Progress Statement and Development Plan Essay Example | Topics and Well Written Essays - 1500 words

Progress Statement and Development Plan - Essay Example Misunderstandings occurred occasionally due to communication breakdown and conflicts arose between team mates when there were different thoughts and ideas. I attempt to develop my communication skills and work in a multicultural group by slowing down my speaking speed and pronounce the words correctly in order to convey my ideas and messages clearly. I also try to improve my vocabularies by extensive reading. Besides that, I would like to make effort in developing my interpersonal skills by practising patience and high tolerance rather than being aggressive when facing conflicts. Two-way communications, mutual understanding and positive feedbacks are important in resolving conflicts and disputes (Agar, 1994). Thus, I have learnt to be a good listener and be open to constructive feedbacks and comments. This is especially important if I am to work in a diversity workplace in the future. Time management is another challenge which I have encountered. I faced obstacles in balancing my in- class time, time spent on assignments, study and entertainment. Time management skill is important in overcoming the problem such as careful planning of work, tight monitoring of progress and revision of plan when necessary (Smith, 1994). It would be useful to set a personal goal and develop a flexible schedule to assist me in prioritising my activities. I plan my day ahead and maintain a list of activities which must be done daily at the same allowing room of flexibility for unexpected incidents. It enables me to recognize tasks which are urgent and in need of special focus and attention followed by the important ones. In this case, I would be able to meet deadlines such as assignments deadline without any last minute rush. This skill would definitely assist me in future career success as the optimum use of time would lead to increase work efficiency and productivity. On the other hand, it ensures that I am not overloaded with work contributing to less stress and pressures. Additio nally, numerical skill is another area which is in need of improvement as it is critical for my accounting module. Numerical skills involve the ability to recognise and utilize numerical data and reflect on a person’s general intelligence and ability to rapidly perceives, processes and calculates numbers (Psychometric Success, 2011). Employers often recognise the importance of numerical skills in work practise and incorporate it as one of the selection criteria in the recruitment process. This is evidenced by the compulsory completion of numerical ability test by candidates during a job interview. The level of tests would however depend on the relevance of skill to the job (Royal Holloway University of London, 2011). As practise make perfect, I am commit to perform mathematical exercise on a weekly basis and apply it on a daily basis to resolve practical calculations. Moreover, I attempt the numerical skills test available online to assess my skills and continuously monitor m y progress. This would not only assist in my current academic success but also increase my employability. Besides that, I would require to enhance my presentation skills as it is useful in every aspect of work and life. Effective presentation and public speaking skills are essential in my university as it is part of the assessment requirements. From a business perspective, it is insufficient to only display capability in work but also be able to be presentable and talk and write well in order to be

Protein Research Essay Example | Topics and Well Written Essays - 500 words

Protein Research - Essay Example they protect the body against bacteria and viruses by immobilizing antibodies that are immediately destroyed by the white blood cells(Whitford, 2005). Contractile proteins such as actin and myosin are responsible for the movement of the body cells through muscle contraction and movement. Enzymes are another category of proteins, and they are responsible for the facilitation of biochemical reactions whereby they speed up the reactions. Proteins of this kind are mainly involved in the digestive system, e.g., the lactase for sugar breakdown and the pepsin for protein breakdown. Another category of proteins is the hormonal proteins which are messenger proteins that help in the coordination of bodily activities(Creighton, 2010). The most common hormonal protein is insulin that controls the blood sugar levels in the body(Creighton, 2010). Other hormonal proteins are oxytocin and somatotropin which stimulate childbirth and protein production in muscle cells respectively. Structural proteins are fibrous and stingy in nature, and they play the role of provision of support to the body cells. An example of structural proteins is the keratins that give strength to protective covering such as hair. Proteins involved in the storage of amino acids such as ovalbumin and casein are categorized as storage proteins(Whitford, 2005). Some proteins such as the hemoglobin and the cytochromes are involved in transportation of molecules around the body, and they fall in the category of transport protein. Proteins are formed by combination of organic compounds called amino acids and they are the building blocks of life. Whereas proteins are digested, amino acids left and the body utilizes them to break down food, grow, produce energy and repair body tissues. Amino acids are classified into three groups namely the essential amino acids, non-essential amino acids and conditional amino acids(Creighton, 2010). The body contains nine essential amino acids, and they are unique since the body

Generics Medicines Regulation Comparison

