Generic medicines and generic substitution: contrasting perspectives of stakeholders in Ireland.

BACKGROUND: The Health (Pricing and Supply of Medical Goods) Act 2013 passed into law in July 2013 and legislated for generic substitution in Ireland. The aim of the study was to ascertain the knowledge and perceptions of stakeholders i.e. patients, pharmacists and prescribers, of generic medicines and to generic substitution with the passing of legislation. METHODS: Three stakeholder specific questionnaires were developed to assess knowledge of and perceptions to generic medicines and generic substitution. Purposive samples of patients, prescribers and pharmacists were analysed. Descriptive quantitative and qualitative analyses were undertaken. RESULTS AND DISCUSSION: A total of 762 healthcare professionals and 353 patients were recruited. The study highlighted that over 84% of patients were familiar with generic medicines and are supportive of the concept of generic substitution. Approximately 74% of prescribers and 84% of pharmacists were supportive of generic substitution in most cases. The main areas of concern highlighted by the healthcare professionals that might impact on the successful implementation of the policy, were the issue of bioequivalence with generic medicines, the computer software systems used at present in general practitioner (GP) surgeries and the availability of branded generics. The findings from this study identify a high baseline rate of acceptance to generic medicines and generic substitution among patients, prescribers and pharmacists in the Irish setting. The concerns of the main stakeholders provide a valuable insight into the potential difficulties that may arise in its implementation, and the need for on-going reassurance and proactive dissemination of the impact of the generic substitution policy. CONCLUSION: The existing positive attitude to generic medicines and generic substitution among key stakeholders in Ireland to generic substitution, combined with appropriate support and collaboration should result in the desired increase in rates of prescribing, dispensing and use of generic medicines.

Nanophotonics for quantum optics using nitrogen-vacancy centers in diamond.

Optical microcavities and waveguides coupled to diamond are needed to enable efficient communication between quantum systems such as nitrogen-vacancy centers which are known already to have long electron spin coherence lifetimes. This paper describes recent progress in realizing microcavities with low loss and small mode volume in two hybrid systems: silica microdisks coupled to diamond nanoparticles, and gallium phosphide microdisks coupled to single-crystal diamond. A theoretical proposal for a gallium phosphide nanowire photonic crystal cavity coupled to diamond is also discussed. Comparing the two material systems, silica microdisks are easier to fabricate and test. However, at low temperature, nitrogen-vacancy centers in bulk diamond are spectrally more stable, and we expect that in the long term the bulk diamond approach will be better suited for on-chip integration of a photonic network.

Observation of nonlinear optical interactions of ultralow levels of light in a tapered optical nanofiber embedded in a hot rubidium vapor.

We report the observation of low-light level optical interactions in a tapered optical nanofiber (TNF) embedded in a hot rubidium vapor. The small optical mode area plays a significant role in the optical properties of the hot vapor Rb-TNF system, allowing nonlinear optical interactions with nW level powers even in the presence of transit-time dephasing rates much larger than the intrinsic linewidth. We demonstrate nonlinear absorption and V-type electromagnetically induced transparency with cw powers below 10 nW, comparable to the best results in any Rb-optical waveguide system. The good performance and flexibility of the Rb-TNF system makes it a very promising candidate for ultralow power resonant nonlinear optical applications.

Kerr-nonlinearity optical parametric oscillation in an ultrahigh-Q toroid microcavity.

Kerr-nonlinearity induced optical parametric oscillation in a microcavity is reported for the first time. Geometrical control of toroid microcavities enables a transition from stimulated Raman to optical parametric-oscillation regimes. Optical parametric oscillation is observed at record low threshold levels (174 micro-Watts of launched power) more than 2 orders of magnitude lower than for optical-fiber-based optical parametric oscillation. In addition to their microscopic size (typically tens of microns), these oscillators are wafer based, exhibit high conversion efficiency (36%), and are operating in a highly ideal "two photon" emission regime, with near-unity (0.97+/-0.03) idler-to-signal ratio.

Ultralow-threshold microcavity Raman laser on a microelectronic chip.

