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At least 307 records · Page 17Linked to original sources
PubMed1978

[Hospital legislation in the Federal Republic of Germany and its effects on psychiatric hospitals (author's transl)].

The article discusses the hospital laws of several land governments enacted subsequent to the hospital financing law of the Federal Government, in respect of the influence exercised by these laws on the internal structure of the hospital. The fact that the laws apply to all kinds of hospitals, and hence also to big psychiatric hospitals, is considered a disadvantage for psychiatric care. Such care is obviously hampered, on the one hand, by the legislative demand for departmentalization of the individual fields according to specialist subjects, representing a setup which is opposed to the realization of patient care in accordance with the requirements of the communities and citizens who expect to be cared for on an individual and not on a schematic basis, whereas, on the other hand, the new structures of management stipulated by the law do not provide for the inclusion of representatives of the new groups of professions now engaged in psychiatric activities. The model of regrouping the hospital structure into sectors instead of medical specialist departments, is presented and contrasted with the proposed model. It is recommended to arrange for representation of the non-medical and non-nursing professions in the managing boards, as well as to take into account the sociotherapeutico-rehabilitative interests as forming part of the conceptual approach to care in psychiatric hospitals, via special hospital committees.

Economics, Hospital↗
PubMed2005

Proposed framework for cleanup and site restoration following a terrorist incident involving radioactive material.

Cleanup following a terrorism incident involving a radiological dispersal device (RDD) or improvised nuclear device (IND) is likely to be technically challenging, costly, and politically charged. Lessons learned from the Top Officials 2 exercise and the increased threat of terrorist use of an RDD or IND have driven federal officials to push for an agreed-upon process for determining appropriate cleanup levels. State and local authorities generally have the ultimate responsibility for final public health decisions in their jurisdictions. In response to terrorist attacks, local authorities are likely to request federal assistance in assessing the risk and establishing appropriate cleanup levels. It is realistic to expect local and state requests for significant federal assistance in planning and implementing recovery operations. State and local authorities may desire "shared accountability" with the federal government in setting the appropriate cleanup levels. Government officials at all levels will face pressure to say how clean is clean enough and how quickly people can re-enter affected areas. Issues arising include (1) the nature of the relationship between the federal, state, and local leadership involved in the recovery efforts and (2) where the funding for recovery comes from. Many agencies, including the U.S. Environmental Protection Agency (EPA), the U.S. Nuclear Regulatory Commission (NRC), and the U.S. Department of Energy (DOE) have long been involved in cleanup activities involving radioactive materials. These agencies have recognized the need for a participatory process and realize the need to remain flexible when faced with possible unprecedented environmental challenges following a terrorist attack. Currently, the Department of Homeland Security has a committee process underway, with participation of the EPA, NRC, DOE, and other federal agencies, to try to resolve these issues and to begin engaging state, local, and tribal governments, and others as appropriate.

Decontamination↗
PubMedDate not supplied

Early experience with 'new federalism' in health insurance regulation.

The authors monitored the implementation of the Health Insurance Portability and Accountability Act (HIPAA) from 1997 to 1999. Regulators in all states and relevant federal agencies were interviewed and applicable laws and regulations studied. The authors found that HIPAA changed legal protections for consumers' health coverage in several ways. They examine how the process of regulating such coverage was affected at the state and federal levels and under an emerging partnership of the two. Despite some early implementation challenges, HIPAA's successes have been significant, although limited by the law's incremental nature.

Career Mobility↗
PubMed1978

[Influence of population growth on national health care (author's transl)].

In the Federal Republic of Germany a decline of population is expected, because fertility is very low. This article deals with the implications of this trend for the health system. On the basis of population models and population forcasts the author comes to the conclusion that in the long run the burden of health costs will not become lower but higher, because of the growing proportion of old people. Nevertheless it is supposed that the influence of other factors than demographic ones may be greater.

Adolescent↗
PubMed2000

[Physicians for Human Rights: a foreign observer at three trials against physicians in Turkey].