Generics Medicines Regulation Comparison Chapter 1 Executive Summary This research will look at the adoption of generic medicines in specific three countries in Europe (The Netherlands, Poland and Portugal). These three countries have a significant difference in adoption; the reasons for this adoption difference can be explained by several regulations which are implemented by these countries. In previous research it is proven that regulations have a direct effect on the adoption however, this research will have a closer look which regulations in specific are important to stimulate generic medicines in the market. Results show that too much regulation around the entry of generic medicines in the market will lead to slow growth adoption in the market compared to countries which adopt less regulation. Recommendations to stimulate the generic medicines in the market will be presented in the last chapter. The problem background A lot of research has been done on the introduction of generic medicines. Examples include the obstacles to generic substitution in Sweden (Anderesson et al. 2005) and the use of generic medicines and the implications for the pharmaceutical market (King Kanavos, 2002). However, there is limited cross-country research examining the relationship between the implementation of regulation, the effects of incentives given to pharmacies and physicians and consecutive adoption of generic medicines. The available research is limited to one of these elements, there has not been made a direct consideration between these elements which influence the adoption of generic medicines. In 1995 the European Medicine Evaluation Agency (EMEA) offers a EU- wide authorization process which replaced the ongoing single authorization process of each country separately, this means that regulation is harmonized regarding the entry of generic medicines The EMEA will approve the generic entry of a medicine before it can be presented on the European pharmaceutical market. This centralized procedure has decreased the approval delays for generic medicines in the EU resulting in the fact that patent regulation and approval procedures for medicines no longer have a large effect on the development of generics (Danzon, et al. 2003). National regulation still has an impact concerning price and reimbursement approval which has to be authorized by national authorities. Moreover, it is examined that generics have had more success in countries with more flexible pricing policies (Garattini Tediosi, 2000) and previous research has shown that the prescription of generic medicines is dependent on the incentives given to pharmacist, and other parties (Hellerstein, 1998). However, with recent reforms in the national regulation systems across European countries, flexible generic pricing policies and incentives given by the national governments are no longer the main determinants of successful entry of generics on the market. Obligatory generic substitution systems and other regulations implemented by European governments have become at dominant factor in explaining the adoption of generic medicines as a consequence that incentives for physicians, pharmacists and patient have decreased due to the obligatory system (Timonen, et al. 2009). This thesis gives an overview of the relation between the adoption of generic medicines and the regulation in three European countries: The Netherlands, Portugal and Poland. These countries are chosen because they have different implementations in regulation concerning generics and the adoption rate in these countries differs significantly. Recommendations for European countries and a conclusion about the most effective method to increase the use of generic medicines in relation with regulation will be exposed. The problem statement The differences among three countries; (The Netherlands, Portugal and Poland), concerning the adoption of generic medicines in relation with regulation and influencing incentives in these European countries. The motive to present these specific three countries is resulting from the fact that the adoption level of generic medicines differs significantly. Therefore a clear image can be provided between the differences of adoption connected with the accompanying regulation adopted in that country concerning generic medicines Dependent variable: adoption of generic medicines Independent variable 1: regulation of generics medicines Research Questions Research question 1: What are the differences in regulation about the use of generic medicines among the Netherlands, Portugal Poland? Research question 2: What is the role of these regulations on the adoption of generics? Relevance The thesis should give European countries and in particular public policy makers, a clear image on the effects incentives can have concerning the adoption of generic when prescribing these medicines, and which type of regulation is the most effective for the increase in adoption of generics. Managerial perspective The prescription of generic medicines is intensively regulated. This results in many implications for pharmaceutical companies especially, concerning the implementation of generic medicines in the market. Considering, the fact that the regulation of the prescription of generic medicines has a direct effect on the use of generic medicines. Therefore the adoption level for generic medicines is likely to change when the regulation changes. Pricing strategies for pharmaceutical companies have a diminishing effect due to the strict pricing regulation implemented by public policy makers. Branding strategies are also complicated to implement in the pharmaceutical industry because of the many regulations adopted. However, branding strategies are very important; they can strengthen the bond between the buyer and the seller (Blackett Robins, 2001). Pharmaceutical companies have to make important decisions regarding the implementation of the generic medicines in the market. They should be aware of all regulation to be able to compete in the pharmaceutical industry. Academic perspective Country-specific results have been presented in several papers how regulation influences the use and adoption of generic medicines. However, a cross-country research on the effects of regulations implemented, in relation to the adoption of generic medicines. More specifically, the effects of incentives, given