In its role of think tank and within the framework of the “Assises du Médicament”, the LIR considered useful to make realize by the researchers of the ESSEC an international study on the policies of management of conflicts of interests.
Four reglementations were studied : United States, Great Britain, Germany and Sweden.
Charcot Marie tooth disease is one of the hereditary motor and sensory neuropathies, a group of varied inherited disorders of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body.
The Hospitals and Outpatient Care Centers Market Analytics Report (http://bit.ly/2a34J1U) provides strategists, marketers and senior management with the critical information they need to assess the global hospitals and outpatient care centers and compare it with other markets and across geographies.
Buy Now
Hospitals and Outpatient Care Centers Global Market Analytics Report is a detailed report giving a unique insight into this market. The report is priced at $2000 for an individual user. To use across your office the price is $3000 and $4000 if you wish to use across a multinational company.
Clients are able to input on the design of the report and highlight points of special interest.
This paper revisits the relationship between health and growth in light of modern endogenous growth theory. We propose an unified framework that encompasses the growth effects of both, the accumulation and the level of health. Based on cross-country regressions where we instrument for both variables, we find that a higher initial level and a higher rate of improvement in life expectancy, both have a significantly positive impact on per capita GDP growth.
Travaux LIR-BIPE présentés à la Presse le 24 septembre 2009 sur
Le Marché du Médicament remboursable (S1-2009) et la Consommation de médicaments en France
Charcot Marie tooth disease is one of the hereditary motor and sensory neuropathies, a group of varied inherited disorders of the peripheral nervous system characterized by progressive loss of muscle tissue and touch sensation across various parts of the body.
The Hospitals and Outpatient Care Centers Market Analytics Report (http://bit.ly/2a34J1U) provides strategists, marketers and senior management with the critical information they need to assess the global hospitals and outpatient care centers and compare it with other markets and across geographies.
Buy Now
Hospitals and Outpatient Care Centers Global Market Analytics Report is a detailed report giving a unique insight into this market. The report is priced at $2000 for an individual user. To use across your office the price is $3000 and $4000 if you wish to use across a multinational company.
Clients are able to input on the design of the report and highlight points of special interest.
This paper revisits the relationship between health and growth in light of modern endogenous growth theory. We propose an unified framework that encompasses the growth effects of both, the accumulation and the level of health. Based on cross-country regressions where we instrument for both variables, we find that a higher initial level and a higher rate of improvement in life expectancy, both have a significantly positive impact on per capita GDP growth.
Travaux LIR-BIPE présentés à la Presse le 24 septembre 2009 sur
Le Marché du Médicament remboursable (S1-2009) et la Consommation de médicaments en France
Impact sur la_longevite_et_croissance_economiqueAssociation LIR
Les déficits cumulés de notre système d’assurance maladie, le vieillissement de notre population, l’augmentation de son espérance de vie, et l’augmentation des coûts associés à l’apparition de nouveaux équipements, posent avec acuité le problème du financement des dépenses de santé.
Si différentes réformes ont été introduites au cours des dernières années pour stabiliser nos dépenses de santé, les effets potentiels sur le secteur de la santé, l’innovation dans les industries et la croissance, ont trop rarement fait l’objet d’analyses approfondies.
Maladie d’Alzheimer, accident vasculaire cérébral, arthrose... Autant de pathologies que chacun d’entre nous connaît, parce qu’elles peuvent toucher une relation, un ami, un parent. Toutefois, la perception qu’on peut en avoir lorsqu’un de nos proches est affecté est largement indépendante du poids de la maladie dans la population générale même si elle est bien évidemment liée aux modalités actuelles de prise en charge.
Capitaliser sur les résultats de l’Enquête 2008
Attractivité de la France au sein de la Recherche Clinique Internationale conduite par le Leem pour conduire une analyse comparative
entre les données des adhérents du LIR
et celles de l’ensemble des participants de l’Industrie
Foi lançado no dia 20/04/2012 o edital para o concurso do TCE-RJ 2012.
Veja, baixe, leia e estude com as vídeo-aulas do Concurso Virtual.
Acesse: www.concursovirtual.com.br
Legal and Ethical Issues Related to Psychiatric EmergenciesT.docxLaticiaGrissomzz
Legal and Ethical Issues Related to Psychiatric Emergencies
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.
To Prepare
· Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
The Assignment
In 2–3 pages, address the following:
· Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
· Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
· Explain the difference between capacity and competency in mental health contexts.
· Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
· Identify one evidence-based suicide risk assessment that you could use to screen patients.
· Identify one evidence-based violence risk assessment that you could use to screen patients.
Attach copies of or links to the suicide and violence risk assessments you selected.
