Conceptualisation and Role of Market Access in Pharmaceutical Industry: A Scoping Review.

BACKGROUND: Understanding the concept and dynamic process of the evolution of professional identity and roles of market access (MA) in the pharmaceutical industry (pharma) is critical to personal, interpersonal, and professional levels of development and impact. OBJECTIVE: The aim was to carry out a scoping review of the conceptualisation of MA within pharma. DATA SOURCES: BioMed Central, WorldCat.org, and Directory of Open Access Journals were searched from 2003 to 2023. STUDY SELECTION: All articles on concepts or definitions and other surrogate terms on MA in pharma were selected. DATA EXTRACTION: Keywords generated from an initial cursory literature search on MA in pharma were used in conjunction with AND/OR as search terms. Using the data charting method, key findings were mapped and summarised descriptively. inductive analysis was performed, allowing codes/themes that are relevant to the concept to emerge. DATA SYNTHESIS: Arskey and O'Malley's six-stage framework and the PRISMA extension for scoping reviews extension checklist were used as the review and reporting templates. The databases search yielded 222 results. Following title and abstract screening, a total of 146 papers were screened, and 127 of them were excluded. Full-text review was conducted for 19 papers that were deemed by two reviewers to meet the eligibility criteria. One of the authors arbitrated on disputed papers for inclusion. Only 14 of the included papers were found to meet the criteria for the final analysis. Five conceptual dimensions of MA in pharma were identified as "right products", "right patient", "right price", "right point" (time), and "right place" (setting). CONCLUSIONS: Market access in pharma is a process that commences with the development and availability of the right products that are proven to be efficacious and disease/condition-specific (including medications, medical devices, and vaccines); specifically produced for the right patients or end users who will maximise best clinical outcomes and economic value; delivered at the right point in a timely, sustained, and efficient manner, given at the right price (commercially viable or reimbursed price that represents good value); and conducted within the economic, policy, societal, and technological contexts, with the overarching goal of achieving the best patient outcomes and ensuring product profitability.

Investigation of the prevalence and factors influencing tobacco and alcohol use among adolescents in Nigeria: A systematic literature review.

The increase in tobacco and alcohol prevalence among Nigerian teenagers necessitates the need to understand the factors influencing use. The aim of this systematic literature review was to synthesis evidence from studies on tobacco and alcohol use among Nigerian adolescents and young adults in order to determine factors influencing tobacco and alcohol use. Six databases MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ScienceDirect, and Google Scholar were used to search for peer-reviewed articles reporting the prevalence and predictors of tobacco and alcohol use among adolescents/youths published between 2010 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided this review. From our search, twelve articles from the 6 geopolitical zones within Nigeria were included. The high prevalence of tobacco and alcohol use among Nigerian adolescents necessitates the need to understand the factors influencing use. A high prevalence rate was recorded among the male gender. Gender, age, and curiosity appear to place adolescents at extra risk for tobacco and alcohol use. Lack of parental monitoring, peer influence, low socio-economic status, low education level, stressful life events, advertisements, availability, and accessibility are factors identified to influence adolescents' alcohol and tobacco use. Alcohol and tobacco use remains a major public health issue as it continues to contribute largely to the growing occurence of diseases globally. Our review showed that adolescents' alcohol and tobacco use behaviour is triggered by various factors on the personal, interpersonal, organisational, community, and policy levels, and these factors are understood to predict or protect against alcohol and tobacco use.

Exploring the lived experience of student nurses perspective of racism within education and clinical practice: Utilising the flipped classroom.

BACKGROUND: The experiential learning gained by student nurses and educators using flipped classroom principles, in conjunction with data from a subsequent study, are explored in this paper. It facilitated a deeper understanding of the 'lived experiences' of racism for Black African-Caribbean student nurses at university and within the clinical practice environment. METHOD: The qualitative approach of 'Conversations with a purpose', using recorded focus group discussions was utilised as a pragmatic research methodology to explore perspectives of nursing students. RESULTS: Direct and indirect racism was experienced by student nurses in both, practice, and educational environments. Common issues that arose centred on patient's refusal of care, poor support of students, discomfort or denial of staff in addressing sensitive issues, questioning of students' clinical competencies, and educators using 'otherness' (ethnicity, and related stereotypes) to emphasise limitations of certain groups of students. DISCUSSION: The flipped classroom can be one way of creating inclusive safe spaces for discussing sensitive topics pertaining to racism, inequity, and social injustice. Nurse educators need to engage in providing awareness around these subjects, that are perceived as uncomfortable and unspoken. Without this, no significant paradigmatic shifts can be made around supporting our students in their lived experience of racism and discrimination.

Investigating the origin and tissue concentration of polycyclic aromatic hydrocarbons in seafood and health risk in Niger Delta, Nigeria.

The origin, tissue concentration, and health risk of polycyclic aromatic hydrocarbons (PAHs) contaminants in three economically important species of seafood, including catfish (Chrysichthys nigrodigitatus), prawns (Macrobrachium macrobrachium), and periwinkles (Tympanotonus fuscatus) from the crude oil-impacted Niger Delta region, were investigated. The concentrations of PAHs were measured by coupled gas chromatography-mass spectrometry after repeated extraction by ultrasonication in hexane and cleaning up in silica gel. The origin of PAHs was deduced using established mathematical protocols. Health risk from the consumption of contaminated seafood was evaluated for 60 kg bodyweight individuals at a fish consumption rate of 36.94 g per person per day. Different tissue concentrations of PAHs residues at low, moderate, and chronic levels were revealed. Mean total PAHs varied from 4.55 to 6.36 mg kg-1 in catfish, 4.61 to 7.75 mg kg-1 in prawns, and 4.91 to 6.14 mg kg-1 in periwinkles. The tissue concentrations were high above PM2.5, enough to suspect PAHs-related health risk, especially among residents who consume a large quantity of seafood. Carcinogenic PAHs index, benzo[a]pyrene, varied from below instrument detection (<0.01) to 0.29 mg kg-1. The estimated carcinogenic potency equivalent concentrations (PEC) of PAH varied from 0.653 to 2.153 above the screening value (SV), 0.01624 in the three species investigated. Mathematical evaluation and dominant tissue concentration of high molecular weight PAHs in all the seafood investigated showed pyrogenic origin of PAHs.