Prehospital Do-Not-Resuscitate Orders: A Survey of State Policies in the United States

1993 ◽  
Vol 8 (4) ◽  
pp. 317-322 ◽  
Author(s):  
James G. Adams
Keyword(s):  
United States ◽  
District Of Columbia ◽  
The United States ◽  
Prehospital Setting ◽  
Do Not Resuscitate ◽  
Working Groups ◽  
Prehospital Emergency ◽  
State Regional ◽  
Legal Opinion ◽  
Dnr Orders

AbstractIntroduction:Many states in the United States ‘have developed policies that enable prehospital emergency medical services (EMS) providers to withhold cardiopulmonary resuscitation (CPR) in the terminally ill. Several states also have policies that enable the implementation of do-not-resuscitate (DNR) orders.Objectives:1) assess which states have statutes governing DNR orders for the prehospital setting; 2) determine which states authorize DNR orders in ways other than by specific state statue; and 3) define those states that had regional protocols which address prehospital DNR orders.Methods:Survey of the state EMS directors in each of the 50 U.S. states, the District of Columbia, and Puerto Rico.Results:As of 1992, specific legislation authorizing the implementation of DNR orders was in place in 11 states. In addition, six others have a legal opinion or policy allowing the implementation of DNR orders. Fourteen additional states have either working groups or legislation pending that address prehospital DNR orders. In only five were there no existing regional protocols for implementation of DNR orders in the prehospital setting.Conclusions:There exists great variation in legal authorization by states for implementation of DNR orders in the prehospital setting. Despite the existence of enabling legislation, many state, regional, or local EMS systems have implemented policies dealing with DNR orders.

scholarly journals Effectiveness of Face Coverings in Mitigating the COVID-19 Pandemic in the United States

2021 ◽  
Vol 18 (7) ◽  
pp. 3666
Author(s):  
Olukayode James Ayodeji ◽  
Seshadri Ramkumar
Keyword(s):  
Public Health ◽  
United States ◽  
District Of Columbia ◽  
Preventive Measure ◽  
The United States ◽  
Protective Measure ◽  
Sharp Change ◽  
The Public ◽  
Public Health Challenges ◽  
Effective Preventive Measure

The COVID-19 pandemic has been one of the biggest public health challenges of the 21st century. Many prevalent measures have been taken to prevent its spread and protect the public. However, the use of face coverings as an effective preventive measure remains contentious. The goal of the current study is to evaluate the effectiveness of face coverings as a protective measure. We examined the effectiveness of face coverings between 1 April and 31 December 2020. This was accomplished by analyzing trends of daily new COVID-19 cases, cumulative confirmed cases, and cases per 100,000 people in different U.S. states, including the District of Columbia. The results indicated a sharp change in trends after face covering mandates. For the 32 states with face covering mandates, 63% and 66% exhibited a downward trend in confirmed cases within 21 and 28 days of implementation, respectively. We estimated that face covering mandates in the 32 states prevented approximately 78,571 and 109,703 cases within 21- and 28-day periods post face covering mandate, respectively. A statistically significant (p = 0.001) negative correlation (−0.54) was observed between the rate of cases and days since the adoption of a face covering mandate. We concluded that the use of face coverings can provide necessary protection if they are properly used.

scholarly journals Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

2021 ◽  
Vol 18 (6) ◽  
pp. 2921
Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  
Keyword(s):  
United States ◽  
District Of Columbia ◽  
Ethnic Disparities ◽  
The United States ◽  
Attributable Mortality ◽  
Race Ethnicity ◽  
Using Data ◽  
Rate Ratios ◽  
Degree Of Association ◽  
Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

Zedan v. Kingdom of Saudi Arabia

1988 ◽  
Vol 82 (4) ◽  
pp. 828-830
Author(s):  
Edward M. Leigh
Keyword(s):  
United States ◽  
Saudi Arabia ◽  
Direct Effect ◽  
District Of Columbia ◽  
The United States ◽  
Telephone Call ◽  
District Court ◽  
Kingdom Of Saudi Arabia ◽  
Court Of Appeals ◽  
American Citizen

Plaintiff Zedan, an American citizen, brought suit in the United States District Court for the District of Columbia against the Kingdom of Saudi Arabia for breach of a contract guaranteeing wages and profits. While performance under the contract occurred in Saudi Arabia, plaintiff alleged that the jurisdictional requirements under the Foreign Sovereign Immunities Act of 1976 (28 U.S.C. §§1330, 1602-1611 (1982)) (FSIA) were satisfied by a recruitment call in California from a representative of the royal overseer of a private Saudi company. The district court granted the Saudi motion to dismiss. On appeal, the United States Court of Appeals for the District of Columbia Circuit (per Silberman, J.) unanimously affirmed and held: (1) that the telephone call did not have the requisite substantiality of contact with the United States; (2) that it was not sufficient to form the basis of a cause of action; and (3) that the alleged breach did not have sufficient direct effect in the United States to satisfy the exceptions to immunity under the FSIA.