NOTE: MY STATE IS ILLINOIS
2
Final Project : Policy Research and Organizational Analysis Report
Precious Teasley
Southern New Hampshire University
IHP-620-Q1591 Economic Principles- healthcare 22TW1
Dr. Scott
October 20, 2022
Introduction
The purpose of this report is to focus on economic principles and how they apply to the field of healthcare. Healthcare facilities need to make economic decisions because they need financial resources to run. They need economic consultants that will help in making strategic economic decisions that will guide healthcare facilities on where and how to spend their money (Hicks, 2020). This ensures that they are wise in their undertakings. This report focuses on Jackson Memorial Hospital, a facility that has more than 1,500 li.
Chapter 4Determinants of the Utilization of Health Car.docxketurahhazelhurst
Chapter 4
Determinants of the
Utilization of Health Care Services
*
LEARNING OBJECTIVES
What are the main factors driving people to seek health care?
How are people influenced by their personal characteristics (such as age, gender, race, income and education) in seeking health care?
What are the main factors and forces that reduce the demand for health care?
What are the main factors that tend to increase the demand for health care?
How do health care coverage and incidence vary geographically?
LO1. What are the main factors driving people to seek health care?Known illness, accident, or injurySymptomsPrevention/check-upSecond opinionLegalAdministrativeDiscretionary
*
Key Words:
LO1. What are the main factors driving people to seek health care? (cont)It is important to identify what type of services is involvedthe reason the patient is seeking carethe relevant stakeholders for the encounterthe personal characteristics that influence the likelihood that an individual will seek care
*
Key Words:
LO2. How are people influenced by their personal characteristics (such as age, gender, race, income and education) in seeking health care?
AgeFirst two years of lifeWomen of childbearing yearsElderlyGenderWomen more than men
*
Key Words:
LO2. How are people influenced by their personal characteristics (such as age, gender, race, income and education) in seeking health care? (cont)
RaceDifficult category to defineDifferences can often be explained by basis of socioeconomic or education differencesCannot assume uniformity within any racial or ethnic groupIncome - helps determine which services are usedEducation - varied
*
Key Words: culture
LO3. What are the main factors and forces that reduce the demand for health care?
Consumer factorsDriven by insurance payers, medical groups, and pharmaceutical benefits management companiesIncrease out-of-pocket expensesDisease preventionElimination or reduction of risky behaviorsSelf-management and educationEnd-of-life issuesPromotion of healthier lifestyle
*
Key Words: consumer-driven healthcare, social marketing, rationing, futility
LO4. What are the main factors that tend to increase the demand for health care?
Provider factorsDriven by profit(?), environmental and cultural events Ways to limit costsDecreasing feesIncreasing or decreasing the number of providersChanging the payment methodReviewing utilization more carefullyImplementing practice guidelines
*
Key Words: provider-induced demand (PID)
LO5. How do health care coverage and incidence vary geographically?
Extreme variations in patterns of careNot related to variation in illness patternsCan be related to Differences in health care systemsDifferences in physicians’ practice stylesPhysicians’ own beliefs about effectiveness of careMedical trainingBeliefs in own abilityDifferences in patient characteristics
*
Key Words:
CONCLUSION
Key factors affect people’s decision to seek health care.Demand is reduced by s ...
Code of ethics and legal practices has been very old element in the professional management of the doctor’s behaviour. The ethical practices or code shows a commitment to act with honesty in extreme situations. At the time patients seek medical treatment they are not just entering a normal social relationship, they often feel vulnerable but required to share and expose important aspects of their lives. Codes of ethical conducts provide some tangible safety to both doctors and patients in such circumstances. In the below report, the researcher is explaining ethical, legal and
professional guidelines and principles for health care as well as its implications in the healthcare sector of the United Kingdom. After reading this report, the reader would be able to understand how healthcare adopts ethical practices at the workplace and ensures protection of patients in their medical treatment.
Getting the deal through life sciences russia 2015Lidings Law Firm
Produced annually by UK publishers Law Business Research Ltd., this 2015 edition of Getting the Deal Through: Life Sciences has been fully revised and updated to cover the key issues of current applicable regulation, including full analysis of important aspects of cross-border transactions and international law. With contributions from leading practitioners active in 26 jurisdictions worldwide, Lidings’ attorneys have authored exclusive coverage of Russian regulation of the life sciences sector, including those issues of most direct relevance to the firm’s major pharmaceutical clients.
Impact sur la_longevite_et_croissance_economiqueAssociation LIR
Les déficits cumulés de notre système d’assurance maladie, le vieillissement de notre population, l’augmentation de son espérance de vie, et l’augmentation des coûts associés à l’apparition de nouveaux équipements, posent avec acuité le problème du financement des dépenses de santé.
Si différentes réformes ont été introduites au cours des dernières années pour stabiliser nos dépenses de santé, les effets potentiels sur le secteur de la santé, l’innovation dans les industries et la croissance, ont trop rarement fait l’objet d’analyses approfondies.
Maladie d’Alzheimer, accident vasculaire cérébral, arthrose... Autant de pathologies que chacun d’entre nous connaît, parce qu’elles peuvent toucher une relation, un ami, un parent. Toutefois, la perception qu’on peut en avoir lorsqu’un de nos proches est affecté est largement indépendante du poids de la maladie dans la population générale même si elle est bien évidemment liée aux modalités actuelles de prise en charge.
