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PubMed1995

[Social legislative and structural deficits of ambulatory management of chronic psychiatric and handicapped patients].

In the past 25 years, psychiatric care for the chronically mentally ill in Germany has improved steadily. However, has improved steadily. However, this patient group continues to be discriminated against, especially in the sphere of outpatient care. The mentally ill often do not meet the requirements that the respective social security agencies, i.e. in particular pension and health insurance, set out for the granting of benefits. Moreover, contrary to scientific knowledge, measures aimed at the treatment of social disabilities are defined not as psychiatric rehabilitation measures, but as measures of social integration. For these reasons welfare is highly overrepresented in the financing of rehabilitation for the mentally ill. In recent years, legislators have attempted to compensate certain cases of discrimination. Significant legislative changes and administrative developments are described and discussed in terms of their implications.

Ambulatory Care↗
PubMed1996

Tough tobacco-control legislation begins to have an impact in Ontario.

In 1994 the Ontario government passed one of the world's toughest packages of antitobacco legislation. The Tobacco Control Act places restrictions on who can sell tobacco products, provides for severe penalties for retailers who sell to minors, bans smoking in many public places and severely restricts the use of designated smoking areas in others. The province has had antismoking legislation before, but enforcement was lax; this time enforcement of the law, particularly as it concerns retailers who sell to minors, has been given priority Brenda Gibson asks if these tough new measures are working.

Commerce↗
PubMed1996

Acetabular fractures before and after the introduction of seatbelt legislation.

OBJECTIVES: To compare the incidence and severity of acetabular fractures and associated injuries before and after seatbelt legislation. DESIGN: A retrospective study. SETTING: Two major trauma centres, which are teaching hospitals. PATIENTS: Three hundred and ninety-three patients who sustained acetabular fractures during the 5 years before and 5 years after seatbelt legislation was enacted. Of these, the fractures in 198 patients (50.4%) resulted from a motor vehicle accident. MAIN OUTCOME MEASURES: The number and severity of acetabular fractures and associated injuries. RESULTS: There has been a significant reduction in the number of acetabular fractures (p = 0.005) since seatbelt use became mandatory, and the complexity of the fractures has decreased. There has also been a marked reduction in associated injuries, such as fractures of other bones, and head, chest and abdominal injuries (p < 0.001). CONCLUSION: The seatbelt law has been a useful preventive measure, resulting in a reduction in the incidence of acetabular fractures and associated injuries.

Acetabulum↗
PubMed1995

A North American model to contain the spread of Aedes albopictus through tire legislation.

The introduction, spread, and establishment of the Asian tiger mosquito, Aedes albopictus, in the United States has been facilitated by used or waste tires. This species has not only caused considerable concern among public health officials but also highlighted that the growing accumulations of used tires are a serious solid waste problem and a challenge to the recycling industry. This paper illustrates how the State of Illinois addressed the public health and solid waste problems associated with waste tires, mosquitoes and mosquito-borne pathogens. The goal of the State was to develop and implement through legislative process the Illinois Waste Tire Act. The purpose of the Waste Tire Act is: 1) to ensure that used and waste tires are collected for disposal and recycling, 2) to provide for the abatement of used and waste tire dumps and associated threats to public health, 3) to encourage the development of used and waste tire processing facilities and technologies, including energy recovery, and 4) to provide for research on vectors associated with used and waste tires, and the diseases they spread. The discussion will include key statutes from the Act and the model used to coordinate the effort of five different governmental agencies. An up-to-date presentation of vector-related research, mandated by the Act, ranging from applied investigations on mosquito control to more basic studies investigations on virus identification using molecular technology will be discussed. Finally a discussion of problems that have been encountered along with solutions dealing with legislative language, multidisciplined agency efforts and interactions with the general public are presented.

Adaptation, Physiological↗
PubMed1996

Will breed-specific legislation reduce dog bites?

So how do we deal with biting dogs? To start with, we must remind ourselves that biting is a natural activity of all dogs, and that there is potential for injury. All dog owners must understand this and must be made aware that they are fully responsible for the actions of their dogs. I am not convinced that this is universally understood by dog owners, nor am I satisfied that every dog owner takes the necessary steps to train and socialize their dog. Owners need to be encouraged to actively work at inhibiting biting behaviour when dogs are young. As well, all dogs should be socialized to accept children, regardless of whether or not there are children living with the dog. Adults without dogs need to learn that dogs don't understand "people's rights," and that dogs should not be expected to act differently with different people. Adults also need to understand that young children should never be left alone with a dog (or a cat) without supervision, and that all children should be taught how to behave around dogs, particulary around dogs they don't know. So long as we have dogs living with us there will be people who get bitten. The most effective way to prevent bites is to encourage dog owners to become knowledgeable about their animals and to train and socialize them so that they can become good dog neighbours. Many municipalities already have by-laws that deal with animal bites, and in Ontario the Dog Owners Liability Act has proven to be effective in confining, restraining or disposing of biting or attacking dogs judged to be a definite threat to public health and safety, and when evidence warrants, there is always Section #221 of the Criminal Code of Canada. Most legislation deals with bites after the fact. If we want to prevent all bites, there is only one sure way and that is to ban all dogs. That is of course as unrealistic as trying to prevent bites by enacting breed specific legislation.

