In-flight Medical Emergencies

In 2018, approximately 2.8 million passengers flew in and out of U.S. airports per day. Twenty-four to 130 in-flight medical emergencies are estimated to occur per 1 million passengers; however, there is no internationally agreed-upon recording or classification system. Up to 70% of in-flight emergencies are managed by the cabin crew without additional assistance. If a health care volunteer is requested, medical professionals should consider if they are in an appropriate condition to render aid, and then identify themselves to cabin crew, perform a history and physical examination, and inform the cabin crew of clinical impressions and recommendations. An aircraft in flight is a physically constrained and resource-limited environment. When needed, an emergency medical kit and automated external defibrillator are available on all U.S. aircraft with at least one flight attendant and a capacity for 30 or more passengers. Coordinated communication with the pilot, any available ground-based medical resources, and flight dispatch is needed if aircraft diversion is recommended. In the United States, medical volunteers are generally protected by the Aviation Medical Assistance Act of 1998. There is no equivalent law governing international travel, and legal jurisdiction depends on the patient's and medical professional's countries of citizenship and the country in which the aircraft is registered.

Pandemic Poses Legal Pitfalls: TMA Seeks Better Liability Shields

Under Texas law, physicians treating COVID-19 patients in a volunteer capacity have potential defenses against lawsuits that might arise from that care. But for non-volunteer physicians on the COVID battlefield - often working in harrowing, overloaded settings, high on patient count and low on equipment - the same liability shields don't exist. And with a resurgence in COVID-19 cases and hospitalizations taking hold in June, the Texas Medical Association continued its pandemic-long push to extend liability protections to all frontline physicians, volunteer or not.

YET ANOTHER ATTACK ON WAGES AND CONDITIONS

An unobjectionable-sounding title obscures the real intent of the latest in a series of Bills which the federal Coalition government is attempting to legislate in its ongoing attempts to undermine employee wages and conditions and attack unions.

EMAC volunteers: liability and workers' compensation

The Emergency Management Assistance Compact (EMAC) provides a mechanism for states to assist each other during natural disasters and other emergencies. Congress ratified EMAC in 1996, and all 50 states and 3 territories have adopted it. EMAC allows a state affected by a disaster to request personnel and materiel from another state. For personnel requests, EMAC provides that the requesting state cover the tort liability and the responding state cover the workers' compensation liability. This article discusses the limitations of EMAC in deploying volunteers and how the Uniform Emergency Volunteer Health Practitioners Act and other provisions address those limitations.

Basic Program Elements for Federal employee Occupational Safety and Health Programs and related matters; Subpart I for Recordkeeping and Reporting Requirements. Final rule

OSHA is issuing a final rule amending the Basic Program Elements to require Federal agencies to submit their occupational injury and illness recordkeeping information to the Bureau of Labor Statistics (BLS) and OSHA on an annual basis. The information, which is already required to be created and maintained by Federal agencies, will be used by BLS to aggregate injury and illness information throughout the Federal government. OSHA will use the information to identify Federal establishments with high incidence rates for targeted inspection, and assist in determining the most effective safety and health training for Federal employees. The final rule also interprets several existing basic program elements in our regulations to clarify requirements applicable to Federal agencies, amends the date when Federal agencies must submit to the Secretary of Labor their annual report on occupational safety and health programs, amends the date when the Secretary of Labor must submit to the President the annual report on Federal agency safety and health, and clarifies that Federal agencies must include uncompensated volunteers when reporting and recording occupational injuries and illnesses.

Online training on fetal alcohol spectrum disorders for court-appointed special advocates volunteers

Fetal alcohol spectrum disorders (FASDs) are a leading cause of developmental disabilities. Children within the child welfare system are five to 10 times more likely than other children to experience these symptoms. Court Appointed Special Advocates (CASA) volunteers are uniquely positioned to identify these children and refer them for assessment and services. This study used a one-group pretest-posttest design to assess the impact of a three-hour online FASDs training on CASA workers' knowledge of FASDs and their comfort and confidence in identifying children with FASDs for referral, advocating for them, and linking them to services. The training and assessment measures were completed by 338 CASA volunteers and staff from 55 CASA locations in Texas. Wilcoxon matched-pairs tests and paired t tests were used to assess change in each of the dependent measures. All comfort and confidence items showed significant improvement from pretest to posttest; there was also a significant improvement in knowledge. These results support the potential of this online training to enhance CASA volunteers' ability to help children with FASDs.

