Interference with the patient-physician relationship

Directory of Open Access Journals (Sweden)

Robbins RA

2012-11-01

Full Text Available No abstract available. Article truncated at 150 words. “Life is like a boomerang. Our thoughts, deeds and words return to us sooner or later, with astounding accuracy.”-Brant M. Bright, former project leader with IBM A recent sounding board in the New England Journal of Medicine discussed legislative interference with the patient-physician relationship (1. The authors, the executive staff leadership of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the American College of Surgeons believe that legislators should abide by principles that put patients’ best interests first. Critical to achieving this goal is respect for the importance of scientific evidence, patient autonomy, and the patient-physician relationship. According to the authors, lawmakers are increasingly intruding into the realm of medical practice, often to satisfy political agendas without regard to established, evidence-based guidelines for care. The article goes on to cite examples including: The Florida ….

Legislative Branch: FY2014 Appropriations

Science.gov (United States)

2013-11-25

for the renovation of the Cannon House Office Building and the condition of the Rayburn building, the effect of the sequester on overtime work, plans...provided by the Joint Committee on Taxation for all revenue legislation (Balanced Budget and Emergency Deficit Control Act of 1985, P.L. 99-177...Committee, the Joint Committee on Taxation , the Office of the Attending Physician, and the Office of Congressional Accessibility Services. The FY2012

Gainsharing Strategies, Physician Champions, Getting Physician Buy In.

Science.gov (United States)

Anoushiravani, Afshin A; Nunley, Ryan M

2017-06-01

As healthcare spending continues to outpace economic growth, legislators and healthcare economists have explored many processes aimed at improving efficiency and reducing waste. Gainsharing or the general concept that organizations and their employees can work together to continually improve outcomes at reduced expenditures in exchange for a portion of the savings has been shown to be effective within the healthcare system. Although gainsharing principles may be applicable to healthcare organizations and their physician partners, specific parameters should be followed when implementing these arrangements. This article will discuss 10 gainsharing strategies aimed at properly aligning healthcare organizations and physicians, which if followed will ensure the successful implementation of gainsharing initiatives. Copyright © 2017. Published by Elsevier Inc.

[Legal issues of physician-assisted euthanasia. Part III--Passive euthanasia, comparison of international legislation, conclusions for medical practice].

Science.gov (United States)

Laux, Johannes; Röbel, Andreas; Parzeller, Markus

2013-01-01

The generic term "passive euthanasia" includes different issues dealing with the omission, discontinuation or termination of life-sustaining or life-prolonging medical treatments. The debate around passive euthanasia focuses on the constitutional right of self-determination of every human being on the one hand and the constitutional mandate of the State to protect human life on the other. Issues of passive euthanasia always require a differentiated approach. Essentially, it comes down to the following: In Germany, the human right of self-determination includes the right to prohibit the performance of life-sustaining treatments, even if this leads to the death of the patient. A physician who does not take life-sustaining treatment measures because this is the free will expressed by the patient is not subject to prosecution. On the other hand, if the physician treats the patient against his will, this can be deemed a punishable act of bodily injury. The patient's will is decisive even if his concrete state of health does no longer allow him to freely express his will. In the Patient's Living Will Act of 2009, the German legislator clarified the juridical assessment of such constellations being of particular relevance in practice. A written living will of a person in which he requests to take or not to take certain medical treatment measures in case that he is no longer able to make the decision himself shall be binding for the people involved in the process of medical treatment. If there is no living will, the supposed will of the patient shall be relevant. In its judgment in the "Putz case", the German Federal Court of Justice ruled in 2010 that actions terminating a life-sustaining treatment that does not correspond to the patient's will must be limited to letting an already ongoing disease process run its course. In this context it is not important, however, whether treatment is discontinued by an active act or by omission. Under certain circumstances, the

Evolution of European Union legislation of herbal medicinal products and its transposition to national legislation in 1965-2007: case Finland.

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Koski, Sari M; Laitinen-Parkkonen, Pirjo; Airaksinen, Marja

2015-01-01

The study aim was to explore the progress of legislation relating to herbal medicinal products in the European Union and compare it with the corresponding progress of the legislation in Finland in 1965-2007. The study was carried out using content analysis. Data were searched from publicly available European Union directives and national acts. All definitions and safety-related requirements for herbal medicinal products were identified. The transposition of safety-related requirements into the national legislation was studied. Medicinal products from plant origins have been part of the European Union legislation since 1965. Most plant-based products have not initially been regarded as medicinal products but rather as some kind of medicine-like products. The official definition of herbal medicinal products was introduced in Directive 2004/24/EC and implemented into the Finnish legislation with the terminology to recognise herbal medicinal products as part of medicinal products. The current safety-related requirements of medicinal products concern analogously herbal medicinal products. Herbal medicinal products have had different definitions in pharmaceutical legislation over the study period in the European Union and Finland. The current definition places herbal medicinal products more clearly under the medicinal products' legislation. Safety-related requirements are now practically identical for all medicinal products. Transposition of the European Union legislation into the national legislation in Finland is apparent. Copyright © 2013 John Wiley & Sons, Ltd.

[Current legislation in the healthcare system 2015/2016].

Science.gov (United States)

Martenstein, I; Wienke, A

2016-05-01

The energy of the legislator in the healthcare system was barely stoppable in 2015. Many new laws have been brought into force and legal initiatives have also been implemented. The Hospital Structure Act, the Treatment Enhancement Act, amendments of the official medical fee schedules for physicians, the Prevention Act, the E-Health Act, the Anti-corruption Act, the hospital admission guidelines and amendments of the model specialty training regulations are just some of the essential alterations that lie ahead of the medical community. This article gives a review of the most important new legislative regulations in the healthcare system and presents the fundamental consequences for the practice.

Legislative framework and regulatory requirements for the introduction of nuclear power

International Nuclear Information System (INIS)

Ha-Vinh, Phuong

1975-01-01

The adoption of appropriate legislation is to be considered as a prerequisite to the introduction of nuclear power in view of the issues that need to be regulated. Preparatory steps should be started at the earliest stage in conjunction with the planning of nuclear power projects. The primary objectives of a licensing scheme are to ensure safety, public health and environmental protection as well as financial protection for third parties in case of nuclear incident. For licensing purposes, a legislative framework and regulatory determinations are required. Within such a framework and pursuant to such regulatory determinations, the elaboration of safety standards, rules, guides and enforcement procedures is to be considered of paramount importance. To this end a number of international recommendations and advisory material prepared by the IAEA provide useful guidance. A licensing process would normally be split into several stages relating to site approval, construction permit, pre-operational tests, and operating licence, each stage being subject to safety assessments and reviews as determined by regulations. Financial protection against nuclear damage has also to be insured. A special regime of nuclear liability has been established by international conventions, based on the principle of strict liability of the operator of a nuclear installation. As a result of such channelling of liability to him, his liability is limited in amount and time. This liability system has the dual purpose of ensuring appropriate protection for potential victims and of relieving the nuclear industry from unlimited liability risks, which would impede practical applications of atomic energy. For the elaboration of nuclear legislation and specialized regulations the Agency's advisory services have proved to be of help to countries embarking on a nuclear power programme. (author)

Emotional and psychological effects of physician-assisted suicide and euthanasia on participating physicians.

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Stevens, Kenneth R

2006-01-01

This is a review and evaluation of medical and public literature regarding the reported emotional and psychological effects of participation in physician-assisted suicide (PAS) and euthanasia on the involved physicians. Articles in medical journals, legislative investigations and the public press were obtained and reviewed to determine what has been reported regarding the effects on physicians who have been personally involved in PAS and euthanasia. The physician is centrally involved in PAS and euthanasia, and the emotional and psychological effects on the participating physician can be substantial. The shift away from the fundamental values of medicine to heal and promote human wholeness can have significant effects on many participating physicians. Doctors describe being profoundly adversely affected, being shocked by the suddenness of the death, being caught up in the patient's drive for assisted suicide, having a sense of powerlessness, and feeling isolated. There is evidence of pressure on and intimidation of doctors by some patients to assist in suicide. The effect of countertransference in the doctor-patient relationship may influence physician involvement in PAS and euthanasia. Many doctors who have participated in euthanasia and/or PAS are adversely affected emotionally and psychologically by their experiences.

The impact of safety legislation

International Nuclear Information System (INIS)

Turner, J.L.; Gill, J.R.

1989-01-01

The impact of medicines legislation for radiopharmaceuticals is discussed with regard to product licensing, production and quality control, marketing authorisation within the EC, licensing exemptions and authorisation for administration. As regards safety legislation for radiopharmaceuticals the requirements of the Ionising Radiations Regulations 1985 are outlined. (UK)

Issues for the Traveling Team Physician.

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Kaeding, Christopher C; Borchers, James

2016-07-01

This article outlines the value of having the team physician traveling with athletes to away venues for competitions or training sessions. At present, this travel presents several issues for the team physician who crosses state lines for taking care of the athletes. In this article, these issues and their possible remedies are discussed. A concern for the travelling team physician is practicing medicine while caring for the team in a state where the physician is not licensed. Another issue can be the transportation of controlled substances in the course of providing optimal care for the team athletes. These two issues are regulatory and legislative issues at both the state and federal levels. On the practical side of being a team physician, the issues of emergency action plans, supplies, and when to transport injured or ill patients are also reviewed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Flexibility in radiation protection legislation

International Nuclear Information System (INIS)

Beaver, P.F.; Gill, J.R.

1980-01-01

The UK approach to radiation protection legislation is described in detail. The advantages are outlined of a flexible approach whereby the objectives of the legislation are clearly identified but the means of achieving these are left open or qualified by terms such as 'where reasonably practicable'. The roles and viewpoints of management and unions in such an approach are discussed especially with respect to legislation such as the Health and Safety at Work Act. Specific topics include requirements for notification of use, criteria for controlled areas and the tasks of the radiation protection adviser. (UK)

Model Legislation for GAAP and GASB.

Science.gov (United States)

Bissell, George E.

1987-01-01

The use of generally accepted accounting principles (GAAP) by all state and local governments may require legislation. Findings from a survey of states to get data on current accounting and financial reporting practices are summarized. Model legislation to provide uniformity in accounting and reporting is presented. (MLF)

Impact of a State Law on Physician Practice in Sports-Related Concussions.

Science.gov (United States)

Flaherty, Michael R; Raybould, Toby; Jamal-Allial, Aziza; Kaafarani, Haytham M A; Lee, Jarone; Gervasini, Alice; Ginsburg, Richard; Mandell, Mark; Donelan, Karen; Masiakos, Peter T

2016-11-01

To determine physician-reported adherence to and support of the 2010 Massachusetts youth concussion law, as well as barriers to care and clinical practice in the context of legislation. Primary care physicians (n = 272) in a large pediatric network were eligible for a cross-sectional survey in 2014. Survey questions addressed key policy and practice provisions: concussion knowledge, state regulations and training, practice patterns, referrals, patient characteristics, and barriers to care. Analyses explored relationships between practice and policy, adjusting for physician demographic and practice characteristics. The survey response rate was 64% among all responders (173 of 272). A total of 146 respondents who had evaluated, treated, or referred patients with a suspected sports-related concussion in the previous year were eligible for analysis. The vast majority (90%) of providers agreed that the current Massachusetts laws regarding sports concussions are necessary and support the major provisions. Three-quarters (74%) had taken a required clinician training course on concussions. Those who took training courses were significantly more likely to develop individualized treatment plans (OR, 3.6; 95% CI, 1.1-11.0). Physician training did not improve screening of youth with concussion for depression or substance use. Most physicians (77%) advised patients to refrain from computer, telephone, or television for various time periods. Physicians reported limited communication with schools. Primary care physicians report being comfortable with the diagnosis and management of concussions, and support statewide regulations; however, adherence to mandated training and specific legal requirements varied. Broader and more frequent training may be necessary to align current best evidence with clinical care and state-mandated practice. Copyright © 2016 Elsevier Inc. All rights reserved.

Challenges Encountered by Connecticut Partner School Districts when Implementing Legislatively Required District Improvement Plans: An Exploratory Study

Science.gov (United States)

Martins, Meghan G.

2010-01-01

This research developed a survey that measures the degree to which challenges are experienced by school and district leaders, and teachers, when attempting to implement legislatively required District Improvement Plans (DIPs). The data indicate that there are certainly challenges when implementing DIPs and that teachers report experiencing a…

Pharmaceutical marketing research and the prescribing physician.

Science.gov (United States)

Greene, Jeremy A

2007-05-15

Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue.

Maritime environmental penal law. International and German legislation

International Nuclear Information System (INIS)

Eller, Jan Frederik

2017-01-01

The book on maritime environmental penal law discusses the following issues: part I: introduction into the importance of oceanic environment and its thread, requirement of protective measures,; part II: focus of the study and terminology: oceanic pollution, maritime environmental legislation, international legislation; part 3: international legislative regulations concerning the protection of maritime environment: avoidance of environmental pollution, maritime legislative agreements, existing protective institutions; part 4: state penal power concerning maritime environmental protection; part 5: statutory offense according to German legislation; perspectives for regulations concerning criminal acts on sea.

Regulating the relationship between physicians and pharmaceutical companies: a qualitative and descriptive analysis of the impact of Israeli legislation.

Science.gov (United States)

Nissanholtz-Gannot, Rachel; Yankellevich, Ariel

2017-09-26

The Israeli National Health Insurance Law was amended in 2010 to require the disclosure of payments above 2500 NIS from pharmaceutical companies (PCs) to medical personnel and organizations. We examined if the law had an impact on the relationship between physicians in the Israeli health system and the pharmaceutical industry. We conducted 42 in-depth semi-structured interviews with representatives of relevant stakeholders regarding the effects and extent of the law and the interviewees' attitudes about regulating the relationship between physicians and PCs. In addition, we analyzed reports on payments from PCs to various components of the health system. The majority of interviewees agreed that transparency is important to the relationship between PCs and physicians and none of them opposed the disclosure of payments. Most interviewees reported to have witnessed a change in the regulatory climate of the relationship between PCs and physicians, prompted mostly by self-regulatory measures of the pharmaceutical industry. The most significant change in this relationship appeared to be the enactment of contractual relations between PCs and physicians. There was a pervasive feeling that self-regulation is more effective than state regulation. The impact of the law on the behavior of individual physicians was claimed to be limited at best. Suggested causes were lack of awareness of the law, particularly among physicians; ambiguous definition of "payments" and loopholes in the law that attract other forms of remuneration to physicians and lack of enforcement of the law. According to reports published by the Ministry of Health, Pharma Israel, and the Israeli Medical association, although there had been some disclosure of payments by both donors and beneficiaries, there were inconsistencies between the total payments disclosed by PCs and those disclosed by their beneficiaries. There is a broad agreement that transparency is important to the PCs-physicians relationship. In

When is physician assisted suicide or euthanasia acceptable?

Science.gov (United States)

Frileux, S; Lelièvre, C; Muñoz Sastre, M T; Mullet, E; Sorum, P C

2003-12-01

To discover what factors affect lay people's judgments of the acceptability of physician assisted suicide and euthanasia and how these factors interact. Participants rated the acceptability of either physician assisted suicide or euthanasia for 72 patient vignettes with a five factor design--that is, all combinations of patient's age (three levels); curability of illness (two levels); degree of suffering (two levels); patient's mental status (two levels), and extent of patient's requests for the procedure (three levels). Convenience sample of 66 young adults, 62 middle aged adults, and 66 older adults living in western France. In accordance with the functional theory of cognition of N H Anderson, main effects, and interactions among patient factors and participants' characteristics were investigated by means of both graphs and ANOVA. Patient requests were the most potent determinant of acceptability. Euthanasia was generally less acceptable than physician assisted suicide, but this difference disappeared when requests were repetitive. As their own age increased, participants placed more weight on patient age as a criterion of acceptability. People's judgments concur with legislation to require a repetition of patients' requests for a life ending act. Younger people, who frequently are decision makers for elderly relatives, place less emphasis on patient's age itself than do older people.

Patient Care Physician Supply and Requirements: Testing COGME Recommendations. Council on Graduate Medical Education, Eighth Report.

Science.gov (United States)

Council on Graduate Medical Education.

This report reassesses recommendations made by the Council on Graduate Medical Education in earlier reports which had, beginning in 1992, addressed the problems of physician oversupply. In this report physician supply and requirements are examined in the context of a health care system increasingly dominated by managed care. Patterns of physician…

Transportation of radioactive materials: a summary of state and local legislative requirements for the period ending December 31, 1985

Energy Technology Data Exchange (ETDEWEB)

Knox, N.P.; Goins, L.F.; Fowler, J.W.; Owen, P.T.

1986-04-01

This report lists 670 adopted US state and local laws that impact the transportation of radioactive materials. The report was generated from information contained in the Legislative Database (LDB), a comprehensive, interactive database developed at the Oak Ridge National Laboratory for the US Department of Energy and the Joint Integration Office. Laws are sorted alphabetically by state, with state and local bills listed separately and sorted by date of adoption. Each citation contains the following information: locale (geographical areas and political jurisdictions affected by the action), bill number, bill title, bill sponsor, history of bill status, comments, and abstract. Seven indexes are provided to assist the reader in locating legislation of interest: locale, bill number, title word (permuted), sponsor, transport restriction (type of transportation restriction specified, e.g., escort, notify, permit, ban), transport mode (mode of transportation specified, e.g., truck, rail, barge), and keyword. This report adds new legislation to the information contained in last year's report, ''Transportation of Radioactive and Hazardous Materials: A Summary of State and Local Legislative Requirements for the Period Ending December 31, 1981,'' ORNL/TM-9563, published in September 1985.

Transportation of radioactive materials: a summary of state and local legislative requirements for the period ending December 31, 1985

International Nuclear Information System (INIS)

Knox, N.P.; Goins, L.F.; Fowler, J.W.; Owen, P.T.

1986-04-01

This report lists 670 adopted US state and local laws that impact the transportation of radioactive materials. The report was generated from information contained in the Legislative Database (LDB), a comprehensive, interactive database developed at the Oak Ridge National Laboratory for the US Department of Energy and the Joint Integration Office. Laws are sorted alphabetically by state, with state and local bills listed separately and sorted by date of adoption. Each citation contains the following information: locale (geographical areas and political jurisdictions affected by the action), bill number, bill title, bill sponsor, history of bill status, comments, and abstract. Seven indexes are provided to assist the reader in locating legislation of interest: locale, bill number, title word (permuted), sponsor, transport restriction (type of transportation restriction specified, e.g., escort, notify, permit, ban), transport mode (mode of transportation specified, e.g., truck, rail, barge), and keyword. This report adds new legislation to the information contained in last year's report, ''Transportation of Radioactive and Hazardous Materials: A Summary of State and Local Legislative Requirements for the Period Ending December 31, 1981,'' ORNL/TM-9563, published in September 1985

Dense breasts: a review of reporting legislation and available supplemental screening options.

Science.gov (United States)

Ho, Jessica M; Jafferjee, Nasima; Covarrubias, Gabriel M; Ghesani, Munir; Handler, Bradley

2014-08-01

The objectives of this article are to discuss the Mammography Quality Standards Act (MQSA) and what it means for patients, define breast density and explain how it is measured, review the new state-based legislation regarding the reporting of dense breast tissue directly to patients and the possibility of an adjunct screening examination, describe possible supplemental screening options and the advantages and disadvantages of each, and outline the current shortcomings and unanswered questions regarding new legislation. Breast density is now established as an independent risk factor for developing breast cancer irrespective of other known risk factors. Women with breast density in the upper quartile have an associated four to five times greater risk of developing breast cancer relative to women with breast density in the lower quartile. Many states have enacted or proposed legislation requiring mammographers to report to patients directly if they have dense breast tissue and recommend discussing the possibility of a supplemental screening examination with their physicians. However, there is currently no consensus as to whether a supplemental screening examination should be pursued or which modality to use. Possible supplemental screening modalities include ultrasound, MRI, digital breast tomosynthesis, and molecular breast imaging. The U.S. Food and Drug Administration recently approved an automated breast ultrasound system for screening whole-breast ultrasound in patients with dense breasts. However, many questions are still unanswered including the impact on morbidity and mortality, cost-effectiveness, and insurance coverage.

Implementing the legislation

International Nuclear Information System (INIS)

Silverstrom, L.

1982-01-01

Leon Silverstrom explained how nuclear waste disposal legislation would be implemented. The legislation provides a framework that recognizes the tremendous number of views and opinions on the subject and provides a mechanism that will allow all these interests to be expressed before final decisions are reached. Implementing procedures are outlined for: (1) the final repository; (2) interim or last resort storage; (3) research and development; (4) the monitored retrievable storage phases. The whole process will involve: environmental assessments and licensing requirements for each phase; construction of a test and evaluation facility; provision for sharing information with the states and interested parties; and procedures for public hearings and state rejection of propoped sites

Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland.

Science.gov (United States)

Fogarty, B J; Gordon, D J

1999-02-01

The efficacy of legislation in reducing firework associated injuries is uncertain as is the nature of the problem within the United Kingdom (UK). In September 1996 the legislation governing firework sale in Northern Ireland was relaxed thus equalling that of the rest of the UK. For the 2 years following the change in legislation we prospectively assessed those patients who were admitted with a firework injury over the Halloween period. We then compared these results with retrospective data for the 3 years prior to the change in firework law. In the pre-legislation series the mean number of patients admitted annually was 0.38 per 100,000 while in the post-legislation series the mean was 0.43 per 100,000. Blast injury to the hand was the commonest injury accounting for 53% of cases in both series. Burn injuries were the second commonest form of injury comprising 30% of all admissions. Of those admitted with a hand injury 47% had at least one finger terminalised and nearly half of those patients admitted with burns (44%) required skin grafting. We conclude that early evidence suggests that liberalisation of the law on firework sale has not resulted in a significant increase in firework related injuries requiring hospital admission.

African American legislators' perceptions of firearm violence prevention legislation.

Science.gov (United States)

Payton, Erica; Thompson, Amy; Price, James H; Sheu, Jiunn-Jye; Dake, Joseph A

2015-06-01

Firearm mortality is the leading cause of death for young African American males, however, few studies have focused on racial/ethnic minority populations and firearm violence. The National Black Caucus of State Legislators advocates for legislation that promotes the health of African Americans. Thus, the purpose of this study was to collect baseline data on African American legislators' perceptions regarding firearm violence in the African American community. A cross-sectional study of African American legislators (n = 612) was conducted to investigate the research questions. Of the 612 questionnaires mailed, 12 were not deliverable, and 170 were returned (28%). Utilizing a three wave mailing process, African American legislators were invited to participate in the study. The majority (88%) of respondents perceived firearm violence to be very serious among African Americans. Few (10%) legislators perceived that addressing legislative issues would be an effective strategy in reducing firearm violence among African Americans. The majority (72%) of legislators perceived the most effective strategy to reducing firearm violence in the African American community should focus on addressing societal issues (e.g. crime and poverty). After adjusting for the number of perceived barriers, the number of perceived benefits was a significant predictor of legislators' perceived effectiveness of firearm violence prevention legislation for 8 of the 24 potential firearm violence prevention legislative bills.

Physician Compare

Data.gov (United States)

U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

Physicians' perceptions of physician-nurse interactions and information needs in China.

Science.gov (United States)

Wen, Dong; Guan, Pengcheng; Zhang, Xingting; Lei, Jianbo

2018-01-01

Good communication between physicians and nurses is important for the understanding of disease status and treatment feedback; however, certain issues in Chinese hospitals could lead to suboptimal physician-nurse communication in clinical work. Convenience sampling was used to recruit participants. Questionnaires were sent to clinical physicians in three top tertiary Grade-A teaching hospitals in China and six hundred and seventeen physicians participated in the survey. (1) Common physician-nurse interactions were shift-change reports and provisional reports when needed, and interactions expected by physicians included face-to-face reports and communication via a phone or mobile device. (2) Most respondents believed that the need for information in physician-nurse interactions was high, information was moderately accurate and timely, and feedback regarding interaction time and satisfaction indicated that they were only average and required improvement. (3) Information needs in physician-nurse interactions differed significantly according to hospital category, role, workplace, and educational background (p < .05). There was a considerable need for information within physician-nurse interactions, and the level of satisfaction with the information obtained was average; requirements for the improvement of communication differed between physicians and nurses because of differences in their characteristics. Currently, the use of information technology in physician-nurse communication was less common but was highly expected by physicians.

On professional and official requirements to physicians in radiation health by sectoral sanitary and epidemiological stations

International Nuclear Information System (INIS)

Usol'tsev, V.I.; Konkina, L.F.; Shishenina, V.I.

1989-01-01

Professional and official requirements (POR) to sanitary physician, which deals with radiation hygiene at the sanitary and epidemiologic stations (SES), are considered. These requirements determine minimum of professional skills and abilities in the field of radiation hygiene. Physician should contribute to the improvement of radiation safety and health indices for personnel and population, and in this case, his activity should not impede the further usage of ionizing radiation sources in the national economy. Sanitary physician, dealing with a actain branch of industry, concerning the problems of radiation hygiene should know the principles of deontology, aims and functions of SES establishment and departments in the field of radiation hygiene, legal principles of radiation safety is basic tasks are as follows: 1) State sanitary inspection of sanitary-hygienic measures for the environmental protection and radiation protection of population; 2) organizational and methodological activity; 3) activity in medical civil defense

Legislating Interprofessional Regulatory Collaboration in Nova Scotia

Directory of Open Access Journals (Sweden)

William Lahey

2013-10-01

Full Text Available To shift health professions regulation from traditional to ‘collaborative’ self-regulation, Nova Scotia has adopted legislation which will: make all self-regulating health professions members of the Regulated Health Professions Network; mandate the Network to facilitate voluntary collaboration among its members; and enable regulators to work together on investigations of patient complaints, to adjust scopes of practice on an ongoing basis and to adjudicate appeals of unsuccessful applicants for registration. The goals are to give health professions regulation the capacity to enable and support the functioning of interprofessional teams. The legislation was adopted primarily for two reasons: collaborative development and unanimous support by all of the province’s self-regulating professions; and alignment with the government’s health care reform agenda and its emphasis on collaborative team-based care. Contrary to the approach of several other provinces, the legislation will enable but not require regulators to collaborate on the premise that consensual collaboration is more likely to happen, to be meaningful and to yield tangible benefits. Support for this approach can be taken from the impressive collaborative work on which the legislation is based. Evaluation will be critical, and the five-year review required by the legislation will give Nova Scotia the opportunity to test not only the legislation but the ideas on which it is based. The extent of the legislation’s reliance on voluntary process will prove to be either its greatest strength or its greatest weakness.

National legislative and regulatory activities

International Nuclear Information System (INIS)

Anon.

2010-01-01

Belarus: general legislation with amendments to laws on the use of atomic energy (2009) and criminal law on acts concerning the use of radioactive sources and administrative law for non criminal violations of radiation safety requirement (2009). Egypt: general legislation with law on activities in the nuclear and radiation field (2010). France: radioactive waste management with a decree establishing a committee on industrial co-ordination of radioactive waste (2010) and third part liability with a law on the recognition and indemnification of victims of nuclear tests conducted by France (2010). Germany: general legislation with a tenth amendment to the atomic energy act (2010), and act on environmental impact assessment (2009) concerning organisation and structure we find a revised version of statutes of the Radiation Protection Commission (2009), about radiation protection we find an act on the protection against non-ionizing radiation (2009), and for transport of radioactive materials we have an ordinance on the international transport of dangerous goods by road (2009). Ireland: In radiation protection we have an order to amend Regulations on active implantable medical devices (2010). Italy: general legislation we have a decree setting out rules for the sitting, construction and operation of nuclear installations (2010). Romania: general legislation with a law on the reorganisation of public authorities (2009). Slovak Republic: general legislation with an amendment of the atomic act (2009). spain: radioactive waste management with a law regulation limited investment companies quoted on the real estate market (2009). Ukraine: general legislation with an overview of recent amendments to laws in the field of nuclear energy (2009). (N.C.)

[Consent and confidentiality in occupational health practice: balance between legal requirements and ethical values].

Science.gov (United States)

Mora, Erika; Franco, G

2010-01-01

The recently introduced Italian law on the protection of workers' health states that the occupational health physician (competent physician) is required to act according to the Code of Ethics of the International Commission on Occupational Health (ICOH). This paper aims at examining the articles of legislative decree 81/2008 dealing with informed consent and confidentiality compared with the corresponding points of the ICOH Ethics Code. Analysis of the relationship between articles 25 and 39 (informed consent) and 18, 20 and 39 (confidentiality) of the decree shows that there are some points of disagreement between the legal requirements and the Code of Ethics, in particular concerning prescribed health surveillance, consent based on appropriate information (points 8, 10 and 12 of the Code) and some aspects of confidentiality (points 10, 20, 21, 22 and 23 of the Code). Although the competent physician is required to act according to the law, the decisional process could lead to a violation of workers' autonomy.

Opinions of Polish occupational medicine physicians on workplace health promotion.

Science.gov (United States)

Puchalski, Krzysztof; Korzeniowska, Elzbieta; Pyzalski, Jacek; Wojtaszczyk, Patrycja

2005-01-01

According to the current Polish legislation on occupational health services, occupational medicine physicians should perform workplace health promotion (WHP) activities as a part of their professional work. The concept of workplace health promotion or health promotion programs, however, has not been defined in this legislation in any way. Therefore, two essential questions arise. First, what is the physicians' attitude towards workplace health issues and second, what is actually carried out under the label of health promotion? The main objective of the research described in this paper was to answer these questions. The survey was carried out by the National Center for Workplace Health Promotion in 2002. A questionnaire prepared by the Center for the purpose of this survey was sent to a random sample of occupational medicine physicians. The results of the survey showed that 53% of occupational medicine physicians consider WHP just as a new name for prophylactics. On the other hand almost all of the respondents (94%) agree that occupational medicine physicians should perform WHP activities and find them useful in improving patients' health (78%). The main obstacle for the development of this activity in the perception of physicians is the lack of interest in workplace health promotion among employers (86%). In the modern understanding of workplace health promotion concept this type of intervention includes not only safety measures and health education, but also a profound organizational change that allows employers, employees and social partners to improve wellbeing of people at work. Each of such projects should facilitate changes necessary to create a health promoting workplace. It also needs a skilled leader--well trained and aware of a multidisciplinary dimension of WHP interventions. Occupational medicine specialists should become natural partners of employers and employees. The majority of the occupational medicine physicians, however, are not sufficiently

Physician-assisted death: attitudes and practices of community pharmacists in East Flanders, Belgium.

Science.gov (United States)

Bilsen, Johan; Bauwens, Marc; Bernheim, Jan; Stichele, Robert Vander; Deliens, Luc

2005-03-01

This study investigates attitudes and practices of community pharmacists with respect to physician-assisted death. Between 15 February and 15 April 2002, we sent anonymous mail questionnaires to 660 community pharmacists in the eastern province of Flanders, Belgium. The response rate was 54% (n = 359). Most of the pharmacists who responded felt that patients have the right to end their own life (73%), and that under certain conditions physicians may assist the patient in dying (euthanasia: 84%; physician-assisted suicide: 61%). Under the prevailing restrictive legislation, a quarter of the pharmacists were willing to dispense lethal drugs for euthanasia versus 86% if it were legalized, but only after being well informed by the physician. The respondents-favour guidelines for pharmacists drafted by their own professional organizations (95%), and enforced by legislation (90%) to ensure careful end-of-life practice. Over the last two years, 7.3% of the responding pharmacists have received a medical prescription for lethal drugs and 6.4% have actually dispensed them. So we can conclude that community pharmacists in East Flanders were not adverse to physician-assisted death, but their cooperation in dispensing lethal drugs was conditional on clinical information about the specific case and on protection by laws and professional guidelines.

[Occupational health and safety management systems: scenarios and perspectives for occupational physicians].

Science.gov (United States)

Santantonio, P; Casciani, M; Bartolucci, G B

2008-01-01

This paper analyzes the role of the occupational physicians, taking into account the new Italian legislation within the frame of CSR, that puts in a new light the physicians inside the Organizations. In this context, Occupational Medicine and Workplace Health Promotion play a central role in most of the items of the Occupational Health and safety management systems, from H&S politics to training, from First Aid to audit and revision systems. From this innovative perspective, the authors try to identify the occupational physician's new challenges and opportunities.

Breast Density Notification Legislation and Breast Cancer Stage at Diagnosis: Early Evidence from the SEER Registry.

Science.gov (United States)

Richman, Ilana; Asch, Steven M; Bendavid, Eran; Bhattacharya, Jay; Owens, Douglas K

2017-06-01

Twenty-eight states have passed breast density notification laws, which require physicians to inform women of a finding of dense breasts on mammography. To evaluate changes in breast cancer stage at diagnosis after enactment of breast density notification legislation. Using a difference-in-differences analysis, we examined changes in stage at diagnosis among women with breast cancer in Connecticut, the first state to enact legislation, compared to changes among women in control states. We used data from the Surveillance, Epidemiology, and End Results Program (SEER) registry, 2005-2013. Women ages 40-74 with breast cancer. Breast density notification legislation, enacted in Connecticut in October of 2009. Breast cancer stage at diagnosis. Our study included 466,930 women, 25,592 of whom lived in Connecticut. Legislation was associated with a 1.38-percentage-point (95 % CI 0.12 to 2.63) increase in the proportion of women in Connecticut versus control states who had localized invasive cancer at the time of diagnosis, and a 1.12-percentage-point (95 % CI -2.21 to -0.08) decline in the proportion of women with ductal carcinoma in situ at diagnosis. Breast density notification legislation was not associated with a change in the proportion of women in Connecticut versus control states with regional-stage (-0.09 percentage points, 95 % CI -1.01 to 1.02) or metastatic disease (-0.24, 95 % CI -0.75 to 0.28). County-level analyses and analyses limited to women younger than 50 found no statistically significant associations. Single intervention state, limited follow-up, potential confounding from unobserved trends. Breast density notification legislation in Connecticut was associated with a small increase in the proportion of women diagnosed with localized invasive breast cancer in individual-level but not county-level analyses. Whether this finding reflects potentially beneficial early detection or potentially harmful overdiagnosis is not known. Legislation was not

Is there a doctor in the house? . . . Or the Senate? Physicians in US Congress, 1960-2004.

Science.gov (United States)

Kraus, Chadd K; Suarez, Thomas A

2004-11-03

The legislative and fiscal influences of Congress, as well as the continuing overall growth in health care spending as a portion of the gross domestic product, make congressional representation by physicians important because physicians have unique expertise in the impact of legislation on patient care and medical practice. To describe physician representation in the US Congress between 1960 and 2004 and relate the results to past representation of physicians in Congress. A retrospective observational study of members of the US Congress from all 50 states and all represented territories, who served from January 1960 to April 2004 (including 108th Congress), using data available in public access databases and congressional biographical records. Physician representation in Congress, including occupation before taking office, state/territory of representation, sex, party affiliation, and time served. During the past 44 years, 25 (1.1%) of 2196 members of Congress were physicians. Physicians in Congress were more likely to be members of the Republican Party (60% vs 45.1% of all members, P = .007) and were similar to other members of Congress in mean years of service (9.2 years for physicians vs 12.3 years for all members, P = .09) and in sex distribution (4.0% female physicians vs 6.8% all female members, P = .57). Physicians in Congress represented 17 states, the Virgin Islands, and Puerto Rico. Physician representation in Congress is low and is in stark contrast with physician roles during the first century of the United States. However, the 8 physicians currently serving in Congress may be indicative of a shift toward more direct influence of physicians in national politics.

Transportation of radioactive and hazardous materials: a summary of state and local legislative requirements for the period ending December 31, 1984

International Nuclear Information System (INIS)

Knox, N.P.; Goins, L.F.; Owen, P.T.

1985-09-01

This report summarizes 513 adopted US state and local laws that impact the transportation of radioactive materials. The report was generated from legislative information contained in the Legislative Data Base (LDB), a comprehensive interactive database developed at the Oak Ridge National Laboratory for the US Department of Energy. The annotated citations alphabetically by state, with state and local bills listed separately and sorted by date of adoption. Each citation contains the following information: locale (geographical areas and political jurisdictions affected by the action), bill number, bill title, bill sponsor, history of bill status, comments, and abstract. Six indexes are provided to assist the reader in locating legislation of interest: locale index, bill number index, title word index (permuted), sponsor index, transport restriction index (type of transportation restriction specified, e.g., escort, notify, permit, ban), transport mode index (mode of transportation specified, e.g., truck, rail, barge), and keyword index. This report updates the information contained in Transportation of Radioactive and Hazardous Materials: A Summary of State and Local Legislative Requirements for the Period ending September 30, 1983, ORNL/TM-8860 (TTC-0485), published in June 1984

Legislation, women, and breastfeeding.

Science.gov (United States)

Gibbons, G

1987-01-01

Governmental policies and legislation aimed at validating the dual role of women as mothers and wage earners can significantly strengthen breastfeeding promotion efforts. Examples of such laws and policies are maternity leave, breastfeeding breaks at the workplace, allowances for pregnant women and new mothers, rooming-in at hospitals, child care at the worksite, flexible work schedules for new mothers, and a national marketing code for breastmilk substitutes. The International labor Organization (ILO) has played an important role in setting international standards to protect working mothers. The ILO defines minimal maternity protection as encompassing: a compulsory period of 6 weeks' leave after delivery; entitlement to a further 6 weeks of leave; the provision during maternity leave of benefits sufficient for the full and healthy maintenance of the child; medical care by a qualified midwife or physician; authorization to interrupt work for the purpose of breastfeeding; and protection from dismissal during maternity leave. In many countries there is a lack of public awareness of existing laws or policies; i.e., working women may not know they are entitled to maternity leave, or pediatricians may not know that the government has developed a marketing code for breastmilk substitutes. Overall, the enactment and enforcement of legislation can ensure the longterm effectiveness of breastfeeding promotion by raising the consciousness of individuals and institutions, putting breastfeeding activities in the wider context of support for women's rights, recognizing the dual roles of women, and institutionalizing and legitimating support for breastfeeding.

An undignified side of death with dignity legislation.

Science.gov (United States)

Plaisted, Dennis

2013-09-01

The primary justification for Death with Dignity legislation has been the principle of respect for autonomy. However, some have objected that if respect for autonomy is the reason for allowing physician-assisted suicide, then why not allow it for people with longer than six months to live? Defenders of the laws have responded that respect for autonomy must be balanced against the state's interest in the lives of its citizens. Persons with less than six months remaining have virtually no life left to protect; persons with more time have a meaningfully long segment of life remaining. The state can therefore overrule their autonomy interests to preserve their lives. This paper will argue that this response constitutes an ironic affront to the dignity of people with less than six months to live, for it implies that their lives are not worth enough for the state to prevent them from committing physician-assisted suicide.

House Calls: Physicians in the US Congress, 2005-2015.

Science.gov (United States)

Goldenberg, Matthew N

2015-11-01

Physicians occupy a prominent position in the US healthcare system, and physicians who serve in Congress may bring a particular perspective, expertise, and influence to health-related legislation. The purpose of this study was to describe physician membership in the US Congress between 2005 and 2015. Congressional biographical records were searched to identify physicians who served in the US Congress from 2005 to 2015. Political and demographic characteristics of physician-members were compared with those of nonphysician-members of Congress and of all US physicians. The numbers of physicians in recent Congresses also were compared with those in each Congress since 1945. A total of 27 physicians representing 17 states have served in Congress since 2005. There has been a significant increase in physician representation since 1987, reaching a high of 20 members (3.7%) in the Congresses immediately following passage of the Patient Protection and Affordable Care Act. Physician-members were mostly men (93%) and more likely than their Congressional colleagues to be Republican (78% vs 53% of all members, P = 0.007) and from the South (63% vs 35% of all members, P = 0.003). Compared with physicians in general, physicians in Congress were more likely to be men (93% vs 70%, P = 0.009) and surgeons (26% vs 11%, P = 0.01). Physician representation in Congress has increased substantially since 2000, potentially reflecting the greater political prominence of healthcare issues, as well as increased interest by and recruitment of physician-candidates. Physicians in Congress differ from their colleagues and from physicians in general in various demographic and political characteristics.

The Prevalence and Special Educational Requirements of Dyscompetent Physicians

Science.gov (United States)

Williams, Betsy W.

2006-01-01

Underperformance among physicians is not well studied or defined; yet, the identification and remediation of physicians who are not performing up to acceptable standards is central to quality care and patient safety. Methods for estimating the prevalence of dyscompetence include evaluating available data on medical errors, malpractice claims,…

The effect of explicit financial incentives on physician behavior.

Science.gov (United States)

Armour, B S; Pitts, M M; Maclean, R; Cangialose, C; Kishel, M; Imai, H; Etchason, J

2001-05-28

Managed care organizations use explicit financial incentives to influence physicians' use of resources. This has contributed to concerns regarding conflicts of interest for physicians and adverse effects on the quality of patient care. In light of recent publicized legislative and legal battles about this issue, we reviewed the literature and analyzed studies that examine the effect of these explicit financial incentives on the behavior of physicians. The method used to undertake the literature review followed the approach set forth in the Cochrane Collaboration handbook. Our literature review revealed a paucity of data on the effect of explicit financial incentives. Based on this limited evidence, explicit incentives that place individual physicians at financial risk appear to be effective in reducing physician resource use. However, the empirical evidence regarding the effectiveness of bonus payments on physician resource use is mixed. Similarly, our review revealed mixed effects of the influence of explicit financial incentives on the quality of patient care. The effect of explicit financial incentives on physician behavior is complicated by a lack of understanding of the incentive structure by the managed care organization and the physician. The lack of a universally acceptable definition of quality renders it important that future researchers identify the term explicitly.

General practitioners’ level of knowledge about their rights and criminal liabilities according to legislation in Turkey

Directory of Open Access Journals (Sweden)

Baki Derhem

2017-12-01

Full Text Available Background . To know legal regulations and to comply with them while providing health care is indispensable for physicians to work in a proper way. Ignorance of the criminal laws may not be an excuse according to Turkish Criminal Code. There is an obligation for physicians to know the law, as well as all citizens. Physicians should possess the scope of competences regarding medicolegal regulations at least. Objectives . The aim of this study is to investigate the knowledge and behaviors of GPs regarding their rights, criminal liabilities and common rules of law that are regulated by legislation. We also aimed to determine how the answers were influenced by sociodemographic factors, educational status of participants and if the participants received any punishment. Material and methods . A total number of 381 physicians working at primary health care services located in Ankara were interviewed face-to-face. We used a 38-item questionnaire that was developed according to current legislation. The collected data was analyzed using SPSS software (Version 11.5. The chi-square test was used in order to compare knowledge-based questions with sociodemographic factors. The Mann-Whitney U test was used for assessing whether the number of correct answers differs with socio-demographic factors or not. A p-value of 0.05 was considered statistically significant. Results . 21.8 percent of the participants were FM specialists, and 78.2% of them were GPs. The mean age of physicians was 46.9 ± 7.6. The median score for correct responses in 18 knowledge-based questions was 8 (min–max: 3–14. In comparison with the working experience with correct answers, there was a statistically significant difference between 1–5 years of experience and 11–15 years and ≥ 16 years (p < 0.001. There was a significant difference in correct answers between the two groups, which were separated according to whether or not they received punishment as a result of a legal

Transportation of radioactive materials: the legislative and regulatory information system

International Nuclear Information System (INIS)

Fore, C.S.

1982-03-01

The US Department of Energy is carrying out a national program to assure the safe shipment of radioactive materials. As part of this overall effort, the Hazardous Materials Information Center of Oak Ridge National Laboratory has developed the comprehensive Legislative and Regulatory Information System, which contains information on federal-, state-, and local-level legislative and regulatory actions pertaining primarily to the shipment of radioactive materials. Specific subject areas chosen to highlight particular transportation restrictions include: (1) identification of state agency responsible for regulating transportation, (2) type of escorts required, (3) areas requiring prior notification, (4) areas requiring permits or licenses, and (5) areas totally banning transportation of all radioactive materials. Other legislative information being categorized and of immediate relevance to the transportation issues is covered under the areas of disposal, storage, and management of radioactive materials; establishment of additional regulations; emergency response regulations; moratoriums on power plant construction and siting; radiation safety and control studies; and remedial action studies. The collected information is abstracted, indexed, and input into one of the two data bases developed under this information system - Current Legislation Data Base and Historical Legislation Data Base. An appendix is included which provides a summary of the state and local laws affecting the transportation of radioactive materials throughout the United States. The Legislative and Regulatory Information System is supported by the Transportation Technology Center located at Sandia National Laboratories, Albuquerque, New Mexico

Transportation of radioactive materials: the legislative and regulatory information system

Energy Technology Data Exchange (ETDEWEB)

Fore, C.S.

1982-03-01

The US Department of Energy is carrying out a national program to assure the safe shipment of radioactive materials. As part of this overall effort, the Hazardous Materials Information Center of Oak Ridge National Laboratory has developed the comprehensive Legislative and Regulatory Information System, which contains information on federal-, state-, and local-level legislative and regulatory actions pertaining primarily to the shipment of radioactive materials. Specific subject areas chosen to highlight particular transportation restrictions include: (1) identification of state agency responsible for regulating transportation, (2) type of escorts required, (3) areas requiring prior notification, (4) areas requiring permits or licenses, and (5) areas totally banning transportation of all radioactive materials. Other legislative information being categorized and of immediate relevance to the transportation issues is covered under the areas of disposal, storage, and management of radioactive materials; establishment of additional regulations; emergency response regulations; moratoriums on power plant construction and siting; radiation safety and control studies; and remedial action studies. The collected information is abstracted, indexed, and input into one of the two data bases developed under this information system - Current Legislation Data Base and Historical Legislation Data Base. An appendix is included which provides a summary of the state and local laws affecting the transportation of radioactive materials throughout the United States. The Legislative and Regulatory Information System is supported by the Transportation Technology Center located at Sandia National Laboratories, Albuquerque, New Mexico.

Enabling legislation and regulatory determinations for a nuclear power programme

International Nuclear Information System (INIS)

Ha-Vinh, Phuong

1975-01-01

Broad definition of the scope of enabling legislation, identification of branches of laws involved in the licensing and regulatory control, overview of some typical licensing practices and provisions, some specific legislative or regulatory requirements including financial security to over nuclear liability. (HP) [de

43 CFR 46.445 - Preparing a legislative environmental impact statement.

Science.gov (United States)

2010-10-01

... IMPLEMENTATION OF THE NATIONAL ENVIRONMENTAL POLICY ACT OF 1969 Environmental Impact Statements § 46.445 Preparing a legislative environmental impact statement. When required under 40 CFR 1506.8, the Department must ensure that a legislative environmental impact statement is included as a part of the formal...

Paid Sick Leave as a Means to Reduce Sickness Presenteeism Among Physicians

Directory of Open Access Journals (Sweden)

Ingrid Steen Rostad

2017-06-01

Full Text Available Recurrent international data show that physicians often attend work while ill, termed sickness presenteeism. The current study investigated if sickness presenteeism scores among European physicians varied according to national paid sick leave legislation. We hypothesized that prevalence of presenteeism was higher in countries with lower levels of paid sick leave. We used repeated cross-sectional survey data, phase I (2004/2005, N = 1326 and phase II (2012/2013, N = 1403, among senior consultants at university hospitals in Sweden, Norway, and Italy. Analyses of variances assessed cross-country differences in presenteeism. To assess the impact of country on presenteeism, we used multiple regression analyses controlled for sex, age, family status, work hours, and work content. The results from phase I supported the initial hypothesis. At phase II, presenteeism scores had decreased among the Italian and Swedish sample. The results are discussed with regard to changes in legislation on workhours and medical liability in Italy and Sweden between phase I and II.

Legislation

International Nuclear Information System (INIS)

2002-01-01

This bulletin contains information about activities of the Nuclear Regulatory Authority of the Slovak Republic (UJD). In this leaflet the legislation activities of the UJD are presented. The Nuclear Regulatory Authority (UJD) of the Slovak Republic, as the central body, performs legislative activities within its competence and defines binding criteria in the area of nuclear safety. In the area of nuclear safety the Act No.130/1998 Coll. 'on peaceful use of nuclear energy' (Atomic Act) is the principal document which came into force on July 1, 1998. Based on the Atomic Act UJD issued decrees on special materials and installations, limits for maximum quantities of nuclear materials at which nuclear damage is not presumed. Furthermore, the regulations are issued which deal with provision of physical protection of nuclear material and radioactive waste, professional ability of employees at nuclear installations, registration and control of nuclear materials, emergency planning for the case of an incident or an events on nuclear installations at their decommissioning, transportation of nuclear materials and radioactive waste. Simultaneously, other 6 regulations are just before the before the completion and they are in various stages of the of the legislative process. In addition, UJD performs remarkable activities in legislative area by preparation of comments to drafts of other relating generally binding legal provisions of the Slovak Republic. UJD also acts as the participant of the review procedure in the area of technical standards and publication. UJD also issues documents which have character of the recommendations, so called safety guides. These guides contain methods and approach how to meet safety requirements presented in binding documents, as acts and decrees. In accordance with the Atomic act it is possible to use nuclear energy or make business in the area of nuclear energy only the basis of the authorisation issued by UJD. Authorisations are following

U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

Science.gov (United States)

Dickinson, George E; Lancaster, Carol J; Clark, David; Ahmedzai, Sam H; Noble, William

2002-01-01

A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

[The REACH legislation: the consumer and environment protection perspective].

Science.gov (United States)

Gundert-Remy, Ursula

2008-12-01

REACH has been initiated with the aim of improving existing legislation. In order to assist in the interpretation of the REACH legislation, guidance documents have been developed, which have only lately become available. According to the REACH annexes and supported by guidance documents, waiving of test requirements will be possible, thus, opening the possibility that under REACH no new (eco)toxicological data will be required. Concerning products, a guidance document was released in April 2008 stating that the substance concentration threshold of 0.1 % (w/w) applies to the article as produced or imported and it does not relate to the homogeneous materials or parts of an article, but relates to the article as such (i.e., as produced or imported). Hence, notification will not be required for many products containing chemicals with properties which place them on the candidate list for authorization. In summary, it is at present not foreseeable whether the expected benefit of the REACH legislation will materialise for the environment and for the health of consumers and at the work place.

Team physicians in college athletics.

