Health Literacy, Diabetes Prevention, and Self-Management

International audienceOBJECTIVE:To identify the factors that can predict physicians' use of electronic prescribing.DESIGN:All primary care physicians who practised in a single geographic region in Quebec were invited to use a free, advanced, research-based electronic prescribing and drug management system. This natural experiment was studied with an expansion of the Technology Acceptance Model (TAM), which was used to explain early adopters' use of this electronic prescribing technology.SETTING:Quebec city region.PARTICIPANTS:A total of 61 primary care physicians who practised in a single geographic region where there was no electronic prescribing.MAIN OUTCOME MEASURES:Actual use of electronic prescribing; physicians' perceptions of and intentions to use electronic prescribing; physician and practice characteristics.RESULTS:During the 9-month study period, 61 primary care physicians located in 26 practice sites used electronic prescribing to write 15 160 electronic prescriptions for 18 604 patients. Physician electronic prescribing rates varied considerably, from a low of 0 to a high of 75 per 100 patient visits, with a mean utilization rate of 30 per 100 patient visits. Overall, 34% of the variance in the use of electronic prescribing was explained by the expanded TAM. Computer experience (P=.001), physicians' information-acquisition style (P=.01), and mean medication use in the practice (P=.02) were significant predictors. Other TAM factors that generally predict new technology adoption (eg, intention to use, perceived ease of use, and perceived usefulness) were not predictive in this study.CONCLUSION:The adoption of electronic prescribing was a highly challenging task, even among early adopters. The insight that this pilot study provides into the determinants of the adoption of electronic prescribing suggests that novel physician-related factors (eg, information-acquisition style) and practice-related variables (eg, prevalence of medication use) influence the adoption of electronic prescribing

Tobacco still a major killer-will we achieve the end game?

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A v. B

Facts: The appellant and his wife were married for many years but remained childless. The appellant began a relationship with a 15 year-old girl, the first respondent, in order to have a child by her, and she did indeed become pregnant and bear his child. When the child was born, the girl wanted the child to be adopted by a third party, but the appellant wanted to raise the child with his wife. The main witness in the trial court was Mr Rami Bar-Giora, an expert psychologist, who testified that if the child were raised by the appellant and the appellant’s wife, he foresaw major risks to the emotional health of the child because of the circumstances of the child’s birth, whether these were revealed to the child or concealed from him. The trial court held that the child was adoptable for two reasons: under section 13(7) of the Adoption Children Law, the appellant was ‘incapable of looking after the child properly because of his behaviour or situation’, and under section 13(8) of the Law, his refusal to give his consent to the adoption derived ‘from an immoral motive’ or was ‘for an unlawful purpose’. Held: (Justices D. Dorner, I. Zamir, G. Bach) The case fell within the scope of section 13(7) of the Adoption of Children Law. The appellant was incapable of looking after the child properly because of the unique circumstances of the case, as described by the expert in his opinion. Section 13(8) of the law was not applicable, since the refusal to consent to adoption was in itself not immoral or unlawful. (Vice-President S. Levin) The case did not fall within the scope of any of the grounds in section 13 of the Law that allow a child to be declared adoptable. Nonetheless, the law should be read to include an additional rule, which provides that a parent may not object to his child being declared adoptable if this is contrary to reasons of public policy with respect to acts which led to the birth of the child. (Justice M. Cheshin) The case did not fall within the scope of any of the grounds in section 13 of the Law that allow a child to be declared adoptable. Nonetheless, a fundamental and independent principle of Israeli law is the principle: ‘Have you committed murder and also taken the inheritance? (I Kings 21, 19). Under this principle, which has the same status as statute, a person may not be allowed to benefit from his misdeeds. Appeal denied

Health Literacy in Context—Settings, Media, and Populations

To date, most published health literacy research has focused on assessing and improving personal skills and abilities. More recently, a better understanding has emerged of the extent to which these skills and abilities are mediated by environmental demands and situational complexities — the context in which health literacy is developed and applied. This has led to much greater attention being given to ways of reducing the situational demands and complexity in which an individual makes a health decision. This collection of papers examines current progress in understanding health literacy "in context", by improving our understanding of the mutual impact of a range of social, economic, environmental, and organisational influences on health literacy. These papers provide unique and original perspectives on the concept, distribution, and application of health literacy in very diverse populations, offering cultural insights and a clear indication of the impact of social and environmental context on health literacy. These perspectives include an examination of differing national policy responses to health literacy illustrating how policy and practice can (and should) respond to this more complete but complex understanding of health literacy. Other papers look at the application of new digital media and the creative harnessing of popular culture as routes to extend the reach and customisation of communications. These papers also illustrate good progress in the evolution of research in the contexts in which health literacy is developed and applied, as well as signaling some areas in which more research would be useful

Ports and Railways Authority v. Zim Integrated Shipping Services, Ltd.

