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After hospital executives trooped to Capitol Hill hearings last week to defend their billing and collection practices for the uninsured, the threat of immediate action to regulate pricing and charity care seemed to pass. The AHA's David Bernd, left, argued that not-for-profits' mission is much wider than just indigent care.
Organizations, particularly Catholic hospitals, schools and social service agencies, should re-examine their relationships to health and medical charities promoting unethical research such as human embryonic stem cell research and therapeutic cloning. Part 6 of the Ethical and Religious Directives provides a helpful framework for ethical analysis and action.
Approximately 2 to 9% of all soft tissue sarcomas are leiomyosarcomas (LMS). LMS arises nearly exclusively as tumors in adults, with peak incidence occurring in the fifth and sixth decades. The purpose of this study was to analyze disease-specific survival and define prognostic factors in patients with this disease who were treated and followed at a single institution. Fifty-eight cases of LMS were identified in the Tumor Registry of the Medical Center of Louisiana at New Orleans (charity Hospital) from 1950 to 1995. Charts were reviewed and tissue blocks reexamined to confirm the diagnosis. Follow-up information was available for 56 of 58 (96%) patients. Univariate and multivariate analyses were performed to analyze which factors predict outcome. The median survival time was 138 months. Univariate analysis identified age (> 48 years), location (retroperitoneal vs other sites), and extent of disease as prognostic factors. Multivariate analysis revealed that only age and the extent of disease at presentation are independent prognostic indicators. Race, sex, and adjuvant therapy were not significant prognostic factors. Surgical resection remains the therapeutic mainstay for patients with LMS. The value of other treatment modalities is largely limited to surgical failures. The data show that the age of the patient and the extent of disease at presentation are the best predictors of long-term survival. LMS has a good prognosis when complete resection of localized lesions can be achieved.
Media appeals encouraging people to sign organ donor cards suggest that donating one's own organs after death or donating the organs of a deceased family member is an act of charity, i.e., something which it would be meritorious for people to do but not wrong to avoid. This paper argues to the contrary that posthumous organ donation is a moral duty, a duty of the type that rests at the base of recently enacted state "Good Samaritan" laws which require a witness to an emergency situation to render aid to the victim(s) when this can be done at minimal cost/risk to the potential rescuer.
Two thousand, two hundred and seven cats from 14 shelters of a major UK cat charity were blood tested for feline coronavirus (FCoV) antibodies. Data was collated on breed, sex, age, number of cats at original location, outdoor access, health status, and time spent in the shelter prior to sampling (range 0 to 4 years). Some cats were also tested for feline leukaemia virus antigen, feline immunodeficiency virus, and Toxoplasma gondii antibodies. The effect of these variables on FCoV seropositivity was explored by multivariable logistic regression. FCoV seropositivity in cats that had spent 5 days or less in a shelter at sampling was significantly associated with a multi-cat origin, cats aged 3 years or less, and Persian breed. Whether pet, stray or feral, health status, indoor/outdoor access, and sex had no significant effect. Overall FCoV seropositivity was associated with time spent in a shelter but this association was not linear. Cats that had spent more than 60 days in a shelter were over five times as likely to be seropositive. This may be the result of a change in husbandry from solitary to communal housing for cats remaining in shelters long term. Rescue of cats for less than 60 days was not associated with a significant increasing risk of seropositivity. Significant variation existed in seropositivity between individual shelters overall and in cats rescued for less than 5 days. These findings may reflect inter-shelter variation in cat husbandry and variation in seropositivity of shelter intake respectively.
We ask whether increasing HMO penetration causes hospitals to cut back on charity care using California hospital discharge data for 1988-1996. There is little evidence at the hospital level that private hospitals respond to HMOs by turning away uninsured and/or Medicaid patients. In the for-profit sector hospitals actually reduce the share of privately insured patients and increase the shares of Medicare patients and Medicaid births. Apparently, HMO penetration reduces the price paid by privately insured patients, making them relatively less attractive to for-profit hospitals.
