s Orthomolecular News Service January 3 & January 7 2014 | I2P: Information to Pharmacists - Archive
Publication Date 01/07/2014         Volume. 6 No. 6   
Information to Pharmacists

Editorial

From the desk of the editor

Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.

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News Flash

Newsflash Updates for July 2014

Newsflash Updates

Regular weekly updates that supplement the regular monthly homepage edition of i2P. 
Access and click on the title links that are illustrated

Comments: 1

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Feature Contribution

Woolworths Pharmacy - Getting One Stage Closer

Neil Johnston

It started with “tablet” computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title Coles Pharmacy Expansion and the Arid PGA Landscape”
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.

Comments: 5

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Intensive Exposition without crossing over with a supermarket

Fiona Sartoretto Verna AIAPP

Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.

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The sure way to drive business away

Gerald Quigley

I attended the Pregnancy, Baby and Children’s Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.

Comments: 1

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‘Marketing Based Medicine’ – how bad is it?

Baz Bardoe

It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of ‘Marketing Based Medicine,’ as psychiatrist Dr Peter Parry terms it, hasn’t as yet generated the kind of universal outrage one might expect.

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Community Pharmacy Research - Are You Involved?

Mark Coleman

Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).

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Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress

Neil Johnston

Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we’re not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.

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Academics on the payroll: the advertising you don't see

Staff Writer

This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people’s attention, advertising is going ‘native’, creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.

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I’ve been thinking about admitting wrong.

Mark Neuenschwander

Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There’s more than one way you could take that, huh? Like Someday when I get around to it (I’m not sure) I may admit that I was wrong about something. Actually, I’ve been thinking about the concept of admitting wrong. So don’t get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, “Doctors make mistakes. Can we talk about it?” had already been viewed by 386,072 others before I watched it last week.

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Dispensing errors – a ripple effect of damage

Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA

Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted “extra vigilance is required to be exercised by pharmacists with these drugs”.
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June
http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning

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Take a vacation from your vocation

Harvey Mackay

Have you ever had one of those days when all you could think was, “Gosh, do I need a vacation.”
Of course you have – because all work and no play aren’t good for anyone.
A vacation doesn’t have to be two weeks on a tropical island, or even a long weekend at the beach. 
A vacation just means taking a break from your everyday activities. 
A change of pace. 
It doesn’t matter where.
Everyone needs a vacation to rejuvenate mentally and physically. 
But did you also know that you can help boost our economy by taking some days off? 
Call it your personal stimulus package.

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Explainer: what is peer review?

Staff Writer

This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We’ve all heard the phrase “peer review” as giving credence to research and scholarly papers, but what does it actually mean?
How does it work?
Peer review is one of the gold standards of science. It’s a process where scientists (“peers”) evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is “double blind” peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.

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Dentists from the dark side?

Loretta Marron OAM BSc

While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?

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Planning for Profit in 2015 – Your key to Business Success

Chris Foster

We are now entering a new financial year and it’s a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Attracting and Retaining Great People

Barry Urquhart

Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language.  In the business lexicon their use can be, and often is evocative and stimulate creative images.  But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to “hot” money draw attention and comment.  The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.

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Updating Your Values - Extending Your Culture

Neil Johnston

Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.

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Evidence-based medicine is broken. Why we need data and technology to fix it

Staff Writer

The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.

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Laropiprant is the Bad One; Niacin is/was/will always be the Good One

Staff Writer

Orthomolecular Medicine News Service, July 25, 2014
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
by W. Todd Penberthy, PhD

(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).

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Culture Drive & Pharmacy Renewal

Neil Johnston

Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – “culture”.
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term “goodwill” which can be eventually translated to a dollar value.

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ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use

Staff Writer

Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company’s ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.

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Pharmacy 2014 - Pharmacy Management Conference

Neil Johnston

The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.

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Generation and Application of Community Pharmacy Research

Neil Johnston

Editor’s Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:

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Orthomolecular News Service January 3 & January 7 2014

Neil Johnston

articles by this author...

