<p> Many studies have examined the association between corporate social responsibility (CSR) and corporate financial performance, but scholars argue that the exact relationship between CSR and corporate financial performance remains unclear. This quantitative study examines the impact of CSR on corporate financial performance in the pharmaceutical industry. The study addresses the research question: What is the financial performance in the pharmaceutical industry among companies that have embraced CSR? The alternative hypothesis predicted positive correlations between financial performance and CSR. The related null hypotheses predicted that there would be no correlations between any of 8 dimensions of CSR and corporate financial performance. Archival data from 18 leading global pharmaceutical companies ranked by Access to Medicine Index were used to answer the research question.</p><p> In 4 of the 8 hypotheses tested, the results show partial support for a positive effect of CSR on corporate financial performance in the pharmaceutical industry based on significant correlations in 2014. Specifically, significant 2014 relationships with corporate financial performance were observed for CSR general access to medicine management, CSR capacity advancement in product development and distribution, CSR product donations and philanthropic activities, and overall CSR. However, no significant 2014 relationships with corporate financial performance were observed for CSR public policy and market influence, CSR research and development, CSR pricing, manufacturing, and distribution, and CSR patents and licensing. In the 8 hypotheses tested, the findings in 2012 did not show any effect of CSR on corporate financial performance in the pharmaceutical industry. The results of this study suggest at the minimum, that CSR does not negatively impact corporate financial performance in the pharmaceutical industry. This study does not support arguments against product donations and philanthropic activities. The partial support for a positive effect of CSR on corporate financial performance and no negative impact of CSR on financial performance in the pharmaceutical industry, could encourage corporate leaders to pay attention to, not only their corporate financial profits, but also ethical, environmental, and social issues such as improving the access to medicines; and contributing to improving society.</p><p>

Cannabis är narkotika och omdiskuterat, särskilt när det gäller dess medicinska användning. Många rykten florerar om mot vad det kan användas till och ett flertal individer med olika sjukdomsbakgrund självmedicinerar sig med Cannabis. Cannabinoider som extraheras från Cannabis kan vara användbara för behandling av en rad olika sjukdomar. Detta arbete fokuserar på att ge en exposé av Cannabisalkaloidernas medicinska värde för personer som upplever smärttillstånd och dess terapeutiska effekt vid sjukdomarna Multipel Skleros (MS) och Parkinsons. Metoden som användes var en litteraturstudie och databaserna PubMed och Cochrane har använts för att ta fram informationen. Studien är baserad på fem artiklar, av vilka två fokuserar på smärtlindring, en på muskelstelhet i samband med MS, en på dyskinesi hos patienter med Parkinsons och en på tics hos individer med Tourettes syndrom. Smärtlindring noterades både i studien där patienterna led av HIV-orsakad smärta och i den neuropatiska smärtstudien. Resultatet hos Parkinsonpatienter blev att dyskinesin försämrades en aning. Hos MS patienter sågs inte någon skillnad i primära effektmåtten men däremot på vissa av de sekundära. Ingen positiv effekt kunde noteras hos patienterna i Tourette-studiens olika skalor förutom i några av deras delmoment.

Helicobacter pylori (HP) är en mycket vanlig bakterie och 50 % av jordens befolkning bär på denna bakterie.  1982 bevisade australiensarna Barry Marshall och Robin Warren att bakterien kunde överleva i magens sura miljö. Bakterien orsakar kronisk inflammation genom att skada slemhinnan i magsäcken och tolvfingertarmen och kan ge upphov till magsår. Efter upptäckten av H. pylori har Världshälsoorganisationen (WHO) deklarerat bakterien som en klass 1-carcinogen. H. pylori-behandlingen består av trippelterapi där två olika sorters antibiotika tillsammans med PPI (protonpumpshämmare) används. På grund av problematiken med antibiotikaresistens samt antibiotikaassocierade biverkningar misslyckas 35 % av H. pylori- behandling vid bruk av förstahandsalternativet. Vid misslyckande måste patienten äta tre eller flera sorters antibiotika som ger fler biverkningar. Probiotika är levande bakteriekultur av flera olika stammar av de ”goda” bakterier som återställer balansen i tarmfloran. Syftet med denna studie var att undersöka om probiotika kan vara ett komplement till antibiotikavid behandling  av  H. pylori- infektioner. Metoden som användes var litteratustudier av randomiserade kliniska studier från databasen PubMed och Google Scholar där olika trippelbehandlingar och probiotika-stammar jämförs på patienter med H. pylori. Resultat från studierna visade att för- och efteradministrering med probiotika i samband med trippelbehandling minskar bakteriehalten och förbättrar eradikeringsresultaten. Samtidigt är probiotikakomplement mycket effektivt vad gäller minskning av antibiotikaassocierade biverkningar. Slutsatsen blev att det krävs ytterligare forskning där stora, långsiktiga och placebokontrollerade studier utförs för att bestämma exakt vilken stam eller hur hög dos av probiotika som bör användas . Studieresultaten visar att tillskott med probiotika kan användas som komplement vid behandling av H. pylori-infektioner eftersom detta ökar patientens livskvalitet genom att reducera symtom som H. pylori orsakar och biverkningar från antibiotika.