Long-term survival, the prognostic effects of race, age, tumor size, number of positive nodes, and presence of grave signs (fixation, peau d'orange/edema, dimpling/retraction, satellite nodules, and ulceration) in this distribution of estrogen receptors (ERs) and progesterone receptors (PRs) were studied in 2480 patients (1815 blacks, 665 whites) diagnosed with localized or regional breast cancer at Charity Hospital of Louisiana at New Orleans (CHNO) from 1948 to 1985 and followed up in the CHNO Tumor Registry. Breast cancer-specific survival rates were 57%, 45%, 41%, 39%, 38%, and 35% at 5, 10, 15, 20, 25, and 30 years, respectively. Size of tumor, clinical status of nodes, and degree of fixation were important prognostic clinical factors, and number of nodes was an important pathologic factor with no additional value of the "grave signs." Size and fixation were related. Independent of size, clinical and pathologic status and fixation were related. ER was related to age and PR was related to number of nodes. The excess mortality from breast cancer at later intervals from diagnoses was small compared with mortality from other causes. Some, but not all, clinical findings were important prognostic indicators. ER and PR were related to some variables with unclear meaning.
BACKGROUND: Nursing literature seldom examines Catholic si. ters as entrepreneurs competing in the hospital marketplac even though they established hospitals throughout the United States in the late 19th and early 20th centuries. OBJECTIVES: This study examines the tension between hospita as businesses and charities by asking how nursing sisters, who took vows of poverty, could build impressive hospital networks. What links did they forge to make hospital building possible? METHOD: Historical methodology is used which draws upon primary sources in archives of three women's religious congregations. These include nuns' constitutions and letters, hospital chronicles, journals, minutes of meetings, annual reports and census records. Secondary sources include nursing hospital, religious, and economic histories. RESULTS: Catholic sisters' entrepreneurial activities were pragmatic adaptions that reflected their commitment to their nursing and hospital establishments. They raised money and formed alliances not to build personal fortunes but to build religious values. Their entrepreneurship and spirituality worked together. DISCUSSION: Sister-nurses' viewed their actions as doing what was necessary to their mission. A finacially stable hospital, with it's large patient population, enhanced the social and spiritual importance of nun's work. Yet, the broad-based corporate culture of Catholic hospitals still needs further study.
A 63-year-old black woman, admitted to Charity Hospital, New Orleans, for treatment of hypertension and congestive heart failure, was found clinically and histopathologically to have Hansen's disease. She had lived most of her life in Orleans Parish and had no known contact as a source of her infection.
Darwinian evolution can explain human cooperative behaviour among non-kin by either direct or indirect reciprocity. In the latter case one does not expect a return for an altruistic act from the recipient as with direct reciprocity, but from another member of the social group. However, the widespread human behaviour of donating to poor people outside the social group, for example, to charity organizations, that are unlikely to reciprocate indirectly and thus are equivalent to defectors in the game is still an evolutionary puzzle. Here we show experimentally that donations made in public to a well-known relief organization resulted both in increased income (that the donors received from the members of their group) and in enhanced political reputation (they were elected to represent the interests of their group). Donations may thus function as an honest signal for one's social reliability.
The elimination of Salmonella charity and Escherichia coli from the Sydney rock oyster, Crassostrea commercialis, was examined during commercial purification of oysters under different water temperatures and salinities. Both organisms were rapidly eliminated at 18 to 22 degrees C. Purification was effective but slower at 24 to 27 degrees C and incomplete and inconsistent at temperatures below 17 degrees C. The oysters suffered stress and were not effectively purified at water salinities of 15 to 20% but were rapidly purified at 32 to 47% salinity. Winter-harvested and summer-harvested oysters were purified similarly in water at 18 to 22 degrees C and 32 to 36% salinity.