Science.gov (United States)

Steiner, Mark E; Quigley, D Bradford; Wang, Frank; Balint, Christopher R; Boland, Arthur L

2005-10-01

There has been little documentation of what constitutes the clinical work of intercollegiate team physicians. Team physicians could be recruited based on the needs of athletes. A multidisciplinary team of physicians is necessary to treat college athletes. Most physician evaluations are for musculoskeletal injuries treated nonoperatively. Descriptive epidemiology study. For a 2-year period, a database was created that recorded information on team physician encounters with intercollegiate athletes at a major university. Data on imaging studies, hospitalizations, and surgeries were also recorded. The diagnoses for physician encounters with all undergraduates through the university's health service were also recorded. More initial athlete evaluations were for musculoskeletal diagnoses (73%) than for general medical diagnoses (27%) (P respiratory infections and dermatologic disorders, or multiple visits for concussions. Football accounted for 22% of all physician encounters, more than any other sport (P athletes did not require a greater number of physician encounters than did the general undergraduate pool of students on a per capita basis. Intercollegiate team physicians primarily treat musculoskeletal injuries that do not require surgery. General medical care is often single evaluations of common conditions and repeat evaluations for concussions.

Physician buy-in for EMRs.

Science.gov (United States)

Yackanicz, Lori; Kerr, Richard; Levick, Donald

2010-01-01

Implementing an EMR in an ambulatory practice requires intense workflow analysis, introduction of new technologies and significant cultural change for the physicians and physician champion. This paper will relate the experience at Lehigh Valley Health Network in the implementation of an ambulatory EMR and with the physician champions that were selected to assist the effort. The choice of a physician champion involves political considerations, variation in leadership and communication styles, and a cornucopia of personalities. Physician leadership has been shown to be a critical success factor for any successful technology implementation. An effective physician champion can help develop and promote a clear vision of an improved future, enlist the support of the physicians and staff, drive the process changes needs and manage the cultural change required. The experience with various types of physician champions will be discussed, including, the "reluctant leader", the "techie leader", the "whiny leader", and the "mature leader". Experiences with each type have resulted in a valuable, "lessons learned" summary. LVHN is a tertiary academic community medical center consisting of 950 beds and over 450 employed physicians. LVHN has been named to the Health and Hospital Network's 100 Top Wired and 25 Most Wireless Hospitals.

Animal rights and animal experimentation. Implications for physicians.

Science.gov (United States)

Gelpi, A. P.

1991-01-01

Practicing physicians are just becoming aware of the animal rights movement, which during the 1980s spawned numerous acts of violence against research facilities throughout the United States. The animal rightists are challenging physicians to show moral justification for the human exploitation of nature and the world of subhuman species. They have aroused public interest in animal welfare, sparked protective legislation for experimental animals, and indirectly encouraged the creation of committees to oversee the conduct of animal experimentation and the conditions of animal confinement. This controversy has necessitated a closer look at the questions of animal experimentation and animal rights against the backdrop of human experimentation and human rights. Physicians and specialists in animal care seek to alleviate suffering and anxiety, and, as moderates, they may be able to bring both sides of the animal rights controversy together in a spirit of mutual tolerance and in the common cause of promoting both human and animal welfare. PMID:1949772

Hawaii state legislator views on e-cigarettes and likelihood of legislative action.

Science.gov (United States)

Juarez, Deborah Taira; Seto, Jason; Guimaraes, Alexander; Masterson, James; Davis, James; Seto, Todd B

2015-01-01

To examine perspectives on e-cigarette use and regulations in Hawaii through key informant interviews with state legislators. E-cigarette use is rapidly increasing, with sales in 2013 topping $1 billion in the United States, but e-cigarettes are still a largely unregulated industry. Although e-cigarettes are thought by most to be a healthier alternative to traditional cigarettes, long-term health effects are not yet known. Semistructured key informant interviews were conducted with Hawaii state legislators (n = 15). We found a lack of consensus among legislators, which suggests that substantial legislative action is unlikely in the upcoming session. However, most legislators believe that some type of incremental legislation will pass, such as enactment of a small tax, limitations on advertising to protect adolescents, or regulations concerning where people can use e-cigarettes. Legislators eagerly await further research to clarify the overall benefits and harms of e-cigarettes at both the individual and population levels.

Euthanasia or physician-assisted suicide? A survey from the Netherlands.

Science.gov (United States)

Kouwenhoven, Pauline S C; van Thiel, Ghislaine J M W; Raijmakers, Natasja J H; Rietjens, Judith A C; van der Heide, Agnes; van Delden, Johannes J M

2014-03-01

Legalizing euthanasia or physician-assisted suicide (PAS) is a current topic of debate in many countries. The Netherlands is the only country where legislation covers both. To study physicians' experiences and attitudes concerning the choice between euthanasia and PAS. A questionnaire including vignettes was sent to a random sample of 1955 Dutch general practitioners, elderly care physicians and medical specialists. In total, 793 physicians (41%) participated. There was no clear preference for euthanasia (36%) or PAS (34%). Two thirds of physicians thought that PAS underlines the autonomy and responsibility of the patient and considered this a reason to choose PAS. Reasons for not choosing PAS were expected practical problems. A minority (22%) discussed the possibility of PAS with their patient in case of a request for assistance in dying. Patients receiving PAS more often experienced psychosocial suffering in comparison with patients receiving euthanasia. In vignettes of patients with a request for assistance in dying due to psychosocial suffering, physicians agreed more often with the performance of PAS than with euthanasia. Dutch physicians perceive a difference between euthanasia and PAS. Although they believe PAS underlines patient autonomy and responsibility, the option of PAS is rarely discussed with the patient. The more psychosocial in nature the patient's suffering, the more physicians choose PAS. In these cases, PAS seems to fulfil physicians' preferences to emphasize patient autonomy and responsibility. Expected technical problems and unfamiliarity with PAS also play a role. Paradoxically, the choice for PAS is predominantly a physician's one.

Physical activity opportunities in Canadian childcare facilities: a provincial/territorial review of legislation.

Science.gov (United States)

Vanderloo, Leigh M; Tucker, Patricia; Ismail, Ali; van Zandvroort, Melissa M

2012-05-01

Preschoolers spend a substantial portion of their day in childcare; therefore, these centers are an ideal venue to encourage healthy active behaviors. It is important that provinces'/territories' childcare legislation encourage physical activity (PA) opportunities. The purpose of this study was to review Canadian provincial/territorial childcare legislation regarding PA participation. Specifically, this review sought to 1) appraise each provincial/territorial childcare regulation for PA requirements, 2) compare such regulations with the NASPE PA guidelines, and 3) appraise these regulations regarding PA infrastructure. A review of all provincial/territorial childcare legislation was performed. Each document was reviewed separately by 2 researchers, and the PA regulations were coded and summarized. The specific provincial/territorial PA requirements (eg, type/frequency of activity) were compared with the NASPE guidelines. PA legislation for Canadian childcare facilities varies greatly. Eight of the thirteen provinces/territories provide PA recommendations; however, none provided specific time requirements for daily PA. All provinces/territories did require access to an outdoor play space. All Canadian provinces/territories lack specific PA guidelines for childcare facilities. The development, implementation, and enforcement of national PA legislation for childcare facilities may aid in tackling the childhood obesity epidemic and assist childcare staff in supporting and encouraging PA participation.

National legislative and regulatory activities

International Nuclear Information System (INIS)

2012-01-01

This section gathers the following national legislative and regulatory activities sorted by country: Bulgaria: General legislation; Czech Republic: General legislation; France: General legislation, Regulatory infrastructure and activity; Germany: General legislation; India: Liability and compensation, Organisation and structure; Ireland: Radiation protection, General legislation; Korea (Republic of): Organisation and structure; Lithuania: Regulatory infrastructure and activity, Radioactive waste management, Radiation protection, international cooperation, Nuclear safety; Poland: General legislation; Romania: Environmental protection; Russian Federation: Radioactive waste management; Slovenia: Nuclear safety; Spain: Liability and compensation, Nuclear security; Sweden: Nuclear safety; Turkey: Radiation protection, Regulatory infrastructure and activity, Nuclear safety, Liability and compensation; United States: General legislation

State health agencies and the legislative policy process.

Science.gov (United States)

Williams-Crowe, S M; Aultman, T V

1994-01-01

A new era of health care reform places increasing pressure on public health leaders and agencies to participate in the public policy arena. Public health professionals have long been comfortable in providing the scientific knowledge base required in policy development. What has been more recent in its evolution, however, is recognition that they must also play an active role in leading and shaping the debate over policy. A profile of effective State legislative policy "entrepreneurs" and their strategies has been developed to assist health agencies in developing such a leadership position. Based on the experiences of State legislative liaison officers, specific strategies for dealing with State legislatures have been identified and are organized into five key areas--agency organization, staff skills, communications, negotiation, and active ongoing involvement. A public health agency must be organized effectively to participate in the legislative policy process. Typically, effective agencies centralize responsibility for policy activities and promote broad and coordinated participation throughout the organization. Playing a key role in the agency's political interventions, the legislative liaison office should be staffed with persons possessing excellent interpersonal skills and a high degree of technical competence. Of central importance to effective legislative policy entrepreneurship is the ability to communicate the agency's position clearly. This includes setting forward a focused policy agenda, documenting policy issues in a meaningful manner, and reaching legislators with the proper information. Once a matter is on the legislative agenda, the agency must be prepared to negotiate and build broad support for the measure. Finally, public health agencies must be active policy players. To take advantage of new opportunities for action, the public health (policy) leader must monitor the political environment continually.By working to anticipate and formulate

New Ontario power legislation aims to protect consumers

Energy Technology Data Exchange (ETDEWEB)

Anon.

2000-09-01

New legislation designed to improve regulation of the electricity sector in Ontario was introduced by the provincial government in June 2000, the first such legislation since the government mandated an open electricity market with the Energy Competition Act of 1998. The new legislation is described as narrowly focused on putting limits on local power rate increases. The legislation was introduced in combination with a directive to the Ontario Energy Board, and is designed to ensure that the Board approves municipal electric utility rates only when certain conditions are met. The Energy Minister was at great pains to point out that the legislation should not be interpreted as the government interfering in the marketplace, it is merely to help the utility wires side of the business during a two-year transition period. Municipal authorities reacted unfavorably to the legislation because it appears to require them to return significant assets to their utilities, assets that they considered as theirs under municipal restructuring. Energy Probe, an environmental advocacy group, suggested an alternative to the legislation, i. e., the government should allow the price increases requested by the municipal utilities to go through, but to leave consumers whole, it should impose a windfall profits tax on municipal governments, use the proceeds to reduce debt retirement taxes in the electricity bill, a leftover from Ontario Hydro's debt and stranded nuclear waste liabilities, and eliminate the province's own electricity tax on consumers. No direct reaction has been received from the Minister to date. If the legislation is passed in its present form it will prevent municipalities from using windfall profits from their utilities to justify rate hikes.

National legislative and regulatory activities

International Nuclear Information System (INIS)

2015-01-01

This section treats of the following National legislative and regulatory activities: 1 - Australia: General legislation - Bill to amend the Australian Radiation Protection and Nuclear Safety Act 1998; 2 - France: General legislation - Law No. 2015-992 of 17 August 2015 on the energy transition for green growth; ASN Report on the state of nuclear safety and radiation protection in France in 2014; 3 - Germany: Radioactive waste management - First Ordinance to amend the 2005 Gorleben Development Freeze Ordinance (2015); 4 - Greece: Radioactive waste management - Joint Ministerial Decision establishing the national policy on the management of spent fuel and radioactive waste; 5 - Lithuania: Nuclear safety and radiological protection - Revised requirements for modifications, Plan for enhancement of nuclear safety, New requirements for the commissioning of nuclear power plants, Revised requirements regulating the provision of information on abnormal events; Radioactive waste management - Revised requirements for acceptance criteria for near surface repository; Nuclear security - Revised requirements for physical protection; 6 - Romania: Licensing and regulatory infrastructure - Government Decision No. 600/2014 for approval of National Nuclear Safety and Security; International co-operation - Government Decision No. 525/2014 for approval of the Co-operation Agreement on the radioactive waste management between the French National Radioactive Waste Management Agency (ANDRA) and Nuclear Agency and Radioactive Waste (ANDR) Strategy; Memorandum of Understanding for Co-operation and Exchange of Information in Nuclear Regulatory Matters between the National Commission for Nuclear Activities Control (CNCAN) of Romania and the President of National Atomic Energy Agency (PAA) of Poland; Government Decision No. 540/2015 for approval of the Agreement between the Government of Romania and the Government of the People's Republic of China regarding co-operation in the peaceful

[A survey carried out among Italian physicians regarding non-required clinical examinations, treatments and procedures in the current clinical practice: results and considerations.

Science.gov (United States)

Vernero, Sandra; Giustetto, Guido

2017-01-01

A survey addressed to all Italian physicians regarding how they behave when a patient asks them to prescribe non-required clinical examinations, treatments and procedures has been carried out for the first time. The survey - realized during the last months of the year 2015 thanks to the collaboration between Slow Medicine and the National Federation of Associations of Doctors, Surgeons and Dentists - is based on a questionnaire given to the America physicians by the ABIM Foundation in 2014. The Italian survey results cannot be compared with the American ones because different approaches were used. 4,263 physicians started to fill in the questionnaire and 3,688 completed it. The results suggest that the physicians that answered the questions are highly aware of the over-usage of diagnostic tests and treatments, and among the main reasons they cite the need of safety and then the fear of legal consequences. Most of the physicians who answered the questions believe to be responsible for giving patients accurate information in order to avoid non-required practices, and that the physician is the right person with the most suitable role to face the problem. Among the most important and useful tools to reduce the prescription of non-required examinations and treatments, physicians indicate the possibility to have much more time available to discuss the different options with their patients, to arrange the evidence-based information material for the patients, and to explain the reform on the physician's responsibility (recently approved as law). Therefore, it stands out the opportunity to apply provisions aimed at providing the patients with more accurate information and at improving the relationship between the physician and the patient by ensuring on the one hand more availability of dedicated time and on the other hand the training of the physicians on scientific topics as well as on topics concerning communication and shared decisions. The communication can be

Physician communication via Internet-enabled technology: A systematic review.

Science.gov (United States)

Barr, Neil G; Randall, Glen E; Archer, Norman P; Musson, David M

2017-10-01

The use of Internet-enabled technology (information and communication technology such as smartphone applications) may enrich information exchange among providers and, consequently, improve health care delivery. The purpose of this systematic review was to gain a greater understanding of the role that Internet-enabled technology plays in enhancing communication among physicians. Studies were identified through a search in three electronic platforms: the Association for Computing Machinery Digital Library, ProQuest, and Web of Science. The search identified 5140 articles; of these, 21 met all inclusion criteria. In general, physicians were satisfied with Internet-enabled technology, but consensus was lacking regarding whether Internet-enabled technology improved efficiency or made a difference to clinical decision-making. Internet-enabled technology can play an important role in enhancing communication among physicians, but the extent of that benefit is influenced by (1) the impact of Internet-enabled technology on existing work practices, (2) the availability of adequate resources, and (3) the nature of institutional elements, such as privacy legislation.

A Health Equity Problem for Low Income Children: Diet Flexibility Requires Physician Authorization.

Science.gov (United States)

Stookey, Jodi D

2015-09-01

USDA programs, such as the Child and Adult Care Food Program (CACFP), School Breakfast Program (SBP), and/or National School Lunch Program (NSLP), enable child care centers and schools to provide free and reduced price meals, daily, to millions of low income children. Despite intention to equalize opportunity for every child to have a healthy diet, USDA program rules may be contributing to child obesity disparities and health inequity. USDA program rules require child care centers and schools to provide meals that include a specified number of servings of particular types of foods and beverages. The rules are designed for the average, healthy weight child to maintain weight and growth. They are not designed for the underweight child to gain weight, obese child to normalize weight, or pre-diabetic child to avoid incident diabetes. The rules allow for only one meal pattern and volume, as opposed to a flexible spectrum of meal patterns and portion sizes. Parents of children who participate in the CACFP, SBP, and/or NSLP do not have control over the amount or composition of the subsidized meals. Parents of overweight, obese, or diabetic children who participate in the subsidized meal programs can request dietary change, special meals or accommodations to address their child's health status, but child care providers and schools are not required to comply with the request unless a licensed physician signs a "Medical statement to request special meals and/or accommodations". Although physicians are the only group authorized to change the foods, beverages, and portion sizes served daily to low income children, they are not doing so. Over the past three years, despite an overweight and obesity prevalence of 30% in San Francisco child care centers serving low income children, zero medical statements were filed to request special meals or accommodations to alter daily meals in order to prevent obesity, treat obesity, or prevent postprandial hyperglycemia. Low income children

42 CFR 414.50 - Physician or other supplier billing for diagnostic tests performed or interpreted by a physician...

Science.gov (United States)

2010-10-01

... HEALTH SERVICES Physicians and Other Practitioners § 414.50 Physician or other supplier billing for... services through such billing physician or other supplier. The “substantially all” requirement will be satisfied if, at the time the billing physician or other supplier submits a claim for a service furnished by...

Transportation of radioactive materials: legislative and regulatory information system

International Nuclear Information System (INIS)

Fore, C.S.; Heiskell, M.M.

1980-01-01

The transportation of radioactive materials, as well as hazardous materials in general, has been an issue of ever-increasing concern and an object of numerous regulations and legislative actions worldwide. The Transportation Technology Center of the US Department of Energy's Sandia Laboratories in Albuquerque, New Mexico, is currently involved in developing a national program to assure the safe shipment of radioactive materials. At Oak Ridge National Laboratory (ORNL), Oak Ridge, Tennessee, this overall effort is being supported in a specialized manner. As part of the Logistics Modeling program at ORNL, the Ecological Sciences Information Center has developed comprehensive data bases containing legislative and regulatory actions relevant to the transportation of hazardous materials. The data bases are separated according to status level of the legislation. The Current Legislation Data Base includes all new legislative actions introduced during the present year (1980) or those bills carried over from the previous year's sessions. The second data file, Historical Legislation Data Base, consists of all legislative actions since 1976 that have passed and become public laws, as well as those actions that were unsuccessful and were classified as denied by law. Currently the data bases include state-, local-, and federal, level legislation, with emphasis on the transportation of radioactive materials. Because of their relevance to the transportation issues, actions involving related subject areas such as, disposal and storage of radioactive wastes, moratoriums on power plant construction, and remedial actions studies, special agencies to regulate shipment of radioactive materials, and requirements of advanced notification, permits and escorts are also included in the data bases

[Is there a physician on board?].

Science.gov (United States)

Andersen, H T

1998-11-01

Physicians responding to emergency calls on board airliners in intercontinental traffic may not be aware of certain legal complications which may arise. For instance, the medical practitioner may hold a license valid in one country, the air carrier may be registered in another, and the patient may be a third state national. Legislation varies between nations, as do court decisions. Physicians may be aware neither of the laws and regulations which apply nor the subtle differences between terms and interpretations used in formal language. This article contains a scenario description from a commercial air liner in intercontinental transit carrying a patient unknown to the physician who responds to a call for medical assistance. The main considerations to be made, the more likely diagnoses and various strategies for immediate interventions are reviewed. Likewise, appraisal and use of medical equipment on board are discussed, as are issues concerning responsibility and liability when equipment is used in supposedly "trained hands". Main themes in the current international medico-legal debate are considered with emphasis on the "Good Samaritan Principle", the responsibility of commercial air carriers, and telemedicine with insurance against law suits. The article concludes with some practical advice to the travelling medical community.

Joint conference on the impact of EU legislation on therapeutic advance.

Science.gov (United States)

Forgó, Nikolaus; Hildebrandt, Martin

2013-12-01

On October 11, 2012, two FP7-funded Research Consortia, CONTRACT (Consent in a Trial and Care Environment) and Academic GMP, held a Joint Conference in Brussels entitled "The Impact of EU Legislation on Therapeutic Advance." Academic researchers including stem cell transplant physicians and cell therapy specialists, legal advocates and representatives from industry, regulatory authorities and patient advocacy groups met with members of the European Parliament and the European Commission. This article summarizes important points of discussion and detailed proposals for improvement. Copyright © 2013 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Physician education: expansion of the radiation protection practice

International Nuclear Information System (INIS)

Classic, Kelly; Carlson, Stephanie; Vetter, Richard J.; Roessler, Genevieve

2008-01-01

Over the past several years, physician knowledge of radiation risk and risk associated with medical exams involving radiation has been studied and found deficient. In some cases, radiation risk was overestimated leading to patient anxiety. In other cases, the risk was underestimated leading to cavalier ordering of medical radiation exams. Even physicians practicing in radiology were unable to accurately assess the risk for their patients. Many of the studies concluded that more effort is needed to educate the physician community on radiation risk. Objectives of the Health Physics Society, a not-for-profit society of radiation safety professionals, include dissemination of radiation safety information and public education. In 1996, the Society launched a Web site as one method to achieve its objectives (www.hps.org). On the Web site, the initial focus was to provide radiation information resources for the public, but more recently that was expanded to include specific resources for teachers, students, legislators and regulators, and first responders. In addition to these, the Society is adding educational resources for physicians. Published studies we reviewed suggest that physician education should include information about radiation risk, radiation effects, the amount of radiation dose from medical exams, and potential doses to the concepts when a mother undergoes medical exams involving radiation. The information we provide includes these topics as well as radiation basics (radiation units, radiation terms, radiation in the environment) separated into brief educational programs (slide shows). To complement these, topical information sheets are available. Also available is a tool allowing physicians to ask individual questions of our experts about radiation, radiation exposure, and radiation risk. This approach of providing information and resources to physicians not only provides a benefit to the physician personally, but especially to his or her patients

Fee-for-service will remain a feature of major payment reforms, requiring more changes in Medicare physician payment.

Science.gov (United States)

Ginsburg, Paul B

2012-09-01

Many health policy analysts envision provider payment reforms currently under development as replacements for the traditional fee-for-service payment system. Reforms include per episode bundled payment and elements of capitation, such as global payments or accountable care organizations. But even if these approaches succeed and are widely adopted, the core method of payment to many physicians for the services they provide is likely to remain fee-for-service. It is therefore critical to address the current shortcomings in the Medicare physician fee schedule, because it will affect physician incentives and will continue to play an important role in determining the payment amounts under payment reform. This article reviews how the current payment system developed and is applied, and it highlights areas that require careful review and modification to ensure the success of broader payment reform.

Physician-Assisted Suicide and Midwest Social Workers: Where Do They Stand?

Science.gov (United States)

Gaston, N Rose; Randall, Jill M; Kiesel, Lisa R

2018-01-01

Physician-assisted suicide (PAS) is explicitly legal in five states and by court decision in one. Legislative bills have been introduced in other states including Minnesota, Iowa, and Wisconsin. This quantitative study was designed to understand Midwest, hospice and palliative care at end-of-life social workers' attitudes toward PAS, preferred terminology, perception of preparedness for the implementation, and awareness of PAS legislation in their state. Sixty-two social workers from Minnesota, Iowa, and Wisconsin completed an anonymous online survey. The results indicated that over one-half of the participants supported PAS legislation and is consistent with previous research on social workers across the country. While there was a range of perceived preparedness for implementation, a majority felt moderately to very prepared. Professional and personal values as well as professional experience influenced their perceived preparedness. Few social workers had accurate awareness of PAS legislation in their state or had attended workshops/events for further education or as a policy advocate. To practice competently and advocate at all levels of practice, hospice and palliative care at end-of-life social workers' need to understand their own attitudes and values toward PAS and pursue additional education around this ethical issue.

Legislation and regulation

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-09-01

This document presents the fulfilling of the Brazilian obligations under the Convention on Nuclear Safety. The Chapter 3 of the document contains some details about the Brazilian legislation and regulation, the nuclear and environmental licensing, and emergency preparedness legislation.

Legislation and regulation

International Nuclear Information System (INIS)

1998-01-01

This document presents the fulfilling of the Brazilian obligations under the Convention on Nuclear Safety. The Chapter 3 of the document contains some details about the Brazilian legislation and regulation, the nuclear and environmental licensing, and emergency preparedness legislation

Licensed physicians – competent physicians?: The new German licensure law as a basis for competency-based curricula

Directory of Open Access Journals (Sweden)

Öchsner, Wolfgang

2005-01-01

Full Text Available Background: Competency-based curricula define their educational goals according to profession-specific roles and competencies. Thus, this type of curricula is outcome-oriented, in contrast to the traditional German curricula, which are mainly procedure-oriented. This study investigates the new licensure legislation in Germany, mandatory for all medical faculties, to see if it allows the development of competency-based curricula.Methods: For the first step we clustered all demands to roles. In step two we transformed the procedure-oriented demands into outcome-oriented competencies, according to the 6 roles found, pursuing strictly the wording of the law.Results: Although the principal goals in the new German licensure law are outcome-oriented, namely three abilities of a certified physician, still the majority of requirements and demands remain procedure-oriented. Clustering resulted in the following six roles: medical expert, health advocate, teamworker, manager, representative of the medical profession and, life-long learner. The relevant competencies for the six roles, we could derive from the standards set by the law.Conclusion: We were able to show that the new German licensure order comprises a useful framework for the development of outcome-oriented, competency-based curricula.

Labelling of end-of-life decisions by physicians.

Science.gov (United States)

Deyaert, Jef; Chambaere, Kenneth; Cohen, Joachim; Roelands, Marc; Deliens, Luc

2014-07-01

Potentially life-shortening medical end-of-life practices (end-of-life decisions (ELDs)) remain subject to conceptual vagueness. This study evaluates how physicians label these practices by examining which of their own practices (described according to the precise act, the intention, the presence of an explicit patient request and the self-estimated degree of life shortening)they label as euthanasia or sedation. We conducted a large stratified random sample of death certificates from 2007 (N=6927).The physicians named on the death certificate were approached by means of a postal questionnaire asking about ELDs made in each case and asked to choose the most appropriate label to describe the ELD. Response rate was 58.4%. In the vast majority of practices labelled as euthanasia, the self-reported actions of the physicians corresponded with the definition in the Belgian euthanasia legislation; practices labelled as palliative or terminal sedation lack clear correspondence with definitions of sedation as presented in existing guidelines. In these cases, an explicit life-shortening intention by means of drug administration was present in 21.6%, life shortening was estimated at more than 24 h in 51% and an explicit patient request was absentin 79.7%. Our results suggest that, unlike euthanasia,the concept of palliative or terminal sedation covers abroad range of practices in the minds of physicians. This ambiguity can be a barrier to appropriate sedation practice and indicates a need for better knowledge of the practice of palliative sedation by physicians.

Legislation and supervision

International Nuclear Information System (INIS)

1998-01-01

In this part next aspects are described: (1) Legislative and supervision-related framework (reviews of structure of supervisory bodies; legislation; state supervision in the nuclear safety area, and state supervision in the area of health protection against radiation are given); (2) Operator's responsibility

Legislation and regulation

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-09-01

This document presents the fulfilling of the Brazilian obligations under the Convention on Nuclear Safety. The Chapter 3 of the document contains some details about the Brazilian legislation and regulation, the legislative and regulatory framework, regulatory body and responsibility of the license holder.

Legislation and regulation

International Nuclear Information System (INIS)

2001-01-01

This document presents the fulfilling of the Brazilian obligations under the Convention on Nuclear Safety. The Chapter 3 of the document contains some details about the Brazilian legislation and regulation, the legislative and regulatory framework, regulatory body and responsibility of the license holder

ARE EXCESSIVE LEGISLATIVE RESTRICTIONS OF PENSION FUND’S INVESTMENTS REQUIRED TO ENSURE THESE FUNDS’ OPERATIONAL STABILITY AND MINIMUM GUARANTED RETURN?

Directory of Open Access Journals (Sweden)

TANJA MARKOVIC HRIBERNIK

2013-02-01

Full Text Available In this paper, it is investigated whether government, when promises pension fund’s members a so-calledminimum guaranteed return, to reduce the exposure of members to financial risks , should at the same timehinders portfolio diversification process of pension funds. We provide a detailed analysis of the connectionbetween the requirements for providing a minimum guaranteed return and managing financial risks on the onehand and the investment structure of pension funds on the other. We intend to demonstrate with an illustrativecase, using the simulation technique and a combination of actual data and some hypothetical one, that byprecisely matching the investments' characteristics to the characteristics of the pension fund's liabilities, someimportant financial risks can even be hedged entirely. We also intend to demonstrate that with theimplementation of a proper policy of risk measurement and management, complemented with stress testingpractices, excessive legislative restrictions for investments are no longer necessary. At the very least,governments should avoid implementing legislation that hinders the portfolio diversification process andtherefore makes pension fund risk management more difficult.

Working with Your Legislative Delegation

Science.gov (United States)

Safransky, Robert J.

2010-01-01

In this article, the author discusses how to work with legislative delegation to get positive legislation passed. Most school districts have a person who is responsible for working with the legislators and informing them of the district's position on bills and issues that arise in each legislative session. Even if one has a full-time or part-time…

[Comparative analysis of occupational health physician's duties based upon legislative decree 81/2008 art. 25 and upon the Ethics Code of the International Commission on Occupational Health].

Science.gov (United States)

Franco, G; Mora, Erika

2009-01-01

Ethical behaviour consists ofindividual choices inspired by knowledge and professional experience derived from the universally acknowledged ethical principles of beneficience/nonmaleficience, autonomy and justice. However, in spite of the unanimous consent on their universal importance, such principles do not usually have the strength of a law. The recently introduced Italian law on the protection of workers' health represents a novelty because it gives the Ethics Code of the International Commission on Occupational Health legal strength. This paper aims at examining article 25 of legislative decree 81/2008 by comparing the points of the Ethics Code and the Deontology Code of the Italian medical profession. The relationships between the 12 points of paragraph 1 of article 25, the 26 points ofthe Code ofEthics and the 75 articles of the Deontology Code are described with regard to the occupational health physician's duties (i) of collaboration with other occupational health professionals, (ii) of organization and execution of health surveillance, (iii) of recording, securing, transmitting of medical files on workers' health and (iv) of employee and employer information on the importance and meaning of health surveillance.

Maritime environmental penal law. International and German legislation; Maritimes Umweltstrafrecht. Voelkerrechtliche Grundlagen und deutsches Recht

Energy Technology Data Exchange (ETDEWEB)

Eller, Jan Frederik

2017-07-01

The book on maritime environmental penal law discusses the following issues: part I: introduction into the importance of oceanic environment and its thread, requirement of protective measures,; part II: focus of the study and terminology: oceanic pollution, maritime environmental legislation, international legislation; part 3: international legislative regulations concerning the protection of maritime environment: avoidance of environmental pollution, maritime legislative agreements, existing protective institutions; part 4: state penal power concerning maritime environmental protection; part 5: statutory offense according to German legislation; perspectives for regulations concerning criminal acts on sea.

FORENSIC DNA BANKING LEGISLATION IN DEVELOPING COUNTRIES: PRIVACY AND CONFIDENTIALITY CONCERNS REGARDING A DRAFT FROM TURKISH LEGISLATION.

Science.gov (United States)

Ilgili, Önder; Arda, Berna

This paper presents and analyses, in terms of privacy and confidentiality, the Turkish Draft Law on National DNA Database prepared in 2004, and concerning the use of DNA analysis for forensic objectives and identity verification in Turkey. After a short introduction including related concepts, we evaluate the draft law and provide articles about confidentiality. The evaluation reminded us of some important topics at international level for the developing countries. As a result, the need for sophisticated legislations about DNA databases, for solutions to issues related to the education of employees, and the technological dependency to other countries emerged as main challenges in terms of confidentiality for the developing countries. As seen in the Turkish Draft Law on National DNA Database, the protection of the fundamental rights and freedoms requires more care during the legislative efforts.

Developing a competency framework for academic physicians.

Science.gov (United States)

Daouk-Öyry, Lina; Zaatari, Ghazi; Sahakian, Tina; Rahal Alameh, Boushra; Mansour, Nabil

2017-03-01

There is a mismatch between the requirements of the multifaceted role of academic physicians and their education. Medical institutions use faculty development initiatives to support their junior academic physicians, however, these rarely revolve around academic physician competencies. The aim of this study was to identify these academic physician competencies and develop a competency framework customized to an organizational context. The authors conducted semi-structured interviews and Critical Incident Technique with 25 academic physicians at a teaching medical center in the Middle East region inquiring about the behaviors of academic physicians in teaching, clinical, research, and administrative roles. Using content analysis, the authors identified 16 competencies: five "Supporting Competencies", common to all four roles of academic physicians, and 11 "Function-Specific Competencies", specific to the role being fulfilled. The developed framework shared similarities with frameworks reported in the literature but also had some distinctions. The framework developed represents a step towards closing the gap between the skills medical students are taught and the skills required of academic physicians. The model was customized to the context of the current organization and included a future orientation and addressed the literature calling for increasing focus on the administrative skills of academic physicians.

Trends in trace element emission legislation - an international overview

Energy Technology Data Exchange (ETDEWEB)

Sloss, L.L.

2003-07-01

Emissions of trace elements have decreased for a variety of reasons in many developed countries. However, the application of more successful control strategies in other industry sectors means that coal combustion is still a relatively important source of some trace elements, especially mercury. International and national legislation is increasingly being applied to trace element emissions. International programmes for trace element reduction are generally in the form of voluntary action plans with recommendations and targets for reduction. National legislation in Europe is commonly in the form of emission limits for specific sources. New legislation in the USA may take the form of best available technology or a minimum emission reduction requirement. It is also possible that mercury could be included in multi-pollutant emissions trading schemes. 52 refs., 4 tabs.

Road tunnels safety according to European legislation

Directory of Open Access Journals (Sweden)

Fedor KÁLLAY

2008-01-01

Full Text Available The article deals with safety of European road tunnels in accordance with actual European legislation. Standards and recommendations of European Commission, PIARC and other professional bodies of the European Union define minimal technological requirements for equipment and operation of the tunnels in scope of Trans-European Road Network.

TENORM legislation - Theory and practice

International Nuclear Information System (INIS)

Tsurikov, N.; Koperski, J.

2002-01-01

Processing of minerals often increases concentrations of naturally occurring radioactive materials (NORM) in mineral concentrates, products and waste streams. This so-called TENORM (Technologically Enhanced Naturally Occurring Radioactive Materials) phenomenon can result in usually very small increases of radiation exposures to workers and the public. However, proposed international radiation protection standards are likely to bring the TENORM issue into the realm of regulatory concern. Verbatim adoption by the national legislation's of the radiation protection standards like those proposed in the IAEA's 1996 Basic Safety Standards (BSS) would present enormous practical problems. Many industries and industrial practices would, for the first time, become subjected to the provisions of radiation protection legislation. Consequently, registration, licensing, occupational and environmental monitoring, statutory reporting, appointment of appropriately qualified staff, new approaches to the management of minerals and waste labeled as 'radioactive', etc. would be required. This would be mirrored by corresponding demands on the regulatory authorities, needing to provide an increased radiation protection regulatory control. In response to new Australian and other national radiation protection legislation that have incorporated the BSS criteria, this paper illustrates their impact on a number of industries that historically have not been considered as dealing with radioactive materials. The paper also proposes a number of initiatives that could be considered. Nationally, those initiatives should aim at adopting radiation protection legislation that is commensurate with the nature of the minerals industry operations, national circumstances, conditions and interests without compromising rational radiation protection practices. Otherwise, non-judicious application of the BSS would result in major diversions of resources from well recognized occupational health and safety issues

Brazilian agriculture and environmental legislation: status and future challenges.

Science.gov (United States)

Sparovek, Gerd; Berndes, Göran; Klug, Israel L F; Barretto, Alberto G O P

2010-08-15

Brazilian agriculture covers about one-third of the land area and is expected to expand further. We assessed the compliance of present Brazilian agriculture with environmental legislation and identified challenges for agricultural development connected to this legislation. We found (i) minor illegal land use in protected areas under public administration, (ii) a large deficit in legal reserves and protected riparian zones on private farmland, and (iii) large areas of unprotected natural vegetation in regions experiencing agriculture expansion. Achieving full compliance with the environmental laws as they presently stand would require drastic changes in agricultural land use, where large agricultural areas are taken out of production and converted back to natural vegetation. The outcome of a full compliance with environmental legislation might not be satisfactory due to leakage, where pristine unprotected areas become converted to compensate for lost production as current agricultural areas are reconverted to protected natural vegetation. Realizing the desired protection of biodiversity and natural vegetation, while expanding agriculture to meet food and biofuel demand, may require a new approach to environmental protection. New legal and regulatory instruments and the establishment of alternative development models should be considered.

Specific Statistics of Czech Legislation

Czech Academy of Sciences Publication Activity Database

Novák, František

2015-01-01

Roč. 5, č. 3 (2015), s. 162-183 ISSN 1805-8396 Institutional support: RVO:68378122 Keywords : legislation * quantitative description of legislation * structure and development of the legislation in the CR Subject RIV: AG - Legal Sciences

IRS proposes ruling on physician recruitment. How a hospital recruits physicians would affect its tax-exempt status.

Science.gov (United States)

Griffith, G M

1996-01-01

On March 15, 1995, the Internal Revenue Service (IRS) announced a proposed revenue ruling stating how certain physician recruitment practices could be implemented without threatening hospitals' tax-exemption. As proposed, the IRS ruling would provide flexibility for recruitment incentives rather than a list of strict physician recruitment guidelines. The proposed ruling is not legally binding until issued in final form, and there is no deadline for finalizing it. In the meantime, however, the standards outlined in the proposed ruling reflect arrangements the IRS likely would approve, which should be an incentive for tax-exempt hospitals to follow reasonable physician recruitment practices. Assuming a hospital complies with other legal requirements such as fraud and abuse laws, it must answer two key tax-exempt status questions for its recruitment or retention package: Will the incentives result in a disguised distribution of profits from the operation of the organization? Is the total incentive package reasonable under all the facts and circumstances, both in absolute total value for physician(s) recruited and in relation to services required by the hospital and the community? The proposed ruling also provides guidance on basic documentation requirements and a process for approving recruitment arrangements.

Physicians' Perspectives Regarding Prescription Drug Monitoring Program Use Within the Department of Veterans Affairs: a Multi-State Qualitative Study.

Science.gov (United States)

Radomski, Thomas R; Bixler, Felicia R; Zickmund, Susan L; Roman, KatieLynn M; Thorpe, Carolyn T; Hale, Jennifer A; Sileanu, Florentina E; Hausmann, Leslie R M; Thorpe, Joshua M; Suda, Katie J; Stroupe, Kevin T; Gordon, Adam J; Good, Chester B; Fine, Michael J; Gellad, Walid F

2018-03-08

The Department of Veterans Affairs (VA) has implemented robust strategies to monitor prescription opioid dispensing, but these strategies have not accounted for opioids prescribed by non-VA providers. State-based prescription drug monitoring programs (PDMPs) are a potential tool to identify VA patients' receipt of opioids from non-VA prescribers, and recent legislation requires their use within VA. To evaluate VA physicians' perspectives and experiences regarding use of PDMPs to monitor Veterans' receipt of opioids from non-VA prescribers. Qualitative study using semi-structured interviews. Forty-two VA primary care physicians who prescribed opioids to 15 or more Veterans in 2015. We sampled physicians from two states with PDMPs (Massachusetts and Illinois) and one without prescriber access to a PDMP at the time of the interviews (Pennsylvania). From February to August 2016, we conducted semi-structured telephone interviews that addressed the following topics regarding PDMPs: overall experiences, barriers to optimal use, and facilitators to improve use. VA physicians broadly supported use of PDMPs or desired access to one, while exhibiting varying patterns of PDMP use dictated by state laws and their clinical judgment. Physicians noted administrative burdens and incomplete or unavailable prescribing data as key barriers to PDMP use. To facilitate use, physicians endorsed (1) linking PDMPs with the VA electronic health record, (2) using templated notes to document PDMP use, and (3) delegating routine PDMP queries to ancillary staff. Despite the time and administrative burdens associated with their use, VA physicians in our study broadly supported PDMPs. The application of our findings to ongoing PDMP implementation efforts may strengthen PDMP use both within and outside VA and improve the safe prescribing of opioids.

Antinomy in Legislation in Indonesia

Directory of Open Access Journals (Sweden)

Zainal Arifin Mochtar

2015-12-01

Full Text Available A number of reality for laws as a production of Parliament and President was canceled by the Constitutional Court, occur as a result of the legislation matter that plural reflects the injustice and legal uncertainty. The high number of judicial review becomes signal less accommodation of citizen interests and rights in a legislation product. The absence of arrangement harmony made by Parliament gives impact on plural legislation sued. This paper attempts to describe some debate antinomy that characterizes the existence of legislation in Indonesia. The analysis showed, antinomy-conflict-norm in the legislation is one thing that is difficult to avoid, especially given the poor-legislative process in the parliament today. In each establishment of legislation, synchronization and norms harmonization is not a major pressing point, but defeated by transnational politics inter-faction in the parliament that actually looked more dominant. But when these norms conflict constituted a rule of law which are simultaneous, dynamic, and meet legal ideals, would not be a problem. As long as not to cause harm to the fulfillment of constitutional rights of citizens.

Family physicians' awareness and knowledge of the Genetic Information Non-Discrimination Act (GINA).

Science.gov (United States)

Laedtke, Amanda L; O'Neill, Suzanne M; Rubinstein, Wendy S; Vogel, Kristen J

2012-04-01

Historically, physicians have expressed concern about their patients' risk of genetic discrimination, which has acted as a barrier to uptake of genetic services. The Genetic Information Nondiscrimination Act of 2008 (GINA) is intended to protect patients against employer and health insurance discrimination. Physicians' awareness and knowledge of GINA has yet to be evaluated. In 2009, we mailed surveys to 1500 randomly selected members of the American Academy of Family Physicians. Questions measured physicians' current knowledge of GINA and their level of concern for genetic discrimination. In total, 401 physicians completed the survey (response rate 26.9%). Approximately half (54.5%) of physicians had no awareness of GINA. Of physicians who reported basic knowledge of GINA, the majority were aware of the protections offered for group health insurance (92.7%), private health insurance (82.9%), and employment (70.7%). Fewer physicians were aware of GINA's limitations regarding life insurance (53.7%) and long-term care insurance (58.8%). Physicians demonstrated highest levels of concern for health insurance, life insurance, and long-term care insurance discrimination, with less concern for employer and family/social discrimination. Level of concern for the risk of genetic discrimination did not correlate significantly with awareness of GINA. Approximately 17 months after GINA was signed into federal law, physicians' knowledge remained limited regarding the existence of this legislation and relevant details. Physicians who are aware of GINA continue to have significant concerns regarding the risk of genetic discrimination. This study reveals the need to further educate physicians about the existence of GINA and the protections offered.

Competition within the physicians' services industry: osteopaths and allopaths.

Science.gov (United States)

Blackstone, E A

1982-01-01

Within the physicians' services industry, doctors of osteopathy are the only "full line" competitors of medical doctors. Given the current interest in merger of the two schools of practice, this Article examines the benefits of having an independent osteopathic school. These benefits include: (1) reduction of the monopoly power of medical doctors in malpractice litigation, fee negotiations with third party payors and the formulation of health policy; (2) greater satisfaction of consumer desires; and (3) diversity and innovation in physicians' training and methods of practice. The Article concludes that society has an interest in discouraging merger of the two groups; osteopathy should be maintained as an independent school of practice. To this end, society should carefully consider the impact of legislation and regulatory policies that may have the unintended effect of eliminating osteopathy as an independent competitor.

Legislation and patients' rights: some necessary remarks.

Science.gov (United States)

Mujovic-Zornic, Hajrija

2007-12-01

The essence of a patient's rights and legislation framework requires an answer to the question on how legislation can work towards better defining, respecting, protecting and effectiveness of these rights. First, it is necessary to give a short introduction to patients' rights, their definition and different classifications. In the long list of human rights, patients' rights obviously take one of the very important places. Human life and health are the values, which, in comparison with all other human values, are considered as values of the highest rank. Patients' rights represent a legal expression of something, which every person basically and naturally expects from a doctor, medical staff, and from a health care system in general. The subject of the second part of this paper presents the intention, scope and conception of necessary legislation. How should it be considered - in a wider sense or as a special law? Some theoretical and practical questions regarding interaction between medical ethics regulation, confidentiality, and legislation are discussed as well. In the European context there are numerous examples of laws with the specific purpose of protecting patients' rights. Special attention and critical review will be paid to the situation of patients' rights in Serbia. The paper concludes with the point that the role of legislation is evidently important, but the traditional view should be replaced with a new one, due to the reason that modem health law puts the protection of patients' rights on a higher level. De lege lata, the whole system of health law in its diversity (civil, penal and administrative) is characterized by better understanding of rights, duties and legal relations, either through regulation or the protection of patients' rights.

Active and Passive Physician-Assisted Dying and the Terminal Disease Requirement.

Science.gov (United States)

Varelius, Jukka

2016-11-01

The view that voluntary active euthanasia and physician-assisted suicide should be made available for terminal patients only is typically warranted by reference to the risks that the procedures are seen to involve. Though they would appear to involve similar risks, the commonly endorsed end-of-life practices referred to as passive euthanasia are available also for non-terminal patients. In this article, I assess whether there is good reason to believe that the risks in question would be bigger in the case of voluntary active euthanasia and physician-assisted suicide than in that of passive euthanasia. I propose that there is not. On that basis, I suggest that limiting access to voluntary active euthanasia and physician-assisted suicide to terminal patients only is not consistent with accepting the existing practices of passive euthanasia. © 2016 John Wiley & Sons Ltd.

Investigation on legal problems encountered by emergency medicine physicians in Turkey.

Science.gov (United States)

Kayipmaz, Afsin Emre; Kavalci, Cemil; Gulalp, Betul; Kocalar, Ummu Gulsum; Giray, Tufan Akin; Yesilagac, Hasan; Ozel, Betul Akbuga; Celikel, Elif; Karagun, Ozlem

2015-01-01

Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases. An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. pmedicine and age. There was a significant difference between number of complaint reports and career (p<0.05). The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and periodical reviews might be beneficial.

Changes in Tax Legislation and Social Responsibility of Taxpayers and Legislative Institutions

Directory of Open Access Journals (Sweden)

Štager Vesna

2018-03-01

Full Text Available The article deals with the cost of tax compliance which arises for taxpayers from tax complexity and the constant changes in tax legislation. A socially responsible institution for the fiscal aggression is the Financial Administration of the Republic of Slovenia, as its powers and responsibilities creates the tax position of individuals, businesses and the entire economy. The aim of our research is to encourage socially responsible behaviour of legislation institutions in adopting the tax legislation, which will help to improve the social responsibility of taxpayers and increase tax compliance.

Acid rain legislation update

International Nuclear Information System (INIS)

Storey, H.L.

1990-01-01

This paper presents the author's view that the coal industry should develop a strategy to respond to the global warming issue. A few weeks ago a speaker stated that the global warming issue placed coal at the crossroads. He stated that global warming legislation, could reduce the consumption of coal by approximately twenty-five percent, without global warming legislation coal would continue to grow at a approximately three percent per year. It is believed there is a path to be traveled between the two options, legislation or no legislation, that can result in coal obtaining the position as the primary fuel source for electrical generating throughout the world. This is a path the coal industry can define and should follow

Information report on state legislation

International Nuclear Information System (INIS)

Landau, M.

1983-06-01

Legislation that would consent to the Central Interstate Low-Level Radioactive Waste Compact has been introduced into Congress as H.R. 3002. Similar legislation is expected to be introduced into the Senate soon. This is the second compact consent legislation to be introduced into Congress this year - the first was the Northwest Compact, introduced in January. States in the Central Compact are AR, KS, LA, NE and OK. Enacted and introduced radioactive waste management legislation in various states is summarized

International environmental legislation; Internationales Umweltrecht

Energy Technology Data Exchange (ETDEWEB)

Proelss, Alexander (ed.) [Trier Univ. (Germany)

2017-07-01

The book on international environmental legislation includes the following contributions: Development, sources and actors concerning the international environmental legislation, cross-national environmental justice, principles of the international environmental legislation, environmental protection by lawsuit, environmental protection and human right, environmental protection and trading, responsibility and liability, peaceful settlement of disputes, climatic change, preservation and sustainable use of the biodiversity, protection of air and space, oceanic protection, protection of inland waters, protection of the Antarctic and Arctic environment, waste and hazardous materials legislation.

National legislative and regulatory activities

International Nuclear Information System (INIS)

2015-01-01

This section treats of the following National legislative and regulatory activities: 1 - Canada: Liability and compensation; 2 - France: Liability and compensation; Nuclear safety and radiological protection; 3 - Greece: Organisation and structure; 4 - Hungary: General legislation; 5 - India: Liability and compensation; 6 - Japan: Liability and compensation; 7 - Korea: Liability and compensation; 8 - Lithuania: General legislation; Transport of radioactive material; 9 - Slovak Republic: International co-operation; Liability and compensation; 10 - Slovenia: General legislation; 11 - Switzerland: Liability and compensation; 12 - United States: Radioactive waste management

The devil is in the details: the pharmaceutical industry's use of gifts to physicians as marketing strategy.

Science.gov (United States)

McFadden, David W; Calvario, Elizabeth; Graves, Cynthia

2007-06-01

Marketing costs exceed 30% of revenues for the pharmaceutical industry, with over 90% of the effort aimed at physicians. Although there are currently unprecedented numbers of regulatory activities focusing on relationships between the pharmaceutical industry and the medical profession, such legislation is often unrecognized or flouted. The potential influence, although minimized by both parties, must not be ignored. Physicians and drug companies will need to re-evaluate their responsibilities to their patients and their shareholders, and both groups should assume proactive and guidance roles in the transformation.

Occupational radiation protection legislation in Israel

International Nuclear Information System (INIS)

Tadmor, J.; Schlesinger, T.; Lemesch, C.

1980-01-01

Various governmental agencies, including the Ministry of Health, the Ministry of Labor and the Israel AEC are responsible for the control of the use of radioactive materials and medical X-ray machines in Israel. Present legislation deals mainly with the legal aspects of the purchase, transport and possession of radioactive materials and the purchase and operation of medical X-ray machines. No legislation refers explicitly to the protection of the worker from ionizing (and non-ionizing) radiation. A special group of experts appointed by the Minister of Labor recently worked out a comprehensive draft law concerning all legal aspects of occupational radiation protection in Israel. Among the main chapters of the draft are: general radiation protection principles, national radiation protection standards, medical supervision of radiation workers, personal monitoring requirements. The present situation with regard to radiation hazard control in Israel and details of the proposed radiation protection law is discussed. (Author)

Status of legislation

International Nuclear Information System (INIS)

Warner, C.

