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PubMed2001

Institutional and legislative issues of emergency management policy in Russia.

The emergency management policy as an organic component of the national development policy in contemporary Russia exists only for a slight more than a decade. However, its basic trends and directions could be revealed. In the legislative area covering technological accidents involving hazardous materials these include increasing differentiation of acts in terms of issue coverage, gradual integration of legislation via enforcement of the so-called systemic (umbrella) acts and increasing incorporation of specific acts, and keeping dominance of federal emergency acts. In addition, emergency legislation and policy programs on communities' protection against major hazards drift from alleviation-oriented towards more mitigation-focused. Meanwhile, the bulk of the existing acts are still specific laws and regulations, which consider most emergency response. In institutional realms the key direction of emergency policy development involved organization and progress of the Unified State System for Emergency Prevention and Elimination of the Russian Federation (USEPE) with EMERCOM as a key coordinator and actor in handling technological hazards and accidents. The detailed analysis of USEPE organizational pattern and operation modes including institutional structure, key functions, means and forces and operation routines is provided. It is argued that the system's logic and flexible organizational framework only to some extent contribute to effective mitigation of the major emergencies and/or disasters. In no less extent it depends on the existing socioeconomic conditions, which have been for a long time unfavorable in Russia and thus seriously constrain the USEPE effectiveness. This provides for ambiguous integral evaluation of the emergency management policy in the 1990s and early 2000s.

Disaster Planning↗
PubMed2002

Seatbelt use, attitudes, and changes in legislation: an international study.

BACKGROUND: The use of seat belts is among the most effective methods of reducing injury in motor vehicle crashes. We examined trends in seat belt use by university students from 13 European countries between 1990 and 2000, in relation to changes in legislation, attitudes, and hazardous driver behaviors. METHODS: Data were collected via an anonymous standardized questionnaire from university students in Belgium, England, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, the Netherlands, Poland, Portugal, and Spain. There were 10,576 respondents in 1990, and 10,294 in 2000. Data were also collected from 1672 students in the United States in 2000. Analyses were performed in early 2002. RESULTS: Reported seat belt use increased from 63% to 73% in male students, and from 66% to 77% in female students over the decade. There were marked increases in seat belt use in countries with changes in legislation or enforcement from 1990 to 2000, with 24% to 64% more respondents reporting seat belt use in 2000. The prevalence of use and noted changes during this period correlated with findings from national surveys (r= 0.91). Attitudes to seat belt use were associated with behavior both within and between countries. Nonuse of seat belts was positively related to alcohol-impaired driving and failure to obey speed limits. CONCLUSIONS: Legislation has a substantial impact on the use of vehicle seat belts, but additional gains require efforts to change attitudes within the university student population.

Accidents, Traffic↗
PubMed2000

Abortion in Brazil: legislation, reality and options.

Abortion is illegal in Brazil except when performed to save the woman's life or in cases of rape. This paper gives a brief history of parliamentary and extra-parliamentary efforts to change abortion-related legislation in Brazil in the past 60 years, the contents of some of the 53 bills that have been tabled in that time, the non-governmental stakeholders involved and the debate itself in recent decades. The authorities in Brazil have never assumed full public responsibility for reproductive health care or family planning, let alone legal abortion; the ambivalence of the medical profession is an important obstacle. Most politicians avoid getting involved in the abortion debate, but the majority of bills in the 1990s have favoured less restrictive legislation. Incremental legislative and health service changes could help to improve the situation for women. Advocacy is probably the most important action, to promote an environment conducive to change. Clandestine abortion is a serious public health problem in Brazil, and the inadequacy of family planning services is one of the causes of this problem. The solutions should be made a priority for the Brazilian public health system.

Abortion, Illegal↗
PubMed1991

Mandated leave: an analysis of federal and state legislation.

Results of a survey of federal and state legislation on family and medical leave, based on proposed legislative activities in 1986 and 1987 and on the outcome of these activities from 1986 to 1991, are presented. Major variations in employee provisions and employer protections are outlined and discussed, and likely directions for future legislation identified.

Adult↗
PubMed1997

Smoking among hospital doctors in Israel and their attitudes regarding anti-smoking legislation.

Anti-smoking legislation has been implemented in several countries. In order to study the attitudes of Israeli doctors to such legislation, 260 hospital doctors were questioned regarding their smoking habits and attitudes towards anti-smoking legislation. It was discovered that 15.8% are current smokers [40% of radiologists, 25% of surgeons and anesthetists, and 8% of internists and pediatricians (P = 0.0005)], of which 76% began smoking before the age of 20, and 54% tried to quit at least once. 24.2% of the current non-smokers are prior smokers who stopped, 92% of non-smokers and 83% of smokers tell their patients to quit (P = 0.10). 69% feel that cigarette sales should be limited to those of 18 y and older, 77% that advertisements for cigarettes should be prohibited, and 74% that nicotine should be recognized as an addictive substance. Doctors who smoke may have difficulty promoting healthy behavior among their patients. They must be offered help in order to quit, and emphasis should be placed on prevention among medical students.

