Boston Medical Center has received a one-year grant for $50,000 from The Avon Foundation to support the Child Witness to Violence Project (CWVP) a counseling, advocacy and outreach program that focuses on young children who are bystanders to community and domestic violence. CWVP will use the grant to create a partnership to train police officers to better recognize and respond to children affected by violence.

Created in 1992, CWVP offers trauma-focused counseling and advocacy to children and their families who have been exposed to violence. The staff of bi-lingual social workers, educational and clinical psychologists, early childhood specialists, a consulting attorney and a consulting pediatrician, work with more than 150 children and their families each year, in addition to implementing both national and state-focused training for health care professionals, police, educators and many other social service professionals who confront issues of children who witness violence.

“We are grateful to The Avon Foundation for their generous donation,” said Betsy McAlister Groves, director of CWVP. “This grant provides us additional resources to help the enormous number of children and families affected by this nationwide issue.”

The grant is part of an annual program of Avon Products, Inc. and the Avon Foundation that invites Avon regional branch offices across the U.S. to nominate worthwhile local non-profit organizations for funding under the Avon Speak Out Against Domestic Violence program.

###

The Avon Foundation was founded in 1955 to improve the lives of women and their families. Flagship programs of the Foundation are the Avon Breast Cancer Crusade and the Speak Out Against Domestic Violence program, which supports domestic violence awareness, education, direct services and prevention initiatives. To date more than $10 million has been awarded to 350 domestic violence organizations across the US.

Source: Michelle Roberts

Boston University

Congressional Democratic leaders on Thursday said they will postpone work on an as much as $150 billion economic stimulus package until January 2009, the Wall Street Journal reports (Reddy, Wall Street Journal, 11/21).

Senate Democrats on Monday introduced a $100.3 billion stimulus package (S 3689) that included $37.8 billion in additional federal Medicaid funds for states and $1 billion in additional funds for NIH, among other provisions (Kaiser Daily Health Policy Report, 11/18). In September, the House approved a $60.8 billion stimulus package that included $14.7 billion in additional federal Medicaid funds for states and $1.2 billion in additional funds for NIH, among other provisions, but the package failed to pass in the Senate (Kaiser Daily Health Policy Report, 9/29).

Congressional Democrats “don’t appear to have enough support for a major stimulus program before January,” as Republicans have raised concerns that such a package would increase the federal budget deficit unnecessarily and would not help the economy in time, according to the Journal.

Rahm Emanuel, chief of staff to President-elect Barack Obama, said that the new administration would make the enactment of a stimulus package the “first order of business” next year. “Obama has indicated a willingness to set aside concerns about deficit spending in the short run to restore the economy,” the Journal reports (Wall Street Journal, 11/21).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The Health and Safety Executive (HSE) is warning of the importance of carrying out risk assessments and implementing safe systems for working at height following the prosecution of a company and one of its employees after an incident in which an elderly man died.

Pervez Mohammed Iqbal, was (on Friday 21st November) ordered, by Wolverhampton Crown Court, to pay ВЈ15,000 in fines, with ВЈ2,800 costs after earlier pleading guilty to breaching Section 2(1) of the Health and Safety at Work Act 1974. This case followed a Police and HSE joint investigation into a fatal incident on 20 April 2007.

The court heard that, on that day, Mr Satnam Singh, 62, fell 5-6 metres (16-20 feet) through a fragile rooflight whilst preparing to undertake work on the roof of a textiles factory in Smethwick. Work had already been undertaken to replace plastic rooflights following a burglary at the site and further work was being undertaken by Kundi Electrical to repair recurring roof leaks. Mr Singh was working under the direction of Pervez Mohammed Iqbal who was carrying out the work for Kundi Electrical.

In undertaking this roofing work, equipment and building materials were being carried across roofs, which are well known in roofing and building industries to be fragile, when Mr Singh fell through and died later in hospital from the injuries sustained.

The roof of the textiles factory was being accessed up a ladder and across several different types of pitched roofs of several factory units and an adjacent engineering company, below which employees were working.

At an earlier hearing, on 11th February 2008, Surjit Singh Kundi trading as Kundi Electrical, from a base in Oldbury, had been ordered, by West Bromwich Magistrates, to pay ВЈ25,000 in fines, with ВЈ2,301 costs after pleading guilty to breaching the Health and Safety at Work Act 1974. This case followed the same investigation into the fatal incident on 20 April 2007.

