Mergers and acquisitions as strategies of business expansion in the pharmaceutical industry

Introduction: The present paper deals with the issue of the increasing usage of corporation mergers and acquisitions strategies within pharmaceutical industry environment. The aim is to identify the triggers of such business phenomenon and the immediate impact on the financial outcome of two powerful biopharmaceutical corporations: Pfizer and GlaxoSmithKline, which have been sampled due to their successful approach of the tactics in question. Materials and Methods: In order to create an overview of the development steps through mergers and acquisitions, the historical data of the two corporations has been consulted, from their official websites. The most relevant events were then associated with adequate information from the financial reports and statements of the two corporations indulged by web-based financial data providers. Results and Discussions: In the past few decades Pfizer and GlaxoSmithKline have purchased or merged with various companies in order to monopolize new markets, diversify products and services portfolios, survive and surpass competitors. The consequences proved to be positive although this approach implies certain capital availability. Conclusions: Results reveal the fact that, as far as the two sampled companies are concerned, acquisitions and mergers are reactions at the pressure of the highly competitive environment. Moreover, the continuous diversification of the market’s needs is also a consistent motive. However, the prevalence and the eminence of mergers and acquisition strategies are conditioned by the tender offer, the announcer’s caliber, research and development status and further other factors determined by the internal and external actors of the market.

Feedback regarding students initial pharmaceutical internship from the University of Medicine and Pharmacy, Cluj-Napoca

Introduction/Aims: The purpose of the study is to evaluate the perception of the organization, the development and the evaluation of the initial stage in the internship of students, in order to improve these activities and to establish the adequate objectives in accordance with the changes concerning the concept of modern pharmacy. Materials and methods: An online survey was made using Google Docs ® -Create Form extension. All results were accumulated and computed using Microsoft Excel ®. The questionnaire consisted of 11 questions, structured on several levels: the objectives and how they can be achieved, internship organization, the internship training (effective participation in specific activities and integration in the pharmaceutical activity), the assessment, the profile of tutor / pharmacy. The questionnaire was completed by students from the Faculty of Pharmacy, University of Medicine and Pharmacy "Iuliu Haţieganu" Cluj Napoca, Romania. Results and discussions. The study was conducted on 308 students (60% of all students from the study years II-IV. 90% of the respondents had actually participated in the internship, whilst 10% only formally participated in this activity. The main responsibilities of the students were: storage and reception of pharmaceutical products (94%, respectively 79%) and working with the receipts (57%). Most of the students appreciate that they were integrated into the work in the pharmacy, this being due largely pharmacist tutor, who expressed interest and ability in mentoring activities. They appreciated that the role of tutor requires 3-5 years of professional experience. In terms of the internship objectives, these should aim at applying the knowledge gained until the graduation year, but also familiarization with activities which might turn into applications for the coming years. 43% of students believe that only 25% of the theoretical knowledge was useful during the internship. 90 % of the total questioned considered useful to develop a practice guideline adapted to the year of study. Conclusions. The professional training of the future pharmacist’s students depends largely on experience gained by students during the internship activity. Feed-back from the students’ shows that they are aware of the usefulness of the internship, but believe the objectives must be updated and a better correlation between work in pharmacy and theoretical knowledge has to be made. A first step is to develop a practical guide adapted to each year of study. The involvement of the tutor pharmacist is also essential to the success of this activity

Riders in the storm: the professions and healthcare governance

The public sector is facing turbulent times and this also challenges the health professions who are expected to serve both the interests of the citizens and the cost-containment and austerity policies of governments. This article seeks to explore the changing role of the health professions. I introduce an approach on ‘citizen professionals’ as active players in the policy process and mediators between the state/policymakers and the citizens/patients. The aim is to highlight a transformative potential of professionalism and the connectedness with other sets of governance, like management. Empirical material from a German case study and a comparative European study serve to illustrate the arguments, drawing on policy analysis and secondary sources. The results bring the complexity of transformations and new emergent forms of professionalism into view that cannot be understood in traditional categories of conflict, exclusion and jurisdiction. Exploring the potential of the health professions to creatively respond to new challenges may reveal new opportunities for innovating healthcare policy beyond market and management.

