Health and Public Policy to Facilitate Effective Prevention and Treatment of Substance Use Disorders Involving Illicit and Prescription Drugs: An American College of Physicians Position Paper

Ann Intern Med. 2017;166(10):733-736.
Authors: Ryan Crowley, Neil Kirschner, Andrew S. Dunn, Sue S. Bornstein
“Substance use disorders involving illicit and prescription drugs are a serious public health issue. In the United States, millions of individuals need treatment for substance use disorders but few receive it. The rising number of drug overdose deaths and the changing legal status of marijuana pose new challenges. In this position paper, the American College of Physicians maintains that substance use disorder is a treatable chronic medical condition and offers recommendations on expanding treatment options, the legal status of marijuana, addressing the opioid epidemic, insurance coverage of substance use disorders treatment, education and workforce, and public health interventions.”
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Italy has introduced mandatory vaccinations and other countries should follow its lead

The Conversation, 2 June 2017
Author: Alberto Giubilini
“Parents will have to provide proof of vaccination when they enrol their children in nursery or preschool. In this respect, the Italian policy follows the example of vaccination policies in the US. But there’s one crucial difference: the Italian law doesn’t allow parents to opt out on the grounds of ‘conscientious objection’.”
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After-hours GP home visits strain the budget (and don’t help emergency departments)

The Conversation, 1 June 2017
Authors: Barbara de Graaff and Mark Nelson
“After-hours home medical services are a burden on our health budget and don’t ease the strain on emergency departments after all, new research shows. The roll out of after-hours GP-type home visits is linked with as much as a ten-fold increase in Medicare claims in one jurisdiction. And rather than reducing the need to visit the emergency department, their rise in popularity has been accompanied by a slight increase in visits. These findings published today in the Australian Family Physician journal, question whether these convenient house calls are really the best use of taxpayers’ money.”
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Wales is leading the world with its new public health law

The Conversation, 31 May 2017
Author: Richard Owen
“Wales’s devolved government is close to enacting another innovative law aimed at bettering the health of its people. the new Public Health (Wales) Bill includes specific provisions for banning smoking in hospital grounds, placing a duty on the Welsh government to produce a national obesity strategy and making pharmacy services more responsive to community needs, the fact that it puts Health Impact Assessments (HIAs) on a statutory footing is the most interesting and important feature. HIAs are a pre-decision assessment of the effects of proposed action – regulations, policy, programmes or projects – by public bodies on human health. It’s a “health in all policies” approach.”
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Independent expert panel to begin mental health review

NSW Health, 22 May 2017
“Five mental health experts with wide reaching clinical and lived experience will join NSW Chief Psychiatrist Dr Murray Wright to begin a review of the practice of seclusion, restraint and observations across the NSW mental health system. Health Minister Brad Hazzard and Mental Health Minister Tanya Davies confirmed the review will consider whether existing legislation, policy, clinical governance and practice standards are consistent with national standards, international best practice and the expectations of patients and the community.”
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Undermining Genetic Privacy? Employee Wellness Programs and the Law

NEJM, 24 May 2017
Authors: Kathy L. Hudson, Karen Pollitz
“Genetic information is becoming ubiquitous in research and medicine. The cost of genetic analysis continues to fall, and its medical and personal value continues to grow. Anticipating this age of genetic medicine, policymakers passed laws and regulations years ago to protect Americans’ privacy and prevent misuse of their health-related information. But a bill moving through the House of Representatives, called the Preserving Employee Wellness Programs Act (H.R. 1313), would preempt key protections. Because the bill, which was sent to the full House by the Education and the Workforce Committee in March, would substantially change legal protections related to the collection and treatment of personal health and genetic information by workplace wellness programs, it should be on the radar screens of physicians, researchers, and the public.”
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State Sepsis Mandates — A New Era for Regulation of Hospital Quality

NEJM, 21 May 2017
Authors: Tina B. Hershey, Jeremy M. Kahn
“Sepsis is a major cause of illness and death in the United States, affecting more than 1.5 million Americans each year at an annual cost of over $20 billion. To improve outcomes of sepsis, policymakers are increasingly using regulatory mechanisms intended to provide incentives to clinicians and hospitals to improve the quality of sepsis care. One such initiative is an unprecedented set of New York State regulations implemented in 2013 and collectively known as “Rory’s Regulations.” Named after Rory Staunton, who died at 12 years of age from sepsis resulting from a soft-tissue infection, Rory’s Regulations mandate that all hospitals in the state use evidence-based protocols for sepsis identification and management and that they report to the state government data on their sepsis-protocol adherence and clinical outcomes.”
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Alzheimer’s Deaths Jump 55 Percent: CDC

WebMD, 25 May 2017
Author: Steven Reinberg
“As more baby boomers age, deaths from Alzheimer’s disease have jumped 55 percent, and in a quarter of those cases the heavy burden of caregiving has fallen on loved ones, U.S. health officials report. “Alzheimer’s disease is a public health problem that affects not only people with Alzheimer’s disease, but also the people who provide care to them, which is often family members,” said report author Christopher Taylor.”
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Many patients with early-stage breast cancer receive costly, inappropriate testing

EurekAlert, 24 May 2017
Author: Fred Hutchinson Cancer Research Center
“A study from Fred Hutchinson Cancer Research Center shows that asymptomatic women who have been treated for early-stage breast cancer often undergo advanced imaging and other tests that provide little if any medical benefit, could have harmful effects and may increase their financial burden.”
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