<p> <i><b>Introduction:</b></i> In humans, bruxism is defined as the grinding or clenching of the teeth. Pathological bruxism can cause damage to dental surfaces, joint pain and many other dentally related issues. Bruxism can be displayed while awake or during sleep. In humans, L-dopa can attenuate bruxism during sleep. To grind down continuously growing teeth, rats display a brux-like behavior while awake. L-dopa&rsquo;s effect on brux-like motor patterns in rats have never been characterized. The influence of L-dopa on masticatory motor patterns has not been investigated in rats or humans. This pilot study used electromyography in three masticatory muscles to test the effects of acute L-dopa on brux-like motor patterns and mastication in rats. </p><p> <i><b>Methods:</b></i> Electromyography (EMGs) fine silver wire electrodes were surgically implanted into the anterior superficial masseter, anterior digastric, and posterior superficial masseter muscles of laboratory rats (<i>Rattus norvegicus</i>) (n=10). The fine silver wire electrodes were run sub-dermally to an electrode pedestal, which was secured to the skull via screws and dental cement. A preamplifier (X10) was attached to the headcap, and sent to a secondary amplifier (x100). This amplified signal was sent to an A/D converter, and digitally recorded with a personal computer. Rats received an IP injection of L-dopa (10mg/kg)/Benserazide (15mg/kg) or saline vehicle. We recorded brux-like EMG bursts for one hour after injection. After the initial hour of brux-like recording, the rats were given food and masticatory EMG bursts were recorded. After recording, at least one hundred onsets and offsets were collected for each behavior. This was done for every animal. For brux-like behavior, the number of episodes per hour, average episode duration, and total time displaying brux-like activity was obtained for each animal and compared using a Mann-Whitney U test. For brux-like and masticatory motor patterns, cycle period (onset-to-onset), burst duration (onset-to-offset), between burst (offset-onset), and cycles per second were recorded for every animal and compared using a Mann-Whitney U test. Phase values, which compare the timing of two muscles, was also obtained. Treatment groups were compared to assess L-dopa&rsquo;s effects on brux-like and masticatory motor patterns. </p><p> <i><b>Results:</b></i> The number of brux-like episodes per hour in controls (&mu;=47.8, SD=18.7) was greater than the group that received the L-dopa treatment (&mu;=16, SD= 12.53); (<i>U</i>=2, p&lt;0.05). Average episode duration and total time displaying brux-like activity per hour did not change (NS). Anterior superficial masseter cycle period, burst duration, between burst, and cycles per second were not different between treatments (NS). Anterior digastric cycle period, burst duration, and between burst were not different between treatments (NS). For the anterior digastric, the L-dopa treatment group had a higher rate of cycles per second (&mu;=7.271, SD=0.973) than the control group (&mu;=9.034, SD=1.422) (<i>U</i>=2, p=.05). We compared the phase relationships between the anterior superficial masseter and anterior digastric using a Watson-Williams F test and found the phase values to be similar (NS). Not enough posterior superficial masseter muscle traces were obtained for statistical test to be performed. The obtained results for the posterior superficial masseter muscle were characterized for future experiments.</p><p> <i><b>Conclusion:</b></i> Although L-dopa attenuates sleep bruxism in humans, it has not been used to assess brux-like motor patterns in rats. Rats display a conscious, brux-like motor pattern that is used to prevent tooth overgrowth. This study is the first to establish that brux-like motor patterns in the conscious rats are attenuated by acute doses of L-dopa. Brux-like motor patterns were attenuated with only a change to anterior digastric cycle period. L-dopa likely plays a role in initiating brux-like motor patterns, but it does not control rhythmogenesis. To our knowledge, mastication has not been examined in detail while under the influence of L-dopa in humans or rats, making this study the first to look at L-dopa&rsquo;s effect on the motor pattern. The masticatory motor patterns remained unchanged between treatment groups (NS). Our study is the first to show that acute L-dopa exposure does not alter masticatory motor patterns. L-dopa does not have a strong influence over the masticatory CPG. This study established an animal model for use on future studies of brux-like behavior. The developed model can be applied in the future for drug interactions and basal ganglion studies.</p><p>

