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This article analyzes the relevance of the comprehensive definition of sexual and reproductive health and rights (SRHR) to adolescents and identifies adolescent-specific implications for the implementation of an essential package of SRHR interventions. The delivery of a comprehensive approach to SRHR targeting adolescents is underpinned by five principles-equity, quality, accountability, multisectorality, and meaningful engagement. All SRHR interventions included in the package are relevant to adolescents, given the diversity of adolescents' SRHR needs and considering their specific attributes, circumstances, and experiences. Ensuring that this package is available, accessible, and acceptable to adolescents requires an approach that looks at adolescents as being biologically and socially distinct from other age groups and acknowledges that they face some specific barriers when accessing SRHR services. This article provides cross-cutting strategies for the implementation of a comprehensive approach to SRHR for adolescents and specific considerations in delivering each intervention in the package of essential SRHR interventions. To further implement the International Conference on Population and Development Programme of Action, a prerequisite for achieving the Sustainable Development Goals, SRHR interventions must be adolescent responsive, delivered through multiple platforms, leveraging multisectoral collaboration, and strengthening accountability and participation., (Copyright © 2019. Published by Elsevier Inc.)

Among the ground-breaking achievements of the International Conference on Population and Development (ICPD) was its call to place adolescent sexual and reproductive health (ASRH) on global health and development agendas. This article reviews progress made in low- and middle-income countries in the 25 years since the ICPD in six areas central to ASRH-adolescent pregnancy, HIV, child marriage, violence against women and girls, female genital mutilation, and menstrual hygiene and health. It also examines the ICPD's contribution to the progress made. The article presents epidemiologic levels and trends; political, research, programmatic and social responses; and factors that helped or hindered progress. To do so, it draws on research evidence and programmatic experience and the expertise and experiences of a wide number of individuals, including youth leaders, in numerous countries and organizations. Overall, looking across the six health topics over a 25-year trajectory, there has been great progress at the global and regional levels in putting adolescent health, and especially adolescent sexual and reproductive health and rights, higher on the agenda, raising investment in this area, building the epidemiologic and evidence-base, and setting norms to guide investment and action. At the national level, too, there has been progress in formulating laws and policies, developing strategies and programs and executing them, and engaging communities and societies in moving the agenda forward. Still, progress has been uneven across issues and geography. Furthermore, it has raced ahead sometimes and has stalled at others. The ICPD's Plan of Action contributed to the progress made in ASRH not just because of its bold call in 1994 but also because it provided a springboard for advocacy, investment, action, and research that remains important to this day., (Copyright © 2019. Published by Elsevier Inc.)

In the 25 years since the 1994 International Conference on Population and Development, significant progress has been made in adolescent sexual and reproductive health and rights (ASRHR). Trend analysis of key ASRHR indicators at global, national, and subnational levels indicates that adolescent girls today are more likely to marry later, delay their first sexual experience, and delay their first childbirth, compared with 25 years ago; they are also more likely to use contraceptives. Despite overall progress, however, unequal progress in many ASRHR outcomes is evident both within and between countries, and in some locations, the state of adolescents' lives has worsened. Population growth in countries with some of the worst shortfalls in ASRHR mean that declining rates, of child marriage, for example, coexist with higher absolute numbers of girls affected, compared with 25 years ago. Emerging trends that warrant closer attention include increasing rates of ovarian and breast cancer among adolescent girls and sharp increases in the proportion of adolescents who are overweight or obese, which has long-term health implications., (Copyright © 2019. Published by Elsevier Inc.)

