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Health Phys ; 112(2): 176-181, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28027158


The world is experiencing change at an unprecedented pace, as reflected in social, cultural, economic, political, and technological advances around the globe. Regulatory agencies, like the U.S. Nuclear Regulatory Commission (NRC), must also transform in response to and in preparation for these changes. In 2014, the NRC staff commenced Project Aim 2020 to transform the agency by enhancing efficiency, agility, and responsiveness, while accomplishing NRC's safety and security mission. Following Commission review and approval in 2015, the NRC began implementing the approved strategies, including strategic workforce planning to provide confidence that NRC will have employees with the right skills and talents at the right time to accomplish the agency's mission. Based on the work conducted so far, ensuring an adequate pipeline of radiation protection professionals is a significant need that NRC shares with states and other government agencies, private industry, academia, as well as international counterparts. NRC is working to ensure that sufficient radiation protection professionals will be available to fulfill its safety and security mission and leverage the work of the National Council on Radiation Protection and Measurements, the Conference of Radiation Control Program Directors, the Health Physics Society, the Organization of Agreement States, the International Atomic Energy Agency, the Nuclear Energy Agency, and others.

Regulamentação Governamental , Física Sanitária/legislação & jurisprudência , Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência , Mão de Obra em Saúde/legislação & jurisprudência , Proteção Radiológica/legislação & jurisprudência , United States Government Agencies/legislação & jurisprudência , Escolha da Profissão , Emprego/legislação & jurisprudência , Fidelidade a Diretrizes/legislação & jurisprudência , Estados Unidos
Neurology ; 86(3): 297-306, 2016 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-26519545


Antiepileptic drugs (AEDs) are among the most common teratogenic drugs prescribed to women of childbearing age. AEDs can induce both anatomical (malformations) and behavioral (cognitive/behavioral deficits) teratogenicity. Only in the last decade have we begun to truly discriminate differential AED developmental effects. Fetal valproate exposure carries a special risk for both anatomical and behavioral teratogenic abnormalities, but the mechanisms and reasons for individual variability are unknown. Intermediate anatomical risks exist for phenobarbital and topiramate. Several AEDs (e.g., lamotrigine and levetiracetam) appear to possess low risks for both anatomical and behavioral teratogenesis. Despite advances in the past decade, our knowledge of the teratogenic risks for most AEDs and the underlying mechanisms remain inadequate. Further, the long-term effects of AEDs in neonates and older children remain uncertain. The pace of progress is slow given the lifelong consequences of diminished developmental outcomes, exposing children unnecessarily to potential adverse effects. It is imperative that new approaches be employed to determine risks more expediently. Our recommendations include a national reporting system for congenital malformations, federal funding of the North American AED Pregnancy Registry, routine meta-analyses of cohort studies to detect teratogenic signals, monitoring of AED prescription practices for women, routine preclinical testing of all new AEDs for neurodevelopmental effects, more specific Food and Drug Administration requirements to establish differential AED cognitive effects in children, and improved funding of basic and clinical research to fully delineate risks and underlying mechanisms for AED-induced anatomical and behavioral teratogenesis.

Anormalidades Induzidas por Medicamentos , Anticonvulsivantes/efeitos adversos , Transtorno do Espectro Autista/induzido quimicamente , Transtornos Cognitivos/induzido quimicamente , Doenças Fetais/induzido quimicamente , Doenças do Recém-Nascido/induzido quimicamente , Teratogênios/farmacologia , United States Government Agencies/normas , Animais , Feminino , Humanos , Recém-Nascido , Gravidez , Estados Unidos , United States Government Agencies/legislação & jurisprudência
J Health Polit Policy Law ; 40(4): 875-86, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26124309


The antitrust laws stand to protect consumers of health care services from conduct that would raise prices, lower quality, and decrease innovation by lessening competition. Importantly, though, vigorous antitrust enforcement does not impede accountable care organizations (ACOs) and similar collaborations that advance these same goals of better and more efficient care; in fact, by fostering competitive markets, the antitrust laws encourage such initiatives. This article summarizes the legal framework that the federal antitrust agencies - the Federal Trade Commission and the Antitrust Division of the US Department of Justice - use to analyze ACOs and other collaborations among health care providers. It outlines the guidance provided by the federal antitrust agencies concerning when ACOs and other provider collaborations likely would harm competition and consumers. In addition, it reviews common antitrust issues that can arise with ACOs and provides examples of enforcement actions that have prevented health care providers from taking or continuing anticompetitive actions.

Organizações de Assistência Responsáveis/legislação & jurisprudência , Leis Antitruste , Comportamento Cooperativo , Competição Econômica/legislação & jurisprudência , Setor de Assistência à Saúde/legislação & jurisprudência , Eficiência Organizacional , Governo Federal , Humanos , Aplicação da Lei , Estados Unidos , United States Government Agencies/legislação & jurisprudência