by policy makers, to pharmaceutical companies and the accompanying marketing strategies implemented by pharmaceutical companies, have not been examined earlier. Overview of the Rest of the Chapters Chapter 2: This chapter gives an overview on the question: What are the differences in adoption of generic medicines between the Netherlands, Portugal and Poland? These three countries will be investigated carefully; previous literature studies will give a clear image about the actual adoption of generic medicines in these countries. Background information will be presented to understand the structure of the chosen countries and the differences in adoption. Chapter 3: Data will be gathered to come to an answer to the research question 1: What are the differences in regulation about the use of generic medicines among the Netherlands, Portugal Poland? Chapter 4: Chapter four will explain the role of regulation on the adoption rate of generic medicines (research question 2). Chapter5: Public policy makers are in general in favour of increasing the use of generic medicines, because of the market advantages. Chapter 5 will give an overview of the most effective policy which is used among the three countries presented earlier in the thesis. Further recommendation to the public policy makers and limitations of the research will be dealt with in this chapter. A conclusion of this research will be presented. Chapter 2: differences in adoption of generic medicines This chapter will give an answer to the differences concerning the adoption of generic medicines between the Netherlands, PortugalandPoland. The level of generic medicine adoption differs significantly across Europe. This chapter will have a look at these differences and the resulting factors that have lead to these differences in adoption. Other implications such as different policy regulations and incentives given to pharmacist by the policy makers will be dealt with in chapter 3. They will be dealt whit in a separate chapter because they are dominant factors in the adoption of generic medicines. A distinction can be made between mature generic markets and developing generic markets (Simoens, 2009). The level of adoption of generic medicines in these countries differs from less than 10 per cent to more than 40 per cent. The share value in the market for generic medicines is 8.8 per cent for the Portugal, 19.8 per cent in the Netherlands and Poland ranks the top with 65.2 per cent (â€Å"A Review on the European†, n.d.). Comparing these figures with other European countries, Portugal falls in the lower range of adoption and Poland is situated in the upper range of the adoption level of generic medicines in their market. According to Simoens and Coster, (2006), Poland and the Netherlands are seen as mature generic markets in Europe, while Portugal is seen as a developing market. There are several factors (historical background and cultural elements), which have influenced the adoption rate of generic medicines in these countries. Clarifications of these elements are stated below. Historical background An explanation for the differences in adoption of generic medicines can partially be explained by the historical differences between the Netherlands, Portugal and Poland. In Western Europe, pricing and reimbursement policies naturally developed as an evolutionary economic process. However, this was not the case for Central and Eastern Europe states (CEE) which are now members of the EU. These CEE countries used to have a socialistic type of economy, and after the fall of the Berlin wall (1989) many of those countries faced political and economic bankruptcy. Large-scale reform was necessary in every single sector to guarantee their economical and political well being. The health care system was also a part of this sector and even today, ongoing reforms are taking place. There is still a lot that has to be done in the CEE countries, specifically within the health care system. Hospital decentralization, modernization and privatization and pricing and reimbursement policies are some examples of areas where further development is preferred (Kazakov, 2007). These necessary reforms and changes are also applicable to Poland. The Netherlands and Portugal do not suffer from these reforms, due to fact of not having a communistic history. Another implication of this socialist history is the fact that Poland was already used to adopt generic medicines, as brand medicines were not available in these countries due the absence of product patents until early 1990s (Simoens de Coster, 2006). Cultural elements Cultural sensitivity is one of the most widely accepted principles among public health (Resnicow, et all. 2000). According to Resnicow (2000), cultural sensitivity indicates â€Å"The extent to which ethnic/cultural characteristics, experiences, norms, values, behavioral patterns, and beliefs of a target population as well as relevant historical, environmental, and social forces are incorporated in the design, delivery, and evaluation of targeted health promotion materials and programs† (page 272). The relation between the pharmacist and the pharmaceutical representative can have a huge impact on the prescription of medicines and therefore on the adoption of generic medicines. Historical developments in Poland have created a positive attitude towards prescribing generic medicines, as prescribing generic medicines has been a common practice in Poland until the early 1990s. In the Netherlands, on the other hand, generic substitution is more driven by the pharmacist (Simoens de Coster, 2006). On average a pharmaceutical company will spend twice as much on marketing to the pharmacist and the public than on research and development (Zipkin, et all. 2005). A more detailed view about the adoption rate of generic medicines concerned the three countries (the Netherlands, Poland and Portugal) are presented below: The Netherlands The Dutch generic market has grown rapidly over time; public expenditure has increased from 185 million euro in 1994, resulting in a market share