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Fifty years of prison suicide in Austria: does legislation have an impact?

The absolute and relative frequency of suicides in jails and prisons in Austria over the 50 years from 1947 to 1996 is described. Important legislational changes regarding the criminal justice system are discussed with regard to possible consequences for the incidence of prisoners' suicides. Within the five decades a significant increase in the absolute numbers of jail and prison suicides was evident in spite of the considerable decrease in the total inmate population. Therefore, the suicide rate of inmates of correctional facilities increased significantly. Possible reasons for this phenomenon are discussed in relation to changes of the criminal law.

Austria↗

Oncology legislative update.

This article reviews current legislative and regulatory issues of importance to the oncology community. Topics include patient protection, Medicare support of clinical trials, research data protection, the Medical Innovation Tax Credit, National Cancer Institute appropriations, and medical record privacy issues. Other topics discussed included funding for stem-cell research, genetic therapy oversight, and coverage for uninsured patients.

Budgets↗

[Responsibility (according to the legislative act "626/1994") in the implementation of preventive measures in the preparation of antiblastic drugs].

The 7th title of the legislative act "626/1994" (and the other normative indications) identifies cavcingenic agents in occupational uses, and also the protections of workers in exposure. Among these agents there are any antiblastic drugs. This is a difficult problem for a correct application of normative indications: it's no possible to replace cavcingenic agents with no cavcingenic agents, as so as it's impossible to operate on "closed cycle". The authors put the attention on the other very important normative indications: "preparations in bordered and isolated room", "minimal exposure", "severe procedures and internal normations", formal "identification of the responsibilities" in the hospital organization (also with the strictly identification of managers and foremen).

Antineoplastic Agents↗

Health care legislative reforms in Armenia: preparations for a purchaser-provider split.

Armenia, the former Soviet republic, is switching its economy to a more market driven system. Where health care is concerned, the previous government planned to introduce an independent State Health Agency managing the available funds. At the same time, this Agency would be authorised to contract with former state hospitals and individual providers. The underlying idea was a partial withdrawal by the state from both the provision and financing of health care. However, since the financing system continued to be based on general taxation, the state's role has remained largely unchanged in this respect. This situation has created new difficulties. To solve the variety of emerging problems, the Armenian government requested technical support from the World Bank. As a member of a multi-disciplinary team, the author will describe some major legal aspects of the underlying health policy reform plan and will conclude that the Agency's establishment will give an important impetus to the Armenian health care legislative reform process.

Armenia↗

[Legal and medico-legal issues in adolescent medicine. A critical review of the present regulation and legislation].

During the last years the Italian Government has taken many different initiatives to protect the adolescents rights to benefit from physical, psychical and social well-being. In particular, various projects concerning the promotion and the support of the school, the family, sport, mass-media, judicial and medical infrastructures, have been organised, promoted and financed. However, it is not always possible to assure a real safeguarding of teenagers rights; this especially happens because the problem concerning the autonomous capacity of minors to consent (or non consent) to the medical treatment is much debated. However, many contradictions still persist about the effective duration of the pediatric age. All the same, it must be noted that the Legislator apparently realised that not only the physical, psychological and social maturity proceed by steps, but also the legal capacity.

Adolescent↗

The nature and legal status of foetal tissue--a ground for separate legislation?

Recently the Dutch government has submitted a Foetal Tissue Bill, containing regulations for all uses of foetal tissue. The Bill probably is to be intergrated in the future Embryo Act that is to regulate dealings with living embryos. This article focuses on the nature and legal status of foetal tissue and on the question of whether it is necessary that legislation separate from existing and future laws on the use of human tissue is necessary or desirable. It is concluded that in this context the use of foetal tissue, being the remains of a foetus that is no longer alive, should preferably not be associated with dealings with embryos but with the use of other human tissue.

Fetal Tissue Transplantation↗

[Protection from cancerogenic and mutagenic agents in the light of the legislative decree n. 66 of February 22, 2000].

This publication provides an updating on Italian legislation regarding occupational carcinogen and mutagen agents. A Law Decree (chapter VII of law 626/94), deals specifically with carcinogen agents and provides a series of mandatory measures under the responsibility of a specific company preventive task aimed towards risk reduction or its complete elimination. The exposure estimation is essential both for future prevention activities as well as for the efficacy evaluation of measures that have already been carried out. The 626/94 Decree amendment (see Decree 66 of 25/2/2000), is a consequence of the EU Directive acknowledgement by Italy, on the protection of workers from risks related to carcinogens/mutagens exposure during work time. These amendments regard both definition parameters such as carcinogens/mutagens, as well as occupational exposure limits introduction for some of these agents i.e. benzene, VCM and wood dusts.