Introducing current ideas, perspectives and issues, to the profession of pharmacy

Editor's Note:
The unnecessary war that is waged on vitamins and other nutritional supplements is continually and routinely engaged.
Is it because they offer a genuine alternative to mainstream medicine? Or a cheaper treatment? Or a safer treatment?
In the war of continuous disinformation it gets harder to separate truth from fiction particularly when it is generated through Big Pharma sources - the same sources that have had massive fines levied against them for publishing fraudulent research, not just once, but multi-times.
Will government ever legislate in this area?


Orthomolecular Medicine News Service, January 3, 2014

No Deaths from Vitamins. None.
Supplement Safety Once Again Confirmed by America's Largest Database
by Andrew W. Saul, Editor
PLUS

Orthomolecular Medicine News Service, January 7, 2014

Regulation of Vitamins: Politics As Usual

Commentary by Rolf Hefti

Orthomolecular Medicine News Service, January 3, 2014

No Deaths from Vitamins. None.
Supplement Safety Once Again Confirmed by America's Largest Database

by Andrew W. Saul, Editor

(OMNS Jan 3, 2014) The 30th annual report from the American Association of Poison Control Centers shows zero deaths from multiple vitamins. And, there were no deaths whatsoever from vitamin A, niacin, vitamin B-6, vitamin C, vitamin D, or vitamin E.

It was claimed that one person died from vitamin supplements in the year 2012, according to AAPCC's interpretation of information collected by the U.S. National Poison Data System. That single alleged "death" was supposedly due to "Other B-Vitamins." Since the AAPCC report specifically indicates no deaths from niacin (B-3) or pyridoxine (B-6), that leaves folic acid, thiamine (B-1), riboflavin (B-2), biotin, pantothenic acid, and cobalamin (B-12) as the remaining B-vitamins that could be implicated. However, the safety record of these vitamins is extraordinarily good; no fatalities have ever been confirmed for any of them.

Even if it were to be allowed that the lone alleged fatality claim was correct, one single death in a year associated with nationwide vitamin supplementation is an astonishingly small number. Well over half of the U.S. population takes daily nutritional supplements. If each of those people took only one single tablet daily, that makes 165,000,000 individual doses per day, for a total of over 60 billion doses annually. Since many persons take far more than just one single vitamin tablet, actual consumption is considerably higher, and the safety of vitamin supplements is all the more remarkable.

Abram Hoffer, MD, PhD, repeatedly said: "No one dies from vitamins." He was right when he said it and he is still right today. The Orthomolecular Medicine News Service invites submission of specific scientific evidence conclusively demonstrating death caused by a vitamin.

There isn't any. Case closed.

References:

Mowry JB, Spyker DA, Cantilena LR Jr, Bailey JE, Ford M. 2012 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 30th Annual Report. Clin Toxicol (Phila). 2013 Dec;51(10):949-1229. doi: 10.3109/15563650.2013.863906. Vitamin data discussed above can be found at the very end of the report, on pages 1197-1200, Table 22B.

Orthomolecular Medicine News Service, January 7, 2014

Regulation of Vitamins: Politics As Usual

Commentary by Rolf Hefti

(OMNS Jan 7, 2014) Medical politics has been pervaded with unfounded, misleading arguments, tantamount to propaganda, instead of good evidence. Over the last several decades, the US mainstream medical establishment and the public health authorities, along with the help of the medical industry-sponsored mass media, have launched and broadcast numerous campaigns touting the value of firmer supplement rules for the American people [1].

The justification usually given is the lack of formal product testing for safety and efficacy, which, it is claimed, makes vitamins a big public health threat. If supplements were to be approved as prescription drugs by the public health authorities (meaning the FDA), this might prevent the alleged danger to the public [2]. After all, the public has been led to believe that medical products approved by the US government are safe and effective.

