials and in the prescription of medicine were investigated and the approximate intake of elements by patients were estimated. Values of elements determined both by AAS and INAA presented excellent agreement. The ranges of elemental concentrations were found to vary from 10 4 to 10 -1 mg/kg in different kinds of herbs. All herbs exhibit extraordinary enrichment capabilities from the environment for elements such as Mn, Zn, Ca, K, Mg, Cd, Cu, Pb and As. Higher contents of Cd, Pb and As in herbs may be attributed to the uptake of these elements from polluted soil due to industrial and anthropogenic activities. It was found that commercial scientific Chinese medicine, SCDBT, contains more elemental concentrations than that of herbs used in the prescription, which may indicate that possible contamination could be caused by unknown ingredients added in the process. A much higher toxic elemental content, such as Pb, Cd and As, has been found in CFH and the daily intake of these elements by the patient will exceed the PTDI values. (author)

  4. Availability of WHO Essential Medicines for Cancer Treatment in Botswana

    Directory of Open Access Journals (Sweden)

    Yehoda M. Martei

    2018-01-01

    Full Text Available Purpose: Stock outs of cancer drugs are potentially fatal but have not been systematically studied in low- and middle-income countries. The aim of this study was to determine the availability and alignment of the Botswana National Essential Medicines List (NEML for cancer drugs with the WHO’s Essential Medicines List (EML. Methods: The availability and cost of cancer drugs were analyzed using data from a weekly stock catalog sent by Botswana’s Central Medical Store to all pharmacy departments in government hospitals. Comparative data were extracted from the WHO EML and the “International Drug Price Indicator Guide-2014” from the Management Sciences for Health. Interviews with key informants were used to collect data on the Botswana NEML and the drug supply chain in the public sector. Results: The 2015 Botswana NEML for cancer had 80.5% alignment with the WHO EML. At least 40% of essential drugs were out of stock for a median duration of 30 days in 2015. Stock outs affected chemotherapy drugs included in first-line regimens for treating potentially curable diseases such as cervical, breast, and colorectal cancer and were not associated with buyer price of therapy. Analyses showed that the median price ratio for procured drugs was greater than 1 for 61% of the NEML drugs, which suggests inefficiency in procurement in the public sector. Conclusions: Botswana has one of the highest alignments of NEML to the WHO EML in the sub-Saharan African region, which is consistent with investment in the health care system evident in other clinical spheres. Better quantification of chemotherapy requirements using data from the National Cancer Registry and resource-sensitive treatment guidelines can help reduce stock outs and facilitate more effective and efficient procurement processes.

  5. A critique of an argument against patent rights for essential medicines

    DEFF Research Database (Denmark)

    Sønderholm, Jørn

    2014-01-01

    holds, namely that patent rights for essential medicines are morally unjustified per se. Throughout this paper, ‘the strong view’ refers to this view. The strong view is one that enjoys considerable support both within and outside the academic community. This paper critically discusses one specific......Thomas Pogge has recently argued that the way in which research and development of essential medicines is incentivized, under existing World Trade Organization rules, should be supplemented with an additional incentivizing mechanism. One might hold a stronger view than the one that Pogge currently...... view also have some grounds for believing that the argument is sound. This belief comes, however, with what is arguably a too high cost, namely that the global institutional order becomes very demanding on taxpaying citizens of high-income countries if it is to be just. One may find acceptance...

  6. Medicine in the 21st century: recommended essential geriatrics competencies for internal medicine and family medicine residents.

    Science.gov (United States)

    Williams, Brent C; Warshaw, Gregg; Fabiny, Anne Rebecca; Lundebjerg Mpa, Nancy; Medina-Walpole, Annette; Sauvigne, Karen; Schwartzberg, Joanne G; Leipzig, Rosanne M

    2010-09-01

    Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential geriatrics competencies common to internal medicine and family medicine residents that build on established national geriatrics competencies for medical students, are feasible within current residency programs, are assessable, and address the Accreditation Council for Graduate Medical Education competencies; and (2) involve key stakeholder organizations in their development and implementation. Initial candidate competencies were defined through small group meetings and a survey of more than 100 experts, followed by detailed item review by 26 program directors and residency clinical educators from key professional organizations. Throughout, an 8-member working group made revisions to maintain consistency and compatibility among the competencies. Support and participation by key stakeholder organizations were secured throughout the project. The process identified 26 competencies in 7 domains: Medication Management; Cognitive, Affective, and Behavioral Health; Complex or Chronic Illness(es) in Older Adults; Palliative and End-of-Life Care; Hospital Patient Safety; Transitions of Care; and Ambulatory Care. The competencies map directly onto the medical student geriatric competencies and the 6 Accreditation Council for Graduate Medical Education Competencies. Through a consensus-building process that included leadership and members of key stakeholder organizations, a concise set of essential geriatrics competencies for internal medicine and family medicine residencies has been developed. These competencies are well aligned with concerns for residency training raised in a recent Medicare Payment Advisory

  7. Efficacy of medicinal essential oils against pathogenic Malassezia sp. isolates.

    Science.gov (United States)

    Khosravi, A R; Shokri, H; Fahimirad, S

    2016-03-01

    The purposes of this study were to evaluate the distribution pattern and population size of Malassezia species in dogs with atopic dermatitis (AD) and the inhibitory efficacy of Zataria multiflora, Thymus kotschyanus, Mentha spicata, Artemisia sieberi, Rosmarinus officinalis and Heracleum persicum essential oils against pathogenic Malassezia isolates. The samples were collected from 5 different anatomical sites of 33 atopic dogs and cultured onto modified Dixon agar (MDA) and Sabouraud dextrose agar (SDA) media. The essential oil extraction was performed by steam distillation using Clevenger system. Anti-Malassezia efficacy of medicinal essential oils and standard drugs was evaluated using broth microdilution method. A total of 103 yeast colonies were isolated from dogs with AD. Eight different Malassezia species were identified as follows: Malassezia pachydermatis (81.4%), M. globosa (7.8%), M. restricta (3.9%), M. sloofiae (2.9%), M. furfur (1%), M. nana (1%), M. obtusa (1%) and M. sympodialis (1%). The most and least infected sites were: anal (21.2%) and ear (10.6%) respectively. M. pachydermatis was the most frequent Malassezia species isolated from both skin and mucosa of dogs with AD. Antifungal susceptibility test revealed the inhibitory efficacy of essential oils on pathogenic Malassezia isolates with minimum inhibitory concentration (MIC(90)) values ranging from 30 to 850 μg/mL. Among the tested oils, Z. multiflora and T. kotschyanus exhibited the highest inhibitory effects (Pessential oils of Z. multiflora and T. kotschyanus showed strong antifungal activity against pathogenic Malassezia species tested. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  8. Does economic incentive matter for rational use of medicine? China's experience from the essential medicines program.

    Science.gov (United States)

    Chen, Mingsheng; Wang, Lijie; Chen, Wen; Zhang, Luying; Jiang, Hongli; Mao, Wenhui

    2014-03-01

    Before the new round of healthcare reform in China, primary healthcare providers could obtain a fixed 15 % or greater mark-up of profits by prescribing and selling medicines. There were concerns that this perverse incentive was a key cause of irrational medicine use. China's new Essential Medicines Program (EMP) was launched in 2009 as part of the national health sector reform initiatives. One of its core policies was to eliminate primary care providers' economic incentives to overprescribe or prescribe unnecessarily expensive drugs, which were regarded as consequences of China's traditional financing system for health institutions. The objective of the study was to measure changes in prescribing patterns in primary healthcare facilities after the removal of the economic incentives for physicians to overprescribe as a result of the implementation of the EMP. A comparison design was applied to 8,258 prescriptions in 2007 and 8,278 prescriptions in 2010, from 83 primary healthcare facilities nationwide. Indicators were adopted to evaluate medicine utilization, which included overall number of medicines, average number of Western and traditional Chinese medicines, pharmaceutical expenditure per outpatient prescription, and proportion of prescriptions that contained two or more antibiotics. We further assessed the use of medicines (antibiotics, infusion, hormones, and intravenous injection) per disease-specific prescription for hypertension, diabetes, coronary artery heart disease, bronchitis, upper respiratory tract infection, and gastritis. A difference-in-difference analysis was employed to evaluate the net policy effect. Overall changes in indicators were not found to be statistically significant between the 2 years. The results varied for different diseases. The number of Western drugs per outpatient prescription decreased while that of traditional Chinese medicines increased. Overuse of antibiotics remained an extensive problem in the treatment of many diseases

  9. Family Medicine Global Health Fellowship Competencies: A Modified Delphi Study.

    Science.gov (United States)

    Rayess, Fadya El; Filip, Anna; Doubeni, Anna; Wilson, Calvin; Haq, Cynthia; Debay, Marc; Anandarajah, Gowri; Heffron, Warren; Jayasekera, Neil; Larson, Paul; Dahlman, Bruce; Valdman, Olga; Hunt, Vince

    2017-02-01

    Many US medical schools and family medicine departments have responded to a growing interest in global health by developing global health fellowships. However, there are no guidelines or consensus statements outlining competencies for global health fellows. Our objective was to develop a mission and core competencies for Family Medicine Global Health Fellowships. A modified Delphi technique was used to develop consensus on fellowship competencies. A panel, comprised of 13 members with dual expertise in global health and medical education, undertook an iterative consensus process, followed by peer review, from April to December 2014. The panel developed a mission statement and identified six domains for family medicine global health fellowships: patient care, medical knowledge, professionalism, communication and leadership, teaching, and scholarship. Each domain includes a set of core and program-specific competencies. The family medicine global health competencies are intended to serve as an educational framework for the design, implementation, and evaluation of individual family medicine global health fellowship programs.

  10. Essential education in communication skills and cultural sensitivities for global public health in an evolving veterinary world.

    Science.gov (United States)

    Kurtz, S M; Adams, C L

    2009-08-01

    In the practise of veterinary medicine and global public health, communication skill is as critical as clinical reasoning and an extensive knowledge base. Effective communication skills and cross-cultural sensitivity are essential across the board for interdisciplinary, international, and local veterinary medicine. This paper offers an evidence-based, three-part framework for developing and sustaining curricula that enhance communication skills and cross-cultural sensitivity so that students are better prepared to practise veterinary medicine in an evolving world. These curricula may well also serve as a conduit for encouraging more veterinary graduates to choose global public health as a career path.

  11. [Effect of implementation of essential medicine system in the primary health care institution in China].

    Science.gov (United States)

    Huang, Donghong; Ren, Xiaohua; Hu, Jingxuan; Shi, Jingcheng; Xia, Da; Sun, Zhenqiu

    2015-02-01

    Our primary health care institution began to implement national essential medicine system in 2009. In past fi ve years, the goal of national essential medicine system has been initially achieved. For examples, medicine price is steadily reducing, the quality of medical services is improving and residents' satisfaction is substantial increasing every year. However, at the same time, we also found some urgent problems needed to be solved. For examples, the range of national essential medicine is limited, which is difficult to guarantee the quality of essential medication. In addition, how to compensate the primary health care institution is still a question.

  12. The effect of essential medicines programme on rational use of medicines in China.

    Science.gov (United States)

    Gong, Yanhong; Yang, Chen; Yin, Xiaoxv; Zhu, Minmin; Yang, Huajie; Wang, Yunxia; Li, Yongbin; Liu, Liqun; Dong, Xiaoxin; Cao, Shiyi; Lu, Zuxun

    2016-02-01

    Irrational use of medicines is a serious problem in China and has been the primary target of China's national essential medicines programme (NEMP). The aim of this study was to evaluate the effect of the NEMP on rational use of medicines in China. A nationwide sample of 3 76 700 prescriptions written by primary care providers from 2007 to 2011 was obtained following a multistage sampling process. Six prescribing indicators were measured: average number of drugs prescribed per prescription, average expenditure per prescription, percentage of prescriptions with antibiotics, with injections, with two or more antibiotics and with corticosteroids. The pre-post with control study design and the difference-in-difference (DID) methodology were employed to evaluate the effect of NEMP. Prescriptions from primary care institutions with the NEMP implementation were better than those without NEMP implementation. Adjusting for the institution's sizes, ownership, economic geographic regions and the year of NEMP implementation, the DID estimator was statistically significant in all prescribing indicators except for the percentage of prescriptions with injection. The number of drugs per prescription decreased by 0.2 per prescription [95% confidence interval (CI): -0.3, -0.1] after the NEMP was implemented; the percentages of prescriptions with antibiotics, with corticosteroids and with two or more antibiotics decreased by 7% (95% CI: -10, -4), 1% (95% CI: -2, 0) and 2% (95% CI: -3, 0), respectively; and the average expenditure per prescription decreased by eight Renminbi Yuan (95% CI: -14, -2). The effect of NEMP on reducing irrational prescribing was greater in public institutions than in private institutions (P rational use of medicines, and the effect is greater in public institutions than in private institutions. However, the irrational use is still high, pointing to the need for further reforms to tackle the underlying causes, such as clinical guidelines and patient

  13. A critique of an argument against patent rights for essential medicines

    Directory of Open Access Journals (Sweden)

    Jorn Sonderholm

    2014-09-01

    Full Text Available Thomas Pogge has recently argued that the way in which research and development of essential medicines is incentivized, under existing World Trade Organization rules, should be supplemented with an additional incentivizing mechanism. One might hold a stronger view than the one that Pogge currently holds, namely that patent rights for essential medicines are morally unjustified per se. Throughout this paper, ‘the strong view’ refers to this view. The strong view is one that enjoys considerable support both within and outside the academic community. This paper critically discusses one specific argument in favor of the strong view. This argument is named the ‘Poggean argument’. This denominator is appropriate because a number of the essential premises of the argument are constituted by propositions that Pogge at some point has defended. The Poggean argument is valid, and defenders of the strong view also have some grounds for believing that the argument is sound. This belief comes, however, with what is arguably a too high cost, namely that the global institutional order becomes very demanding on taxpaying citizens of high-income countries if it is to be just. One may find acceptance of this cost relatively unproblematic, but this cost is, it is argued, unacceptable to anyone who has views on distributive justice that are sympathetic to the core tenets of libertarianism.

  14. Price and availability survey of essential medicines in the Harare ...

    African Journals Online (AJOL)

    their innovator and/or generic equivalents) in both private retail and public pharmacies. Setting: Private and public sector retail pharmacies in Harare metropolitan province, Zimbabwe. Materials and Methods: Forty medicines were selected for ...

  15. The crisis in access to essential medicines in India: key issues which call for action.

    Science.gov (United States)

    Bhargava, Anurag; Kalantri, S P

    2013-01-01

    The government is planning to introduce free generic and essential medicines in public health facilities. Most people in India buy healthcare from the private sector, a compulsion that accounts for a high proportion of healthcare-related expenditure. To reduce the burden of healthcare costs, the government must improve availability and affordability of generic and essential medicines in the market. It can do so because India's large pharmaceutical industry is a major source of generic medicines worldwide. In this article, we discuss three factors that have impeded access to generic and essential medicines: (1) mistaken notions among policymakers, prescribers and patients about branded drugs and generic drugs in India; (2) high prices of medicines due to the progressive dismantling of the system of regulation of medicine prices, and (3) a drug approval and regulatory system that allows medicines (including fixed dose combinations) of doubtful efficacy, rationale, safety and public health relevance to dominate the market at the cost of access to affordable generic and essential medicines. The consequences of ill-health and wasted expenditure on drugs raise issues of public health ethics.Improving access to essential medicines in India is an urgent public health and ethical imperative. This should include improved public provisioning, a system of regulation of drug prices, and an evidence-based drug approval process.

  16. PIXE determination of essential trace elements in some traditional Chinese medicines

    International Nuclear Information System (INIS)

    Xiao, L.; Qin, J.F.

    1990-01-01

    The essential trace elements in 30 traditional Chinese medicines, (24 tonics and 6 nontonics) were determined by proton-induced X-ray emission. The authors' previous suggestion that traditional Chinese medicines may be classified by the order of magnitude of their essential trace elements, thus indicating their pharmacological effects, is not justified. The pharmacological effect of a trace element or its essentiality may be dependent on some ligand that can be chelated with it. A nonlinear mapping algorithm, however, shows that the 30 traditional Chinese medicines are nearly separated into two groups, indicating their tonic or nontonic pharmacological effects

  17. Global view on radiation protection in medicine

    International Nuclear Information System (INIS)

    Vano, E.

    2011-01-01

    When planning good management of ionising radiation in medicine, key factors such as ensuring that health professionals work together and convincing them that radiation protection (RP) represents a substantial part of the quality management system in their clinical practice are of utmost importance. The United Nations Scientific Committee on the Effects of Atomic Radiation has decided that one of the thematic priorities will be medical radiation exposure of patients. The International Commission on Radiological Protection has recently updated the report on RP in medicine and continues to work on focused documents centred on specific areas where advice is needed. The roles of the International Atomic Energy Agency, World Health Organization and the European Commission, in the area of RP in medicine, are described in the present document. The industry, the standardisation organisations as well as many scientific and professional societies are also dedicating significant effort to radiation safety aspects in medicine. Some of the efforts and priorities contemplated in RP in medicine over the coming years are suggested. The best outcome will be accomplished when all the actors, i.e. medical doctors, other health professionals, regulators, health authorities and the industry manage to work together. (authors)

  18. Foreign Direct Investments Expansion – Essential Globalization Factor

    Directory of Open Access Journals (Sweden)

    Cătălin Emilian HUIDUMAC PETRESCU

    2011-01-01

    Full Text Available We live in a time when the world economy is constantly changing. Foreign direct investments is one of the most dynamic part of the world economy and in a continuous globalization, those international financial flows determining the traders to know their defining elements and to adopt a specific management in the international affairs field. We are viewers of an unprecedented expansion of foreign direct investments, essential factor of the globalization development process. The paper analyzes the evolution of FDI so far, along with a brief illustration as the main trends of international financial flows for 2010 and 2011. In the context of economic globalization, it is absolutely necessary to clear out a study on the various economic activities, especially on the differences between countries. The analysis of these differences is particularly important as it helps improve and optimize the strategies adopted by foreign transnational companies. In the past 15 years, one observes that most companies in emerging countries, characterized by a great expansion, have adopted in the first phase of their existence, corporate strategies that gave them the opportunity to become global companies. According to surveys, after reaching the first goal, becoming a multinational or a transnational company, they have developed new business models beyond the classical principles and strategies. It is anticipated that in the coming decades, the strategies of emerging companies will be influenced by functional specialization, which, according to experts, influence the process of globalization. The analysis of strategies adopted by companies in emerging countries is absolutely necessary because the results cannot be overlooked. For example, until 2004, only five Asian companies were part of the top 100 transnational companies. The study was carried out by UNCTAD and the identification criterion was the size of foreign assets. In 2006, 14% of world total FDI came from

  19. In which developing countries are patents on essential medicines being filed?

    Science.gov (United States)

    Beall, Reed F; Blanchet, Rosanne; Attaran, Amir

    2017-06-26

    This article is based upon data gathered during a study conducted in partnership with the World Intellectual Property Organization on the patent status of products appearing on the World Health Organization's 2013 Model List of Essential Medicines (MLEM). It is a statistical analysis aimed at answering: in which developing countries are patents on essential medicines being filed? Patent data were collected by linking those listed in the United States and Canada's medicine patent registers to corresponding patents in developing countries using two international patent databases (INPADOC and Derwent) via a commerical-grade patent search platform (Thomson Innovation). The respective supplier companies were then contacted to correct and verify our data. We next tallied the number of MLEM patents per developing country. Spearman correlations were done to assess bivariate relationships between variables, and a multivariate regression model was developed to explain the number of MLEM patents in each country using SPSS 23.0. A subset of 20 of the 375 (5%) products on the 2013 MLEM fit our inclusion criteria. The patent estate reports (i.e., the global list of patents for a given drug) varied greatly in their number with a median of 48 patents (interquartile range [IQR]: 26-76). Their geographic reach had a median of 15% of the developing countries sampled (IQR: 8-28%). The number of developing countries covered appeared to increase with the age of the patent estate (r = .433, p = 0.028). The number of MLEM patents per country was significantly positively associated with human development index (HDI), gross domestic income (GDI) per capita, total healthcare expenditure per capita, population size, the Rule of Law Index, and average education level. Population size, GDI per capita, and healthcare expenditure (in % of national expenditure) were predictors of the number of MLEM patents in countries (p = 0.001, p = 0.001, p = 0.009, respectively). Population

  20. [Design and implementation of supply security monitoring and analysis system for Chinese patent medicines supply in national essential medicines].

    Science.gov (United States)

    Wang, Hui; Zhang, Xiao-Bo; Huang, Lu-Qi; Guo, Lan-Ping; Wang, Ling; Zhao, Yu-Ping; Yang, Guang

    2017-11-01

    The supply of Chinese patent medicine is influenced by the price of raw materials (Chinese herbal medicines) and the stock of resources. On the one hand, raw material prices show cyclical volatility or even irreversible soaring, making the price of Chinese patent medicine is not stable or even the highest cost of hanging upside down. On the other hand, due to lack of resources or disable some of the proprietary Chinese medicine was forced to stop production. Based on the micro-service architecture and Redis cluster deployment Based on the micro-service architecture and Redis cluster deployment, the supply security monitoring and analysis system for Chinese patent medicines in national essential medicines has realized the dynamic monitoring and intelligence warning of herbs and Chinese patent medicine by connecting and integrating the database of Chinese medicine resources, the dynamic monitoring system of traditional Chinese medicine resources and the basic medicine database of Chinese patent medicine. Copyright© by the Chinese Pharmaceutical Association.

  1. A critical comparison between the World Health Organization list of essential medicines for children and the Brazilian list of essential medicines (Rename

    Directory of Open Access Journals (Sweden)

    Helena Lutéscia L. Coelho

    2013-03-01

    Conclusion: The lack of age-appropriate formulations of essential medicines for children in Brazil includes important therapeutic groups and indispensable drugs for severe clinical conditions. Some of these products exist in the Brazilian pharmaceutical market, but not in public facilities; others could be produced by national laboratories with commercial interest or stimulated by a specific governmental policy, as in other countries.

  2. Development of a provisional essential medicines list for children in Canada: consensus process.

    Science.gov (United States)

    Woods, Hannah; Oronsaye, Efosa; Bali, Anjli; Rajakulasingam, Yathavan; Lee, Taehoon; Umali, Norman; Cohen, Eyal; Finkelstein, Yaron; Offringa, Martin; Persaud, Nav

    2018-03-26

    Worldwide, many countries have developed a list of essential medicines for children to improve prescribing. We aimed to create an essential medicines list for children in Canada. We adapted the previously created preliminary list of essential medicines for adults in Canada and the WHO Model List of Essential Medicines for Children to create a provisional list of essential medicines for children in Canada. Canadian clinicians made suggestions for changes. Literature relevant to each suggestion was presented to clinician-scientists, who used a modified nominal group technique to make recommendations on the suggestions. Ontario Public Drug Programs prescription data were reviewed to identify commonly prescribed medications missing from the list. Literature relevant to these medications was shared with a clinician-scientist review panel to determine which should be added, and a revised list was developed. A total of 76 items were removed from the list of essential medicines for adults in Canada because they were not indicated for use in children or were not relevant in the Canadian health care context; 7 medications were added to the child list based on Ontario Public Drugs Programs prescribing data and clinician-scientist review. Suggestions to add, remove or substitute medications were made by peer-reviewers and resulted in removal of 1 medication and replacement of 1 medication. The process produced a provisional list of 67 essential medications for children. A provisional list of 67 essential medicines for children was created through a peer-reviewed, multistep process based on current clinical evidence, Canadian clinical practice guidelines and historical prescribing data. It is publicly posted at http://cleanmeds.ca/. The list should be further developed based on wider input and should be continuously revised based on emerging evidence of the safety and effectiveness of these medicines in all pediatric age groups. Copyright 2018, Joule Inc. or its licensors.

  3. Necessary conditions for the globalization of traditional Chinese medicine.

    Science.gov (United States)

    Yu, Bei-Bei; Gong, Xiu-Lin

    2011-03-01

    With the current trend of globalization, unprecedented opportunities and enormous changes have emerged for the global development of traditional Chinese medicine (TCM). However, many old and new challenges and problems still remain, including partial or limited comprehension of acupuncture, oriental medicine and TCM, the existence of non-standardized institutes of TCM and acupuncture training schools, unqualified TCM practitioners, and problems concerning Chinese herbal medicine and inexperience in conducting TCM business. These problems will doubtlessly impede the further development of TCM worldwide in the foreseeable future. It is also clear that the globalization of TCM will require a large scale systematic project and constitute an arduous historical task. This paper aims to consolidate 6 strategic development modes to reinforce and facilitate the process of TCM globalization through a detailed analysis of both the present status and existing problems concerning the development of TCM in the United States.

  4. Essential medicines: an overview of some milestones in the last forty years (1975-2013

    Directory of Open Access Journals (Sweden)

    José Antonio Pagés

    2013-06-01

    Full Text Available Despite progress in the last four decades in terms of access to essential medicines, more than a third of the world population especially from the poorest countries have serious difficulties in accessing the medicines they need at an affordable price and with the right quality. Already in 1975 the 28th World Health Assembly discussed the need to set recommendations regarding selection and acquisition of medicines at reasonable prices and proven quality to meet national health needs. Consequently in 1977, the first WHO Model List of Essential Medicines was prepared by an expert committee. Since then, the list has been subjected to a series of updating and dissemination processes, together with discussion about the cost, patents and quality of medicines, as well as information on safety and effectiveness of each drug that is listed. The article addresses how this process has evolved from the beginning to present day.

  5. GLOBAL TEAM MANAGEMENT: AN ESSENTIAL COMPONENT OF FIRMS’ INNOVATION STRATEGY

    Directory of Open Access Journals (Sweden)

    AZİM ÖZTÜRK

    2013-05-01

    Full Text Available In the world marketplace some firms compete successfully and others fail to gain global competitive advantage. Some researchers argue that innovation strategy is the answer to successfully meeting today’s and tomorrow’s global business challenges.  An important aspect of the innovation strategy is managing global teams effectively.  Thus, firms of tomorrow will be characterized by values such as teamwork, innovation, cultural diversity, and a global mindset.  The rapid globalization of business, and increasing competition will continue to drive the need for effective teamwork and/in innovation management.  The purpose of our research is to gain insight into global team management and its role as a major component of innovation strategy.  We discuss the changing and developing functions of teamwork, examine the characteristics of global teams, and finally offer a process to achieve effective global team management.

  6. Impact of global medicine on urologic education.

    Science.gov (United States)

    Shukla, Aseem R

    2011-04-01

    Collaborative and academic partnerships between institutions in North America and those in resource-limited nations are a burgeoning trend. Leveraging the academic quality and outcomes-based infrastructure of university medical centers to increase surgical capacity in regions where urologic disease burden is immense offers potentially bilateral opportunities. Host institutions benefit from exposure to contemporary surgical approaches, while the surgical volume enables larger-scale collaborative outcome studies and exposure of residents-in-training to rare pathophysiology. This article surveys this growing trend in globalizing health care specific to urology, and the development of a program focused on urologic education at a tertiary referral center in India.

  7. Herbal medicine research and global health: an ethical analysis.

    Science.gov (United States)

    Tilburt, Jon C; Kaptchuk, Ted J

    2008-08-01

    Governments, international agencies and corporations are increasingly investing in traditional herbal medicine research. Yet little literature addresses ethical challenges in this research. In this paper, we apply concepts in a comprehensive ethical framework for clinical research to international traditional herbal medicine research. We examine in detail three key, underappreciated dimensions of the ethical framework in which particularly difficult questions arise for international herbal medicine research: social value, scientific validity and favourable risk-benefit ratio. Significant challenges exist in determining shared concepts of social value, scientific validity and favourable risk-benefit ratio across international research collaborations. However, we argue that collaborative partnership, including democratic deliberation, offers the context and process by which many of the ethical challenges in international herbal medicine research can, and should be, resolved. By "cross-training" investigators, and investing in safety-monitoring infrastructure, the issues identified by this comprehensive framework can promote ethically sound international herbal medicine research that contributes to global health.

  8. Global medicinal chemistry and GPCR conference: interview with Stevan Djuric.

    Science.gov (United States)

    Djuric, Stevan

    2018-04-01

    Stevan Djuric speaks to Benjamin Walden, Commissioning Editor. Stevan Djuric is head of the global Medicinal Chemistry Leadership Team at AbbVie and is also Vice President of the Discovery Chemistry and Technology organization within their Discovery organization and chemistry outsourcing activities. He spoke at the Global-Medicinal-Chemistry and GPCR summit on the imperative to develop chemistry related technology that can reduce cycle time, cost of goods and improve probability of success. To this end, he discussed his efforts in the chemistry technology area with a focus on integrated synthesis-purification bioassay, and flow photochemistry and high temperature chemistry platforms.

  9. Screening of Antibacterial Activities of Essential Oils from Selected Medicinal Plants

    Energy Technology Data Exchange (ETDEWEB)

    Phyo, Le Le; Thwe, Moe Moe; Than, Mar Lar

    2010-12-15

    Essential oils were extracted from the five medicinal plants (Syzygium aromaticum Linn, Cinnamoum tamala. Nees, Piper betle. Linn, Ocimum sanctum, Clausena exacavata Burn) by steam distillation method and percolation method with petroleum ether. These plants do not contain cyanogenic glycosides according to phytochemical tests. Essential oils from these plants were also tested on antimicrobial activity by agar well diffusion method. It was observed that essential oils extracted from these five plants have various effects on Gram-positive and Gram-negative bacteria and fungus. Among them, essential oils of Syzygium aromaticum possess the highest antimicrobial activity aganist all test organisms. B. pumalis and Calbican are the most susceptible to the five plants.

  10. Screening of Antibacterial Activities of Essential Oils from Selected Medicinal Plants

    International Nuclear Information System (INIS)

    Le Le Phyo; Moe Moe Thwe; Mar Lar Than

    2010-12-01

    Essential oils were extracted from the five medicinal plants (Syzygium aromaticum Linn, Cinnamoum tamala. Nees, Piper betle. Linn, Ocimum sanctum, Clausena exacavata Burn) by steam distillation method and percolation method with petroleum ether. These plants do not contain cyanogenic glycosides according to phytochemical tests. Essential oils from these plants were also tested on antimicrobial activity by agar well diffusion method. It was observed that essential oils extracted from these five plants have various effects on Gram-positive and Gram-negative bacteria and fungus. Among them, essential oils of Syzygium aromaticum possess the highest antimicrobial activity aganist all test organisms. B. pumalis and Calbican are the most susceptible to the five plants.

  11. Aromatic Medicinal Plants of the Lamiaceae Family from Uzbekistan: Ethnopharmacology, Essential Oils Composition, and Biological Activities

    Directory of Open Access Journals (Sweden)

    Nilufar Z. Mamadalieva

    2017-02-01

    Full Text Available Plants of the Lamiaceae family are important ornamental, medicinal, and aromatic plants, many of which produce essential oils that are used in traditional and modern medicine, and in the food, cosmetics, and pharmaceutical industry. Various species of the genera Hyssopus, Leonurus, Mentha, Nepeta, Origanum, Perovskia, Phlomis, Salvia, Scutellaria, and Ziziphora are widespread throughout the world, are the most popular plants in Uzbek traditional remedies, and are often used for the treatment of wounds, gastritis, infections, dermatitis, bronchitis, and inflammation. Extensive studies of the chemical components of these plants have led to the identification of many compounds, as well as essentials oils, with medicinal and other commercial values. The purpose of this review is to provide a critical overview of the literature surrounding the traditional uses, ethnopharmacology, biological activities, and essential oils composition of aromatic plants of the family Lamiaceae, from the Uzbek flora.

  12. What are the Essential Success Strategies for Global CIOs?

    Institute of Scientific and Technical Information of China (English)

    Jay Crotts

    2010-01-01

    @@ As a CIO in the global environment,my biggest challenge is to understand the dynamics of how my company operates in each country.Acquiring an understanding of how market maturity affects business strategy helps me develop an IT strategy that supports local markets while enhancing them with the global resources,processes and efficiencies at our disposal.

  13. Burnout Syndrome: Global Medicine Volunteering as a Possible Treatment Strategy.

    Science.gov (United States)

    Iserson, Kenneth V

    2018-04-01

    In the last few decades, "burnout syndrome" has become more common among clinicians, or at least more frequently recognized. Methods to prevent and treat burnout have had inconsistent results. Simultaneously, clinicians' interest in global medicine has increased dramatically, offering a possible intervention strategy for burnout while providing help to underserved areas. Caused by a variety of stressors, burnout syndrome ultimately results in physicians feeling that their work no longer embodies why they entered the medical field. This attitude harms clinicians, their patients and colleagues, and society. Few consistently successful interventions exist. At the same time, clinicians' interest in global medicine has risen exponentially. This paper reviews the basics of both phenomena and posits that global medicine experiences, although greatly assisting target populations, also may offer a strategy for combating burnout by reconnecting physicians with their love of the profession. Because studies have shown that regular volunteering improves mental health, short-term global medicine experiences may reinvigorate and reengage clinicians on the verge of, or suffering from, persistent burnout syndrome. Fortuitously, this intervention often will greatly benefit medically underserved populations. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Essential oil composition and nutrient analysis of selected medicinal plants in Sultanate of Oman

    Directory of Open Access Journals (Sweden)

    Javid Hussain

    2013-12-01

    Full Text Available Objective: To evaluate the nutrients and essential oils of five medicinal plants, Juniperus excelsa (J. excelsa, Dodonaea viscosa, Euryops pinifolius, Teucrium polium (T. polium, and Helianthemum lippii that were collected from Jabal Al Akhdar, Oman. Methods: Proximate parameters (moisture, dry matter, ash, crude fats, proteins, fibers, nitrogen, carbohydrates, and energy values and nutrient analysis (K, Na, Ca, Fe, P, Mg etc. were evaluated in the five medicinal plants using standard techniques. On the basis of these analysis, T. polium and J. excels were selected for essential oil analysis using a rapid solvent-free microwave extraction method and GC-MS. Results: The results showed that leaves of J. excelsa had highest proportion of crude fats, fibers and energy value while ash was highest in T. polium. J. excelsa was also rich in essential minerals such as calcium, magnesium, potassium and iron while the trace elements and heavy metals composition was marginal. A rapid solvent-free microwave extraction method to extract oil from medicinal plants species showed that only T. polium and J. excelsa yielded oil. The chemical composition of essential oils showed higher proportion of delta-3-carene, limonene, β-eudesmol, ledeneoxide (II, α-trans-bergamatene, linalyl acetate and germacrene. Conclusions: J. excelsa and T. polium are a good source of proximate, minerals and essential oils, which can be considered for healthy life besides their medicinal values.

  15. Traditional medicines and globalization: current and future perspectives in ethnopharmacology

    Directory of Open Access Journals (Sweden)

    Marco eLeonti

    2013-07-01

    Full Text Available The ethnopharmacological approach towards the understanding and appraisal of traditional and herbal medicines is characterized by the inclusions of the social as well as the natural sciences. Anthropological field-observations describing the local use of nature-derived medicines are the basis for ethnopharmacological enquiries. The multidisciplinary scientific validation of indigenous drugs is of relevance to modern societies at large and helps to sustain local health care practices. Especially with respect to therapies related to ageing related, chronic and infectious diseases traditional medicines offer promising alternatives to biomedicine. Bioassays applied in ethnopharmacology represent the molecular characteristics and complexities of the disease or symptoms for which an indigenous drug is used in traditional medicine to variable depth and extent. One-dimensional in vitro approaches rarely cope with the complexity of human diseases and ignore the concept of polypharmacological synergies. The recent focus on holistic approaches and systems biology in medicinal plant research represents the trend towards the description and the understanding of complex multi-parameter systems.Ethnopharmacopoeias are non-static cultural constructs shaped by belief and knowledge systems. Intensified globalization and economic liberalism currently accelerates the interchange between local and global pharmacopoeias via international trade, television, the World Wide Web and print media. The increased infiltration of newly generated biomedical knowledge and introduction of foreign medicines into local pharmacopoeias leads to syncretic developments and generates a feedback loop. While modern and post-modern cultures and knowledge systems adapt and transform the global impact, they become more relevant for ethnopharmacology. Moreover, what is traditional, alternative or complementary medicine depends on the adopted historic-cultural perspective.

  16. Traditional medicines and globalization: current and future perspectives in ethnopharmacology.

    Science.gov (United States)

    Leonti, Marco; Casu, Laura

    2013-01-01

    The ethnopharmacological approach toward the understanding and appraisal of traditional and herbal medicines is characterized by the inclusions of the social as well as the natural sciences. Anthropological field-observations describing the local use of nature-derived medicines are the basis for ethnopharmacological enquiries. The multidisciplinary scientific validation of indigenous drugs is of relevance to modern societies at large and helps to sustain local health care practices. Especially with respect to therapies related to aging related, chronic and infectious diseases traditional medicines offer promising alternatives to biomedicine. Bioassays applied in ethnopharmacology represent the molecular characteristics and complexities of the disease or symptoms for which an indigenous drug is used in "traditional" medicine to variable depth and extent. One-dimensional in vitro approaches rarely cope with the complexity of human diseases and ignore the concept of polypharmacological synergies. The recent focus on holistic approaches and systems biology in medicinal plant research represents the trend toward the description and the understanding of complex multi-parameter systems. Ethnopharmacopoeias are non-static cultural constructs shaped by belief and knowledge systems. Intensified globalization and economic liberalism currently accelerates the interchange between local and global pharmacopoeias via international trade, television, the World Wide Web and print media. The increased infiltration of newly generated biomedical knowledge and introduction of "foreign" medicines into local pharmacopoeias leads to syncretic developments and generates a feedback loop. While modern and post-modern cultures and knowledge systems adapt and transform the global impact, they become more relevant for ethnopharmacology. Moreover, what is traditional, alternative or complementary medicine depends on the adopted historic-cultural perspective.

  17. Plant essential oils potency as natural antibiotic in Indonesian medicinal herb of “jamu”

    Science.gov (United States)

    Soetjipto, H.; Martono, Y.

    2017-02-01

    The main purposes of this study are to compile antibacterial activity data of essential oils from Indonesian’s plants in order which can be used as a natural antibiotic in “jamu” to increase potential Indonesian medicinal herb. By using Agar Diffusing method, Bioautography and Gas Chromatography Mass Spectrum, respectively, antibacterial activity and chemical compounds of 12 plants essential oils were studied in the Natural Product Chemistry Laboratory, Department of Chemistry, Faculty of Science and Mathematics, Satya Wacana Christian University, Salatiga since 2007 until 2015. The results of this studies showed that all of the essential oils have a medium to a strong antibacterial activity which are in the range of 30 - 2,500 μg and 80-5,000 μg. Further on, the essential oils analyzed by GCMS showed that each essential oils have different dominant compounds. These data can be used as basic doses in the usage of essential oils as natural antibiotics.

  18. Repellent Activity of Eight Essential Oils of Chinese Medicinal Herbs t oBlattella germanica L.

    Directory of Open Access Journals (Sweden)

    Zhi Long Liu

    2011-01-01

    Full Text Available Eight e ssential oil s of Chinese medicinal herbs ( Angelica sinensis , Curuma aeruginosa , Cyperus rotundus , Eucalyptus robusta , Illicium verum , Lindera aggregate , Ocimum basilicum , and Zanthoxylum bungeanum w ere obtained by hydrodistillation and the essential oil of Eucalyptus robusta leaves was analyzed by gas chromatography-mass spectrometry (GC-MS. A total of 22 components of the essential oil of E. robusta were identified. The principal compounds in E . robusta essential oil were α- p inene (28.74% and 1,8- c ineole (27.18%, spathulenol (6.63%, globulol (6.53% and ρ - m enth-1-en-8-ol (5.20%. The 8 essential oil s and two main components, α -pinene and 1, 8-cineole of the essential oil of E. robusta were evaluated repellency against nymphs of the German cockroaches . Strong repellency (Class V was obtained for Cyperus rotundus and Eucalyptus robusta essential oils and α- p inene and 1, 8- c ineole . However, Illicium verum essential oil possessed weak (Class I repellency. At a concentration of 5 ppm, all the 8 essential oils and the two compounds showed repellent activity after one hour exposure. At 1 ppm concentration, essential oil of Cyperus rotundus showed strong repellency and Class IV repellency was obtained for essential oil of E. robusta and the two compounds after one hour exposure. However, essential oils of I . verum and Lindera aggregata showed strong attractiveness to the German cockroaches at a concentration of 1 ppm .

  19. Is the Brazilian pharmaceutical policy ensuring population access to essential medicines?

    Directory of Open Access Journals (Sweden)

    Bertoldi Andréa

    2012-03-01

    Full Text Available Abstract Background To evaluate medicine prices, availability and affordability in Brazil, considering the differences across three types of medicines (originator brands, generics and similar medicines and different types of facilities (private pharmacies, public sector pharmacies and “popular pharmacies”. Methods Data on prices and availability of 50 medicines were collected in 56 pharmacies across six cities in Southern Brazil using the World Health Organization / Health Action International methodology. Median prices obtained were divided by international reference prices to derive the median price ratio (MPR. Results In the private sector, prices were 8.6 MPR for similar medicines, 11.3 MRP for generics and 18.7 MRP for originator brands, respectively. Mean availability was 65%, 74% and 48% for originator brands, generics and similar medicines, respectively. In the public sector, mean availability of similar medicines was 2–7 times higher than that of generics. Mean overall availability in the public sector ranged from 68.8% to 81.7%. In “popular pharmacies”, mean availability was greater than 90% in all cities. Conclusions Availability of medicines in the public sector does not meet the challenge of supplying essential medicines to the entire population, as stated in the Brazilian constitution. This has unavoidable repercussions for affordability, particularly amongst the lower socio-economic strata.

  20. Essential oil of Croton flavens L. (Welensali), a medicinal plant from Curacao

    NARCIS (Netherlands)

    Woerdenbag, HJ; Bos, R; van Meeteren, HE; Baarslag, JJJ; de Jong-van den Berg, LTW; Pras, N; do Rego Kuster, G; Petronia, RRL

    2000-01-01

    The volatile constituents from aerial and underground parts of Croton flavens L., a medicinal plant from Curacao, were investigated by GC and GC/MS (EI) analysis. The various plant parts yielded 0.27-0.50%, (v/w) essential oil on a dry weight basis. There were only small differences in the

  1. Human Rights and Drug Control : Access to Controlled Essential Medicines in Resource-Constrained Countries

    NARCIS (Netherlands)

    Gispen, M.E.C.

    2017-01-01

    Millions of people worldwide suffer a range of health and socio-economic related problems because of inadequate availability and use of controlled essential medicines like morphine and codeine for pain treatment. As a result, millions of people, often living in lesser-advanced conditions, suffer in

  2. Human rights & intellectual property for universal access to new essential medicines

    NARCIS (Netherlands)

    Perehudoff, Katrina; 't Hoen, Elisabeth; Babar, Zaheer

    2018-01-01

    This chapter illustrates how human rights principles can help governments, even those with the most modest budgets, scale-up universal access to expensive essential medicines. The key message is that governments have legally binding human rights obligations to immediately take steps to provide

  3. First Universities Allied for Essential Medicines (UAEM) Neglected Diseases and Innovation Symposium

    OpenAIRE

    Musselwhite, Laura W.; Maciag, Karolina; Lankowski, Alex; Gretes, Michael C.; Wellems, Thomas E.; Tavera, Gloria; Goulding, Rebecca E.; Guillen, Ethan

    2012-01-01

    Universities Allied for Essential Medicines organized its first Neglected Diseases and Innovation Symposium to address expanding roles of public sector research institutions in innovation in research and development of biomedical technologies for treatment of diseases, particularly neglected tropical diseases. Universities and other public research institutions are increasingly integrated into the pharmaceutical innovation system. Academic entities now routinely undertake robust high-throughp...

  4. Availability of essential medicines in primary health care of the Brazilian Unified Health System.

    Science.gov (United States)

    Nascimento, Renata Cristina Rezende Macedo do; Álvares, Juliana; Guerra, Augusto Afonso; Gomes, Isabel Cristina; Costa, Ediná Alves; Leite, Silvana Nair; Costa, Karen Sarmento; Soeiro, Orlando Mario; Guibu, Ione Aquemi; Karnikowski, Margô Gomes de Oliveira; Acurcio, Francisco de Assis

    2017-11-13

    To characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS). This is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename - National List of Essential Medicines) of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals). The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed. One thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis. The low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain management. The different views on the availability of tracer

  5. Availability of essential medicines in primary health care of the Brazilian Unified Health System

    Directory of Open Access Journals (Sweden)

    Renata Cristina Rezende Macedo do Nascimento

    2017-11-01

    Full Text Available ABSTRACT OBJECTIVE To characterize the availability of tracer medicines in pharmaceutical services in primary health care of the Brazilian Unified Health System (SUS. METHODS This is a cross-sectional and evaluative study, part of the Pesquisa Nacional Sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015. To analyze the availability of medicines, we verified 50 items selected from the Relação Nacional de Medicamentos Essenciais (Rename – National List of Essential Medicines of 2012. Observation scripts were applied to medicine dispensing services in the primary health care. Interviews were carried out with patients, health care professionals, and public managers, using semi-structured questionnaires. The availability index was presented as the percentage of health units where the medicines were available. For statistical analysis, absolute, relative, and mean frequencies were presented (with 95% confidence intervals. The comparison of groups was carried out by Pearson Chi-square tests or variance analysis, when needed. RESULTS One thousand, one hundred, and seventy-five observation scripts were filled in a national representative sample composed by 273 cities. Statistically significant differences were observed regarding the type of unit, infrastructure, and presence of a pharmacist between regions of Brazil. The average availability of tracer medicines in primary health care was 52.9%, with differences between regions and sampling strata. This index increased to 62.5% when phytotherapic medicines were excluded. We found limited availability of medicines for treatment of chronic and epidemiological diseases, such as tuberculosis and congenital syphilis. CONCLUSIONS The low availability of essential medicines purchased centrally by the Brazilian Ministry of Health indicates deficiencies in supply chain

  6. Global Emergency Medicine: A review of the literature from 2017.

    Science.gov (United States)

    Becker, Torben K; Trehan, Indi; Hayward, Alison Schroth; Hexom, Braden J; Kivlehan, Sean M; Lunney, Kevin M; Modi, Payal; Osei-Ampofo, Maxwell; Pousson, Amelia; Cho, Daniel K; Levine, Adam C

    2018-05-23

    The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year, 17,722 articles written in three languages were identified by our electronic search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. Another two reviewers searched the gray literature, yielding an additional 11 articles. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 848 articles met our inclusion criteria and underwent full review. 63% were categorized as emergency care in resource-limited settings, 23% as disaster and humanitarian response, and 14% as emergency medicine development. 21 articles received scores of 18.5 or higher out of a maximum score 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed a Cohen's Kappa of 0.344. In 2017, the total number of articles identified by our search continued to increase. Studies and reviews with a focus on infectious diseases, pediatrics, and trauma represented the majority of top-scoring articles. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. Systems Approaches: A Global and Historical Perspective on Integrative Medicine

    Science.gov (United States)

    2012-01-01

    The globalization of healing systems is a dance of cultural awareness and cultural dominance that has arisen throughout history. With the development of greater communication and interest in whole-systems approaches to healing, the opportunity for the development of a global perspective on healing has emerged with new life force. The birth of integrative holistic healing systems in the West, such as naturopathic, homeopathic, anthroposophic, integral and functional medicine, and others, echoes the ocean of wisdom present in traditional healing systems, such as traditional Chinese medicine (TCM) and Ayurveda. In working to integrate the lessons from these systems, we see the inextricable link between man and the natural world, we work to understand the root cause of disease, we focus on the whole person to return balance, and we use empiric observation in large populations over time to grasp the interrelationships inherent in the whole-systems view of illness and wellness. PMID:24278794

  8. Global Emergency Medicine: A Review of the Literature From 2016.

    Science.gov (United States)

    Becker, Torben K; Hansoti, Bhakti; Bartels, Susan; Hayward, Alison Schroth; Hexom, Braden J; Lunney, Kevin M; Marsh, Regan H; Osei-Ampofo, Maxwell; Trehan, Indi; Chang, Julia; Levine, Adam C

    2017-09-01

    The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of peer-reviewed and gray literature relevant to global emergency medicine (EM) to identify, review, and disseminate the most important new research in this field to a global audience of academics and clinical practitioners. This year 13,890 articles written in four languages were identified by our search. These articles were distributed among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the gray literature. All articles that were deemed appropriate by at least one reviewer and approved by their editor underwent formal scoring of overall quality and importance. Two independent reviewers scored all articles. A total of 716 articles met our inclusion criteria and underwent full review. Fifty-nine percent were categorized as emergency care in resource-limited settings, 17% as EM development, and 24% as disaster and humanitarian response. Nineteen articles received scores of 18.5 or higher out of a maximum score of 20 and were selected for formal summary and critique. Inter-rater reliability testing between reviewers revealed Cohen's kappa of 0.441. In 2016, the total number of articles identified by our search continued to increase. The proportion of articles in each of the three categories remained stable. Studies and reviews with a focus on infectious diseases, pediatrics, and the use of ultrasound in resource-limited settings represented the majority of articles selected for final review. © 2017 The Authors. Academic Emergency Medicine published by Wiley Periodicals, Inc. on behalf of the Society for Academic Emergency Medicine (SAEM).

  9. The antibacterial and antifungal activity of essential oils extracted from Guatemalan medicinal plants.

    Science.gov (United States)

    Miller, Andrew B; Cates, Rex G; Lawrence, Michael; Soria, J Alfonso Fuentes; Espinoza, Luis V; Martinez, Jose Vicente; Arbizú, Dany A

    2015-04-01

    Essential oils are prevalent in many medicinal plants used for oral hygiene and treatment of diseases. Medicinal plant species were extracted to determine the essential oil content. Those producing sufficient oil were screened for activity against Staphylococcus aureus, Escherichia coli, Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. Plant samples were collected, frozen, and essential oils were extracted by steam distillation. Minimum inhibitory concentrations (MIC) were determined using a tube dilution assay for those species yielding sufficient oil. Fifty-nine of the 141 plant species produced sufficient oil for collection and 12 species not previously reported to produce essential oils were identified. Essential oil extracts from 32 species exhibited activity against one or more microbes. Oils from eight species were highly inhibitory to S. mutans, four species were highly inhibitory to C. albicans, and 19 species yielded MIC values less than the reference drugs. RESULTS suggest that 11 species were highly inhibitory to the microbes tested and merit further investigation. Oils from Cinnamomum zeylanicum Blume (Lauraceae), Citrus aurantiifolia (Christm.) Swingle (Rutaceae), Lippia graveolens Kunth (Verbenaceae), and Origanum vulgare L. (Lamiaceae) yielded highly significant or moderate activity against all microbes and have potential as antimicrobial agents. Teas prepared by decoction or infusion are known methods for extracting essential oils. Oils from 11 species were highly active against the microbes tested and merit investigation as to their potential for addressing health-related issues and in oral hygiene.

  10. Global Implementation of Genomic Medicine: We Are Not Alone

    Science.gov (United States)

    Manolio, Teri A.; Abramowicz, Marc; Al-Mulla, Fahd; Anderson, Warwick; Balling, Rudi; Berger, Adam C.; Bleyl, Steven; Chakravarti, Aravinda; Chantratita, Wasun; Chisholm, Rex L.; Dissanayake, Vajira H. W.; Dunn, Michael; Dzau, Victor J.; Han, Bok-Ghee; Hubbard, Tim; Kolbe, Anne; Korf, Bruce; Kubo, Michiaki; Lasko, Paul; Leego, Erkki; Mahasirimongkol, Surakameth; Majumdar, Partha P.; Matthijs, Gert; McLeod, Howard L.; Metspalu, Andres; Meulien, Pierre; Miyano, Satoru; Naparstek, Yaakov; O’Rourke, P. Pearl; Patrinos, George P.; Rehm, Heidi L.; Relling, Mary V.; Rennert, Gad; Rodriguez, Laura Lyman; Roden, Dan M.; Shuldiner, Alan R.; Sinha, Sukdev; Tan, Patrick; Ulfendahl, Mats; Ward, Robyn; Williams, Marc S.; Wong, John E.L.; Green, Eric D.; Ginsburg, Geoffrey S.

    2016-01-01

    Advances in high-throughput genomic technologies coupled with a growing number of genomic results potentially useful in clinical care have led to ground-breaking genomic medicine implementation programs in various nations. Many of these innovative programs capitalize on unique local capabilities arising from the structure of their health care systems or their cultural or political milieu, as well as from unusual burdens of disease or risk alleles. Many such programs are being conducted in relative isolation and might benefit from sharing of approaches and lessons learned in other nations. The National Human Genome Research Institute recently brought together 25 of these groups from around the world to describe and compare projects, examine the current state of implementation and desired near-term capabilities, and identify opportunities for collaboration to promote the responsible implementation of genomic medicine. The wide variety of nascent programs in diverse settings demonstrates that implementation of genomic medicine is expanding globally in varied and highly innovative ways. Opportunities for collaboration abound in the areas of evidence generation, health information technology, education, workforce development, pharmacogenomics, and policy and regulatory issues. Several international organizations that are already facilitating effective research collaborations should engage to ensure implementation proceeds collaboratively without potentially wasteful duplication. Efforts to coalesce these groups around concrete but compelling signature projects, such as global eradication of genetically-mediated drug reactions or developing a truly global genomic variant data resource across a wide number of ethnicities, would accelerate appropriate implementation of genomics to improve clinical care world-wide. PMID:26041702

  11. Regenerative medicine in Europe: global competition and innovation governance.

    Science.gov (United States)

    Hogarth, Stuart; Salter, Brian

    2010-11-01

    Leading European nations with strong biotech sectors, such as the UK and Germany, are investing heavily in regenerative medicine, seeking competitive advantage in this emerging sector. However, in the broader biopharmaceutical sector, the EU is outperformed by the USA on all metrics, reflecting longstanding problems: limited venture capital finance, a fragmented patent system, and relatively weak relations between academia and industry. The current global downturn has exacerbated these difficulties. The crisis comes at a time when the EU is reframing its approach to the governance of innovation and renewing its commitment to the goal of making Europe the leading player in the global knowledge economy. If the EU is to gain a competitive advantage in the regenerative medicine sector then it must coordinate a complex multilevel governance framework that encompasses the EU, member states and regional authorities. This article takes stock of Europe's current competitive position within the global bioeconomy, drawing on a variety of metrics in the three intersecting spheres of innovation governance: science, market and society. These data then provide a platform for reviewing the problems of innovation governance faced by the EU and the strategic choices that have to be confronted in the regenerative medicine sector.

  12. Essential medicines in Tanzania: does the new delivery system improve supply and accountability?

    Science.gov (United States)

    Mikkelsen-Lopez, Inez; Cowley, Peter; Kasale, Harun; Mbuya, Conrad; Reid, Graham; de Savigny, Don

    2014-02-01

    Objective : Assess whether reform in the Tanzanian medicines delivery system from a central 'push' kit system to a decentralized 'pull' Integrated Logistics System (ILS) has improved medicines accountability. Methods : Rufiji District in Tanzania was used as a case study. Data on medicines ordered and patients seen were compiled from routine information at six public health facilities in 1999 under the kit system and in 2009 under the ILS. Three medicines were included for comparison: an antimalarial, anthelmintic and oral rehydration salts (ORS). Results : The quality of the 2009 data was hampered by incorrect quantification calculations for orders, especially for antimalarials. Between the periods 1999 and 2009, the percent of unaccounted antimalarials fell from 60 to 18%, while the percent of unaccounted anthelmintic medicines went from 82 to 71%. Accounting for ORS, on the other hand, did not improve as the unaccounted amounts increased from 64 to 81% during the same period. Conclusions : The ILS has not adequately addressed accountability concerns seen under the kit system due to a combination of governance and system-design challenges. These quantification weaknesses are likely to have contributed to the frequent periods of antimalarial stock-out experienced in Tanzania since 2009. We propose regular reconciliation between the health information system and the medicines delivery system, thereby improving visibility and guiding interventions to increase the availability of essential medicines.

  13. The essentials of a global index for cognitive function

    Directory of Open Access Journals (Sweden)

    Antony Joseph Mathew

    2017-09-01

    Full Text Available Cognition is comprised of the faculties: perception, creativity, intuition, and ratiocination. Optimal levels of cognition are needed for independent functioning and balanced living. With an aging population that continues to grow, dietary supplements that tilt the balance towards maintenance of cognition are being marketed for vulnerable populations facing these challenges. Randomized clinical trials provide the causal inference necessary to define the efficacy of emerging nutraceuticals. Cognition testing, in particular, requires a battery of tests that encompass all brain regions involved in cognition so as to provide endpoints necessary for product validation. The lack of well controlled studies for comparison analyses, limited sample sizes, ambiguous dosages, and poor cognitive measures result in data that cannot be compared across studies to determine the efficacy of supplements claiming to enhance cognition. Clinical trials for the nutraceutical industry should consider the multifaceted nature of supplements, where clinical endpoints must be comprehensive while remaining feasible. Combining endpoints of cognition with physiological biomarkers of immunity and metabolism to arrive at a global index for cognitive health may be necessary for claim substantiation in order to fully justify and scientifically validate improvements in cognitive health. The issues and needs of a global index will be discussed here.