1982-01-01

The status of the House legislation, the major differences between the House and Senate legislation and a preview of what is likely to take place during the lame duck session in December are presented. The House legislation provides: long-term program leading toward permanent disposal of nuclear waste; an interim program for storage and for expansion of storage space for spent fuel; provides an R and D component through what is called a test and evaluation facility; an alternative long-term storage program based on a proposal to be completed by the Department of Energy on what's called Monitored Retrievable Storage; full upfront financing of the program through user fees based on contracts between the government and the users of the nuclear waste disposal services

Investigation on legal problems encountered by emergency medicine physicians in Turkey.

Directory of Open Access Journals (Sweden)

Afsin Emre Kayipmaz

Full Text Available Medicine is a profession that carries certain risks. One risky area of practice is the emergency department. Emergency physicians diagnose and treat a high volume of patients, and are also responsible for preparing reports for forensic cases. In this study, we aim to investigate emergency physicians' legal-administrative problems and reveal their level of understanding on forensic cases.An electronic questionnaire form was prepared after the approval of an ethical committee. This form was sent to the residents, specialists and academicians of emergency medicine by e-mail. The physicians were asked to fill out the form online. All the gathered data was analyzed. Descriptive statistics were presented as frequency percentages with mean and standard deviation. Chi-square tests were used to compare the groups. Correlation between number of complaint cases and age, sex, career, institution, and duration of service in emergency department were investigated. p<0.05 was considered statistically significant.294 physicians participated in the questionnaire. According to the questionnaire, 170 of the physicians were reported to the patient communication units due to medical malpractice. Mean number of compliant reports was 3.20±3.5. 29 of the physicians received administrative penalties. 42 of the physicians were judged in the court for medical malpractice. 1 physician was fined 5000 Turkish Liras as a result of these judgments.We found that the number of complaint reports is negatively correlated with duration of service in emergency medicine and age. There was a significant difference between number of complaint reports and career (p<0.05. The physicians' level of awareness on forensic cases was found to be insufficient. Lack of legislation knowledge may be an important cause of complaint reports concerning emergency physicians, who have a high load of patients. Thus, we think that increasing the frequency of post-graduate education sessions and

Social Media Use Among Physicians and Trainees: Results of a National Medical Oncology Physician Survey.

Science.gov (United States)

Adilman, Rachel; Rajmohan, Yanchini; Brooks, Edward; Urgoiti, Gloria Roldan; Chung, Caroline; Hammad, Nazik; Trinkaus, Martina; Naseem, Madiha; Simmons, Christine; Adilman, Rachel; Rajmohan, Yanchini; Brooks, Edward; Roldan Urgoiti, Gloria; Chung, Caroline; Hammad, Nazik; Trinkaus, Martina; Naseem, Madiha; Simmons, Christine

2016-01-01

Cancer management requires coordinated care from many health care providers, and its complexity requires physicians be up to date on current research. Web-based social media support physician collaboration and information sharing, but the extent to which physicians use social media for these purposes remains unknown. The complex field of oncology will benefit from increased use of online social media to enhance physician communication, education, and mentorship. To facilitate this, patterns of social media use among oncologists must be better understood. A nine-item survey investigating physician social media use, designed using online survey software, was distributed via e-mail to 680 oncology physicians and physicians in training in Canada. Responses were analyzed using descriptive statistics. A total of 207 responses (30%) were received; 72% of respondents reported using social media. Social media use was highest, at 93%, in respondents age 25 to 34 years and lowest, at 39%, in those age 45 to 54 years. This demonstrates a significant gap in social media use between younger users and mid- to late-career users. The main barrier to use was lack of free time. The identified gap in social media use between age cohorts may have negative implications for communication in oncology. Despite advancements in social media and efforts to integrate social media into medical education, most oncologists and trainees use social media rarely, which, along with the age-related gap in use, may have consequences for collaboration and education in oncology. Investigations to further understand barriers to social media use should be undertaken to enhance physician collaboration and knowledge sharing through social media.

National legislative and regulatory activities

International Nuclear Information System (INIS)

2014-01-01

This section of the Bulletin presents a summary of the recent national legislative and regulatory activities sorted by country and topic: - Algeria: Nuclear security. - France: Radioactive waste management; Nuclear safety and radiological protection; General legislation; International co-operation. - Germany: International trade. - Indonesia: Nuclear security, General legislation. - Ireland: Nuclear safety and radiological protection; General legislation. - Lithuania: Nuclear security; Nuclear safety and radiological protection. - Slovak Republic: International co-operation; Liability and compensation; Environmental protection. - Switzerland: Radioactive waste management. - United Arab Emirates: Liability and compensation. - United States: Radioactive waste management; Licensing and regulatory infrastructure

Overview of physician-hospital ventures.

Science.gov (United States)

Cohn, Kenneth H; Allyn, Thomas R; Rosenfield, Robert H; Schwartz, Richard

2005-01-01

An ongoing environment of reimbursement lagging behind escalating expenses has led physicians to explore new sources of revenue. The goal of physician-hospital ventures is to create a valuable entity that benefits patients, physicians, and the hospital. Physicians may choose to invest in healthcare facilities to improve patient care and obtain increased control over daily operations. If so, they should seek counsel to avoid violating Stark laws and anti-kickback laws. Modalities for investing in physician-hospital ventures are joint equity (stock) ventures, participating bond transactions (PBTs), and contractual integration, a new method to align the goals of specialists and hospital management without using joint equity ventures. Physicians and management should invest time in developing a shared vision of the future before beginning contract negotiations. Successful partnering requires transparency and stepwise building of trust. The greatest gain in joint ventures arises when both sides become active owners, rather than passive investors.

[Risk management in health care systems: the new legislative orientations in medical civil responsibility].

Science.gov (United States)

Tomassini, A; Signorelli, C; Colzani, E

2004-01-01

The recent radical change in the relationships between physicians and patients has increased the frequency of malpractice. Consequently, on one hand, many physicians got used to avoiding any possible risk of denunciation by applying the so called "defensive medicine", while on the other hand, the insurance companies raised the prices of their premiums for policies concerning civil responsibility of health operators. In order to avoid this "vicious circle", some health structures created Units for the Risk Management related to malpractice, while others took advantage of the collaboration of Associations for Patients' Rights to create database about the most frequent medical mistakes. The need for a legislative change has been accepted by the Parliament which expects with the proposal n.108 (approved in spring 2002 by the Commission for Hygiene and Health of the Senate) to attribute the civil responsibility of the physicians to the hospitals (both private and public) for which they work, to constitute a Register of experts and to accelerate the legal disputes. The problem is complex and still to be solved, but it seems that time for a strong intervention in order to improve the situation has to come.

An MBA: the utility and effect on physicians' careers.

Science.gov (United States)

Parekh, Selene G; Singh, Bikramjit

2007-02-01

Higher economic, legislative, legal, and administrative constraints in health-care services in the United States have led to an increase in physician dissatisfaction and a decrease in physician morale. In this study, we attempted to understand the motivation for a physician to enroll in a business school, and to discover the utility of the Master of Business Administration degree and how it changed the career path for the practicing clinician. We conducted a retrospective study in which a twenty-seven-question survey was distributed by the United States Postal Service and by e-mail to 161 physician graduates of three East Coast business schools. The results were evaluated, and a statistical analysis was performed. Eighty-seven physicians (54%) responded. Eight surveys were discarded because of incomplete data or stray marks, leaving seventy-nine surveys. The average age of the respondents was 41.4 years. The major motivations for going back to school included learning the business aspects of the health-care system (fifty-three respondents; 67%) and obtaining a more interesting job (forty-one respondents; 52%). The time that the respondents allocated for health-care-related activities before and after obtaining the degree was 58.3% and 31.8%, respectively, for patient care (p administrative responsibilities (p principles (thirty-three; 42%), working within a team (twenty-seven; 34%), and negotiating effectively (twenty-five; 32%). Sixty-four physicians (81%) believed that their business degree had been very useful or essential in the advancement of their careers. Many physicians decide to acquire a Master of Business Administration degree to understand the business of medicine. After they complete the degree program, their practice patterns substantially change, which is reflected particularly by an increase in time spent on administrative responsibilities. In order for physicians to overcome the multifaceted challenges of the evolving health-care system, it is

Box-ticking and Olympic high jumping - Physicians' perceptions and acceptance of national physician validation systems.

Science.gov (United States)

Sehlbach, Carolin; Govaerts, Marjan J B; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-05-24

National physician validation systems aim to ensure lifelong learning through periodic appraisals of physicians' competence. Their effectiveness is determined by physicians' acceptance of and commitment to the system. This study, therefore, sought to explore physicians' perceptions and self-reported acceptance of validation across three different physician validation systems in Europe. Using a constructivist grounded-theory approach, we conducted semi-structured interviews with 32 respiratory specialists from three countries with markedly different validation systems: Germany, which has a mandatory, credit-based system oriented to continuing professional development; Denmark, with mandatory annual dialogs and ensuing, non-compulsory activities; and the UK, with a mandatory, portfolio-based revalidation system. We analyzed interview data with a view to identifying factors influencing physicians' perceptions and acceptance. Factors that influenced acceptance were the assessment's authenticity and alignment of its requirements with clinical practice, physicians' beliefs about learning, perceived autonomy, and organizational support. Users' acceptance levels determine any system's effectiveness. To support lifelong learning effectively, national physician validation systems must be carefully designed and integrated into daily practice. Involving physicians in their design may render systems more authentic and improve alignment between individual ambitions and the systems' goals, thereby promoting acceptance.

Notification of suspected and unexpected serious adverse reactions according to the Clinical Trials Directive - A descriptive analysis of the legislation and the requirements in a European context

DEFF Research Database (Denmark)

Larsen, Ellen Moseholm; Grarup, Jesper; Gey, Daniela Christine

2010-01-01

The European Clinical Trials Directive (CTD) came into force on May 1st 2004. The CTD provides the legal basis for monitoring the safety of clinical trials and covers the requirements for notification of SUSAR. Implementation of the CTD into national legislation in each Member State has resulted...... in various interpretations of CTD requirements. The objective of this paper is to investigate how the European Member States administer the safety reporting requirements of the CTD and to clarify the requirements for SUSAR notification in the different Member States. Data was collected through publicly...

Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

Directory of Open Access Journals (Sweden)

Erwin Stolz

Full Text Available Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia.A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971. Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1 abstract description of euthanasia, (2 abstract description of physician-assisted suicide, (3 the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4 the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations including authoritarianism were tested via multiple logistic regression analyses.Rejection was highest in the case of the neonate (69% and lowest for the case of the older cancer patient (35%. A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate.Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

Determinants of Public Attitudes towards Euthanasia in Adults and Physician-Assisted Death in Neonates in Austria: A National Survey.

Science.gov (United States)

Stolz, Erwin; Burkert, Nathalie; Großschädl, Franziska; Rásky, Éva; Stronegger, Willibald J; Freidl, Wolfgang

2015-01-01

Euthanasia remains a controversial topic in both public discourses and legislation. Although some determinants of acceptance of euthanasia and physician-assisted death have been identified in previous studies, there is still a shortage of information whether different forms of euthanasia are supported by the same or different sub-populations and whether authoritarian personality dispositions are linked to attitudes towards euthanasia. A large, representative face-to-face survey was conducted in Austria in 2014 (n = 1,971). Respondents faced three scenarios of euthanasia and one of physician assisted death differing regarding the level of specificity, voluntariness and subject, requiring either approval or rejection: (1) abstract description of euthanasia, (2) abstract description of physician-assisted suicide, (3) the case of euthanasia of a terminally-ill 79-year old cancer patient, and (4) the case of non-voluntary, physician assisted death of a severely disabled or ill neonate. A number of potential determinants for rejection ordered in three categories (socio-demographic, personal experience, orientations) including authoritarianism were tested via multiple logistic regression analyses. Rejection was highest in the case of the neonate (69%) and lowest for the case of the older cancer patient (35%). A consistent negative impact of religiosity on the acceptance across all scenarios and differential effects for socio-economic status, area of residence, religious confession, liberalism, and authoritarianism were found. Individuals with a stronger authoritarian personality disposition were more likely to reject physician-assisted suicide for adults but at the same time also more likely to approve of physician-assisted death of a disabled neonate. Euthanasia in adults was supported by a partially different sub-population than assisted death of disabled neonates.

Physician-assisted dying: thoughts drawn from Albert Camus' writing.

Science.gov (United States)

Bozzaro, Claudia

2018-03-20

Physician-assisted dying (assisted suicide and euthanasia) is currently an intensely discussed topic in several countries. Despite differences in legislation and application, countries with end-of-life laws have similar eligibility criteria for assistance in dying: individuals must be in a hopeless situation and experience unbearable suffering. Hopelessness, as a basic aspect of the human condition, is a central topic in Albert Camus' philosophical work The Myth of Sisyphus, which addresses the question of suicide. Suffering in the face of a hopeless situation, and the way doctors approach this suffering, is the topic of his novel The Plague, which describes the story of a city confronted with a plague epidemic. In this paper, I draw philosophical and ethical conclusions about physician-assisted dying based on an analysis of central concepts in the work of Camus-specifically, those treated in The Myth of Sisyphus and The Plague. On the basis of my interpretation of Camus' work, I argue that hopelessness and unbearable suffering are useless as eligibility criteria for physician-assisted dying, given that they do not sufficiently elucidate where the line should be drawn between patients who should to be eligible for assistance and those who should not.

Physician suicide.

Science.gov (United States)

Preven, D W

1981-01-01

The topic of physician suicide has been viewed from several perspectives. The recent studies which suggest that the problem may be less dramatic statistically, do not lessen the emotional trauma that all experience when their lives are touched by the grim event. Keeping in mind that much remains to be learned about suicides in general, and physician suicide specifically, a few suggestions have been offered. As one approach to primary prevention, medical school curriculum should include programs that promote more self-awareness in doctors of their emotional needs. If the physician cannot heal himself, perhaps he can learn to recognize the need for assistance. Intervention (secondary prevention) requires that doctors have the capacity to believe that anyone, regardless of status, can be suicidal. Professional roles should not prevent colleague and friend from identifying prodromal clues. Finally, "postvention" (tertiary prevention) offers the survivors, be they family, colleagues or patients, the opportunity to deal with the searing loss in a therapeutic way.

Physician-Owned Hospitals

Data.gov (United States)

U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

Physician performance feedback in a Canadian academic center.

Science.gov (United States)

Garvin, Dennis; Worthington, James; McGuire, Shaun; Burgetz, Stephanie; Forster, Alan J; Patey, Andrea; Gerin-Lajoie, Caroline; Turnbull, Jeffrey; Roth, Virginia

2017-10-02

Purpose This paper aims at the implementation and early evaluation of a comprehensive, formative annual physician performance feedback process in a large academic health-care organization. Design/methodology/approach A mixed methods approach was used to introduce a formative feedback process to provide physicians with comprehensive feedback on performance and to support professional development. This initiative responded to organization-wide engagement surveys through which physicians identified effective performance feedback as a priority. In 2013, physicians primarily affiliated with the organization participated in a performance feedback process, and physician satisfaction and participant perceptions were explored through participant survey responses and physician leader focus groups. Training was required for physician leaders prior to conducting performance feedback discussions. Findings This process was completed by 98 per cent of eligible physicians, and 30 per cent completed an evaluation survey. While physicians endorsed the concept of a formative feedback process, process improvement opportunities were identified. Qualitative analysis revealed the following process improvement themes: simplify the tool, ensure leaders follow process, eliminate redundancies in data collection (through academic or licensing requirements) and provide objective quality metrics. Following physician leader training on performance feedback, 98 per cent of leaders who completed an evaluation questionnaire agreed or strongly agreed that the performance feedback process was useful and that training objectives were met. Originality/value This paper introduces a physician performance feedback model, leadership training approach and first-year implementation outcomes. The results of this study will be useful to health administrators and physician leaders interested in implementing physician performance feedback or improving physician engagement.

Environmental analysis for building legislation purposes. A challenge to science and policy making

NARCIS (Netherlands)

Scholten, N.P.M.; Huppes, G.; Haes, H.A.U. de

2000-01-01

The Dutch Government is cooperating with the building industry to prepare legislation for environmental performance requirements for dwellings and residential buildings. These requirements, also known as dubo-eisen (requirements for sustainable building) will have to apply to all newly built

[Physician retirement from clinical practice: how and when].

Science.gov (United States)

Wolpert Barraza, Enrique

2011-01-01

In Mexico there is no legislation as to when a physician should retire from active practice as it is the case in other countries. The Mexican Social Security for instance, in its global working contract between the authorities and the employees, for the period 2009-2011 clearly stated that after 30 years of service for men and 27 for women the employee may retire but the physician can still work in another institution or in private practice for as long as he or she wants. In this article, the experience of distinguished Mexican surgeons who had written in the past in relation to this topic is acknowledged. A brief description of the retirement of physicians in Spain where the National Health System retire physicians from practice at age 65 and in some cases at age 70 is discussed. The author analyzes what happens in other activities of human mankind such as in the arts, painting, architecture, music, physics and philosophy, where there are plenty of outstanding examples of men and women doing their best work well over the age of 65. The names of some distinguished Mexican physicians past presidents of the Academy of Medicine are mentioned, all of them legends in the field of medicine who worked or continue to work many, many years after the age of 65. The author recognizes the process of accreditation and certification of medical specialists in Mexico that is carried out by the 47 specialty councils that have the recognition of the National Committee for Medical Specialties: CONACEM. Finally he offers his personal thoughts about what a physician may do when he or she is thinking of retiring and urges them not to throw away their personal experiences of many years in medical practice but instead to utilize the social networks such as Twitter or Facebook in order to continue to provide their expertise to young physicians who may benefit greatly.

Coping with EU environmental legislation

DEFF Research Database (Denmark)

Anker, Helle Tegner; de Graaf, Kars; Purdy, Ray

2015-01-01

A ‘burden reducing’ agenda has spurred an increased interest in how EU environmental legislation is transposed into national legislation—most prominently reflected in the principle of ‘no gold-plating’. Yet, an important question is to what extent transposition principles and practices may ensure...... on coherence and accessibility with respect to environmental legislation and that such issues deserve more attention in the transposition process.......A ‘burden reducing’ agenda has spurred an increased interest in how EU environmental legislation is transposed into national legislation—most prominently reflected in the principle of ‘no gold-plating’. Yet, an important question is to what extent transposition principles and practices may ensure...... a coherent and accessible body of environmental legislation, while at the same time ensuring adequate transposition of EU environmental legislation. This article analyses the existence, or emergence, of transposition principles and practices in three Member States—the United Kingdom, the Netherlands...

The new Italian IVF legislation.

Science.gov (United States)

Benagiano, Giuseppe; Gianaroli, Luca

2004-08-01

Last February, the Italian Parliament gave final approval to a new Law regulating assisted reproduction technology. The new legislation fell short of the expectations of infertile couples and of all specialists in the field. There are three problems with the new Italian law; they involve social issues, human rights and the application of technology. The present paper focuses on the fact that the new rules infringe upon basic human rights and the proper application of IVF technology, because they mandate procedures that are against the best interest of the woman seeking pregnancy. The main point of controversy is the combination of a mandatory limit of three embryos for transfer, and an obligation to reimplant all produced embryos; cryopreservation of excess embryos is prohibited. Obviously, this decreases the chances of most women to achieve pregnancy, while at the same time it increases the number and complexity of procedures they need to undergo and may expose some to an unacceptable increase in the risk of multiple pregnancy. The new law is inspired by the desire to protect every newly produced embryo; this is a commendable aim, although it is in total opposition to a law passed over 25 years ago that liberalized voluntary termination of first trimester pregnancies. This means that today Italy has a law that protects every early, pre-implantation embryo, and another that allows the 'suppression' of every post-implantation one. From a technical point of view, given the low level of human fecundity, the only way to prevent the 'loss' of even one preimplantation embryo is to simply ban IVF altogether, an option that Italian legislators obviously did not have the courage to opt for. The tragedy is that Italian infertile couples are now confronted with new rules that not only severely limit the ability of physicians to correctly apply IVF technology, but are so confused that, depending on the interpretation, anyone may try to nullify the main ideological premise upon

Enact legislation supporting residential property assessed clean energy financing (PACE)

Energy Technology Data Exchange (ETDEWEB)

Saha, Devashree

2012-11-15

Congress should enact legislation that supports residential property assessed clean energy (PACE) programs in the nation’s states and metropolitan areas. Such legislation should require the Federal Housing Finance Agency (FHFA) to allow Fannie Mae and Freddie Mac to purchase residential mortgages with PACE assessments while at the same time providing responsible underwriting standards and a set of benchmarks for residential PACE assessments in order to minimize financial risks to mortgage holders. Congressional support of residential PACE financing will improve energy efficiency, encourage job creation, and foster economic growth in the nation’s state and metropolitan areas.

Navigating SA's climate change legislation

International Nuclear Information System (INIS)

Dickey, Suzanne

2006-01-01

It is proposed that there should be a legislation to address climate change and Greenhouse Gas Emission Reduction Bill. South Australian Government Greenhouse Strategy and climate change legislation in light of the far-reaching implications this legislation could have on clients, who face the impacts of climate change in the business and natural environment. It is a commitment to reduce greenhouse gas emissions in South Australia by 2050 to 60 per cent of 1990 levels

Euthanasia and physician-assisted suicide policy in The Netherlands and Oregon: a comparative analysis.

Science.gov (United States)

Patel, Kant

2004-01-01

This article presents a comparative analysis of euthanasia and physician-assisted suicide policy in The Netherlands and the state of Oregon in the United States. The topics of euthanasia and physician-assisted suicide are discussed in the context of the historical setting of The Netherlands and the United States with special emphasis placed on public opinion, role of the courts and the legislative bodies, and opinions of physicians. Major similarities and differences in the laws of The Netherlands and Oregon are discussed. The article examines whether the passage of the law has led to a slide down the slippery slope in The Netherlands and Oregon as had been suggested by the opponents of the law. The article concludes that the empirical evidence does not support the contention of the opponents. However, the author argues that the potential for this happening is much greater in The Netherlands than in Oregon.

Federal legislative and regulatory incentives and disincentives for industrial waste reduction

International Nuclear Information System (INIS)

Cordes, R.; Nixon, J.

1991-10-01

The Office of Industrial Technologies (OIT) within the US DOE has recently initiated the Industrial Waste Reduction Program, which is designed to reduce industrial energy use and pollution by reducing the amount of waste materials generated. The Program's primary focus is to develop and commercialize waste reduction technologies and practices in conjunction with industrial partners. OIT recognizes that adoption of these technologies is often inhibited by an assortment of institutional barriers that are unrelated to technical or economic performance. Therefore, OIT is examining selected barriers to industrial waste reduction to help identify and remove impediments to wider technology implementation. This report examines the incentives and disincentives to industrial waste reduction that are provided in an assortment of legislation and regulations. The intent is to shed light on how our environmental laws affect industry's implementation of waste reduction, what particular problems exist with current legislation/regulations, and what general options are available for correcting any deficiencies. Our study was confined strictly to federal legislation and regulations. During the course of the study, (March and May 1991), we examined 16 pieces of existing legislation and their attendant regulations plus 22 pieces of proposed legislation. In addition, the authors consulted representatives from industry and from the government agencies administering or sponsoring the legislation. The Resource Conservation and Recovery Act (RCRA) is by far the most comprehensive and dominant piece of legislation affecting solid waste disposal. This is because RCRA, which governs, the management of both nonhazardous and hazardous waste, places the most restrictive requirements on industry. Other important pieces of legislation that exert a direct influence on waste reduction per se include the Clean Air Act and the Pollution Prevention Act. 90 refs., 12 tabs

From drafting guideline to error detection: Automating style checking for legislative texts

OpenAIRE

Höfler Stefan; Sugisaki Kyoko

2012-01-01

This paper reports on the development of methods for the automated detection of violations of style guidelines for legislative texts, and their implementation in a prototypical tool. To this aim, the approach of error modelling employed in automated style checkers for technical writing is enhanced to meet the requirements of legislative editing. The paper identifies and discusses the two main sets of challenges that have to be tackled in this process: (i) the provision of domain-specific NLP ...

Regulatory control, legislation and framework

International Nuclear Information System (INIS)

Parthasarathy, K.S.

1998-01-01

The legislation and regulations, a regulatory authority to authorise and inspect the regulated activities and to enforce the legislation and regulations, sufficient financial and man-power resources are the essential parts of a national infrastructure to implement the Basic Safety Standards. The legal framework consists of legislation (Act passed by Parliament) and the regulations (framed by the government and endorsed by the Parliament). This paper is primarily deals with the the legal framework set up in India for atomic energy activities

EU legislations affecting safety data availability of cosmetic ingredients.

Science.gov (United States)

Pauwels, Marleen; Rogiers, Vera

2007-12-01

With the introduction of the 6th and 7th Amendments (OJ L151, 32-37, 23 June 1993; OJ L066, 26-35, 11 March 2003) to the Cosmetic Products Directive (OJ L262, 169-200, 27 September 1976), imposing a testing and marketing ban on cosmetic products tested on animals, the retrieval of toxicological data on individual ingredients became of greater need. Since the majority of cosmetic ingredients are used for many other purposes than their cosmetic function, they fall under the scope of more than one EU Directive. An overview is given of EU legislation that could potentially affect the availability and interpretation of cosmetic safety data. It will become clear that, although cosmetics are regulated by a specific so-called "vertical" legislation, "horizontal" influences from other products' legislations play a role since they determine the type and amount of data that theoretically could be found on the specific substances they regulate. This knowledge is necessary while performing extended searches in databases and becomes indispensable when initiating negotiations with manufacturers or suppliers for obtaining the safety data required.

Harmonization of Legislation of a Candidate Country with EU Legislation: Insights from the Prism of the Citizens of Macedonia

Directory of Open Access Journals (Sweden)

Abdula Azizi

2013-05-01

Full Text Available Since the majority of the Western Balkan countries remain although they have expressed a willingness to join the EU, it is considered necessary to examine the topic of harmonization of national legislation of these countries with the EU legislation. So while until now, to this problem is not devoted adequate attention in scientific circles, it is considered necessary to explain and analyze the theoretical aspect of the harmonization of the legislation of the candidate countries with EU legislation, while they also learned things fr survey was conducted with the citizens of Macedonia where they express their opinions on the harmonization of Macedonian legislation and government policies related to Euro hope that in the future this work will encourage research and other activities related to government policy on the harmonization of national legislation with EU legislation.

Legislative Process For National Atomic Energy Laws Various Legal Approaches And Lessons Learned

International Nuclear Information System (INIS)

Ali, A.M.

2008-01-01

Legislative Process for National Atomic Energy Laws (NAELs) aim at establishing a legal base for the peaceful uses of nuclear energy. Various approaches (partial and comprehensive) to draft the NAELs are studied. The paper also studies some national nuclear energy laws through a comparative legal analysis and the important developments that have taken place in the legislative process for NAELs. There are lessons learned from the legislative process for NAELs. First, each state must develop its own legislative framework based on its own situation. Second, although the NAELs have common features, they vary considerably due to national legal traditions, social, economic circumstances and cultural values. Third, the NAELs have also evolved in time. Fourth, the technical standards, rules and guidelines should not be part of legislation issued by the Parliament because they would also facilitate quick adaption to new technical developments. Fifth, interface between legal and technical issues, requiring legal and technical experts to interact with each other. Sixth, continuing assessment that may lead to amendments to the law over time

[The operational role of the occupational health physician in the assessment and management of health risks related to night risks].

Science.gov (United States)

Mucci, Nicola; Giorgi, Gabriele; Gonnelli, Irene Margherita; Garbarino, Sergio; Cupelli, Vincenzo; Arcangelil, Giulio

2016-01-01

The operational role of the occupational health physician in the assessment and management of health risks related to night work. Night work, in the last 30-40 years, has been extended to almost all areas of employment. The potential effects on workers' health--related to the disruption of circadian rhythms--are now well defined and studied in the Literature. All issues about the protection of safety and health for night workers are governed by the Italian Legislative Decree no. 66/2003 and subsequent amendments. The management of night work hasn't been included into the main Law on Occupational Safety and Health (Italian Legislative Decree no. 81/2008 and subsequent amendments) and a coordination between the two disciplines is desirable. The occupational health physician, as a global consultant for the protection of all health issues into a company, has to evaluate the potential effects of night work on health, both individually and as a group of workers. In this way, the physician may use either traditional tools (history, physical examination, blood tests) or innovative tools (questionnaires, health promotion programs, interventions on shift schedules). In the management of night work is useful to employ schedules that respect both psychophysical integrity and social welfare of workers and the needs of the production. The occupational health physician plays a significant role in information and training of workers, both individually and as a group of workers, and in the organization of health promotion programs (whit a voluntary participation by the workers).

Legislations the field of food irradiation

International Nuclear Information System (INIS)

1987-05-01

An outline is given of the national legislation in 39 countries in the field of food irradiation. Where available the following information is given for each country: form of legislation, object of legislation including information on the irradiation treatment, the import and export trade of irradiated food, the package labelling and the authorization and control of the irradiation procedures

Synthesis of Automated Vehicle Legislation

Science.gov (United States)

2017-10-01

This report provides a synthesis of issues addressed by state legislation regarding automated vehicles (AV); AV technologies are rapidly evolving and many states have developed legislation to govern AV testing and deployment and to assure safety on p...

Nuclear liability legislation in Slovenia

International Nuclear Information System (INIS)

Skraban, A.

2000-01-01

This paper gives some basic data about nuclear installations in Slovenia, reviews Slovenian national legislation in the field of third-party liability for nuclear damage, applicability of the international nuclear liability treaties in the Slovenian legal system and outlines some main provisions of national legislation. It also aims to give some facts about history and present status of nuclear insurance pool and the insurance of nuclear risks in Slovenia. Paper finally indicates also some future legislative steps with respect to nuclear third party liability, at national and international level. (author)

The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians.

Science.gov (United States)

Schaden, Eva; Herczeg, Petra; Hacker, Stefan; Schopper, Andrea; Krenn, Claus G

2010-10-21

Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation.In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008). Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care) an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.

Flexibility in radiation protection legislation -the UK approach

International Nuclear Information System (INIS)

Beaver, P.F.; Gill, J.R.

1980-01-01

The case for flexibility in the formulation of radiation protection legislation and that for precise invariable requirements which are applicable to all users of ionising radiations are presented. It is asserted that greater participation on the part of persons affected in the shaping of legislation brings with it a commitment to flexibility if consensus is to be achieved. The nature of the participative and consultative processes in the UK is described. The means by which flexibility will be inbuilt into future UK legislation are discussed, taking as examples, three particular areas: a) Notification of use of ionising radiations, where flexibility needs to be introduced to take care of improved knowledge of potential risk, the avoidance of bureaucratic procedures, and the wide variation in practice from one work activity to another; b) The definition of controlled areas, where flexibility is needed to cope with the wide range of potential use situations, yet if controlled areas are to be the route to defining Category A workers, where that flexibility must be restrained to ensure proper categorysation and effective enforcement; c) The criteria for the need to appoint and for the selection of radiation protection advisers where flexibility must be invoked to ensure that any particular task is matched by the quality of the radiation protection adviser concerned. It is concluded that the proposed UK legislation will achieve flexibility where this is appropriate and cost-effective and on the other hand demand adherence to strictly expressed levels of exposure where that is appropriate. (author)

Legislative Framework for Landscape Planning in Latvia

Science.gov (United States)

Nitavska, Natalija; Zigmunde, Daiga

2017-10-01

With the adoption and the ratification of the European Landscape Convention a legally justified need for a clear landscape policy was grounded in the European countries. It includes the elaboration of the new and the improvement of the existing legislative documents on landscape planning, protection and management. The aim of the particular study is to analyse the existing legislative documents in Latvia influencing landscape planning on different scales / and the implementation of the European Landscape Convention. The study emphasizes the complex structure of the Latvian legislative framework affected by the distribution of the normative documents under the various ministries. Therefore, the main problem is unclear responsibility levels and organizational system for solving the issues regarding landscape planning, protection and management. Thus the various discussions between the involved disciplines and responsible institutions are arising. Two groups of the legislative documents influencing the implementation of the landscape policy in Latvia are detected within the study. The first group is strategic documents determining main landscape planning principles and directions at European, national, regional and professional or sectoral level. The second group is operational documents providing a set of actions for the landscape planning, protection and management at the local or the municipality level. The study concludes that operational documents developed by the municipalities are in high importance because of their direct influence on the landscape planning in Latvia. This often leads to the different landscape planning requirements included in the normative documents of the neighbouring municipalities, although the spatial and ecological borders of the visual landscape do not fit with the formal borders of the municipalities. Thus, it is essential to develop the common principles and actions that would be incumbent on all municipalities to provide the

Legislative and Judicial Information Systems.

Science.gov (United States)

Becker, Louise Giovane

1983-01-01

Reviews computer applications in judicial, legal, and legislative information activities being used to support litigation and court administration, assist in searching for legislation and laws, aid criminal justice information systems, and provide appropriate bibliographic and reference assistance. Management issues in automating systems are…

Legal Principles and Legislative Instrumentalism

NARCIS (Netherlands)

Gribnau, J.L.M.; Soeteman, A.

2003-01-01

Instrumentalist legislation usually underestimates the importance of legal principles in modern law. Legal principles are the normative core of a value oriented conception of law. They function as essential criteria of evaluation for lawmaking by the legislator and the executive. In fact,

Legislation and litigation related to low-level radiation injury claims

International Nuclear Information System (INIS)

McCraw, T.

1985-01-01

Current legislation and litigation related to radiation exposure will have an enormous impact on the radiation protection and monitoring requirements of the future. A brief review of some proposed injury compensation bills for veterans and a recent court decision for low-level radiation injury claims are reviewed

Perceptions of patients, families, physicians and nurses regarding challenges in cancer disclosure: A descriptive qualitative study.

Science.gov (United States)

Ehsani, Maryam; Taleghani, Fariba; Hematti, Simin; Abazari, Parvaneh

2016-12-01

The findings of numerous studies have illustrated that there is still a high proportion of cancer patients in Eastern and Middle-East countries including Iran, who are not properly informed of their disease due to the concealment atmosphere which still prevails. This descriptive qualitative study is aimed at exploring perceptions of patients, patients' family members, physicians and nurses regarding cancer disclosure challenges. Thirty-five participants (15 patients, 6 family members, 9 physicians, and 5 nurses) were selected through purposive sampling. The data were collected through in-depth interviews; after which they were analyzed using a qualitative content analysis with an inductive approach. Data analysis revealed the following three categories: first, challenges related to healthcare system which deals with the deficiencies, strains and concerns in medical setting and healthcare team training; second, challenges related to family insistence on concealment which includes their fear of cancer disclosure and its negative impact on the patients; and third, challenges related to policy making which consists of deficiencies in legislative and supportive institutions for advocacy of truth telling. Successful move from concealment to effective disclosure attitude in cancer patients in Iran requires a national determination for resolving challenges in medical education as well as other different social, cultural and policy making dimensions. Copyright © 2016. Published by Elsevier Ltd.

[Incorporation of the Hazard Analysis and Critical Control Point system (HACCP) in food legislation].

Science.gov (United States)

Castellanos Rey, Liliana C; Villamil Jiménez, Luis C; Romero Prada, Jaime R

2004-01-01

The Hazard Analysis and Critical Control Point system (HACCP), recommended by different international organizations as the Codex Alimentarius Commission, the World Trade Organization (WTO), the International Office of Epizootics (OIE) and the International Convention for Vegetables Protection (ICPV) amongst others, contributes to ensuring the innocuity of food along the agro-alimentary chain and requires of Good Manufacturing Practices (GMP) for its implementation, GMP's which are legislated in most countries. Since 1997, Colombia has set rules and legislation for application of HACCP system in agreement with international standards. This paper discusses the potential and difficulties of the legislation enforcement and suggests some policy implications towards food safety.

Physicians' preferences for asthma guidelines implementation.

Science.gov (United States)

Kang, Min-Koo; Kim, Byung-Keun; Kim, Tae-Wan; Kim, Sae-Hoon; Kang, Hye-Ryun; Park, Heung-Woo; Chang, Yoon-Seok; Kim, Sun-Sin; Min, Kyung-Up; Kim, You-Young; Cho, Sang-Heon

2010-10-01

Patient care based on asthma guidelines is cost-effective and leads to improved treatment outcomes. However, ineffective implementation strategies interfere with the use of these recommendations in clinical practice. This study investigated physicians' preferences for asthma guidelines, including content, supporting evidence, learning strategies, format, and placement in the clinical workplace. We obtained information through a questionnaire survey. The questionnaire was distributed to physicians attending continuing medical education courses and sent to other physicians by airmail, e-mail, and facsimile. A total of 183 physicians responded (male to female ratio, 2.3:1; mean age, 40.4±9.9 years); 89.9% of respondents were internists or pediatricians, and 51.7% were primary care physicians. Physicians preferred information that described asthma medications, classified the disease according to severity and level of control, and provided methods of evaluation/treatment/monitoring and management of acute exacerbation. The most effective strategies for encouraging the use of the guidelines were through continuing medical education and discussions with colleagues. Physicians required supporting evidence in the form of randomized controlled trials and expert consensus. They preferred that the guidelines be presented as algorithms or flow charts/flow diagrams on plastic sheets, pocket cards, or in electronic medical records. This study identified the items of the asthma guidelines preferred by physicians in Korea. Asthma guidelines with physicians' preferences would encourage their implementation in clinical practice.

US legislative proposals for nuclear export controls

International Nuclear Information System (INIS)

Donnelly, W.H.

1977-01-01

Some of the topics covered are: Congress' perception of proliferation; completed legislation for non-proliferation; partially complete legislative initiatives in the 94th Congress; non-proliferation measures defeated or vetoed; and legislation for non-proliferation in the 95th Congress

Impact of changed legislation on skin tests: the present and future

NARCIS (Netherlands)

Klimek, Ludger; Hoffmann, Hans Jürgen; Kugler, Alexa; Muraro, Antonella; Hellings, Peter W.

2016-01-01

To discuss the impact of current European Union regulations on the availability of commercially available skin test allergens in European member states. European Union legislations now define diagnostic allergens to be medicine requiring market authorization of every individual diagnostic allergen

Nuclear legislation in Czech Republic

International Nuclear Information System (INIS)

Stuller, J.

1996-01-01

The paper presents the status of nuclear legislation in the Czech Republic, specifying the fields of nuclear activities covered, partially covered and uncovered by the present legislation. The licensing process and the competence and powers of the State Office for Nuclear Safety are also briefly described

Legislation for nuclear disaster

International Nuclear Information System (INIS)

Nagata, Shozo

2012-01-01

Fukushima nuclear disaster accident clarified problems on nuclear-related legislation and its application. Legislation for nuclear disaster (LNA) could not respond to severe accident because assumed size of accident was not enough. After emergency event corresponding to the article 15 of LNA, was reported by the operator, more than two hours passed by the issuance of Emergency State Declaration. Off-site center could not work at all. This article reviewed outline of LNA and introduced discussion on the reform of legislation and its application. Reform discussion should be focused on swift and effective response readiness to emergency: 1) operator's substantial nuclear emergency drilling, (2) reinforcement of government's headquarters for emergency response, (3) after nuclear emergency, government's headquarters remained to enhance resident's safety from radiation hazard and (4) enactment of nuclear emergency preparedness guidelines for local communities. (T. Tanaka)

Legislative coalitions with incomplete information.

Science.gov (United States)

Dragu, Tiberiu; Laver, Michael

2017-03-14

In most parliamentary democracies, proportional representation electoral rules mean that no single party controls a majority of seats in the legislature. This in turn means that the formation of majority legislative coalitions in such settings is of critical political importance. Conventional approaches to modeling the formation of such legislative coalitions typically make the "common knowledge" assumption that the preferences of all politicians are public information. In this paper, we develop a theoretical framework to investigate which legislative coalitions form when politicians' policy preferences are private information, not known with certainty by the other politicians with whom they are negotiating over what policies to implement. The model we develop has distinctive implications. It suggests that legislative coalitions should typically be either of the center left or the center right. In other words our model, distinctively, predicts only center-left or center-right policy coalitions, not coalitions comprising the median party plus parties both to its left and to its right.

Seminar on present and future Spanish Legislation on nuclear energy

International Nuclear Information System (INIS)

1986-01-01

The Proceedings of the Seminar contain the papers presented and the conclusions of each Session. The topics cover Spanish nuclear legislation including the licensing of nuclear power plants and control, analysed in the context of legislation in other fields and the new requirements since Spain joined the European Communities. Other papers deal with the origin and evolution of Spanish nuclear law, the competent international organizations and the nuclear third party liability regime set in place by the international conventions in that field. Also discussed are the national regulations on radioactive waste management and the competent authorities. Finally, a revision of the Spanish Nuclear Energy Act is considered necessary in the light of developments since its inception [fr

Impact of the legislation on electric utilities

International Nuclear Information System (INIS)

De Long, M.

1982-01-01

The possible impact of Federal nuclear waste legislation on electric utilities is discussed. The proposed legislation will set forth a well defined program enabling utilities with nuclear plants to make long term plans under a statutory mandate committed to an available technology and implementation timetable. The legislation includes the necessary specificity for the utility companies to fulfill their responsibilities in describing their waste disposal plans to their customers, the concerned public, and state and local legislators

26 CFR 1.501(h)-1 - Application of the expenditure test to expenditures to influence legislation; introduction.

Science.gov (United States)

2010-04-01

... expenditures to influence legislation; introduction. 1.501(h)-1 Section 1.501(h)-1 Internal Revenue INTERNAL...) Exempt Organizations § 1.501(h)-1 Application of the expenditure test to expenditures to influence... attempting to influence legislation, (except as otherwise provided in subsection (h)).” This requirement is...

Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.

Science.gov (United States)

McKenna, Mindi K; Gartland, Myles P; Pugno, Perry A

2004-01-01

Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

Status of legislation

International Nuclear Information System (INIS)

Gilman, P.

1982-01-01

The Senate passed 69 to 6 legislation to provide a comprehensive nuclear waste policy. This legislation restates some things the Department of Energy is already doing. It modifies some others, and in some cases it provides new authorities, principally in those areas of state participation and in the area of financing of the program. Some of the provisions of the Senate bill are: schedule for a number of items in the disposal of nuclear waste, the first being an area referred to as away-from reactor storage; a timetable for geologic disposal; a plan for the long-term storage of nuclear waste for spent fuels; a financing mechanism; and states participation

New common program requirements for the resident physician workforce and the omission of strategic napping: A missed opportunity.

Science.gov (United States)

Shnayder, Michelle M; St Onge, Joan E; Caban-Martinez, Alberto J

2017-09-01

Napping has known benefits for fatigue mitigation and improved alertness. However the Accreditation Council for Graduate Medical Education (ACGME) New Common Program Requirements recently removed the 16 h work limit for PGY1 residents and removed any suggestions of napping. We utilized a cross-sectional study design to administer a 44-item questionnaire in June 2016 to 858 residents and fellows at one large urban academic medical center. We assessed: 1) resident physician sentiment of work environment supportiveness for napping at work; and 2) agreement with 2011 ACGME guidelines on workweek hour limitations and strategic napping recommendations. While 89% of residents reported access to an on-call room at work, only 20% felt their work environment supported a culture of napping while at work. Over 76% expressed agreement with the 2011 ACGME work-hour restrictions. Strategies to support napping and well-being within the resident physician workforce and organizational setting are warranted. © 2017 Wiley Periodicals, Inc.

Competition and safety as reflected in the legislation concerning technical supervision - are they incompatible

International Nuclear Information System (INIS)

Roth, H.A.

1986-01-01

The author discusses the conflicts between competition and safety in the legislation on technical supervision, the requirements on specific sectors, and the consequences of the concentration of the functions of technical supervision in the hands of the Technical Supervisory Board (TUEV). The demand to give more room for competition is found to have no legal basis in fundamental law. It therefore rests with the legislator to concert the one with the other. (orig./HP) [de

Changes in public attitudes towards confidential adolescent sexual and reproductive health services in Lithuania after the introduction of new legislation

DEFF Research Database (Denmark)

Jaruseviciene, Lina; Zaborskis, Apolinaras; Sauliune, Skirmante

2015-01-01

was employed to estimate absolute differences in prevalence of belief in whether or not adolescents would find confidentiality important when consulting a physician on SRH issues. A log-binomial regression model was fitted to estimate the relative changes (prevalence ratio) of the independent variables......BACKGROUND: In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. This study sets out to explore changes in Lithuanian residents' attitudes towards confidentiality protection in adolescent sexual....... RESULTS: The total number of respondents was 1054 (response rate 83%) in 2005 and 1002 (response rate 80%) in 2012. The proportion of respondents who reported a belief that adolescents would find confidentiality important when seeing a physician for SRH issues increased significantly from 62% in 2005...

29 CFR 784.102 - General legislative history.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false General legislative history. 784.102 Section 784.102 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION, DEPARTMENT OF LABOR STATEMENTS OF GENERAL... Aquatic Products Legislative History of Exemptions § 784.102 General legislative history. (a) As orginally...

The National Day for the Libyan Physician

Directory of Open Access Journals (Sweden)

Elmahdi A. Elkhammas

2007-03-01

Full Text Available The health sector is a vital component of the growth and maintenance of every economy. When you examine any country’s annual budget, you immediately recognize that a large proportion goes to the healthcare sector. You may also see it is a part of expenditure and not of productivity. In other words, healthcare is a liability item when it comes to the budget. Libya is no exception.The goal of the health planners is to allocate the healthcare budget in ways that will ultimately result in a healthier society. In Libya, unfortunately, it is not clear how much of the budget goes to the health profession and health care delivery, and how much of it is spent on administrative issues. When you focus on the health sector you discover that it is really a significant mover of the productivity line. It is very simple. Healthy citizens are more likely to go to school and be educated. They are also more likely to have steady employment and be productive members of the society. That is not the subject of these comments. No one can deny that the Libyan physicians are on the frontline when it comes to criticism of the health services in Libya. I agree that they should be on the frontline. After all, medical schools in Libya started many years before the creation of other colleges for allied health professionals. They have a major share of responsibility in keeping our citizens healthy. It is also their responsibility to treat those who become sick. This requires a health system with a solid, transparent, ethical, and well organized structure. This is not the subject of my comments either. The purpose of my comments today is to draw attention to the Libyan physicians and recognize them once a year. I feel that they are busy with their work and the basic ingredients of life in a developing country. I also believe that they are relatively forgotten by society. What I would like to propose is the creation of a national observation for the Libyan physician. I think

Physician-industry relations. Part 1: individual physicians.

Science.gov (United States)

Coyle, Susan L

2002-03-05

This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies. Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient's best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions. Many physicians and physicians-in-training think they are impervious to commercial influence. However, recent studies show that accepting industry hospitality and gifts, even drug samples, can compromise judgment about medical information and subsequent decisions about patient care. It is up to the physician to judge whether a gift is acceptable. A very general guideline is that it is ethical to accept modest gifts that advance medical practice. It is clearly unethical to accept gifts or services that obligate the physician to reciprocate. Conflicts of interest can arise from other financial ties between physicians and industry, whether to outside companies or self-owned businesses. Such ties include honorariums for speaking or writing about a company's product, payment for participating in clinic-based research, and referrals to medical resources. All of these relationships have the potential to influence a physician's attitudes and practices. This paper explores the ethical quandaries involved and offers guidelines for ethical business relationships.

Validation of the Physician-Pharmacist Collaborative Index for physicians in Malaysia.

Science.gov (United States)

Sellappans, Renukha; Ng, Chirk Jenn; Lai, Pauline Siew Mei

2015-12-01

Establishing a collaborative working relationship between doctors and pharmacists is essential for the effective provision of pharmaceutical care. The Physician-Pharmacist Collaborative Index (PPCI) was developed to assess the professional exchanges between doctors and pharmacists. Two versions of the PPCI was developed: one for physicians and one for pharmacists. However, these instruments have not been validated in Malaysia. To determine the validity and reliability of the PPCI for physicians in Malaysia. An urban tertiary hospital in Malaysia. This prospective study was conducted from June to August 2014. Doctors were grouped as either a "collaborator" or a "non-collaborator". Collaborators were doctors who regularly worked with one particular clinical pharmacist in their ward, while non-collaborators were doctors who interacted with any random pharmacist who answered the general pharmacy telephone line whenever they required assistance on medication-related enquiries, as they did not have a clinical pharmacist in their ward. Collaborators were firstly identified by the clinical pharmacist he/she worked with, then invited to participate in this study through email, as it was difficult to locate and approach them personally. Non-collaborators were sampled conveniently by approaching them in person as these doctors could be easily sampled from any wards without a clinical pharmacist. The PPCI for physicians was administered at baseline and 2 weeks later. Validity (face validity, factor analysis and discriminative validity) and reliability (internal consistency and test-retest) of the PPCI for physicians. A total of 116 doctors (18 collaborators and 98 non-collaborators) were recruited. Confirmatory factor analysis confirmed that the PPCI for physicians was a 3-factor model. The correlation of the mean domain scores ranged from 0.711 to 0.787. "Collaborators" had significantly higher scores compared to "non-collaborators" (81.4 ± 10.1 vs. 69.3 ± 12.1, p Malaysia.

29 CFR 783.28 - General legislative history.

Science.gov (United States)

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false General legislative history. 783.28 Section 783.28 Labor... TO EMPLOYEES EMPLOYED AS SEAMEN Legislative History and Judicial Construction of the Exemptions § 783.28 General legislative history. As originally enacted in 1938, section 13(a)(3) of the Fair Labor...

"You Say Tomato, I Say Solanum Lycopersicum Containing Beta-ionone and Phenylacetaldehyde": an Analysis of Connecticut's GMO Labeling Legislation.

Science.gov (United States)

Nunziato, Travis

2014-01-01

"You Say Tomato, I Say Solanum Lycopersicum Containing Beta-ionone and Phenylacetaldehyde" discusses the importance of requiring labels on products that contain genetically modified organisms, focusing on Connecticut's GMO Labeling statutes, as it is they are the first of their kind in the nation. The article will compare Connecticut's law to the legislation found in Australia, highlighting the positive aspects of Connecticut's bill and identifying its key weaknesses, namely the "trigger clause" found in the statute. Part I will provide an overview of Genetic Modification and provide a brief history of Biotechnology. It will also provide a brief overview of the federal regulatory framework in biotechnology, as well as evaluate the United States Food and Drug Association's role of regulating genetic modification. Part I will conclude by discussing how the American public has shown that labeling GMOs is important, and something that should occur. Part II of this article will explore Connecticut's recent legislation requiring labels on products that contain GMOs. Part III will explore Australia's legislation requiring labels on products containing GMOs, comparing Australia's law to Connecticut's legislation.

