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Virtual private networks can provide reliable IT connections.

A VPN is a private network that uses a public network, such as the Internet, to connect remote sites and users together. Instead of using a dedicated hard-wired connection as in a trusted connection or leased lines, a VPN uses a virtual connection routed through the Internet from the organization's private network to the remote site or employee. Typical VPN services allow for security in terms of data encryption as well as means to authenticate, authorize, and account for all the traffic. VPN services allow the organization to use whatever network operating system they wish as it also encapsulate your data into the protocols needed to transport data across public lines. The intention of this IT World article was to give the reader an introduction to VPNs. Keep in mind that there are no standard models for a VPN. You're likely to come across many vendors presenting the virtues of their VPN applications and devices when you Google "VPN." However the general uses, concepts, and principles outlined here should give you a fighting chance to read through the marketing language in the online ads and "white papers."

Biotechnology↗

Prevalence of Mycobacterium bovis infection in cervids on privately owned ranches.

OBJECTIVE: To determine prevalence of tuberculosis caused by infection with Mycobacterium bovis in cervids on privately owned ranches in northeastern lower Michigan. DESIGN: Epidemiologic survey. ANIMALS: Cervids on 96 privately owned ranches. PROCEDURES: A combination of slaughter and skin tuberculin testing was used to collect data. Infection with M. bovis was confirmed by use of standard necropsy and bacteriologic culture techniques. RESULTS: Cervids with tuberculosis were detected on 1 of the 96 ranches. The apparent prevalence of tuberculosis in cervids from the 96 ranches was 1.1 cases/100 cervids (21 cases/1,867 cervids tested). For the ranch with infected cervids, prevalence of infection with M. bovis was 12.1 cases/100 cervids (21 cases/174 cervids tested). No obvious gross lesions were seen in 8 of 21 white-tailed deer and 1 coyote with culture-confirmed M. bovis infection. CONCLUSIONS AND CLINICAL RELEVANCE: The lack of visible lesions in a substantial proportion of infected animals should be taken into consideration in studies involving detection and prevalence of tuberculosis.

Animals↗

Comparison of demands of sustained attentional events between public and private children's television programs.

The durations and variability of changing events were analyzed for 20 min. each of 13 children's television programs. These programs included selections from both publically and privately produced shows. Significantly different patterns of attentional demands were found between the programs. Public television programming is characterized by longer and more variable durations of sustained attentional events, while private television programming is best described as having fast-paced shorter events. The implications of this finding for difficulties in learning by school-age children to attend for longer periods are discussed.

Attention↗

Why patients choose to purchase a hearing aid privately.

A questionnaire survey was undertaken of patients who had recently purchased a private hearing aid. They were asked their reasons for choosing a private aid in preference to an NHS aid. Cosmetic considerations and the failings of Health Service provisions were the most commonly cited reasons.

Aged↗

Drug use among public and private secondary school students in Puerto Rico.

This paper reports results of the first wave of a two-wave panel survey carried out on a representative sample of Puerto Rican public and private secondary school students in the 1974--1975 academic year. Twelve percent of the students reported the use of one or more illicit drugs. The illicit drug most frequently used was marijuana. A greater proportion of adolescents have used alcohol and tobacco than any of the illegal drugs. Private school students of both sexes reported more use of illicit and licit drugs than their public school peers, suggesting that socio-economic factors may be influencing Puerto Rican adolescent drug behavior. Differences between Puerto Rican adolescents vary significantly depending on sex and suggest that Puerto Rican sociocultural conditions may have an important effect upon male-female drug use patterns. One of the most significant findings of the study is the high frequency of drug use among Puerto Rican adolescents who ever lived in other countries.

Adolescent↗

Quantification of repertoire diversity of influenza-specific epitopes with predominant public or private TCR usage.