  14. Trypanocidal and cytotoxic activities of essential oils from medicinal plants of Northeast of Brazil.

    Science.gov (United States)

    Borges, Andrezza Raposo; Aires, Juliana Ramos de Albuquerque; Higino, Taciana Mirely Maciel; de Medeiros, Maria das Graças Freire; Citó, Antonia Maria das Graças Lopes; Lopes, José Arimatéia Dantas; de Figueiredo, Regina Celia Bressan Queiroz

    2012-10-01

    Chagas disease, caused by Trypanosoma cruzi, is an important cause of mortality and morbidity in Latin America. There are no vaccines available, the chemotherapy used to treat this illness has serious side effects and its efficacy on the chronic phase of disease is still a matter of debate. In a search for alternative treatment for Chagas disease, essential oils extracted from traditional medicinal plants Lippia sidoides, Lippia origanoides, Chenopodium ambrosioides, Ocimum gratissimum, Justicia pectorales and Vitex agnus-castus were investigated in vitro for trypanocidal and cytotoxic activities. Essential Oils were extracted by hydrodistillation and submitted to chemical analysis by gas chromatography/mass spectrometry. The concentration of essential oils necessary to inhibit 50% of the epimastigotes or amastigotes growth (IC(50)) and to kill 50% of trypomastigote forms (LC(50)) was estimated. The most prevalent chemical constituents of these essential oils were monoterpenes and sesquiterpenes. All essential oils tested demonstrated an inhibitory effect on the parasite growth and survival. L. sidoides and L. origanoides essential oils were the most effective against trypomastigote and amastigote forms respectively. No significant cytotoxic effects were observed in mouse peritoneal macrophages incubated with essential oils which were more selective against the parasites than mammalian cells. Taken together, our results point towards the use of these essential oils as potential chemotherapeutic agent against T. cruzi. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Analysis of essential elements in medicinal plants and their respective soils by neutron activation analysis

    International Nuclear Information System (INIS)

    Ratna Raju, M.; Madhusudhana Rao, P.V.; Vijayalakshmi, D.; Raju, M.K.; Brahmaji Rao, J.S.; Seshadreesan, N.P.; Venkatasubramani, C.R.

    2014-01-01

    In this study, the essential elements for humans in selected medicinal plants and their respective growing soils are measured by Neutron Activation Analysis. The concentrations of Na, K, Fe, Br, Al, Mn, Cl, Ca and Mg were analyzed using 20 kW KAMINI Reactor, Indira Gandhi Centre for Atomic Research (IGCAR), Kalpakkam. Results show that justification for the usage of these medicinal plants in the treatment of various diseases. Moreover, these results can be useful for preparing dosage of the herbal formulations. (author)

  16. Building essential biodiversity variables (EBVs) of species distribution and abundance at a global scale

    NARCIS (Netherlands)

    Kissling, W.D.; Ahumada, J.A.; Bowser, A.; Fernandez, M.; Fernández, N.; Garcia, E.A.; Guralnick, R.P.; Isaac, N.J.B.; Kelling, S.; Los, W.; McRae, L.; Mihoub, J.-B.; Obst, M.; Santamaria, M.; Skidmore, A.K.; Williams, K.J.; Agosti, D.; Amariles, D.; Arvanitidis, C.; Bastin, L.; De Leo, F.; Egloff, W.; Elith, J.; Hobern, D.; Martin, D.; Pereira, H.M.; Pesole, G.; Peterseil, J.; Saarenmaa, H.; Schigel, D.; Schmeller, D.S.; Segata, N.; Turak, E.; Uhlir, P.F.; Wee, B.; Hardisty, A.R.

    2018-01-01

    Much biodiversity data is collected worldwide, but it remains challenging to assemble the scattered knowledge for assessing biodiversity status and trends. The concept of Essential Biodiversity Variables (EBVs) was introduced to structure biodiversity monitoring globally, and to harmonize and

  17. An economic justification for open access to essential medicine patents in developing countries.

    Science.gov (United States)

    Flynn, Sean; Hollis, Aidan; Palmedo, Mike

    2009-01-01

    This paper offers an economic rationale for compulsory licensing of needed medicines in developing countries. The patent system is based on a trade-off between the "deadweight losses" caused by market power and the incentive to innovate created by increased profits from monopoly pricing during the period of the patent. However, markets for essential medicines under patent in developing countries with high income inequality are characterized by highly convex demand curves, producing large deadweight losses relative to potential profits when monopoly firms exercise profit-maximizing pricing strategies. As a result, these markets are systematically ill-suited to exclusive marketing rights, a problem which can be corrected through compulsory licensing. Open licenses that permit any qualified firm to supply the market on the same terms, such as may be available under licenses of right or essential facility legal standards, can be used to mitigate the negative effects of government-granted patents, thereby increasing overall social welfare.

  18. Neuroprotective and Anti-Aging Potentials of Essential Oils from Aromatic and Medicinal Plants

    OpenAIRE

    Ayaz, Muhammad; Sadiq, Abdul; Junaid, Muhammad; Ullah, Farhat; Subhan, Fazal; Ahmed, Jawad

    2017-01-01

    The use of essential oils (EOs) and their components is known since long in traditional medicine and aromatherapy for the management of various diseases, and is further increased in the recent times. The neuroprotective and anti-aging potentials of EOs and their possible mechanism of actions were evaluated by numerous researchers around the globe. Several clinically important EOs and their components from Nigella sativa, Acorus gramineus, Lavandula angustifolia, Eucalyptus globulus, Mentha pi...

  19. Availability and affordability of essential medicines for children in the Western part of Ethiopia: implication for access

    OpenAIRE

    Sado, Edao; Sufa, Alemu

    2016-01-01

    Background Essential medicines (EMs) are those medicines which satisfy the priority health care needs of the population. Although it is a fundamental human right, access to essential medicines has been a big challenge in developing countries particularly for children. WHO recommends assessing the current situations on availability and affordability of EMs as the first step towards enhancing access to them. Therefore, the aim of this study was to assess access to EMs for children based on avai...

  20. Levels of Essential Elements in Different Medicinal Plants Determined by Using Inductively Coupled Plasma Mass Spectrometry

    Directory of Open Access Journals (Sweden)

    Eid I. Brima

    2018-01-01

    Full Text Available The objective of this study was to investigate the content of essential elements in medicinal plants in the Kingdom of Saudi Arabia (KSA. Five different medical plants (mahareeb (Cymbopogon schoenanthus, sheeh (Artemisia vulgaris, harjal (Cynanchum argel delile, nabipoot (Equisetum arvense, and cafmariam (Vitex agnus-castus were collected from Madina city in the KSA. Five elements Fe, Mn, Zn, Cu, and Se were determined by using inductively coupled plasma mass spectrometry (ICP-MS. Fe levels were the highest and Se levels were the lowest in all plants. The range levels of all elements in all plants were as follows: Fe 193.4–1757.9, Mn 23.6–143.7, Zn 15.4–32.7, Se 0.13–0.92, and Cu 11.3–21.8 µg/g. Intakes of essential elements from the medical plants in infusion were calculated: Fe 4.6–13.4, Mn 6.7–123.2, Zn 7.0–42.7, Se 0.14–1.5, and Cu 1.5–5.0 µg/dose. The calculated intakes of essential elements for all plants did not exceed the daily intake set by the World Health Organization (WHO and European Food Safety Authority (EFSA. These medicinal plants may be useful sources of essential elements, which are vital for health.

  1. A review of existing and emerging digital technologies to combat the global trade in fake medicines.

    Science.gov (United States)

    Mackey, Tim K; Nayyar, Gaurvika

    2017-05-01

    The globalization of the pharmaceutical supply chain has introduced new challenges, chief among them, fighting the international criminal trade in fake medicines. As the manufacture, supply, and distribution of drugs becomes more complex, so does the need for innovative technology-based solutions to protect patients globally. Areas covered: We conducted a multidisciplinary review of the science/health, information technology, computer science, and general academic literature with the aim of identifying cutting-edge existing and emerging 'digital' solutions to combat fake medicines. Our review identified five distinct categories of technology including mobile, radio frequency identification, advanced computational methods, online verification, and blockchain technology. Expert opinion: Digital fake medicine solutions are unifying platforms that integrate different types of anti-counterfeiting technologies as complementary solutions, improve information sharing and data collection, and are designed to overcome existing barriers of adoption and implementation. Investment in this next generation technology is essential to ensure the future security and integrity of the global drug supply chain.

  2. Biological, medicinal and toxicological significance of Eucalyptus leaf essential oil: a review.

    Science.gov (United States)

    Dhakad, Ashok K; Pandey, Vijay V; Beg, Sobia; Rawat, Janhvi M; Singh, Avtar

    2018-02-01

    The genus Eucalyptus L'Heritier comprises about 900 species, of which more than 300 species contain volatile essential oil in their leaves. About 20 species, within these, have a high content of 1,8-cineole (more than 70%), commercially used for the production of essential oils in the pharmaceutical and cosmetic industries. However, Eucalyptus is extensively planted for pulp, plywood and solid wood production, but its leaf aromatic oil has astounding widespread biological activities, including antimicrobial, antiseptic, antioxidant, chemotherapeutic, respiratory and gastrointestinal disorder treatment, wound healing, and insecticidal/insect repellent, herbicidal, acaricidal, nematicidal, and perfumes, soap making and grease remover. In the present review, we have made an attempt to congregate the biological ingredients of leaf essential oil, leaf oil as a natural medicine, and pharmacological and toxicological values of the leaf oil of different Eucalyptus species worldwide. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  3. Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces

    Directory of Open Access Journals (Sweden)

    Ross-Degnan Dennis

    2010-07-01

    Full Text Available Abstract Background The current health care reform in China launched in 2009 tackles the problem of access to appropriate medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the reform process, we investigated the manufacturing, purchasing, and prescribing of essential medicines in two provinces. Methods We conducted surveys in 2007 of all manufacturers (n = 253 and of 59 purposively selected retail and 63 hospital pharmacies in Shandong and Gansu provinces to assess production and supply of products on the 2004 National Essential Medicines List (NEML, as well as factors underlying decision making about production and supply. We also reviewed prescriptions (n = 5456 in health facilities to calculate standard indicators of appropriate medicines use. Results Overall, manufacturers in Shandong and Gansu produced only 62% and 50%, respectively, of the essential medicines they were licensed to produce. Of a randomly selected 10% of NEML products, retail pharmacies stocked up to 60% of Western products. Median availability in hospital pharmacies ranged from 19% to 69%. Manufacturer and retail pharmacy managers based decisions on medicines production and stocking on economic considerations, while hospital pharmacy managers cited clinical need. Between 64% and 86% of prescriptions contained an essential medicine. However, overprescribing of antibiotics (34%-77% of prescriptions and injectables (22%-61% for adult non-infectious outpatient consultations was common. Conclusions We found that manufacturers, retail pharmacies, and hospital pharmacies paid limited attention to China's 2004 NEML in their decisions to manufacture, purchase, and stock essential medicines. We also found that prescribing of essential medicines was frequently inappropriate. These results should inform strategies to improve affordable access to essential medicines under the current health care reform.

  4. Availability and use of essential medicines in China: manufacturing, supply, and prescribing in Shandong and Gansu provinces.

    Science.gov (United States)

    Chen, Wen; Tang, Shenglan; Sun, Jing; Ross-Degnan, Dennis; Wagner, Anita K

    2010-07-17

    The current health care reform in China launched in 2009 tackles the problem of access to appropriate medicines for its 1.3 billion people by focusing on providing essential medicines to all. To provide evidence for the reform process, we investigated the manufacturing, purchasing, and prescribing of essential medicines in two provinces. We conducted surveys in 2007 of all manufacturers (n = 253) and of 59 purposively selected retail and 63 hospital pharmacies in Shandong and Gansu provinces to assess production and supply of products on the 2004 National Essential Medicines List (NEML), as well as factors underlying decision making about production and supply. We also reviewed prescriptions (n = 5456) in health facilities to calculate standard indicators of appropriate medicines use. Overall, manufacturers in Shandong and Gansu produced only 62% and 50%, respectively, of the essential medicines they were licensed to produce. Of a randomly selected 10% of NEML products, retail pharmacies stocked up to 60% of Western products. Median availability in hospital pharmacies ranged from 19% to 69%. Manufacturer and retail pharmacy managers based decisions on medicines production and stocking on economic considerations, while hospital pharmacy managers cited clinical need. Between 64% and 86% of prescriptions contained an essential medicine. However, overprescribing of antibiotics (34%-77% of prescriptions) and injectables (22%-61%) for adult non-infectious outpatient consultations was common. We found that manufacturers, retail pharmacies, and hospital pharmacies paid limited attention to China's 2004 NEML in their decisions to manufacture, purchase, and stock essential medicines. We also found that prescribing of essential medicines was frequently inappropriate. These results should inform strategies to improve affordable access to essential medicines under the current health care reform.

  5. Evaluating availability and price of essential medicines in Boston area (Massachusetts, USA) using WHO/HAI methodology.

    Science.gov (United States)

    Sharma, Abhishek; Rorden, Lindsey; Ewen, Margaret; Laing, Richard

    2016-01-01

    Many patients even those with health insurance pay out-of-pocket for medicines. We investigated the availability and prices of essential medicines in the Boston area. Using the WHO/HAI methodology, availability and undiscounted price data for both originator brand (OB) and lowest price generic (LPG) equivalent versions of 25 essential medicines (14 prescription; 11 over-the-counter (OTC)) were obtained from 17 private pharmacies. The inclusion and prices of 26 essential medicines in seven pharmacy discount programs were also studied. The medicine prices were compared with international reference prices (IRPs). In surveyed pharmacies, the OB medicines were less available as compared to the generics. The OB and LPG versions of OTC medicines were 21.33 and 11.53 times the IRP, respectively. The median prices of prescription medicines were higher, with OB and LPG versions at 158.14 and 38.03 times the IRP, respectively. In studied pharmacy discount programs, the price ratios of surveyed medicines varied from 4.4-13.9. While noting the WHO target that consumers should pay no more than four times the IRPs, medicine prices were considerably higher in the Boston area. The prices for medicines included in the pharmacy discount programs were closest to WHO's target. Consumers should shop around, as medicine inclusion and prices vary across discount programs. In order for consumers to identify meaningful potential savings through comparison shopping, price transparency is needed.

  6. Globalization and perinatal medicine--how do we respond?

    Science.gov (United States)

    Kurjak, Asim; Di Renzo, Gian Carlo; Stanojevic, Milan

    2010-04-01

    Globalization is both inevitable and usually desirable and contains advantageous and disadvantageous issues. It is a source of both hope and of apprehension and is an accelerating process in flow of information, technology, goods and services, and production means. Globalization has a complex influence on perinatal health. The bonds that link perinatologists together transcend geographic, political, religious, and lingual differences, resulting in a globalization that optimizes perinatal care. In this review, we will discuss some of the global problems facing modern perinatologists. Close to 1.5 billion people in the world, live in extreme poverty, a situation which is particularly stark in the developing world, where 80% of them live. Poor people have little or no access to qualified health services and education, and do not participate in the decisions critical to their day-to-day lives. Poverty cannot be defined solely in terms of lack of income. A person, a family, even a nation is not deemed poor only because of low economic resources. Little or no access to health services, lack of access to safe water and adequate nutrition, illiteracy or low educational level, and a distorted perception of rights and needs are also essential components of poverty. Expression of poverty in perinatal health care in developing countries are high maternal death and morbidity rates, huge perinatal and childhood losses, and high birth rates. There are good reasons to define it as a global tragedy in our time. Although the mankind has come quite far because the development of civilization and more advances in the health care were made during the past 100 years than in all previous human history, some inhabitants of our planet are not able to experience it. According to some data, every 3 s a newborn dies, and every minute a pregnant woman dies in the globalized world. All together over 10 million deaths every year, which indicates that health security is not strong enough. It is

  7. The status of adolescent medicine: Building a global adolescent workforce

    Science.gov (United States)

    Lee, Lana; Upadhya, Krishna K; Matson, Pamela; Adger, Hoover; Trent, Maria E

    2016-01-01

    Remarkable public health achievements to reduce infant and child mortality and improve the health and well-being of children worldwide have successfully resulted in increased survival and a growing population of young people aged 10–24 years. Population trends indicate that the current generation of 1.8 billion young people is the largest in history, but there is a scarcity of dedicated resources available to effectively meet the health needs of adolescents and young adults worldwide. Growing recognition of the pivotal roles young people play in the cultures, societies, and countries in which they live has spurred an expanding global movement to address the needs of this special population. Building an effective global workforce of highly-skilled adolescent health professionals who understand the unique biological, psychological, behavioral, social, and environmental factors that impact the health of adolescents is a critical step in addressing the health needs of the growing cohort of young people. In this review, we aim to: 1) Define a global assessment of the health needs for adolescents around the world; 2) Describe examples of current training programs and requirements in Adolescent Medicine; 3) Identify existing gaps and barriers to develop an effective adolescent health workforce; and 4) Develop a call for targeted actions to build capacity of the adolescent health workforce, broaden culturally relevant research and evidence-based intervention strategies, and reinforce existing interdisciplinary global networks of youth advocates and adolescent health professionals to maximize the opportunities for training, research, and care delivery. PMID:26167974

  8. Evaluating the quality and use of economic data in decisions about essential medicines.

    Science.gov (United States)

    Moucheraud, Corrina; Wirtz, Veronika J; Reich, Michael R

    2015-10-01

    To evaluate the quality of economic data provided in applications to the World Health Organization (WHO) Model List of Essential Medicines and to evaluate the role of these data in decision-making by the expert committee that considers the applications. We analysed applications submitted to the WHO Expert Committee on the Selection and Use of Essential Medicines between 2002 and 2013. The completeness of data on the price and cost-effectiveness of medicines was extracted from application documents and coded using a four-point scale. We recorded whether or not the expert committee discussed economic information and the outcomes of each application. Associations between the completeness of economic data and application outcomes were assessed using χ 2 tests. The expert committee received 134 applications. Only eight applications (6%) included complete price data and economic evaluation data. Many applicants omitted or misinterpreted the economic evaluation section of the application form. Despite the lack of economic data, all applications were reviewed by the committee. There was no significant association between the completeness of economic information and application outcomes. The expert committee tried to address information gaps in applications by further review and analysis of data related to the application. The World Health Organization should revise the instructions to applicants on economic data requirements; develop new mechanisms to assist applicants in completing the application process; and define methods for the use of economic data in decision-making.

  9. Vitamin D, Essential Minerals, and Toxic Elements: Exploring Interactions between Nutrients and Toxicants in Clinical Medicine

    Science.gov (United States)

    Schwalfenberg, Gerry K.; Genuis, Stephen J.

    2015-01-01

    In clinical medicine, increasing attention is being directed towards the important areas of nutritional biochemistry and toxicant bioaccumulation as they relate to human health and chronic disease. Optimal nutritional status, including healthy levels of vitamin D and essential minerals, is requisite for proper physiological function; conversely, accrual of toxic elements has the potential to impair normal physiology. It is evident that vitamin D intake can facilitate the absorption and assimilation of essential inorganic elements (such as calcium, magnesium, copper, zinc, iron, and selenium) but also the uptake of toxic elements (such as lead, arsenic, aluminum, cobalt, and strontium). Furthermore, sufficiency of essential minerals appears to resist the uptake of toxic metals. This paper explores the literature to determine a suitable clinical approach with regard to vitamin D and essential mineral intake to achieve optimal biological function and to avoid harm in order to prevent and overcome illness. It appears preferable to secure essential mineral status in conjunction with adequate vitamin D, as intake of vitamin D in the absence of mineral sufficiency may result in facilitation of toxic element absorption with potential adverse clinical outcomes. PMID:26347061

  10. Allelopathic activity of medicinal plant essential oils on seed germination and vigor of lettuce achenes

    Directory of Open Access Journals (Sweden)

    Cíntia Alvarenga Santos Fraga de Miranda

    2015-07-01

    Full Text Available In recent years, essential oils have gained commercial interest in the agricultural area, mainly for their allelopathic, insecticidal, antifungal, antimicrobial and antioxidant properties, and, also for their natural compounds, which have generally displayed low toxicity, relatively low cost and rapid degradation in the environment. Medicinal plants have emerged as potential suppliers of essential oils because of their ethnopharmacological utility. The aim of this study was to evaluate the allelopathic potential of essential oils extracted from fresh leaves of lemon grass (Cymbopogon citratus, wild basil (Ocimum gratissimum L. and sweet basil (Ocimum basilicum L. with regard to their major constituents (citral, eugenol and cineol, respectively in different application forms (direct contact and the effect of volatile constituents on the germination and vigor of lettuce seeds (cultivar Regina SF 3500. The effects of the oils and their major components were evaluated with regard to the variables: first germination count, total germination, GVI (germination velocity index, seedling dry weight and average lengths of shoots and lettuce roots. The essential oils from lemon grass and basil displayed allelopathic potentials on seed germination and vigor of lettuce achenes that can be assigned to their respective major constituents citral and eugenol. On the other hand, the allelopathic effect of the essential oil from basil was a consequence of the combined effect of all the components, regardless the application method.

  11. Allelopatic effects of some medicinal plant essential oils on plant seeds germination

    Directory of Open Access Journals (Sweden)

    ALI SHOKOUHIAN

    2016-04-01

    Full Text Available The effect of essential oils from some medicinal plants on seed germination was studied with the aim of assessing their potential use as bioherbicides. The experiment was conducted as factorial based on completely randomized design (CRD with three replications. Seeds of 3 summer crops including lettuce (Lactuca sativa, pepper (Piper longum and tomato (Solanum lycopersicum were exposed to essential oils of rosemary (Rosmarinus officinalis, thyme (Thymus vulgaris and anise (Pimpinella anisum at 3 different concentrations (25 and 50% diluted and undiluted. Treated seeds were grown in a growth chamber at 25°C for 5 days. The number of germinated seeds in each Petri dish was daily counted. After five days seed germination percentage (Ge was calculated. Biplot analysis was performed using genotype plus genotype environment interaction (GGE method. Results showed that the allelopathic effect on Ge was varied among studied plants, which was mainly due to i differences in the composition of the studied essential oils and ii different allelopathic effects of the studied essential oils on Ge. Accordingly, compared to the individual use, combining several essential oils would have a greater inhibitory effect on Ge of weeds.

  12. The availability of essential medicines for mental healthcare in Sofala, Mozambique

    Science.gov (United States)

    Wagenaar, Bradley H.; Stergachis, Andy; Rao, Deepa; Hoek, Roxanne; Cumbe, Vasco; Napúa, Manuel; Sherr, Kenneth

    2015-01-01

    Objective We assessed the availability of essential medicines for mental healthcare (MH) across levels of the public healthcare system to aid in future systems planning. Design Non-expired MH medications were assessed in 24 public health facilities and 13 district warehouses across Sofala Province, Mozambique, from July to August 2014. Medication categories included: antipsychotics, antidepressants, benzodiazepines, antiepileptics and mood stabilizers, and anticholinergics and antihistamines. Results Only 7 of 12 (58.3%) district warehouses, 11 of 24 (45.8%) of all health facilities, and 10 of 12 (83.3%) of facilities with trained MH staff had availability of at least one medication of each category. Thioridazine was the most commonly available antipsychotic across all facilities (9 of 24, 37.5%), while chlorpromazine and thioridazine were most common at facilities providing MH care (8 of 12, 66.7%). The atypical antipsychotic risperidone was not available at any facility or district warehouse. Amitriptyline was the most commonly available antidepressant (10 of 12 districts; 12 of 24 overall facilities; 9 or 12 MH facilities). Despite being on the national essential drug list, fluoxetine was only available at one quaternary-level facility and no district warehouses. Conclusions Essential psychotropic medicines are routinely unavailable at public health facilities. Current essential drug lists include six typical but no atypical antipsychotics, which is concerning given the side-effect profiles of typical antipsychotics. Ensuring consistent availability of at least one selective serotonin reuptake inhibitor should also be a priority, as they are essential for the treatment of individuals with underlying cardiovascular disease and/or suicidal ideation. Similar to successful task-sharing approaches used for HIV/AIDS, mid-level providers could be retrained and certified to prescribe and monitor first-line psychotropic regimens. PMID:26081970

  13. Chemical compositions of essential oils from two Artemisia species used in Mongolian traditional medicine

    Directory of Open Access Journals (Sweden)

    Javzmaa N

    2018-02-01

    Full Text Available Essential oils of aromatic and medicinal plants generally have a diverse range of activities because they possess many active constituents that work through a several modes of action. Artemisia, the largest genus of the family Asteraceae, has a number of effects against human and plant diseases. The main purpose of the present study was to investigate chemical compositions of essential oils of two Artemisia species, Artemisia palustris L and Artemisia sericea Weber ex Stechm from the Mongolian steppe zone using gas chromatography and gas chromatography-mass spectrometry. The essential oil of A.palustris was characterized by the presence of monoterpene hydrocarbons such as  trans-β-ocimene (59.1%, cis-β-ocimene (11.6% and myrcene (7.1%, while the oil of A.sericea was dominated by the presence of three oxygenated monoterpenoids as 1,8-cineole (25.8%, borneol (22.5% and camphor (18.8% which are used for preparation of a fragrance and medicinal products.

  14. Medical education, global health and travel medicine: a modern student's experience.

    Science.gov (United States)

    Tissingh, Elizabeth Khadija

    2009-01-01

    Today's medical student will practice medicine in a globalised world, where an understanding of travel medicine and global health will be vital. Students at UK medical schools are keen to learn more about these areas and yet receive little specific training. Tomorrow's doctors should be taught about global health and travel medicine if they are to be prepared to work in tomorrow's world.

  15. Integrating patient empowerment as an essential characteristic of the discipline of general practice/family medicine.

    Science.gov (United States)

    Mola, Ernesto; De Bonis, Judith A; Giancane, Raffaele

    2008-01-01

    Efforts to improve the quality of healthcare for patients with chronic conditions have resulted in growing evidence supporting the inclusion of patient empowerment as a key ingredient of care. In 2002, WONCA Europe issued the European Definition of General Practice/Family Medicine, which is currently considered the point of reference for European health institutions and general medical practice. Patient empowerment does not appear among the 11 characteristics of the discipline. The aim of this study is to show that many characteristics of general practice are already oriented towards patient empowerment. Therefore, promoting patient empowerment and self-management should be included as a characteristic of the discipline. The following investigation was conducted: analysing the concept and approach to empowerment as applied to healthcare in the literature; examining whether aspects of empowerment are already part of general medical practice; and identifying reasons why the European definition of general practice/family medicine should contain empowerment as a characteristic of the discipline. General practice/family medicine is the most suitable setting for promoting patient empowerment, because many of its characteristics are already oriented towards encouraging it and because its widespread presence can ensure the generalization of empowerment promotion and self-management education to the totality of patients and communities. "Promoting patient empowerment and self-management" should be considered one of the essential characteristics of general practice/family medicine and should be included in its definition.

  16. First Universities Allied for Essential Medicines (UAEM) Neglected Diseases and Innovation Symposium.

    Science.gov (United States)

    Musselwhite, Laura W; Maciag, Karolina; Lankowski, Alex; Gretes, Michael C; Wellems, Thomas E; Tavera, Gloria; Goulding, Rebecca E; Guillen, Ethan

    2012-01-01

    Universities Allied for Essential Medicines organized its first Neglected Diseases and Innovation Symposium to address expanding roles of public sector research institutions in innovation in research and development of biomedical technologies for treatment of diseases, particularly neglected tropical diseases. Universities and other public research institutions are increasingly integrated into the pharmaceutical innovation system. Academic entities now routinely undertake robust high-throughput screening and medicinal chemistry research programs to identify lead compounds for small molecule drugs and novel drug targets. Furthermore, product development partnerships are emerging between academic institutions, non-profit entities, and biotechnology and pharmaceutical companies to create diagnostics, therapies, and vaccines for diseases of the poor. With not for profit mission statements, open access publishing standards, open source platforms for data sharing and collaboration, and a shift in focus to more translational research, universities and other public research institutions are well-placed to accelerate development of medical technologies, particularly for neglected tropical diseases.

  17. [Possibilities for Universities to Influence Global Pricing of Medicines].

    Science.gov (United States)

    Jaehn, Philipp; Inhoffen, Johannes; Scheer, Jana; Streicher, Felix; Gesine Huhn, Anna; Lance, Christopher

    2017-07-01

    People in countries of the global south are affected by a unique spectrum of diseases, while costs for health care are a huge burden in the context of poverty. Furthermore, non-communicable diseases increasingly play a role in these countries. The management of translational research, potential clinical applications and marketing of new drugs in Germany is thus getting more and more important for global health. Regarding this, universities have a particular responsibility for two reasons. First, through basic research, they contribute significantly to the development of new medicines. Second, the university is a public institution and has thus the responsibility to return the gained knowledge to the public. Marketing of publicly funded innovations should provide benefits to patients in wealthy and poor countries alike. As a first step towards this goal, we demand the introduction of a globally responsible licensing policy at German universities. Different mechanisms which have been described in the German speaking areas such as "Equitable Licensing" provide a basis for the realization of this ambitious aim and have been introduced successfully at the universities of Muenster, Tuebingen and Freiburg. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Quantification of total and water extractable essential elements in medicinal plants used for stomach problems

    International Nuclear Information System (INIS)

    Sahito, S.R.; Kazi, T.G.; Shar, G.Q.; Mangrio, A.M; Shaikh, M.S.

    2004-01-01

    The role of elements particularly trace elements in health and disease is well known. Present study has been undertaken in our laboratories to quantify the commonly occurring elements in three medicinal plans. Peganum harmala Linn, Phyllanthus emblica Linn, Tamarix dioca used for stomach problems using atomic absorption spectrophotometer. Wet digestion method has been used to extract the acid extractable metals. Samples were boiled in water to obtain water extractable metals. The validation of the method was checked with the NBS-1570 (Spinach) as Standard Reference Material. Levels of essential elements were found high as compared to concentration of toxic elements. The considerable amounts of essential such as calcium, magnesium, potassium, zinc and iron were found in all these plant samples. (author)

  19. Radioactive Study of Malagasy medicinal plants and essential oil by gamma spectrometry

    International Nuclear Information System (INIS)

    RAMAROSON, V.

    1997-01-01

    Medicinal plants and essential oil derived from environmental samples such as plants, flowers, bushes or wild trees. Then, it is normal that naturally occuring radionuclides from Thorium and Uranium series on the one hand, K-40, a primordial radionuclide and common for all the samples on the other hand have been identified in such samples. Their activity are very low as it was expected to be, and Pb-210, one of the most radiotoxic among all natural radionuclides was not detected. Particularly, for essential oil, only the light radionuclide K-40 remains in the obtained oil, it is estimated that heavy metals such as Pb-212, identified in plants could not follow the vapour phase during the distillation process. However, detected counts per second of K-40 decrease from plants to oil which are then non-radioactive [fr

  20. Essential Public Health Competencies for Medical Students: Establishing a Consensus in Family Medicine.

    Science.gov (United States)

    Morley, Christopher P; Rosas, Scott R; Mishori, Ranit; Jordan, William; Jarris, Yumi Shitama; Competencies Work Group, Family Medicine/Public Health; Prunuske, Jacob

    2017-01-01

    Phenomenon: The integration of public health (PH) competency training into medical education, and further integration of PH and primary care, has been urged by the U.S. Institute of Medicine. However, PH competencies are numerous, and no consensus exists over which competencies are most important for adoption by current trainees. Our objective was to conduct a group concept mapping exercise with stakeholders identifying the most important and feasible PH skills to incorporate in medical and residency curricula. We utilized a group concept mapping technique via the Concept System Global Max ( http://www.conceptsystems.com ), where family medicine educators and PH professionals completed the phrase, "A key Public Health competency for physicians-in-training to learn is …" with 1-10 statements. The statement list was edited for duplication and other issues; stakeholders then sorted the statements and rated them for importance and feasibility of integration. Multidimensional scaling and cluster analysis were used to create a two-dimensional point map of domains of PH training, allowing visual comparison of groupings of related ideas and relative importance of these ideas. There were 116 nonduplicative statements (225 total) suggested by 120 participants. Three metacategories of competencies emerged: Clinic, Community & Culture, Health System Understanding, and Population Health Science & Data. Insights: We identified and organized a set of topics that serve as a foundation for the integration of family medicine and PH education. Incorporating these topics into medical education is viewed as important and feasible by family medicine educators and PH professions.

  1. Rational Basis for the Use of Bergamot Essential Oil in Complementary Medicine to Treat Chronic Pain.

    Science.gov (United States)

    Rombolà, L; Amantea, D; Russo, R; Adornetto, A; Berliocchi, L; Tridico, L; Corasaniti, M T; Sakurada, S; Sakurada, T; Bagetta, G; Morrone, L A

    2016-01-01

    In complementary medicine, aromatherapy uses essential oils to improve agitation and aggression observed in dementia, mood, depression, anxiety and chronic pain. Preclinical research studies have reported that the essential oil obtained from bergamot (BEO) fruit (Citrus bergamia, Risso) modifies normal and pathological synaptic plasticity implicated, for instance, in nociceptive and neuropathic pain. Interestingly, recent results indicated that BEO modulates sensitive perception of pain in different models of nociceptive, inflammatory and neuropathic pain modulating endogenous systems. Thus, local administration of BEO inhibited the nociceptive behavioral effect induced by intraplantar injection of capsaicin or formalin in mice. Similar effects were observed with linalool and linalyl acetate, major volatile components of the phytocomplex, Pharmacological studies showed that the latter effects are reversed by local or systemic pretreatment with the opioid antagonist naloxone hydrochloride alike with naloxone methiodide, high affinity peripheral μ-opioid receptor antagonist. These results and the synergistic effect observed following systemic or intrathecal injection of an inactive dose of morphine with BEO or linalool indicated an activation of peripheral opioid system. Recently, in neuropathic pain models systemic or local administration of BEO or linalool induced antiallodynic effects. In particular, in partial sciatic nerve ligation (PSNL) model, intraplantar injection of the phytocomplex or linalool in the ipsilateral hindpaw, but not in the contralateral, reduced PSNL-induced extracellularsignal- regulated kinase (ERK) activation and mechanical allodynia. In neuropathic pain high doses of morphine are needed to reduce pain. Interestingly, combination of inactive doses of BEO or linalool with a low dose of morphine induced antiallodynic effects in mice. Peripheral cannabinoid and opioid systems appear to be involved in the antinociception produced by

  2. Essential Oils from the Medicinal Herbs Upregulate Dopamine Transporter in Rat Pheochromocytoma Cells.

    Science.gov (United States)

    Choi, Min Sun; Choi, Bang-sub; Kim, Sang Heon; Pak, Sok Cheon; Jang, Chul Ho; Chin, Young-Won; Kim, Young-Mi; Kim, Dong-il; Jeon, Songhee; Koo, Byung-Soo

    2015-10-01

    The dopamine transporter (DAT) protein, a component of the dopamine system, undergoes adaptive neurobiological changes from drug abuse. Prevention of relapse and reduction of withdrawal symptoms are still the major limitations in the current pharmacological treatments of drug addiction. The present study aimed to investigate the effects of essential oils extracted from Elsholtzia ciliata, Shinchim, Angelicae gigantis Radix, and Eugenia caryophyllata, well-known traditional Korean medicines for addiction, on the modulation of dopamine system in amphetamine-treated cells and to explore the possible mechanism underlying its therapeutic effect. The potential cytotoxic effect of essential oils was evaluated in PC12 rat pheochromocytoma cells using cell viability assays. Quantification of DAT, p-CREB, p-MAPK, and p-Akt was done by immunoblotting. DAT was significantly reduced in cells treated with 50 μM of amphetamine in a time-dependent manner. No significant toxicity of essential oils from Elsholtzia ciliata and Shinchim was observed at doses of 10, 25, and 50 μg/mL. However, essential oils from A. gigantis Radix at a dose of 100 μg/mL and E. caryophyllata at doses of 50 and 100 μg/mL showed cytotoxicity. Treatment with GBR 12909, a highly selective DAT inhibitor, significantly increased DAT expression compared with that of amphetamine only by enhancing phosphorylation of mitogen-activated protein kinases (MAPK) and Akt. In addition, essential oils effectively induced hyperphosphorylation of cyclic-AMP response element-binding protein (CREB), MAPK, and Akt, which resulted in DAT upregulation. Our study implies that the essential oils may rehabilitate brain dopamine function through increased DAT availability in abstinent former drug users.

  3. Access to essential medicines for sexual and reproductive health care: the role of the pharmaceutical industry and international regulation.

    Science.gov (United States)

    Cottingham, Jane; Berer, Marge

    2011-11-01

    The range of medicines and technologies that are essential for sexual and reproductive health care is well established, but access to them is far from universally assured, particularly in less developed countries. This paper shows how the pharmaceutical industry plays a major role in the lack of access to essential medicines for sexual and reproductive health care, by a) investing in products for profit-making reasons despite their negative health impact (e.g. hormone replacement therapy), b) marketing new essential medicines at prices beyond the reach of countries that most need them (e.g. HPV vaccines), and c) failing to invest in the development of new products (e.g. microbicides and medical abortion pills). Small companies, some of them non-profit-making, struggle to fill some of that demand (e.g. for female condoms). International patent protection contributes to high prices of medicines, and while international agreements such as compulsory licensing under TRIPS and the Medicines Patent Pool allow for mechanisms to enable poorer countries to get access to essential medicines, the obstacles created by "big pharma" are daunting. All these barriers have fostered a market in sub-standard medicines (e.g. fake medical abortion pills sold over the internet). An agenda driven by sexual and reproductive health needs, based on the right to health, must focus on universal access to essential medicines at prices developing countries can afford. We call for greater public investment in essential medicines, expanded production of affordable generic drugs, and the development of broad strategic plans, that include affordable medicines and technologies, for addressing identified public health problems, such as cervical cancer. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  4. Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada.

    Science.gov (United States)

    Morgan, Steven G; Li, Winny; Yau, Brandon; Persaud, Nav

    2017-02-27

    Canada's universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada. We compared prices of these essential medicines in Canada with prices in the United States, Sweden and New Zealand. We estimated the cost of adding universal public drug coverage of these essential medicines based on anticipated effects on medication use and pricing. The 117 essential medicines on the model list accounted for 44% of all prescriptions and 30% of total prescription drug expenditures in 2015. Average prices of generic essential medicines were 47% lower in the US, 60% lower in Sweden and 84% lower in New Zealand; brand-name drugs were priced 43% lower in the US. Estimated savings from universal public coverage of these essential medicines was $4.27 billion per year (range $2.72 billion to $5.83 billion; 28% reduction) for patients and private drug plan sponsors, at an incremental government cost of $1.23 billion per year (range $373 million to $1.98 billion; 11% reduction). Our analysis showed that adding universal public coverage of essential medicines to the existing public drug plans in Canada could address most of Canadians' pharmaceutical needs and save billions of dollars annually. Doing so may be a pragmatic step forward while more comprehensive pharmacare reforms are planned. © 2017 Canadian Medical Association or its licensors.

  5. Pharmacist's contribution to the promotion of access and rational use of essential medicines in SUS.

    Science.gov (United States)

    Melo, Daniela Oliveira de; Castro, Lia Lusitana Cardozo de

    2017-01-01

    to describe the pharmaceutical inclusion process in a Basic Health Unit multidisciplinary team and evaluate results related to rational use and promotion of access to essential medicines. This is a descriptive, cross-sectional study conducted in a primary care health unit in the city of São Paulo. Pharmacist's activities were evaluated regarding the service structure and organization and prescribing quality improvement, guidance method creation, and implementation of clinical pharmacy service. Data measured before and after the interventions and between 2010 and 2011 were analyzed using Pearson´s chi-square test with a significance level of 5%, and odds ratio. Pharmacist's activities had statistically significant result in drug shortage reduction; prescribing quality improvement associated with an increased proportion of prescriptions met; decrease in the total of prescribed drugs among patients receiving pharmacotherapeutic follow-up and, comparing the years 2010 and 2011, changes in the pharmacotherapy recommendations have gained increased acceptance level. Pharmacist's activities may effectively provide rational use and promotion of access to essential medicines.

  6. The collision of rights and its impact on access to essential medicines: Challenges for South America

    Directory of Open Access Journals (Sweden)

    Raúl Allard Soto

    2018-05-01

    Full Text Available The collision between intellectual property rights and the right to health due to obligations assumed simultaneously –the WTO trips Agreement and the United Nations International Covenant on Economic, Social and Cultural Rights– by the twelve countries of South America, has had a profound impact regarding their populations access to essential medicines. The paper reports this situation in the region, while placing it in the context of the debate on trade and human rights, which has been particularly strong since the beginning of this century in the field of public health. The need for South American countries to strengthen intraregional cooperation as well as the promotion of South-South cooperation in access to essential medicines, taking into account the prevalence of pharmaceutical patents held by private laboratories in the northern hemisphere, is underlined. The advances made in this direction by the South American Health Council of Unasur, together with its actions as a regional bloc at the WTO meetings, are promising steps that must be complemented by the development of joint drug production capabilities.

  7. A national survey on availability, price and affordability of selected essential medicines for non communicable diseases in Sri Lanka.

    Science.gov (United States)

    Dabare, Panthihage Ruvini L; Wanigatunge, Chandanie A; Beneragama, Bvs Hemantha

    2014-08-08

    Access to medicines is a universal right. Low availability and low affordability of medicines are issues that deny this right to a significant proportion of the world population. The objective of this study was to determine the availability, price and affordability of essential medicines prescribed to treat non communicable diseases in Sri Lanka. Methodology was based on the 2nd edition of the World Health Organization Health Action International Manual. A country survey was conducted and facilities representing both public and private pharmacies were selected. A total of 109 facilities was surveyed. At each facility data on the availability and prices of 50 essential medicines for non communicable diseases were collected. Percentage availability, median price of originator brand and lowest priced generic, median price ratio to the International Reference Price were calculated for surveyed medicines. Affordability was determined using the daily incomes of the lowest--paid unskilled government worker. Semi government community pharmacies had the highest (>80%) availability while outdoor pharmacies of public health care facilities, private pharmacies and outdoor pharmacies of private hospital showed a fairly high availability (50 - 80%) of surveyed medicines.Unit price of 76% of selected individual medicines was less than ten Sri Lankan rupees. Out of these 28% of medicines cost less than one Sri Lanka rupee. For 21 of the surveyed medicines the median price ratio to the international reference price was less than one. The prices of originator brands for 14 surveyed medicines were more than five times that of the lowest price generics.Less than a single day's wages was adequate to purchase a month's supply of the lowest priced generic of more than 67% of surveyed medicines. The availability of selected essential medicines was fairly high in both public and private sectors in Sri Lanka. Most medicines are affordable to the lowest income earners in the community. There

  8. A national survey on availability, price and affordability of selected essential medicines for non communicable diseases in Sri Lanka

    OpenAIRE

    Dabare, Panthihage Ruvini L; Wanigatunge, Chandanie A; Beneragama, BVS Hemantha

    2014-01-01

    Background Access to medicines is a universal right. Low availability and low affordability of medicines are issues that deny this right to a significant proportion of the world population. The objective of this study was to determine the availability, price and affordability of essential medicines prescribed to treat non communicable diseases in Sri Lanka. Methods Methodology was based on the 2nd edition of the World Health Organization Health Action International Manual. A country survey wa...

  9. Health Care Financing in Ethiopia: Implications on Access to Essential Medicines.

    Science.gov (United States)

    Ali, Eskinder Eshetu

    2014-09-01

    The Ethiopian health care system is under tremendous reform. One of the issues high on the agenda is health care financing. In an effort to protect citizens from catastrophic effects of the clearly high share of out-of-pocket expenditure, the government is currently working to introduce health insurance. This article aims to highlight the components of the Ethiopian health care financing reform and discuss its implications on access to essential medicines. A desk review of government policy documents and proclamations was done. Moreover, a review of the scientific literature was done via PubMed and search of other local journals not indexed in PubMed. Revenue retention by health facilities, systematizing the fee waiver system, standardizing exemption services, outsourcing of nonclinical services, user fee setting and revision, initiation of compulsory health insurance (community-based health insurance and social health insurance), establishment of a private wing in public hospitals, and health facility autonomy were the main components of the health care financing reform in Ethiopia. Although limited, the evidence shows that there is increased health care utilization, access to medicines, and quality of services as a result of the reforms. Encouraging progress has been made in the implementation of health care financing reforms in Ethiopia. However, there is shortage of evidence on the effect of the health care financing reforms on access to essential medicines in the country. Thus, a clear need exists for well-organized research on the issue. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  10. Implementing differential pricing for essential medicines via country-specific bilateral negotiated discounts.

    Science.gov (United States)

    Tetteh, Ebenezer Kwabena

    2009-01-01

    It is widely acknowledged that limited access to essential medicines undermines efforts at improving the health and economic well-being of low-income populations. This has spurred on a number of solutions, including differential pricing based on the economics of price discrimination. A desirable feature of differential pricing is its potential ability to reconcile static and dynamic efficiency concerns. There are, however, various shades of differential pricing and this paper aims to evaluate their consistency with economic theory. Starting with the report of the workshop on 'Differential Pricing and Financing of Essential Drugs' held by secretariats of the World Trade Organization and WHO in Hosbjor, Norway, in 2001, this paper takes issue with how differential pricing has been defined as a tool for improving access to essential drug benefits. The paper notes that inadequate attention has been given to policies and institutional arrangements for creating, expressing and maintaining 'truly' price-elastic demands in low-income nations and for segmenting markets. In addition, considerations of equity and solidarity have distracted policy advocates from balancing conflicting, yet well intended, views and general rules. The paper argues why differential pricing should be implemented via country-specific bilateral negotiated discounts. It maintains that it is feasible to muster an environment conducive to profitable differential pricing whilst satisfying general rules and concerns about self-reliance, transparency, accountability, equity and solidarity.

  11. Essential Oils from Ugandan Aromatic Medicinal Plants: Chemical Composition and Growth Inhibitory Effects on Oral Pathogens

    Directory of Open Access Journals (Sweden)

    Francis Ocheng

    2015-01-01

    Full Text Available The study assessed the growth inhibitory effects of essential oils extracted from ten Ugandan medicinal plants (Bidens pilosa, Helichrysum odoratissimum, Vernonia amygdalina, Hoslundia opposita, Ocimum gratissimum, Cymbopogon citratus, Cymbopogon nardus, Teclea nobilis, Zanthoxylum chalybeum, and Lantana trifolia used traditionally in the management of oral diseases against oral pathogens. Chemical compositions of the oils were explored by GC-MS. Inhibitory effects of the oils were assessed on periodontopathic Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and cariogenic Streptococcus mutans and Lactobacillus acidophilus using broth dilution methods at concentrations of 1%, 0.1%, and 0.01%. The most sensitive organism was A. actinomycetemcomitans. Its growth was markedly inhibited by six of the oils at all the concentrations tested. Essential oil from C. nardus exhibited the highest activity with complete growth inhibition of A. actinomycetemcomitans and P. gingivalis at all the three concentrations tested, the major constituents in the oil being mainly oxygenated sesquiterpenes. Most of the oils exhibited limited effects on L. acidophilus. We conclude that essential oils from the studied plants show marked growth inhibitory effects on periodontopathic A. actinomycetemcomitans and P. gingivalis, moderate effects on cariogenic S. mutans, and the least effect on L. acidophilus. The present study constitutes a basis for further investigations and development of certain oils into alternative antiplaque agents.

  12. Essential Oils from Ugandan Aromatic Medicinal Plants: Chemical Composition and Growth Inhibitory Effects on Oral Pathogens

    Science.gov (United States)

    Ocheng, Francis; Bwanga, Freddie; Joloba, Moses; Softrata, Abier; Azeem, Muhammad; Pütsep, Katrin; Borg-Karlson, Anna-Karin; Obua, Celestino; Gustafsson, Anders

    2015-01-01

    The study assessed the growth inhibitory effects of essential oils extracted from ten Ugandan medicinal plants (Bidens pilosa, Helichrysum odoratissimum, Vernonia amygdalina, Hoslundia opposita, Ocimum gratissimum, Cymbopogon citratus, Cymbopogon nardus, Teclea nobilis, Zanthoxylum chalybeum, and Lantana trifolia) used traditionally in the management of oral diseases against oral pathogens. Chemical compositions of the oils were explored by GC-MS. Inhibitory effects of the oils were assessed on periodontopathic Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans and cariogenic Streptococcus mutans and Lactobacillus acidophilus using broth dilution methods at concentrations of 1%, 0.1%, and 0.01%. The most sensitive organism was A. actinomycetemcomitans. Its growth was markedly inhibited by six of the oils at all the concentrations tested. Essential oil from C. nardus exhibited the highest activity with complete growth inhibition of A. actinomycetemcomitans and P. gingivalis at all the three concentrations tested, the major constituents in the oil being mainly oxygenated sesquiterpenes. Most of the oils exhibited limited effects on L. acidophilus. We conclude that essential oils from the studied plants show marked growth inhibitory effects on periodontopathic A. actinomycetemcomitans and P. gingivalis, moderate effects on cariogenic S. mutans, and the least effect on L. acidophilus. The present study constitutes a basis for further investigations and development of certain oils into alternative antiplaque agents. PMID:26170872

  13. Antibacterial and Anticandidal Activity of Essential Oils of some Medicinal Plants in Saudi Arabia

    International Nuclear Information System (INIS)

    Abed, Kawther F

    2007-01-01

    The antibacterial and anticandidal properties of essential oils obtained from 7 plant species used in traditional medicine in Saudi Arabia and other Middle East countries were evaluated for activity against test bacteria; Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa and Candida albicans using an agar dilution method. Our results showed that oils from Azadirachta indica, Ziziphus spine, Matricaria chamomilla, Agrimonia eupatoria and Lupinus albus, even at the highest concentration did not inhibit any of the tested organisms. The essential oil extracted from Juniperus communis and Lavandula hybrida plants did not show any antibacterial activities. However, essential oil extracts from Juniperus communis and Lavandula hybrida exhibited varying degrees of growth inhibition of Candida albicans. The minimum inhibitory concentrations were 2.0%( v/v) of Juniper oil and 0.5% (v/v) for Lavender oil against Candida albicans. Our results suggest that the anticandidal properties of Juniper and Lavender oils may be further investigated to explore the possibility of using them in the treatment of candidal infections. (author)

  14. Impact of price deregulation policy on the affordability of essential medicines for women's health: a panel data analysis.

    Science.gov (United States)

    Liu, Junjie; Wang, Liming; Liu, Chenxi; Zhang, Xinping

    2017-12-01

    A new policy which required deregulation on prices of off-patent medicines for women's health during procurement was introduced in China in September 2015. The current study examines this policy's impact on the affordability of essential medicines for women's health. Based on product-level panel data, a fixed effect regression model is employed by using procurement records from Hubei Centralist Tender for Drug Purchase platform. In the model, Affordability was measured with prices. The Competition consists of two parts: generic competition and therapeutic class competition which are measured with generic competitors and therapeutic substitutes. Instrument variable is used to deal with endogeneity. The policy helped control prices of essential medicines for women's health. Generic competition helped control prices, however, therapeutic class competition caused higher prices. The new policy helped enhance the affordability of essential medicines for women's health as expected, which provides empirical evidence on price deregulation. Besides, generic competition is important in price control despite strict regulatory system in China.

  15. Assessment of the impact of market regulation in Mali on the price of essential medicines provided through the private sector.

    Science.gov (United States)

    Maïga, Diadié; Williams-Jones, Bryn

    2010-10-01

    In 1998, the government of Mali adopted a national pharmaceutical policy aimed at promoting a supply system for generic essential medicines that would guarantee equal access for all citizens. Distribution and delivery is a shared responsibility of both public and private sectors (wholesalers and pharmacies). To influence private sector behaviour, the national policy uses a combination of government regulation and market forces. In 2006, the government issued a decree fixing maximum prices in the private sector for 107 prescription drugs from the national list of 426 essential medicines. The current study assessed the impact of this intervention on the evolution of market prices (wholesale and retail), and the subsequent availability and public access to essential medicines in Mali. A cross-sectional descriptive survey was conducted in February and May 2006, and January 2009, with 16 wholesalers and 30 private drugstores in Bamako, Mali. The overall availability of essential medicines at private wholesalers (p=1) and pharmacies (p=0.53) was identical before and after the enforcement of the 2006 decree fixing maximum drug prices. Contrary to concerns expressed by wholesalers and pharmacies, and the other stakeholders, the decree did not impact negatively on availability of essential medicines. In fact, median wholesale prices in 2009 were 25.6% less than those fixed by the decree. In private pharmacies, retail prices were only 3% more expensive than the recommended prices, compared with being 25.5% more expensive prior to enforcement of the decree. The study shows that prices of essential medicines in Mali have evolved favourably towards the prices recommended by the government decree. Further, the study contributes to mounting evidence that market regulation by governments does not necessarily negatively affect drug availability; in fact, given the reduction in prices, the study shows that Malians arguably have better access to more affordable essential medicines

  16. Possibility for use essential oils in veterinary medicine and animal husbandry with special emphasis on oregano oil

    Directory of Open Access Journals (Sweden)

    Vučinić Marijana

    2012-01-01

    Full Text Available The paper reviews the latest studies on possible applications of oregano essential oil in veterinary medicine and animal livestock production. The first part of the paper deals with the definition of essential oils, possibilities for their extraction from plants, possibilities for their application in human and veterinary medicine, the interest of a science in essential oils, and, essential oils classification based on their use in human and veterinary medicine. The second part of the review deals with the properties of oregano essential oil, its main active principles, carvacrol and thymol and its application in veterinary medicine and animal livestock production. Oregano essential oil may be applied in animal feed, in the treatment of coccidiosis of domestic animals and candidiasis. It can be applied as a larvicide, repellent, insecticide and acaricide. It is used in aquaculture to treat fish diseases caused by bacteria and parasites or in the hatchery industry as a disinfectant for eggs or for disinfection of manure. The greatest potential of oregano essential oil is the possibility of its application in organic agriculture and organic animal husbandry. [Projekat Ministarstva nauke Republike Srbije, br. TR 31087

  17. The Quality of Selected Essential Medicines Sold in Accredited Drug Dispensing Outlets and Pharmacies in Tanzania.

    Directory of Open Access Journals (Sweden)

    Eliangiringa Kaale

    Full Text Available The purpose of this study was to investigate the quality of a select group of medicines sold in accredited drug dispensing outlets (ADDOs and pharmacies in different regions of Tanzania as part of an in-depth cross-sectional assessment of community access to medicines and community use of medicines.We collected 242 samples of amoxicillin trihydrate, artemether-lumefantrine (ALu, co-trimoxazole, ergometrine maleate, paracetamol, and quinine from selected ADDOs and pharmacies in Mbeya, Morogoro, Singida, and Tanga regions. The analysis included physical examination and testing with validated analytical techniques. Assays for eight of nine products were conducted using high-performance thin-layer chromatography (HPTLC. For ALu tablets, we used a two-tiered approach, where tier 1 was a semi-quantitative Global Pharma Health Fund-Minilab® method and tier 2 was high-performance liquid chromatography (HPLC as described in The International Pharmacopoeia's monograph for artemether-lumefantrine.The physical examination of samples revealed no defects in the solid and oral liquid dosage forms, but unusual discoloration in an injectable solution, ergometrine maleate. For ALu, the results showed that of 38 samples, 31 (81.6% passed tier 1 testing and 7 (18.4% gave inconclusive drug content results. The inconclusive ALu samples were submitted for tier 2 testing and all met the quality standards. The pass rate using the HPTLC and TLC/HPLC assays was 93.8%; the failures were the ergometrine maleate samples purchased from both ADDOs and pharmacies. The disintegration testing of the solid dosage forms was conducted in accordance with US Pharmacopeia monographs. Only two samples of paracetamol, 1.2% of the solid dosage forms, failed to comply to standards. The study revealed a high overall rate of 92.6% of samples that met the quality standards. Although the overall failure rate was 7.4%, it is important to note that this was largely limited to one product and

  18. The Quality of Selected Essential Medicines Sold in Accredited Drug Dispensing Outlets and Pharmacies in Tanzania.

    Science.gov (United States)

    Kaale, Eliangiringa; Manyanga, Vicky; Chambuso, Mhina; Liana, Jafary; Rutta, Edmund; Embrey, Martha; Layloff, Thomas; Johnson, Keith

    2016-01-01

    The purpose of this study was to investigate the quality of a select group of medicines sold in accredited drug dispensing outlets (ADDOs) and pharmacies in different regions of Tanzania as part of an in-depth cross-sectional assessment of community access to medicines and community use of medicines. We collected 242 samples of amoxicillin trihydrate, artemether-lumefantrine (ALu), co-trimoxazole, ergometrine maleate, paracetamol, and quinine from selected ADDOs and pharmacies in Mbeya, Morogoro, Singida, and Tanga regions. The analysis included physical examination and testing with validated analytical techniques. Assays for eight of nine products were conducted using high-performance thin-layer chromatography (HPTLC). For ALu tablets, we used a two-tiered approach, where tier 1 was a semi-quantitative Global Pharma Health Fund-Minilab® method and tier 2 was high-performance liquid chromatography (HPLC) as described in The International Pharmacopoeia's monograph for artemether-lumefantrine. The physical examination of samples revealed no defects in the solid and oral liquid dosage forms, but unusual discoloration in an injectable solution, ergometrine maleate. For ALu, the results showed that of 38 samples, 31 (81.6%) passed tier 1 testing and 7 (18.4%) gave inconclusive drug content results. The inconclusive ALu samples were submitted for tier 2 testing and all met the quality standards. The pass rate using the HPTLC and TLC/HPLC assays was 93.8%; the failures were the ergometrine maleate samples purchased from both ADDOs and pharmacies. The disintegration testing of the solid dosage forms was conducted in accordance with US Pharmacopeia monographs. Only two samples of paracetamol, 1.2% of the solid dosage forms, failed to comply to standards. The study revealed a high overall rate of 92.6% of samples that met the quality standards. Although the overall failure rate was 7.4%, it is important to note that this was largely limited to one product and likely due to

  19. Counterfeit Drug Penetration into Global Legitimate Medicine Supply Chains: A Global Assessment

    Science.gov (United States)

    Mackey, Tim K.; Liang, Bryan A.; York, Peter; Kubic, Thomas

    2015-01-01

    Counterfeit medicines are a global public health risk. We assess counterfeit reports involving the legitimate supply chain using 2009–2011 data from the Pharmaceutical Security Institute Counterfeit Incident System (PSI CIS) database that uses both open and nonpublic data sources. Of the 1,510 identified CIS reports involving counterfeits, 27.6% reported China as the source country of the incident/detection. Further, 51.3% were reported as counterfeit but the specific counterfeit subcategory was not known or verifiable. The most prevalent therapeutic category was anti-infectives (21.1%) with most reports originating from health-related government agencies. Geographically, Asian and Latin American regions and, economically, middle-income markets were most represented. A total of 127 (64.8%) of a total of 196 countries had no legitimate supply chain CIS counterfeit reports. Improvements in surveillance, including detection of security breaches, data collection, analysis, and dissemination are urgently needed to address public health needs to combat the global counterfeit medicines trade. PMID:25897059

  20. The Impact of the National Essential Medicines Policy on Rational Drug Use in Primary Care Institutions in Jiangsu Province of China.

