Medicine and pharmacy — facts and myths about the development of an innovative pharmaceutical industry in Poland

Innovation is fundamental to the pharmaceutical industry and a key to improvements in healthcare. Its effectiveness depends on huge, constant investments in research. This innovative industry directly affects the course of studies in healthcare and medicine. Its efforts translate directly into the length and quality of our lives. For several years now, the progress underway in pharmaceutical industry has produced measurable benefits. Doctors have new pharmaceuticals at their disposal, including many types of antibiotics and anti-viral drugs, vaccines and a wide range of drugs which save lives or make them more comfortable. In the near future, ever more efficient cures for neoplastic, rheumatic, neurological, psychic, metabolic, circulatory or respiratory diseases can be expected. Innovation is necessary. The human population is ageing, and the task of an innovative pharmaceutical industry is to keep it in a good condition. The use of innovative drugs can translate directly into lowering the costs of illness. A continuous reduction in spending on healthcare has been observed. The costs of inventing an innovative drug are enormous though (US$ 800 million), and studies on a new drug last between 10 and 13 years. An essential element in recovering the incurred costs and ensuring funds needed for new research is protection by patent. Innovative pharmaceutical companies in Poland are committed to increasing the competitiveness and sustaining the development of not only the market, but also the entire pharmaceutical sector. It is a group of companies of crucial importance to the Polish healthcare system, as it influences improvement in the quality of medical services. Through their investments and spending on research and development, innovative companies accelerate economic growth. In Poland, the innovative pharmaceutical industry is represented by the Association of Pharmaceutical Companies Representatives in Poland (SPFFwP). An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

高述情障碍者的情绪图式特征

采用混合实验设计,以情绪词和情绪图片为实验材料,选取不同述情障碍得分的大学生为被试,通过三个实验考察了高述情障碍者的情绪图式特征。研究结果发现：（1）高述情障碍组被试对情绪词的效价判断反应时显著长于低述情障碍组,述情障碍各维度得分均与情绪词的效价判断反应时呈显著正相关;（2）高述情障碍组被试对情绪图片的效价判断反应时与低述情障碍组相比差异不显著;（3）高述情障碍组被试情绪图式联结所需反应时显著长于低述情障碍组,情感描述困难与情绪图式联结所需反应时之间相关显著。研究结论如下：高述情障碍者存在情绪语言图式和参考性链接上的缺陷,而在情绪意象上并不存在积极/消极区分能力方面的缺陷     

医生与药业的关系：利益冲突重要根源

药业与医生的关系在最近40年日益受到医学界与社会的重视。药业以并不昂贵的馈赠及其他手段,资助学术交流、医学教育和医学研究,深刻地影响着临床医生的行为和诊治决策,从而危及医学的科学性和医学职业精神,加重了病人的负担,且祸及病人健康。药业与医生的这种关系,是道德与金钱关系的赤裸表现,是资本对医学的无情侵略。从道德、法律、行业管理等诸多方面正确规范行业与医生的相互关系,避免当前面临的种种弊端,维护医学的科学性,保护病人与社会公众的利益,刻不容缓。     

内隐追随理论:概念、测量、前因及后果

内隐追随理论,是个体心目中既存的关于追随者的特质和行为的认知结构或图式,是当前组织行为研究领域中的一个新兴的概念。内隐追随理论与X-Y理论、内隐绩效理论等既有区别又有联系。内隐追随理论研究的理论基础主要可归纳为认知分类模型、信息加工模型及联结主义网络模型等。现有研究还对内隐追随理论的测量、前因变量和后果变量等进行了初步的探讨。未来研究中,可能会注重开发更有效的测验工具,深入探索影响内隐追随理论形成的因素,采用多种方法进一步澄清变量间的因果联系,以及加强内隐追随理论的本土化研究等。     

医生与药业的关系:利益冲突重要根源

药业与医生的关系在最近40年日益受到医学界与社会的重视。药业以并不昂贵的馈赠及其他手段,资助学术交流、医学教育和医学研究,深刻地影响着临床医生的行为和诊治决策,从而危及医学的科学性和医学职业精神,加重了病人的负担,且祸及病人健康。药业与医生的这种关系,是道德与金钱关系的赤裸表现,是资本对医学的无情侵略。从道德、法律、行业管理等诸多方面正确规范行业与医生的相互关系,避免当前面临的种种弊端,维护医学的科学性,保护病人与社会公众的利益,刻不容缓。     

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。

     

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。

     

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。

     

A new look at the schema therapy model: organization and role of early maladaptive schemas

This study reexamined the organization of Young’s 18 early maladaptive schemas and their hypothesized associations with experiences of need-thwarting parental experiences in childhood and the “vulnerable child” mode of emotional distress in adulthood. A large Danish sample (N = 1054) of 658 clinical- and 391 nonclinical adults completed measures of early maladaptive schemas, parenting styles, and the vulnerable child mode. We identified four higher-order schema domains as most appropriate in terms of interpretability and empirical indices (“Disconnection & Rejection”, “Impaired Autonomy & Performance”, “Excessive Responsibility & Standards”, and “Impaired Limits”). All four schema domains were differentially associated with conceptually relevant need-thwarting parental experiences. Apart from “Impaired Limits”, the schema domains meaningfully accounted for the association between need-thwarting parental experiences in childhood and emotional states of feeling like a “vulnerable child” in adulthood. We conclude that four domains of early maladaptive schemas are empirically and conceptually consistent with Young’s schema therapy model of personality pathology and longstanding emotional disorders. Findings warrant replication using different populations and if possible a prospective multi-method design. A scoring key for computing the four schema domains is provided.     

The Ethics of Pharma–Physician Relations in Pakistan: “When in Rome”

This article investigates the pervasive influence of the pharmaceutical industry in Pakistan and primarily the attitudes of the medical community toward such interactions. We used an inductive approach informed by grounded theory principles to analyze interviews and focus groups with consultants, residents, medical students, and a pharmaceutical industry representative in Karachi and Lahore (n = 27), and participant-observation data from two biomedical conferences. Data were then analyzed through a deontological and teleological ethical theoretical framework. Findings highlight the reasons leading to the continuation of norms including weak regulations, physicians’ expectations of receiving favors, and limited exposure to bioethics education. Recommendations for practice, policy, and research are discussed.