Adolescent↗
PubMed1996

Legislative seasons.... What lies ahead.

Tort reform remains top priority in the Society's legislative efforts. While the May 7 Rally for Change played a large part in the passage of liability reform language, only continued pressure by physicians will ensure victory in the Senate as well. Take a look in the Legislative Crystal Ball at what part you can play.

Forecasting↗
PubMed1995

Legislating to preserve women's autonomy during pregnancy.

Women are often excluded from the process of medical decision making during pregnancy, even though medical decisions that are made by health care professionals affect them personally and affect the future well-being of the unborn. Women in general and pregnant women in particular, will feel the impact of new genetic tests and technologies, designed to predict and even treat certain genetic problems during pregnancy, through prenatal diagnosis, foetal surgery and foetal gene therapy. This may be the first of several implications that new genetics technologies will hold for women's autonomy during pregnancy. Does genetic testing of a foetus empower women or pose an unanticipated threat to autonomy? To address these issues, there is a need to articulate a feminist perspective on genetic testing and possibly to legislate protection of women's rights during prenatal care. This article raises, but does not answer, several important issues regarding the implications of new developments in genetic testing that will affect pregnant women's autonomy in medical decision making. The article concludes that, although there are United States constitutional protections for the right to abortion and in turn, therapeutic abortion, an unfavourable chain of precedents regarding women's autonomy during pregnancy makes it imperative that there be strong legislation providing assurances that information will be given to pregnant women about the genetic testing process; that women will be made aware of their right to refuse treatment; that the law will require health care professionals to give adequate information to pregnant women regarding possible treatment outcomes in order to make an informed choice; and that there will be adequate protection for the right to confidentiality of information regarding prenatal prognosis, in order to safeguard autonomous decision making during pregnancy.

Female↗
PubMed1996

Organ transplantation in the mirror of the recent world-wide legislation.

Transplantation constitutes a rapidly changing field for medicolegal law-markers. Until two or three decades ago there were no laws governing organ transplants, and at least some of these processes fell within the realm of human experimentation. An extensive legislative work has been accomplished since then in order to catch up with the expeditious scientific progress. Transplantation is a definite medical process which requires a definite legal response. No wonder that some issues are dealt with by national laws in similar manners. Nevertheless, practice makes perfect, and recent legislations have gained experience and drawn their lessons from the former ones. The present review will analyze the guidelines concerning a few substantial issues, like distribution of organs, costs and donations, the removal-when and how allowed, and restrictions and conditions of removal. These and other issues have recently been formed by the following legislatures: Argentine, Canada, Columbia, Finland, France, India, Italy, Krygystan, Mexico, Peru, Portugal, Romania, Russia, USA and by the Council of Europe.

Guidelines as Topic↗
PubMed1997

Genetic discrimination and health insurance: a call for legislative action.

Fear of genetic discrimination in health insurance is a growing reality. Individuals who might otherwise choose genetic testing may decline it based on their fear that they or their family members will not be able to obtain or maintain health insurance coverage. This commentary notes the evolving legislative efforts to address genetic discrimination in health insurance and urges physicians to help move this legislative agenda forward.

Genetic Diseases, Inborn↗
PubMedDate not supplied

[Occupational risks and repetitive strain injuries in the Italian legislation].

Based on the experience gained from several criminal proceedings handled by the Public Prosecutor's Office in Turin, the author presents and discusses the Italian legislation covering the prevention of musculo-skeletal pathologies of the upper limbs in the workplace. In particular, the author examines the obligations associated with issuing medical reports on such disorders, and focusses attention on the obligations of the employer with respect to prevention (i.e. technical, organisational and procedural measures), monitoring employee health and the provision of training and information for employees in the light of both existing legislation (Italian Civil Code, DPR 303/56 and DPR 1124/65) and more recent regulations (D. Lgs. 626/94).

Cumulative Trauma Disorders↗
PubMed1997

"Community health care: serving Colorado's uninsured"--a health policy legislative proposal.

