Critical Perspectives to Advance Educational Equity and Health Justice.

A robust body of research supports the centrality of K-12 education to health and well-being. Critical perspectives, particularly Critical Race Theory (CRT) and Dis/ability Critical Race Studies (DisCrit), can deepen and widen health justice's exploration of how and why a range of educational inequities drive health disparities. The CRT approaches of counternarrative storytelling, race consciousness, intersectionality, and praxis can help scholars, researchers, policymakers, and advocates understand the disparate negative health impacts of education law and policy on students of color, students with disabilities, and those with intersecting identities. Critical perspectives focus upon and strengthen the necessary exploration of how structural racism, ableism, and other systemic barriers manifest in education and drive health disparities so that these barriers can be removed.

Civil society: the catalyst for ensuring health in the age of sustainable development.

Sustainable Development Goal Three is rightly ambitious, but achieving it will require doing global health differently. Among other things, progressive civil society organisations will need to be recognised and supported as vital partners in achieving the necessary transformations. We argue, using illustrative examples, that a robust civil society can fulfill eight essential global health functions. These include producing compelling moral arguments for action, building coalitions beyond the health sector, introducing novel policy alternatives, enhancing the legitimacy of global health initiatives and institutions, strengthening systems for health, enhancing accountability systems, mitigating the commercial determinants of health and ensuring rights-based approaches. Given that civil society activism has catalyzed tremendous progress in global health, there is a need to invest in and support it as a global public good to ensure that the 2030 Agenda for Sustainable Development can be realised.

The Americans With Disabilities Act and Voice Disorders: Practical Guidelines for Voice Clinicians.

OBJECTIVE: The Americans with Disabilities Act Amendments Act of 2008 (ADAAA) resulted in changes to the legal definition of disability and substantially affected how those with voice disorders may qualify for reasonable accommodations under the law. However, there has been little guidance and a lack of awareness about these changes within the voice literature. This article examines the Americans with Disabilities Act of 1990 (ADA), the changes made in 2008 (ADAAA), and how the law applies to individuals with voice disorders. STUDY DESIGN: This is a review article. METHODS: The ADA and ADAAA are summarized with a particular focus on individuals with voice disorders. Types of reasonable accommodations within the workplace are suggested, and online resources are provided which outline the disclosure and accommodation process. Practical examples are used to provide guidance for clinicians who may be involved in counseling this clinical population. RESULTS/CONCLUSIONS: Many individuals with voice disorders may not realize that their conditions can be classified as disabilities under the law, entitling them to workplace accommodations and time off to pursue medical treatment. However, disclosure laws such as the right to refrain from mentioning a disability during a job interview may not be protective of individuals with severe voice impairments, as symptoms are often difficult to conceal. Clinical implications and directions for future research are discussed.

Children of perestroika: the changing socioeconomic conditions in Russia and Ukraine and their effect on the psychological well-being of high-school adolescents.

The present study investigates how the changing socioeconomic conditions in Russia and Ukraine affect the psychological well-being of high-school adolescents in these countries. Six indexes of psychological well-being, the adolescents' perception of the economic conditions in their families, perceived parental practices (care and autonomy providing), and perceived social support were measured in 1999 and 2007. Macro-level socioeconomic conditions in Russia and Ukraine, as well as the adolescents' perception of the economic conditions in their family, substantially improved from 1999 to 2007. However, the psychological well-being of the adolescents, as well as their perception of parental practices and the social support received from parents, peers, and teachers did not change. Russian adolescents consistently reported higher self-esteem and school competence than their Ukrainian peers, as well as higher parental care and autonomy providing, and higher social support received from peers. At the individual level, perceived parental care and autonomy providing, as well as perceived social support from parents, peers, and teachers were the major contributors to the adolescents' psychological well-being. The obtained results are discussed in light of the conservation of resources and ecological systems theories.