The H-2Db-restricted CD8 T cell immune response to influenza A is directed at two well-described epitopes, nucleoprotein 366 (NP366) and acid polymerase 224 (PA224). The responses to the two epitopes are very different. The epitope NP366-specific response is dominated by TCR clonotypes that are public (shared by most mice), whereas the epitope PA224-specific response is private (unique within each infected animal). In addition to being public, the NP366-specific response is dominated by a few clonotypes, when T cell clonotypes expressing the Vbeta8.3 element are analyzed. Herein, we show that this response is similarly public when the NP366+Vbeta4+ CD8 T cell response is analyzed. Furthermore, to determine whether these features resulted in differences in total TCR diversity in the NP366+ and PA224+ responses, we quantified the number of different CD8 T clonotypes responding to each epitope. We calculated that 50-550 clonotypes recognized each epitope in individual mice. Thus, although the character of the response to the two epitopes appeared to be different (private and diverse vs public and dominated by a few clonotypes), similar numbers of precursor cells responded to both epitopes and this number was of similar magnitude to that previously reported for other viral CD8 T cell epitopes. Therefore, even in CD8 T cell responses that appear to be oligoclonotypic, the total response is highly diverse.

Animals↗

A survey of survivors of acute stroke discharged from hospital to private nursing homes in Nottingham.

Increasing numbers of disabled elderly stroke survivors are being discharged from hospital to Private Nursing Homes. However, there is little data available on which specific guidelines for the care of stroke patients in these homes can be based. A survey was undertaken therefore, to review patients on their discharge from hospital to Private Nursing Homes, and to assess the severity of their disability and handicap before and after entering the home. Nearly all patients were severely disabled on discharge from hospital, and the Barthel Activities of Daily Living scores of the survivors showed no significant change after four months. High levels of emotional distress and loneliness were identified by the Nottingham Health Profile, with little change after four months of nursing home care. The National Health Service has a continuing responsibility for the welfare of such vulnerable elderly people. The findings of this survey indicate that the emphasis of their care should be on the management of severe physical disability, exploitation of opportunities for further rehabilitation, alleviation of emotional distress and loneliness and, where appropriate, the provision of humane terminal care.

Activities of Daily Living↗

Whither private health insurance? Self-destruction or rebirth?

The American public increasingly finds itself disenchanted with the system for health care financing in this country. Three forms of reform proposal are examined: those that place the locus of primary responsibility for health insurance coverage on the individual, those that would rely on employer mandates with patients and government bearing the residual responsibility, and those that lodge chief financial responsibility with the government, and act as primary agent for cost control. The second approach, government-mandated employer-provided health insurance, appears to be the most politically viable at this time. However, that option is likely to be acceptable to the business community only if the mandate is coupled with additional regulation of private health insurance. Specifically, private health insurance in such a system likely would be based on mandatory open enrollment, community-rated premiums, and all-payer reimbursement, under which every payer pays a given provider the same fee for the same service.

Consumer Behavior↗

Competing for private patient revenue.

The opportunity to maximise revenue from private patients is now available to NHS hospitals. A survey of UGMs found that most felt they could compete with private hospitals but identified a number of obstacles. David Jones analyses the survey.

Attitude of Health Personnel↗

The NAPPH (National Association of Private Psychiatric Hospitals) today--under new management. Interview by John Herrmann.

When Robert L. Trachtenberg took over the executive directorship of the National Association of Private Psychiatric Hospitals some five months ago, he walked into a situation wherein several psychiatric specialty hospitals in Texas were under fire. "There were a lot of questions," Trachtenberg says, "and challenges to the credibility of psychiatric hospitals." He was referring to the Texas state investigation into abuses by personnel within psychiatric hospitals. Last year, the Texas Senate Interim Committee on Health and Human Services conducted an eight-month investigation into the conduct of the state's psychiatric hospitals after a newspaper article recounted the unconventional way in which a 14-year old boy was picked up and admitted to a psychiatric facility. After a number of public hearings, three private agencies overseeing Texas psychiatric hospitals adopted rules to prevent further problems in the areas of patient rights, fraudulent billing, patient recruitment and the admission and discharge process. The Senate Interim Committee, however, felt these rules needed to be codified into law and has drafted over 30 bills to be presented to the Texas legislature as omnibus legislation next January. Trachtenberg went to work to iron out methods to encourage better overseeing and state governance, as well as tackling the related issues of standards of care and managed care/utilization review. His background as Deputy Administrator of the Alcohol, Drug Abuse and Mental Health Administration within HHS provided him with a broad spectrum of knowledge about the field of psychiatry and its problems, and his vast experience in federal government--over 32 years of running domestic programs--enable him to have a keen sense of what can get done, and how. Health Systems REVIEW recently discussed the role of the NAPPH under its new leader, Bob Trachtenberg. What follows is an edited version of that conversation.

