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Results for “Mandatory Programs”

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At least 1,315 records · Page 73Linked to original sources
PubMed1983

Constrained total shoulder arthroplasty. Long-term follow-up observations.

Constrained total shoulder arthroplasty is a salvage procedure for patients with disabling pain and a nonfunctioning rotator cuff mechanism. Considering the advanced pathologic process and severe symptoms of these patients, the results of pain relief are gratifying. Many of the patients have weak or absent deltoid muscles, and active overhead motion is not possible. A method of attaching the metal glenoid to the scapula has been designed to reduce the risk of loosening. However, constrained total shoulder arthroplasty does produce considerable stress on bony attachments. Careful patient selection and an excellent, carefully supervised postoperative rehabilitation program are mandatory for success. Before considering a constrained total joint arthroplasty, the surgeon should carefully assess the patient's needs and consider other less extensive shoulder reconstructions.

Adult↗
PubMed1981

Should states require child passenger protection?

Motor vehicle accidents are the leading cause of death and injury in children over one year of age in the United States. In response to this problem, bills have been introduced in the legislatures of more than twenty states that would require children to be restrained when riding in motor vehicles. Details such as age limits and types of allowable restraint devices have varied with the individual proposals. Laws have been passed in Tennessee and Rhode Island requiring child passengers to be restrained under certain circumstances. In both these states, as well as in many other states where similar laws have been proposed, objections have been raised on the basis of individual and family rights. A state legislative commission has drafted a Proposed Model Law: Every driver transporting a child under the age of five years in a motor vehicle registered in this state and operated on the roadways, streets, or highways of this state shall provide for the protection of the child by properly using a child passenger restraint system meeting applicable Federal Motor Vehicle Safety Standards. Is such a law a necessary protection, or does it violate due process, privacy, and the right of parents to raise children as they see fit? Does it also discriminate economically?

Accidents, Traffic↗
PubMed1995

Hybridizing the health care plans of Hawaii, Oregon, and Singapore.

Universal coverage requires costcontainment. Working models of health care coverage from Hawaii, Oregon, and Singapore address different aspects of cost-containment. Hybridizing the three produces the following system: A percentage of an individual's salary is mandatorily set aside in an individual medical account. Using these savings, the individual purchases catastrophic medical insurance with a managed care organization. Residual funds are used as a deductible or co-payment and to purchase additional medical services as desired. Enough funds should accumulate during an individual's working life to enable continued coverage after retirement. The basic health care package needs to be limited and is defined by a systematic and rational process based on cost-benefit analysis and democratic consensus regarding priorities and coverage. Medicaid recipients get the same basic package from managed care organizations as that available to the rest of the population; low wage earners receive sliding-scale subsidies from the government. Co-payments and deductibles remain in place except for beneficial preventive services.

Bioethics↗
PubMed1995

Forensic DNA data banking by state crime laboratories.

This article reports the results of a survey of the responsible crime laboratories in the first 19 states with legislation establishing forensic DNA data banks. The survey inquired into the labs' policies and procedures regarding the collection, storage, and analysis of samples; the retention of samples and data; search protocols; access to samples and data by third parties; and related matters. The research suggests that (1) the number of samples collected from convicted offenders for DNA data banking has far surpassed the number that have been analyzed; (2) data banks have already been used in a small but growing number of cases, to locate suspects and to identify associations between unresolved cases; (3) crime labs currently plan to retain indefinitely the samples collected for their data banks; and (4) the nature and extent of security safeguards that crime labs have implemented for their data banks vary among states. The recently enacted DNA Identification Act (1994) will provide $40 million in federal matching grants to states for DNA analysis activities, so long as states comply with specified quality-assurance standards, submit to external proficiency testing, and limit access to DNA information. Although these additional funds should help to ease some sample backlogs, it remains unclear how labs will allocate the funds, as between analyzing samples for their data banks and testing evidence samples in cases without suspects. The DNA Identification Act provides penalties for the disclosure or obtaining of DNA data held by data banks that participate in CODIS, the FBI's evolving national network of DNA data banks, but individual crime labs must also develop stringent internal safeguards to prevent breaches of data-bank security.

Civil Rights↗