value of 8.5 per cent. In 2004 the market share has increased to 17.7 per cent; this means that the value has almost doubled. The market share increased also dramatically from 19.9 per cent in 1994 to 44.3 percent in 2004 (Simoens de Coster, 2006). Results from an EGA survey conducted in 2007; show that the market share of generic medicines has increased to more than 50 per cent (see figure 2 and 3 in appendix B). Poland Due to historical implications mentioned before, Poland has a very mature generic market. In 2006 the market shares of Poland were 60 per cent by value and close to 80 per cent by volume (see figure 2 and 3 in appendix B). Portugal In the 1990s the generic medicines adoption in Portugal did not exceed more than 1 per cent. An introduction in the generic policy in the year 2000 caused for an increase in market share of 8 per cent measured until 2004. An explanation of the generic policy will be provided in chapter 3 (Simoens de Coster, 2006). Recent results from an EGA survey implemented in 2007 show that the market share has slightly increased to almost 10 per cent (see figure 2 and 3 in appendix B). Chapter 3: differences in regulation about the use of generic medicines What are the differences in regulation about the use of generic medicines among the Netherlands, Portugal Poland? There are several domains in regulation which will eventually influence the structure of the market and determine how the pharmaceutical companies can operate most effectively in this pharmaceutical market. This thesis presents the most important domains where regulations are implemented; market authorisation, pricing, incentives, and marketing implications. Market authorisation In Europe, the process regarding market authorisation is very complex. Market access for generic medicines may differ from country to country; this holds there is little transparency regarding the entry of generic medicines in Europe. A pharmaceutical company may receive market authorisation to enter the market in a specific country. However, other regulations regarding the reimbursement and price of the generic product still need to be determined by the government. This means the process, concerning the entry of the generic medicine, can be delayed up to three times (â€Å"A Review on the European Generic Pharmaceutical Market in 2005†, n.d.). The EU directive was introduced to create a better system regarding the entry of generic medicines in Europe. There is a transparency directive, 89/105/EEC, which specifies that there is a 90 day limit regarding the reimbursement and pricing decision. However, the time delays vary from country to country (Garattini Tediosi, 2000). The table below (â€Å"A Review on the European Generic Pharmaceutical Market in 2005†, n.d.) gives an overview of the times delays per country for price approval to enter the market. With respect to the countries in this thesis, the table above (â€Å"A Review on the European Generic Pharmaceutical Market in 2005†, n.d.). shows the following: Poland does not have a time delay because the pricing and reimbursement approvals are granted together with the market authorisation of the generic medicines. In the Netherlands, we can see a delay of between 10 and 15 days which could be defined as a relatively efficient time to approval compared to other countries in Europe. Portugal is very inefficient with the entry of the generic medicines, the status of pricing and reimbursement will only be given after a 90-day delay (â€Å"A Review on the European†, n.d.). Pricing Price regulations are only applicable when the generic medicines will be reimbursed. The most effective regulation is a price restriction on the maximum reimbursement of that specific medicine or a maximum price that pharmaceutical companies may charge the medicine users (Danzon Keuffel, 2007). Most European countries, including the countries in this study, have introduced a reference price system. A reference price system entails that there are regulations which will restrict the reimbursement level of generic medicines, but that the price of the generic medicines itself will be uncontrolled. Under the reference price system, groups are clustered into certain reimbursement level, based either on the same compound or different compounds but with the same mode of action or with a similar name. All products that are placed in the same group are reimbursed at the same price per daily dose, which is also called the reference price. In general, the reference price in a group will be set at the level of the cheapest medicine or the median in that group. If pharmaceutical manufacturers price their product above the reference price, the user of the generic medicines needs to pay the outstanding amount above the reference price. There are two different pricing systems in Europe: a generic free pricing system and a generic price-regulated system. Both systems determine the degree of adoption of generic medicines. In a generic free pricing system companies can decide on the height of the price of a new generic medicine introduced in the market themselves, in contrary to a price regulated system (Simoens, 2010). The reference pricing system has three levels of implementation, the higher the level of the system is, the more the prices are regulated. Poland has a low reference pricing system, the Netherlands could be defined as a medium reference pricing system and Portugal uses a high reference pricing system. As presented in the table below (Bongers Carradinha, 2009), one can see which European countries fall in a regulated price system and have no free pricing system. Consumer implications The patients themselves (the demand side) play an important role in the prescription of generic medicines. Physicians and pharmacists and other contributing parties will prescribe generic medicines to reduce the costs for the payer, which is in this case the consumer of the medicine. Patient co-payment Pricing and reimbursement systems play a role for the patient. The patient will contribute to the financing of the health care