BACKGROUND & AIMS: :This article reviews the current statistics of employment and work-related injuries and illness in China, as well as the history of occupational health and safety legislation in the country. Comprehensive, newly promulgated workplace health and safety legislation is described, and the specific responsibilities of employers, government agencies, trade unions, and employees are detailed. The government's implementation plan for this and prior legislation is also outlined.

背景与目标： ：本文回顾了中国目前与就业和工作有关的工伤和疾病的统计数据，以及该国职业健康和安全法规的历史。描述了新颁布的全面的工作场所健康和安全法规，并详细说明了雇主，政府机构，工会和雇员的具体职责。还概述了政府针对此法规和先前法规的实施计划。

BACKGROUND & AIMS: :Psychiatrists are urged to get involved in promoting legislation and public policy debates in state legislatures to effectively advocate for positive change in legislation and policy making. This column focuses on strategies that New Hampshire Psychiatric Society members have found effective in engaging policy makers and legislators in a dialogue that assertively promotes the views of patients with mental illness and the profession of psychiatry.

背景与目标： ：敦促精神科医生参与州立法机关的立法和公共政策辩论，以有效倡导立法和政策制定的积极变化。本专栏重点介绍新罕布什尔州精神病学会成员发现的有效地使决策者和立法者参与对话的策略，该对话断然地提倡了精神病患者和精神病学界的观点。

BACKGROUND & AIMS: BACKGROUND:Little is known about how U.S. physicians' political affiliations, specialties, or sense of social responsibility relate to their reactions to health care reform legislation. OBJECTIVE:To assess U.S. physicians' impressions about the direction of U.S. health care under the Affordable Care Act (ACA), whether that legislation will make reimbursement more or less fair, and examine how those judgments relate to political affiliation and perceived social responsibility. DESIGN:A cross-sectional, mailed, self-reported survey. PARTICIPANTS:Simple random sample of 3,897 U.S. physicians. MAIN MEASURES:Views on the ACA in general, reimbursement under the ACA in particular, and perceived social responsibility. KEY RESULTS:Among 2,556 physicians who responded (RR2: 65 %), approximately two out of five (41 %) believed that the ACA will turn U.S. health care in the right direction and make physician reimbursement less fair (44 %). Seventy-two percent of physicians endorsed a general professional obligation to address societal health policy issues, 65 % agreed that every physician is professionally obligated to care for the uninsured or underinsured, and half (55 %) were willing to accept limits on coverage for expensive drugs and procedures for the sake of expanding access to basic health care. In multivariable analyses, liberals and independents were both substantially more likely to endorse the ACA (OR 33.0 [95 % CI, 23.6-46.2]; OR 5.0 [95 % CI, 3.7-6.8], respectively), as were physicians reporting a salary (OR 1.7 [95 % CI, 1.2-2.5]) or salary plus bonus (OR 1.4 [95 % CI, 1.1-1.9) compensation type. In the same multivariate models, those who agreed that addressing societal health policy issues are within the scope of their professional obligations (OR 1.5 [95 % CI, 1.0-2.0]), who believe physicians are professionally obligated to care for the uninsured / under-insured (OR 1.7 [95 % CI, 1.3-2.4]), and who agreed with limiting coverage for expensive drugs and procedures to expand insurance coverage (OR 2.3 [95 % CI, 1.8-3.0]), were all significantly more likely to endorse the ACA. Surgeons and procedural specialists were less likely to endorse it (OR 0.5 [95 % CI, 0.4-0.7], OR 0.6 [95 % CI, 0.5-0.9], respectively). CONCLUSIONS:Significant subsets of U.S. physicians express concerns about the direction of U.S. health care under recent health care reform legislation. Those opinions appear intertwined with political affiliation, type of medical specialty, as well as perceived social responsibility.

