Suchergebnisse

Protection of early development contributes to health of next generations. Congenital anomalies (and other adverse reproductive outcomes) are an important public health issue and early indicator of public health risks, as early development is influenced by many risk factors (e.g., nutrition, lifestyles, pollution, infections, medications, etc). Effective primary prevention requires an integrated "One Health" approach, linking knowledge and action. This requires surveillance of health events and potential health-damaging factors, science-based risk analysis, citizens' empowerment and education of health professionals. From the policy standpoint, joint budgeting mechanisms are needed to sustain with equity intersectoral actions (involving policy domains of health, social affairs, education, agriculture and environment). States should devote resources to strengthen registries and systematic data collection for surveillance of congenital anomalies, to better inform national prevention strategies. Investing in primary prevention based on scientific evidence is essential to support sustainable and resilient health systems and sustainable development of the society. ; This research was supported by the Health Programme of European Union, in the framework of the Joint Action for Rare Diseases, Project n. 677024 "Promoting Implementation of Recommendations on Policy, Information and Data for Rare Diseases – RD-ACTION" ; Sí

Objectives: The aim of this study was to review the impact of new reimbursement requirements for medicines in the Slovak Republic based on legislation that came into force in January 2018. Methods: The new legislation was reviewed. The reimbursement dossiers for medicines and health technology assessments and appraisals, justifications for reimbursement decisions, final reimbursement decisions, and all aspects of the appeal mechanisms have been transparently published on the website of the Slovak Ministry of Health and were used for this analysis. Results: Based on the new legislation, there was no need to submit information about relative effectiveness and cost-effectiveness of medicines with less than 1:50,000 eligible patients prior to reimbursement decisions, and the cost-effectiveness threshold has been increased for all other medicines. The estimated impact of the 2-year budget for the 59 medicines submitted for reimbursement without relative effectiveness and cost-effectiveness analysis was €181,273,698, based on the published submission dossiers. The estimated impact of the 2-year budget for the 45 medicines with evidence of relative effectiveness and cost-effectiveness was €178,566,634. In contrast to the easier market access criteria for new original medicines, the new legislation enforces stricter price erosion criteria for generic and biosimilar medicines. Consequently, the number of generic and biosimilar entries was reduced from 242 in 2017 to 224 in 2018. Conclusions: Although some of the new reimbursement applications were not approved by the Ministry of Health, many new medicines were added to the Slovak pharmaceutical reimbursement list based on "balanced assessment" requirements; hence, the system became financially unsustainable. It was necessary to change the legislation from January 2019.

The practice so far has indicated that there is a sensitive relationship that exists between social and economic subsystem of sustainable development, therefore this research suggests comparison of the states of these two subsystems as a new conceptual frame which is essential for strategic conceptualization of development. The research pointed out a rather visible collision between the achieved degree of economic and social development in the countries of South Eastern Europe in respect to Germany and France, which were taken into consideration as two of the most developed countries in the European Union and in the entire world. The indicators which are given in this research point to the necessity of further scientific and practical consideration of strategic conceptualization of relationship between economics and society.

Consideration of the property of action is proposed to provide a more meaningful definition of efficient energy use and sustainable production in ecosystems. Action has physical dimensions similar to angular momentum, its magnitude varying with mass, spatial configuration and relative motion. In this article, the relationship of action to thermodynamic processes such as the spontaneous increase in entropy of the second law is explained and the utility of action for measuring changes in energy and material distribution is promoted. In particular, the view that increases in entropy and action are equivalent to disorder is challenged. Given that the development of action states may be assigned an economic value and the various sources of free energy assigned a price, action theory may provide a novel mechanism for the economic allocation of resources. The importance of the diversity and redundancy of energy resources and work processes to optimize action is highlighted.

International audience ; This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

International audience ; This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Abstract
Higher education has long been the cornerstone of success in the United States. Historically Black Colleges and Universities (HBCUs) have provided educational opportunities to African American students since the late 1800s. HBCUs have produced some of the most influential and successful graduates in all fields of study. HBCUs have produced some of the most influential and successful graduates in all fields of study. Writers like Toni Morrison, current U.S. Vice President Kamala Harris, civil rights leaders like Martin Luther King Jr., and entertainment icons like Oprah Winfrey are just a few of the most famous and influential graduates of HBCUs. These graduates have successfully succeeded in their respective fields and indelibly impacted society. HBCUs have also been instrumental in helping to close the achievement gap between African American and white students and have provided a safe and supportive environment for African American students to pursue their educational goals. This paper explores the organizational strategy and marketplace sustainability of HBCUs in the post-COVID-19 competitive higher education marketplace.