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Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 991 records · Page 55Linked to original sources
PubMed2004

The pharmaceutical industry's responsibility for protecting human subjects of clinical trials in developing nations.

Pharmaceutical companies increasingly perform clinical trials in developing nations. Governments of host nations see the trials as a way to provide otherwise unaffordable medical care, while trial sponsors are drawn to those countries by lower costs, the prevalence of diseases rare in developed nations, and large numbers of impoverished patients. Local governments, however, fail to police trials, and the FDA does not monitor trials in foreign countries, resulting in the routine violation of international standards for the protection of human subjects. This Note proposes independent accreditation of those institutions involved in clinical trials--the institutional review boards which oversee trial protocol; the organizations, such as pharmaceutical companies, which sponsor the trials; and the research organizations that conduct the trials. Accreditation, similar to that used in the footwear and apparel industries, would increase the transparency of pharmaceutical trials and would enable the United States government and consumers to hold trial sponsors accountable for their actions.

Accreditation↗
PubMed1992

For the good of the child.

Legislative activities of the past 10 years have led many hospitals to develop grassroots advocacy programs that focus on specific issues. At Cardinal Glennon Children's Hospital, St. Louis, advocacy efforts involve employees, physicians, board members, and others. Situated near the Missouri-Illinois border, Cardinal Glennon serves patients from both states and deals with the legislatures and government agencies of each. Cardinal Glennon has formed alliances with children's hospitals in Missouri and in Illinois to lobby for fair funding from both states' Medicaid programs. Cardinal Glennon has formed a public policy committee that evaluates issues, sets priorities, and identifies trends. Hospital staff work with legislators from both states, inviting them for a first-hand look at children's needs. The hospital has also formed the Letter-Writing Advocacy Committee. Committee members write their representatives, stating their viewpoint on specific issues. Cardinal Glennon sponsors the Southern Illinois Perinatal Program. The hospital is also home to Missouri's regional poison control center, which in 1991 saved the state of Missouri $400,000 in Medicaid funds and saved private insurance carriers approximately $2.2 million. Cardinal Glennon's advocacy efforts extend beyond specific hospital programs, however, Hospital representatives often testify to legislative committees on more universal issues such as child abuse, lead poisoning, primary care needs, and trauma care.

Catholicism↗
PubMed2006

Private-sector research ethics: marketing or good conflicts management? The 2005 John J. Conley Lecture on Medical Ethics.

Pharmaceutical companies are major sponsors of biomedical research. Most scholars and policymakers focus their attention on government and academic oversight activities, however. In this article, I consider the role of pharmaceutical companies' internal ethics statements in guiding decisions about corporate research and development (R&D). I review materials from drug company websites and contributions from the business and medical ethics literature that address ethical responsibilities of businesses in general and pharmaceutical companies in particular. I discuss positive and negative uses of pharmaceutical companies' ethics materials and describe shortcomings in the companies' existing ethics programs. To guide employees and reassure outsiders, companies must add rigor, independence, and transparency to their R&D ethics programs.

Biomedical Research↗
PubMed1987

Sociocultural assumptions of federally sponsored Follow Through programs.

Time and money have been invested in the implementation and evaluation of the national Follow Through Project in the United States. Although the project has been successful in many respects and has generated a fairly extensive literature within psychology, education, and the other social sciences, relatively little theoretical attention has been directed toward sociocultural factors. The present article provides a critical retrospective analysis of the sociocultural assumptions, dynamics, and implications of Project Follow Through within a psychological framework.

Behavior Therapy↗
PubMed1979

A multi-program cost analysis and planning model for social service programs.

Social service administrators and planners in both the private and public sector are increasingly being held fiscally and programmatically accountable by both sponsors and consumers of services. This paper provides an examination of the trend toward program budgeting and its various techniques which can assist the administrator-planner in developing a more accountable program. A specific approach to cost analysis and planning for multi-program social service agencies is explored through its application in an actual agency setting. The model's application to other social service programs is also discussed.

Budgets↗
PubMed2000

Science or public relations? The inside story of the Asbestosis Research Council, 1957-1990.

In 1957, the leading British asbestos companies (Turner & Newall, Cape Asbestos, and British Belting & Asbestos) founded the Asbestosis Research Council (ARC). This was a response to rising asbestosis and asbestos cancer mortality in the UK and the attendant political and social problems that threatened the existence of the asbestos industry. An ARC research program was launched, that by the 1970s was mainly based within the Institute of Occupational Medicine at Edinburgh University. By the end of the 1980s, well over a hundred papers had been published with ARC support. The bulk of the work involved animal experiments and the chemical analysis of fibers, but the asbestos companies showed little enthusiasm for wider epidemiological studies or for exploring the cancer threat. The sponsoring companies dictated the ARC's research strategy and also vetted (and sometimes censored) publications; while using the ARC as a counterweight to government regulation and media attacks. The ARC's history highlights the compromises that were made by individual scientists and demonstrates the dilemmas inherent in industry-controlled research.