    Science.gov (United States)

    Chao, Jianqian; Gu, Jiangyi; Zhang, Hua; Chen, Huanghui; Wu, Zhenchun

    2018-01-01

    Essential medicine policy is a successful global health policy to promote rational drug use. The aim of this study was to evaluate the impact of the National Essential Medicines Policy (NEMP) on the rational drug use in primary care institutions in Jiangsu Province of China. In this exploratory study, a multistage, stratified, random sampling was used to select 3400 prescriptions from 17 primary care institutions who implemented the NEMP before (Jan 2010) and after the implementation of the NEMP (Jan 2014). The analyses were performed in SPSS 18.0 and SPSS Clementine client. After the implementation of the NEMP, the percentage of prescribed EML (Essential Medicines List) drugs rose significantly, the average number of drugs per prescription and average cost per prescription were declined significantly, while the differences of the prescription proportion of antibiotics and injection were not statistically significant. BP (Back Propagation) neural network analysis showed that the average number of drugs per prescription, the number of using antibiotics and hormone, regional differences, size of institutions, sponsorship, financial income of institutions, doctor degree, outpatient and emergency visits person times were important factors affecting the prescription costs, among these the average number of drugs per prescription has the greatest effect. The NEMP can promote the rational use of drugs in some degree, but its role is limited. We should not focus only on the EML but also make comprehensive NEMP.

  1. Essential competencies in global health research for medical trainees: A narrative review.

    Science.gov (United States)

    White, Mary T; Satterfield, Caley A; Blackard, Jason T

    2017-09-01

    Participation in short-term educational experiences in global health (STEGHs) among medical trainees is increasingly accompanied by interest in conducting research while abroad. Because formal training in both global health and research methods is currently under-represented in most medical curricula, trainees are often unfamiliar with the knowledge, attitudes, and skills necessary to design and conduct research successfully. This narrative review identifies essential global health research competencies for medical trainees engaged in STEGHs. The authors searched the literature using the terms global health, competency, research, research methods/process/training, scholarly project, medical student, and medical education/education. Because articles directly addressing global health research competencies for medical trainees were limited, the authors additionally drew on the broader literature addressing general research competencies and global health competencies. Articles yielded by the literature search, combined with established guidelines in research ethics and global health ethics, were used to identify six core domains and twenty discrete competencies fundamental to global health research at a level appropriate for medical trainees enrolled in STEGHs. Consideration was given to diverse research modalities, varying levels of training, and the availability of mentoring and on-site support. Research may provide important benefits to medical trainees and host partners. These competencies provide a starting point; however, circumstances at any host site may necessitate additional competencies specific to that setting. These competencies are also limited by the methodology employed in their development and the need for additional perspectives from host partners. The competencies identified outline basic knowledge, attitudes, and skills necessary for medical trainees to conduct limited global health research while participating in STEGHS. They may also be used as a

  2. Patient assessment of effectiveness and satisfaction with traditional medicine, globalized complementary and alternative medicines, and allopathic medicines for cancer in Pakistan.

    Science.gov (United States)

    Tovey, Philip; Broom, Alex; Chatwin, John; Hafeez, Muhammad; Ahmad, Salma

    2005-09-01

    Virtually no research has been conducted on patient assessments of traditional medicines and allopathic medicines for cancer care in poorer countries marked by pluralistic medical environments. Pakistan represents an excellent case for such a study because of the coexistence of culturally and historically specific indigenous traditional medicine, the strong presence of allopathic medicine, and, to a lesser extent, the availability of some globalized complementary and alternative medicines. To gain a preliminary understanding of cancer patients' perceptions of effectiveness and satisfaction with traditional medicine, globalized complementary and alternative medicine, and allopathy in the context of a pluralistic medical environment. Structured survey of 362 cancer patients, from diverse regions in the Punjab province and Northwest Frontier province, who were being treated in 4 different hospitals in Lahore, Pakistan. Use of traditional medicine remains high among cancer patients, with traditional healers used by the majority of those surveyed. Although patients' perceptions of the overall effectiveness of traditional medicines for treating cancer are low, those patients who do use traditional medicines still have high levels of satisfaction with these modalities. This is distinct from levels of satisfaction with, and perceptions of effectiveness of, Western cancer treatments, which were synonymous in this group of patients. Important differences in patient perceptions were found within groups (eg, between different forms of traditional healers) as well as between them. This study showed considerable support for complementary and alternative medicine/traditional medicine but also significant variation in usage of and perceptions of local traditional medicines. More research needs to be done to explore the social processes underlying this variation in cancer patients' preferences for particular traditional medicines.

  3. Chemical composition and antifungal activity of essential oils from medicinal plants of Kazakhstan.

    Science.gov (United States)

    Sampietro, Diego A; Gomez, Analía de Los A; Jimenez, Cristina M; Lizarraga, Emilio F; Ibatayev, Zharkyn A; Suleimen, Yerlan M; Catalán, Cesar A

    2017-06-01

    The composition of essential oils from leaves of Kazakhstan medicinal plants was analysed by GC-MS. The major compounds identified were 1,8-cineole (34.2%), myrcene (19.1%) and α-pinene (9.4%) in Ajania fruticulosa; 1,8-cineole (21.0%), β-thujone (11.0%), camphor (8.5%), borneol (7.3%) and α-thujone (6.5%), in Achillea nobilis; camphor (47.3%), 1,8-cineole (23.9%), camphene (9.8%) and β-thujone (6.0%) in Artemisia terrae-albae; 1,8-cineole(55.8%) and β-pinene (6.2%) in Hyssopus ambiguus; α-thuyene(46.3%) and δ-cadinene(6.3%) in Juniperus sibirica; sabinene (64%) in Juniperus sabina; and α-pinene (51.5%), β-phellandrene (11.2%) and δ-cadinene (6.3%) in Pinus sibirica. The essential oils did not show antifungal effect (MIC > 1.20 mg/mL) on Aspergillus carbonarius and Aspergillus niger, while the oils from A. nobilis, A. terrae-albae, H. ambiguus and J. sabina exhibited moderate and moderate to weak antimicrobial activities on Fusarium verticillioides (MIC = 0.60 mg/mL) and Fusarium graminearum (MIC = 0.60-1.20 mg/mL), respectively. A principal component analysis associated the antifungal activity (r 2  > 0.80, p = 0.05) with the presence of borneol, camphor, camphene, 1,8-cineole,α- and β-thujone, and of the oxygenated monoterpenes.

  4. Use of WONCA global standards to evaluate family medicine postgraduate education for curriculum development and review in Nepal and Myanmar.

    Science.gov (United States)

    Gibson, Christine; Ladak, Farah; Shrestha, Ashis; Yadav, Bharat; Thu, Kyaw; Aye, Tin

    2016-09-01

    Family medicine is an integral part of primary care within health systems. Globally, training programmes exhibit a great degree of variability in content and skill acquisition. While this may in part reflect the needs of a given setting, there exists standard criteria that all family medicine programmes should consider core activities. WONCA has provided an open-access list of standards that their expert community considers essential for family medicine (GP) post-graduate training. Evaluation of developing or existing training programmes using these standards can provide insight into the degree of variability, gaps within programmes and equally as important, gaps within recommendations. In collaboration with the host institution, two family medicine programmes in Nepal and Myanmar were evaluated based on WONCA global standards. The results of the evaluation demonstrated that such a process can allow for critical review of curriculum in various stages of development and evaluation. The implications of reviewing training programmes according to WONCA standards can lead to enhanced training world-wide and standardisation of training for post-graduate family medicine.

  5. Traditional Chinese Medicine Syndromes for Essential Hypertension: A Literature Analysis of 13,272 Patients

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2014-01-01

    Full Text Available Background. To simplify traditional Chinese medicine syndrome differentiation and allow researchers to master syndrome differentiation for hypertension, this paper retrospectively studied the literature and analyzed syndrome elements corresponding to hypertension syndromes. Methods. Six databases including PubMed, EMBASE, Chinese Bio-Medical Literature Database, Chinese National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan-fang Data were searched from 1/January/2003 to 30/October/2013. We included all clinical literature testing hypertension syndromes and retrospectively studied the hypertension literature published from 2003 to 2013. Descriptive statistics calculated frequencies and percentages. Results. 13,272 patients with essential hypertension were included. Clinical features of hypertension could be attributed to 11 kinds of syndrome factors. Among them, seven syndrome factors were excess, while four syndrome factors were deficient. Syndrome targets were mainly in the liver and related to the kidney and spleen. There were 33 combination syndromes. Frequency of single-factor syndromes was 31.77% and frequency of two-factor syndromes was 62.26%. Conclusions. Excess syndrome factors of hypertension patients include yang hyperactivity, blood stasis, phlegm turbidity, internal dampness, and internal fire. Deficient syndrome factors of hypertension patients are yin deficiency and yang deficiency. Yin deficiency with yang hyperactivity, phlegm-dampness retention, and deficiency of both yin and yang were the three most common syndromes in clinical combination.

  6. Neuroprotective and Anti-Aging Potentials of Essential Oils from Aromatic and Medicinal Plants

    Directory of Open Access Journals (Sweden)

    Muhammad Ayaz

    2017-05-01

    Full Text Available The use of essential oils (EOs and their components is known since long in traditional medicine and aromatherapy for the management of various diseases, and is further increased in the recent times. The neuroprotective and anti-aging potentials of EOs and their possible mechanism of actions were evaluated by numerous researchers around the globe. Several clinically important EOs and their components from Nigella sativa, Acorus gramineus, Lavandula angustifolia, Eucalyptus globulus, Mentha piperita, Rosmarinus officinalis, Jasminum sambac, Piper nigrum and so many other plants are reported for neuroprotective effects. This review article was aimed to summarize the current finding on EOs tested against neurodegenerative disorders like Alzheimer disease (AD and dementia. The effects of EOs on pathological targets of AD and dementia including amyloid deposition (Aβ, neurofibrillary tangles (NFTs, cholinergic hypofunction, oxidative stress and glutamatergic abnormalities were focused. Furthermore, effects of EOs on other neurological disorders including anxiety, depression, cognitive hypofunction epilepsy and convulsions were also evaluated in detail. In conclusion, EOs were effective on several pathological targets and have improved cognitive performance in animal models and human subjects. Thus, EOs can be developed as multi-potent agents against neurological disorders with better efficacy, safety and cost effectiveness.

  7. Neuroprotective and Anti-Aging Potentials of Essential Oils from Aromatic and Medicinal Plants.

    Science.gov (United States)

    Ayaz, Muhammad; Sadiq, Abdul; Junaid, Muhammad; Ullah, Farhat; Subhan, Fazal; Ahmed, Jawad

    2017-01-01

    The use of essential oils (EOs) and their components is known since long in traditional medicine and aromatherapy for the management of various diseases, and is further increased in the recent times. The neuroprotective and anti-aging potentials of EOs and their possible mechanism of actions were evaluated by numerous researchers around the globe. Several clinically important EOs and their components from Nigella sativa , Acorus gramineus, Lavandula angustifolia, Eucalyptus globulus, Mentha piperita, Rosmarinus officinalis, Jasminum sambac, Piper nigrum and so many other plants are reported for neuroprotective effects. This review article was aimed to summarize the current finding on EOs tested against neurodegenerative disorders like Alzheimer disease (AD) and dementia. The effects of EOs on pathological targets of AD and dementia including amyloid deposition (Aβ), neurofibrillary tangles (NFTs), cholinergic hypofunction, oxidative stress and glutamatergic abnormalities were focused. Furthermore, effects of EOs on other neurological disorders including anxiety, depression, cognitive hypofunction epilepsy and convulsions were also evaluated in detail. In conclusion, EOs were effective on several pathological targets and have improved cognitive performance in animal models and human subjects. Thus, EOs can be developed as multi-potent agents against neurological disorders with better efficacy, safety and cost effectiveness.

  8. Herbal medicine research and global health: an ethical analysis

    OpenAIRE

    Tilburt, Jon C; Kaptchuk, Ted J

    2008-01-01

    Governments, international agencies and corporations are increasingly investing in traditional herbal medicine research. Yet little literature addresses ethical challenges in this research. In this paper, we apply concepts in a comprehensive ethical framework for clinical research to international traditional herbal medicine research. We examine in detail three key, underappreciated dimensions of the ethical framework in which particularly difficult questions arise for international herbal me...

  9. Global medicinal uses of Euphorbia L. (Euphorbiaceae)

    DEFF Research Database (Denmark)

    Ernst, Madeleine; Grace, Olwen M; Saslis Lagoudakis, Haris

    2015-01-01

    in Australia, topical application of latex of Euphorbia peplus L. is used as a home treatment for skin cancer and actinic keratosis. Its use in Australian folk medicine has inspired the release of the drug Picato ® (ingenol mebutate), and further fostered interest in natural products and medicinal uses...

  10. Realising the right to sexual and reproductive health : Access to essential medicines for medical abortion as a core obligation

    NARCIS (Netherlands)

    Perehudoff, Katrina; Berro Pizzarossa, Lucia; Stekelenburg, Jelle

    2018-01-01

    BACKGROUND: WHO has a pivotal role to play as the leading international agency promoting good practices in health and human rights. In 2005, mifepristone and misoprostol were added to WHO's Model List of Essential Medicines for combined use to terminate unwanted pregnancies. However, these drugs

  11. A Delphi study among internal medicine clinicians to determine which therapeutic information is essential to record in a medical record.

    Science.gov (United States)

    van Unen, Robert J; Tichelaar, Jelle; Nanayakkara, Prabath W B; van Agtmael, Michiel A; Richir, Milan C; de Vries, Theo P G M

    2015-12-01

    Several studies have demonstrated that using a template for recording general and diagnostic information in the medical record (MR) improves the completeness of MR documentation, communication between doctors, and performance of doctors. However, little is known about how therapeutic information should be structured in the MR. The aim of this study was to investigate which specific therapeutic information registrars and consultants in internal medicine consider essential to record in the MR. Therefore, we carried out a 2-round Internet Delphi study. Fifty-nine items were assessed on a 5-point scale; an item was considered important if ≥ 80% of the respondents awarded it a score of 4 or 5. In total, 26 registrars and 30 consultants in internal medicine completed both rounds of the study. Overall, they considered it essential to include information about 11 items in the MR. Subgroup analyses revealed that the registrars considered 8 additional items essential, whereas the consultants considered 1 additional item essential to record. Study findings can be used as a starting point to develop a structured section of the MR for therapeutic information for both paper and electronic MRs. This section should contain at least 11 items considered essential by registrars and clinical consultants in internal medicine. © 2015, The American College of Clinical Pharmacology.

  12. Quantification of scientific output in cardiovascular medicine: A perspective based on global data

    NARCIS (Netherlands)

    G.A. Rodriguez-Granillo (Gaston); A. Rodriguez (Alfredo Chapin); N. Bruining (Nico); J. Milei (José); J. Aoki (Jiro); K. Tsuchida (Keiichi); R. del Valle-Fernández (Raquel); C.A. Arampatzis (Chourmouzios); A.T.L. Ong (Andrew); P.A. Lemos Neto (Pedro); R. Ayala (Rosa); H.M. Garcia-Garcia (Hector); F. Saia (Francesco); M. Valgimigli (Marco); E.S. Regar (Eveline); E. McFadden (Eugene); G.G. Biondi-Zoccai (Giuseppe); E. Barbenza (Ezequiel); P. Schoenhagen (Paul); P.W.J.C. Serruys (Patrick)

    2013-01-01

    textabstractAims: We sought to explore whether global and regional scientific output in cardiovascular medicine is associated with economic variables and follows the same trend as medicine and as science overall. Methods and results: We registered the number of documents, number of citations,

  13. Preliminary study of the molluscicidal and larvicidal properties of some essential oils and phytochemicals from medicinal plants

    Directory of Open Access Journals (Sweden)

    Aristides M. Leite

    Full Text Available This study aimed to evaluate the molluscicidal and larvicidal activity of some essential oils and phytochemicals from medicinal plants. Molluscicide and larvicidal activity were determined by, respectively, the lethality bioassays using Artemia salina Leach. Artemiidae and Aedes aegypti L. Culicidae larvae. Essential oils from Eugenia uniflora L. Myrtaceae, Laurus nobilis L. Lauraceae, Origanum vulgare L. Lamiaceae and the phytochemicals α-pinene and eugenol presented citotoxicity toward Artemia salina with CL50 values between 9.59 and 253.43 μL/mL. Essential oils from E. uniflora, M. piperita, O. vulgare and R. officinalis showed embryotoxicity on Aedes aegypti larvae with a viability inhibition between 40 and 100%. These results show the bioactivity of the assayed essential oils and phytochemicals and, partially, justify their insertion in further evaluation in order to establish a safe exploitation of their biological potentiality.

  14. The synergy of the whole: building a global system for clinical trials to accelerate medicines development.

    Science.gov (United States)

    Koski, Greg; Tobin, Mary F; Whalen, Matthew

    2014-10-01

    The pharmaceutical industry, once highly respected, productive, and profitable, is in the throes of major change driven by many forces, including economics, science, regulation, and ethics. A variety of initiatives and partnerships have been launched to improve efficiency and productivity but without significant effect because they have failed to consider the process as a system. Addressing the challenges facing this complex endeavor requires more than modifications of individual processes; it requires a fully integrated application of systems thinking and an understanding of the desired goals and complex interactions among essential components and stakeholders of the whole. A multistakeholder collaborative effort, led by the Alliance for Clinical Research Excellence and Safety (ACRES), a global nonprofit organization operating in the public interest, is now under way to build a shared global system for clinical research. Its systems approach focuses on the interconnection of stakeholders at critical points of interaction within 4 operational domains: site development and support, quality management, information technology, and safety. The ACRES initiatives, Site Accreditation and Standards, Product Safety Culture, Global Ethical Review and Regulatory Innovation, and Quality Assurance and Safety, focus on building and implementing systems solutions. Underpinning these initiatives is an open, shared, integrated technology (site and optics and quality informatics initiative). We describe the rationale, challenges, progress, and successes of this effort to date and lessons learned. The complexity and fragmentation of the intensely proprietary ecosystem of drug development, challenging regulatory climate, and magnitude of the endeavor itself pose significant challenges, but the economic, social, and scientific rewards will more than justify the effort. An effective alliance model requires a willingness of multiple stakeholders to work together to build a shared system

  15. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches.

    Science.gov (United States)

    Redwood-Campbell, Lynda; Pakes, Barry; Rouleau, Katherine; MacDonald, Colla J; Arya, Neil; Purkey, Eva; Schultz, Karen; Dhatt, Reena; Wilson, Briana; Hadi, Abdullahel; Pottie, Kevin

    2011-07-22

    Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied

  16. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Directory of Open Access Journals (Sweden)

    Wilson Briana

    2011-07-01

    Full Text Available Abstract Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the

  17. Globalizing the history of disease, medicine, and public health in Latin America.

    Science.gov (United States)

    Espinosa, Mariola

    2013-12-01

    The history of Latin America, the history of disease, medicine, and public health, and global history are deeply intertwined, but the intersection of these three fields has not yet attracted sustained attention from historians. Recent developments in the historiography of disease, medicine, and public health in Latin America suggest, however, that a distinctive, global approach to the topic is beginning to emerge. This essay identifies the distinguishing characteristic of this approach as an attentiveness to transfers of contagions, cures, and medical knowledge from Latin America to the rest of the world and then summarizes a few episodes that demonstrate its promise. While national as well as colonial and neocolonial histories of Latin America have made important contributions to our understanding, works taking the global approach have the potential to contribute more directly to the decentering of the global history of disease, medicine, and public health.

  18. Availability and affordability of essential medicines for children in the Western part of Ethiopia: implication for access.

    Science.gov (United States)

    Sado, Edao; Sufa, Alemu

    2016-03-15

    Essential medicines (EMs) are those medicines which satisfy the priority health care needs of the population. Although it is a fundamental human right, access to essential medicines has been a big challenge in developing countries particularly for children. WHO recommends assessing the current situations on availability and affordability of EMs as the first step towards enhancing access to them. Therefore, the aim of this study was to assess access to EMs for children based on availability, affordability, and price. We adapted the WHO and Health Action International tools to measure availability, affordability, and prices of EMs. We collected data on 22 EMs for children from 15 public to 40 private sectors' drug outlets in east Wollega zone. Availability was expressed as percentage of drug outlets per sector that stocked surveyed medicines on the day of data collection, and prices were expressed as median price ratio. Affordability was measured as the number of daily wages required for the lowest-paid government unskilled worker (1.04 US $per day) to purchase one standard treatment of an acute condition or treatment for a chronic condition for a month. The average availability of essential medicines was 43 % at public and 42.8 % at private sectors. Lowest priced medicines were sold at median of 1.18 and 1.54 times their international reference prices (IRP) in the public and private sectors, respectively. Half of these medicines were priced at 0.90 to 1.3 in the public sector and 1.23 to 2.07 in the private sector times their respective IRP. Patient prices were 36 % times higher in the private sector than in the public sector. Medicines were unaffordable for treatment of common conditions prevalent in the zone at both public and private sectors as they cost a day or more days' wages for the lowest paid government unskilled worker. Access to EMs to children is hampered by low availability and high price which is unaffordable. Thus, further study on larger scale is

  19. Distribution of essential medicines to primary care institutions in Hubei of China: effects of centralized procurement arrangements.

    Science.gov (United States)

    Yang, Lianping; Huang, Cunrui; Liu, Chaojie

    2017-11-14

    Poor distribution of essential medicines to primary care institutions has attracted criticism since China adopted provincial centralized regional tendering and procurement systems. This study evaluated the impact of new procurement arrangements that limit the number of distributors at the county level in Hubei province, China. Procurement ordering and distribution data were collected from four counties that pioneered a new distribution arrangement (commencing September 2012) compared with six counties that continued the existing arrangement over the period from August 2011 to September 2013. The new arrangement allowed primary care institutions and/or suppliers to select a local distributor from a limited panel (from 3 to 5) of government nominated distributors. Difference-in-differences analyses were performed to assess the impact of the new arrangements on delivery and receipt of essential medicines. Overall, the new distribution arrangement has not improved distribution of essential medicines to primary care institutions. On the contrary, we found a 7.78-19.85 percentage point (p Procurement arrangements need to consider the special characteristics of rural facilities. In a county, there are more rural primary care institutions than urban ones. On average, rural primary care institutions demand more and are more geographically dispersed compared to their urban counterparts, which may impose increased distribution costs.

  20. Nuclear energy-an essential option for sustainable development of global economy

    International Nuclear Information System (INIS)

    Tokio Kanoh

    2005-01-01

    Increased use of nuclear energy is an essential option for us to take the sustainable development of the global economy. The reasons are as follows: 1. Energy demand, especially in oil demand; 2. Environmental impact, especially greenhouse effect and carbon dioxide emissions, CO 2 emissions to be reduced 40% by increased use of nuclear power; 3. In the era of hydrogen, nuclear power can contribute in two ways. One is hydrogen production by electrolysis of water in conventional light water reactors powered by less costly late night electricity and the other by paralysis using high temperature gas produced in a high temperature testing reactor, Electric power consumption will increase 50% from 1990 to 2050. What is striking about his projection is types of fuels in use for power generation at that time which will consist of 60% nuclear, 10% hydro and 10% of other renewable energies. In other words, nearly 80% of fuels will be non-fossil sources

  1. An evaluation of the Essential Medicines List, Standard Treatment Guidelines and prescribing restrictions, as an integrated strategy to enhance quality, efficacy and safety of and improve access to essential medicines in Papua New Guinea.

    Science.gov (United States)

    Joshua, Isaac B; Passmore, Phillip R; Sunderland, Bruce V

    2016-05-01

    The World Health Organization (WHO) has advocated the development and use of country specific Standard Treatment Guidelines (STGs) and Essential Medicines Lists (EML) as strategies to promote the rational use of medicines. When implemented effectively STGs offer many health advantages. Papua New Guinea (PNG) has official STGs and a Medical and Dental Catalogue (MDC) which serves as a national EML for use at different levels of health facilities. This study evaluated consistency between the PNG Adult STGs (2003 and 2012) and those for children (2005 and 2011) with respect to the MDCs (2002, 2012) for six chronic and/or acute diseases: asthma, arthritis, diabetes, hypertension, pneumonia and psychosis. Additionally, the potential impact of prescriber level restrictions on rational medicines use for patient's living in rural areas, where no medical officer is present, was evaluated. Almost all drugs included in the STGs for each disease state evaluated were listed in the MDCs. However, significant discrepancies occurred between the recommended treatments in the STGs with the range of related medicines listed in the MDCs. Many medicines recommended in the STGs for chronic diseases had prescriber level restrictions hindering access for most of the PNG population who live in rural and remote areas. In addition many more medicines were listed in the MDCs which are commonly used to treat arthritis, high blood pressure and psychosis than were recommended in the STGs contributing to inappropriate prescribing. We recommend the public health and rational use of medicines deficiencies associated with these findings are addressed requiring: reviewing prescriber level restrictions; updating the STGs; aligning the MDC to reflect recommendations in the STGs; establishing the process where the MDC would automatically be updated based on any changes made to the STGs; and developing STGs for higher levels of care. © The Author 2015. Published by Oxford University Press. All rights

  2. Assessment of Essential Medicines Stock-Outs at Health Centers in ...

    African Journals Online (AJOL)

    data, we received an ethical review exemption from the. Rwanda National Ethics Committee. Methods ... pharmacies can purchase medicines from private medical stores or receive .... practice for HIV/AIDS and tuberculosis laboratory.

  3. Chemical and biological characterization of novel essential oils from Eremophila bignoniiflora (F. Muell) (Myoporaceae): a traditional Aboriginal Australian bush medicine.

    Science.gov (United States)

    Sadgrove, Nicholas John; Hitchcock, Maria; Watson, Kenneth; Jones, Graham Lloyd

    2013-10-01

    Essential oils were extracted by hydrodistillation from the traditional Australian medicinal plant Eremophila bignoniiflora, characterized chemically and then screened for bioactivity. Characterization and quantification were completed using gas chromatography-mass spectrometry (GC-MS) and GC-flame ionization detection, respectively. Antimicrobial capacity was assessed using disc diffusion and micro-titre plate broth dilution and further characterized using thin layer chromatography followed by bioautography to assign activity to separated individual active components. Antifungal capacity was investigated using micro-titre plate broth dilution against pathogenic Trichophyton species. Free radical scavenging ability was assessed using the diphenylpicrylhydradyl reaction in methanol. The predominant components of the essential oil were fenchyl-acetate and bornyl-acetate. However, bioautography indicated antimicrobial ability to be largely linked to the less abundant, more polar constituents. Oils displayed only modest antifungal ability against pathogenic Trichophyton species associated with dermatophytosis, but moderate to high antimicrobial activity, particularly against the yeast Candida albicans and the bacteria Staphylococcus epidermidis. Essential oils exhibited relatively low free radical scavenging ability. Speculation over the role of essential oils in the traditional medicinal applications of E. bignoniiflora follows, exploring correlations between traditional use and investigated bioactivities. Copyright © 2012 John Wiley & Sons, Ltd.

  4. Essential ocean variables for global sustained observations of biodiversity and ecosystem changes.

    Science.gov (United States)

    Miloslavich, Patricia; Bax, Nicholas J; Simmons, Samantha E; Klein, Eduardo; Appeltans, Ward; Aburto-Oropeza, Octavio; Andersen Garcia, Melissa; Batten, Sonia D; Benedetti-Cecchi, Lisandro; Checkley, David M; Chiba, Sanae; Duffy, J Emmett; Dunn, Daniel C; Fischer, Albert; Gunn, John; Kudela, Raphael; Marsac, Francis; Muller-Karger, Frank E; Obura, David; Shin, Yunne-Jai

    2018-04-05

    Sustained observations of marine biodiversity and ecosystems focused on specific conservation and management problems are needed around the world to effectively mitigate or manage changes resulting from anthropogenic pressures. These observations, while complex and expensive, are required by the international scientific, governance and policy communities to provide baselines against which the effects of human pressures and climate change may be measured and reported, and resources allocated to implement solutions. To identify biological and ecological essential ocean variables (EOVs) for implementation within a global ocean observing system that is relevant for science, informs society, and technologically feasible, we used a driver-pressure-state-impact-response (DPSIR) model. We (1) examined relevant international agreements to identify societal drivers and pressures on marine resources and ecosystems, (2) evaluated the temporal and spatial scales of variables measured by 100+ observing programs, and (3) analysed the impact and scalability of these variables and how they contribute to address societal and scientific issues. EOVs were related to the status of ecosystem components (phytoplankton and zooplankton biomass and diversity, and abundance and distribution of fish, marine turtles, birds and mammals), and to the extent and health of ecosystems (cover and composition of hard coral, seagrass, mangrove and macroalgal canopy). Benthic invertebrate abundance and distribution and microbe diversity and biomass were identified as emerging EOVs to be developed based on emerging requirements and new technologies. The temporal scale at which any shifts in biological systems will be detected will vary across the EOVs, the properties being monitored and the length of the existing time-series. Global implementation to deliver useful products will require collaboration of the scientific and policy sectors and a significant commitment to improve human and infrastructure

  5. Investigation of Antileishmanial Effect of Alcoholic Extract and Essential Oil of Medicinal Plant Leaf Black Alfalfa (Medicago Lupulina), on The Number of Clinical Isolates of Leishmania Major Promastigotes in Vitro

    OpenAIRE

    E Gharirvand Eskandari; M Doudi

    2016-01-01

    Introduction: Leishmaniasis has created enormous global health problems. Side effects, drug resistance and the lack of effective vaccines had led to the new effective compounds effective of plants. The aim of this study was to introduce a traditional medicinal plant called Black alfalfa (Medicago Lupulina) that can be used as a valuable resource against cutaneous leishmaniasis. Methods: In this experimental study, alcoholic extract was prepared by maceration and essential oil by distillat...

  6. Current Status and Future Perspective in the Globalization of Traditional Chinese Medicines

    OpenAIRE

    Wan-Ying Wu; Wen-Zhi Yang; Jin-Jun Hou; De-An Guo

    2015-01-01

    Globalization of traditional Chinese medicines started around 1996, which was initiated by the Chinese government. However, substantial progress was only achieved in recent years including the adoption of TCM quality monographs in the western pharmacopoeias (United States Pharmacopoeia and European Pharmacopoeia) and registration in main stream drug regulatory agencies such as US Food and Drug Administration (FDA) and European Medicines Agency (EMA). So far, several TCM herbal quality monogra...

  7. Chitosan encapsulation of essential oil "cocktails" with well-defined binary Zn(II)-Schiff base species targeting antibacterial medicinal nanotechnology.

    Science.gov (United States)

    Halevas, Eleftherios; Nday, Christiane M; Chatzigeorgiou, Evanthia; Varsamis, Vasileios; Eleftheriadou, Despoina; Jackson, Graham E; Litsardakis, Georgios; Lazari, Diamanto; Ypsilantis, Konstantinos; Salifoglou, Athanasios

    2017-11-01

    The advent of biodegradable nanomaterials with enhanced antibacterial activity stands as a challenge to the global research community. In an attempt to pursue the development of novel antibacterial medicinal nanotechnology, we herein a) synthesized ionic-gelated chitosan nanoparticles, b) compared and evaluated the antibacterial activity of essential oils extracted from nine different herbs (Greek origin) and their combinations with a well-defined antibacterial Zn(II)-Schiff base compound, and c) encapsulated the most effective hybrid combination of Zn(II)-essential oils inside the chitosan matrix, thereby targeting well-formulated nanoparticles of distinct biological impact. The empty and loaded chitosan nanoparticles were physicochemically characterized by FT-IR, Thermogravimetric Analysis (TGA), Scanning Electron Microscopy (SEM), with the entrapment and drug release studies being conducted through UV-Visible and atomic absorption techniques. The antimicrobial properties of the novel hybrid materials were demonstrated against Gram positive (S. aureus, B. subtilis, and B. cereus) and Gram negative (E. coli and X. campestris) bacteria using modified agar diffusion methods. The collective physicochemical profile of the hybrid Zn(II)-essential oil cocktails, formulated so as to achieve optimal activity when loaded to chitosan nanoparticles, signifies the importance of design in the development of efficient nanomedicinal pharmaceuticals a) based on both natural products and biogenic metal ionic cofactors, and b) targeting bacterial infections and drug resistance. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Intraspecific variation in essential oil composition of the medicinal plant Lippia integrifolia (Verbenaceae). Evidence for five chemotypes.

    Science.gov (United States)

    Marcial, Guillermo; de Lampasona, Marina P; Vega, Marta I; Lizarraga, Emilio; Viturro, Carmen I; Slanis, Alberto; Juárez, Miguel A; Elechosa, Miguel A; Catalán, César A N

    2016-02-01

    The aerial parts of Lippia integrifolia (incayuyo) are widely used in northwestern and central Argentina for their medicinal and aromatic properties. The essential oil composition of thirty-one wild populations of L. integrifolia covering most of its natural range was analyzed by GC and GC-MS. A total of one hundred and fifty two terpenoids were identified in the essential oils. Sesquiterpenoids were the dominant components in all but one of the collections analyzed, the only exception being a sample collected in San Juan province where monoterpenoids amounted to 51%. Five clearly defined chemotypes were observed. One possessed an exquisite and delicate sweet aroma with trans-davanone as dominant component (usually above 80%). Another with an exotic floral odour was rich in oxygenated sesquiterpenoids based on the rare lippifoliane and africanane skeletons. The trans-davanone chemotype is the first report of an essential oil containing that sesquiterpene ketone as the main constituent. The absolute configuration of trans-davanone from L. integrifolia was established as 6S, 7S, 10S, the enantiomer of trans-davanone from 'davana oil' (Artemisia pallens). Wild plants belonging to trans-davanone and lippifolienone chemotypes were propagated and cultivated in the same parcel of land in Santa Maria, Catamarca. The essential oil compositions of the cultivated plants were essentially identical to the original plants in the wild, indicating that the essential oil composition is largely under genetic control. Specimens collected near the Bolivian border that initially were identified as L. boliviana Rusby yielded an essential oil practically identical to the trans-davanone chemotype of L. integrifolia supporting the recent view that L. integrifolia (Gris.) Hieron. and L. boliviana Rusby are synonymous. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Access to Paediatric Essential Medicines: A Survey of Prices, Availability, Affordability and Price Components in Shaanxi Province, China

    Science.gov (United States)

    Wang, Xiao; Fang, Yu; Yang, Shimin; Jiang, Minghuan; Yan, Kangkang; Wu, Lina; Lv, Bing; Shen, Qian

    2014-01-01

    Objective To evaluate the prices and availability of paediatric essential medicines in Shaanxi Province, China. Methods Price and availability data for 28 paediatric essential medicines were collected from 60 public hospitals and 60 retail pharmacies in six areas of Shaanxi Province using a standardised methodology developed by the World Health Organization and Health Action International, during November to December 2012. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Data on medicine price components were collected from hospitals, wholesalers and distributors to obtain price mark-ups. Findings The mean availabilities of originator brands (OBs) and lowest-priced generics (LPGs) were 10.8% and 27.3% in the public hospitals and 11.9% and 20.6% in the private pharmacies. The public procurement and retail prices were 2.25 and 2.59 times the international reference prices (IRPs) for three OBs, and 0.52 and 0.93 times for 20 LPGs. In the private sector, the final prices for OBs and LPGs were 3.89 and 1.25 times their IRPs. The final price in the private sector was 2.7% lower than in the public sector for OBs, and 14.1% higher for LPGs. Generally, standard treatments cost less than 1 day’s wages in both sectors. Distribution mark-ups applied to brand salbutamol in Xi'an was 65.5%, and up to 185.3% for generic. Cumulative mark-ups for LPGs in Ankang were also high, from 33% to 50%. The manufacturer’s selling price is the largest contributor to the final price in both areas. Conclusions The government should approve a list of national paediatric essential medicines. The availability, price and affordability of these should be improved in both public hospitals and private pharmacies to enable children to obtain effective treatment. Measures should be taken to improve the efficiency of the centralised medicine purchasing system. PMID:24595099

  10. Access to paediatric essential medicines: a survey of prices, availability, affordability and price components in Shaanxi Province, China.

    Directory of Open Access Journals (Sweden)

    Xiao Wang

    Full Text Available OBJECTIVE: To evaluate the prices and availability of paediatric essential medicines in Shaanxi Province, China. METHODS: Price and availability data for 28 paediatric essential medicines were collected from 60 public hospitals and 60 retail pharmacies in six areas of Shaanxi Province using a standardised methodology developed by the World Health Organization and Health Action International, during November to December 2012. Affordability was measured as the number of days' wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Data on medicine price components were collected from hospitals, wholesalers and distributors to obtain price mark-ups. FINDINGS: The mean availabilities of originator brands (OBs and lowest-priced generics (LPGs were 10.8% and 27.3% in the public hospitals and 11.9% and 20.6% in the private pharmacies. The public procurement and retail prices were 2.25 and 2.59 times the international reference prices (IRPs for three OBs, and 0.52 and 0.93 times for 20 LPGs. In the private sector, the final prices for OBs and LPGs were 3.89 and 1.25 times their IRPs. The final price in the private sector was 2.7% lower than in the public sector for OBs, and 14.1% higher for LPGs. Generally, standard treatments cost less than 1 day's wages in both sectors. Distribution mark-ups applied to brand salbutamol in Xi'an was 65.5%, and up to 185.3% for generic. Cumulative mark-ups for LPGs in Ankang were also high, from 33% to 50%. The manufacturer's selling price is the largest contributor to the final price in both areas. CONCLUSIONS: The government should approve a list of national paediatric essential medicines. The availability, price and affordability of these should be improved in both public hospitals and private pharmacies to enable children to obtain effective treatment. Measures should be taken to improve the efficiency of the centralised medicine purchasing system.

  11. Transfer of 210Po, 210Pb and 238U from some medicinal plants to their essential oils

    International Nuclear Information System (INIS)

    Al-Masri, M.S.; Amin, Y.; Ibrahim, S.; Nassri, M.

    2015-01-01

    Essential oils were extracted from 35 medicinal plants used by Syrians, organic compounds were determined in these oils and concentrations of 210 Po 210 Pb and 238 U were determined in the original plants and in the essential oils. The results showed that the highest activity concentrations of 210 Po and 210 Pb were found in leaves with large surfaces and in Sage were as high as 73.5 Bq kg −1 and 73.2 Bq kg −1 , respectively. The activity concentration of 238 U was as high as 4.26 Bq kg −1 in Aloe. On the other hand, activity concentrations of 210 Po ranged between 0.2 and 71.1 Bq kg −1 in extracted essential oils for Rosemary and False yellowhead, respectively. The activity concentration of 210 Pb reached 63.7 Bq kg −1 in Aloe oil. The activity concentrations of 238 U were very low in all extracted oils; the highest value was 0.31 Bq kg −1 in peel of Orange oil. The transfer of 210 Po and 210 Pb from plant to its oil was the highest for Eugenia; 7.1% and 5.5% for 210 Po and 210 Pb, respectively. A linear relationship was found between the transfer factor of radionuclides from plant to its essential oil and the chemical content of this oil. - Highlights: • Natural radionuclides 210 Po, 210 Pb and 238 U were determined in 35 medicinal plants and their essential oils. • The highest activity concentration of 210 Po and 210 Pb were 73.5 Bq kg −1 and 73.2 Bq kg −1 in Sage, respectively. • The transfer of 210 Po and 210 Pb from Eugenia plant to its oil was the highest amongst other plants. • The data obtained in this study can be considered the first reported data for medicinal plants and their oils in Syria

  12. Where We Fall Down: Tensions in Teaching Social Medicine and Global Health.

    Science.gov (United States)

    Finnegan, Amy; Morse, Michelle; Nadas, Marisa; Westerhaus, Michael

    As global health interest has risen, so too has the relevance of education on the social determinants of health and health equity. Social medicine offers a particularly salient framework for educating on the social determinants of health, health disparities, and health equity. SocMed and EqualHealth, 2 unique but related organizations, offer annual global health courses in Uganda, Haiti, and the United States, which train students to understand and respond to the social determinants of health through praxis, self-reflection and self-awareness, and building collaborative partnerships across difference. The aim of this paper is to describe an innovative pedagogical approach to teaching social medicine and global health. We draw on the notion of praxis, which illuminates the value of iterative reflection and action, to critically examine our points of weakness as educators in order to derive lessons with broad applicability for those engaged in global health work. The data for this paper were collected through an autoethnography of teaching 10 global health social medicine courses in Uganda and Haiti since 2010. It draws on revealing descriptions from participant observation, student feedback collected in anonymous course evaluations, and ongoing relationships with alumni. Critical analysis reveals 3 significant and complicated tensions raised by our courses. The first point of weakness pertains to issues of course ownership by North American outsiders. The second tension emerges from explicit acknowledgment of social and economic inequities among our students and faculty. Finally, there are ongoing challenges of sustaining positive momentum toward social change after transformative course experiences. Although successful in generating transformative learning experiences, these courses expose significant fracture points worth interrogating as educators, activists, and global health practitioners. Ultimately, we have identified a need for building equitable

  13. The Investigation of Decontamination Effects of Ozone Gas on Microbial Load and Essential Oil of Several Medicinal Plants

    Directory of Open Access Journals (Sweden)

    Razieh VALI ASILL

    2013-02-01

    Full Text Available Today, Ozone as a disinfectant method, without putting on the harmful effects on human and plant products, it is alternative common methods for disinfection of plant material. The research as a factorial experiment was conducted on the basis of randomized complete block design with three replications and the effects of Ozone gas on decreasing the microbial load of some important medicinal plants include: Peppermint (Mentha piperita, Summer savory (Satureja hortensis, Indian valerian(Valeriana wallichii, Meliss (Melissa officinalis and Iranian thyme (Zataria multiflora were investigated. Medicinal plants leaves were treated with Ozone gas concentration 0.3, 0.6 and 0.9 ml/L at times of 10 and 30 then total count, coliform and mold and yeast of the samples were studied. The result showed that Ozone gas decreases microbial load of medicinal plants samples. But Ozone gas and Ozone gas in medicinal plants interaction effect had no effect on essential oil content. The lowest and the highest of microbial load were detected in samples treated with concentration of 0.9 ml/L of Ozone gas and control respectively. The highest and the lowest of microbial load were observed in Iranian thyme and Indian valerian respectively. Also result showed that Ozone gas treatment for 30 min had the greatest of effect in reducing the microbial load and 0.9 ml/L Ozone gas concentration had the lowest of microbial load. Results of this survey reflect that the use of Ozone as a method of disinfection for medicinal plants is a decontamination.

  14. Building essential biodiversity variables (EBVs) of species distribution and abundance at a global scale.

    Science.gov (United States)

    Kissling, W Daniel; Ahumada, Jorge A; Bowser, Anne; Fernandez, Miguel; Fernández, Néstor; García, Enrique Alonso; Guralnick, Robert P; Isaac, Nick J B; Kelling, Steve; Los, Wouter; McRae, Louise; Mihoub, Jean-Baptiste; Obst, Matthias; Santamaria, Monica; Skidmore, Andrew K; Williams, Kristen J; Agosti, Donat; Amariles, Daniel; Arvanitidis, Christos; Bastin, Lucy; De Leo, Francesca; Egloff, Willi; Elith, Jane; Hobern, Donald; Martin, David; Pereira, Henrique M; Pesole, Graziano; Peterseil, Johannes; Saarenmaa, Hannu; Schigel, Dmitry; Schmeller, Dirk S; Segata, Nicola; Turak, Eren; Uhlir, Paul F; Wee, Brian; Hardisty, Alex R

    2018-02-01

    Much biodiversity data is collected worldwide, but it remains challenging to assemble the scattered knowledge for assessing biodiversity status and trends. The concept of Essential Biodiversity Variables (EBVs) was introduced to structure biodiversity monitoring globally, and to harmonize and standardize biodiversity data from disparate sources to capture a minimum set of critical variables required to study, report and manage biodiversity change. Here, we assess the challenges of a 'Big Data' approach to building global EBV data products across taxa and spatiotemporal scales, focusing on species distribution and abundance. The majority of currently available data on species distributions derives from incidentally reported observations or from surveys where presence-only or presence-absence data are sampled repeatedly with standardized protocols. Most abundance data come from opportunistic population counts or from population time series using standardized protocols (e.g. repeated surveys of the same population from single or multiple sites). Enormous complexity exists in integrating these heterogeneous, multi-source data sets across space, time, taxa and different sampling methods. Integration of such data into global EBV data products requires correcting biases introduced by imperfect detection and varying sampling effort, dealing with different spatial resolution and extents, harmonizing measurement units from different data sources or sampling methods, applying statistical tools and models for spatial inter- or extrapolation, and quantifying sources of uncertainty and errors in data and models. To support the development of EBVs by the Group on Earth Observations Biodiversity Observation Network (GEO BON), we identify 11 key workflow steps that will operationalize the process of building EBV data products within and across research infrastructures worldwide. These workflow steps take multiple sequential activities into account, including identification and

  15. Barriers and facilitators to the quality use of essential medicines for maternal health in low-resource countries: An Ishikawa framework.

    Science.gov (United States)

    Tran, Dan N; Bero, Lisa A

    2015-06-01

    An estimated 800 women die every day due to complications related to pregnancy or childbirth. Complications such as postpartum haemorrhage (PPH) and pre-eclampsia and eclampsia can be prevented by the appropriate use of essential medicines. The objective of this study was to identify the common barriers and facilitators to the availability and use of oxytocin, ergometrine, and magnesium sulfate (MgSO4) - essential medicines indicated for the prevention and treatment of PPH and pre-eclampsia and eclampsia. We analyzed seven UNFPA/WHO reports published in 2008-2010. These reports summarized country-wide rapid assessments of access to and use of essential medicines for maternal health in Mongolia, Nepal, Laos, the Democratic People's Republic of Korea (DPRK), the Philippines, Vanuatu, and the Solomon Islands. We used a "fishbone" (Ishikawa) diagram as the analytic framework to identify facilitators and barriers at four health-system levels: government/regulatory, pharmaceutical supply, health facility, and health professional. Common facilitators to the quality use of essential medicines for maternal health were observed at the government/regulatory and health professional level. A majority of countries had these medicines listed in their essential medicines lists. Awareness of the medicines was generally high among health professionals. Common barriers were identified at all health-system levels. First, standard treatment guidelines were not available, updated, or standardized. Second, there was an inadequate capacity to forecast and procure medicines. Third, a required MgSO4 antidote was often not available and the storage conditions for oxytocin were deficient. The "fishbone" Ishikawa diagram is a useful tool for describing the findings of rapid assessments of quality use of essential medicines for maternal health across countries. The facilitators and barriers identified should guide the development of tailored intervention programs to improve and expand the use

  16. Barriers and facilitators to the quality use of essential medicines for maternal health in low–resource countries: An Ishikawa framework

    Directory of Open Access Journals (Sweden)

    Dan N. Tran

    2015-06-01

    Full Text Available Background An estimated 800 women die every day due to complications related to pregnancy or childbirth. Complications such as postpartum haemorrhage (PPH and pre–eclampsia and eclampsia can be prevented by the appropriate use of essential medicines. The objective of this study was to identify the common barriers and facilitators to the availability and use of oxytocin, ergometrine, and magnesium sulfate (MgSO4 – essential medicines indicated for the prevention and treatment of PPH and pre–eclampsia and eclampsia. Methods We analyzed seven UNFPA/WHO reports published in 2008–2010. These reports summarized country–wide rapid assessments of access to and use of essential medicines for maternal health in Mongolia, Nepal, Laos, the Democratic People's Republic of Korea (DPRK, the Philippines, Vanuatu, and the Solomon Islands. We used a “fishbone” (Ishikawa diagram as the analytic framework to identify facilitators and barriers at four health–system levels: government/regulatory, pharmaceutical supply, health facility, and health professional. Results Common facilitators to the quality use of essential medicines for maternal health were observed at the government/regulatory and health professional level. A majority of countries had these medicines listed in their essential medicines lists. Awareness of the medicines was generally high among health professionals. Common barriers were identified at all health–system levels. First, standard treatment guidelines were not available, updated, or standardized. Second, there was an inadequate capacity to forecast and procure medicines. Third, a required MgSO4 antidote was often not available and the storage conditions for oxytocin were deficient. Conclusions The “fishbone” Ishikawa diagram is a useful tool for describing the findings of rapid assessments of quality use of essential medicines for maternal health across countries. The facilitators and barriers identified should guide the

  17. [Mechanism and implication of regulation of the pricing of essential medicines in the private pharmaceutical sector in Mali].

    Science.gov (United States)

    Maïga, D; Maïga, S; Maïga, M D

    2010-04-01

    The healthcare and pharmaceutical professions in Mali were privatized in 1985. Privatization led to swift expansion of the private sector and upset the balance that had existed between the public and private sectors. A national pharmaceutical policy did not emerge until a decade later. Its purpose was to promote a system ensuring fair access to essential generic medicines for all. It was hoped that synergy between the two sectors would promote that objective. However, the policy calling for distribution of essential generic medicine through the private sector was not accompanied by an adequate system for pricing. This problem led the government to adopt a price regulation policy to realign market dynamics with public health goals. This experience shows that a sustained effort from public policy makers is necessary to prevail against the professional and business interests that can conflict with the public interest. Analysis of this experience also demonstrates the need to improve, restructure, and control the pharmaceutical industry. The government must continue to play its crucial role in the context of limited resources and inequality between consumers and pharmaceutical companies.

  18. The Currency of Consciousness: Neurology, Specialization, and the Global Practices of Medicine.

    Science.gov (United States)

    Casper, Stephen T

    2016-01-01

    This article explores the formation of a global community of neurologists between 1918 and 1970. Relying chiefly upon documents located in Anglo-American archives, its argument follows a narrative from money to memory, and posits that this global community of neurologists formed not out of a shared science and medicine of the nervous system, but out of shared dispositions in tastes, values, and culture. The localism and heterogeneity of the science and medicine of the nervous system was in fact so pronounced that neurologists - especially when they worked as "global citizens" - were forced to focus upon their superficial commonalities rather than examine local distinctions. This avoidance of a direct effort to define the content of neurology - or at least to confront their differences - exercised a peculiar influence on the specialty. Neurologists and their "official memory" became negotiated, and even imagined constructs. Consequently, these diverse cultures were ultimately subordinated to dominant economic interests.

  19. The impact of globalization on public health: implications for the UK Faculty of Public Health Medicine.

    Science.gov (United States)

    Lee, K

    2000-09-01

    There has been substantial discussion of globalization in the scholarly and popular press yet limited attention so far among public health professionals. This is so despite the many potential impacts of globalization on public health. Defining public health broadly, as focused on the collective health of populations requiring a range of intersectoral activities, globalization can be seen to have particular relevance. Globalization, in turn, can be defined as a process that is changing the nature of human interaction across a wide range of spheres and along at least three dimensions. Understanding public health and globalization in these ways suggests the urgent need for research to better understand the linkages between the two, and effective policy responses by a range of public health institutions, including the UK Faculty of Public Health Medicine. The paper is based on a review of secondary literature on globalization that led to the development of a conceptual framework for understanding potential impacts on the determinants of health and public health. The paper then discusses major areas of public health in relation to these potential impacts. It concludes with recommendations on how the UK Faculty of Public Health Medicine might contribute to addressing these impacts through its various activities. Although there is growing attention to the importance of globalization to public health, there has been limited research and policy development in the United Kingdom. The UK Faculty of Public Health Medicine needs to play an active role in bringing relevant issues to the attention of policy makers, and encourage its members to take up research, teaching and policy initiatives. The potential impacts of globalization support a broader understanding and practice of public health that embraces a wide range of health determinants.

  20. The global pipeline of new medicines for the control and elimination of malaria

    Science.gov (United States)

    2012-01-01

    Over the past decade, there has been a transformation in the portfolio of medicines to combat malaria. New fixed-dose artemisinin combination therapy is available, with four different types having received approval from Stringent Regulatory Authorities or the World Health Organization (WHO). However, there is still scope for improvement. The Malaria Eradication Research agenda identified several gaps in the current portfolio. Simpler regimens, such as a single-dose cure are needed, compared with the current three-day treatment. In addition, new medicines that prevent transmission and also relapse are needed, but with better safety profiles than current medicines. There is also a big opportunity for new medicines to prevent reinfection and to provide chemoprotection. This study reviews the global portfolio of new medicines in development against malaria, as of the summer of 2012. Cell-based phenotypic screening, and ‘fast followers’ of clinically validated classes, mean that there are now many new classes of molecules starting in clinical development, especially for the blood stages of malaria. There remain significant gaps for medicines blocking transmission, preventing relapse, and long-duration molecules for chemoprotection. The nascent pipeline of new medicines is significantly stronger than five years ago. However, there are still risks ahead in clinical development and sustainable funding of clinical studies is vital if this early promise is going to be delivered. PMID:22958514

  1. New Academic Partnerships in Global Health: Innovations at Mount Sinai School of Medicine

    Science.gov (United States)

    Landrigan, Philip J.; Ripp, Jonathan; Murphy, Ramon J. C.; Claudio, Luz; Jao, Jennifer; Hexom, Braden; Bloom, Harrison G.; Shirazian, Taraneh; Elahi, Ebby; Koplan, Jeffrey P.

    2011-01-01

    Global health has become an increasingly important focus of education, research, and clinical service in North American universities and academic health centers. Today there are at least 49 academically based global health programs in the United States and Canada, as compared with only one in 1999. A new academic society, the Consortium of Universities for Global Health, was established in 2008 and has grown significantly. This sharp expansion reflects convergence of 3 factors: (1) rapidly growing student and faculty interest in global health; (2) growing realization–powerfully catalyzed by the acquired immune deficiency syndrome epidemic, the emergence of other new infections, climate change, and globalization–that health problems are interconnected, cross national borders, and are global in nature; and (3) rapid expansion in resources for global health. This article examines the evolution of the concept of global health and describes the driving forces that have accelerated interest in the field. It traces the development of global health programs in academic health centers in the United States. It presents a blueprint for a new school-wide global health program at Mount Sinai School of Medicine. The mission of that program, Mount Sinai Global Health, is to enhance global health as an academic field of study within the Mount Sinai community and to improve the health of people around the world. Mount Sinai Global Health is uniting and building synergies among strong, existing global health programs within Mount Sinai; it is training the next generation of physicians and health scientists to be leaders in global health; it is making novel discoveries that translate into blueprints for improving health worldwide; and it builds on Mount Sinai’s long and proud tradition of providing medical and surgical care in places where need is great and resources few. PMID:21598272

  2. ANTIOXIDANT CAPACITY, MINERAL CONTENT AND ESSENTIAL OIL COMPOSITION FROM SELECT ALGERIAN MEDICINAL PLANTS

    Directory of Open Access Journals (Sweden)

    Hadjira Guenane1

    2017-10-01

    Full Text Available The objective of the present study was to analyze the total antioxidant capacity, minerals contents of four plants (Juniperus oxycedrus, Thymus capitatus, Laurus nobilis and Eruca vesicaria and chemical composition of the essential oils of the aerial parts of T. capitatus. Their antioxidant activity was assessed by DPPH, ABTS and FRAPS assays. Total phenol and flavonoid contents of the extracts were also determined. The results showed that the L. nobilis extract had the highest total phenolic and flavonoids contents (19.11 ± 0.22 mg GAE•g-1 dw, 4.47 ± 0.12 mg QE•g-1 dw, respectively. The extract of E. vesicaria had the highest value of TEAC for scavenging DPPH, whereas L. nobilis extract was active for ABTS and FRAP. GC/MS analysis revealed that the essential oil from the aerial parts of T. capitatus contained thirty-seven compounds; thymol was the major constituent (82.79 %. Atomic absorption spectroscopy showed high levels of Ca, K, Mg and Fe, and trace amounts of Zn, Cu and Mn in all four extracts.

  3. Effects of chlorhexidine, essential oils and herbal medicines (Salvia, Chamomile, Calendula) on human fibroblast in vitro.

    Science.gov (United States)

    Wyganowska-Swiatkowska, Marzena; Urbaniak, Paulina; Szkaradkiewicz, Anna; Jankun, Jerzy; Kotwicka, Malgorzata

    2016-01-01

    Antiseptic rinses have been successfully used in inflammatory states of the gums and oral cavity mucosa. Antibacterial effects of chlorhexidine, essential oils and some herbs are well documented. Reaction of host tissue to these substances has much poorer documentation. The aim of the study was to analyse the influence of chlorhexidine (CHX), essential oil (EO: thymol, 0.064%; eucalyptol, 0.092%; methyl salicylate, 0.060%; menthol, 0.042%) mouth rinses and salvia, chamomile and calendula brews on fibroblast biology in vitro. The human fibroblast CCD16 line cells were cultured in incubation media which contained the examined substances. After 24 and 48 hours, the cell morphology, relative growth and apoptosis were evaluated. Exposure of fibroblasts to CHX, EO or salvia caused various changes in cell morphology. Cells cultured for 48 hours with CHX revealed a noticeably elongated shape of while cells cultured in high EO concentration or with salvia were considerably smaller and contracted with fewer projections. Chlorhexidine, EO and salvia reduced the fibroblast proliferation rate and stimulated cell death. Both reactions to EO were dose dependent. Cells exposure to chamomile or calendula brews did not change morphology or proliferation of fibroblasts. The results of this in vitro study showed that in contrast to chamomile and calendula, the brews of EO, CHX or salvia had a negative influence on fibroblast biology.

