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PubMed1987

Proverbs provides guidelines for management in next century.

Management in the next century will require skills and techniques that focus on technology, financial planning, information processing, and other technical areas, but other critical management concerns cannot be ignored. The Chief of Naval Operations' Commission on Personal Excellence and National Security has defined education, health, and ethical behavior as the three critical national security issues in the next century. Certain trends in the United States--the shrinking size of the entry-level labor force, shortfall in high school graduates' ability to succeed in the workplace, escalating healthcare expenditures, and failure of training to produce its intended results--increase the need for managers to focus on these issues. Organizing people, groups, and organizations to achieve excellence requires a set of guidelines with proven sensitivity, truth in many situations, strength, and durability. The book of Proverbs, although 2000 years old, provides such rules that address the issues of education, health, and ethical behavior. These guidelines can be used to strengthen managers' ability to meet the challenges of the twenty-first century.

Administrative Personnel↗
PubMed1967

Academic research: Foster defends DoD support in universities.

The United States has evolved a pattern of association between our universities and the Department of Defense. This association has led to major achievements in science and engineering, and has strengthened both national security and the national academic research base. Those who would make sweeping changes in this successfully evolving pattern should consider the whole case, all of the consequences for the country, from the many points of view. The issues must be tested in the larger context of all support to academic research, and the entire range of national groups and goals.

Financing, Government↗
PubMed2006

Gender differences in reoffending after discharge from medium-secure units. National cohort study in England and Wales.

BACKGROUND: Previous research has shown that there are gender differences in reoffending after discharge from medium-secure units, but these have not been adequately explained. AIMS: To investigate gender differences in reoffending after discharge from medium-secure psychiatric units. METHOD: All people discharged from medium-secure units in England and Wales between April 1997 and March 1998 were followed up for 1 year (n=959; 12% women). Reoffending was estimated by collecting reconviction data from the Home Office's Offenders' Index or from files at the mental health unit up to 2 years after discharge. RESULTS: Women were less likely than men to be reconvicted within 2 years of discharge (9% v. 16%, OR=0.49, 95% CI 0.25-0.98). Adjustments for history of self-harm, drug or alcohol problems and previous offending substantially reduced the gender difference. In the full model the OR was 0.97 (95% CI 0.45-2.12). CONCLUSIONS: Some or all of the gender differences in reoffending between men and women are explained by self-harm, alcohol and drug problems and previous criminal history.

Adolescent↗
PubMed2004

DARPA on your mind.

Applied science may once again play a decisive role in changing the face of armed conflict, and the rest of human affairs, by shifting the battlefield to our very brains. The national-security establishment--and particularly the Pentagon's Defense Advanced Research Projects Agency (DARPA)--supports research at the intersection of neuroscience and national security that could ultimately enable authorities to do things like enhance (or muddle, or erase) memory, monitor crowds for individuals whose brain patterns correlate with aggressive behaviors, or control weapons from afar merely with thoughts. What are the dangers of such information falling into "the wrong hands," and are there any "right hands" for this kind of knowledge? Is any extension of human abilities justified by the need for government to protect its society?

Behavior Control↗
PubMed1988

Zatu No. AN V 28 FP-PRES setting forth the Refugees Regulations, 3 August 1988.

This legislation provides that a National Refugees Commission is to make all decisions relating to granting of refugee status and the loss of such status. A representative of the UN High Commissioner for Refugees is to be present as a consultant at all meetings in which such decisions are made. These decisions can be revised in cases in which new information appears. Persons receiving refugee status can be expelled from Burkina Faso only for reasons of national security, if they engage in activities that threaten public order, or if they are sentenced to loss of liberty for a crime or offense of a certain level of seriousness. Except for overriding reasons of national security, they may not be expelled before being allowed to present their defense to the National Commission, which must give its opinion. Nor may they be expelled until a reasonable period has passed in which they are permitted to look for another country that will admit them. Refugees seeking employment are to be treated in the same manner as foreigners from the country that has concluded with Burkina Faso an agreement that is the most favorable with respect to the desired activity. They are to receive the same treatment as nationals with respect to access to education and the amount of enrollment fees.

Africa↗
PubMed1999

Results of European projects enabling secure regional, national and international health care networks.

