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Under the Physician Payments Sunshine Act, drug and device manufacturers and group purchasing organizations will report to the Centers for Medicare and Medicaid Services payments made to physicians and teaching hospitals, and the data will be posted on a public website. The new Physician Payments Sunshine Act requires public reporting of payments to physicians and teaching hospitals from pharmaceutical and medical device companies, as well as reporting of certain ownership interests (see box). Sponsored by Senators Charles Grassley (R-IA) and Herb Kohl (D-WI) and supported by consumer advocates, the law covers meals, honoraria, travel expenses, and grants from manufacturers, as well as ownership or investment interests in group purchasing organizations (GPOs), by physicians or members of their immediate family. Information will be posted on a public website that will identify physicians who have received payments or hold ownership. Data collection begins . . .

Will new rules requiring drug and device companies to disclose payments to physicians and teaching hospitals have the intended effects? Disclosure's benefits are unlikely to be realized without the activation of “learned intermediaries,” such as health insurers. After extensive public comment, the Centers for Medicare and Medicaid Services (CMS) issued final regulations in February implementing the Physician Payments Sunshine Act, enacted as part of the Affordable Care Act. 1 The 287-page document details requirements for producers of drugs, biologics, devices, and medical supplies to disclose virtually all transfers of value to physicians and teaching hospitals. The provisions were intended to help patients make more informed decisions and to deter financial relationships that might inflate health care costs. 1 The rules go well beyond preexisting law but stop short of directly regulating financial relationships. Given that CMS projects compliance costs . . .

At an understaffed and underresourced urban African training hospital, Malawian medical students learn to be doctors while foreign medical students, visiting Malawi as clinical tourists on short-term électives, learn about \"global health.\" Scientific ideas circulate fast there; clinical tourists circulate readily from outside to Malawi but not the reverse; medical technologies circulate slowly, erratically, and sometimes not at all. Medicine's uneven globalization is on full display. I extend scholarship on moral imaginations and medical imaginaries to propose that students map these wards variously as places in which—or from which—they seek a better medicine. Clinical tourists, enacting their own moral maps, also become representatives of medicine \"out there\": points on the maps of others. Ethnographic data show that for Malawians, clinical tourists are colleagues, foils against whom they construct ideas about a superior and distinctly Malawian medicine and visions of possible alternative futures for themselves. In einem unterbesetzten, unterfinanzierten afrikanischen Lehrkrankenhaus werden malawische Medizinstudenten zu Ärzten ausgebildet. Auch ausländische Medizinstudenten studieren dort; sie besuchen Malawi als \"klinische Touristen\" für kurzfristige Aufenthalte, bei denen sie Wahlfächer belegen und etwas über \"globale Gesundheit\" lernen. Wissenschaftliche Ideen zirkulieren dort schnell. Medizinische Technologien verbreiten sich langsam, unregelmäßig, und manchmal überhaupt nicht: die ungleiche Globalisierung der Medizin ist unübersehbar, ich erweitere die Literatur über moralische und medizinische Imaginationen und argumentiere, dass die Studenten sich diese Krankenhausabteilungen auf \"moralischen Karten\" vorstellen, entweder als Orte wo—oder von wo aus—sie eine \"bessere Medizin\" anstreben. Klinische Touristen (die ihren eigenen moralischen Karten folgen) repräsentieren außerdem die Medizin \"da draußen\": Sie werden zu Punkten auf den \"moralischen Karten\" Anderer. Für malawische Medizinstudenten sind diese ausländischen klinischen Touristen Kollegen, ein Hintergrund, vor dem sie Ideen einer überlegenen und spezifisch malawischen Medizin und alternative Zukunftsvisionen für sich selbst konstruieren. Dans un hôpital d'enseignement africain, en sous-effectif et manquant de ressources, les étudiants malawiens apprennent à être médecins alors que les étudiants étrangers, « touristes cliniques » en visite au Malawi, s'informent sur la « santé publique mondiale ». Les idées scientifiques circulent rapidement; les touristes circulent facilement de l'étranger au Malawi mais pas vice-versa; quand les technologies médicales circulent, c'est lentement. La mondialisation inégale de la médecine est exposée. J'accrois la recherche sur les imaginations morales et imaginaires médicaux, argumentant que les étudiants dépeignent cette expérience comme étant un lieu où, et par l'intermédiaire duquel, ils recherchent une médecine meilleure. Les touristes affichent leur scheme moral et représentent également la médecine de « là-bas »: des repères pour les autres. Les données ethnographiques démontrent que pour les Malawiens, les touristes sont des collègues à travers qui ils construisent les concepts d'une médecine malawienne supérieure et d'un avenir différent.

By promoting ID and questioning evolution, Dover's elected school board aligned itself with national public opinion, which consistently shows a majority favors teaching Biblical creationism in addition to evolution [2]. [...]a 2005 poll conducted by the Pew Forum on Religion and Public Life reports that 38% of Americans would prefer that creationism was taught instead of evolution [3]. [...]few state school boards can formally consider measures like the one adopted in Dover without scrutiny and challenge from organizations representing the scientific profession.

With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS), cost per day (CPD), inpatient mortality rate (IMR), and length of stay (LOS), using a generalized additive model. There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001), from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role. However, purely market-oriented health-care reform could also misguide future healthcare reform.

The right to educational inclusion for students with intellectual disability (SWID) requires the development of good assessment and intervention practices from holistic perspectives not exclusively focused on the academic limitations that SWID may present. These practices are settled in Spain, via regulations drawn up by each Autonomous Community (AC). The variety of existing regulations demands a critical review of the decisions taken to promote the inclusion of those students. current regulations-in-force in each AC that regulate attention to diversity (AD) have been were analyzed by using a checklist that includes the variables that defining each stage of the AD process and the ways of providing supports that favor the development, learning and participation of SWID. attention to diversity measures in each AC emphasize organizational and curricular issues, with no AC following holistic approaches in both assessment and intervention, but rather neglecting self-determination and the promotion of quality of life for SWID. guidelines for the development of new legal frameworks and professional practices based on the latest evidence-based models of attention to SWID and on the results are discussed.

In the letter to Johann Malawana, chair of the BMA's Junior Doctors Committee, Hunt said that the new contract would not cut junior doctors' pay or increase their working hours. The letter comes after Dan Poulter, a former Conservative health minister, criticised the government's handling of the junior doctors' contract. 2 Sarah Wollaston, conservative MP and chair of the parliamentary health select committee, has also expressed concerns about the consequences of imposing the new contract on junior doctors. 3 Responding to Hunt's letter, Maureen Baker, chair of the Royal College of General Practitioners, said she was pleased that Hunt had \"listened to our concerns, particularly around GP recruitment with the inclusion of pay protection for doctors who change to shortage specialties such as general practice.\"