Capitaliser sur les résultats de l’Enquête 2008
Attractivité de la France au sein de la Recherche Clinique Internationale conduite par le Leem pour conduire une analyse comparative
entre les données des adhérents du LIR
et celles de l’ensemble des participants de l’Industrie
Foi lançado no dia 20/04/2012 o edital para o concurso do TCE-RJ 2012.
Veja, baixe, leia e estude com as vídeo-aulas do Concurso Virtual.
Acesse: www.concursovirtual.com.br
Legal and Ethical Issues Related to Psychiatric EmergenciesT.docxLaticiaGrissomzz
Legal and Ethical Issues Related to Psychiatric Emergencies
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.
To Prepare
· Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
The Assignment
In 2–3 pages, address the following:
· Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
· Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
· Explain the difference between capacity and competency in mental health contexts.
· Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
· Identify one evidence-based suicide risk assessment that you could use to screen patients.
· Identify one evidence-based violence risk assessment that you could use to screen patients.
Attach copies of or links to the suicide and violence risk assessments you selected.
NOTE: MY STATE IS ILLINOIS
2
Final Project : Policy Research and Organizational Analysis Report
Precious Teasley
Southern New Hampshire University
IHP-620-Q1591 Economic Principles- healthcare 22TW1
Dr. Scott
October 20, 2022
Introduction
The purpose of this report is to focus on economic principles and how they apply to the field of healthcare. Healthcare facilities need to make economic decisions because they need financial resources to run. They need economic consultants that will help in making strategic economic decisions that will guide healthcare facilities on where and how to spend their money (Hicks, 2020). This ensures that they are wise in their undertakings. This report focuses on Jackson Memorial Hospital, a facility that has more than 1,500 li.
Chapter 4Determinants of the Utilization of Health Car.docxketurahhazelhurst
Chapter 4
Determinants of the
Utilization of Health Care Services
*
LEARNING OBJECTIVES
What are the main factors driving people to seek health care?
How are people influenced by their personal characteristics (such as age, gender, race, income and education) in seeking health care?
What are the main factors and forces that reduce the demand for health care?
What are the main factors that tend to increase the demand for health care?
How do health care coverage and incidence vary geographically?
LO1. What are the main factors driving people to seek health care?Known illness, accident, or injurySymptomsPrevention/check-upSecond opinionLegalAdministrativeDiscretionary
*
Key Words:
LO1. What are the main factors driving people to seek health care? (cont)It is important to identify what type of services is involvedthe reason the patient is seeking carethe relevant stakeholders for the encounterthe personal characteristics that influence the likelihood that an individual will seek care
*
Key Words:
LO2. How are people influenced by their personal characteristics (such as age, gender, race, income and education) in seeking health care?
AgeFirst two years of lifeWomen of childbearing yearsElderlyGenderWomen more than men
*
Key Words:
LO2. How are people influenced by their personal characteristics (such as age, gender, race, income and education) in seeking health care? (cont)
RaceDifficult category to defineDifferences can often be explained by basis of socioeconomic or education differencesCannot assume uniformity within any racial or ethnic groupIncome - helps determine which services are usedEducation - varied
*
Key Words: culture
LO3. What are the main factors and forces that reduce the demand for health care?
Consumer factorsDriven by insurance payers, medical groups, and pharmaceutical benefits management companiesIncrease out-of-pocket expensesDisease preventionElimination or reduction of risky behaviorsSelf-management and educationEnd-of-life issuesPromotion of healthier lifestyle
*
Key Words: consumer-driven healthcare, social marketing, rationing, futility
LO4. What are the main factors that tend to increase the demand for health care?
Provider factorsDriven by profit(?), environmental and cultural events Ways to limit costsDecreasing feesIncreasing or decreasing the number of providersChanging the payment methodReviewing utilization more carefullyImplementing practice guidelines
*
Key Words: provider-induced demand (PID)
LO5. How do health care coverage and incidence vary geographically?
Extreme variations in patterns of careNot related to variation in illness patternsCan be related to Differences in health care systemsDifferences in physicians’ practice stylesPhysicians’ own beliefs about effectiveness of careMedical trainingBeliefs in own abilityDifferences in patient characteristics
*
Key Words:
CONCLUSION
Key factors affect people’s decision to seek health care.Demand is reduced by s ...
Code of ethics and legal practices has been very old element in the professional management of the doctor’s behaviour. The ethical practices or code shows a commitment to act with honesty in extreme situations. At the time patients seek medical treatment they are not just entering a normal social relationship, they often feel vulnerable but required to share and expose important aspects of their lives. Codes of ethical conducts provide some tangible safety to both doctors and patients in such circumstances. In the below report, the researcher is explaining ethical, legal and
professional guidelines and principles for health care as well as its implications in the healthcare sector of the United Kingdom. After reading this report, the reader would be able to understand how healthcare adopts ethical practices at the workplace and ensures protection of patients in their medical treatment.
