Considerations for state-imposed conditions on healthcare provider transactions

The widespread consolidation of health systems, hospitals, and physicians has contributed to the high price of healthcare across the United States. While federal antitrust enforcers continue to play an important role in overseeing large mergers, acquisitions, and other consolidating transactions of major healthcare providers, state oversight over healthcare markets is essential to slow consolidation more broadly and address market failures across the country. State laws govern the scope of authority held by state attorneys general and other state agencies to receive notice of, review, and approve, conditionally approve, or block healthcare provider transactions, which can significantly impact the breadth and content of oversight. While blocking potentially anticompetitive transactions can help states maintain any competitive forces that remain in the market, in some situations, approving a transaction with conditions may be the best path forward. Applying conditions to transactions may allow state officials to oversee and govern the behavior of providers post-transaction while states pursue other legislative fixes. Although the use of conditions is a relatively common practice at the state level, little research has been done to explore their use among states. Following a search in all 50 states, this paper examines decisions from state officials imposing conditions intended to address the impacts of transactions on healthcare price, access, and quality and provides recommendations for the effective use of conditions moving forward.

Accelerated extractable studies of borosilicate glass containers

This article describes the use of an accelerated extractable procedure for borosilicate glass containers. The procedure, which is very similar to a protocol developed by a PDA Task Force, includes the monitoring of Si, Na, K, Al, Ba, Ca, Mg, Fe, and Zn in the extracts as well as measurements of pH change and total extractables. Unlike the PDA protocol, which uses H2O as the sole extraction solution, the procedure outlined in this report used a variety of unbuffered (pH congruent to 4, H2O, pH congruent to 6.5, pH congruent to 8.0, pH congruent to 9.5, and pH congruent to 10.4) and buffered (pH = 8 and pH = 10) aqueous extraction media. Studies were completed for several borosilicate glasses, including a mixture of tubing vials, molded vials, and ampoules from US and European suppliers. Results of these studies are presented in this article and are discussed in terms of the interactions between borosilicate glasses and aqueous solutions.

Cancer, the public, and the radiographer

All radiographers can help bring about more cancer cures. In this context one's specialty--diagnosis or therapy--is less important than the fact that, because radiographers are seen by the public to be knowledgeable about health matters, they can exert an influence on how people think about the cancers. Why public attitudes to cancer adversely affect the number of patients cured and how radiographers might help improve the present lamentable situation is the subject of this paper.

Radiotherapists and cancer education

This paper argues three main points. First, that education has a vital part to play in the train of events that might lead to the cure of more patients with cancer in certain sites. Secondly, evidence is presented to show that the type of education that is needed must be of a special, and carefully devised kind. And, thirdly, it is argued that of all medical specialists involved in cancer treatment radiotherapists are uniquely placed to stimulate and to support cancer education programmes.