Budgets versus Bans: How U.S. Law Restricts Germline Gene Editing

In late 2019, He Jiankui, the Chinese scientist who created the world's first gene-edited babies, and two embryologists were sentenced to prison and fined. Thirteen months earlier, when the world first learned about the experiment, He and his colleagues drew swift and nearly uniform international condemnation for prematurely moving to human trials, for the risks they took with the children's health, and for He's secrecy. The organizing committee for the second genome editing summit said the experiment failed to conform with international norms." In the United States, the legal picture is complex. No doubt the specific experiment He performed would have run afoul of long-standing research regulations due to its problems with informed consent and ethical review. But other laws also affect this kind of work, in particular, a budget rider that for the past four years has been included in federal appropriations legislation.

Ordinance 3992/2017: challenges and advances for resource management in the Brazilian Unified Health System (SUS)

To advance in order to overcome the challenge of enabling greater autonomy in the use of financial resources in the Unified Health System (SUS), system managers agreed that transfers from the Union to other federated entities will be carried out through a financial investment account and a costing account. Over the past few years, states and municipalities managed more than 34,000 bank accounts dedicated to the Union’s on-lendings, in which balance exceeded R$8 billion. However, from 2018, Ordinance 3,992/2017 unequivocally separated the budget flow from the financial flow, and the fund-to-fund transfers started to be carried out in only 11,190 bank accounts. Since then, managers have had financial autonomy in the management of financial resources received from the Union, if in accordance with the parameters established in their respective budget items at the end of each fiscal year.

"We make a direct impact on people's lives": Youth empowerment in the context of a youth-led participatory budgeting project

Participatory budgeting [PB] is a democratic process whereby community members determine how to spend governmental funds. Youth-led PB is relatively new, occurring in select U.S. cities. During youth-led PB, youth collect ideas, develop proposals, and advertise community improvement projects for which they, citywide, cast deciding votes. The study examined opportunities for the empowerment youth at each stage of a youth-led PB project. Data collection included individual interviews with 31 youths and adult stakeholders, 3 focus groups with youths, and 7 observations of meetings. The data were analyzed using consensual qualitative research methods. Findings align well with the psychological empowerment literature and demonstrate several opportunities for empowerment throughout the PB project, including feeling in charge of the process, understanding and allocating resources, and influencing positive community change. Findings also demonstrate potential barriers to empowerment, including understanding bureaucratic decision making, and influencing policy. PB is relevant to furthering our understanding of the empowerment of youth. The youths who participated in the present study expressed feelings of competence, purpose, and an ability to use the skills learned to engage fellow youths in the PB process. Additional empirical research is needed to examine the dimensions of empowerment at each stage of the PB process.

Trump budget cuts threaten response to Zika and other disease outbreaks

Extreme weather events coupled with milder winters as global temperatures rise have created environments that are breeding ground for diseases, including mosquito-borne infections.

The 21st Century Christmas Tree Act

On the surface, it looks like every healthcare special interest and their 1,400 lobbyists won an early Christmas present courtesy of the 21st Century Cures Act, which passed the House of Representatives by a whopping 392-26 margin last week and appears headed for Senate passage and enactment.

The Balanced Budget Act of 1997 and U.S. Hospital Operations

The Balanced Budget Act (BBA) of 1997 initiated several changes to Medicare payment policy in an effort to slow the growth of hospital Medicare payments and ensure the future of the Medicare Hospital Insurance Trust Fund. Although subsequent federal legislation relaxed some original proposals, restored funds were limited and directed to specific types of hospitals. In addition, these Medicare policy changes came at a time when hospitals faced private sector payment constraints. This paper assesses the short-term effects of the BBA on operations of nonprofit hospitals in the United States and compares these effects to those observed in the early 1980s during implementation of the Medicare prospective payment system (PPS). We found that some operational changes instituted by hospitals facing financial pressures from the BBA were similar to those observed for hospitals that faced pressure from Medicare PPS, including efforts to contain Medicare cost growth, to expand outpatient service provision, and to contain hospital staffing. However, during PPS implementation hospitals experienced declining inpatient use and growing profit margins, whereas post-BBA hospitals experienced growing inpatient use and declining margins.

Do your bit in the week of action for children

It should be obvious that improving the health of the nation's children makes sense, but in these days of annualised budgets and rolling news, it is all too easy for those running our health service to take short-term decisions. So it is good to know that the nurses at Public Health England are striving to ensure that our young people's wellbeing is pushed up the agenda.