Carcinogens↗

[Good opportunities to prevent contact eczema through legislation].

Allergic contact dermatitis is often caused by allergenic substances in products. Legislation can be a useful tool in the prevention of contact dermatitis, by limiting skin exposure to contact allergens in chemical products, cosmetics and hygiene products and nickel-containing objects in contact with the skin. A brief review is given of the most important EU Directives, some national regulations and standardisation projects aiming at the prevention of contact dermatitis. It is essential that medical scientific experts support, with their expert knowledge, national and European authorities.

Allergens↗

[Development of animal welfare legislation for the European Community].

Animal welfare is of increasing importance for the European Community, which is reinforced by the Protocol to the EC Treaty on protection and welfare of animals. After the recent improvements to the legislation on the protection of pigs, the next priority for the Commission is the further development of the standards of animal transportation, particularly since a report of the Commission pointed out shortcomings in the enforcement of the existing rules in this area.

Animal Welfare↗

[Ethical, psycho-social, legislative and economic aspects of surgical treatment of the hypoplastic left heart syndrome].

Hypoplastic left heart syndrome (HLHS) represents a lethal congenital heart disease, which used to be considered inoperable. The improvement of results of cardiac surgery in neonates improved also the prognosis of patients with this heart lesion. HLHS, however, continues to be an unresolved problem from ethical, psychological, social and economical points of view. Opinions regarding the care for these patients depend on economical, political, cultural and religious factors. Based on recent experience it is evident, that HLHS is an operable disease in a child, who without surgery would otherwise die. Approximately 40% of patients with HLHS can live 15 years after surgery. The long-term prognosis remains, however, unclear. Because of the need of demanding care for a patient with HLHS, it is necessary to see also the quality of life and hear the opinion of parents. Psychomotor development and the quality of life may be altered by complications. An individualized approach in fetuses and neonates with HLHS on the basis of prenatal diagnosis, analysis of risk factors, provision of detailed informations to parents and indications for surgery in neonates having chance for an acceptable result is considered to be the most acceptable solution. In the future it will be necessary to concentrate the research on prenatal diagnostics, treatment and postoperative follow-up including psychomotor development and quality of life. In the preparation of legislative, which would reflect more sensitively the contemporary possibilities of medicine and at the same time regard the problems of health care organization, as well as social and economic aspects, narrow interdisciplinary cooperation will be required.

Cardiac Surgical Procedures↗

[Is preimplantation diagnosis legal?--on the need for harmonizing legislation].

Whether PGD is already legally permitted in Germany today is a moot point. A guidelines draft of the Germany's Federal General Medical Council, the Bundesärztekammer, on pre-implantation genetic diagnostics that--like the earlier findings of the ethics commission of the German federal state of the Rhineland-Palatinate--assumed that the method is admissible, if certain clearly-defined indications are present and a rigorous testing procedure has been established, has given the discussion a new impetus. The discussion is in full swing, with calls by politicians for the legislator to pass a regulation mounting. Of late, though, constitutional objections have been raised against a positive-law regulation. Such a simple legal move to regulate PGD, it is claimed, would violate the constitutionally-guaranteed right to inviolable human dignity. Critics, however, point out that such an absolute inviolability does not exist. According to them, not only the verdicts by the German Federal Constitutional Court, the Bundesverfassungsgericht, on the reform of section 218 of the German Federal Penal Code (StGB)--the paragraph that specifies the conditions under which an abortion is not punished--that relativize (in terms of the indication model) one claim to existence with respect to another, but also the approval in terms of pharmaceutical and medicine-products law of nidation-blocking agents, serve to show this. If the condition of being a human being were made to coincide with the completion of the genetic code upon the completion of the process of fertilisation, then one tended to forget, the critics noted, that this attendant dignity was not properly "infused with life" unless nidation had been successful. Without nidation everything were fragmentary, the total protection of human dignity according to Article 1 Section 1 of the Federal Republic's Basic Law, Germany's constitution, notwithstanding. During every in vitro fertilisation embryo transfer is conditional upon a variety of factors the presence of which is not noted until after fertilisation has taken place. On the part of the embryos, too, certain conditions have to be met whose presence at the moment of fertilisation is not assured. Thus an embryo with, for instance, defects that can be visually detected will not be transferred. With regard to these facts too the opponents of pre-implantation genetic diagnostics must be challenged to answer the question of why an embryo with visually-detectable defects should undoubtedly be allowed to be discarded, but the act of searching for "internal" defects be banned. Thus the fact remains that the mere acceptance of the loss of created embryos does not make artificial insemination a punishable offense, as long as the motive for the act is to bring about pregnancy. To achieve legal security for the couples and the physicians involved the law on the protection of embryos should be changed. The new regulations should determine under which conditions PGD is permissible. As is already the case for other norms that apply to reproductive medicine, but also for the practice of abortion, these regulations should contain an analogous right of refusal for the professionals involved. The laws relating to the healing professions, to the professional chambers, as well as the regulations of the various German federal states (which together constitute the Federal Republic of Germany) that apply to the professions should be amended accordingly.