Adult↗
PubMed2002

Medicare medical nutrition therapy: legislative process and product.

The new Medicare benefit, medical nutrition therapy (MNT), came into effect January 2002-the product of a lengthy legislative process. Over several years, evidence-based advocacy by groups such as the American Diabetic Association and the National Kidney Foundation led to a legislative product that was introduced and passed by Congress. More recently, the legislation entered an implementation process, including the most recent Coverage Determination phase. The definition of MNT and the scientific evidence supporting it are presented. Evidence-based nutrition now enters a new phase of implementation and additional analysis.

Dietetics↗
PubMed2006

Comparison of European national legislation efficiency on the reduction of air pollutant emissions.

Since 1995, the Institute for Environment and Development in Portugal has obtained >300 stack samples from various point sources of Portuguese industries. A coherent database was made with the collected results. The limit values fixed by several European legal documents consulted, Portuguese, Spanish, French, Italian, and Dutch emission legislation, were applied to the Institute for Environment and Development stack sampling inventory (from 1995 to 2000) to evaluate the efficiency of these standards in promoting the control and reduction of atmospheric pollutants emissions, especially regarding nitrogen oxides, sulfur dioxide, and particulate matter. The conclusion was that the original Portuguese legislation was not restrictive enough and not very efficient regarding emissions reduction. In contrast, the Dutch and Italian legislations are quite restrictive but very efficient concerning emission control for the three pollutants analyzed. One of the outcomes of this study was the publication of a new law in Portugal regulating the emissions of atmospheric pollutants. The strategy of this emissions control law follows the conclusions found in this study including the concept of a mass flow threshold and different approaches depending on source dimension.

Air Pollutants↗
PubMed2005

In-car cell phone use and hazards following hands free legislation.

OBJECTIVE: A new law took effect in Finland at the beginning of 2003 which prohibits the handheld use of mobile phones while driving a motor vehicle. The purpose of this study was to assess the impact of the law on phone usage and self-reported safety during the first few months and 16 months later to determine whether the initial level of compliance with the law had been sustained. METHODS: Data were collected by Gallup home poll before (spring 2002) and after legislation took effect (spring 2003 and 2004). A representative sample of drivers who owned a cell phone (n = 836 to 966) was interviewed each time. On-road observations were also collected in four cities for 2003 and 2004. RESULTS: Just after the law, 97% of drivers were aware of the new hands free legislation. In sharp contrast to the pre-law rate of 16%, 43% reported not using the phone while driving immediately after the law and 41% one year later. The occasional users especially reduced their use of phones while driving. The law was correlated to reductions in self-reported handheld use of cell phones while driving, from 55.6% pre-law to 15.2% immediately after passage. In spite of this change, however, the hands free legislation did not reduce self-reported involvement of Finnish drivers in phone-related hazards. Handheld usage was still lower in 2004 than pre-law (20.0%), but the 32% increase from 2003 was significant. Observational data collected in Finland in 2003 and 2004 showed an even higher upward trend in handheld use (87% increase, from 3.1% to 5.8%; pre-law data were not available), and matched a similar increase reported by McCartt and Geary (2004) in their observational evaluation of New York's handheld mobile phone law. CONCLUSION: The self-reports indicate that the hands-free law reduced handheld phone use, among occasional users especially, but did not reduce phone-related hazards. The effect of the law on phone use substantially declined within one year.

Adult↗
PubMed2004

Child motor vehicle occupant and pedestrian casualties before and after enactment of child restraint seats legislation in Japan.

PROBLEM: Prevention of injuries to child passengers is a significant public health priority, as motor vehicle-related injuries remain a leading cause of death for children in Japan. The purpose of compulsory child restraint seats legislation in April 2000 was to reduce the number of child passengers killed or injured in motor vehicle crashes. METHODS: The objectives of this preliminary evaluation are to measure the effectiveness, benefits and usage of safety seats for child passengers aged 1-5 years by analysing the child casualty data for the period of 1997--2002. Population and vehicle miles travelled based injury and fatality rates were used to compare before and after legislation trends in child casualties. RESULTS: Despite overall increases in the use of child restraint seats (as observed by different national surveys), overall casualty rates in motor vehicle occupants in the 1-5 year age group did not change (fatalities and serious injuries) or even increased (minor injuries). CONCLUSIONS: Casualties among restrained children have not decreased since the law came to effect in the year 2000, perhaps because of incorrect usage of the seats. Given that exposure to crash environments is increasing, traffic safety advocates and public health community need to be aware of the importance of child restraints as a means of reducing the likelihood of injury. It is necessary to implement effective community-based child safety seat campaigns to disseminate the information on appropriate restraint use and to increase efforts to enforce the existing legislation.