Medication non-adherence, the extent to which a person's behavior does not coincide with medical or health advice, is a serious public health issue. Objectives: 1) Develop a new typology of medication non-adherence, 2) Develop models to predict different types of non-adherence based on Andersen Behavioral Model (ABM) and Leventhal's Common Sense Model (CSM), and 3) Test the models across two different medications used in treating disease conditions with varying symptomatology. Methodology: A new typology of medication non-adherence was developed through literature review of the frequently reported reasons for non-adherence based on the possibility of a cognitive process intervention directed towards patients and the mutability of interventions. The typology was analyzed qualitatively and quantitatively. A new self-reported scale to measure non-adherence was developed from the frequently reported reasons and compared to the Morisky scale. The conceptual models developed using ABM and CSM were tested using regression techniques to identify significant predictors of non-adherence. Results: Qualitative analysis supported the typology from the literature review, yet the quantitative exploratory factor analysis did not support it. Instead, four types of non-adherence each for cholesterol lowering (non-adherence due to managing issues, multiple medication issues, belief issues with medications, forgetfulness due to busy schedule) and asthma maintenance medications (non-adherence due to managing and availability issues, beliefs and convenience issues, cost issues, forgetfulness due to busy schedule) were identified. Predisposing factors such as concern beliefs in medications, enabling factors such as self efficacy, and need factors such as self health and illness perceptions, and severity of disease were significant predictors of medication non-adherence. The Reasons scale had moderate levels of agreement with the Morisky scale based on kappa coefficients. Conclusion: No one typology of medication non-adherence fit cholesterol lowering and asthma maintenance medications, and the typology was driven by type of disease condition and reasons for non-adherence. The Reasons scale measured and categorized non-adherence better than the Morisky scale. Adding CSM to ABM facilitated in identifying predictors of medication non-adherence.

Primär binjurebarkinsufficiens beror på frånvaro av binjurevävnad och är ett livshotande tillstånd som behandlas med glukokortikoidersättningsterapi som tyvärr är suboptimal eftersom den naturliga ökningen av serumkortisol som sker under natten och når en topp på morgonen är svår att efterlikna. Majoriteten av patienter med binjurebarksvikt ersätts med hydrokortison med omedelbar frisättning som ges två eller tre gånger dagligen vilket förser dem med onormalt höga serumhydrokortisonnivåer vilket orsakar följdsjukdomar och förkortar livslängden. Majoriteten av patienterna med Addisons sjukdom rapporterar försämrad hälsorelaterad livskvalitet. Hypofys-binjureaxeln har varit föremål för intensiva studier under många år utan viktiga förbättringar för AI-patienternas hälsa och livskvalitet men forskning i kombination med den nutida avancerade medicinska teknologin har möjliggjort att få fram en mer naturtrogen behandling och så höja Addison-patienternas livskvalitet och livslängd. För närvarande finns det två behandlingstyper, den traditionella tabletten på 10 mg 3 x1 och den nyare, en kortisontablett med modifierad frisättning, 20 mg 1x1. Syftet med denna litteraturstudie är att genom jämförelse av de två ovannämnda hormonersättnings-behandlingarna komma fram till den mest optimala för Addison- patienternas livslängd och livskvalitet. Av de 13 inkluderade artiklarna framgick det att behandlingen med den nya modifierade-release hydrokortisontabletten ger en dygnsplasmakortisolprofil som är mest lik den fysiologiska. Detta i sin följd leder till: Minskat blodtryck, minskad BMI, förbättrad glukosmetabolism, förbättrad bentäthet, förbättrad livskvalitet, bättre immunsvar och färre återkommande infektioner.