背景与目标： 背景：关于美国医生的政治背景，专长或社会责任感与他们对医疗改革立法的反应之间的关系知之甚少。
目的：评估《可负担医疗法案》（ACA）下美国医生对美国医疗保健方向的印象，该立法是否会使报销或多或少是公平的，并研究这些判断与政治归属和可察觉的社会责任之间的关系。
设计：横断面，邮寄，自我报告的调查。
参与者：3,897名美国医生的简单随机样本。
主要指标：对ACA的总体看法，尤其是ACA下的报销，以及感知到的社会责任。
关键结果：在做出回应的2556名医生中（RR2：65％），大约五分之二（41％）认为ACA将使美国的医疗保健朝着正确的方向发展，并使医师的报销不太公平（44％）。 72％的医生认可了解决社会卫生政策问题的一般专业义务，65％的人同意每位医生都有专业义务照顾未投保或未投保的保险，一半（55％）的人愿意接受针对昂贵医疗保险的限额药物和程序，以扩大获得基本医疗保健的机会。在多变量分析中，自由主义者和独立者都更有可能认可ACA（分别为OR 33.0 [95％CI，23.6-46.2]; OR 5.0 [95％CI，3.7-6.8]），医生报告的是薪水（OR 1.7 [95％CI，1.2-2.5]）或薪金加奖金（OR 1.4 [95％CI，1.1-1.9）薪酬类型。在相同的多元模型中，那些同意解决社会卫生政策问题在其专业义务范围内的人（OR 1.5 [95％CI，1.0-2.0]），他们相信医师在专业上有义务照顾未保险的/未成年人保险（OR 1.7 [95％CI，1.3-2.4]），并同意限制昂贵药物的承保范围和扩大保险范围的程序（OR 2.3 [95％CI，1.8-3.0]），都明显更有可能认可ACA。外科医生和程序专家不太可能认可它（OR 0.5 [95％CI，0.4-0.7]，或0.6 [95％CI，0.5-0.9]）。
结论：根据最近的医疗保健改革立法，相当一部分美国医师对美国医疗保健的方向表示担忧。这些意见似乎与政治派别，医疗专业的类型以及人们认为的社会责任交织在一起。

BACKGROUND & AIMS: :The sustainable management of chemicals and their associated wastes-especially legacy stockpiles-is always challenging. Developing countries face particular difficulties as they often have insufficient treatment and disposal capacity, have limited resources and many lack an appropriate and effective regulatory framework. This paper describes the objectives and the approach of the Egyptian-German Twinning Project under the European Neighbourhood Policy to improve the strategy of managing hazardous substances in the Egyptian Environmental Affairs Agency (EEAA) between November 2008 and May 2011. It also provides an introduction to the Republic of Egypt's legal and administrative system regarding chemical controls. Subsequently, options for a new chemical management strategy consistent with the recommendations of the United Nations Chemicals Conventions are proposed. The Egyptian legal and administrative system is discussed in relation to the United Nations' recommendations and current European Union legislation for the sound management of chemicals. We also discuss a strategy for the EEAA to use the existing Egyptian legal system to implement the United Nations' Globally Harmonized System of Classification and Labelling of Chemicals, the Stockholm Convention and other proposed regulatory frameworks. The analysis, the results, and the recommendations presented may be useful for other developing countries in a comparable position to Egypt aspiring to update their legislation and administration to the international standards of sound management of chemicals.

背景与目标： ：化学品及其相关废物（尤其是遗留库存）的可持续管理始终面临挑战。发展中国家面临特别的困难，因为它们往往没有足够的处理和处置能力，资源有限，而且许多国家缺乏适当和有效的监管框架。本文介绍了“欧洲邻国政策”下的“埃及-德国孪生项目”的目标和方法，以改善埃及环境事务局（EEAA）在2008年11月至2011年5月之间管理有害物质的策略。埃及共和国有关化学控制的法律和行政制度。随后，提出了与联合国化学品公约的建议相一致的新化学品管理战略的备选方案。讨论了埃及的法律和行政制度，涉及联合国的建议和欧盟目前对化学品进行无害管理的立法。我们还讨论了EEAA使用现有埃及法律体系实施联合国《全球化学品统一分类和标签制度》，《斯德哥尔摩公约》和其他拟议监管框架的战略。所提出的分析，结果和建议对其他处于与埃及相似地位的发展中国家可能有用，这些国家希望将其立法和行政管理更新为化学品无害管理的国际标准。

BACKGROUND & AIMS: OBJECTIVE: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. METHOD:Analysis of previously confidential BAT company documents. RESULTS: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. CONCLUSIONS: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.

