scholarly journals Factors Impacting Pharmaceutical Prices and Affordability: Narrative Review

Pharmacy ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Kah Seng Lee ◽  
Yaman Walid Kassab ◽  
Nur Akmar Taha ◽  
Zainol Akbar Zainal
Keyword(s):  
Narrative Review ◽  
Financial Advisors ◽  
Cost Information ◽  
Electronic Prescription ◽  
Related Information ◽  
Pharmaceutical Distribution ◽  
Out Of Pocket Expenses ◽  
Additional Charges ◽  
The Impact ◽  
Pharmaceutical Prices

Increasing prescription drug pricing often reflects additional work stress on medical professionals because they function as financial advisors for patients and help them manage out-of-pocket expenses. Providers or prescribers wish to help patients with prescription costs but often lack related information. Healthcare plan providers try to display prescription and drug cost information on their websites, but such data may not be linked to electronic prescription software. A mark-up is defined as the additional charges and costs that are applied to the price of a product for the purpose of covering overhead costs, distribution charges, and profit. Therefore, the policies implemented in the pharmaceutical distribution chain might include the regulation of wholesale and retails mark-ups and pharmaceutical remuneration. If mark-ups are regulated, countries are highly recommended to use regressive mark-ups rather than fixed percentage mark-ups. This narrative review provides insights into the framework of pharmaceutical mark-up systems by describing different factors impacting pharmaceutical prices and affordability. These include the interplay of medicine pricing and the supply chain, the impact of pertinent laws and regulation and out-of-pocket expenditure.

The Impact of a Highly Publicized Celebrity Suicide on Suicide-Related Online Information Seeking

Crisis ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 207-209 ◽  
Author(s):  
Florian Arendt ◽  
Sebastian Scherr
Keyword(s):  
Suicide Prevention ◽  
Information Seeking ◽  
The Internet ◽  
Online Information ◽  
Search Queries ◽  
Related Information ◽  
Search Terms ◽  
Celebrity Suicide ◽  
Online Information Seeking ◽  
The Impact

Abstract. Background: Research has already acknowledged the importance of the Internet in suicide prevention as search engines such as Google are increasingly used in seeking both helpful and harmful suicide-related information. Aims: We aimed to assess the impact of a highly publicized suicide by a Hollywood actor on suicide-related online information seeking. Method: We tested the impact of the highly publicized suicide of Robin Williams on volumes of suicide-related search queries. Results: Both harmful and helpful search terms increased immediately after the actor's suicide, with a substantial jump of harmful queries. Limitations: The study has limitations (e.g., possible validity threats of the query share measure, use of ambiguous search terms). Conclusion: Online suicide prevention efforts should try to increase online users' awareness of and motivation to seek help, for which Google's own helpline box could play an even more crucial role in the future.

Quality of Life and Mental Health of Infertile Women Affected by Endometriosis: A Narrative Review

2019 ◽  
Vol 15 (4) ◽  
pp. 238-244
Author(s):  
Cristina Zarbo ◽  
Agostino Brugnera ◽  
Rita Secomandi ◽  
Ilario Candeloro ◽  
Chiara Malandrino ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Narrative Review ◽  
Stress Perception ◽  
Infertile Women ◽  
Assisted Reproductive Treatment ◽  
General Quality ◽  
The Impact ◽  
Test Outcomes

Objective: Infertility has a severe impact on quality of life and mental health. This condition could be exacerbated by the existence of comorbid medical disease, like endometriosis. The aim of this critical narrative review is the examination of the state of the art about the quality of life and mental health in infertile women with endometriosis. Methods: We performed a rigorous and systematic search for studies on multiple electronic databases. A total of 6 papers were included in the review and were subjected to interpretative and critical narrative synthesis. Results and Discussion: Major findings are resumed in the following points: (a) infertile women with endometriosis when compared to infertile ones without endometriosis show higher depression, stress perception, and anxiety, and lower general quality of life; (b) quality of life specifically related to infertility is similar among women with and without endometriosis and seems to be related to personality and beliefs factors; (c) giving birth to a child is related to better mental quality of life; (d) during assisted reproductive treatment (ART) stimulation, infertile women with endometriosis have a decrease of dysmenorrhea and dyspareunia; (e) satisfaction of ART is related to the number of attempts, treatment accomplishment and pregnancy test outcomes. Clinical implications of these findings and suggestions for future researches were discussed. Conclusion: Concluding, it is crucial to assess the psychological factors related to endometriosis and infertility to reduce the impact of these diseases on quality of life and mental health, provide adequate support to these patients, improve their satisfaction and increase the change to get pregnant.

scholarly journals Virological Factors Associated with Failure to the Latest Generation of Direct Acting Agents (DAA) and Re-Treatment Strategy: A Narrative Review