system, in particular with the co-payment arrangement. This is a common practice in all European countries (with the exception of Malta), but the implementation of co-payment differs significantly across countries. Nevertheless, in all countries that employ a co-payment arrangement a financial contribution is made by the medicine user. Patient co-payment arrangements can strongly influence the end decision of the patient on which medicines to take (â€Å"A Review on the European Generic Pharmaceutical Market in 2005†, n.d.). The reimbursement of generic medicines is taken care of through an insurance model; however the co-payment arrangement is based on a percentage of the cost of the medicine (Kazakov, 2007). Pricing regulation related to the countries in the thesis; The Netherlands uses an enforcing pricing regulation, which sets a maximum for the pricing of medicines. In 1996, this system was implemented. In general, it led to a decrease of 15 per cent of the average medicine price in the market (Simoens de Coster, 2006). However, the prices of generic medicines in the Netherlands still tended to be higher compared to other EU countries. Mediation in short-term pricing strategies such as implementing similar pricing systems, have increased and stimulated the share in the markets for generic medicines, where competition already existed (Bongers Carradinha, 2009). Polish medicine prices tend to be lower compared to other EU countries. They work with a price regulated system for generic medicines. The pharmaceutical companies want to be absorbed in the reimbursement list for medicines. The reference price in Poland is set just below or just above the cheapest generic medicines in the Polish market (Simoens, 2009). Pharmaceutical companies may price their product above the reference price, taking into account that as a result they will not be placed on the reimbursement list (Kazakov, 2007). Portugal established a regulation which says that the minimum price difference of generic medicines and brand medicines should be a least 35 per cent in 2001. In 2005 Portugal agreed to reduce the overall medicine prices by 6 per cent. Of that 6 per cent 4.17 per cent had to be reduced by the pharmaceutical company and the other 1.93 per cent had to be reduced by the wholesalers and pharmacists. The reference price system was introduced in 2003 where the reference price was set at the level of the most expensive generic medicine (Simoens de Coster, 2006). Despite the fact Portugal has a developed market, the market share concerning generic medicines is still relatively low compared to other countries in Europe. Regardless, of the fact that companies producing generic medicines provide affordable treatments to patients, other savings can only be achieved if government supply side policy initiatives are designed to increase the competitiveness of generic medicines in the market (Bongers Carradinha, 2009). Incentives To establish a generic medicine market, the supply side (pricing system) needs to be supplemented by demand side policies which create incentives for physicians, pharmacists, and patients to use generic medicines (Simoens de Coster, 2006). The Netherlands Instruments to promote generic medicines have been in place for a long time and have been widely accepted in the Netherlands (Vogler Schmickl, 2010). Incentives for physicians The Dutch government has stimulated physicians to prescribe generic medicines, which is supported by an electronic prescription system. In the Netherlands it is customary to develop and implement guidelines and treatment protocols on how to prescribe generic medicines in order to efficiently increase the adoption of generic medicines. An important feature is that there are no sanctions for physicians who do not prescribe generic medicines (Simoens de Coster, 2006). Incentives for pharmacists Generic substitution is allowed for the pharmacist when the physician and the patient agree with it, however, it could be indicated by the physician that generic substitution is not permitted due to health reasons. This means that when a branded drugs patent has expired pharmacists are allowed to distribute a generic substitution unless indicated otherwise by the physician. Health insurers have also agreed upon several targets for the pharmacist in distributing generic medicines (Simoens de Coster, 2006). Generic substitution has been connected to financial incentives for the pharmacist for a long time, however these incentives have been abolished since 2004. Nevertheless, the adoption in the market of generic substitution has not decreased (Vogler Schmickl, 2010). Incentives for the patients In the Netherlands the patients do not have a financial incentive to buy generic medicines because there are no patient co-payments arrangements. Nevertheless, patients do have to pay the outstanding amount when the price of the medicines is above the reference price, which is set by the government (Simoens de Coster, 2006). Poland Incentives for physicians Physicians are not intensively encouraged to prescribe generic medicines. Due to the historical background physicians are already accustomed with the use and prescription of generic medicines (Simoens de Coster, 2006). Incentives for pharmacist Generic substitution is allowed by pharmacists; whenever a branded drug is prescribed a pharmacist may replace this by a generic substitution. Pharmacists are obliged to inform the patients about the generic substitution. Price reductions implemented by pharmaceutical companies encourage pharmacists to prescribe generic medicines (Simoens, 2009). Incentives for the patient There are four levels of reimbursement for the patient. The first level includes a fixed amount per prescription which will be reimbursed when these are essential medicines. The second and third level consist of supplementary medicines which will be charged to the patient through the co-patient system. The patients have to pay 30 to 50 per cent themselves. The fourth level holds that other prescribed medicines which are not on the