背景与目标： 目的：研究英美烟草公司（BAT）如何利用体育赞助来规避泰国的烟草促销限制，泰国既是一个重要的新兴市场，又是世界烟草控制的领导者。
方法：分析先前机密的BAT公司文件。
结果：自1987年成立以来，英美烟草公司在泰国的体育赞助计划一直具有政治敏感性和法律上的模棱两可。鉴于泰国禁止进口卷烟，早期活动为走私品牌提供了促销支持。英美烟草公司对当地羽毛球，斯诺克，足球和板球比赛的资助为其品牌吸引了大量媒体报道。在《贸易和关税总协定》决定迫使泰国向进口商品开放卷烟市场之后，泰国于1992年实施的烟草控制立法确立了世界上限制性最强的营销环境之一。英美烟草公司的赞助策略已转向集会和摩托车赛车，使用区域比赛的广播来破坏国家法规。英美烟草公司试图控制个人运动，并形成媒体报道以最大程度地提高品牌知名度。采用了对抗性方法，测试了合法性的限制，并要求积极执法以确保遵守法律。
结论：文件显示，在广告限制日益增加的情况下，体育赞助为烟草公司提供了机会。在1992年烟草控制法规颁布之前，在泰国举办的赞助活动通过结合全球和本地形象来推广国际品牌。随后的“将区域划分为防御性”战略反映了国际体育运动超越国内限制的能力。这些跨国影响可以通过《烟草控制框架公约》得到有效处理，但需要就特定协议进行谈判。

BACKGROUND & AIMS: OBJECTIVE:To evaluate pollution by second-hand smoke in a sample of hospitality venues before and after the implementation of smoke-free legislation. METHODS:A cross sectional, before-after study was conducted in 2008 and 2011 after the total ban. A SidePack Aerosol monitor was used both inside and outside the hospitality venues to measure fine breathable particles (PM2.5). A total of 43 places with pre- and post-legislation measurements were included. RESULTS:The median indoor pollution in hospitality venues was 204.2μg/m(3) in 2008 and 18.82μg/m(3) in 2011; the average outdoor PM2.5 concentration was 47.04μg/m(3) in 2008 and 18.82μg/m(3) in 2011. Pollution was higher in bars and cafeterias, followed by pubs and discos. Before the law was implemented, pollution was 4.34 times higher indoors than outdoors; in 2011 the average indoor PM2.5 concentration decreased by 90.88%. CONCLUSIONS:Only a complete ban is able to protect workers and customers against the health risks of second-hand smoke exposure.

背景与目标： 目的：在实施无烟立法前后，评估接待场所样本中的二手烟污染。
方法：在全面禁令实施之后，于2008年和2011年进行了一项横断面的前后研究。在接待场所的内部和外部都使用了SidePack气溶胶监测仪，以测量可呼吸的细颗粒物（PM2.5）。总共有43个地方进行了立法前和立法后的测量。
结果：酒店场所的室内污染中位数在2008年为204.2μg/ m（3），在2011年为18.82μg/ m（3）;室外PM2.5的平均浓度在2008年为47.04μg/ m（3），在2011年为18.82μg/ m（3）。酒吧和自助餐厅的污染程度更高，其次是酒吧和迪斯科舞厅。在实施该法律之前，室内污染是室外的4.34倍。 2011年，室内平均PM2.5浓度下降了90.88％。
结论：只有全面的禁令才能保护工人和客户免受二手烟暴露对健康的危害。

BACKGROUND & AIMS: :Despite recent changes in legislation in several countries and general reduction in the use of animals in biomedical research, the impatience of antivivisectionists to see reductions in animal experimentation shows no signs of abating. Gerhard Zbinden analyses the reasons for this continuing dissatisfaction, arguing that real progress has been made in biomedical research, but that the complexities of developing internationally recognized regulations constitute a barrier to rapid change in product safety testing methods.