Attitudes and beliefs regarding direct-to-consumer advertising of pharmaceutical drugs: an exploratory comparison of physicians and pharmaceutical sales representatives.

Science.gov (United States)

Schulz, Steven A; Broekemier, Gregory M; Burkink, Tim J

2014-01-01

Even with many changes in regulation in recent years, direct-to-consumer advertising (DTCA) of pharmaceutical drugs remains a complicated and contentious issue. Many in our society argue for increased legislation of DTCA while others believe that DTCA serves a useful purpose and should not be overregulated. This study was designed to compare attitudes and beliefs regarding DTCA held by two key stakeholder groups, physicians and pharmaceutical sales representatives. A questionnaire was created, pretested, and administered to 30 physicians and 30 pharmaceutical sales representatives to investigate these issues. Significant differences between these two groups were found and implications for DTCA are discussed.

The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians

Directory of Open Access Journals (Sweden)

Schopper Andrea

2010-10-01

Full Text Available Abstract Background Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation. In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008. Methods Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. Results There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. Conclusion A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.

National legislative and regulatory activities

International Nuclear Information System (INIS)

2016-01-01

This section treats of the following National legislative and regulatory activities: 1 - France: General legislation, regulations and instruments; Nuclear trade (including non-proliferation); International co-operation; 2 - India: Licensing and regulatory infrastructure; Liability and compensation; 3 - Ireland: Nuclear safety and radiological protection (including nuclear emergency planning); Transport of radioactive material; Nuclear trade (including non-proliferation); 4 - Lithuania: Licensing and regulatory infrastructure; Nuclear safety and radiological protection (including nuclear emergency planning); Radioactive waste management; 5 - Luxembourg: Nuclear safety and radiological protection (including nuclear emergency planning); 6 - Slovak Republic: International co-operation; General legislation, regulations and instruments; 7 - Spain: Radioactive materials (including physical protection); Radioactive waste management; 8 - United States: Licensing and regulatory infrastructure

Physicians and Insider Trading.

Science.gov (United States)

Kesselheim, Aaron S; Sinha, Michael S; Joffe, Steven

2015-12-01

Although insider trading is illegal, recent high-profile cases have involved physicians and scientists who are part of corporate governance or who have access to information about clinical trials of investigational products. Insider trading occurs when a person in possession of information that might affect the share price of a company's stock uses that information to buy or sell securities--or supplies that information to others who buy or sell--when the person is expected to keep such information confidential. The input that physicians and scientists provide to business leaders can serve legitimate social functions, but insider trading threatens to undermine any positive outcomes of these relationships. We review insider-trading rules and consider approaches to securities fraud in the health care field. Given the magnitude of the potential financial rewards, the ease of concealing illegal conduct, and the absence of identifiable victims, the temptation for physicians and scientists to engage in insider trading will always be present. Minimizing the occurrence of insider trading will require robust education, strictly enforced contractual provisions, and selective prohibitions against high-risk conduct, such as participation in expert consulting networks and online physician forums, by those individuals with access to valuable inside information.

Legislating for advocacy: The case of whistleblowing.

Science.gov (United States)

Watson, Chanel L; O'Connor, Tom

2017-05-01

The role of nurses as patient advocates is one which is well recognised, supported and the subject of a broad body of literature. One of the key impediments to the role of the nurse as patient advocate is the lack of support and legislative frameworks. Within a broad range of activities constituting advocacy, whistleblowing is currently the subject of much discussion in the light of the Mid Staffordshire inquiry in the United Kingdom (UK) and other instances of patient mistreatment. As a result steps to amend existing whistleblowing legislation where it exists or introduce it where it does not are underway. This paper traces the development of legislation for advocacy. The authors argue that while any legislation supporting advocacy is welcome, legislation on its own will not encourage or enable nurses to whistleblow.

Legislative Basis of Pedagogical Education in Japan

Science.gov (United States)

Kuchai, Tetiana

2014-01-01

Legal framework policy of Japan in the field of education has been analyzed. The problem of influence of legislative materials on the development of education in Japan, its legislative support has been considered. It has been defined that directive materials affect the development of education system in Japan. Legislation policy of the country is…

The congressional viewpoint: Deficit reduction and risk legislation

Energy Technology Data Exchange (ETDEWEB)

Chakoff, H.E.

1995-12-31

This presentation will provide a current congressional status of legislation related to low-level waste and DOE cleanup. Key legislation discussed will include S. 755 for Privatization of the Uranium Enrichment Corporation and the markup of H.R. 1020, the Nuclear Waste Legislation. In addition, the session will include a discussion of legislation related to the approval of the Texas compact.

The congressional viewpoint: Deficit reduction and risk legislation

International Nuclear Information System (INIS)

Chakoff, H.E.

1995-01-01

This presentation will provide a current congressional status of legislation related to low-level waste and DOE cleanup. Key legislation discussed will include S. 755 for Privatization of the Uranium Enrichment Corporation and the markup of H.R. 1020, the Nuclear Waste Legislation. In addition, the session will include a discussion of legislation related to the approval of the Texas compact

Legislation and regulatory infrastructure for the safety of radioactive waste management

International Nuclear Information System (INIS)

Hoegberg, L.

2000-01-01

The essential generic characteristics of a national legislative and regulatory system for the safety of radioactive waste management are defined and discussed. The Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management as well as other relevant international legal instruments and guidelines are discussed. Special emphasis is given to the following characteristics of a national legislative and regulatory system: (i) definition of responsibilities, (ii) financing of future costs, (iii) nuclear and radiation safety requirements, (iv) siting and licensing procedures, (v) regulatory functions, and (vi) international co-operation. It is concluded that there exists an internationally endorsed basis for establishing effective national legislation and regulatory infrastructures for the safety of radioactive waste management. It is underlined that the continuing internationalization of the nuclear industry stresses the need for national legislation and regulatory infrastructure to be based on such internationally endorsed principles and standards. It is pointed out that regulators are accountable to the public and have to gain public trust by being active in the public arena, demonstrating their competence and integrity. Finally, prescriptive and goal-oriented international safety regimes are briefly discussed in the light of experience so far gained with the Convention on Nuclear Safety. (author)

Towards Uniformity of Radiation Protection Legislation in a Multi-jurisdictional country- the Australian Experience

International Nuclear Information System (INIS)

Koperski, J. G.

2004-01-01

Australia is a federation of nine jurisdictions, each with independent radiation protection legislation. The existing legislative non-uniformity across the jurisdictions has constituted an impediment for operators who must comply with differing legislative requirements in different jurisdictions. To address this issue, a National Competition Policy Review of Radiation Protection Legislation took place in 2000/2001. It has produced 19 Recommendations, which addressed objectives of the legislation, the need to regulate, alternative regulatory approaches, national uniformity, licensing and registration, strict and prescriptive standards, advertising and promotional activities, compliance costs and cost recovery issues. The Review has recommended that jurisdictions should retain the regulatory approach to achieve radiation protection objectives rather than leave them to be decided by market forces. But the approach should be performance-based, i.e. outcome-focused rather than prescriptive. An Implementation Plan of the Recommendations has been created which, by the end of 2004, will produce the National Directory for Radiation Protection. The Directory, which will become a consolidated repository of radiation protection standards, guidelines, codes of practice and administrative principles will provide a uniform national framework for radiation protection legislation in Australia. It will provide guidance for the jurisdictions redrawing their legislations. Because of its central role in shaping future legislation, the Directory will contain only those provisions, which have passed a formal process (process for issue resolution) concluded by an approval by the Australian Health Ministers Conference. Such process will also expedite the uniform adoption nationwide of legislative trends emerging from international radiation protection recommendations and standards. This Australian model might be a viable example for other multi-jurisdictional countries to consider

New psychoactive substances legislation in Ireland - Perspectives from academia.

Science.gov (United States)

Kavanagh, Pierce V; Power, John D

2014-01-01

The emergence of 'legal highs' or 'new psychoactive substances' (NPS) on the Irish market is reflective of their appearance in many countries, with some notable exceptions. The official response to the situation is examined here by looking at Irish controlled drugs legislation and drug enforcement policies as enacted in recent years and their effects on academic research on NPS. The philosophy and practice of outright bans of scheduled substances has not been effective in delivering the stated aims of illicit drug control, namely harm reduction. With these legislative changes, we have witnessed the removal of the 'legitimate' sale and open marketing of a number of NPS to the general public in commercial retail premises. However, as legislation was enacted, suppliers and vendors rapidly changed the contents of their legal high products from now controlled to non-controlled substances. We have found that it is administratively challenging to perform scientific research on controlled substances at academic institutions. It is desirable to gather analytical, pharmacological, and toxicological data on these substances as they emerge on the market but due to the restrictive nature of licensing requirements, once a substance or generic class of substances is controlled, this becomes more difficult. The facts that any quantity of substance, no matter how small, is controlled, the nomenclature used to describe compounds is not consistent within the enacted legislation and the use of catch-all classes of compounds with the intention of controlling many similar molecular structures, all create problematic issues for academic researchers. Copyright © 2014 John Wiley & Sons, Ltd.

Legislation and Equality in Basic Education for All in China

Science.gov (United States)

Law, Wing-Wah; Pan, Su-Yan

2009-01-01

In China, legislation exists which requires compulsory schooling for all students of school age. This article examines the functions of and the constraints on using law to institutionalize equality in basic education. It argues that, in China, law is a last resort, holding governments of various levels accountable. Law can be a device of social…

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

should not be left unsupervised to care for critically ill patients. In settings in which the acuity is high, physicians who have completed residency should provide direct supervision for resident physicians. Supervising physicians should always be physically in the hospital for supervision of resident physicians who care for critically ill patientsThe ACGME should explicitly define "good" supervision by specialty and by year of training. Explicit requirements for intensity and level of training for supervision of specific clinical scenarios should be providedCenters for Medicare and Medicaid Services (CMS) should use graduate medical education funding to provide incentives to programs with proven, effective levels of supervision. Although this action would require federal legislation, reimbursement rules would help to ensure that hospitals pay attention to the importance of good supervision and require it from their training programs. RESIDENT PHYSICIAN WORK HOURS: Although the IOM "Sleep, supervision and safety" report provides a comprehensive review and discussion of all aspects of graduate medical education training, the report's focal point is its recommendations regarding the hours that resident physicians are currently required to work. A considerable body of scientific evidence, much of it cited by the Institute of Medicine report, describes deteriorating performance in fatigued humans, as well as specific studies on resident physician fatigue and preventable medical errors. The question before this conference was what work redesign and cultural changes are needed to reform work hours as recommended by the Institute of Medicine's evidence-based report? Extensive scientific data demonstrate that shifts exceeding 12-16 hours without sleep are unsafe. Several principles should be followed in efforts to reduce consecutive hours below this level and achieve safer work schedules. The recommendations are: Limit resident physician work hours to 12-16 hour maximum shifts

Progress in Slovak nuclear legislation in 2011-2012

International Nuclear Information System (INIS)

Pospisil, Martin

2012-01-01

In the legislative area, the Nuclear Regulatory Authority of the Slovak Republic focused on 3 basic topics. First, the Slovak Atomic Act (Act No. 541/2004 on peaceful use of nuclear energy) was amended to include provisions of Council Directive 2009/71/Euratom. The key changes concerned the definition of a nuclear installation, introduction of a definition of safety culture, detailed specification of administrative, technical, organisational and financial requirements for licensees aimed to ensure nuclear safety quality management. Second, preparatory work was done on 2 new regulations: regulation on the requirements for nuclear safety and regulation on quality management. Third, regulations encompassing changes in the Atomic Act were prepared. (orig.)

Transfer pricing as tax avoidance under different legislative schemes

OpenAIRE

Holzmann, Carolin Maria

2016-01-01

This paper investigates transfer pricing as tax avoidance before and after reforms of anti-avoidance legislation. The reforms introduced and tightened obligatory documentation requirements for transfer prices to enforce that multinational enterprises (MNEs) set internal transfer prices at an arm’s-length. Linking data from the Microdatabase Statistics on International Trade in Services that comprehends prices of MNEs’ international service transactions to the Microdatabase Direct Investment, ...

The practice and earnings of preventive medicine physicians.

Science.gov (United States)

Salive, M E

1992-01-01

A shortage of preventive medicine (PM) physicians exists in the United States. Researchers know little about these physicians' earnings and practice characteristics. The American College of Preventive Medicine (ACPM) mailed a survey to all self-identified PM physicians on the American Medical Association (AMA) Physician Masterfile. A total of 3,771 (54%) responded; respondents' sex and region of residence were typical for PM physicians in general, with a slight excess of older physicians and those reporting board certification. A total of 2,664 (71%) were working full time, with median earnings of $85,000 (mean $90,000). Among full-time physicians, relatively higher earnings were associated with the following characteristics: male sex; age 45 to 64 years; major source of income from clinical, business, or industrial sources, rather than governmental or academic; and PM board certification. Full-time PM physicians earned much less than office-based private practitioners in several primary care specialties in 1989. The gap in earnings between PM specialists in government positions and those in the private sector is also substantial. Both disparities may require creative solutions.

Equality, Legal Certainty and Tax Legislation in the Netherlands
Fundamental Legal Principles as Checks on Legislative Power: A Case Study

Directory of Open Access Journals (Sweden)

Hans Gribnau

2013-03-01

Full Text Available Fundamental legal principles may function as a check on legislative power protecting citizens against arbitrary interferences with their liberty. This contribution deals with the principle of equality and the principle of certainty. First, the testing of legislation against the principle of equality is presented as a case study of constitutional review. In the Netherlands, the constitutional dialogue between the legislator and the Dutch Supreme Court revolving around the principle of equality demonstrates a fair amount of subtle details. As a result, constitutional review can hardly be called an all or nothing affair.Secondly, retroactive tax legislation is dealt with. The legislator does seem to take the principle of legal certainty, another fundamental legal principle, quite seriously, although no testing of statutory legislation is possible by the courts. With regard to retroactive tax legislation the Government has committed itself in a memorandum, requested by Parliament, to adhere to rules of conduct with regard to different situations where it deems retroactive tax legislation to be justified. Thus, a soft law instrument facilitates a dialogue between different partners in the business of law-making.

From wastewater to fertilisers--Technical overview and critical review of European legislation governing phosphorus recycling.

Science.gov (United States)

Hukari, Sirja; Hermann, Ludwig; Nättorp, Anders

2016-01-15

The present paper is based on an analysis of the EU legislation regulating phosphorus recovery and recycling from wastewater stream, in particular as fertiliser. To recover phosphorus, operators need to deal with market regulations, health and environment protection laws. Often, several permits and lengthy authorisation processes for both installation (e.g. environmental impact assessment) and the recovered phosphorus (e.g. End-of-Waste, REACH) are required. Exemptions to certain registration processes for recoverers are in place but rarely applied. National solutions are often needed. Emerging recovery and recycling sectors are affected by legislation in different ways: Wastewater treatment plants are obliged to remove phosphorus but may also recover it in low quantities for operational reasons. Permit processes allowing recovery and recycling operations next to water purification should thus be rationalised. In contrast, the fertiliser industry relies on legal quality requirements, ensuring their market reputation. For start-ups, raw-material sourcing and related legislation will be the key. Phosphorus recycling is governed by fragmented decision-making in regional administrations. Active regulatory support, such as recycling obligation or subsidies, is lacking. Legislation harmonisation, inclusion of recycled phosphorus in existing fertiliser regulations and support of new operators would speed up market penetration of novel technologies, reduce phosphorus losses and safeguard European quality standards.

Legislating tolerance: Spain's national public smoking law.

Science.gov (United States)

Muggli, Monique E; Lockhart, Nikki J; Ebbert, Jon O; Jiménez-Ruiz, Carlos A; Riesco Miranda, Juan Antonio; Hurt, Richard D

2010-02-01

While Spain's national tobacco control legislation prohibits smoking in many indoor public places, the law provides for an exception to the prohibition of smoking by allowing separate seating sections and ventilation options in certain public places such as bars and restaurants, hotels and airports. Accordingly, Spain's law is not aligned with Article 8 Guidelines of the World Health Organization's Framework Convention on Tobacco Control, which requires parties to ensure universal protection against secondhand smoke exposure in all enclosed public places, workplaces and on all means of public transport. Spain's law is currently being promoted by the tobacco companies in other countries as a model for smoke-free legislation. In order to prevent weakening of smoke-free laws in other countries through industry-supported exceptions, we investigated the tactics used by the tobacco companies before the implementation of the new law and assessed the consequences of these actions in the hospitality sector. Internal tobacco industry documents made public through US litigation settlements dating back to the 1980s were searched in 2008-9. Documents show that tobacco companies sought to protect hospitality venues from smoking restrictions by promoting separate seating for smokers and ineffective ventilation technologies, supporting an unenforceable voluntary agreement between the Madrid local government and the hospitality industry, influencing ventilation standards setting and manipulating Spanish media. The Spanish National Assembly should adopt comprehensive smoke-free legislation that does not accommodate the interests of the tobacco industry. In doing so, Spain's smoke-free public places law would be better aligned with the Framework Convention on Tobacco Control.

Nuclear Regulatory Legislation

International Nuclear Information System (INIS)

1989-08-01

This compilation of statutes and material pertaining to nuclear regulatory legislation through the 100th Congress, 2nd Session, has been prepared by the Office of the General Counsel, US Nuclear Regulatory Commission, with the assistance of staff, for use as an internal resource document. Persons using this document are placed on notice that it may not be used as an authoritative citation in lieu of the primary legislative sources. Furthermore, while every effort has been made to ensure the completeness and accuracy of this material, neither the United States Government, the Nuclear Regulatory Commission, nor any of their employees makes any expressed or implied warranty or assumes liability for the accuracy or completeness of the material presented in this compilation

Legislative vulnerability of minority groups.

Science.gov (United States)

Paula, Carlos Eduardo Artiaga; Silva, Ana Paula da; Bittar, Cléria Maria Lôbo

2017-12-01

Minorities are in an inferior position in society and therefore vulnerable in many aspects. This study analyzes legislative vulnerability and aims to categorize as "weak" or "strong" the protection conferred by law to the following minorities: elderly, disabled, LGBT, Indians, women, children/ adolescents and black people. In order to do so, it was developed a documental research in 30 federal laws in which legal provisions were searched to protect minorities. Next, the articles were organized in the following categories: civil, criminal, administrative, labor and procedural, to be analyzed afterwards. Legal protection was considered "strong" when there were legal provisions that observed the five categories and "weak" when it did not meet this criterion. It was noted that six groups have "strong" legislative protection, which elides the assertion that minorities are outside the law. The exception is the LGBT group, whose legislative protection is weak. In addition, consecrating rights through laws strengthens the institutional channels for minorities to demand their rights. Finally, it was observed that the legislative protection granted tominorities is not homogeneous but rather discriminatory, and there is an interference by the majority group in the rights regulation of vulnerable groups.

[Attitudes of Polish occupational medicine physicians towards a proposal of requirements for occupational medicine training in Europe].

Science.gov (United States)

Indulski, J A; Boczkowski, A; Mikulski, M

1998-01-01

In order to determine key competences required of occupational medicine specialists, common throughout Europe, a questionnaire has been developed and distributed among several European countries. The questionnaire contained 115 subjects related to 8 fields of activities carried out by occupational medicine physicians (occupational hazards to health, assessment of disability and fitness for work, communications, research methods, management, environmental medicine, occupational health law and ethics, and health promotion). In each of these fields, competences were classified into three following categories: knowledge, experience and skills. Respondents were asked to allocate a score from 0 to 5 for each subject, where 0 = not necessary; 1 = of minimum importance, and 5 = most important or essential. In Poland the questionnaire was distributed among two groups of specialists: group I--experienced specialists in occupational medicine (leading representatives of occupational health care management), and group II--relatively younger and less experienced occupational medicine physicians, participating in the specialist training, organised by The Nofer Institute of Occupational Medicine. A comprehensive analysis of the completed questionnaires was carried out in two dimensions: substantive (the importance of individual competences as perceived by Polish specialists in occupational medicine), and comparative (evaluation and interpretation of similarities and differences between two groups of respondents). A hierarchy of requirements, occupational medicine training in Poland is to satisfy, was reconstructed with two sets of competences, one recognised by respondents as needless and the other recognised as useful with different grades of importance. Some characteristic differences in opinions between two groups studies were highlighted.

National legislative and regulatory activities

International Nuclear Information System (INIS)

Anon.

2009-01-01

This part gathers the national legislative and regulatory activities. The subjects tackled are as follow: radiological protection (Belgium), transport of radioactive materials (Belgium, France), general legislation (Brazil, Ireland, Republic of Moldova, Serbia, Turkey), third part liability (Japan), radioactive waste management (Korea, Romania, Slovenia, Usa), regime of radioactive materials (Romania), organisation and structure (Switzerland), regime of nuclear installations (Usa), regulations on nuclear trade (Usa). (N.C)

Legislation on university technology transfer and research management 2012

International Nuclear Information System (INIS)

2012-02-01

This book deals with legislation on university technology transfer in 2012, which includes invention promotion act, legislation on technology transfer and promotion of industrialization, legislation on industrial education and industrial cooperation, and special legislation on venture business. It lists the legislation related research and development by government department : fundamental law of scientific technique, law on evaluation and management of domestic research development business, national science and technology council and the patent office.

Physician leadership: a health-care system's investment in the future of quality care.

Science.gov (United States)

Orlando, Rocco; Haytaian, Marcia

2012-08-01

The current state of health care and its reform will require physician leaders to take on greater management responsibilities, which will require a set of organizational and leadership competencies that traditional medical education does not provide. Physician leaders can form a bridge between the clinical and administrative sides of a health-care organization, serving to further the organization's strategy for growth and success. Recognizing that the health-care industry is rapidly changing and physician leaders will play a key role in that transformation, Hartford HealthCare has established a Physician Leadership Development Institute that provides advanced leadership skills and management education to select physicians practicing within the health-care system.

Linking energy efficiency legislation and the agricultural sector in South Africa

Directory of Open Access Journals (Sweden)

Joseph N. Lekunze

2017-04-01

Full Text Available There are different ways of measuring energy efficiency. Although there is no generally agreed definition of the concept, it should, however, always be approached according to particular circumstances and contexts. As such, technological, operational, performance and equipment efficiencies should be taken into consideration. Generally, energy utilisation in most sectors of the South African economy is inefficient. This requires more energy needs to be generated in order to cater for losses. An increase in generation causes environmental problems at global, regional and local levels. A review of literature on energy efficiency was undertaken and a gap identified between legislation and efficiency in the agricultural sector. This article seeks to suggest ways of implementing an energy legislation in this sector in South Africa. Such implementation will address concerns in terms of harnessing, generating and utilising energy in different sectors in South Africa. Legislation is vital in reducing energy consumption in the agricultural sector. It also ensures efficient use of energy and the maintenance of current levels of production.

Physician practice management companies: should physicians be scared?

Science.gov (United States)

Scott-Rotter, A E; Brown, J A

1999-01-01

Physician practice management companies (PPMCs) manage nonclinical aspects of physician care and control physician groups by buying practice assets. Until recently, PPMCs were a favorite of Wall Street. Suddenly, in early 1998, the collapse of the MedPartners-PhyCor merger led to the rapid fall of most PPMC stock, thereby increasing wariness of physicians to sell to or invest in PPMCs. This article explores not only the broken promises made by and false assumptions about PPMCs, but also suggests criteria that physicians should use and questions would-be PPMC members should ask before joining. Criteria include: demonstrated expertise, a company philosophy that promotes professional autonomy, financial stability, freedom from litigation, and satisfied physicians already in the PPMC. The authors recommend that physicians seek out relatively small, single-specialty PPMCs, which hold the best promise of generating profits and permitting professional control over clinical decisions.

Regulating nanomaterials: bottlenecks and perspectives in EU legislation on chemicals and products

NARCIS (Netherlands)

Vogelezang-Stoute, E.

2012-01-01

This article examines some of the challenges that nanomaterials involve for the EU legislator, due to the specific features of these materials and their uncertain risks for human health and the environment. The reporting and information requirements for the marketing of nanomaterials form a focal

Mental health legislation and human rights in England, Wales and the Republic of Ireland.

Science.gov (United States)

Kelly, Brendan D

2011-01-01

In 2005, the World Health Organization (WHO) published its Resource Book on Mental Health, Human Rights and Legislation (Geneva: WHO) presenting a detailed statement of human rights issues which need to be addressed in national legislation relating to mental health. The purpose of this paper is to determine the extent to which revised mental health legislation in England, Wales (2007) and Ireland (2001) accords with these standards (excluding standards relating solely to children or mentally-ill offenders). Legislation in England and Wales meets 90 (54.2%) of the 166 WHO standards examined, while legislation in Ireland meets 80 standards (48.2%). Areas of high compliance include definitions of mental disorder, relatively robust procedures for involuntary admission and treatment (although provision of information remains suboptimal) and clarity regarding offences and penalties Areas of medium compliance relate to competence, capacity and consent (with a particular deficit in capacity legislation in Ireland), oversight and review (which exclude long-term voluntary patients and require more robust complaints procedures), and rules governing special treatments, seclusion and restraint. Areas of low compliance relate to promoting rights (impacting on other areas within legislation, such as information management), voluntary patients (especially non-protesting, incapacitated patients), protection of vulnerable groups and emergency treatment. The greatest single deficit in both jurisdictions relates to economic and social rights. There are four key areas in need of rectification and clarification in relation to mental health legislation in England, Wales and Ireland; these relate to (1) measures to protect and promote the rights of voluntary patients; (2) issues relating to competence, capacity and consent (especially in Ireland); (3) the role of "common law" in relation to mental health law (especially in England and Wales); and (4) the extent to which each jurisdiction

The relationship between physician humility, physician-patient communication, and patient health.

Science.gov (United States)

Ruberton, Peter M; Huynh, Ho P; Miller, Tricia A; Kruse, Elliott; Chancellor, Joseph; Lyubomirsky, Sonja

2016-07-01

Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical visit. Primary care physician-patient interactions (297 patients across 100 physicians) were rated for the physician's humility and the effectiveness of the physician-patient communication. Additionally, patients reported their overall health and physicians and patients reported their satisfaction with the interaction. Within-physician fluctuations in physician humility and self-reported patient health positively predicted one another, and mean-level differences in physician humility predicted effective physician-patient communication, even when controlling for the patient's and physician's satisfaction with the visit and the physician's frustration with the patient. The results suggest that humble, rather than paternalistic or arrogant, physicians are most effective at working with their patients. Interventions to improve physician humility may promote better communication between health care providers and patients, and, in turn, better patient outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Accounting for graduate medical education production of primary care physicians and general surgeons: timing of measurement matters.

Science.gov (United States)

Petterson, Stephen; Burke, Matthew; Phillips, Robert; Teevan, Bridget

2011-05-01

Legislation proposed in 2009 to expand GME set institutional primary care and general surgery production eligibility thresholds at 25% at entry into training. The authors measured institutions' production of primary care physicians and general surgeons on completion of first residency versus two to four years after graduation to inform debate and explore residency expansion and physician workforce implications. Production of primary care physicians and general surgeons was assessed by retrospective analysis of the 2009 American Medical Association Masterfile, which includes physicians' training institution, residency specialty, and year of completion for up to six training experiences. The authors measured production rates for each institution based on physicians completing their first residency during 2005-2007 in family or internal medicine, pediatrics, or general surgery. They then reassessed rates to account for those who completed additional training. They compared these rates with proposed expansion eligibility thresholds and current workforce needs. Of 116,004 physicians completing their first residency, 54,245 (46.8%) were in primary care and general surgery. Of 683 training institutions, 586 met the 25% threshold for expansion eligibility. At two to four years out, only 29,963 physicians (25.8%) remained in primary care or general surgery, and 135 institutions lost eligibility. A 35% threshold eliminated 314 institutions collectively training 93,774 residents (80.8%). Residency expansion thresholds that do not account for production at least two to four years after completion of first residency overestimate eligibility. The overall primary care production rate from GME will not sustain the current physician workforce composition. Copyright © by the Association of American medical Colleges.

The Political Economy of Collective Labour Legislation in Taiwan

Directory of Open Access Journals (Sweden)

James W. Y. Wang

2010-01-01

Full Text Available This article provides a seminal analysis of collective labour legislation in Taiwan. A chronological review of Taiwan’s legislative process suggests that the context of incorporation, institutional framework, mechanisms for delivering reforms, and sequence of reforms together shape the legislative outcomes of labour reforms at the collective level. While most labour legislation was revised and passed after the preceding sequence of economic transition, the reform of collective labour rights was greatly constrained by the flexible labour-market structure. In order for politicians to form new alliances with labour organizations, legislation of collective labour rights was a strategy to cultivate support during electoral periods. Consequently, the industrial relations changed following the enactment of substantial reform-oriented labour legislation. Theore-tically, the historical analysis of legislative procedure unveils evolutionary reform paths for collective labour rights in new democracies. At the same time, empirically, Taiwan demonstrates an alternative reform path in combination with incremental steps and progressive agendas. For new democracies of small economy, a window of opportunity for the progress in collective labour legislation remains open today, albeit with limitations.

Legislative Bargaining and Incremental Budgeting

OpenAIRE

Dhammika Dharmapala

2002-01-01

The notion of 'incrementalism', formulated by Aaron Wildavsky in the 1960's, has been extremely influential in the public budgeting literature. In essence, it entails the claim that legislators engaged in budgetary policymaking accept past allocations, and decide only on the allocation of increments to revenue. Wildavsky explained incrementalism with reference to the cognitive limitations of lawmakers and their desire to reduce conflict. This paper uses a legislative bargaining framework to u...

Physicians' Efficacy Requirements for Prescribing Medications to Persons with Alzheimer's Disease

Science.gov (United States)

Oremus, Mark; Wolfson, Christina; Bergman, Howard; Vandal, Alain C.

2007-01-01

Physicians (N=803) were contacted via postal survey and given two sets of efficacy measures for drug treatments in Alzheimer's disease: (a) the time that patients spend in a mild or moderate state of disease; (b) levels of modification to disease progression in the areas of cognition, behaviour, and mood, and ability to perform basic activities of…

Does State Legislation Improve Nursing Workforce Diversity?

Science.gov (United States)

Travers, Jasmine; Smaldone, Arlene; Cohn, Elizabeth Gross

2015-08-01

A health-care workforce representative of our nation's diversity is a health and research priority. Although racial and ethnic minorities represent 37% of Americans, they comprise only 16% of the nursing workforce. The purpose of this study was to examine the effect of state legislation on minority recruitment to nursing. Using data from the National Conference of State Legislatures, American Association of Colleges of Nursing, and U.S. census, we compared minority enrollment in baccalaureate nursing programs of states (Texas, Virginia, Michigan, California, Florida, Connecticut, and Arkansas) before and 3 years after enacting legislation with geographically adjacent states without legislation. Data were analyzed using descriptive and chi-square statistics. Following legislation, Arkansas (13.8%-24.5%), California (3.3%-5.4%), and Michigan (8.0%-10.0%) significantly increased enrollment of Blacks, and Florida (11.8%-15.4%) and Texas (11.2%-13.9%) significantly increased enrollment of Hispanic baccalaureate nursing students. States that tied legislation to funding, encouragement, and reimbursement had larger enrollment gains and greater minority representation. © The Author(s) 2015.

An analysis of state legislation on community trails.

Science.gov (United States)

Eyler, Amy; Lankford, Tina; Chriqui, Jamie; Evenson, Kelly R; Kruger, Judy; Tompkins, Nancy; Voorhees, Carolyn; Zieff, Susan; Aytur, Semra; Brownson, Ross

2010-03-01

Trails provide opportunities for recreation, transportation and activity. The purpose of this article is to describe state legislation related to community trails, to analyze legislation content, and to evaluate legislation on inclusion of evidence-informed elements. State trail legislation from 2001 to 2008 was identified using online legislative databases. An analysis of evidence-informed elements included in the legislation was conducted. These elements included: funding, liability, accessibility, connectivity, and maintenance. Of the total 991 trail bills, 516 (52.0%) were appropriations bills, of which 167 (32.2%) were enacted. We analyzed 475 (48%) nonappropriation trail bills of which 139 (29.3%) were enacted. The percentage of enactment of appropriations bills decreased over time while enactment of nonappropriations trail bills increased. Over half of the nonappropriations trail bills included at least 1 evidence-informed element, most commonly funding. Few bills contained liability, connectivity, accessibility, or maintenance. There is opportunity for providing evidence-informed information to policy-makers to potentially influence bill content. The number of bills with a funding element demonstrates that fiscal support for trails is an important policy lever that state legislatures may use to support trails. Lastly, trails should be considered in over-all state-level physical activity legislation to provide opportunities for communities to be active.

Physician views on practicing professionalism in the corporate age.

Science.gov (United States)

Castellani, B; Wear, D

2000-07-01

Arnold Relman argues that medical education does not prepare students and residents to practice their profession in today's corporate health care system. Corporate health care administrators agree: Physicians enter the workforce unskilled in contract negotiation, evidence-based medicine, navigating bureaucratic systems, and so forth. What about practicing physicians? Do they agree as well? According to this study, they do. Feeling like decentered double agents and unprepared, physicians find themselves professionally lost, struggling to balance issues of cost and care and expressing lots of negativity toward the cultures of medicine and managed care. However, physicians are resilient. A group of physicians, who may be called proactive, are meeting the professional demands of corporate health care by becoming sophisticated about its bureaucratic organization and the ways in which their professional and personal commitments fit within the system. Following the lead of proactive physicians, the authors support Relman's thesis and education for both students and physicians requires a major overhaul.

An Overview of Pending Asylum and Refugee Legislation in the US Congress

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Melanie Nezer

2014-05-01

Full Text Available There has been no significant legislation related to the asylum process enacted in Congress in nearly a decade.  In 1996, the Illegal Immigration Reform and Immigration Responsibility Act (IIRIRA became law, rolling back protections for asylum seekers by including a one-year deadline for filing asylum applications, subjecting asylum seekers to “expedited removal” procedures, and expanding the detention of asylum seekers. In 2005, Congress enacted the REAL ID Act, which created additional legal barriers to asylum, including new requirements for proving an asylum claim. During the past several sessions of Congress, bills have been introduced that would make significant changes to the country’s asylum laws and refugee admissions program. This paper provides an overview of the pending legislation and the changes proposed.  This overview is instructive in understanding (1 which members of Congress have demonstrated interest and leadership in refugee and asylum issues; (2 which refugee and asylum reform issues have been of most interest to members of Congress in recent years; (3 the different approaches to refugee and asylum issues by members of Congress who have shown leadership on these issues; and (4 which provisions have been enacted, which have gained traction, and which remain pending without significant movement through the legislative process.While it is difficult to imagine in the current partisan climate how any asylum or refugee legislation could be enacted into law, some legislative provisions have been reintroduced over a number of sessions of Congress and some have a history of bipartisan support.  Legislation focused on a group of particular interest or concern to members of Congress could gain traction.  A more comprehensive legislative approach framed by the need generally to improve the system could be less effective, particularly in the context of the years-long stalemate on comprehensive immigration reform

Perspectives for environmental radiation protection in EU radiation protection legislation

International Nuclear Information System (INIS)

Janssens, A.

2000-01-01

The basis of EU radiation protection legislation is the EURATOM Trealy. It is discussed whether the Treaty offers a legal basis for the protection of the natural environment. The incorporation of provisions pertaining to the nuclear fuel cycle or to radioactive substances in general environmental legislation is explained, as well as the possible implications of international conventions subscribed by the European Union. The European Commission is in the process of developing an overall approach to risk analysis for the protection of health, consumer interests, and the environment. It is examined to what extent the consideration of the impact of radiation on the natural environment fits in the overall framework and whether the principles underlying classical radiation protection are applicable to biota. Specific attention is given to situations where high levels of environmental radioactivity would require intervention. (Author)

Swiss legislation on dog ownership

CERN Multimedia

DSU Department

2008-01-01

The Swiss Permanent Mission in Geneva has requested CERN to inform the members of its personnel that a notice relating to Swiss legislation on dog ownership has been published on-line at the following address: http://www.eda.admin.ch/eda/en/home/topics/intorg/un/unge/gepri/pet.html This legislation is applicable to all international civil servants who own a dog. Relations with the Host States Service mailto:relations.secretariat@cern.ch http://www.cern.ch/relations/

Environmental legislation as the legal framework for mitigating natural hazards in Spain

Science.gov (United States)

Garrido, Jesús; Arana, Estanislao; Jiménez Soto, Ignacio; Delgado, José

2015-04-01

In Spain, the socioeconomic losses due to natural hazards (floods, earthquakes or landslides) are considerable, and the indirect costs associated with them are rarely considered because they are very difficult to evaluate. The prevention of losses due to natural hazards is more economic and efficient through legislation and spatial planning rather than through structural measures, such as walls, anchorages or structural reinforcements. However, there isn't a Spanish natural hazards law and national and regional sector legislation make only sparse mention of them. After 1978, when the Spanish Constitution was enacted, the Autonomous Communities (Spanish regions) were able to legislate according to the different competences (urban planning, environment or civil protection), which were established in the Constitution. In the 1990's, the Civil Protection legislation (national law and regional civil protection tools) dealt specifically with natural hazards (floods, earthquakes and volcanoes), but this was before any soil, seismic or hydrological studies were recommended in the national sector legislation. On the other hand, some Autonomous Communities referred to natural hazards in the Environmental Impact Assessment legislation (EIA) and also in the spatial and urban planning legislation and tools. The National Land Act, enacted in 1998, established, for the first time, that those lands exposed to natural hazards should be classified as non-developable. The Spanish recast text of the Land Act, enacted by Royal Legislative Decree 2/2008, requires that a natural hazards map be included in the Environmental Sustainability Report (ESR), which is compulsory for all master plans, according to the provisions set out by Act 9/2006, known as Spanish Strategic Environmental Assessment (SEA). Consequently, the environmental legislation, after the aforementioned transposition of the SEA European Directive 2001/42/EC, is the legal framework to prevent losses due to natural hazards

How to save distressed IDS-physician marriages: a case study.

Science.gov (United States)

Collins, H; Johnson, B A

1998-04-01

A hospital-driven IDS that encounters serious problems resulting from ownership of a physician practice should address those problems by focusing on three core areas: vision and leadership, effectiveness of operations, and physician compensation arrangements. If changes in these areas do not lead to improvements, the IDS may need to consider organizational restructuring. In one case study, a hospital-driven IDS faced the problem of owning a poorly performing MSO with a captive physician group. The IDS's governing board determined that the organization lacked effective communication with the physicians and that realization of the organization's vision would require greater physician involvement in organizational decision making. The organization is expected to undergo some corporate reorganization in which physicians will acquire an equity interest in the enterprise.

Can visual arts training improve physician performance?

Science.gov (United States)

Katz, Joel T; Khoshbin, Shahram

2014-01-01

Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts - a subset of medical humanities - into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation.

Matrix organization increases physician, management cooperation.

Science.gov (United States)

Boissoneau, R; Williams, F G; Cowley, J L

1984-04-01

Because of the development of multihospital systems and the establishment of diagnosis related groups, hospitals increasingly will establish matrix organizations for their corporate structures. St. Luke's Hospital adopted the matrix concept in the mid-1970s, utilizing program administrators for each specialty service or "clinical center of excellence." Such centers have been developed in digestive diseases, cardiovascular and pulmonary medicine, orthopedics and rheumatology, ophthalmology, and behavioral health. The program administrator's functions are diverse: To serve as primary liaison between physicians and the hospital; To project levels of program utilization and patient and physician satisfaction, to identify areas requiring administrative and marketing emphasis, and to develop the program's marketing plan; To develop, implement, and evaluate the program's strategic, operational, and financial plans; To recruit physicians to practice at St. Luke's and to cultivate referrals from outside physicians; To participate in selecting members of all board and medical staff committees relating to the particular specialty area; and To determine the need for new programs within the specialty area and to develop services. As indicated by a medical staff survey, most physicians at St. Luke's believe that the program administrator system has improved communication with the hospital administration, that the program administrator is able to respond effectively to physician requests and problems, and that the quality of patient care has been enhanced. A great majority said they would recommend the system to other hospitals.

The Indian civil liability for nuclear damage act, 2010. Legislation with flaws?

International Nuclear Information System (INIS)

Pelzer, Norbert

2011-01-01

1. India has had no special legislation so far about liability under civil law for nuclear damage. Instead, the general law about damages outside of contractual provisions applied. 2. The ambitious Indian civil nuclear program requires intensified international cooperation. The potential partners in that cooperation demand that liability regulations be adopted on the basis of the principles of the international nuclear liability conventions so as to grant legal assurance to their export industries. 3. In May 2010, draft liability legislation was introduced into the Indian parliament. Final deliberations were held on August 30, 2010. On September 21, 2010, the President confirmed the draft legislation, thereby making it law. The draft legislation had been a matter of dispute in India from the outset. 4. The law applies to nuclear facilities owned or controlled by the Indian central government. Only the government or government institutions or state-owned companies can be owners of a nuclear facility. The owner is liable without fault having to be proven. The details of liability follow the provisions of the liability conventions. 5. The law provides for legal channelling of liability to the owner of a nuclear facility. 6. Regular courts of law have no competence to rule about claims for damages under the law. Instead, a 'Claims Commissioner' appointed ad hoc by the government, or a 'Nuclear Claims Commission,' are competent. 7. The 2010 Indian nuclear liability law is a piece of legislation with deficiencies. Key elements are incompatible with the principles of international nuclear liability regimes. (orig.)

Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity.

Science.gov (United States)

Contratto, Erin; Romp, Katherine; Estrada, Carlos A; Agne, April; Willett, Lisa L

2017-05-01

To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured. Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%-100%), personal balance (43%-71%), and burnout (weekly, 43%-14%; callousness, 14%-0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April-June 2014; after, April-June 2015; range -9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention. This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

LEGISLATIVE, ACCOUNTING AND FISCAL NON-CONFORMITIES

Directory of Open Access Journals (Sweden)

PALIU – POPA LUCIA

2016-12-01

Full Text Available In the context of the debate analysis from the last decades on the relationship between accounting and taxation, independence or dependence of the accounting rules from the tax ones and taking into consideration that the independence of the two leads to permanent and even significant differences between the accounting and tax profit, I found that certain terms are regulated differently in accounting legislation in our country compared to fiscal one or the legislation in the economic field. Taken from this perspective the main objective of this scientific approach is the identification of accounting and tax legislative nonconformities and the proposal of the ways to solve them so as to eliminate, where possible, differentiated professional interpretations.

LEGISLATIVE, ACCOUNTING AND FISCAL NON-CONFORMITIES

Directory of Open Access Journals (Sweden)

PALIU – POPA LUCIA

2017-12-01

Full Text Available In the context of the debate analysis from the last decades on the relationship between accounting and taxation, independence or dependence of the accounting rules from the tax ones and taking into consideration that the independence of the two leads to permanent and even significant differences between the accounting and tax profit, I found that certain terms are regulated differently in accounting legislation in our country compared to fiscal one or the legislation in the economic field. Taken from this perspective the main objective of this scientific approach is the identification of accounting and tax legislative nonconformities and the proposal of the ways to solve them so as to eliminate, where possible, differentiated professional interpretations.

CFC legislation in the European Union

Directory of Open Access Journals (Sweden)

Cvjetković Cvjetana M.

2015-01-01

Full Text Available In this paper the author considers CFC legislation in the Member States of the European Union, and points to the official attitude of the institutions of the European Union toward CFC legislation. Special attention in this paper is focused on Judgment of the Court of Justice of the European Union in the case Cadbury Schweppes. The aim of the paper is to analyze CFC legislation in the Member States in order to determine its basic characteristics, as well as to determine its compatibility with freedoms guaranteed by the primary law of the European Union, i.e. with Judgment of the Court of Justice of the European Union in the Cadbury Schweppes case.

The Role of Physicians in State-Sponsored Corporal Punishment.

Science.gov (United States)

Muaygil, Ruaim

2016-07-01

The question of whether there is justification for physicians to participate in state-sanctioned corporal punishment has prompted long and heated debates around the world. Several recent and high-profile sentences requiring physician assistance have brought the conversation to Saudi Arabia. Whether a physician is asked to participate actively or to assess prisoners' ability to withstand this form of punishment, can there be an ethical justification for medical training and skills being put toward these purposes? The aim of this article is to examine aspects of Islamic law along with the different professional and religious obligations of Saudi Arabian physicians, and how these elements may inform the debate.

Waste to energy plant operation under the influence of market and legislation conditioned changes

DEFF Research Database (Denmark)

Tomic, Tihomir; Dominkovic, Dominik Franjo; Pfeifer, Antun

2017-01-01

, waste-to-energy plants need to be adapted to market operation. This influence is tracked by the gate-fee volatility. The operation of the waste-to-energy plant on electricity markets is simulated by using EnergyPLAN and heat market is simulated in Matlab, based on hourly marginal costs. The results have......In this paper, gate-fee changes of the waste-to-energy plants are investigated in the conditions set by European Union legislation and by the introduction of the new heat market. Waste management and sustainable energy supply are core issues of sustainable development of regions, especially urban...... areas. These two energy flows logically come together in the combined heat and power facility by waste incineration. However, the implementation of new legislation influences quantity and quality of municipal waste and operation of waste-to-energy systems. Once the legislation requirements are met...

Guns, schools, and mental illness: potential concerns for physicians and mental health professionals.

Science.gov (United States)

Hall, Ryan Chaloner Winton; Friedman, Susan Hatters

2013-11-01

Since the recent shootings in Tucson, Arizona; Aurora, Colorado; and Newtown, Connecticut, there has been an ever-increasing state and national debate regarding gun control. All 3 shootings involved an alleged shooter who attended college, and in hindsight, evidence of a mental illness was potentially present in these individuals while in school. What appears to be different about the current round of debate is that both pro-gun control and anti-gun control advocates are focusing on mentally ill individuals, early detection of mental illness during school years, and the interactions of such individuals with physicians and the mental health system as a way to solve gun violence. This raises multiple questions for our profession about the apparent increase in these types of events, dangerousness in mentally ill individuals, when to intervene (voluntary vs involuntary), and what role physicians should play in the debate and ongoing prevention. As is evident from the historic Tarasoff court case, physicians and mental health professionals often have new regulations/duties, changes in the physician-patient relationship, and increased liability resulting from high-profile events such as these. Given that in many ways the prediction of who will actually commit a violent act is difficult to determine with accuracy, physicians need to be cautious with how the current gun debate evolves not only for ourselves (eg, increased liability, becoming de facto agents of the state) but for our patients as well (eg, increased stigma, erosion of civil liberties, and changes in the physician-patient relationship). We provide examples of potential troublesome legislation and suggestions on what can be done to improve safety for our patients and for the public. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Forecasting the global shortage of physicians: an economic- and needs-based approach

Science.gov (United States)

Liu, Jenny X; Kinfu, Yohannes; Dal Poz, Mario R

2008-01-01

Abstract Objective Global achievements in health may be limited by critical shortages of health-care workers. To help guide workforce policy, we estimate the future demand for, need for and supply of physicians, by WHO region, to determine where likely shortages will occur by 2015, the target date of the Millennium Development Goals. Methods Using World Bank and WHO data on physicians per capita from 1980 to 2001 for 158 countries, we employ two modelling approaches for estimating the future global requirement for physicians. A needs-based model determines the number of physicians per capita required to achieve 80% coverage of live births by a skilled health-care attendant. In contrast, our economic model identifies the number of physicians per capita that are likely to be demanded, given each country’s economic growth. These estimates are compared to the future supply of physicians projected by extrapolating the historical rate of increase in physicians per capita for each country. Findings By 2015, the global supply of physicians appears to be in balance with projected economic demand. Because our measure of need reflects the minimum level of workforce density required to provide a basic health service that is met in all but the least developed countries, the needs-based estimates predict a global surplus of physicians. However, on a regional basis, both models predict shortages for many countries in the WHO African Region in 2015, with some countries experiencing a needs-based shortage, a demand-based shortage, or both. Conclusion The type of policy intervention needed to alleviate projected shortages, such as increasing health-care training or adopting measures to discourage migration, depends on the type of shortage projected. PMID:18670663

Survey of United States Army Physician Opinion: The Issue of Written ’Do Not Resuscitate’ Orders

Science.gov (United States)

1984-08-01

Westminister Press, 1975), p. 176-7. 71Cushing, p. 29. 72Alexander, p. 26. 73Kevin M. McIntyre, "Mediolegal Aspects of Decision Making in Resuscitation and Life...34Physicians Opinions Toward Legislation Defining Death and Withholding Life Support," Southern Medical Journal 74 (February 1981): 215-18. 82Norman K...Louis S. Let the Patient Decide. Philadelphia: The Westminister Press, 1978. Browning, Mary H. and Lewis, Edith P. comps. The Dying Patient: A Nursing

Accountability legislation: Implications for financial and performance reporting

Directory of Open Access Journals (Sweden)

Daphne Rixon

2012-03-01

Full Text Available The purpose of this case study is to first examine the implications of accountability legislation on the financial and performance reporting of a public sector agency in the Canadian province of Newfoundland and Labrador and secondly, to compare the level of accountability with Stewart’s (1984 ladder of accountability. This paper is based on the first phase of a two-phase study. The first phase focuses on the initial impacts of accountability legislation on agencies and the challenges created by the legislation’s ‘one size fits all’ approach. The second phase of this study will examine the impact of the legislation on stakeholders after it has been in operation for five years. The second phase will include interviews with stakeholders to ascertain the level of satisfaction with the new legislation. The first phase of the study is significant since it highlights how governments could consider stakeholder needs when drafting such legislation. This research contributes to the body of literature on stakeholder accountability since there is a paucity of research focused specifically on the impact of accountability legislation on public sector agencies. An important contribution of this paper is the introduction of a framework for legislated accountability reporting. The main theoretical frameworks used to analyse the findings are Stewart’s (1984 ladder of accountability in conjunction with Friedman and Miles (2006 ladder of stakeholder management and engagement.