Using ultrahigh-Q toroid microcavities on a chip, we demonstrate a monolithic microcavity Raman laser. Cavity photon lifetimes in excess of 100 ns combined with mode volumes typically of less than 1000 (microm)3 significantly reduce the threshold for stimulated Raman scattering. In conjunction with the high ideality of a tapered optical fiber coupling junction, stimulated Raman lasing is observed at an ultralow threshold (as low as 74 microW of fiber-launched power at 1550 nm) with high efficiency (up to 45% at the critical coupling point) in good agreement with theoretical modeling. Equally important, the wafer-scale nature of these devices should permit integration with other photonic, mechanical, or electrical functionality on a chip.

Ideality in a fiber-taper-coupled microresonator system for application to cavity quantum electrodynamics.

The ability to achieve near lossless coupling between a waveguide and a resonator is fundamental to many quantum-optical studies as well as to practical applications of such structures. The nature of loss at the junction is described by a figure of merit called ideality. It is shown here that under appropriate conditions ideality in excess of 99.97% is possible using fiber-taper coupling to high-Q silica microspheres. To verify this level of coupling, a technique is introduced that can both measure ideality over a range of coupling strengths and provide a practical diagnostic of parasitic coupling within the fiber-taper-waveguide junction.

Ultra-high-Q toroid microcavity on a chip.

The circulation of light within dielectric volumes enables storage of optical power near specific resonant frequencies and is important in a wide range of fields including cavity quantum electrodynamics, photonics, biosensing and nonlinear optics. Optical trajectories occur near the interface of the volume with its surroundings, making their performance strongly dependent upon interface quality. With a nearly atomic-scale surface finish, surface-tension-induced microcavities such as liquid droplets or spheres are superior to all other dielectric microresonant structures when comparing photon lifetime or, equivalently, cavity Q factor. Despite these advantageous properties, the physical characteristics of such systems are not easily controlled during fabrication. It is known that wafer-based processing of resonators can achieve parallel processing and control, as well as integration with other functions. However, such resonators-on-a-chip suffer from Q factors that are many orders of magnitude lower than for surface-tension-induced microcavities, making them unsuitable for ultra-high-Q experiments. Here we demonstrate a process for producing silica toroid-shaped microresonators-on-a-chip with Q factors in excess of 100 million using a combination of lithography, dry etching and a selective reflow process. Such a high Q value was previously attainable only by droplets or microspheres and represents an improvement of nearly four orders of magnitude over previous chip-based resonators.

Ultralow-threshold Raman laser using a spherical dielectric microcavity.

The ability to confine and store optical energy in small volumes has implications in fields ranging from cavity quantum electrodynamics to photonics. Of all cavity geometries, micrometre-sized dielectric spherical resonators are the best in terms of their ability to store energy for long periods of time within small volumes. In the sphere, light orbits near the surface, where long confinement times (high Q) effectively wrap a large interaction distance into a tiny volume. This characteristic makes such resonators uniquely suited for studies of nonlinear coupling of light with matter. Early work recognized these attributes through Raman excitation in microdroplets-but microdroplets have not been used in practical applications. Here we demonstrate a micrometre-scale, nonlinear Raman source that has a highly efficient pump-signal conversion (higher than 35%) and pump thresholds nearly 1,000 times lower than shown before. This represents a route to compact, ultralow-threshold sources for numerous wavelength bands that are usually difficult to access. Equally important, this system can provide a compact and simple building block for studying nonlinear optical effects and the quantum aspects of light.

Modal coupling in traveling-wave resonators.

High-Q traveling-wave-resonators can enter a regime in which even minute scattering amplitudes associated with either bulk or surface imperfections can drive the system into the so-called strong modal coupling regime. Resonators that enter this regime have their coupling properties radically altered and can mimic a narrowband reflector. We experimentally confirm recently predicted deviations from criticality in such strongly coupled systems. Observations of resonators that had Q>10(8) and modal coupling parameters as large as 30 were shown to reflect more than 94% of an incoming optical signal within a narrow bandwidth of 40 MHz.

Undergraduate admission policies, practices, and procedures for applicants with learning disabilities.

This study examined (a) the academic and nonacademic criteria used by admission personnel to determine the eligibility of undergraduate applicants with learning disabilities, (b) agreement of criteria used by institutions of varying competitiveness, and (c) the frequency with which admission personnel conduct validity studies on these criteria. A nonrandom sample consisting of 66 state universities and colleges in the Northeast was surveyed. The results suggest that the academic and nonacademic criteria employed are similar to those employed for applicants without learning disabilities, the criteria used by different types of institutions differ significantly, and admission personnel do not conduct validity studies. Further clarification and validation of admission criteria appears warranted.