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At least 721 records · Page 40Linked to original sources
PubMed1998

Demonstration of surgical telerobotics and virtual telepresence by Internet + ISDN from Monterey (USA) to Milan (Italy).

This paper deals with the connection which has been held on 8th July 1997 in collaboration with the JPL of the NASA, Pasadena, California, between the Eighth International Conference on the Advanced Robotics (ICAR '97) in course at Monterey, California and the Telerobotics Laboratory of Politecnico di Milano connected in a multipoint teleconference through the MCU of Rome with the Aula Magna of the same Politecnico and the Palace Business of the Giureconsulti of the Chamber of Commerce of Milan. The demonstration has allowed to telecontrol a scara robot of the Sankyo and an ABB robot, which have affected simulations of operations of biopsy to the prostate, to the liver and to the breast, a mechanical hand and a model of a car, disposed in a space destined to reproduce the Martian ground, from Monterey to Milan by means of the INTERNET+ISDN connection from. In fact the event has taken place four days after the landing on Mars happily successful of the spatial probe Pathfinder from which it has gone out the "Sojourner" robot, telecontrolled from the JPL of the NASA, which has begun to take photos of the Martian ground and also some of these images have been transmitted in the course of the connection.

Algorithms↗
PubMed1994

A case of wrongful use of quality management. Summit Health, Ltd., v. Pinhas.

Summit Health, Ltd., v. Pinhas liberalized the jurisdiction of the Sherman Antitrust Act to include cases of intrastate hospital credentialing. The U.S. Supreme Court decision eased the requirements for plaintiffs to sue when they perceived that health care organizations were acting as monopolies. The court removed the defense that a plaintiff had to prove that the decision of a health care organization affected interstate commerce for the case to be heard in court. Important as the case is in antitrust law, however, greater lessons can be gained by health care organizations from analyzing the events that led to the lawsuit.

Antitrust Laws↗
PubMed1984

Potential extension of strict products liability to hospitals: P & T committee liability.

Members of Pharmacy and Therapeutics (P & T) Committees and materials managers should be aware of the current trend of court decisions to extend strict products liability or liability without the showing of fault, to hospitals and providers of health care services in favor of innocent consumer-patients. Traditionally, a hospital's defense if charged with strict liability (in tort) was that its primary business is to provide services and not sell products. Recent Texas strict products liability judicial decisions have questioned, but not resolved, whether or not a hospital does sell or legally introduce a product into the stream of commerce. Since it is the function of materials managers, or in the case of pharmaceuticals the P & T Committee, to make the decisions on products that will be used in the hospital, the precedence established by the Texas cases portend further judicial extension of strict liability to providers of health care services.

Consumer Product Safety↗
PubMed1987

Minimizing antitrust and corporate liability risks.

To avoid antitrust problems, health care organizations must conduct a fair hearing on decisions related to physicians' staff appointment or privileges. To win such litigation, the physician must show some effect on interstate commerce and prove a conspiracy. These cases are usually reviewed not as a per se violation (in which motives and other relative factors are not considered) but under the rule of reason test--that is, the court considers whether the action was more procompetitive or anticompetitive. Hospitals can protect themselves by using admission criteria related to their interests and excluding potential competitors from staffing decisions. Hospitals that are underused, are geographically isolated, or offer unique services will have the least latitude in staffing decisions. Physicians getting together to agree on charges constitutes price fixing--a per se violation. Preferred provider organizations can avoid price fixing by using the "messenger" or "supermessenger" approach to negotiating payment, in which they relay information between individual physicians and the payer. Having an outside committee establish the fee is another possibility. To minimize antitrust concerns, joint ventures should include pooling of capital, shared risk, enhanced competitive pressure, and efficiencies and economies of scale. In malpractice suits, hospitals--including their boards of trustees--are liable for the actions of their physicians. Boards must exercise their ultimate authority for staffing decisions. More malpractice cases are arising and awards are increasing in U.S. society, while at the same time companies that offered liability insurance are withdrawing from the market.(ABSTRACT TRUNCATED AT 250 WORDS)

Economic Competition↗
PubMed1988

The national effort to improve access to trauma care: an interview with U.S. Representative Henry A. Waxman. Interview by Cynthia A. Brown.

The United States Congress is currently considering legislation to encourage states to plan, develop, and implement regional trauma care systems. The two bills--S. 10, introduced by Senator Alan Cranston (D-CA), and H.R. 3133, introduced by Representative Jim Bates (D-CA)--would require that these systems comply with the trauma care standards developed by the American College of Surgeons' Committee on Trauma. Significant progress is being made toward enactment of the House bill, H.R. 3133, due in large part to the efforts of the proposal's original cosponsor, Representative Henry A. Waxman (D-CA). Representative Waxman is Chairman of the Energy and Commerce Subcommittee on Health and the Environment, which has jurisdiction over federal programs involving emergency medical services systems, and he has played a key role in shaping and refining the House bill. In recognition of recent Congressional action designating May as National Trauma Awareness Month, Representative Waxman agreed to be interviewed for the Bulletin and to discuss H.R. 3133 and his view of the federal government's role in improving access to expert care for victims of injury.