Establishing CASA as an evidence-based practice

In this article the authors examine the evidentiary status of the Court Appointed Special Advocates (CASA) program through a review of current research findings and a critical analysis of the study methodologies used to produce those findings. Due to the equivocal research findings and widespread methodological weaknesses (most notably selection bias) in the literature base, it is determined that there is not currently enough evidence to establish CASA as an evidence-based practice. In spite of the challenges to the feasibility of such research, a future research agenda is suggested that calls for the execution of large randomized controlled trials in order to produce findings that will inform a deeper understanding of CASA effectiveness in improving child outcomes.

[Medical surveillance of Italian Red Cross Volunteers: actual limits of law, technical and scientific problems. The experience of Red Cross Provincial Committee of Monza and Brianza]

Our research describes a medical surveillance, not included in usual Occupational Health activities, carried out in last year among Red Cross Volunteers active in Monza e Brianza Provincial Committee. This medical surveillance has been managed according to internal rules of Red Cross and national specific Laws. We report data concerning medical examination of 1285 volunteers, their consequences on their voluntary activities, problems arisen during and after medical controls. Starting from results of our medical controls, we evaluated legal and organizational possibilities of evolution of medical surveillance of Red Cross Volunteers specifically and more generally of Civil Protection Volunteers, considering specific new law recently promulgated which seem partially not homogeneous with 81/08 Decree.

Targeting cyclone relief within the village: kinship, sharing, and capture

This article investigates the targeting of cyclone relief within villages in Fiji. It focuses on how relief allocation is linked with informal risk sharing and elite capture, both of which are directly related to kinship. The results are as follows. First, food aid is initially targeted toward kin groups according to their aggregate shocks and then shared among group members. Right after the cyclone, when aid is scarce, households with damage to their housing and with greater crop damage are allocated less aid within the group. Instead, they receive greater net private transfers in other forms, especially in labor sharing. Consistent patterns are found in village, cropping, and housing rehabilitations. Second, there is no elite capture of food aid in the kin group, and instead, traditional kin leaders share food with others; however, non-kin-based community leaders capture aid when it is allocated across kin groups. Third, distinct from food aid demanded by all, tarpaulins demanded by victims only strongly target individual housing damage at the village level—not the kin group—independent of social status. As with food aid, victims with greater crop damage are given a lower priority. Implications for relief policies are discussed.

Prosocial behavior on the Net

Volunteers and charitable organizations contribute significantly to community welfare through their prosocial behavior: that is, discretionary behavior such as assisting, comforting, sharing, and cooperating intended to help worthy beneficiaries. This essay focuses on prosocial behavior on the Internet. It describes how offline charitable organizations are using the Net to become more efficient and effective. It also considers entirely new models of Net-based volunteer behavior directed at creating socially beneficial information goods and services. After exploring the scope and diversity of online prosocial behavior, the essay focuses on ways to encourage this kind of behavior through appropriate task and social structures, motivational signals, and trust indicators. It concludes by asking how local offline communities ultimately could be diminished or strengthened as prosocial behavior increases online.

Examining the long-term racial disparities in health and economic conditions among Hurricane Katrina survivors: policy implications for Gulf Coast recovery

This study examines disparities in the long-term health, emotional well-being, and economic consequences of the 2005 Gulf Coast hurricanes. Researchers analyzed the responses of 216 Black and 508 White Hurricane Katrina survivors who participated in the ABC News Hurricane Katrina Anniversary Poll in 2006. Self-reported data of the long-term negative impact of the hurricane on personal health, emotional well-being, and finances were regressed on race, income, and measures of loss, injury, family mortality, anxiety, and confidence in the government. Descriptive analyses, stepwise logistic regression, and analyses of variance revealed that Black hurricane survivors more frequently reported hurricane-related problems with personal health, emotional well-being, and finances. In addition, Blacks were more likely than Whites to report the loss of friends, relatives, and personal property.

Attitudes to abortion in the era of reform: evidence from the Abortion Law Reform Association correspondence

This article examines letters sent by members of the general public to the Abortion Law Reform Association (ALRA) in the decade immediately before the 1967 Abortion Act. It shows how a voluntary organisation, in their aim of supporting a specific cause of unclear legality, called forth correspondence from those in need. In detailing the personal predicaments of those facing an unwanted pregnancy, this body of correspondence was readily deployed by ALRA in their efforts to mobilise support for abortion law reform, thus exercising a political function. A close examination of the content of the letters and the epistolary strategies adopted by their writers reveals that as much as they were a lobbying tool for changes in abortion law, these letters were discursively shaped by debates surrounding that very reform.