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 432
Author(s):  
Lorenzo Onorato ◽  
Mariantonietta Pisaturo ◽  
Mario Starace ◽  
Carmine Minichini ◽  
Alessandra Di Fraia ◽  
...  
Keyword(s):  
Liver Disease ◽  
Hepatitis C ◽  
Antiviral Agents ◽  
Clinical Problem ◽  
Narrative Review ◽  
Factors Associated ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
The Impact ◽  
Direct Acting Antiviral Agents

The availability of all oral direct acting antiviral agents (DAAs) has revolutionized the management of HCV infections in recent years, allowing to achieve a sustained virological response (SVR) in more than 95% of cases, irrespective of hepatitis C Virus (HCV) genotype or staging of liver disease. Although rare, the failure to the latest-generation regimens (grazoprevir/elbasvir, sofosbuvir/velpatasvir, pibrentasvir/glecaprevir) represents a serious clinical problem, since the data available in the literature on the virological characteristics and management of these patients are few. The aim of the present narrative review was to provide an overview of the impact of baseline RASs in patients treated with the latest-generation DAAs and to analyze the efficacy of the available retreatment strategies in those who have failed these regimens.

Immunoglobulin levels in systemic lupus erythematosus: A narrative review

Lupus ◽  
2021 ◽  
pp. 096120332110047
Author(s):  
Ibrahim Almaghlouth ◽  
Sindhu R Johnson ◽  
Eleanor Pullenayegum ◽  
Dafna Gladman ◽  
Murray Urowitz
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Narrative Review ◽  
Special Focus ◽  
Immunoglobulin Level ◽  
Systemic Lupus ◽  
External Threats ◽  
Self Tolerance ◽  
Low Levels ◽  
The Impact

Immunoglobulins play a fundamental role in the protection of the human body against internal and external threats. They also contribute to the immune system homeostasis and maintenance of self-tolerance. Hypogammaglobulinemia is occasionally encountered in routine clinical practice by rheumatologists. Low levels of immunoglobulins can occur as primary or secondary issues and may predispose patients to various forms of infection. However, the impact of the low immunoglobulin level abnormality varies with the underlying condition. In this narrative review, we shed light on the overall types and functions of immunoglobulins for clinicians. We discuss important principles of immunoglobulin measurements. We then consider the primary and secondary causes of low immunoglobulins with a special focus on hypogammaglobulinemia in patients with systemic lupus erythematosus (SLE).

scholarly journals Alice in Suicideland: Exploring the Suicidal Ideation Mechanism through the Sense of Connectedness and Help-Seeking Behaviors

2021 ◽  
Vol 18 (7) ◽  
pp. 3681
Author(s):  
Minh-Hoang Nguyen ◽  
Tam-Tri Le ◽  
Hong-Kong To Nguyen ◽  
Manh-Toan Ho ◽  
Huyen T. Thanh Nguyen ◽  
...  
Keyword(s):  
International Students ◽  
Suicidal Ideation ◽  
Help Seeking ◽  
Suicidal Thoughts ◽  
Help Seeking Behaviors ◽  
Negatively Associated ◽  
Related Information ◽  
Cultural Responses ◽  
The Impact ◽  
Informal Help

On average, one person dies by suicide every 40 s. However, extant studies have largely focused on the risk factors for suicidal behaviors, not so much on the formation of suicidal thoughts. Therefore, we attempt to explain how suicidal thoughts arise and persist inside one’s mind using a multifiltering information mechanism called Mindsponge. Bayesian analysis with Hamiltonian Markov Chain Monte Carlo (MCMC) technique was run on a dataset of multinational students (N = 268) of an international university in Japan. Item 9 in the PHQ-9 was used to survey suicidal ideation. The associations among four main variables, namely, (i) suicidal ideation, (ii) help-seeking willingness (informal and formal sources), (iii) sense of connectedness, and (iv) information inaccessibility (represented by being international students), were tested in four models. Sense of connectedness is negatively associated with suicidal ideation, but its effect becomes less impactful when interacting with international students. The impact of a sense of connectedness on informal help-seeking willingness (toward family members) among international students is also lessened. Informal help-seeking is negatively associated with suicidal ideation, whereas formal help is positive. The findings support our assumption on three fundamental conditions for preventing suicidal thoughts: (i) a high degree of belongingness, (ii) accessibility to help-related information, and (iii) healthy perceived cultural responses towards mental health. Therefore, systematically coordinated programs are necessary to effectively tackle suicidal ideation.

scholarly journals The Impact of the COVID-19 Pandemic on Urology Residents: a Narrative Review

2021 ◽  
Vol 22 (9) ◽  
Author(s):  
Johnathan A. Khusid ◽  
Mahyar Kashani ◽  
Lauren E. Fink ◽  
Corey S. Weinstein ◽  
Mantu Gupta
Keyword(s):  
Narrative Review ◽  
The Impact

