Testing Drugs and Attesting Cures: Pharmaceutical Monopolies and Military Contracts in Eighteenth-Century France.

This article explores the role of testing in the allocation of royal monopoly privileges for drugs in eighteenth-century France by following the multi-generational fortunes of a single "secret remedy" from 1713 to 1776: the poudre fébrifuge of the Chevalier de Guiller. On at least five occasions, this drug was tested on patients in order to decide whether it should be protected by a privilege and whether or not its vendors should be awarded lucrative contracts to supply it in bulk to the French military. Although efforts were made early in the century to test the drug through large-scale hospital trials and to relegate privilege granting to a bureaucratic commission, the case of the poudre fébrifuge instead suggests that military expediency and relatively small-scale trials administered personally by royal practitioners remained decisive in determining whether or not a drug received a monopoly privilege or a military contract.

Del Hospital Municipal de Trujillo y del cese de las Hermanas Amantes de Jesús / O Hospital Municipal de Trujillo ea cessação de amantes Irmãs de Jesus / Municipal Hospital of Trujillo and the cessation of Lovers Sisters of Jesus

Los objetivos del estudio fueron realizar una descripción del hospital municipal y de las obras acometidas, exponer las condiciones del convenio entre el Ayuntamiento y las religiosas y describir los cambios que se producen durante 1894. Se ha realizado un estudio histórico-documental durante los años 2014-2015 de los legajos depositados en el Archivo Municipal de Trujillo. El Hospital de la ciudad de Trujillo estaba destinado a la atención de ciudadanos, militares y transeúntes enfermos. La atención a los enfermos fue realizada por las Hermanas Amantes de Jesús y María Inmaculada desde el año 1890. En la labor asistencial, las religiosas fueron ayudadas por una enfermera y un enfermero contratados por el Ayuntamiento. Durante 1894 se produjeron una serie de cambios, promovidos por la Corporación Local de la ciudad, que provocaron que las religiosas cesaran su labor asistencial. Estos cambios se vieron motivados por las quejas recibidas por los enfermos ingresados y por lo costoso que la atención resultaba para el Ayuntamiento. El cese de las hermanas llevaría a que el Ayuntamiento tuviera la necesidad de estudiar una nueva organización a nivel de régimen y administración (AU)

O alvo de este estudo foi a descrição do hospital e das obras de remodelação do mesmo, assim como expor as condições do contrato entre as religiosas e a Câmara. Descrevem-se também as alterações producidas durante 1894. Em 2014 e 2015 realizou-se un trabalho de investigação dos documentos depositados no Arquivo Municipal da cidade de Trujillo. O Hospital Municipal da cidade de Trujillo, estava destinado ao atendimento de cidadãos, militares e transeuntes doentes. O tratamento dos doentes foi realizado pelas Irmãs Amantes de Jesus e Maria Imaculada desde o ano 1890. Para dar assistência às irmãs seriam contratados uma enfermeira e um enfermeiro, pagos pela Câmara Municipal. Durante 1894 a Câmara Municipal efetuou uma série de alterações que produziram a cessação da tarefa assistencial das raligiosas. Esatas alterações foram originadas pelas queixas de alguns dos doentes e pelas elevadas despesas que a Câmara Municipal tinha que pagar pela manutenção do hospital. Com a cessação da atividadde das irmãs a Câmara começou a estudar uma nova organização do regime e da administração da instituição (AU)

The objectives were to make a description of the hospital and the works undertaken, exposing the conditions of the agreement between the city and religious and describe changes that occur during 1894. There has been a historical documentary study during the years 2014-2015 of the files deposited in the Municipal Archives of Trujillo. The Municipal Hospital in the city of Trujillo, was destined to service citizens, sick soldiers and bystanders. The Sisters Lovers of Jesus and Mary Immaculate performed treatment of patients since the year 1890. To assist the sisters would be hired a nurse and a nurse, paid by the city. During 1894 the City Council performed changes that produced the cessation of the assistance service of religious. The changes originated by the complaints of some patients and the high costs that the City Council had to pay for hospital maintenance. With the cessation, the religious began to study a new organization of the regime and the management of the institution (AU)

[Continuing Medical Education in Germany - mandatory and voluntary obligations]. / Ärztliche Fortbildung in Deutschland -Pflicht und Freiwilligkeit.

After 1945 the common medical training infrastructure was broken up into two different political systems. While in the Federal Republic of Germany the structure was based on physicians' self-governance, in the German Democratic Republic medical professional structures were organised by the government. After the unification of the two German states, which took place on October 3, 1990, the centralistic structure was replaced by the system of physician self-governance. Before January 1, 2004, continuing medical education (CME) in West Germany relied on a system of voluntary obligations. In East Germany, though, professional CMEs were compulsory; they were called "obligatorische periphere Fortbildung." Based on 15 expert interviews on the topic of "CME in Germany", the different circumstances and conditions were analysed taking account of the historical background. Only selected professionals with experience in both German states (one with a federal, the other with a centralistic system), were chosen for the survey.

Analysing contractual environments: lessons from Indigenous health in Canada, Australia and New Zealand.

Contracting in health care is a mechanism used by the governments of Canada, Australia and New Zealand to improve the participation of marginalized populations in primary health care and improve responsiveness to local needs. As a result, complex contractual environments have emerged. The literature on contracting in health has tended to focus on the pros and cons of classical versus relational contracts from the funder's perspective. This article proposes an analytical framework to explore the strengths and weaknesses of contractual environments that depend on a number of classical contracts, a single relational contract or a mix of the two. Examples from indigenous contracting environments are used to inform the elaboration of the framework. Results show that contractual environments that rely on a multiplicity of specific contracts are administratively onerous, while constraining opportunities for local responsiveness. Contractual environments dominated by a single relational contract produce a more flexible and administratively streamlined system.

Supplier behaviour and public contracting in the English agency nursing market.

The worldwide expansion in the use of private firms to deliver public services and infrastructure has promoted a substantial literature on public sector contract and relationship management. This literature is currently dominated by the notion that supplier relationships should be based upon trust. Less prominent are more sceptical approaches that emphasize the need to assiduously manage potential supplier exploitation and opportunism. This article addresses this imbalance by focusing upon the recent experience of the English National Health Service (NHS) in its dealings with its nursing agencies. Between 1997 and 2001, the NHS was subjected to considerable exploitation and opportunism. This forced managers to adopt a supply strategy based upon an assiduous use of e-auctions, framework agreements and quality audits. The article assesses the effectiveness of this strategy and reflects upon whether a more defensive approach to contract and relationship management offers a viable alternative to one based upon trust.

Doctors five: African-American contract surgeons in the Spanish-American War.

The role played by African-American contract surgeons during the Spanish-American War has been a neglected aspect of the war's medical history. These men left their civilian practices, as did their white colleagues, to serve in the U.S. Army for relatively (even for the time) little compensation. After the war, as "civilian employees," they were not even eligible for a pension. Patriotism motivated their call to arms.

Master Samuel Ebrej ophthalmic surgeon of Dubrovnik and contracts relating to medical services dating from 1414.

Throughout the Middle Ages, Dubrovnik maintained active and regular commercial and maritime contacts with various cities and states of the Mediterranean. These activities led to the organisation of a health care system and the development of medicine. With respect to the economic, commercial and maritime aspects of the culture of this city state, Dubrovnik became open to the civilising progress of the region and period. The brief visit of the Mediaeval ophthalmologist, Master Samuel Ebrej supports this fact.