Over the last two decades, an enormous amount of scientic effort has been devoted to studying the relationship between vitamin E and prostate cancer. This effort is well justied, since prostate cancer remains the most common cancer in American men after skin cancer and is the second leading cause of cancer deaths: over 220,000 men will develop prostate each year (U.S. Cancer Statistics Working Group 2011). Nevertheless, large-scale, well-designed clinical intervention studies have not shown that alpha-tocopherol prevents prostate cancer or cancer in general (Lippman et al. 2009; Ju et al. 2010; Wada 2012). Alpha-tocopherol is the primary form of vitamin E in the plasma of fasting subjects and the primary form of vitamin E in most vitamin supplements. Gamma-tocopherol is, however, the primary dietary form of vitamin E. Vitamin E is a term that refers to at least eight different compounds that fall into two general categories: tocopherols and tocotrienols. Tocotrienols are normally not present in human plasma at detectable levels, yet the evidence for their role in preventing prostate cancer is both extensive and compelling (Conte et al. 2004; Srivastava and Gupta 2006; McAnally et al. 2007; Barve et al. 2009; Campbell et al. 2011; Luk et al. 2011). Excellent reviews are available on the general anticancer effects of tocotrienols (Wada 2009, 2012; Ju et al. 2010). It is unlikely that an anticancer effect could be achieved by consuming a tocotrienol rich diet, and instead a supplement-possibly in the form of a soft gel-would be necessary. Despite the ever-increasing data supporting the antiprostate cancer role of tocotrienols, a well-designed chemoprevention trial has yet to be conducted. Given the negative results with alpha-tocopherol chemoprevention trials, a future prostate cancer chemoprevention trial with another isoform of vitamin E must be well justied and designed. Moreover, the cost effectiveness of any future tocotrienol chemoprevention trial must be given high priority.

Gender differences in drug use in Sweden – a systematic analysis of changes taking place during a decade Background: From a global perspective, Sweden upholds a high-quality healthcare provided on equal terms. Despite this, there are differences in health and living conditions as well as drug utilization between men and women. Aim: The aim of this study was to analyze how gender differences in drug use in Sweden have changed over the past 10 years. Specifically, to observe within which pharmacological groups large increases and decreases have taken place between 2011 and 2021. Method: A quantitative cross-sectional study was conducted to compare the prevalence of drug use between women and men in 2011 and 2021. The study used data from the Swedish Prescribed drug register containing information about all dispensed prescription drugs. Results: The gender differences differ depending on whether the differences are analyzed in relative or absolute terms. The largest sex difference in absolute numbers was antibiotics with a greater use were in women, while lipid lowering agents were showed the highest use among males. The largest increase in relative gender difference from 2011 to 2021 was for antimigrane preparations while the relative gender differences has decreased most substantially for mineral substances. Conclusion: The study shows that gender differences still exist and have not decreased in the last 10 years. Some findings on gender differences could be explained using research on prevalence of diseases between the sexes, while some differences could not be justified using medical explanations. Unexplainable gender differences can be explained by normative structures that exist and affect healthcare in Swedish society.

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It is a well reported fact that large number of drugs coming of the drug discovery pipeline show poor aqueous solubility. Eutectic mixture formation of poorly soluble drugs with hydrophilic carriers has been used to enhance the dissolution rate of such poorly soluble drugs. Eutectic mixtures are solid dispersions where the drug and the carrier are both in crystalline form. The eutectic mixture has a lower melting point than either component. Eutectic mixtures are thermodynamically stable systems. The feasibility of developing a dosage form from an eutectic mixture depends on the phase diagram. Poloxamers are polyoxyethylene-polyoxypropylene-polyoxyethylene block polymers which have surfactant properties. Phase diagram construction and dissolution rate enhancement mechanism in crystalline poloxamer based eutectics has not been reported in pharmaceutical literature. This thesis involved the detailed study of poloxamer 188 (PL 188) based eutectic mixtures. Eutectic mixture formation between PL 188 and drugs with diverse physicochemical properties was proved. Accurate experimental phase diagrams were constructed using solid state characterization techniques and theoretical phase diagrams were predicted using Lacoulonche et al's model. The model was accurate in predicting the phase diagrams of most drugs. Discrepancies were observed in case of drugs showing hydrogen bonding interactions with PL 188. This was confirmed by a blue shift of the carbonyl band using fourier transform infra-red spectroscopy. A unique novel graphical method for estimating the accurate eutectic composition of PL 188 based eutectics with about 50 mg of drug was devised. PL 188 was effective in improving the dissolution rate of a poorly soluble drug ibuprofen in pH 1, 4.5 and 7.2. For the first time a detailed study establishing melting point depression due to eutectic formation as a reason for dissolution enhancement was described. Contrary to expectation it was realized that maximum dissolution rate enhancement takes place at drug ratios well above the eutectic composition. The utility of PL 188 as a eutectic mixture carrier was shown by comparing ketoprofen PL 188 eutectic mixtures with ketoprofen soluplus (glass solutions) and ketoprofen urea solid dispersions(amorphous precipitation in crystalline carrier). The ketoprofen PL 188 eutectic mixtures had better dissolution enhancing effect and physical stability. / Pharmaceutical Sciences