reimbursement list will be fully paid by the medicine user (the patient). However, initiatives to inform the patients about generic medicines have not been presented (Simoens de Coster, 2006). Portugal Incentives for physicians In 2002, a regulation was implemented in Portugal which formulated that from that moment on physicians would be obliged to prescribe a generic medicine if possible. However, physicians and pharmacists are free to add brand medicines to prescriptions that include more than one medicine, of which at least one is generic. The physicians are to inform the patient about other generic medicines and the accompanying price differences. Even though guidelines are available, the system has not been fully implemented. An explanation for this is that the physicians and the pharmacists are neither being rewarded for prescribing, nor being punished when not prescribing generic medicines (Simoens de Coster, 2006). Incentives for pharmacists Physicians can indicate whether they permit generic substitution on the prescription form. In the cases that generic substitution is allowed by the physician, the pharmacists have to prescribe the cheapest generic medicines available. Pharmacists do not have any financial incentive to prescribe generic medicines as the generic margins for pharmacists have been dramatically low since the introduction of the regulation in 2005 (the overall reduction of generic medicines prices) (Simoens de Coster, 2006). Incentives for patients Portugal has 5 different levels of reimbursement. In the first level 100 per cent of the medicine will be reimbursed when they are classified as life saving. The second level holds that 95 per cent of the medicines will be reimbursed, the third level holds 70 per cent, the fourth level 40 per cent, and the fifth level holds a percentage of 20 per cent. Patients with a low income will receive a 15 per cent additional compensation on the stated reimbursement level. Until 2005, patients were rewarded with a 10 per cent additional reimbursement when they asked for a generic substitution. However, with the abolishment of the reward system of 10 per cent, the patient will now only receive a price reduction of 6 per cent for the use of generic medicines. The patient does not have an incentive but rather a discouraging effect to use generic medicines. Nevertheless, pro-generic campaigns have been introduced by the government since 2006; the effects of these campaigns are not yet clear (Simoens de Coster, 2006). Previous research shows that the patient co-payment arrangement in Poland and Portugal plays a visible role in stimulating the use and adoption for generic medicines (Simoens de Coster, 2006). For an overall overview of the regulation implemented across these three countries a table is presented below. Marketing implications A generic medicine should appear under the international non-proprietary name (INN). This entails, that a generic medicine should be marketed without a commercial brand name but in fact, three categories there can be distinguished; branded generics (copies of generic medicines with their own brand name), semi-branded generics (products marketed under the INN following the name of the manufacturer of the medicines) and medicines marketed under INN (Garattini Tediosi, 2000). The EU directive 65/65/EEC was established, to approve marketing of a drug. An allowance for introducing a generic medicine and detailing these medicines should be supported by several data available of the generic medicines (for example clinical data.) There are a lot of restrictions concerning advertisements and promotion activities of pharmaceutical products. These are presented by the The European Parliament and the Council of the European Union (2004) .Together with price regulation, advertising plays an important role in the pharmaceutical market. In general patients are uninformed about the most effective and available treatments, they depend on the diagnosis and treatment suggestion from the physician. Since the physician will prescribe the medicine it can be stated that they will directly affect the extent of competition between different treatments and medicines available. Therefore it not remarkable that the physician is the target of huge advertisement campaigns and that detailing in the pharmaceutical industry is mainly focused on physicians (Kà ¶nigbauer, 2006). The volume of detailing in the pharmaceutical market depends on several factors such as: the prevalence of the disease, the amount of competition for the medicine, the number of physicians who might prescribe the generic medicines, and like any other product in a market, taking into account the product life cycle of the product (Berndt, et al 2007). Chapter 4 What is the role of these regulations on the adoption of generics? Market authorisation Approval of generic medicines The success of a gene

Database design process Essay -- essays research papers

Abstract Database Systems has a practical, hands-on approach that makes it uniquely suited to providing a strong foundation in good database design practice. Database design is more art than science. While it's true that a properly designed database should follow the normal forms and the relational model, you still have to come up with a design that reflects the business you are trying to model. This paper shows describes design process of database project. The importance of Completing the Design Process An important point to keep in mind is that the level of structural integrity and data integrity is in direct proportion to how thoroughly the design process is followed. The less time spent on the design process, the greater the risk of encountering problems with the database. While thoroughly following the database design process may not eliminate all of the problems you may encounter when designing a database, it will greatly help to minimize them. Also in an RDBMS software program a well-designed database is easier to implement than a poorly designed database. (Michael J. Hernandez, 1996) Key database Design Concepts