Abortion, Induced↗

International report: sludge management and related legislation.

This report comprises the present sludge management practices with special view to agricultural utilization in the European Union and some accessing countries in eastern Europe in comparison with countries from Asia, the United States of America, South Africa and Australia. Information is given on the respective legislation and on future trends.

Agriculture↗

Lactic acid bacteria in a changing legislative environment.

The benefits of using lactic acid bacteria in the food chain, both through direct consumption and production of ingredients, are increasingly recognised by the food industry and consumers alike. The regulatory environment surrounding these products is diverse, covering foods and food ingredients, processing aids, feed additives and dietary supplements. On a global basis, there are different approaches taken by the various regulatory authorities. While in Europe, the national legislation is gradually being harmonized, predominantly through the Novel Foods Regulation, there is still a wide disparity between the stringency of regulation of microbial products fed to animals and the comparatively relaxed approach to 'non-novel' microbial products intended for human consumption. In the United States, the onus is on self-regulation of the manufacturer, with the Generally Recognised As Safe (GRAS) and Dietary Supplement Health Education Act (DSHEA) notification schemes encouraging industry to be more open about the ingredients they market. In Japan, the Foods for Special Health Use system continues to gain recognition as more products are approved, and is a potential model for other countries in regulating functional foods. Despite the different approaches to regulating these products, safety of microorganisms such as lactic acid bacteria in the food chain is paramount in all countries. This paper discusses the regulatory requirements of microbial products, predominantly lactic acid bacteria within the global markets, focusing mainly on the developments in Europe.

Dietary Supplements↗

Putting state legislative issues in context.

Dramatic changes in the past decade have occurred in the areas of delegated prescriptive authority for physician assistants (PAs), determination of scope of practice, relations with organized medicine, and participation by PAs in regulation of the profession. As PAs continue in their role of extending care to underserved populations, state legislation and regulations may have to be modified to optimize PA utilization in mental and behavioral health, chronic disease management, and occupational health.

Drug Prescriptions↗

Employment and disability in the United Kingdom: an outline of recent legislative and policy changes.

In 1996, a paper (Floyd, 1996), on the Vocational Rehabilitation Services in the United Kingdom, reviewed the way in which the services had evolved during the past 50 years, since the end of the second world war. The author described the Disabled Persons (Employment) Act 1944 and the development of rehabilitation and placement services and sheltered workshops over the years. He also gave readers a glimpse of possible future changes, and, in particular, speculated that the UK might follow the United States in the professional training and development of employment and vocational rehabilitation personnel. This paper describes first the main services currently provided by Government and then outlines the quite significant legislative changes and one major policy development that have taken place in the past five years. This includes an overview of the Disability Discrimination Act 1995 which came into force in late 1996, a brief look at some of the early outcomes, and describes the latest proposals for amendment. A description of the major policy development (New Deal for Disabled People) is also given but it is too soon to report on its effectiveness. Whether the changes will lead to any lasting improvement in labour market participation by disabled people, remains an unanswered question; certainly, up to the present, from a statistical point of view, it seems that the position remains much the same (Curtis J, forthcoming). The paper concludes with discussion of the latest key issues and returns to the question raised in 1996 about the training of employment and rehabilitation personnel.

Civil Rights↗

The use of bicycle helmets in a western Canadian province without legislation.

INTRODUCTION: This study examined the use of helmets in adults, adolescents, and children in a western Canadian province that has no helmet legislation. METHODS: A prospective survey of cyclists in two urban Alberta regions was completed. Cyclist demographics, helmet wearing and helmet use were recorded. RESULTS: Helmets were observed in 2,259 (55%; 99% CI: 52-57) of 4,141 cyclists; however, only 75% (CI 71, 78) were wearing the helmet properly. Patterns of use varied according to age: 75% (CI 71, 78) of children, 29% (CI 23, 34) of adolescents, and 52% (CI 49, 55) of adults wore helmets. Percentages were higher in Calgary than Edmonton (63% vs. 45%; p < 0.0001) and females wore helmets more often (64% vs. 50%; p < 0.0001). DISCUSSION: These results identify large within- and between-region variation in the use of cycling helmets in Alberta. Injury prevention planners need to use these data to adopt interventions that are focused on age groupings, gender, and place of residence.

Adolescent↗