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Chapter 8 contains an in-depth case study of the opioid mass tort litigation in federal and state courts. It describes the inception and development of the opioid drug crisis and how the opioid crisis affected state and local municipalities, in requiring additional expenditures of money to provide medical, policing, and various social services to communities affected by the crisis. The chapter describes the initiation of opiod litigation, the hundreds of lawsuit, consolidation and transfer of all the opioid litigation into a federal MDL under Judge Dan Polsters supervision in the Northern District of Ohio. The chapter chronicles the management and litigation in the federal MDL proceedings and Judge Polsters approval of a public nuisance claim which actually went to trial. The chapter narrates the resulting, cascading opioid settlements with opioid manufacturers, distributors, and pharmacies concurrent with and after the MDL bellwether public nuisance trial. The chapter further chronicles the fate of opioid public nuisance in state courts, with a notable rejection of a public nuisance claim by the Oklahoma Supreme Court. The chapter ends by documenting the many state court opioid settlements during 2021-2022.
The tenth to thirteenth centuries were formative in the creation of what we now know as Chinese cuisine, including its rich regional diversity. The foods that people in the Song, Liao, and Jin ate were dependent on what the natural environment provided or what could be acquired through trade. But food and drink were also products of cultural preferences that evolved over time and came to identify economic, social, and ethnic difference. Song, Khitan, and Jurchen foodways differed significantly, rooted in the experiences of steppe and agrarian life as well as the diversity of cultures. People encountered unfamiliar food and drink in the cities andthrough diplomatic and commercial exchanges between Song and its neighbors. The food and drink people consumed were also deeply tied to the theory and practice of Chinese medicine, which reached new levels of standardization and sophistication during the Song and Jin. How were medical traditions transmitted through texts and teachers? How did the state promote and regulate medical knowledge and practice? The spread of printing and commercial publishing made information about food and medicine more widely available to the literate, and others could gain access to this knowledge through oral and visual transmission.
To study whether changes in drug preferences in the Dutch guideline for the treatment of Urinary Tract Infection (UTI) for General Practitioners (GPs) in 2013, resulted in corresponding changes in antibiotic dispensing.
Background:
For the treatment of uncomplicated UTI, nitrofurantoin remained the first choice, while fosfomycin became the second choice and changed ranks with trimethoprim. For a subsequent febrile UTI, ciprofloxacin became the first choice and changed ranks with amoxicillin/clavulanic acid, co-trimoxazole remained the third choice.
Methods:
In this observational cross-sectional study, routinely collected dispensing data from the Dutch Foundation of Pharmaceutical Statistics from 2012 to 2017 were used. The number of women 18 years and older, treated with one of the guideline antibiotics for uncomplicated UTI and subsequent febrile UTI were analysed annually. Proportions were calculated. Data were stratified for age categories. Failure of uncomplicated UTI treatment was defined as the dispensing of an antibiotic for febrile UTI within 14 days after the dispensing of an antibiotic for uncomplicated UTI.
Findings:
Data were available from 81% of all pharmacies in 2012 to 89% in 2017. Percentages of women dispensed nitrofurantoin were relatively stable with 87.4% in 2012 and 84.4% in 2017. Percentages of women dispensed fosfomycin increased from 5.4% in 2012 to 21.8% in 2017, whereas percentages of women dispensed trimethoprim decreased from 17.8% to 8.0%. Within age categories, the percentage of women dispensed fosfomycin increased from 12.4% in women 18–30 years old to 36.7% in women above 80 years old. Percentages of women dispensed antibiotics for febrile UTI remained stable at 5% annually. Percentages of women receiving ciprofloxacin increased from 1.9% in 2012 to 3.3% in 2017, while those receiving amoxicillin/clavulanic acid decreased from 2.9% to 1.8%. New guideline recommendations resulted in corresponding changes in dispensed antibiotics for uncomplicated UTI and subsequent febrile UTI. Drug choices differed for age categories.
Community pharmacies could provide access for clients to commercial weight management organizations. We evaluated recruitment, referral and outcomes of adults provided with free vouchers by community pharmacies to attend Scottish Slimmers classes.
Design
Prospective cohort design with qualitative interviews with clients and pharmacy personnel. Scottish Slimmers collected weight and attendance data.
Setting
Pharmacies in Aberdeen City, Scotland.
Subjects
Clients aged ≥18 years with BMI≥30 kg/m2.
Results
Ten of twenty-three pharmacies were recruited; eight successfully recruited clients. Of 129 clients recruited, ninety-seven (75 %) attended at least one class and fifty-one (40 %) attended all twelve classes. At baseline, clients’ mean weight was 99·4 (sd 17·5) kg, mean BMI was 37·8 (sd 6·0) kg/m2. After 12 weeks, mean weight change was −3·7 % (last observation carried forward) or −2·8 % (baseline observation carried forward) for all ninety-seven clients. Client interviews indicated that many individuals would have not addressed their weight problems if this referral service had not been available. They had positive attitudes towards the pharmacy signposting service, attributed to the use of consultation rooms for privacy, receiving professional service from personnel and ongoing support and encouragement. The free provision of 12-week access facilitated participation. Service providers had positive attitudes and indicated their willingness to provide this service in future.
Conclusions
Community pharmacies could be used to increase access to weight management services, with pharmacy personnel providing additional support to clients. Future provision of pharmacy referral schemes should be evaluated on a larger scale with an economic evaluation.
The objective of this study was to quantify the potential retail pharmacy vaccine administration capacity and its possible impact on pandemic influenza vaccine uptake.
Methods
We developed a discrete event simulation model by use of ExtendSim software (Imagine That Inc, San Jose, CA) to forecast the potential effect of retail pharmacy vaccine administration on total weekly vaccine administration and the time needed to reach 80% vaccination coverage with a single dose of vaccine per person.
Results
Results showed that weekly national vaccine administration capacity increased to 25 million doses per week when retail pharmacist vaccination capacity was included in the model. In addition, the time to achieve 80% vaccination coverage nationally was reduced by 7 weeks, assuming high public demand for vaccination. The results for individual states varied considerably, but in 48 states the inclusion of pharmacies improved time to 80% coverage.
Conclusions
Pharmacists can increase the numbers of pandemic influenza vaccine doses administered and reduce the time to achieve 80% single-dose coverage. These results support efforts to ensure pharmacist vaccinators are integrated into pandemic vaccine response planning. (Disaster Med Public Health Preparedness. 2017;11:587–593)
This research investigates whether the importance of information scope for decision making mediates the relations between dimensions of strategic orientation, perceived environmental uncertainty (PEU) and organisational effectiveness in the retail pharmacy industry. Data from a survey of NSW pharmacies was analysed using structural equation modelling. Although two dimensions of strategic orientation – product-market development and market scope – were positively associated with information scope, the direct organisational benefits and mediating role of broad scope information were disconfirmed and no link between information scope and PEU was found. The results suggest the need for rethinking theoretical models of information scope. Implications for retail pharmacies and organisations interested in the effectiveness of those businesses are discussed.