Hospitals, Psychiatric↗

Marketing wellness for private practice. Carolina Heart, Greenville, NC.

"Wellness," the marketing mantra of the '90s among managed care organizations and large hospitals, might well be expanded to private practices as well. Carolina Heart, a private cardiology practice in Greenville, N.C., is now the area resource for heart disease prevention.

Behavior Therapy↗

Medicare private contracting: increasing patient choice and access?

Congress modified the Medicare program through the Balanced Budget Act of 1997 to expand patient choices for payment to physicians and certain other practitioners by allowing private contracting. This represents a shift in policy that has broad consequences for health care financing and program integrity. The effect of private contracting on quality and access to care remains unknown. Quality and access should be the most important measures of its success or failure. Out of pocket costs to seniors and vulnerable patients must also be watched closely.

Aged↗

Private pension plans, 1950-74.

During the past quarter century, private pension plans have enjoyed a healthy growth. Although the rate of growth has slackened somewhat during recent years, the private pension movement is now a major contributor to the income maintenance needs of the American worker during retirement. The passage of pension reform legislation in 1974 offers an appropriate milestone year for measuring the current status of pension plans and the progress that has been made to date.

Costs and Cost Analysis↗

Ageing Britain: private lives . . .

Author looks at the increased use of private residential accomodation by local authorities and focuses on the inadequacy of statutory controls on private homes.

Aged↗

A comparison of organisational climates of public and private hospitals abroad.

Are organisational climates in private hospitals compared to public hospitals, more favourable? To assess the differences, motivational orientations, perceived satisfaction with intrinsic aspects of the job, professional commitment orientations and perceived organisational climates by the medical professionals, senior administrative and professional nursing personnel are compared. All the groups in the public hospital tended to be higher in motivational orientations. On the other hand, all the groups in private hospital showed higher satisfaction with intrinsic aspects of the job, professional commitment orientations, and perceived favourableness of the organisational climate. The differences were found to be not significant.

Hospital Administration↗

Private Land Mobile Radio Services; amendment of the commission's rules concerning mobile station, control point and control system authorization procedures for common user systems for a certain MHz frequency--Federal Communications Commission. Final rule.

The Commission is amending its rules and regulations in Part 90--Private Land Mobile Radio Service, by adopting a new temporary licensing procedure for special mobile radio systems (SMRS's) and multiple licensed mobile relay stations operating in the 806-821 and the 851-866 megahertz (MHz) bands. This new system of licensing will benefit radio users by enabling them to begin operations more quickly than in the past, and will not in any way lessen the ability of the Commission to determine whether an applicant is eligible and otherwise possesses the necessary qualifications to be permanently licensed to operate in these bands. This new system is a part of the Commission's on-going program for reviewing its rules and regulations and eliminating unnecessary burdens on licensees to facilitate the administration of the Private Land Mobile Radio Service.

Licensure↗

Interconnection of private land mobile radio systems with the public switched telephone network in certain MHz bands--Federal Communications Commission. Final rule.

This document adopts new rules to enable private radio communication systems licensed under Part 90 in the 800 MHz bands to interconnect with the facilities of the public switched telephone network. These rules are necessary to enable private licensees to better utilize their radio systems by allowing interconnected operation under certain conditions. An accompanying petition for rulemaking is dismissed as moot.

Radio↗

Treating the aged: how the public system affects the private system.

The elderly are an increasingly numerous group within the population. They have a high incidence of treatable psychiatric conditions, yet are psychiatrically underserved. This article reviews the experiences of the Douglas Gardens Community Mental Health Center of Miami Beach in treating older individuals living in the community. Over 12 percent of these patients needed psychiatric hospitalization in 1982 in private community facilities. Information about these patients and comparative data from a typical inpatient facility are described. A new trend seems to be emerging which will move the public sector further away from the treatment of the elderly. An opportunity for the private sector is, therefore, developing.

Aged↗