[Legal consequences of suboptimal medical treatment]. / Rechtliche Konsequenzen suboptimaler Arzneimitteltherapie.

The legal framework of the statutory health insurance does not legitimize substandard therapy. There is no civil case law allowing for prescriptions that are not in line with the current "state of the art" procedures for economical reasons.

Participation in research studies: factors associated with failing to meet minority recruitment goals.

PURPOSE: To determine the recruitment goals that investigators set for racial/ethnic minorities and the factors associated with failure to meet those goals. METHODS: Four hundred forty principal investigators (PIs) conducting clinical research funded by the National Heart, Lung, and Blood Institute (NHLBI) in 2001 completed a mailed survey providing their minority recruitment goals and enrollment data for their most recent NHLBI-funded study. RESULTS: Ninety-two percent of PIs set goals for African Americans, 68% for Hispanics, 55% for Asian Americans, 35% for Native Hawaiians/Pacific Islanders, and 23% of PIs set recruitment goals for American Indians/Native Alaskans. Among those PIs who did set minority recruitment goals, the mean goal for the recruitment of African Americans was 31%, 16% for Hispanics, and 9% for Asian Americans. Twenty-seven percent of PIs failed to meet their recruitment goals for African Americans, 23% for Asian Americans, and 23% for Hispanics. After adjusting for multiple investigator and trial characteristics, the type of study (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.2, 3.4 for observational vs. phase III trial) completion of study enrollment (OR 2.0; 95% CI 1.2, 3.4), and PI identification of a larger number of major barriers to participation (OR 1.8; 95% CI 1.1, 3.0) were all associated with failure to meet recruitment goals for African Americans. However, no factors were consistently associated with failure to meet recruitment goals across different racial/ethnic groups. CONCLUSIONS: Investigators often do not set recruitment goals for some racial/ethnic groups. Factors associated with failure to meet recruitment goals vary in the recruitment of different minority groups.

Genes, race, and population: avoiding a collision of categories.

A wide array of federal mandates have a profound impact on the use of racial and ethnic categories in biomedical research, clinical practice, product development, and health policy. Current discussions over the appropriate use of racial and ethnic categories in biomedical contexts have largely focused on the practices of individual researchers. By contrast, our discussion focuses on relations between the daily practices of biomedical professionals and federal regulatory mandates. It draws upon the legal doctrine of equal protection to move beyond such debates and to propose guidelines to address the structural forces imposed by federal regulations that mandate how data about race and ethnicity are used in biomedical research. It offers a framework to manage the tension involved in using existing federally mandated categories of race and ethnicity alongside new scientific findings about human genetic variation.

A civil rights primer for healthcare organizations.

"Diversity helps us build a better product for the diverse customers we're serving," says University of Michigan Hospitals' Ellen J. Gaucher. And several healthcare organizations stand out for their efforts to build a diverse workforce. Leaders agree that an atmosphere open to diversity starts at the top. They identify four major steps that board members and senior executives can take to ensure a system that welcomes all racial and ethnic groups into the fold.

Almost a revolution: an international perspective on the law of involuntary commitment.

To what extent have developments in commitment law around the world paralleled trends in the United States in the last three decades? Although the American emphasis on dangerousness criteria and strigent procedural rights has been echoed in a number of other countries, it has not dominated reform in most nations. The leading alternative has been the 1983 Mental Health Act in England and Wales, with its focus on the "health and safety" of the patient, as well as protection of other persons, and its avoidance of judicial hearings. How have these reforms fared? Extensive data from the United States, and more limited data from other countries, suggest that reforms in general are resisted when they are seen as shifting the focus away from patients' treatment needs. When law fails to reflect widely held moral sentiments, it is molded in practice to conform more closely to those sentiments. It is helpful to recognize that a variety of approaches to mental health law are consistent with reasonable protection of civil liberties in a democratic society. Greater attention to practices in other countries may help reformers expand the menu of options in policy debates.