Ethically Allocating COVID-19 Drugs Via Pre-approval Access and Emergency Use Authorization

Abstract

Allocating access to unapproved COVID-19 drugs available via Pre-Approval Access pathways or Emergency Use Authorization raises unique challenges at the intersection of clinical care and research. In conditions of scarcity, prioritization approaches should minimize harm, maximize benefit, and promote fairness. To promote continued data collection, patients seeking access to unproven COVID-19 drugs should receive lower priority for allocation when they decline to participate in clinical trials, either of the requested drug or other investigational products, offering a comparable balance of risks and benefits; special attention should be paid to concerns of voluntariness and distrust. In addition, institutional treatment protocols that can contribute more robust real world data should be preferred to single patient requests for access, with priority for inclusion based on traditional clinical allocation criteria relying on available evidence. Fairness demands distribution of these protocols across a diverse range of sites, particularly those serving marginalized populations, among other protections.     

Vulnerability schemas of individuals in couples relationships: a cognitive perspective

The professional literature has recently given attention to addressing individual schemas in couples relationships, with particular emphasis on the fact that individual vulnerability has a significant impact on couples relationships. This article addresses how this vulnerability can be restructured during the course of couples therapy. Case vignettes are used to illustrate how the model can be applied. Some of the implications of this model are considered in the discussion section.Authors note: Portions of this article were published in Norwegian by the first author and appear in Nordby, T.T. (2002): Kognitiv parterapi. En tilnærming som ivaretar betydningen av den individuelle sårbarheten i samspillet. Reprinted by permission of Fokus på familien 30, 46–60.     

道家药匮理论在《圣济总录》中的转型与利用

药匮早期是指道家炼丹时所用的容器及辅料,有内外匮之分,后世医家借鉴道家药匮思想发挥到药物炮制中,内匮运用偏于炮制药物辅料之性,外匮则兼有辅料及容器的双重特性。通过归纳分析《圣济总录》中外匮和内匮的具体应用,研究后世医家运用道家药匮思想在中药炮制上的反映,进一步阐释药匮在药物炮制中发挥的具体作用。探讨药匮思想的起源与发展,深入挖掘药匮应用与道家炼丹之间的关系,剖析后世医家运用药匮的历史沿革及药性理论的发展,探索医家在药匮思想上的继承与创新,对临床中药炮制的发展和应用具有借鉴指导意义。

     

叙事医学在社区糖尿病患者管理中的应用

通过阐述叙事医学模式在社区糖尿病患者管理中的应用,探讨了叙事医学应用于社区糖尿病患者管理的模式及意义,并分析了该模式现有的不足,如患者缺乏认可度、药师叙事能力不足、患者随访困难等。认为药师在患者管理中引入叙事医学模式,有助于发现患者潜在用药风险,为患者提供个性化用药服务,提高其生存质量,同时提高药师人文素养,实现自我价值。以此模式作为社区药学人文建设的切入点,拓展叙事医学的临床领域。

     

企业社会责任视角下“制造疾病”现象的成因及对策研究

制药企业除应履行一般企业的社会责任外,因其产品的特殊性还应以“安全、健康”为首要职责,并通过协调自身“福利性”与“盈利性”实现可持续发展。企业参与和影响新的疾病定义和标准制定的主要原因是缺失社会责任意识,盲目追求短期经济利益。此外,制定主体不明确,制定流程不规范;法制体系仍不完备,监督体系不够健全等也是导致“制造疾病”现象发生的潜在原因。因此,应采取加强制药企业社会责任意识建设;规范疾病定义和标准制定主体和流程;完善“制造疾病”法律法规和监督体系等措施减少“制造疾病”现象的发生。