Physicians have a professional obligation to be among the first to defend human rights. Accordingly they have established organisations in many countries to that aim, which are united in the International Federation of Health and Human Rights Organisations (IFHHRO). The author was invited by this federation to attend several trials against members of the Turkish sister organisation. In one of them the doctor's duty to protect his patients' privacy was at stake. This physician has since been acquitted because of insufficient evidence. In Turkish society there are opposed conservative and liberal democratic forces: on the one hand people try to maintain the democratic and constitutional state, on the other some circles hold the opinion that undemocratic and inhuman measures are necessary to counter the dangers of terrorist movements. Even in the Netherlands the right of physicians not to reveal confidential information regarding 'illegal immigrants' has recently been challenged, and until now the medical organisations have not protested.

Civil Rights↗
PubMed1977

[The development of antibiotics resistance among Salmonella bacteria of animal origin in the Federal Republic of Germany and Berlin (West). 5th communication: 1974 Annual report (author's transl)].

2713 salmonella strains having been isolated by veterinary laboratories in the Federal Republic of Germany including West Berlin in 1974 were tested for resistance to tetracyclines, ampicillin, chloramphenicol, kanamycin, gentamycin, furazolidone, nitrofurazone, and trimethoprim. 21.7% of the strains tested were resistant to one or several of the antibacterially effective substances examined. The proportion of the resistant strains amounted to 52% for S. typhimurium and 4.7% for S. typhimurium var. copenhagen, 16.8% for S. enteritidis, and 22.1% for S. panama, 85.1% of all resistant strains belonged to these types. Out of 589 resistant strains found, resistance determinants were present in 93.7% to tetracyclines, 34.6% to ampicillin, 32.4% to chloramphenicol, 25.3% to kanamycin, 3.4% to furazolidone, and 0.5% to nitrofurazone. 1 strain of S. typhimurium var. copenhagen had a transmissible determinant of resistance to trimethoprim. No strain was resistant to gentamycin. 93.4% of the strains transmitted resistance determinants to E. coli K-12. A transmission of resisance to furazolidone and nitrofurazone could not be demonstrated. The serotypes were exhibiting clear-cut differences in their resistances patterns.

Animals↗
PubMed1977

[The development of antibiotics resistance among Salmonella bacteria of animal origin in the Federal Republic of Germany and Berlin (West). 6th communication: 1975 Annual report (author's transl)].

2563 salmonella strains having been isolated by veterinary laboratories in the Federal Republic of Germany including West Berlin in 1975 were tested for resistance to tetracyclines, ampicillin, chloramphenicol, kanamycin, gentamycin, furazolidone, nitrofurazone, and trimethoprim. 11.4% of the strains tested were resistant to one or several of the above mentioned substances. The proportion of the resistant strains amounted to 36.0% for S. typhimurium, and 4.3% for S. typhimurium var. copenhagen, as well as 70% for S. dublin. 79.4% of all resistant strains belonged to these types. For S. panama, the proportion of resistant strains decreased to 6.7%. Out of 291 resistant strains found, resistance determinants were present in 89.0% to tetracyclines, 47.0% to chloramphenicol, 28.5% to ampicillin, 24.1% to kanamycin, and 4.1% to furazolidone. Resistance determinants to gentamycin, nitro-furazone, and trimethoprim did not occur, 81.1% of the strains transmitted resistance determinants to E. coli K-12. A transmission of resistance to furazolidone could not be demonstrated. The different serotypes exhibited clear-cut differences in their resistance patterns.

Animals↗
PubMed1980

[The suitability of bioindicators according to DIN 58948 part 4 for monitoring gas-sterilizers (author's transl)].