Getting the deal through life sciences russia 2015Lidings Law Firm
Produced annually by UK publishers Law Business Research Ltd., this 2015 edition of Getting the Deal Through: Life Sciences has been fully revised and updated to cover the key issues of current applicable regulation, including full analysis of important aspects of cross-border transactions and international law. With contributions from leading practitioners active in 26 jurisdictions worldwide, Lidings’ attorneys have authored exclusive coverage of Russian regulation of the life sciences sector, including those issues of most direct relevance to the firm’s major pharmaceutical clients.
Auditing Healthcare Focus Arrangements for Regulatory CompliancePYA, P.C.
PYA Principal Tynan Kugler and Consulting Manager Susan Thomas presented “Auditing Healthcare Focus Arrangements for Regulatory Compliance: Physicians, Management Services, Post-Discharge Care, Ambulance Services, and Specialty Care.” Their presentation:
- Describes what constitutes a focus arrangement for healthcare organizations.
- Explains the implications of Stark Law and Anti-Kickback violations, along with Corporate Integrity Agreement focus arrangement requirements.
- Discusses essential focus arrangement procedures to facilitate regulatory compliance.
- Provides an example design of an audit plan approach for focus arrangements.
Pat 1Choose one of the following practices and either support .docxherbertwilson5999
Pat 1
Choose one of the following practices and either support or challenge its objective based on your professional experience or experiences learned throughout your graduate program studies.
1.
· Rolling planning and budget cycles
· An enterprise architecture
· Different funding buckets
· Relationship managers
· A prioritization rubric
One file
Part 2
Write a six to eight (6-8) page paper in which you:
1. Propose the rights you would like your shareholders to have.
2. Compare the costs and benefits that apply to your company specifically to make the decision of whether or not to “go public”.
3. Discuss the principle issues associated with conflict of interest and transactions in shares that you may run in to.
4. Explain the tactics that your corporate management will use to defend against takeovers.
5. Use at least three (3) quality academic resources in this assignment. Note: Wikipedia and other Websites do not qualify as academic resources
Both is separate files
FINANCIAL ENVIRONMENTS WORKSHEET.
Financial Environments Worksheet
For-Profit Organizations
Not-for-Profit Organizations
Government Organizations
Specific Examples
1. Mt. Sinai Medical Center- Miami Beach Florida.
2. Cleveland Clinic Hospital-Weston, Florida.
3. Edward White Skilled Nursing Unit-St. Petersburg, Florida.
1. St. Anthony’s Hospital- St. Petersburg, Florida.
2. Regents Park Sunrise-Sunrise, Florida.(Nursing Home)
3. Mercy Hospital, Inc.-Miami
1. Alexander Sander Nininger State Veterans’ Nursing Home-Pembroke Pines, Florida
2. Jackson memorial –Miami, Florida.
3. Brown ward General Hospital-Ft. Lauderdale Florida.
Similarities between Environments
· All of them follow the same health regulations as set by the health governing body and other relevant authorities.
· All these entities must follow ethical regulation in their duty of delivering their services
· All these entities must recruit employees with the same training which help them provide their services to their esteemed customers. (Horwitz, 2012).
· The activities of governments and not for profit entities are governed by their budgets and not by the market since they cannot deliver their services beyond their budgets.
· Whether it is nonprofit, for- profit or government health facilities, they offer community benefits services. For example, parenting education, health education, stop smoking programs etcetera.
· Nonprofit and government environment works solely for the public interest. (Nursing Home Rank, 2012).
Differences between Environments
1. They are owned by private investors or people with private equity interest who provide services with a sole purpose of making profits
2. They have an obligation of paying taxes to IRS
3. They trying making money for their investors by making the hospitals feel and look more comfortable. They even pay their staff more than in not- for- profit and government entities.
1. The entities in this category have no ownership interests. .
stress management - kims hospital mba project report Srikanth V
Stress management can be defined as interventions designed to reduce the impact of stressors in the workplace. These can have an individual focus, aimed at increasing an individual’s ability to cope with stressors. The goal of Stress Management is to manage the stress of everyday life among employees. Many different methods may be employed, such as bio-feedback, meditation and massage. Counselors work with individuals in order to determine what stress management program will work best for that person.
Work plays a critical role in the lives of individuals which has contributed to the phenomenon of stress for both individual employees and the organizations. Stress, at work, is one of the threats in providing a healthy platform of work to employees. The stress induced due to roles performed by individuals as employees at workplace, has been one of the most persuasive organizational stressors, the outcomes of which have been found to be costly to the organization. The previous studies in this area of research indicate that the role stress as a phenomenon has hardly been understood in its entirety and comprehensively in case of commercial banks particularly in the Indian context. The highly competitive banking industry has levied varied role requirements on employees resulting into stress.