HSE Inspector Georgina Speake said:

“The roofs which were being repaired and those being used for access were totally unprotected, exposing anyone crossing them to the most serious risks. Iqbal had failed to undertake a suitable and sufficient risk assessment to identify the risks associated with the work being undertaken. Findings should have been passed on to employees so that they were aware of the hazards and then measures needed to minimise the risks put in place. The risk was wholly predictable, therefore avoidable. Such falls remain one of the biggest killers in the construction industry and last year, across the country, 45 people died after falling while working at height.

“Many incidents can be avoided if employers identify a safe way of tackling a job, provide all necessary protective equipment and ensure that workers or casual employees are fully trained and properly supervised. In this instance there were a number of optional methods and routes of access which would have greatly reduced the risk. Precautions that need to be taken to prevent falls are often simple and there is free guidance readily available to help employers take the right action.”

Notes

1. Section 2 (1) of the Health and Safety at Work etc Act 1974 states “It shall be the duty of every employer to ensure, so far as it is reasonably practicable, the health, safety and welfare at work of all his employees.”

2. More information on preventing falls from height can be found on HSE’s website at hse/falls/index.htm

HSE

Rapid research advances have led to speculation that neuroscience may provide tools to boost memory, detect lies and even increase one’s intelligence. But such advances have ethical implications and policies are not in place to cope with the consequences.

The first-ever meeting of the Neuroethics Society, to be held 13-14 November at the AAAS Headquarters in 1200 New York Ave NW, Washington, DC, will bring together neuroscientists, psychologists, lawyers, philosophers and others to discuss the implications of the work. The meeting will include a debate on cognitive enhancement and sessions on such topics as the use of neuroscience in law enforcement and national security and decision-making and free will.

The Society’s president Steven Hyman, neurobiologist at Harvard Medical School and Provost of Harvard University, will speak on treating mental illness in children during the 13 November session on “Neuroethics of Pediatric Bipolar Disorder.” In the same session, Ben Vitiello, scientific program director at the National Institute of Mental Health, will discuss possible implications and controversies that a diagnosis of bipolar disorder in childhood can produce.

Bioethicists Julian Savulescu of the University of Oxford and Carter Snead of the University of Notre Dame will debate cognitive enhancement, such as drugs that boost memory and attention and ward-off sleep. Savulescu says that it is our “moral obligation to enhance cognition,” listing personal, social and economic benefits that might accrue from more mental ability. But Savulescu cautions that cognitive enhancement must be pursued in parallel with moral enhancement, or else our newly gained smarts could “enhance the ability to wreak havoc.”

Snead says that cognitive enhancement is a complicated question, that a categorical “no” is not the answer and that a framework for thinking through cognitive enhancement is needed.

In addition to discussions of how to tweak minds, participants at the Neuroethics Society meeting will discuss whether technology can be used to read minds. Want to find out if a criminal defendant is lying in court, if your employees are abusing Internet use while at work or if your teenager is sneaking out after curfew? Hank Greeley, a law professor at Stanford University, will discuss the feasibility of lie-detection devices during the session “Neuroethics of Forensic Neuroscience” on 14 November.

“There are already three companies selling fMRI-based lie detection services in the United States,” Greeley said in a Q&A with the Dana Foundation: dana/news/features/detail.aspx?id=13364. And in India in June, a judge used a brain scan as proof that a woman had “experiential knowledge” of a murder. The brain scan was part of the evidence used to sentence the woman to life in prison.

“The problem is that we have no good proof and no strong reason to believe that those lie-detection services are actually very reliable,” said Greeley in the Q&A. Even if the services are reliable, who is to say when they should and should not be used?

“Despite the immaturity of the science and uncertainties regarding its use, that hasn’t stopped entrepreneurs from marketing scantly peer-reviewed devices or methods to the public,” said Mark Frankel, director of the AAAS Scientific Freedom, Responsibility and Law Program and a member of the program committee for the Neuroethics Society meeting. “There is a need for greater public education and protection,” he said.

