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At least 145 records · Page 8Linked to original sources
PubMed1977

State supplementation under SSI, 1975.

This article summarizes State supplementation activities under SSI for 1975. It discusses changes in the State programs that occurred during 1975 and presents some comparisons with data for 1974--the initial year of the SSI program. A slight shift occurred in the distribution of recipients by eligibility category for Federal and State supplementation from 1974 to 1975. During 1975 a few States changed from Federal administration to State administration of their mandatory supplementation programs while a few others initiated or expanded their optional supplementation programs. Several States also increased their supplements during the year.

Financing, Government↗
PubMed1992

The feasibility of mandatory HIV testing for health professionals and other special populations.

Infection with the human immunodeficiency virus (HIV) has become an increasingly important public health problem. Due to the profound increase in the incidence of the disease, testing has become an important tool in prevention efforts as well as treatment. In view of the dire prognosis associated with the diagnosis of HIV infection, there is a great deal of interest in mandatory HIV testing of special groups. Mandatory testing has been implemented for several groups such as the United States military. However, there are a number of issues to be considered before implementing a mandatory testing program. These include the predictive value and accuracy of the tests themselves, confidentiality and the social ramifications of breaches in confidentiality, the likelihood of forcing high risk persons underground to avoid testing, and the constitutionality of a mandatory testing policy. Since the discovery of the apparent transmission of HIV infection from a dentist to his patients, there has been increasing interest in a policy mandating the testing of health professionals. However, in view of the low risk of transmission to patients, it would be ill-advised to require HIV testing of health care workers. In general, the benefits of a mandatory testing policy do not outweigh the human and financial costs it would engender.

AIDS Serodiagnosis↗
PubMed1990

Technical workshop report: Working Group II: agricultural occupational health and safety services for farmers and ranchers.

This work group felt that there is compelling evidence that effective occupational health services are essential to improve the serious occupational safety and health problems in agriculture. Program initiatives may be stimulated by federal and state governments, but development and implementation must involve the grassroots farm community and local resources. Other countries (Sweden, Finland, Canada) are far ahead of the United States in this area and serve as examples. Developing services should be comprehensive and should include clinical, technical, and educational efforts. Marketing programs to the public must include grassroots involvement. Surveillance and program evaluation are essential in any new program efforts. Funding such programs must be shared by federal, state, local, and private resources. Regulatory options should be a minimal part of such a program, but mandatory rollover protective devices and mandatory reporting seems to be one feasible regulatory option.

Accidents, Occupational↗
PubMed1980

Antabuse: medication in exchange for a limited freedom--is it legal?

Recidivism among alcohol offenders--drunken drivers in particular--has led courts to experiment with programs that attempt to rehabilitate problem drinkers. One such program, in El Cajon, California, offers defendants the choice of going to jail or of submitting to a year of treatment with Antabuse, a potent drug that reacts with alcohol to produce intensely painful physical symptoms. In addition, Antabuse subjects the recipient to the risk of toxic side effects. According to the authors, the El Cajon program fails to inform defendants of the full risks and effects of Antabuse. Further, the authors maintain that the program uses the threat of a jail sentence to coerce defendants into consenting to Antabuse therapy. The authors conclude that defendants' consent is so tained by these factors that the program amounts to involuntary treatment. Consequently, the authors suggest that the El Cajon program violates defendants' constitutional right to privacy. Finally, the severity of the Antabuse-alcohol reaction leads the authors to contend that the program constitutes cruel and unusual punishment.

Accident Prevention↗
PubMed1992

The stigma of disease: implications of genetic screening.

As the field of human genetics successfully continues to unravel the secrets of an individual's genetic makeup, the social processes of stigmatization and ostracism of those with "undesirable" traits have the potential to increase. An historical example that may shed light on the problems of applying genetic technology to disease prevention is the institution of quarantine. This essay discusses the concept of "quarantine mentality" and the desire for healthy society to separate itself from those labeled "ill" or abnormal, and addresses two episodes in American history when genetics was applied to the formulation of social policy toward the "diseased": the eugenics movement of the early 20th century and the early attempts of genetic screening programs for sickle cell anemia during the 1970s.

Anemia, Sickle Cell↗
PubMedDate not supplied

Newborn genetic screening: ethical and social considerations for the nineties.

As we head into the next decade, the impact of the use of genetic screening programs for immunological surveillance purposes (such as for HIV) and for possible DNA typing should not be underestimated. The authors present ten principles which seek to reaffirm the basic tenents of neonatal screening programs -- the benefit of newborns. These principles are both protective and yet open to the complex ethical and social considerations raised by such new uses of newborn genetic screening programs.

