The Chorioallantoic Membrane Assay in Nanotoxicological Research-An Alternative for In Vivo Experimentation.

Nanomaterials unveil many applicational possibilities for technical and medical purposes, which range from imaging techniques to the use as drug carriers. Prior to any human application, analysis of undesired effects and characterization of their toxicological profile is mandatory. To address this topic, animal models, and rodent models in particular, are most frequently used. However, as the reproducibility and transferability to the human organism of animal experimental data is increasingly questioned and the awareness of animal welfare in society increases at the same time, methodological alternatives are urgently required. The chorioallantoic membrane (CAM) assay is an increasingly popular in ovo experimental organism suitable for replacement of rodent experimentation. In this review, we outline several application fields for the CAM assay in the field of nanotoxicology. Furthermore, analytical methods applicable with this model were evaluated in detail. We further discuss ethical, financial, and bureaucratic aspects and benchmark the assay with other established in vivo models such as rodents.

Long-term care issue brief: end of life issues: year end report-2004.

End of life care is a broad issues that encompasses many issues. Three of the larger issues are assisted suicide, chronic pain management, and advance health care directives. Assisted suicide has emerged as one of the most controversial ethical issues in the medical community, and one that is complicated more by technological advances that have allowed people to live longer. But as policymakers debate assisted suicide policy, state lawmakers must also examine ways to improve pain management and end-of-life care for people who suffer from terminal illnesses. Lawmakers are also grappling with ways to make it easier for individuals to specify their end-of-life wishes through advance health care directives.

Providers issue brief: nursing home staffing standards: year end report-2003.

For more than a decade, lawmakers have focused on improving care in the nation's nursing homes by mandating tighter regulations for the industry. With a growing elderly population and findings that suggest a majority of nursing facilities are understaffed to the point of endangering the health of patients, states and the federal government are strengthening their resolve to crack down on delinquent facilities and introduce minimum requirements for staffing levels to improve quality of care. A common way states have chosen to impose these requirements is through minimum staff-to-patient ratios, but states also must address how to fund mandated staff increases.

Providers issue brief: family caregiving: year end report-2003.

In response to the national Family Caregiver Support Program, created in the Older Americans Act of 2000, states have implemented or expanded programs to assist family and informal caregivers in providing care to frail and disabled individuals. As long-term care costs continue to rise, states are looking to help people who care for elderly individuals by keeping them off Medicaid and out of costly nursing homes.

Finance issue brief: long-term care insurance: year end report-2003.

A 1996 federal law made it more attractive for states to consider long-term care insurance, and states have responded by implementing policies to make the purchase of these long-term care coverage more affordable and consumer-friendly. At present, policymakers continue to debate the future role of private long-term care insurance in subsidizing the increasing demand for long-term care services.

Providers issue brief: nursing home liability insurance: year end report-2003.

States have been plagued in recent years by dramatic increases in nursing home liability insurance premiums and the flights of insurance carriers. This has forced many nursing homes to operate with substandard levels of coverage or sometimes no coverage at all. As this crisis worsens, many states are taking action to protect both nursing home providers and residents.

Providers issue brief: end of life issues: year end report-2003.

Assisted suicide has emerged as one of the most controversial ethical issues in the medical community, and one that is complicated more by technological advances that have allowed people to live longer. But as policymakers debate assisted suicide policy, state lawmakers must also examine ways to improve pain management and end-of-life care for people who suffer from terminal illnesses.