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- Ekman, A., et al.
(författare)
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Designing a process for a monopoly to transform to a free market competitor -the swedish pharmacy system
- 2011
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Ingår i: ICED 11 - 18th International Conference on Engineering Design - Impacting Society Through Engineering Design. - 9781904670230 ; , s. 153-163
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Konferensbidrag (refereegranskat)abstract
- The purpose of this paper is to discuss how a political driven transition of a large company, Apoteket AB in Sweden with 12,000 employees - the pharmacy state monopoly - can be designed and managed to become a free market competitive player. The reregulation process, with a great variety of stakeholders involved, has since 2006 been followed, documented and analyzed. In the domain of pharmacy products and services - essential for health and well-being - a design and innovation process must be handled with care for balancing pharmaceutical and business strategies. The research contribution and expected learning outcome of this paper are to give insights; first on processes and methods for organizational designs and transformation; second to get experience from designing and implementing a management strategy to lead the reregulation to success; and third to get knowledge on how traditional professional roles can be changed and developed by designing a process with clear goals, conscious learning and a communicative strategy. Copyright © 2002-2012 The Design Society. All rights reserved.
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- Bosworth, H. B., et al.
(författare)
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Medication adherence: a call for action
- 2011
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Ingår i: American heart journal. - : Elsevier BV. - 1097-6744 .- 0002-8703. ; 162:3, s. 412-24
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Tidskriftsartikel (refereegranskat)abstract
- Poor adherence to efficacious cardiovascular-related medications has led to considerable morbidity, mortality, and avoidable health care costs. This article provides results of a recent think-tank meeting in which various stakeholder groups representing key experts from consumers, community health providers, the academic community, decision-making government officials (Food and Drug Administration, National Institutes of Health, etc), and industry scientists met to evaluate the current status of medication adherence and provide recommendations for improving outcomes. Below, we review the magnitude of the problem of medication adherence, prevalence, impact, and cost. We then summarize proven effective approaches and conclude with a discussion of recommendations to address this growing and significant public health issue of medication nonadherence.
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| 7. |
- Ekman, Inger, 1952, et al.
(författare)
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Heart rate reduction with ivabradine and health related quality of life in patients with chronic heart failure: results from the SHIFT study
- 2011
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Ingår i: European heart journal. - : Oxford University Press (OUP). - 1522-9645 .- 0195-668X. ; 32:19, s. 2395-2404
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Tidskriftsartikel (refereegranskat)abstract
- AimsHeart failure (HF) has a major impact on health-related quality of life (HQoL). The aim was to evaluate whether heart rate (HR) reduction with ivabradine can translate into increased HQoL in parallel to a reduction of primary outcomes in SHIFT.Methods and resultsIn symptomatic patients with systolic HF treated with recommended background therapy, HQoL was assessed by Kansas City Cardiomyopathy Questionnaire (KCCQ) containing the following dimensions: overall summary score (OSS) and clinical summary score (CSS), analysed at baseline, and 4, 12, and 24 months, and last post-baseline visit. A total of 1944 patients (968 ivabradine, 976 placebo) were evaluated. At 12 months, incidence of clinical events (cardiovascular death or hospital admission for HF) was inversely associated with KCCQ scores. Ivabradine reduced HR by 10.1 bpm (placebo-corrected, P < 0.001) and improved KCCQ by 1.8 for CSS and 2.4 for OSS (placebo-corrected, P = 0.02 and P < 0.01, respectively); these changes were associated with the change in HR for both CSS (P < 0.001) and OSS (P < 0.001). The relationship was found in both allocation groups though the changes were more pronounced in the ivabradine group. Health-related quality of life at follow-up was better preserved in the ivabradine group compared with placebo; poorest outcomes were seen in the placebo group with lowest KCCQ scores (<50).ConclusionIn patients with systolic HF, low HQoL is associated with an increased rate of cardiovascular death or hospital admission for HF. Reduction in HR with ivabradine is associated with improved HQoL. The magnitude of HR reduction is related to the extent of improvement in HQoL.
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| 9. |
- Lebens, Michael, 1956, et al.
(författare)
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Construction of novel vaccine strains of Vibrio cholerae co-expressing the Inaba and Ogawa serotype antigens
- 2011
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Ingår i: Vaccine. - : Elsevier BV. - 0264-410X .- 1873-2518. ; 29:43, s. 7505-7513
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Tidskriftsartikel (refereegranskat)abstract
- The approach of inducing protective immunity against cholera by oral vaccination with killed whole Vibrio cholerae cells is effective, but the complexity of current cholera vaccines makes them difficult and relatively expensive to manufacture, especially if recombinant cholera toxin B subunit is included in the formulation. In an effort to simplify the composition of a new generation of oral cholera vaccines we have generated a novel non-toxigenic candidate vaccine strain of V. cholerae O1 that stably expresses both the Ogawa and Inaba serotype antigens on its surface. This was done by introducing a functional wbeT gene without a functional promoter into the chromosome of an O1 Inaba strain. The resulting low levels of expression of the wbeT gene product allowed for the desired partial serotype switching. This strain (MS1342) can potentially replace the three virulent strains used in currently manufactured cholera vaccines. Oral immunization of mice with formalin-killed MS1342 bacteria gave rise to Ogawa-specific, Inaba-specific and cross-reactive serum antibodies that were detectable both by lipopolysaccharide (LPS)-specific ELISAs and as vibriocidal antibodies that are considered to predict protective efficacy. These responses as well as intestinal mucosal IgA anti-LPS antibody responses were fully comparable with those obtained by immunization with the internationally licensed oral cholera vaccine Dukoral ®. We propose that such a strain may form the basis of a single strain killed whole cell cholera vaccine protecting against cholera caused by either the Inaba or Ogawa serotype of V. cholerae O1.
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