Compared to the previous year, the share of healthcare expenditure in the state budget of Ukraine has decreased, which is associated with increased funding for the security and defense sector. In ...terms of gross domestic product, healthcare spending has reduced to 2.8 %, which corresponds to the figures for 2019. These circumstances indicate the importance of proper budget utilization, including effectively regulating medicine prices. One of the key elements of rational healthcare budget usage is the development and implementation of external reference pricing (ERP). A well-formulated and implemented ERP policy for pharmaceuticals contributes to improving patient access to essential medicines (EMs).
The aim of this study is to analyze the current status of ERP implementation in Ukraine and provide recommendations for improving this policy.
Materials and methods. During the research process, an analysis of the ERP’s current regulatory framework was conducted, and ERP implementation in Ukraine was assessed according to adherence to the 14 best practice principles of ERP proposed by Sullivan, Kanavos & Kalo in 2015.
Results. In Ukraine, ERP has been introduced for medicines from the National Essential Medicine Lists (NEML) and the “Affordable Medicines” program. The Ministry of Health (MoH) of Ukraine has approved a Register of marginal wholesale prices for medicines purchased with state budget funds and subject to price regulation. Currently, the register includes 1239 medicinal products, of which 1233 are from NEML and 6 have undergone Health Technology Assessment (HTA). Approximately 58 % of medicines have a set price through ERP, 24 % are regulated by internal reference pricing (IRP), and nearly 18 % have declared prices. This indicates a lack of uniformity in approaches to price regulation for medicines and requires further improvements. According to the latest update of the Register of medicines for reimbursement under the state medical guarantees program, there are 486 medicines, including 72 insulins and 21 immunosuppressive medicines (184 medicines are provided with co-payment). Different approaches, including different reference countries and price calculation algorithms, are applied for the price regulation of medicines in NEML and the “Affordable Medicines” program. An assessment of the implementation of the ERP system in Ukraine based on the 14 best practice principles of ERP proposed by Sullivan, Kanavos & Kalo in 2015 showed that the current policy does not adhere to all principles.
Conclusions. The analysis revealed different approaches to pricing for medicines NEML and the “Affordable Medicines” program, indicating the need for harmonizing pricing policies for different lists. The adoption of a unified positive list can contribute to improving pricing policies and efficient resource utilization. Collecting, disseminating, and exchanging data on drug prices is crucial to support transparency in pricing and its control. Regular monitoring of prices in the market will help ensure compliance with pricing policies and take appropriate measures in case of violations. The implementation of a unified pricing regulation policy for medicines in Ukraine is an important step towards European integration and compliance with international standards.
This paper reports the results of an international interlaboratory study led by the National Institute of Standards and Technology (NIST) on the measurement of high-pressure surface excess carbon ...dioxide adsorption isotherms on NIST Reference Material RM 8852 (ammonium ZSM-5 zeolite), at 293.15 K (20 °C) from 1 kPa up to 4.5 MPa. Eleven laboratories participated in this exercise and, for the first time, high-pressure adsorption reference data are reported using a reference material. An empirical reference equation
n
e
x
=
d
(
1
+
exp
-
ln
(
P
)
+
a
/
b
)
c
,
n
ex
-surface excess uptake (mmol/g),
P
-equilibrium pressure (MPa),
a
= −6.22,
b
= 1.97,
c
= 4.73, and
d
= 3.87 along with the 95% uncertainty interval (
U
k
= 2
= 0.075 mmol/g) were determined for the reference isotherm using a Bayesian, Markov Chain Monte Carlo method. Together, this zeolitic reference material and the associated adsorption data provide a means for laboratories to test and validate high-pressure adsorption equipment and measurements. Recommendations are provided for measuring reliable high-pressure adsorption isotherms using this material, including activation procedures, data processing methods to determine surface excess uptake, and the appropriate equation of state to be used.
Paradoxes of Media and Information Literacy contributes to ongoing conversations about control of knowledge and different ways of knowing. It does so by analysing why media and information literacy ...(MIL) is proposed as a solution for addressing the current information crisis. Questioning why MIL is commonly believed to wield such power, the book throws into sharp relief several paradoxes that are built into common understandings of such literacies. Haider and Sundin take the reader on a journey across different fields of practice, research and policymaking, including librarianship, information studies, teaching and journalism, media and communication and the educational sciences. The authors also consider national information policy proposals and the recommendations of NGOs or international bodies, such as UNESCO and the OECD. Showing that MIL plays an active role in contemporary controversies, such as those on climate change or vaccination, Haider and Sundin argue that such controversies challenge existing notions of fact and ignorance, trust and doubt, and our understanding of information access and information control. The book thus argues for the need to unpack and understand the contradictions forming around these notions in relation to MIL, rather than attempting to arrive at a single, comprehensive definition. Paradoxes of Media and Information Literacy combines careful analytical and conceptual discussions with an in-depth understanding of information practices and of the contemporary information infrastructure. It is essential reading for scholars and students engaged in library and information studies, media and communication, journalism studies and the educational sciences.
Shock of the New Udell, Chad; Woodill, Gary
2023, 2019-04-02, 2019.
eBook
Find the Leading Edge in a Disrupted World.Planning our response to disruption seems impossible. Most new and emerging technologies have been in development for decades, but as soon as they land on ...our doorstep, they inspire the shock of the new. How do you, as a learning professional, prepare for what you don't know is coming? How do you judge what is important and what is just a fad?In Shock of the New: The Challenge and Promise of Emerging Learning Technologies, Chad Udell and Gary Woodill create a new framework for anticipating emerging learning technologies, outlining six key perspectives you should consider with any new technology. They examine some of the day's most commonly discussed emerging technologies and pose the questions that will point the way to your own strategy. These insights aren't limited to specific applications; they give you an approach you can apply to any new tech coming your way, so you're always braced for the shock of the new.Udell and Woodill optimistically point out that emerging technologies will help us make sense of our increasingly complex world; many more changes will occur over the next decade, so buckle up! What was once science fiction has just become real-and now is your opportunity to be on the leading edge.