These anti-vitamin politics are exemplified in recent mainstream media releases. For example, an article titled "So Many Supplements, So Little Regulation" suggested that a pressing need exists for stricter regulation of vitamin supplements [3]. It attempted to make a case for better supplement policies because of grave safety issues. Some food supplements have been found to contain drugs that should require a prescription. However, unlike the platitudes offered by medical officialdom in favor of tougher vitamin regulations, the facts tell a different story.

Supplements Are Very Safe

Annual reports of the American Association of Poison Control Centers over the last three decades clearly show that nutritional supplements are much safer than over-the-counter drugs, even aspirin. Vitamin supplements aren't harmful like drugs. Even though vitamin supplements are not regulated as drugs, vitamin supplements also don't cause deaths . . . at all [4]. So, the claim that vitamin supplements are a significant danger to public health is wrong.

The Real Culprit

On the other hand, prescription drugs, properly taken (never mind poisoning by improper intake) are a major cause of death in the US, killing well over 100,000 people every year [5,6,7]. This is a major public health threat. FDA approved, firmly regulated drugs are causing gigantic harm to the public. Why, then, the brouhaha about FDA "safety" approval of vitamins? It's evident that the public knows the terrible safety record of prescription drugs and is concerned about it. Many drugs are very unsafe. And the FDA drug review procedure that tests drugs for side effects and sets the allowable usage is flawed.

The depiction of US healthcare by the aforementioned article should have read, "So Many Supplements, So Little Regulation, So Little Harm." And, most importantly, it should have pointed out the big threat to public health by stating, "So Many Medical Drugs, So Much Regulation, So Much Harm." Instead, the article resorted to disinformation about vitamins, accommodating the standard party line in disease care. The pharmaceutical industry and their colleagues in the medical profession demand a high standard of proof of safety for food supplements but evidently have not attained this for their own medical products.

"The foxes are guarding the hen-house. Pharmaceutical companies submit their own safety studies for FDA approval of a new drug. Drug companies have paid billions of dollars in fines for unethical practices and documented direct harm, including deaths, among other side effects. The public's confidence in the FDA is undeserved."
(Ralph Campbell, M.D.)

The highest standard of proof of safety (and efficacy) is testing in the real world, where vitamins are safe and effective at preventing disease and improving health. The FDA's product safety approval process neither prevents nor eliminates grave threats to public health [8,9]. Clearly, there exists urgency and necessity to protect public health from the hazards of prescription drugs. In contrast, there is little urgency or necessity for more rigorous regulation of vitamin supplements as drugs. The endless string of crusades for more vitamin regulations indicates political and profit motives are likely involved.

Profit Pushes Politics

Human history all too often repeats itself. The mode of repetition centers mainly around power, domination, and greed - and widespread public ignorance and indifference about their nature and influence - leading to a vicious cycle of injustice and war. In the healthcare industry, the dominant player is orthodox medicine. A variety of therapeutic modalities (for instance, nutritional medicine) are minority players. In recent decades, alternative medicine has experienced massive expansion [10,11]. This development is in large part due to new rules implemented by the U.S. Congress in 1994 that gave the American people unrestricted access to vitamin supplements, facilitating industry growth.

Concurrently, for more than two decades the pharmaceutical-medical industry (orthodox medicine) has been a major influence on the FDA, with their own help from Congress [12]. This put the government in a conflict-of-interest situation: the industry the FDA is supposed to regulate by law is also, at the same time, paying the agency enormous sums of money. This resulted in the FDA increasingly making decisions favorable to the medical-pharmaceutical industry, supporting that industry's self-serving "disease care" interests [1,9]. From its inception, the overriding interest of organized medicine has been to generate profits and to assure its monopoly status in healthcare Over the last 100 years, medicine has had a history of ostracizing relevant competitors who encroach on the profits in its bottom line [13-15]. Throughout much of that history, the FDA has been a willing assistant and enforcer of the medical profession's profit interests [1,12,16].