Limitation of Private Attending Pediatricians' Neonatal Intensive Care Privileges in Level III Institutions Throughout the United States

PEDIATRICS ◽  
1994 ◽  
Vol 94 (2) ◽  
pp. 190-193
Author(s):  
Rita G. Harper ◽  
Concepcion G. Sia ◽  
Regina Spinazzola ◽  
Raul A. Wapnir ◽  
Shahnaz Orner ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care ◽  
Health Care Providers ◽  
Curriculum Design ◽  
Neonatal Intensive Care ◽  
District Of Columbia ◽  
The United States ◽  
Geographic Region ◽  
Neonatal Intensive Care Units ◽  
Care Providers

Objective. To determine the privileges of Private Attending Pediatricians (PAP) in caring for newborns requiring intensive (ITC), intermediate (IMC), or continuing (CC) care in Level III neonatal intensive care units (NICUs) throughout the United States. Design. A two-page mail questionnaire was sent to 429 Level III NICUs to obtain the statement best describing the PAPs' privileges, the number of PAP, and some of the PAPs' functions. Level III NICUs were classified by geographic region as Eastern, Central, or Western United States. Results. Responses were received from 301 NICUs (70%) representing 48 states, the District of Columbia, and >9000 PAP. Twenty-two institutions had no PAP. In the remaining 279 institutions, 96% (267/279) had restricted the PAPs' privileges partially or completely. In 32% (88/279), the PAP were not allowed to render any type of NICU care. In 18% (51/279) of the institutions, the PAP were allowed to render CC only. In 27% (76/279) of the institutions, the PAP were allowed to render IMC and CC only. Limitation of PAPs' privileges were reported in all geographic areas in the U.S., were more pronounced in the Eastern than the Central or Western sections of the country, and were noted in institutions with small (≤10) as well as large (≥60) numbers of PAP. Limitation of PAPs' privileges was determined by the PAP him/herself in many institutions. Proficiency in resuscitation was considered to be a needed skill. Communication with parents of an infant under the care of a neonatologist was encouraged. Conclusions. The PAPs' privileges were limited partially or completely in most Level III NICUs. Knowledge of this restricted role impacts significantly on curriculum design for pediatric house officers, number and type of health care providers required for Level III NICUs and future house officer's career choices.

Marijuana Use and Breastfeeding

2012 ◽  
Vol 3 (3) ◽  
pp. 101-107 ◽  
Author(s):  
Carrie W. Miller
Keyword(s):  
United States ◽  
Adverse Effects ◽  
Motor Development ◽  
District Of Columbia ◽  
Medical Marijuana ◽  
Marijuana Use ◽  
The United States ◽  
Breastfed Infants ◽  
Feeding Difficulty ◽  
Medical Marijuana Use

Marijuana is one of the most widely used recreational substances in the United States, with high rates of use during peak childbearing years. Medical marijuana use is also becoming more widely accepted in the United States, with legalization in 17 states and the District of Columbia. The available literature suggests that maternal marijuana use during breastfeeding is associated with potentially negative outcomes for infants and children. Adverse effects can include feeding difficulty, lethargy, and delayed cognitive and motor development. Mothers considered heavy or chronic users of marijuana are advised to not breastfeed infants. The aim of this article is to examine the prevalence of marijuana use, the potential effects on breastfed infants, and current recommendations from lactation experts.

Prison Crowding: The Response of Probation and Parole

1984 ◽  
Vol 30 (1) ◽  
pp. 141-153 ◽  
Author(s):  
Peter Finn
Keyword(s):  
United States ◽  
District Of Columbia ◽  
The United States ◽  
Probation And Parole

A systemwide approach is needed to relieve the extensive prison crowding problems in the United States that reached its highest level in 1982, with 43,000 inmates added to the country's federal and state facilities. Interviews with 31 probation and parole officials in 30 states and the District of Columbia were conducted to determine the role these agencies are currently playing in the effort to alleviate prison crowding. The results indicate that there have been relatively few changes in probation programs designed to reduce prison crowding.

The Alloxysta (Hymenoptera: Figitidae: Charipinae) type material in the United States National Museum of Natural History and the Canadian National Collection of Insects

2013 ◽  
Vol 145 (6) ◽  
pp. 603-625 ◽  
Author(s):  
Mar Ferrer-Suay ◽  
Jesús Selfa ◽  
Juli Pujade-Villar
Keyword(s):  
United States ◽  
Natural History ◽  
District Of Columbia ◽  
The United States ◽  
Type Material ◽  
Valid Species ◽  
Nominal Species ◽  
National Museum ◽  
United States National Museum ◽  
Nomina Dubia

AbstractAlloxysta Förster, 1869 (Hymenoptera: Figitidae) type material of 19 nominal species deposited in the Canadian National Collection of Insects (Ottawa, Ontario, Canada) and the United States National Museum of Natural History (Washington, District of Columbia, United States of America) were studied. Nine species are treated as valid: A. australiae (Ashmead, 1900), A. commensuratus Andrews, 1978, A. japonicus (Ashmead, 1904), A. lachni (Ashmead, 1885), A. longiventris Baker, 1896, A. minuscula Andrews, 1978, A. nothofagi Andrews, 1976, A. vandenboschi Andrews, 1978, and A. xanthopsis (Ashmead, 1896). The following synonymies are established: A. affinis (Baker, 1896) and A. quebeci Andrews, 1978 junior synonyms of A. castanea (Hartig, 1841); A. alaskensis Ashmead, 1902 and A. coniferensis Andrews, 1978 junior synonyms of A. macrophadna (Hartig, 1841); A. bicolor (Baker, 1896) and A. anthracina Andrews, 1978 junior synonyms of A. obscurata (Hartig, 1840); A. dicksoni Andrews, 1978 junior synonym of A. pilipennis (Hartig, 1840); and A. leguminosa (Weld, 1920), A. megourae (Ashmead, 1887), and A. rauchi Andrews, 1978 junior synonyms of A. brevis (Thomson, 1862). The type material of A. schlingeri Andrews, 1978 and A. halli Andrews, 1978 could not be found and we consider them as nomina dubia. Alloxysta vandenboschi Andrews is removed from synonymy with A. obscurata and considered a valid species. Comments on the type material are given. Complete redescriptions and images are presented for the valid species.

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