Evaluation of IMRT and VMAT techniques with and without flattening filter using pareto optimal fronts

Mestrado em Radiações Aplicadas às Tecnologias da Saúde.

Association of FTO and PPARG polymorphisms with obesity in Portuguese women

Purpose: We evaluated the association between risk of obesity in the Portuguese population and two obesity-related single-nucleotide gene polymorphisms: fat-mass and obesity-associated (FTO) rs9939609 and peroxisome proliferator-activated receptor gamma (PPARG) rs1801282. Patients and methods: A total of 194 Portuguese premenopausal female Caucasians aged between 18 and 50 years (95 with body mass index [BMI] ≥30 g/m2, 99 controls with BMI 18.5–24.9 kg/m2) participated in this study. The association of the single-nucleotide polymorphisms with obesity was determined by odds ratio calculation with 95% confidence intervals. Results: Significant differences in allelic expression of FTO rs9939609 (P<0.05) were found between control and case groups, indicating a 2.5-higher risk for obesity in the presence of both risk alleles when comparing the control group with the entire obese group. A fourfold-higher risk was found for subjects with class III obesity compared to those with classes I and II. No significant differences in BMI were found between the control and case groups for PPARG rs1801282 (P>0.05). Conclusion: For the first time, a study involving an adult Portuguese population shows that individuals harboring both risk alleles in the FTO gene locus are at higher risk for obesity, which is in agreement to what has been reported for other European populations.

Population structure in high shore littorinids: contrast between riprap and rocky shores

World Congress of Malacology, Ponta Delgada, July 22-28, 2013.

Efeitos do treinamento aeróbio intervalado periodizado sobre os parâmetros antropométricos, bioquímicos e clínicos em portadores de síndrome metabólica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

IL23R polymorphisms influence phenotype and response to therapy in patients with ulcerative colitis

Objective - We aimed to identify the clinical and genetic [IL23 receptor (IL23R) single nucleotide polymorphisms (SNPs)] predictors of response to therapy in patients with ulcerative colitis. Patients and methods - A total of 174 patients with ulcerative colitis, 99 women and 75 men, were included. The mean age of the patients was 47±15 years and the mean disease duration was 11±9 years. The number of patients classified as responders (R) or nonresponders (NR) to several therapies was as follows: 110 R and 53 NR to mesalazine (5-ASA), 28 R and 20 NR to azathioprine (AZT), 18 R and 7 NR to infliximab. Clinical and demographic variables were recorded. A total of four SNPs were studied: IL23R G1142A, C2370A, G43045A, and G9T. Genotyping was performed by real-time PCR using Taqman probes. Results - Older patients were more prone to respond to 5-ASA (P=0.004), whereas those with pancolitis were less likely to respond to such therapies (P=0.002). Patients with extraintestinal manifestations (EIMs) were less likely to respond to 5-ASA (P=0.001), AZT (P=0.03), and corticosteroids (P=0.06). Carriers of the mutant allele for IL23R SNPs had a significantly higher probability of developing EIMs (P<0.05), a higher probability of being refractory to 5-ASA (P<0.03), but a higher likelihood of responding to AZT (P=0.05). A significant synergism was observed between IL23R C2370A and EIMs with respect to nonresponse to 5-ASA (P=0.03). Conclusion - Besides extent of disease and age at disease onset, the presence of EIMs may be a marker of refractoriness to 5-ASA, corticosteroids, and AZT. IL23R SNPs are associated both with EIMs and with nonresponse to 5-ASA and corticosteroids.

