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At least 883 records · Page 49Linked to original sources
PubMed1996

Legislating for user involvement in the United Kingdom: mental health services and the NHS and Community Care Act 1990.

Recent legislation in the U.K., particularly the NHS and Community Care Act 1990, has encouraged the direct participation of service users in the planning and management of care services. This paper explores evidence of how the interests of service users experiencing mental distress are represented within community care services in the U.K. and the extent to which this leads to a devolution of power to those service users. The evidence is drawn from a survey of principal officers in social services departments responsible for mental health services and interviews with 135 service users. This reveals considerable confusion about the meaning and purpose of user involvement and about how service users can best be represented; little evidence, despite users' interest in it, of power-sharing; and limited commitment of resources to make further participation possible. The conclusion considers how, in the light of this evidence, Central and Local Government might further develop user involvement.

Attitude of Health Personnel↗
PubMed1995

The use of legislation in cases of squalor.

In this paper, some of the legislation that can be used to treat people living in squalor is described. It can be used to enforce cleaning of the squalor for the individual or his/her neighbours' benefit.

Humans↗
PubMed1984

Incidence of ocular injuries from road traffic accidents after introduction of seat belt legislation.

A prospective study was performed to characterize any change in the pattern of ocular injuries following the introduction of compulsory front seat belt wear on 1 February 1983. During a 24-week period in 1981 (1 February to 31 July), 24 patients with eye and adnexal injuries as a result of motor car road traffic accidents (RTAs) were seen at the Bristol Eye Hospital: 12 of these patients required emergency surgery. In the identical period two years later (1 February to 31 July 1983), only 6 patients suffered ocular injury from RTAs: 3 of these required emergency surgery. All patients in the latter series obeying the legislation on seat belt use were injured by flying glass, indicating a possible change in pattern of injury. The decrease in incidence of ocular injuries from RTAs between the two series was shown to be statistically significant. The compulsory fitting of laminated glass to all new cars in Great Britain and Europe is strongly advised.

Accidents, Traffic↗
PubMed1998

Mental health legislation and the right to appropriate treatment.

OBJECTIVE: To demonstrate how mental health legislation and its implementation can detract from a patient's "right to health." METHOD: The author surveyed colleagues working at the London and St Thomas Psychiatric Hospitals about cases where the structure or implementation of the Mental Health Act in Ontario impeded the provision of good psychiatric care. RESULTS: Four clinical vignettes illustrate specific problems; possible solutions to these difficulties are suggested. CONCLUSION: Physicians must remain vigilant in their role as advocates for patients' right to appropriate treatment.

Adult↗
PubMed1990

HIV infection in sexually transmissible disease practice in Sydney: the effects of legislation, public education and changing clinical spectrum.

The experience with human immunodeficiency virus (HIV) infection of a private inner-city sexually transmissible diseases (STD) clinic in Sydney was quantified. Between February 1984 and March 1988, 2073 of the Clinic's patients were tested for antibodies to HIV on 5095 occasions. Of those tested, 538 (26%) were positive for antibodies to HIV: 532 (98.9%) of the seropositives had practised male homosexual intercourse. This is the highest reported seroprevalence of HIV for any primary care service in Australia. Those individuals seropositive because of other risk behaviours were detected by voluntary contact tracing rather than by screening. Female prostitution was not found to be a risk factor for HIV. In general, rates of first HIV antibody tests were adversely affected by threatening legislation, and temporarily stimulated (among lower-risk persons) by a national television campaign. These data suggest that much of the counselling, detection and management of HIV infection in Australia is occurring in private practice, and that STD services (private and public) are at the forefront of the HIV epidemic. This has implications for disease surveillance and control, health services planning and medical education.

Adult↗
PubMed1996

The growth of cost-effectiveness assessment in environmental health legislation.

Current controversy over the Government's intentions to introduce a cost-benefit philosophy into environmental decision making should be put into perspective. The legislative requirement for comparing costs with effectiveness is not new. There is, however, an increasing tendency for such assessments which will necessitate a greater attention to research into environmental health outcomes.

Cost-Benefit Analysis↗
PubMed2003

Clinical pastoral education and post privacy legislation: an Australian perspective.