In the Federal Republic of Germany bioindicators according to DIN 58948, Part 4, are generally used for testing the efficacy of ethylene oxide sterilizers. They are based on spores of Bacillus subtilis dried in sheep-blood on the bottom of a small test tube. As some authors doubted the resistance of these indicators to ethylene oxide especially in comparison with spore soil and spores of Clostridium perfringens, three different test procedures were performed showing that spores of sulfite reducing clostridia (Cl. perfringens included) are less resistant to ethylene oxide than spores of B. subtilis. The results are summarized in tables 1 to 3. They are discussed with regard to literature on the subject with special emphasis to the significance of occlusion of spores in insoluble crystals. It is concluded that spores of B. subtilis are the most suitable test-organisms for monitoring ethylene oxide sterilization and that spore soil cannot be used for this purpose.

Bacillus subtilis↗
PubMed1985

Registration requirements within the German Federal Health Office.

Public health authorities responsible for consumer protection in connection with the use of chemical products are faced with several conflicting requirements. In addition to the primary requirements of protecting human health and assessing the balance between benefits and risks, the authorities are faced with the need to identify appropriate tests, to avoid unnecessary testing in experimental animals, to adapt existing test guidelines in the light of new technological and scientific developments and to make optimal use of the facilities and expertise available. Among the measures being taken by the German Federal Health Office to resolve these difficulties, particularly in connection with the testing of chemicals for skin and eye irritancy, are the evaluation of alternatives to animal tests, the encouragement of more effective screening and use of existing test results, promotion of the international exchange of test data, and support for proposed changes in the use of the Draize test.

Animal Testing Alternatives↗
PubMedDate not supplied

The complexities of multi-level governance in public health.

This article reviews some of the challenges to developing national public health programs, focussing on the distribution of constitutional authority for public health and governance challenges that arise from this. Constitutional authority for public health resides primarily with the provinces. The federal government has obtained the authority to legislate in this area primarily through its power over criminal law. Challenges facing the establishment of national public health programs include the ambiguity over constitutional responsibility, challenges in managing externalities and spillovers, and issues related to funding and data ownership. Policy-making is also complicated by the importance of municipal and supranational governments in public health. National programs need to be structured in a way that balances the advantages of regional approaches to public health challenges with the benefits of a coordinated central response. To do so, policy-makers need to address unique challenges to public health governance.

Canada↗
PubMed1977

[Causes and outward forms of poverty in old age (author's transl)].

In the Federal Rupublic nearly 20% of the elderly people live on the edge of below the property-line, which is well-marked by public assistance. In spite of legal claims 75% of the needy elderly do not explore all possible avenues. The ascertainment of this high percentage which had been never estimated exactly-about which, hitherto, impressionistic or opportunistic declarations have been made rather than reliable assertions-is a result of a representative empirical research. The authors have conducted structured interviews, analysis of official files and explorative interviews with old people and with those who are, in a broad sense, competent regarding their need. The analysis of the old peoples' social biographies significantly showed the invariance regarding the class the necessitous belong to; generally workers or people of the farming section either become or remain poor. Deficient vocational education is the beginning of a lifelong outstanding external determination. Their non-problematical replaceability at work surrenders them to the enterpreneur's calculation. When growing older they often endure professional depreciation and financial reduction. After they have retired, need encreases. Individual failure is not the cause for poverty, however the belonging to the working-classes; all those belonging to these classes are potentially poor, due to their replaceability and exchangeability at work. At the lower end of the class-hierarchy potential poverty changes into actual poverty. Causative regarding formation of these classes is the fact, that the material possibilities of the social production cannot be used by the actual producers. The causes for poverty which reproduces itself always within the same classes can't be removed by legal means which can only relief poverty.

Age Factors↗
PubMed1983

Medicare and Medicaid program; withholding the federal share of payments to recover Medicare or Medicaid overpayments--Health Care Financing Administration. Proposed rule.