  4. Current Status and Future Perspective in the Globalization of Traditional Chinese Medicines

    Directory of Open Access Journals (Sweden)

    Wan-Ying Wu

    2015-01-01

    Full Text Available Globalization of traditional Chinese medicines started around 1996, which was initiated by the Chinese government. However, substantial progress was only achieved in recent years including the adoption of TCM quality monographs in the western pharmacopoeias (United States Pharmacopoeia and European Pharmacopoeia and registration in main stream drug regulatory agencies such as US Food and Drug Administration (FDA and European Medicines Agency (EMA. So far, several TCM herbal quality monographs were adopted by the United States Pharmacopoeia including Chinese Salvia, Ganoderma lucidum and Panax notoginseng, etc. Over 45 TCM quality monographs were recorded in the European Pharmacopoeia with 20 more in progress. After the successful registration of the first TCM product named Diao Xin Xue Kang as traditional medicine via the Medicines Evaluation Board of the Netherlands, several other TCM herbal products are in the registration process in several European member states. So far, there has been still not any TCM product authorized as a drug by the FDA regardless of a few TCM products in phase III or phase II clinical trials. This review summarizes the progress made in the globalization of traditional Chinese medicines in recent years and future issues in this regard.

  5. An exploratory study on equity in funding allocation for essential medicines and health supplies in Uganda's public sector.

    Science.gov (United States)

    Kusemererwa, Donna; Alban, Anita; Obua, Ocwa Thomas; Trap, Birna

    2016-08-30

    To ascertain equity in financing for essential medicines and health supplies (EMHS) in Uganda, this paper explores the relationships among government funding allocations for EMHS, patient load, and medicines availability across facilities at different levels of care. We collected data on EMHS allocations and availability of selected vital medicines from 43 purposively sampled hospitals and the highest level health centers (HC IV), 44 randomly selected lower-level health facilities (HC II, III), and from over 400 facility health information system records and National Medical Stores records. The data were analyzed to determine allocations per patient within and across levels of care and the effects of allocations on product availability. EMHS funding allocations per patient varied widely within facilities at the same level, and allocations per patient between levels overlapped considerably. For example, HC IV allocations per patient ranged from US$0.25 to US$2.14 (1:9 ratio of lowest to highest allocation), and over 75 % of HC IV facilities had the same or lower average allocation per patient than HC III facilities. Overall, 43 % of all the facilities had optimal stock levels, 27 % were understocked, and 30 % were overstocked. Using simulations, we reduced the ratio between the highest and lowest allocations per patient within a level of care to less than two and eliminated the overlap in allocation per patient between levels. Inequity in EMHS allocation is demonstrated by the wide range of funding allocations per patient and the corresponding disparities in medicines availability. We show that using patient load to calculate EMHS allocations has the potential to improve equity significantly. However, more research in this area is urgently needed. The article does not report any results of human participants. It is implemented in collaboration with the Uganda's Ministry of Health, Pharmacy Division.

  6. More than just a hobby: building an academic career in global emergency medicine.

    Science.gov (United States)

    Martin, Ian B K; Levine, Adam C; Kayden, Stephanie; Hauswald, Mark

    2014-07-01

    As the specialty of emergency medicine (EM) continues to spread around the world, a growing number of academic emergency physicians have become involved in global EM development, research, and teaching. While academic departments have always found this work laudable, they have only recently begun to accept global EM as a rigorous academic pursuit in its own right. This article describes how emergency physicians can translate their global health work into "academic currency" within both the clinician-educator and clinician-researcher tracks. The authors discuss the impact of various types of additional training, including global EM fellowships, for launching a career in global EM. Clearly delineated clinician-researcher and clinician-educator tracks are important for documenting achievement in global EM. Reflecting a growing interest in global health, more of today's EM faculty members are ascending the academic ranks as global EM specialists. Whether attempting to climb the academic ladder as a clinician-educator or clinician-researcher, advanced planning and the firm support of one's academic chair is crucial to the success of the promotion process. Given the relative youth of the subspecialty of global EM, however, it will take time for the pathways to academic promotion to become well delineated. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Antimicrobial activity and phytochemical analysis of crude extracts and essential oils from medicinal plants.

    Science.gov (United States)

    Silva, N C C; Barbosa, L; Seito, L N; Fernandes, A

    2012-01-01

    We aimed to establish a phytochemical analysis of the crude extracts and performed GC-MS of the essential oils (EOs) of Eugenia uniflora L. (Myrtaceae) and Asteraceae species Baccharis dracunculifolia DC, Matricaria chamomilla L. and Vernonia polyanthes Less, as well as determining their antimicrobial activity. Establishment of the minimal inhibitory concentrations of the crude extracts and EOs against 16 Staphylococcus aureus and 16 Escherichia coli strains from human specimens was carried out using the dilution method in Mueller-Hinton agar. Some phenolic compounds with antimicrobial properties were established, and all EOs had a higher antimicrobial activity than the extracts. Matricaria chamomilla extract and E. uniflora EO were efficient against S. aureus strains, while E. uniflora and V. polyanthes extracts and V. polyanthes EO showed the best antimicrobial activity against E. coli strains. Staphylococcus aureus strains were more susceptible to the tested plant products than E. coli, but all natural products promoted antimicrobial growth inhibition.

  8. In-vitro antibacterial activity of essential oils extracted from locally available medicinal plants

    International Nuclear Information System (INIS)

    Ara, G.; Shawar, D.; Akbar, A.; Kanwal, F.; Imran, M.

    2011-01-01

    Extraction of essential oils from locally available species of four plants, Nigella sativa, Syzygium aromaticum, Cinnamomum tenuis and Curcuma aromatica was carried out using steam distillation followed by ether extraction. Dried and purified extracted oils were screened for their antibacterial activity against three bacterial strains namely, Bacillus lichaniformis (Gram +ve), Micrococcus leutus (Gram +ve) and Salmonella Typhimurium (Gram -ve) using Mc. Cartney's method. Minimum Inhibition Concentration (MIC) values of these oils were also determined. It was observed that the oils extracted from Nigella sativa and Cinnamomum tenuis were found to be more potent as compared to other two species. With the exception of Nigella sativa, all the other oils showed bacterial inhibition at 50 mmol concentration. These results support that these plant oils can be used to cure bacterial infections and may also have role as pharmaceuticals and preservatives. (author)

  9. Antibacterial Effects of the Essential Oils of Commonly Consumed Medicinal Herbs Using an In Vitro Model

    Directory of Open Access Journals (Sweden)

    Dejan Brkić

    2010-10-01

    Full Text Available The chemical composition and antibacterial activity of essential oils from 10 commonly consumed herbs: Citrus aurantium, C. limon, Lavandula angustifolia, Matricaria chamomilla, Mentha piperita, M. spicata, Ocimum basilicum, Origanum vulgare, Thymus vulgaris and Salvia officinalis have been determined. The antibacterial activity of these oils and their main components; i.e. camphor, carvacrol, 1,8-cineole, linalool, linalyl acetate, limonene, menthol, a-pinene, b-pinene, and thymol were assayed against the human pathogenic bacteria Bacillus subtilis, Enterobacter cloacae, Escherichia coli O157:H7, Micrococcus flavus, Proteus mirabilis, Pseudomonas aeruginosa, Salmonella enteritidis, S. epidermidis, S. typhimurium, and Staphylococcus aureus. The highest and broadest activity was shown by O. vulgare oil. Carvacrol had the highest antibacterial activity among the tested components.

  10. Antibacterial effects of the essential oils of commonly consumed medicinal herbs using an in vitro model.

    Science.gov (United States)

    Soković, Marina; Glamočlija, Jasmina; Marin, Petar D; Brkić, Dejan; van Griensven, Leo J L D

    2010-10-27

    The chemical composition and antibacterial activity of essential oils from 10 commonly consumed herbs: Citrus aurantium, C. limon, Lavandula angustifolia, Matricaria chamomilla, Mentha piperita, M. spicata, Ocimum basilicum, Origanum vulgare, Thymus vulgaris and Salvia officinalis have been determined. The antibacterial activity of these oils and their main components; i.e. camphor, carvacrol, 1,8-cineole, linalool, linalyl acetate, limonene, menthol, a-pinene, b-pinene, and thymol were assayed against the human pathogenic bacteria Bacillus subtilis, Enterobacter cloacae, Escherichia coli O157:H7, Micrococcus flavus, Proteus mirabilis, Pseudomonas aeruginosa, Salmonella enteritidis, S. epidermidis, S. typhimurium, and Staphylococcus aureus. The highest and broadest activity was shown by O. vulgare oil. Carvacrol had the highest antibacterial activity among the tested components.

  11. Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

    Science.gov (United States)

    Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

    2016-09-01

    Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations.

  12. Towards global interoperability for supporting biodiversity research on Essential Biodiversity Variables (EBVs)

    NARCIS (Netherlands)

    Kissling, W.D.; Hardisty, A.; García, E.A.; Santamaria, M.; De Leo, F.; Pesole, G.; Freyhof, J.; Manset, D.; Wissel, S.; Konijn, J.; Los, W.

    2015-01-01

    Essential biodiversity variables (EBVs) have been proposed by the Group on Earth Observations Biodiversity Observation Network (GEO BON) to identify a minimum set of essential measurements that are required for studying, monitoring and reporting biodiversity and ecosystem change. Despite the initial

  13. Biological Control Against the Cowpea Weevil (Callosobruchus Chinensis L., Coleoptera: Bruchidae Using Essential Oils of Some Medicinal Plants

    Directory of Open Access Journals (Sweden)

    Fatiha Righi Assia

    2014-07-01

    Full Text Available Chickpea (Cicer arietinum L. is a valuable foodstuff but unfortunately this legume is prone to insect attacks from the chick pea weevil (Callosobruchus chinensis L.. This serious pest damages the chickpea and causes decreases in the yield and in the nutritional quality. Biological control is being used to deal with this problem. We tried different doses of the essential oils of three new medicinal plants, namely Salvia verbenaca L., Scilla maritima L., and Artemisia herba-alba Asso to limit the damage of the chick pea weevil pest, and to protect consumer’s health. To determine the effect and efficiency of the oil, the tests were conducted using the different biological parameters of fertility, longevity, and fecundity, under controlled temperature and relative humidity (28°C and 75%. The effectiveness of organic oils was demonstrated. We tested these oils on the germination of seeds. The obtained results showed that the tested plant oils have a real organic insecticide effect. The essential oil of Artemisia proved most effective as a biocide; achieving a mortality rate of 100%. A significant reduction in longevity was observed under the effect of 30 μl of S. maritima (1.3 days and S. verbenaca (2.8, 4.6 days, respectively, for males and females compared to 8 and 15 days for the control. For fecundity, an inhibition of oviposition was obtained using 30 μl of Salvia and Scilla essential oils. The test on the seed germination using different essential oils, showed no damage to the germinating seeds. The germination rate was 99%. These findings suggest that the tested plants can be used as a bioinsecticide for control of the C. chinensis pest of stored products.

  14. Allelopathic effect of essential oils of medicinal plants in Bidens pilosa L.

    Directory of Open Access Journals (Sweden)

    M.C.S. Alves

    2014-01-01

    Full Text Available We determined the inhibitory allelopathic effects of the volatile extracts of Cinnamomum zeylanicum Ness, Lippia sidoides Cham. and Cymbopogum nardus L. on seed germination and root growth of seedlings of Bidens pilosa. The experiment was conducted at the Seed Analysis Laboratory of the Department of Plant Science, Federal University of Ceará. For this end, we used oils at the concentrations of 0.01, 0.02, 0.04 and 0.08% (v/v. Five treatments were used for each of the oils arranged in a completely randomized design with four replications of 25 seeds. The seeds were sown in Petri dishes lined with filter paper moistened with distilled water and, aiming at the indirect contact with each oil, two sheets of filter paper were placed on top of the lid, in which three (3 mL of each oil solution were added. Then, the dishes were incubated in a germination chamber at 25°C. The pH did not contribute to alter the results; the volatile extracts of essential oils of C. zeylanicum, L. sidoides and C. nardus inhibited seed germination and root growth of seedlings of B. pilosa, which shows allelopathic potential; and the concentration of 0.08% of oils caused the overall deterioration of the roots and death of seedlings of B. pilosa.

  15. Availability and affordability of essential medicines: exploring the health seeking behaviours and health service utilisation for children under-5 years living in squatter settlement of Karachi, Pakistan.

    Science.gov (United States)

    Shafiq, Yasir; Shaikh, Babar Tasneem; Kumar, Ramesh

    2011-01-01

    Child health outcomes in the poor communities are largely affected by the non-availability of essential medicines at government health facilities and non-affordability of prescribed medicines at private retail pharmacies. This phenomenon largely defines health seeking behaviours and health service utilisation patterns of the families of the children. Using observational visits, we examined the shelf-availability of medicines for children less than 5 years of age at a rural health centre and conducted focus group discussions with the mothers to explore the effects of non-availability and non-affordability of medicines. We also validated all information by interviewing the health care providers of the area. We found that erratic and insufficient supply of essential medicines at the government health facility and a limited purchasing power to buy medicines from a retail pharmacy, led to considerable 'financial burden' on the poor people, non-compliance with the treatment, health care seeking from informal health providers and healer shopping. This trend has a serious repercussion on the health seeking behaviours and of course the health outcomes, especially among children. On the users' side, health education and health promotion campaign must be instituted to explain the adverse effects on child health ensure appropriate health care seeking behaviours. For the supply side, the health care authorities must ensure the availability of essential medicines for the children at the government facilities. Local community representatives must be involved in the matters related to medicines stock management at the facility.

  16. Survey on the availability, price and affordability of selected essential medicines for non-communicable diseases in community pharmacies of Kathmandu valley.

    Science.gov (United States)

    Shrestha, Rajeev; Ghale, Anish; Chapagain, Bijay Raj; Gyawali, Mahasagar; Acharya, Trishna

    2017-01-01

    The access to essential medicines for non-communicable disease treatment is unacceptably low worldwide. The fundamental right to health cannot be fulfilled without equitable access to essential medicines. A cross-sectional study was carried out in 94 community pharmacies of Kathmandu valley. Non-probability quota sampling method was adopted for the purpose. Village Development Committees with more than 5000 populations were included in the study. The availability of the selected essential medicines, their price and producer identity were observed. Data entry and analysis were carried out in Microsoft Excel and Statistical package for social science. The availability of the essential medicines was not 100% in Kathmandu valley. High competition and high price variation were seen in metformin 500 mg (254.6%) and atorvastatin 10 mg (327.6%). The study showed that maximum (54.7%) brands were manufactured in Nepal. Furthermore, atorvastatin 10 mg (0.6 day wage) was found to be quite expensive, and glibenclamide 5 mg (0.1 day wage) was the cheapest one for diabetes mellitus treatment for 1 month of treatment period compared to daily wages of other essential medicines. The availability of the selected essential medicines was found to be ununiform and insufficient in the entire region. High competition was observed in the products with high price variation, and the access to cost-effective brand was poor. Furthermore, it was found that government salary is affordable to treat non-communicable disease with the help of the essential medicines.

  17. The globalization of training in adolescent health and medicine: one size does not fit all.

    Science.gov (United States)

    Leslie, Karen

    2016-08-01

    Adolescent medicine across the globe is practiced within a variety of healthcare models, with the shared vision of the promotion of optimal health outcomes for adolescents. In the past decade, there has been a call for transformation in how health professionals are trained, with recommendations that there be adoption of a global outlook, a multiprofessional perspective and a systems approach that considers the connections between education and health systems. Many individuals and groups are now examining how best to accomplish this educational reform. There are tensions between the call for globally accepted standards of education models and practice (a one-size fits all approach) and the need to promote the ability for education practices to be interpreted and transformed to best suit local contexts. This paper discusses some of the key considerations for 'importing' training program models for adolescent health and medicine, including the importance of cultural alignment and the utilization of best evidence and practice in health professions education.

  18. Reducing stock-outs of essential tuberculosis medicines: a system dynamics modelling approach to supply chain management.

    Science.gov (United States)

    Bam, L; McLaren, Z M; Coetzee, E; von Leipzig, K H

    2017-10-01

    The under-performance of supply chains presents a significant hindrance to disease control in developing countries. Stock-outs of essential medicines lead to treatment interruption which can force changes in patient drug regimens, drive drug resistance and increase mortality. This study is one of few to quantitatively evaluate the effectiveness of supply chain policies in reducing shortages and costs. This study develops a systems dynamics simulation model of the downstream supply chain for amikacin, a second-line tuberculosis drug using 10 years of South African data. We evaluate current supply chain performance in terms of reliability, responsiveness and agility, following the widely-used Supply Chain Operation Reference framework. We simulate 141 scenarios that represent different combinations of supplier characteristics, inventory management strategies and demand forecasting methods to identify the Pareto optimal set of management policies that jointly minimize the number of shortages and total cost. Despite long supplier lead times and unpredictable demand, the amikacin supply chain is 98% reliable and agile enough to accommodate a 20% increase in demand without a shortage. However, this is accomplished by overstocking amikacin by 167%, which incurs high holding costs. The responsiveness of suppliers is low: only 57% of orders are delivered to the central provincial drug depot within one month. We identify three Pareto optimal safety stock management policies. Short supplier lead time can produce Pareto optimal outcomes even in the absence of other optimal policies. This study produces concrete, actionable guidelines to cost-effectively reduce stock-outs by implementing optimal supply chain policies. Preferentially selecting drug suppliers with short lead times accommodates unexpected changes in demand. Optimal supply chain management should be an essential component of national policy to reduce the mortality rate. © The Author 2017. Published by Oxford

  19. Integration of molecular pathology, epidemiology and social science for global precision medicine.

    Science.gov (United States)

    Nishi, Akihiro; Milner, Danny A; Giovannucci, Edward L; Nishihara, Reiko; Tan, Andy S; Kawachi, Ichiro; Ogino, Shuji

    2016-01-01

    The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science.

  20. WHO and national lists of essential medicines in Mexico, Central and South America, and the Caribbean: are they adequate to promote paediatric endocrinology and diabetes care?

    Science.gov (United States)

    Rowlands, Amanda; Acosta-Gualandri, Alejandra; Guevara-Aguirre, Jaime; Chanoine, Jean-Pierre

    2016-01-01

    Paediatric endocrinology and diabetes is a paediatric specialty with less common conditions and higher cost medicines. Access to medicines for our specialty in low and middle income countries remains limited. We analysed the content of the WHO (children and adults) and of all available national Model Lists of Essential Medicines (EMLs) for Mexico, the Caribbean, Central and South America from a paediatric endocrinology and diabetes standpoint. A master list of medicines deemed necessary in paediatric endocrinology and diabetes was established and compared with the WHO and national EMLs, taking into account the gross national income. The WHO EMLs, which are largely recognised as an international benchmark and drive the content of the national EMLs, included many but not all medicines present on our master list. Interestingly, several national EMLs from richer countries included medicines that were not present in the WHO EMLs. Our analysis suggests that these medicines could be considered by the WHO for inclusion in their EMLs, which may promote the adoption of more medicines by individual countries. We also propose several changes to the WHO and national EMLs that could facilitate access to medicines in our specialty: age cut-off for a child using physical maturity rather than a set age limit; greater standardisation of the formatting of the national EMLs for easier comparison and collaborations between countries; greater emphasis on age-specificity and population-specificity for some medicines; and formatting of the EMLs in a disease-focused manner rather than as individual medicines. PMID:28588968

  1. The International Atomic Energy Agency's activities in radiation medicine and cancer: promoting global health through diplomacy.

    Science.gov (United States)

    Deatsch-Kratochvil, Amanda N; Pascual, Thomas Neil; Kesner, Adam; Rosenblatt, Eduardo; Chhem, Rethy K

    2013-02-01

    Global health has been an issue of seemingly low political importance in comparison with issues that have direct bearing on countries' national security. Recently, health has experienced a "political revolution" or a rise in political importance. Today, we face substantial global health challenges, from the spread of infectious disease, gaps in basic maternal and child health care, to the globalization of cancer. A recent estimate states that the "overall lifetime risk of developing cancer (both sexes) is expected to rise from more than one in three to one in two by 2015." These issues pose significant threats to international health security. To successfully combat these grave challenges, the international community must embrace and engage in global health diplomacy, defined by scholars Thomas Novotny and Vicanne Adams as a political activity aimed at improving global health, while at the same time maintaining and strengthening international relations. The IAEA (International Atomic Energy Agency) is an international organization with a unique mandate to "accelerate and enlarge the contribution of atomic energy to peace, health, and prosperity throughout the world." This article discusses global health diplomacy, reviews the IAEA's program activities in human health by focusing on radiation medicine and cancer, and the peaceful applications of atomic energy within the context of global health diplomacy. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  2. Chemical composition and repellency of essential oils from four medicinal plants against Ixodes ricinus nymphs (Acari: Ixodidae).

    Science.gov (United States)

    El-Seedi, Hesham R; Khalil, Nasr S; Azeem, Muhammad; Taher, Eman A; Göransson, Ulf; Pålsson, Katinka; Borg-Karlson, Anna-Karin

    2012-09-01

    In our search for effective tick repellents from plant origin, we investigated the effect of essential oils of four medicinal and culinary plants belonging to the family Lamiaceae on nymphs of the tick Ixodes ricinus (L.). The essential oils of the dry leaves of Rosmarinus officinalis (Rosemary) (L.), Mentha spicata (Spearmint) (L.), Origanum majorana (Majoram) (L.), and Ocimum basilicum (Basil) (L.) were isolated by steam distillation and 15 microg/cm2 concentration of oils was tested against ticks in a laboratory bioassay. The oils of R. officinalis, M. spicata, and O. majorana showed strong repellency against the ticks 100, 93.2, and 84.3%, respectively, whereas O. basilicum only showed 64.5% repellency. When tested in the field, the oils of R. officinalis and M. spicata showed 68.3 and 59.4% repellency at a concentration of 6.5 microg/cm2 on the test cloths. The oils were analyzed by gas chromatography mass spectrometry and the major compounds from the most repellent oils were 1,8-cineole, camphor, linalool, 4-terpineol, borneol, and carvone.

  3. Essential Oils from Leaves of Medicinal Plants of Brazilian Flora: Chemical Composition and Activity against Candida Species

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    Maria da Conceição Mendes Ferreira da Costa

    2017-05-01

    Full Text Available Background: The biotechnological potential of medicinal plants from Brazilian Caatinga and the Atlantic Forest has not been extensively studied. Thus, screening programs are important in prospecting for compounds for developing new drugs. The purpose of this study was to determine the chemical composition and to evaluate the anti-Candida activity of essential oils from leaves of Hymenaea courbaril var. courbaril, Myroxylon peruiferum, and Vismia guianensis. Methods: The oils were extracted through hydrodistillation and their chemical compositions were analyzed by gas chromatography coupled with mass spectrometry. Antifungal activity against C. albicans, C. tropicalis, C. parapsilosis, C. glabrata, and C. krusei was evaluated by determining the minimal inhibitory (MIC and fungicidal (MFC concentrations. Results: The major compounds of the oils were caryophyllene oxide and trans-caryophyllene for H. courbaril; spathulenol, α-pinene, and caryophyllene oxide for M. peruiferum; and caryophyllene oxide and humulene epoxide II for V. guianensis oil. The oils showed antifungal activity against all the strains tested, and the MIC values ranged between 0.625 and 1.25 μL/mL and MFC from 0.625 to 2.5 μL/mL. Conclusion: The essential oils from the species studied have the potential to be evaluated as clinical applications in the treatment of candidiasis.

  4. Global and public health core competencies for nursing education: A systematic review of essential competencies.

    Science.gov (United States)

    Clark, Megan; Raffray, Marie; Hendricks, Kristin; Gagnon, Anita J

    2016-05-01

    Nurses are learning and practicing in an increasingly global world. Both nursing schools and nursing students are seeking guidance as they integrate global health into their learning and teaching. This systematic review is intended to identify the most common global and public health core competencies found in the literature and better inform schools of nursing wishing to include global health content in their curricula. Systematic review. An online search of CINAHL and Medline databases, as well as, inclusion of pertinent gray literature was conducted for articles published before 2013. Relevant literature for global health (GH) and public and community health (PH/CH) competencies was reviewed to determine recommendations of both competencies using a combination of search terms. Studies must have addressed competencies as defined in the literature and must have been pertinent to GH or PH/CH. The databases were systematically searched and after reading the full content of the included studies, key concepts were extracted and synthesized. Twenty-five studies were identified and resulted in a list of 14 global health core competencies. These competencies are applicable to a variety of health disciplines, but particularly can inform the efforts of nursing schools to integrate global health concepts into their curricula. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Assessing the impact of the Australia-United States Free Trade Agreement on Australian and global medicines policy

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    Searles Andrew

    2005-10-01

    Full Text Available Abstract On 1 January 2005, a controversial trade agreement entered into force between Australia and the United States. Though heralded by the parties as facilitating the removal of barriers to free trade (in ways not achievable in multilateral fora, it also contained many trade-restricting intellectual property provisions and others uniquely related to altering pharmaceutical regulation and public health policy in Australia. The latter appear to have particularly focused on the world-respected process of federal government reimbursement after expert cost-effectiveness evaluation, popularly known as the Pharmaceutical Benefits Scheme ('PBS'. It remains uncertain what sort of impacts – if any – the Australia-United States Free Trade Agreement ('AUSFTA' will have on PBS processes such as reference pricing and their important role in facilitating equitable and affordable access to essential medicines. This is now the field of inquiry for a major three year Australian Research Council ('ARC'-funded study bringing together a team of senior researchers in regulatory theory from the Australian National University and pharmacoeconomics from the University of Newcastle. The project proposes to monitor, assess and analyse the real and potential impacts of the AUSFTA in this area, providing Australian policy-makers with continuing expertise and options. To the extent that the AUSFTA medicines provisions may represent animportant precedent in a global strategy by industry oncost-effectiveness evaluation of pharmaceuticals, the study will also beof great interest to policy makers in other jurisdictions.

  6. A Global Perspective: Reframing the History of Health, Medicine, and Disease.

    Science.gov (United States)

    Harrison, Mark

    2015-01-01

    The emergence of global history has been one of the more notable features of academic history over the past three decades. Although historians of disease were among the pioneers of one of its earlier incarnations-world history-the recent "global turn" has made relatively little impact on histories of health, disease, and medicine. Most continue to be framed by familiar entities such as the colony or nation-state or are confined to particular medical "traditions." This article aims to show what can be gained from taking a broader perspective. Its purpose is not to replace other ways of seeing or to write a new "grand narrative" but to show how transnational and transimperial approaches are vital to understanding some of the key issues with which historians of health, disease, and medicine are concerned. Moving on from an analysis of earlier periods of integration, the article offers some reflections on our own era of globalization and on the emerging field of global health.

  7. Medicines

    Science.gov (United States)

    Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...

  8. Tackling the global mental health challenge: a psychosomatic medicine/consultation-liaison psychiatry perspective.

    Science.gov (United States)

    Bauer, Amy M; Fielke, Ken; Brayley, John; Araya, Mesfin; Alem, Atalay; Frankel, Bernard L; Fricchione, Gregory L

    2010-01-01

    Consultation-liaison (C-L) psychiatry, informed by principles of psychosomatic medicine, is well-positioned to address the global impact of mental disorders through primary care C-L models. The authors review the international burden of mental disorders, highlighting medical comorbidity, undertreatment, and the rationale for enhancing primary-care management. C-L psychiatry fosters the skills required for global mental health work. The authors describe successful C-L models developed in a low-income country (Ethiopia) and an under-resourced region of a high-income country (Australia). C-L psychiatrists have the potential to marshal their unique skill-set to reduce the global burden of mental disorders.

  9. Eyes wide open: an essay on developing an engaged awareness in global medicine and public health.

    Science.gov (United States)

    Ventres, William B; Fort, Meredith P

    2014-10-28

    There is a growing understanding of the role social determinants such as poverty, gender discrimination, racial prejudice, and economic inequality play on health and illness. While these determinants and effects may be challenging to identify in parts of high-income countries, they are patently obvious in many other areas of the world. How we react to these determinants and effects depends on what historical, cultural, ideological, and psychological characteristics we bring to our encounters with inequity, as well as how our feelings and thoughts inform our values and actions. To address these issues, we share a series of questions we have asked ourselves-United States' citizens with experience living and working in Central America-in relation to our encounters with inequity. We offer a conceptual framework for contemplating responses in hopes of promoting among educators and practitioners in medicine and public health an engaged awareness of how our every day work either perpetuates or breaks down barriers of social difference. We review key moments in our own experiences as global health practitioners to provide context for these questions. Introspective reflection can help professionals in global medicine and public health recognize the dynamic roles that they play in the world. Such reflection can bring us closer to appreciating the forces that have worked both for and in opposition to global health, human rights, and well-being. It can help us recognize how place, time, environment, and context form the social determination of health. It is from this holistic perspective of social relations that we can work to effect fair, equitable, and protective environments as they relate to global medicine and public health.

  10. Voicing as an Essential Problem of Communication: Language and Education of Chinese Immigrant Children in Globalization

    Science.gov (United States)

    Dong, Jie; Dong, Yan

    2013-01-01

    This article explores voicing processes of identity construction among labor immigrants both inside China and in the Dutch Chinese Diaspora. We provide ethnographically grounded data oriented toward a theoretical point: voicing is an essential problem in communication. Whether one is able to achieve his voice--an outcome of a communicative…

  11. The Cost-Effectiveness of Low-Cost Essential Antihypertensive Medicines for Hypertension Control in China: A Modelling Study.

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    Dongfeng Gu

    2015-08-01

    Full Text Available Hypertension is China's leading cardiovascular disease risk factor. Improved hypertension control in China would result in result in enormous health gains in the world's largest population. A computer simulation model projected the cost-effectiveness of hypertension treatment in Chinese adults, assuming a range of essential medicines list drug costs.The Cardiovascular Disease Policy Model-China, a Markov-style computer simulation model, simulated hypertension screening, essential medicines program implementation, hypertension control program administration, drug treatment and monitoring costs, disease-related costs, and quality-adjusted life years (QALYs gained by preventing cardiovascular disease or lost because of drug side effects in untreated hypertensive adults aged 35-84 y over 2015-2025. Cost-effectiveness was assessed in cardiovascular disease patients (secondary prevention and for two blood pressure ranges in primary prevention (stage one, 140-159/90-99 mm Hg; stage two, ≥160/≥100 mm Hg. Treatment of isolated systolic hypertension and combined systolic and diastolic hypertension were modeled as a reduction in systolic blood pressure; treatment of isolated diastolic hypertension was modeled as a reduction in diastolic blood pressure. One-way and probabilistic sensitivity analyses explored ranges of antihypertensive drug effectiveness and costs, monitoring frequency, medication adherence, side effect severity, background hypertension prevalence, antihypertensive medication treatment, case fatality, incidence and prevalence, and cardiovascular disease treatment costs. Median antihypertensive costs from Shanghai and Yunnan province were entered into the model in order to estimate the effects of very low and high drug prices. Incremental cost-effectiveness ratios less than the per capita gross domestic product of China (11,900 international dollars [Int$] in 2015 were considered cost-effective. Treating hypertensive adults with prior

  12. Assessing 15 proposals for promoting innovation and access to medicines globally.

    Science.gov (United States)

    Hoffman, Steven J; So, Karen

    2014-01-01

    There is widespread recognition that the existing global systems for innovation and access to medicines need reform. Billions of people do not have access to the medicines they need, and market failures prevent new drugs from being developed for diseases that primarily affect the global poor. The World Health Organization's Consultative Expert Working Group on Research and Development: Financing and Coordination (CEWG) analyzed numerous proposals for reform. The aim of this article is to build on these previous inquiries. We conducted a structured analysis that grouped proposals into five broad opportunities for global policy reform to help researchers and decision makers to meaningfully evaluate each proposal in comparison with similar proposals. Proposals were also analyzed along three important dimensions-potential health impact, financial implications, and political feasibility-further facilitating the comparison and application of this information. Upon analysis, no one solution was deemed a panacea, as many (often competing) considerations need to be taken into account. However, some proposals, particularly product development partnership and prizes, appeared more promising and feasible at this time and deserve further attention. More research is needed into the effectiveness of these mechanisms and their transferability across jurisdictions. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Integration of Molecular Pathology, Epidemiology, and Social Science for Global Precision Medicine

    Science.gov (United States)

    Nishi, Akihiro; Milner, Danny A; Giovannucci, Edward L.; Nishihara, Reiko; Tan, Andy S.; Kawachi, Ichiro; Ogino, Shuji

    2015-01-01

    Summary The precision medicine concept and the unique disease principle imply that each patient has unique pathogenic processes resulting from heterogeneous cellular genetic and epigenetic alterations, and interactions between cells (including immune cells) and exposures, including dietary, environmental, microbial, and lifestyle factors. As a core method field in population health science and medicine, epidemiology is a growing scientific discipline that can analyze disease risk factors, and develop statistical methodologies to maximize utilization of big data on populations and disease pathology. The evolving transdisciplinary field of molecular pathological epidemiology (MPE) can advance biomedical and health research by linking exposures to molecular pathologic signatures, enhancing causal inference, and identifying potential biomarkers for clinical impact. The MPE approach can be applied to any diseases, although it has been most commonly used in neoplastic diseases (including breast, lung and colorectal cancers) because of availability of various molecular diagnostic tests. However, use of state-of-the-art genomic, epigenomic and other omic technologies and expensive drugs in modern healthcare systems increases racial, ethnic and socioeconomic disparities. To address this, we propose to integrate molecular pathology, epidemiology, and social science. Social epidemiology integrates the latter two fields. The integrative social MPE model can embrace sociology, economics and precision medicine, address global health disparities and inequalities, and elucidate biological effects of social environments, behaviors, and networks. We foresee advancements of molecular medicine, including molecular diagnostics, biomedical imaging, and targeted therapeutics, which should benefit individuals in a global population, by means of an interdisciplinary approach of integrative MPE and social health science. PMID:26636627

  14. The impacts of implementation of National Essential Medicines Policies on primary healthcare institutions: a cross-sectional study in China.

    Science.gov (United States)

    Guo, Zhigang; Guan, Xiaodong; Shi, Luwen

    2017-11-13

    In 2009, China implemented the National Essential Medicines Policies (NEMPs) as part of a new round of medical system reforms. This study aims to evaluate the impacts of the NEMPs on primary healthcare institutions and discuss the roles of the policies in the new healthcare reforms of China. The study selected a total of six representative provinces of China, generating a sample of 261 primary healthcare institutions from August to December in 2010. A questionnaire survey developed by the study team was distributed to all of the primary healthcare institutions. Nine indicators from three dimensions as the outcome variables were used and calculated to evaluate the impacts of implementation of policies. All of the outcome variables were tested using independent-samples T test between the treatment group (with the NEMPs implemented) and the control group (without the NEMPs implemented). The ratio of drug sales and institution revenues at primary healthcare institutions was 42.99% in the treatment group, which was significantly lower than the control group (53.90%, p financial subsidies of the treatment group was shown to be higher (30.78% VS 20.82%, p institutions, the improvement of the mechanisms for government investment, and the healthcare pricing system. Meanwhile, the gaps between urban and rural areas need to be addressed. In conclusion, the NEMPs of China are instrumental to the aim of providing basic healthcare services to every citizen.

  15. Self-care essential extras: an integration of holistic nursing, functional medicine, and health coaching to promote therapeutic lifestyle change and decrease chronic disease.

    Science.gov (United States)

    Scattergood, Donna M

    2010-01-01

    The Essential Vitality Program blends holistic nursing, functional medicine, and health coaching to promote lifestyle changes that modify risk factors of costly chronic disease. Karl is a client who experienced enhanced vitality, decreased chronic pain and medications use, and improved meaningful functioning, by partnering with a holistic nurse coach.

  16. Improving global health governance to combat counterfeit medicines: a proposal for a UNODC-WHO-Interpol trilateral mechanism.

    Science.gov (United States)

    Mackey, Tim K; Liang, Bryan A

    2013-10-31

    Perhaps no greater challenge exists for public health, patient safety, and shared global health security, than fake/falsified/fraudulent, poor quality unregulated drugs, also commonly known as "counterfeit medicines", now endemic in the global drug supply chain. Counterfeit medicines are prevalent everywhere, from traditional healthcare settings to unregulated sectors, including the Internet. These dangerous medicines are expanding in both therapeutic and geographic scope, threatening patient lives, leading to antimicrobial resistance, and profiting criminal actors. Despite clear global public health threats, surveillance for counterfeit medicines remains extremely limited, with available data pointing to an increasing global criminal trade that has yet to be addressed appropriately. Efforts by a variety of public and private sector entities, national governments, and international organizations have made inroads in combating this illicit trade, but are stymied by ineffectual governance and divergent interests. Specifically, recent efforts by the World Health Organization, the primary international public health agency, have failed to adequately incorporate the broad array of stakeholders necessary to combat the problem. This has left the task of combating counterfeit medicines to other organizations such as UN Office of Drugs and Crime and Interpol in order to fill this policy gap. To address the current failure of the international community to mobilize against the worldwide counterfeit medicines threat, we recommend the establishment of an enhanced global health governance trilateral mechanism between WHO, UNODC, and Interpol to leverage the respective strengths and resources of these organizations. This would allow these critical organizations, already engaged in the fight against counterfeit medicines, to focus on and coordinate their respective domains of transnational crime prevention, public health, and law enforcement field operations. Specifically, by

  17. Development of global health education at Johns Hopkins University School of Medicine: a student-driven initiative

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    Dane Moran

    2015-07-01

    Full Text Available Global health is increasingly present in the formal educational curricula of medical schools across North America. In 2008, students at Johns Hopkins University School of Medicine (JHUSOM perceived a lack of structured global health education in the existing curriculum and began working with the administration to enhance global health learning opportunities, particularly in resource-poor settings. Key events in the development of global health education have included the introduction of a global health intersession mandatory for all first-year students; required pre-departure ethics training for students before all international electives; and the development of a clinical global health elective (Global Health Leadership Program, GHLP. The main challenges to improving global health education for medical students have included securing funding, obtaining institutional support, and developing an interprofessional program that benefits from the resources of the Schools of Medicine, Public Health, and Nursing. Strategies used included objectively demonstrating the need for and barriers to more structured global health experiences; obtaining guidance and modifying existing resources from other institutions and relevant educational websites; and harnessing institution-specific strengths including the large Johns Hopkins global research footprint and existing interprofessional collaborations across the three schools. The Johns Hopkins experience demonstrates that with a supportive administration, students can play an important and effective role in improving global health educational opportunities. The strategies we used may be informative for other students and educators looking to implement global health programs at their own institutions.

  18. Eight Essential Foods in Iranian Traditional Medicine and their Role in Health Promotion and Well-being.

    Science.gov (United States)

    Zeinalian, Mehrdad; Eshaghi, Mehdi; Hadian, Mahdi; Naji, Homayoun; Marandi, Sayed Mohammad Masoud; Asgary, Sedigheh

    2017-01-01

    Eight essential foods (EEF) described in Iranian traditional medicine (ITM) have a determinant role to balance human temperament insuring health and well-being. EEF included oral, imaginary, auditory, visual, olfactory, touch, sexual, and familiarity food. Oral foods should be halal, compatible with individual temper, consumed up twice a day, and compatible with different seasons and geographic conditions. Imaginary food consists of the individual thought content which is directly related to mental and physical fitness. It helps to balance temperament if be free of negative thoughts such as suspicion and distrust to others. Auditory food includes all sounds surrounding us, some of which are sedative and help to balance temperaments, such as natural sounds, and spiritual and beautiful words. Visual food includes everything in the range of human vision which is impressive on his/her thought. Natural beautiful scenes have almost a warm temper and help to balance human temperament. Olfactory food includes odors which stimulate the smell. Touch food includes all materials in direct contact with body skin, like clothes, which have a determinant role in temper moderation in the case of being natural. Sexual food complies with the human need to express his/her love and/or is loved, so its fulfillment could prevent human mal-temperament. Familiarity food can be provided by companion with friends and family members and has a significant role to insure well-being. Given the comprehensiveness of EEF in ITM which covers all human health-related aspects, we can insure health and well-being among our population by promoting and public educating of these principles.

  19. Eight essential foods in Iranian traditional medicine and their role in health promotion and well-being

    Directory of Open Access Journals (Sweden)

    Mehrdad Zeinalian

    2017-01-01

    Full Text Available Eight essential foods (EEF described in Iranian traditional medicine (ITM have a determinant role to balance human temperament insuring health and well-being. EEF included oral, imaginary, auditory, visual, olfactory, touch, sexual, and familiarity food. Oral foods should be halal, compatible with individual temper, consumed up twice a day, and compatible with different seasons and geographic conditions. Imaginary food consists of the individual thought content which is directly related to mental and physical fitness. It helps to balance temperament if be free of negative thoughts such as suspicion and distrust to others. Auditory food includes all sounds surrounding us, some of which are sedative and help to balance temperaments, such as natural sounds, and spiritual and beautiful words. Visual food includes everything in the range of human vision which is impressive on his/her thought. Natural beautiful scenes have almost a warm temper and help to balance human temperament. Olfactory food includes odors which stimulate the smell. Touch food includes all materials in direct contact with body skin, like clothes, which have a determinant role in temper moderation in the case of being natural. Sexual food complies with the human need to express his/her love and/or is loved, so its fulfillment could prevent human mal-temperament. Familiarity food can be provided by companion with friends and family members and has a significant role to insure well-being. Given the comprehensiveness of EEF in ITM which covers all human health-related aspects, we can insure health and well-being among our population by promoting and public educating of these principles.

  20. Global-scale equatorial Rossby waves as an essential component of solar internal dynamics

    Science.gov (United States)

    Löptien, Björn; Gizon, Laurent; Birch, Aaron C.; Schou, Jesper; Proxauf, Bastian; Duvall, Thomas L.; Bogart, Richard S.; Christensen, Ulrich R.

    2018-05-01

    The Sun’s complex dynamics is controlled by buoyancy and rotation in the convection zone. Large-scale flows are dominated by vortical motions1 and appear to be weaker than expected in the solar interior2. One possibility is that waves of vorticity due to the Coriolis force, known as Rossby waves3 or r modes4, remove energy from convection at the largest scales5. However, the presence of these waves in the Sun is still debated. Here, we unambiguously discover and characterize retrograde-propagating vorticity waves in the shallow subsurface layers of the Sun at azimuthal wavenumbers below 15, with the dispersion relation of textbook sectoral Rossby waves. The waves have lifetimes of several months, well-defined mode frequencies below twice the solar rotational frequency, and eigenfunctions of vorticity that peak at the equator. Rossby waves have nearly as much vorticity as the convection at the same scales, thus they are an essential component of solar dynamics. We observe a transition from turbulence-like to wave-like dynamics around the Rhines scale6 of angular wavenumber of approximately 20. This transition might provide an explanation for the puzzling deficit of kinetic energy at the largest spatial scales.

  1. Synthesis and Assimilation Systems - Essential Adjuncts to the Global Ocean Observing System

    Science.gov (United States)

    Rienecker, Michele M.; Balmaseda, Magdalena; Awaji, Toshiyuki; Barnier, Bernard; Behringer, David; Bell, Mike; Bourassa, Mark; Brasseur, Pierre; Breivik, Lars-Anders; Carton, James; hide

    2009-01-01

    Ocean assimilation systems synthesize diverse in situ and satellite data streams into four-dimensional state estimates by combining the various observations with the model. Assimilation is particularly important for the ocean where subsurface observations, even today, are sparse and intermittent compared with the scales needed to represent ocean variability and where satellites only sense the surface. Developments in assimilation and in the observing system have advanced our understanding and prediction of ocean variations at mesoscale and climate scales. Use of these systems for assessing the observing system helps identify the strengths of each observation type. Results indicate that the ocean remains under-sampled and that further improvements in the observing system are needed. Prospects for future advances lie in improved models and better estimates of error statistics for both models and observations. Future developments will be increasingly towards consistent analyses across components of the Earth system. However, even today ocean synthesis and assimilation systems are providing products that are useful for many applications and should be considered an integral part of the global ocean observing and information system.

  2. Chemical Composition and antiproliferative activity of essential oil from the leaves of a medicinal herb, Levisticum officinale, against UMSCC1 head and neck squamous carcinoma cells.

    Science.gov (United States)

    Sertel, Serkan; Eichhorn, Tolga; Plinkert, Peter K; Efferth, Thomas

    2011-01-01

    Oral squamous cell carcinoma (OSCC) is a challenging disease with a high mortality rate. Natural products represent a valuable source for the development of novel anticancer drugs. We investigated the cytotoxic potential of essential oil from the leaves of a medicinal plant, Levisticum officinale (lovage) on head and neck squamous carcinoma cells (HNSCC). Cytotoxicity of lovage essential oil was investigated on the HNSCC cell line, UMSCC1. Additionally, we performed pharmacogenomics analyses. Lovage essential oil extract had an IC₅₀ value of 292.6 μg/ml. Genes involved in apoptosis, cancer, cellular growth and cell cycle regulation were the most prominently affected in microarray analyses. The three pathways to be most significantly regulated were extracellular signal-regulated kinase 5 (ERK5) signaling, integrin-linked kinase (ILK) signaling, virus entry via endocytic pathways and p53 signaling. Levisticum officinale essential oil inhibits human HNSCC cell growth.

  3. Antioxidant activity, phenolic content, and peroxide value of essential oil and extracts of some medicinal and aromatic plants used as condiments and herbal teas in Turkey.

    Science.gov (United States)

    Ozcan, Mehmet Musa; Erel, Ozcan; Herken, Emine Etöz

    2009-02-01

    The antioxidant activity, total peroxide values, and total phenol contents of several medicinal and aromatic plant essential oil and extracts from Turkey were examined. Total phenolic contents were determined using a spectrophotometric technique and calculated as gallic acid equivalents. Total antioxidant activity of essential oil and extracts varied from 0.6853 to 1.3113 and 0.3189 to 0.6119 micromol of Trolox equivalents/g, respectively. The total phenolic content of essential oil ranged from 0.0871 to 0.5919 mg of gallic acid/g dry weight. However, the total phenolic contents of extracts were found to be higher compared with those of essential oils. The amount of total peroxide values of oils varied from 7.31 (pickling herb) to 58.23 (bitter fennel flower) mumol of H(2)O(2)/g. As a result, it is shown that medicinal plant derivatives such as extract and essential oils can be useful as a potential source of total phenol, peroxide, and antioxidant capacity for protection of processed foods.

  4. Does the development of new medicinal products in the European Union address global and regional health concerns?

    Directory of Open Access Journals (Sweden)

    Álvarez-Martín Elena

    2010-12-01

    Full Text Available Abstract Background Since 1995, approval for many new medicinal products has been obtained through a centralized procedure in the European Union. In recent years, the use of summary measures of population health has become widespread. We investigated whether efforts to develop innovative medicines are focusing on the most relevant conditions from a global public health perspective. Methods We reviewed the information on new medicinal products approved by centralized procedure from 1995 to 2009, information that is available to the public in the European Commission Register of medicinal products and the European Public Assessment Reports from the European Medicines Agency. Morbidity and mortality data were included for each disease group, according to the Global Burden of Disease project. We evaluated the association between authorized medicinal products and burden of disease measures based on disability-adjusted life years (DALYs in the European Union and worldwide. Results We considered 520 marketing authorizations for medicinal products and 338 active ingredients. New authorizations were seen to increase over the period analyzed. There was a positive, high correlation between DALYs and new medicinal product development (ρ = 0.619, p = 0.005 in the European Union, and a moderate correlation for middle-low-income countries (ρ = 0.497, p = 0.030 and worldwide (ρ = 0.490, p = 0.033. The most neglected conditions at the European level (based on their attributable health losses were neuropsychiatric diseases, cardiovascular diseases, respiratory diseases, sense organ conditions, and digestive diseases, while globally, they were perinatal conditions, respiratory infections, sense organ conditions, respiratory diseases, and digestive diseases. Conclusions We find that the development of new medicinal products is higher for some diseases than others. Pharmaceutical industry leaders and policymakers are invited to consider the implications of this

  5. Integrative medical therapy: examination of meditation's therapeutic and global medicinal outcomes via nitric oxide (review).

    Science.gov (United States)

    Stefano, George B; Esch, Tobias

    2005-10-01

    Relaxation techniques are part of the integrative medicine movement that is of growing importance for mainstream medicine. Complementary medical therapies have the potential to affect many physiological systems. Repeatedly studies show the benefits of the placebo response and relaxation techniques in the treatment of hypertension, cardiac arrhythmias, chronic pain, insomnia, anxiety and mild and moderate depression, premenstrual syndrome, and infertility. In itself, relaxation is characterized by a decreased metabolism, heart rate, blood pressure, and rate of breathing as well as an increase in skin temperature. Relaxation approaches, such as progressive muscle relaxation, autogenic training, meditation and biofeedback, are effective in lowering systolic and diastolic blood pressure in hypertensive patients by a significant margin. Given this association with changes in vascular tone, we have hypothesized that nitric oxide, a demonstrated vasodilator substance, contribute to physiological activity of relaxation approaches. We examined the scientific literature concerning the disorders noted earlier for their nitric oxide involvement in an attempt to provide a molecular rationale for the positive effects of relaxation approaches, which are physiological and cognitive process. We conclude that constitutive nitric oxide may crucially contribute to potentially beneficial outcomes and effects in diverse pathologies, exerting a global healing effect.

  6. Organizational barriers associated with the implementation of national essential medicines policy: A cross-sectional study of township hospitals in China.

    Science.gov (United States)

    Yang, Lianping; Liu, Chaojie; Ferrier, J Adamm; Zhang, Xinping

    2015-11-01

    This study identifies potential organizational barriers associated with the implementation of the Chinese National Essential Medicines Policy (NEMP) in rural primary health care institutions. We used a multistage sampling strategy to select 90 township hospitals from six provinces, two from each of eastern, middle, and western China. Data relating to eight core NEMP indicators and institutional characteristics were collected from January to September 2011, using a questionnaire. Prescription-associated indicators were calculated from 9000 outpatient prescriptions selected at random. We categorized the eight NEMP indicators using an exploratory factor analysis, and performed linear regressions to determine the association between the factor scores and institution-level characteristics. The results identified three main factors. Overall, low levels of expenditure of medicines (F1) and poor performance in rational use of medicines (F2) were evident. The availability of medicines (F3) varied significantly across both hospitals and regions. Factor scores had no significant relationship with hospital size (in terms of number of beds and health workers); however, they were associated with revenue and structure of the hospital, patient service load, and support for health workers. Regression analyses showed that public finance per health worker was negatively associated with the availability of medicines (p finance from local governments may reduce medicine stock lines of township hospitals and lead them to seek alternative sources of income, jeopardizing their capacity to meet the needs of local consumers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Investigation of Antileishmanial Effect of Alcoholic Extract and Essential Oil of Medicinal Plant Leaf Black Alfalfa (Medicago Lupulina, on The Number of Clinical Isolates of Leishmania Major Promastigotes in Vitro

    Directory of Open Access Journals (Sweden)

    E Gharirvand Eskandari

    2016-05-01

    Full Text Available Introduction: Leishmaniasis has created enormous global health problems. Side effects, drug resistance and the lack of effective vaccines had led to the new effective compounds effective of plants. The aim of this study was to introduce a traditional medicinal plant called Black alfalfa (Medicago Lupulina that can be used as a valuable resource against cutaneous leishmaniasis. Methods: In this experimental study, alcoholic extract was prepared by maceration and essential oil by distillation water method. Leishmania major promastigotes were cultured at 25 ± 2° C in N.N.N culturemedium, then in Schneider and next were cultured in RPMI- 1640. afterward, using MTT (Methyl Thiazole Tetrazolium, the IC50 (Inhibitory Concentrations 50% for extracts, essence and Glucantime were determined. The results using Tukey and t-test were analyzed and were presented by software SPSS16. MTT assay were repeated. 3 times for each sample. Results: IC50 for alfalfa leaf extract and essential oil of black alfalfa and Glucantime against L. major promastigotes was determined after 24, 48 and 72 hours, 240, 130 and 69 micrograms per ml, and 801, 340 and 190 micrograms per ml, also 26, 19 and 11 micrograms per ml , respectively. There was a significant differences between the IC50 plant extract and essential oil and Glucantime after 24, 48 and 72 hours. Conclusion: Alcoholic extracts and essential oil the plant had significant anti leishmaniasis effects in vitro. In this way, it can be considered as an anti-leishmaniasis among the herbs.

  8. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

  9. Trypanosoma brucei Inhibition by Essential Oils from Medicinal and Aromatic Plants Traditionally Used in Cameroon (Azadirachta indica, Aframomum melegueta, Aframomum daniellii, Clausena anisata, Dichrostachys cinerea and Echinops giganteus).

    Science.gov (United States)

    Kamte, Stephane L Ngahang; Ranjbarian, Farahnaz; Campagnaro, Gustavo Daniel; Nya, Prosper C Biapa; Mbuntcha, Hélène; Woguem, Verlaine; Womeni, Hilaire Macaire; Ta, Léon Azefack; Giordani, Cristiano; Barboni, Luciano; Benelli, Giovanni; Cappellacci, Loredana; Hofer, Anders; Petrelli, Riccardo; Maggi, Filippo

    2017-07-06

    Essential oils are complex mixtures of volatile components produced by the plant secondary metabolism and consist mainly of monoterpenes and sesquiterpenes and, to a minor extent, of aromatic and aliphatic compounds. They are exploited in several fields such as perfumery, food, pharmaceutics, and cosmetics. Essential oils have long-standing uses in the treatment of infectious diseases and parasitosis in humans and animals. In this regard, their therapeutic potential against human African trypanosomiasis (HAT) has not been fully explored. In the present work, we have selected six medicinal and aromatic plants ( Azadirachta indica , Aframomum melegueta , Aframomum daniellii , Clausena anisata , Dichrostachys cinerea , and Echinops giganteus ) traditionally used in Cameroon to treat several disorders, including infections and parasitic diseases, and evaluated the activity of their essential oils against Trypanosma brucei TC221. Their selectivity was also determined with Balb/3T3 (mouse embryonic fibroblast cell line) cells as a reference. The results showed that the essential oils from A. indica , A . daniellii , and E. giganteus were the most active ones, with half maximal inhibitory concentration (IC 50 ) values of 15.21, 7.65, and 10.50 µg/mL, respectively. These essential oils were characterized by different chemical compounds such as sesquiterpene hydrocarbons, monoterpene hydrocarbons, and oxygenated sesquiterpenes. Some of their main components were assayed as well on T. brucei TC221, and their effects were linked to those of essential oils.

  10. Improving health care globally: a critical review of the necessity of family medicine research and recommendations to build research capacity.

    NARCIS (Netherlands)

    Weel, C. van; Rosser, W.W.

    2004-01-01

    An invitational conference led by the World Organization of Family Doctors (Wonca) involving selected delegates from 34 countries was held in Kingston, Ontario, Canada, March 8 to12, 2003. The conference theme was "Improving Health Globally: The Necessity of Family Medicine Research." Guiding

  11. Global Use of Traditional and Complementary Medicine in Childhood Cancer: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Caroline Diorio

    2017-12-01

    Full Text Available Purpose: Traditional and complementary medicine (T&CM strategies are commonly used in pediatric oncology. Patterns may vary based on country income. We systematically reviewed published studies describing T&CM use among pediatric oncology patients in low-income countries (LIC/LMIC, middle-income countries (UMIC, and high-income countries (HIC. Objectives included describing estimated prevalence of use, reasons for use, perceived effectiveness, modalities used, rates of disclosure, and reporting of delayed or abandoned treatment. Methods: MEDLINE, EMBASE, Global Health, CINAHL, PsycINFO, Allied and Complementary Medicine Database, Cochrane Database of Systematic Reviews, and ProceedingsFirst were searched. Inclusion criteria were primary studies involving children younger than the age of 18 years, undergoing active treatment of cancer, and any T&CM use. Exclusion criteria included no pediatric oncology–specific outcomes and studies involving only children off active treatment. Data were extracted by two reviewers using a systematic data extraction form determined a priori. Results: Sixty-five studies published between 1977 and 2015 were included, representing 61 unique data sets and 7,219 children from 34 countries. The prevalence of T&CM use ranged from 6% to 100%. Median rates of use were significantly different in LIC/LMIC (66.7% ± 19%, UMIC (60% ± 26%, and HIC (47.2% ± 20%; P = .02. Rates of disclosure differed significantly by country income, with higher median rates in HIC. Seven studies reported on treatment abandonment or delays. Conclusion: The use of T&CM in pediatric oncology is common worldwide, with higher median prevalence of use reported in LIC/LMIC. Further research is warranted to examine the impact on treatment abandonment and delay.

  12. Antibacterial Effects of the Essential Oils of CommonlyConsumed Medicinal Herbs Using an In Vitro Model.

    NARCIS (Netherlands)

    Sokovic, M.; Glamoclija, J.; Marin, P.D.; Brkic, D.; Griensven, van L.J.L.D.