Other commercial applications of neuroscience are emerging, such as using brain scans to detect personality types; online dating sites; and teaching tools. In the 14 November session “The Business of Neuroscience,” AAAS’s Frankel will discuss the ethical and regulatory issues related to commercializing neuroscience, as well as the social and political implications. A cognitive neuroscientist, an entrepreneur and a journalist who has written on the emergence of genetic testing and its marketing to consumers also will be panelists in the session.

###

The meeting is hosted by the AAAS (aaas/), the world’s largest general scientific society. The Greenwald Foundation (greenwall/) provided student travel stipends, and the Dana Foundation (dana/) provided in-kind services.

For more information on the program for the Neuroethics Society meeting: neuroethicssociety/

Source: Molly McElroy

American Association for the Advancement of Science

Snakebites cause considerable death and injury worldwide and pose an
important yet neglected threat to public health, says new research published
in this week’s PLoS Medicine. The study used the most comprehensive methods
yet to estimate that at least 421,000 envenomings and 20,000 deaths from
snakebites occur each year, especially in South and South East Asia and
sub-Saharan Africa.

To estimate death and injury from snakebite, Janaka de Silva (University of
Kelaniya, Sri Lanka) and colleagues conducted a systematic review of the
scientific literature, reviewed county-specific mortality data from
databases maintained by United Nations organizations, and identified
unpublished information from Ministries of Health, National Poison Centres,
and snakebite experts on snakebites in countries that do not have reliable
data on snakebite incidence and mortality.

This data retrieval produced information for many of the world’s 227
countries, which were grouped into 21 geographical regions. The researchers
estimate that 421,000 envenomings and 20,000 deaths occur worldwide from
snakebite each year, but warn that these figures may be as high as 1,841,000
envenomings and 94,000 deaths, especially in areas of sub-Saharan Africa and
South Asia where antivenoms are hard to obtain. India has the highest
estimated annual envenomings and deaths: 81,000, and 11,000 respectively.

In a related Perspective article, Jean-Philippe Chippaux from the the
Institut de Recherche pour le DГ©veloppement in La Paz, Bolivia and
uninvolved in the research, argues that this study is a “preliminary but
essential step in improving accessibility of anitvenoms and the treatment of
snakebite.” Dr. Chippaux notes the dire situation of antivenom availability
and cost in Africa – a situation that could be worsened by the current
global economic crisis-where the price of a vial of antivenom is the
equivalent of several months of income for most rural families. Better
information on the global burden of snakebite would help understand how much
antivenom needs to be produced and in what areas it needs to be distributed,
he says. As de Silva and colleagues conclude, despite their careful
methodology, more population-based studies of incidence and mortality from
snakebite are urgently needed.

Citation: Estimation of the global burden of snakebite.
Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK,
Pathmeswaran A, et al. (2008)
PLoS Med 5(11): e218. doi:10.1371/journal.pmed.0050218
Click here to view article online

Citation: Chippaux J-P (2008) Estimating the global burden of snakebite can
help to improve management. PLoS Med 5(11): e221.
doi:10.1371/journal.pmed.0050221
Click here to view article online

About PLoS Medicine

PLoS Medicine is an open access, freely available international medical
journal. It publishes original research that enhances our understanding of
human health and disease, together with commentary and analysis of important
global health issues. For more information, visit
plosmedicine

About the Public Library of Science

The Public Library of Science (PLoS) is a non-profit organization of
scientists and physicians committed to making the world’s scientific and
medical literature a freely available public resource.

Public Library of Science

Citing a recent Boston Globe investigation, officials from some large academic medical centers and community hospitals in Massachusetts this week sent a letter to Gov. Deval Patrick (D) requesting an investigation into how some hospitals in the state receive higher payments from insurers, even though there are no obvious differences in the quality of care that those hospitals provide — especially for the most common procedures, the Boston Globe reports (Krasner, Boston Globe, 11/20).

According to an ongoing investigation by a Globe Spotlight Team, a recent review of private insurance data found that some hospitals in the state receive payments from insurers that on average are about 15% to 60% more than payments for the same procedure at competing hospitals. The hospitals that receive the highest rates are those that have the bargaining clout — often based on a powerful brand name and elite reputation or geographical location — to demand higher insurance payments (Kaiser Daily Health Policy Report, 11/17).