Darning, doylies and dancing: the work of the Leeds Association of Girls' Clubs (1904-1913)

The Leeds Association of Girls' Clubs (LAGC) was set up by a group of women, including Hilda Hargrove, Dr Lucy Buckley and Mary and Margaret Harvey, to promote collaboration between the city's girls' clubs. The organisation epitomised women working in partnership whilst reflecting their differing philanthropic and political interests. However LAGC's collaborative approach resulted in liberal consensus which downplayed the significance of girls' working conditions. Throughout the decade LAGC's focus was its annual competitions. These featured utilitarian and decorative handicrafts (darning and doylies) enshrining both frugality and aspiration, alongside dance and drill which channelled girls' vigour. Nevertheless, LAGC's resilience resulted in an organisation which is still in existence.

Constructing citizenship? Women, welfare and refugees in France, 1939-1940

Women were central to the provision of welfare services in France during the refugee crises of the late 1930s. By building on the services created during the First World War, women, as either volunteers or professionals, actively cared for refugees and others during the Spanish Civil War (1936-39), the phoney war (September 1939-May 1940) and the German invasion of 1940. French women's involvement with refugee aid enabled them to develop a sense of autonomous civil and political activism, especially—although not exclusively—in their work with the French Red Cross. In addition, the history of welfare activities for refugees illuminates how ordinary people dealt with the extraordinary circumstances of war, invasion and the forced movement of populations.

Who cares in Nicaragua? A care regime in an exclusionary social policy context

In Latin American countries with historically strong social policy regimes (such as those in the Southern Cone), neoliberal policies are usually blamed for the increased burden of female unpaid work. However, studying the Nicaraguan care regime in two clearly defined periods — the Sandinista and the neoliberal eras — suggests that this argument may not hold in the case of countries with highly familialist social policy regimes. Despite major economic, political and policy shifts, the role of female unpaid work, both within the family and in the community, remains persistent and pivotal, and was significant long before the onset of neoliberal policies. Nicaragua's care regime has been highly dependent on the ‘community’ or ‘voluntary’ work of mostly women. This has also been, and continues to be, vital for the viability of many public social programmes.

Visiting the mentally ill: volunteer visitors at Saskatchewan hospital, Weyburn 1950-1965

This article offers a glimpse into the lives and activities of some of the patients, volunteers and staff in the Saskatchewan mental health system during the period of deinstitutionalization. Drawing on her own experience as a patient in psychiatric wards as well as ongoing research in the history of mental health, it features the role of Regina Volunteer Visitors in Saskatchewan Hospital, Weyburn and examines the importance of occupational and recreational therapies and activities in improving the lives of the patients in that institution. It emphasizes the perspectives of patients and volunteers who actively worked to develop recreational activities, with the intention of helping individuals connect with the surrounding communities. The views and perspectives presented here are drawn from a variety of historical and oral interview sources, including views from visitors to the asylum and patients who lived within its walls. The author has also been a consumer of mental health services, and spent time in the Provincial Mental Hospital in North Battleford. The article therefore makes an important contribution to enhancing our understanding of the social history of deinstitutionalization, not only for its unique source base, but also because those sources have been examined and explained to readers through the perspectives of a former patient herself. This article draws significant attention to the changing opportunities for patients as they interacted with the women's volunteer groups, as well as to how the changes brought about by the encroaching deinstitutionalization, care in the community, and decisions from "above" affected the individuals on the ground.

Protection for 'have-a-go' nurses

Stopping to help at an accident or giving first aid to someone in an emergency can be a daunting task for a nurse. Doctors have, for many years, been reluctant to volunteer in such situations for fear of being sued. Professional health regulators appear to encourage nurses to stop and help victims, as long as he/she works within his/her competencies. In practice, the situation has been difficult and there have been attempts by the compensation culture to ‘have a go’ at those who try their best to help people in difficulty. For example, there was one case of a child who drowned because when the police arrived at the scene they could not enter the water because they had no water rescue training. Much of the red tape surrounding these events relates to this country’s over-zealous health and safety laws. In fact, David Cameron has said that the ‘fear of transgressing’ UK and EU rules sometimes meant people ‘stand aside when others need help’

[What is a physician's legal responsibility in an airplane?]

A physician travelling frequently by air is likely to receive sooner or later a call for medical help during the flight. According to the Finnish law the physician has a duty to help any patient that needs urgent medical assistance and this duty applies even in the airplane. The extent of required assistance is mostly dependent on the actual skills of the physician. Temporary incapacity caused, e.g., by intoxication does not abolish the physician's duty to help but justifies the omission of procedures that are adversely influenced by the alcohol intake.

