Patient Access, Unmet Medical Need, Expected Benefits, and Concerns Related to the Utilisation of Biosimilars in Eastern European Countries: A Survey of Experts.

This policy research aims to map patient access barriers to biologic treatments, to explore how increased uptake of biosimilars may lower these hurdles and to identify factors limiting the increased utilisation of biosimilars. A policy survey was developed to review these questions in 10 Central and Eastern European (CEE) and Commonwealth of Independent States (CIS) countries. Two experts (one public and one private sector representative) from each country completed the survey. Questions were related to patient access, purchasing, clinical practice, and real-world data collection on both original biologics and biosimilars. Restrictions on the number of patients that can be treated and related waiting lists were reported as key patient access barriers. According to respondents, for both clinicians and payers the primary benefit of switching patients to biosimilars would be to treat more patients. However, concerns with therapeutic equivalence and fear of immunogenicity may reduce utilisation of biosimilars. Similar limitations in patient access to both original biologics and biosimilars raise concerns about the appropriateness and success of current biosimilar policies in CEE and CIS countries. The conceptual framework for additional real-world data collection exists in all countries which may provide a basis for future risk-management activities including vigorous pharmacovigilance data collection.

Early understanding of the socially mediated representational function of pictures.

The present two studies investigated whether toddlers' ability to use pictures in problem solving could be facilitated by making available the social context in which pictures were created. To make this social context available, we introduced an Experimental treatment in which the creator was intentionally drawing different objects. In Experiment-1, due to this treatment, children performed better in the Test in which the Experimenter was drawing the Test-pictures of the retrieval task. In Experiment-2, after the same Experimental treatment the facilitative effect was replicated although the social context was removed in the Test phase by using pre-drawn Test-pictures without any drawing action in the retrieval task. The results suggest that a treatment which offers the opportunity to understand the socially mediated representational function of pictures enables children to perform better when contextualizing pictures in current reality. These two experiments revealed a novel way to facilitate children's picture comprehension by identifying an underlying factor that can explain children's difficulty in picture comprehension.

Communicating shared knowledge in infancy.

Object-directed emotion expressions provide two types of information: They can convey the expressers' person-specific subjective disposition toward objects, or they can be used communicatively as referential symbolic devices to convey culturally shared valence-related knowledge about referents that can be generalized to other individuals. By presenting object-directed emotion expressions in communicative versus noncommunicative contexts, we demonstrated that 18-month-olds can flexibly assign either a person-centered interpretation or an object-centered interpretation to referential emotion displays. When addressed by ostensive signals of communication, infants generalized their object-centered interpretation of the emotion display to other individuals as well, whereas in the noncommunicative emotion-expression context, they attributed to the emoting agent a person-specific subjective dispositional attitude without generalizing this attribution as relevant to other individuals. The findings indicate that, as proposed by natural pedagogy theory, infants are prepared to learn shared cultural knowledge from nonverbal communicative demonstrations addressed to them at a remarkably early age.

[Impaired theory of mind in anorexia nervosa]. / Tudatelméleti deficit anorexia nervosában.

Anorexia nervosa (AN) is a severe mental illness, which is characterized by a continuously growing occurrence in the population and by the shift of the onset for earlier ages. The understanding of factors playing role in AN and the importance of effective prevention is an essential issue in science as well as in the society. AN also affects the social domain of life, patients with AN may exhibit impaired social interaction, social isolation, difficulties in emotion recognition and egocentric thinking in cognitive processing. Therefore, the aim of present study was to investigate the theory of mind (ToM) deficits is anorexia nervosa. Although previous studies have reported ToM deficits in autism and in schizophrenia, the number of studies investigating ToM functioning in eating disorders are particularly low. Even though ToM difficulties, such as the affective ToM impairments were found in AN, however, the evidence of cognitive ToM deficits in anorexia patients is still lacking. Twenty anorexia nervosa patients and 20 healthy control adolescent girls participated in the experiment. EDI, BAT, Fallon-Rozin Test and Anamoprhic Micro Body Image Assesment Programme questionnaires and body-image tests were applied to discriminate anorexia nervosa group from healthy control group. The Hungarian version of Faux Pas Recognition Test was applied to evaluate ToM functioning. Compared to healthy control group, impairment in ToM functioning was found in AN group, especially in affective mental state attribution. Our results can raise new aspects for research, therapy and prevention of anorexia nervosa.

On pedagogy.

Humans are adapted to spontaneously transfer relevant cultural knowledge to conspecifics and to fast-learn the contents of such teaching through a human-specific social learning system called 'pedagogy' (Csibra & Gergely, 2006). Pedagogical knowledge transfer is triggered by specific communicative cues (such as eye-contact, contingent reactivity, the prosodic pattern of 'motherese', and being addressed by one's own name). Infants show special sensitivity to such 'ostensive' cues that signal the teacher's communicative intention to manifest new and relevant knowledge about a referent object. Pedagogy offers a novel functional perspective to interpret a variety of early emerging triadic communicative interactions between adults and infants about novel objects they are jointly attending to. The currently dominant interpretation of such triadic communications (mindreading) holds that infants interpret others' object-directed manifestations in terms of subjective mental states (such as emotions, dispositions, or intentions) that they attribute to the other person's mind. We contrast the pedagogical versus the mindreading account in a new study testing 14-month-olds' interpretation of others' object-directed emotion expressions observed in a communicative cueing context. We end by discussing the far-reaching implications of the pedagogical perspective for a wide range of early social-cognitive competences, and for providing new directions for future research on child development.