A Survey of Italian Physicians' Opinion about Stem Cells Research: What Doctors Prefer and What the Law Requires

Directory of Open Access Journals (Sweden)

Paola Frati

2014-01-01

Full Text Available To evaluate the Italian physicians' knowledge/information level about the therapeutic potential of stem cells, the research choice between embryonic and cordonal stem cells, and the preference between autologous and heterologous storage of cordonal stem cells, we performed a national survey. The questionnaire—distributed to 3361 physicians—involved physicians of different religious orientations and of different medical specialities. Most of the physicians involved (67% were Catholics, and the majority were gynaecologists and paediatricians (43% who are mainly in charge to inform future mothers about the possibility of cordonal stem cells conservation. The majority of the physicians interviewed do not have specific knowledge about stem cells (59%, most of them having only generic information (92%. The largest part of physicians prefer to use umbilical cord blood cells rather than embryonic stem cells. Nevertheless, a large percentage of physicians were in favour of embryo research, especially when embryos are supernumerary (44% versus 34%. Eighty-seven % of the physicians interviewed proved to have a general knowledge about stem cells and believe in their therapeutic potential. They prefer research on cordonal stem cells rather than on embryo stem cells. Although they are in favour of heterologous stem cells donation, they still prefer cryopreservation for personal use.

The role of cognitive reasoning and decision making and user testing in the enhancement of communication of legislative messages in a digital age

Directory of Open Access Journals (Sweden)

Andrew Nkunika

2015-06-01

Full Text Available Legislative drafting is an essential means devised for the facilitation of the implementation of government policies by governments in various jurisdictions. The drafting of legislation has to take into account the various users of the legislation and balance their various interests while maintaining the policy objectives for which the legislation is enacted.  The changing needs of the users of legislation have necessitated the revision of the manner in which regulatory messages are communicated to users more effectively.  The changing needs of users consequently require constant analysis in order to ensure that the legislation developed is increasingly capable of more effective implementation. Legislation has traditionally been viewed as a complex and technical myriad of words that are beyond the attainment of an ordinary user despite it being designed to regulate the very fabric of the user’s existence in a civilised society. Further, legislation has in some instances been criticised from being too detached from the aspiration of the people that it regulates. This challenge is further exacerbated by the fact that compliance with increasingly complex legislation is becoming more and more essential as society continues to evolve and be influenced by technology and other factors that require a revision of the traditional view and utility of legislation. The changing uses of legislation and the increasing diversity of its users has given rise to the increased need to test the usability of legislation in order to ensure that the regulatory messages that it presents are usable by the various audiences at which it is targeted, on a cognitive level, in order to ensure its universal application to the greatest extent possible. This discussion aims to examine the role of cognitive reasoning and decision making as well as user testing in the legislative drafting process and how this can be used to ensure more effective communication of regulatory

Turkish nuclear legislation: Developments for a nuclear newcomer

International Nuclear Information System (INIS)

Ercan, Erinc; Schneider, Horst

2013-01-01

The scope of legal investigation in this article focuses on nuclear legislation with regard to siting, construction, operation and decommissioning of NPPs, taking into account the main issues of nuclear safety, security, safeguards, radiological protection and nuclear third party liability. The state of existing legislation and, furthermore, of drafts published or announced related to substantive regulations and organisational aspects are at the centre of this article. International conventions and agreements, national legislation consisting of the constitution, laws, decrees and regulations as binding norms and otherwise, directives and non-binding guides provide the legal structure for nuclear activities. The evaluation of Turkish nuclear legislation with regard to the accomplishment of the obligations under, in particular, the CNS and Euratom directives, leads finally to the perspective on the specific issues that should be addressed in the regulation of nuclear energy for Turkey's future energy needs and to ensure conformity with international standards of the International Atomic Energy Agency (IAEA) and the OECD Nuclear Energy Agency (NEA). A brief discussion of Turkish energy legislation and institutional structure is necessary, because NPPs also need a licence for electricity production under Turkey's energy legislation. The Turkish government is aiming for greater privatisation in the energy sector. The current electricity market is governed, on the one hand, by the Electricity Market Law and Electricity Market License Regulation, which requires NPPs to have an electricity production licence and, on the other hand, by specific institutions. In terms of the Electricity Market Law, private legal entities who wish to obtain an electricity generation licence must 'be established as incorporated or limited liability companies in accordance with the provisions of the Turkish Commercial Law'. The relevant institutions in Turkey's energy sector include: the Energy

Thermoelectric power plant legislation in Italy: Public participation

International Nuclear Information System (INIS)

Dell'Anno, P.

1991-01-01

Existing Italian legislation describes public involvement in fossil fuel power plant environmental impacts assessments as merely the opportunity to express interest, since it does not acknowledge, in the usual procedural formulas, any actual role to be played by the public. This paper illustrates this point in its examination of the myriad of procedural requirements prescribed by Italian laws governing power plant feasibility analyses. It demonstrates that the recent addition of the environmental element to the standard economic and technological elements in proposal evaluations requires that efforts be made to reduce the complexity of administrative procedures, and that mechanisms be created to allow the public, who will be most affected by any final ruling, a greater say in the decision making

Acid rain legislation and local areas

International Nuclear Information System (INIS)

Jones, G.H.B.

1992-01-01

This study explores the local economic impacts of the phase I requirements of the 1990 acid rain legislation. This legislation allows electric utilities to adopt least cost ways of reducing sulfur dioxide pollution. The impact on employment, income and size distribution of income due to a switch to low sulfur coal is examined for a selected number of high sulfur coal producing counties in southern Illinois. In order to achieve the above objectives a generalized non-survey input-output model, IMPLAN (Impact Analysis for Planning), is employed to estimate first- and second-order employment and income effects of a switch to low sulfur coal. Two models, I and II, are constructed to provide these estimates. In Model I, income is generated and adjusted to reflect income retained and spent within the four county region. In Model II, no adjustment is made for flows into and out of the region. In addition to adjustments in income, adjustments in direct employment impacts were made in both models to account for retirements. Scenarios reflecting different degrees of coal switching, low and high switching options, were examined under both models. With regards to size distribution impacts, a newly developed operational model compatible with IMPLAN and developed by Rose et al (1988) was employed. This model is a member of a class of models collectively termed extended input-output models. As in the case of employment and income, allowance was made for income generated, retained and spent within the four counties in the assessment of income distribution impacts. The findings indicate that the adverse effects of a switch to low sulfur coal under the 1990 acid rain legislation will primarily hurt the coal mining industry. Coal mining employment and income will be adversely affected. Employment and income declines in other industries in the region will be fairly slight. Second, income distribution becomes slightly more equal for the local area due to acid rain control

Can Visual Arts Training Improve Physician Performance?

Science.gov (United States)

Katz, Joel T.; Khoshbin, Shahram

2014-01-01

Clinical educators use medical humanities as a means to improve patient care by training more self-aware, thoughtful, and collaborative physicians. We present three examples of integrating fine arts — a subset of medical humanities — into the preclinical and clinical training as models that can be adapted to other medical environments to address a wide variety of perceived deficiencies. This novel teaching method has promise to improve physician skills, but requires further validation. PMID:25125749

Administrative, institutional and legislative issues on agricultural waste exploitation in Turkey

International Nuclear Information System (INIS)

Kaya, Durmus; Baban, Ahmet; Dikec, Stephanie; Canka Kilic, Fatma

2008-01-01

In this study, the influence of non-technical issues on the exploitation of agricultural waste in Turkey was investigated in accordance with the work program requirements for the project entitled ''Exploitation of Agricultural Waste in Turkey'' under the EU Life Third Countries Program. The study has been organized and presented according to the following four phases: (i) study of existing Turkish legislation and the administrative and institutional framework, (ii) review and analysis of the EU policy and legislation relevant to agricultural waste, including identification of potential market instruments, (iii) identification of barriers to the promotion of agricultural waste exploitation in Turkey, and (iv) Identification of gaps and formulation of recommendations. An ultimate objective of this study is to transfer the European experience and practices relative to the overall framework of managing agricultural waste. (author)

The relationship between administrative court control and legislative control

International Nuclear Information System (INIS)

Beckmann, M.

1986-01-01

The legislator can determine the extent of control of administrative courts by reduction of substantive conditions. The author has the opinion that the judicial control cannot be stricter than the legislative control. For the range of the control of administrative courts is decisive, to what extent the legislator is forced to proper legislative settlements. In this context the author discusses the Kalkar-decision of the Federal Constitutional Court of 1978. (CW) [de

Dissolution Threats and Legislative Bargaining

DEFF Research Database (Denmark)

Becher, Michael; Christiansen, Flemming Juul

2015-01-01

Chief executives in many parliamentary democracies have the power to dissolve the legislature. Despite a well-developed literature on the endogenous timing of parliamentary elections, political scientists know remarkably little about the strategic use of dissolution power to influence policymaking....... To address this gap, we propose and empirically evaluate a theoretical model of legislative bargaining in the shadow of executive dissolution power. The model implies that the chief executive's public support and legislative strength, as well as the time until the next constitutionally mandated election...

Electronic Health Record Use a Bitter Pill for Many Physicians.

Science.gov (United States)

Meigs, Stephen L; Solomon, Michael

2016-01-01

Electronic health record (EHR) adoption among office-based physician practices in the United States has increased significantly in the past decade. However, the challenges of using EHRs have resulted in growing dissatisfaction with the systems among many of these physicians. The purpose of this qualitative multiple-case study was to increase understanding of physician perceptions regarding the value of using EHR technology. Important findings included the belief among physicians that EHR systems need to be more user-friendly and adaptable to individual clinic workflow preferences, physician beliefs that lack of interoperability among EHRs is a major barrier to meaningful use of the systems, and physician beliefs that EHR use does not improve the quality of care provided to patients. These findings suggest that although government initiatives to encourage EHR adoption among office-based physician practices have produced positive results, additional support may be required in the future to maintain this momentum.

Сoncept of national legislative initiative and its types

Directory of Open Access Journals (Sweden)

А. Л. Крутько

2015-11-01

Full Text Available . National legislative initiative is a new instrument of popular wills demonstration as compared to different forms of direct democracy. In most of developed democracies this institution regulated at the constitutional/ legislative level. But in the modern Ukraine its constitutional legal regulation is absent, due disregard of its possibilities and lack of understanding of its essence. Paper objective. This article an aim is to analyze in details the definition of «national legislative initiative» and determinate its basic types according to theoretical insights and foreign current law. Recent research and publications analysis. The domestic and foreign scholars works on scientific research of national legislative initiative institution such as V.N. Rudenko, O.M. Mudra, V.M. Shapoval, V.F. Nesterovich, J. F. Zimmerman and etc. Their works were foundational at the time of writing. Paper main body. With the help of big definition dictionary and new encyclopedic dictionary it was found the etymology of the concept «initiative» which is characterized as the basis, also found meaning of «legislative initiative», «national initiative» and «national legislative initiative». It was argued impossibility an identification of «national initiative» with «national legislative initiative». The current definitions of the national legislative initiative were analyzed in the article. It was noted that suggested terms were limited only by identification of institute’s apparent indicator and withhold essence. This is precisely why four types of the national legislative initiative’s realization are briefly examined for the complex determination of the definition. These types depending on what role the legislator are assigning to citizen, who are the main actors of initiative. And on the basis of this analysis the author provided his own definition of «the national legislative initiative». The author had notes that the proposed definition was not

The Association of Academic Health Sciences Libraries' legislative activities and the Joint Medical Library Association/Association of Academic Health Sciences Libraries Legislative Task Force.

Science.gov (United States)

Zenan, Joan S

2003-04-01

The Association of Academic Health Sciences Libraries' (AAHSL's) involvement in national legislative activities and other advocacy initiatives has evolved and matured over the last twenty-five years. Some activities conducted by the Medical Library Association's (MLA's) Legislative Committee from 1976 to 1984 are highlighted to show the evolution of MLA's and AAHSL's interests in collaborating on national legislative issues, which resulted in an agreement to form a joint legislative task force. The history, work, challenges, and accomplishments of the Joint MLA/AAHSL Legislative Task Force, formed in 1985, are discussed.

Legislative amendments and informal politics in the European Union

DEFF Research Database (Denmark)

Cross, James P.; Hermansson, Henrik

2017-01-01

the Commission’s proposals and the final legislative outcome passed by the European Union. It does so by implementing minimum edit distance algorithms to measure changes between legislative proposals and outcomes. The findings suggest that legislative amendments are determined by the formal and informal...... institutional structures in which negotiations take place and characteristics of the proposal itself. Our conclusions contribute to the ongoing debate on the nature and distribution of legislative powers in the European Union....

Educational Policy Making in the State Legislature: Legislator as Policy Expert.

Science.gov (United States)

Weaver, Sue Wells; Geske, Terry G.

1997-01-01

Examines the legislator's role as education policy expert in the legislative policymaking process. In a study of Louisiana state legislators, analysis of variance was used to determine expert legislators' degree of influence in formulating educational policy, given differences in policy types, information sources, and legislators' work roles.…

Nuclear Regulatory legislation

International Nuclear Information System (INIS)

1984-06-01

This compilation of statutes and material pertaining to nuclear regulatory legislation through the 97th Congress, 2nd Session, has been prepared by the Office of the Executive Legal Director, U.S. Nuclear Regulatory Commission, with the assistance of staff, for use as an internal resource document

Job Satisfaction Among Academic Family Physicians.

Science.gov (United States)

Agana, Denny Fe; Porter, Maribeth; Hatch, Robert; Rubin, Daniel; Carek, Peter

2017-09-01

Family physicians report some of the highest rates of burnout among their physician peers. Over the past few years, this rate has increased and work-life balance has decreased. In academic medicine, many report lack of career satisfaction and have considered leaving academia. Our aim was to explore the factors that contribute to job satisfaction and burnout in faculty members in a family medicine department. Six academic family medicine clinics were invited to participate in this qualitative study. Focus groups were conducted to allow for free-flowing, rich dialogue between the moderator and the physician participants. Transcripts were analyzed in a systematic manner by independent investigators trained in grounded theory. The constant comparison method was used to code and synthesize the qualitative data. Six main themes emerged: time (62%), benefits (9%), resources (8%), undervalue (8%), physician well-being (7%), and practice demand (6%). Within the main theme of time, four subthemes emerged: administrative tasks/emails (61%), teaching (17%), electronic medical records (EMR) requirements (13%), and patient care (9%). Academic family physicians believe that a main contributor to job satisfaction is time. They desire more resources, like staff, to assist with increasing work demands. Overall, they enjoy the academic primary care environment. Future directions would include identifying the specific time restraints that prevent them from completing tasks, the type of staff that would assist with the work demands, and the life stressors the physicians are experiencing.

Preventing non-communicable disease in Oman, a legislative review.

Science.gov (United States)

Al-Bahlani, Sabah; Mabry, Ruth

2014-06-01

The burden of non-communicable disease (NCD) is a major global concern and is projected to increase by 15% over the next 10 years. NCD is the leading cause of mortality in Oman and other countries of the Gulf Cooperation Council (GCC). Some of the most successful interventions to address NCD include legislations like banning smoking in public places. A desk review of available policies and legislations related to the behavioural risk factors of NCD from the GCC and from Oman was conducted with a focus on policies and legislations related to food, physical activity and tobacco. The review identified numerous documents; most were policies and resolutions related to tobacco control. Although only a few documents were laws, a majority were issued by non-health sectors. This policy review is the first effort in the GCC to consolidate information on the regulatory framework for the three key risk behaviours in the region, tobacco use, unhealthy diet and physical inactivity. Further work is needed to strengthen the regulatory framework, at both the national and regional levels, to strengthen tobacco control as well as to improve dietary patterns and physical activity levels. Given that a bulk of laws, regulations and policies are beyond the scope of the health sector, significant advocacy efforts are required to generate a multisectoral response. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Legislative policy in Brazil : limits and possibilities

NARCIS (Netherlands)

De, Paula F.

2018-01-01

This doctoral thesis discusses the limits and possibilities for developing a new legislative-regulatory policy in Brazil, understood as a public policy whose purpose is to improve the process of drafting legislation and regulation and to increase the quality of rules. It considers the

Tradition and change in power industry legislation

International Nuclear Information System (INIS)

Baur, J.F.; Boerner, B.; Friauf, K.H.; Salzwedel, J.; Selmer, P.

1986-01-01

On September 24-25, 1985 the 15th conference of the Institute for Energy Law took place in Cologne. This book contains five of the lectures held at the conference. They deal with the following subjects: Constitutional restrictions of autonomous energy policy of the Land governments; compulsory connection to and use of district heating; is there any necessity for amending the anti-trust law for reasons of energy policy; environmental law - planning law - gaps in the legislation concerning the energy sector; Energy Industry Law - are there legislative deficiencies, or is it an adequate, correct legislative instrument. (HSCH) [de

Medicare physician payment systems: impact of 2011 schedule on interventional pain management.

Science.gov (United States)

Manchikanti, Laxmaiah; Singh, Vijay; Caraway, David L; Benyamin, Ramsin M; Hirsch, Joshua A

2011-01-01

Physicians in the United States have been affected by significant changes in the patterns of medical practice evolving over the last several decades. The recently passed affordable health care law, termed the Patient Protection and Affordable Care Act of 2010 (the ACA, for short) affects physicians more than any other law. Physician services are an integral part of health care. Physicians are paid in the United States for their personal services. This payment also includes the overhead expenses for maintaining an office and providing services. The payment system is highly variable in the private insurance market; however, governmental systems have a formula-based payment, mostly based on the Medicare payment system. Physician services are billed under Part B. Since the inception of the Medicare program in 1965, several methods have been used to determine the amounts paid to physicians for each covered service. Initially, the payment systems compensated physicians on the basis of their charges. In 1975, just over 10 years after the inception of the Medicare program, payments changed so as not to exceed the increase in the Medical Economic Index (MEI). Nevertheless, the policy failed to curb increases in costs, leading to the determination of a yearly change in fees by legislation from 1984 to 1991. In 1992, the fee schedule essentially replaced the prior payment system that was based on the physician's charges, which also failed to live up to expectations for operational success. Then, in 1998, the sustainable growth rate (SGR) system was introduced. In 2009, multiple attempts were made by Congress to repeal the formula - rather unsuccessfully. Consequently, the SGR formula continues to hamper physician payments. The mechanism of the SGR includes 3 components that are incorporated into a statutory formula: expenditure targets, growth rate period, and annual adjustments of payment rates for physician services. Further, the relative value of a physician fee schedule

Evidence and argument in policymaking: development of workplace smoking legislation

Directory of Open Access Journals (Sweden)

Bero Lisa A

2009-06-01

Full Text Available Abstract Background We sought to identify factors that affect the passage of public health legislation by examining the use of arguments, particularly arguments presenting research evidence, in legislative debates regarding workplace smoking restrictions. Methods We conducted a case-study based content analysis of legislative materials used in the development of six state workplace smoking laws, including written and spoken testimony and the text of proposed and passed bills and amendments. We coded testimony given before legislators for arguments used, and identified the institutional affiliations of presenters and their position on the legislation. We compared patterns in the arguments made in testimony to the relative strength of each state's final legislation. Results Greater discussion of scientific evidence within testimony given was associated with the passage of workplace smoking legislation that provided greater protection for public health, regardless of whether supporters outnumbered opponents or vice versa. Conclusion Our findings suggest that an emphasis on scientific discourse, relative to other arguments made in legislative testimony, might help produce political outcomes that favor public health.

Moral autonomy in Australian legislation and military doctrine

Directory of Open Access Journals (Sweden)

Richard Adams

2013-09-01

Full Text Available Australian legislation and military doctrine stipulate that soldiers ‘subjugate their will’ to government, and fight in any war the government declares. Neither legislation nor doctrine enables the conscience of soldiers. Together, provisions of legislation and doctrine seem to take soldiers for granted. And, rather than strengthening the military instrument, the convention of legislation and doctrine seems to weaken the democratic foundations upon which the military may be shaped as a force for justice. Denied liberty of their conscience, soldiers are denied the foundational right of democratic citizenship and construed as utensils of the State. This article critiques the idea of moral agency in Australian legislation and military doctrine and is concerned with the obligation of the State to safeguard the moral integrity of individual soldiers, so soldiers might serve with a fully formed moral assurance to advance justice in the world. Beyond its explicit focus on the convention of Australian thought, this article raises questions of far-reaching relevance. The provisos of Australian legislation and doctrine are an analogue of western thinking. Thus, this discussion challenges many assumptions concerning military duty and effectiveness. Discussion will additionally provoke some reassessment of the expectations democratic societies hold of their soldiers.

'Pivotal politics' in US energy and climate legislation

International Nuclear Information System (INIS)

Skodvin, Tora

2010-01-01

In the 110th Congress (2007-2008) legislation related to climate change was introduced at a faster pace than in any previous Congress, yet it did not result in a corresponding increase in enacted climate-related laws. A pertinent example of the political infeasibility of climate policy change in the 110th Congress is the case of tax credit extensions for production of renewable energy. While this issue in itself was uncontroversial, the extensions were only adopted in the 11th hour, after innumerable failed attempts. With an analytical point of departure in Krehbiel's theory of pivotal politics, this paper seeks to identify pivotal legislators in the case of the tax credit extensions and discusses how changes in the composition of pivotal legislators in the 111th Congress (2009-2010) may impact the prospects of moving climate legislation more generally. The analysis indicates that a majority of the legislative pivots in the case of tax credit extensions were Republican senators representing coal-producing states. In the case of climate change, however, the regional dimension is likely to be more significant for Democratic voting behaviour. Thus, the opportunity space for climate legislation in the 111th Congress remains narrow even with a reinforced Democratic majority in Congress.

Environmental Legislation in China: Achievements, Challenges and Trends

Directory of Open Access Journals (Sweden)

Zhilin Mu

2014-12-01

Full Text Available Compared to the environmental legislation of many developed countries, China’s environmental legislation was initiated late, beginning in 1979, but nevertheless has obtained considerable achievements. As many as thirty environmental laws have provided rules regarding prevention and control of pollution, resource utilization, and ecological protection in China. However, China’s environmental legislation still faces a series of challenges and problems, including that the sustainable development concept has not yet been fully implemented, as well as presence of gaps and non-coordination phenomena between laws and regulations, unclear responsibility, imperfect system design, imbalance between rights and obligations, higher impacts resulted from the GDP-centralized economy, lack of operability and instruments in the legal content, as well as difficulty of public participation. In contrast, China’s environmental legislation has improved, as a result of learning from experience in developed countries and introducing innovations stimulated by domestic environmental pressure. Looking into the future, increased attention to environmental protection and ecological consciousness paid by China’s new leaders will bring a valuable opportunity to China’s further development concerning environmental legislation. In the future, there are prospects for the gradual improvement of legal approaches, continuous improvements of legislation to mitigate environmental problems, and more opportunities to strengthen public participation can be predicted.

Colombian mining legislation

International Nuclear Information System (INIS)

Mendoza Delgado, Eva Isolina

2004-01-01

The paper makes a historical recount of the mining legislation in Colombia, it is about the more relevant aspects of the Code of Mines, like they are the title miner, obligations, economic aspects, integration of mining areas and of the benefits contemplated in the law 685 of 2001

Turnaround distressed physician practices. 20 tips for success.

Science.gov (United States)

Wolper, L F

1999-01-01

Physician practices are restructuring through merger and acquisition, and sale to practice management companies and to hospital systems. Many also are expanding internally by recruiting new physicians and opening additional offices. For many these strategies are working, but many others are experiencing operational and financial distress and failure that arise from rapid organizational growth without concomitant infrastructural change. Further, in the last several months, many national and regional practice management companies have decided to withdraw from the business, and others have declared bankruptcy. The number of physician practices that are in financial and operational distress is unprecedented. These groups require a solution, as proposed in this article.

Liver transplantation for nontransplant physicians

Directory of Open Access Journals (Sweden)

Amany AbdelMaqsod Sholkamy

2014-01-01

Full Text Available Many of the nontransplant physicians who manage hepatic patients (internists and hepatologists keep asking about liver transplantation. The purpose of this article is to highlight important topics a nontransplant colleague may require in his practice. There are many topics in this respect; however, three most important topics need to be highlighted; those are; the time of referral to transplantation, the indications and contraindications and the metabolic issues regarding a transplanted patient. Still, there are no clear guidelines for the management of many of the metabolic issues regarding liver transplanted patients. And this why, collaborative efforts of transplant and nontransplant physicians are needed to conduct multicenter, long term randomized controlled trials and proper follow up programs.

The Association of Academic Health Sciences Libraries' legislative activities and the Joint Medical Library Association/Association of Academic Health Sciences Libraries Legislative Task Force

OpenAIRE

Zenan, Joan S.

2003-01-01

The Association of Academic Health Sciences Libraries' (AAHSL's) involvement in national legislative activities and other advocacy initiatives has evolved and matured over the last twenty-five years. Some activities conducted by the Medical Library Association's (MLA's) Legislative Committee from 1976 to 1984 are highlighted to show the evolution of MLA's and AAHSL's interests in collaborating on national legislative issues, which resulted in an agreement to form a joint legislative task forc...

Reconsidering the Affordable Care Act's Restrictions on Physician-Owned Hospitals: Analysis of CMS Data on Total Hip and Knee Arthroplasty.

Science.gov (United States)

Courtney, P Maxwell; Darrith, Brian; Bohl, Daniel D; Frisch, Nicholas B; Della Valle, Craig J

2017-11-15

Concerns about financial incentives and increased costs prompted legislation limiting the expansion of physician-owned hospitals in 2010. Supporters of physician-owned hospitals argue that they improve the value of care by improving quality and reducing costs. The purpose of the present study was to determine whether physician-owned and non-physician-owned hospitals differ in terms of costs, outcomes, and patient satisfaction in the setting of total hip arthroplasty (THA) and total knee arthroplasty (TKA). With use of the U.S. Centers for Medicare & Medicaid Services (CMS) Inpatient Charge Data, we identified 45 physician-owned and 2,657 non-physician-owned hospitals that performed ≥11 primary TKA and THA procedures in 2014. Cost data, patient-satisfaction scores, and risk-adjusted complication and 30-day readmission scores for knee and hip arthroplasty patients were obtained from the multiyear CMS Hospital Compare database. Physician-owned hospitals received lower mean Medicare payments than did non-physician-owned hospitals for THA and TKA procedures ($11,106 compared with $12,699; p = 0.002). While the 30-day readmission score did not differ significantly between the 2 types of hospitals (4.48 compared with 4.62 for physician-owned and non-physician-owned, respectively; p = 0.104), physician-owned hospitals had a lower risk-adjusted complication score (2.83 compared with 3.04; p = 0.015). Physician-owned hospitals outperformed non-physician-owned hospitals in all patient-satisfaction categories, including mean linear scores for recommending the hospital (93.9 compared with 87.9; p CMS payment methodology. Our findings suggest that physician-owned hospitals are associated with lower mean Medicare costs, fewer complications, and higher patient satisfaction following THA and TKA than non-physician-owned hospitals. Policymakers should consider these data when debating the current moratorium on physician-owned hospital expansion. Therapeutic Level III. See

Cognitive analysis of physicians' medication ordering activity.

Science.gov (United States)

Pelayo, Sylvia; Leroy, Nicolas; Guerlinger, Sandra; Degoulet, Patrice; Meaux, Jean-Jacques; Beuscart-Zéphir, Marie-Catherine

2005-01-01

Computerized Physician Order Entry (CPOE) addresses critical functions in healthcare systems. As the name clearly indicates, these systems focus on order entry. With regard to medication orders, such systems generally force physicians to enter exhaustively documented orders. But a cognitive analysis of the physician's medication ordering task shows that order entry is the last (and least) important step of the entire cognitive therapeutic decision making task. We performed a comparative analysis of these complex cognitive tasks in two working environments, computer-based and paper-based. The results showed that information gathering, selection and interpretation are critical cognitive functions to support the therapeutic decision making. Thus the most important requirement from the physician's perspective would be an efficient display of relevant information provided first in the form of a summarized view of the patient's current treatment, followed by in a more detailed focused display of those items pertinent to the current situation. The CPOE system examined obviously failed to provide the physicians this critical summarized view. Following these results, consistent with users' complaints, the Company decided to engage in a significant re-engineering process of their application.

Administrative, institutional and legislative issues on agricultural waste exploitation in Turkey

Energy Technology Data Exchange (ETDEWEB)

Kaya, Durmus; Baban, Ahmet; Dikec, Stephanie [TUBITAK MRC Chemistry and Enviorenment Institute, P.O. Box 21, 41470 Gebze-Kocaeli (Turkey); Canka Kilic, Fatma [Kocaeli University, KMYO, Department of Air Conditioning and Refrigeration, Kullar/Kocaeli (Turkey)

2008-02-15

In this study, the influence of non-technical issues on the exploitation of agricultural waste in Turkey was investigated in accordance with the work program requirements for the project entitled ''Exploitation of Agricultural Waste in Turkey'' under the EU Life Third Countries Program. The study has been organized and presented according to the following four phases: (i) study of existing Turkish legislation and the administrative and institutional framework, (ii) review and analysis of the EU policy and legislation relevant to agricultural waste, including identification of potential market instruments, (iii) identification of barriers to the promotion of agricultural waste exploitation in Turkey, and (iv) Identification of gaps and formulation of recommendations. An ultimate objective of this study is to transfer the European experience and practices relative to the overall framework of managing agricultural waste. (author)

A Survey of Italian Physicians' Opinion about Stem Cells Research: What Doctors Prefer and What the Law Requires

OpenAIRE

Frati, Paola; Gulino, Matteo; Pacchiarotti, Arianna; D'Errico, Stefano; Sicuro, Lorella; Fineschi, Vittorio

2014-01-01

To evaluate the Italian physicians' knowledge/information level about the therapeutic potential of stem cells, the research choice between embryonic and cordonal stem cells, and the preference between autologous and heterologous storage of cordonal stem cells, we performed a national survey. The questionnaire—distributed to 3361 physicians—involved physicians of different religious orientations and of different medical specialities. Most of the physicians involved (67%) were Catholics, and th...

Show us the money: lessons in transparency from state pharmaceutical marketing disclosure laws.

Science.gov (United States)

Chimonas, Susan; Rozario, Natassia M; Rothman, David J

2010-02-01

To assess legislation requiring drug companies to report gifts to providers, and to evaluate the information obtained. Data included legislation in Vermont, Minnesota, Maine, Massachusetts, West Virginia, and the District of Columbia, and company disclosure data from Vermont. We evaluated the strengths and weaknesses of state legislation. We also analyzed 4 years of company disclosures from Vermont, assessing the value and distribution of industry-provider exchanges and identifying emerging trends in companies' practices. State legislation is publically available. We obtained Vermont's data through requests to the state's Attorney General's office. Of the state laws, only Vermont's yielded robust, publically available data. These data show gifting was dominated by a few major corporations, and Companies were especially generous to specialists in psychiatry, endocrinology/diabetes/metabolism, internal medicine, and neurology. Companies increasingly used loopholes in the law to avoid public scrutiny. Disclosure laws are an important first step in bringing greater transparency to physician-industry relationships. But flaws and weaknesses limit the states' ability to render physician-industry exchanges fully transparent. Future efforts should build on these lessons to render physician-industry relationships fully transparent.

Government capacities and stakeholders: what facilitates ehealth legislation?

Science.gov (United States)

2014-01-01

Background Newly established high-technology areas such as eHealth require regulations regarding the interoperability of health information infrastructures and data protection. It is argued that government capacities as well as the extent to which public and private organizations participate in policy-making determine the level of eHealth legislation. Both explanatory factors are influenced by international organizations that provide knowledge transfer and encourage private actor participation. Methods Data analysis is based on the Global Observatory for eHealth - ATLAS eHealth country profiles which summarizes eHealth policies in 114 countries. Data analysis was carried out using two-component hurdle models with a truncated Poisson model for positive counts and a hurdle component model with a binomial distribution for zero or greater counts. Results The analysis reveals that the participation of private organizations such as donors has negative effects on the level of eHealth legislation. The impact of public-private partnerships (PPPs) depends on the degree of government capacities already available and on democratic regimes. Democracies are more responsive to these new regulatory demands than autocracies. Democracies find it easier to transfer knowledge out of PPPs than autocracies. Government capacities increase the knowledge transfer effect of PPPs, thus leading to more eHealth legislation. Conclusions All international regimes – the WHO, the EU, and the OECD – promote PPPs in order to ensure the construction of a national eHealth infrastructure. This paper shows that the development of government capacities in the eHealth domain has to be given a higher priority than the establishment of PPPs, since the existence of some (initial) capacities is the sine qua non of further capacity building. PMID:24410989

Terrorism and anti-terror legislation - the terrorised legislator? A comparison of counter-terrorism legislation and its implications on human rights in the legal systems of the United Kingdom, Spain, Germany, and France

NARCIS (Netherlands)

Oehmichen, Anna

2009-01-01

The thesis deals with the history of terrorism and counter-terrorism legislation, focussing on the legislation in the UK, Spain, Germany and France, in the last 30 years, and analysing its compatibility with national and European human rights standards.

Harmonization of the Romanian legislation in the field of civil liability for nuclear damages with the international legislation in the field

International Nuclear Information System (INIS)

Chiripus, Vlad

2005-01-01

The paper is an overview of the Romanian legal provisions in the filed of civil liability for nuclear damages in the last three decades introducing the concept and the evolution of its legal regime towards a total harmonization with the European legislation. Its modernity even from (and in spite of) its communist beginnings in 1947 (Law no. 61 regarding the deployment of nuclear activities in the Romanian Socialist Republic) is emphasized. It focuses on the key laws - Law no. 703/2001 on civil liability for nuclear damages, and Government Decision no. 894/2003 for the approval of the Norms for enforcement of Law no. 703/2001- that currently define the Romanian regime for civil liability for nuclear damages. This encompasses the relevant responsibilities of nuclear operators, the Romanian nuclear damage compensation system, statute of limitation for claims, types of insurance and financial guarantees. These refer civil liability for nuclear damages, limits of nuclear operators' liability, specific requirements regarding the insurance, responsibilities of control and supervision bodies, assessment of nuclear damage. This makes Romania - in terms of legislation - one of the most advanced countries in the field. (author)

Autopsy issues in German Federal Republic transplantation legislation until 1997.

Science.gov (United States)

Schweikardt, Christoph

2014-01-01

This article analyzes the relevance of autopsy issues for German Federal Republic transplantation legislation until 1997 against the background of legal traditions and the distribution of constitutional legislative powers. It is based on Federal Ministry of Justice records and German Parliament documents on transplantation legislation. Transplantation and autopsy legislation started with close ties in the 1970s. Viewing transplantation legislation as relevant for future autopsy regulation contributed to the decision to stall transplantation legislation, because the interests of the federal government and the medical profession converged to avoid subsequent restrictions on the practice of conducting autopsies and procuring tissues for transplantation. Sublegal norms were insufficient for the prosecution of the organ trade and area-wide transplantation regulation after the reunification of Germany. In contrast to autopsy issues, legislative power for transplantation issues was extended to the federal level by an amendment to the constitution, allowing decision making for Germany as a whole.

Legislation on violence against women: overview of key components.

Science.gov (United States)

Ortiz-Barreda, Gaby; Vives-Cases, Carmen

2013-01-01

This study aimed to determine if legislation on violence against women (VAW) worldwide contains key components recommended by the Pan American Health Organization (PAHO) and the United Nations (UN) to help strengthen VAW prevention and provide better integrated victim protection, support, and care. A systematic search for VAW legislation using international legal databases and other electronic sources plus data from previous research identified 124 countries/territories with some type of VAW legislation. Full legal texts were found for legislation from 104 countries/territories. Those available in English, Portuguese, and Spanish were downloaded and compiled and the selection criteria applied (use of any of the common terms related to VAW, including intimate partner violence (IPV), and reference to at least two of six sectors (education, health, judicial system, mass media, police, and social services) with regard to VAW interventions (protection, support, and care). A final sample from 80 countries/territories was selected and analyzed for the presence of key components recommended by PAHO and the UN (reference to the term "violence against women" in the title; definitions of different types of VAW; identification of women as beneficiaries; and promotion of (reference to) the participation of multiple sectors in VAW interventions). Few countries/territories specifically identified women as the beneficiaries of their VAW legislation, including those that labeled their legislation "domestic violence" law ( n = 51), of which only two explicitly mentioned women as complainants/survivors. Only 28 countries/territories defined the main forms of VAW (economic, physical, psychological, and sexual) in their VAW legislation. Most highlighted the role of the judicial system, followed by that of social services and the police. Only 28 mentioned the health sector. Despite considerable efforts worldwide to strengthen VAW legislation, most VAW laws do not incorporate the key

Legislative processes in transition : comparative study of the legislative processes in Finland, Slovenia and the United Kingdom as a source of inspiration for enhancing the efficiency of the Dutch legislative process

NARCIS (Netherlands)

Voermans, W.; Napel, H.-M. ten; Diamant, M.; Groothuis, M.; Steunenberg, B.; Passchier, R.; Pack, S.

2012-01-01

The main research question of the current study is when whether the efficiency of the Dutch legislative procedure for parliamentary acts indeed constitutes a problem, in particular if compared to the achievements of legislative processes in several other European countries and, if that turns out to

Impact, regulation and health policy implications of physician migration in OECD countries

Directory of Open Access Journals (Sweden)

Simoens Steven

2004-07-01

Full Text Available Abstract Background In the face of rising demand for medical services due to ageing populations, physician migration flows are increasingly affecting the supply of physicians in Organisation for Economic Co-operation and development (OECD countries. This paper offers an integrated perspective on the impact of physician migration on home and host countries and discusses international regulation and policy approaches governing physician migration. Methods Information about migration flows, international regulation and policies governing physician migration were derived from two questionnaires sent to OECD countries, a secondary analysis of EUROSTAT Labour Force Surveys, a literature review and official policy documents of OECD countries. Results OECD countries increasingly perceive immigration of foreign physicians as a way of sustaining their physician workforce. As a result, countries have entered into international agreements regulating physician migration, although their success has been limited due to the imposition of licensing requirements and the protection of vested interests by domestic physicians. OECD countries have therefore adopted specific policies designed to stimulate the immigration of foreign physicians, whilst minimising its negative impact on the home country. Measures promoting immigration have included international recruitment campaigns, less strict immigration requirements and arrangements that foster shared learning between health care systems. Policies restricting the societal costs of physician emigration from developing countries such as good practice guidelines and taxes on host countries have not yet produced their expected effect or in some cases have not been established at all. Conclusions Although OECD countries generally favour long-term policies of national self-sufficiency to sustain their physician workforce, such policies usually co-exist with short-term or medium-term policies to attract foreign physicians

New protein sources and food legislation

DEFF Research Database (Denmark)

Belluco, Simone; Halloran, Afton Marina Szasz; Ricci, Antonia

2017-01-01

Growing global food demand has generated a greater interest in the consumption of new and diversified protein sources. Novel foodstuffs represent a challenge for food law as they need proper safety assessments before obtaining market permission. The case of edible insects and European law is a good...... representation of this issue because a selection of food grade insect species may be available on the European market in the coming years. However, European legislation does not explicitly address edible insects. Consequently, this has left a grey area, allowing different interpretations of the legislation among....... Particular attention will be paid to the evolution of legislation and to the experiences of both EU and non-EU countries. In recent years, a number of different stakeholders have supported the legalization of edible insect consumption in Europe, but market permission is just the first step towards a new...

DEVELOPMENTS IN THE CONSTITUTIONAL REVIEW. CONSTITUTIONAL COURT BETWEEN THE STATUS OF NEGATIVE LEGISLATOR AND THE STATUS OF POSITIVE CO-LEGISLATOR

Directory of Open Access Journals (Sweden)

Marieta Safta

2012-11-01

Full Text Available The study wants to emphasize that Constitutional Courts belonging to the European model depart from their traditional role as ”negative legislator” – which refers to the effect of their acts consisting in removal from the legal system of those rules contrary to the Basic Law -, becoming, to a certain extent, a ”positive legislator”. Official interpreters of the Constitution, Constitutional Courts assume, sometimes, a role of co-legislators, creating provisions they deduct from the Constitution - when controlling the absence of legislation or legislative omissions -, and revealing the content of constitutional and even infraconstitutional rules accordingly with the Constitution in their case-law, whose effects are nothing but specific forms of „impulse” or „coercion” of the legislator to proceed in a certain sense, and whose continuous development guides the evolution of the entire legal system. Case – law selected presents ways in which the Constitutional Court of Romania is associated to law-making activity. Without minimizing in any way its traditional role as "negative legislator", the study refers mainly to acts and situations that give expression to the creative role of the Constitutional Court of Romania.

Naval Maritime Physician : Roles and Challenges

Directory of Open Access Journals (Sweden)

Ranjan Sarkar

2016-01-01

Roles and challenges: Good maritime medicalpractice involves meeting numerous challenges of clinical, occupational, emergency, trauma and psychiatric medicine, in addition on board physicians must also have, in depth knowledge of pschycosomatic conditions due to stress andfatigue of crew and special conditions such as diving accidents and accidents involving aquatic animals. The situation on board requires extraordinary skills as interventions are difficult, both physically and technically, because the conditions at sea are often acrobatic and at certain times evacuation is also not possible due to weather and operational constraints. Thus the role naval doctor on board ships is truly of an all round physicians, a team mate and a good leader. Conclusion: In conclusion, responsibilities of Naval Maritime Physician is not limited to clinical activities but is multifaceted and objective training about the specifics of warships′ environment and related health problems is the key to achieve professional excellence in every sphere.

The Role of School Nurses, Challenges, and Reactions to Delegation Legislation: A Qualitative Approach.

Science.gov (United States)

Lineberry, Michelle; Whitney, Elizabeth; Noland, Melody

2018-06-01

Passage of new laws, national standards regarding delegation, and the recommendation for at least one full-time nurse in every school have provided more visibility to the role of school nurses. Recent legislative amendments in Kentucky presented an opportunity to examine how the role of the school nurse is changing. Aims were to describe the (1) role of school nurses in Kentucky, (2) impact of school nurses, (3) challenges faced by school nurses, and (4) impact of budget cuts and legislation. Three focus groups were conducted. School nurses faced challenges of limited time and resources, communication barriers, and multiple documentation requirements. Nurses' greatest impacts were their availability, recognition of psychosocial problems and health concerns, and connection with resources. Nurses had not yet encountered many changes due to new legislation that expanded delegation of diabetes-related tasks to unlicensed school personnel, but some had concerns about possible negative effects while others expressed support.

[The issue of harm reduction in Polish legislation concerning drug addiction. A comparative study].

Science.gov (United States)

Sobeyko, Justyna

2008-01-01

The aim of work is the assessment of legal permissibility for health and social harm reduction programmes resulting from drug use in the context of the polish legislation on narcotic drug use and drug addiction. The thesis outlines harm reduction programmes implemented worldwide, role of penal code in counteracting both narcotic drug supply and demand, attitude of United Nations and European Union to the drug problem including harm reduction programmes, solutions adopted in the selected European Union member states. The main part of the thesis presents the evolution of polish legislation regarding drug use and analysis of legal permissibility for harm reduction programmes in this context. The conclusion inferred is the statement that implementation of the harm reduction programmes requires a certain minimal depenalisation of the drug use by a legislator and the fact that restrictive legal system impedes programme realization. Thus the thesis postulates depenalisation of small drug quantities for personal use.

The Interagency Breakdown: Why We Need Legislative Reform to Coordinate Execution of the National Security Strategy

National Research Council Canada - National Science Library

Borkowski, David C

2008-01-01

To meet the national security demands of the 21st century, the U.S. Government's interagency structure and process require legislative reform equivalent to an interagency Goldwater-Nichols Act. The U.S...

Legislations combating counterfeit drugs in Hong Kong.

Science.gov (United States)

Lai, C W; Chan, W K

2013-08-01

To understand legislation combating counterfeit drugs in Hong Kong. This study consisted of two parts. In part I, counterfeit drugs–related ordinances and court cases were reviewed. In part II, indepth interviews of the stakeholders were described. Hong Kong. All Hong Kong ordinances were screened manually to identify those combating counterfeit drugs. Court cases were searched for each of the identified cases. Then, the relevant judgement justifications were analysed to identify sentencing issues. Indepth interviews with the stakeholders were conducted to understand their perceptions about such legislation. Trade Marks Ordinance, Patents Ordinance, Trade Descriptions Ordinance, and Pharmacy and Poisons Ordinance were current legislative items combating counterfeit drugs. Sentencing criteria depended on: intention to deceive, quantity of seized drugs, presence of expected therapeutic effect or toxic ingredients, previous criminal records, cooperativeness with Customs officers, honest confessions, pleas of guilty, types of drugs, and precautionary measures to prevent sale of counterfeit drugs. Stakeholders’ perceptions were explored with respect to legislation regarding the scale and significance of the counterfeit drug problem, penalties and deterrents, drug-specific legislation and authority, and inspections and enforcement. To plug the loopholes, a specific law with heavy penalties should be adopted. This could be supplemented by non-legal measures like education of judges, lawyers, and the public; publishing the names of offending pharmacies; and emphasising the role of pharmacists to the public.

[Biological risk in health. Risk to third parties: medical-legal focus. Responsible behavior of the competent physician].

Science.gov (United States)

Rodriguez, Daniele

2010-01-01

The responsibility of the occupational physician (OP) is discussed within the particular topic of biological risk generated by health care workers (HCW) versus third parties in health care settings. The present contribution offers keys of interpretation regarding current Italian legislation and passed sentences, taking into account principles of occupational medicine, the ICOH code of ethics for occupational health professionals, as well as duties and tasks of OP, employers and employees. Most of the responsibilities stand on employers, but OP has a primary duty of information and to judge fitness for work. It is underlined the difficult interpretation of the current legislation and indications. Behaviour of the OP could be censored in case of particular fitness for work or in case of inadequate information, as well as if the comprehension of information is not verified or when indication to minimize the risk are not controlled.

Legislative proposal for a controlled foreign companies regime in Poland from an international perspective

Directory of Open Access Journals (Sweden)

Magdalena Małgorzata Hybka

2014-12-01

Full Text Available Tackling corporate profit shifting requires appropriate anti-avoidance measures. This article reviews one of these measures, a controlled foreign companies (corporations regime. It has been implemented in many countries, in some of them as early as the 1960s. The need for its introduction has also been expressed on many occasions by the Polish legislator. The article is composed of three sections. The first considers the reasons for the implementation of the analyzed regime. The second describes the controlled foreign corporation legislation in the USA and selected European Union member states. The last section is devoted to a bill on taxing controlled foreign companies in Poland.

Defenses to malpractice: what every emergency physician should know.

Science.gov (United States)

Hudson, Michael Jason; Moore, Gregory P

2011-12-01

Emergency medicine is a high-risk specialty that carries a constant risk of malpractice litigation. Fear of malpractice litigation can lead to less-than-optimal patient care as well as impairments in physician quality of life. Although malpractice fear can be ubiquitous among emergency physicians, most receive little to no education on malpractice. Medical malpractice requires that 1) The physician had a duty, 2) The physician breached the duty, 3) There was harm to the patient, and 4) The harm was caused by the physician's breach of duty. Even if all four medical malpractice conditions are met, there are still special legal defenses that have been and can be used in court to exonerate the physician. These defenses include assumption of the risk, Good Samaritan, contributory negligence, comparative fault, sudden emergency, respectable minority, two schools of thought, and clinical innovation. These legal defenses are illustrated and explained using defining precedent cases as well as hypothetical examples that are directly applicable to emergency medical practice. Knowledge of these special legal defenses can help emergency physicians minimize their risk of litigation when caring for patients. Published by Elsevier Inc.

National legislative and regulatory activities

International Nuclear Information System (INIS)

2013-01-01

This section compiles the presentations of the following texts sorted by country. Armenia - Licensing and regulatory infrastructure: New design safety requirements adopted, New seismic hazard assessment guidelines adopted; France - Licensing and regulatory infrastructure: Decree No. 2012-1248 of 9 November 2012 authorising the ITER Organisation to create the 'ITER' basic nuclear installation in Saint-Paul-lez-Durance (Bouches-du-Rhone); - Nuclear security: Law No. 2012-1473 of 28 December 2012 authorizing the approval of the Amendment to the Convention on the Physical Protection of Nuclear Material; - Nuclear safety and radiological protection: Complementary safety assessments. Follow-up of the stress tests carried out on French nuclear power plants. Action Plan of the French Nuclear Safety Authority (ASN) - December 2012; - International cooperation: Decree No. 2012-1178 of 22 October 2012 publishing the Cooperation Agreement between the government of the French Republic and the government of the Republic of Tunisia for the development of peaceful uses of nuclear energy, signed in Tunis on 23 April 2009; Decree No. 2012-1180 of 22 October 2012 publishing the Cooperation Agreement between the government of the French Republic and the government of Mongolia in the field of nuclear energy (with annex), signed in Ulaanbaatar on 14 October 2010; Germany - General legislation: Bill to amend the Atomic Energy Act to expedite the retrieval of radioactive waste from and to decommission the Asse II Mine (2013); Act to amend the Act on Environmental Legal Remedies and other environmental provisions (2013); - Radiation protection: General administrative rules on Section 47 of the Radiation Protection Ordinance (2012); - Nuclear Safety: Safety requirements for nuclear power plants (2012); - Transport of radioactive material: International Transport of Dangerous Goods by Road (2010, 2012); - Regulations on nuclear trade (including non-proliferation): Export List (2013); Greece

Access to Legislation in Europe: Overview and Future Trends

Directory of Open Access Journals (Sweden)

Martynas Mockus

2013-08-01

Full Text Available The article analyses problems facing electronic legislation development (especially legislation processes of publishing acts in EU and EFTA member countries. All European countries were publishing acts officially on paper until the end of year 2000. The way of publishing acts officially was the same in all Europe countries, except that some counties had one “official journal” in which legal acts and other official documents and legal notices were published, and other countries had separate legal gazettes for acts publishing and an official gazette for publishing other official documents and legal notices. At the beginning of 2001 Norway started to publish acts officially in digital form, and only 12-20 times a year paper editions to present the statutes and regulations enacted since the publication of the previous issue are published. In 2002 Estonia decided to finish the publishing of paper editions, and started to publish acts only electronically. Till 2011 more than 10 European countries started to publish acts officially in digital format. Author discusses the advantages, principles, and legitimate expectation of electronic legislation. For future electronic legislation information systems developments the following principles should be a guide: broad/universal and equal access to legislation, reliability of the means of publicity, integrity of information, easy access to the requisite information. The advantages of digital act forms, and internet based publications are instantaneous outreach to the public, free of charge, information easily accessible and retrievable, voluminous technical acts easier to handle, no printing costs, more environmentally-friendly, more and more people use ICT to seek information, no time constraints to the availability of data, legal certainty will be granted. The author thinks that before creating future digital legislation information systems, some procedures shall be done. If we want to have pan

Access to Legislation in Europe: Overview and Future Trends

Directory of Open Access Journals (Sweden)

Martynas Mockus

2011-12-01

Full Text Available The article analyses problems facing electronic legislation development (especially legislation processes of publishing acts in EU and EFTA member countries.All European countries were publishing acts officially on paper until the end of year 2000. The way of publishing acts officially was the same in all Europe countries, except that some counties had one “official journal” in which legal acts and other official documents and legal notices were published, and other countries had separate legal gazettes for acts publishing and an official gazette for publishing other official documents and legal notices.At the beginning of 2001 Norway started to publish acts officially in digital form, and only 12-20 times a year paper editions to present the statutes and regulations enacted since the publication of the previous issue are published. In 2002 Estonia decided to finish the publishing of paper editions, and started to publish acts only electronically. Till 2011 more than 10 European countries started to publish acts officially in digital format.Author discusses the advantages, principles, and legitimate expectation of electronic legislation. For future electronic legislation information systems developments the following principles should be a guide: broad/universal and equal access to legislation, reliability of the means of publicity, integrity of information, easy access to the requisite information. The advantages of digital act forms, and internet based publications are instantaneous outreach to the public, free of charge, information easily accessible and retrievable, voluminous technical acts easier to handle, no printing costs, more environmentally-friendly, more and more people use ICT to seek information, no time constraints to the availability of data, legal certainty will be granted.The author thinks that before creating future digital legislation information systems, some procedures shall be done. If we want to have pan

Brazilian nuclear legislation. Revision n.1/2002

International Nuclear Information System (INIS)

Matos, Gilberto Cardoso de

2002-01-01

This work intends to facilitate the access to the Brazilian nuclear legislation and other legal instruments, foreseeing the use of nuclear energy and ionizing radiation in health, work and environment areas up to 2002. Legislation on the civil liability of nuclear damage, the law of licensing taxes, controlling and inspection are also included

California Attorney General opines: California's nuclear legislation unconstitutional

International Nuclear Information System (INIS)

Gabin, V.

