Emergency Care EMTALA Alterations During the COVID-19 Pandemic in the United States

The coronavirus 2019 pandemic has affected almost every aspect of health care delivery in the United States, and the emergency medicine system has been hit particularly hard while dealing with this public health crisis. In an unprecedented time in our history, medical systems and clinicians have been asked to be creative, flexible, and innovative, all while continuing to uphold the important standards in the US health care system. To continue providing quality services to patients during this extraordinary time, care providers, organizations, administrators, and insurers have needed to alter longstanding models and procedures to respond to the dynamics of a pandemic. The Emergency Medicine Treatment and Active Labor Act of 1986, or EMTALA, is 1 example of where these alterations have allowed health care facilities and clinicians to continue their work of caring for patients while protecting both the patients and the clinicians themselves from infectious exposures at the same time.     

某医疗机构核医学工作场所劳务派遣保洁人员的职业健康管理

近几年，"劳务派遣"成了医疗机构终末消毒、保洁、垃圾回收等工作新的用工形式。由于多数用工单位和用人单位不清楚对劳务派遣人员职业健康管理中各自应承担的责任和义务，以至于劳务派遣工在劳动过程中应享有的劳动保护权益未获得切实保障。本文就某医疗机构核医学工作场所劳务派遣保洁人员的职业健康管理监督案例进行讨论。     

Principles and strategies of effective community participation

A framework is offered for understanding the conceptual basisand the strategic implications of community participation, inachieving Health for All goals. Special focus is given to themeaning, settings and levels of participation in official decision-makingstructures and at the community level. Questions such ‘howis participation facilitated?’, ‘who participates?’and ‘what are the benefits and obstacles to participation?’are geared primarily towards the needs of individuals who functionat the city level and expect practical strategic advice andguidance. The structure of the 1989 WHO Healthy Cities Symposiumwhich was devoted to community action was based on the frameworkand conceptual approach of this paper.     

Healthy communities: reflections on building alliances in Canada. A view from the middle

The author is currently working in the office of Health Promotion,Ministry of Health in British Columbia. For the past 17 yearsshe has worked in Health and Welfare Canada as an advocate forcitizen participation in developing health programs and policies. This article is based on her experience as an advocate and bureaucratin translating and mediating health promotion rhetoric intoaction. The Canadian Healthy Communities and Strengthening Communitiesprojects are used as examples in analyzing the opportunitiesand contradictions in building alliances.     

Development and evaluation of a breast cancer prevention decision aid for higher-risk women

Objective To develop and evaluate the effectiveness of a breast cancer prevention decision aid for women aged 50 and older at higher risk of breast cancer. Design Pre‐test–post‐test study using decision aid alone and in combination with counselling. Setting Breast Cancer Risk Assessment Clinic. Participants Twenty‐seven women aged 50–69 with 1.66% or higher 5‐year risk of breast cancer. Intervention Self‐administered breast cancer prevention decision aid. Main outcome measures Acceptability; decisional conflict; knowledge; realistic expectations; choice predisposition; intention to improve life‐style practices; psychological distress; and satisfaction with preparation for consultation. Results The decision aid alone, or in combination with counselling, decreased some dimensions of decisional conflict, increased knowledge (P < 0.01), and created more realistic expectations (P < 0.01). The aid in combination with counselling, significantly reduced decisional conflict (P < 0.01) and psychological distress (P < 0.02), helped the uncertain become certain (P < 0.02), and increased intentions to adopt healthier life‐style practices (P < 0.03). Women rated the aid as acceptable, and both women and practitioners were satisfied with the effect it had on the counselling session. Conclusion The decision aid shows promise as a useful decision support tool. Further research should compare the effect of the decision aid in combination with counselling to counselling alone.     

Social participation and life-style: A longitudinal and cohort study

This study focuses on changes occurring in one area of life-style, social participation during retirement. The population consisted of four cohorts, born in 1905–06, 1909–10, 1917–18, and 1921–22. In the longitudinal study the members of the oldest cohort were interviewed five times at the ages of 66, 70, 74, 78 and 82 years. In the cohort study the subjects were interviewed at the age of 66. Interests decreased after the age of 78 among men and women. Also, formal social participation declined with age among men and women. There were no cohort differences among men, but among women formal social participation was higher in the younger cohorts than in the older ones. In the longitudinal study education correlated positively with the interests index at almost all ages among both men and women. In the cohort study correlations between interests index and education were lower in the younger cohorts than in the older ones.Paper originally presented at the XIVth International Congress of Gerontology, Acapulo, Mexico 18–23 June 1989.     

The Effects of Incentives and Research Requirements on Participation Rates for a Community-Based Preventive Intervention Research Study

This investigation utilized prospective survey data to examine the influence of a research incentive ($100) and requirement (videotaping) on decisions to participate in prevention research. Individuals were significantly attracted by the incentive, and marginally deterred by the requirement. Interaction analyses revealed that the positive incentive effect was stronger among prospective participants with less education and who were otherwise less likely to participate. These findings indicate that monetary incentives can be useful for increasing participation rates, and may help reduce sampling bias by increasing rates most strongly among individuals who are typically less likely to take part in research projects.