O papel da pressão positiva durante a broncofibroscopia: ventilação não invasiva vs válvula de pressão positiva contínua

Introdução: A realização de broncofibroscopia (BF) a doentes com insuficiência Respiratória grave tem riscos e muitas vezes está contra-indicada. A aplicação de ventilação mecânica não invasiva (VMNI) para assistir a ventilação espontânea durante a BF pode ser constituir uma boa alternativa . Objectivo: Comparar a utilização de VMNI e do CPAP Boussignac (CB), durante a BF, em doentes hipoxémicos e/ou hipercápnicos. Materiais e Metodos: 9 pacientes (1feminino) com hipoxemia definida por PaO2/FiO2<200 com necessidade de (BF) foram elegíveis para o estudo. Cinco indivíduos foram randomizados para o grupo VMNI (G1) e 4 para o grupo CB (G2). Resultados: A pressão parcial arterial de oxigénio (PaO2) melhorou no grupo total: 65,9 (21,9) vs de 94,4 (75,9) pós BF, p=0,03, assim como a relação PaO2/FiO2: 131,7 (129,0) e 150,7 (161, 3), pós BF, p=0,04. A saturação periférica de O2 média durante a BF não foi significativamente diferente comparando os dois grupos: 96,1 (6,9) no G1 vs 97,3 (0,3) no G2, (p=0,62). No G1, 1 paciente foi intubado. Conclusão: Estes resultados sugerem que a pressão positiva tem um papel importante como técnica coadjuvante da BF em pacientes hipoxémicos graves (PaO2/FiO2<200). Neste estudo preliminar nenhuma vantagem da VMNI vs CB.

Variabilidade introduzida pelo operador no processamento dos estudos Gated-SPECT do miocárdio

Introdução – Os estudos Gated – Single Photon Emission Computed Tomography (SPECT) são uma das técnicas de imagiologia cardíaca que mais evoluiu nas últimas décadas. Para a análise das imagens obtidas, a utilização de softwares de quantificação leva a um aumento da reprodutibilidade e exatidão das interpretações. O objetivo deste estudo consiste em avaliar, em estudos Gated-SPECT, a variabilidade intra e interoperador de parâmetros quantitativos de função e perfusão do miocárdio, obtidos com os softwares Quantitative Gated SPECT (QGS) e Quantitative Perfusion SPECT (QPS). Material e métodos – Recorreu-se a uma amostra não probabilística por conveniência de 52 pacientes, que realizaram estudos Gated-SPECT do miocárdio por razões clínicas e que integravam a base de dados da estação de processamento da Xeleris da ESTeSL. Os cinquenta e dois estudos foram divididos em dois grupos distintos: Grupo I (GI) de 17 pacientes com imagens com perfusão do miocárdio normal; Grupo II (GII) de 35 pacientes que apresentavam defeito de perfusão nas imagens Gated-SPECT. Todos os estudos foram processados 5 vezes por 4 operadores independentes (com experiência de 3 anos em Serviços de Medicina Nuclear com casuística média de 15 exames/semana de estudos Gated-SPECT). Para a avaliação da variabilidade intra e interoperador foi utilizado o teste estatístico de Friedman, considerando α=0,01. Resultados e discussão – Para todos os parâmetros avaliados, os respectivos valores de p não traduziram diferenças estatisticamente significativas (p>α). Assim, não foi verificada variabilidade intra ou interoperador significativa no processamento dos estudos Gated-SPECT do miocárdio. Conclusão – Os softwares QGS e QPS são reprodutíveis na quantificação dos parâmetros de função e perfusão avaliados, não existindo variabilidade introduzida pelo operador.