    2010-01-01

    The chemical composition and antibacterial activity of essential oils from 10 commonly consumed herbs: Citrus aurantium, C. limon, Lavandula angustifolia, Matricaria chamomilla, Mentha piperita, M. spicata, Ocimum basilicum, Origanum vulgare, Thymus vulgaris and Salvia officinalis have been

  13. Combination of gamma radiation and essential oils from medicinal plants in managing Tribolium castaneum contamination of stored products

    International Nuclear Information System (INIS)

    Ahmadi, Mehrdad; Abd-alla, Adly Mohamed M.; Moharramipour, Saeid

    2013-01-01

    Effectiveness of management of insect infestation of stored products with essential oils as viable alternatives to synthetic insecticides can be enhanced with gamma radiation. We studied effects of sublethal doses of essential oils from Rosmarinus officinalis (L.) and Perovskia atriplicifolia (Benth) (safe natural insecticides) in combination with gamma radiation on mortality of adults of Tribolium castaneum (Herbst). The insects were subjected to two radiation doses and two concentrations of the essential oils in the air. This combined treatment increased the mortality, which was also 3–6 times higher than could be expected from the sum of the effects of each of the treatments. The synergistic effect was more pronounced in the case of R. officinalis (L.) than in the case of P. atriplicifolia (Benth). The experiments have shown that the known insecticidal effectiveness of the essential oils can be enhanced by preliminary irradiation. Possible approaches to implementation of the combined treatment are discussed. - Highlights: • The mortality of T. castaneum increased with an increase of the radiation dose. • R. officinalis was more toxic to T. castaneum than P. atriplicifolia. • Gamma radiation and essential oils could be used as combined methods in IPM. • Combination of radiation with essential oils made a synergistic effect. • The synergistic effect of the R–G was much more appropriate from P–G

  14. The use of global rating scales for OSCEs in veterinary medicine.

    Directory of Open Access Journals (Sweden)

    Emma K Read

    Full Text Available OSCEs (Objective Structured Clinical Examinations are widely used in health professions to assess clinical skills competence. Raters use standardized binary checklists (CL or multi-dimensional global rating scales (GRS to score candidates performing specific tasks. This study assessed the reliability of CL and GRS scores in the assessment of veterinary students, and is the first study to demonstrate the reliability of GRS within veterinary medical education. Twelve raters from two different schools (6 from University of Calgary [UCVM] and 6 from Royal (Dick School of Veterinary Studies [R(DSVS] were asked to score 12 students (6 from each school. All raters assessed all students (video recordings during 4 OSCE stations (bovine haltering, gowning and gloving, equine bandaging and skin suturing. Raters scored students using a CL, followed by the GRS. Novice raters (6 R(DSVS were assessed independently of expert raters (6 UCVM. Generalizability theory (G theory, analysis of variance (ANOVA and t-tests were used to determine the reliability of rater scores, assess any between school differences (by student, by rater, and determine if there were differences between CL and GRS scores. There was no significant difference in rater performance with use of the CL or the GRS. Scores from the CL were significantly higher than scores from the GRS. The reliability of checklist scores were .42 and .76 for novice and expert raters respectively. The reliability of the global rating scale scores were .7 and .86 for novice and expert raters respectively. A decision study (D-study showed that once trained using CL, GRS could be utilized to reliably score clinical skills in veterinary medicine with both novice and experienced raters.

  15. Antimycobacterial natural products from Moroccan medicinal plants: Chemical composition, bacteriostatic and bactericidal profile of Thymus satureioides and Mentha pulegium essential oils

    Institute of Scientific and Technical Information of China (English)

    Marwa Chraibi; Abdellah Farah; Sara Lebrazi; Oumaima El Amine; Mohammed Iraqui Houssaini; Kawtar Fikri-Benbrahim

    2016-01-01

    Objective: To evaluate the susceptibility of Mycobacterium aurum and Mycobacterium smegmatis in vitro to the essential oils obtained from two medicinal plants: Thymus satureioides(T. satureioides) and Mentha pulegium(M. pulegium), and to study their chemical composition.Methods: The aerial parts of T. satureioides and M. pulegium(leaves and stems) were hydro-distillated using a Clevenger-type apparatus and essential oils were analyzed and identified by gas chromatography-mass spectrometry. Antimycobacterial screening of essential oils was performed on the basis of the inhibition zone diameter by disc diffusion method against two mycobacterial strains whereas the minimal inhibitory concentration and minimal bactericidal concentration were determined by using the micro-dilution method.Results: Chemical analysis of their aerial part’s essential oils gave as major compounds,borneol(34.26%), carvacrol(31.21%) and thymol(3.71%) for T. satureioides and R(+)-pulegone(75.48%), carvone(6.66%) and dihydrocarvone(4.64%) for M. pulegium.Thereafter their antimycobacterial effect evaluation, using the micro-dilution method,indicated that minimal inhibitory concentration values of T. satureioides essential oil ranged from 0.062% to 0.015%(v/v) and from 0.125% to 0.031%(v/v) for M. pulegium respectively against Mycobacterium aurum and Mycobacterium smegmatis.Conclusions: It is clearly evident from the results obtained that the Moroccan medicinal plants have great potential to be used as anti-tuberculosis agents. These findings may help scientists to undertake several research projects to discover useful natural product as new anti-tuberculosis drug.

  16. Antimycobacterial natural products from Moroccan medicinal plants:Chemical composition, bacteriostatic and bactericidal profile of Thymus satureioides and Mentha pulegium essential oils

    Institute of Scientific and Technical Information of China (English)

    Marwa Chraibi; Abdellah Farah; Sara Lebrazi; Oumaima El Amine; Mohammed Iraqui Houssaini; Kawtar Fikri-Benbrahim

    2016-01-01

    Objective: To evaluate the susceptibility of Mycobacterium aurum and Mycobacterium smegmatis in vitro to the essential oils obtained from two medicinal plants: Thymus satureioides (T. satureioides) and Mentha pulegium (M. pulegium), and to study their chemical composition. Methods: The aerial parts of T. satureioides and M. pulegium (leaves and stems) were hydro-distillated using a Clevenger-type apparatus and essential oils were analyzed and identified by gas chromatography-mass spectrometry. Antimycobacterial screening of essential oils was performed on the basis of the inhibition zone diameter by disc diffusion method against two mycobacterial strains whereas the minimal inhibitory concentration and minimal bactericidal concentration were determined by using the micro-dilution method. Results: Chemical analysis of their aerial part's essential oils gave as major compounds, borneol (34.26%), carvacrol (31.21%) and thymol (3.71%) for T. satureioides and R(+)-pulegone (75.48%), carvone (6.66%) and dihydrocarvone (4.64%) for M. pulegium. Thereafter their antimycobacterial effect evaluation, using the micro-dilution method, indicated that minimal inhibitory concentration values of T. satureioides essential oil ranged from 0.062%to 0.015%(v/v) and from 0.125%to 0.031%(v/v) for M. pulegium respectively against Mycobacterium aurum and Mycobacterium smegmatis. Conclusions: It is clearly evident from the results obtained that the Moroccan medicinal plants have great potential to be used as anti-tuberculosis agents. These findings may help scientists to undertake several research projects to discover useful natural product as new anti-tuberculosis drug.

  17. Phytochemical analysis and cytotoxicity towards multidrug-resistant leukemia cells of essential oils derived from Lebanese medicinal plants.

    Science.gov (United States)

    Saab, Antoine M; Guerrini, Alessandra; Sacchetti, Gianni; Maietti, Silvia; Zeino, Maʼen; Arend, Joachim; Gambari, Roberto; Bernardi, Francesco; Efferth, Thomas

    2012-12-01

    Juniperus excelsa fruit essential oil as well as J. oxycedrus, Cedrus libani, and Pinus pinea wood essential oils have been obtained with yields between 2.2 ± 0.3 % to 3.4 ± 0.5 % and analyzed by gas chromatography. Sesquiterpenes mainly characterized C. libani and J. oxycedrus essential oils, while in P. pinea and J. excelsa, monoterpenes were the most abundant compounds. In J. oxycedrus, cis-calamenene (7.8 %), cuparene (3.8 %), and cis-thujopsenal (2.0 %) have been detected for the first time. The cytotoxic activity of these essential oils against drug-sensitive CCRF-CEM and multidrug-resistant P-glycoprotein-expressing CEM/ADR5000 leukemia cells has been investigated (IC₅₀ values: 29.46 to 61.54 µg/mL). Remarkably, multidrug-resistant CEM/ADR5000 cells did not reveal cross-resistance, indicating that these essential oils might be useful to treat otherwise drug-resistant and refractory tumors. Georg Thieme Verlag KG Stuttgart · New York.

  18. Free Open Access Medical Education (FOAM in Emergency Medicine: The Global Distribution of Users in 2016

    Directory of Open Access Journals (Sweden)

    Jennifer W. Bellows

    2018-04-01

    Full Text Available Introduction: Free open-access medical education (FOAM is a collection of interactive online medical education resources—free and accessible to students, physicians and other learners. This novel approach to medical education has the potential to reach learners across the globe; however, the extent of its global uptake is unknown. Methods: This descriptive report evaluates the 2016 web analytics data from a convenience sample of FOAM blogs and websites with a focus on emergency medicine (EM and critical care. The number of times a site was accessed, or “sessions”, was categorized by country of access, cross-referenced with World Bank data for population and income level, and then analyzed using simple descriptive statistics and geographic mapping. Results: We analyzed 12 FOAM blogs published from six countries, with a total reported volume of approximately 18.7 million sessions worldwide in 2016. High-income countries accounted for 73.7% of population-weighted FOAM blog and website sessions in 2016, while upper-middle income countries, lower-middle income countries and low-income countries accounted for 17.5%, 8.5% and 0.3%, respectively. Conclusion: FOAM, while largely used in high-income countries, is used in low- and middle-income countries as well. The potential to provide free, online training resources for EM in places where formal training is limited is significant and thus is prime for further investigation.

  19. Global volatile profile of virgin olive oils flavoured by aromatic/medicinal plants.

    Science.gov (United States)

    Perestrelo, R; Silva, C; Silva, P; Câmara, J S

    2017-07-15

    The global volatile profile of commercial virgin olive oils and flavoured olive oils with aromatic/medicinal plants, was established using liquid-liquid microextraction (LLME) and headspace solid-phase microextraction (HS-SPME) combined with gas chromatography-quadrupole mass spectrometry (GC-qMS). More than 60 volatile organic compounds (VOCs belonging to different groups were identified using both methods. Olive oils volatile profile was slightly influenced by maceration process, which occurred at room temperature (20±2°C) for 15days. The predominant differences were observed in terpenoids group, since some of them were only identified in the flavoured olive oils, while others showed an increase with the maceration process. VOCs mass transfer from plants to olive oils could explain the observed results. Principal components analysis (PCA) applied to LLME/GC-qMS data allowed to distinguish the olive oils. The flavoured oils would increase the use of olive oil among consumers as consequence of the improvement of its aromatic profile and healthy properties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Access to diagnostic tests and essential medicines for cardiovascular diseases and diabetes care: cost, availability and affordability in the West Region of Cameroon.

    Directory of Open Access Journals (Sweden)

    Ahmadou M Jingi

    Full Text Available To assess the availability and affordability of medicines and routine tests for cardiovascular disease (CVD and diabetes in the West region of Cameroon, a low-income setting.A survey was conducted on the availability and cost of twelve routine tests and twenty medicines for CVD and diabetes in eight health districts (four urban and four rural covering over 60% of the population of the region (1.8 million. We analyzed the percentage of tests and medicines available, the median price against the international reference price (median price ratio for the medicines, and affordability in terms of the number of days' wages it would cost the lowest-paid unskilled government worker for initial investigation tests and procurement for one month of treatment.The availability of tests varied between 10% for the ECG to 100% for the fasting blood sugar. The average cost for the initial investigation using the minimum tests cost 29.76 days' wages. The availability of medicines varied from 36.4% to 59.1% in urban and from 9.1% to 50% in rural settings. Only metformin and benzathine-benzylpenicilline had a median price ratio of ≤ 1.5, with statins being largely unaffordable (at least 30.51 days' wages. One month of combination treatment for coronary heart disease costs at least 40.87 days' wages.The investigation and management of patients with medium-to-high cardiovascular risk remains largely unavailable and unaffordable in this setting. An effective non-communicable disease program should lay emphasis on primary prevention, and improve affordable access to essential medicines in public outlets.

  1. In vitro total phenolics, flavonoids contents and antioxidant activity of essential oil, various organic extracts from the leaves of tropical medicinal plant Tetrastigma from Sabah.

    Science.gov (United States)

    Hossain, M Amzad; Shah, Muhammad Dawood; Gnanaraj, Charles; Iqbal, Muhammad

    2011-09-01

    To detect the in vitro total phenolics, flavonoids contents and antioxidant activity of essential oil, various organic extracts from the leaves of tropical medicinal plant Tetrastigma from Sabah. The dry powder leaves of Tetrastigma were extracted with different organic solvent such as hexane, ethyl acetate, chloroform, butanol and aqueous methanol. The total phenolic and total flavonoids contents of the essential oil and various organic extracts such as hexane, ethyl acetate, chloroform, butanol and aqueous ethanol were determined by Folin - Ciocalteu method and the assayed antioxidant activity was determined in vitro models such as antioxidant capacity by radical scavenging activity using α, α-diphenyl- β-picrylhydrazyl (DPPH) method. The total phenolic contents of the essential oil and different extracts as gallic acid equivalents were found to be highest in methanol extract (386.22 mg/g) followed by ethyl acetate (190.89 mg/g), chloroform (175.89 mg/g), hexane (173.44 mg/g), and butanol extract (131.72 mg/g) and the phenolic contents not detected in essential oil. The antioxidant capacity of the essential oil and different extracts as ascorbic acid standard was in the order of methanol extract > ethyl acetate extract >chloroform> butanol > hexane extract also the antioxidant activity was not detected in essential oil. The findings show that the extent of antioxidant activity of the essential oil and all extracts are in accordance with the amount of phenolics present in that extract. Leaves of Tetrastigma being rich in phenolics may provide a good source of antioxidant. Copyright © 2011 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  2. Stem Cell and Regenerative Medicine Global Conference (SCRGC) 2016 (August 23-24, 2016 - Gyeonggi-do, Korea).

    Science.gov (United States)

    Vertès, A

    2016-10-01

    In its third edition, the Stem Cell and Regenerative Medicine Global Conference (SCRGC) organized by the Global Stem Cell & Regenerative Medicine Acceleration Center (GSRAC) was focused on breaking barriers to accelerate the pace of innovation and development of the regenerative medicine industry. GSRAC is both a think tank and a global network of key opinion leaders from the public and the private sectors. GSRAC was commissioned in 2011 by the Ministry of Health and Welfare (MOHW) of Korea. GSRAC's primary mission is to enable and accelerate the delivery of innovative technologies to patients who are affected by currently untreatable diseases. This goal is notably achieved by resolving hurdles in the field of regenerative medicine. With a total of 30 speakers and panelists from 8 different countries and more than 400 attendees from an array of institutions including hospitals, clinics, biotechnology companies, pharmaceutical companies, scientists, as well as policy makers, the 2-day SCRGC highlighted critical challenges and paths to resolving them in policy and regulatory, and industrial-scale manufacturing of gene-based and cell-based therapies, comprising plenary lectures and sessions covering strategic policy, regulatory, reimbursement and business development, and business of manufacturing, and production technologies. Several of these presentations are summarized in this report. Copyright 2016 Prous Science, S.A.U. or its licensors. All rights reserved.

  3. A possible role of partially pyrolysed essential oils in Australian Aboriginal traditional ceremonial and medicinal smoking applications of Eremophila longifolia (R. Br.) F. Muell (Scrophulariaceae).

    Science.gov (United States)

    Sadgrove, N J; Jones, G L

    2013-06-03

    Eremophila longifolia is one of the most respected of the traditional medicines used by Australian Aboriginal people. Customary use involves smoldering the leaves over hot embers of a fire to produce an acrid smoke, believed to have therapeutic effects broadly consistent with antimicrobial, antifungal and anti-inflammatory capacity. The current study aims to examine the contribution of partially pyrolysed and non-pyrolysed essential oils in traditional usage of Eremophila longifolia. Non-pyrolysed and partially pyrolysed essential oils were produced by hydrodistillation and part-wet/part-dry distillation, respectively. All samples were tested for antimicrobial activity by broth dilution. Some of these samples were further treated to an incrementally stepped temperature profile in a novel procedure employing a commercial thermocycler in an attempt to mimic the effect of temperature gradients produced during smoking ceremonies. Components from the pyrodistilled oils were compared with the non-pyrodistilled oils, using GC-MS, GC-FID and HPLC-PAD. The 2,2-diphenyl-1-picrylhydrazyl method, was used to compare free radical scavenging ability. Partially pyrolysed oils had approximately three or more times greater antimicrobial activity, enhanced in cultures warmed incrementally to 60°C and held for 30s and further enhanced if held for 2 min. Partially pyrolysed oils showed a radical scavenging capacity 30-700 times greater than the corresponding non-pyrolysed oils. HPLC-PAD revealed the presence of additional constituents not present in the fresh essential oil. These results, by showing enhanced antimicrobial and antioxidant activities, provide the first known Western scientific justification for the smoking ceremonies involving leaves of Eremophila longifolia. During customary use, both partially pyrolysed as well as non-pyrolysed essential oils may contribute significantly to the overall intended medicinal effect. Copyright © 2013 Elsevier Ireland Ltd. All rights

  4. Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? A comparison study.

    NARCIS (Netherlands)

    Ivanovska, V.; Leufkens, H.G.; Rademaker, C.M.A.; Zisovska, E.; Pijnenbrug, M.W.; Dijk, L. van; Mantel-Teeuwisse, A.K.

    2017-01-01

    Objective: There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of

  5. Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? : A comparison study

    NARCIS (Netherlands)

    Ivanovska, Verica; Leufkens, Hubert G; Rademaker, Carin Ma; Zisovska, Elizabeta; Pijnenburg, Mariëlle W; van Dijk, Liset; Mantel-Teeuwisse, Aukje K

    OBJECTIVE: There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of

  6. Are age-appropriate antibiotic formulations missing from the WHO list of essential medicines for children? : A comparison study

    NARCIS (Netherlands)

    Ivanovska, Verica; Leufkens, Hubert G.; Rademaker, Carin M A; Zisovska, Elizabeta; Pijnenburg, Mariëlle W.; van Dijk, Liset; Mantel-Teeuwisse, Aukje K.

    Objective There is a global call for formulations, which are better suited for children of different age categories and in a variety of settings. One key public health area of interest is age-appropriate paediatric antibiotics. We aimed to identify clinically relevant paediatric formulations of

  7. Frontline health workers as brokers: provider perceptions, experiences and mitigating strategies to improve access to essential medicines in South Africa.

    Science.gov (United States)

    Magadzire, Bvudzai Priscilla; Budden, Ashwin; Ward, Kim; Jeffery, Roger; Sanders, David

    2014-11-05

    Front-line health providers have a unique role as brokers (patient advocates) between the health system and patients in ensuring access to medicines (ATM). ATM is a fundamental component of health systems. This paper examines in a South African context supply- and demand- ATM barriers from the provider perspective using a five dimensional framework: availability (fit between existing resources and clients' needs); accessibility (fit between physical location of healthcare and location of clients); accommodation (fit between the organisation of services and clients' practical circumstances); acceptability (fit between clients' and providers' mutual expectations and appropriateness of care) and affordability (fit between cost of care and ability to pay). This cross-sectional, qualitative study uses semi-structured interviews with nurses, pharmacy personnel and doctors. Thirty-six providers were purposively recruited from six public sector Community Health Centres in two districts in the Eastern Cape Province representing both rural and urban settings. Content analysis combined structured coding and grounded theory approaches. Finally, the five dimensional framework was applied to illustrate the interconnected facets of the issue. Factors perceived to affect ATM were identified. Availability of medicines was hampered by logistical bottlenecks in the medicines supply chain; poor public transport networks affected accessibility. Organization of disease programmes meshed poorly with the needs of patients with comorbidities and circular migrants who move between provinces searching for economic opportunities, proximity to services such as social grants and shopping centres influenced where patients obtain medicines. Acceptability was affected by, for example, HIV related stigma leading patients to seek distant services. Travel costs exacerbated by the interplay of several ATM barriers influenced affordability. Providers play a brokerage role by adopting flexible

  8. Chemical and biological characterisation of solvent extracts and essential oils from leaves and fruit of two Australian species of Pittosporum (Pittosporaceae) used in aboriginal medicinal practice.

    Science.gov (United States)

    Sadgrove, Nicholas John; Jones, Graham Lloyd

    2013-02-13

    Although no known medicinal use for Pittosporum undulatum Vent. (Pittosporaceae) has been recorded, anecdotal evidence suggests that Australian Aboriginal people used Pittosporum angustifolium Lodd., G. Lodd. & W. Lodd. topically for eczema, pruritis or to induce lactation in mothers following child-birth and internally for coughs, colds or cramps. Essential oil composition and bioactivity as well as differential solvent extract antimicrobial activity from Pittosporum angustifolium are investigated here first, to partially describe the composition of volatiles released in traditional applications of Pittosporum angustifolium for colds or as a lactagogue, and second to investigate antibacterial activity related to topical applications. Essential oils were also investigated from Pittosporum undulatum Vent., first to enhance essential oil data produced in previous studies, and second as a comparison to Pittosporum angustifolium. Essential oils were hydrodistilled from fruit and leaves of both species using a modified approach to lessen the negative (frothing) effect of saponins. This was achieved by floating pumice or pearlite obsidian over the mixture to crush the suds formed while boiling. Essential oil extracts were analysed using GC-MS, quantified using GC-FID then screened for antimicrobial activity using a micro-titre plate broth dilution assay (MIC). Using dichloromethane, methanol, hexane and H(2)O as solvents, extracts were produced from leaves and fruit of Pittosporum angustifolium and screened for antimicrobial activity and qualitative phytochemical character. Although the essential oil from leaves and fruit of Pittosporum undulatum demonstrated some component variation, the essential oil from fruits of Pittosporum angustifolium had major constituents that strongly varied according to the geographical location of collection, suggesting the existence of at least two chemotypes; one with high abundance of acetic acid decyl ester. This chemotype had high

  9. Developing an administrative plan for transfusion medicine--a global perspective.

    Science.gov (United States)

    Sullivan, Patrick

    2005-10-01

    Throughout the world blood services aim to provide a life-saving service by ensuring an adequate supply of safe blood. However, across the world blood services are at very different levels of development. Consequently, the actions taken in one country or region would not be appropriate in another. This paper aims to identify how suitable solutions can be developed to match the different prevailing circumstances of an individual country or region. In trying to do this it is important to look at the whole of the supply chain within a blood service and identify the part where a change could make the biggest impact. Four key areas are identified that are integral to this. These are the donor, testing of blood, hemovigilance, and overall management arrangements. Whilst the first two have largely been addressed in highly developed countries, there is still much work that could be done in these areas in developing countries. In particular, a move to voluntary nonremunerated donors worldwide would significantly improve overall safety. Hemovigilance systems are identified as a powerful tool to influence policy development, yet these are largely under developed throughout the world. In order to make high impact and sustainable changes it is important that those in the blood industry across the world work together to improve education and training, to share experience of best practice, and to move to develop agreed standards in transfusion medicine. It is imperative that developed countries recognize the importance of working with developing countries if the safety of the global blood supply is to be maintained and improved.

  10. How front-line healthcare workers respond to stock-outs of essential medicines in the Eastern Cape Province of South Africa.

    Science.gov (United States)

    Hodes, R; Price, I; Bungane, N; Toska, E; Cluver, L

    2017-08-25

    Shortages of essential medicines are a daily occurrence in many of South Africa (SA)'s public health facilities. This study focuses on the responses of healthcare workers to stock-outs, investigating how actors at the 'front line' of public health delivery understand, experience and respond to shortages of essential medicines and equipment in their facilities. Findings are based on focus groups, observations and interviews with healthcare workers and patients at healthcare facilities in the Eastern Cape Province of SA, conducted as part of the Mzantsi Wakho study. The research revealed a discrepancy between 'informal' definitions of stock-outs and their reporting through formal stock-out management channels. Front-line healthcare workers had designed their own systems for classifying the severity of stock-outs, based on the product in question, and on their potential to access stocks from other facilities. Beyond formal systems of procurement and supply, healthcare workers had established vast networks of alternative communication and action, often using personal resources to procure medical supplies. Stock-outs were only reported when informal methods of stock-sharing did not secure top-up supplies. These findings have implications for understanding the frequency and severity of stock-outs, and for taking action to prevent and manage stock-outs effectively.

  11. Evolutionary history and leaf succulence as explanations for medicinal use in aloes and the global popularity of Aloe vera.

    Science.gov (United States)

    Grace, Olwen M; Buerki, Sven; Symonds, Matthew R E; Forest, Félix; van Wyk, Abraham E; Smith, Gideon F; Klopper, Ronell R; Bjorå, Charlotte S; Neale, Sophie; Demissew, Sebsebe; Simmonds, Monique S J; Rønsted, Nina

    2015-02-26

    Aloe vera supports a substantial global trade yet its wild origins, and explanations for its popularity over 500 related Aloe species in one of the world's largest succulent groups, have remained uncertain. We developed an explicit phylogenetic framework to explore links between the rich traditions of medicinal use and leaf succulence in aloes. The phylogenetic hypothesis clarifies the origins of Aloe vera to the Arabian Peninsula at the northernmost limits of the range for aloes. The genus Aloe originated in southern Africa ~16 million years ago and underwent two major radiations driven by different speciation processes, giving rise to the extraordinary diversity known today. Large, succulent leaves typical of medicinal aloes arose during the most recent diversification ~10 million years ago and are strongly correlated to the phylogeny and to the likelihood of a species being used for medicine. A significant, albeit weak, phylogenetic signal is evident in the medicinal uses of aloes, suggesting that the properties for which they are valued do not occur randomly across the branches of the phylogenetic tree. Phylogenetic investigation of plant use and leaf succulence among aloes has yielded new explanations for the extraordinary market dominance of Aloe vera. The industry preference for Aloe vera appears to be due to its proximity to important historic trade routes, and early introduction to trade and cultivation. Well-developed succulent leaf mesophyll tissue, an adaptive feature that likely contributed to the ecological success of the genus Aloe, is the main predictor for medicinal use among Aloe species, whereas evolutionary loss of succulence tends to be associated with losses of medicinal use. Phylogenetic analyses of plant use offer potential to understand patterns in the value of global plant diversity.

  12. Short-term differences in drug prices after implementation of the national essential medicines system: A case study in rural Jiangxi Province, China.

    Science.gov (United States)

    Wang, Junyong; Liu, Xia; Wang, Suzhen; Chen, Heli; Wang, Xun; Zhou, Wei; Wang, Li; Zhu, Yanchen; Zheng, Xianping; Hao, Mo

    2015-01-01

    China's 2009 national essential medicine system (NEMS) was designed to reduce prices through a zero-markup policy and a centralized bidding system. To analyze NEMS's short-term impact on drug prices, we estimated the retail and wholesale prices before and after the reform at health institutions in rural Jiangxi Province. We undertook two cross-sectional surveys of prices of 39 medicines in November 2008 and May 2010, calculated inflation adjusted prices, and used the Wilcoxon signed-rank and rank-sum tests to examine price changes at different health institutions. Retail prices at pilot (P health centers decreased significantly, whereas the declines at retail pharmacies (P = 0.57) and village clinics (P = 0.29) were insignificant. The decline at pilot township health centers was the largest, compared with other kinds of health institutions (P health institutions, the centralized bidding system was insufficient to lower wholesale prices. A drug price management system should be constructed to control medicine prices and a long-term price information system is needed to monitor price changes.

  13. Does providing more services increase the primary hospitals' revenue? An assessment of national essential medicine policy based on 2,675 counties in China.

    Directory of Open Access Journals (Sweden)

    Fei Chen

    Full Text Available To understand whether the increased outpatient service provision (OSP brings in enough additional income (excluding income from essential medicine for primary hospitals (INCOME to compensate for reduced costs of medicine.The two outcomes, annual OSP and INCOME for the period of 2008-2012, were collected from 34,506 primary hospitals in 2,675 counties in 31 provinces in China by the national surveillance system. The data had a four-level hierarchical structure; time points were nested within primary hospital, hospitals within county, and counties within province. We fitted bivariate five-level random effects regression models to examine correlations between OSP and INCOME in terms of their mean values and dose-response effects of the essential medicine policy (EMP. We adjusted for the effects of time period and selected hospital resources.The estimated correlation coefficients between the two outcomes' mean values were strongly positive among provinces (r = 0.910, moderately positive among counties (r = 0.380, and none among hospitals (r = 0.002 and time (r = 0.007. The correlation between their policy effects was weakly positive among provinces (r = 0.234, but none at the county and hospital levels. However, there were markedly negative correlation coefficients between the mean and policy effects at -0.328 for OSP and -0.541 for INCOME at the hospital level.There was no evidence to suggest an association between the two outcomes in terms of their mean values and dose-response effects of EMP at the hospital level. This indicated that increased OSP did not bring enough additional INCOME. Sustainable mechanisms to compensate primary hospitals are needed.

  14. Chemical composition, in vitro antioxidant and anti-inflammatory properties of essential oils of four dietary and medicinal plants from Cameroon.

    Science.gov (United States)

    Ndoye Foe, Florentine Marie-Chantal; Tchinang, Tatiana Flore Kemegni; Nyegue, Ascencion Maximilienne; Abdou, Jean-Pierre; Yaya, Abel Joel Gbaweng; Tchinda, Alembert Tiabou; Essame, Jean-Louis Oyono; Etoa, François-Xavier

    2016-04-07

    In the Cameroonian traditional medicine, plants of the Capparidaceae, Euphorbiaceae and Liliaceae families are used to treat several metabolic diseases. These plants are rich in various compounds belonging to the glucosinolates and thiosulfinates family. Till date, very little studies have been done aiming at assessing the antioxidant and inflammatory properties of the essential oils (EOs) of these plants. Essential oils are volatile extracts produced by secondary metabolism. They are usually constituted of terpens and may also contain specific non terpenic components such as glucosinolates and thiosulfinates for the species that are being considered in the present study. This study highlights and compares the chemical composition, antioxidant and anti-inflammatory properties of the essential oils of the stem barks of Drypetes gossweileri (Euphorbiaceae), roots of Pentadiplandra brazzeana (Capparidaceae), red bulbs of Allium cepa and Alium sativum (Liliaceae) collected in Cameroon (Central Africa). The essential oils were extracted by hydrodistillation and analyzed by gas chromatography (GC) and gas chromatography coupled to mass spectrometry (GC-MS). In vitro antioxidant activities were determined using the radical scavenging assay, total phenolic content, ferric reducing antioxidant power (FRAP) assay and determination of antioxidant activity index (AAI) according to the method described by Scherer and Godoy. The anti-inflammatory activities were evaluated using albumin denaturation method. Differences (p essential oil were diallyl trisulfide (41.62 %), diallyl disulfide (19.74 %), allyl methyl trisulfide (12.95 %), diallyl sulfide (7.1 %) and diallyl tetrasulfide (4.22 %). Those of Allium cepa essential oil were diallyl trisulfide (22.17 %), dipropyl trisulfide (11.11 %), 2-methyl-3,4-dithiaheptane (9.88 %), methyl propyl trisulfide (8.14 %), dipropyl tetrasulfide (8.07 %) and 2-propenyl propyl disulfide (5.15 %). Drypetes gossweileri and Pentadiplandra

  15. Comparison of sample preparation methods for the determination of essential and toxic elements in important indigenous medicinal plant Aloe barbadensis

    International Nuclear Information System (INIS)

    Sahito, S.R.; Kazi, T.G.; Kazi, G.H.; Jakhrani, M.A.; Wattoo, M.H.S.

    2002-01-01

    The role of elements particularly traces elements in health and disease is now well established. In this paper we investigate the presence of various elements in very important herb Aloe barbadensis, it is commonly used in different ailments especially of elementary tract. We used four extraction methods for the determination of total elements in Aloe barbadensis. The procedure, which is found to be more efficient and decompose the biological material, is nitric acid and 30% hydrogen peroxide as compared to other method. The sample of plants was collected from surrounding of Hyderabad; Sindh University and vouches specimens were prepared following the standard herbarium techniques. Fifteen essential, trace and toxic elements such as Zn, Cr, K, Mg, Ca, Na, Fe, Pb, Al, Ba, Mn, Co, Ni and Cd were determined in plant and in its decoction. Using Flame Atomic Absorption Spectrophotometer Hitachi Model 180-50. It is noted that, level of essential elements was found high as compare to the level of toxic elements. (author)

  16. Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

    Science.gov (United States)

    Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy; Babigumira, Joseph B

    2014-10-11

    Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes. This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use. This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

  17. Comparison of the antibacterial activity of essential oils and extracts of medicinal and culinary herbs to investigate potential new treatments for irritable bowel syndrome

    Science.gov (United States)

    2013-01-01

    Background Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder, which may result from alteration of the gastrointestinal microbiota following gastrointestinal infection, or with intestinal dysbiosis or small intestinal bacterial overgrowth. This may be treated with antibiotics, but there is concern that widespread antibiotic use might lead to antibiotic resistance. Some herbal medicines have been shown to be beneficial, but their mechanism(s) of action remain incompletely understood. To try to understand whether antibacterial properties might be involved in the efficacy of these herbal medicines, and to investigate potential new treatments for IBS, we have conducted a preliminary study in vitro to compare the antibacterial activity of the essential oils of culinary and medicinal herbs against the bacterium, Esherichia coli. Methods Essential oils were tested for their ability to inhibit E. coli growth in disc diffusion assays and in liquid culture, and to kill E. coli in a zone of clearance assay. Extracts of coriander, lemon balm and spearmint leaves were tested for their antibacterial activity in the disc diffusion assay. Disc diffusion and zone of clearance assays were analysed by two-tailed t tests whereas ANOVA was performed for the turbidometric assays. Results Most of the oils exhibited antibacterial activity in all three assays, however peppermint, lemon balm and coriander seed oils were most potent, with peppermint and coriander seed oils being more potent than the antibiotic rifaximin in the disc diffusion assay. The compounds present in these oils were identified by gas chromatography mass spectrometry. Finally, extracts were made of spearmint, lemon balm and coriander leaves with various solvents and these were tested for their antibacterial activity against E. coli in the disc diffusion assay. In each case, extracts made with ethanol and methanol exhibited potent antibacterial activity. Conclusions Many of the essential oils

  18. Evaluation of a Structured Predeparture Orientation at the David Geffen School of Medicine's Global Health Education Programs.

    Science.gov (United States)

    Herbst de Cortina, Sasha; Arora, Gitanjli; Wells, Traci; Hoffman, Risa M

    2016-03-01

    Given the lack of a standardized approach to medical student global health predeparture preparation, we evaluated an in-person, interactive predeparture orientation (PDO) at the University of California Los Angeles (UCLA) to understand program strengths, weaknesses, and areas for improvement. We administered anonymous surveys to assess the structure and content of the PDO and also surveyed a subset of students after travel on the utility of the PDO. We used Fisher's exact test to evaluate the association between prior global health experience and satisfaction with the PDO. One hundred and five students attended the PDO between 2010 and 2014 and completed the survey. One hundred and four students (99.0%) reported learning new information. Major strengths included faculty mentorship (N = 38, 19.7%), opportunities to interact with the UCLA global health community (N = 34, 17.6%), and sharing global health experiences (N = 32, 16.6%). Of students surveyed after their elective, 94.4% (N = 51) agreed or strongly agreed that the PDO provided effective preparation. Students with prior global health experience found the PDO to be as useful as students without experience (92.7% versus 94.4%, P = 1.0). On the basis of these findings, we believe that a well-composed PDO is beneficial for students participating in global health experiences and recommend further comparative studies of PDO content and delivery. © The American Society of Tropical Medicine and Hygiene.

  19. Determination of macro, essential trace elements, toxic heavy metal concentrations, crude oil extracts and ash composition from Saudi Arabian fruits and vegetables having medicinal values

    Directory of Open Access Journals (Sweden)

    Hana R. Alzahrani

    2017-11-01

    Full Text Available The concentrations of essential elements (Mg, Ca, Na, K, Fe, Zn, Se, Al, Ni, and Cu and toxic heavy metals (Pb, As, Cr, Cd, and Cr from Saudi Arabian fruits and vegetables were determined by inductively coupled plasma optical emission spectrophotometry (ICP/OES. Two types of butters, Caralluma munbayana and Caralluma hesperidum, Vigna (Vigna unguiculata, common fig (Ficus carica, Annona seeds (Annonaceae seeds, Annona fruits (Annonaceae fruits, Fennel (Foeniculum vulgare, and Fennel flowers (Nigella sativa were investigated, because they are used by indigenous groups as traditional medicines with Soxhlet-extraction and dry-ashing protocol. The estimated daily dietary element intake in food samples was further calculated in order to evaluate the element dietary intake and fruit and vegetable consumption pattern of the indigenes of Saudi Arabia. The crude oil and ash compositions varied widely, but suggested that most of the foods were good sources of oils and minerals. The figures-of-merit of the ICP-OES calibration curves were excellent with good linearity (R2 > 0.9921. The use of ICP-OES in this study allowed the accurate analysis and the detection of the elements at low levels. Essential elements (K, Ca, Na, and Mg had the highest concentrations while toxic heavy metals (As, Pb, and Cd had the lowest in the foods. Essential element pairs (Mg-Na, Mg-Ca, Fe-Al were highly correlated, suggesting that these foods are sources of multiple nutrients. Toxic element pairs (Pb-Cd, Pb-As, and Cd-As, however, were poorly correlated in the foods, suggesting that these elements do not have a common source in these foods. Average consumption of these foods should provide the recommended daily allowances of essential elements, but will not expose consumers to toxic heavy metals. The ICP-OES method was validated by determining method detection limits and percent recoveries of laboratory-fortified blanks, which were generally 90–100%.

  20. Research into microscopic structure and essential oils of endemic medicinal plant species Satureja subspicata Bartl. ex Vis. (Lamiaceae

    Directory of Open Access Journals (Sweden)

    Sulejman Redžić

    2008-05-01

    Full Text Available In this study we looked into the cells and histological organization of leaves (Saturejae folium as well as a phyto-chemical composition of overground parts (Saturejae herba of endemic species Satureja subspicata Bartl. ex Vis. (Lamiaceae collected during year 2003 on south slopes of mountain Velez in Herzegovina. Microscopic organization was analyzed in wet slides using light microscope. Estimation of stomata index was done according to Ph. Yug. IV. Chemical composition of overground material extracts was determined by thin layer chromatography (TLC using thymol as a reference. In our research we found the following: Leaf structure of the analyzed species Satureja subspicata points at numerous specificities in anatomical and histological sense. In histological sense, leaf is of ventral type, with differentiated upper and lower epidermis and palisade and spongy tissue in between. Stoma index assigned according to Ph. Yug. IV leads to a conclusion that it is the case of diastitic stomata, which is common feature of most species from Lamiaceae family. Comparative qualitative analysis of essential oils in species Satureja subspicata showed similarities with other species from Lamiaceae family such as Thymus L. (thymol. In fact, we found more common substances that are part of the species Satureja montana L. extract, but in different concentrations.

  1. Scotblood 2007: Tackling local and global issues in transfusion medicine - donor recruitment, effective use of blood, stem cell plasticity, and vCJD.

    Science.gov (United States)

    Bessos, Hagop; Fraser, Robin; Seghatchian, Jerard

    2008-02-01

    This commentary briefly highlights some of the local and the global contemporary issues affecting transfusion medicine worldwide. The main areas of focus addressed this year were: donor recruitment, stem cell plasticity, the effective use of blood, and vCJD.

  2. Urban-rural inequality regarding drug prescriptions in primary care facilities - a pre-post comparison of the National Essential Medicines Scheme of China.

    Science.gov (United States)

    Yao, Qiang; Liu, Chaojie; Ferrier, J Adamm; Liu, Zhiyong; Sun, Ju

    2015-07-30

    To assess the impact of the National Essential Medicines Scheme (NEMS) with respect to urban-rural inequalities regarding drug prescriptions in primary care facilities. A stratified two-stage random sampling strategy was used to sample 23,040 prescriptions from 192 primary care facilities from 2009 to 2010. Difference-in-Difference (DID) analyses were performed to test the association between NEMS and urban-rural gaps in prescription patterns. Between-Group Variance and Theil Index were calculated to measure urban-rural absolute and relative disparities in drug prescriptions. The use of the Essential Medicines List (EML) achieved a compliance rate of up to 90% in both urban and rural facilities. An overall reduction of average prescription cost improved economic access to drugs for patients in both areas. However, we observed an increased urban-rural disparity in average expenditure per prescription. The rate of antibiotics and glucocorticoids prescription remained high, despite a reduced disparity between urban and rural facilities. The average incidence of antibiotic prescription increased slightly in urban facilities (62 to 63%) and reduced in rural facilities (67% to 66%). The urban-rural disparity in the use of parenteral administration (injections and infusions) increased, albeit at a high level in both areas (44%-52%). NEMS interventions are effective in reducing the overall average prescription costs. Despite the increased use of the EML, indicator performances with respect to rational drug prescribing and use remain poor and exceed the WHO/INRUD recommended cutoff values and worldwide benchmarks. There is an increased gap between urban and rural areas in the use of parenteral administration and expenditure per prescription.

  3. Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets

    Directory of Open Access Journals (Sweden)

    Hochstadt Jenny

    2010-05-01

    Full Text Available Abstract Background Universal access to antiretroviral therapy (ART in low- and middle-income countries faces numerous challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral (ARV medicines, limited financing, and few fixed-dose combination (FDC products. Global initiatives aim to promote efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions. Methods We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to describe the market from 2002-2008. We examine relationships between market trends and: World Health Organization (WHO HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal and United States (US Food and Drug Administration (FDA approvals; and procurement policies of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM, US President's Emergency Plan for AIDS Relief (PEPFAR and UNITAID. Results WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively. 2009 guidelines replaced a stavudine-based regimen ($88/person/year with more expensive zidovudine- ($154-260/person/year or tenofovir-based ($244-465/person/year regimens. Purchase volumes for ARVs newly-recommended in 2006 (emtricitabine, tenofovir increased >15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only after FDA approval in 2006. Price trends for single-component generic medicines mirrored generic FDC prices. Two large-scale purchasers, PEPFAR and UNITAID, together accounted for 53%, 84%, and 77% of market volume for abacavir, emtricitabine, and tenofovir, respectively, in 2008. PEPFAR and UNITAID purchases were often split across two manufacturers. Conclusions Global initiatives

  4. Intervening in global markets to improve access to HIV/AIDS treatment: an analysis of international policies and the dynamics of global antiretroviral medicines markets.

    Science.gov (United States)

    Waning, Brenda; Kyle, Margaret; Diedrichsen, Ellen; Soucy, Lyne; Hochstadt, Jenny; Bärnighausen, Till; Moon, Suerie

    2010-05-25

    Universal access to antiretroviral therapy (ART) in low- and middle-income countries faces numerous challenges: increasing numbers of people needing ART, new guidelines recommending more expensive antiretroviral (ARV) medicines, limited financing, and few fixed-dose combination (FDC) products. Global initiatives aim to promote efficient global ARV markets, yet little is known about market dynamics and the impact of global policy interventions. We utilize several data sources, including 12,958 donor-funded, adult first-line ARV purchase transactions, to describe the market from 2002-2008. We examine relationships between market trends and: World Health Organization (WHO) HIV/AIDS treatment guidelines; WHO Prequalification Programme (WHO Prequal) and United States (US) Food and Drug Administration (FDA) approvals; and procurement policies of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM), US President's Emergency Plan for AIDS Relief (PEPFAR) and UNITAID. WHO recommended 7, 4, 24, and 6 first-line regimens in 2002, 2003, 2006 and 2009 guidelines, respectively. 2009 guidelines replaced a stavudine-based regimen ($88/person/year) with more expensive zidovudine- ($154-260/person/year) or tenofovir-based ($244-465/person/year) regimens. Purchase volumes for ARVs newly-recommended in 2006 (emtricitabine, tenofovir) increased >15-fold from 2006 to 2008. Twenty-four generic FDCs were quality-approved for older regimens but only four for newer regimens. Generic FDCs were available to GFATM recipients in 2004 but to PEPFAR recipients only after FDA approval in 2006. Price trends for single-component generic medicines mirrored generic FDC prices. Two large-scale purchasers, PEPFAR and UNITAID, together accounted for 53%, 84%, and 77% of market volume for abacavir, emtricitabine, and tenofovir, respectively, in 2008. PEPFAR and UNITAID purchases were often split across two manufacturers. Global initiatives facilitated the creation of fairly efficient markets

  5. Perceived impacts of the national essential medicines system: a cross-sectional survey of health workers in urban community health services in China.

    Science.gov (United States)

    Zhang, Tao; Liu, Chaojie; Ren, Jianping; Wang, Sheng; Huang, Xianhong; Guo, Qing

    2017-07-10

    This study aimed to investigate the perceptions of primary care workers about the impacts of the national essential medicines policy (NEMP). A cross-sectional questionnaire survey was undertaken in 42 urban community health centres randomly selected from four provinces in China. 791 primary care workers rated the impacts of the NEMP on a 5-point Likert scale. An average score for the impacts of the NEMP on four aspects (the practice of health workers, interactions of patients with health workers, operations of health centres and provision of medicines) was calculated, each ranging from 0 to 100. A higher score indicates a more positive rating. Linear regression models were established to determine the sociodemographic characteristics (region, age, gender, profession, training, income) that were associated with the ratings. The respondents gave an average rating score of 65.61±11.76, 63.17±13.62, 66.35±13.02 and 67.26±11.60 for the impacts of the NEMP on health workers, patients, health centres and provision of medicines, respectively. Respondents from the central region rated the NEMP higher than those from the eastern and western regions. The pharmacists (β=5.457~7.558, pimpacts (as perceived by the health workers) on health services delivery in primary care settings. However, the impacts of the NEMP vary by region, professional practice and the income level of health workers. It is important to maintain support from physicians through income subsidies (to compensate for potential loss) and training. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Localizing Global Medicine: Challenges and Opportunities in Cervical Screening in an Indigenous Community in Ecuador.

    Science.gov (United States)

    Nugus, Peter; Désalliers, Julie; Morales, Juana; Graves, Lisa; Evans, Andrea; Macaulay, Ann C

    2018-04-01

    This participatory research study examines the tensions and opportunities in accessing allopathic medicine, or biomedicine, in the context of a cervical cancer screening program in a rural indigenous community of Northern Ecuador. Focusing on the influence of social networks, the article extends research on "re-appropriation" of biomedicine. It does so by recognizing two competing tensions expressed through social interactions: suspicion of allopathic medicine and the desire to maximize one's health. Semistructured individual interviews and focus groups were conducted with 28 women who had previously participated in a government-sponsored cervical screening program. From inductive thematic analysis, the article traces these women's active agency in navigating coherent paths of health. Despite drawing on social networks to overcome formidable challenges, the participants faced enduring system obstacles-the organizational effects of the networks of allopathic medicine. Such obstacles need to be understood to reconcile competing knowledge systems and improve health care access in underresourced communities.

  7. Unexpected healers: Chinese medicine in the age of global migration (Lima and California, 1850-1930).

    Science.gov (United States)

    Palma, Patricia

    2018-03-01

    The massive waves of Chinese migrants arriving in California and Lima in the second half of the nineteenth century played a crucial role in expanding Chinese medicine in both settings. From the late 1860s on, herbalists expanded their healing system beyond their ethnic community, transforming Chinese medicine into one of the healing practices most widely adopted by the local population. This article uses a comparative approach to examine the diverging trajectories of Chinese healers in Peru and the USA, as well as the social and political factors that determined how this foreign medical knowledge adapted to its new environments.

  8. Impact of pharmacy worker training and deployment on access to essential medicines for children under five in Malawi: a cluster quasi-experimental evaluation.

    Science.gov (United States)

    Babigumira, Joseph B; Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy

    2017-09-11

    Poor access to essential medicines is common in many low- and middle-income countries, partly due to an insufficient and inadequately trained workforce to manage the medicines supply chain. We conducted a prospective impact evaluation of the training and deployment of pharmacy assistants (PAs) to rural health centers in Malawi. A quasi-experimental design was used to compare access to medicines in two districts where newly trained PAs were deployed to health centers (intervention) and two districts with no trained PAs at health centers (comparison). A baseline household survey and two annual post-intervention household surveys were conducted. We studied children under five years with a history of fever, cough and difficulty in breathing, and diarrhea in the previous two weeks. We collected data on access to antimalarials, antibiotics and oral rehydration salts (ORS) during the childrens' symptomatic periods. We used difference-in-differences regression models to estimate the impact of PA training and deployment on access to medicines. We included 3974 children across the three rounds of annual surveys: 1840 (46%) in the districts with PAs deployed at health centers and 2096 (53%) in districts with no PAs deployed at health centers. Approximately 80% of children had a fever, nearly 30% had a cough, and 43% had diarrhea in the previous two weeks. In the first year of the program, the presence of a PA led to a significant 74% increase in the odds of access to any antimalarial, and a significant 49% increase in the odds of access to artemisinin combination therapies. This effect was restricted to the first year post-intervention. There was no effect of presence of a PA on access to antibiotics or ORS. The training and deployment of pharmacy assistants to rural health centers in Malawi increased access to antimalarial medications over the first year, but the effect was attenuated over the second year. Pharmacy assistants training and deployment demonstrated no impact on

  9. The Globalization of Traditional Medicine in Northern Peru: From Shamanism to Molecules

    Science.gov (United States)

    Bussmann, Rainer W.

    2013-01-01

    Northern Peru represents the center of the Andean “health axis,” with roots going back to traditional practices of Cupisnique culture (1000 BC). For more than a decade of research, semistructured interviews were conducted with healers, collectors, and sellers of medicinal plants. In addition, bioassays were carried out to evaluate the efficacy and toxicity of plants found. Most of the 510 species encountered were native to Peru (83%). Fifty percent of the plants used in colonial times have disappeared from the pharmacopoeia. Market vendors specialized either on common and exotic plants, plants for common ailments, and plants only used by healers or on plants with magical purposes. Over 974 preparations with up to 29 different ingredients were used to treat 164 health conditions. Almost 65% of the medicinal plants were applied in these mixtures. Antibacterial activity was confirmed in most plants used for infections. Twenty-four percent of the aqueous extracts and 76% of the ethanolic extracts showed toxicity. Traditional preparation methods take this into account when choosing the appropriate solvent for the preparation of a remedy. The increasing demand for medicinal species did not increase the cultivation of medicinal plants. Most species are wild collected, causing doubts about the sustainability of trade. PMID:24454490

  10. Essentials of Periodontal Medicine in Preventive Medicine

    OpenAIRE

    Gulati, Minkle; Anand, Vishal; Jain, Nikil; Anand, Bhargavi; Bahuguna, Rohit; Govila, Vivek; Rastogi, Pavitra

    2013-01-01

    Influence of systemic disorders on periodontal diseases is well established. However, of growing interest is the effect of periodontal diseases on numerous systemic diseases or conditions like cardiovascular disease, cerebrovascular disease, diabetes, pre-term low birth weight babies, preeclampsia, respiratory infections and others including osteoporosis, cancer, rheumatoid arthritis, erectile dysfunction, Alzheimer′s disease, gastrointestinal disease, prostatitis, renal diseases, which has a...

  11. [Internal medicine and the holistic approach to the patient between globalization and advanced technologies].

    Science.gov (United States)

    Dammacco, Franco

    2012-06-01

    Although Internal Medicine (IM) has played for many years a crucial role in the medical education and in the diagnostic framing of the most common diseases, starting from the beginning of the 70's the knowledge explosion, the recognition of the multidisciplinary nature of IM and the consequent impossibility for the Internist to master an ever growing array of notions have resulted in the development of specialized disciplines restricted to pathologies of single organs or apparatus. The parcelling out of medical knowledge has thus induced the onset of a number of specializations stemmed from IM and, as a direct consequence, an identity crisis of the same IM. Social transformations and variations in the epidemiology of several diseases have contributed to such crisis, including aging, frailty and disability, polypathology and chronicity. In the last few years, however, IM has regained a central role in medicine, in that the Internist is an expert of "medicine of complexity" and the only specialist able to envisage an holistic approach to the patient. The development of biotechnologies, characterized on one side by nanotechnologies and on the other by the instruments of diagnostic imaging, has provided an important contribution to make clinical medicine more and more precise and reliable. The genomic analysis of novel pharmacological targets has opened new therapeutic horizons, especially in the oncology field. A striking aspect of modern medicine, again based on unreasonable expectations of improvement and recovery, is the progressive increment of malpractice claims leading to an indemnity payment. Defensive medicine has been the answer to face this growing problem: physicians are in fact induced to prescribe a much higher number of often unnecessary examinations and laboratory tests, that result in a wasting rise of health costs. In view of the rapidly changing reality, it seems fair to ask the question as to whether in our country the medical education is abreast

  12. Development and validation of a new global well-being outcomes rating scale for integrative medicine research

    Directory of Open Access Journals (Sweden)

    Bell Iris R

    2004-01-01

    Full Text Available Abstract Background Researchers are finding limitations of currently available disease-focused questionnaire tools for outcome studies in complementary and alternative medicine/integrative medicine (CAM/IM. Methods Three substudies investigated the new one-item visual analogue Arizona Integrative Outcomes Scale (AIOS, which assesses self-rated global sense of spiritual, social, mental, emotional, and physical well-being over the past 24 hours and the past month. The first study tested the scale's ability to discriminate unhealthy individuals (n = 50 from healthy individuals (n = 50 in a rehabilitation outpatient clinic sample. The second study examined the concurrent validity of the AIOS by comparing ratings of global well-being to degree of psychological distress as measured by the Brief Symptom Inventory (BSI in undergraduate college students (N = 458. The third study evaluated the relationships between the AIOS and positively- and negatively-valenced tools (Positive and Negative Affect Scale and the Positive States of Mind Scale in a different sample of undergraduate students (N = 62. Results Substudy (i Rehabilitation patients scored significantly lower than the healthy controls on both forms of the AIOS and a current global health rating. The AIOS 24-hours correlated moderately and significantly with global health (patients r = 0.50; controls r = 0.45. AIOS 1-month correlations with global health were stronger within the controls (patients r = 0.36; controls r = 0.50. Controls (r = 0.64 had a higher correlation between the AIOS 24-hour and 1-month forms than did the patients (r = 0.33, which is consistent with the presumptive improvement in the patients' condition over the previous 30 days in rehabilitation. Substudy (ii In undergraduate students, AIOS scores were inversely related to distress ratings, as measured by the global severity index on the BSI (rAIOS24h = -0.42, rAIOS1month = -0.40. Substudy (iii AIOS scores were significantly

  13. An Appeal to the Global Health Community for a Tripartite Innovation: An "Essential Diagnostics List," "Health in All Policies," and "See-Through 21(st) Century Science and Ethics".

    Science.gov (United States)

    Dove, Edward S; Barlas, I Ömer; Birch, Kean; Boehme, Catharina; Borda-Rodriguez, Alexander; Byne, William M; Chaverneff, Florence; Coşkun, Yavuz; Dahl, Marja-Liisa; Dereli, Türkay; Diwakar, Shyam; Elbeyli, Levent; Endrenyi, Laszlo; Eroğlu-Kesim, Belgin; Ferguson, Lynnette R; Güngör, Kıvanç; Gürsoy, Ulvi; Hekim, Nezih; Huzair, Farah; Kaushik, Kabeer; Kickbusch, Ilona; Kıroğlu, Olcay; Kolker, Eugene; Könönen, Eija; Lin, Biaoyang; Llerena, Adrian; Malhan, Faruk; Nair, Bipin; Patrinos, George P; Şardaş, Semra; Sert, Özlem; Srivastava, Sanjeeva; Steuten, Lotte M G; Toraman, Cengiz; Vayena, Effy; Wang, Wei; Warnich, Louise; Özdemir, Vural

    2015-08-01

    Diagnostics spanning a wide range of new biotechnologies, including proteomics, metabolomics, and nanotechnology, are emerging as companion tests to innovative medicines. In this Opinion, we present the rationale for promulgating an "Essential Diagnostics List." Additionally, we explain the ways in which adopting a vision for "Health in All Policies" could link essential diagnostics with robust and timely societal outcomes such as sustainable development, human rights, gender parity, and alleviation of poverty. We do so in three ways. First, we propose the need for a new, "see through" taxonomy for knowledge-based innovation as we transition from the material industries (e.g., textiles, plastic, cement, glass) dominant in the 20(th) century to the anticipated knowledge industry of the 21st century. If knowledge is the currency of the present century, then it is sensible to adopt an approach that thoroughly examines scientific knowledge, starting with the production aims, methods, quality, distribution, access, and the ends it purports to serve. Second, we explain that this knowledge trajectory focus on innovation is crucial and applicable across all sectors, including public, private, or public-private partnerships, as it underscores the fact that scientific knowledge is a co-product of technology, human values, and social systems. By making the value systems embedded in scientific design and knowledge co-production transparent, we all stand to benefit from sustainable and transparent science. Third, we appeal to the global health community to consider the necessary qualities of good governance for 21st century organizations that will embark on developing essential diagnostics. These have importance not only for science and knowledge-based innovation, but also for the ways in which we can build open, healthy, and peaceful civil societies today and for future generations.

  14. Global Advances in Health and Medicine Through Systems Biology: An Example From the Netherlands

    OpenAIRE

    van der Heijden, Marianne J.E.; Schroen, Yan

    2012-01-01

    Globally, healthcare systems are facing problems with increasing healthcare costs due to chronic diseases. Cardiovascular disease, cancer, diabetes, depression, and chronic lung disease are some of the top chronic diseases that put pressure on our healthcare systems and are very difficult to resolve. The chronic diseases mentioned are often lifestyle-related and require a personalized approach. The solutions that we currently have at hand seem to be insufficient in meeting the needs of the pa...