背景与目标： ：尽管最近几个国家的立法有所变化，并且生物医学研究中动物的使用普遍减少，但抗活体解剖学家急于看到动物实验的减少并未显示出减弱的迹象。 Gerhard Zbinden分析了这种持续不满的原因，认为生物医学研究已经取得了真正的进展，但是制定国际认可的法规的复杂性构成了产品安全测试方法快速变化的障碍。

BACKGROUND & AIMS: OBJECTIVE:To examine how a government committed to a voluntary approach was forced by an effective advocacy coalition to introduce comprehensive smoke-free legislation. METHODS:A diary was kept from the start of the campaign in 2003, backed up by journal and press articles, and information downloaded from the web. Regular public opinion polls were also carried out to supplement government surveys and polls conducted by the media. RESULTS:The 1997 Labour Government was committed to a voluntary approach to deal with the problem of secondhand smoke. By 2003, efforts to persuade government to introduce regulation of workplace secondhand smoke through a health and safety code of practice with exemptions for the hospitality trade, had failed. Despite a lack of support from the government, including the health minister, a new strategy by health advocates focusing on comprehensive workplace legislation was able to succeed. CONCLUSIONS:In a democracy it is crucial to develop public knowledge and belief in the extent of the risks of secondhand smoke. Gaining public and media support for the issue can ensure that government has to take action and that the legislation will be enforceable. The interests of the tobacco industry and the hospitality trade differ and this can be used to gain hospitality trade support for comprehensive national legislation in order to ensure a level playing field and protection from litigation.

背景与目标： 目的：研究有效的倡导联盟如何迫使政府对自愿性方法作出承诺，以引入全面的无烟立法。
方法：从2003年竞选开始以来就保留了日记，并以日记和新闻文章以及从网上下载的信息为后盾。还进行了定期的民意调查，以补充政府的调查和媒体的民意调查。
结果：1997年工党政府致力于采取自愿措施来解决二手烟问题。到2003年，试图说服政府通过健康和安全行为守则对酒店二手烟进行管制的规定并获得了招待业豁免，但这种努力失败了。尽管缺乏包括卫生部长在内的政府的支持，但卫生倡导者针对综合工作场所立法的新战略还是取得了成功。
结论：在民主国家中，发展公众对二手烟危害程度的认识和信念至关重要。在此问题上获得公众和媒体的支持可以确保政府必须采取行动，并且该立法将是可执行的。烟草业和酒店业的利益各不相同，这可用于获得对国家综合立法的酒店业支持，以确保公平的竞争环境和免受诉讼的侵害。

BACKGROUND & AIMS: Introduction:In 2011, the Spanish partial smoke-free legislation was extended to affect all enclosed settings, including hospitality venues and selected outdoor areas. This study evaluated the change in self-reported exposure to secondhand smoke among the adult, nonsmoking population. Methods:Two cross-sectional surveys were conducted on nationally representative samples of the adult (≥18 years) nonsmoking Spanish population. One was conducted in 2006 (6 months after the first ban) and the other in 2011, 6 months after the new ban was implemented. We assessed the prevalence and 95% confidence interval (CI) of self-reported exposure to secondhand smoke in various settings, and the corresponding adjusted prevalence ratios (PR) and 95% CIs. Results:Overall, the self-reported exposure to secondhand smoke fell from 71.9% (95% CI: 70.1%-73.7%) in 2006 to 45.2% (95% CI: 43.1%-47.3%) in 2011 (PR = 0.43; 95% CI: 0.39-0.47). Specifically, self-reported exposure significantly decreased from 29.2% to 12.7% (PR = 0.36; 95% CI: 0.31-0.42) in the home, from 35.0% to 13.0% (PR = 0.40; 95% CI: 0.33-0.49) at work/education venues, from 56.2% to 32.2% (PR = 0.44; 95% CI: 0.39-0.48) during leisure time (mainly hospitality venues, but also venues other than work/education venues and home), and from 40.6% to 12.7% (PR = 0.24; 95% CI: 0.21-0.29) in transportation vehicles/stations. Conclusions:The prevalence of secondhand smoke exposure among nonsmokers decreased after implementation of a comprehensive smoke-free legislation in Spain. In addition to the expected reduction in exposure during leisure time, we observed reductions in settings that were not subject to the new legislation, such as homes, outdoor bus stops, and train stations. Implications:Exposure to secondhand smoke in selected outdoor settings may be further reduced by extending smoke-free legislation.