In the letter, Marshall Carter, chair of the Boston Medical Center, said that the Globe article “shone a very important light on the widening inequities in our health care system.” He wrote, “The disparities in payments from private insurers to certain favored providers without a clear connection to quality or greater cost efficiency should trouble us all,” adding, “The Globe Spotlight article demonstrated that so-called ‘supplemental’ payments do, in fact, come in different forms. For large and powerful hospitals that care for patients with higher incomes and the best insurance plans, those subsidies come in the form of higher payments from private insurers.”

Ellen Zane, president and CEO of Tufts Medical Center, wrote, “Clout, over anything else, has driven insurers to disproportionately and inappropriately pay some providers more than others.” She continued, “There are huge imbalances in this market — not just between teaching hospitals and community hospitals, but among the various teaching hospitals,” adding, “Tufts Medical Center offers the same (advanced) services as [Children's Hospital Boston] and Partners HealthCare, but is paid at unsustainably low reimbursement rates — well below our real costs.”

Paul Levy, CEO of Beth Israel Deaconess Medical Center, wrote, “We had heard talk about these payment differentials before, but to see them in black and white is startling and discouraging for those of us who are pursuing a quality and safety agenda.”

In a statement, Rich Copp — a spokesperson for Partners, which according to the Globe has been the “greatest beneficiary” of the payment discrepancies — said, “We agree that there is a health care cost crisis, but it is not unique to Massachusetts,” adding, “While we take exception to a number of points that were made (in the Globe report), including the use of outdated data to compare the quality of patient care, we welcome a dialogue on these issues, and believe the community will benefit from an honest and open discussion of all sides.”

Consumer Web Site
In related news, the state Health Care Quality and Cost Council on Wednesday approved the development of a new Web site that is scheduled to be launched next month and that will include hospital payment data from insurers and hospital rankings based on quality measures for dozens of inpatient and outpatient procedures, the Globe reports (Boston Globe, 11/20).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

While mainstream news coverage is still a primary source of information for the latest in policy debates and the health care marketplace, online blogs have become a significant part of the media landscape, often presenting new perspectives on policy issues and drawing attention to under-reported topics. To provide complete coverage of health policy issues, the Kaiser Daily Health Policy Report offers readers a window into the world of blogs in a roundup of health policy-related blog posts. “Blog Watch,” published on Tuesdays and Fridays, tracks a wide range of blogs, providing a brief description and relevant links for highlighted posts.

Igor Volsky on the Center for American Progress Action Fund’s Wonk Room blog provides a roundup of health-related ballot initiatives around the nation.

Judith Graham of the Chicago Tribune’s Triage discusses changes in Medicare prescription drug plans and what they mean for low-income individuals receiving subsidies.

Jenny Sullivan on Families USA’s Stand Up for Health Care points to new briefs examining the demographics of uninsured children in the states, saying, “Medicaid and CHIP are an essential source of quality, affordable care for these hard-working families.”

Health Populi’s Jane Sarasohn-Kahn discusses McCain and Obama voters’ differing opinions about health reform and health care as a priority based on survey data in a New England Journal of Medicine article.

Managed Care Matters’ Joe Paduda looks at news that Sen. Edward Kennedy (D-Mass.) might be crafting health reform legislation, saying that although it is “impossible to know,” Paduda predicts a Kennedy plan would allow anyone to buy into Medicare, create a minimum set of benefits insurers must provide and prohibit medical underwriting.

Marilyn Werber Serafini of the National Journal’s Health Care Expert Blog asks, “How do you see the outcome of the presidential election changing the health care reform debate? Or, how will the congressional elections’ outcome affect it?” Responses follow from Stuart Butler, Newt Gingrich, John Goodman and Donna Shalala.

Yuval Levin on the National Review Online’s The Corner writes that the question of whether health care should be seen as a right is part of a “long line of efforts to turn the health care debate into a matter of pure ethics, so that the immense practical problems with government-financed or government-run health care don’t have to be considered.” Levin describes two schools of thought — emphasizing the market versus more government involvement — and continues, “There are many good and intelligent people in both camps, and there are many in between as well. But their dispute is a practical and largely economic one.”