  15. The American Society of Clinical Oncology's Efforts to Support Global Cancer Medicine

    Science.gov (United States)

    El-Saghir, Nagi S.; Cufer, Tanja; Cazap, Eduardo; de Guzman, Roselle; Othieno-Abinya, Nicholas Anthony; Sanchez, Jose Angel; Pyle, Doug

    2016-01-01

    Despite much progress in the management of malignant diseases, the number of new cases and cancer-related deaths continues to rise around the world. More than half of new cases occur in economically developing countries, where more than two thirds of cancer deaths are expected. However, implementation of all necessary steps to accomplish the dissemination of state-of-the-art prevention, diagnosis, and management will require increased allocation of resources, and, more importantly, harmonization of the efforts of hundreds of national and international public health agencies, policy-setting bodies, governments, pharmaceutical companies, and philanthropic organizations. More than 30% of the members of the American Society of Clinical Oncology (ASCO) reside and practice outside US borders, and more than half of attendees at all of the scientific congresses and symposia organized by ASCO are international. As cancer has become an increasingly global disease, ASCO has evolved as a global organization. The ASCO Board of Directors currently includes members from France, Brazil, and Canada. In 2013, the ASCO Board of Directors identified a number of strategic priorities for the future. Recognizing the importance of non-US members to the society, their first strategic priority was improving the society's service to non-US members and defining these members' identity in the international oncology community. This article reviews current ASCO activities in the international arena and its future plans in global oncology. PMID:26578614

  16. Global strategies to reduce the price of antiretroviral medicines: evidence from transactional databases.

    Science.gov (United States)

    Waning, Brenda; Kaplan, Warren; King, Alexis C; Lawrence, Danielle A; Leufkens, Hubert G; Fox, Matthew P

    2009-07-01

    To estimate the impact of global strategies, such as pooled procurement arrangements, third-party price negotiation and differential pricing, on reducing the price of antiretrovirals (ARVs), which currently hinders universal access to HIV/AIDS treatment. We estimated the impact of global strategies to reduce ARV prices using data on 7253 procurement transactions (July 2002-October 2007) from databases hosted by WHO and the Global Fund to Fight AIDS, Tuberculosis and Malaria. For 19 of 24 ARV dosage forms, we detected no association between price and volume purchased. For the other five ARVs, high-volume purchases were 4-21% less expensive than medium- or low-volume purchases. Nine of 13 generic ARVs were priced 6-36% lower when purchased under the Clinton Foundation HIV/AIDS Initiative (CHAI). Fifteen of 18 branded ARVs were priced 23-498% higher for differentially priced purchases compared with non-CHAI generic purchases. However, two branded, differentially priced ARVs were priced 63% and 73% lower, respectively, than generic non-CHAI equivalents. Large purchase volumes did not necessarily result in lower ARV prices. Although current plans for pooled procurement will further increase purchase volumes, savings are uncertain and should be balanced against programmatic costs. Third-party negotiation by CHAI resulted in lower generic ARV prices. Generics were less expensive than differentially priced branded ARVs, except where little generic competition exists. Alternative strategies for reducing ARV prices, such as streamlining financial management systems, improving demand forecasting and removing barriers to generics, should be explored.

  17. Evolutionary history and leaf succulence as explanations for medicinal use in aloes and the global popularity of Aloe vera

    DEFF Research Database (Denmark)

    Grace, Olwen Megan; Buerki, Sven; Symonds, Matthew RE

    2015-01-01

    Background: Aloe vera supports a substantial global trade yet its wild origins, and explanations for its popularity over 500 related Aloe species in one of the world’s largest succulent groups, have remained uncertain. We developed an explicit phylogenetic framework to explore links between...... the rich traditions of medicinal use and leaf succulence in aloes. Results: The phylogenetic hypothesis clarifies the origins of Aloe vera to the Arabian Peninsula at the northernmost limits of the range for aloes. The genus Aloe originated in southern Africa ~16 million years ago and underwent two major...... succulence among aloes has yielded new explanations for the extraordinary market dominance of Aloe vera. The industry preference for Aloe vera appears to be due to its proximity to important historic trade routes, and early introduction to trade and cultivation. Well-developed succulent leaf mesophyll tissue...

  18. A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota

    DEFF Research Database (Denmark)

    Cantas, L.; Shah, Syed Q A; Cavaco, Lina

    2013-01-01

    The discovery and introduction of antimicrobial agents to clinical medicine was one of the greatest medical triumphs of the 20th century that revolutionized the treatment of bacterial infections. However, the gradual emergence of populations of antimicrobial-resistant pathogenic bacteria resulting...... from use, misuse, and abuse of antimicrobials has today become a major global health concern. Antimicrobial resistance (AMR) genes have been suggested to originate from environmental bacteria, as clinically relevant resistance genes have been detected on the chromosome of environmental bacteria....... As only a few new antimicrobials have been developed in the last decade, the further evolution of resistance poses a serious threat to public health. Urgent measures are required not only to minimize the use of antimicrobials for prophylactic and therapeutic purposes but also to look for alternative...

  19. Defining Essential Biodiversity Variables (EBVs) as a contribution to Essential Ocean Variables (EOVs): A Core Task of the Marine Biodiversity Observation Network (MBON) to Accelerate Integration of Biological Observations in the Global Ocean Observing System (GOOS)

    Science.gov (United States)

    Pearlman, J.; Muller-Karger, F. E.; Sousa Pinto, I.; Costello, M. J.; Duffy, J. E.; Appeltans, W.; Fischer, A. S.; Canonico, G.; Klein, E.; Obura, D.; Montes, E.; Miloslavich, P.; Howard, M.

    2017-12-01

    The Marine Biodiversity Observation Network (MBON) is a networking effort under the umbrella of the Group on Earth Observations Biodiversity Observation Network (GEO BON). The objective of the MBON is to link existing groups engaged in ocean observation and help define practical indices to deploy in an operational manner to track changes in the number of marine species, the abundance and biomass of marine organisms, the diverse interactions between organisms and the environment, and the variability and change of specific habitats of interest. MBON serves as the biodiversity arm of Blue Planet, the initiative of the Group on Earth Observations (GEO) for the benefit of society. The Global Ocean Observing System (GOOS) was established under the auspices of the Intergovernmental Oceanographic Commission (IOC) in 1991 to organize international ocean observing efforts. The mission of the GOOS is to support monitoring to improve the management of marine and coastal ecosystems and resources, and to enable scientific research. GOOS is engaged in a continuing, rigorous process of identifying Essential Ocean Variables (EOVs). MBON is working with GOOS and the Ocean Biogeographic Information System (OBIS, also under the IOC) to define Essential Biodiversity Variables (EBVs) as those Essential Ocean Variables (EOVs) that have explicit taxonomic records associated with them. For practical purposes, EBVs are a subset of the EOVs. The focus is to promote the integration of biological EOVs including EBVs into the existing and planned national and international ocean observing systems. The definition avoids a proliferation of 'essential' variables across multiple organizations. MBON will continue to advance practical and wide use of EBVs and related EOV. This is an effective way to contribute to several UN assessments (e.g., from IPBES, IPCC, and the World Ocean Assessment under the UN Regular Process), UN Sustainable Development Goals, and to address targets and goals defined under

  20. Franchise medicine: how I avoid being a commodity in a global market.

    Science.gov (United States)

    Constantinides, Minas

    2010-02-01

    As facial plastic surgery becomes more global, pressures for practices to become commoditized will increase. Commoditized practices are those in which price drives the quality of the product. Franchised surgical practices have also recently increased within the United States and abroad. These are always commoditized by their corporate philosophies. There are better ways to create value than to lower price to compete with a neighboring practice. By establishing a Transcendent Relationship of growth, both the surgeon and the patient are more satisfied with their facial plastic surgical experiences. Key tools helpful in predicting future directions for a practice, the Four Compass Points and the Average Best Patient, will be introduced. Thieme Medical Publishers.

  1. Globalization

    Directory of Open Access Journals (Sweden)

    Tulio Rosembuj

    2006-12-01

    Full Text Available There is no singular globalization, nor is the result of an individual agent. We could start by saying that global action has different angles and subjects who perform it are different, as well as its objectives. The global is an invisible invasion of materials and immediate effects.

  2. Globalization

    OpenAIRE

    Tulio Rosembuj

    2006-01-01

    There is no singular globalization, nor is the result of an individual agent. We could start by saying that global action has different angles and subjects who perform it are different, as well as its objectives. The global is an invisible invasion of materials and immediate effects.

  3. Double Standards in Global Health: Medicine, Human Rights Law and Multidrug-Resistant TB Treatment Policy.

    Science.gov (United States)

    Nicholson, Thomas; Admay, Catherine; Shakow, Aaron; Keshavjee, Salmaan

    2016-06-01

    The human rights arguments that underpinned the fight against HIV over the last three decades were poised, but ultimately failed, to provide a similar foundation for success against multidrug-resistant TB (MDR-TB) and other diseases of the poor. With more than 1.5 million deaths since 2000 attributed to strains of MDR-TB, and with half a million new, and mostly untreated, MDR-TB cases in the world each year, the stakes could not be higher. The World Health Organization (WHO), whose mandate is to champion the attainment by all peoples of the highest possible level of health, recommended unsound medical treatment for MDR-TB patients in resource-poor settings from 1993-2002. Citing cost considerations, WHO did not recommend the available standard of care that had been successfully used to contain and defeat MDR-TB in rich countries. By acting as a strategic gatekeeper in its technical advisory role to donor agencies and countries, it also facilitated the global implementation of a double standard for TB care in low- and middle-income countries (LMICs), upending important legal and scientific priorities. This raises serious questions about whether the organization violated international human rights standards and those established in its own constitution. While calling for additional analysis and discussion on this topic, the authors propose that policymakers should reject double standards of this kind and instead embrace the challenge of implementing the highest standard of care on a global level.

  4. Global view on the radiological protection of patients: Position paper by the World Federation of Nuclear Medicine and Biology

    International Nuclear Information System (INIS)

    Amaral, H.

    2001-01-01

    The World Federation of Nuclear Medicine and Biology (WFNMB) is an organization with 60 member countries that are represented by their national nuclear medicine societies and whose main aim is to promote the correct use of this form of medical specialization. Medical research must now comply with strict bioethics criteria that are applied almost universally. Factors such as social value, scientific validity, the risk/benefit ratio and respect for people participating in research are now indispensable in the design of any scientific project. One of the great advances in medicine and medical research has been the acceptance that obtaining the informed consent of people participating in the research is an essential requirement. This also means that we have to make sure that the individuals understand the aim of the study and are aware of its risks and potential benefits as well as the existence of possible alternatives. We are thus obliged to respect their free-dom of choice to participate in, or subject themselves to, a study on an entirely voluntary basis, and their complete freedom to leave a study if they so desire. I would like to take up one final point that relates to the rational use of resources. Until quite recently, it was thought that any lawfully available technological resource could be used, a view that was especially true in relation to medicine. Nowadays, however, there is a strong trend towards the view that the use of both diagnostic and therapeutic techniques must be based on scientific evidence of their usefulness. The empirical use of available resources, without some evidence justifying this use and without a favourable cost-benefit ratio, is no longer accepted as good practice. Conferences such as this one are undoubtedly the most serious manner in which we can tackle these problems, and the conclusions and recommendations we reach must be widely disseminated in the community. The medical applications of radiation have the greatest potential

  5. Proceedings of INC 02. International Nuclear Conference 2002: Global Trends and Perspectives, Seminar II: Medicine and Health

    International Nuclear Information System (INIS)

    2002-01-01

    The papers discuss the uses of radiations and radioisotopes in Medicine and Health, it included the area of nuclear medicine, biomedical radiography, radiopharmaceuticals; isotope production; cancer treatment, etc

  6. Disparities in availability of essential medicines to treat non-communicable diseases in Uganda: A Poisson analysis using the Service Availability and Readiness Assessment.

    Science.gov (United States)

    Armstrong-Hough, Mari; Kishore, Sandeep P; Byakika, Sarah; Mutungi, Gerald; Nunez-Smith, Marcella; Schwartz, Jeremy I

    2018-01-01

    Although the WHO-developed Service Availability and Readiness Assessment (SARA) tool is a comprehensive and widely applied survey of health facility preparedness, SARA data have not previously been used to model predictors of readiness. We sought to demonstrate that SARA data can be used to model availability of essential medicines for treating non-communicable diseases (EM-NCD). We fit a Poisson regression model using 2013 SARA data from 196 Ugandan health facilities. The outcome was total number of different EM-NCD available. Basic amenities, equipment, region, health facility type, managing authority, NCD diagnostic capacity, and range of HIV services were tested as predictor variables. In multivariate models, we found significant associations between EM-NCD availability and region, managing authority, facility type, and range of HIV services. For-profit facilities' EM-NCD counts were 98% higher than public facilities (p < .001). General hospitals and referral health centers had 98% (p = .004) and 105% (p = .002) higher counts compared to primary health centers. Facilities in the North and East had significantly lower counts than those in the capital region (p = 0.015; p = 0.003). Offering HIV care was associated with 35% lower EM-NCD counts (p = 0.006). Offering HIV counseling and testing was associated with 57% higher counts (p = 0.048). We identified multiple within-country disparities in availability of EM-NCD in Uganda. Our findings can be used to identify gaps and guide distribution of limited resources. While the primary purpose of SARA is to assess and monitor health services readiness, we show that it can also be an important resource for answering complex research and policy questions requiring multivariate analysis.

  7. A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota

    Directory of Open Access Journals (Sweden)

    Leon eCantas

    2013-05-01

    Full Text Available The discovery and introduction of antimicrobial agents to clinical medicine was one of the greatest medical triumphs of the 20th century that revolutionized the treatment of bacterial infections. However, the gradual emergence of populations of antimicrobial-resistant pathogenic bacteria resulting from use, misuse and abuse of antimicrobials has today become a major global health concern. Antimicrobial resistance genes have been suggested to originate from environmental bacteria, as clinically relevant resistance genes have been detected on the chromosome of environmental bacteria. As only a few new antimicrobials have been developed in the last decade, the further evolution of resistance poses a serious threat to public health. Urgent measures are required not only to minimize the use of antimicrobials for prophylactic and therapeutic purposes but also to look for alternative strategies for the control of bacterial infections. This review examines the global picture of antibacterial resistance, factors that favor its spread, strategies and limitations for its control and the need for continuous training of all stake-holders i.e. medical, veterinary, public health and other relevant professionals as well as human consumers of antibiotic drugs, in the appropriate use of antimicrobials.

  8. A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota

    Science.gov (United States)

    Cantas, L.; Shah, Syed Q. A.; Cavaco, L. M.; Manaia, C. M.; Walsh, F.; Popowska, M.; Garelick, H.; Bürgmann, H.; Sørum, H.

    2013-01-01

    The discovery and introduction of antimicrobial agents to clinical medicine was one of the greatest medical triumphs of the 20th century that revolutionized the treatment of bacterial infections. However, the gradual emergence of populations of antimicrobial-resistant pathogenic bacteria resulting from use, misuse, and abuse of antimicrobials has today become a major global health concern. Antimicrobial resistance (AMR) genes have been suggested to originate from environmental bacteria, as clinically relevant resistance genes have been detected on the chromosome of environmental bacteria. As only a few new antimicrobials have been developed in the last decade, the further evolution of resistance poses a serious threat to public health. Urgent measures are required not only to minimize the use of antimicrobials for prophylactic and therapeutic purposes but also to look for alternative strategies for the control of bacterial infections. This review examines the global picture of antimicrobial resistance, factors that favor its spread, strategies, and limitations for its control and the need for continuous training of all stake-holders i.e., medical, veterinary, public health, and other relevant professionals as well as human consumers, in the appropriate use of antimicrobial drugs. PMID:23675371

  9. Geographic trends in research output and citations in veterinary medicine: insight into global research capacity, species specialization, and interdisciplinary relationships

    Science.gov (United States)

    2013-01-01

    in most other regions and countries. Conclusions Bibliographic data reflect the demographic changes affecting veterinary medicine worldwide and provide insight into current and changing global research capacity, specialization, and interdisciplinary affiliations. A more detailed analysis of species-specific trends is warranted and could contribute to a better understanding of educational and workforce needs in veterinary medicine. PMID:23758872

  10. Evaluating the Past, Present, and Future of Regenerative Medicine: A Global View.

    Science.gov (United States)

    Ronfard, Vincent; Vertès, Alain A; May, Michael H; Dupraz, Anne; van Dyke, Mark E; Bayon, Yves

    2017-04-01

    "Evaluating the Past and Present of Regenerative Medicine (RM)" was the first part of an Industry Symposium dedicated to the subject during the 2015 TERMIS World Congress in Boston. This working session presented a critical review of the current RM landscape in Europe and North America with possible projections for the future. Interestingly, the RM development cycle seems to obey the Gartner hype cycle, now at the enlightenment phase, after past exaggerated expectations and discouragements, as suggested by increasing numbers of clinical trials and recent market approvals of RM solutions in both Europe (Glybera and Holoclar ® from Chiesi Pharma and Strimvelis ® from GSK) and Japan (Remestemcel-L from Mesoblast ® ). The successful commercial translation of RM research is governed by five major drivers: (i) fully validated manufacturing capability for autologous or allogeneic products, (ii) reimbursement for targeted clinical indications with high and demonstrable medico-economic benefits versus standard of care, (iii) implication of regulatory bodies in the design and development plan of any RM solution, which should be well characterized, robust, with proven consistent efficacy and an acceptable and controlled positive benefit/risk ratio, (iv) collaborations facilitated by multicompetence hubs/consortia of excellence, (v) well-thought-out clinical development plans for reducing the risk of failure. Benefiting from past and present experience, the RM burgeoning industry is expected to accelerate the market release of cost-effective RM products with real curative potential for specific clinical indications with high unmet needs. This should be achieved by wisely leveraging all possible synergies of the different stakeholders, for example, patients, clinicians, reimbursement and health technology assessment (HTA) agencies, regulatory authorities, public/private investors, academia, and companies.

  11. Unpredictable, unpreventable and impersonal medicine: global disaster response in the 21st century.

    Science.gov (United States)

    Andrews, Russell J; Quintana, Leonidas M

    2015-01-01

    The United Nations has recognized the devastating consequences of "unpredictable, unpreventable and impersonal" disasters-at least US $2 trillion in economic damage and more than 1.3 million lives lost from natural disasters in the last two decades alone. In many disasters (both natural and man-made) hundreds-and in major earthquakes, thousands-of lives are lost in the first days following the event because of the lack of medical/surgical facilities to treat those with potentially survivable injuries. Disasters disrupt and destroy not only medical facilities in the disaster zone but also infrastructure (roads, airports, electricity) and potentially local healthcare personnel as well. To minimize morbidity and mortality from disasters, medical treatment must begin immediately, within minutes ideally, but certainly within 24 h (not the days to weeks currently seen in medical response to disasters). This requires that all resources-medical equipment and support, and healthcare personnel-be portable and readily available; transport to the disaster site will usually require helicopters, as military medical response teams in developed countries have demonstrated. Some of the resources available and in development for immediate medical response for disasters-from portable CT scanners to telesurgical capabilities-are described. For immediate deployment, these resources-medical equipment and personnel-must be ready for deployment on a moment's notice and not require administrative approvals or bureaucratic authorizations from numerous national and international agencies, as is presently the case. Following the "trauma center/stroke center" model, disaster response incorporating "disaster response centers" would be seamlessly integrated into the ongoing daily healthcare delivery systems worldwide, from medical education and specialty training (resident/registrar) to acute and subacute intensive care to long-term rehabilitation. The benefits of such a global disaster

  12. Globalization

    OpenAIRE

    Andru?cã Maria Carmen

    2013-01-01

    The field of globalization has highlighted an interdependence implied by a more harmonious understanding determined by the daily interaction between nations through the inducement of peace and the management of streamlining and the effectiveness of the global economy. For the functioning of the globalization, the developing countries that can be helped by the developed ones must be involved. The international community can contribute to the institution of the development environment of the gl...

  13. Global advances in health and medicine through systems biology: an example from the Netherlands.

    Science.gov (United States)

    van der Heijden, Marianne J E; Schroen, Yan

    2012-09-01

    Globally, healthcare systems are facing problems with increasing healthcare costs due to chronic diseases. Cardiovascular disease, cancer, diabetes, depression, and chronic lung disease are some of the top chronic diseases that put pressure on our healthcare systems and are very difficult to resolve. The chronic diseases mentioned are often lifestyle-related and require a personalized approach. The solutions that we currently have at hand seem to be insufficient in meeting the needs of the patients and of our healthcare systems: the cracks in our systems are showing. Patients with chronic illness and multimorbidity find themselves caught in a web of referrals between medical specialists and conflicting treatment plans. As a result, they are consuming a lot of healthcare without actually reaching their goal: attaining the most optimal quality of life and the least physical burden possible. In short, mechanisms that previously functioned perfectly must now be replaced by new approaches. The supply of the healthcare system no longer meets the demands of society.

  14. Pharmacogenomics and Global Precision Medicine in the Context of Adverse Drug Reactions: Top 10 Opportunities and Challenges for the Next Decade.

    Science.gov (United States)

    Alessandrini, Marco; Chaudhry, Mamoonah; Dodgen, Tyren M; Pepper, Michael S

    2016-10-01

    In a move indicative of the enthusiastic support of precision medicine, the U.S. President Barack Obama announced the Precision Medicine Initiative in January 2015. The global precision medicine ecosystem is, thus, receiving generous support from the United States ($215 million), and numerous other governments have followed suit. In the context of precision medicine, drug treatment and prediction of its outcomes have been important for nearly six decades in the field of pharmacogenomics. The field offers an elegant solution for minimizing the effects and occurrence of adverse drug reactions (ADRs). The Clinical Pharmacogenetics Implementation Consortium (CPIC) plays an important role in this context, and it aims at specifically guiding the translation of clinically relevant and evidence-based pharmacogenomics research. In this forward-looking analysis, we make particular reference to several of the CPIC guidelines and their role in guiding the treatment of highly relevant diseases, namely cardiovascular disease, major depressive disorder, cancer, and human immunodeficiency virus, with a view to predicting and managing ADRs. In addition, we provide a list of the top 10 crosscutting opportunities and challenges facing the fields of precision medicine and pharmacogenomics, which have broad applicability independent of the drug class involved. Many of these opportunities and challenges pertain to infrastructure, study design, policy, and science culture in the early 21st century. Ultimately, rational pharmacogenomics study design and the acquisition of comprehensive phenotypic data that proportionately match the genomics data should be an imperative as we move forward toward global precision medicine.

  15. Global landscape assessment of screening technologies for medicine quality assurance: stakeholder perceptions and practices from ten countries.

    Science.gov (United States)

    Roth, Lukas; Nalim, Ameena; Turesson, Beth; Krech, Laura

    2018-04-25

    The spread of substandard and falsified (SF) medical products constitutes a growing global public health concern. Some countries use portable, handheld screening technologies (STs) in the field to accelerate detection of SF medicines and reduce the number of medicine samples that undergo costly and time-consuming confirmatory analysis. A multi-country, multi-stakeholder landscape assessment utilizing qualitative methodology was used to examine practices and perceptions related to the use of STs. Qualitative interview guides were designed using the results of a literature review and comprised of open-ended questions with the study participants, who were from national medicine regulatory authorities, pharmaceutical manufacturers, pharmacies, and distributors. Ten geographically and economically diverse countries were selected: Argentina, China, Egypt, India, Jordan, Mexico, Nigeria, Philippines, the United States, and Zimbabwe. Of the completed 53 interviews, 32 were in-person, 16 were phone interviews, and 5 were via written questionnaires. Data analysis shows a wide variation in understanding and usage of STs in different sectors. Virtually all of the study participants indicated a lack of objective, accessible information on STs to advise them on what technologies would be beneficial for their needs. Study participants also described their ideal capabilities of the next generation of STs, including shareable spectral libraries, lower acquisition costs, lesser training requirements, and in-country maintenance and technical support. The results and recommendations presented in this article can be used to help regulators communicate and justify their needs to acquire and invest in new STs. There is a need for additional standardized, trustworthy and scientifically sound evaluations of STs, and to support regulators to effectively deploy the most promising technologies. ST manufacturers can take into account some of the limitations of the technologies the interviewees

  16. Study of some Ayurvedic Indian medicinal plants for the essential trace elemental contents by instrumental neutron activation analysis and atomic absorption spectroscopy techniques

    International Nuclear Information System (INIS)

    Lokhande, R.S.; Singare, P.U.; Andhele, M.L.; Acharya, R.; Nair, A.G.C.; Reddy, A.V.R.

    2009-01-01

    Elemental analysis of some medicinal plants used in the Indian Ayurvedic system was performed by employing instrumental neutron activation analysis (INAA) and atomic absorption spectroscopy (AAS) techniques. The samples were irradiated with thermal neutrons in a nuclear reactor and the induced activity was counted by gamma ray spectrometry using an efficiency calibrated high resolution high purity germanium (HPGe) detector. Most of the medicinal plants were found to be rich in one or more of the elements under study. The variation in elemental concentration in same medicinal plants samples collected in summer, winter and rainy seasons was studied and the biological effects of these elements on human beings are discussed. (orig.)

  17. Essentials of 3D biofabrication and translation

    CERN Document Server

    Atala, Anthony

    2015-01-01

    Essentials of 3D Biofabrication and Translation discusses the techniques that are making bioprinting a viable alternative in regenerative medicine. The book runs the gamut of topics related to the subject, including hydrogels and polymers, nanotechnology, toxicity testing, and drug screening platforms, also introducing current applications in the cardiac, skeletal, and nervous systems, and organ construction. Leaders in clinical medicine and translational science provide a global perspective of the transformative nature of this field, including the use of cells, biomaterials, and macromolecules to create basic building blocks of tissues and organs, all of which are driving the field of biofabrication to transform regenerative medicine. Provides a new and versatile method to fabricating living tissue Discusses future applications for 3D bioprinting technologies, including use in the cardiac, skeletal, and nervous systems, and organ construction Describes current approaches and future challenges for translation...

  18. Globalization

    DEFF Research Database (Denmark)

    Plum, Maja

    Globalization is often referred to as external to education - a state of affair facing the modern curriculum with numerous challenges. In this paper it is examined as internal to curriculum; analysed as a problematization in a Foucaultian sense. That is, as a complex of attentions, worries, ways...... of reasoning, producing curricular variables. The analysis is made through an example of early childhood curriculum in Danish Pre-school, and the way the curricular variable of the pre-school child comes into being through globalization as a problematization, carried forth by the comparative practices of PISA...

  19. Globalization

    OpenAIRE

    F. Gerard Adams

    2008-01-01

    The rapid globalization of the world economy is causing fundamental changes in patterns of trade and finance. Some economists have argued that globalization has arrived and that the world is “flat†. While the geographic scope of markets has increased, the author argues that new patterns of trade and finance are a result of the discrepancies between “old†countries and “new†. As the differences are gradually wiped out, particularly if knowledge and technology spread worldwide, the t...

  20. Quality of generic medicines in South Africa

    DEFF Research Database (Denmark)

    Patel, Aarti; Gauld, Robin; Norris, Pauline

    2012-01-01

    Generic Medicines are an important policy option allowing for access to affordable, essential medicines. Quality of generic medicines must be guaranteed through the activities of national medicines regulatory authorities. Existing negative perceptions surrounding the quality of generic medicines ...

  1. Global Land Product Validation Protocols: An Initiative of the CEOS Working Group on Calibration and Validation to Evaluate Satellite-derived Essential Climate Variables

    Science.gov (United States)

    Guillevic, P. C.; Nickeson, J. E.; Roman, M. O.; camacho De Coca, F.; Wang, Z.; Schaepman-Strub, G.

    2016-12-01

    The Global Climate Observing System (GCOS) has specified the need to systematically produce and validate Essential Climate Variables (ECVs). The Committee on Earth Observation Satellites (CEOS) Working Group on Calibration and Validation (WGCV) and in particular its subgroup on Land Product Validation (LPV) is playing a key coordination role leveraging the international expertise required to address actions related to the validation of global land ECVs. The primary objective of the LPV subgroup is to set standards for validation methods and reporting in order to provide traceable and reliable uncertainty estimates for scientists and stakeholders. The Subgroup is comprised of 9 focus areas that encompass 10 land surface variables. The activities of each focus area are coordinated by two international co-leads and currently include leaf area index (LAI) and fraction of absorbed photosynthetically active radiation (FAPAR), vegetation phenology, surface albedo, fire disturbance, snow cover, land cover and land use change, soil moisture, land surface temperature (LST) and emissivity. Recent additions to the focus areas include vegetation indices and biomass. The development of best practice validation protocols is a core activity of CEOS LPV with the objective to standardize the evaluation of land surface products. LPV has identified four validation levels corresponding to increasing spatial and temporal representativeness of reference samples used to perform validation. Best practice validation protocols (1) provide the definition of variables, ancillary information and uncertainty metrics, (2) describe available data sources and methods to establish reference validation datasets with SI traceability, and (3) describe evaluation methods and reporting. An overview on validation best practice components will be presented based on the LAI and LST protocol efforts to date.

  2. GLOBAL OPIOID EPIDEMIC: DOOMED TO FAIL WITHOUT GENETICALLY BASED PRECISION ADDICTION MEDICINE (PAM™): LESSONS LEARNED FROM AMERICA.

    Science.gov (United States)

    Blum, Kenneth; Modestino, Edward J; Gondré-Lewis, Marjorie C; Neary, Jennifer; Siwicki, David; Hauser, Mary; Barh, Debmalya; Steinberg, Bruce; Badgaiyan, Rajendra D

    2017-01-01

    It is a reality that globally opioid deaths have soared for men and women of all social, economic status and age from heroin and fentanyl overdoses. Specifically, in the United States, deaths from narcotic overdoses have reached alarming metrics since 2010. In fact, the Fentanyl rise is driven by drug dealers who sell it as heroin or who use it to lace cocaine or to make illegal counterfeit prescription opioids. The President's Commission on the crisis has linked the death toll as equivalent to "September 11th every three weeks." In fact, The U.S. Centre for Disease Control (CDC) released data showing that opioid-related overdoses were up 15% in the first three quarters of 2016 compared to 2015. Various governmental organizations including NIDA, are actively seeking solutions. However, we argue that unless the scientific community embraces genetic addiction risk coupled with potential precision or personalized medicine to induce "dopamine homeostasis" it will fail. We now have evidence that a ten-gene and eleven single nucleotide polymorphism (SNP) panel predicts Addiction Severity Index (ASI) for both alcohol and drugs of abuse (e.g., Opioids). In a large multi-addiction centre study involving seven diverse treatment programs, the genetic addiction risk score (GARS ™ ) was shown to have a predictive relationship with ASI-MV derived alcohol (≥ seven alleles), and other drugs (≥ 4 alleles) severity risk scores. In a number of neuroimaging studies, we also display that in both animal (bench) and abstinent Chinese severe heroin-dependent patients (bedside), BOLD dopamine activation across the brain reward circuitry revealed increases in resting state functional connectivity as well volume connectivity. It is also known that published nutrigenomic (coupling gene polymorphisms with altered KB220z) studies reveal improved clinical outcomes related to obesity.

  3. The Joint Committee for Traceability in Laboratory Medicine (JCTLM): A Global Approach to Promote the Standardisation of Clinical Laboratory Test Results

    OpenAIRE

    Armbruster, David; Miller, Richard R

    2007-01-01

    Clinical laboratories are moving towards global standardisation to produce equivalent test results across space and time. Standardisation allows use of evidence-based medicine, eliminates the need of method-specific reference intervals, decision levels and cut-offs, and can be achieved by application of metrological principles. For example, in vitro diagnostics (IVD) manufacturers can make kit calibrators traceable to internationally recognised reference materials and reference methods.

  4. Report on the Medicinal Use of Eleven Lamiaceae Species in Lebanon and Rationalization of Their Antimicrobial Potential by Examination of the Chemical Composition and Antimicrobial Activity of Their Essential Oils.

    Science.gov (United States)

    Khoury, Madona; Stien, Didier; Eparvier, Véronique; Ouaini, Naïm; El Beyrouthy, Marc

    2016-01-01

    Many Lamiaceae species are consumed in the Lebanese cuisine as food or condiment and are largely used in the traditional medicine of Lebanon to treat various diseases, including microbial infections. In this article we report the traditional medicinal uses of eleven Lamiaceae species: Coridothymus capitatus L., Lavandula stoechas L., Lavandula angustifolia Mill., Mentha spicata L. subsp. condensata , Origanum syriacum L., Rosmarinus officinalis , Salvia fruticosa Miller., Satureja cuneifolia Ten., Satureja thymbra L., Thymbra spicata L., and Vitex agnus-castus L. and study the chemical composition and antimicrobial activity of their essential oils (EOs). Our survey showed that Lamiaceae species are mainly used against gastrointestinal disorders and microbial infections. Chemical analysis of the EOs obtained from these plants allowed us to identify seventy-five compounds describing more than 90% of the relative composition of each EO. Essential oils with high amounts of thymol and carvacrol possessed the strongest antimicrobial activity. As expected, these two compounds demonstrated an interesting antifungal efficacy against the filamentous fungus T. rubrum . Our results confirmed that some of the Lamiaceae species used in Lebanon ethnopharmacological practices as antimicrobial agents do possess antibacterial and antifungal potential consistent with their use in alternative or complementary medicine.

  5. Report on the Medicinal Use of Eleven Lamiaceae Species in Lebanon and Rationalization of Their Antimicrobial Potential by Examination of the Chemical Composition and Antimicrobial Activity of Their Essential Oils

    Science.gov (United States)

    Khoury, Madona; Eparvier, Véronique; Ouaini, Naïm

    2016-01-01

    Many Lamiaceae species are consumed in the Lebanese cuisine as food or condiment and are largely used in the traditional medicine of Lebanon to treat various diseases, including microbial infections. In this article we report the traditional medicinal uses of eleven Lamiaceae species: Coridothymus capitatus L., Lavandula stoechas L., Lavandula angustifolia Mill., Mentha spicata L. subsp. condensata, Origanum syriacum L., Rosmarinus officinalis, Salvia fruticosa Miller., Satureja cuneifolia Ten., Satureja thymbra L., Thymbra spicata L., and Vitex agnus-castus L. and study the chemical composition and antimicrobial activity of their essential oils (EOs). Our survey showed that Lamiaceae species are mainly used against gastrointestinal disorders and microbial infections. Chemical analysis of the EOs obtained from these plants allowed us to identify seventy-five compounds describing more than 90% of the relative composition of each EO. Essential oils with high amounts of thymol and carvacrol possessed the strongest antimicrobial activity. As expected, these two compounds demonstrated an interesting antifungal efficacy against the filamentous fungus T. rubrum. Our results confirmed that some of the Lamiaceae species used in Lebanon ethnopharmacological practices as antimicrobial agents do possess antibacterial and antifungal potential consistent with their use in alternative or complementary medicine. PMID:28053641

  6. Report on the Medicinal Use of Eleven Lamiaceae Species in Lebanon and Rationalization of Their Antimicrobial Potential by Examination of the Chemical Composition and Antimicrobial Activity of Their Essential Oils

    Directory of Open Access Journals (Sweden)

    Madona Khoury

    2016-01-01

    Full Text Available Many Lamiaceae species are consumed in the Lebanese cuisine as food or condiment and are largely used in the traditional medicine of Lebanon to treat various diseases, including microbial infections. In this article we report the traditional medicinal uses of eleven Lamiaceae species: Coridothymus capitatus L., Lavandula stoechas L., Lavandula angustifolia Mill., Mentha spicata L. subsp. condensata, Origanum syriacum L., Rosmarinus officinalis, Salvia fruticosa Miller., Satureja cuneifolia Ten., Satureja thymbra L., Thymbra spicata L., and Vitex agnus-castus L. and study the chemical composition and antimicrobial activity of their essential oils (EOs. Our survey showed that Lamiaceae species are mainly used against gastrointestinal disorders and microbial infections. Chemical analysis of the EOs obtained from these plants allowed us to identify seventy-five compounds describing more than 90% of the relative composition of each EO. Essential oils with high amounts of thymol and carvacrol possessed the strongest antimicrobial activity. As expected, these two compounds demonstrated an interesting antifungal efficacy against the filamentous fungus T. rubrum. Our results confirmed that some of the Lamiaceae species used in Lebanon ethnopharmacological practices as antimicrobial agents do possess antibacterial and antifungal potential consistent with their use in alternative or complementary medicine.

  7. Antimycobacterial natural products from Moroccan medicinal plants: Chemical composition, bacteriostatic and bactericidal profile of Thymus satureioides and Mentha pulegium essential oils

    Directory of Open Access Journals (Sweden)

    Marwa Chraibi

    2016-10-01

    Conclusions: It is clearly evident from the results obtained that the Moroccan medicinal plants have great potential to be used as anti-tuberculosis agents. These findings may help scientists to undertake several research projects to discover useful natural product as new anti-tuberculosis drug.

  8. Global medicine: Is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

    Science.gov (United States)

    2013-01-01

    Background Doctor and healthcare worker (HCW) strikes are a global phenomenon with the potential to negatively impact on the quality of healthcare services and the doctor-patient relationship. Strikes are a legitimate deadlock breaking mechanism employed when labour negotiations have reached an impasse during collective bargaining. Striking doctors usually have a moral dilemma between adherence to the Hippocratic tenets of the medical profession and fiduciary obligation to patients. In such circumstances the ethical principles of respect for autonomy, justice and beneficence all come into conflict, whereby doctors struggle with their role as ordinary employees who are rightfully entitled to a just wage for just work versus their moral obligations to patients and society. Discussion It has been argued that to deny any group of workers, including "essential workers" the right to strike is akin to enslavement which is ethically and morally indefensible. While HCW strikes occur globally, the impact appears more severe in developing countries challenged by poorer socio-economic circumstances, embedded infrastructural deficiencies, and lack of viable alternative means of obtaining healthcare. These communities appear to satisfy the criteria for vulnerability and may be deserving of special ethical consideration when doctor and HCW strikes are contemplated. Summary The right to strike is considered a fundamental right whose derogation would be inimical to the proper functioning of employer/employee collective bargaining in democratic societies. Motivations for HCW strikes include the natural pressure to fulfil human needs and the paradigm shift in modern medical practice, from self-employment and benevolent paternalism, to managed healthcare and consumer rights. Minimizing the incidence and impact of HCW strikes will require an ethical approach from all stakeholders, and recognition that all parties have an equal moral obligation to serve the best interests of society

  9. Global medicine: is it ethical or morally justifiable for doctors and other healthcare workers to go on strike?

    Science.gov (United States)

    Chima, Sylvester C

    2013-01-01

    Doctor and healthcare worker (HCW) strikes are a global phenomenon with the potential to negatively impact on the quality of healthcare services and the doctor-patient relationship. Strikes are a legitimate deadlock breaking mechanism employed when labour negotiations have reached an impasse during collective bargaining. Striking doctors usually have a moral dilemma between adherence to the Hippocratic tenets of the medical profession and fiduciary obligation to patients. In such circumstances the ethical principles of respect for autonomy, justice and beneficence all come into conflict, whereby doctors struggle with their role as ordinary employees who are rightfully entitled to a just wage for just work versus their moral obligations to patients and society. It has been argued that to deny any group of workers, including "essential workers" the right to strike is akin to enslavement which is ethically and morally indefensible. While HCW strikes occur globally, the impact appears more severe in developing countries challenged by poorer socio-economic circumstances, embedded infrastructural deficiencies, and lack of viable alternative means of obtaining healthcare. These communities appear to satisfy the criteria for vulnerability and may be deserving of special ethical consideration when doctor and HCW strikes are contemplated. The right to strike is considered a fundamental right whose derogation would be inimical to the proper functioning of employer/employee collective bargaining in democratic societies. Motivations for HCW strikes include the natural pressure to fulfil human needs and the paradigm shift in modern medical practice, from self-employment and benevolent paternalism, to managed healthcare and consumer rights. Minimizing the incidence and impact of HCW strikes will require an ethical approach from all stakeholders, and recognition that all parties have an equal moral obligation to serve the best interests of society. Employers should implement

  10. Radiation in medicine: Origins, risks and aspirations.

    Science.gov (United States)

    Donya, Mohamed; Radford, Mark; ElGuindy, Ahmed; Firmin, David; Yacoub, Magdi H

    2014-01-01

    The use of radiation in medicine is now pervasive and routine. From their crude beginnings 100 years ago, diagnostic radiology, nuclear medicine and radiation therapy have all evolved into advanced techniques, and are regarded as essential tools across all branches and specialties of medicine. The inherent properties of ionizing radiation provide many benefits, but can also cause potential harm. Its use within medical practice thus involves an informed judgment regarding the risk/benefit ratio. This judgment requires not only medical knowledge, but also an understanding of radiation itself. This work provides a global perspective on radiation risks, exposure and mitigation strategies.

  11. The role of global traditional and complementary systems of medicine in the treatment of mental health disorders.

    Science.gov (United States)

    Gureje, Oye; Nortje, Gareth; Makanjuola, Victor; Oladeji, Bibilola D; Seedat, Soraya; Jenkins, Rachel

    2015-02-01

    Traditional and complementary systems of medicine include a broad range of practices, which are commonly embedded in cultural milieus and reflect community beliefs, experiences, religion, and spirituality. Two major components of this system are discernible: complementary alternative medicine and traditional medicine, with different clientele and correlates of patronage. Evidence from around the world suggests that a traditional or complementary system of medicine is commonly used by a large number of people with mental illness. Practitioners of traditional medicine in low-income and middle-income countries fill a major gap in mental health service delivery. Although some overlap exists in the diagnostic approaches of traditional and complementary systems of medicine and conventional biomedicine, some major differences exist, largely in the understanding of the nature and cause of mental disorders. Treatments used by providers of traditional and complementary systems of medicine, especially traditional and faith healers in low-income and middle-income countries, might sometimes fail to meet widespread understandings of human rights and humane care. Nevertheless, collaborative engagement between traditional and complementary systems of medicine and conventional biomedicine might be possible in the care of people with mental illness. The best model to bring about that collaboration will need to be established by the needs of the extant mental health system in a country. Research is needed to provide an empirical basis for the feasibility of such collaboration, to clearly delineate its boundaries, and to test its effectiveness in bringing about improved patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. David Bowie and the Art of Slow Innovation: A Fast-Second Winner Strategy for Biotechnology and Precision Medicine Global Development.

    Science.gov (United States)

    Özdemir, Vural; Patrinos, George P

    2017-11-01

    Original ideas and innovation cannot always be ordered like a courier service and delivered fresh to our desk at 9 am. Yet, most creativity-based organizations, careers, and professions, science and biotechnology innovation included, emphasize the speed as the prevailing ideology. But a narrow focus on speed has several and overlooked shortcomings. For example, it does not offer the opportunity to draw from, and stitch together disparate concepts and practices for truly disruptive innovation. Preventing false starts, learning from others' or our own mistakes, and customizing innovations for local community needs are difficult in a speed-hungry innovation ecosystem. We introduce a new strategy, the Fast-Second Winner, specifically in relation to global development of biotechnologies and precision medicine. This à la carte global development strategy envisions a midstream entry into the innovation ecosystem. Moreover, we draw from the works of the late David Bowie who defied rigid classifications as an artist and prolific innovator, and introduce the concept and practice of slow innovation that bodes well with the Fast-Second Winner strategy. A type of slow innovation, the Fast-Second Winner is actually fast and sustainable in the long term, and efficient by reducing false starts in new precision medicine application contexts and geographies, learning from other innovators' failures, and shaping innovations for the local community needs. The establishment of Centers for Fast-Second Innovation (CFSIs), and their funding, for example, by crowdfunding and other innovative mechanisms, could be timely for omics and precision medicine global development. If precision medicine is about tailoring drug treatments and various health interventions to individuals, we suggest to start from tailoring new ideas, and focus not only on how much we innovate but also what and how we innovate. In principle, the Fast-Second Winner can be applied to omics and other biotechnology

  13. Future of palliative medicine

    Directory of Open Access Journals (Sweden)

    Sushma Bhatnagar

    2015-01-01

    Full Text Available A ′need-supply′ and ′requirement-distribution mismatch′ along with a continuingneed explosion are the biggest hurdles faced by palliative medicine today. It is the need of the hour to provide an unbiased, equitable and evidence-based palliative care to those in need irrespective of the diagnosis, prognosis, social and economic status or geographical location. Palliative care as a fundamental human right, ensuring provision throughout the illness spectrum, global as well as region-specific capacity building, uniform availability of essential drugs at an affordable price, a multidisciplinary team approachand caregiver-support are some of the achievable goals for the future. This supplanted with a strong political commitment, professional dedication and ′public-private partnerships′ are necessaryto tackle the existing hurdles and the exponentially increasing future need. For effectively going ahead it is of utmost importance to integrate palliative medicine into medical education, healthcare system and societal framework.

  14. Essentials of Risk Theory

    NARCIS (Netherlands)

    Roeser, S.; Hillerbrand, R.; Sandin, P.; Peterson, M.B.

    2012-01-01

    Risk has become one of the main topics in fields as diverse as engineering, medicine and economics, and it is also studied by social scientists, psychologists and legal scholars. This Springer Essentials version offers an overview of the in-depth handbook and highlights some of the main points

  15. Caracterização de demandas judiciais de fornecimento de medicamentos "essenciais" no Estado do Rio de Janeiro, Brasil Characterization of lawsuits for the supply of "essential" medicines in the State of Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Edais Pepe

    2010-03-01

    Full Text Available O reconhecimento do direito à saúde possui duas repercussões práticas: a responsabilidade ética e legal do poder público em assegurar atenção integral à saúde da população, e a possibilidade de o cidadão reivindicar judicialmente o cumprimento desta obrigação estatal. Este estudo objetivou pesquisar as demandas de medicamentos considerados essenciais nas decisões da 2ª instância do Tribunal de Justiça do Estado do Rio de Janeiro, Brasil, em 2006. Foram analisados 185 processos e em três casos o pedido foi negado. Os tempos medianos entre início da ação e decisão liminar, sentença na 1a instância, e acórdão na 2ª instância, foram de 7, 239 e 478 dias, respectivamente. Em 98 processos o medicamento pode ser identificado e em 80,6% havia solicitação de ao menos um medicamento não pertencente aos elencos oficiais. Isto sugere que, além de problemas relacionados à aquisição, distribuição e dispensação de itens listados, os não selecionados em listas oficiais foram também grande motivação da demanda. Os medicamentos mais solicitados foram os dos sistemas cardiovascular e nervoso central.Recognition of the right to health raises two practical issues: the government's ethical and legal duty to ensure comprehensive health care and citizens' recourse to legal action to guarantee this right. This study focused on lawsuits to demand "essential" medicines, filed at the State Court of Appeals in Rio de Janeiro, Brazil, in 2006. One hundred and eighty-five suits were examined, and the claims were granted in all but three cases. Median times between filing the suit, the injunction, first ruling, and appellate ruling were 7, 239, and 478 days respectively. In 80.6% of the 98 suits in which the specific medicines could be identified, at least one drug did not belong to any publicly funded list of medicines. This could indicate that lawsuits demanding "essential" drugs were motivated not only by problems in procurement

  16. Mapping SLCO1B1 Genetic Variation for Global Precision Medicine in Understudied Regions in Africa: A Focus on Zulu and Cape Admixed Populations.

    Science.gov (United States)

    Hoosain, Nisreen; Pearce, Brendon; Jacobs, Clifford; Benjeddou, Mongi

    2016-09-01

    The U.S. President Barack Obama has announced, in his State of the Union address on January 20, 2015, the Precision Medicine Initiative, a US$215-million program. For global precision medicine to become a reality, however, biological and environmental "variome" in previously understudied populations ought to be mapped and catalogued. Chief among the molecular targets that warrant global mapping is the organic anion-transporting polypeptide 1B1 (OATP1B1), encoded by solute carrier organic anion transporter family member 1B1 (SLCO1B1), a hepatic uptake transporter predominantly expressed in the basolateral side of hepatocytes. Human OATP1B1 plays a crucial role in the transport of a wide variety of substrates. This includes endogenous compounds such as bile salts as well as medicines, including benzylpenicillin, methotrexate, pravastatin, and rifampicin, and natural toxins microcystin and phalloidin. Genetic variations observed in the SLCO1B1 gene have been associated with altered in vitro and in vivo OATP1B1 transport activity, and consequently influencing patients' response to medicines, toxins, and susceptibility to common complex diseases. Well-characterized haplotypes, *5 (RS4149056C) and *15 (RS4149056T), have been associated with a strikingly reduced uptake of multiple OATP1B1 substrates, including estrone-3-sulfate, estradiol-17β-d-glucuronide, atorvastatin, cerivastatin, pravastatin, and rifampicin. In particular, RS4149056C is observed in 60% of the Cape admixed (CA) population and is associated with increased plasma concentrations of many statins as well as fexofenadine and repaglinide. We designed and optimized a SNaPshot minisequencing panel to characterize the variants of relevance for precision medicine in the clinic. We report here the first study on allele and genotype frequencies for 10 nonsynonymous, 4 synonymous, and 6 intronic single-nucleotide polymorphisms of SLCO1B1 in the Zulu and CA populations of South Africa. These variants are further

  17. [The role of German official medicines control laboratories in combating counterfeit medicines].

    Science.gov (United States)

    Wiegard, Andrea; Heuermann, Matthias

    2017-11-01

    An official medicines control laboratory (OMCL) provides an important contribution to combat counterfeit and illegal medicines. The OMCL supports the competent authorities in controlling the quality of authorised medicinal products in the legal supply chain. For detecting counterfeit medicines in the legal supply chain, a risk-based approach in choice of products is conducted. Furthermore, the OMCL analyses suspicious medicines from the illegal supply chain for any other authority. The chemical analysis of a suspicious sample is needed to identify such a sample as a counterfeit medicine. The analytical results are fundamental for the evaluation of the legal status of the product and for the assessment of it's inherent hazard to public health. The global market of illegal medicines is rapidly changing. Therefore a good national and international working liaison and co-operation between laboratories and authorities is obligatory to protect public health. The OMCL provides important knowledge of new trends in counterfeit and illegal medicines. Hence, it is an essential part in surveillance of medicinal products. The efficient networking enables prompt official interventions. Thus, risks for the public health by substandard medicines were reduced. Beside the chemical analysis, the OMCL can help to raise public awareness about counterfeit and illegal medicines. In Germany, the risk of counterfeit medicines reaching patients through the legal supply chain is still low, but the possibility cannot be ignored.

  18. Modern science for better quality control of medicinal products "Towards global harmonization of 3Rs in biologicals": The report of an EPAA workshop.

    Science.gov (United States)

    Schutte, Katrin; Szczepanska, Anna; Halder, Marlies; Cussler, Klaus; Sauer, Ursula G; Stirling, Catrina; Uhlrich, Sylvie; Wilk-Zasadna, Iwona; John, David; Bopst, Martin; Garbe, Joerg; Glansbeek, Harrie L; Levis, Robin; Serreyn, Pieter-Jan; Smith, Dean; Stickings, Paul

    2017-07-01

    This article summarizes the outcome of an international workshop organized by the European Partnership for Alternative Approaches to Animal Testing (EPAA) on Modern science for better quality control of medicinal products: Towards global harmonization of 3Rs in biologicals. As regards the safety testing of biologicals, the workshop participants agreed to actively encourage the deletion of abnormal toxicity tests and target animal batch safety tests from all relevant legal requirements and guidance documents (country-specific guidelines, pharmacopoeia monographs, WHO recommendations). To facilitate the global regulatory acceptance of non-animal methods for the potency testing of, e.g., human diphtheria and tetanus vaccines and veterinary swine erysipelas vaccines, international convergence on the scientific principles of the use of appropriately validated in vitro assays for replacing in vivo methods was identified as an overarching goal. The establishment of scientific requirements for new assays was recognized as a further means to unify regulatory approaches in different jurisdictions. It was recommended to include key regulators and manufacturers early in the corresponding discussions. Manufacturers and responsible expert groups, e.g. at the European Directorate for the Quality of Medicines and Health Care of the Council of Europe or the European Medicines Agency, were invited to consider leadership for international collaboration. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. In vitro effect of essential oils from aromatic and medicinal plants on mushroom pathogens: Verticillium fungicola var. fungicola, Mycogone perniciosa, and Cladobotryum sp.

    Directory of Open Access Journals (Sweden)

    Tanović Brankica

    2009-01-01

    Full Text Available Lavender, anise, chamomile, fennel, geranium, oregano, parsley, and sage essential oils were tested for their effectiveness against mushroom pathogens: Verticillium fungicola var. fungicola, Mycogone perniciosa, and Cladobotryum sp. Isolates were exposed to the volatile phase of the oils and then ventilated in order to determine if the effect of the oil was lethal to the pathogen. Oregano and geranium oils were the most toxic, having a fungicidal effect at 0.02-0.08 μl/ml of air, depending on the pathogen. Oregano oil was characterized by high content of carvacrol and thymol, while citranelol and geraniol were the main components of geranium oil.

  20. Lessons from Cuba for Global Precision Medicine: CYP2D6 Genotype Is Not a Robust Predictor of CYP2D6 Ultrarapid Metabolism.

    Science.gov (United States)

    Dorado, Pedro; González, Idilio; Naranjo, María Eugenia G; de Andrés, Fernando; Peñas-Lledó, Eva María; Calzadilla, Luis Ramón; LLerena, Adrián

    2017-01-01

    A long-standing question and dilemma in precision medicine is whether and to what extent genotyping or phenotyping drug metabolizing enzymes such as CYP2D6 can be used in real-life global clinical and societal settings. Although in an ideal world using both genotype and phenotype biomarkers are desirable, this is not always feasible for economic and practical reasons. Moreover, an additional barrier for clinical implementation of precision medicine is the lack of correlation between genotype and phenotype, considering that most of the current methods include only genotyping. Thus, the present study evaluated, using dextromethorphan as a phenotyping probe, the relationship between CYP2D6 phenotype and CYP2D6 genotype, especially for the ultrarapid metabolizer (UM) phenotype. We report in this study, to the best of our knowledge, the first comparative clinical pharmacogenomics study in a Cuban population sample (N = 174 healthy volunteers) and show that the CYP2D6 genotype is not a robust predictor of the CYP2D6 ultrarapid metabolizer (mUM) status in Cubans. Importantly, the ultrarapid CYP2D6 phenotype can result in a host of health outcomes, such as drug resistance associated with subtherapeutic drug concentrations, overexposure to active drug metabolites, and altered sensitivity to certain human diseases by virtue of altered metabolism of endogenous substrates of CYP2D6. Hence, phenotyping tests for CYP2D6 UMs appear to be a particular necessity for precision medicine in the Cuban population. Finally, in consideration of ethical and inclusive representation in global science, we recommend further precision medicine biomarker research and funding in support of neglected or understudied populations worldwide.

  1. Bernard Lerer: recipient of the 2014 inaugural Werner Kalow Responsible Innovation Prize in Global Omics and Personalized Medicine (Pacific Rim Association for Clinical Pharmacogenetics).

    Science.gov (United States)

    Ozdemir, Vural; Endrenyi, Laszlo; Aynacıoğlu, Sükrü; Bragazzi, Nicola Luigi; Dandara, Collet; Dove, Edward S; Ferguson, Lynnette R; Geraci, Christy Jo; Hafen, Ernst; Kesim, Belgin Eroğlu; Kolker, Eugene; Lee, Edmund J D; Llerena, Adrian; Nacak, Muradiye; Shimoda, Kazutaka; Someya, Toshiyuki; Srivastava, Sanjeeva; Tomlinson, Brian; Vayena, Effy; Warnich, Louise; Yaşar, Umit

    2014-04-01

    This article announces the recipient of the 2014 inaugural Werner Kalow Responsible Innovation Prize in Global Omics and Personalized Medicine by the Pacific Rim Association for Clinical Pharmacogenetics (PRACP): Bernard Lerer, professor of psychiatry and director of the Biological Psychiatry Laboratory, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. The Werner Kalow Responsible Innovation Prize is given to an exceptional interdisciplinary scholar who has made highly innovative and enduring contributions to global omics science and personalized medicine, with both vertical and horizontal (transdisciplinary) impacts. The prize is established in memory of a beloved colleague, mentor, and friend, the late Professor Werner Kalow, who cultivated the idea and practice of pharmacogenetics in modern therapeutics commencing in the 1950s. PRACP, the prize's sponsor, is one of the longest standing learned societies in the Asia-Pacific region, and was founded by Kalow and colleagues more than two decades ago in the then-emerging field of pharmacogenetics. In announcing this inaugural prize and its winner, we seek to highlight the works of prize winner, Professor Lerer. Additionally, we contextualize the significance of the prize by recalling the life and works of Professor Kalow and providing a brief socio-technical history of the rise of pharmacogenetics and personalized medicine as a veritable form of 21(st) century scientific practice. The article also fills a void in previous social science analyses of pharmacogenetics, by bringing to the fore the works of Kalow from 1995 to 2008, when he presciently noted the rise of yet another field of postgenomics inquiry--pharmacoepigenetics--that railed against genetic determinism and underscored the temporal and spatial plasticity of genetic components of drug response, with invention of the repeated drug administration (RDA) method that estimates the dynamic heritabilities of drug response. The prize goes a long way

  2. Essential Tremor

    Science.gov (United States)

    ... Treatment There is no definitive cure for essential tremor. Symptomatic drug therapy may include propranolol or other beta blockers and primidone, an anticonvulsant drug. Eliminating tremor "triggers" ...

  3. [Inheritance and innovation of traditional Chinese medicinal authentication].

    Science.gov (United States)

    Zhao, Zhong-zhen; Chen, Hu-biao; Xiao, Pei-gen; Guo, Ping; Liang, Zhi-tao; Hung, Fanny; Wong, Lai-lai; Brand, Eric; Liu, Jing

    2015-09-01

    Chinese medicinal authentication is fundamental for the standardization and globalization of Chinese medicine. The discipline of authentication addresses difficult issues that have remained unresolved for thousands of years, and is essential for preserving safety. Chinese medicinal authentication has both scientific and traditional cultural connotations; the use of scientific methods to elucidate traditional experience-based differentiation carries the legacy of Chinese medicine forward, and offers immediate practical significance and long-term scientific value. In this paper, a path of inheritance and innovation is explored through the scientific exposition of Chinese medicinal authentication, featuring a review of specialized publications, the establishment of a Chinese medicine specimen center and Chinese medicinal image databases, the expansion of authentication technologies, and the formation of a cultural project dedicated to the Compedium of Materia Medica.