Coercion↗
PubMedDate not supplied

Motivational interviewing in a group setting with mandated clients: a pilot study.

Some clients who are court-ordered to undergo substance abuse treatment are not able or willing to identify treatment-related goals. This situation can cause difficulties in the therapeutic relationship and compromise treatment. To address this problem, we offered a group-based motivational enhancement program prior to standard treatment. Over 2 years, 73 clients attended the motivation group while 94 did not. Compared to those who did not, those who attended the motivation group were significantly less likely to meet criteria for substance abuse dependence, they attended a higher proportion of their treatment sessions, and they were more likely to have completed treatment. After controlling for diagnosis, employment, and age, attending the motivation group was still related to higher rates of attendance and treatment completion. A motivation group may promote better participation in substance abuse treatment programs among persons who do not identify treatment goals. Additional research is needed to draw firm conclusions.

Adult↗
PubMed1988

Concerns of medical and pediatric house officers about acquiring AIDS from their patients.

To assess the degree of house officers' concerns about acquiring AIDS (acquired immunodeficiency syndrome) from their patients, we surveyed 263 medical and pediatric interns and residents in four housestaff training programs affiliated with seven New York City hospitals with large AIDS patient populations; 258 questionnaires (98 per cent) were returned. Thirty-six per cent of medical and 17 per cent of pediatric house officers reported percutaneous exposures to needles contaminated with blood of AIDS patients. Forty-eight per cent of medical and 30 per cent of pediatric house officers reported a moderate to major concern about acquiring AIDS from their patients. Greater concern about personal risk was noted in those house officers who were earlier in their residency training, who reported having treated a greater number of AIDS patients, and who were in medicine rather than pediatrics programs. Twenty-five per cent of all respondents reported that they would not continue to care for AIDS patients if given a choice. The results demonstrate a substantial degree of concern about acquiring AIDS among house officers caring for AIDS patients and suggest the need for housestaff program administrators for formally address these concerns.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Expanding health insurance coverage: who will pay?

Recent discussions on extending health insurance to the more than thirty million uninsured Americans have focused on two strategies: expanding the Medicaid program and mandating that employers sponsor coverage for their employees. This analysis, using a microsimulation model of the U.S. health care financing system, suggests that these two options would result in very different distributions of financial burden. Employer-sponsored coverage is financed in a highly regressive fashion, in contrast to the Medicaid program, which is proportional to income. Furthermore, the burden of paying for health care under Medicaid varies little among generations, whereas the cost of employer-sponsored care is lowest in households headed by persons over sixty-five years old. Low health status populations do not pay disproportionately higher taxes or premiums to finance either the Medicaid program or employer-sponsored coverage. Their incomes, however, are more effectively protected by Medicaid, because it offers more comprehensive benefits.

Costs and Cost Analysis↗
PubMed1991

Compulsory treatment for drug-dependent persons: justifications for a public health approach to drug dependency.

Compulsory treatment for drug users is often rejected as neither an effective nor an acceptable exercise of state authority. Recent research studies indicate that compulsory treatment can work and that, if carefully put into effect, it can represent an important public health component of the response to drug use. Finally, a program of compulsory treatment can be shaped with concerns for due process in mind, so that civil liberties will not be violated.

Behavior Control↗
PubMed1990

HIV infection, pregnant women, and newborns: A policy proposal for information and testing.

As the public health impact of human immunodeficiency virus (HIV) infection in women and children has increased, so has interest in screening pregnant women and newborns for evidence of HIV infection. However, screening of pregnant women and newborns raises profound moral, legal, and policy issues. In this article, we present and defend a detailed 10-point program of policy recommendations for both pregnant women and newborns. We advocate informing all pregnant women and new mothers about the HIV epidemic and the availability of testing.

AIDS Serodiagnosis↗
PubMed1987

The prevention of acquired immunodeficiency syndrome in the United States. An objective strategy for medicine, public health, business, and the community.

Human immunodeficiency virus (HIV) is one of the most virulent infectious agents ever encountered. This virus, estimated to kill up to a half of those infected, has spread to more than 1 million Americans. There is no safe and effective treatment. Nor is there a vaccine. From our understanding of HIV transmission, further spread of the virus can be stopped by the use of various techniques. The combined use of education-motivation-skill building, serologic screening, and contact tracing/notification could eliminate or substantially reduce transmission. To accomplish this reduction an immense concerted effort by physicians, public health practitioners, business, and community organizations is required to get across the simple prevention messages. Those messages are: Any sexual intercourse (outside of mutually monogamous or HIV antibody-negative relationships) must be protected with a condom. Do not share unsterile needles or syringes. All women who may have been exposed should seek HIV-antibody testing before becoming pregnant and, if positive, avoid pregnancy. Only through a concerted, vigorous, and sustained prevention program that deals frankly with this problem will those individuals at risk be reached and motivated to take personal responsibility to protect themselves. Without such an effort, acquired immunodeficiency syndrome will continue to kill ever-increasing numbers of Americans.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Who are the donors in organ donation? The family's perspective in mandated choice.