The 1994 International Conference on Population and Development established a basis for the advancement of adolescent sexual and reproductive health and rights (ASRHR) that endures today. Twenty-five years later, our vision for the future warrants reflection based on a clear understanding of the opportunities and challenges before us. Inclusion of adolescents on global, regional, and national agendas; increased investment in ASRHR policies and programs; renewed commitments to universal health coverage; increased school enrollment; and advances in technology are all critical opportunities we can and must leverage to catalyze progress for adolescents. At the same time, a range of significant challenges remain, have newly emerged, or can be seen on the horizon, including persistent denial of adolescent sexuality; entrenched gender inequality; resistance to meaningfully engaging adolescents and young people in political and programmatic processes; weak systems, integration, and multisectoral coordination; changes in population dynamics; humanitarian and climate crises; and changes in family and community structures. To achieve as much progress toward our vision for ASRHR as possible, the global ASRHR community must take strategic and specific steps in the next 10 years within five areas for action: (1) mobilize and make full use of political and social support for ASRHR policies and programs; (2) increase and make effective use of external and domestic funding for ASRHR; (3) develop, communicate, apply, and monitor enabling and protective laws and policies for ASRHR; (4) use and improve available ASRHR data and evidence to strengthen advocacy, policies, and programs; and (5) manage the implementation of ASRHR strategies at scale with quality and equity., (Copyright © 2019. Published by Elsevier Inc.)

This study presents a survey of state statutes which restrict the civil rights of persons with a mental illness or who have been declared mentally incompetent. Five civil rights (voting, holding public office, jury service, parenting, and marriage) are examined. The results of this study are compared with the results of studies conducted in 1989 and 1999 to determine what changes have occurred over time in the restriction of civil rights of those suffering from mental health problems. This comparison reveals that states continue to restrict the rights of the mentally ill and incompetent, and that there is a trend towards increased restriction of political rights, including the right to vote and hold public office.

The struggle to achieve the legalization of same-gender adoption is ongoing. Notably, not until 2011 was adoption by a lesbian, gay, bisexual, or transgender individual legalized in all 50 states and the District of Columbia, and adoption by same-gender couples is still illegal in many states. Anti-adoption forces are ever-present: From 2011 to 2013, at least five states passed laws granting faith-based agencies the right to refuse service to same-gender couples or to give preference to heterosexual couples. The aim of this article is, first, to examine the challenges confronting the legalization of same-gender adoption; second, to report the current legal status of same-gender adoption for each state; third, to report on Americans' attitudes toward the legalization of same-gender adoption from 1994 to 2012, drawing from previously published surveys of a cross section of Americans; and, fourth, to explore the implications for social work practice, including social advocacy and social policy implementation.

The Civil Partnership Act 2004, which came into force in December 2005 allowing same-sex couples in the UK to register their relationship for the first time, celebrated its fifth anniversary in December 2010. This article examines civil partnership in England and Wales, five years on from its introduction. The characteristics of those forming civil partnerships between 2005 and 2010 including age, sex and previous marital/civil partnership status are examined. These are then compared with the characteristics of those marrying over the same period. Further comparisons are also made between civil partnership dissolutions and divorce. The article presents estimates of the number of people currently in civil partnerships and children of civil partners. Finally the article examines attitudes towards same-sex and civil partner couples both in the UK and in other countries across Europe.

This article reviews much of the history of the Surgeon General's Call to Action to Improve the Health and Wellness of Persons with Disabilities and its implications 5 years after publication. This article also reviews historical trends related to disability legislation such as the Social Security Act, the Civil Rights Era and the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, and the New Freedom Initiative. Most Americans will have a disability at some point in their lives. The etiologies of disabilities are many, including genetic, congenital, traumatic, or due to chronic illnesses or the aging process., (Copyright © 2010 Elsevier Inc. All rights reserved.)

