Prescription For Conflict

Raises key questions about topics in the pharmaceutical industry, including how the risks of side effects are weighed, if privatization of that risk is prudent, and the high prices for drugs.

Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.

This book addresses the over-prescribing of antidepressants in people with mostly mild and subthreshold depression. It outlines the steep increase in antidepressant prescription and critically examines the current scientific evidence on the efficacy and safety of antidepressants in depression. The book is not only concerned with the conflicting views as to whether antidepressants are useful or ineffective in various forms of depression, but also aims at detailing how flaws in the conduct and reporting of antidepressant trials have led to an overestimation of benefits and underestimation of harms. The transformation of the diagnostic concept of depression from a rare but serious disorder to an over-inclusive, highly prevalent but predominantly mild and self-limiting disorder is central to the books argument. It maintains that biological reductionism in psychiatry and pharmaceutical marketing reframed depression as a brain disorder, corroborating the overemphasis on drug treatment in both research and practice. Finally, the author goes on to explore how pharmaceutical companies have distorted the scientific literature on the efficacy and safety of antidepressants and how patient advocacy groups, leading academics, and medical organisations with pervasive financial ties to the industry helped to promote systematically biased benefit-harm evaluations, affecting public attitudes towards antidepressants as well as medical education, training, and practice.

We often conceptualize that older adults retire into a life of carefree luxury among palm trees, golf courses, and pristine beaches. Unfortunately, reality differs today – many retire in place, and often it is the case they retire in rural areas far from hospitals and care-giving centers. For instance, over half of the older population in the state of Minnesota lives in small towns away from the center of care, which is Minneapolis/St. Paul. This year, ICOST 2008 aimed at focusing on this important reality and on gerontechnology––the use of technology to enhance the quality of life of older adults in rural lands. We had a strong technical program this year spanning many critical topics incl- ing: remote monitoring and tele-care, access control and privacy preservation, und- standing user requirements and needs, autonomic learning and reasoning about user behavior, activities and contexts, user interface design, middleware for sensing and actuation in smart homes, cognitive assistants, context-aware service provisioning, among other topics. We received a total of 54 submissions of papers, abstracts and posters, from 14 diff- ent countries. Through a blind review process, we accepted 24 full papers, 9 abstracts, and 7 posters. Each submission received two or three reviews with the exception of a few that received four reviews. We are thankful to all the reviewers who helped in the review process including members of the Technical Committee and the additional reviewers that we needed to compensate for unreturned reviews.

Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.

We are living in a world full of innovations for the elderly and people with special needs to use smart assistive technologies and smart homes to more easily perform activities of daily living, to continue in social participation, to engage in entertainment and leisure activities, and to enjoy living independently. These innovations are inspired by new technologies leveraging all aspects of ambient and pervasive intel- gence with related theories, technologies, methods, applications, and services on ub- uitous, pervasive, AmI, universal, mobile, embedded, wearable, augmented, invisible, hidden, context-aware, calm, amorphous, sentient, proactive, post–PC, everyday, autonomic computing from the engineering, business and organizational perspectives. In the field of smart homes and health telematics, significant research is underway to enable aging and disabled people to use smart assistive technologies and smart homes to foster independent living and to offer them an enhanced quality of life. A smart home is a vision of the future where computers and computing devices will be available naturally and unobtrusively anywhere, anytime, and by different means in our daily living, working, learning, business, and infotainment environments. Such a vision opens tremendous opportunities for numerous novel services/applications that are more immersive, more intelligent, and more interactive in both real and cyber spaces.