Accidents, Traffic↗
PubMed2001

Closing the gaps in genetics legislation and policy: a report by the new york state task force on life and the law.

The New York State Task Force on Life and the Law, a state bioethical policy commission, recently completed a project addressing the ethical, legal, and social concerns surrounding the predictive uses of genetic testing. Its report, Genetic Testing and Screening in the Age of Genomic Medicine, makes legislative, public policy, and practice recommendations on a host of issues. As part of this project, the Task Force reviewed the current policy and legislative landscapes related to confidentiality protections for genetic information and the use of genetic information by insurers. It also assessed requirements for informed consent to clinical genetic testing and for the use of clinical samples for genetics research. The Task Force considered gaps and unintended consequences of relevant genetic testing legislation and assessed its flexibility to address new uses of genetic testing, such as pharmacogenetic testing, and new ways of offering tests, such as multiplex testing panels. The Task Force also considered the relevance of the pleiotropic characteristic of genes for issues of informed consent to genetic testing and the confidentiality of genetic information. The Task Force's recommendations, presented here, seek to promote the appropriate uses of clinical genetic testing and research while preventing potential harms.

Bioethics↗
PubMed1998

Developing genetic privacy legislation: the South Carolina experience.

The availability of presymptomatic and predisposition genetic testing has spawned the need for legislation prohibiting health insurance discrimination on the basis of genetic information. The federal effort, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, falls short by protecting only those who access insurance through group plans. A committee of University of South Carolina professionals convened in 1996 to develop legislation in support of genetic privacy for the state of South Carolina. The legislation prevents health insurance companies from denying coverage or setting insurance rates on the basis of genetic information. It also protects the privacy of genetic information and prohibits performance of genetic tests without specific informed consent. In preparing the bill, genetic privacy laws from other states were reviewed, and a modified version of the Virginia law adopted. The South Carolina Committee for the Protection of Genetic Privacy version went a step further by including enforcement language and excluding Virginia's sunset clause. The definition of genetic information encompassed genetic test results, and importantly, includes family history of genetic disease. Our experience in navigating through the state legislature and working through opposition from the health insurance lobby is detailed herein.

Confidentiality↗
PubMed1994

Supports for community-based mental health care: an optimistic review of federal legislation.

For the past 50 years, federal legislation has been a key force in shaping the delivery of public mental health services. This article describes and summarizes recent relevant federal legislative initiatives and analyzes their potential in providing support, either explicit or implicit, for community-based mental health care for adults in the United States. These legislative mandates and options can be a source of optimism and ammunition for advocates and change agents as they continue to work vigorously to improve the mental health services system.

Community Mental Health Services↗
PubMed2004

Would legislation imposing single embryo transfer be a feasible way to reduce the rate of multiple pregnancies after IVF treatment?

Due to increased maternal and fetal risks, there is a strong opinion in favor of single embryo transfer (SET) in order to reduce the high multiple pregnancy rate after IVF. We have evaluated the effects on pregnancy rate and twinning of recent Swedish legislation on SET. The study comprised three embryo transfer (ET) periods: period I, autumn 2001-spring 2002 (n=609), with a double embryo transfer (DET) policy; period II, autumn 2002 (n=320), a transitional period; and period III, January-September 2003 (n=433), with a SET policy. During the three periods, the SET rates were 25.1, 55.5 and 72.7%, respectively (Kruskal-Wallis test P<0.0001). There was no difference in clinical pregnancy rates (33.3, 32.8 and 37.4%, respectively) (P=0.4), but the twinning rate was significantly lower in the third period (6.2 versus 22.6% in period I and 16.3% in period II) (P<0.005). After introducing a SET policy, the expected decline of twinning was met at an unchanged clinical pregnancy rate. Thus, the SET legislation had no negative consequences for the couples. On the contrary, the lower rate of twinning is expected to reduce the severity and rate of pregnancy complications after IVF. Whether legislation or voluntary SET is the most feasible way to proceed, in order to reduce the multiple pregnancy rates after IVF, can be debated.

Adult↗
PubMed2006

Legislating fear and the public health in gilded age Massachusetts.