Before a design effort can proceed full speed ahead, the designer must first take time to understand the business. Understanding the business involves understanding the entities, data, and rules within an organization, and then converting these attributes of the business into a business model. Then, the designer must have a solid comprehension of the proposed database model. Finally, the designer will convert the business model into a database model, using a design methodology, whether automated or a manual process. (Ryan Stephens & Ronald Plew, 2002) General Design Process Following table list general steps of database design Step Description 1 Requirements collection and analysis 2 Conceptual database design 3 Choice of a DBMS 4 Data model mapping (also called logical database design) 5 Physical database design 6 Database system implementation (Elmasri, Ramez, & Navathe, Shamkant B., 1994) Creating the application is the last step ¡Ã‚ ªnot the first! Many developers take an idea for an application, bu... ... levels of normalization, but the primary levels are the first, second, and third normal forms. Each level has a rule or two that must be followed. Following all of the rules will help ensure that your database is well organized and flexible. To take an idea from inception through to fruition, you should follow a design process. This process essentially says "think before you act." Discuss rules, requirements, and objectives, and then create the final version of your normalized tables. Reference 1. Elmasri, Ramez, & Navathe, Shamkant B., Fundamentals of Database Systems, Second Edition, Addison-Wesley Publishing Company, 1994, ISBN 0-8053-1748-1, pages 450-452.), retrieved from website http://www.ibiblio.org/faint/finosaur/db/ , Feb 06, 2005 2. Michael J. Hernandez, Database Design For Mere Mortals, Chapter 4, 1996, retrieved from UOP resource safari Tech Books Online website, Feb 06,2005 3. Ryan Stephens & Ronald Plew, Key database design concepts, 2002, retrieved from website http://searchdatabase.techtarget.com/originalContent/0,289142,sid13_gci812028,00.html, Feb 06, 2005

Request to Conduct Research

HLM Cruise Lines has been under intense media scrutiny as of late due to our unethical practice of releasing untreated wastewater into the oceans. As the world's second largest cruise company, it should be our duty to protect the waters upon which we sail. Therefore, I would like to be released from my current duties in order to research alternative methods of managing the waste produced on our ships. At the conclusion of my research, a formal report will be provided to you. Significance of this research. As the World becomes more environmentally conscious, there is a demand that the Cruise line industry be held responsible for the environmental damage that our vessels produce. This has caused the federal government to heighten its watch for violators. Gone are the days of lax federal and state laws; heavy fines and suspensions are now the norm. The cruise industry has paid more than $55 million in fines since 1998 (Friends of the Earth, 2009), which makes this research so important to our company. Problem Our Cruise ships generate hundreds of thousands of gallons of human sewage and offer a host of amenities that create pollutants, including dry-cleaning, pools, hair salons, restaurants, photo processing, and spas. In one week alone, our largest cruise ship, â€Å"The Mickey†, can generate approximately 1 million gallons of gray water; 210,000 gallons of sewage; 25,000 gallons of oily bilge water; 100 gallons of hazardous or toxic waste; and 50 tons of garbage and solid waste. This sewage contains pollutants including fecal matter, bacteria, viruses, pathogens, hazardous waste and pharmaceuticals, all of which can be harmful to human health and aquatic life. (Kline, 2009). (Placeholder1)Our current practice of dumping this untreated waste directly into the ocean is wrecking havoc on the ecological systems of the waters we travel. Completed Research I have already researched the preventative methods used by other cruise lines. For example, Celebrity Cruises’ flagship vessel, the Solstice, includes a water filtration system to return all black water and wastewater to near pristine conditions before it is dumped back into the ocean. Royal Caribbean recently invested $100 million into their fleet to convert their onboard wastewater treatment system to an advanced purification system (Underwood, 2010). These examples shows how far behind the power curve we are. Additional Information Researches into â€Å"greener† cruise ships have been going on for several years. EPA believes that solution research might help improve understanding of the quantities of waste generated by cruise ships, impacts of discharges and emissions, and the potential for new control technologies. (U. S. Environmental Protection Agency, 2008) Benefits of the Investigation After having an opportunity to research for alternative methods of waste management, I am confident we will be able to implement methods that are significantly less harmful to the environment than our current process. This would not only benefit the environment, but also boost our public image. We must prove that we are not only concerned about pollution, but also dedicated to preventing it. Conclusion Given the phenomenal growth in our industry and the potential for increasing impacts on the marine environment, I believe it is our duty to continue to look for new, more environmentally friendly ways to manage our ship’s waste. Making smart environmental choices can also be economical. Remember, it is always cheaper and easier to clean up pollution at the source. After it has dispersed throughout the environment, the costs of cleanup, remediation, and disciplinary fees are many magnitudes higher. I would like to begin the research one week from now on Thursday, June 28, 2013. Please inform me of the approval and/or disapproval status by Tuesday, June 23. I may be reached by telephone at (0310) 777-9311 or by email at [email  protected] com. Thank you.