Thus the nonsensical attempts and bogus arguments presented by the ruling medical elite in support of firmer vitamin laws, under the pretext of "protecting public health", are in reality attempts to stifle, diminish, and eradicate the booming supplement industry [1]. These specious motions are acts of injustice to the public. After all, the contrived campaigns are rock-solid evidence of politics.

Capricious anti-supplement crusades will never be in the best interest of American health, simply because the foxes guard the henhouse. Many people call it a scam. I call it a repetition of the history of organized medicine.

(Rolf Hefti is an independent investigator, author, and the founder of http://www.Supplements-And-Health.com )

References:

1. Emord JW, "The Rise of Tyranny", Sentinel Press, 2008. ISBN-13: 978-0982059500

2. Angell M, Kassirer JP, "Alternative medicine: the risks of untested and unregulated remedies", N Engl J Med. 1998 Sep 17;339(12):839-41.

3. Scutti S, "So Many Supplements, So Little Regulation", Newsweek.com, 15-Nov-2013, http://www.newsweek.com/so-many-supplements-so-little-regulation-3267

4. Saul AW, "No Deaths from Vitamins. None." Orthomolecular Medicine News Service, January 3, 2014. http://orthomolecular.org/resources/omns/v10n01.shtml

5. Lazarou J, Pomeranz BH, Corey PN, "Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies", JAMA, 1998 Apr 15;279(15):1200-5.

6. Dean C, Feldman M, Rasio D, Smith D, Null G, "Death By Medicine", Independent review commissioned by the Nutrition Institute of America, 2003. http://orthomolecular.org/library/jom/2005/pdf/2005-v20n01-p021.pdf

7. Leape, LL, "Errors in medicine.", Clinical Chimica Acta, 2009 Jun;404(1):2-5. Epub 2009 Mar 18.

8. Abramson J, "Overdosed America: The Broken Promise of American Medicine", 2008. Harper Perennial; ISBN-13: 978-0061344763

9. Light DW, Lexchin J, Darrow JJ, "Institutional corruption of pharmaceuticals and the myth of safe and effective drugs", J Law Med Ethics. 2013 Fall;41(3):590-600.

10. Koplan JP, Annest JL, Layde PM, Rubin GL, "Nutrient intake and supplementation in the United States (NHANES II)", Am J Public Health. 1986 Mar;76(3):287-9.

11. Bailey RL, Gahche JJ, Lentino CV, Dwyer JT, Engel JS, Thomas PR, Betz JM, Sempos CT, Picciano MF, "Dietary supplement use in the United States, 2003- 2006.", J Nutr. 2011 Feb;141(2):261-6.

12. Angell M, "Taking back the FDA", The Boston Globe, 26-Feb-2007 http://www.boston.com/yourlife/health/diseases/articles/2007/02/26/taking_back_the_fda

13. Coulter, HL, Divided Legacy, Volume III: Science and Ethics in American Medicine, 1800-1914. North Atlantic Books; 2nd edition (1993) ISBN-13: 978-0913028964

14. Carter JP, "Racketeering in Medicine: The Suppression of Alternatives", 1992. Hampton Roads Pub, ISBN-13: 978-1878901323

15. Aaron C, Lincoln T, "The Other Drug War 2003: Drug Companies Deploy An Army Of 675 Lobbyists To Protect Profits.", Washington (DC): Public Citizen Congress Watch; June 2003. Available: http://www.citizen.org/documents/Other_Drug_War2003.pdf [accessed Dec-2013]

16. Lewis H, "Crony Capitalism in America 2008-2012", 2013. AC2 Books ISBN-13: 978-0988726727

Return to home

Submitted by Payam Tizabgar on Sat, 25/01/2014 - 09:07.

Neil thank you,

This is very helpful info...I am a pharmacist so this is great stuff to know.

Payam

http://www.mysmcpharmacy.com

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