Janet Wale

Much has changed in individual and policy level patient advocacy in the years since the late 1980s when HIV/AIDS activists challenged the United States medical product regulator and aspects of how randomised controlled trials are conducted. Delays in access to innovative, life-saving medical interventions continue to be a key topic. We provide stor...

Understanding health as a human right creates a legal obligation on countries to ensure access to timely, acceptable, and affordable health care. We highlight the importance of a meaningful role for civil society in improving access to well-regulated quality medical products in Africa; to support and be part of a regional social contract approach f...

The Covid-19 pandemic has highlighted global knowledge about, but lack of equitable access to, life-changing medicines, and other innovative medical products by populations in African low and middle income countries. The World Health Organization (WHO) and other international non-profit foundations and organizations are constantly striving to addre...

Health technology assessment (HTA) is intended to determine the value of health technologies and, once a technology is recommended for funding, bridge clinical research and practice. Understanding the values and beliefs expressed by patients and health professionals can help guide this knowledge transfer and work toward managing the expectations of...

Background Health technology assessment (HTA) agencies have an important role in the evaluation and approval of new technologies. They determine their value within a health system so to promote equitable, quality care with available healthcare resources. Many HTA agencies have some mechanism for involving patients in their processes, but there is g...

Plain English summary Melbourne Genomics Health Alliance was established in 2013 to steer genomics into health care in Victoria, Australia. The Community Advisory Group (CAG) was formed soon after to provide advice and insights from the patient perspective. The CAG has added value to the Alliance’s complex research-to-clinical service program of wo...

Introduction/Objectives: Health authorities are facing increasing challenges to the sustainability of their healthcare systems because of the growing expenditures on medicines, including new, high-priced oncology medicines, and changes in disease prevalence in their ageing populations. Medicine prices in European countries are greatly affected by t...

Introduction The Australian Council on Healthcare Standards (ACHS) sponsored an expert-led, consensus-driven, four-stage process, based on a modified Delphi methodology, to determine a set of clinical indicators as quality measures of cancer service provision in Australia. This was done in response to requests from institutional health care provide...

Health technology assessment (HTA) recommendations informed by patient concerns are seen to ensure democracy and legitimacy. We explored how written and oral patient involvement in two HTAs was reported on in publicly available final recommendations and discussion summaries of appraisal committees from three HTA bodies. We aimed to gain insights in...

Introduction It is known that complementary and alternative medicine (CAM) use can be high in people with cancer. Despite a plethora of information about CAMs on the internet, reliable, evidence-based information about potential interactions between CAMs and pharmaceuticals is not readily accessible to consumers. An online pharmaceutical-CAM intera...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To compare the effectiveness and safety of respiratory therapy used routinely by physiotherapists to remove bronchial secretions and improve ventilation and health outcomes of mechanically ventilated adult patients. To determine which techniques within respirato...

Objectives: Some countries make considerable effort to involve patients and patient groups in their health technology assessment (HTA) processes; others are only just considering or are yet to consider patient involvement in HTA. Methods: This commentary offers four arguments why patient involvement should be prioritized by those HTA agencies th...

This chapter reflects on some key themes emerging in this book. The book provides a starting point for HTA bodies and academics to consider, research, develop, pilot and implement patient involvement processes in collaboration with patients and other stakeholders. The first step is to reiterate what we mean by patient involvement in HTA, then give...

At a national level, the Australian Government has two main HTA committees that make recommendations to the health minister/government for public funding of health interventions. These are the Pharmaceutical Benefits Advisory Committee (PBAC) for medications and vaccines and Medical Services Advisory Committee (MSAC) for medical services, diagnosti...

Plain Language Summary Health Technology Assessment (HTA) is an evidence-based decision-making process, focusing on evaluating health technologies for funding within a healthcare system. ‘Health technologies’ include medications, medical devices, diagnostics, medical procedures and services. Health Technology Assessment international (HTAi) is a gl...

Plain English summary A number of health technology assessment (HTA) organisations have developed processes to engage patients in the assessment of new health technologies such as pharmaceuticals, diagnostic tests, devices or medical procedures. Typically, this involves the HTA agency providing an opportunity for patient advocates and their patient...

At a health system level, the importance of patient and public input into healthcare decision making is well recognised. Patient and public involvement not only provides a mechanism to legitimise decisions, but also contributes to improved translation of these decisions into practice, ultimately leading to better patient outcomes. Recent reviews in...

Policy makers, healthcare managers, and HTA producers are increasingly interested in exploring strategies for involving the public and patients in HTA activities [1, 7]. While public involvement in HTA can be a response to the need for more transparency and accountability in decisions regarding funding of drugs, devices, and healthcare procedures [...

Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimize their use. The objective is to review case histories among health authorities to improve the utilization and expenditure...

Introduction: Medicines have made an appreciable contribution to improving patient care in recent years. However, European and other countries are increasingly struggling to fund new premium priced medicines. This has resulted in models to optimise their utilisation as well as multiple initiatives to improve the prescribing of established medicines...

This article is a call for action to the relevant stakeholders to improve access to care and treatment for patients with rare diseases in the Asia-Pacific region by looking into three main areas: (a) developing legislative definitions to confer enforceable protection, (b) creating or strengthening policies by objectively measuring the impact brough...

Background: There are potential conflicts between authorities and companies to fund new premium priced drugs especially where there are effectiveness, safety and/or budget concerns. Dabigatran, a new oral anticoagulant for the prevention of stroke in patients with non-valvular atrial fibrillation (AF), exemplifies this issue. Whilst new effective t...

Background: There are potential conflicts between authorities and companies to fund new premium priced drugs especially where there are safety and/or budget concerns. Dabigatran, a new oral anticoagulant for the prevention of stroke in patients with non-valvular atrial fibrillation (AF), exemplifies this issue. Whilst new effective treatments are n...

This is the protocol for a review and there is no abstract. The objectives are as follows: To compare the effectiveness and safety of respiratory therapy used routinely by physiotherapists to remove bronchial secretions and improve ventilation and health outcomes of mechanically ventilated adult patients. To determine which techniques within respir...

The Internet has become a major source of health information for the general public and has the potential to influence health behaviours; however, most people lack the knowledge and skills to use it insightfully. This paper reports on the evaluation of a community education program, in which a team of clinicians and consumer representatives from a...

Governments and other payers are yet to determine optimal processes by which to review the safety, effectiveness, and cost-effectiveness of technologies and procedures that are in active use within health systems, and rescind funding (partially or fully) from those that display poor profiles against these parameters. To further progress a disinvest...

Background: The Cochrane Consumer Network is an internet-based community of international users of health care contributing to the work of The Cochrane Collaboration, whose mission is to inform healthcare decision making through development of systematic reviews of best evidence on healthcare interventions. Objective: To prioritize existing revi...

The Cochrane Consumer Network (CCNet) is an international organization of volunteers, operating through the Internet, to enhance the accessibility and relevance of Cochrane systematic reviews and to promote evidence-based health care through consumer and community participation. This article presents the accomplishments and challenges of involving...

The Effective Consumer Scale (EC-17) comprises 17 items measuring the main skills and behaviors people need to effectively manage their healthcare. We tested the responsiveness of the EC-17. Participants, in 2 waves of a 6-week Arthritis Self-Management Program (ASMP) from Arthritis Ireland, received a questionnaire at the first and last week of th...

Programs and initiatives have been created to empower, educate, and provide information to consumers; these are sometimes generically known as self-management interventions. Evaluating and comparing such programs has been a challenge, as many skills that consumers believe are important to manage and participate in their individual healthcare are no...

Summary1. The classical single receptor competitive occupancy model accurately describes the joint action of an agonist (isoprenaline) and a β-adrenoceptor antagonist (propranolol) or some partial agonists (dichlorisoprenaline, practolol) on the positive chronotropic response in rats which have been depleted of catacholamines.2. The mathematical fo...

This chapter sets out to emphasise the place for patient-centred care with provision of the relevant information and effective communication that forms the basis of informed consent to, and preparation for, an occasion of anaesthesia. Patient-relevant outcomes are important to consider in clinical research that sets out to inform best practice and...

The OMERACT 7 Effective Musculoskeletal Consumer Workshop brought together people with rheumatoid arthritis, healthcare professionals, and researchers to discuss what they thought made a musculoskeletal consumer effective at managing their disease. Preliminary work before OMERACT provided a draft list of potential characteristics of an effective co...

The in vivo role of nitric oxide in inflammatory cell migration, vascular permeability and the development of hyperresponsiveness to methacholine (MCh) was studied in rats 24 h following ovalbumin (OVA) challenge. The NO synthase (NOS) inhibitors N(G)-mono-methyl-L-arginine (L-NMMA; nonselective), aminoguanidine (two-fold inducible NOS-selective),...

The potential role of respiratory infections in altering the development of atopy and asthma is complex. Infections have been suggested to be effective in preventing the induction of T-helper 2-polarized allergen-specific immunity in early life, but also to exacerbate asthma in older, sensitized individuals. The mechanism(s) underlying these effect...