Joanne Kenen on the New America Foundation’s New Health Dialogue discusses a new book by the Center for American Progress and the Institute on Medicine as a Profession about improving the health care system through overhauling health care delivery.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

A recent report by the United Kingdom’s Royal College of Nursing found that 48% of the 5,000 nurses polled had been injured by a needle previously used on a patient during their careers, with about one-third fearing risk of exposure to bloodborne diseases such as HIV and hepatitis, BBC News reports (BBC News, 11/19). According to the PA/Google, the survey also found that although most nurses who had experienced a needle injury were provided with information about risks from their employer, 28% were not. In addition, about one-third of nurses within the National Health Service who had experienced an injury regarded the support they received from their employer as adequate (PA/Google, 11/19). According to BBC News, one-quarter of nurses who said they experienced needle sticks reported that their employer did not provide them with post-exposure prophylaxis. In addition, a poll of nurses in the report revealed that nearly half of the nurses do not have access to safety devices, such as shielded needles, that could protect nurses from infections like HIV and hepatitis, RCN said.

RCN General Secretary Peter Carter said, “It is clear that needle injuries are an everyday threat for nurses” (BBC News, 11/19). Currently, 94% of employers have a policy that covers prevention and reporting of needle stick injuries, but only 55% of the nurses surveyed had received training from their employer on safe needle use. Ninety-six percent of nurses said they use needles as part of their jobs, according to the PA/Google. Carter said, “Government and employers in the NHS need to start taking this issue seriously by introducing needle policies and investing in safer alternatives to traditional needles so that these accidents don’t happen in the first place” (PA/Google, 11/19). An NHS Employers spokesperson said the agency acknowledges the RCN report and takes the “issue of needle stick injuries very seriously” (BBC News, 11/19).


The report is available online.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Pennsylvania Gov. Ed Rendell (D) on Wednesday announced that he has extended through June 30, 2009, an executive order that allows the Pennsylvania Health Care Cost Containment Council to continue operating, the Philadelphia Inquirer reports. Without the extension, PHC4 — which collects records on millions of hospital visits and outpatient procedures to help rein in health care spending — would have been shut down at the end of this month. The state Legislature will have the opportunity to renew PHC4 when it convenes in January.

Rendell said, “PHC4 has been responsible for a lot of very, very important advances in the health care delivery system,” adding, “I have the power to extend their life span, and I did just that.” Pennsylvania Chamber of Business Director of Government Affairs Sam Denisco said, “We are pleased that the governor has essentially given new life to the council” (Goldstein/Worden, Philadelphia Inquirer, 11/20). Rendell noted that the agency should reduce its $5.3 million budget by 4.25% — the same amount other agencies must cut because of a state budget shortfall (Pittsburgh Post-Gazette, 11/20).

In related news, Rendell reiterated his pledge not to approve an extension of a program that provides medical malpractice insurance assistance for doctors until his health insurance proposal is approved. The state House on Wednesday, the last day of its 2008 session, rejected a measure to extend the abatement program (Philadelphia Inquirer, 11/20).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The Royal Society(1) today commented on a new Which? report(2) that has found that nanomaterials are being used in a wide range of cosmetics.

Professor Dame Ann Dowling, Chair of the Royal Society working group on nanotechnologies, said:

“We highlighted in our study in 2004 that nanoparticles of a chemical can have different properties to the same chemical in its larger form. And this is why nanoparticles are so exciting.

“However, when cosmetics companies are seeking to exploit these novel qualities in their products they must ensure that their safety testing methods take account of these qualities. The Royal Society has been calling, for the last four years, for companies to make public the safety testing methods they have been using on their nanoproducts. We are disappointed at continuing lack of transparency in this area.

“More research does need to be done on the effects of manufactured nanoparticles on human health and the environment. This is important so that regulation can be built on a proper understanding of any risks. The Government has, by its own admission, recognised that progress has been slow in this area.”

The Royal Society is an independent academy promoting the natural and applied sciences. Founded in 1660, the Society has three roles, as the UK academy of science, as a learned Society, and as a funding agency. It responds to individual demand with selection by merit, not by field. As we prepare for our 350th anniversary in 2010, we are working to achieve five strategic priorities, to:

- Invest in future scientific leaders and in innovation
- Influence policymaking with the best scientific advice
- Invigorate science and mathematics education
- Increase access to the best science internationally
- Inspire an interest in the joy, wonder and excitement of scientific discovery

Source
Sue Windebank
Press and Public Relations
The Royal Society, London