Recently introduced privacy legislation in Australia has required that professional associations approaching education from the perspective of human cases review their standards and develop new policies and procedures to protect the privacy of individuals. In this article, the author explores the disruption created for Clinical Pastoral Education by the introduction of these privacy laws, demonstrates that it is possible to be loyal to both a commitment to privacy and learning from "living human documents," develop strategies for changing the educational culture, and establish new procedures, strategies, and policy.

Australia↗
PubMedDate not supplied

Occupational light-vehicle use and OHS legislative frameworks: an Australian example.

Occupational light vehicle (OLV) use and associated exposures and hazards in the Australian context are described. Available insurance data indicate that the OLV injury burden, which is greater than that of other work-road users, is growing as OLV use changes incidental to workers' primary occupations and work patterns. Legislation that affects OLV users is reviewed and the shifting of the burden of responsibility for injured or killed OLV users between workers' compensation, motor accident insurance and public health systems is described. Changes to OHS regulatory frameworks are proposed to better address OLV-relevant policy and practice. These issues are relevant for many international jurisdictions.

Accidents, Traffic↗
PubMed2006

Knowledge of the abortion legislation among South African women: a cross-sectional study.

BACKGROUND: In order to ensure that legalized abortion in South Africa improves reproductive health, women must know that abortion is a legal option in the case of unwanted pregnancy. This study investigated knowledge of abortion legislation eight years after the introduction of legal abortion services in one province of South Africa. METHODS: In 2004/2005, we conducted a cross-sectional study among 831 sexually-active women attending 26 public health clinics in one urban and one rural health region of the Western Cape Province. RESULTS: Thirty-two percent of women did not know that abortion is currently legal. Among those who knew of legal abortion, few had knowledge of the time restrictions involved. CONCLUSION: In South Africa there is an unmet need among women for information on abortion. Strategies should be developed to address this gap so that women are fully informed of their rights to a safe and legal termination of pregnancy.

Journal Article↗
PubMed2004

The Society for Clinical Trials supports United States legislation mandating trials registration. Position paper.

The official position of the Society for Clinical Trials is to support legislation in the United States and internationally that mandates registration of all controlled clinicals trials at or before enrollment of the first participant. The major trial sponsor would be responsible for ensuring contribution of trial information. The mechanism for registering trials would be through research ethics review boards, and registration would be required for ethics approval and before trial initiation. Standardized data and a unique identification number would be available for each registered trial.

Controlled Clinical Trials as Topic↗
PubMed2006

The Society for Clinical Trials opposes US legislation to permit marketing of unproven medical therapies for seriously ill patients.

The proposed Bill S.1956 is a bad law. Wide early access to minimally tested treatments cannot be expected to lead to better or more compassionate care of the seriously ill patient. The long history of medicine is replete with treatments that initially seemed promising to patients, doctors, and especially to their own inventors, but which careful study revealed to be worthless or harmful. We understand the desperate plight of these patients and the importance of hope for them and their families. However, although the proposed law is portrayed as an effort to help patients in desperate need of treatment, in fact its effect would be to undermine the system of scientifically valid testing of new drugs that has been a bulwark of health care for several decades. The effect of the law would be to provide many more possible choices of treatment but much less information upon which to make the choice. Patients would be very unlikely to end up receiving an effective treatment. They would be much more likely to receive useless or possibly harmful treatments in the last days of their lives. The Society for Clinical Trials strongly opposes this legislation.

Clinical Trials as Topic↗
PubMed1990

Legislative incapacity: the congressional role in environmental policy-making and the case of Superfund.

Congress plays a central role in national environmental policy formation but appears ill equipped to set policy priorities and devise integrative legislation. Fragmentation of authority among a multiplicity of committees and subcommittees, especially in the House, contributes to these problems. This pattern is evident in the evolution of Superfund, the national program to clean up abandoned hazardous waste sites. The prolonged process of reauthorization in the 1980s contributed to serious program delay and failed to resolve a number of fundamental questions concerning the national cleanup effort. Institutional reforms could contribute to a more effective congressional role in future environmental policy deliberations.

Environmental Health↗
PubMed1993

The courts, health care reform, and the reconstruction of American social legislation.