Family: the Foundation of a Strong Society

Family: The Foundation of a Strong Society â€Å"We the people of the Unites States, in order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity† (The Preamble to the American Constitution). Of the five principles that are stated in the Preamble, one is fundamentally unique and that is to promote the general Welfare. The responsibility to promote the common good rests not just with the government, but with all citizens.Our Founding Fathers established all the rights in the Constitution not for the individual's gain, but for the common good. Marriage is important because it affirms what our Founding Fathers understood; the purpose for this country is to use our freedoms to promote the common good. There is no question that marriage is beneficial to society because it promotes the common good for children, adults, and society. The evidence exists to show that children who are raised by their biological, married parents are more likely to become happy, healthy, and morally upright citizens in the future.According to one study, â€Å"fathers who are involved in their child’s life produce children who have better emotional health, do better academically, and attain higher job status as adults† (Carlson, Corcoran 783). Other studies have shown that â€Å"adults who believed their mother was accessible and devoted to them in childhood were less likely to suffer from depression and low self-esteem as adults. They were also found to be more resilient in dealing with life changing events† (Hojat 213).Children need to know that their parents are always there for them. Life has enough pressures on its own without having to deal with uninvolved parents. According to a 2003 Gallup Poll, most adults desire to marry and have children, so adults, too, are able to enjoy many benefits of marriage. On e benefit of marriage is greater wealth and higher incomes. â€Å"One study found that married men earn approximately 22 percent more than men who never married† (Stratton 210). Not only do married men enjoy a higher income, they may enjoy better health.According to a study in 2000 it was discovered that â€Å"married persons have the lowest occurrences of diseases such as diabetes, hypertension and heart disease† (Pienta, Hayward, Jenkins 575). Benefits of marriage do not only affect men, but marriage also affects women. A U. S. Department of Justice report in May 2000 found that married women had lower rates of violent abuse by a spouse, while divorced women had the highest rates of violence by their spouse, ex-spouse or boyfriend. The social, health, and economic aspects of marriage are additional benefits that lead to stronger communities and a stronger society.Married women are less likely to turn to abortion than unmarried women. Research performed by the Center for Bio-Ethical Reform states that, â€Å"64. 4% of all abortions are performed on never-married women; Married women account for 18. 4% of all abortions and divorced women obtain 9. 4%. † Therefore, human life is protected. With fewer abortions, each stage of life is more likely to have greater impact in every phase of life. Not only is life valued more, but so is independence from outside influences. Strong marriages result in less dependency upon the government.According to a recent study by Bridgette Maher, â€Å"divorce in America costs taxpayers $33. 3 billion per year. † Married couples also tend to show greater responsibility in life than do their single counterparts. Another study showed â€Å"People who are married are more likely than their unmarried counterparts to vote, volunteer and become involved in church and the schools† (Keyes). Over the years, marriage has been severely weakened by societal pressures. We have allowed the definition of marriag e to be re-defined. Lifelong, monogamous marriages must become the accepted normalcy.Marriage should be a place of refuge for all of its members and a haven for children. Marriage is hard work and takes much give and take in each relationship. However, marriage is justified by the many social and economic benefits for children, adults and society and is therefore a foundation of a strong society. American automobile executive, Lee Iacocca, sums it up, â€Å"The only rock I know that stays steady, the only institution I know that works is the family. † Works Cited â€Å"Abortion Statistics. † The Center for Bio-Ethical Reform. N. p. , n. d. Web. 14 Oct. 2012. Who's having abortions (marital status)? 64. 4% of all abortions are performed on never-married women; Married women account for 18. 4% of all abortions and divorced women obtain 9. 4%. Carlson, Marcia J. , and Mary E. Corcoran. â€Å"Family Structure and Children's Behavioral and Cognitive Outcomes. † Journ al of Marriage and Family 63. 3 (2001): 779-92. Print. For example studies have shown that fathers that are involved in their child’s life produce children who have better emotional health, do better academically, and attain higher job status as adults.Henshaw, S. K. â€Å"Unintended Pregnancy in the United States. † Family Planning Perspectives 30. 1 (1998): 24-29. Web. Most women getting abortions (83%) are unmarried; 67% have never married, and 16% are separated, divorced, or widowed. Married women are significantly less likely than unmarried women to resolve unintended pregnancies through abortion. Hojat, Mohammadreza. â€Å"Satisfaction With Early Relationships With Parents and Psychosocial Attributes in Adulthood: Which Parent Contributes More? † The Journal of Genetic Psychology 159. (1998): 203-20. Print. Other studies have shown that adults who believed their mother was accessible and devoted to them in childhood were less likely to suffer from depressi on and low self-esteem as adults. They were also found to be more resilient in dealing with life changing events. Keyes, Corey L. M. â€Å"Social Civility in the United States. † Sociological Inquiry 72. 3 (2002): 393-408. Print. People who are married are more likely than their unmarried counterparts to vote, volunteer and become involved in church and the schools.Maher, Bridgette. â€Å"The Benefits of Marriage. † The Benefits of Marriage. N. p. , n. d. Web. 09 Oct. 2012. . According to a recent study, divorce in America costs taxpayers $33. 3 billion per year. David G. Schramm, â€Å"What Could Divorce Be Costing Your State? The Costly Consequences of Divorce in Utah: The Impact on Couples, Communities, and Government,† A Preliminary Report, June 25, 2003, Publication in Process, Department of Family, Consumer, and Human Development, Utah State University. Pienta, A. M. , M.D. Hayward, and K. R. Jenkins. â€Å"Health Consequences of Marriage for the Retireme nt Years. † Journal of Family Issues 21. 5 (2000): 559-86. Print. Another study in 2000, found that married persons have the lowest occurrences of diseases such as diabetes, hypertension and heart disease. Stratton, Leslie S. â€Å"Examining The Wage Differential For Married And Cohabiting Men. † Economic Inquiry 40. 2 (2002): 199-212. Print. One study found that married men earn approximately 22 percent more than men who never married.