Based on the work of the ISHTAR, the TRUSTHEALTH1, the EUROMED-ETS and the MEDSEC project funded by the European Commission, the synergetic results of these different projects in providing a security infrastructure for the test environment of an oncological network will be demonstrated. The ISHTAR project investigated security issues in Health Care Establishments (HCE). It provides guidance for threat and risk analysis, and defines a schema for specification and implementation of appropriate security services and mechanisms to respond to the HCE security requirements of both communication and application security concepts. The TRUSTHEALTH1 project dealt with specification and test implementation of basic security services and mechanisms based on Health Professional Cards (HPC) and Trusted Third Party (TTP) services. Within the EUROMED-ETS project, the security solution has been extended to the Internet environment and WWW tools, successfully creating an Internet-based international TTP structure between the universities of Athens, Calabria, and Magdeburg. Finally, in the MEDSEC project the specification and implementation of a generic EDI security solution has been delivered to provide secure communication between applications and sites. In the ongoing TRUSTHEALTH2 project, the results of all these projects will be implemented in a real environment of cancer care.

Algorithms↗
PubMed2004

Biodefense research: can secrecy and safety coexist?

Over the next 10 years, the United States will spend 6 billion US dollars to develop countermeasures against biological and chemical weapons. Much of this research on highly virulent pathogens will be done in academic settings around the country. This article explores the challenges in ensuring secrecy to protect national security while accommodating the right of local communities to have access to safety information regarding select agents and laboratory-acquired infections. Secrecy has been defended as being vital for protecting national security. Problems with secrecy can include the misinterpretation of intentions, particularly in laboratories located in nuclear weapons design facilities, and the restricted access to information relevant to public health and safety. While federal select agent legislation requires laboratories to have emergency plans in place with first responders, these plans do not necessarily include public health professionals, who will be responsible for any future public health action, such as quarantine, surveillance, or mass vaccinations, in the unlikely event that a laboratory-acquired infection spreads into a community. Laboratory-acquired infections do occur, even with the best safety mechanisms in place; however, the epidemiology of the incidence and severity of these infections are not known since there is no national surveillance reporting system. Evidence suggests that many of these infections occur in the absence of an actual laboratory accident. The best emergency plans and surveillance systems are only as good as the participation and vigilance of the laboratory workers themselves. Thus, laboratory workers have a responsibility to themselves and others to report all laboratory accidents and spills, regardless how minor. In addition, they should have a lower threshold than normal in seeking medical attention when feeling ill, and their physicians should be aware of what pathogens they work with to reduce the risk of a delay in diagnosis.

Bioterrorism↗
PubMed2004

Protecting America's secrets while maintaining academic freedom.

The terrorist attacks of September 11, 2001, and the subsequent anthrax mail attacks, have had a profound impact on Americans' personal and professional lives and have sparked an active debate regarding the delicate balance between the need for national security and the pursuit of academic freedom. Although academic freedom can be defined in many ways, there are four primary tenets of freedom in an academic environment: freedom to research, freedom to publish, freedom to teach, and freedom to speak. Each of these tenets has come under attack in the wake of September 11, 2001. In this report the author further defines academic freedom and reflects upon recent events that have had a real or perceived impact on this freedom, including (1) attempts to categorize and restrict some research as "sensitive," (2) implementation of export control laws and select agent regulations, (3) limitations on the publication of research findings, (4) prohibition of certain foreign nationals from collaborating with U.S. researchers and receiving education and training in U.S. colleges and universities, and (5) restraint of faculty free speech. The author offers some suggestions as to how academia might achieve a proper balance between protecting our national security while promoting and maintaining academic freedom.

Editorial Policies↗
PubMed2004

The HIPAA privacy rule and bioterrorism planning, prevention, and response.

Effective bioterrorism planning, prevention, and response require information sharing between various entities, ranging from public health authorities and health-care workers to national security and law enforcement officials. While the source of much information exchanged may be nonidentifiable, many entities legitimately need access to personally identifiable health information (or "protected health information" [PHI]) in planning for and responding to a bioterrorism event. The HIPAA Privacy Rule allows for essential exchanges of health data during a public health emergency while protecting against unnecessary disclosures of PHI. In the event of a bioterrorist attack, the Privacy Rule allows covered entities to disclose PHI without individual authorization in the following instances: (1) for treatment by health-care providers, (2) to avert a serious threat to health or safety, (3) to public health authorities for public health purposes, (4) to protect national security, (5) to law enforcement under certain conditions, and (6) for judicial or administrative proceedings. Despite these favorable disclosure provisions, some privacy challenges remain. The flow of PHI may be slowed by misunderstandings of the Privacy Rule's accounting requirement. In addition, in a bioterrorism scenario, nontraditional entities may find themselves acting as health-care providers, triggering Privacy Rule provisions. Finally, the potential for de facto disclosures of individuals' disease or exposure status increases where conspicuous treatment methods, isolation, or quarantine are implemented without additional measures to protect privacy. Understanding the Privacy Rule's impact on bioterrorism planning and response ensures that various entities can conduct their activities with needed information while still protecting individual privacy.

