Suchergebnisse

Though the problem of childhood lead poisoning has been recognized for more than a century, it remains an important threat to children's health and development. This comparative policy assessment examines and compares environmental and public health policies to prevent children's exposure of three major lead producing countries. Germany, the USA and Australia were used to explore a range of approaches primarily at the national level to identify best practice, how the lack of finding any 'safe exposure' level has been incorporated into policy, and to consider if any international harmonization has occurred. We searched the peer-reviewed literature, government websites, policy documents and grey literature to identify how and when policies were developed, implemented and revised. From this analysis, we present a chronology and discussion of national policy approaches for the main sources of lead exposure for children in each country. We found significant differences in timing and comprehensiveness of environmental policies related to lead. There are significant differences among the countries in biomonitoring and identifying pathways of exposure, with limited information available in Germany and Australia. Though there are significant gaps, the US has the most comprehensive regulations relating to old lead paint in housing, while in Australia, a regulatory framework is lacking. Though all three countries regulate lead in air, the US has the most health protective standard, while Australia lacks the ability to ensure that states meet the national standard. Though each country has developed regulatory frameworks for lead that have reduced children's exposure, none of the three countries have a comprehensive set of policies that respond to the scientific evidence that there is no identified threshold for lead exposure. While there are differences in the relative importance of lead exposure pathways among the three countries, suggesting the need for different prevention emphases, there is also a strong argument for more international harmonization of exposure standards at the most protective levels. Some environmental policies incorporate current scientific understanding of lead toxicity, however, we identified gaps in standards and enforcement, and as a result, exposure continues to affect the health of children in all three countries.

Background A diagnosis of serious mental illness can impact on the whole family. Families informally provide significant amounts of care but are disproportionately at risk of carer burden when compared to those supporting people with other long-term conditions. Shared decision making (SDM) is an ethical model of health communication associated with positive health outcomes, however there has been little research to evaluate how routinely family are invited to participate in SDM, or what this looks like in practice. Objective This UK study aimed to better understand how the family caregivers of those diagnosed with SMI are currently involved in decision making, particularly decisions about treatment options including prescribed medication. Objectives were to:- • Explore the extent to which family members wish to be involved in decisions about prescribed medication • Determine how and when professionals engage family in these decisions • Identify barriers and facilitators associated with the engagement of family in decisions about treatment. Participants Open-ended questions were sent to professionals and family members to elicit written responses. Qualitative responses were analysed thematically. Results Themes included the definition of involvement and 'rules of engagement'. Staff members are gatekeepers for family involvement and the process is not democratic. Family and staff ascribe practical, rather than recovery-oriented roles to family, with preoccupation around notions of adherence. Conclusions Staff members need support, training and education to apply SDM. Time to exchange information is vital but practically difficult. Negotiated teams, comprising of staff, service users, family, peers as applicable, with ascribed roles and responsibilities could support SDM.

THIS ARTICLE OUTLINES THE THREE MAJOR IDENTIFIABLE APPROACHES WHICH MAY BE TAKEN TOWARDS THE FUTURE REGULATION AND SUPERVISION OF BANKING IN THE EUROPEAN UNION (EU). A DISCUSSION OF THE REASONS FOR SUCH REGULATION AND PRUDENTIAL SUPERVISION IS FOLLOWED BY AN ASSESSMENT OF RECENT RELEVANT EXPERIENCE. THE VERY SUBSTANTIAL ECONOMIC COSTS OF POORLY DESIGNED REGULATION AND INADEQUATE SUPERVISION ARE ALSO ILLUSTRATED.

Argues that self-interest plays a decisive role in shaping attitudes toward smoking restrictions and cigarette taxes. Data from 2 random samples indicate that nonsmokers are far more enthusiastic about tightening smoking restrictions and increasing cigarette taxes than smokers, particularly heavy smokers. Discusses several explanations for the apparent discrepancy between these results and the pattern of null findings characteristic of the self-interest literature. (Abstract amended)