The article presents a hypothetical legislative proposal titled "Community Health Care: Serving the Uninsured." Briefly stated, the purpose of this legislation is to encourage public and private initiatives to provide health care for the uninsured, the indigent, and the underinsured citizens of Colorado. Lessons learned from this project can facilitate APNs' understanding of the issues surrounding the development of health policy.

Colorado↗
PubMed1998

Collaboration of national organizations and the legislative means to advance pulmonary rehabilitation.

Getting involved in the public policy process empowers health care professionals to help ensure the preservation of patient rights. An organization must form strong relationships with legislators using simple yet occasionally unconventional strategies. Too few patients currently have access to rehabilitative services. Passing national legislation promoting patient access to pulmonary rehabilitation will have a great impact by enabling more and more patients to take advantage of pulmonary rehabilitation programs because they are fully reimbursed.

Health Policy↗
PubMed1998

[Liquidation of barriers: realization issues and legislative aspects].

Designing for the handicapped persons, aiming at the liquidation of the barriers is actually an essential part of the architects activity. It results from the fact that the handicapped persons issue became the interdisciplinary one. The architect, being responsible for the living space and environment creation, is to design the friendly environment for the handicapped persons. The space favourable for the handicapped is favourable for all. There are many aspects of the designing for the handicapped; legislative or execution issues are the examples. The legislative aspect is presented in this paper on the base of the contemporary legal rules of the Polish Republic, whereas the execution aspect is introduced and discussed on the basis of the two projects designed by the Design Bureau in Cracow and being currently in realization. These are: housing & service unit (Boruty-Spiechowicza Str., Cracow) and the Faculty of Philosophy complex at the Jesuits College (Kopernika Str., Cracow).

Architectural Accessibility↗
PubMed1978

[Establishing prevention in federal legislation].

History and present situation of legislation on the cantonal and federal levels are briefly discussed. Special attention is given to the planned federal law on prevention which should provide a frame for various measures aiming at primary prevention of illnesses and accidents.

Drug and Narcotic Control↗
PubMed2002

Changing social policy: Grassroots to legislation.

Health care in the United States has evolved into a multimillion dollar business. As the health care industry has grown, so too has government regulation and involvement. As both insurers and patients vie to get the most for their health care dollars, federal and state governments attempt to mediate, prevent fraud and abuse, and protect all parties involved. Consumers feel the effects of this "tug of war" in the form of higher copayments, premiums, and out-of-pocket costs, as well as denial of coverage. This denial of coverage sparked a very successful grassroots effort to stop commercial insurers in the state of Connecticut from defining ostomy supplies as cosmetic and thus denying reimbursement. A tremendous amount of collaboration between Connecticut WOC nurses, state legislators, local American Cancer Society advocates, United Ostomy Association chapter members, and health care providers resulted in a powerful mobilization and support for House Bill No. 5120. This bill went beyond defining ostomy supplies as medically necessary but also set a minimum rate for reimbursement. Social policy changed, improving the lives of Connecticut citizens with an ostomy. Although many people fear they do not have the power to make necessary changes in government, this experience proved otherwise. The collaboration that occurred was patient advocacy at its best. This article describes the process that allowed this successful collaboration to take place with the hope that others will be inspired to get involved with patient advocacy through political involvement. It is the intention of this work to capture the essence of dedication of a grassroots campaign involving a small group of well-organized, highly focused participants who were responsible for changing public health care policy in the state of Connecticut.

Connecticut↗
PubMed2000

[Pain management in view of current new legislative updates and their practical consequences in Austria].

Although the WHO edited guidelines for pain treatment as early as 1986, practical management has frequently remained inadequate, especially in cancer patients. Traditional adherence to restrictions from the former Austrian Controlled Drug Act which have resulted in ongoing limitations in the prescription of opioids as well as complicated formal regulations in the current law represent two major obstacles. As a consequence, recent legislation of a "state of the art" pain management in Austria facilitates adequate provision of analgesics on the one hand, and may, on the other, even result in claims for indemnity should these be withhold.

Analgesics, Opioid↗
PubMed2002

Review of drug-related legislation in the Republic of Fiji Islands.

The development of new drug-related legislation for Fiji commenced in 1996 when two draft Bills, namely the Pharmacy Bill and the Poisons and Therapeutics Goods Bill, which had been based on World Health Organisation (WHO) drafts, were prepared and circulated for comment. During a six-week period in 1998, the consultant analysed comments on the drafts, co-ordinated stakeholder meetings, and provided workshops for the identified major stakeholders. Implementation of the outcomes from the consultancy has been delayed by first, a democratic change in Government and the resulting establishment of new priorities, secondly by a coup with subsequent interim administration, and thirdly by return to democracy with priority reassessment by the new Government.

Complementary Therapies↗