Models of home care services for persons with dementia: a narrative review

2015 ◽  
Vol 27 (10) ◽  
pp. 1593-1600 ◽  
Author(s):  
Lee-Fay Low ◽  
Jennifer Fletcher
Keyword(s):  
Case Management ◽  
Home Care ◽  
Integrated Care ◽  
Community Dwelling ◽  
Narrative Review ◽  
Nursing Home Admission ◽  
Community Based ◽  
People With Dementia ◽  
The Impact ◽  
Community Based Services

ABSTRACTBackground:Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care.Methods:We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs.Results:Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study.Conclusions:There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

Cerebral oxygenation monitoring in patients during and after cardiac arrest -- a narrative review of current methods and evidence

2021 ◽  
Keyword(s):  
Cardiac Arrest ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
The Body ◽  
Narrative Review ◽  
Oxygen Balance ◽  
Monitoring Methods ◽  
Venous Oxygen Saturation ◽  
Oxygenation Monitoring ◽  
The Impact

Hypoxic-ischemic brain injury (HIBI) is a leading cause of mortality in post-cardiac arrest (post-CA) patients who successfully survive the initial cardiopulmonary resuscitation (CPR) but later die in the Intensive Care Unit (ICU). Therefore, a key priority of post-resuscitation ICU care is to prevent and limit the impact of HIBI by optimizing the balance between cerebral oxygen delivery and demand. Traditionally, an optimal systemic oxygen balance is considered to ensure the brain’s oxygen balance. However, the validity of this assumption is uncertain, as the brain constitutes only 2%of the body mass while accounting for approximately 20% of basal oxygen consumption at rest. Hence, there is a real need to monitor cerebral oxygenation realistically. Several imaging and bedside monitoring methods are available for cerebral oxygenation monitoring in post-CA patients. Unfortunately, each of them has its limitations. Imaging methods require transporting a critically ill unstable patient to the scanner. Moreover, they provide an assessment of the oxygenation state only at a particular moment, while brain oxygenation is dynamic. Bedside methods, specifically near-infrared spectroscopy (NIRS), brain tissue oxygen tension (PbtO2), and jugular venous oxygen saturation monitoring (SjvO2), have not often been used in studies involving post-CA patients. Hence there is ambiguity regarding clear recommendations for using these bedside monitors. Presently, the most promising option seems to be using the NIRS as an indicator of effective CPR. We present a narrative review focusing on bedside methods and discuss the evidence for their use in adult patients after cardiac arrest.

041 Alteration of Threat-Related Information Processing During Extended Sleep Deprivation

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A18-A18
Author(s):  
Sara Alger ◽  
John Hughes ◽  
Thomas Balkin ◽  
Tracy Jill Doty
Keyword(s):  
Sleep Deprivation ◽  
Negative Mood ◽  
Multiple Time ◽  
High Expectation ◽  
Medicine Research ◽  
Related Information ◽  
Recovery Sleep ◽  
Threat Processing ◽  
Fearful Face ◽  
The Impact

Abstract Introduction Threat-related information is preferentially processed, facilitating quick and efficient responses. However, the impact of extended sleep deprivation on perception of and response to threatening information is not well known. Sleep loss may increase amygdalar activity and negative mood, potentially facilitating threat processing. However, it also reduces cognitive function, possibly impairing ability to respond. The present study assessed the extent to which extended sleep deprivation modulates threat processing using a threat expectation paradigm. Methods Twenty-one participants underwent one baseline night of sleep followed by 62hrs total sleep deprivation (TSD) and one recovery night of sleep (12hrs). Threat expectation task performance was assessed at baseline, at multiple time points during TSD, and following recovery sleep. To control for circadian influence, performance at three 1100 sessions (baseline, 52hrs into TSD, and recovery) were compared. The threat expectation task involved determining whether a presented face was fearful (i.e., signaled threat) or neutral. Faces were presented at three expectation levels: 80%, 50%, and 20% chance of viewing a fearful face. Results Overall, responses were faster (F=9.77, p=0.001) and more accurate (F=11.48, p=0.001) when the type of face (fearful or neutral) was expected. Accuracy significantly decreased over TSD (t=7.71, p<0.001) and recovered following subsequent sleep. Fear bias was calculated for accuracy (accuracy for fearful face minus neutral face). Under conditions of high expectation (80%) of viewing a fearful face, fear bias increased across TSD (t=-1.95, p=0.07). Although accuracy to both fearful and neutral faces significantly declined across TSD (both p<0.001), decline for neutral faces was greater, thus increasing fear bias. Importantly, the increased bias toward fear was still evident compared to baseline following a 12-hour recovery sleep opportunity, (t=-1.93, p=0.07). Conclusion Extended sleep deprivation, common in operational environments where there is also high expectation of encountering threat, impairs cognitive control and is thought to enhance amygdala activity. These data show that, consequently, cognitive resources become biased toward biologically adaptive behaviors (i.e., threat processing) at the expense of attending and responding more broadly to all stimuli. This behavior is not reversed with a single extended sleep opportunity. Support (if any) Department of Defense Military Operational Medicine Research Program (MOMRP)

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