The Patient Advocacy Program, built on an already existing, sympathetic hospital staff, has placed added emphasis on the physician-patient relationship which recently has been obscured by increasing technology, mechanization, and third party process. Furthermore, the Patient Advocacy Program stresses that the patient is the most important reason for the focus of the physician and staff. We have tried to exhibit not only true professionalism, but also true charity, by giving more than is expected and in return receiving an appreciative and satisfying response from patients, parents, and responsible parties.
As CEO at the Daughters of Charity National Health System West in California, Michael D. Connelly, 37, oversees operations of six hospitals, a job he's held for just a year. But his innovative management style predates his move west to a long career at a DCNHS hospital in Chicago where he is credited with "taking the bull by the horns" and spearheading a turnaround. Mr. Connelly's accomplishments have earned him this year's Young Executive of the Year award from the American College of Healthcare Executives.
Through financial crunches, political reversals and accreditation threats, Elliott Roberts has summoned the patience to persevere as chief executive officer of Charity Hospital at New Orleans.
Recent policy initiatives attempt to link the tax treatment of nonprofit hospitals more closely with the provision of social benefits. A key issue in defining these benefits is the treatment of "community benefit" programs and services. While their costs are often unreimbursed, these programs differ from traditional charity care in terms of the populations whom they benefit and the motivation for their provision. Community benefit programs are typically targeted to the general population, rather than the poor or other underserved groups, and often serve a marketing function.
For several reasons, in industrialized countries like ours, there is a growing number of people who require institutional or private help to survive. The Valencian Charity Association has been running a free dining hall for more than 300 people since 1906, which serves lunch (2 courses, bread, fruit, and a dairy product) and a sandwich dinner. The objective of this study is to evaluate the degree of adjustment of the diet offered to the nutritional needs of those who eat there. For this, we calculated the amounts of each of the foods included in a monthly menu, expressed in g or ml per person per day, and these are transformed into energy supply and nutritional supply, and these are then compared to the recommended ingestion of the Spanish population. The menus provided, considered to be the sole dietary intake of those eating there, provide proteins, thiamin, cyanocobalamine, retinol, and vitamin C in amounts that are similar or greater than those recommended for both sexes and all age groups, while the zinc, magnesium, pyridoxine, folates, and tocopherol quantities are less than 54% of the recommended ingestion for the groups with the greatest needs (adolescents or pregnant or lactating women). Supplementing the basic diet with a breakfast (glass of whole milk with sugar and Maria cookies), a yogurt, a portion of dried fruits, and a portion of fruit for dinner, would increase the supply of magnesium, folates, and vitamin E to levels that meet the requirements of the most needy, those of pregnant and lactating women, but the levels of pyridoxine would continue to be low, just like in other studies, and the recommended intake levels hereof appear unattainable even if this diet is supplemented with nutrients that can easily be accessed by this population group.
The ideas of the Age of Enlightenment brought about an important advance in the attitudes regarding education and the importance that children have in society. This made it possible to start opening dispensaries, to paying more attention to child care, to contemplating special measures in the care for foundlings and for those mothers who were not able to give birth to their children inside a family structure. This article analyzes the cases of foundlings in La Coruña during the 18th and 19th centuries bearing in mind the care provided by the Charity Hospital in La Coruña and in the Maternity Center in Lugo. A summary of this article was presented as a open communication at the 16th National Congress of Nursing for Neonatal and Pediatrics Intensive Care.
One hundred and thirty-eight people of 431 who attended a charity function fell ill with gastro-enteritis mainly between 12 and 72 hours later. Three people were ill at the event, and a further three became ill within two hours of the event. A cohort study undertaken using a postal questionnaire showed that illness was statistically associated with having eaten cream, mints, or profiteroles. The duration of illness ranged from two to 120 hours, with a median of 48 hours. Twenty-three of the cases sent a stool sample to the laboratory. Six of these were taken to the laboratory within three days of the onset of illness and examined for bacteria before being sent for virological examination by electron microscopy (EM) and polymerase chain reaction (PCR). All six were positive for small round structured virus (SRSV) on PCR, and negative on EM. The illness was likely to have been transmitted both by foodborne transmission and person to person spread at the event.