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We thank Fan Jin for her contributions in implementing the study in Shanghai and Bethanie Hull for technical assistance in the preparation of this manuscript. This study would not have been possible without the support of all of the study participants and research staff of the Shanghai endometrial cancer study. Contributors: All authors contributed to analysis and preparation of the manuscript. ZXR directed field operations, and JRC directed the laboratory work. XOS was the principal investigator, responsible for designing and directing implementation of the overall study, and is the guarantor of this paper. Funding: This work was funded by United States Public Health Service USPHS ; grant number R01CA92585 from the National Cancer Institute.
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References 1. 2. Baker AM, Meredith JW, Haponik EF. Pneumonia in intubated trauma patients. J Respir Crit Care Med 1996; 153: 343349. Cunnion KM, Weber DJ, Broadhead WE, Hanson LC, Pieper CF, Rutala WA. Risk factors for nosocomial pneumonia: Comparing adult criticalcare population. J Respir Crit Care Med 1996; 153: 158162. Fagon JY, Chastre J, Hance AJ, Montravers P, Novara A, Gibert C. Nosocomial pneumonia in ventilated patients: a cohort study evaluating attributable mortality and hospital stay. J Med 1993; 94: 281288. Heyland DK, Cook DJ, Griffith L, Keenan SP, Brun Buisson C. The attributable morbidity and mortality of ventilator-associated pneumonia in the critically ill patient. The Canadian Critical Trials Group. J Respir Crit Care Med 1999; 159: 12491256. Kollef MH, Silver P, Murphy DM, Trovillion E. The effect of late-onset ventilator-associated pneumonia in determining patient mortality. Chest 1995; 108: 1655 Leroy O, Guilley J, Georges H, et al. Effect of and imitrex, for example, hyzaar dosing. Proposition. The notion of a wireless "highway" proved to be an apt metaphor. In it, the derived value is not on the highway itself, but of the value adding activities that spring up along it. Take the case of the wireless barcode application, for example. Having a pervasive wireless environment already in place, Vassar Brothers would in essence be able to "plug in" the barcode system and have it available anywhere in the hospital. This has a direct impact on the way Christiano proposed to assess its business value: Since the wireless infrastructure is an implicit part of the bar coding application, a portion of its payoff should be allocated to the wireless infrastructure investment. This same principle holds true for future applications and communications services that are implemented down the road, with each essentially paying a "toll" to leverage the wireless highway. Making it happen: breadth, depth and an ecosystem of partners Given the green light to proceed, Christiano began assembling the resources he needed to move ahead with a wireless initiative. The selection of technology and solution partners was particularly crucial, given the breadth and complexity of the technologies that would be employed. For Christiano, one of the key governing principles behind this process was that Vassar Brothers was neither a technology company nor a systems integrator. Hence, he would need a provider that not only had the technology, but could pull it all together and manage the project seamlessly. In addition to having the right tools to do the job, Christiano also sought a vendor that would commit itself to Vassar Brothers success despite the risks associated with such a unique and complex undertaking. He found that vendor in IBM Global Technology Services, which proposed to combine its own healthcare and process expertise with the wireless technology and expertise of its Business Partner InnerWireless. "It was important to us that InnerWireless was more than just a standard partner cooperating on a project, " says Christiano. "We saw InnerWireless as an essential part of IBM's wireless strategy and a great mesh with IBM's core capabilities." One of the key challenges facing the team was the need to design a solution that would deliver outstanding performance in spite of an. With the state or other laws and regulations. What can the organization and the practitioner do to prepare for this inevitable situation? First, the installation of the compliance plan on a company-wide basis is an obvious requirement. Unfortunately, it will have to be a fairly complex and involved compliance program to keep track of all the potential legal issues that might arise. Often this is not seen by the company as an immediate need, as the company wants to expend its existing resources in growth and expansion rather than compliance. However, a compliance program certainly should be recommended and implemented if possible. Second, the practitioner must have in place a central mechanism to handle complaints and lawsuits. This means that there must be a strictly enforced company policy that any complaints from a regulatory agency or a consumer must be delivered to a central site and that the practitioner be made aware of those complaints and concerns. In this way, the practitioner can be made aware much earlier of the potential regulatory actions or lawsuits that may arise. Oftentimes, this early warning will allow the issue to be resolved much more amicably and without undue publicity. Third, given the knowledge that oftentimes your client may be in violation of a state law or regulation means that there are two alternatives--a policy decision must be made and how to respond to these regulatory actions on a company-wide basis. The company can respond in a very litigious fashion. This means vigorously defending against any regulatory complaint and utilizing all the procedural and legal mechanisms to create difficulties for any regulatory agency attempting to prosecute the organization. A second alternative is to try to develop a reputation for credibility and honesty with the regulators. If the company and the attorney respond quickly and emphatically to try to correct any problems that might exist, the regulators will often agree in a solution and a consequence that is palatable to the company. Of course, there are often personalities involved in each of the states or regulatory organizations that make it impossible to use a conciliatory technique. However, some thought needs to be put into these issues before the fast growth or expansion occurs. Any attorney advising a new company on this type of development needs to be as clear as possible that there will be violation and that the company must have plans and a policy to deal with those problems. CONCLUSION As retail medicine becomes ever-increasingly the method for delivering and marketing medical services, the practitioner will have to become more cognizant and wary of the interrelationships between state and federal regulations, as well as the interrelationship between health care advertising, licensing, and marketing restrictions. This will require the health care practitioner to become even more knowledgeable in additional areas of the law in order to guide his or her client through a very complex legal and regulatory scheme and isosorbide. 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A new PPRS scheme started on 1 January PJ, 6 November 2004, p669 and PJ, 18 25 December 2004, p873 ; with the promise that there would be a consultation on branded generics. The consultation proposes that "standard" branded generics should no longer be covered by PPRS and instead be transferred to the new arrangements for the reimbursement of generic medicines. A "standard" branded generic medicine is defined as: "An out of patent product to which the manufacturer supplier, who is not the originator company, has applied a brand name and that is comparable to a true generic and development in the prices of branded medicines supplied to the NHS, " the consultation states. "The Government does not believe that it is acceptable for the NHS to pay a similar price to the originator branded product for branded generic medicines which have not incurred significant R&D and where a comparable true generic is available." Therefore, it proposes that the future reimbursement price of standard branded generic medicines will be the lesser of the revised Drug Tariff price of the comparable true generic medicine or the list price of the standard branded generic medicine.The consultation closes on 15 April 2005. A consultation on future arrangements for reimbursement of generic medicines closed in October 2003 PJ, 6 September 2003, p295 ; and an announcement on the outcome is awaited. However, this week's consultation document states: "The revised Drug Tariff price will be determined by new arrangements whereby quarterly data will be collected from manufacturers and wholesalers and an index for determining the Drug Tariff price will be calculated from that data and levoxyl and hyzaar, because generic drug for hyzaar. 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I remember vividly the pride with which one elderly priest informed me none of his charges died in the past year. 1 Members of the Interfaith Center on Corporate Responsibility are supporting their colleagues in AIDS-impacted regions with a massive effort to encourage new policies at Abbott Laboratories, Bristol-Myers Squibb, GlaxoSmithKline, Merck, Johnson & Johnson, Pfizer, and the biotechnology company Gilead Sciences to increase access to life-saving medicines. Sister Vicki Bergkamp of the Adorers of the Blood of Christ, and Chair of the HIV AIDS Caucus at ICCR, explains "ICCR Members see the ravages of HIV and AIDS in their daily work in Africa, India, and China. Our.

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