Containment strategies

Inference engine The inference engine represents the central problem-solving subsystem. It contains strategies for using the information contained in the... 

A variety of containment strategies employ floating solid objects to control the rate of gaseous emissions from surface impoundments. These include synthetic membrane covers, rafts, and hollow plastic spheres. Synthetic membrane covers are feasible where the out-gassing of volatiles due to biological activity is not expected. Selection of the liner material must be... 

Another containment strategy for condensible or water-soluble emissions is to use a water quench system with the discharge being sparged into a large volume of cool liquid. 

SD Horn, PD Sharkey, DM Tracy, CE Horn, B James, F Goodwin. Intended and unintended consequences of HMO cost-containment strategies results from the managed care outcomes project. Am J Managed Care 2 253-264, 1996. 

In general, the results confirm the short-term nature of the pharmaceutical cost containment strategy. The trend followed by spending in the long term effectively shows a return to the initial levels prior to the measures. 

Reeder, C., et al., "Economic Impact of Cost Containment Strategies in Third Party Programmes in the U.S. ( Part 1)," Pharmaeconomics, 4, 92-103 (1993). 

Traditional cost-containment measures are not always consistent with improved patient care. Thus attention has turned toward demonstrating the value of health care. A full evaluation of relevant costs and consequences differentiates outcomes research from traditional cost-containment strategies. Costs are defined as the value of the resources consumed by a program or treatment alternative. Consequences are defined as the effects, outputs, and outcomes of the program or treatment alternative (Eisenberg, 1989). 

The most conservative and safest potent-compound containment strategy depends on the use of engineering controls in both the processing equipment and the manufacturing facility. Specific design features of a high-containment facility should include the following 46... 

The above aspects are covered in more detail in Table 16.3.1 It should be kept in mind that Table 16.3 discusses general facility designs to consider when developing a containment strategy for highly potent compounds. However, each consideration is subject to rigorous risk assessment. Practically, this means a determination of whether the consideration or practice is required or is a nice extra to control exposures to an appropriate level. 

The ionically bonded sodium bromide receives two electrons, and loses two +ve sodium cations to form sodium tri-bromide (see Porterfield, 1993). An alternative homogeneous reaction route to tri-bromide is to bubble bromine (Br2) through aqueous sodium bromide. Accordingly, the electrochemically formed tri-bromide has an associated atmosphere of bromine from homogeneous dissociation. Such bromine is corrosive, but is contained by the fluorinated plastic tanks and by one side of the (Na ) Nafion perm-selective membrane. Nafion is itself a compound with many fluorine atoms. Bromine is very much lower than fluorine in chemical reactivity, so that the bromine containment strategy is complete, and the selection of the bromide electrolyte seen to be a well-considered choice. 

In response to rapidly increasing health care costs, private insurance companies and employers (who pay the premiums in whole or in part for their employees) have increased their part in implementing cost-containment strategies. A dramatic effort has been the application of business principles to purchasing and vendor selection and payment for and selection of health care providers and institutions of care. 

Because of cost-containment strategies of both the private and governmental sectors, hospital utilization has declined. This has resulted in a decline in the number of patient beds, the average length of stay, and patient bed census. The present predominant view is that hospitalization of any patient, regardless of revenue source, is to be avoided wherever possible. Only those patients for whom hospitalization can be fully justified are admitted. 

In addition to complexing metals in the aqueous phase, humic materials can also remove metals and radionuclides contained within the mineral matrix (18). The factors that control this behavior are not well understood however, it has direct implications on waste storage and containment strategies. The binding of organic and inorganic contaminants to humic substances is known to alter their bioavailability (41). Organic contaminants that are associated with humic substances are essentially unavailable for uptake by biota. In most cases studied, toxic metals associated with humic materials also have reduced uptake. With the new focus on bioremediation of polluted are as, the effect of the association of pollutants with humic materials on their phytotoxic properties must be considered, particularly for bound metals and radionuclides. 

To more fully understand the impact of managed care on the pharmaceutical industry, a look at managed care s cost-containment strategies and continued movement toward multiple payers will be presented first, followed by the influential market dynamics of increased competition and changing demographics. Concluding the section will be a discussion of how these factors have impacted the pharmaceutical industry s research and development priorities and product life cycles. 

In addition to the influence of a growing geriatric market segment on pharmaceutical industry research and development, each of the other managed care and market influences -cost-containment strategies, multiple payers and market competition - have collectively impacted pharmaceutical research and development. The pharmaceutical industry is highly... 

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