1979-01-01

The California Attorney General found three sections of the state's nuclear regulation code to be in violation of Federal authority and the State Constitution. Legislation and court cases since 1946 are quoted to support the Attorney General's position. The Warren--Alquist Act, which requires a demonstrated technology for reprocessing fuel rods or disposing of high-level wastes before a nuclear plant can be licensed, is unconstitutional because it usurps Federal control and allows the state to permanently block nuclear facility construction and certification. States' rights in the area of radiological health and safety are supplanted by the Federal government

Social media: physicians-to-physicians education and communication.

Science.gov (United States)

Fehring, Keith A; De Martino, Ivan; McLawhorn, Alexander S; Sculco, Peter K

2017-06-01

Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians. Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique. Social networking instead is mostly centered on sharing of data, discussion of confidential topics, and job seeking. Quality of educational contents and data confidentiality represent the major drawbacks of these platforms. Orthopedic surgeons must be aware that the quality of the videos should be better controlled and regulated to avoid inaccurate information that may have a significant impact especially on trainees that are more prone to use this type of resources. Sharing of data and discussion of confidential topics should be extremely secure according the HIPAA regulations in order to protect patients' confidentiality.

LEVEL OF COMPETENCIES OF FAMILY PHYSICIANS IN KOSOVO FROM DIFFERENT PERSPECTIVES.

Science.gov (United States)

Bojaj, Gazmend; Skeraj, Fitim; Czabanowska, Katarzyna; Burazeri, Genc

2016-10-01

The aim of this analysis was to compare the level of self-perceived competencies of primary health care physicians in Kosovo with patients' viewpoint, as well as the necessary (required) level of such competencies from decision-makers' standpoint. Three cross-sectional studies were carried out in Kosovo in 2013 including: i) a representative sample of 1340 primary health care users aged ≥18 years (49% men; overall mean age: 50.5±17.9 years; response rate: 89%); ii) a representative sample of 597 primary health care physicians (49% men; overall mean age: 46.0±9.4 years; response rate: 90%), and; iii) a nationwide representative sample of 100 decision-makers operating at different primary health care institutions or public health agencies in Kosovo (63% men; mean age: 47.7±5.7 years). A structured self-administered questionnaire (consisting of 37 items) was used in the three surveys in order to assess physicians' competencies regarding different domains of the quality of health care. There was a significant gap in the level of self-perceived physicians' competencies and patients' perspective in transitional Kosovo. Furthermore, there was a gap in the level of self-perceived physicians' competencies and the necessary (required) level of physicians' competencies from decision-makers perspective which was less evident in Prishtina, but considerable in the other regions of Kosovo. Our analysis provides valuable evidence about the level of competencies of primary health care physicians in Kosovo from different stakeholders' perspectives. There is an urgent need for continuous professional development of family physicians in post-war Kosovo.

Knowledge and attitudes towards cardiopulmonary resuscitation and defibrillation amongst Asian primary health care physicians

Directory of Open Access Journals (Sweden)

Marcus Eh Ong

2009-11-01

Full Text Available Marcus Eh Ong1, Susan Yap1, Kim P Chan1, Papia Sultana2, Venkataraman Anantharaman11Department of Emergency Medicine, 2Department of Clinical Research, Singapore General Hospital, SingaporeObjective: To assess the knowledge and attitudes of local primary health care physicians in relation to cardiopulmonary resuscitation (CPR and defibrillation.Methods: We conducted a survey on general practitioners in Singapore by using a self-administered questionnaire that comprised 29 questions.Results: The response rate was 80%, with 60 of 75 physicians completing the questionnaire. The average age of the respondents was 52 years. Sixty percent of them reported that they knew how to operate an automated external defibrillator (AED, and 38% had attended AED training. Only 36% were willing to perform mouth-to-mouth ventilation during CPR, and 53% preferred chest compression-only resuscitation (CCR to standard CPR. We found those aged <50 years were more likely to be trained in basic cardiac life support (BCLS (P < 0.001 and advanced cardiac life support (P = 0.005 or to have ever attended to a patient with cardiac arrest (P = 0.007. Female physicians tended to agree that all clinics should have AEDs (P = 0.005 and support legislation to make AEDs compulsory in clinics (P < 0.001. We also found that a large proportion of physicians who were trained in BCLS (P = 0.006 were willing to perform mouth-to-mouth ventilation.Conclusion: Most local primary care physicians realize the importance of defibrillation, and the majority prefer CCR to standard CPR.Keywords: general practitioners, cardiac arrest, resuscitation, defibrillation, attitude, knowledge

Review of Legislation and Regulatory Framework in Ukraine with Regard to Environmental Radiation Monitoring

International Nuclear Information System (INIS)

Goldammer, Wolfgang; Batandjieva, Borislava; Nasvit, Oleg; German, Olga

2009-06-01

The aim of this review is to compare the current legal basis and regulatory framework in Ukraine to the relevant international safety requirements and to identify shortcomings, such as deficiencies and internal contradictions. However, no assessment of its practical implementation is made beyond the aspects related to environmental radiation monitoring. The report focuses on 13 areas present in the in the Ukrainian legislation and regulatory framework: R-1 Radiation monitoring R-2 Definition of responsibilities R-3 Normal situations R-4 Emergencies R-5 Long-term monitoring R-6 Intervention in cases of lasting exposure R-7 Use of monitoring data R-8 Record keeping R-9 Reporting to the regulatory authority R-10 Public information R-11 Human and financial resources R-12 Transboundary aspects R-13 Quality assurance. For each topic a description of the current situation and an evaluation is carried out. Ranking is then supplied supported by its evaluation. In brief these categories are: A: The national legal and regulatory documents are harmonised in substance with the international safety requirements; B: Substantial differences exist between the national and international requirements which should be addressed with the view to harmonise the legislation; C: Substantial deficiencies exist in the legal and/or regulatory bases which results in no or at least partial compliance with international safety requirements. P: In addition practical issues are also provided to indicates where practical implementation of the legislation and regulatory basis is not adequate in all respects. This report then presents main observations and conclusions of the review. On this basis, the report derives general suggestions for improvement of the legal and regulatory bases. These should be considered by the Ukrainian Government and the regulatory authorities within an action plan to improve the legal basis for radiological monitoring of the environment and to facilitate its implementation

Review of Legislation and Regulatory Framework in Ukraine with Regard to Environmental Radiation Monitoring

Energy Technology Data Exchange (ETDEWEB)

Goldammer, Wolfgang; Batandjieva, Borislava (Private Consultants (Ukraine)); Nasvit, Oleg (National Security and Defence Council of Ukraine, Kyiv (Ukraine)); German, Olga (Swedish Radiation Safety Authority, Stockholm (Sweden))

2009-06-15

The aim of this review is to compare the current legal basis and regulatory framework in Ukraine to the relevant international safety requirements and to identify shortcomings, such as deficiencies and internal contradictions. However, no assessment of its practical implementation is made beyond the aspects related to environmental radiation monitoring. The report focuses on 13 areas present in the in the Ukrainian legislation and regulatory framework: R-1 Radiation monitoring R-2 Definition of responsibilities R-3 Normal situations R-4 Emergencies R-5 Long-term monitoring R-6 Intervention in cases of lasting exposure R-7 Use of monitoring data R-8 Record keeping R-9 Reporting to the regulatory authority R-10 Public information R-11 Human and financial resources R-12 Transboundary aspects R-13 Quality assurance. For each topic a description of the current situation and an evaluation is carried out. Ranking is then supplied supported by its evaluation. In brief these categories are: A: The national legal and regulatory documents are harmonised in substance with the international safety requirements; B: Substantial differences exist between the national and international requirements which should be addressed with the view to harmonise the legislation; C: Substantial deficiencies exist in the legal and/or regulatory bases which results in no or at least partial compliance with international safety requirements. P: In addition practical issues are also provided to indicates where practical implementation of the legislation and regulatory basis is not adequate in all respects. This report then presents main observations and conclusions of the review. On this basis, the report derives general suggestions for improvement of the legal and regulatory bases. These should be considered by the Ukrainian Government and the regulatory authorities within an action plan to improve the legal basis for radiological monitoring of the environment and to facilitate its implementation

[The public health legislation in conditions of globalization].

Science.gov (United States)

Yefremov, D V; Jyliyaeva, E P

2013-01-01

The article demonstrates the impact of globalization on development of public health legislation at the international level and in particular countries. The legislation is considered as a tool to decrease the globalization health risks for population

Physician self-referral and physician-owned specialty facilities.

Science.gov (United States)

Casalino, Lawrence P

2008-06-01

Physician self-referral ranges from suggesting a follow-up appointment, to sending a patient to a facility in which the doctor has an ownership interest or financial relationship. Physician referral to facilities in which the physicians have an ownership interest is becoming increasingly common and not always medically appropriate. This Synthesis reviews the evidence on physician self-referral arrangements, their effect on costs and utilization, and their effect on general hospitals. Key findings include: the rise in self-referral is sparked by financial, regulatory and clinical incentives, including patient convenience and doctors trying to preserve their income in the changing health care landscape. Strong evidence suggests self-referral leads to increased usage of health care services; but there is insufficient evidence to determine whether this increased usage reflects doctors meeting an unmet need or ordering clinically inappropriate care. The more significant a physician's financial interest in a facility, the more likely the doctor is to refer patients there. Arrangements through which doctors receive fees for patient referrals to third-party centers, such as "pay-per-click," time-share, and leasing arrangements, do not seem to offer benefits beyond increasing physician income. So far, the profit margins of general hospitals have not been harmed by the rise in doctor-owned facilities.

[Physician versus 'off-label" ordinance].

Science.gov (United States)

Kordus, Katarzyna; Spiewak, Radosław

2015-01-01

Polish physicians are obliged by legislation to prescribe drugs authorized for the sale in the Republic of Poland, based on registration documentation, including the Summaries of Product Characteristics (SPC). So called 'off label' treatment occurs in case of the conflict between prescription and information contained in the SPC, which may be considered as a 'medical experiment'. In case of adverse drug reactions, such classification excludes the responsibility of the marketing authorization holders, and damages are not covered by obligatory third party insurance, which can pose financial and legal consequences to the doctor. Deviations from SPC-compliant prescription may include a different way of drug administration, drug administration compliant with the indications yet in patients for whom there is no specified drug dosage, or in case of an indication not contained in the SPC. Medicinal products with equivalent active component, form and dose can have different registration indications in the SPC, and the actively promoted dispensation of less expensive substitutes by the pharmacists may, against doctor's will, result in the use that is non-compliant with registration of the substitute drug. Pharmacotherapy of 'orphan diseases', for which there are no registered medicinal products, also becomes an essential issue as it forces doctors into 'off-label' prescriptions. Moreover, the reimbursement of drugs in most cases is limited to medicinal products that are prescribed according to the registration indications. The pleas by medical professionals to make ordination and reimbursement of drugs depend on active pharmaceutical ingredient and evidence of efficacy, as well as to introduce Evidence Based Medicine (EBM) standards for the treatment of diseases, did not receive proper attention from the governing bodies. Therefore, a fundamental question remains unanswered as to what should be the principal gauge for physicians' therapeutic decision: the ethics, conscience

Sexual violence legislation in sub-Saharan Africa: the need for strengthened medico-legal linkages.

Science.gov (United States)

Kilonzo, Nduku; Ndung'u, Njoki; Nthamburi, Nerida; Ajema, Caroline; Taegtmeyer, Miriam; Theobald, Sally; Tolhurst, Rachel

2009-11-01

Six sub-Saharan African countries currently have laws on sexual violence, including Kenya, and eight others have provisions on sexual violence in other legislation. Effective legislation requires functioning medico-legal linkages to enable both justice to be done in cases of sexual violence and the provision of health services for survivors of sexual violence. The health sector also needs to provide post-rape care services and collect and deliver evidence to the criminal justice system. This paper reviews existing data on sexual violence in sub-Saharan Africa, and summarises the content of sexual violence legislation in the region and the strengths and weaknesses of existing medico-legal linkages, using Kenya as a case study. Many sub-Saharan African countries do not yet have comprehensive post-rape care services, nor substantial co-ordination between HIV and sexual and reproductive health services, the legal and judicial systems, and sexual violence legislation. These need to be integrated by cross-referrals, using standardised referral guidelines and pathways, treatment protocols, and medico-legal procedures. Common training approaches and harmonised information across sectors, and common indicators, would facilitate government accountability. Joint and collaborative planning and working at country level, through sharing of information and data between the different systems remain key to achieving this.

Law, policy and the use of non-physicians in family planning service delivery.

Science.gov (United States)

Paxman, J M

1979-04-01

A great deal of attention is being devoted to the use of nonphysicians to provide such fertility control services as contraception, sterilization, and abortion. Legal obstacles exist, however, which must be overcome before the role of nonphysicians can be expanded. Such obstacles include medical practice statutes, nursing and midwifery legislation, and laws and regulations directly related to such fertility control measures as the provision of contraceptions and the performance of sterilizations. On the other hand, the following 3 main approaches have been used to permit increased participation of nonphysicians: delegation of tasks by physicians, liberal interpretation of existing laws, and authorization. Thus, the important elements in expanding the roles of nonphysicians are 1) authorization; 2) training; 3) qualification; 4) supervision; and 5) opportunities for referrals to physicians. The ultimate role of paramedicals will depend upon the continued simplification of technology, the results of research on the quality of care which they can provide, the attitudes of the medical profession, and the elimination of the legal ambiguities and obstacles which exist.

Physician Fee Schedule National Payment Amount File

Data.gov (United States)

U.S. Department of Health & Human Services — The significant size of the Physician Fee Schedule Payment Amount File-National requires that database programs (e.g., Access, dBase, FoxPro, etc.) be used to read...

Nuclear Liability Legislation in Slovenia

International Nuclear Information System (INIS)

Skraban, A.

1998-01-01

This paper reviews Slovenian national legislation in the field of third party liability for nuclear damage, applicability of the international nuclear liability treaties in Slovenia legal system and outlines some main provisions of national legislation. It is worth mentioning that legal instruments covering third party liability and compulsory insurance of such liability exist in Slovenia for almost 20 years and that our nuclear facilities are covered by relevant international treaties and conventions in this field, among them also by the Vienna Convention on Civil Liability for Nuclear Damage (from 1977) and the Joint Protocol Relating to the Application of the Vienna Convention and the Paris Convention (from 1994). (author)

A legislative program to plan energy strategies for the 21st century and to demonstrate the role of nuclear power

International Nuclear Information System (INIS)

McKlveen, J.W.; Blitz, P.

1989-01-01

In April 1989, the State Legislative Leaders Foundation and Arizona State University presented a national program, Energy Strategies for the 21st Century. Participants included state legislative leaders and key committee chairs from across the nation. The purpose of this program was to give legislative leaders an opportunity to examine and discuss many of the critical issues that will shape future energy policy. The participants were actively involved in developing realistic energy strategies. The scenarios had to use available and realistic future energy technologies. Their solutions were required to be both economically and environmentally compatible and acceptable to their constituents

THE INFLUENCES OF CHANGES IN TAX LEGISLATION

Directory of Open Access Journals (Sweden)

MORAR IOAN DAN

2013-07-01

Full Text Available Taxation is a fairly important field in the relationship between taxpayers and tax authorities, especially given the frequent changes in specific legislation. Legislative changes affect the patrimonial position of the taxpayers, but also their behavior, therefore this phenomenon is important to advise those interested and also to analyze the changes resulting from changes in tax legislation. This paper aims to meaningfully present the latest legislative changes and to analyze their influences on taxpayers and on budget revenues from taxes subject to change. The research methodology is based on comparison and inference, based on previous analyzes for such studies on the tax system. In the literature there are known ways and methods of increasing the tax burden and, based on these variables, in the present paper we will highlight the particular influences on the taxpayer’s , loaded by weight imposed by the official distribution of the tax burden. The implications of legislative changes in tax matters should be sought in the innermost chord of taxpayers and also in the increasingly large and patched pockets of the modern state. In the first place, we will point out the implications on changing tax procedures, in terms of the workload for the taxpayer and the tax collectors. By accurately and relevantly analyzing the influences generated by such changes, the author aims to demonstrate the harmful influences of some changes in terms of discouraging investments and honest labor.

Senior academic physicians and retirement considerations.

Science.gov (United States)

Moss, Arthur J; Greenberg, Henry; Dwyer, Edward M; Klein, Helmut; Ryan, Daniel; Francis, Charles; Marcus, Frank; Eberly, Shirley; Benhorin, Jesaia; Bodenheimer, Monty; Brown, Mary; Case, Robert; Gillespie, John; Goldstein, Robert; Haigney, Mark; Krone, Ronald; Lichstein, Edgar; Locati, Emanuela; Oakes, David; Thomsen, Poul Erik Bloch; Zareba, Wojciech

2013-01-01

An increasing number of academic senior physicians are approaching their potential retirement in good health with accumulated clinical and research experience that can be a valuable asset to an academic institution. Considering the need to let the next generation ascend to leadership roles, when and how should a medical career be brought to a close? We explore the roles for academic medical faculty as they move into their senior years and approach various retirement options. The individual and institutional considerations require a frank dialogue among the interested parties to optimize the benefits while minimizing the risks for both. In the United States there is no fixed age for retirement as there is in Europe, but European physicians are initiating changes. What is certain is that careful planning, innovative thinking, and the incorporation of new patterns of medical practice are all part of this complex transition and timing of senior academic physicians into retirement. Copyright © 2013 Elsevier Inc. All rights reserved.

Legislative impacts on Savannah River waste management operations

International Nuclear Information System (INIS)

Bauer, J.D.

1987-01-01

Today everyone has to be prepared to meet the challenges presented by new legislative actions. The Savannah River Plant is also impacted by this legislation as the exclusive nature of the Atomic Energy Act slowly erodes. This paper discusses the management of three types of radioactive waste from the production of defense nuclear materials and the impacts of major environmental legislation on the handling of these wastes. The paper briefly discusses the major environmental statutes, covers the statutes impact on the technical processes and, finally, considers the nontechnical impact of the statutes

Dental complications of gastro-oesophageal reflux disease: guidance for physicians.

Science.gov (United States)

Lee, Robert J; Aminian, Amin; Brunton, Paul

2017-06-01

There is potential for gastro-oesophageal reflux disease (GORD) to be under-diagnosed by physicians. A quick, focused examination, requiring no special equipment, of a patients' dentition can assist in making a more accurate diagnosis where GORD is suspected. Guidance is provided for physicians as to what intra-oral signs are suggestive of intrinsic dental erosion, which is a clinical feature of GORD and its associated conditions. Use of this information will, it is suggested, improve outcomes for patients where GORD is suspected. © 2016 Royal Australasian College of Physicians.

Changes in public attitudes towards confidential adolescent sexual and reproductive health services in Lithuania after the introduction of new legislation: findings from the cross-sectional surveys conducted in 2005 and 2012.

Science.gov (United States)

Jaruseviciene, Lina; Zaborskis, Apolinaras; Sauliune, Skirmante; Jarusevicius, Gediminas; Lazarus, Jeffrey V

2015-09-04

In Lithuania, the right to confidentiality in healthcare for adolescents over the age of 16 was guaranteed in 2010 through the adoption of new legislation. This study sets out to explore changes in Lithuanian residents' attitudes towards confidentiality protection in adolescent sexual and reproductive healthcare (SRH) by comparing data from surveys administered in 2005 and 2012. For both surveys, the participants were random samples of the Lithuanian residents aged 16 to 74. A 23-item questionnaire was used in 2005 and complemented with 2 items in 2012. Linear regression analysis was employed to estimate absolute differences in prevalence of belief in whether or not adolescents would find confidentiality important when consulting a physician on SRH issues. A log-binomial regression model was fitted to estimate the relative changes (prevalence ratio) of the independent variables. The total number of respondents was 1054 (response rate 83%) in 2005 and 1002 (response rate 80%) in 2012. The proportion of respondents who reported a belief that adolescents would find confidentiality important when seeing a physician for SRH issues increased significantly from 62% in 2005 to 73% in 2012. Regardless of their belief in the importance of confidentiality, in 2012 respondents more often indicated positive outcomes on the relations between the physician and the minor patient, such as increased trust of the adolescent in the physician and more frequent visits to physicians. However, study participants who believed that adolescents would find confidentiality important in 2012 were less optimistic about potential positive outcomes of further legal consolidation of adolescents' right to confidentiality than in 2005. Younger respondents were the most optimistic about potential outcomes if laws were enacted to further protect adolescent confidentiality. This study uncovers the dynamics of public attitudes towards the socially and ethically sensitive issue of adolescent SRH. Our

Engaging Australian physicians in evidence-based medicine: a representative national survey.

Science.gov (United States)

Toulkidis, V; Donnelly, N J; Ward, J E

2005-01-01

To assess Australian adult physicians' views about evidence-based medicine (EBM) and quality improvement (QI). Cross-sectional postal survey of two hundred and forty-four randomly selected Australian physicians (78.5% response rate). Physicians' views about the promotion of EBM and QI and their impact on patient care, strategies to support better clinical practice and self-reported understanding of EBM terms. Sixty-eight per cent (95% confidence interval (CI): 62-74%) of physicians had a positive view of the current promotion of EBM in Australia. Significantly fewer (45%; 95% CI: 38-51%) were so positive about QI (P evidence, significantly fewer (21%; 95% CI: 17-27%) agreed they had sufficient time to do so (P Australian physicians have positive views of EBM, QI appears less well regarded. Initiatives to improve quality and safety that incorporate principles and language of EBM will likely be received better by physicians than isolated QI. Further enhancement of EBM requires concomitant attention to physician training, workplace infrastructure and supportive professional development.

[History of psychiatric legislation in Italy].

Science.gov (United States)

Stocco, Ester; Dario, Claudia; Piazzi, Gioia; Fiori Nastro, Paolo

2009-01-01

The different models of mental illness which have followed one another in Italian psychiatry have been linked to the history of psychiatric legislation and its various attempts at reform. The first law of the newly United State which unified legislations and former procedures, whose prevalent psychiatric theories were those that referred to degeneration, was the law 36/1904 that set up the asylums. Accordingly psychiatric praxis was focused on social protection and custody, given that the mentally ill was seen as incurable; Fascism added the inmate's obligation to be enrolled in the judicial register. Afterwards numerous attempts to reform the psychiatric legislation were made that eventually gave rise to law 431/1968 which paved the way to territorial psychiatry. Law 180/1978 changed the organization of Italian psychiatry abolishing asylums and the concept of dangerousness, including psychiatry in the National Health Service but adopting an idea of mental illness as simply social unease.

Domestic hygienic legislation concerning population radiation protection

International Nuclear Information System (INIS)

Marej, A.N.

1984-01-01

Problems and principles of domestic sanitary legislation, concerning population radiation protection, are considered. The legislation envisages preventive measures, directed to contamination preventation of the main environmental objects, it regulates their content in the objects, their human intake and ionizing radiation doses, which might affect population. Existing domestic hygienic guides and safety standards for personnel and population are enumerated and characterized

Firearm Legislation and Fatal Police Shootings in the United States.

Science.gov (United States)

Kivisto, Aaron J; Ray, Bradley; Phalen, Peter L

2017-07-01

To examine whether stricter firearm legislation is associated with rates of fatal police shootings. We used a cross-sectional, state-level design to evaluate the effect of state-level firearm legislation on rates of fatal police shootings from January 1, 2015, through October 31, 2016. We measured state-level variation in firearm laws with legislative scorecards from the Brady Center, and for fatal police shootings we used The Counted, an online database maintained by The Guardian. State-level firearm legislation was significantly associated with lower rates of fatal police shootings (incidence rate ratio = 0.961; 95% confidence interval = 0.939, 0.984). When we controlled for sociodemographic factors, states in the top quartile of legislative strength had a 51% lower incidence rate than did states in the lowest quartile. Laws aimed at strengthening background checks, promoting safe storage, and reducing gun trafficking were associated with fewer fatal police shootings. Legislative restrictions on firearms are associated with reductions in fatal police shootings. Public Health Implications. Although further research is necessary to determine causality and potential mechanisms, firearm legislation is a potential policy solution for reducing fatal police shootings in the United States.

Hygienic quality of raw milk with regard to legislation

Directory of Open Access Journals (Sweden)

Slavko Kirin

2001-01-01

Full Text Available Hygienic quality of raw milk is basic indicator of hygienic conditionduring processing and handling of milk as well as economical valorisation of animal product as a raw material in dairy products manufacture. Thus, total bacterial count in 1 mL of raw milk is used in modern legislation in milk pricing system. Apart from the economical and technological reasons hygienic quality of raw milk is also important from the health safety issue. In this paper microbiological quality legislation, set down by the EU and Croatian directives, are presented. Apart form the total microorganisms number the normative on the somatic cell number in row milk, as one of the quality indicators, are also presented. Pricing system of raw milk with regard to hygienic quality, current legislation especially from the point of view of a new legislation on row milk quality as well as suggestions to faster association into progressive dairy, legislation are listed.

Fear of Life, Fear of Death, and Fear of Causing Death: How Legislative Changes on Assisted Dying Are Doomed to Fail.

Science.gov (United States)

Häyry, Matti

2018-01-01

Fear of life, fear of death, and fear of causing death form a combination that prevents reasoned changes in laws concerning end-of-life situations. This is shown systematically in this article using the methods of conceptual analysis. Prevalent fears are explicated and interpreted to see how their meanings differ depending on the chosen normative stance. When the meanings have been clarified, the impact of the fears on the motivations and justifications of potential legislative reforms are assessed. Two main normative stances are evoked. The first makes an appeal to individual self-determination, or autonomy, and the second to the traditional professional ethics of physicians. These views partly share qualifying elements, including incurability and irreversibility of the patient's medical condition, proximity of death, the unbearable nature of suffering, and issues of voluntariness further shade the matter. The conclusion is that although many motives to change end-of-life laws are admirable, they are partly contradictory, as are calls for autonomy and appeals to professional ethics; to a degree that good, principled legislative solutions remain improbable in the foreseeable future.

How do physicians discuss e-health with patients? the relationship of physicians' e-health beliefs to physician mediation styles.

Science.gov (United States)

Fujioka, Yuki; Stewart, Erin

2013-01-01

A survey of 104 physicians examined the role of physicians' evaluation of the quality of e-health and beliefs about the influence of patients' use of e-health in how physicians discuss e-health materials with patients. Physicians' lower (poor) evaluation of the quality of e-health content predicted more negative mediation (counter-reinforcement of e-health content). Perceived benefits of patients' e-health use predicted more positive (endorsement of e-health content). Physician's perceived concerns (negative influence) regarding patients' e-health use were not a significant predictor for their mediation styles. Results, challenging the utility of restrictive mediation, suggested reconceptualizing it as redirective mediation in a medical interaction. The study suggested that patient-generated e-health-related inquiries invite physician mediation in medical consultations. Findings and implications are discussed in light of the literature of physician-patient interaction, incorporating the theory of parental mediation of media into a medical context.

Compliance of the legal treatment of experimental animals in Serbian legislation with the legislation of the European Union

Directory of Open Access Journals (Sweden)

Vidić-Trninić Jelena

2013-01-01

Full Text Available The author focuses on compliance of the legal treatment of experimental animals in Serbian law with the provisions of the European legislation. Analysing, on one hand, the treatment that experimental animals have under the law of European Union, and on the other hand, the treatment that they have in the law of Serbia, in accordance with the relevant acts and subordinate legislation acts, this article seeks to answer the question whether the degree of legal protection of experimental animals in domestic law is satisfactory, as well as whether and to what extent the relevant national legislation complies with the European standards. At the same time, the article attempts to point out the appropriate measures necessary to be taken in the future in order to achieve as high quality and comprehensive protection of experimental animals as possible in Serbian law.

A quantitative day in the life of a Saskatchewan rural physician.

Science.gov (United States)

Harrison, Emmett; Dhillon, Paul B A

2018-01-01

Rural family physicians are often required to meet a wide variety of medical service demands that are otherwise the responsibility of specialty physicians in urban centres. However, many rural physicians enjoy the practice variety and ability to meet patients' medical needs through this wider spectrum of care. We aimed to quantify and summarize the workload and clinical disorders seen by rural family physicians in Saskatchewan relative to urban family physicians. We used Saskatchewan Ministry of Health billing data for 2015/16 to compare rural and urban care provision. The data were summarized in a graphic 1-month format to portray a typical month in the life of a rural physician in the province. In the office setting, rural family physicians saw 16.8% more cardiac presentations in adults over 65 years of age than did urban family physicians; otherwise, there were no significant differences in the top office diagnosis categories seen by the 2 groups. Differences were apparent, however, in the hospital setting: urban family physicians saw more patients presenting with pain and, reflective of centralization of obstetric delivery services, performed more deliveries than did rural physicians. There are differences in the clinical presentations seen by rural and urban family physicians, and these need to be considered by new physicians considering rural practice. Our simple visual depiction of average workload, vacation and activity levels of rural physicians can further inform medical residents on the realities of working in rural Saskatchewan as a family physician. A more complete understanding of clinical workload expectations may promote recruitment of resident physicians.

Colorectal cancer screening awareness among physicians in Greece

Directory of Open Access Journals (Sweden)

Chatzimichalis Georgios

2006-06-01

Full Text Available Abstract Background Data comparison between SEER and EUROCARE database provided evidence that colorectal cancer survival in USA is higher than in European countries. Since adjustment for stage at diagnosis markedly reduces the survival differences, a screening bias was hypothesized. Considering the important role of primary care in screening activities, the purpose of the study was to investigate the colorectal cancer screening awareness among Hellenic physicians. Methods 211 primary care physicians were surveyed by mean of a self-reported prescription-habits questionnaire. Both physicians' colorectal cancer screening behaviors and colorectal cancer screening recommendations during usual check-up visits were analyzed. Results Only 50% of physicians were found to recommend screening for colorectal cancer during usual check-up visits, and only 25% prescribed cost-effective procedures. The percentage of physicians recommending stool occult blood test and sigmoidoscopy was 24% and 4% respectively. Only 48% and 23% of physicians recognized a cancer screening value for stool occult blood test and sigmoidoscopy. Colorectal screening recommendations were statistically lower among physicians aged 30 or less (p = 0.012. No differences were found when gender, level and type of specialization were analyzed, even though specialists in general practice showed a trend for better prescription (p = 0.054. Conclusion Contemporary recommendations for colorectal cancer screening are not followed by implementation in primary care setting. Education on presymptomatic control and screening practice monitoring are required if primary care is to make a major impact on colorectal cancer mortality.

42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

Science.gov (United States)

2010-10-01

... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians. (a...

Work resumption at the price of distrust: a qualitative study on return to work legislation in the Netherlands

Science.gov (United States)

2013-01-01

appeared to be valid to understand the cases studied, but the additional factor distrust also played a role. Conclusions Legislation appeared to support cooperation, but awareness of a mutual dependence, trust, knowledge about the legislation and personal norms regarding recovery and RTW are also important. Professionals such as occupational physicians should support this to attain a degree of cooperation that is necessary for effective RTW. PMID:23421974

Military legislation: explaining military officers' writing deficiencies

OpenAIRE

Borysov, Andrii

2016-01-01

Approved for public release; distribution is unlimited In performing jobs related to national security and defense, personnel must comply with rules and decisions communicated in the form of written legislation, which includes directives, memos, instructions, manuals, standard operating procedures, and reports. Incorrect understanding of legislative provisions may lead to disastrous consequences, making clear communication through these documents paramount. The vast majority of military of...

Canadian Firearms Legislation and Effects on Homicide 1974 to 2008

Science.gov (United States)

Langmann, Caillin

2012-01-01

Canada has implemented legislation covering all firearms since 1977 and presents a model to examine incremental firearms control. The effect of legislation on homicide by firearm and the subcategory, spousal homicide, is controversial and has not been well studied to date. Legislative effects on homicide and spousal homicide were analyzed using…

A Critique of the Key Legislative Framework Guiding Civil Liberties ...

African Journals Online (AJOL)

Key legislative framework presented in this paper is within the areas of media and access to information, individual rights and freedoms, as well as legislation pertaining to the conduct of elections. In some cases, colonial legislation that politicians claimed to have repealed was reincarnated, as the post-colonial dispensation ...

Does the physician's emotional intelligence matter? Impacts of the physician's emotional intelligence on the trust, patient-physician relationship, and satisfaction.

Science.gov (United States)

Weng, Hui-Ching

2008-01-01

Much of the literature pertinent to management indicates that service providers with high emotional intelligence (EI) receive higher customer satisfaction scores. Previous studies offer limited evidence regarding the impact of physician's EI on patient-physician relationship. Using a multilevel and multisource data approach, the current study aimed to build a model that demonstrated the impact of a physician's EI on the patient's trust and the patient-physician relationship. The survey sample included 983 outpatients and 39 physicians representing 11 specialties. Results of path analyses demonstrated that the ratio of patient's follow-up visits (p impact of patient's trust on patient's satisfaction was mediated by the patient-physician relationship at a significant level (p relationship had a significantly positive effect on patient's satisfaction (p relationship; however, mutual trust and professional respect between nurses and physicians play a critical role in reinforcing the patient-physician relationship to effect improvements in the provision of patient-centered care.

Impact of Scotland's comprehensive, smoke-free legislation on stroke.

Directory of Open Access Journals (Sweden)

Daniel F Mackay

Full Text Available Previous studies have reported a reduction in acute coronary events following smoke-free legislation. Evidence is lacking on whether stroke is also reduced. The aim was to determine whether the incidence of stroke, overall and by sub-type, fell following introduction of smoke-free legislation across Scotland on 26 March 2006.A negative binomial regression model was used to determine whether the introduction of smoke-free legislation resulted in a step and/or slope change in stroke incidence. The model was adjusted for age-group, sex, socioeconomic deprivation quintile, urban/rural residence and month. Interaction tests were also performed. Routine hospital administrative data and death certificates were used to identify all hospital admissions and pre-hospital deaths due to stroke (ICD10 codes I61, I63 and I64 in Scotland between 2000 and 2010 inclusive. Prior to the legislation, rates of all stroke, intracerebral haemorrhage and unspecified stroke were decreasing, whilst cerebral infarction was increasing at 0.97% per annum. Following the legislation, there was a dramatic fall in cerebral infarctions that persisted for around 20 months. No visible effect was observed for other types of stroke. The model confirmed an 8.90% (95% CI 4.85, 12.77, p<0.001 stepwise reduction in cerebral infarction at the time the legislation was implemented, after adjustment for potential confounders.Following introduction of national, comprehensive smoke-free legislation there was a selective reduction in cerebral infarction that was not apparent in other types of stroke.

Criteria for the use of monoclonal antibodies, legislation and ethical considerations

International Nuclear Information System (INIS)

Cox, P.H.

1993-01-01

The criteria governing the in vivo use of monoclonal antibodies in humans are based upon a number of legal requirements with respect to radiation hygiene, pharmaceutical legislation, radiopharmaceutical legislation and regulations with respect to products arising from biotechnology. This in itself has led to a complicated situation which has undoubtedly restricted the development of valuable diagnostic and potential therapeutic agents. From the ethical point of view there are also important considerations, firstly with respect to the methods of producing antibodies, which has resulted in the discontinuation of the raising of antibodies in murine ascites, and secondly in consideration of the ethics of administering labelled antibodies to healthy volunteers and to patients who may not necessarily benefit personally from the procedure. These factors must be evaluated in the light of the EEC document 'Good clinical practice for trials in medicinal products in the European Community from the CPMP working party on Efficacy of Medicinal Products'. (author)

45 CFR 604.200 - Agency and legislative liaison.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Agency and legislative liaison. 604.200 Section 604.200 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NEW RESTRICTIONS ON LOBBYING Activities by Own Employees § 604.200 Agency and legislative liaison. (a...

A legislator`s guide to municipal solid waste management

Energy Technology Data Exchange (ETDEWEB)

Starkey, D; Hill, K

1996-08-01

The purpose of this guide is to allow individual state legislators to gain a better understanding of municipal solid waste (MSW) management issues in general, and examine the applicability of these concerns to their state. This guide incorporates a discussion of MSW management issues and a comprehensive overview of the components of an integrated solid waste management system. Major MSW topics discussed include current management issues affecting states, federal activities, and state laws and local activities. Solid waste characteristics and management approaches are also detailed.

Factors for and against establishing and working in private practice correlated with work-related behavior and experience patterns of Ferman physicians in Schleswig-Holstein: A 2-year longitudinal study

Directory of Open Access Journals (Sweden)

Edgar Voltmer

2017-06-01

Full Text Available Objectives: To identify factors in favor of or against establishing and working in private practice, to determine the quality of life and work-related behavior and experience patterns of German physicians working in private practice, and to analyze the correlation of those factors. Material and Methods: A representative sample of physicians in private practice in Schleswig-Holstein, Germany, was surveyed according to a 2-year longitudinal design (T1 – 2008, N = 549 and T2 – 2010, N = 414. The study included 22 items regarding the attractiveness of establishing and working in private practice, and the questionnaires: the Short Form-12 Health Survey (SF-12, and Work-related Behavior and Experience Pattern (Arbeitsbezogenes Verhaltens- und Erlebensmuster – AVEM. Results: Job satisfaction among those private practitioners decreased over time but their willingness to choose the profession once again remained unchanged. Patient care and the continuity of physician-patient relationship encouraged establishing and working in private practice; state regulation, financial risk, and administrative effort weighed against it. At both T1 and T2, physicians scored significantly lower for mental health than general population. About 20% of physicians showed a healthy behavior and experience pattern but 40% of them showed the pattern of reduced working motivation. About 20% of participants were at elevated risk for overexertion and for burnout. Physical and mental health as well as the total distribution of patterns did not change significantly during the 2-year observation period. Physicians at higher burnout risk rated tasks related to patient care considerably less positively than those with healthy pattern. Conclusions: In order to improve job satisfaction and quality of life, and to make private practice more attractive, those German physicians require a improved legislation, b educational programs that promote the attractiveness of private practice

Toward accommodating physicians' conscientious objections: an argument for public disclosure.

Science.gov (United States)

Harter, Thomas D

2015-03-01

This paper aims to demonstrate how public disclosure can be used to balance physicians' conscientious objections with their professional obligations to patients--specifically respect for patient autonomy and informed consent. It is argued here that physicians should be permitted to exercise conscientious objections, but that they have a professional obligation to provide advance notification to patients about those objections. It is further argued here that public disclosure is an appropriate and ethically justifiable limit to the principle of advance notification. The argument for publicly disclosing physicians' conscientious objections is made in this paper by discussing three practical benefits of public disclosure in medicine, and then addressing how publicly disclosing physicians' conscientious objections is not an undue invasion of privacy. Three additional concerns with public disclosure of physicians' conscientious objections are briefly addressed--potential harassment of physicians, workplace discrimination, and mischaracterising physicians' professional aptitude--concluding that each of these concerns requires further deliberation in the realm of business ethics. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Legislation, standards and methods for mercury emissions control

Energy Technology Data Exchange (ETDEWEB)

NONE

2012-04-15

Mercury is an element of growing global concern. The United Nations Environment Programme plans to finalise and ratify a new global legally-binding convention on mercury by 2013. Canada already has legislation on mercury emissions from coal-fired utilities and the USA has recently released the new Mercury and Air Toxics Standard. Although other countries may not have mercury-specific legislation as such, many have legislation which results in significant co-benefit mercury reduction due to the installation of effective flue-gas cleaning technologies. This report reviews the current situation and trends in mercury emission legislation and, where possible, discusses the actions that will be taken under proposed or impending standards globally and regionally. The report also reviews the methods currently applied for mercury control and for mercury emission measurement with emphasis on the methodologies most appropriate for compliance. Examples of the methods of mercury control currently deployed in the USA, Canada and elsewhere are included.

First and foremost, physicians: the clinical versus leadership identities of physician leaders.

Science.gov (United States)

Quinn, Joann Farrell; Perelli, Sheri

2016-06-20

Purpose - Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach - Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings - These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications - Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications - These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer

Cross-border reproductive care for law evasion: should physicians be allowed to help infertility patients evade the law of their own country?

Science.gov (United States)

Van Hoof, Wannes; Pennings, Guido; De Sutter, Petra

2016-07-01

There are fundamental differences between countries with regard to legislation on assisted reproduction. Many infertility patients are looking to evade the law of their own country and make use of reproductive services abroad. The role of the local physician in cross-border reproductive care for law evasion has been characterized as "channeling local patients to foreign medical establishments" and "against the spirit and essence of the law". The logical view is that by supporting CBRC for law evasion, physicians are essentially supporting immoral behavior. We will tackle this position on two levels. First, we will argue that governments should generally be tolerant toward people with different positions on assisted reproduction. Second, we will show that contributing to cross-border reproductive care for law evasion is not necessarily immoral, because the prima facie wrongness of complicity in law evasion can be outweighed by the fact that physicians should act in the best interest of the patient. Several countries have tried to prevent local physicians from helping patients to make use of reproductive services abroad, but they should rather leave it up to the individual physicians to decide whether or not to support a particular patient. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

45 CFR 1230.200 - Agency and legislative liaison.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Agency and legislative liaison. 1230.200 Section 1230.200 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE NEW RESTRICTIONS ON LOBBYING Activities by Own Employees § 1230.200 Agency and legislative...

Physician scientist research pathway leading to certification by the American Board of Pathology.

Science.gov (United States)

Weiss, Sharon W; Johnson, Rebecca L

2016-06-01

In 2014, the American Board of Pathology, in response to the pathology community, approved a physician scientist research pathway (PSRP). This brief report summarizes the history of and objectives for creating the physician scientist research pathway and the requirements of the American Board of Pathology for the certification of physician scientist research pathway trainees. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

HIPAA for physicians in the information age.

Science.gov (United States)

Kavoussi, Shaheen C; Huang, John J; Tsai, James C; Kempton, James E

2014-08-01

The increased prominence of electronic health records, email, mobile devices, and social media has transformed the health care environment by providing both physicians and patients with opportunities for rapid communication and knowledge exchange. However, these technological advances require increased attention to patient privacy under the Health Insurance Portability and Accountability Act (HIPAA). Instant access to large amounts of electronic protected health information (PHI) merits the highest standard of network security and HIPAA training for all staff members. Physicians are responsible for protecting PHI stored on portable devices. Personal, residential, and public wireless connections are not certified with HIPAA-compliant Business Associate Agreements and are unsuitablefor PHI. A professional and privacy-oriented approach to electronic communication, online activity, and social media is imperative to maintaining public trust in physician integrity. As new technologies are integrated into health care practice, the assurance of privacy will encourage patients to continue to seek medical care.

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

services. Resident physicians should not be left unsupervised to care for critically ill patients. In settings in which the acuity is high, physicians who have completed residency should provide direct supervision for resident physicians. Supervising physicians should always be physically in the hospital for supervision of resident physicians who care for critically ill patientsThe ACGME should explicitly define “good” supervision by specialty and by year of training. Explicit requirements for intensity and level of training for supervision of specific clinical scenarios should be providedCenters for Medicare and Medicaid Services (CMS) should use graduate medical education funding to provide incentives to programs with proven, effective levels of supervision. Although this action would require federal legislation, reimbursement rules would help to ensure that hospitals pay attention to the importance of good supervision and require it from their training programs Resident physician work hours Although the IOM “Sleep, supervision and safety” report provides a comprehensive review and discussion of all aspects of graduate medical education training, the report’s focal point is its recommendations regarding the hours that resident physicians are currently required to work. A considerable body of scientific evidence, much of it cited by the Institute of Medicine report, describes deteriorating performance in fatigued humans, as well as specific studies on resident physician fatigue and preventable medical errors. The question before this conference was what work redesign and cultural changes are needed to reform work hours as recommended by the Institute of Medicine’s evidence-based report? Extensive scientific data demonstrate that shifts exceeding 12–16 hours without sleep are unsafe. Several principles should be followed in efforts to reduce consecutive hours below this level and achieve safer work schedules. The recommendations are: Limit resident physician

Food Irradiation. Standing legislation

International Nuclear Information System (INIS)

Verdejo S, M.

1997-01-01

The standing legislation in Mexico on food irradiation matter has its basis on the Constitutional Policy of the Mexican United States on the 4 Th. article by its refers to Secretary of Health, 27 Th. article to the Secretary of Energy and 123 Th. of the Secretary of Work and Social Security. The laws and regulations emanated of the proper Constitution establishing the general features which gives the normative frame to this activity. The general regulations of Radiological Safety expedited by the National Commission for Nuclear Safety and Safeguards to state the specifications which must be fulfill the industrial installations which utilizing ionizing radiations, between this line is founded, just as the requirements for the responsible of the radiological protection and the operation of these establishments. The project of Regulation of the General Health Law in matter of Sanitary Control of Benefits and Services, that in short time will be officialized, include a specific chapter on food irradiation which considers the International Organizations Recommendations and the pertaining harmonization stated for Latin America, which elaboration was in charge of specialized group where Mexico was participant. Additionally, the Secretary of Health has a Mexican Official Standard NOM-033-SSA1-1993 named 'Food irradiation; permissible doses in foods, raw materials and support additives' standing from the year 1995, where is established the associated requirements to the control registers, service constancies and dose limits for different groups of foods, moreover of the specific guidelines for its process. This standard will be adequate considering the updating Regulation of Benefits and Services and the limits established the Regulation for Latin America. The associated laws that cover in general terms it would be the requirements for food irradiation although such term is not manageable. (Author)

National legislative and regulatory activities

International Nuclear Information System (INIS)

Anon.

2001-01-01

These columns treat of the legislative and regulatory activities of different OECD countries: Australia (environment protection and biodiversity conservation act and regulations, 1999-2000); Bulgaria (basic standards for radiation protection, 2000); France (decree on the standard tax charged on polluting activities due from operators of installations classified for environmental protection purposes, 2000; amendment of the orders on the transport of dangerous goods by road and by rail, 2000); Georgia (law on nuclear and radiation safety, 1998); Germany (amendments to nuclear legislation implementing EURATOM directives, 2000; amendment to the nuclear third party liability provisions of the atomic energy act, 2001; amendment to the foreign trade ordinance, 2000; ordinance on the treatment of foodstuffs with radiation, 2000; general administrative regulations on radioactivity limits in food and feeds); Ireland (European communities regulations on foodstuffs treated with ionizing radiations, 2000); Japan (law for nuclear sitting area development, 2000; Republic of Korea (amendments to the act on compensation for nuclear damage, 2001); Latvia (act on radiation safety and nuclear safety, 2000); Lithuania (resolution approving the decommissioning program for Unit 1, Ignalina NPP, 2001); Luxembourg (grand-ducal regulations on the protection of the public against the risks resulting from ionizing radiation, 2000; grand-ducal regulations relating to foods and food ingredients treated with ionizing radiation, 2000); Mexico (norm regarding selection, qualification and training requirements for staff of a NPP, 2000; norm regarding solid residue as radioactive waste, 2000); Mongolia (law on nuclear weapons free status and its implementing resolution, 2000); Netherlands (amendment to the nuclear energy act, 2000); Norway (act on radiation and use of radiation, 2000); Pakistan (nuclear authority ordinance, 2001); Poland (atomic energy act, 2000); Spain (royal decree on activities

A Call for Action to Improve Occupational Health and Safety in Ghana and a Critical Look at the Existing Legal Requirement and Legislation.

Science.gov (United States)

Annan, Joe-Steve; Addai, Emmanuel K; Tulashie, Samuel K

2015-06-01

Occupational health and safety (OHS) is a broad field of professional practice, which involves specialists from different disciplines including but not limited to engineers, occupational health physicians, physical and biological scientists, economists, and statisticians. The preventive systems required to ensure workers are protected from injuries and illnesses dwell heavily on engineers; however, the extent to which the engineer can go regarding planning and implementing preventive measures is dependent on specific legal requirements, leadership commitment from the company, organization, and nation. The objective of this paper is to identify the areas of opportunities for improvements in OHS management in Ghana with regard to the nation's legal requirements, commitment of the Ghana government, and Ghanaian leadership as well as appropriate structuring of Ghanaian institutions responsible for monitoring and managing OHS in Ghana. This paper identified Ghana's fragmented legal requirements concerning OHS, which are under different jurisdictions with unclear responsibilities and accountabilities. The paper also highlights the training needs of Ghanaian academic institutions regarding OHS. Among other recommendations made including structuring of Ghanaian institutions to manage OHS in line with the ILO-OSH 2001, this paper aligns the recommendations with the articles and elements of International Labour Organization convention number 155 and OHSAS 18001 elements.

