Fair credit reporting medical information regulations. Final rules.
The OCC, Board, FDIC, OTS, and NCUA (Agencies) are publishing final rules to implement section 411 of the Fair and Accurate Credit Transactions Act of 2003 (FACT Act). The final rules create exceptions to the statute's general prohibition on creditors obtaining or using medical information pertaining to a consumer in connection with any determination of the consumer's eligibility, or continued eligibility, for credit for all creditors. The exceptions permit creditors to obtain or use medical information in connection with credit eligibility determinations where necessary and appropriate for legitimate purposes, consistent with the Congressional intent to restrict the use of medical information for inappropriate purposes. The final rules also create limited exceptions to permit affiliates to share medical information with each other without becoming consumer reporting agencies. The final rules are substantially similar to the rules adopted by the Agencies on an interim final basis in June 2005. (+info)
What same sex civil partnerships may mean for health.
A growing number of countries have introduced a form of marriage or civil partnership registration for same sex couples. Marriage confers health benefits on heterosexual men and women and similar benefits could arise from same sex civil unions. The authors argue that legal and social recognition of same sex relationships may reduce discrimination, increase the stability of same sex relationships, and lead to better physical and mental health for gay and lesbian people. (+info)
HIPAA administrative simplification: enforcement. Final rule.
The Secretary of Health and Human Services is adopting rules for the imposition of civil money penalties on entities that violate rules adopted by the Secretary to implement the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 (HIPAA). The final rule amends the existing rules relating to the investigation of noncompliance to make them apply to all of the HIPAA Administrative Simplification rules, rather than exclusively to the privacy standards. It also amends the existing rules relating to the process for imposition of civil money penalties. Among other matters, the final rule clarifies and elaborates upon the investigation process, bases for liability, determination of the penalty amount, grounds for waiver, conduct of the hearing, and the appeal process. (+info)
Using quantitative and qualitative data in health services research - what happens when mixed method findings conflict? [ISRCTN61522618].
BACKGROUND: In this methodological paper we document the interpretation of a mixed methods study and outline an approach to dealing with apparent discrepancies between qualitative and quantitative research data in a pilot study evaluating whether welfare rights advice has an impact on health and social outcomes among a population aged 60 and over. METHODS: Quantitative and qualitative data were collected contemporaneously. Quantitative data were collected from 126 men and women aged over 60 within a randomised controlled trial. Participants received a full welfare benefits assessment which successfully identified additional financial and non-financial resources for 60% of them. A range of demographic, health and social outcome measures were assessed at baseline, 6, 12 and 24 month follow up. Qualitative data were collected from a sub-sample of 25 participants purposively selected to take part in individual interviews to examine the perceived impact of welfare rights advice. RESULTS: Separate analysis of the quantitative and qualitative data revealed discrepant findings. The quantitative data showed little evidence of significant differences of a size that would be of practical or clinical interest, suggesting that the intervention had no impact on these outcome measures. The qualitative data suggested wide-ranging impacts, indicating that the intervention had a positive effect. Six ways of further exploring these data were considered: (i) treating the methods as fundamentally different; (ii) exploring the methodological rigour of each component; (iii) exploring dataset comparability; (iv) collecting further data and making further comparisons; (v) exploring the process of the intervention; and (vi) exploring whether the outcomes of the two components match. CONCLUSION: The study demonstrates how using mixed methods can lead to different and sometimes conflicting accounts and, using this six step approach, how such discrepancies can be harnessed to interrogate each dataset more fully. Not only does this enhance the robustness of the study, it may lead to different conclusions from those that would have been drawn through relying on one method alone and demonstrates the value of collecting both types of data within a single study. More widespread use of mixed methods in trials of complex interventions is likely to enhance the overall quality of the evidence base. (+info)
Event- and context-specific normative misperceptions and high-risk drinking: 21st birthday celebrations and football tailgating.
OBJECTIVE: Negative alcohol-related consequences often occur during specific events and in specific contexts (e.g., 21st birthday celebrations and tailgating parties). A lack of available event- and context-specific interventions suggests the need to better understand factors associated with heavy drinking in these contexts, with an eye toward developing specific interventions. The purpose of this research was to lay the foundation for developing personalized normative feedback interventions for 21st birthday celebratory drinking and tailgating drinking by evaluating whether students overestimate norms in these specific contexts, as they do more generally. METHOD: Perceived descriptive norms and alcohol consumption were assessed at event- and context-specific levels in two studies. Study 1 included 119 students turning 21 years old who reported their 21st birthday drinking behavior and estimated the typical number of drinks consumed by students celebrating their 21st birthday. Study 2 included 140 undergraduates drawn from a stratified random sample who reported their behavior regarding drinking and tailgating and their perceived norms for typical drinking and tailgating behavior. RESULTS: Results from Study 1 revealed that students overestimated peer drinking during 21 st birthday celebrations, and this overestimation was associated with heavier drinking on one's own 21st birthday. In Study 2, students underestimated the percentage of tailgaters who drank but overestimated typical consumption. Overestimation was consistently associated with heavier drinking during tailgating. CONCLUSIONS: Successful correction of general normative misperceptions has been shown to reduce drinking in other research. Documentation of normative misperceptions for specific events and contexts provided by these results represents an important step in developing event- and context-specific interventions utilizing specific normative feedback. (+info)
A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings.
BACKGROUND: Socio-economic variations in health, including variations in health according to wealth and income, have been widely reported. A potential method of improving the health of the most deprived groups is to increase their income. State funded welfare programmes of financial benefits and benefits in kind are common in developed countries. However, there is evidence of widespread under claiming of welfare benefits by those eligible for them. One method of exploring the health effects of income supplementation is, therefore, to measure the health effects of welfare benefit maximisation programmes. We conducted a systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. METHODS: Published and unpublished literature was accessed through searches of electronic databases, websites and an internet search engine; hand searches of journals; suggestions from experts; and reference lists of relevant publications. Data on the intervention delivered, evaluation performed, and outcome data on health, social and economic measures were abstracted and assessed by pairs of independent reviewers. Results are reported in narrative form. RESULTS: 55 studies were included in the review. Only seven studies included a comparison or control group. There was evidence that welfare rights advice delivered in healthcare settings results in financial benefits. There was little evidence that the advice resulted in measurable health or social benefits. This is primarily due to lack of good quality evidence, rather than evidence of an absence of effect. CONCLUSION: There are good theoretical reasons why income supplementation should improve health, but currently little evidence of adequate robustness and quality to indicate that the impact goes beyond increasing income. (+info)
The rhetorician's craft, distinctions in science, and political morality.
In his response to Szasz' Secular Humanism and Scientific Psychiatry, the author considers the use of rhetorical devices in Szasz' work, Szasz' avoidance of acknowledging psychiatry's scientific distinctions, and Szaszian libertarianism versus liberalism. (+info)
The challenge of mandatory evacuation: providing for and deciding for.
Insufficient attention has been given to the ethical and legal questions surrounding mandatory evacuation in disasters and emergencies. We argue that mandatory evacuation orders entail a governmental duty both to provide for people and to decide for people: Government must trigger the provision of critical resources as well as vigorous and persistent efforts to persuade reluctant citizens to leave. Public health professionals, with their experience in weighing costs and risks in the face of uncertainty and balancing individual liberties with the need to protect the common welfare, offer a unique perspective that should be brought to bear in emergencies and disasters. (+info)