scholarly journals A review of proposals to reform the regulation of complementary medicines

2009 ◽  
Vol 33 (2) ◽  
pp. 279 ◽  
Author(s):  
Ken J Harvey

In 2003, the Therapeutic Goods Administration instituted a major recall of products made by Pan Pharmaceuticals Limited. Later that year, an expert committee produced 49 recommendations for complementary medicines reform, many of which were to be implemented by the proposed Australia New Zealand Therapeutic Products Authority (ANZTPA). In 2008, the Pan Pharmaceuticals affair reached some conclusion in the courts, the ANZTPA had been abandoned and the case for reform had intensified. There was widespread and increasing use of complementary medicines yet consumers were often unaware that, unlike conventional medicines, these medicines were not evaluated for efficacy. The justification of this two-tiered regulatory system was that complementary medicines are relatively low-risk products. However low risk does not mean no risk. A number of consumers have been shown to use these products for conditions where there is no evidence of effect, potentially placing them at risk. In addition, promotion often overstates their benefits while minimising and sometimes denying known adverse effects and drug interactions. Complaint procedures are overloaded and the ?sanctions? available do not deter repeat offenders. A number of regulatory reforms have been suggested to overcome these problems; they are reviewed in this paper.

2021 ◽  
Author(s):  
◽  
Gabriele Hufschmidt

<p>The aim of this research is to identify temporal changes of risk from landsliding for several locations in New Zealand (the Western Hutt Hills, close to Wellington; Te Arai, close to Gisborne; Mt.Cook/Aoraki Village, South Island). While risk analysis usually targets a particular point in time, this research includes several five-year intervals (based on census years) starting in 1981 until 2006. The scale of this analysis is the community level. Risk is not expressed as an absolute level of loss, for example a dollar value or the number of fatalities. Risk is rather considered as the probability and extent of adverse effects on a community inferred from landsliding. As such, risk is relative: the aim is to quantify risk for a community relative to another point in time, and relative to other communities. In addition, the degree to which risk levels vary between communities is quantified. The objectives of the risk analysis are to: 1. establish landslide hazard, i.e. the frequency and magnitude of landsliding for each location, 2. develop an index of social vulnerability per census year and community, 3. develop an index of social resilience per census year and community, 4. combine 1.-3. and, together with exposure ('elements at risk'), determine risk from landsliding for each community through time.</p>


2021 ◽  
Author(s):  
◽  
Gabriele Hufschmidt

<p>The aim of this research is to identify temporal changes of risk from landsliding for several locations in New Zealand (the Western Hutt Hills, close to Wellington; Te Arai, close to Gisborne; Mt.Cook/Aoraki Village, South Island). While risk analysis usually targets a particular point in time, this research includes several five-year intervals (based on census years) starting in 1981 until 2006. The scale of this analysis is the community level. Risk is not expressed as an absolute level of loss, for example a dollar value or the number of fatalities. Risk is rather considered as the probability and extent of adverse effects on a community inferred from landsliding. As such, risk is relative: the aim is to quantify risk for a community relative to another point in time, and relative to other communities. In addition, the degree to which risk levels vary between communities is quantified. The objectives of the risk analysis are to: 1. establish landslide hazard, i.e. the frequency and magnitude of landsliding for each location, 2. develop an index of social vulnerability per census year and community, 3. develop an index of social resilience per census year and community, 4. combine 1.-3. and, together with exposure ('elements at risk'), determine risk from landsliding for each community through time.</p>


2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.


2017 ◽  
Vol 70 ◽  
pp. 310-314
Author(s):  
J.L. Tyson ◽  
S.J. Dobson ◽  
M.A. Manning

Pseudomonas syringae pv. actinidiae (Psa) causes bacterial canker of kiwifruit, which is an ongoing threat to New Zealand kiwifruit production. Disease control depends on orchard practices such as removal of visibly diseased material, pruning during low-risk periods, and the application of foliar bactericides. Although the use of copper compounds on Actinidia species (kiwifruit) can cause phytotoxicity, copper-based formulations remain a key component of Psa control in New Zealand. The effect of single copper applications on Psa infection of ‘Hort16A’ trap plants was studied over the Spring of 2014 (Sept—Nov). Psa leaf spots were observed at the beginning of October, appearing first on the untreated plants. Although the copper sprays did not achieve complete protection, particularly as the inoculum built up during November, the copper-sprayed plants always had less disease than the untreated plants.