Evidence that families requested to permit organ donation refuse half the time has led to proposals for mandated choice. Under mandated choice, a person's donation wishes would be collected and retrieved at death, and requests to families would be avoided. There are both ethical and logistic problems with mandated choice. The view of the family should be respected in organ requests, even when patient wishes are known. Public sentiment against overriding family wishes could cause low rates of pro-donation registration. Caregivers have usually refused to take organs when families oppose donation. Logistic issues with mandated choice include the cost and complexity of maintaining a national database on donors and the enforcement of registration. No such database of adults currently exists, even for tax purposes. Two states that have mandated choice programs through departments of motor vehicles report relatively low number of pro-donation registrants compared with nondonors or undecided persons. Public education and voluntary donor identification hold more potential to increase donation.

Adult↗
PubMed1979

Structured educational program for staff development.

The development of a mandatory continuing education program for the pharmacy staff of a 675-bed hospital with 10 decentralized pharmacy satellites is described. The therapeutic topics selected for presentation were antibiotics, immunology and adverse drug reactions, diabetes mellitus and acid-base disorders. The format for each subject included a pretest of basic knowledge, a comprehensive lecture, a tape recording, supplemental handout material and readings, and a posttest. Posttests were scheduled three to four weeks following lectures to allow preparation time. Questionnaires were used to evaluate acceptance of the program. Posttest scores for each of the four topics were significantly better than pretest scores (p less than or equal to 0.0001). Questionnaire responses indicated that 97% of the participants believed the program to be worthwhile, and 94% voted to continue the series. The success and acceptance of this approach to continuing education support its application to a comprehensive program of staff development.

Chicago↗
PubMed1993

Economic analysis of a mastitis monitoring and control program in four dairy herds.

Mastitis monitoring and control programs were instituted in 4 Illinois dairy herds for 12 months. Two herds had high mean monthly bulk tank somatic cell counts (> 490,000 cells/ml) and 2 had low mean monthly bulk tank somatic cell counts (< 260,000 cells/ml) at the start of the study. The mastitis monitoring and control programs included mandatory mastitis control measures, as well as individualized control measures that were based on results of bacterial cultures of milk, bulk tank milk analyses, milking machine and milking procedure evaluations, and environmental inspections in each herd. Changes in mastitis prevalence, clinical mastitis incidence, milk yield, and individual cow somatic cell counts were evaluated, and an economic analysis was performed for each herd. Mastitis-associated economic losses during the study period ranged from $161.79 to $344.16/lactating cow in the 4 herds. Gross economic benefits resulted when mastitis-associated losses were lower with the monitoring and control program than predicted without it. There were no gross economic benefits in the herds with low somatic cell counts, and, when the marginal costs of the programs were added, there were large net losses ($84.06 and $113.01/lactating cow) in those herds. Gross economic benefits resulted in both of the herds with high somatic cell counts. However, in 1 of the herds, the marginal costs of the program exceeded the benefits, resulting in a net loss of $12.96/lactating cow. The net loss was attributed primarily to poor producer compliance with recommendations. There was a net economic benefit of $19.11/lactating cow in the other herd with high somatic cell counts, in which producer compliance was better.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Reducing unnecessary psychiatric consultations for informed consent by liaison with administration.

The frequency of a psychiatric consultation being requested to assess a patients' capacity to give informed consent varies among institutions, with most recent surveys reporting a frequency of between 3% and 8% of all consultations. At Montefiore Medical Center, a hospital policy was interpreted as mandating such consultations for all patients with possible or even definite lack of decisional capacity. From 1987 to 1988, 55% of all psychiatric consultations in the institution were for consent. Only 9% of the consent patients seen had an Axis I diagnosis other than organic mental syndrome (OMS). Because many of these consultations were believed to be unnecessary, with patient clearly able or unable to give consent, the consultation service worked first with administration to modify the guidelines, and then educated the medical and nursing staff as to when consultation was indicated. With this program, the number of consent consultations fell from 958 in 1988 to 177 in 1990, representing a major saving of staff time and third-party billings. In this era of cost containment and outside review of professional practices, psychiatrists must take responsibility for identifying areas where patient services and billings for them are not justified by clinical indications.

Aged↗