Bioterrorism↗
PubMed2004

A look behind the scenes: bioterrorism, smallpox, and public health policy.

The September 11, 2001 terrorist attacks on the World Trade Center and continued conflict in Middle Eastern countries has provoked a strong interest in issues of national security. On December 13, 2002 the Bush Administration announced its smallpox vaccination policy, the first nationwide "proactive" measure to address the threat of bioterrorism. The Program has received mixed reactions as a result of partisan issues, tensions in public health policy and federal and state jurisdiction, conflicting scientific views, and different risk assessments. The slow pace of the program, the difficulties surrounding its implementation, and the debates regarding its validity serves as a "case study" to demonstrate current short-comings in federal and state anti-terrorist and public health policies. The focus will be on the states' public health laws and emergency preparedness plans through an analysis of the proposed Model State Emergency Preparedness Act. Updating current public health laws combined with increased funding of scientific research and the foresight to act "proactively" will reach far beyond improving national security. These efforts serve the dual purpose of deterring future terrorist attacks while greatly improving responses to a number of other health emergencies and disasters.

Biological Warfare↗
PubMed2006

Integrating hospitals into community emergency preparedness planning.

BACKGROUND: Strong community linkages are essential to a health care organization's overall preparedness for emergencies. OBJECTIVE: To assess community emergency preparedness linkages among hospitals, public health officials, and first responders and to investigate the influence of community hazards, previous preparation for an event requiring national security oversight, and experience responding to actual disasters. DESIGN: With expert advice from an advisory panel, a mailed questionnaire was used to assess linkage issues related to training and drills, equipment, surveillance, laboratory testing, surge capacity, incident management, and communication. SETTING: A simple random sample of 1750 U.S. medical-surgical hospitals. PARTICIPANTS: Of 678 hospital representatives that agreed to participate, 575 (33%) completed the questionnaire in early 2004. Respondents were hospital personnel responsible for environmental safety, emergency management, infection control, administration, emergency services, and security. MEASUREMENTS: Prevalence and breadth of participation in community-wide planning; examination of 17 basic elements in a weighted analysis. RESULTS: In a weighted analysis, most hospitals (88.2% [95% CI, 84.1% to 92.3%]) engaged in community-wide drills and exercises, and most (82.2% [CI, 77.8% to 86.5%]) conducted a collaborative threat and vulnerability analysis with community responders. Of all respondents, 57.3% (CI, 52.1% to 62.5%) reported that their community plans addressed the hospital's need for additional supplies and equipment, and 73.0% (CI, 68.1% to 77.9%) reported that decontamination capacity needs were addressed. Fewer reported a direct link to the Health Alert Network (54.4% [CI, 49.3% to 59.5%]) and around-the-clock access to a live voice from a public health department (40.0% [CI, 35.0% to 45.0%]). Performance on many of 17 basic elements was better in large and urban hospitals and was associated with a high number of perceived hazards, previous national security event preparation, and experience in actual response. LIMITATIONS: Responses reflect hospitals' self-perception of linkages. The quality of linkages and the extent of possible biases favoring positive responses were not assessed. CONCLUSIONS: In this baseline assessment, most hospitals reported substantial integration. However, results suggest that relationships between hospitals, public health departments, and other critical response entities are not adequately robust. Suggestions for enhancing linkages are discussed.

Community Health Services↗
PubMed2002

Shining light on "Dark Winter".

On 22--23 June 2001, the Johns Hopkins Center for Civilian Biodefense Strategies, in collaboration with the Center for Strategic and International Studies, the Analytic Services Institute for Homeland Security, and the Oklahoma National Memorial Institute for the Prevention of Terrorism, held a senior-level exercise entitled "Dark Winter" that simulated a covert smallpox attack on the United States. The first such exercise of its kind, Dark Winter was constructed to examine the challenges that senior-level policy makers would face if confronted with a bioterrorist attack that initiated outbreaks of highly contagious disease. The exercise was intended to increase awareness of the scope and character of the threat posed by biological weapons among senior national security experts and to bring about actions that would improve prevention and response strategies.

Administrative Personnel↗