The in vivo role of nitric oxide in inflammatory cell migration, vascular permeability and the development of hyperresponsiveness to methacholine (MCh) was studied in rats 24 h following ovalbumin (OVA) challenge. The NO synthase (NOS) inhibitors N(G)-mono-methyl-L-arginine (L-NMMA; nonselective), aminoguanidine (two-fold inducible NOS-selective),...

We investigated the effects of a selective beta(2)-agonist, salbutamol, and of phosphodiesterase type 4 inhibition with 4-(3-butoxy-4-methoxy benzyl)-2-imidazolidinone (Ro-20-1724) on the airway and parenchymal mechanics during steady-state constriction induced by MCh administered as an aerosol or intravenously (iv). The wave-tube technique was use...

It has previously been shown that M1 cholinergic receptors are involved in the parenchymal response to inhaled methacholine in puppies using the M1 selective antagonist pirenzepine. Although M3 receptors are responsible for acetylcholine induced bronchoconstriction in isolated rat lung, the role of M1 receptors has not been determined in the rat in...

To determine the role of M1 muscarinic receptors in the response of the pulmonary parenchyma to inhaled methacholine (MCh), 20 mongrel, out-bred puppies, 8-10 weeks of age were challenged following pretreatment with either saline (control), UH-AH37 (a combined M1 & M3 receptor blocker), or pirenzepine (a relatively selective M1 receptor blocker). I...

The clinical benefit of beta-adrenoceptor partial agonists is still debated. To clarify the situation, epanolol, ICI 141,292 [N-[-2-(3-o-cyanophenoxy-2-hydroxypropylamino)ethyl]-4- hydroxyphenylactamide], has been developed to assess the role of modest beta-adrenoceptor partial agonist activity in humans. Animal studies have shown that epanolol is...

The clinical benefit of [beta]-adrenoceptor partial agonists is still debated. To clarify the situation, epanolol, ICI 141,292 [N-[-2-(3-o-cyanophenoxy-2-hydroxypro-pylamino)ethyl]-4-hydroxyphenylactamide], has been developed to assess the role of modest [beta]-adrenoceptor partial agonist activity in humans. Animal studies have shown that epanolol...

(±)‐Isoprenaline (Iso), (−)−adrenaline (Ad), (−)−noradrenaline (NA), (±)‐phenylephrine (Phe) and the β 2 ‐selective adrenoceptor agonist (±)‐fenoterol (Fen) caused a concentration‐dependent relaxation of human isolated bronchial preparations. Iso, Ad and NA caused complete relaxation of both spontaneous and carbachol‐induced bronchial tone. Fen, wh...

(±)‐Isoprenaline (Iso), (−)‐adrenaline (Ad), (−)‐noradrenaline (NA), the β 2 ‐selective adrenoceptor agonist (±)‐fenoterol (Fen) and the β 1 ‐selective adrenoceptor agonist (±)‐RO363 caused concentration‐dependent relaxation of preparations of pig bronchus pre‐contracted with carbachol 40 ng/ml (0.22 μ M ). Iso, Ad, NA and Fen caused complete relax...

While specific antagonists of the [beta]1-adrenoceptor, such as atenolol and betaxolol, are widely available, a potent specific antagonist selective for the [beta]2-adrenoceptor has yet to be described. Previously described [beta]2-selective antagonists such as butoxamine, H 35/25, and IPS 339 are lacking in potency, specificity, or appropriate [be...

While specific antagonists of the beta 1-adrenoceptor, such as atenolol and betaxolol, are widely available, a potent specific antagonist selective for the beta 2-adrenoceptor has yet to be described. Previously described beta 2-selective antagonists such as butoxamine, H 35/25, and IPS 339 are lacking in potency, specificity, or appropriate beta 2...

Responses of preparations of human and porcine isolated bronchus and pulmonary artery to carbachol (CCh), methacholine, histamine, 5‐hydroxytryptamine (5‐HT), (−)‐noradrenaline (NA), (−)adrenaline (Adr) and (±)‐isoprenaline (Iso) were compared with responses to the same agonists in isolated lung parenchyma strips. All preparations from both human a...

Responses to (±)‐isoprenaline (Iso), (−)‐adrenaline (Adr) and (−)‐noradrenaline (NA) were compared in isolated preparations of human and porcine lung parenchyma strip. The order of relaxant potencies of these catecholamines in both human and porcine lung parenchyma was Iso > Adr > NA (1:0.24:0.01, human; 1:0.21:0.01, pig). These results suggest tha...

1. The intrinsic sympathomimetic acitivity of a range of β-adrenoceptor antagonists and its relationship to β-adrenoceptor blockade was studied in pentobarbitone-anaesthetized, vagotomized rats which had been depleted of catecholamines by pretreatment with syrosingopine. Dichlorisoprenaline, practolol, oxprenolol, pindolol and acebutolol, produced...