Stress is something that happens in our daily lives and is usually associated with a particular event such as work, family or other responsibilities. There are many situations that we cannot control, but there are ways to control how we deal with certain situations. Effective stress management is something that our lives can go a little more smoothly. Stress management is as simple as taking a walk. It was been proven that physical activities would improve a person’s mental health, help with depression, and relieve the side effects of stress. This makes a person’s heart rate increase and will be more likely to be affected by stress. It is vital that stress management techniques are implemented into our daily lives. Coping with stress is an individualized task and one method over another may not be superior. A person that is stressed takes so much away from his or her health and performance levels.
1. IntroductionImpact Analysis1.1 What is the change impact a.docxjackiewalcutt
1. Introduction
Impact Analysis
1.1 What is the change impact analysis?
1.2 Why to perform change impact analysis? (benefits, application)
1.3 Risk/Challenges of Change impact analysis
2. Classification of the change impact analysis
2.1 ………………………………
2.2 ……………………………..
2.3 ……………………………..
3. Change impact analysis techniques
3.1…………………..
3.2…………………
3.3…………….
4. Literature Review
5. Conclusion
6. Bibliography
7. Impact analysis tools
If you have any point to add then let me know so, I can search on that point as well.
Running head: EXAMINING THE FINANCIAL CHARACTERISTICS OF HEALTH CARE DELIVERY ALONG WITH MANAGING COSTS, REVENUES, AND HUMAN RESOURCES.
1
5
EXAMINING THE FINANCIAL CHARACTERISTICS OF HEALTH CARE DELIVERY ALONG WITH MANAGING COSTS, REVENUES, AND HUMAN RESOURCES
Examining the Financial Characteristics of Health Care Delivery Along with Managing Costs, Revenues, and Human Resources
Carolyn Y. Finley
HCA 340
Instructor: Elaine Testerman
OUTLINE Comment by Elaine Testerman: The outline looks very good, check the few details I pointed out, then you are ready to start the week five work.
I. Introduction
The procurement of health care services is of incredible consideration toward individuals everywhere throughout the world. Various parts are interfaced together with a specific end goal to make a medicinal services conveyance framework compelling. The paper will depict in detail the monetary components of a human services conveyance. Notwithstanding this, the paper will likewise address the issue of incomes, expense and human assets with respect to the health care delivery.
II. Thesis Statement
"An efficient human resource service alongside proper harmony between the expense and income assumes an exceptionally successful part in the procurement of value of the provision of quality health care services."
The thesis is focused around the research with respect to the monetary parts of health awareness services. The paper is focused around the part of the components expressed in the proposition explanation with a specific end goal to guarantee the nature of medicinal services conveyance to the overall population everywhere throughout the world. It is proven from exploration that these components decidedly help towards the effectiveness of the general framework. A nation can upgrade the nature of medicinal services benefits by concentrating on the significant segments.
III. Financial aspects of health care delivery
Oversaw Health Care is discussed on various viewpoints; nature and inception of oversaw forethought, the idea of the demise of oversaw consideration and the current condition of oversaw mind in the U.S. health awareness framework. Anyone in America, who has utilized health care insurance through their executive, eventually accomplished oversaw mind. What is overseen mind and how can it influence us? Comment by Elaine Testerman: Is this the word you meant to use?
IV. Reason behind the increasing health care co ...
Expected with 3-4hrs today 041220151, Discuss the impact of .docxdelciegreeks
Expected with 3-4hrs today 04/12/2015
1, Discuss the impact of health policy on individuals, on health related organizations, and on interest groups.
2, Who are demanders and suppliers of health policies? What motivates each in the political marketplace?
3, Discuss the involvement of interest groups in the political circumstances that affect agenda setting. Incorporate the specific ways they influence agenda setting in your response
4, What congressional committee are most important to health policy? Briefly describe their roles.
5, Discuss legislative oversight of policy implementation
6, What does it mean to characterized policy implementation as public management?
7. Discuss the concept of incrementalism in public policymaking.
8. Describe, in general terms, the operation stage of policy implementation
9. Discuss the effect of policy on its own implementation
10. What two major areas of concern do individual share with health-related organization and interest groups regarding policies and the process through are produced? Why are these concerns more easily addressed by organizations and groups than individuals?
.
Consommation de medicaments_dans_5_pays_europeensAssociation LIR
Le niveau de consommation de médicaments en France est souvent considéré comme étant l’un des plus importants d’Europe. Cette étude cherche à vérifier la persistance de cette affirmation sur la période 2000-2004 en comparant les niveaux de consommation de 7 classes de médicaments en Allemagne, Espagne, France, Italie et Royaume-Uni. Non seulement la France n’était plus en 2004 le premier consommateur dans les 7 classes étudiées mais on constate un rapprochement aussi bien des niveaux de consommation que des structures de consommation entre les 5 pays.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Policies for Conflicts of Interest
Paris, March 2011
In its role of think tank and within the framework of the “Assises du
Médicament”, the LIR considered useful to make realize by the researchers of
the ESSEC an international study on the policies of management of conflicts of
interests.