Scientific experiments show that specific and difficult goals can lead to higher performance than do vague and simple goals. Therefore, we study a goal-reference-point decision-making method that ...considers multiple expert-reference-points and the difficulty grade in a single-stage decision-making problem. First, based on the prior information set, an optimization model is built to obtain the distance range between the attribute value and the goal-reference-point. Next, based on the principle of minimizing the distance between the attribute value and its difficulty grade, an optimization model is built to divide the difficulty grades into several distance ranges. Moreover, based on the principle of maximum entropy, an optimization model that considers the given difficulty grade is built to obtain the weights of experts. Afterward, the ranking values of alternatives are calculated according to the goal-reference-point and prospect theory. Finally, a real-world case of the distribution network planning evaluation and a method comparison illustrate the feasibility and validity of the proposed method.
In this research work, deep machine learning-based methods together with a novel data augmentation are developed for predicting flicker, voltage dip, harmonics, and interharmonics originating from ...highly time-varying electric arc furnace (EAF) currents and voltage. The aim with the prediction is to counteract both the response and reaction time delays of active power filters (APFs) specifically designed for electric arc furnaces (EAF). Multiple synchronous reference frame (MSRF) analysis is used to decompose the frequency components of the EAF current and voltage waveforms into dqo components. Then using low-pass filters and prediction of the future values of these dqo components, reference signals for APFs are generated. Three different methods have been developed. In two of them, a low-pass Butterworth filter is used together with a linear finite impulse response (FIR)-based prediction or long short-term memory network (LSTM) for prediction. In the third method, a deep convolutional neural network (CNN) combined with a LSTM network is used to filter and predict at the same time. For a 40-ms prediction horizon, the proposed methods provide 2.06%, 0.31%, 0.99% prediction errors of the dqo components for the Butterworth and linear prediction, Butterworth and LSTM, and CNN with LSTM, respectively. The error of the predicted reconstructed waveforms of flicker, harmonics, and interharmonics resulted in 8.5%, 1.90%, and 3.2% reconstruction errors for the abovementioned methods. Finally, a Simulink and GPU-based implementation of predictive APF using Butterworth filter + LSTM and a trivial APF resulted 96% and 60% efficiency on compensation of EAF current interharmonics.
Excess sodium intake is a risk factor for non-communicable diseases (NCDs), such as cardiovascular diseases and hypertension. Therefore, many countries have set nutrient reference values for sodium, ...specifically for the prevention of NCDs, and intake is routinely monitored by nutrition surveys. In this review, we aimed to compare the global nutrient reference values and national intakes of sodium, along with the methods of intake assessment used. Data were obtained for Australia, Canada, Ireland, Japan, the UK, the US, and the European Food Safety Authority (EFSA), where information was accessible online in English or Japanese. We collected the following information regarding sodium intake: the term used for reference values to prevent NCDs; year when reference values were established or revised; reference values to prevent NCDs; target NCDs; designation of nutrition survey; method for estimating intake; and average intake. The reference values ranged from 2,000 mg (Australia and EFSA) to 2,953 mg (Japan). Sodium intake ranged from 2,431 mg (Australia) to 3,958 mg (Japan). Out of seven countries/institutions, five used dietary assessment, and two used sodium urinary excretion for estimating dietary sodium intake. Among the dietary assessment methods, the 24-h dietary recall was most frequently used. National sodium intake exceeded the reference values in all countries, and reduction of sodium intake remains a global challenge.
Background
Cystatin C is a key GFR biomarker. Recently, Siemens recalibrated the assay based on certified reference material ERM-DA471/IFCC. The NIH-funded longitudinal chronic kidney disease in ...children (CKiD) study has > 3000 cystatin C measurements based on a pre-IFCC calibrator provided by Siemens. Since cystatin C values for CKiD are now standardized to IFCC certified reference material, it is important to relate the IFCC-calibrated results to the previous values so that there are no discontinuous results.
Methods
We diluted cystatin C ERM-DA471/IFCC (5.48 mg/L) into buffer and compared results with predicted ones. We then updated the cystatin C application on our BN II nephelometer to provide results based on pre-IFCC and IFCC calibrations of CKiD specimens simultaneously. We assayed 51 previously analyzed sera and 62 fresh additional specimens.
Results
The predicted concentrations from the IFCC standard were consistently 17% higher than the measured values using the pre-IFCC calibration (
y
= 1.1686
x
). Similarly, the re-run and fresh sample concentrations were 17% higher via the IFCC calibration than by the pre-IFCC calibration (
y
= 1.168
x
). There was very high reliability in the measurements using the previous calibration for re-run specimens (0.99) and for 33 pristine specimens using IFCC calibration (0.99).
Conclusions
We confirm the recalibration proposed by Siemens. To convert pre-IFCC results to IFCC-calibrated concentrations, the value is multiplied by 1.17. Conversely, one divides IFCC-calibrated results by 1.17 to estimate GFR via previously published pre-IFCC CKiD eGFR equations. For older adolescents, cystatin C has already been standardized and can be directly applied to the CKD-EPI equations.
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