The influence of experience and training in a group of novice observers: a jackknife alternative free-response receiver operating characteristic analysis

Purpose - The study evaluates the pre- and post-training lesion localisation ability of a group of novice observers. Parallels are drawn with the performance of inexperienced radiographers taking part in preliminary clinical evaluation (PCE) and ‘red-dot’ systems, operating within radiography practice. Materials and methods - Thirty-four novice observers searched 92 images for simulated lesions. Pre-training and post-training evaluations were completed following the free-response the receiver operating characteristic (FROC) method. Training consisted of observer performance methodology, the characteristics of the simulated lesions and information on lesion frequency. Jackknife alternative FROC (JAFROC) and highest rating inferred ROC analyses were performed to evaluate performance difference on lesion-based and case-based decisions. The significance level of the test was set at 0.05 to control the probability of Type I error. Results - JAFROC analysis (F(3,33) = 26.34, p < 0.0001) and highest-rating inferred ROC analysis (F(3,33) = 10.65, p = 0.0026) revealed a statistically significant difference in lesion detection performance. The JAFROC figure-of-merit was 0.563 (95% CI 0.512,0.614) pre-training and 0.677 (95% CI 0.639,0.715) post-training. Highest rating inferred ROC figure-of-merit was 0.728 (95% CI 0.701,0.755) pre-training and 0.772 (95% CI 0.750,0.793) post-training. Conclusions - This study has demonstrated that novice observer performance can improve significantly. This study design may have relevance in the assessment of inexperienced radiographers taking part in PCE or commenting scheme for trauma.

Impact of academic exposure on health status of university students

OBJECTIVE: To assess the impact of academic life on health status of university students. METHODS: Longitudinal study including 154 undergraduate students from the Universidade de Aveiro, Portugal, with at least two years of follow-up observations. Sociodemographic and behavioral characteristics were collected using questionnaires. Students' weight, height, blood pressure, serum glucose, serum lipids and serum homocysteine levels were measured. Regression analysis was performed using linear mixed-effect models, allowing for random effects at the participant level. RESULTS: A higher rate of dyslipidemia (44.0% vs. 28.6%), overweight (16.3% vs. 12.5%) and smoking (19.3% vs. 0.0%) was found among students exposed to the academic life when compared to freshmen. Physical inactivity was about 80%. Total cholesterol, high density lipoprotein-cholesterol (HDL-C), triglycerides, systolic blood pressure, and physical activity levels were significantly associated with gender (p<0.001). Academic exposure was associated with increased low density lipoprotein-cholesterol (LDL-C) levels (about 1.12 times), and marginally with total cholesterol levels (p=0.041). CONCLUSIONS: High education level does not seem to have a protective effect favoring a healthier lifestyle and being enrolled in health-related areas does not seem either to positively affect students' behaviors. Increased risk factors for non-transmissible diseases in university students raise concerns about their well-being. These results should support the implementation of health promotion and prevention programs at universities.

Influence of mixtures of acenaphthylene and benzo[a] anthracene on their degradation by Pleurotus ostreatus in sandy soil

Purpose Polycyclic aromatic hydrocarbons (PAHs) are a class of organic compounds commonly found as soil contaminants. Fungal degradation is considered as an environmentally friendly and cost-effective approach to remove PAHs from soil. Acenaphthylene (Ace) and Benzo[a]anthracene (BaA) are two PAHs that can coexist in soils; however, the influence of the presence of each other on their biodegradation has not been studied. The biodegradation of Ace and BaA, alone and in mixtures, by the white rot fungus Pleurotus ostreatus was studied in a sandy soil. Materials and methods Experimental microcosms containing soil spiked with different concentrations of Ace and BaAwere inoculated with P. ostreatus. Initial (t 0) and final (after 15 days of incubation) soil concentrations of Ace and BaA were determined after extraction of the PAHs. Results and discussion P. ostreatus was able to degrade 57.7% of the Ace in soil spiked at 30 mg kg−1 dry soil and 65.8% of Ace in soil spiked at 60 mg kg−1 dry soil. The degradation efficiency of BaA by P. ostreatus was 86.7 and 77.4% in soil spiked with Ace at 30 and 60 mg kg−1 dry soil, respectively. After 15 days of incubation, there were no significant differences in Ace concentration between soil spiked with Ace and soil spiked with Ace + BaA, irrespective of the initial soil concentration of both PAHs. There were also no differences in BaA concentration between soil spiked with BaA and soil spiked with BaA + Ace. Conclusions The results indicate that the fungal degradation of Ace and BaA was not influenced by the presence of each other’s PAH in sandy soil. Bioremediation of soils contaminated with Ace and BaA using P. ostreatus is a promising approach to eliminate these PAHs from the environment.