Facts: The present case raises the question of liability for damage caused during the course of pilotage of a ship. A ship and a dock were damaged during the course of the pilotage of a ship in the dock. The owner of the Ship, Zim Integrated Shipping Services, Ltd. repaired the damage that was caused to the Ship, and demanded that the Ports and Railways Authority reimburse it for the cost of the repair. The owner based the demand on the negligence of the Ports and Railways Authority and the negligence of the pilot for whose actions it was claimed the Ports and Railways Authority bore vicarious liability. The two central questions that were addressed were: do the owners of a ship have a cause of action against the employer of a pilot who caused damage to a ship in the course of piloting in the area of a port? And, if so, how is the liability to be distributed between the owners of the ship and the pilot’s employer if the damage was caused by the joint fault of the pilot and the ship’s crew. The District Court imposed two thirds of the liability for the damage on the pilot, and the remaining third on the captain. The court, based on vicarious liability attributed the liability of the pilot to the Ports and Railways Authority and the liability of the captain to Zim. The practical ramification of this distribution is that Zim’s suit against the Ports and Railways Authority was successful only in part and the Ports and Railways Authority was required to pay Zim two thirds of the cost of repair of the ship. The Ports and Railways Authority appealed this decision. Held: The Court partially allowed the respondent’s appeal. The court determined that the Ports and Railways Authority alone is liable to Zim by way of vicarious liability for the pilot’s negligence. However, the pilot, were he to be sued to compensate Zim for the damage caused to the Ship, would only be obligated, given the contributory negligence of the captain, for half the damage. Therefore, the Ports and Railways Authority is only obligated to compensate Zim for half of the damage. The appellants were ordered to pay the respondent’s fees in the sum of NIS 30,000

International Handbook of Health Literacy : Research, practice and policy across the lifespan

Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International Handbook of Health Literacy : Research, practice and policy across the lifespan. Bristol: Policy Press, University of Bristol; 2019

Nahmani v. Nahmani

Facts: Ruth and Daniel Nahmani, a married couple, were unable to have a child because of an operation that Ruth underwent. They therefore decided to try in-vitro fertilization of Ruth’s ova with Daniel’s sperm and implanting the fertilized ova in a surrogate mother. Under Israeli law, surrogacy was not permitted and in-vitro fertilization was only permitted for implantation in the mother. Because of the great expense of the in-vitro fertilization procedure in the United States, the couple petitioned the Supreme Court, sitting as the High Court of Justice, to allow the in-vitro fertilization procedure to be conducted in Israel, for the purpose of surrogacy in the United States. In that proceeding (HCJ 1237/91), a consent judgment was given allowing the in-vitro fertilization procedure to be done in Israel. The procedure was carried out at Assuta Hospital. Subsequently, Daniel left Ruth and went to live with another woman, who bore him a child. Ruth applied to Assuta Hospital to release the fertilized ova into her possession for the purpose of the surrogacy procedure in the United States, but Daniel opposed this. Assuta Hospital therefore refused to release the fertilized ova. Ruth applied to the Haifa District Court for an order against the hospital to release the fertilized ova, and in its judgment the District Court gave such an order. Daniel appealed the judgment of the District Court to the Supreme Court. Held: (Majority opinion — Justice T. Strasberg-Cohen, Vice-President Barak, Justice D. Levin, Justice I. Zamir) Although a spouse’s right to be a parent is a basic right, this right does not impose a duty on the other spouse to help realize this right. If a spouse does not perform the customary marital duties, these cannot be enforced and the only remedy is divorce. It is not proper legal policy to force someone to be a parent against his will. The consent of Daniel Nahmani to the in-vitro fertilization procedure created a ‘weak’ agreement that cannot be enforced under the strict laws of contract. In addition, the consent to the procedure did not imply consent to continue the procedure even after a separation. (Minority opinion — Justice Ts. E. Tal) The husband was estopped from opposing the continuation of procedure by promissory estoppel, since he gave his consent, his wife reasonably relied on this consent, and she did so irreversibly, by fertilizing her ova with her husband’s sperm

Local Building v. Holzman

Facts: Two appeals (CA 5546/97 and CA 6417/97) were joined in this case due to the similarity of the legal question they raised. In both cases the question arose as to the authority to reduce compensation in the expropriation of land for public purposes and in particular the question arose whether a plot of land can be expropriated in its entirety with significant reduction in compensation. Held: The appeal in CA 5546/97 was dismissed and the appeal in CA 6417/97 was partially affirmed. In that case the Local Planning and Construction Committee in Haifa was ordered to pay the appellants in the entirety for the parcel that was expropriated; other portions of the District Court decision were left as is

Weiss v. Prime Minister

Facts: The Prime Minister resigned, and he and the Ministers of the outgoing government continued to fulfill their duties as prime minister and ministers until the new government was to take office. In this framework the outgoing government continued to conduct political negotiations with the Palestinian Authority with the aim of reaching an agreement before the elections. Held: The majority opinion was written by President Barak. The petitioners claimed that the outgoing government was not authorized to conduct the political negotiation. They asked the court to direct the government to end the political negotiation until the establishment of a new government following the special elections. The basic issues that were addressed in this case were: what is the scope of the authority and discretion of an outgoing government? Is it permitted to conduct political negotiation and sign an agreement? And what is the scope of judicial review of decisions of the outgoing government

Measuring children’s health literacy. Current approaches and challenges

Bollweg TM, Okan O. Measuring children’s health literacy. Current approaches and challenges. In: Okan O, Bauer U, Levin-Zamir D, Pinheiro P, Sørensen K, eds. International handbook of health literacy. Research, practice and policy across the life-span. Bristol: Policy Press; 2019: 83-97