Four reglementations were studied : United States, Great Britain, Germany and
Sweden.
Contents
Introduction................................................................................................................................................ 2
1. What is a conflict of interest?............................................................................................................. 2
2. Who is covered by the COI policies? .................................................................................................. 2
3. What are the interests that should be declared?................................................................................ 3
4. When and how should interests be declared?.................................................................................... 4
5. What are the limits for the interests’ declaration? ............................................................................ 4
6. Are the conflicts of interest information published?......................................................................... 5
7. Who is responsible of managing conflict of interest? How is it handled? ........................................ 5
Recommendations ...................................................................................................................................... 6
References................................................................................................................................................... 8
2. Chaire ESSEC Santé Page 2
Introduction
Each country and even each regulatory body has its own approach to cope with conflicts of interest
(COI) in the health system. A systemic review of the policies and rules of COI was done for the United
States of America (USA,) for the European Medicines Agency and for three European countries
(United Kingdom, Germany, and Sweden) by searching the official websites of their health agencies
and institutions:
- In USA, the department of Health and Human Services (DHHS), the Food and Drug
Administration (FDA), the National Institutes of Health (NIH) and the Office of Extramural
Research (OER);
- In UK, the Department of Health (DH), the National Institute for Health and Clinical
Excellence (NICE), the Medicines and Health Care products Regulatory Agency (MHRA) and
the National Health Services (NHS);
- In Germany, the Institute for Quality and Efficiency in Health Care (IQWIG) and the Federal
Joint Committee (G-BA);
- In Sweden, the Swedish research council and a common guidance for the Dental and
Pharmaceutical Benefits Agency (TLV), the Medical Products Agency (MPA), the National
Board of Health and Welfare, the National Food Administration, the Swedish Council on
Health Technology Assessment (SBU), Swedish Institute for Communicable Disease Control
(SMI) and the Swedish National Institute of Public Health.
The focus of this study is to analyze the policies and guidance in the field of conflicts of interest. Thus,
a list of questions was elaborated.
1. What is a conflict of interests?
A conflict of interest is a situation in which financial or other personal considerations have the
potential to compromise or bias professional judgment and objectivity. It involves the abuse - actual,
apparent, or potential - of the trust that people have in professionals. [1]
According to the Institute of Medicine, “a conflict of interest is a set of circumstances that creates a risk
that professional judgment or actions regarding a primary interest will be unduly influenced by a
secondary interest.” Primary interest varies according to the purpose of a professional activity and
secondary interests may include not only financial gain but also the desire for professional
advancement, recognition for personal achievement, and favors to friends and family or to students
and colleagues. [2]
2. Who is covered by the COI policies?
The entire chain of the health system and specially the decision makers are target for conflicts of
interest. Policies and regulations are implemented by institutions in order to ensure the impartiality of
individuals and to avoid bias decisions. The COI policies apply to two different groups: internals and
externals to the institutions. (See Table 1)
Table 1 – Individuals covered by COI Policies
Internals Externals
All Employees of institutions Clinical investigators when applying for a
marketing authorization
Scientific committee members Clinical investigators conducting / participating
3. Chaire ESSEC Santé Page 3
in the studies
Commissions Applicable manufacturers or applicable groups
purchasing organization that provides payment
or other transfer
Chairman and other non-executive members of
boards
Patients and consumers invited to attend and
take part in advisory board meetings, committees
activities or oral debates
Chairs and members of the advisory boards to the
institution
Experts and independent contractors
Working Groups Physicians
3. What are the interests that should be declared?
Based on the literature review, the kinds of interests that need to be declared can be classified as
follows:
• Specific or Non Specific to the question under discussion:
This classification is defined in the NICE code of practice for declaring and dealing with conflicts
of interests. The interest is regarded specific when it is related to the product or service being
evaluated; and non-specific when it is unrelated to the matter under consideration.
NB: The FDA classified the question under discussion and not only the interest. The FDA has a
decision’s tool for participation of special and regular government employees. In the first question
of the tool, the subject matter of the meeting has to be defined as a particular matter or not. “Will
the meeting itself or governmental action of which it is a part involve deliberation, decision, or
action that is focused upon the interests of specific persons, or a discrete and identifiable class of
persons?” [3] The topics could potentially affect such a large number of persons or organizations,
that they would not be considered a particular matter. In this case, the participation and voting of
an employee is permitted without a waiver. (See Appendix 1)
• Personal/ Non-Personal:
This classification was shown in the context of the MHRA Code of Practice. “A personal interest
involves the payment, in any form, to an individual personally, by a pharmaceutical company
whose business may be directly affected by the advice of the advisory body”. [4] “A non-personal
interest involves payment that benefits a department for which an individual is responsible, but is
not received by the member personally”. [4]
• Direct / Indirect:
For the EMA, the interests in pharmaceutical industry are divided into direct and indirect
interests. The first one includes employment, consultancy, patent, and financial interests, and the
second one includes investigator and funds.