Author(s):  
Lisa Kremer ◽  
David Reith ◽  
Natalie J. Medlicott ◽  
Mary J. Sime ◽  
Liza Edmonds ◽  
...  

Objective This study was aimed to determine mydriatic regimen(s) used in neonatal units in Aotearoa New Zealand (NZ) and Australia and to estimate the frequency of adverse drug events following mydriatic administration in preterm neonates. Study Design A cross-sectional survey was sent to neonatal nursing staff listed in the Australian and New Zealand Neonatal Network contact list. Participants were asked to state what mydriatic regimen they use, and to estimate the frequency of adverse drug events when eye drops were administered for retinopathy of prematurity eye examinations (ROPEE). Results Thirteen different mydriatic regimens were identified; phenylephrine 2.5% and cyclopentolate 0.5% (1 standard drop of each) was the most commonly used regimen. Two of the regimens exceeded adult doses and five regimens included a mydriatic that is equivalent to an adult dose. Following mydriatic instillation, the three most common adverse effects were apnea, tachycardia, and periorbital pallor. Conclusion Low-concentration single-microdrop regimens are currently in use and resulting in successful ROPEE, yet doses exceeding adult doses are in use throughout Aotearoa NZ and Australian units. We know from this dataset that neonates are experiencing unwanted and potentially preventable, adverse effects associated with mydriatics, and every effort should be made to minimize this risk. Key Points


2002 ◽  
Vol 37 (10) ◽  
pp. 1113-1126 ◽  
Author(s):  
Joyce A. Generali

“Black-box” warnings report valuable postmarketing safety data about prescription drugs, keeping practitioners informed about potential adverse events, drug interactions, key dosing information, monitoring and administration requirements, and at-risk patient populations. They are especially crucial for newly approved agents. A list of agents with black-box warnings does not currently exist; however Hospital Pharmacy will be publishing comprehensive lists by drug category in this column until November 2002. At that time, a complete list in wall chart form will be released. Hospital Pharmacy will update the data as salient information becomes available.


2021 ◽  
Author(s):  
Ralph Maddison ◽  
Nilufar Baghaei ◽  
Amanda Jane Calder ◽  
Rinki Murphy ◽  
Varsha Parag ◽  
...  

UNSTRUCTURED Objective: To determine the comparative use and knowledge effects of two prototype serious games for health on healthy lifestyle knowledge in youth aged 9-16 years at risk for type 2 diabetes (T2D). Methods: A three-arm parallel randomized controlled pilot trial was undertaken to assess use of the game, and the effect of the game on healthy lifestyle and T2D diabetes knowledge. Participants were allocated to ‘Diabetic Jumper’ (n=7), ‘Ari and Friends’ (n=8), or a control game (n=8). All participants completed healthy lifestyle and T2D knowledge questionnaires at baseline, immediately after game play, and four weeks after game play. Game attitudes and preferences were also assessed. The primary outcome was the use of the game, specifically, the number of minutes played over four weeks. Results: There were no statistical differences in healthy lifestyle knowledge or diabetes knowledge over time or across games. Only one participant accessed the game for an extended period, playing the game for a total of 33 min over 4 weeks. Conclusion: Two prototype serious were unsuccessful at sustaining long-term play outside a clinic environment. However, the potential for these games to be used as stimulus to engage young people with healthy lifestyle and diabetes knowledge in a clinic setting should be further explored. Suggested improvements for future studies are discussed. Trial Registration: Australia New Zealand Clinical Trials Registry, ACTRN12619000380190. Registered 11 March 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377123 Funding: The trial was funded by a Health Research Council of New Zealand Feasibility grant.


Sign in / Sign up

Export Citation Format

Share Document