We propose to amend Medicare and Medicaid regulations to implement sections 905 of the Omnibus Reconciliation Act of 1980 (Pub. L. 96-499) and 2104 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35). Section 905 expands HCFA's authority to withhold the Federal share of Medicaid payments in order to recover Medicare overpayments. Section 2104 provides new authority for HCFA to withhold Medicare payments to recover Medicaid overpayments. The provisions apply with respect to institutions or persons that participate (or have participated) in both programs, and to whom an overpayment under either program may have been made but cannot be recovered under that program. The intent of the statute is to facilitate recovery through offset of payments due the entity under the second program. Previously, HCFA could suspend Federal Medicaid payments to State agencies to recover Medicare overpayments for an institutional provider of Medicare services when that provider (1) had withdrawn or been terminated from participation in the Medicare program; (2) failed to repay or make satisfactory arrangements to repay the appropriate information to determine the amount of overpayment, if any. No authority existed with respect to individual practitioners or other suppliers, nor was there any provision for recovering Medicaid overpayments through Medicare.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1990

Pitfalls in state-authorized treatment of minors.

Recently a federal court in Georgia ruled that several physicians and several state officials could be sued for state-authorized treatment of a minor over his father's objection. State authorization protects providers only if it is properly obtained and the authorizing official has the power to grant the authorization in the existing circumstances.

Adolescent↗
PubMed2005

[Establishment of branch practices in the German healthcare system].

The physicians in the German out-patient healthcare system are normally bound to treat their patients in locally-registered practices. Exceptions to this commitment are external practice rooms and branch practices. For special services, a physician can run external rooms close to his practice. Branch practices, in contrast, have to be authorized by the regional physicians' association. The requisites in this respect are concretely defined (and partially increased) in a new regulation within the federal framework agreements. The authorization obligation applies also to the establishment of branch practices in medical care centers.

Delivery of Health Care↗
PubMed2001

Agents of bioterrorism. Preparing for bioterrorism at the community health care level.

Bioterrorism preparedness is clearly a goal for the health care community, working in concert with city, county, state, and federal public health and emergency authorities and in collaboration with law enforcement at the local and federal levels. Opening the channels of communication between all groups involved, obtaining the necessary resources, and maintaining an understanding of the potential agents and the diseases they cause will foster a smooth transition to a rational program directed at patient, personnel, and community safety.

Anthrax↗
PubMed1979

[The Federal Rehabilitation Council - a review of the last decade and prospects for the future (author's transl)].

Ten years have now passed since the foundation of the Federal Rehabilitation Council. Its work has both reflected and guided the development of rehabilitation in the Federal Republic of Germany in the last ten years. The Federal Rehabilitation Council has given its members the opportunity of bringing their services and benefits into line. It has submitted suggestions for improvements of the legislative provisions to the legislative body. Special attention has been given, in this context, to the conclusion of the "special agreements" on behalf of the different rehabilitation agencies designed to ensure the speedy and smooth completion of the rehabilitation process. Furthermore, the Federal Rehabilitation Council has attended to the problems of the disabled and defended the interest of various disability groups. In addition, the Federal Rehabilitation Council has endeavoured to contribute to the international exchange of experience. Special attention has been placed on public education. As rehabilitation will not be allowed to stand still, the Federal Rehabilitation Council will base its future work on this principle.

Adult↗
PubMed1979

[Conclusions and recommendations of the FVE (Federation of Veterinarians in the EEC) on animal welfare (author's transl)].

During the past thiry years, systems were developed in animal husbandry which raise serious questions for animal welfare with regard to nutrition and housing. The main cause of these problems consists in the fact that the development of these systems is governed solely be economic, expense - saving principles. The livestock breeder is not mainly to blame for these systems, nor is the agricultural scientist who invented them. Society as a whole is responsible for the fact that the welfare of production animals is in conflict with the expressed demand for cheap mass-production. Veterinary surgeons cannot avoid these questions, because their co-operation is requested in these intensive animal husbandry systems. They are also asked to preform interference procedures or mutilations to render animals suitable for these systems. As only decisions on EEC level can lead to the beginning of a solution of the above problems, the FVE has attempted to reconcile the views of national associations in order to provide precise veterinary advice to the EEC Commission. As a result, the Federation formulated thirty-three conclusions and recommendations, which are reviewed in detail in this paper.

Animal Feed↗