Between 1876 and 1881 Massachusetts experienced an outbreak of human rabies (hydrophobia). The entire state--the Governor, the legislature, the State Board of Health, newspapers, and the citizenry and elected officials of every town and city--reacted to the disease. Central to the response was the Commonwealth's legislature--called the General Court. Through public hearings, their own debates, and the passage of legislation, it resolved widespread fear and anger, mediated conflicting concepts of disease, and promoted social solidarity in the face of an epidemic. This article first narrates the General Court's legislative actions; it then examines the conflicting understandings of disease causality; finally, it explores the social and political rituals the legislature drew upon to deal with this public health crisis. Arguing that public health legislation is simultaneously instrumental and symbolic, this article demonstrates that attention to both enriches the study of epidemics, historical and yet to come.

Disease Outbreaks↗
PubMed2006

Legislation on smoking in enclosed public places in Scotland: how will we evaluate the impact?

BACKGROUND: From 26 March 2006, smoking will be prohibited in wholly and substantially enclosed public places in Scotland, and it will be an offence to permit smoking or to smoke in no-smoking premises. We anticipate that implementation of the smoke-free legislation will result in significant health gains associated with reductions in exposure to both environmental tobacco smoke (ETS) and personal tobacco consumption as well as other social and economic impacts. METHODS: Health Scotland in conjunction with the Information Services Division (ISD) Scotland and the Scottish Executive have developed a comprehensive evaluation strategy to assess the expected short-term, intermediate and long-term outcomes. Using routine health, behavioural and economic data and commissioned research, we will assess the impact of the smoke-free legislation in eight key outcome areas--knowledge and attitudes, ETS exposure, compliance, culture, smoking prevalence and tobacco consumption, tobacco-related morbidity and mortality, economic impacts on the hospitality sector and health inequalities. CONCLUSION: The findings from this evaluation will make a significant contribution to the international understanding of the health effects of exposure to ETS and the broader social, cultural and economic impacts of smoke-free legislation.

Air Pollution, Indoor↗
PubMed1987

Impact of routine inquiry legislation in Oregon on eye donations.

Routine inquiry legislation can significantly affect procurement of donor eye tissues. Oregon Revised Statute (ORS) 97.268 was the first legislation of this type passed in the United States. In the first 12 months under this legislation, the Oregon Lions Eye Bank obtained, 2,312 eyes, sustaining a 135% increase in donor eye procurement over the yearly average for 1984-1985. During the first 12 months of routine inquiry, 484 corneas suitable for penetrating keratoplasty were obtained versus an annual average of 291 corneas for 1984-1985. Tissues for other transplant purposes and for research have similarly become more available. Age of donor tissue appears to be increasing slightly due to the disproportionate increase of donor eyes from the 70-or-over population. The Oregon Donor Program, the public and professional education coalition of the transplant programs in the state of Oregon, has played an invaluable role in making this penalty-free law a success.

Corneal Transplantation↗
PubMed2004

A critique of emerging European legislation in the pharmaceutical industry: a clinical trials analysis.

The objective of this paper is to critique emerging legislation in the pharmaceutical industry, focusing on the clinical trials sector. Possible changes are identified and discussed inrelation to their impact on phase I clinical trials conducted in the UK. It is concluded that smaller contract research organisations, which have benefited in the past from European Union legislative variation, may have resource problems in trying to cope with the changing business environment created through legislative harmonization. These SMEs must use this opportunity to seek clinical trials research partnerships in a new harmonized EU market.

Clinical Trials as Topic↗
PubMed2006

The impact on histopathology practice of new human tissue legislation in the UK.

The undisclosed or unauthorized retention of tissue from autopsies in the UK and elsewhere has caused considerable public concern and much distress to some families. Histopathologists involved in these cases have also been discomfited. These events have exposed deficiencies in prevailing legislation, principally in the Human Tissue Act 1961 and the Coroners Rules 1984. New human tissue legislation comes into force in the UK in September 2006. The Human Tissue Act 2004 and the Human Tissue (Scotland) Act 2006 make it unlawful to remove, store and use tissue from the dead without appropriate authority. The Human Tissue Act 2004, which does not apply in Scotland, also prohibits the removal, storage and use of tissue from living individuals for purposes specified in the Act unless appropriate consent has been obtained. The Coroners (Amendment) Rules 2005, which came into force in June 2005, introduced new arrangements for dealing with the retention of tissue from bodies undergoing coroner's autopsies. This new legislative regime is intended to create a climate in which pathologists, patients and the public can have confidence that tissue is used appropriately and, when necessary, with proper authority or valid consent. However, other than in Scotland, there may be unintended consequences arising from restrictions on archiving, for audit and diagnostic review, tissue samples from coronial autopsies.

Autopsy↗