General Surgery↗
PubMed1987

Federal financial participation in state assistance expenditures; federal matching shares for aid to families with dependent children, Medicaid, and aid to needy aged, blind, or disabled persons for October 1, 1988 through September 30, 1989--HHS. Notice.

The Federal Percentages and Federal Medical Assistance Percentages for Fiscal Year 1989 have been calculated pursuant to the Social Security Act (the Act). These percentages will be effective from October 1, 1988 through September 30, 1989. This notice announces the calculated "Federal percentages" and "Federal medical assistance percentages" that we will use in determining the amount of Federal matching in State welfare and medical expenditures. The table gives figures for each of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Title XIX of the Act exists in each jurisdiction, title IV-A in all jurisdictions except American Samoa and the Northern Mariana Islands, titles I, X, and XIV operate only in Guam and the Virgin Islands, while title XVI (AABD) operates only in Puerto Rico. The percentages in this notice apply to State expenditures for assistance payments and medical services (except family planning which is subject to a higher matching rate). The statute provides separately for Federal matching of administrative costs. Sections (1101(a)(8) and 1905(b) of the Act, as revised by section 9528 of Pub. L. 99-272, require the Secretary of Health and Human Services to publish these percentages each year. The Secretary is to figure the percentages, by formulas in sections 1101(a)(8) and 1905(b) of the Act, from the Department of Commerce's statistics of average income per person in each State and in the Nation as a whole. The percentages are within upper and lower limits given in those two sections of the Act.(ABSTRACT TRUNCATED AT 250 WORDS)

Aid to Families with Dependent Children↗
PubMed1988

Dissecting health care markets: large versus small businesses.

This article reports the results of a mail survey of businesses in Tulsa, Oklahoma (population 377,900 in the city and 745,300 in the surrounding metropolitan area). The purpose of the research was to analyze differences in health care provision and perspectives between large and small businesses. The survey of 3,200 members of the city's chamber of commerce yielded 640 responses. Analysis of the data revealed distinct differences between the two segments of the health care industry. The findings suggest that market opportunities exist for the development of health care delivery system programs aimed at small businesses.

Cost Control↗
PubMed1989

Medicare program; national coverage decisions--HCFA. General notice.

This notice lists those current Medicare national coverage decisions which have been issued in the Medicare Coverage Issues Manual (HCFA Pub. 6). These national coverage decisions are also widely distributed through the U.S. Government Printing Office, the National Technical Information Service, and private publishers such as the Commerce Clearing House. From time to time, some of the individual decisions have been published in the Federal Register. In this Federal Register notice, HCFA is publishing a compilation of these national coverage decisions. We will publish subsequent national coverage decisions in the Federal Register on a quarterly basis.

Aged↗
PubMed1989

Federal financial participation in state assistance expenditures; federal matching shares for aid to needy aged, blind, or disabled persons for October 1, 1990 through September 30, 1991--HHS. Notice.

The Federal Percentages and Federal Medical Assistance Percentages for Fiscal Year 1991 have been calculated pursuant to the Social Security Act (the Act). These percentages will be effective from October 1, 1990 through September 30, 1991. This notice announces the calculated "Federal percentages" and "Federal medical assistance percentages" that we will use in determining the amount of Federal matching in State welfare and medical expenditures. The table gives figures for each of the 50 States, the District of Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Northern Mariana Islands. Programs under title XIX of the Act exist in each jurisdiction; title IV-A programs in all jurisdictions except American Samoa and the Northern Mariana Islands; programs under titles I, X, and XIV operate only in Guam and the Virgin Islands; while a program under title XVI (AABD) operates only in Puerto Rico. The percentages in this notice apply to State expenditures for assistance payments and medical services (except family planning which is subject to a higher matching rate). The statute provides separately for Federal matching of administrative costs. Sections 1101(a)(8) and 1905(b) of the Act, as revised by section 9528 of Pub. L. 99-272, require the Secretary of Health and Human Services to publish these percentages each year. The secretary is to figure the percentages, by formulas in sections 1101(a)(8) and 1905(b) of the Act, from the Department of Commerce's statistics of average income per person in each State and in the Nation as a whole. The percentages are within upper and lower limits, given in those two sections of the Act.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1976

The physico-chemical basis for the freeze-drying process.