A Call for Action to Improve Occupational Health and Safety in Ghana and a Critical Look at the Existing Legal Requirement and Legislation

Directory of Open Access Journals (Sweden)

Joe-Steve Annan

2015-06-01

Full Text Available Occupational health and safety (OHS is a broad field of professional practice, which involves specialists from different disciplines including but not limited to engineers, occupational health physicians, physical and biological scientists, economists, and statisticians. The preventive systems required to ensure workers are protected from injuries and illnesses dwell heavily on engineers; however, the extent to which the engineer can go regarding planning and implementing preventive measures is dependent on specific legal requirements, leadership commitment from the company, organization, and nation. The objective of this paper is to identify the areas of opportunities for improvements in OHS management in Ghana with regard to the nation's legal requirements, commitment of the Ghana government, and Ghanaian leadership as well as appropriate structuring of Ghanaian institutions responsible for monitoring and managing OHS in Ghana. This paper identified Ghana's fragmented legal requirements concerning OHS, which are under different jurisdictions with unclear responsibilities and accountabilities. The paper also highlights the training needs of Ghanaian academic institutions regarding OHS. Among other recommendations made including structuring of Ghanaian institutions to manage OHS in line with the ILO-OSH 2001, this paper aligns the recommendations with the articles and elements of International Labour Organization convention number 155 and OHSAS 18001 elements.

THE RESPONSIBILITY OF PHYSICIAN TO PREPARE A FORENSIC AND MEDICAL REPORT

Directory of Open Access Journals (Sweden)

Mehmet TOYGAR

2006-12-01

Full Text Available Physicians have responsibilities to prepare forensic and expertise reports besides their role in treatment, diagnosis and preventive medicine. A physician who engaged in treatment should have sufficient knowledge and experience to prepare the requested forensic or medical expertise reports. These expertise reports are usually requested either by criminal law or civil law courts, besides, calculation of the physical disabilities should be demanded at the basis of Armed Forces Pension Fund (OYAK Law and monetary compensation. New Turkish Penal Code highlights the new implementations about severity of injuries caused by trauma. According to the interpretation of Military Supreme Court, the severity of injuries caused by trauma in Military Penal Code is evaluated under the light of Turkish Penal Code. Determination of the rate of disabilities in general body functions and loss of daily activity have been often requested for reports concerning the civil law. Different legislations have been used for reports at the basis of monetary compensation. The purpose of this study is to scrutinize the problems encountered while preparing forensic and medical expertise reports and implementing the relevant and appropriate legal procedure and to emphasize the important points to be considered during the preparation of these expertise reports. [TAF Prev Med Bull 2006; 5(6.000: 466-475

Religiosity and the Wish of Older Adults for Physician-Assisted Suicide

Directory of Open Access Journals (Sweden)

Sylvie Lapierre

2018-02-01

Full Text Available In industrialized countries, population ageing is associated with intense discussions on the issue of dying with dignity. Some countries have legalized assisted suicide and authorized physicians to provide the knowledge and/or means for suffering patients to end their life. The goal of this study was to ascertain if religiosity could be a predicting factor of older adults’ wish for physician-assisted suicide (PAS. A sample of 216 men and women over 60 years (M = 72.5 answered the following question: “Would you disagree or agree with assisted suicide for yourself if you were very sick and would die in the near future?” They also completed questionnaires on religiosity, ageism and death anxiety. A regression analysis showed that religiosity explained a significant (F(1211 = 19.62; p < 0.001 proportion (7.7% of the variance in the wish for PAS (full model R2 = 0.17. Religiosity seems to reduce the likelihood that older adults would ask for PAS if they had a terminal illness, while ageism and death anxiety seemed to have the opposite effect. Health professionals and legislators must be aware that psychosocial and spiritual variables have an important influence on the wish for PAS.

ExpertiSZe, a tool for determining the effects of social security legislation

NARCIS (Netherlands)

Svensson, Jorgen S.; Kordelaar, P.J.M.; Kordelaar, P.J.M.; Wassink, J.G.J.; van 't Eind, G.J.; Grütters, C.A.F.M.

1992-01-01

Social security legislation plays an important role in the Dutch society. In view of this, the effects of social security legislation have to be analysed carefully before new legislation can be made. Due to the growing complexity of legislation on the social security domain, this analysis has become

New legislative regulations for ensuring radiation protection using ionizing radiation sources in medicine

International Nuclear Information System (INIS)

Boehm, K.

2018-01-01

European Commission Directive No. 2013/59 / EURATOM laying down basic safety requirements for the provision of radiation protection regulates the provision of radiation protection for workers with radiation sources and residents in all areas of use of ionizing radiation sources. This Directive also addresses radiation protection in the use of ionizing radiation sources in medicine. The European Commission Directive regulates the requirements for radiation protection but also extends to its scope and provisions on the use of medical radiation sources (so-called m edical exposure ) in the scope of further legislation in the field of health care, which has to be amended and modified or possibly issued new. It was necessary in the preparation of the new act on radiation protection to amend simultaneously Act no. 576/2004 on the provision of health care and services related to provision of health care and Act no. 578/2004 on Health care Providers, Health care Professionals and Organizations in Health Care and to prepare a series of implementing regulations not only to the Law on Radiation Protection but also to the Laws governing the Provision of Health Care. The paper presents changes to existing legislation on radiation protection in medical radiation and new requirements for the construction and operation of health workplaces with radiation sources, the protection of the health of patients, the requirements for instrumentation used for medical radiation and radiological instrumentation tests. (authors)

75 FR 17854 - Travel Expenses of State Legislators

Science.gov (United States)

2010-04-08

... residence within the taxpayer's legislative district as the taxpayer's tax home. In addition, as a result of... section 162(h), a matter of Federal law. See Morgan v. Commissioner, 309 U.S. 78, 81 (1940) (``If it is... place of residence within the legislative district represented by the taxpayer is the taxpayer's home...

12 CFR 411.200 - Agency and legislative liaison.

Science.gov (United States)

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Agency and legislative liaison. 411.200 Section 411.200 Banks and Banking EXPORT-IMPORT BANK OF THE UNITED STATES NEW RESTRICTIONS ON LOBBYING Activities by Own Employees § 411.200 Agency and legislative liaison. (a) The prohibition on the use of...

Legislation on treating animals in human care

OpenAIRE

Konečná, Petra

2016-01-01

1 Abstract This Master's thesis entitled Legislation on treating animals in human care compares Czech and Australian legislation in selected aspects of three categories of animals in human care - farm animals, companion animals and animals used for scientific and other research purposes. The thesis is composed of 5 main chapters. The first chapter describes sources of law regarding treating animals in human care from the perspectives of international law, European Union law, federal Czech law...

Information report on state legislation

International Nuclear Information System (INIS)

1982-01-01

Summaries of laws enacted by states, during 1982, dealing with the management of low-level radioactive wastes are presented in this report. Also included are adopted resolutions, introduced legislation and introduced resolutions

Physician heal thyself

African Journals Online (AJOL)

Compared to overweight or obese physicians, normal‑weight physicians were significantly more likely to discuss weight loss with their obese patients, according to a study among. 500 primary care physicians, undertaken by researchers at the Johns Hopkins Bloomberg School of Public Health.[4]. A recent, highly accessed ...

Inclusive Education in Spain: Promoting Advocacy by Legislation

Science.gov (United States)

De Luis, Edurne Chocarro

2016-01-01

This article reviews the journey of special education in Spain by considering the legal frameworks. It examines the extent to which legislation has tapped into the feelings of society in general towards people with disabilities who wish to secure inclusion in both education and society. It tracks the evolution of legislation, originally based on a…

Iranian Physicians' Perspectives Regarding Nurse-Physician Professional Communication: Implications for Nurses.

Science.gov (United States)

Esmaeilpour-Bandboni, Mohammad; Vaismoradi, Mojtaba; Salsali, Mahvash; Snelgrove, Sherrill; Sheldon, Lisa Kennedy

2017-08-01

Nurse-physician professional communication affects the effectiveness and performance of the health care team and the quality of care delivered to the patient. This study aimed to explore the perspectives and experiences of physicians on nurse-physician professional communication in an urban area of Iran. Semistructured interviews were conducted with 15 physicians selected using a purposive sampling method. Physicians from different medical specialties were chosen from 4 teaching hospitals in an urban area of Iran. The data were analyzed with content analysis and themes developed. Three themes developed during data analysis: "seeking the formal methods of communication to ensure patient care," "nurses' professional attributes for professional communication," and "patients' health conditions as the mediators of professional communication." Nurses need to be informed of the perspectives and experiences of physicians on professional communication. Our findings can improve nurses' understandings of professional communication that could inform the development of educational and training programs for nurses and physicians. There is a need to incorporate communication courses during degree education and design interprofessional training regarding communication in clinical settings to improve teamwork and patient care. Open discussions between nurses and physicians, training sessions about how to improve their knowledge about barriers to and facilitators of effective professional communication, and key terms and phrases commonly used in patient care are suggested.

Statewide Policy Change in Pediatric Dental Care, and the Impact on Pediatric Dental and Physician Visits.

Science.gov (United States)

Zlotnick, Cheryl; Tam, Tammy; Ye, Yu

2017-10-01

Introduction In 2007, the California signed legislation mandating a dental visit for all children entering kindergarten or first grade; no such mandate was made for physician visits. This study examines the impact of this policy change on the risk factors associated with obtaining pediatric dental and physician health care visits. Methods Every 2 years, California Health Interview Survey conducts a statewide survey on a representative community sample. This cross-sectional study took advantage of these data to conduct a "natural experiment" assessing the impact of this policy change on both pediatric physician and dental care visits in the past year. Samples included surveys of adults and children (ages 5-11) on years 2005 (n = 5096), 2007 (n = 4324) and 2009 (n = 4100). Results Although few changes in risk factors were noted in pediatric physician visits, a gradual decrease in risk factors was found in pediatric dental visits from 2005 to 2009. Report of no dental visit was less likely for: younger children (OR -0.81, CI 0.75-0.88), insured children (OR 0.34, CI 0.22-0.53), and children who had a physician's visit last year (OR 0.37, CI 0.25-0.53) in 2005. By 2007, absence of insurance was the only risk factor related to having no dental visit (OR 0.34, CI 0.19-0.61). By 2009, no a priori measured risk factors were associated with not having a dental visit for children aged 5-11 years. Conclusions A statewide policy mandating pediatric dental visits appears to have reduced disparities. A policy for medical care may contribute to similar benefits.

Recognizing a fundamental liberty interest protecting the right to die: an analysis of statutes which criminalize or legalize physician-assisted suicide.

Science.gov (United States)

Tarnow, W J

1996-01-01

Physician-assisted suicide is one of the most controversial issues in society today. We live in an age where medical technology has developed so fast and so far that those who would have swiftly succumbed to deadly diseases in the not too distant past are now living, or, rather, being kept alive long past the point of meaningful existence. Although everyone sympathizes with the painful plight of the terminally ill, the specter of physician-assisted suicide gives many pause, and rightfully so: one need only think of the carbon monoxide contraption in the back of Dr. Death's infamous van to realize that society must address the issue of the right to die. Is there any solution to this great debate? In this note, Mr. William Tarnow passionately answers in the affirmative. Mr. Tarnow analyzes the constitutionality of state statutes which either criminalize or legalize physician-assisted suicide under both the Due Process and Equal Protection Clauses of the Constitution of the United States. The note also considers the case law, largely from the federal Ninth Circuit Court of Appeals, invalidating and upholding such statutes under the Constitution. Arguing that there is indeed a constitutional liberty interest in physician-assisted suicide, Mr. Tarnow concludes by suggesting that state legislatures can and must create legislation that legalizes physician-assisted suicide and passes constitutional muster.

An intervention to increase patients' trust in their physicians. Stanford Trust Study Physician Group.

Science.gov (United States)

Thom, D H; Bloch, D A; Segal, E S

1999-02-01

To investigate the effect of a one-day workshop in which physicians were taught trust-building behaviors on their patients' levels of trust and on outcomes of care. In 1994, the study recruited 20 community-based family physicians and enrolled 412 consecutive adult patients from those physicians' practices. Ten of the physicians (the intervention group) were randomly assigned to receive a one-day training course in building and maintaining patients' trust. Outcomes were patients' trust in their physicians, patients' and physicians' satisfaction with the office visit, continuity in the patient-physician relationship, patients' adherence to their treatment plans, and the numbers of diagnostic tests and referrals. Physicians and patients in the intervention and control groups were similar in demographic and other data. There was no significant difference in any outcome. Although their overall ratings were not statistically significantly different, the patients of physicians in the intervention group reported more positive physician behaviors than did the patients of physicians in the control group. The trust-building workshop had no measurable effect on patients' trust or on outcomes hypothesized to be related to trust.

[Alcohol and work: the role of the company physician in the occupational health and safety management systems].

Science.gov (United States)

Patussi, V; Muran, A

2010-01-01

The organization of safety in the working places and the increasing attention to behaviours and life styles of workers that may lead to increasing occupational risks are the pick innovative aspects of the recent changes in our country's legislation about occupational safety. In this organization, the role of the company physician is becoming more and more important and his work of evaluation beginning with the knowledge both of the working places and of the workers's lifestyles, is irreplaceable. His role in organizing the managing standards of occupational safety and health cannot be limited to health supervision but must be an essential element in risk assessment in the prevision of workplaces and of safe working conditions, in workers training and information, in organizing the control system of each business. The present paper examines--referring to the current regulation--the duties and functions of a company physician when facing the problems concerning the working risks tied to alcohol assumption.

The physician as a source of hospital capital.

Science.gov (United States)

Fried, J M

1984-06-01

As hospitals search for means of financing renovation during the next decade, physicians will represent a source of capital through tax-shelter financing. Limited partnerships, condominiums , and joint ventures in acquiring medical equipment or syndicating existing facilities are among the most promising investment vehicles for taking advantage of tax benefits that normally do not apply to nonprofit institutions. In a hospital-physician limited partnership, tax deductions are passed through to the partners, of which there are two kinds: general partners and limited partners. Income (or loss) and tax credits from the entire venture can be divided among the partners and reflected on an individual limited partner's tax return. Rather than shouldering the whole cost of renovating a medical office building, thereby losing the potential tax credit, a hospital could carry out the renovation through a limited partnership with physicians. This would reduce the hospital's capital costs and debt requirements, maintain its credit, and enable it to take advantage of the depreciation deduction. In a condominium venture, the individual physician actually owns the office within which he or she works. As with the limited partnership, the hospital will want to restrict physicians' ability to dispose of their ownership interests.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of sexual orientation on state legislators' behavior and priorities.

Science.gov (United States)

Herrick, Rebekah

2009-01-01

This article explores whether sexual orientation, surrogate representation, and political factors affect legislators' work on gay, lesbian, and bisexual (GLB) interests, and whether the latter explains away the influence of sexual orientation. A survey of openly GLB state legislators and their colleagues was conducted to measure legislators' campaign issues, legislative priorities, surrogate representation, and ambition. This information is supplemented with bill introduction and district data. The results indicate that legislators' sexual orientation strongly influences their work on GLB issues and although surrogate representation and electoral considerations also affect GLB work, they do not explain away the importance of sexual orientation. The implications of this for the relationship between descriptive and substantive representation are explored.

Physician Appraisals: Key Challenges

Directory of Open Access Journals (Sweden)

Klich Jacek

2017-06-01

Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

Sonora Legislators and their Constitution, 1857-1861

Directory of Open Access Journals (Sweden)

Zulema Trejo

2010-01-01

Full Text Available This paper describes the members of the Sonora constituent congress (1857-61, and analyzes the debates they held regarding the project for the state's Constitution, which would follow the lines estblished by the 1857 Federal Constitution. It also points out the relations between each legislator's trajectory and politicial affiliation (as far as available sources allow for this, and the proposals he presented during the legislative debates that gave place to the 1861 Constitution of Sonora.

The economic impact of merger control legislation

OpenAIRE

Carletti, Elena; Hartmann, Philipp; Onega, Steven

2007-01-01

We construct a unique dataset of legislative reforms in merger control legislation that occurred in nineteen industrial countries in the period 1987-2004, and investigate the economic impact of these changes on stock prices. In line with the hypothesis that merger control should challenge anticompetitive mergers and thus limit future monopolistic profits, we find that the strengthening of merger control decreases the stock prices of non-financial firms. In contrast, we find that bank stock pr...

Efficient lighting in buildings: The lack of legislation in Portugal

International Nuclear Information System (INIS)

Almeida, António Manuel; Martins, António Gomes

2014-01-01

The behavior of building designers is conditioned by the existing legislation and regulations in the national context in which they operate. However, in the Portuguese legislation there are no rules concerning the use of daylight, and therefore, designers are not stimulated to adopt solutions that make use of the existing potential of sunlight availability. In the same way, it is difficult to understand the lack of specific regulation, with quantified targets, limiting power density of artificial lighting installed inside buildings. The present opportunity, generated by the need to carry out the revision of Portuguese building energy systems regulation, should be used to fill the existing gap in national legislation regarding those matters. In this paper the authors present some proposals for future legislation that will have as central purpose the utilization of efficient lighting systems and the promotion of architectural solutions that optimize the use of daylighting. It is possible, and desirable, to add new directives to national legislation that contribute to the improvement of Portuguese buildings, characterized by its good performance in terms of daylight availability, and at the same time, increasing the energy efficiency and reducing the energy consumption of lighting systems installed in those buildings. - Highlights: • In the Portuguese legislation there are no rules concerning the use of daylight. • Lack of specific regulation limiting power density of artificial lighting. • Revision of Portuguese building energy systems regulation. • Some proposals for future legislation. • Improvement of Portuguese buildings promoting energy efficiency

Some considerations regarding the reforms of nuclear liability legislation in the United States

International Nuclear Information System (INIS)

Welck, S. von

1980-01-01

In the United States, as in the Federal Republic of Germany and in Switzerland, some thought is presently being given to reforms of nuclear liability legislation. In each case it was either triggered or influenced by the Three Mile Island incident of March 28, 1979. Some of the current thinking in the United States has already been incorporated in a number of draft bills now before Congress for deliberation and decision. Other draft bills on reforms of U.S. nuclear liability law have been announced. It is certain that this reform of nuclear liability legislation in the United States will be carried out not only with determination and the political will to improve the present situation, but also with the required caution and prudence, and that it will keep Congress busy not only for this term, but also next year. (orig.) [de

U.S.: proposed federal legislation to allow condom distribution and HIV testing in prison.

Science.gov (United States)

Dolinsky, Anna

2007-05-01

Representative Barbara Lee (D-CA) is reintroducing legislation in the U.S. House of Representatives that would require federal correctional facilities to allow community organizations to distribute condoms and provide voluntary counselling and testing for HIV and STDs for inmates. The bill has been referred to the House Judiciary Committee's Subcommittee on Crime, Terrorism, and Homeland Security.

Problems encountered in embodying the principles of ICRP-26 and the revised IAEA safety standards into UK national legislation

International Nuclear Information System (INIS)

Beaver, P.F.

1979-01-01

This paper describes the United Kingdom procedures and format for safety legislation and goes on to show how the necessary legislation for radiological protection will fit into the general framework. The United Kingdom, as a member of the European Community and EURATOM, is bound to implement the Euratom Directive on radiological protection within the next few years. The latest draft of the Directive takes account of the recommendations of ICRP-26 and further, a recent draft of the revised IAEA Basic Safety Standards is a composite of both the Directive and ICRP-26. Thus, the effect of embodying the principles of the Directive is to embody the principles of ICRP-26 and the Basic Safety Standards. Some of the problems which have been met are described and in particular there is discussion of the problems arising from the incorporation of the three ICRP-26 facets of dose control, namely justification, optimization and limitation, into a legislative package. The UK system of evolving safety legislation now requires considerable participation by all the parties affected (or by their representatives). This paper indicates that the involvement of persons affected, coupled with a legislative package which consists of a hierarchy of (a) regulations; (b) codes of practice; and (c) guidance notes, will result in the fundamental principles of ICRP-26 being incorporated into UK legislation in a totally acceptable way. (author)

Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives.

Science.gov (United States)

Wright, David Kenneth; Fishman, Jennifer R; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

2015-01-01

Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. We conducted a discourse analysis of print media on physicians' perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician's perspective. We identified 3 predominant discourses about physicians' public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies.

Fifty years of German nuclear legislation

International Nuclear Information System (INIS)

Heller, W.

2006-01-01

The political situation and the state of legislation after World War II make it difficult to pinpoint a precise date of origin of German nuclear legislation. The restrictions imposed by the Allied High Commission (AHC) without any exception put a ban on the production of uranium and thorium metal as well as the construction of nuclear reactors. These restrictions were lifted expressly when the German Atomic Energy Act (AtG) entered into force on January 1, 1960, i.e. much later than the formal step of gaining sovereignty, which was marked by the protocol of May 5, 1955 terminating the Occupation Statute. In October 1955, the German federal government established the then Federal Ministry for Atomic Matters also in an attempt to reconnect to developments in nuclear fission in other parts of the Western world. To supersede the AHC law, the German federal government in December 1956 publicized a draft Atomic Energy Act. It is safe, therefore, to consider that year the starting point of German atomic legislation. This step was followed by deliberations preparatory to the adoption of the Atomic Energy Act. In 1957, however, adoption failed because no two-thirds majority was reached to amend the Basic Law, i.e. the Constitution. As a consequence, some federal states saw the need to adopt state legislation to regulate this area. On December 3, 1959, a new draft Atomic Energy Act was adopted by the German federal parliament after the second and third readings - coupled with an amendment to the Basic Law on that same day - with the votes of the opposition and with one abstention. (orig.)

Family physician perceptions of working with LGBTQ patients: physician training needs.

Science.gov (United States)

Beagan, Brenda; Fredericks, Erin; Bryson, Mary

2015-01-01

Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

Family physician perceptions of working with LGBTQ patients: physician training needs

Directory of Open Access Journals (Sweden)

Brenda Beagan

2015-04-01

Full Text Available Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ. Understanding physician perceptions of this area of practice may aid in developing improved education. Method: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Results: Three major themes emerged: 1 Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2 Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3 Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

The impact of legislation on divorce: a hazard function approach.

Science.gov (United States)

Kidd, M P

1995-01-01

"The paper examines the impact of the introduction of no-fault divorce legislation in Australia. The approach used is rather novel, a hazard model of the divorce rate is estimated with the role of legislation captured via a time-varying covariate. The paper concludes that contrary to U.S. empirical evidence, no-fault divorce legislation appears to have had a positive impact upon the divorce rate in Australia." excerpt

Generic legislation of new psychoactive drugs.

Science.gov (United States)

van Amsterdam, Jan; Nutt, David; van den Brink, Wim

2013-03-01

New psychoactive drugs (NPDs, new psychoactive substances) enter the market all the time. However, it takes several months to ban these NPDs and immediate action is generally not possible. Several European countries and drug enforcement officers insist on a faster procedure to ban NPDs. Introduction of generic legislation, in which clusters of psychotropic drugs are banned in advance, has been mentioned as a possible solution. Here we discuss the pros and cons of such an approach. First, generic legislation could unintentionally increase the expenditures of enforcement, black market practices, administrative burden and health risks for users. Second, it may have a negative impact on research and the development of new treatments. Third, due to the complexity of generic legislation, problems in the enforcement are anticipated due to lack of knowledge about the chemical nomenclature. Finally, various legal options are already available to ban the use, sale and trade of NPDs. We therefore conclude that the currently used scientific benefit-risk evaluation should be continued to limit the adverse health effects of NPDs. Only in emergency cases, where fatal incidents (may) occur, should this approach be overruled.

Legal Framework of Franchise Agreement Compared to the Legislation Status in Yemen

Directory of Open Access Journals (Sweden)

رشاد نعمان العامري

2017-10-01

Full Text Available Franchise is a modern style created as a need for trade to increase projects size. It differs from the authorization to use the trademark because the latter only requires licensing of the licensee's trademark, unlike the Franchise contract, in which it goes beyond the need to convey technical knowledge from Franchisor to Franchisee. In Yemen, Franchise has not received any private legal legislation till the moment, necessitating applying contract articles, contracts general principles and some provisions embodied in the texts of other laws that are suitable to be applied to some of its issues and provisions, in addition to what is inspired by provisions in foreign laws. This study aimed to distinguish franchise agreement from similar contracts that have become common in the commercial field; to identify important legal and practical problems facing franchise agreement as well as suggest solutions to address such problems; and to propose regulatory principles that can be used by the Yemeni legislator in the future when enacting laws that govern franchise agreement. To achieve these objectives, the study followed a descriptive analytical method. The study concludes that the franchise agreement has not received any special legal legislation in Yemen so far; and also the franchise agreement is characterized by a complex nature and has special features. Keywords: Franchise, Trade mark, Technical knowledge, Franchisor, Franchisee.

Developing a Physician Management & Leadership Program (PMLP) in Newfoundland and Labrador.

Science.gov (United States)

Maddalena, Victor; Fleet, Lisa

2015-01-01

This article aims to document the process the province of Newfoundland and Labrador used to develop an innovative Physician Management and Leadership Program (PMLP). The PMLP is a collaborative initiative among Memorial University (Faculty of Medicine and Faculty of Business), the Government of Newfoundland and Labrador, and the Regional Health Authorities. As challenges facing health-care systems become more complex there is a growing need for management and leadership training for physicians. Memorial University Faculty of Medicine and the Gardiner Centre in the Faculty of Business in partnership with Regional Health Authorities and the Government of Newfoundland and Labrador identified the need for a leadership and management education program for physician leaders. A provincial needs assessment of physician leaders was conducted to identify educational needs to fill this identified gap. A Steering Committee was formed to guide the design and implementation and monitor delivery of the 10 module Physician Management and Leadership Program (PMLP). Designing management and leadership education programs to serve physicians who practice in a large, predominately rural geographic area can be challenging and requires efficient use of available resources and technology. While there are many physician management and leadership programs available in Canada and abroad, the PMLP was designed to meet the specific educational needs of physician leaders in Newfoundland and Labrador.

Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians.

Science.gov (United States)

Eyal, Nir; Cancedda, Corrado; Kyamanywa, Patrick; Hurst, Samia A

2015-12-30

Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system. © 2016 by Kerman University of Medical Sciences.

Legal Framework of Franchise Agreement Compared to the Legislation Status in Yemen

OpenAIRE

رشاد نعمان العامري

2017-01-01

Franchise is a modern style created as a need for trade to increase projects size. It differs from the authorization to use the trademark because the latter only requires licensing of the licensee's trademark, unlike the Franchise contract, in which it goes beyond the need to convey technical knowledge from Franchisor to Franchisee. In Yemen, Franchise has not received any private legal legislation till the moment, necessitating applying contract articles, contracts general principles and som...

The Ethical and Legal Dilemma in Terminating the Physician-Patient Relationship.

Science.gov (United States)

Senderovitch, Helen

2016-05-01

A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient. It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours. The relationship is secured with both trust and respect, for without trust, the patient may hold back from stating their conditions which will result in the physician not providing them with all the care they require. Sometimes, lack of some of these key characteristics of the physician-patient relationship and other circumstances, may cause either the patient or the physician to terminate the relationship. Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship. Both the law and ethical principles play a role in the decisions made by the physician in regards to their relationship with the patient, but regardless, the physician has the obligation to make sure their patient is receiving care by one means or another.

Legislation in the electricity economy 1980

International Nuclear Information System (INIS)

Antoni, W.; Haeusler, C.; Hermann, H.P.; Meyer-Woebse, G.; Schmidt, K.

1981-01-01

The authors survey substantial developments of legislation in the electricity economy in 1980. They deal with prominent, legal subjects of a political nature and discuss questions posed by the interpretation and application of laws with regard to supply concepts, to the 4th amendment to the anti-trust law, to legislation relating to the anti-trust law, to recommendations by the Investigation Committee, to rate approvals, general terms and conditions governing supplies, to atomic energy law, to the environmental protection law, to the law relating to the conservation of nature and preservation of rural amenities, to the law relating to roads and to developments of tax laws. (HSCH) [de

Impact of the legislation on consumers

International Nuclear Information System (INIS)

Lee, D.O.

1982-01-01

Douglas Lee points out that the question of nuclear waste will not go away. Nuclear waste is with us and consumers should support legislation to deal with the problem once and for all. The spent fuel is growing, and twenty-nine nuclear plants will face onsite storage problems in this decade. If these plants shut down, consumers will face higher electric generating costs if a switch to a more expensive fuel is necssary, or if the utilities are forced to purchase power of the grid. The cost of waste disposal under this proposed legislation will amount to about 75 cents per month for those electric customers serviced by nuclear plants

Equal pay legislation and the gender wage gap

OpenAIRE

Polachek, Solomon W.

2014-01-01

Despite equal pay legislation dating back 50 years, American women still earn 22% less than their male counterparts. In the UK, with its Equal Pay Act of 1970, and France, which legislated in 1972, the gap is 21% and 17% respectively, and in Australia it remains around 17%. Thus, the gender pay gap continues to be an important policy issue.

Associations Between Physician Empathy, Physician Characteristics, and Standardized Measures of Patient Experience.

Science.gov (United States)

Chaitoff, Alexander; Sun, Bob; Windover, Amy; Bokar, Daniel; Featherall, Joseph; Rothberg, Michael B; Misra-Hebert, Anita D

2017-10-01

To identify correlates of physician empathy and determine whether physician empathy is related to standardized measures of patient experience. Demographic, professional, and empathy data were collected during 2013-2015 from Cleveland Clinic Health System physicians prior to participation in mandatory communication skills training. Empathy was assessed using the Jefferson Scale of Empathy. Data were also collected for seven measures (six provider communication items and overall provider rating) from the visit-specific and 12-month Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) surveys. Associations between empathy and provider characteristics were assessed by linear regression, ANOVA, or a nonparametric equivalent. Significant predictors were included in a multivariable linear regression model. Correlations between empathy and CG-CAHPS scores were assessed using Spearman rank correlation coefficients. In bivariable analysis (n = 847 physicians), female sex (P empathy scores. In multivariable analysis, female sex (P empathy scores. Of the seven CG-CAHPS measures, scores on five for the 583 physicians with visit-specific data and on three for the 277 physicians with 12-month data were positively correlated with empathy. Specialty and sex were independently associated with physician empathy. Empathy was correlated with higher scores on multiple CG-CAHPS items, suggesting improving physician empathy might play a role in improving patient experience.

Attitudes of pharmacists and physicians to antibiotic policies in hospitals.

Science.gov (United States)

Adu, A; Simpson, J M; Armour, C L

1999-06-01

Antibiotic therapy in hospitals has substantial impact on patient outcome and the pharmacy drug budget. Antibiotic policies have been implemented by some hospitals to improve the quality of patient outcome and cost of antibiotic therapy. Antibiotic policies impose certain requirements on pharmacists and physicians. Pharmacists' and physicians' attitudes to and opinions about antibiotic policies are likely to affect the usefulness of such policies. To determine the attitudes of pharmacists and physicians to antibiotic policies in New South Wales (NSW) hospitals. Pharmacists and physicians in NSW public hospitals were surveyed to determine their attitudes to and opinions on antibiotic policies. A simple one-stage cluster sample of 241 pharmacists and a two-stage cluster sample of 701 physicians were obtained. Factor analysis was used to identify the attitudinal dimensions. General linear modelling was used to investigate the effects of predictor variables on outcome variables. The response rates were 91% and 77% for pharmacists and physicians, respectively. Factor analysis identified three dimensions of attitude to antibiotic policies: that they encourage rational antibiotic use; that they improve the quality of antibiotic prescribing and that they are associated with some problems. The reliability of these factors (Cronbach's alpha) ranged from 0.71 to 0.74, and was 0.90 for the overall attitude scale. Pharmacists and physicians had a positive overall attitude to antibiotic policies. Whereas physicians recognize that antibiotic policies improve the quality of prescribing, this was highly correlated with identification of problems (alpha = 0.71). In urban hospitals, pharmacists were more likely than physicians to associate antibiotics with problems. There was a positive overall attitude to hospital antibiotic policies expressed by pharmacists and physicians.

Physicians' intentions and use of three patient decision aids

Directory of Open Access Journals (Sweden)

Mitchell Susan L

2007-07-01

Full Text Available Abstract Background Decision aids are evidence based tools that assist patients in making informed values-based choices and supplement the patient-clinician interaction. While there is evidence to show that decision aids improve key indicators of patients' decision quality, relatively little is known about physicians' acceptance of decision aids or factors that influence their decision to use them. The purpose of this study was to describe physicians' perceptions of three decision aids, their expressed intent to use them, and their subsequent use of them. Methods We conducted a cross-sectional survey of random samples of Canadian respirologists, family physicians, and geriatricians. Three decision aids representing a range of health decisions were evaluated. The survey elicited physicians' opinions on the characteristics of the decision aid and their willingness to use it. Physicians who indicated a strong likelihood of using the decision aid were contacted three months later regarding their actual use of the decision aid. Results Of the 580 eligible physicians, 47% (n = 270 returned completed questionnaires. More than 85% of the respondents felt the decision aid was well developed and that it presented the essential information for decision making in an understandable, balanced, and unbiased manner. A majority of respondents (>80% also felt that the decision aid would guide patients in a logical way, preparing them to participate in decision making and to reach a decision. Fewer physicians ( Conclusion Despite strong support for the format, content, and quality of patient decision aids, and physicians' stated intentions to adopt them into clinical practice, most did not use them within three months of completing the survey. There is a wide gap between intention and behaviour. Further research is required to study the determinants of this intention-behaviour gap and to develop interventions aimed at barriers to physicians' use of decision aids.

Providing primary health care with non-physicians.

Science.gov (United States)

Chen, P C

1984-04-01

The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.

Legislator voting and behavioral science theory: a systematic review.

Science.gov (United States)

Tung, Gregory J; Vernick, Jon S; Reiney, Erin V; Gielen, Andrea C

2012-11-01

To examine the application of behavioral science theories to explain the voting behavior of legislators for public health policies. We conducted a systematic review to identify studies that examined factors associated with legislator support, intention to vote, or actual votes on public health policies, emphasizing those grounded in behavior science theory. Twenty-one papers met our inclusion criteria, and 6 were explicitly grounded in a behavioral science theory. Behavioral science theories, and the theory of planned behavior in particular, provide a framework for understanding legislator voting behavior and can be used by advocates to advance pro-health policies.

How online sales and promotion of snus contravenes current European Union legislation.

Science.gov (United States)

Peeters, Silvy; Gilmore, Anna B

2013-07-01

The European Union (EU) Tobacco Products Directive that bans sales of snus (a form of oral tobacco) in EU countries other than Sweden is currently under review. Major tobacco companies favour the ban being overturned. This study aims to explore compliance with the current ban on snus sales and examines the conduct of online snus vendors, including their compliance with two other EU Directives on excise and tobacco advertising and Swedish legislation banning sales of snus outside Sweden. To determine who is currently distributing snus via the internet in the EU, searches were carried out in Google, followed by searches in the WHOIS and Amadeus databases. Five online test purchases of snus were made in each of 10 EU Member States using a standardised protocol. Feedback from the test purchases and further analysis of the websites accessed for test purchases were used to critically examine snus retailers' conduct. The majority of online vendors operate from Sweden and target non-Swedish EU citizens. Test purchases were successfully made in all 10 EU Member States; of 43 orders placed, only two failed. Age verification relied only on self-report. The majority of sales applied Swedish taxes, contrary to EU requirements. Copious sales promotion activities, many price based, are incorporated in these websites contravening the EU regulation, and three test purchases were delivered with gifts. Snus is currently being sold on the single market via the internet in contravention of Swedish legislation and three EU Directives. The apparent willingness of the tobacco industry to contravene EU and Swedish legislation and profit from unlawful sales raises questions about their status as stakeholders in consultations on future policy developments. The findings highlight how national and regional tobacco control legislation can be undermined in an increasingly globalised world.

Recent US legislative actions

International Nuclear Information System (INIS)

Daniel, P.

1987-01-01

A view on legislative events in the US from the outside is presented. The author comments on the general principles and advantages of free trade against the possibility of an embargo into the US on uranium, on the issue of sanctions against South Africa, and Namibia, and how these issues affect the world market for uranium

The paradoxes of application of the legislation on personal data

Directory of Open Access Journals (Sweden)

Natalia A. Bobrova

2018-01-01

Full Text Available The subject. The article is devoted to the analysis of legislation on personal data and it’s enforcement in the educational process in higher educational institutions.The purpose of the article is highlight controversies in legislation on personal data, generating mistakes in enforcement during the educational procedures.The description of methodology. The author uses methods of complex analysis, synthesis, as well as formal-logical and formal-legal methods.The main results and scope of their application. The practice of interpreting the concepts of “personal data”, “confidential personal data”, “official secret”, “publicly available personal data” is extremely contradictory.Currently, there are hundreds departmental regulatory legal acts about various aspects of the protection of official secrets. Analysis of these acts shows that the rules aimed at preserving the confidentiality of official information regulate the following aspects of the functioning of state and municipal bodies, institutions and organizations: (a ensuring access to official information; (b providing state and municipal services; (c document flow and record keeping; (d staffing; (e anti-corruption; (f use of information systems; (g interaction with the media; (h prevention of conflicts of interest.The study load cannot be attributed to the personal data, that requires the consent of the teacher to be processed. The study load is nothing more than publicly available information, arising from the principles of collegiality of educational process management, competitiveness of education, its openness and transparency, that are established in the legislation on education.Conclusions. Extended interpretation of confidential personal data and inclusion of the teaching load to it is unacceptable. This contributes to conflicts of interest, corrupt factors and devaluation of higher education.

Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians.

Science.gov (United States)

Bell, Darrel J; Bringman, Jay; Bush, Andrew; Phillips, Owen P

2006-11-01

Physician job satisfaction has been the subject of much research. However, no studies have been conducted comparing academic and private practice physician satisfaction in obstetrics and gynecology. This study was undertaken to measure satisfaction levels for academic and private practice obstetrician-gynecologists and compare different aspects of their practice that contributed to their satisfaction. A survey was mailed to randomly selected obstetrician-gynecologists in Memphis, TN; Birmingham, AL; Little Rock, AR; and Jackson, MS. Physicians were asked to respond to questions concerning demographics and career satisfaction. They were also asked to assess the contribution of 13 different aspects of their practice in contributing to their job selection and satisfaction using a Likert scale. A score of 1 meant the physician completely disagreed with a statement regarding a factor's contribution or was completely dissatisfied; a score of 5 meant the physician completely agreed with a factor's contribution or was completely satisfied. Simple descriptive statistics, as well as the 2-sample t test, were used. Likert scale values were assumed to be interval measurements. Of the 297 questionnaires mailed, 129 (43%) physicians responded. Ninety-five (74%) respondents rated their overall satisfaction as 4 or 5. No significant difference was found between academic and private physicians when comparing overall job satisfaction (P = .25). When compared to private practice physicians, the aspects most likely contributing to overall job satisfaction for academic physicians were the ability to teach, conduct research, and practice variety (P = .0001, P = .0001, and P = .007, respectively). When compared with academic physicians, the aspects most likely contributing to job satisfaction for private practice physicians were autonomy, physician-patient relationship, and insurance reimbursement (P = .0058, P = .0001, and P = .0098, respectively). When choosing a practice setting

Invited Article: Threats to physician autonomy in a performance-based reimbursement system.

Science.gov (United States)

Larriviere, Daniel G; Bernat, James L

2008-06-10

Physician autonomy is currently threatened by the external application of pay for performance standards and required conformity to practice guidelines. This phenomenon is being driven by concerns over the economic viability of increasing per capita health care expenditures without a concomitant rise in favorable health outcomes and by the unjustified marked variations among physicians' practice patterns. Proponents contend that altering the reimbursement system to encourage physicians to make choices based upon the best available evidence would be one way to ensure better outcomes per health care dollar spent. Although physician autonomy is most easily justified when decisions are made by appealing to the best available evidence, incentivizing decision-making risks sacrificing physician autonomy to political and social forces if the limitations of evidence-based medicine are not respected. Any reimbursement system designed to encourage physicians to utilize the best available evidence by providing financial incentives must recognize physicians who try to play to the numbers as well as physicians who refuse to follow the best available evidence if doing so would conflict with good medicine or patient preferences. By designing, promulgating, and updating evidence-based clinical practice guidelines, medical specialty societies can limit threats to physician autonomy while improving medical practice.

Financial Ties Between Emergency Physicians and Industry: Insights From Open Payments Data.

Science.gov (United States)

Fleischman, William; Ross, Joseph S; Melnick, Edward R; Newman, David H; Venkatesh, Arjun K

2016-08-01

The Open Payments program requires reporting of payments by medical product companies to teaching hospitals and licensed physicians. We seek to describe nonresearch, nonroyalty payments made to emergency physicians in the United States. We performed a descriptive analysis of the most recent Open Payments data released to the public by the Centers for Medicare & Medicaid Services covering the 2014 calendar year. We calculated the median payment, the total pay per physician, the types of payments, and the drugs and devices associated with payments to emergency physicians. For context, we also calculated total pay per physician and the percentage of active physicians receiving payments for all specialties. There were 46,405 payments totaling $10,693,310 to 12,883 emergency physicians, representing 30% of active emergency physicians in 2013. The percentage of active physicians within a specialty who received a payment ranged from 14.6% in preventive medicine to 91% in orthopedic surgery. The median payment and median total pay to emergency physicians were $16 (interquartile range $12 to $68) and $44 (interquartile range $16 to $123), respectively. The majority of payments (83%) were less than $100. Food and beverage (86%) was the most frequent type of payment. The most common products associated with payments to emergency physicians were rivaroxaban, apixaban, ticagrelor, ceftaroline, canagliflozin, dabigatran, and alteplase. Nearly a third of emergency physicians received nonresearch, nonroyalty payments from industry in 2014. Most payments were of small monetary value and for activities related to the marketing of antithrombotic drugs. Copyright © 2016 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Participation without representation? Senior opinion, legislative behavior, and federal health reform.

Science.gov (United States)

Bradley, Katharine W V; Chen, Jowei

2014-04-01

Why do legislators sometimes engage in behavior that deviates from the expressed policy preferences of constituents who participate in politics at high rates? We examine this puzzle in the context of Democratic legislators' representation of their senior citizen constituents on the Patient Protection and Affordable Care Act of 2010 (ACA). We find that legislators' roll-call votes on the ACA did not reflect the stated preferences of their respective senior constituents; by contrast, these roll-call votes did reflect the preferences of nonsenior adults. We draw upon a theoretical framework developed by Mansbridge to explain this apparent nonresponsiveness to seniors on the ACA. This framework distinguishes between promissory representation, whereby legislators merely respond to constituents' preferences, and anticipatory representation, whereby legislators respond to constituents' underlying policy interests, even when such interests conflict with expressed preferences. By considering the Medicare provisions in the ACA and analyzing Democratic legislators' floor speeches on health reform, we provide preliminary evidence that members of Congress engaged in anticipatory representation of their senior constituents by attempting to educate seniors about how the ACA serves their policy interests.

Tuberculosis Notification by Private Sector' Physicians in Tehran.

Science.gov (United States)

Ahmadi, Ayat; Nedjat, Saharnaz; Gholami, Jaleh; Majdzadeh, Reza

2015-01-01

A small proportion of physicians adhere to tuberculosis (TB) notification regulations, particularly in the private sector. In most developing countries, the private sector has dominance over delivering services in big cities. In such circumstances deviation from the TB treatment protocol is frequently happening. This study sought to estimate TB notification in the private sector and settle on determinants of TB notification by private sector physicians. A population-based study has been conducted; private physicians at their clinics were interviewed. The total number of 443 private sectors' physicians has been chosen by the stratified random sampling method. Appropriate descriptive analysis was used to describe the study's participants. Logistic regression was used for bivariable and multivariable analysis. The response rate of the study was 90.06 (399%). Among responders, who had stated that they were suspicious of TB over the recent year, 62 (16.45%) stated that they reported cases of TB at least once during the same period. Having reporting requirements and the number of visited patients was significantly related to TB suspicious (odds ratio = 2.84, confidence interval: 1.62-5, P private sector by simple and quick interventions. It seems that a considerable fraction of private sector physicians, not all of them, will notify TB if they are provided with primary information and primary resources. To optimize the TB notification, however, intersectoral interventions are more likely to be successful.

[Minors visits (ages 14-18) at primary clinics without an accompanying guardian: attitudes of primary care physicians of Clalit Health Services - South District].

Science.gov (United States)

Hildesheimer, Efrat; Orkin, Jacob; Biderman, Aya

2010-04-01

According to Israeli law, for a minor to receive medical treatment, the physician is obligated to obtain informed consent from the minor's parents. In practice, minors under the age of 18 often attend the clinics on their own. In past years, only a few attempts have been made to revise the law, however, none were implemented. To evaluate the attitudes and knowledge of physicians in primary care clinics regarding the legal aspects of minors' visits at the clinics, relating to how widespread is the phenomena, the influencing factors, the physician's opinion and approach. A descriptive study based on self-administered questionnaires that were distributed by post during 2005, to primary care physicians belonging to Clalit Health Services, south district. The questionnaires included demographic details, attitudes and knowledge of minors' visits. Analysis of 103 questionnaires found that minors attending clinics without their parent is a common phenomenon. The reasons noted were: acquaintance with the parents, and that their children are "mature enough". The physician's knowledge about the Israeli law on the subject was found to be deficient: 56% answered incorrectly to questions on which the law is very clear, and in most of the other questions many claimed they did not know the correct answer. Many of the physicians think that minors should not visit the clinic by themselves; only 6% attended an educational program related to this matter. The subject of minors attending clinics without an accompanying parent warrants discussion, and clear and updated legislation. In addition, as stems from the study, there is a need to update physicians regarding this issue.

National legislative and regulatory activities

International Nuclear Information System (INIS)

2017-01-01

This section treats of the following National legislative and regulatory activities: 1 - Algeria, Nuclear safety and radiological protection, Executive Decree No. 17-126 of 27 March 2017; 2 - Belgium, Liability and compensation, Law of 7 December 2016 modifying the law of 22 July 1985 on third party liability in the field of nuclear energy; 3 - Canada, Liability and compensation, Ratification by Canada of the Convention on Supplementary Compensation for Nuclear Damage; 4 - France, Radioactive waste management: Decree No. 2017-231 of 23 February 2017 implementing Article L. 542-1-2 of the French Environmental Code (Code de l'environnement) and setting out the provisions of the National Radioactive Material and Waste Management Plan; and Order of 23 February 2017 implementing Decree No. 2017-231 of 23 February 2017 implementing Article L. 542-1-2 of the French Environmental Code setting out the provisions of the National Radioactive Material and Waste Management Plan; Liability and compensation: Order of 10 November 2016 amending the Appendix to the Order of 19 August 2016, setting the list of reduced liability amount sites pursuant to Decree No. 2016-333 of 21 March 2016 implementing Article L. 597-28 of the Environmental Code and relating to third party liability in the nuclear energy field; International co-operation: Decree No. 2016-1225 of 16 September 2016 making public the Protocol to the Co-operation Agreement between the Government of the French Republic and the Government of the Hashemite Kingdom of Jordan for the Development of the Pacific Uses of Nuclear Energy, signed in Paris on 27 August 2008; 5 - Germany, Transport of radioactive materials: New Versions of Ordinances on the Transport of Dangerous Goods (2017); Radioactive Waste Management: Act on the Reorganisation of the Responsibility of Nuclear Waste Disposal (2017); 6 - Lithuania, Nuclear security: Cyber security; Nuclear installations: Free release criteria of buildings and site of nuclear

Physician-patient communication in HIV disease: the importance of patient, physician, and visit characteristics.

Science.gov (United States)

Wilson, I B; Kaplan, S

2000-12-15

Although previous work that considered a variety of chronic conditions has shown that higher quality physician-patient communication care is related to better health outcomes, the quality of physician-patient communication itself for patients with HIV disease has not been well studied. To determine the relationship of patient, visit, physician, and physician practice characteristics to two measures of physician-patient communication for patients with HIV disease. Cross-sectional survey of physicians and patients. Cohort study enrolling patients from throughout eastern Massachusetts. 264 patients with HIV disease and their their primary HIV physicians (n = 69). Two measures of physician-patient communication were used, a five-item general communication measure (Cronbach's alpha = 0.93), and a four-item HIV-specific communication measure that included items about alcohol, drug use, and sexual behaviors (Cronbach's alpha = 0.92). The mean age of patients was 39. 5 years, 24% patients were women, 31.1% were nonwhite, and 52% indicated same-sex contact as their principal HIV risk factor. The mean age of physicians was 39.1 years, 33.3% were female, 39.7% were specialists, and 25.0% self-identified as gay, lesbian, or bisexual. In multivariable models relating patient and visit characteristics to general communication, longer reported visit length (pbetter communication. The interaction of patient gender and visit length was also significant (p =.02); longer visit length was more strongly associated with better general communication for male than female patients. In similar models relating patient and visit characteristics to HIV-specific communication, longer visit length (p better communication. In multivariable models relating physician and practice characteristics to general communication no variables were significant. However, both female physician gender (p =.002) and gay/lesbian/bisexual sexual preference (p =.003) were significantly associated with better HIV

Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians

Directory of Open Access Journals (Sweden)

Nir Eyal

2016-03-01

Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.

Norway's ICT Accessibility Legislation, Methods and Indicators.

Science.gov (United States)

Rygg, Malin; Rømen, Dagfinn; Sterri, Brynhild Runa

2016-01-01

This paper gives an overview of the Norwegian legislation on Universal Design of information and communication technology (ICT) and how the Norwegian Authority for Universal Design of ICT works to enforce and achieve the goals behind the legislation. The Authority uses indicators to check websites for compliance with the regulations. This paper describes the rationale and intended use for the indicators and how they are used for both supervision and benchmarks as well as a way of gathering data to give an overview of the current state of Universal Design of websites in Norway.

Physician assessments of drug seeking behavior: A mixed methods study.