• Pecuniary / Non-pecuniary:
The nature of the interests declared is mainly financial. In fact, all agencies requested the
disclosure of the pecuniary interests and only NICE enquires the declaration of non-pecuniary
interests. These latter may be difficult to measure and to be quantified, but have a real influence on
individuals. NICE defined the non-pecuniary interests as clear opinion, public statement about the
matter under consideration, holding office in a professional organization or advocacy group with a
direct interest in the matter under consideration and other reputational risks in relation to an
intervention under review.
• Family interests:
The FDA requests the financial interests of the immediate family of the government employee
(spouse, minor child or general partner). NICE and MHRA enquires the declaration of “family
interests”. The Swedish common guidance for the 7 institutions also requires the disclosure of the
4. Chaire ESSEC Santé Page 4
interests “of family members and close relationships”. However, this is not the case for the EMA;
this type of declaration is not requested.
4. When and how should interests be declared?
The declarations of interests are made on appointment, before meetings, or / and annually. It depends
on the status of the person declaring the interests. In USA, the regular and special government
employees at the FDA need to declare their interests prior to each meeting. In Sweden, it is required
from the external expert to update his declaration whenever a change occurs. The EMA has a special
approach for the declaration of the COI. First, all members and experts should be included in the EMA
Expert Database. A disclosure of interests is then required prior to the first appointment. Based on the
information provided, the level of COI risk is evaluated. If the information on individuals deemed to
have ‘high risk’ COI, the case is referred to the Declaration of Interests Assessment Group (DIAG),
which assesses their acceptability for involvement in EMA activities.
The declarations are mostly reported on papers such as the FDA and NICE declaration forms. The
electronic form (eRA) is used by the US institutions that are applying for grants from the NIH. It also
applies for the companies to disclosure their payments to physicians and others, according to the
Sunshine Act.
The control of declarations is not mentioned by any agency. The disclosure of conflicts of interest is a
declaration of honor.
5. What are the limits for the interest’s declaration?
It is complicated to identify what are the limits for the interests’ declaration and when the ties could
have an effect on the agency’s ability to act objectively and impartially [5]. Two limits can be observed.
Firstly, the thresholds of financial interests differ leading to question about the appropriate financial
limit to fix. The EMA experts for example, are asked to indicate if the value of financial interests
exceeds 50 000 Euros. [6] The FDA enquiries from the clinical investigator who conducts any clinical
study submitted in a marketing application, to declare any equity interest that exceeds 50 000 dollars
in value and other sorts of significant payments that have a cumulative monetary value of 25 000
dollars or more. Financial conflicts of interests are tangible interests but how to define the threshold
from which the value of the financial interest becomes a risk for conflict. A financial interest does not
have to be greater for a bigger influence. Social science research suggests that the influence may
operate without an individual being conscious of it and that gifts of small value may influence
decisions. [2]
Secondly, the time limits requested for the declarations also vary. In Sweden, a fixed time limit of 2 to
3 years is proposed, while the EMA requested information for the last five years. The Swedish common
guidance highlights that it is difficult to specify the time required for “neutralization” of an experts past
assignment, once regarded as an unacceptable conflict of interest, in order to allow a new assignment
in a similar issue from an agency. The length of such a period must however be dependent on the type
and scope of the relationship, the nature of the assignment, and its economic significance. [5] In UK,
the annual declaration of the chairmen and members of the MHRA must include all the financial
interests in the pharmaceutical industry currently held or held in the last 12 months but not restricted
to this period.
5. Chaire ESSEC Santé Page 5
6. Are the conflicts of interests information published?
In the literature review, the COI information is made public for all institutions. However, the kind of
information provided differs. Interests declared to the MHRA are published each year in the Annual
Reports of the Commission on Human Medicines and Section 4 Committees. This publication will
provide only the name of the committee chairman or member, the source of the interest (e.g. the
company name); it will not provide any financial information nor numbers (e.g. for shares) nor
identify the family member or other holding the interest by name. Furthermore, the decisions on
participating in the committee meetings are recorded in the minutes that are publicly available on the
MHRA web site. [6]
Declarations of interest made by experts to the EMA are accessible to public, either on the agency’s
website or in its offices. Also, certain information about the outcomes of EMA COI policies and
procedures, such as assessments made by the Declaration of Interests Assessment Group (DIAG), is
made available on request. [6]
In Germany, IQWIG declarations of interests are presented and published in a tabular summarization.
7. Who is responsible of managing conflict of interests? How is it handled?
When reviewing the policies on conflict of interests, it is hard to identify for some agencies the entity
responsible of managing the declaration of COI. For example, the EMA does not specify in the
procedure of the handling of the COI, the entity that assigns preliminary the risk level of COI before
referring the individual to the DIAG. As well, NICE does not specify the responsible entity of handling
COI. Yet, the IQWIG has a committee for the conflicts of interest to evaluate the declaration of experts.