背景与目标： 简介：2011年，西班牙将部分禁烟法规扩大到所有封闭环境，包括接待场所和部分室外区域。这项研究评估了成年人，非吸烟人群自我报告的二手烟暴露量的变化。
方法：对西班牙非吸烟成年人（≥18岁）的全国代表性样本进行了两次横断面调查。一项是在2006年（第一次禁令后6个月）进行的，另一次是在2011年，即新禁令实施后6个月进行的。我们评估了各种情况下自我报告的二手烟暴露的患病率和95％置信区间（CI），以及相应的调整患病率（PR）和95％CI。
结果：总体而言，自我报告的二手烟暴露从2006年的71.9％（95％CI：70.1％-73.7％）下降到2011年的45.2％（95％CI：43.1％-47.3％）（PR = 0.43; 95％CI：0.39-0.47）。具体而言，家庭中自我报告的暴露从29.2％显着降低至12.7％（PR = 0.36; 95％CI：0.31-0.42），从35.0％降低至13.0％（PR = 0.40; 95％CI：0.33-0.49）在工作/教育场所，闲暇时间（主要是招待场所，也包括工作/教育场所和家庭以外的场所）从56.2％增至32.2％（PR = 0.44; 95％CI：0.39-0.48），并且从40.6％到运输车辆/车站的12.7％（PR = 0.24; 95％CI：0.21-0.29）。
结论：西班牙实施了全面的无烟立法后，不吸烟者中二手烟暴露的患病率下降了。除了可以预期减少休闲时间的暴露外，我们还观察到了房屋，户外公交车站和火车站等不受新法规约束的环境的减少。
含义：通过扩大无烟法规，可以进一步减少在选定的室外环境下接触二手烟的机会。

BACKGROUND & AIMS: :Pseudoephedrine (PSE) is one of the main ingredients used to manufacture methamphetamine (MA); approximately 700 to 1000 PSE pills are necessary to "cook" a batch of MA. Steps have been taken to decrease the availability of ingredients needed to concoct MA. On May 21, 2005, the state of Iowa enacted a strict law, making PSE a Schedule V Controlled substance, restricting PSE availability, and sales. Using the same 6-month time frames in 2004 and 2005, we retrospectively compared epidemiological data on burn patients in the year before the new PSE law and again immediately after the law was enacted. Data collected between May 21 to December 31, 2004 and 2005 included sex, age, length of stay, body surface area burn, urine drug toxicity status, insurance status, and cost of hospital stay. Reports on statewide MA laboratory incidents were provided by the Office of Drug Control Policy. In 2004, Iowa ranked second in the nation for MA lab incidents, seizing an average of 120 labs per month. In 2006, Iowa ranked eighth in the nation for MA lab incidents, when only 20 labs per month were seized, an 83% decreased from the previous year. By limiting the availability of PSE, Iowa saw a marked decrease in MA laboratory-related incidents, leading to a drastic decrease in MA related burns statewide.

背景与目标： ：伪麻黄碱（PSE）是用于制造甲基苯丙胺（MA）的主要成分之一；大约需要700到1000个PSE药丸来“煮制”一批MA。已经采取措施减少炮制MA所需成分的可用性。 2005年5月21日，爱荷华州制定了严格的法律，将PSE列为附表V受控物质，限制了PSE的供应和销售。使用2004年和2005年相同的6个月时间框架，我们回顾性比较了新《 PSE法》颁布前一年和该法颁布后立即进行的烧伤患者的流行病学数据。在2004年5月21日至12月31日至2005年之间收集的数据包括性别，年龄，住院时间，体表烧伤，尿液药物中毒状态，保险状态和住院费用。药物管制政策办公室提供了有关全州MA实验室事件的报告。 2004年，爱荷华州在MA实验室事件方面名列全美第二，平均每月要夺取120个实验室。 2006年，爱荷华州在MA实验室事件中排名全国第八，每月仅缉获20个实验室，比上一年下降了83％。通过限制PSE的可用性，爱荷华州看到与MA实验室相关的事件明显减少，从而导致全州与MA相关的烧伤急剧减少。