Asbestos↗
PubMed2004

The distributional consequences of a Medicare premium support proposal.

This article analyzes the distributional consequences of enacting a particular premium support proposal known as Breaux-Frist I. Under the proposal, the federal government would contribute a certain amount toward the purchase of Medicare coverage, based on the premiums charged by different health plans. Beneficiaries could choose something akin to the traditional fee-for-service option or a privately sponsored ealth plan such as a health maintenance organization. The article simulates the expected distributional impacts in three areas: among beneficiaries who choose to retain fee-for-service coverage, between different geographic areas, and according to various beneficiary characteristics. We find that the legislation would result in increased premiums for beneficiaries remaining in the Medicare fee-for-service program as a result of unfavorable selection; lead to a geographic redistribution in premium payments, with those living in areas with high levels of Medicare expenditures paying more; and a much lower financial burden than is the case now for near-poor beneficiaries who do not have full Medicaid coverage. Finally, the article discusses how these results compare to those that may occur under the premium support demonstration project, beginning in 2010, established under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.

Aged↗
PubMed1996

Medicare beneficiary counseling programs: what are they and do they work?

Medicare beneficiaries face myriad rules, conditions, and exceptions under the Medicare program. As a result, State Information, Counseling, and Assistance (ICA) programs were established or enhanced with Federal funding as part of the Omnibus Budget Reconciliation Act (OBRA) of 1990. ICA programs utilize a volunteer-based and locally-sponsored support system to deliver free and unbiased counseling on the Medicare program and related health insurance issues. This article discusses the effectiveness of the ICA model. Because the ICA programs serve as a vital link between HCFA and its beneficiaries, information about the programs' success may be useful to HCFA and other policymakers during this era of consumer information.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

Uneasy alliances: managed care plans formed by safety-net providers.

Health care providers that have traditionally served the poor are forming their own managed care plans, often in alliance with local safety-net peers. These alliances make it easier to raise needed capital, increase the pool of likely enrollees, and enable plans to benefit from efficiencies of scale. At the same time, however, the alliances often are undermined by conflicts of interest among the different sponsors and between the sponsors and the plan. This paper suggests that these plans are most likely to do well when the state makes special efforts to help and when plans have the leadership and financial reserves to take advantage of their supportive state policies.

Conflict of Interest↗
PubMedDate not supplied

Funding system incentives and the restructuring of health care.

The 1970s and 1980s were decades of rapid growth in health care services and expenditures in Canada. Numerous government sponsored reports laid our principles for restructured health services delivery. These principles included directions such as community orientation, continuity of care and health promotion. The principles were similar, and so were the results: throughout Canada there has been limited action on these principles.

Capitation Fee↗
PubMed1996

The community health center and family practice residency training.

Community health centers (CHCs), sponsored by US Public Health Service (USPHS) Section 330, represent successful models of the application of community-oriented primary care principles. Recently, increased interest has been shown in conducting medical education programs in CHCs. The USPHS has tried to facilitate this interest, particularly through its support of establishing linkages between CHCs and family practice residency programs. In this paper, we describe an integrated CHC-family practice residency continuity training clinic program. We discuss the challenges inherent to conducting family practice residency training in the CHC, including the educational content of clinical experiences, the impact of provider productivity expectations, the academic and operational governance of the program, and the financial considerations pertinent to the integrated function of the program. We conclude that while the clinical experiences available in the CHC differ somewhat from mainstream family practice, successful adaptations can be made, and a CHC offers a rich educational environment. We also conclude that the challenges inherent to integrated CHC-family practice residency programs can be successfully addressed. Of great concern, however, are financial considerations relevant to the operation of such integrated programs. These considerations underscore the urgent need for a reassessment of the funding of ambulatory clinical medical education.

Ambulatory Care↗
PubMed1989

A consumer-choice health plan for the 1990s. Universal health insurance in a system designed to promote quality and economy (1).