Because of budgetary and other political pressures, American health care reform (and other social reform) legislation is often not enforced, or is implemented in ways that undermine its egalitarian goals. About 25 years ago the federal courts began to try to reduce this gap between statutory promise and policy reality by interpreting federal funding laws as creating rights for their ultimate beneficiaries, including low-income patients and the providers who serve them. This major innovation in the concept of legal rights was confirmed by hundreds of judicial decisions and accepted by Congress itself. Over the past few years, however, a new Supreme Court, led by Chief Justice William Rehnquist, has issued opinions denying that such rights exist and vastly increasing agency power to reduce important statutory provisions to virtually meaningless formalities. Thus, at the very moment that national health care reform is prominent on the political agenda, the federal courts are abandoning a rights-enforcing role that may be critical for the reform's success. This article explains the struggle around the courts' rights-enforcing role, defends the role, and suggests ways that it can be maintained even if the courts themselves are not currently in a good position to fulfill it.

Civil Rights↗
PubMed2000

Cardiac transplantation under new legislation for organ transplantation in Japan: report of two cases.

During the past 2 years since new legislation for organ transplantation from brain-dead donors came into effect in Japan, 3 cardiac transplants have been carried out, 2 of which were performed at the National Cardiovascular Center (NCVC). The recipient cases were 46- and 25-year-old male patients who suffered from end-stage dilated cardiomyopathy and had been listed for cardiac transplantation in the Japan Organ Transplantation Network as status I candidates. The first patient was supported by the use of a paracorporeal air-driven left ventricular assist device of the NCVC type, and had a moderate degree of renal and hepatic dysfunction at the time of transplantation. Donor hearts were transported from distant hospitals (Tokyo and Miyagi prefecture) and the transportation time was 1 h 33 min and 2h 4 min, respectively. The operation was performed by the standard technique (Lower-Shumway) in the first patient and by the bicaval anastomosis technique in the second patient. Reperfusion of the transplanted heart was performed retrogradely through the coronary sinus utilizing leukocyte-depleted blood with a gradual increase in temperature. Total ischemic time was 3 h 34 min and 3 h 35 min, respectively. Weaning from the cardiopulmonary bypass was easy and uneventful in each patient. Immunosuppressive therapy was conducted with OKT-3 induction in the first patient because of the coexisting renal dysfunction and with a triple immunosuppressive regimen for both patients. Routine endomyocardial biopsy showed acute rejection of less than grade Ib, and the patients were discharged on the 65th and 46th postoperative day, respectively. At present, both patients are in the NYHA class I state and are ready to return to work. The uneventful recovery seen in these patients shows the advances made in transplant medicine, including the progress and improvement of immunosuppressive therapy, surgical techniques, myocardial protection, and detection and treatment of infection. Further efforts are required to fully establish the cardiac transplantation program in Japan.

Adult↗
PubMed2001

Ear deformity in children following high ear-piercing: current practice, consent issues and legislation.

In this presentation we examine the practice of high ear-piercing in children, the issue of informed consent and current legislation. We sampled current practice and consent policy by visiting nine establishments in Sheffield providing this service. There were two high street department stores, two fashion accessory outlets and five body-piercing studios. Enquiries were made as to the technique used, knowledge of complications, customer counselling and consent policy. A photograph of an ear with a cosmetic deformity following high ear-piercing was shown and awareness of this possible outcome was noted. Two ear-piercing techniques were identified, either a spring-loaded gun firing a blunt stud or the use of a body-piercing needle. The fashion accessory outlets were prepared to pierce any part of the ear using a spring-loaded gun in children under 16 years of age. There was a general lack of knowledge about possible serious complications. Two of the body piercers would not perform high ear-piercing on clients under the age of 16 years. The body piercers use a disposable needle and were of the opinion that using a spring-loaded gun shatters the cartilage and increases the risk of infection. The best technique is open to debate and it may be that the perceived unsavoury environment of the body-piercing studio represents a safer option than the more respectable or cheaper alternatives. The practice of body piercing in the UK remains uncontrolled.

Adolescent↗
PubMedDate not supplied

Decontamination of medical devices: legislation and compliance to practice.

The amount of legislation and guidelines published on decontamination reflects the current attitude of politicians and the general public to the desire to reduce the risk of infection. Incidents, such as bovine spongiform encephalopathy (BSE) in cattle with the subsequent risk of transmission of variant Creutzfeldt-Jakob disease (VCJD), require greater compliance by healthcare workers to the guidance both in the hospital and the wider community. The change in care provision and the demands of government in training and education. This article will look at recent government guidance and the implications it has for clinical practice.

Decontamination↗