BACKGROUND & AIMS: :Sex workers globally face high levels of violence. In Canada, im/migrant sex workers who work in indoor venues may be uniquely targeted by police due to immigration policies, racialized policing, and the conflation of trafficking and sex work. In 2014, Canada passed end-demand legislation that purportedly encourages sex workers to report violence to police; however, little research has evaluated its impact. Using interrupted time series and multivariable logistic regression, we examined proportions of reporting violent incidents to police among sex workers who had experienced workplace violence (2010-2017), including potential changes prior to and following end-demand legislation. We then modeled the independent effects of im/migrant status and place of work on reporting violence. Among sex workers who experienced recent violence during the 7.5-year study (n=367), 38.2% of all participants and 12.7% of im/migrants reported violence to police, and there was no significant change in violence reporting after end-demand legislation. Our results suggest that end-demand laws do not remove barriers to justice faced by sex workers and instead actually perpetuate harms, particularly for racialized im/migrant and indoor workers. Policy reforms to decriminalize sex work, address discriminatory policing, and promote access to safety and justice are urgently needed.

背景与目标： ：全球的性工作者面临高水平的暴力行为。在加拿大，由于移民政策，种族化警务以及人口贩运和性工作的结合，在室内场所工作的移民性工作者可能会成为警察的唯一目标。 2014年，加拿大通过了最终需求立法，据称鼓励性工作者向警察举报暴力；但是，很少有研究评估其影响。我们使用中断的时间序列和多变量Logistic回归，研究了经历过工作场所暴力（2010-2017年）的性工作者中向警察报告暴力事件的比例，包括最终需求立法前后的潜在变化。然后，我们模拟了移民身份和工作地点对举报暴力行为的独立影响。在7.5年的研究中，最近经历过暴力的性工作者（n = 367）中，有38.2％的参与者和12.7％的移民/移民向警察报告了暴力行为，在最终立法后，暴力行为报告没有显着变化。我们的研究结果表明，最终需求法律并没有消除性工作者面临的正义障碍，反而实际上使危害长期存在，特别是对于种族化的移民/移徙工人和室内工人。迫切需要进行政策改革，以使性工作合法化，解决歧视性警务并促进获得安全和正义的机会。

BACKGROUND & AIMS: :Mental health legislation is necessary to protect the rights of people with mental disorders, a vulnerable section of society. Ireland's new Mental Health Act 2001 was fully implemented in 2006 with the intent of bringing Irish legislation more in line with international standards, such as the European Convention on Human Rights and United Nations Principles for the Protection of Persons with Mental Illness. The new legislation introduced several important reforms in relation to involuntary admission, independent reviews of involuntary detention, consent to treatment, and treatment of children and adolescents. It also presented significant challenges in terms of service delivery and resources within Irish mental health services. Both mental health service users and providers reported a range of difficulties with the new legislation. In this article, we analyze the Irish Mental Health Act focusing on the enhanced protection that it provides for patients, but also highlighting some areas of concern such as the conduct of mental health tribunals, consent and capacity problems, resource allocation, and disruptions in mental health service delivery.

背景与目标： ：精神健康立法对于保护精神疾病患者（社会中的弱势群体）的权利是必要的。爱尔兰的新《 2001年精神健康法》已于2006年全面实施，目的是使爱尔兰的立法更加符合国际标准，例如《欧洲人权公约》和《联合国保护精神病患者原则》。新立法对非自愿入院，对非自愿拘留进行独立审查，同意接受治疗以及对儿童和青少年的待遇进行了几项重要的改革。它还在爱尔兰精神卫生服务的服务提供和资源方面提出了重大挑战。精神卫生服务的使用者和提供者都报告了新法规的一系列困难。在本文中，我们分析了《爱尔兰精神卫生法》，重点是为患者提供增强的保护，同时强调了一些令人关注的领域，例如精神卫生法庭的行为，同意和能力问题，资源分配以及精神障碍卫生服务提供。

BACKGROUND & AIMS: Confidentiality laws of most states are in need of a thorough review. They lack consistency in the treatment of recipients of mental health services, and they frequently provide no guidelines at all on significant issues. The newly adopted Illinois Act serves as an example of the work of mental health professionals in the passage of new legislation; it is suggested as a model for those seeking to draft new confidentiality codes for other states.