Estudo da implementação da filosofia Lean na indústria Portuguesa

A forte competitividade dos mercados a nível nacional e internacional tem levado muitas empresas a estudar métodos e técnicas de incremento à eliminação dos desperdícios, à redução de custos e tempos, ao aumento da qualidade e da flexibilidade, tendo a filosofia lean um papel crucial na prossecução destes objectivos. Desde os seus primórdios, a avaliação da implementação da filosofia lean no universo das empresas é uma questão de investigação na área de conhecimento da gestão industrial. Embora a nível individual as diferentes empresas possam quantificar e avaliar os resultados da aplicação do lean, a grande dificuldade surge quando se pretende obter uma comparação por sector ou tipo de actividade económica. Existem países onde a prática do lean tem sido prioritária e as empresas ocupam a vanguarda nesta área de conhecimento. No entanto, em Portugal, existe uma clara dificuldade em se determinar até que ponto o tecido empresarial português assimilou esta filosofia e que resultados têm obtido com a prática do lean. Este trabalho apresenta um estudo realizado a partir de um inquérito, obtido através de um questionário on-line, às empresas que operam em Portugal de forma a estudar e analisar o estado actual do lean em Portugal e antever tendências futuras numa perspectiva de evolução da aplicação desta metodologia de gestão de processos produtivos. Em resultado deste estudo foi possível identificar quais são os grandes obstáculos à introdução do lean, áreas em que se observou sucesso ou menor impacto e quais as ferramentas e técnicas mais usadas por sector. Como resultado deste estudo é convicção do autor que foi possível obter uma fotografia abrangente do actual estado de implementação do lean e desta forma caracterizar as áreas que seguem na vanguarda da implementação do lean, e as áreas que ainda apresentam um desenvolvimento incipiente. Desta forma parece ao autor que o presente estudo apresenta grande utilidade para o mundo académico bem como para o tecido empresarial português.

The Dark Side of Organizational Change: The Moderating Role of Political Behavior and Organizational Cynicism

Workplace aggression is a factor that shapes the interaction between individuals and their work environment and produces many undesirable outcomes, sometimes introducing heavy costs for organizations. Only through a comprehensive understanding of the genesis of workplace aggression is possible to develop strategies and interventions to minimize its nefarious effects. The existent body of knowledge has already identified several individual, situational and contextual antecedents of workplace aggression, although this is a research area where significant gaps occur and many issues were still not addressed Dupré and Barling (2006). According to Baron and Neuman (1998) one of these predictors is organizational change, since certain changes in the work environment (e.g., changes in management) can lead to increased aggression. This paper intends to contribute to workplace aggression research by studying its relationship with organizational change, considering a moderating role of political behaviors and organizational cynicism (Ammeter et al., 2002, Ferris et al., 2002). The literature review suggests that mediators and moderators that intervene in the relationships between workplace aggression and its antecedents are understudied topics. James (2005) sustains that organizational politics is related to cynicism and the empirical research of Miranda (2008) has identified leadership political behavior as an antecedent of cynicism but these two variables were not yet investigated regarding their relationship with workplace aggression. This investigation was operationalized using several scales including the Organizational Change Questionnaire-climate of change, processes, and readiness (Bouckenooghe, Devos and Broeck, 2009), a Workplace Aggression Scale (Vicente and D’Oliveira, 2008, 2009, 2010), an Organizational Cynicism Scale (Wanous, Reichers and Austin, 1994) and a Political Behavior Questionnaire (Yukl and Falbe, 1990). Participants representing a wide variety of jobs across many organizations were surveyed. The results of the study and its implications will be presented and discussed. This study contribution is also discussed in what concerns organizational change practices in organizations.