1. The effects of propranolol, atenolol (ICI 66,082), practolol and pindolol on heart rate and maximal left ventricular dp/dt, atrioventricular conduction time, mean aortic flow and diastolic blood pressure during cardiac pacing were investigated over a wide dose range (0.025-4.0 mg/kg, i.v.) in dogs anaesthetized with pentobarbitone. 2. Propranolo...

1. The effects of propranolol, atenolol (ICI 66,082), practolol and pindolol on heart rate and maximal left ventricular dp/dt, atrioventricular conduction time, mean aortic flow and diastolic blood pressure during cardiac pacing were investigated over a wide dose range (0.025-4.0 mg/kg, i.v.) in dogs anaesthetized with pentobarbitone.2. Propranolol...

1. The classical single receptor competitive occupancy model accurately describes the joint action of an agonist (isoprenaline) and a beta-adrenoceptor antagonist (propranolol) or some partial agonists (dichlorisoprenaline, practolol) on the positive chronotropic response in rats which have been depleted of catacholamines. 2. The mathematical form...

The concept of using a specific β-adrenoceptor antagonist to protect the ischemic or threatened ischemic myocardium from sympathetic drive as treatment of angina pectoris and myocardial infarction was pioneered by Black. This chapter discusses various β-adrenergic blocking agents, which are in use and those, which are in clinical trial phase. Four...

The effects of cumulative i.v. doses of the β-blocking drrugs practonol, oxprenolol, sotalol, (±)-propanolol and dexpropranolol upon , left ventricular strain gauge measurements and atrioventricular conduction times have been determined at fixed rates in open-chested vagotomized normal and catecholamine-depleted dogs.Practolol, oxprenolol, sotalol...

The mechanism of β-receptor antagonism by propranolol and practolol was investigated on rabbit isolated atrium preparations. Both drugs produced a parallel shift in the log. dose-response curve of isoprenaline without a decrease in the maximal response, suggesting that the antagonism was competitive. The pA2 values for propranolol and practolol wer...

The ability of 2-,3- or 4-methyl and nitro analogues of 1-isopropylamino-3-phenoxypropan-2-ol to antagonize the chronotropic action of isoprenaline was studied on isolated guinea-pig right atria and in anaesthetized cats A pA2 value in vitro and the dose producing 50% inhibition in vivo (ID50) could be determined for all compounds in contrast to an...

Thesis (Ph. D.)--University of Leeds (Dept. of Pharmacology), 1975.

The β-receptor blocking actions of ICI 50172 were compared with those of propranolol, pronethalol and MJ 1999. It antagonized the cardiac effects but did not affect the depressor action of isoprenaline in the anaesthetized cat. The dose-effect curve for ICI 50172 was flatter than for the other antagonists. Autonomic reflexes did not account for the...

Vagal escape was initiated in chloralose anaesthetised cats. A sympathetic component is involved in vagal escape. Concomitant β-receptor stimulation produced by sympathomimetic amines or cocaine increased, and blockade of sympathetic effects with β-receptor antagonists or with St-155 (2-(2,6-dichlorophenylamino)-2-imidazoline hydrochloride) decreas...

The specificity of the β-receptor antagonists propranolol and LB 46 [4-(2-hydroxy-3-isopropyl-aminopropoxy)-indole] has been compared by determination of their quinidine-like activities and antagonistic activity against isoprenaline, adrenaline, acetylcholine and histamine. LB 46 was 5 to 10 times more potent than propranolol as a β-receptor antago...

Low doses of propranolol having specific β-receptor blocking activity abolished arrhythmias induced by ouabain in 7 out of 21 cats. In 9 of the remaining experiments, propanolol abolished arrhythmias only after it was given in higher doses which had quinidine-like activity.In the presence of sub-arrhythmic doses of ouabain, stimulation of the cardi...

The threshold anti-arrhythmic doses of the (3-receptor antagonists propranolol, MJ 1999' (4-(2-isopropylamin o1-hydroxyethyl)-methanesulphonanilide) and Ciba 39089 Ba (1-isopropylamino-2-hydroxy-3-(0-allyloxyphenoxy)propane) required to prevent or revert arrhythmias induced by adrenaline-methylchloroform and ouabain respectively were determined in...

pA2 values and changes in the effective refractory period of atria have been studied using β-receptor antagonists and procainamide. Propranolol had the highest specificity for β-receptors. Pronethalol and Ciba 39089 Ba (1-isopropylamino-2-hydroxy-3-(0-allyloxy-phenoxy)-propane) showed high anti-histaminic activity, and MJ 1999 (4-(2-isopropylamino-...