Gender and the transmission of civic engagement: assessing the influences on youth civic activity

The study of civic activity has become a central focus for many social scientists over the past decade, generating considerable research and debate. Previous studies have largely overlooked the role of youth socialization into civic life, most notably in the settings of home and school. Further, differences along gender lines in civic capacity have not been given sufficient attention in past studies. This study adds to the literature by examining the potential pathways in the development of youth civic activity and potential, utilizing both gender-neutral and gender-specific structural equation modeling of data from the 1996 National Household Education Survey. Results indicate that involvement by parents in their child's schooling plays a crucial, mediating role in the relationship between adult and youth civic activity. Gender differences are minimal; thus adult school involvement is crucial for transmitting civic culture from parents to both female and male youth.

Legal briefing: Crisis standards of care and legal protections during disasters and emergencies

This article outlines current safe harbors in the law for healthcare practitioners who work in a disaster setting. It reviews available legal protection in crisis situations with respect to the Emergency Medical Treatment and Labor Act (EMTALA), criminal liability, and licensure.

Health as a context for social and gender activism: female volunteer health workers in Iran

Having reversed its pronatalist policies in 1988, the Islamic Republic of Iran implemented one of the most successful family planning programs in the developing world. This achievement, particularly in urban centers, is largely attributable to a large women-led volunteer health worker program for low-income urban neighborhoods. Research in three cities demonstrates that this successful program has had a host of unintended consequences. In a context where citizen mobilization and activism are highly restricted, volunteers have seized this new state-sanctioned space and successfully negotiated many of the familial, cultural, and state restrictions on women. They have expanded their mandate from one focused on health activism into one of social, if not political, activism, highlighting the ways in which citizens blur the boundaries of state and civil society under restrictive political systems prevalent in many of the Middle Eastern societies.

Currents in contemporary ethics. Malpractice immunity for volunteer physicians in Public Health Emergencies: adding insult to injury

There is widespread concern among public health and emergency response officials that there could be a shortage of health care providers in a public health emergency. At least the following three factors could cause an inadequate supply of physicians, nurses, and other health care providers: (1) the severity of the emergency might greatly increase the demand for health services and outstrip the available supply; (2) health care providers might become unavailable because of their own high rates of illness, as was the case in the SARS epidemic; and (3) many health care providers might not report for duty for personal, family, or professional reasons.

One way of addressing the shortage is to encourage health care providers from unaffected areas or parts of the country to volunteer their services. A variety of measures have been enacted to facilitate the use of such volunteers.

How do voluntary organizations foster protest? The role of organizational involvement on individual protest participation

Prior research shows that members of voluntary organizations are more likely to protest than nonmembers. But why, among members, do some protest while others do not? I explore whether organizational involvement-the extent in which members engage in the "life" of their organizations-affects protest. I identify four dimensions of involvement-time and money contributions, participation in activities, psychological attachment, and embeddedness in interpersonal communication networks. Only the first dimension has robust effects on protest, and they are nonlinear: intermediate contributors have the highest protest rates. The three other dimensions substantially increase protest only under specific "involvement profiles."

Shield the volunteers: state, federal laws protect physicians from liability

Physicians wanting to volunteer their services at a free clinic need not be overly concerned about being sued. State and federal laws offer protection and make it difficult for a plaintiff to succeed.

Philanthropies croisées: a joint venture in public health at Lyon (1917-1940)

Since the end of the First World War the Rockefeller Foundation has spearheaded a large-scale programme in the field of education for the health professions (doctors and nurses). In several countries throughout the world, but with its efforts concentrated on Europe, it has financed schools, constructed information networks, granted research scholarships and awarded training bursaries. In so doing it has not, however, been in the business of propagating an irresistible "American model," nor has it pursued a huge undertaking in disinterested aid. Through an attempt to contextualize these programmes, to bring to light the existence of common reference points, to retrace the work with local participants and to appraise cleavages within the philanthropic apparatus, this article proposes a fine-grained reading of the role of the Rockefeller Foundation at the Faculté de Médecine (Faculty of Medicine) and the Ecole d'Infirmières et d'assistantes sociales (Training School for Nurses and Social Workers) in Lyon between 1917- and 1940. It analyses these institutions in terms of the transactions, negotiations and appropriations that highlight their joint-venture character and it identifies their varied impact.