As for the FDA, the FDA ethic’s staff handles the declaration of the COI.
The actions listed below are the main measures taken by the health authorities in order to handle the
COI:
• Exclusion from the meeting / the project:
The FDA is using a decision making tool to evaluate the risk of COI in the participation of an
individual. It is an Algorithm of 10 steps. At each step, a decision is taken to authorize or not an
employee to assist to FDA meetings. At the last step, a waiver can be issued if the need for the
special government employee’s services “outweighs the potential for a conflict of interest”, and if
the financial interest of a regular government employee is “not substantial as to be deemed likely
to affect the integrity of the services provided by that individual”.
• Requesting additional information:
A conflict of interest may exist for the clinical investigator conducting studies that the FDA relies
on to establish that the product is effective. In this case, the FDA can request that the applicant for
marketing authorization submits additional data.
• Suspension of funds:
The NIH in USA may suspend the grants for an institution if a conflict of interest appears.
• Money penalties:
According to the Sunshine Act, a manufacturer or organization is subject to civil money penalties
for each payment or other transfer not reported as required. The penalty is not less than $1,000,
but not more than $10,000 if failure to report, and not less than $10,000, but not more than
$100,000 if knowing failure to report.
6. Chaire ESSEC Santé Page 6
• Imprisonment:
According to the Department of Health in UK, any person who contravenes Medicines
(Advertising) regulation 21 is guilty of an offence, and liable, on summary conviction to a fine not
exceeding £5000, and/or to imprisonment for a term not exceeding two years.
Recommendations
It is an established fact that it is easy to damage an agency’s credibility, but extremely difficult and
time-consuming to repair the damage. [5] Relying on a disclosure of financial and non financial
interests rather than managing or eliminating them is a problem. [7] Thus, managing a COI is essential
; but, handling COI is a major challenge because of the complex relationships between government,
academia and industry. [8].
There are three main problems that can affect the efficacy of a policy: (1) the individuals’ failure to
declare on purpose or not, (2) the control of the declarations and (3) the handling of the COI. Success
in implementing rules and standards is only possible if the different conflicts of interest systems are
shaped to the needs of the specific administration, taking the particularities of the administrative
culture and political context into account. [9] The Institute of Medicine suggests a list of criteria for
Evaluating Conflict of Interest Policies. [2] (See Table 2)
Table 2 – Criteria for evaluating conflict of interest
Criterion Description
Proportionality Is the policy most efficiently directed at the most important conflicts?
Transparency Is the policy comprehensible and accessible to the individuals and institutions
that may be affected by the policy?
Accountability Does the policy indicate who is responsible for enforcing and revising it?
Fairness Does the policy apply equally to all relevant groups within an institution and in
different institutions?
The following list of points can be considered:
- A standard and single declaration to a unique receptor but specific rules per institution;
- Double declaration by the donor and the beneficiary;
- An identified committee for handling conflicts of interest;
- An “Algorithm d’aide à la décision” (or assessment tool) to evaluating the COI and managing
them.
8. Chaire ESSEC Santé Page 8
References
1
Responsible conduct of research. Conflict of Interest. Columbia University. Available on line:
http://ccnmtl.columbia.edu/projects/rcr/rcr_conflicts/foundation/index.html#1_1. Last Accessed March 07, 2011.
2
IOM (Institute of Medicine). Conflict of Interest in Medical Research, Education, and Practice. Washington, DC:
The National Academies Press. 2009.
3
U.S. Department of Health and Human Services – Food and Drug Administration. Guidance for the public, FDA
advisory committee members, and FDA staff on procedures for determining conflict of interest and eligibility for
participation in FDA advisory committees. 2008.
4
Medicines and Healthcare products Regulatory Agency. Code of Practice for chairmen and members of the
commission on human medicines, certain section 4 committees and experts advisory groups. Medicines Act 1968
– Advisory Bodies annual reports 2009.
5
Addressing Conflicts of Interest in Appointing External Experts. Sweden.
6
Lexchin J, O’Donovan O. Prohibiting or ‘managing’ conflict of interest? A review of policies and procedures in
three European drug regulation agencies. Social Science and Medicine, 2010, Vol.70, pp. 643 – 647.
7
Rodwin MA. Conflicts of Interests and the future of Medicine – the United States, France and Japan. Oxford
University Press. 2011.
8
Rockey SJ, Collins FS. Managing Financial Conflict of interest in Biomedical Research. Journal of American
Medical Association. Published online May 24, 2010
9
Demmke C, Bovens M, Henökl T, van Lierop K, Moilanen T, Pikker G and Salminen A. Regulating Conflicts of
Interest for Holders of Public Office in the European Union. European Commission - Bureau of European Policy
Advisers. October, 2007.