背景与目标： 大多数州的保密法都需要进行彻底的审查。他们在接受精神卫生服务的人的待遇上缺乏一致性，而且经常在重大问题上根本没有提供任何指导。新通过的《伊利诺伊州法》是精神保健专业人员通过新立法工作的一个例子；对于那些试图为其他州起草新的机密代码的人而言，建议将其作为模型。

BACKGROUND & AIMS: BACKGROUND:Chemical accidents occur often across the United States, endangering the health and safety of many people. The Superfund Amendments and Reauthorization Act of 1986 (SARA) requires that communities increase their planning for medical response to these accidents. So far, little evidence has come forth that supports the notion that environmental legislation, such as SARA, improves preparedness for such accidents. METHODS:A one-group pretest/post-test longitudinal design was used to survey the medical directors of emergency departments in all acute care hospitals in the State of New York. Data were collected by mail survey and telephone follow-up in 1986 before the passage of SARA (Time1), and in 1989 after its implementation (Time2). RESULTS:Ninety-four percent of the directors responded at Time1 and 72% at Time2. In New York State, hospital preparedness for chemical accidents improved significantly during the study interval. The longer a hospital had a plan for response to chemical accidents, the more elements of preparedness were in place. Further, as a group, the hospitals that were the least prepared were located in the areas at highest risk. CONCLUSION:Environmental legislation can influence the manner by which health care organizations prepare for environmental emergencies.

背景与目标： 背景：化学事故在美国各地经常发生，危及许多人的健康和安全。 1986年的《超级基金修正案和重新授权法》（SARA）要求社区增加对这些事故的医疗响应的计划。迄今为止，几乎没有证据支持这样的观点，即诸如SARA之类的环境立法可以提高此类事故的防范能力。
方法：采用一组前/后测试的纵向设计，对纽约州所有急诊医院急诊科的医疗主管进行调查。在SARA通过之前（1986年，Time1），在1989年实施之后（Time2），通过邮件调查和电话随访收集了数据。
结果：94％的董事在Time1做出回应，而72％的董事在Time2做出回应。在纽约州，在研究期间，医院对化学事故的防范能力显着提高。医院制定应对化学事故的计划的时间越长，准备工作的要素就越多。此外，作为一个整体，准备最少的医院位于风险最高的地区。
结论：环境立法可以影响卫生保健组织为环境紧急事件做准备的方式。

BACKGROUND & AIMS: BACKGROUND:The Netherlands and Belgium legalized euthanasia in 2002. AIM:In this study we describe and compare cases of reported euthanasia and physician-assisted suicide in the first 5 years of legislation. DESIGN/SETTING/PARTICIPANTS:The databases of the cases reported in Belgium and the Netherlands were made available by the review committees. We compared characteristics of all cases reported between September 2002-December 2007. RESULTS:In the Netherlands 10,319 cases were reported, in Belgium 1917. Gender and age distributions were similar in both countries. Most patients suffered from cancer (83-87%), but patients more often suffered from diseases of the nervous system in Belgium (8.3% vs. 3.9%). In the Netherlands, reported euthanasia more often occurred at home compared with Belgium (81% vs. 42%), where it occurred more often in hospital (52% vs. 9%). In the Netherlands, all cases were based on the oral request of a competent patient. In Belgium, 2.1% of the reported cases was based on an advance directive. CONCLUSIONS:We conclude that countries debating legislation must realise that the rules and procedures for euthanasia they would agree upon and the way they are codified or not into law may influence the practice that develops once the legislation is effected or what part of that practice is reported.

背景与目标： 背景：荷兰和比利时于2002年将安乐死合法化。
目的：在这项研究中，我们描述并比较了立法的头5年内报告的安乐死和医生协助自杀的案例。
设计/案情/参加者：比利时和荷兰报告的案件数据库由审查委员会提供。我们比较了2002年9月至2007年12月之间报告的所有病例的特征。
结果：在荷兰，1917年报告了10,319例病例。两个国家的性别和年龄分布相似。在比利时，大多数患者患有癌症（83-87％），但比利时患者更常患有神经系统疾病（8.3％对3.9％）。在荷兰，与比利时（81％比42％）相比，安乐死在家中发生的频率更高（后者在医院里发生的频率更高（52％对9％））。在荷兰，所有病例均基于有能力的患者的口头要求。在比利时，报告的病例中有2.1％是基于预先医疗指示。
结论：我们得出结论，辩论立法的国家必须认识到，他们将同意的安乐死规则和程序以及将其编纂为法律或不纳入法律的方式可能会影响立法一旦生效或报告了该行为的哪一部分，就会发展这种行为。 。