To the extent that the final form and quality of a freeze-dried product depends on the way the freeze-drying is conducted, an understanding of the many factors involved is most important. The numerous effects of the design and mode of operation of the freeze-drying equipment on the course of the process need to be known, as do the properties intrinsic to the material to be freeze-dried. Much can be learned and predicted from the study of the "supplemented phase diagram", a series of experimental plots describing the equilibrium and the non-equilibrium phase behavior of the system in question. Such diagrams map and distinguish eutectic and amorphous phase behavior. Further information is available from gravimetric studies allowing the construction of "desorption isotherms", the plots describing the loss of sorbed water accompanying the sublimation of ice, frequently termed "secondary drying". These plots relate the water retained by the product to the "water activity", or relative humidity at different temperatures. Observations in the freeze-drying microscope contribute additional information, in that they reveal the actual course of the process at the microscopic level. These and other laboratory findings facilitate the analysis and comparison of pilot-plant and commercical scale processing experiences. Where scientific and engineering factors appear to interrelate, the nature and extent of the interdependence can often be determined.

Crystallization↗
PubMed1976

[Disinfection of sewage waters from rendering plants with peracetic acid].

In our experiments, peracetic acid--known in commerce as "Wolfasteril" was tested as a new and efficient disinfectant to disinfect sewage waters from rendering plants. Peracetic acid was used in experiments in concentration of 0.1 to 1.0% for 30 sec. to 60 min. As a comparative agent, 5% chloramine was used. Results obtained in preliminary and main experiments proved that peracetic acid is fully appropriate to disinfect biologically cleaned sewage waters in rendering plants. Sewage waters supplying the main stream has to pass mostly a short section after having left the water clarifier. Consequently, the concentration of 1% peracetic acid acting for 30 sec. is the optimum one. The recommendation of this application norm for peracetic acid in water clarifiers from rendering plants being at least suitable in controlling disasters.

Acetates↗
PubMed1999

Group practices explore EDI options.

Although physician groups have been relatively slow to take advantage of electronic commerce, more are discovering the benefits. Once group practice administrators get beyond their initial trepidation and realize that EDI is efficient, many are pleased with the results. And some are automating other transactions, including verifying patient eligibility for insurance coverage, gaining insurance authorization for referrals to specialists and checking the status of claims.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1998

The need for a holistic view of telemedicine, focused on patients and society as prime stakeholders.

Telemedicine provides the scope to remove the barrier of distance from delivery of health care. In so doing it has the potential to strengthen primary care and local health delivery, and to optimise the use of secondary and tertiary specialist resources. However, it can have disbenefits and perverse effects which are as yet inadequately addressed. Development of telemedicine to date has been led by new technological opportunities, linked to clinical interests. Whilst not inappropriate, this alone is not adequate. All health care activities should be to promote health and treat ill-health, and therefore the interests of the consumer and of society should predominate. More complete research and policy analysis of telemedicine are therefore needed. This paper argues for a more holistic and integrated view of telemedicine to be taken, to ensure that technology is harnessed to meet need. To this end, it puts telemedicine into the overall context of health care interests, and describes methodologies to assess patient attitudes and societal priorities. Given the need to avoid the unanticipated adverse effects which have bedevilled other new health care technologies, and the particular risks of uncontrolled consultations and commerce across national boundaries, the paper goes on to advocate routine use of integrated risk analysis of telemedicine applications at research and policy levels. The need for an effects-orientated analytic framework, and for international policy collaboration to protect users of services available by global telecommunications, is identified.

Health Policy↗
PubMed1999

Willingness to donate organs and tissues in Vietnam.

CONTEXT: Few studies on public attitudes toward organ and tissue donation have been carried out in Asia. OBJECTIVE: To determine demographic influences on attitudes toward organ and tissue donation in Vietnam. DESIGN: Face-to-face interviews. SETTING: Tan Binh District, Ho Chi Minh City, Vietnam. PARTICIPANTS: Random sample of adults (N = 785). MAIN OUTCOME MEASURES: Awareness of donation and transplantation, acceptance of organ and tissue donation. RESULTS: 75% of respondents stated they had heard of organ or tissue donation, but only 55% were aware of organ and tissue transplantation taking place in Vietnam. Forty-eight percent of Buddhists and 27.5% of Christians had either no knowledge or incorrect knowledge about their religion's official position toward donation and transplantation. Sixty-four percent stated they would give consent for the donation of their decreased relative's tissues and organs, 66% would themselves become posthumous donors, and 21% to 22% would donate multiple organs and tissues. A significant association was found between respondents' acceptance of organ and tissue donation and their educational level, sex, occupation, and awareness of transplantation. Most respondents stated that their willingness to donate depended on whether other family members agreed. Many noted the importance of preventing commerce in organ and tissue transplantation but were in favor of providing healthcare for the donor's family or monetary incentives as a reward for donating. CONCLUSION: Nearly two thirds of urban Vietnamese surveyed were willing to donate organs or tissues after death. Their willingness was related to awareness of transplantation, sex, education level, and occupation.