  4. Essential tremor

    Science.gov (United States)

    ... such as: Smoking and smokeless tobacco Overactive thyroid ( hyperthyroidism ) Suddenly stopping alcohol after drinking a lot for ... from the medicines used to treat your tremor Prevention Alcoholic beverages in small quantities may decrease tremors. ...

  5. [The Caribbean origins of the National Public Health System in the USA: a global approach to the history of medicine and public health in Latin America].

    Science.gov (United States)

    Espinosa, Mariola

    2015-01-01

    This article defines global history in relation to the history of medicine and public health. It argues that a global approach to history opens up a space for examining the reverberations transmitted from the geographic periphery towards western regions, which have traditionally dominated modern historiography. It analyzes two medical interventions in the Caribbean in the late nineteenth and early twentieth century, showing how these events had profound consequences in the USA. The successes achieved in the Caribbean in terms of yellow fever and ancylostoma control, as well as providing a model for health campaigns in the southern USA, inspired the centralization of public health in North America under the centralizing control of the federal government.

  6. Global health and global health ethics

    National Research Council Canada - National Science Library

    Benatar, S. R; Brock, Gillian

    2011-01-01

    ...? What are our responsibilities and how can we improve global health? Global Health and Global Health Ethics addresses these questions from the perspective of a range of disciplines, including medicine, philosophy and the social sciences...

  7. KNIME essentials

    CERN Document Server

    Bakos, Gábor

    2013-01-01

    KNIME Essentials is a practical guide aimed at getting the results you want, as quickly as possible.""Knime Essentials"" is written for data analysts looking to quickly get up to speed using the market leader in data processing tools, KNIME. No knowledge of KNIME is required, but we will assume that you have some background in data processing.

  8. Astronomy essentials

    CERN Document Server

    Brass, Charles O

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Astronomy includes the historical perspective of astronomy, sky basics and the celestial coordinate systems, a model and the origin of the solar system, the sun, the planets, Kepler'

  9. Highlights from the WIN 2017 Symposium, 26-27 June 2017, Paris, France: 'Expediting Global Innovation in Precision Cancer Medicine'.

    Science.gov (United States)

    Davies, Will

    2017-01-01

    The Worldwide Innovative Networking (WIN) symposium brings together representatives from academic institutions, pharmaceutical partners, technology companies and charitable organisations from across the globe for an annual summit, discussing ongoing research and the latest developments in precision medicine. Now, in its seventh year, the aims of the WIN consortium's annual meeting, to foster communication and collaboration between members and deliver clinical trial results that improve the care and outcomes of patients are presented in open dialogue to encourage debate and discussion. This year, the meeting was held in Paris, France from 26-27 June and consisted of six plenary sessions, two debates, and poster presentations from attendees. In keeping with the consortium's goals, presentations and posters focused on the development and integration of new therapies and updates in genome-based medicine. Among the presentations at this year's meeting, much of the focus fell on design and implementation of new designs of clinical trials, moving away from decades-long assessments of thousands of patients towards a nimble, adaptive design fitting the edicts of personalised medicine and delving into greater depths within genomic data, ranging beyond genome analysis to chart new targets in ligandomics, proteogenomics and more.

  10. Essential oils of medicinal plants from the central andes of Argentina: chemical composition, and antifungal, antibacterial, and insect-repellent activities.

    Science.gov (United States)

    Lima, Beatriz; López, Sandra; Luna, Lorena; Agüero, María B; Aragón, Liliana; Tapia, Alejandro; Zacchino, Susana; López, María L; Zygadlo, Julio; Feresin, Gabriela E

    2011-05-01

    The antifungal, antibacterial, and insect-repellent activities of the essential oils (EOs) of Acantholippia seriphioides, Artemisia mendozana, Gymnophyton polycephalum, Satureja parvifolia, Tagetes mendocina, and Lippia integrifolia, collected in the Central Andes area, province of San Juan, Argentina, were investigated. The dermatophytes Microsporum gypseum, Trichophyton mentagrophytes, and T. rubrum were inhibited by the EOs of G. polycephalum, L. integrifolia, and S. parvifolia, with minimum inhibitory concentrations (MICs) between 31.2 and 1000 μg/ml. Moreover, all EOs presented moderate activity against the bacteria tested, and the L. integrifolia and G. polycephalum EOs showed excellent repellent properties against Triatoma infestans, the Chagas disease vector, with repellency values between 60 and 100%. The A. seriphioides, G. polycephalum, and L. integrifolia EOs, obtained by hydrodistillation, were characterized by GC-FID and GC/MS analyses. The highest number of components (40) was identified in L. integrifolia EO, which, along with that of A. seriphioides, contained important amounts of oxygenated monoterpenes (44.35 and 29.72%, resp.). Thymol (27.61%) and carvacrol (13.24%) were the main components of A. seriphioides EO, and borneol, lippifoli-1(6)-en-5-one, and terpinen-4-ol (>8.5%) were the principal compounds of L. integrifolia EO. These results support the idea that oxygenated monoterpenes are the bioactive fractions of the EOs. Finally, the study shows that these Andean species might be used to treat superficial fungal infections and to improve the local Chagas disease situation by vector-control. Copyright © 2011 Verlag Helvetica Chimica Acta AG, Zürich.

  11. Essentials of Endodontic Microsurgery

    Science.gov (United States)

    2010-04-01

    Holtzman DJ, et al. Quality of root-end preparations using ultrasonic and rotary instrumentation in cadavers. J Endod 2000;26:281. 39. Peters CI...00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Essentials of Endodontic Microsurgery 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT... Endodontic Program,Harvard School of Dental Medicine,Boston,MA 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME(S) AND

  12. Nuclear medicine

    International Nuclear Information System (INIS)

    Kand, Purushottam

    2012-01-01

    Nuclear medicine is a specialized area of radiology that uses very small amounts of radioactive materials to examine organ function and structure. Nuclear medicine is older than CT, ultrasound and MRI. It was first used in patients over 60-70 years ago. Today it is an established medical specialty and offers procedures that are essential in many medical specialities like nephrology, pediatrics, cardiology, psychiatry, endocrinology and oncology. Nuclear medicine refers to medicine (a pharmaceutical) that is attached to a small quantity of radioactive material (a radioisotope). This combination is called a radiopharmaceutical. There are many radiopharmaceuticals like DTPA, DMSA, HIDA, MIBI and MDP available to study different parts of the body like kidneys, heart and bones etc. Nuclear medicine uses radiation coming from inside a patient's body where as conventional radiology exposes patients to radiation from outside the body. Thus nuclear imaging study is a physiological imaging, whereas diagnostic radiology is anatomical imaging. It combines many different disciplines like chemistry, physics mathematics, computer technology, and medicine. It helps in diagnosis and to treat abnormalities very early in the progression of a disease. The information provides a quick and accurate diagnosis of wide range of conditions and diseases in a person of any age. These tests are painless and most scans expose patients to only minimal and safe amounts of radiation. The amount of radiation received from a nuclear medicine procedure is comparable to, or often many times less than, that of a diagnostic X-ray. Nuclear medicine provides an effective means of examining whether some tissues/organs are functioning properly. Therapy using nuclear medicine in an effective, safe and relatively inexpensive way of controlling and in some cases eliminating, conditions such as overactive thyroid, thyroid cancer and arthritis. Nuclear medicine imaging is unique because it provides doctors with

  13. Sclerorhachis Platyrachis (Boiss. Podlech Ex Rech. F.: an Indigenous Medicinal Plant from Northeastern Iran; Essential Oil Composition, Total Flavonoid Content and Antioxidant Activity

    Directory of Open Access Journals (Sweden)

    Hashem Akhlaghi

    2015-04-01

    Full Text Available In this study, the essential oil obtained by hydrodistillation of the aerial parts of Sclerorhachis platyrachis (Boiss. Podlech ex Rech. f. (Compositae, growing wild in Sabzevar, Khorasan Razavi Province (Iran, was analyzed by GC and GC/MS. The total yield of volatiles was 0.38% (w/w. Sixty- three compounds representing 89.2% of the aerial parts oil were identified.  The main components of the oil were β-pinene (17.5% and γ-terpinene (15.4%. The oil was rich in monoterpenoids, and among them, monoterpene hydrocarbons (48.7% predominated over oxygenated monoterpenes (11.8%. The total flavonoid content of different extracts of the plant was in the range 52.4-172.3 mg/g, with the maximum amount being in the methanol extract. The antioxidant activities of the extracts were also measured based on radical scavenging activity of antioxidants using the 1, 1-diphenyl-2-picrylhydrazyl (DPPH method. The results showed that IC50 values of extracts of S. platyrachis are higher than for the standard synthetic antioxidants, BHT, ascorbic acid and gallic acid. Normal 0 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi; mso-bidi-language:AR-SA;}    

  14. Activated learning; providing structure in global health education at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA)- a pilot study.

    Science.gov (United States)

    Jordan, Jaime; Hoffman, Risa; Arora, Gitanjli; Coates, Wendy

    2016-02-16

    Global health rotations are increasingly popular amongst medical students. The training abroad is highly variable and there is a recognized need for global health curriculum development. We sought to create and evaluate a curriculum, applicable to any global health rotation, that requires students to take an active role in their education and promotes engagement. Prospective, observational, mixed method study of 4th year medical students enrolled in global health courses at UCLA in 2011-12. Course directors identified 4 topics common to all rotations (traditional medicine, health systems, limited resources, pathology) and developed activities for students to complete abroad: observation, interview and reflection on resources, pathology, medical practices; and compare/contrast their experience with the US healthcare system. Students posted responses on a discussion board moderated by US faculty. After the rotation, students completed an anonymous internet-based evaluative survey. Responses were tabulated. Qualitative data from discussion board postings and free response survey items were analyzed using the framework method. 14 (100 %) students completed the Activated Learning assignment. 12 submitted the post rotation survey (85.7 %). Activated Learning enhanced GH education for 67 % and facilitated engagement in the local medical culture for 67 %. Qualitative analysis of discussion board posting demonstrated multiple areas of knowledge gain and analysis of free response survey items revealed 5 major themes supporting Activated Learning: guided learning, stimulation of discussion, shared interactions, cultural understanding, and knowledge of global healthcare systems. Increased interactivity emerged as the major theme for future improvement. The results of this study suggest that an Activated Learning program may enhance education, standardize curricular objectives across multiple sites and promote engagement in local medical culture, pathology and delivery

  15. Global bioethics and governance : views from FAO and India on the ethics of biotechnology in agriculture and medicine

    OpenAIRE

    Bhardwaj, Minakshi

    2003-01-01

    The overall objective of this research was to analyse the role of ethics in the global governance of biotechnology. How do people apply biological knowledge in the service of humankind and the environment? The present thesis contains two major case studies related to governance of biotechnology and ethics. ...

  16. Global Cardiovascular Risk Assessment by Family Physicians in Suez Canal University-Family Medicine Centers-Egypt.

    Science.gov (United States)

    Nour-Eldein, Hebatallah; Abdelsalam, Shimaa A; Nasr, Gamila M; Abdelwahed, Hassan A

    2013-01-01

    The close sustained contact of family physician with their patients and local community makes preventive care an integral part of their routine work. Most cardiovascular diseases (CVD) can be prevented by addressing their risk factors. There are several guidelines that recommend different CV risk assessment tools to support CV prevention strategies. This study aimed to assess awareness and attitude of global CV risk assessment and use of their tools by family physicians; aiming to improve CV prevention service. The current study is a cross-sectional descriptive analytic. Sixty-five family physicians were asked to respond to, validated anonymous questionnaire to collect data about characteristics of family physicians, their awareness, attitude, current use, barriers, and recommendations of global CV risk assessment. Statistical Package for Social Sciences (SPSS) version 18 was used for data entry and analysis. Awareness of guidelines of global CV risk assessment was relatively higher regarding the American guidelines (30.8%) than that recommended by World Health Organization (WHO) for Egypt (20.2%). 50.8% of participants had favorable attitude. There was statistical significant relationship between attitude scores and physician characteristics; age (P = 0.003), qualification (P = 0.001) and number of patients seen per week (P = 0.009). Routine use of global CV risk assessment tools was reported only (23%) by family physicians. Relative higher attitude scores than use of global CV risk assessment tools in practice. The most frequent barriers were related to lack of resources and shortage in training/skills and the raised suggestions were towards training.

  17. The role of supplemental ultraviolet-B radiation in altering the metabolite profile, essential oil content and composition, and free radical scavenging activities of Coleus forskohlii, an indigenous medicinal plant.

    Science.gov (United States)

    Takshak, Swabha; Agrawal, S B

    2016-04-01

    The effects of supplemental ultraviolet-B (s-UV-B; 3.6 kJ m(-2) day(-1) above ambient) radiation were investigated on plant metabolite profile, essential oil content and composition, and free radical scavenging capacities of methanolic extracts of Coleus forskohlii (an indigenous medicinal plant) grown under field conditions. Essential oil was isolated using hydrodistillation technique while alterations in metabolite profile and oil composition were determined via gas chromatography-mass spectroscopy (GC-MS). Leaf and root methanolic extracts were investigated via various in vitro assays for their DPPH radical-, superoxide radical-, hydrogen peroxide-, hydroxyl radical-, and nitric oxide radical scavenging activities, ferrous ion chelating activity, and reducing power. Phytochemical analysis revealed the presence of alkaloids, anthocyanins, coumarins, flavonoids, glycosides, phenols, saponins, steroids, tannins, and terpenoids. Oil content was found to be reduced (by ∼7 %) in supplemental UV-B (s-UV-B) treated plants; the composition of the plant extracts as well as essential oil was also considerably altered. Methanolic extracts from treated plant organs showed more potency as free radical scavengers (their EC50 values being lower than their respective controls). Anomalies were observed in Fe(2+) chelating activity for both leaves and roots. The present study concludes that s-UV-B adversely affects oil content in C. forskohlii and also alters the composition and contents of metabolites in both plant extracts and oil. The results also denote that s-UV-B treated plant organs might be more effective in safeguarding against oxidative stress, though further studies are required to authenticate these findings.

  18. Cruise ships and bush medicine: globalization on the Atlantic Coast of Nicaragua and effects on the health of Creole women.

    Science.gov (United States)

    Mitchell, Emma McKim; Steeves, Richard; Dillingham, Rebecca

    2015-01-01

    Global health research into the relationship between health, economic inequalities, and globalization is necessary to address increasing health disparities in low income countries. Nicaragua has high levels of poverty and extreme poverty when compared with other Central and South American Countries. Photovoice and ethnographic research methods were used to explore health experiences of Creole women in Bluefields, Nicaragua and the intersections between culture, socioeconomic status, and gender. Twelve Creole women participants, ages 18-45. After initial focus groups, participants used disposable cameras to document health experiences. Follow-up interviews were conducted about the meaning of each photo. Participants then selected photos to be included in a city-wide photoshow. In initial focus groups, participants described great distress over changes they perceived in Creole culture and how these changes affect the health of the next generation. Participants related most of these changes to the economy and globalization. Photos taken were primarily of aspects of Creole culture, including household practices and traditional remedies from Creole culture. Findings on the relationships between culture, disease, and community-identified health risks in this minority population can help health care providers and public health policymakers develop and sustain culturally appropriate health interventions. © 2014 Wiley Periodicals, Inc.

  19. Cruise ships and bush medicine: Globalization on the Atlantic Coast of Nicaragua and effects on the health of Creole women

    Science.gov (United States)

    Mitchell, Emma McKim; Steeves, Richard; Dillingham, Rebecca

    2014-01-01

    Objectives Global health research into the relationship between health, economic inequalities, and globalization is necessary to address increasing health disparities in low income countries. Nicaragua has high levels of poverty and extreme poverty when compared with other Central and South American Countries. Design Photovoice and ethnographic research methods were used to explore health experiences of Creole women in Bluefields, Nicaragua and the intersections between culture, socioeconomic status, and gender. Sample Twelve Creole women participants, ages 18–45. Measurements After initial focus groups, participants used disposable cameras to document health experiences. Follow up interviews were conducted about the meaning of each photo. Participants then selected photos to be included in a city-wide photoshow. Results In initial focus groups, participants described great distress over changes they perceived in Creole culture and how these changes affect the health of the next generation. Participants related most of these changes to the economy and globalization. Photos taken were primarily of aspects of Creole culture, including household practices and traditional remedies from Creole culture. Conclusions Findings on the relationships between culture, disease and community-identified health risks in this minority population can help healthcare providers and public health policy makers develop and sustain culturally appropriate health interventions. PMID:24766610

  20. Essential AOP

    DEFF Research Database (Denmark)

    De Fraine, Bruno; Ernst, Erik; Südholt, Mario

    2010-01-01

    Aspect-oriented programming (AOP) has produced interesting language designs, but also ad hoc semantics that needs clarification. We contribute to this clarification with a calculus that models essential AOP, both simpler and more general than existing formalizations. In AOP, advice may intercept...

  1. Highcharts essentials

    CERN Document Server

    Shahid, Bilal

    2014-01-01

    If you are a web developer with a basic knowledge of HTML, CSS, and JavaScript and want to quickly get started with this web charting technology, this is the book for you. This book will also serve as an essential guide to those who have probably used a similar library and are now looking at migrating to Highcharts.

  2. Swift essentials

    CERN Document Server

    Blewitt, Alex

    2014-01-01

    Whether you are a seasoned Objective-C developer or new to the Xcode platform, Swift Essentials will provide you with all you need to know to get started with the language. Prior experience with iOS development is not necessary, but will be helpful to get the most out of the book.

  3. Bernard Lerer: Recipient of the 2014 Inaugural Werner Kalow Responsible Innovation Prize in Global Omics and Personalized Medicine (Pacific Rim Association for Clinical Pharmacogenetics)

    Science.gov (United States)

    Aynacıoğlu, Şükrü; Bragazzi, Nicola Luigi; Dandara, Collet; Dove, Edward S.; Ferguson, Lynnette R.; Geraci, Christy Jo; Hafen, Ernst; Kesim, Belgin Eroğlu; Kolker, Eugene; Lee, Edmund J.D.; LLerena, Adrian; Nacak, Muradiye; Shimoda, Kazutaka; Someya, Toshiyuki; Srivastava, Sanjeeva; Tomlinson, Brian; Vayena, Effy; Warnich, Louise; Yaşar, Ümit

    2014-01-01

    Abstract This article announces the recipient of the 2014 inaugural Werner Kalow Responsible Innovation Prize in Global Omics and Personalized Medicine by the Pacific Rim Association for Clinical Pharmacogenetics (PRACP): Bernard Lerer, professor of psychiatry and director of the Biological Psychiatry Laboratory, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. The Werner Kalow Responsible Innovation Prize is given to an exceptional interdisciplinary scholar who has made highly innovative and enduring contributions to global omics science and personalized medicine, with both vertical and horizontal (transdisciplinary) impacts. The prize is established in memory of a beloved colleague, mentor, and friend, the late Professor Werner Kalow, who cultivated the idea and practice of pharmacogenetics in modern therapeutics commencing in the 1950s. PRACP, the prize's sponsor, is one of the longest standing learned societies in the Asia-Pacific region, and was founded by Kalow and colleagues more than two decades ago in the then-emerging field of pharmacogenetics. In announcing this inaugural prize and its winner, we seek to highlight the works of prize winner, Professor Lerer. Additionally, we contextualize the significance of the prize by recalling the life and works of Professor Kalow and providing a brief socio-technical history of the rise of pharmacogenetics and personalized medicine as a veritable form of 21st century scientific practice. The article also fills a void in previous social science analyses of pharmacogenetics, by bringing to the fore the works of Kalow from 1995 to 2008, when he presciently noted the rise of yet another field of postgenomics inquiry—pharmacoepigenetics—that railed against genetic determinism and underscored the temporal and spatial plasticity of genetic components of drug response, with invention of the repeated drug administration (RDA) method that estimates the dynamic heritabilities of drug response. The prize goes a

  4. Insect pollination and self-incompatibility in edible and/or medicinal crops in southwestern China, a global hotspot of biodiversity.

    Science.gov (United States)

    Ren, Zong-Xin; Wang, Hong; Bernhardt, Peter; Li, De-Zhu

    2014-10-01

    An increasing global demand for food, coupled with the widespread decline of pollinator diversity, remains an international concern in agriculture and genetic conservation. In particular, there are large gaps in the study of the pollination of economically important and traditionally grown species in China. Many plant species grown in China are both edible and used medicinally. The country retains extensive written records of agricultural and apicultural practices, facilitating contemporary studies of some important taxa. Here, we focus on Yunnan in southwestern China, a mega-biodiversity hotspot for medicinal/food plants. We used plant and insect taxa as model systems to understand the patterns and consequences of pollinator deficit to crops. We identified several gaps and limitations in research on the pollination ecology and breeding systems of domesticated taxa and their wild relatives in Yunnan and asked the following questions: (1) What is known about pollination systems of edible and medicinal plants in Yunnan? (2) What are the most important pollinators of Codonopsis subglobosa (Campanulaceae)? (3) How important are native pollinator species for maximizing yield in Chinese crops compared with the introduced Apis mellifera? We found that some crops that require cross-pollination now depend exclusively on hand pollination. Three domesticated crops are dependent primarily on the native but semidomesticated Apis cerana and the introduced A. mellifera. Other species of wild pollinators often play important roles for certain specialty crops (e.g., Vespa velutina pollinates Codonopsis subglobosa). We propose a more systematic and comprehensive approach to applied research in the future. © 2014 Botanical Society of America, Inc.

  5. Nanotechnology in global medicine and human biosecurity: private interests, policy dilemmas, and the calibration of public health law.

    Science.gov (United States)

    Faunce, Thomas A

    2007-01-01

    This paper considers how best to approach dilemmas posed to global health and biosecurity policy by increasing advances in practical applications of nanotechnology. The type of nano-technology policy dilemmas discussed include: (1) expenditure of public funds, (2) public-funded research priorities, (3) public confidence in government and science and, finally, (4) public safety. The article examines the value in this context of a legal obligation that the development of relevant public health law be calibrated against less corporate-influenced norms issuing from bioethics and international human rights.

  6. Holistic actions are essential to combat the global public health burden of non-viral sexually transmitted infections: challenges and future perspectives.

    Science.gov (United States)

    Unemo, Magnus

    2014-06-01

    Sexually transmitted infections (STIs) represent a significant international public health burden. These infections result in substantial morbidity, mortality and economic costs globally, and require more attention and resources internationally. This special focus issue of Expert Review of Anti Infective Therapy invited key opinion leaders to review and discuss the challenges associated with the diagnosis and treatment of non-viral STIs. The issue also elucidates the future perspectives, ways forward and holistic actions imperative to effectively combat these STIs.

  7. Essential Oils and Antifungal Activity

    Science.gov (United States)

    Coppola, Raffaele; De Feo, Vincenzo

    2017-01-01

    Since ancient times, folk medicine and agro-food science have benefitted from the use of plant derivatives, such as essential oils, to combat different diseases, as well as to preserve food. In Nature, essential oils play a fundamental role in protecting the plant from biotic and abiotic attacks to which it may be subjected. Many researchers have analyzed in detail the modes of action of essential oils and most of their components. The purpose of this brief review is to describe the properties of essential oils, principally as antifungal agents, and their role in blocking cell communication mechanisms, fungal biofilm formation, and mycotoxin production. PMID:29099084

  8. Nuclear medicine

    International Nuclear Information System (INIS)

    Sibille, L.; Nalda, E.; Collombier, L.; Kotzki, P.O.; Boudousq, V.

    2011-01-01

    Nuclear medicine is a medical specialty using the properties of radioactivity. Radioactive markers associated with vectors are used as a tracer or radiopharmaceutical for diagnostic purposes and/or therapy. Since its birth more than half a century ago, it has become essential in the care of many patients, particularly in oncology. After some definitions, this paper presents the main nuclear techniques - imaging for diagnostic, radiopharmaceuticals as therapeutic agents, intra-operative detection, technique of radioimmunoassay - and the future of this field. (authors)

  9. Effect of essential oils of medicinal plants on leaf blotch in Tanzania grass Efeito de óleos essenciais de plantas medicinais sobre a helmintosporiose do capim Tanzânia

    Directory of Open Access Journals (Sweden)

    Gil Rodrigues dos Santos

    2013-09-01

    Full Text Available Leaf spots caused by phyto-pathogenic fungi, can reduce the production of forage plants. The essential oils of medicinal plants have antimicrobial potential. The objective here was to evaluate the fungotoxicity in vitro of the essential oils of lemongrass (Cymbopogon citratus (DC. Stapf (Poaceae, citronella (Cymbopogon nardus (L. Rendle (Poaceae, lemon balm (Lippia alba (Mill. NE Br ex Britton & P. Wilson (Verbenaceae and peppermint (Mentha piperita L. (Lamiaceae on the fungus Helminthosporium sp. and the in vivo effect of these oils and of commercial neem oil (Azadirachta indica A. Juss. (Meliaceae on leaf blotch in Panicum maximum Jacq. cv. Tanzania-1. The mycelial growth of the fungus was evaluated over five periods (2; 4; 6; 8 and 10 days from incubation and with five concentrations of essential oils (C1 = 250 ppm; C2 = 500 ppm; C3 = 750 ppm; C4 = 1,000 ppm e C5 = 1,250 ppm. As an alternative control, the preventative and curative effect on leaf blotch of five oil-based treatments were evaluated: lemongrass, citronella, lemon balm, peppermint and neem in four concentrations (2,500; 5,000; 7,500 and 10,000 ppm. The essential oils of lemongrass and citronella were the most effective in reducing mycelial growth of Helminthosporium sp. With the essential oil of lemongrass, the pathogen presented the highest growth concentration (1.250 ppm. The results obtained showed that all the essential oils and concentrations tested presented a preventive and curative effect, reducing the severity of leaf blotch.Manchas foliares, causadas por fungos fitopatogênicos, podem reduzir a produção de forrageiras. Óleos essenciais de plantas medicinais apresentam potencial antimicrobiano. Objetivou-se avaliar a fungitoxicidade in vitro dos óleos essenciais de capim-limão (Cymbopogon citratus (DC. Stapf (Poaceae, citronela (Cymbopogon nardus (L. Rendle (Poaceae, erva-cidreira (Lippia alba (Mill. N.E. Br. ex Britton & P. Wilson (Verbenaceae e hortel

  10. Optimizing clinical operations as part of a global emergency medicine initiative in Kumasi, Ghana: application of Lean manufacturing principals to low-resource health systems.

    Science.gov (United States)

    Carter, Patrick M; Desmond, Jeffery S; Akanbobnaab, Christopher; Oteng, Rockefeller A; Rominski, Sarah D; Barsan, William G; Cunningham, Rebecca M

    2012-03-01

    Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems, but use of Lean in low to middle income countries with developing emergency medicine (EM) systems has not been well characterized. To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital (KATH) in Ghana and to identify key lessons learned to aid future global EM initiatives. A 3-week Lean improvement program focused on the hospital admissions process at KATH was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem-solving techniques worked well in a low-resource system without modification; 7) using Lean highlighted that important changes do not require an influx of resources; and

  11. Linux Essentials

    CERN Document Server

    Smith, Roderick W

    2012-01-01

    A unique, full-color introduction to Linux fundamentals Serving as a low-cost, secure alternative to expensive operating systems, Linux is a UNIX-based, open source operating system. Full-color and concise, this beginner's guide takes a learning-by-doing approach to understanding the essentials of Linux. Each chapter begins by clearly identifying what you will learn in the chapter, followed by a straightforward discussion of concepts that leads you right into hands-on tutorials. Chapters conclude with additional exercises and review questions, allowing you to reinforce and measure your underst

  12. Essential SQLAlchemy

    CERN Document Server

    Copeland, Rick

    2008-01-01

    Essential SQLAlchemy introduces a high-level open-source code library that makes it easier for Python programmers to access relational databases such as Oracle, DB2, MySQL, PostgreSQL, and SQLite. SQLAlchemy has become increasingly popular since its release, but it still lacks good offline documentation. This practical book fills the gap, and because a developer wrote it, you get an objective look at SQLAlchemy's tools rather than an advocate's description of all the "cool" features. SQLAlchemy includes both a database server-independent SQL expression language and an object-relational mappe

  13. Prezi essentials

    CERN Document Server

    Sinclair, Domi

    2014-01-01

    If you want to learn Prezi, and specifically design within Prezi, this is the book for you. Perhaps you already know a bit about Prezi but have never used it, or perhaps you have used Prezi before but want to learn how to incorporate your own custom design elements. In either case, this book will get you up and running quickly. It would be helpful to have a bit of familiarity with basic design concepts and the use of Prezi, but prior experience is not essential.

  14. Travel medicine

    Science.gov (United States)

    Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

    2014-01-01

    Abstract Objective To define the practice of travel medicine, provide the basics of a comprehensive pretravel consultation for international travelers, and assist in identifying patients who might require referral to travel medicine professionals. Sources of information Guidelines and recommendations on travel medicine and travel-related illnesses by national and international travel health authorities were reviewed. MEDLINE and EMBASE searches for related literature were also performed. Main message Travel medicine is a highly dynamic specialty that focuses on pretravel preventive care. A comprehensive risk assessment for each individual traveler is essential in order to accurately evaluate traveler-, itinerary-, and destination-specific risks, and to advise on the most appropriate risk management interventions to promote health and prevent adverse health outcomes during travel. Vaccinations might also be required and should be personalized according to the individual traveler’s immunization history, travel itinerary, and the amount of time available before departure. Conclusion A traveler’s health and safety depends on a practitioner’s level of expertise in providing pretravel counseling and vaccinations, if required. Those who advise travelers are encouraged to be aware of the extent of this responsibility and to refer all high-risk travelers to travel medicine professionals whenever possible. PMID:25500599

  15. Mesopotamian medicine.

    Science.gov (United States)

    Retief, F P; Cilliers, L

    2007-01-01

    Although the Mesopotamian civilisation is as old as that of Egypt and might even have predated it, we know much less about Mesopotamian medicine, mainly because the cuneiform source material is less well researched. Medical healers existed from the middle of the 3rd millennium. In line with the strong theocratic state culture, healers were closely integrated with the powerful priestly fraternity, and were essentially of three main kinds: barû (seers) who were experts in divination, âshipu (exorcists), and asû (healing priests) who tended directly to the sick. All illness was accepted as sent by gods, demons and other evil spirits, either as retribution for sins or as malevolent visitations. Treatment revolved around identification of the offending supernatural power, appeasement of the angry gods, for example by offering amulets or incantations, exorcism of evil spirits, as well as a measure of empirical therapy aimed against certain recognised symptom complexes. Medical practice was rigidly codified, starting with Hammurabi's Code in the 18th century BC and persisting to the late 1st millennium BC. Works like the so-called Diagnostic Handbook, the Assyrian Herbal and Prescription Texts describe the rationale of Mesopotamian medicine, based predominantly on supernatural concepts, although rudimentary traces of empirical medicine are discernible. There is evidence that Egyptian medicine might have been influenced by Mesopotamian practices, but Greek rational medicine as it evolved in the 5th/4th centuries BC almost certainly had no significant Mesopotamian roots.

  16. Essential astrophysics

    CERN Document Server

    Lang, Kenneth R

    2013-01-01

    Essential Astrophysics is a book to learn or teach from, as well as a fundamental reference volume for anyone interested in astronomy and astrophysics. It presents astrophysics from basic principles without requiring any previous study of astronomy or astrophysics. It serves as a comprehensive introductory text, which takes the student through the field of astrophysics in lecture-sized chapters of basic physical principles applied to the cosmos. This one-semester overview will be enjoyed by undergraduate students with an interest in the physical sciences, such as astronomy, chemistry, engineering or physics, as well as by any curious student interested in learning about our celestial science. The mathematics required for understanding the text is on the level of simple algebra, for that is all that is needed to describe the fundamental principles. The text is of sufficient breadth and depth to prepare the interested student for more advanced specialized courses in the future. Astronomical examples are provide...

  17. Asthma essentials

    Directory of Open Access Journals (Sweden)

    Timothy Greene

    2013-12-01

    Full Text Available Asthma is a chronic, reversible obstructive disease that when in exacerbation can present to the emergency department in a spectrum of severity. Prompt recognition of the potentially severely ill asthmatic requires a careful history and physical exam while considering alternative diagnoses for the presenting symptoms. Early administration of salbutamol and corticosteroids is indicated in almost all patients with other medications such as ipratropium and magnesium and supportive modalities like BiPAP reserved for sicker patients. The global impact of asthma is increasing, especially amongst children. While the benign clinical presentation is most common and mortality has decreased in recent decades due to improved recognition and care, the ubiquity of the condition and frequent lack of regular outpatient management contribute to the disease claiming 250,000 lives worldwide annually. The emergency physician must be prepared to assess and appropriately manage both the young child with a mild wheeze and the adult in respiratory failure.

  18. The medicine from behind

    NARCIS (Netherlands)

    Andel, Van Tinde; Onselen, Van Sabine; Myren, Britt; Towns, Alexandra; Quiroz, Diana

    2015-01-01

    Ethnopharmacological relevance Purgative enemas form an integral part of African traditional medicine. Besides possible benefits, serious health risks of rectal herbal therapy have been described in literature. To design appropriate health education programs, it is essential to understand

  19. Evaluating a Human Rights-Based Advocacy Approach to Expanding Access to Pain Medicines and Palliative Care: Global Advocacy and Case Studies from India, Kenya, and Ukraine.

    Science.gov (United States)

    Lohman, Diederik; Amon, Joseph J

    2015-12-10

    Palliative care has been defined as care that is person-centered and attentive to physical symptoms and psychological, social, and existential distress in patients with severe or life-threatening illness. The identification of access to palliative care and pain treatment as a human rights issue first emerged among palliative care advocates, physicians, and lawyers in the 1990s, with a basis in the right to health and the right to be free from cruel, inhuman, and degrading treatment. Using a case study approach, we evaluate the results of a human rights-based advocacy approach on access to pain medicine and palliative care in India, Kenya, and Ukraine. In each country, human rights advocacy helped raise awareness of the issue, identify structural barriers to care, define government obligations, and contribute to the reform of laws, policies, and practices impeding the availability of palliative care services. In addition, advocacy efforts stimulated civil society engagement and high-level political leadership that fostered the implementation of human rights-based palliative care programs. Globally, access to palliative care was increasingly recognized by human rights bodies and within global health and drug policy organizations as a government obligation central to the right to health. Copyright © 2015 Lohman, Amon. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

  20. Autecology Essential Oil Composition, Antibacterial, Anti Candidacies and Ethnopharmacological Survey of Ferula Gummosa L. As Anti Infection to Treat Of Vaginal Infections in Traditional Medicine of Razavi Khorasan Province (North East of Iran

    Directory of Open Access Journals (Sweden)

    Mazandarani Masoumeh

    2015-04-01

    Full Text Available Objective: Ferula gummosa Boiss. (Apiaceae family, which has been used in traditional medicine of Iran as anti vaginal infection, anti-sinusitis, sedative, and anti-inflammation. Materials and Methods: In this research, the gums of plant root were collected from the Heidary nature reserve in Razavi Khorasan Province (Iran in August 2012. The ethnopharmacological data about traditional uses of plant were obtained from the rural healers (women 67-75 year of this region. Essential oil of the plant root gum was obtained by hydrodistillation (Clevenger apparatus and was analyzed by gas chromatography–mass spectrometry. Antibacterial activity of plant ethanolic extract was studied in vitro against Candida albicans and 9 Gram-positive and negative bacteria using well method and the minimum inhibitory concentration (MIC assay. Results: Results showed that a total of 39 components have been identified in the plant sampl oil, representing 81% of the total oil and β-pinene (19.88%, guaiol (8%, shyobunone (6.96%, delta-cadinene (4.65%, α-pinene (3.16 %, β-phellandrene (3.28% and myrtenol (2.8%, were the main essential oil composition, respectively. The results from antibacterial screening (Table 2, were showed that C. albicans (25.2 ± 1.6, Staphylococcus epidermidis (23.6 ± 0.7 mm, Staphylococcus aureus (21.3 ± 0.2 mm, Escherichia coli (16.5 ± 0.8 mm, Bacillus cereus (19.5 ± 0.1 mm, Enterococcus faecalis (17.2 ± 0.8 mm and Pseudomonas aeroginosa ( 17.8 ± 0.2 mm inhibition zone and MIC (35.4-112 μg/ml were the most sensitive pathogenes to the plant extract respectively, which followed Shigella (12.3 ± 0.3 mm and Klebsiella pneumonia (12.5 ± 0.2 mm were found to be moderate sensitive bacteria and then the Salmonella typhymorium which completely was resistant to plant root extract. Conclusion: According to these results, it can be concluded that the extract of F. gummosa L. have suitable antimicrobial and anti-Candidacies activity, which can be

  1. The current uses of radiation in medicine

    International Nuclear Information System (INIS)

    Shrimpton, P.C.

    2001-01-01

    Ionizing radiation is firmly established as an essential tool for diagnosis and therapy in medicine, although patterns of use vary widely around the world. Diagnostic examinations are conducted mainly with X rays (diagnostic radiology) and less commonly by administering radiopharmaceuticals to patients (nuclear medicine). Radiotherapy is mostly carried out using external beams of radiation (teletherapy), although some patients receive direct applications of sealed radionuclide sources (brachytherapy) or therapeutic administrations of radiopharmaceuticals. Global data from the United Nations Scientific Committee on the Effects of Atomic Radiation indicate an annual total of about 2500 million diagnostic radiological examinations in 1996: 78% involving medical X rays (at a mean rate of 330 per 1000 world population), 21% involving dental X rays (mean rate 90 per 1000) and only 1% involving nuclear medicine (mean rate 5.6 per 1000). Over 90% of the estimated annual total of about 5.5 million complete courses of radiation treatment are conducted by teletherapy or brachytherapy, with mean rates of 0.8 and 0.07 per 1000 world population, respectively; radiopharmaceuticals are used in only 7% of all treatments (mean rate 0.065 per 1000). Over three quarters of all diagnostic procedures and over half of all treatments occur in developed countries, which collectively represent only one quarter of the world population. The general global trend is for increasing numbers of procedures. The paper discusses the current uses of radiation in medicine, including diagnostic radiology, diagnostic nuclear medicine and radiotherapy. (author)

  2. The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group

    Directory of Open Access Journals (Sweden)

    Berendonk, Christoph

    2015-10-01

    Full Text Available Objective: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. Methods: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning, implemented in the examination (implementation and subsequently evaluated (reflection. The presented results are the product of this iterative procedure.Results: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation and the meetings of the standardised patient trainers (standardisation have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination.Conclusion: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a

  3. Use of non-steroidal anti-inflammatory drugs that elevate cardiovascular risk: an examination of sales and essential medicines lists in low-, middle-, and high-income countries.

    Directory of Open Access Journals (Sweden)

    Patricia McGettigan

    Full Text Available BACKGROUND: Certain non-steroidal anti-inflammatory drugs (NSAIDs (e.g., rofecoxib [Vioxx] increase the risk of heart attack and stroke and should be avoided in patients at high risk of cardiovascular events. Rates of cardiovascular disease are high and rising in many low- and middle-income countries. We studied the extent to which evidence on cardiovascular risk with NSAIDs has translated into guidance and sales in 15 countries. METHODS AND FINDINGS: Data on the relative risk (RR of cardiovascular events with individual NSAIDs were derived from meta-analyses of randomised trials and controlled observational studies. Listing of individual NSAIDs on Essential Medicines Lists (EMLs was obtained from the World Health Organization. NSAID sales or prescription data for 15 low-, middle-, and high-income countries were obtained from Intercontinental Medical Statistics Health (IMS Health or national prescription pricing audit (in the case of England and Canada. Three drugs (rofecoxib, diclofenac, etoricoxib ranked consistently highest in terms of cardiovascular risk compared with nonuse. Naproxen was associated with a low risk. Diclofenac was listed on 74 national EMLs, naproxen on just 27. Rofecoxib use was not documented in any country. Diclofenac and etoricoxib accounted for one-third of total NSAID usage across the 15 countries (median 33.2%, range 14.7-58.7%. This proportion did not vary between low- and high-income countries. Diclofenac was by far the most commonly used NSAID, with a market share close to that of the next three most popular drugs combined. Naproxen had an average market share of less than 10%. CONCLUSIONS: Listing of NSAIDs on national EMLs should take account of cardiovascular risk, with preference given to low risk drugs. Diclofenac has a risk very similar to rofecoxib, which was withdrawn from worldwide markets owing to cardiovascular toxicity. Diclofenac should be removed from EMLs.

  4. Optimizing Clinical Operations as part of a Global Emergency Medicine Initiative in Kumasi, Ghana: Application of Lean Manufacturing Principals to Low Resource Health Systems

    Science.gov (United States)

    Carter, Patrick M.; Desmond, Jeffery S.; Akanbobnaab, Christopher; Oteng, Rockefeller A.; Rominski, Sarah; Barsan, William G.; Cunningham, Rebecca

    2012-01-01

    Background Although many global health programs focus on providing clinical care or medical education, improving clinical operations can have a significant effect on patient care delivery, especially in developing health systems without high-level operations management. Lean manufacturing techniques have been effective in decreasing emergency department (ED) length of stay, patient waiting times, numbers of patients leaving without being seen, and door-to-balloon times for ST-elevation myocardial infarction in developed health systems; but use of Lean in low to middle income countries with developing emergency medicine systems has not been well characterized. Objectives To describe the application of Lean manufacturing techniques to improve clinical operations at Komfo Anokye Teaching Hospital in Ghana and to identify key lessons learned to aid future global EM initiatives. Methods A three-week Lean improvement program focused on the hospital admissions process at Komfo Anokye Teaching Hospital was completed by a 14-person team in six stages: problem definition, scope of project planning, value stream mapping, root cause analysis, future state planning, and implementation planning. Results The authors identified eight lessons learned during our use of Lean to optimize the operations of an ED in a global health setting: 1) the Lean process aided in building a partnership with Ghanaian colleagues; 2) obtaining and maintaining senior institutional support is necessary and challenging; 3) addressing power differences among the team to obtain feedback from all team members is critical to successful Lean analysis; 4) choosing a manageable initial project is critical to influence long-term Lean use in a new environment; 5) data intensive Lean tools can be adapted and are effective in a less resourced health system; 6) several Lean tools focused on team problem solving techniques worked well in a low resource system without modification; 7) using Lean highlighted that

  5. Imaging and development of medicines

    International Nuclear Information System (INIS)

    Syrota, A.

    2000-01-01

    The last developments in medical imaging allow visualization of medicines in organism. Today, these techniques: positron emission tomography (PET) and single photon emission computed tomography (SPECT) play an essential role in the production and the development of new medicines. The medicinal substances labelled with radioisotopes permit to improve the understanding of medicines' action mode. The spectacular advances were observed in the field of medicines acting on the brain (F.M.)

  6. Nuclear Medicine

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Nuclear Medicine What is nuclear medicine? What are radioactive tracers? ... funded researchers advancing nuclear medicine? What is nuclear medicine? Nuclear medicine is a medical specialty that uses ...

  7. Innovative Approaches to Increase Access to Medicines in Developing Countries

    Directory of Open Access Journals (Sweden)

    Hilde Stevens

    2017-12-01

    Full Text Available Access to essential medicines is problematic for one third of all persons worldwide. The price of many medicines (i.e., drugs, vaccines, and diagnostics is unaffordable to the majority of the population in need, especially in least-developed countries, but also increasingly in middle-income countries. Several innovative approaches, based on partnerships, intellectual property, and pricing, are used to stimulate innovation, promote healthcare delivery, and reduce global health disparities. No single approach suffices, and therefore stakeholders need to further engage in partnerships promoting knowledge and technology transfer in assuring essential medicines to be manufactured, authorized, and distributed in low- and middle-income countries (LMICs in an effort of making them available at affordable and acceptable conditions.

  8. Global issues in environmental medicine.

    Science.gov (United States)

    Goldstein, B D

    1993-03-01

    This overview will discuss a number of the issues posed by the challenge of international environmental health. The reasons that environmental problems occurring elsewhere in the world are of importance to occupational and environmental physicians in North America include the interconnectedness of the biosphere of our planet so that environmental alterations in one part of the globe can have an adverse outcome on our health and well-being; the often high levels of pollution and environmental degradation elsewhere provide an opportunity to determine and predict adverse consequences of environmental agents pertinent to protecting our own health; and, most importantly, our own ability to provide assistance in helping economic development occur in a setting of low risk of environmental pollution.

  9. Global Cancer Humanitarian Award

    Science.gov (United States)

    Pat Garcia-Gonzalez of the Max Foundation accepted the first annual NCI Global Cancer Medicine Humanitarian Award for her work in chronic myeloid leukemia at the NCI, Center for Global Health Symposium for Global Cancer Research, held in Boston on March 25, 2015.

  10. Practical nuclear medicine

    CERN Document Server

    Gemmell, Howard G; Sharp, Peter F

    2006-01-01

    Nuclear medicine plays a crucial role in patient care, and this book is an essential guide for all practitioners to the many techniques that inform clinical management. The first part covers the scientific basis of nuclear medicine, the rest of the book deals with clinical applications. Diagnostic imaging has an increasingly important role in patient management and, despite advances in other modalities (functional MRI and spiral CT), nuclear medicine continues to make its unique contribution by its ability to demonstrate physiological function. This book is also expanded by covering areas of d

  11. Chemical composition of essential oils and in vitro antioxidant activity of fresh and dry leaves crude extracts of medicinal plant of Lactuca Sativa L. native to Sultanate of Oman.

    Science.gov (United States)

    Al Nomaani, Rahma Said Salim; Hossain, Mohammad Amzad; Weli, Afaf Mohammed; Al-Riyami, Qasim; Al-Sabahi, Jamal Nasser

    2013-05-01

    To isolate and analyse the chemical composition in the essential oils and free radical scavenging activity of different crude extracts from the fresh and dry leaves of vegetable plants of Lactuca sativa L. (L. sativa). The essential oils and volatile chemical constituents were isolated from the fresh and dry leaves of L. sativa (lettuce) grown in Sultanate of Oman by hydro distillation method. The antioxidant activity of the crude extracts was carried out by well established free radical scavenging activity (DPPH) method. About 20 chemical compounds of different concentration representing 83.07% and 79.88% respectively were isolated and identified by gas chromatography-mass spectroscopy in the essential oils isolated from the fresh and dry leaves as α-pinene (5.11% and 4.05%), γ-cymene (2.07% and 1.92%), thymol (11.55% and 10.73%), durenol (52.00% and 49.79%), α-terpinene (1.66% and 1.34%), thymol acetate (0.99% and 0.67%), caryophyllene (2.11% and 1.98%), spathulenol (3.09% and 2.98%), camphene (4.11% and 3.65%), limonene (1.28% and 1.11%) representing these major chemical compounds. However, some other minor chemical constituents were also isolated and identified from the essential oil of lettuce including β-pinene, α-terpinolene, linalool, 4-terpineol, α-terpineol, o-methylthymol, L-alloaromadendrene and viridiflorene. The chemical constituents in the essential oils from the locally grown lettuce were identified in the following classes or groups of chemical compounds such as monoterpenes, sesquiterpenes volatile organic compounds and their oxygenated hydrocarbons. Therefore, the essential oils and the crude extracts from Omani vegetable species of lettuce are active candidates which would be used as antioxidant, antifungal or antimicrobial agents in new drugs preparation for therapy of infectious diseases.

  12. Aerospace Medicine

    Science.gov (United States)

    Michaud, Vince

    2015-01-01

    NASA Aerospace Medicine overview - Aerospace Medicine is that specialty area of medicine concerned with the determination and maintenance of the health, safety, and performance of those who fly in the air or in space.

  13. Levels of essential and non-essential metals in Rhamnus prinoides ...

    African Journals Online (AJOL)

    The objective of this study was to assess the levels of essential and toxic metals in leaf and stem of Rhamnus prinoides which are used for bitterness of local alcoholic beverages in Ethiopia and as traditional medicine in some African countries. Levels of essential metals (Ca, Mg, Cr, Mn, Fe, Co, Ni, Cu and Zn) and toxic ...

  14. Pharmacokinetic profile of phytoconstituent(s isolated from medicinal plants—A comprehensive review

    Directory of Open Access Journals (Sweden)

    Piyush Mehta

    2015-10-01

    Full Text Available Herbal medicine, the backbone of traditional medicine, has played an important role in human health and welfare for a long period. Traditional therapeutic approaches of regional significance are found in Africa, South and Central America, China, India, Tibet, Indonesia, and the Pacific Islands. The considerable scientific significance and commercial potential of traditional medicines have resulted in increased international attention and global market demands for herbal medicines, especially Chinese herbal medicines. Herbal medicines currently are the primary form of health care for the poor in the developing countries, and also are widely used as a supplement or substitute for conventional drugs in developed countries. These traditional medicines have a pivotal role in the treatment of various ailments and more than 50% of drugs used in Western pharmacopoeia are isolated from herbs or derived from modifications of chemicals found in plants. Herbal medicines usually contain a complex mixture of various bioactive molecules, which make its standardization complicated, and there is little information about all compounds responsible for pharmacological activity. Several research papers have been published that claim pharmacological activity of herbal medicines but few are discussing the role of the exact phytoconstituent. Understanding the pharmacokinetic profile of such phytoconstituents is essential. Although there are research papers that deal with pharmacokinetic properties of phytoconstituents, there are a number of phytoconstituents yet to be explored for their kinetic properties. This article reviews the pharmacokinetic profile of 50 different therapeutically effective traditional medicinal plants from the year 2003 onward.

  15. Im/mobilities and dis/connectivities in medical globalisation: How global is Global Health?

    Science.gov (United States)

    Dilger, Hansjörg; Mattes, Dominik

    2018-03-01

    The interdisciplinary, politically contested field of Global Health has often been described as a consequence of, and response to, an intensification of the mobilities of, and connectivities between, people, pathogens, ideas, and infrastructure across national borders and large distances. However, such global mobilities and connectivities are not as omnidirectional and unpatterned as the rhetoric of many Global Health actors suggests. Instead, we argue that they are suffused by a plethora of institutional, national, and global political agendas, and substantially shaped by transnational and postcolonial power relations. Furthermore, the configurations that are typically subsumed under the category of Global Health represent only a minor part of the range of im/mobilities and dis/connectivities that are essential for understanding transformations of epidemiological patterns, health care infrastructures, and the responses to health-related challenges in a globalising world. In order to broaden such a limiting analytical perspective, we propose to expand the analytical focus in studying Global Health phenomena by paying close attention to the myriad ways in which particular im/mobilities and dis/connectivities constitute medicine and well-being in global and transnational settings. Pursuing a conceptual shift from studies of 'Global Health' to studying 'medical globalization' may carve out new analytical ground for such an endeavour.

  16. Introductory physics of nuclear medicine. Third edition

    International Nuclear Information System (INIS)

    Chandra, R.

    1987-01-01

    The new third edition includes essential details and many examples and problems taken from the routine practice of nuclear medicine. Basic principles and underlying concepts are explained, although it is assumed that the reader has some current use as a bone densitometer. For resident physicians in nuclear medicine, residents in pathology, radiology, and internal medicine, and students of nuclear medicine technology, the third edition offers a simplified and reliable approach to the physics and basic sciences of nuclear medicine

  17. Nuclear medicine

    International Nuclear Information System (INIS)

    Lentle, B.C.

    1986-01-01

    Several growth areas for nuclear medicine were defined. Among them were: cardiac nuclear medicine, neuro-psychiatric nuclear medicine, and cancer diagnosis through direct tumor imaging. A powerful new tool, Positron Emission Tomography (PET) was lauded as the impetus for new developments in nuclear medicine. The political environment (funding, degree of autonomy) was discussed, as were the economic and scientific environments

  18. Heart failure - medicines

    Science.gov (United States)

    CHF - medicines; Congestive heart failure - medicines; Cardiomyopathy - medicines; HF - medicines ... You will need to take most of your heart failure medicines every day. Some medicines are taken ...

  19. Partnerships in global health and collaborative governance: lessons learnt from the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals.

    Science.gov (United States)

    Beran, David; Aebischer Perone, Sigiriya; Alcoba, Gabriel; Bischoff, Alexandre; Bussien, Claire-Lise; Eperon, Gilles; Hagon, Olivier; Heller, Olivia; Jacquerioz Bausch, Frédérique; Perone, Nicolas; Vogel, Thomas; Chappuis, François

    2016-04-29

    In 2007 the "Crisp Report" on international partnerships increased interest in Northern countries on the way their links with Southern partners operated. Since its establishment in 2007 the Division of Tropical and Humanitarian Medicine at the Geneva University Hospitals has developed a variety of partnerships. Frameworks to assess these partnerships are needed and recent attention in the field of public management on collaborative governance may provide a useful approach for analyzing international collaborations. Projects of the Division of Tropical and Humanitarian Medicine were analyzed by collaborators within the Division using the model proposed by Emerson and colleagues for collaborative governance, which comprises different components that assess the collaborative process. International projects within the Division of Tropical and Humanitarian Medicine can be divided into four categories: Human resource development; Humanitarian response; Neglected Tropical Diseases and Noncommunicable diseases. For each of these projects there was a clear leader from the Division of Tropical and Humanitarian Medicine as well as a local counterpart. These individuals were seen as leaders both due to their role in establishing the collaboration as well as their technical expertise. Across these projects the actual partners vary greatly. This diversity means a wide range of contributions to the collaboration, but also complexity in managing different interests. A common definition of the collaborative aims in each of the projects is both a formal and informal process. Legal, financial and administrative aspects of the collaboration are the formal elements. These can be a challenge based on different administrative requirements. Friendship is part of the informal aspects and helps contribute to a relationship that is not exclusively professional. Using collaborative governance allows the complexity of managing partnerships to be presented. The framework used highlights the

  20. Addressing the challenge of high-priced prescription drugs in the era of precision medicine : a systematic review of drug life cycles, therapeutic drug markets and regulatory frameworks.

    NARCIS (Netherlands)

    van der Gronde, T.; Uyl-de Groot, Carin A; Pieters, A.H.L.M.

    2017-01-01

    Context. Recent public outcry has highlighted the rising cost of prescription drugs worldwide, which in several disease areas outpaces other health care expenditures and results in a suboptimal global availability of essential medicines. Method. A systematic review of Pubmed, the Financial Times,

  1. Addressing the challenge of high-priced prescription drugs in the era of precision medicine : A systematic review of drug life cycles, therapeutic drug markets and regulatory frameworks

    NARCIS (Netherlands)

    Gronde, T.V. (Toon van der); C.A. Uyl-de Groot (Carin); Pieters, T. (Toine)

    2017-01-01

    markdownabstractCONTEXT: Recent public outcry has highlighted the rising cost of prescription drugs worldwide, which in several disease areas outpaces other health care expenditures and results in a suboptimal global availability of essential medicines. METHOD: A systematic review of Pubmed, the

  2. Interpretive Medicine

    Science.gov (United States)

    Reeve, Joanne

    2010-01-01

    Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the

  3. Essential oil extraction with concentrating solar thermal energy

    OpenAIRE

    Veynandt, François

    2015-01-01

    Material complementari del cas estudi "Essential oil extraction with concentrating solar thermal energy”, part component del llibre "Case studies for developing globally responsible engineers" Peer Reviewed

  4. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Management Sciences for Health (MSH) defined ... Poor supply chains, weak stock ... pharmacies and patent medicine stores for their ACT supply. ..... Global Health Observatory (GHO); program. ... logistics of supply and distribution is yet to be.

  5. Global benchmarking of medical student learning outcomes? Implementation and pilot results of the International Foundations of Medicine Clinical Sciences Exam at The University of Queensland, Australia.

    Science.gov (United States)

    Wilkinson, David; Schafer, Jennifer; Hewett, David; Eley, Diann; Swanson, Dave

    2014-01-01

    To report pilot results for international benchmarking of learning outcomes among 426 final year medical students at the University of Queensland (UQ), Australia. Students took the International Foundations of Medicine (IFOM) Clinical Sciences Exam (CSE) developed by the National Board of Medical Examiners, USA, as a required formative assessment. IFOM CSE comprises 160 multiple-choice questions in medicine, surgery, obstetrics, paediatrics and mental health, taken over 4.5 hours. Significant implementation issues; IFOM scores and benchmarking with International Comparison Group (ICG) scores and United States Medical Licensing Exam (USMLE) Step 2 Clinical Knowledge (CK) scores; and correlation with UQ medical degree cumulative grade point average (GPA). Implementation as an online exam, under university-mandated conditions was successful. Mean IFOM score was 531.3 (maximum 779-minimum 200). The UQ cohort performed better (31% scored below 500) than the ICG (55% below 500). However 49% of the UQ cohort did not meet the USMLE Step 2 CK minimum score. Correlation between IFOM scores and UQ cumulative GPA was reasonable at 0.552 (p benchmarking is feasible and provides a variety of useful benchmarking opportunities.

  6. Treatment of Essential Tremor

    Science.gov (United States)

    ... for PATIENTS and their FAMILIES TREATMENT OF ESSENTIAL TREMOR This fact sheet is provided to help you understand which therapies help treat essential tremor. Neurologists from the American Academy of Neurology are ...

  7. Mining the essential oils of the Anthemideae

    African Journals Online (AJOL)

    Administrator

    herbal forms of medicine and relaxation (such as aromatherapy), and .... (Flower bud, aerial part, cell suspension) α-farnesene 0-91, 3-OH .... (Leaf, stem); camphor 32, pulegone 15, 1,8-cineole 13. n.s. ..... Volatile oil-containing drugs and essential oils have ...... Achillea asplenifolia Vent. through multiple shoot regeneration.