Directory of Open Access Journals (Sweden)

Michael A Fischer

Full Text Available Pain complaints are common, but clinicians are increasingly concerned about overuse of opioid pain medications. This may lead patients with actual pain to be stigmatized as "drug-seeking," or attempting to obtain medications they do not require medically. We assessed whether patient requests for specific opioid pain medication would lead physicians to classify them as drug-seeking and change management decisions.Mixed-methods analysis of interviews with 192 office-based primary care physicians after viewing video vignettes depicting patients presenting with back pain. For each presentation physicians were randomly assigned to see either an active request for a specific medication or a more general request for help with pain. The main outcome was assignment by the physician of "drug-seeking" as a potential diagnosis among patients presenting with back pain. Additional outcomes included other actions the physician would take and whether the physician would prescribe the medication requested. A potential diagnosis of drug-seeking behavior was included by 21% of physicians seeing a specific request for oxycodone vs. 3% for a general request for help with back pain(p<0.001. In multivariable models an active request was most strongly associated with a physician-assigned diagnosis of drug-seeking behavior(OR 8.10; 95% CI 2.11-31.15;p = 0.002; other major patient and physician characteristics, including gender and race, did not have strong associations with drug-seeking diagnosis. Physicians described short courses of opioid medications as a strategy for managing patients with pain while avoiding opioid overuse.When patients make a specific request for opioid pain medication, physicians are far more likely to suspect that they are drug-seeking. Physician suspicion of drug-seeking behavior did not vary by patient characteristics, including gender and race. The strategies used to assess patients further varied widely. These findings indicate a need for

Burnout among physicians

OpenAIRE

Romani, Maya; Ashkar, Khalil

2014-01-01

Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to ...

ACHP | News | Legislation Passes Senate

Science.gov (United States)

Hillary Clinton. "Bipartisan approval of this legislation by an overwhelming margin reflects the Bingaman, former Senator Pete Domenici, and Senators Hillary Clinton and Richard Burr." At a Capitol , who introduced the House version; Sen. Hillary Clinton and former Sen.Pete Domenici, who introduced

Physician-Rating Web Sites: Ethical Implications.

Science.gov (United States)

Samora, Julie Balch; Lifchez, Scott D; Blazar, Philip E

2016-01-01

To understand the ethical and professional implications of physician behavior changes secondary to online physician-rating Web sites (PRWs). The American Society for Surgery of the Hand (ASSH) Ethics and Professionalism Committee surveyed the ASSH membership regarding PRWs. We sent a 14-item questionnaire to 2,664 active ASSH members who practice in both private and academic settings in the United States. We received 312 responses, a 12% response incidence. More than 65% of the respondents had a slightly or highly unfavorable impression of these Web sites. Only 34% of respondents had ever updated or created a profile for PRWs, although 62% had observed inaccuracies in their profile. Almost 90% of respondents had not made any changes in their practice owing to comments or reviews. One-third of respondents had solicited favorable reviews from patients, and 3% of respondents have paid to improve their ratings. PRWs are going to become more prevalent, and more research is needed to fully understand the implications. There are several ethical implications that PRWs pose to practicing physicians. We contend that it is morally unsound to pay for good reviews. The recourse for physicians when an inaccurate and potentially libelous review has been written is unclear. Some physicians have required patients to sign a waiver preventing them from posting negative comments online. We propose the development of a task force to assess the professional, ethical, and legal implications of PRWs, including working with companies to improve accuracy of information, oversight, and feedback opportunities. It is expected that PRWs will play an increasing role in the future; it is unclear whether there will be a uniform reporting system, or whether these online ratings will influence referral patterns and/or quality improvement. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

State insurance parity legislation for autism services and family financial burden.

Science.gov (United States)

Parish, Susan; Thomas, Kathleen; Rose, Roderick; Kilany, Mona; McConville, Robert

2012-06-01

We examined the association between states' legislative mandates that private insurance cover autism services and the health care-related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N  =  2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.

Effectiveness of a Unique Support Group for Physicians in a Physician Health Program.

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Sanchez, Luis T; Candilis, Philip J; Arnstein, Fredrick; Eaton, Judith; Barnes Blood, Diana; Chinman, Gary A; Bresnahan, Linda R

2016-01-01

State Physician Health Programs (PHPs) assess, support, and monitor physicians with mental, behavioral, medical, and substance abuse problems. Since their formation in the 1970s, PHPs have offered support groups following the 12-step model for recovery from substance use disorders (SUDs). However, few programs have developed support groups for physicians without SUDs. This study at the Massachusetts PHP (Physician Health Services Inc.) represents the first effort to survey physician attitudes concerning a unique support group that goes beyond classic addiction models. The group was initiated because of the observation that physicians with problems other than SUDs did not fit easily into the 12-step framework. It was hypothesized that such a group would be effective in helping participants control workplace stress, improve professional and personal relationships, and manage medical and psychiatric difficulties. With a response rate of 43% (85 respondents), the survey identified a strong overall impact of the Physician Health Services Inc. support group, identifying positive effects in all areas of personal and professional life: family and friends, wellness, professional relationships, and career. Respondents identified the role of the facilitator as particularly important, underscoring the facilitator's capacity to welcome participants, manage interactions, set limits, and maintain a supportive emotional tone. The implications for physician health extend from supporting a broader application of this model to using a skilled facilitator to manage groups intended to reduce the stress and burnout of present-day medical practice. The results encourage PHPs, hospitals, medical practices, and physician groups to consider implementing facilitated support groups as an additional tool for maintaining physician health.

Better Physician's 'Black Bags'

Science.gov (United States)

1976-01-01

The "black bag" is outgrowth of astronaut monitoring technology from NASA's Johnson Space Center. Technically known as the portable medical status system, a highly advanced physician's "black bag" weighs less than 30 pounds, yet contains equipment for monitoring and recording vital signs, electrocardiograms, and electroencephalograms. Liquid crystal displays are used to present 15 digits of data simultaneously for long periods of time without excessive use of battery power. Single printed circuit card contains all circuitry required to measure and display vital signs such as heart and respiration rate, temperature, and blood pressure.

Impact of race on the professional lives of physicians of African descent.

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Nunez-Smith, Marcella; Curry, Leslie A; Bigby, JudyAnn; Berg, David; Krumholz, Harlan M; Bradley, Elizabeth H

2007-01-02

Increasing the racial and ethnic diversity of the physician workforce is a national priority. However, insight into the professional experiences of minority physicians is limited. This knowledge is fundamental to developing effective strategies to recruit, retain, and support a diverse physician workforce. To characterize how physicians of African descent experience race in the workplace. Qualitative study based on in-person and in-depth racially concordant interviews using a standard discussion guide. The 6 New England states in the United States. 25 practicing physicians of African descent representing a diverse range of primary practice settings, specialties, and ages. Professional experiences of physicians of African descent. 1) Awareness of race permeates the experience of physicians of African descent in the health care workplace; 2) race-related experiences shape interpersonal interactions and define the institutional climate; 3) responses to perceived racism at work vary along a spectrum from minimization to confrontation; 4) the health care workplace is often silent on issues of race; and 5) collective race-related experiences can result in "racial fatigue," with personal and professional consequences for physicians. The study was restricted to New England and may not reflect the experiences of physicians in other geographic regions. The findings are meant to be hypothesis-generating and require additional follow-up studies. The issue of race remains a pervasive influence in the work lives of physicians of African descent. Without sufficient attention to the specific ways in which race shapes physicians' work experiences, health care organizations are unlikely to create environments that successfully foster and sustain a diverse physician workforce.

The value of EHR-based assessment of physician competency: An investigative effort with internal medicine physicians.

Science.gov (United States)

Venta, Kimberly; Baker, Erin; Fidopiastis, Cali; Stanney, Kay

2017-12-01

The purpose of this study was to investigate the potential of developing an EHR-based model of physician competency, named the Skill Deficiency Evaluation Toolkit for Eliminating Competency-loss Trends (Skill-DETECT), which presents the opportunity to use EHR-based models to inform selection of Continued Medical Education (CME) opportunities specifically targeted at maintaining proficiency. The IBM Explorys platform provided outpatient Electronic Health Records (EHRs) representing 76 physicians with over 5000 patients combined. These data were used to develop the Skill-DETECT model, a predictive hybrid model composed of a rule-based model, logistic regression model, and a thresholding model, which predicts cognitive clinical skill deficiencies in internal medicine physicians. A three-phase approach was then used to statistically validate the model performance. Subject Matter Expert (SME) panel reviews resulted in a 100% overall approval rate of the rule based model. Area under the receiver-operating characteristic curves calculated for each logistic regression curve resulted in values between 0.76 and 0.92, which indicated exceptional performance. Normality, skewness, and kurtosis were determined and confirmed that the distribution of values output from the thresholding model were unimodal and peaked, which confirmed effectiveness and generalizability. The validation has confirmed that the Skill-DETECT model has a strong ability to evaluate EHR data and support the identification of internal medicine cognitive clinical skills that are deficient or are of higher likelihood of becoming deficient and thus require remediation, which will allow both physician and medical organizations to fine tune training efforts. Copyright © 2017 Elsevier B.V. All rights reserved.

Physician wages across specialties: informing the physician reimbursement debate.

Science.gov (United States)

Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

2010-10-25

Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

WHAT HAPPENS WHEN THE JUDICIARY SWITCHES ROLES WITH THE LEGISLATOR? AN INNOVATIVE ISRAELI VERSION OF A MIXED JURISDICTION

Directory of Open Access Journals (Sweden)

Haim Sandberg

2012-09-01

Full Text Available Civil Law codices are analytic, abstract and removed from the specific influence of particular cases. When rules are codified In Common Law systems they reflect a collection of rulings and not a collection of analytic principles. These differences stem from the nature and the motivations of the legislative enterprise. Civil-continental legislation originates in a legislative initiative “from above”. It is driven by the aspiration for legal harmony and completeness, and was originally formulated by academics. Legislation in the common-law countries results from a "bottom up" effect in which reality dictates the nature of the developing rules, step by step.Civil law systems like Common Law systems accept the supremacy of the statutory law over judge-made law. Yet when the judiciary has the authority or the power to influence the legislative agenda there is a veritable role switch. In a manner resembling continental-style legislation, the court reviewing existing legislation determines an abstract principle, usually in reliance on a particular constitutional text, and it is the legislature that is required to distill the principles into specific legislative norms, a function normally fulfilled by the common law court. The question forming the basis of this paper is the nature of the legislative process and the legislation produced by this kind of relationship. The paper addresses this question through the narrow prism of a detailed examination of a particular Israeli test case in which the Israeli Supreme Court handed down a ruling on a fundamental principle but on its own initiative delegated to the legislature the task of implementing it and providing a specific legislative enactment of this principle, on the basis of which the Court would then rule on the concrete case. The result in this particular case was that the traditional roles of the respective branches were reversed. The practical result of the move to delegate the implementation of

ALCOHOL RELATED TRAFFIC SAFETY LEGISLATION

Directory of Open Access Journals (Sweden)

E.B.R. DESAPRIYA

2002-01-01

Full Text Available There is a substantial amount of evidence from experimental studies to indicate that a variety of individual skills are impaired at blood alcohol concentrations (BACs well below 0.05%. Epidemiological studies indicate that the risk of a crash increases sharply for drivers with BACs below 0.05%. The correlation between drunk driving and the risk of traffic accidents has been established on the individual as well as the aggregate level. The BAC level legally permitted is a public policy decision by legislators, while scientists can present experimental and epidemiological evidence indicating the BAC level at which psychomotor skills deteriorate and accident probabilities increase. There is considerable epidemiological evidence to support the fact that the risk of alcohol impaired drivers being involved in traffic crashes rises with increasing BAC's. By contrast, the evidence on the BAC at which a driver should be regarded as committing an offence has been the subject of much debate and various legislative decisions. Historically, per se laws specify BAC levels which are a compromise figure intended to reflect both the point at which a driver becomes significantly more likely to be involved in an accident than a comparative driver with a zero BAC and that which is politically acceptable, but falls within the BAC region of increased accident liability. Therefore, the per se legislation in most countries has not kept pace with scientific progress. This study suggests that if saving lives on the road is an important issue, then, passing laws that incorporate scientific and epidemiological studies, is necessary.

Assessment of the accessibility legislation in Spain and its effective application

Directory of Open Access Journals (Sweden)

Jesús Hernández-Galán

2014-10-01

Full Text Available The existence of legislation on accessibility does not always imply it is enforced effectively. This article aims to answer the following question: Is the existence of accessibility legislation enough to make physical environments truly accessible?This study assesses the current Spanish legislation as well as any existing voluntary regulations in the country. This assessment is done chronologically, so as to show the historical evolution of the accessibility regulations in Spain.In order to determine whether accessibility legislation has been truly effectively enforced, the issue is studied as it affects Spanish municipalities with respect to urban planning, public buildings, public transportation and websites. The conclusion of this study is that the existence of accessibility legislation per se is not enough to ensure its practical application, and ultimately, to render physical environments, products and services accessible to the majority of the population regardless of their functional capabilities.

Physician's self-perceived abilities at primary care settings in Indonesia.

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Istiono, Wahyudi; Claramita, Mora; Ekawati, Fitriana Murriya; Gayatri, Aghnaa; Sutomo, Adi Heru; Kusnanto, Hari; Graber, Mark Alan

2015-01-01

Southeast Asian countries with better-skilled primary care physicians have been shown to have better health outcomes. However, in Indonesia, there has been a large number of inappropriate referrals, leading to suboptimal health outcomes. This study aimed to examine the reasons underlying the unnecessary referrals as related to Indonesian physicians' standard of abilities. This was a multiple-case study that explored physicians' self-evaluation of their abilities. Self-evaluation questionnaires were constructed from the Indonesian Standards of Physicians Competences of 2006-2012 (ISPC), which is a list of 155 diseases. This study was undertaken in three cities, three towns, and one "border-less developed" area during 2011-2014. The study involved 184 physicians in those seven districts. Data were collected using one-on-one, in-depth interviews, focus group discussions (FGDs), and clinical observations. This study found that primary care physicians in Indonesia felt that they were competent to handle less than one-third of "typical" primary care cases. The reasons were limited understanding of person-centered care principles and limited patient care services to diagnosis and treatment of common biomedical problems. Additionally, physical facilities in primary care settings are lacking. Strengthening primary health care in Indonesia requires upscaling doctors' abilities in managing health problems through more structured graduate education in family medicine, which emphasizes the bio-psycho-socio-cultural background of persons; secondly, standardizing primary care facilities to support physicians' performance is critical. Finally, a strong national health policy that recognizes the essential role of primary care physicians in health outcomes is an urgent need.

Physicians-Pharmaceutical Sales Representatives Interactions and Conflict of Interest

Directory of Open Access Journals (Sweden)

Avinash R. Patwardhan MD

2016-09-01

Full Text Available Physician-industry relationships have come a long way since serious debates began after a 1990 Senate Committee on Labor and Human Resources report on the topic. On one side, the Sun Shine Act of 2007, now a part of the Patient Protection and Affordable Care Act that mandates disclosure of payments and gifts to the physicians, has injected more transparency into the relationships, and on the other side, numerous voluntary self-regulation guidelines have been instituted to protect patients. However, despite these commendable efforts, problem persists. Taking the specific case of physician-pharmaceutical sales representative (PSR interactions, also called as detailing, where the PSRs lobby physicians to prescribe their brand drugs while bringing them gifts on the side, an August 2016 article concluded that gifts as small as $20 are associated with higher prescribing rates. A close examination reveals the intricacies of the relationships. Though PSRs ultimately want to push their drugs, more than gifts, they also bring the ready-made synthesized knowledge about the drugs, something the busy physicians, starving for time to read the literature themselves, find hard to let go. Conscientious physicians are not unaware of the marketing tactics. And yet, physicians too are humans. It is also the nature of their job that requires an innate cognitive dissonance to be functional in medical practice, a trait that sometimes works against them in case of PSR interactions. Besides, PSRs too follow the dictates of the shareholders of their companies. Therefore, if they try to influence physicians using social psychology, it is a job they are asked to do. The complexity of relationships creates conundrums that are hard to tackle. This commentary examines various dimensions of these relationships. In the end, a few suggestions are offered as a way forward.

Physicians-Pharmaceutical Sales Representatives Interactions and Conflict of Interest

Science.gov (United States)

Patwardhan, Avinash R.

2016-01-01

Physician-industry relationships have come a long way since serious debates began after a 1990 Senate Committee on Labor and Human Resources report on the topic. On one side, the Sun Shine Act of 2007, now a part of the Patient Protection and Affordable Care Act that mandates disclosure of payments and gifts to the physicians, has injected more transparency into the relationships, and on the other side, numerous voluntary self-regulation guidelines have been instituted to protect patients. However, despite these commendable efforts, problem persists. Taking the specific case of physician-pharmaceutical sales representative (PSR) interactions, also called as detailing, where the PSRs lobby physicians to prescribe their brand drugs while bringing them gifts on the side, an August 2016 article concluded that gifts as small as $20 are associated with higher prescribing rates. A close examination reveals the intricacies of the relationships. Though PSRs ultimately want to push their drugs, more than gifts, they also bring the ready-made synthesized knowledge about the drugs, something the busy physicians, starving for time to read the literature themselves, find hard to let go. Conscientious physicians are not unaware of the marketing tactics. And yet, physicians too are humans. It is also the nature of their job that requires an innate cognitive dissonance to be functional in medical practice, a trait that sometimes works against them in case of PSR interactions. Besides, PSRs too follow the dictates of the shareholders of their companies. Therefore, if they try to influence physicians using social psychology, it is a job they are asked to do. The complexity of relationships creates conundrums that are hard to tackle. This commentary examines various dimensions of these relationships. In the end, a few suggestions are offered as a way forward. PMID:27637269

Behavioral Response to Plastic Bag Legislation in Botswana

OpenAIRE

Dikgang, Johane; Visser, Martine

2010-01-01

This paper investigates the use of charges and standards in dealing with a common externality, plastic litter from shopping bags in Botswana. The country passed a plastic bag tax (effective 2007) to curb the plastic bag demand. Interestingly, the legislation did not force retailers to charge for plastic bags, which they did voluntarily at different prices. We assessed the environmental effectiveness and efficiency of the plastic bag legislation by analyzing consumers’ sensitivity to the impro...

Relationships of multitasking, physicians' strain, and performance: an observational study in ward physicians.

Science.gov (United States)

Weigl, Matthias; Müller, Andreas; Sevdalis, Nick; Angerer, Peter

2013-03-01

Simultaneous task performance ("multitasking") is common in hospital physicians' work and is implicated as a major determinant for enhanced strain and detrimental performance. The aim was to determine the impact of multitasking by hospital physicians on their self reported strain and performance. A prospective observational time-and-motion study in a Community Hospital was conducted. Twenty-seven hospital physicians (surgical and internal specialties) were observed in 40 full-shift observations. Observed physicians reported twice on their self-monitored strain and performance during the observation time. Associations of observed multitasking events and subsequent strain and performance appraisals were calculated. About 21% of the working time physicians were engaged in simultaneous activities. The average time spent in multitasking activities correlated significantly with subsequently reported strain (r = 0.27, P = 0.018). The number of instances of multitasking activities correlated with self-monitored performance to a marginally significant level (r = 0.19, P = 0.098). Physicians who engage in multitasking activities tend to self-report better performance but at the cost of enhanced psychophysical strain. Hence, physicians do not perceive their own multitasking activities as a source for deficient performance, for example, medical errors. Readjustment of workload, improved organization of work for hospital physicians, and training programs to improve physicians' skills in dealing with multiple clinical demands, prioritization, and efficient task allocation may be useful avenues to explore to reduce the potentially negative impact of simultaneous task performance in clinical settings.

Physicians and Physician Trainees Rarely Identify or Address Overweight/Obesity in Hospitalized Children.

Science.gov (United States)

King, Marta A; Nkoy, Flory L; Maloney, Christopher G; Mihalopoulos, Nicole L

2015-10-01

To determine how frequently physicians identify and address overweight/obesity in hospitalized children and to compare physician documentation across training level (medical student, intern, resident, attending). We conducted a retrospective chart review. Using an administrative database, Centers for Disease Control and Prevention body mass index calculator, and random sampling technique, we identified a study population of 300 children aged 2-18 years with overweight/obesity hospitalized on the general medical service of a tertiary care pediatric hospital. We reviewed admission, progress, and discharge notes to determine how frequently physicians and physician trainees identified (documented in history, physical exam, or assessment) and addressed (documented in hospital or discharge plan) overweight/obesity. Physicians and physician trainees identified overweight/obesity in 8.3% (n = 25) and addressed it in 4% (n = 12) of 300 hospitalized children with overweight/obesity. Interns were most likely to document overweight/obesity in history (8.3% of the 266 patients they followed). Attendings were most likely to document overweight/obesity in physical examination (8.3%), assessment (4%), and plan (4%) of the 300 patients they followed. Medical students were least likely to document overweight/obesity including it in the assessment (0.4%) and plan (0.4%) of the 244 hospitalized children with overweight/obesity they followed. Physicians and physician trainees rarely identify or address overweight/obesity in hospitalized children. This represents a missed opportunity for both patient care and physician trainee education. Copyright © 2015 Elsevier Inc. All rights reserved.

CDC STATE System Tobacco Legislation - Tax

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2017. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation-Tax. The STATE System...

CDC STATE System Tobacco Legislation - Tax

Data.gov (United States)

U.S. Department of Health & Human Services — 1995-2018. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Legislation-Tax. The STATE System...

Electronic health record innovations: Helping physicians - One less click at a time.

Science.gov (United States)

Guo, Uta; Chen, Lu; Mehta, Parag H

2017-09-01

Physician burnout is becoming an epidemic, due to the pressures of being productive, an imperfect electronic health record (EHR) system, and limited face-to-face time with patients. Poor usability in EHR-user interface can force users to go through more steps (i.e. more clicks on the computer) in accomplishing a task. This increased 'click burden' is a source of frustration for physicians. In the light of increased click burden and time due to meaningful use requirements, there is a need to improve the physician's experience by creating innovations in EHR. This case study describes an attempt by physicians at NewYork-Presbyterian Brooklyn Methodist Hospital to enhance the EHR experience with more efficient methods of documentation, chart review, ordering and patient safety. The EHR innovations trialled in this study were: a mobile documentation application; abnormal test results auto-populated into an EHR patient summary; physician alerts to reduce inappropriate test ordering; and a system of safety alerts on a dashboard. These innovations led to decreased click burden and allowed physicians to spend less time on the computer and more time with patients. Physician-driven changes to EHR systems have the potential to streamline virtual workflows and the management of health information and to improve patient safety, reduce physician burnout and increase physician job satisfaction.

Thailand--lighting up a dark market: British American tobacco, sports sponsorship and the circumvention of legislation.

Science.gov (United States)

MacKenzie, Ross; Collin, Jeff; Sriwongcharoen, Kobkul

2007-01-01

To examine how British American Tobacco (BAT) used sports sponsorship to circumvent restrictions on tobacco promotion in Thailand, both a key emerging market and a world leader in tobacco control. Analysis of previously confidential BAT company documents. Since its inception in 1987, BAT's sports sponsorship programme in Thailand has been politically sensitive and legally ambiguous. Given Thailand's ban on imported cigarettes, early events provided promotional support to smuggled brands. BAT's funding of local badminton, snooker, football and cricket tournaments generated substantial media coverage for its brands. After the General Agreement on Trade and Tariffs decision that obliged Thailand to open its cigarette market to imports, Thailand's 1992 tobacco control legislation established one of the world's most restrictive marketing environments. BAT's sponsorship strategy shifted to rallying and motorbike racing, using broadcasts of regional competitions to undermine national regulations. BAT sought to dominate individual sports and to shape media coverage to maximise brand awareness. An adversarial approach was adopted, testing the limits of legality and requiring active enforcement to secure compliance with legislation. The documents show the opportunities offered by sports sponsorship to tobacco companies amid increasing advertising restrictions. Before the 1992 tobacco control legislation, sponsored events in Thailand promoted international brands by combining global and local imagery. The subsequent strategy of "regionalisation as defensibility" reflected the capacity of international sport to transcend domestic restrictions. These transnational effects may be effectively dealt with via the Framework Convention on Tobacco Control, but will require the negotiation of a specific protocol.

Good to great: using 360-degree feedback to improve physician emotional intelligence.

Science.gov (United States)

Hammerly, Milton E; Harmon, Larry; Schwaitzberg, Steven D

2014-01-01

The past decade has seen intense interest and dramatic change in how hospitals and physician organizations review physician behaviors. The characteristics of successful physicians extend past their technical and cognitive skills. Two of the six core clinical competencies (professionalism and interpersonal/communication skills) endorsed by the Accreditation Council for Graduate Medical Education, the American Board of Medical Specialties, and The Joint Commission require physicians to succeed in measures associated with emotional intelligence (EI). Using 360-degree anonymous feedback surveys to screen for improvement opportunities in these two core competencies enables organizations to selectively offer education to further develop physician EI. Incorporating routine use of these tools and interventions into ongoing professional practice evaluation and focused professional practice evaluation processes may be a cost-effective strategy for preventing disruptive behaviors and increasing the likelihood of success when transitioning to an employed practice model. On the basis of a literature review, we determined that physician EI plays a key role in leadership; teamwork; and clinical, financial, and organizational outcomes. This finding has significant implications for healthcare executives seeking to enhance physician alignment and transition to a team-based delivery model.

Physicians' impression on the elders' functionality influences decision making for emergency care.

Science.gov (United States)

Rodríguez-Molinero, Alejandro; López-Diéguez, María; Tabuenca, Ana I; de la Cruz, Juan J; Banegas, José R

2010-09-01

This study analyzes the elements that compose the emergency physicians' criterion for selecting elderly patients for intensive care treatment. This issue has not been studied in-depth. A cross-sectional study was conducted at 4 university teaching hospitals, covering 101 randomly selected elderly patients admitted to emergency department and their respective physicians. Physicians were asked to forecast their plans for treatment or therapeutic abstention, in the event that patients might require aggressive measures (cardiopulmonary resuscitation or admission to critical care units). Data were collected on physicians' reasons for taking such decisions and their patients' functional capacity and cognitive status (Katz index and Informant Questionnaire on Cognitive Decline in the Elderly). A logistic regression model was constructed taking physicians' decisions as the dependent variables and adjusting for patient factors and physician impressions. The functional status reported by reliable informants and the mental status measured by validated instruments were not coincident with the physicians' perception (functional status κ, 0.47; mental status κ, 0.26). A multivariate analysis showed that the age and the functional and mental status of patients, as perceived by the physicians, were the variables that better explained the physicians' decisions. Physicians' impressions on the functional and mental status of their patients significantly influenced their selection of patients for high-intensity treatments despite the fact that some of these impressions were not correct. Copyright © 2010 Elsevier Inc. All rights reserved.

Protocol for an economic evaluation alongside the University Health Network Whiplash Intervention Trial: cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario

OpenAIRE

van der Velde Gabrielle; Côté Pierre; Bayoumi Ahmed M; Cassidy J David; Boyle Eleanor; Shearer Heather M; Stupar Maja; Jacobs Craig; Ammendolia Carlo; Carette Simon; van Tulder Maurits

2011-01-01

Abstract Background Whiplash injury affects 83% of persons in a traffic collision and leads to whiplash-associated disorders (WAD). A major challenge facing health care decision makers is identifying cost-effective interventions due to lack of economic evidence. Our objective is to compare the cost-effectiveness of: 1) physician-based education and activation, 2) a rehabilitation program developed by Aviva Canada (a group of property and casualty insurance providers), and 3) the legislated st...

Studying physician effects on patient outcomes: physician interactional style and performance on quality of care indicators.

Science.gov (United States)

Franks, Peter; Jerant, Anthony F; Fiscella, Kevin; Shields, Cleveland G; Tancredi, Daniel J; Epstein, Ronald M

2006-01-01

Many prior studies which suggest a relationship between physician interactional style and patient outcomes may have been confounded by relying solely on patient reports, examining very few patients per physician, or not demonstrating evidence of a physician effect on the outcomes. We examined whether physician interactional style, measured both by patient report and objective encounter ratings, is related to performance on quality of care indicators. We also tested for the presence of physician effects on the performance indicators. Using data on 100 US primary care physician (PCP) claims data on 1,21,606 of their managed care patients, survey data on 4746 of their visiting patients, and audiotaped encounters of 2 standardized patients with each physician, we examined the relationships between claims-based quality of care indicators and both survey-derived patient perceptions of their physicians and objective ratings of interactional style in the audiotaped standardized patient encounters. Multi-level models examined whether physician effects (variance components) on care indicators were mediated by patient perceptions or objective ratings of interactional style. We found significant physician effects associated with glycohemoglobin and cholesterol testing. There was also a clinically significant association between better patient perceptions of their physicians and more glycohemoglobin testing. Multi-level analyses revealed, however, that the physician effect on glycohemoglobin testing was not mediated by patient perceived physician interaction style. In conclusion, similar to prior studies, we found evidence of an apparent relationship between patient perceptions of their physician and patient outcomes. However, the apparent relationships found in this study between patient perceptions of their physicians and patient care processes do not reflect physician style, but presumably reflect unmeasured patient confounding. Multi-level modeling may contribute to better

Estimated time spent on preventive services by primary care physicians

Directory of Open Access Journals (Sweden)

Gradison Margaret

2008-12-01

Full Text Available Abstract Background Delivery of preventive health services in primary care is lacking. One of the main barriers is lack of time. We estimated the amount of time primary care physicians spend on important preventive health services. Methods We analyzed a large dataset of primary care (family and internal medicine visits using the National Ambulatory Medical Care Survey (2001–4; analyses were conducted 2007–8. Multiple linear regression was used to estimate the amount of time spent delivering each preventive service, controlling for demographic covariates. Results Preventive visits were longer than chronic care visits (M = 22.4, SD = 11.8, M = 18.9, SD = 9.2, respectively. New patients required more time from physicians. Services on which physicians spent relatively more time were prostate specific antigen (PSA, cholesterol, Papanicolaou (Pap smear, mammography, exercise counseling, and blood pressure. Physicians spent less time than recommended on two "A" rated ("good evidence" services, tobacco cessation and Pap smear (in preventive visits, and one "B" rated ("at least fair evidence" service, nutrition counseling. Physicians spent substantial time on two services that have an "I" rating ("inconclusive evidence of effectiveness", PSA and exercise counseling. Conclusion Even with limited time, physicians address many of the "A" rated services adequately. However, they may be spending less time than recommended for important services, especially smoking cessation, Pap smear, and nutrition counseling. Future research is needed to understand how physicians decide how to allocate their time to address preventive health.

The Emerging Legislative Role in Education

Science.gov (United States)

Rosenthal, Alan

1977-01-01

Changes in the capacity, internal distribution of power, habits of work, and composition of state legislators have increased their involvement and assertiveness in educational policy formation, oversight, and control. (Author/MLF)

National legislative and regulatory activities: Armenia, Australia, Austria, Belgium, Brazil, France, Germany, Hungary, India, Ireland, Lithuania, Moldova, Poland, Portugal, Romania, Slovenia, Sweden, Ukraine, United States

International Nuclear Information System (INIS)

Anon.

2012-01-01

Armenia: Nuclear safety and radiation protection (New procedure for investigation of nuclear power plant operational events, New requirements for the accounting of radiation sources). Australia: Radioactive waste management (New law regarding the development of a radioactive waste management facility). Austria: Nuclear safety and radiation protection (Substantive changes to nuclear safety and radiation protection requirements). Belgium: Nuclear security (New requirements for the protection of critical infrastructures); Nuclear safety (Changes to safety measures for nuclear facilities); Nuclear safety and radiation protection (New requirements regarding the detection of orphan sources, New requirements regarding medical uses of radiation, A new framework for monitoring radon exposure). Brazil: Nuclear security (Establishment of new nuclear security organisation). France: Liability and compensation (Increase in the amount of operator liability in case of nuclear incident); General legislation (New comprehensive requirements for basic nuclear installations, New report by the Court of Auditors (Cour des Comptes) on the costs of nuclear energy). Germany: Nuclear safety and radiation protection (Amendments to the Radiation Protection Ordinance and to the X-Rays Ordinance); Transport of radioactive material (New consolidated versions of Ordinances on the Transport of Dangerous Goods); International trade (Changes to the list of foreign trade laws and regulations, Changes to the basic legal instruments governing foreign trade). Hungary: Nuclear safety and radiation protection (Changes to nuclear safety requirements); General legislation (Modification of Act CXVI of 1996 on Atomic Energy). India: Liability and compensation (Final versions of recent liability and compensation legislation available online). Ireland: Transport of radioactive material (New regulations relating to the transport of dangerous goods by road). Lithuania: Licensing and regulatory infrastructure

Re-enactment of power economy legislation failed

International Nuclear Information System (INIS)

Heller, W.

2002-01-01

Comment on the failed vote in the German Federal Parliament about the re-enactment of power economy legislation. The amendments were mainly intended to translate into national law the EU Single Market Directive of June 22, 1998 about common regulations of the gas market. The legislative process had included a mediation procedure between the two chambers of parliament, i.e. the Bundestag and the Bundesrat, had been rejected once more by the Bundesrat, and was to have been adopted by an absolute majority vote of the Bundestag, the so-called Chancellor's majority, still in this parliamentary term. (orig.)

And Affirmative Speeches Shall "Not" Serve as Legislative Intent!

Science.gov (United States)

Benoit, William L.; Follert, Vincent F.

Legislative intent as a debate tactic is drawn from the judicial system as a fundamental concept in the interpretation of statutes. Two paradigms for the application of legislative intent have emerged: (1) the courts will examine the affirmative proposal after enactment to bring it into line with the intent of the affirmative team, and (2) the…

Attending National Library Legislative Day: Why Is It Important?

Science.gov (United States)

Young, Robyn

2009-01-01

Prior to this year, the National Library Legislative Day never really held much importance for the author as a school library media specialist. However, this feeling changed after she attended her first National Library Legislative Day in May of 2008. The goal of this day is to allow everyday practicing professionals to speak with their national…

Employment protection legislation in Croatia

Directory of Open Access Journals (Sweden)

Marina Kunovac

2014-06-01

Full Text Available According to business climate and competitiveness indicators published by international organisations, Croatia is a country with a rigid labour market and a high level of the legal protection of employees. Given that an Act on Amendments to the Labour Act (OG 73/13 entered into force in Croatia in June 2013, this paper examines changes in employment protection legislation in Croatia and Central and Eastern European (CEE countries, as well as in Croatia's main trading partners during the period between 2008 and 2013. A cross-country comparison shows a strong downward trend in legal employment protection in most CEE countries during the observed period, primarily as concerns individual dismissal in the cases of regular employment contracts, while in the case of temporary employment the protection strengthened slightly. On the other hand, despite the adoption of amendments to the Labour Act (LA, Croatian labour legislation governing employment protection for regular employment contracts remains relatively inflexible compared to that in other countries.

Pharmaceutical industry gifts to physicians: patient beliefs and trust in physicians and the health care system.

Science.gov (United States)

Grande, David; Shea, Judy A; Armstrong, Katrina

2012-03-01

Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system. To measure patient perceptions about the prevalence of industry gifts and their relationship to trust in doctors and the health care system. Cross sectional random digit dial telephone survey. African-American and White adults in 40 large metropolitan areas. Respondents' beliefs about whether their physician and physicians in general receive industry gifts, physician trust, and health care system distrust. Overall, 55% of respondents believe their physician receives gifts, and 34% believe almost all doctors receive gifts. Respondents of higher socioeconomic status (income, education) and younger age were more likely to believe their physician receives gifts. In multivariate analyses, those that believe their personal physician receives gifts were more likely to report low physician trust (OR 2.26, 95% CI 1.56-3.30) and high health care system distrust (OR 2.03, 95% CI 1.49-2.77). Similarly, those that believe almost all doctors accept gifts were more likely to report low physician trust (OR 1.69, 95% CI 1.25-2.29) and high health care system distrust (OR 2.57, 95% CI 1.82-3.62). Patients perceive physician-industry gift relationships as common. Patients that believe gift relationships exist report lower levels of physician trust and higher rates of health care system distrust. Greater efforts to limit industry-physician gifts could have positive effects beyond reducing influences on physician behavior.

Opinions of health care professionals and the public after eight years of euthanasia legislation in the Netherlands: a mixed methods approach.

Science.gov (United States)

Kouwenhoven, Pauline S C; Raijmakers, Natasja J H; van Delden, Johannes J M; Rietjens, Judith A C; Schermer, Maartje H N; van Thiel, Ghislaine J M W; Trappenburg, Margo J; van de Vathorst, Suzanne; van der Vegt, Bea J; Vezzoni, Cristiano; Weyers, Heleen; van Tol, Donald G; van der Heide, Agnes

2013-03-01

The practice of euthanasia and physician-assisted suicide (PAS) in the Netherlands has been regulated since 2002 by the Euthanasia Act. In the ongoing debate about the interpretation of this Act, comparative information about the opinions of the different stakeholders is needed. To evaluate the opinions of Dutch physicians, nurses and the general public on the legal requirements for euthanasia and PAS. A cross-sectional survey among Dutch physicians and nurses in primary and secondary care and members of the Dutch general public, followed by qualitative interviews among selected respondents. The participants were: 793 physicians, 1243 nurses and 1960 members of the general public who completed the questionnaire; 83 were interviewed. Most respondents agreed with the requirement of a patient request (64-88%) and the absence of a requirement concerning life expectancy (48-71%). PAS was thought acceptable by 24-39% of respondents for patients requesting it because of mental suffering due to loss of control, chronic depression or early dementia. In the case of severe dementia, one third of physicians, 58% of nurses and 77% of the general public agreed with performing euthanasia based on an advance directive. Interviewees illustrated these findings and supported the Act. Health care professionals and the general public mostly support the legal requirements for euthanasia and PAS. The law permits euthanasia or PAS for mental suffering but this possibility is not widely endorsed. The general public is more liberal towards euthanasia for advanced dementia than health care professionals. We conclude that there is ample support for the law after eight years of legal euthanasia.

1979 New Mexico legislative session: energy issues and legislation

International Nuclear Information System (INIS)

Barsumian, L.; Vandevender, S.G.

1979-10-01

This report is an account of the energy legislation and associated issues considered during the 1979 session of the 34th New Mexico Legislature. The session's major issue was the federal study of a proposed nuclear Waste Isolation Pilot Plant (WIPP) in New Mexico. A large proportion of time and effort was spent on resolving the state's formal position toward the federal project. However, other energy concerns were also significant even though they were neither as controversial nor as visible as the primary issue. The two most important laws enacted were the Radioactive Waste Consultation Act and the Radioactive Waste Transportation Act. The Legislature considered 47 other energy-related bills, of which 17 were enacted

Physician to investigator: clinical practice to clinical research--ethical, operational, and financial considerations.

Science.gov (United States)

Pierre, Christine

2008-01-01

Physicians who participate in clinical research studies gain benefits for themselves, their practice, and their patients. Historically, private practice physicians have chosen to defer to their counterparts in academic medicine when it comes to contributing to scientific advancement through clinical studies. A growing number of private practice physicians are now taking a serious second look and deciding that there are unique benefits for both the practice and the patient. Physicians who decide to participate in clinical research should give serious consideration to the time and resources that are required to meet both federal regulations and industry standards. In addition, ethical and scientific principles for assuring the protection of human research subjects must be a paramount commitment.

Perceptions of trust in physician-managers.

Science.gov (United States)

Cregård, Anna; Eriksson, Nomie

2015-01-01

The purpose of this paper is to explore the dual role of physician-managers through an examination of perceptions of trust and distrust in physician-managers. The healthcare sector needs physicians to lead. Physicians in part-time managerial positions who continue their medical practice are called part-time physician-managers. This paper explores this dual role through an examination of perceptions of trust and distrust in physician-managers. The study takes a qualitative research approach in which interviews and focus group discussions with physician-managers and nurse-managers provide the empirical data. An analytical model, with the three elements of ability, benevolence and integrity, was used in the analysis of trust and distrust in physician-managers. The respondents (physician-managers and nurse-managers) perceived both an increase and a decrease in physicians' trust in the physician-managers. Because elements of distrust were more numerous and more severe than elements of trust, the physician-managers received negative perceptions of their role. This paper's findings are based on perceptions of perceptions. The physicians were not interviewed on their trust and distrust of physician-managers. The healthcare sector must pay attention to the diverse expectations of the physician-manager role that is based on both managerial and medical logics. Hospital management should provide proper support to physician-managers in their dual role to ensure their willingness to continue to assume managerial responsibilities. The paper takes an original approach in its research into the dual role of physician-managers who work under two conflicting logics: the medical logic and the managerial logic. The focus on perceived trust and distrust in physician-managers is a new perspective on this complicated role.

Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study.

Science.gov (United States)

Emmert, Martin; Meier, Florian; Pisch, Frank; Sander, Uwe

2013-08-28

Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be

The legislative perspective

International Nuclear Information System (INIS)

Hartman, L.

1990-01-01

This paper reports that the United States Congress has only recently become interested in the issue of ballistic missile proliferation. It was primarily as a result of the outcome of the debate over chemical weapons legislation that Congress joined the issue of ballistic missile proliferation in the matter of restraints on foreign countries, particularly those based in Missile Technology Control Regime (MTCR) countries. This paper addresses the following questions: Is it Congress's place to enforce compliance with international agreements? More importantly, will such measures have the desired effect?

Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

Science.gov (United States)

Compton, Michael T; Frank, Erica

2011-01-01

In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

Physician Self-directed Learning and Education

Directory of Open Access Journals (Sweden)

Masami Tagawa

2008-07-01

Full Text Available Physicians are expected to be life-long learners because updated and effective patient care should be provided while medical and clinical knowledge and skills and social requirements for patient care are rapidly changing. Also, qualified clinical competence needs long periods of training and each physician has to continually learn as long as he/she works as a professional. Self-directed learning is an important factor in adult learning. Medical students' readiness for self-directed learning is not high, and should be improved by medical school and postgraduate training curricula. Garrison proposed a comprehensive model of self-directed learning, and it has dimensions of motivation (entering and task, self-monitoring (responsibility, and self-management (responsibility. To teach individual self-directed learning competencies, the following are important: (1 situate learners to experience “real” problems; (2 encourage learners to reflect on their own performance; (3 create an educational atmosphere in clinical training situations. In 2005, a 2-year mandatory residency program was implemented in Japan, and fewer medical school graduates took residency programs in medical school hospitals and advanced specialty programs provided by medical school departments. Medical school departments provide traditional, but life-long clinical training opportunities. Under the new residency program, an additional postgraduate and continuing medical training system has to be built up to maintain and confirm a physician's competencies. If physicians do clinical work using a scholarly way of thinking with critical analysis of their own competencies and improvement by reflection, they will become an excellent life-long learner.

Predictors of regional Medicare expenditures for otolaryngology physician services.

Science.gov (United States)

Smith, Alden; Handorf, Elizabeth; Arjmand, Ellis; Lango, Miriam N

2017-06-01

To describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. Cross-sectional study. The average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program. In 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor. Wide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. NA. Laryngoscope, 127:1312-1317, 2017. © 2016 The American Laryngological, Rhinological and Otological Society

Impact of ARPANS-like legislation on minerals industry in Australia - the TENORM issue

International Nuclear Information System (INIS)

Koperski, J.

2001-01-01

Processing of minerals results in increased concentrations of the naturally occurring radioactive materials (NORM) in mineral products and/or process wastes, relative to those in the source materials. Due to the current legislative trends this technologically enhanced naturally occurring radioactive material (TENORM) phenomenon may bring mineral processing practices, including disposal of NORM-elevated wastes, into the realm of regulatory concern for practically all mineral-processing operations in Australia. The 1999 Australian Radiation Protection and Nuclear Safety (ARPANS) legislation has been based on the 1996 International Basic Safety Standards (BSS) recommended by the International Atomic Energy Agency (IAEA). As such, it contains very restrictive exemption criteria from the provisions of the legislation. ARPANS legislation is only binding upon Commonwealth entities. They, incidentally, do not include minerals industry operations. This legislation has been incompatible with the nature of the minerals industry. However, the current legislative developments have been aimed at imposing this legislation onto States and Territories. If this happens, and the current ARPANS legislative exemption criteria are not rationalised, major radiation safety-related operational and administrative impacts on the Australian minerals industry will occur. They will result in a marked burden to the national economy for yet to be clearly identified health and safety benefits. It is thus recommended that, without compromising rational radiation protection principles and practices, legislation commensurate with the nature of the minerals industry operations, national and state circumstances, conditions and interests be adopted in Australia. Such legislation would follow the spirit of the IAEA 1996 recommendations. Copyright (2001) Australasian Radiation Protection Society Inc

Radiologic reports : attitudes, preferred type, and opinion of referring physicians

International Nuclear Information System (INIS)

Kim, Won Young; Hwang, Seong Su; Ahn, Myeong Im and others

2001-01-01

To determine referring physicians' general attitudes, preferred reporting types, and opinions on radiologic reports. A survey questionnaire was distributed to the 315 staff and residents of four university hospitals with 400 to 800 beds, and a total of 228 physicians responded. The questionnaire aimed to determine of the general attitude of referring physicians to radiologic reports, the type of report they preferred, and other opinions and suggestions. The responses elicited, as well as discrepancies among residents, staff, internist, and surgeons, were analyzed. Most referring physicians replied that they read an entire report regardless of its length, and the second majority read the conclusion first and then the remainder of the report only if clarification was required. With regard to report length, physicians answered that reports describing the findings of conventional radiography were often too short, while those dealing with MRI were verbose. The majority experienced occasional confusion when reading a report, the major cause being grammatical errors and incomprehensible sentence structure. When confused, most physicians consulted the radiologist ; staff showed a greater inclination than residents to pursue this option. Most physicians preferred brief phrases or telegraphic-style sentences to a style which stressed completeness and detail, a preference which was statistically higher among residents than staff. Whereas physicians favored a brief radiologic report in cases of normal radiologic findings, conventional radiologic studies or no clinical findings, they wished to see a more detailed report in cases of abnormal radiologic findings, specific radiologic studies (special radiographs, US, CT, or MRI), or positive clinical findings. This need for more detail was expressed more frequently by internists than by surgeons. If implemented, the results of this study can be expected to enhance the quality and comprehensibility of radiologic reports, and may

How to use pre-employment medical examinations and comply with Anti-Discrimination legislation

Energy Technology Data Exchange (ETDEWEB)

Scholz, D. [Sparke Helmore Solicitors and Notaries, Sydney, NSW (Australia)

1998-12-31

The law including legislation such as the Occupational Health and Safety Act 1983 imposes stringent obligations on employers to ensure the health and safety of their employees. The use of pre-employment medical examinations is one tool that employers can use to assess the suitability of applicant for a particular position and protect themselves from persecution or claims for compensation or damages. At the same time, however, legislation such as The Disability Discrimination Act 1992 (Commonwealth) (DDA) and The Anti-Discrimination Act 1977 (New South wales) (ADA) affords protection to individuals against discrimination. This legislation is intended to ensure, as far as is practicable, that people with disabilities are treated equally to other members of the community and are brought into the mainstream of our society as far as possible. It makes it unlawful for employers to discriminate against prospective employees because of their disability. In the context of pre-employment medicals, the protection from discrimination is designed to ensure that job applicants with disabilities have as much opportunity to obtain employment as able bodied applicants. Employers must ensure that they use pre-employment medical examinations in a way that is both relevant for their workplace and complies with the requirements of Anti-Discrimination legislation. The definition of discrimination in the Federal and State Acts is virtually identical except for variations in the type and extent of various exceptions. Complainants are free to choose between State and Federal jurisdiction in situations which are covered by both. While the Equal Opportunity Tribunal (State) cannot order damages in excess of 40,000,000 dollars there is no limit on the amount of damages the Human Rights and Equal Opportunity Commission (Federal) can award.

General review of quality assurance system requirements. The utility or customer requirement

International Nuclear Information System (INIS)

Fowler, J.L.

1976-01-01

What are the customer's Quality Assurance requirements and how does he convey these to his contractor, or apply them to himself. Many documents have been prepared mostly by countries with high technology availability and it is significant to note that many of the documents, particularly those of the United States of America, were prepared for nuclear safety related plant, but the logic of these documents equally applied to heavy engineering projects that are cost effective, and this is the current thinking and practice within the CEGB (Central Electricity Generating Board). Some documents have legislative backing, others rely on contractual disciplines, but they all appear to repeat the same basic requirements, so why does one continue to write more documents. The basic problem is that customers have to satisfy differing national legislative, economic and commercial requirements and, like all discerning customers, wish to reserve the right to satisfy their own needs, which are very often highly specialized. The CEGB are aware of this problem and are actively co-operating with most of the national and international authorities who are leading in this field, with a view to obtaining compatibility of requirements, but now there still remains the problem of satisfying national custom and practice. (author)

[Tuberculosis and refusal of treatment: resorting to legislation on serious health threats].

Science.gov (United States)

Bouvet, R; Le Gueut, M

2013-06-01

Clinicians are regularly confronted with the question of refusal of treatment from patients with tuberculosis. For several years, the French public health authorities have been studying the possibility of compelling treatment or isolation, but no plan has been implemented even though European and American experiences have shown the effectiveness of restrictive measures. Neither the statutory exceptions to the principle of consent to medical treatment nor the conditions of implementation of "required care" allow legally binding measures against patients refusing care or isolation. The legislation on serious health threats has recently been applied to the situation of a refusal of treatment in the context of tuberculosis. It allowed the patient to be ordered to observe prescribed care and the possibility of forced isolation in the event of breach of this order. The legislation on serious health threats is a response to the question of refusal of treatment from patients with tuberculosis. However the opinion of the legal authority as to its necessity and proportionality to the risk remains unknown. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Physicians' strikes and the competing bases of physicians' moral obligations.

Science.gov (United States)

MacDougall, D Robert

2013-09-01

Many authors have addressed the morality of physicians' strikes on the assumption that medical practice is morally different from other kinds of occupations. This article analyzes three prominent theoretical accounts that attempt to ground such special moral obligations for physicians--practice-based accounts, utilitarian accounts, and social contract accounts--and assesses their applicability to the problem of the morality of strikes. After critiquing these views, it offers a fourth view grounding special moral obligations in voluntary commitments, and explains why this is a preferable basis for understanding physicians' moral obligations in general and especially as pertaining to strikes.

Design requirements for the new reactor