Adult↗
PubMed1999

Apothecary.now.

The race is on to e-volutionize the nation's $100 billion prescription drug business à la Amazon.com. There's just one cyber-size glitch: Most doctors aren't set up for e-commerce, which means calling, faxing, or snail-mailing scripts to Internet pharmacies. E-volution? Maybe. Revolution? Hardly.

Clinical Pharmacy Information Systems↗
PubMed1999

Organophosphate-induced delayed neurotoxicity of triarylphosphates.

This paper reviews the characteristics of organophosphate-induced delayed neurotoxicity, its mechanism, lesions, species sensitivities and structure activity-relationships as they relate to the class of compounds known as triaryl phosphates. The triaryl phosphates have been widely used in commerce for over thirty years as flame retardants in fluids and plastics. Concern has been raised regarding their potential to cause organophosphate-induced delayed neurotoxicity (OPIDN), due to structural similarities to the potent neurotoxicant, tri-ortho cresyl phosphate (TOCP). Based on research on many pure isomers, Johnson (1975a, 1975b) found that certain structural features are required for a triaryl phosphate to react with the enzyme, neuropathy target enzyme (NTE), in a manner which induces OPIDN. Results of acute hen OPIDN studies, the experimental model of choice, support his findings as regards the structure-activity relationships for commercial triaryl phosphates. Thus, standard acute hen OPIDN studies on triphenyl phosphate and butylated triaryl phosphates fail to demonstrate a potential to elicit OPIDN by these products after a single dose. Studies on the mixed isopropyl phenyl phosphates indicate that, while some are neurotoxic, they are much less potent than tricresyl phosphate (TCP) and TOCP in the induction of OPIDN. Most commercial isopropylated triaryl phosphates lacked the potential to induce acute OPIDN using a limit dose of 2000 mg/kg. Although in early studies these compounds appeared to be neurotoxic, they were generally tested at excessively high doses, often exceeding 10,000 mg/kg in acute hen OPIDN studies. In contrast to the isopropylated and butylated triaryl phosphate products, TCP, and especially its ortho substituted isomer, TOCP, were found to be neurotoxic in both acute and subchronic hen OPIDN studies. Recent advances in the synthesis of commercial TCP products have resulted in products with reduced neurotoxic potential (McCormick et al, 1993). As an example, when 3% TCP in aviation oil was dosed acutely at 5000 mg/kg, or for 90 days at 1000 mg/kg/day, no delayed neurotoxicity was noted (Daughtrey et al., 1990, 1996). These data are indicative of the safety of these aviation lubricants at use levels currently employed.

Animals↗
PubMed1999

Determination of regulatory review period for purposes of patent extension; Therma Choice Uterine Ballon Therapy System. Food and Drug Administration, HHS. Notice.

The Food and Drug Administration (FDA) has determined the regulatory review period for Therma Choice5 Uterine Ballon Therapy System and is publishing this notice of that determination as required by law. FDA has made the determination because of the submission of an application to the Commissioner of Patents and Trademarks, Department of Commerce, for the extension of a patent which claims that medical device.

Catheter Ablation↗
PubMedDate not supplied

The current status of positron emission tomography.

Positron emission tomography (PET), invented over 25 years ago, is the only imaging technique that provides images of the biological basis of disease. Since disease is a biological process, PET routinely detects disease when other imaging studies, such as CT and MRI, are normal. In addition to its clinical effectiveness, PET has been shown to reduce costs, primarily due to the elimination of other less accurate diagnostic tests and ineffective surgeries. PET has been determined to be applicable to a number of specific applications in the areas of: imaging cancer patients, characterizing myocardial blood flow and viability, and brain imaging in various physiological and pathologic conditions. Tremendous progress has been made in resolving the regulatory and reimbursement issues facing the field of PET. Working with HCFA, representatives of the Institute for Clinical PET and the Society of Nuclear Medicine have brought about expanded HCFA coverage for PET. When HCFA first authorized payment for PET, all coverage decisions were restricted to HCFA and an expanded national coverage policy. HCFA revised its national coverage policy in 1997; this was the first of several steps taken by HCFA towards careful expansion of PET reimbursement. In March 1999, three new indications for whole-body PET scans were added to Medicare's coverage policy. The Institute for Clinical PET is continuing to work with HCFA on continued, appropriate expansion of the coverage policy. This article is partially excerpted from a written statement made by Terry Douglass, Ph.D., president of CTI, Inc., on May 12, 1999, before the Senate Committee on Commerce, Science and Transportation and its Subcommittee on Science, Technology and Space. This was part of the committee's study of "Emerging Technologies in the New Millennium."

Breast Neoplasms↗