  8. The convergence of medicine and neurotoxins: a focus on botulinum toxin type A and its application in aesthetic medicine--a global, evidence-based botulinum toxin consensus education initiative: part II: incorporating botulinum toxin into aesthetic clinical practice.

    Science.gov (United States)

    Carruthers, Jean; Fournier, Nathalie; Kerscher, Martina; Ruiz-Avila, Javier; Trindade de Almeida, Ada R; Kaeuper, Gina

    2013-03-01

    The new world of safe aesthetic injectables has become increasingly popular with patients. Not only is there less risk than with surgery, but there is also significantly less downtime to interfere with patients' normal work and social schedules. Botulinum toxin (BoNT) type A (BoNTA) is an indispensable tool used in aesthetic medicine, and its broad appeal has made it a hallmark of modern culture. The key to using BoNTA to its best effect is to understand patient-specific factors that will determine the treatment plan and the physician's ability to personalize injection strategies. To present international expert viewpoints and consensus on some of the contemporary best practices in aesthetic BoNTA, so that beginner and advanced injectors may find pearls that provide practical benefits. Expert aesthetic physicians convened to discuss their approaches to treatment with BoNT. The discussions and consensus from this meeting were used to provide an up-to-date review of treatment strategies to improve patient results. Information is presented on patient management and assessment, documentation and consent, aesthetic scales, injection strategies, dilution, dosing, and adverse events. A range of product- and patient-specific factors influence the treatment plan. Truly optimized outcomes are possible only when the treating physician has the requisite knowledge, experience, and vision to use BoNTA as part of a unique solution for each patient's specific needs. © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  9. Diabetes Medicines

    Science.gov (United States)

    Diabetes means your blood glucose, or blood sugar, levels are too high. If you can't control your diabetes with wise food choices and physical activity, you may need diabetes medicines. The kind of medicine you take depends ...

  10. Herbal Medicine

    Science.gov (United States)

    ... used for its scent, flavor, or therapeutic properties. Herbal medicines are one type of dietary supplement. They are ... extracts, and fresh or dried plants. People use herbal medicines to try to maintain or improve their health. ...

  11. Addressing legal and political barriers to global pharmaceutical access: options for remedying the impact of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the imposition of TRIPS-plus standards.

    Science.gov (United States)

    Cohen-Kohler, Jillian Clare; Forman, Lisa; Lipkus, Nathaniel

    2008-07-01

    Despite myriad programs aimed at increasing access to essential medicines in the developing world, the global drug gap persists. This paper focuses on the major legal and political constraints preventing implementation of coordinated global policy solutions - particularly, the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and bilateral and regional free trade agreements. We argue that several policy and research routes should be taken to mitigate the restrictive impact of TRIPS and TRIPS-plus rules, including greater use of TRIPS flexibilities, advancement of human rights, and an ethical framework for essential medicines distribution, and a broader campaign that debates the legitimacy of TRIPS and TRIPS-plus standards themselves.

  12. Global emergency medicine journal club: a social media discussion about the Age-Adjusted D-Dimer Cutoff Levels To Rule Out Pulmonary Embolism trial.

    Science.gov (United States)

    Rezaie, Salim R; Swaminathan, Anand; Chan, Teresa; Shaikh, Sam; Lin, Michelle

    2015-05-01

    Annals of Emergency Medicine collaborated with an educational Web site, Academic Life in Emergency Medicine (ALiEM), to host an online discussion session featuring the 2014 Journal of the American Medical Association publication on the Age-Adjusted D-Dimer Cutoff Levels to Rule Out Pulmonary Embolism (ADJUST-PE) trial by Righini et al. The objective is to describe a 14-day (August 25 to September 7, 2014) worldwide academic dialogue among clinicians in regard to 4 preselected questions about the age-adjusted D-dimer cutoff to detect pulmonary embolism. Five online facilitators hosted the multimodal discussion on the ALiEM Web site, Twitter, and Google Hangout. Comments across the social media platforms were curated for this report, as framed by the 4 preselected questions, and engagement was tracked through various Web analytic tools. Blog and Twitter comments, as well as video expert commentary involving the ADJUST-PE trial, are summarized. The dialogue resulted in 1,169 page views from 391 cities in 52 countries on the ALiEM Web site, 502,485 Twitter impressions, and 159 views of the video interview with experts. A postdiscussion summary on the Journal Jam podcast resulted in 3,962 downloads in its first week of publication during September 16 to 23, 2014. Common themes that arose in the multimodal discussions included the heterogeneity of practices, D-dimer assays, provider knowledge about these assays, and prevalence rates in different areas of the world. This educational approach using social media technologies demonstrates a free, asynchronous means to engage a worldwide audience in scholarly discourse. Copyright © 2015 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  13. Folk Medicine

    Science.gov (United States)

    ... lead’s effects on health. How to tell if herbal medicines or folk medicines contain lead You only can ... as high as 90%. Ghasard, an Indian folk medicine, has also been found to contain lead. It is a brown powder used as a tonic. Ba-baw-san is a Chinese herbal remedy that contains lead. It is used to ...

  14. Human resource development contributes to the creation of outstanding regenerative medicine products

    Directory of Open Access Journals (Sweden)

    Fusako Nishigaki

    2017-12-01

    Full Text Available Regenerative medicine is currently the focus of global attention. Countries all around the world are actively working to create new regenerative treatment modalities through pioneering research and novel technologies. This is wonderful news for patients who could not be treated with existing medical options. New venture businesses and companies are being established in regenerative medicine and their rapid industrialization is anticipated. However, to ensure high-quality products, human resources qualified in research and development and the manufacturing of these products are essential. The Forum for Innovative Regenerative Medicine (FIRM conducted a questionnaire of its industry members to examine the training and hiring of people in research and development, product creation, manufacturing, and more. Regenerative medicine is a brand new field; thus, many different businesses will need to cooperate together. People with a broad range of technical skills, abilities, and knowledge will be in demand, with various levels of expertise, from basic to advanced.

  15. Approach to Health Supporting System Using Traditional Chinese Medicine

    Science.gov (United States)

    Watsuji, Tadashi; Shinohara, Shoji; Arita, Seizaburo

    The primary prevention of disease related to the lifestyle is an essential theme in medical research. Preventing before it arises is the important concept in traditional Chinese medicine (TCM). Since TCM, which emphasizes individual physical condition in medical treatment, has recently attracted considerable attention globally, objective diagnostic methods in TCM have been investigated in this work. Firstly, the fuzzy theory was applied to develop a tongue diagnosis supporting system based on the tongue diagnosis in TCM. Secondly, the usefulness of TCM health questionnaire was examined to identify individual physical condition. Our results suggest that the TCM health questionnaire is useful in the construction of a health supporting system based on TCM.

  16. Globalization and democracy

    Directory of Open Access Journals (Sweden)

    DEEPAK NAYYAR

    2015-09-01

    Full Text Available ABSTRACTThe gathering momentum of globalization in the world economy has coincided with the spread of political democracy across countries. Economies have become global. But politics remains national. This essay explores the relationship between globalization and democracy, which is neither linear nor characterized by structural rigidities. It seeks to analyze how globalization might constrain degrees of freedom for nation states and space for democratic politics, and how political democracy within countries might exercise some checks and balances on markets and globalization. The essential argument is that the relationship between globalization and democracy is dialectical and does not conform to ideological caricatures.

  17. Benefits of global partnerships to facilitate access to medicines in developing countries: a multi-country analysis of patients and patient outcomes in GIPAP

    Directory of Open Access Journals (Sweden)

    Vandoros Sotiris

    2009-12-01

    Full Text Available Abstract Background Access to medicines in developing countries continues to be a significant problem due to lack of insurance and lack of affordability. Chronic Myeloid Leukemia (CML, a rare disease, can be treated effectively, but the pharmaceutical treatment available (imatinib is costly and unaffordable by most patients. GIPAP, is a programme set up between a manufacturer and an NGO to provide free treatment to eligible CML patients in 80 countries worldwide. Objectives To discuss the socio-economic and demographic characteristics of patients participating in GIPAP; to research the impact GIPAP is having on health outcomes (survival of assistance-eligible CML patients; and to discuss the determinants of such outcomes and whether there are any variations according to socio-economic, demographic, or geographical criteria. Methods Data for 13,568 patients across 15 countries, available quarterly, were analysed over the 2005-2007 period. Ordered Probit panel data analysis was used to analyze the determinants of a patient's progress in terms of participation in the programme. Four waves of patients entering quarterly in 2005 were used to evaluate patient survival over the sample period. Results All patients in the sample are eligible to receive treatment provided they report to a facility quarterly. 62.3% of patients were male and 37.7% female. The majority (84.4% entered during the chronic phase of the disease and their average age was 38.4 years. Having controlled for age, location and occupation, the analysis showed that patients were significantly much more likely to move towards a better health state after receiving treatment irrespective of their disease stage at the point of entry to the program (OR = 30.5, α = 1%; and that the larger the gap between diagnosis and approval for participation in the program, the more likely it is that patients' condition deteriorates (OR = 0.995, α = 1%, due to absence of treatment. Regressions to account

  18. Benefits of global partnerships to facilitate access to medicines in developing countries: a multi-country analysis of patients and patient outcomes in GIPAP.

    Science.gov (United States)

    Kanavos, Panos; Vandoros, Sotiris; Garcia-Gonzalez, Pat

    2009-12-31

    Access to medicines in developing countries continues to be a significant problem due to lack of insurance and lack of affordability. Chronic Myeloid Leukemia (CML), a rare disease, can be treated effectively, but the pharmaceutical treatment available (imatinib) is costly and unaffordable by most patients. GIPAP, is a programme set up between a manufacturer and an NGO to provide free treatment to eligible CML patients in 80 countries worldwide. To discuss the socio-economic and demographic characteristics of patients participating in GIPAP; to research the impact GIPAP is having on health outcomes (survival) of assistance-eligible CML patients; and to discuss the determinants of such outcomes and whether there are any variations according to socio-economic, demographic, or geographical criteria. Data for 13,568 patients across 15 countries, available quarterly, were analysed over the 2005-2007 period. Ordered Probit panel data analysis was used to analyze the determinants of a patient's progress in terms of participation in the programme. Four waves of patients entering quarterly in 2005 were used to evaluate patient survival over the sample period. All patients in the sample are eligible to receive treatment provided they report to a facility quarterly. 62.3% of patients were male and 37.7% female. The majority (84.4%) entered during the chronic phase of the disease and their average age was 38.4 years. Having controlled for age, location and occupation, the analysis showed that patients were significantly much more likely to move towards a better health state after receiving treatment irrespective of their disease stage at the point of entry to the program (OR = 30.5, alpha = 1%); and that the larger the gap between diagnosis and approval for participation in the program, the more likely it is that patients' condition deteriorates (OR = 0.995, alpha = 1%), due to absence of treatment. Regressions to account for the effect of large countries (India, China

  19. Use Medicines Safely

    Science.gov (United States)

    ... Prescription Medicines 1 of 7 sections The Basics: Prescription Medicines There are different types of medicine. The 2 ... medicine are prescription and over-the-counter (OTC). Prescription medicines Prescription medicines are medicines you can get only ...

  20. Electric circuits essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Electric Circuits I includes units, notation, resistive circuits, experimental laws, transient circuits, network theorems, techniques of circuit analysis, sinusoidal analysis, polyph

  1. Calculus III essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Calculus III includes vector analysis, real valued functions, partial differentiation, multiple integrations, vector fields, and infinite series.

  2. Statistics I essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Statistics I covers include frequency distributions, numerical methods of describing data, measures of variability, parameters of distributions, probability theory, and distributions.

  3. Pre-calculus essentials

    CERN Document Server

    Woodward, Ernest

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Pre-Calculus reviews sets, numbers, operations and properties, coordinate geometry, fundamental algebraic topics, solving equations and inequalities, functions, trigonometry, exponents

  4. Transport phenomena II essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Transport Phenomena II covers forced convention, temperature distribution, free convection, diffusitivity and the mechanism of mass transfer, convective mass transfer, concentration

  5. Differential equations I essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Differential Equations I covers first- and second-order equations, series solutions, higher-order linear equations, and the Laplace transform.

  6. Heat transfer II essentials

    CERN Document Server

    REA, The Editors of

    1988-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Heat Transfer II reviews correlations for forced convection, free convection, heat exchangers, radiation heat transfer, and boiling and condensation.

  7. Numerical analysis II essentials

    CERN Document Server

    REA, The Editors of; Staff of Research Education Association

    1989-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Numerical Analysis II covers simultaneous linear systems and matrix methods, differential equations, Fourier transformations, partial differential equations, and Monte Carlo methods.

  8. Algebra & trigonometry II essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Algebra & Trigonometry II includes logarithms, sequences and series, permutations, combinations and probability, vectors, matrices, determinants and systems of equations, mathematica

  9. Modern algebra essentials

    CERN Document Server

    Lutfiyya, Lutfi A

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Modern Algebra includes set theory, operations, relations, basic properties of the integers, group theory, and ring theory.

  10. Business statistics I essentials

    CERN Document Server

    Clark, Louise

    2014-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Business Statistics I includes descriptive statistics, introduction to probability, probability distributions, sampling and sampling distributions, interval estimation, and hypothesis t

  11. Computer science I essentials

    CERN Document Server

    Raus, Randall

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Computer Science I includes fundamental computer concepts, number representations, Boolean algebra, switching circuits, and computer architecture.

  12. Biosynthesis and therapeutic properties of Lavandula essential oil constituents.

    Science.gov (United States)

    Woronuk, Grant; Demissie, Zerihun; Rheault, Mark; Mahmoud, Soheil

    2011-01-01

    Lavenders and their essential oils have been used in alternative medicine for several centuries. The volatile compounds that comprise lavender essential oils, including linalool and linalyl acetate, have demonstrative therapeutic properties, and the relative abundance of these metabolites is greatly influenced by the genetics and environment of the developing plants. With the rapid progress of molecular biology and the genomic sciences, our understanding of essential oil biosynthesis has greatly improved over the past few decades. At the same time, there is a recent surge of interest in the use of natural remedies, including lavender essential oils, in alternative medicine and aromatherapy. This article provides a review of recent developments related to the biosynthesis and medicinal properties of lavender essential oils. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Nuclear medicine therapy

    CERN Document Server

    Eary, Janet F

    2013-01-01

    One in three of the 30 million Americans who are hospitalized are diagnosed or treated with nuclear medicine techniques. This text provides a succinct overview and detailed set of procedures and considerations for patient therapy with unsealed radioactivity sources.  Serving as a complete literature reference for therapy with radiopharmaceuticals currently utilized in practice, this source covers the role of the physician in radionuclide therapy, and essential procedures and protocols required by health care personnel.

  14. Essentials of musculoskeletal examination

    African Journals Online (AJOL)

    2011-08-01

    Aug 1, 2011 ... Professor of Rheumatology, Department of Medicine, University of Cape Town ... confidence is acquired in relation to the abdominal and gastrointestinal ... the clinician to consider fracture, metastases or aortic aneurysm. The.

  15. Nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, S M [Bhabha Atomic Research Centre, Bombay (India). Radiation Medicine Centre

    1967-01-01

    The article deals with the growth of nuclear medicine in India. Radiopharmaceuticals both in elemental form and radiolabelled compounds became commercially available in India in 1961. Objectives and educational efforts of the Radiation Medicine Centre setup in Bombay are mentioned. In vivo tests of nuclear medicine such as imaging procedures, dynamic studies, dilution studies, thyroid function studies, renal function studies, linear function studies, blood flow, and absorption studies are reported. Techniques of radioimmunoassay are also mentioned.

  16. The Imperative for Improved Global Economic Coordination

    OpenAIRE

    Stiglitz, Joseph E.

    2009-01-01

    While global coordination is absolutely essential, success in achieving it may prove difficult because economic globalization has outpaced political globalization. If we are to succeed, we will have to manage coordination better than we have in the past.

  17. Nuclear medicine

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    The area of nuclear medicine, the development of artificially produced radioactive isotopes for medical applications, is relatively recent. Among the subjects covered in a lengthy discussion are the following: history of development; impact of nuclear medicine; understanding the most effective use of radioisotopes; most significant uses of nuclear medicine radioimmunoassays; description of equipment designed for use in the field of nuclear medicine (counters, scanning system, display systems, gamma camera); description of radioisotopes used and their purposes; quality control. Numerous historical photographs are included. 52 refs

  18. Essential Bacillus subtilis genes

    DEFF Research Database (Denmark)

    Kobayashi, K.; Ehrlich, S.D.; Albertini, A.

    2003-01-01

    To estimate the minimal gene set required to sustain bacterial life in nutritious conditions, we carried out a systematic inactivation of Bacillus subtilis genes. Among approximate to4,100 genes of the organism, only 192 were shown to be indispensable by this or previous work. Another 79 genes were...... predicted to be essential. The vast majority of essential genes were categorized in relatively few domains of cell metabolism, with about half involved in information processing, one-fifth involved in the synthesis of cell envelope and the determination of cell shape and division, and one-tenth related...... to cell energetics. Only 4% of essential genes encode unknown functions. Most essential genes are present throughout a wide range of Bacteria, and almost 70% can also be found in Archaea and Eucarya. However, essential genes related to cell envelope, shape, division, and respiration tend to be lost from...

  19. Harnessing Knowledge on Very Important Pharmacogenes CYP2C9 and CYP2C19 Variation for Precision Medicine in Resource-Limited Global Conflict Zones.

    Science.gov (United States)

    Barlas, İbrahim Ömer; Sezgin, Orhan; Dandara, Collet; Türköz, Gözde; Yengel, Emre; Cindi, Zinhle; Ankaralı, Handan; Şardaş, Semra

    2016-10-01

    communities in Mersin and the Eastern Mediterranean region. This study can serve as a catalyst to invest in research in Syrian populations currently living in the Eastern Mediterranean. The findings have salience for rapid and rational regulatory decision-making for worldwide precision medicine and, specifically, "pharmacogenovigilance-guided bridging of pharmacokinetics" across world populations in the current era of planetary scale migration.

  20. Biomedical informatics and translational medicine

    Directory of Open Access Journals (Sweden)

    Sarkar Indra

    2010-02-01

    Full Text Available Abstract Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians" can be essential members of translational medicine teams.

  1. Nanomedicine: The Medicine of Tomorrow

    Science.gov (United States)

    Logothetidis, S.

    Nowadays nanotechnology has become a technological field with great potential since it can be applied in almost every aspect of modern life. One of the sectors where nanotechnology is expected to play a vital role is the field of medical science. The interaction of nanotechnology with medicine gave birth to a completely new scientific field called nanomedicine. Nanomedicine is a field that aims to use the nanotechnology tools and principles in order to improve human health in every possible way. Nanotechnology provides monitoring tools and technology platforms that can be used in terms of detection, diagnostic, bioanalysis and imaging. New nanoscale drug-delivery systems are constantly designed with different morphological and chemical characteristics and unique specificity against tumours, offering a less harmful approach alternative to chemo- and radiotherapies. Furthermore, nanotechnology has led to great breakthroughs in the field of tissue engineering, making the replacement of damaged tissues and organs a much feasible procedure. The thorough analysis of bio and non-bio interactions achieved by versatile nanotools is essential for the design and development of highly performed medical implants. The continuous revolution in nanotechnology will result in the fabrication of nanostructures with properties and functionalities that can benefit patient's physiology faster and more effectively than conventional medical procedures and protocols. The number of nanoscale therapeutical products is rapidly growing since more and more nanomedical designs are reaching the global market. However the nanotoxic impact that these designs can have on human health is an era that requires still more investigation. The development of specific guidance documents at a European level for the safety evaluation of nanotechnology products in medicine is strongly recommended and the need for further research in nanotoxicology is identified. Ethical and moral concerns also need to be

  2. Value-based medicine: concepts and application

    OpenAIRE

    Jong-Myon Bae

    2015-01-01

    Global healthcare in the 21st century is characterized by evidence-based medicine (EBM), patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM) as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and conver...

  3. Globalization of healthcare.

    Science.gov (United States)

    2012-05-01

    Globalization-the increasing transnational circulation of money, goods, people, ideas, and information worldwide-is generally recognized as one of the most powerful forces shaping our current and future history. How is it affecting healthcare, and in that context, what is the purpose and significance of Global Advances in Health and Medicine (GAHM), publisher of this journal? Our goal is not homogenization but rather to provide an opportunity for integration, convergence, and collaboration across cultures. By respecting and conserving the richness and diversity of each new medicine, we embrace globalization. Globalization is of course not new; it began in the Renaissance and particularly with the 15th- and 16th-century voyages of exploration by Columbus, Magellan, and others. Since the beginning of time, there have been interactions and exchanges among different peoples and cultures. However, the current magnitude of globalization is unprecedented and yet still expanding rapidly.

  4. Key Topics in Sports Medicine

    OpenAIRE

    2006-01-01

    Key Topics in Sports Medicine is a single quick reference source for sports and exercise medicine. It presents the essential information from across relevant topic areas, and includes both the core and emerging issues in this rapidly developing field. It covers: 1) Sports injuries, rehabilitation and injury prevention, 2) Exercise physiology, fitness testing and training, 3) Drugs in sport, 4) Exercise and health promotion, 5) Sport and exercise for special and clinical populations, 6) The ps...

  5. Chemical composition and toxic activity of essential oil of ...

    African Journals Online (AJOL)

    During our screening program for new agrochemicals from Chinese medicinal herbs, essential oil of Caryopteris incana aerial parts was found to possess strong insecticidal activities against the maize weevil, Sitophilus zeamais. A total of 37 components of the essential oil were identified by GC and GC/MS. Estragole ...

  6. Legal and policy foundations for global generic competition: Promoting affordable drug pricing in developing societies.

    Science.gov (United States)

    Zapatero Miguel, Pablo

    2015-01-01

    The so-called 'TRIPS flexibilities' restated in 2001 by the World Trade Organization's Doha Declaration on TRIPS and Public Health offer a variety of policy avenues for promoting global price-based competition for essential medicines, and thus for improving access to affordable medicines in the developing world. In recent years, developing countries and international organisations alike have begun to explore the potentialities of global generic markets and competition generally, and also of using compulsory licensing to remedy anti-competitive practices (e.g. excessive pricing) through TRIPS-compatible antitrust enforcement. These and other 'pro-competitive' TRIPS flexibilities currently available provide the critical leverage and policy space necessary to improve access to affordable medicines in the developing world.

  7. Vulnerable Medicine

    Science.gov (United States)

    Bochner, Arthur P.

    2009-01-01

    In "Narrative Medicine: Honoring the Stories of Illness," Rita Charon paints an original and humane portrait of what it can mean to be a doctor, to live a life immersed in sickness and dedicated to wellness. Charon drops the veil, inviting readers to look at the secret, subjective, emotional face of medicine, a zone of self-censored feelings and…

  8. Medicinal claims

    NARCIS (Netherlands)

    Meulen, van der Bernd

    2017-01-01

    Under EU medicinal law, substances presented as having properties for treating or preventing disease are medicinal products by virtue of their presentation. EU food law prohibits attributing to any food the property of preventing, treating or curing a disease. However, if certain conditions are

  9. Physics I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Physics I includes vectors and scalars, one-dimensional motion, plane motion, dynamics of a particle, work and energy, conservation of energy, dynamics of systems of particles, rotation

  10. Electronics II essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Electronics II covers operational amplifiers, feedback and frequency compensation of OP amps, multivibrators, logic gates and families, Boolean algebra, registers, counters, arithmet

  11. Thermodynamics I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Thermodynamics I includes review of properties and states of a pure substance, work and heat, energy and the first law of thermodynamics, entropy and the second law of thermodynamics

  12. C programming language essentials

    CERN Document Server

    Ackermann, Ernest C

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. C Programming Language discusses fundamental notions, data types and objects, expressions, statements, declarations, function and program structure, the preprocessor, and the standar

  13. Electronics I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Electronics I covers fundamentals of semiconductor devices, junction diodes, bipolar junction transistors, power supplies, multitransistor circuits, small signals, low-frequency anal

  14. Thermodynamics II essentials

    CERN Document Server

    REA, The Editors of

    2013-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Thermodynamics II includes review of thermodynamic relations, power and refrigeration cycles, mixtures and solutions, chemical reactions, chemical equilibrium, and flow through nozzl

  15. Group theory I essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Group Theory I includes sets and mapping, groupoids and semi-groups, groups, isomorphisms and homomorphisms, cyclic groups, the Sylow theorems, and finite p-groups.

  16. Boolean algebra essentials

    CERN Document Server

    Solomon, Alan D

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Boolean Algebra includes set theory, sentential calculus, fundamental ideas of Boolean algebras, lattices, rings and Boolean algebras, the structure of a Boolean algebra, and Boolean

  17. Laplace transforms essentials

    CERN Document Server

    Shafii-Mousavi, Morteza

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Laplace Transforms includes the Laplace transform, the inverse Laplace transform, special functions and properties, applications to ordinary linear differential equations, Fourier tr

  18. Physical chemistry II essentials

    CERN Document Server

    REA, The Editors of

    1992-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Physical Chemistry II includes reaction mechanisms, theoretical approaches to chemical kinetics, gravitational work, electrical and magnetic work, surface work, kinetic theory, collisional and transport properties of gases, statistical mechanics, matter and waves, quantum mechanics, and rotations and vibrations of atoms and molecules.

  19. Statistics II essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Statistics II discusses sampling theory, statistical inference, independent and dependent variables, correlation theory, experimental design, count data, chi-square test, and time se

  20. Algebra & trigonometry I essentials

    CERN Document Server

    REA, Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Algebra & Trigonometry I includes sets and set operations, number systems and fundamental algebraic laws and operations, exponents and radicals, polynomials and rational expressions, eq

  1. Geometry I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Geometry I includes methods of proof, points, lines, planes, angles, congruent angles and line segments, triangles, parallelism, quadrilaterals, geometric inequalities, and geometric

  2. Transport phenomena I essentials

    CERN Document Server

    REA, The Editors of

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Transport Phenomena I includes viscosity, flow of Newtonian fluids, velocity distribution in laminar flow, velocity distributions with more than one independent variable, thermal con

  3. Data structures II essentials

    CERN Document Server

    Smolarski, Dennis C

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Data Structures II includes sets, trees, advanced sorting, elementary graph theory, hashing, memory management and garbage collection, and appendices on recursion vs. iteration, alge

  4. Computer science II essentials

    CERN Document Server

    Raus, Randall

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Computer Science II includes organization of a computer, memory and input/output, coding, data structures, and program development. Also included is an overview of the most commonly

  5. Data structures I essentials

    CERN Document Server

    Smolarski, Dennis C

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Data Structures I includes scalar variables, arrays and records, elementary sorting, searching, linked lists, queues, and appendices of binary notation and subprogram parameter passi

  6. Set theory essentials

    CERN Document Server

    Milewski, Emil G

    2012-01-01

    REA's Essentials provide quick and easy access to critical information in a variety of different fields, ranging from the most basic to the most advanced. As its name implies, these concise, comprehensive study guides summarize the essentials of the field covered. Essentials are helpful when preparing for exams, doing homework and will remain a lasting reference source for students, teachers, and professionals. Set Theory includes elementary logic, sets, relations, functions, denumerable and non-denumerable sets, cardinal numbers, Cantor's theorem, axiom of choice, and order relations.

  7. [Evolutionary medicine].

    Science.gov (United States)

    Wjst, M

    2013-12-01

    Evolutionary medicine allows new insights into long standing medical problems. Are we "really stoneagers on the fast lane"? This insight might have enormous consequences and will allow new answers that could never been provided by traditional anthropology. Only now this is made possible using data from molecular medicine and systems biology. Thereby evolutionary medicine takes a leap from a merely theoretical discipline to practical fields - reproductive, nutritional and preventive medicine, as well as microbiology, immunology and psychiatry. Evolutionary medicine is not another "just so story" but a serious candidate for the medical curriculum providing a universal understanding of health and disease based on our biological origin. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Constipation and Herbal medicine

    Directory of Open Access Journals (Sweden)

    Norio eIizuka

    2015-04-01

    Full Text Available Constipation is characterized by a variety of bowel symptoms such as difficulty passing stool, hard stool, and a feeling of incomplete evacuation. The multifactorial causes of constipation limit the clinical efficacy of current conventional treatments that use a single drug that acts through only one pathway. To complement the shortcomings of the current Western medical model and provide a complete holistic approach, herbal medicines capable of targeting multiple organs and cellular sites may be used. In Japan, many herbs and herbal combinations have traditionally been used as foods and medicines. Currently, Japanese physicians use standardized herbal combinations that provide consistent and essential quality and quantity.This review highlights representative Japanese herbal medicines (JHMs, Rhei rhizoma-based JHMs including Daiokanzoto and Mashiningan, and Kenchuto-based JHMs including Keishikashakuyakuto and Daikenchuto, which coordinate the motility of the alimentary tract. This review provides a framework to better understand the clinical and pharmacological efficacies of JHMs on constipation according to the unique theory of Japanese traditional medicine, known as Kampo medicine.

  9. Renewable Energy Essentials: Hydropower

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    Hydropower is currently the most common form of renewable energy and plays an important part in global power generation. Worldwide hydropower produced 3 288 TWh, just over 16% of global electricity production in 2008, and the overall technical potential for hydropower is estimated to be more than 16 400 TWh/yr.

  10. Nuclear medicine resources manual

    International Nuclear Information System (INIS)

    2006-02-01

    Over the past decade many IAEA programmes have significantly enhanced the capabilities of numerous Member States in the field of nuclear medicine. Functional imaging using nuclear medicine procedures has become an indispensable tool for the diagnosis, treatment planning and management of patients. However, due to the heterogeneous growth and development of nuclear medicine in the IAEA's Member States, the operating standards of practice vary considerably from country to country and region to region. This publication is the result of the work of over 30 international professionals who have assisted the IAEA in the process of standardization and harmonization. This manual sets out the prerequisites for the establishment of a nuclear medicine service, including basic infrastructure, suitable premises, reliable supply of electricity, maintenance of a steady temperature, dust exclusion for gamma cameras and radiopharmacy dispensaries. It offers clear guidance on human resources and training needs for medical doctors, technologists, radiopharmaceutical scientists, physicists and specialist nurses in the practice of nuclear medicine. The manual describes the requirements for safe preparation and quality control of radiopharmaceuticals. In addition, it contains essential requirements for maintenance of facilities and instruments, for radiation hygiene and for optimization of nuclear medicine operational performance with the use of working clinical protocols. The result is a comprehensive guide at an international level that contains practical suggestions based on the experience of professionals around the globe. This publication will be of interest to nuclear medicine physicians, radiologists, medical educationalists, diagnostic centre managers, medical physicists, medical technologists, radiopharmacists, specialist nurses, clinical scientists and those engaged in quality assurance and control systems in public health in both developed and developing countries

  11. Roitt's essential immunology

    National Research Council Canada - National Science Library

    Delves, Peter J; Roitt, Ivan M

    2011-01-01

    ... of the immune system, the hallmark easy-reading style of Roitt's Essential Immunology clearly explains the key principles needed by medical and health sciences students, from the basis of immunity to clinical applications...

  12. Benign Essential Blepharospasm

    Science.gov (United States)

    ... the same for many years; and, in rare cases, improve spontaneously. Clinical Trials Throughout the U.S. and Worldwide NINDS Clinical Trials Related ... Definition Benign essential blepharospasm (BEB) is a progressive neurological ...

  13. Marketingmanagement : De essentie

    NARCIS (Netherlands)

    Kotler, P.J.; Keller, K.; Robben, H.S.J.

    2007-01-01

    'Marketingmanagement, de essentie' biedt een volledige introductie in modern marketingmanagement. De nieuwste concepten en onderzoeksresultaten komen aan bod. Zo wordt veel aandacht besteed aan holistische marketing en is de impact van technologische ontwikkelingen op hedendaagse marketing in deze

  14. Marketing management : De essentie

    NARCIS (Netherlands)

    Kotler, P.J.; Keller, K.; Robben, H.S.J.

    2010-01-01

    'Marketingmanagement, de essentie' biedt een volledige introductie in modern marketingmanagement. De nieuwste concepten en onderzoeksresultaten komen aan bod. Zo wordt veel aandacht besteed aan holistische marketing en is de impact van technologische ontwikkelingen op hedendaagse marketing in deze

  15. Islam Is Essential for General Education

    Science.gov (United States)

    Meacham, Jack

    2015-01-01

    The religion of Islam is often portrayed with false and negative stereotypes. If we expect our students to understand and participate in the global world and to be informed and engaged citizens in a democratic America, then it is essential that they develop a basic and sound understanding of Islam. Furthermore, learning about Islam can facilitate…

  16. Essential software architecture

    CERN Document Server

    Gorton, Ian

    2011-01-01

    Job titles like ""Technical Architect"" and ""Chief Architect"" nowadays abound in software industry, yet many people suspect that ""architecture"" is one of the most overused and least understood terms in professional software development. Gorton's book tries to resolve this dilemma. It concisely describes the essential elements of knowledge and key skills required to be a software architect. The explanations encompass the essentials of architecture thinking, practices, and supporting technologies. They range from a general understanding of structure and quality attributes through technical i

  17. Recent history of nuclear medicine

    International Nuclear Information System (INIS)

    Potchen, E.J.; Gift, D.A.

    1988-01-01

    Diagnostic nuclear medicine's recent history is characterized both by significant change and by growing participation in efforts to quantify the impact of nuclear medicine procedures on clinical judgment and patient management, as well as to develop methods for studying the efficacy of diagnostic procedures in general. The replacement of many nuclear medicine procedures that at one time were considered essential standards of clinical care by newer, more efficient and effective modalities has been complimented by the continued development of increasingly sophisticated applications of scintigraphic tracer methods

  18. Nuclear medicine, a proven partnership

    International Nuclear Information System (INIS)

    Henderson, L. A.

    2009-01-01

    Full text:Ultrasonography is the modality of choice for demonstrating many cystic structures within the body. However nuclear medicine is often able to demonstrate functional disturbance where ultrasound and conventional radiography are unsuccessful. A case is presented in which a 16 day old male child presented to nuclear medicine with a right upper quadrant cyst found in ultrasound with exact location equivocal. Determining the location and nature of the cyst was essential to the treatment team for patient management. A hepatobiliary study was performed and evidence of a choledochal cyst was found. In partnership with ultrasound, nuclear medicine was able to identify a possibly malignant structure and consequently patient management was determined.

  19. Precision medicine for nurses: 101.

    Science.gov (United States)

    Lemoine, Colleen

    2014-05-01

    To introduce the key concepts and terms associated with precision medicine and support understanding of future developments in the field by providing an overview and history of precision medicine, related ethical considerations, and nursing implications. Current nursing, medical and basic science literature. Rapid progress in understanding the oncogenic drivers associated with cancer is leading to a shift toward precision medicine, where treatment is based on targeting specific genetic and epigenetic alterations associated with a particular cancer. Nurses will need to embrace the paradigm shift to precision medicine, expend the effort necessary to learn the essential terminology, concepts and principles, and work collaboratively with physician colleagues to best position our patients to maximize the potential that precision medicine can offer. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. OLD AND NEW ECONOMIC GLOBALIZATION

    OpenAIRE

    Elena MĂRGULESCU

    2015-01-01

    The retrospective of the theoretical approaches of the phenomenon of economic globalization in the last three decades emphasizes the movement of attention from the globalization of markets, from the'80s, to the globalization of production and services in the current decade. This trend is essentially the result of implementing new strategies by multinational and transnational companies. We try in this context to draw a line between the "globalization of markets" and the "globalization of produ...

  1. Specific features of medicines safety and pharmacovigilance in Africa

    Science.gov (United States)

    Pal, Shanthi N.; Olsson, Sten; Dodoo, Alexander; Bencheikh, Rachida Soulayami

    2012-01-01

    The thalidomide tragedy in the late 1950s and early 1960s served as a wakeup call and raised questions about the safety of medicinal products. The developed countries rose to the challenge putting in place systems to ensure the safety of medicines. However, this was not the case for low-resource settings because of prevailing factors inherent in them. This paper reviews some of these features and the current status of pharmacovigilance in Africa. The health systems in most of the 54 countries of Africa are essentially weak, lacking in basic infrastructure, personnel, equipment and facilities. The recent mass deployment of medicines to address diseases of public health significance in Africa poses additional challenges to the health system with notable safety concerns. Other safety issues of note include substandard and counterfeit medicines, medication errors and quality of medicinal products. The first national pharmacovigilance centres established in Africa with membership of the World Health Organization (WHO) international drug monitoring programme were in Morocco and South Africa in 1992. Of the 104 full member countries in the programme, there are now 24 African countries with a further nine countries as associate members. The pharmacovigilance systems operational in African countries are based essentially on spontaneous reporting facilitated by the introduction of the new tool Vigiflow. The individual case safety reports committed to the WHO global database (Vigibase) attest to the growth of pharmacovigilance in Africa with the number of reports rising from 2695 in 2000 to over 25,000 in 2010. There is need to engage the various identified challenges of the weak pharmacovigilance systems in the African setting and to focus efforts on how to provide resources, infrastructure and expertise. Raising the level of awareness among healthcare providers, developing training curricula for healthcare professionals, provisions for paediatric and geriatric

  2. Emergency medicine in Dubai, UAE.

    Science.gov (United States)

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-08-18

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  3. Emergency medicine in Dubai, UAE

    OpenAIRE

    Partridge, Robert; Abbo, Michael; Virk, Alamjit

    2009-01-01

    Dubai has rapidly risen to prominence in the Persian Gulf region as a center of global commerce and tourism and as a cultural crossroad between East and West. The health-care infrastructure has undergone rapid development. Collaborations with academic medical centers now exist to advance clinical care, teaching and research. Emergency medicine has also advanced and is undergoing dynamic change. Dubai may soon emerge as a regional leader in emergency medicine training and practice.

  4. Animal models in fetal medicine and obstetrics

    DEFF Research Database (Denmark)

    Dahl Andersen, Maria; Alstrup, Aage Kristian Olsen; Duvald, Christina Søndergaard

    2018-01-01

    Animal models remain essential to understand the fundamental mechanisms occurring in fetal medicine and obstetric diseases, such as intrauterine growth restriction, preeclampsia and gestational diabetes. These vary regarding the employed method used for induction of the disease, and vary regardin...

  5. High blood pressure - medicine-related

    Science.gov (United States)

    Drug-induced hypertension is high blood pressure caused by using a chemical substance or medicine. ... of the arteries There are several types of high blood pressure : Essential hypertension has no cause that can be ...

  6. Systematic thinks of nuclear medicine diagnosis

    International Nuclear Information System (INIS)

    Wang Jing

    2002-01-01

    For proper diagnosis using nuclear medicine techniques, an integrated man-machine system should be the starting point; the best choice should be the essential purpose and modeling is the necessary method

  7. Computer applications in veterinary medicine | Hassan | Nigerian ...

    African Journals Online (AJOL)

    ... become essential tools in almost every field of research and applied technology. ... Computers in veterinary medicine have been used for veterinary education; ... agro-veterinary project design, monitoring and implementation; preparation of ...

  8. Ayurvedic Medicine

    Science.gov (United States)

    ... to the biologic humors of the ancient Greek system. Using these concepts, Ayurvedic physicians prescribe individualized treatments, including compounds of herbs or proprietary ingredients, and diet, exercise, and lifestyle recommendations. The majority of India’s population uses Ayurvedic medicine ...

  9. COPD Medicine

    Science.gov (United States)

    ... Education & Training Home Treatment & Programs Medications COPD Medications COPD Medications Make an Appointment Ask a Question Refer ... control the symptoms of chronic obstructive pulmonary disease (COPD). Most people with COPD take long-acting medicine ...

  10. Some radionuclides are essential for the development of medicines

    International Nuclear Information System (INIS)

    Taran, F.

    2016-01-01

    Radionuclides are used to validate drugs on animals. The marking of the drug is made by replacing some molecules by a radioactive equivalent: carbon is replaced by carbon-14 and hydrogen by tritium. Specific features of carbon-14 and tritium like long half lives and a high sensitivity to detection: 10 pico-moles for carbon-14 and 10 atto-moles for tritium, make both nuclides very useful for studying the action and the migration of the drug molecules inside the animal body. For instance studies on the taxotere drug have shown that the drug underwent several transformations in the animal body: an oxidation followed by a double cut-off of the molecules. Radioactive tracers are also used to assess the amount of the drug that is necessary to trigger a beneficial effect and also the amount of the drug that must be absorbed by the patient in order to get the right amount of the drug on the organ that is necessary to treat it. The use of nano-drugs that limits the amount of drugs injected requires a more accurate assessment of the drug migration in the animal body, so radioactive tracers will be very useful to validate treatments with nano-drugs. A study on carbon nano-tubes particles marked with carbon-14 and injected in animals has shown that these nano-tubes can stay long (at least 1 year) in animal bodies and are not suitable for carrying drugs. (A.C.)

  11. Bioactivity of essential oils from medicinal plants of Cameroon and ...

    African Journals Online (AJOL)

    The EOs of Eucalyptus globulus, Cymbopogon citratus, Xylopia aethiopica, Thymus vulgaris, Ocimum canum, Cananga odorata, Citrus medica, Citrus paradisi and Citrus reticulata were screened against the most incriminated bacterial species using the spot-on-agar test and microdilution methods. Some of the EOs with ...

  12. Pharmaceutical patents and access to essential medicines in sub ...

    African Journals Online (AJOL)

    Jane

    2011-09-30

    Sep 30, 2011 ... 2Faculty of Law, Universiti Kebangsaan Malaysia, 43600 UKM Bangi, ... ensure that their IP systems are supportive of public healthcare needs. .... advent of TRIPS (International Intellectual Property .... But the IMF and the World Bank structural adjustment ...... Treatise, Cambridge University Press, England.

  13. Nuclear medicine

    International Nuclear Information System (INIS)

    Blanquet, Paul; Blanc, Daniel.

    1976-01-01

    The applications of radioisotopes in medical diagnostics are briefly reviewed. Each organ system is considered and the Nuclear medicine procedures pertinent to that system are discussed. This includes, the principle of the test, the detector and the radiopharmaceutical used, the procedure followed and the clinical results obtained. The various types of radiation detectors presently employed in Nuclear Medicine are surveyed, including scanners, gamma cameras, positron cameras and procedures for obtaining tomographic presentation of radionuclide distributions [fr

  14. Nuclear medicine

    International Nuclear Information System (INIS)

    Chamberlain, M.J.

    1986-01-01

    Despite an aggressive, competitive diagnostic radiology department, the University Hospital, London, Ontario has seen a decline of 11% total (in vivo and in the laboratory) in the nuclear medicine workload between 1982 and 1985. The decline of in vivo work alone was 24%. This trend has already been noted in the U.S.. Nuclear medicine is no longer 'a large volume prosperous specialty of wide diagnostic application'

  15. Python essential reference

    CERN Document Server

    Beazley, David M

    2009-01-01

    Python Essential Reference is the definitive reference guide to the Python programming language — the one authoritative handbook that reliably untangles and explains both the core Python language and the most essential parts of the Python library. Designed for the professional programmer, the book is concise, to the point, and highly accessible. It also includes detailed information on the Python library and many advanced subjects that is not available in either the official Python documentation or any other single reference source. Thoroughly updated to reflect the significant new programming language features and library modules that have been introduced in Python 2.6 and Python 3, the fourth edition of Python Essential Reference is the definitive guide for programmers who need to modernize existing Python code or who are planning an eventual migration to Python 3. Programmers starting a new Python project will find detailed coverage of contemporary Python programming idioms.

  16. Globalization of Healthcare

    Science.gov (United States)

    2012-01-01

    Globalization—the increasing transnational circulation of money, goods, people, ideas, and information worldwide—is generally recognized as one of the most powerful forces shaping our current and future history. How is it affecting healthcare, and in that context, what is the purpose and significance of Global Advances in Health and Medicine (GAHM), publisher of this journal? Our goal is not homogenization but rather to provide an opportunity for integration, convergence, and collaboration across cultures. By respecting and conserving the richness and diversity of each new medicine, we embrace globalization. Globalization is of course not new; it began in the Renaissance and particularly with the 15th- and 16th-century voyages of exploration by Columbus, Magellan, and others. Since the beginning of time, there have been interactions and exchanges among different peoples and cultures. However, the current magnitude of globalization is unprecedented and yet still expanding rapidly. PMID:24278809

  17. Physics Essentials For Dummies

    CERN Document Server

    Holzner, Steven

    2010-01-01

    For students who just need to know the vital concepts of physics, whether as a refresher, for exam prep, or as a reference, Physics Essentials For Dummies is a must-have guide. Free of ramp-up and ancillary material, Physics Essentials For Dummies contains content focused on key topics only. It provides discrete explanations of critical concepts taught in an introductory physics course, from force and motion to momentum and kinetics. This guide is also a perfect reference for parents who need to review critical physics concepts as they help high school students with homework assignments, as we

  18. Essentials of Computational Electromagnetics

    CERN Document Server

    Sheng, Xin-Qing

    2012-01-01

    Essentials of Computational Electromagnetics provides an in-depth introduction of the three main full-wave numerical methods in computational electromagnetics (CEM); namely, the method of moment (MoM), the finite element method (FEM), and the finite-difference time-domain (FDTD) method. Numerous monographs can be found addressing one of the above three methods. However, few give a broad general overview of essentials embodied in these methods, or were published too early to include recent advances. Furthermore, many existing monographs only present the final numerical results without specifyin

  19. Programmatic activities of IAEA in nuclear medicine

    International Nuclear Information System (INIS)

    Padhy, A.K.

    2004-01-01

    Nuclear medicine is high-tech medicine. Nevertheless, it is essential for addressing important health problems of people living in developing countries also. Not only is it sometimes expensive to start with, it also involves a lot of technical know-how, requiring transfer of technology from developed to the developing countries. The rapid development of nuclear medicine, of sophisticated instrumentation and radiopharmaceuticals has resulted in an enormous increase in costs and in the need for maintaining quality. These constitute a challenge and a venture when promoting nuclear medicine globally and particularly in developing countries. No other international organization except IAEA has any specific mandate for application of nuclear energy in the area of human health. WHO has no specific programin nuclear medicine, hence the importance of IAEA's involvement. The IAEA has, ever since its inception, given high priority to enhancing the awareness and capabilities of developing member states to employ nuclear technology for health care and medical research. Much of the Agency promoted research in nuclear medicine is delivered through the so called co-ordinated research projects (CRPs). The CRPs are normally organised as multi-center, prospective studies so that large volume of scientific data could be generated in a short period of 18-24 months. The research is normally done within an operational frame work, established and co-ordinated by the IAEA. The reason for this is that the results can be compared despite site or country specific differences. The methods and materials used for such studies usually conform to a predetermined standard. The protocols for various investigations, criteria for patient selection, mode of arriving at a final diagnosis and analysis of data from these multi-center studies are normally agreed upon by the Chief Scientific Investigators from each participating institution and the IAEA prior to the start of the actual work programme. The

  20. Global challenges of graduate level Ayurvedic education: A survey

    Science.gov (United States)

    Patwardhan, Kishor; Gehlot, Sangeeta; Singh, Girish; Rathore, H.C.S.

    2010-01-01

    In the present day scenario, Ayurveda is globally being perceived in several contradictory ways. Poor quality of Ayurveda graduates produced as a result of poorly structured and poorly regulated education system is at least one of the important factors responsible for this scenario. The present study was carried out to evaluate the ‘Global challenges of graduate level Ayurvedic education’ and is based on the responses of Ayurvedic students and Ayurvedic teachers from various educational institutions of India to a methodically validated questionnaire. As the study indicates, the poor standard of Ayurvedic education in India is definitely a cause of concern. The curriculum of Bachelor of Ayurvedic Medicine and Surgery (BAMS) course of studies is required to be reviewed and restructured. The syllabi are required to be updated with certain relevant topics like laws governing the intellectual property rights, basic procedures of standardization of medicinal products, fundamental methods of evaluating the toxicity of the medicinal products, essentials of healthcare management and the basics of cultivation and marketing of medicinal plants. Furthermore, the study suggests that the Ayurvedic academicians are required to be trained in standard methods of research and documentation skills, and the educational institutions are required to be encouraged to contribute their share in building up the evidence base for Ayurveda in the form of quality education and research. PMID:20532099

  1. Global health justice and governance.

    Science.gov (United States)

    Ruger, Jennifer Prah

    2012-01-01

    While there is a growing body of work on moral issues and global governance in the fields of global justice and international relations, little work has connected principles of global health justice with those of global health governance for a theory of global health. Such a theory would enable analysis and evaluation of the current global health system and would ethically and empirically ground proposals for reforming it to more closely align with moral values. Global health governance has been framed as an issue of national security, human security, human rights, and global public goods. The global health governance literature is essentially untethered to a theorized framework to illuminate or evaluate governance. This article ties global health justice and ethics to principles for governing the global health realm, developing a theoretical framework for global and domestic institutions and actors.

  2. ESSENTIAL DYNAMICS OF PROTEINS

    NARCIS (Netherlands)

    AMADEI, A; LINSSEN, ABM; BERENDSEN, HJC

    1993-01-01

    Analysis of extended molecular dynamics (MD) simulations of lysozyme in vacuo and in aqueous solution reveals that it is possible to separate the configurational space into two subspaces: (1) an ''essential'' subspace containing only a few degrees of freedom in which anharmonic motion occurs that

  3. Essential Palatal Myoclonus

    Directory of Open Access Journals (Sweden)

    Bhuwan Raj Pandey

    2017-06-01

    Full Text Available Introduction: Palatal myoclonus is a rare condition presenting with clicking sound in ear or muscle tremor in pharynx. There are two varieties: essential and symptomatic. Various treatment options exists ranging from watchful observation to botulinum toxin injection. We have not found any reported case of palatal myoclonus from our country. Here we present a case of essential palatal myoclonus managed with clonazepam. Case report: A young female presented in Ear Nose and Throat clinic with complain of auditory click and spontaneous rhythmic movement of throat muscles for eight months. On examination, there was involuntary, rhythmic contraction of bilateral soft-palate, uvula, and base of tongue. Neurological, eye, and peripheral examination were normal. A diagnosis of essential palatal myoclonus was made. It was managed successfully with clonazepam; patient was still on low dose clonazepam at the time of making this report. Conclusion: Essential palatal myoclonus can be clinically diagnosed and managed even in settings where MRI is not available or affordable.

  4. The 2003 essential. AREVA

    International Nuclear Information System (INIS)

    2004-07-01

    This document presents the essential activities of the Areva Group, a world nuclear industry leader. This group proposes technological solutions to produce the nuclear energy and to transport the electric power. It develops connection systems for the telecommunication, the computers and the automotive industry. Key data on the program management, the sustainable development activities and the different divisions are provided. (A.L.B.)

  5. Essential trichomegaly: case report

    Directory of Open Access Journals (Sweden)

    Julia Dutra Rossetto

    2013-02-01

    Full Text Available The present study reports two cases of symptomatic essential trichomegaly. Trichomegaly may develop in various diseases, including anorexia nervosa, hypothyroidism, pregnancy, pretibial myxedema, systemic lupus erythematosus, vernal keratoconjunctivitis, and uveitis. The exact incidence trichomegaly is unknown, and the condition remains sporadically reported. Two cases of symptomatic trichomegaly without any associated systemic disorder are presented in this paper.

  6. Ancient Greek in modern language of medicine

    OpenAIRE

    Marković Vera

    2007-01-01

    In order to standardize language of medicine, it is essential to have a good command of ancient Greek and Latin. We cannot deny a huge impact of ancient Greek medicine on medical terminology. Compounds of Greek origin related to terms for organs, illnesses, inflammations, surgical procedures etc. have been listed as examples. They contain Greek prefixes and suffixes transcribed into Latin and they have been analyzed. It may be concluded that the modern language of medicine basically represent...

  7. Radiation in medicine: Origins, risks and aspirations.

    OpenAIRE

    Donya, M; Radford, M; ElGuindy, A; Firmin, D; Yacoub, MH

    2014-01-01

    The use of radiation in medicine is now pervasive and routine. From their crude beginnings 100 years ago, diagnostic radiology, nuclear medicine and radiation therapy have all evolved into advanced techniques, and are regarded as essential tools across all branches and specialties of medicine. The inherent properties of ionizing radiation provide many benefits, but can also cause potential harm. Its use within medical practice thus involves an informed judgment regarding the risk/benefit rati...

  8. Essential oils: extraction, bioactivities, and their uses for food preservation.

    Science.gov (United States)

    Tongnuanchan, Phakawat; Benjakul, Soottawat

    2014-07-01

    Essential oils are concentrated liquids of complex mixtures of volatile compounds and can be extracted from several plant organs. Essential oils are a good source of several bioactive compounds, which possess antioxidative and antimicrobial properties. In addition, some essential oils have been used as medicine. Furthermore, the uses of essential oils have received increasing attention as the natural additives for the shelf-life extension of food products, due to the risk in using synthetic preservatives. Essential oils can be incorporated into packaging, in which they can provide multifunctions termed "active or smart packaging." Those essential oils are able to modify the matrix of packaging materials, thereby rendering the improved properties. This review covers up-to-date literatures on essential oils including sources, chemical composition, extraction methods, bioactivities, and their applications, particularly with the emphasis on preservation and the shelf-life extension of food products. © 2014 Institute of Food Technologists®

  9. [On rhetorics and medicine].

    Science.gov (United States)

    Ohry, Avi; Gitay, Yehoshua

    2008-04-01

    The beginning of Rhetorics can be found in ancient Greece (Corax, Gorgias, Aristo). The science of the proper use of language in order to explain or convince, was very popular until the 17th century. Rhetorics had influenced all levels of intellectual European life, including medical teaching. and practice (Cabanis). Currently, rhetorics have become popular again in: the media, politics, academic and social life and medicine. Medical and allied health professions students, should learn how to speak correctly, how to implement ethical and behavioral essentials (Osler, Asher).

  10. Medicines by Design

    Science.gov (United States)

    ... Home > Science Education > Medicines By Design Medicines By Design Spotlight Nature's Medicine Cabinet A Medicine's Life Inside ... hunt for drugs of the future. Medicines By Design in PDF | E-PUB Tell Us What You ...

  11. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses ... limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of ...

  12. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  13. General Nuclear Medicine

    Science.gov (United States)

    ... Resources Professions Site Index A-Z General Nuclear Medicine Nuclear medicine imaging uses small amounts of radioactive ... of General Nuclear Medicine? What is General Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  14. Children's (Pediatric) Nuclear Medicine

    Science.gov (United States)

    ... Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small amounts ... Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical imaging ...

  15. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... News Physician Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging ... the limitations of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch ...

  16. Children's (Pediatric) Nuclear Medicine

    Medline Plus

    Full Text Available ... Resources Professions Site Index A-Z Children's (Pediatric) Nuclear Medicine Children’s (pediatric) nuclear medicine imaging uses small ... of Children's Nuclear Medicine? What is Children's (Pediatric) Nuclear Medicine? Nuclear medicine is a branch of medical ...

  17. Global Geomorphology

    Science.gov (United States)

    Douglas, I.

    1985-01-01

    Any global view of landforms must include an evaluation of the link between plate tectonics and geomorphology. To explain the broad features of the continents and ocean floors, a basic distinction between the tectogene and cratogene part of the Earth's surface must be made. The tectogene areas are those that are dominated by crustal movements, earthquakes and volcanicity at the present time and are essentially those of the great mountain belts and mid ocean ridges. Cratogene areas comprise the plate interiors, especially the old lands of Gondwanaland and Laurasia. Fundamental as this division between plate margin areas and plate interiors is, it cannot be said to be a simple case of a distinction between tectonically active and stable areas. Indeed, in terms of megageomorphology, former plate margins and tectonic activity up to 600 million years ago have to be considered.

  18. Global engineering

    International Nuclear Information System (INIS)

    Plass, L.

    2001-01-01

    This article considers the challenges posed by the declining orders in the plant engineering and contracting business in Germany, the need to remain competitive, and essential preconditions for mastering the challenge. The change in engineering approach is illustrated by the building of a methanol plant in Argentina by Lurgi with the basic engineering completed in Frankfurt with involvement of key personnel from Poland, completely engineered subsystems from a Brazilian subsupplier, and detailed engineering work in Frankfurt. The production of methanol from natural gas using the LurgiMega/Methanol process is used as a typical example of the industrial plant construction sector. The prerequisites for successful global engineering are listed, and error costs in plant construction, possible savings, and process intensification are discussed

  19. [Medicinal cannabis].

    Science.gov (United States)

    Van der Meersch, H; Verschuere, A P; Bottriaux, F

    2006-01-01

    Pharmaceutical grade cannabis is available to Dutch patients from public pharmacies in the Netherlands. The first part of this paper reviews the pharmaceutical and pharmacological properties of medicinal cannabis. Detailed information about its composition and quality, potential applications, methods of administration, adverse reactions, drug interactions and safety during pregnancy or breastfeeding are given. The second part deals with the legal aspects of dispensing medicinal cannabis through pharmacies in view of the Belgian and Dutch legislation. The last part discusses the present Belgian regulation about the possession of cannabis.

  20. Nuclear medicine

    International Nuclear Information System (INIS)

    Reichelt, H.G.

    1980-01-01

    Nuclear medicine as a complex diagnostical method is used mainly to detect functional organic disorders, to locate disorders and for radioimmunologic assays (RIA) in vitro. In surgery, its indication range comprises the thyroid (in vivo and in vitro), liver and bile ducts, skeletal and joint diseases, disorders of the cerebro-spinal liquor system and the urologic disorders. In the early detection of tumors, the search for metastases and tumor after-care, scintiscanning and the tumor marcher method (CEA) can be of great practical advantage, but the value of myocardial sciritiscanning in cardiac respectively coronary disorders is restricted. The paper is also concerned with the radiation doses in nuclear medicine. (orig.) [de