America's health care economy is a paradox of excess and deprivation. We spend more than 11 percent of the gross national product on health care, yet roughly 35 million Americans have no financial protection from medical expenses. To an increasing degree, the present financing system is inflationary, unfair, and wasteful. In its place we need a strategy that addresses the whole system, offers financial protection from health care expenses to all, and promotes the development of economical financing and delivery arrangements. Such a strategy must be designed to be broadly acceptable in our society. To remedy the deprivation, we propose that everyone not covered by Medicare, Medicaid, or some other public program be enabled to buy affordable coverage, either through their employers or through a "public sponsor." To attack the excess, we propose a strategy of managed competition in which collective agents, called sponsors, such as the Health Care Financing Administration and large employers, contract with competing health plans and manage a process of informed cost-conscious consumer choice that rewards providers who deliver high-quality care economically.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed2000

Agenda for women's health research. Improving women's musculoskeletal health.

Increased attention and resources focused on women's health during the past decade have resulted in new offices, policies, and programs of the Federal government. The Office of Research on Women's Health, established by the National Institutes of Health in 1990, is a focal point for all National Institutes of Health-supported efforts to improve women's health through biomedical and behavioral research. The Office of Research on Women's Health ensures women's appropriate inclusion in research studies supported by the National Institutes of Health. Through the development of a comprehensive agenda for research on women's health, the Office of Research on Women's Health encourages the consideration of gender issues and gender differences in health and disease in research sponsored by the National Institutes of Health. The importance of research to study and improve women's musculoskeletal health has become increasingly recognized. Clinicians, researchers, and representatives of professional and advocacy organizations concerned with women's musculoskeletal health participated in the development of the initial research agenda on women's health in 1991 and participated in the meetings to update and revise the agenda in 1996 and 1997. As a result of meetings convened to review and revise the agenda on women's health for the twenty-first century, many recommendations for additional research on women's musculoskeletal health have been developed and now are being implemented across the National Institutes of Health.

Female↗
PubMed2004

Sources of information about MDMA (3,4-methylenedioxymethamphetamine): perceived accuracy, importance, and implications for prevention among young adult users.

The goal of this cross-sectional study was to assess the perceived accuracy and the importance of various sources of information about MDMA/ecstasy among young adult users. A respondent driven sampling plan was used to recruit a community sample of recent ecstasy users (n = 304), aged 18-30, in Ohio, who responded to structured interviews. Friends, drug abuse treatment programs, and physicians were perceived to be the most accurate sources of information about ecstasy by 45.7, 37.2, and 30.3% of the sample, respectively. Friends were considered the most important source of information about ecstasy (40.2%), followed by web sites like DanceSafe (16.2%), and MTV/VH1 television specials (6.9%). About half the sample used the Internet to obtain information about ecstasy, with younger and more educated participants significantly more likely to do so. Educated users were also significantly more likely to consider the Internet to be an important source of information. Web sites like DanceSafe were visited by four times as many users as government-sponsored web sites. Findings support the development of peer-oriented, network strategies to reach ecstasy users with prevention messages. Efforts to make prevention web sites more attractive should be considered.

Adolescent↗
PubMed2005

Commentary: creating research capacity in complementary medicine.

A House of Lords Report recently recommended the creation of 'centres of excellence' for research into complementary medicine. The UK government decided not to follow this advice but to sponsor nine research fellowships each supervising a PhD student. An analysis of past researchers at the unit in Exeter suggest that 'centres of excellence' are an effective means of generating research capacity in this area. It is suggested that this approach is likely to be more productive than the present governmental strategy.

Complementary Therapies↗
PubMedDate not supplied

Perceptions of population policy, development, and family planning programs in northern Nigeria.

In this article, local perceptions of family planning programs and federal population policy are examined, based on responses to a childbirth survey and on interviews with a range of individuals in one northern Nigerian town. The respondents' differing perceptions of the relationship between population and national development reflect distinctive ideas about political authority, population policy, and family planning programs, about development, and about domestic and international political affairs. Local suspicions about the Nigerian population policy and family planning programs suggest that they cannot be implemented in isolation from broader political and economic concerns. This distrust has ramifications for current family planning programs and reproductive health initiatives undertaken by Western-sponsored aid projects.

Adolescent↗
PubMed2004

A marketing solution: managed care woes?

Two interrelated problems are included among the causes of managed care woes: the dramatic increase in unhealthy lifestyles together with the results these have had on health services utilization and expenditures; and the dramatic increase in consumer demand for "lifestyle" or quality of life (QoL) enhancing products and services. Together these are helping to drive managed care toward a crisis, in both commercial and government-sponsored insurance survival prospects. Aside from the frequently mentioned problem of our aging population and the shifting balance between the number of healthy young workers paying in, vs. unhealthy or older workers spending out, these problems greatly exacerbate the double-digit inflation that has become a recurring characteristic of health insurance premiums, and threaten the very existence of managed care.

Health Behavior↗