The aim of this work is to compare medical research productivity between democratic countries and their relatively undemocratic neighbors to identify mechanisms to promote medical research. Country of authorship was determined manually for articles published in 14 medical journals in 2005, and compared pairwise for democracies vs. relatively undemocratic nations: Israel vs. the rest of the Middle East; Japan vs. Russia; South Korea vs. North Korea; and Taiwan or Hong Kong vs. Mainland China. Democracies were quantitatively defined according to the Freedom House Index and the Economist's Index of Democracy. The frequency of publication of Israeli authors of unsolicited articles (excludes editorials) was found to be 1.08%, while its percentage of the world population is only .11% (OR = 9.97, 95%-ORCI: 4.30-23.1, P < 0.0001). This increase was invariant for more prestigious original articles (investigations) vs. less prestigious review articles or case reports, and for more prestigious high-impact factor journals vs. less prestigious low-impact factor journals. This increase was apparently not due to political favoritism: the relative frequency (RF) of Israeli authors of unsolicited articles was significantly higher than the RF of Israeli authors of solicited articles (i.e., invited editorials) (1.08% vs. 0.13%, OR = 8.38, 95%-ORCI = 1.46-48.1, P = 0.007); and was significantly higher than the RF of Israeli editorial board members (1.08% vs. 0.08%, OR = 13.0, 95%-ORCI = 2.27-74.7, P < 0.0001). Contrariwise, the frequency of publication of authors from the Middle East excluding Israel was 0.30%, while its percentage of the world population is 4.04% (OR = 0.071, 95%-ORCI = 0.04-0.12, P < 0.0001). The OR of Israeli authorship was incredibly 140.4-fold higher than the OR of the MEEI! The OR of authors of other democratic countries was also more than 100-fold the OR of authors of their undemocratic neighbors: Japan (OR = 4.93, 95%-ORCI = 3.82-6.36, P < 0.0001) vs. Russia (OR = 0.005, 95%-ORCI = 0.00-0.06, P < 0.0001); South Korea (OR = 3.48, 95%-ORCI = 2.29-5.31, P < 0.0001) vs. North Korea (OR < 0.36, 95%-ORCI = 0.00-0.35, P < 0.0001); Taiwan (OR = 5.12, 95%-ORCI = 2.85-9.19, P < 0.0001) or Hong Kong (OR = 9.21, 95%-ORCI = 3.51-24.2, P < 0.0001) vs. Mainland China (OR = 0.028, 95%-ORCI = 0.019-0.041, P < 0.0001). The OR of national authorship was closely correlated with two indices of democracy: correlation coefficient with Freedom House Index = 0.83, and correlation coefficient with the Economist's Democracy Index = 0.76. The OR of national authorship was also (mildly less) correlated with per capita income (corr. coeff. = 0.75). In conclusion, five democracies exhibit a remarkably higher relative frequency of medical publications than their relatively undemocratic neighbors. The relative frequency of authorship was, furthermore, extremely strongly correlated with democracy and political freedom. The freedom hypothesis may help explain this phenomenon: political freedom and liberty in democracies may promote intellectual creativity and medical research. This hypothesis should be tested by a multivariate analysis of univariate risk factors of medical authorship for all nations.

This survey reviews significant state and federal court decisions from 2006 and 2007 involving health, life, and disability insurance. Also reviewed is a June 2008 Supreme Court decision in the disability insurance realm, affirming that a conflict of interest exists when an ERISA plan sponsor or insurer fulfills the dual role of determining plan benefits and paying those benefits but noting that the conflict is merely one factor in considering the legality of benefit denials. In addition, this years' survey includes compelling decisions in the life and health arena, including cases addressing statutory penalties and mandated benefits, as well as some ERISA decisions of note. This year, the Texas Supreme Court held that Texas's most recent version of the prompt payment statute abolished the common law interpleader exception and allowed the prevailing adverse claimant in an interpleader action filed beyond the sixty-day statutory period to recover statutory interest and attorney fees from the insurer. Meanwhile, the Court of Appeals of New York upheld the constitutionality of a statute mandating coverage for contraceptives in those employer-sponsored health plans that offer prescription drug coverage, including those plans sponsored by faith-based social service organizations. In the ERISA context, litigants continue to fight over the standard of review with varying results. In a unique assault on the arbitrary and capricious standard of review, the Fourth Circuit found that an ERISA plan abused its discretion when it failed to apply the doctrine of contra proferentem to construe ambiguous plan terms against itself. In more hopeful news for plan insurers, the Tenth Circuit held that claimants are not entitled to review and rebut medical opinions generated during the administrative appeal of a claim denial before a final decision is reached unless such reports contain new factual information.

In six national samples (a total of 11,863 respondents) of the Dutch population, aged 16 and over, the denial of equal rights (in housing, inheriting, and adoption) for lesbians and gay men decreased from 1980 and 1985, and remained stable between 1985 and 1993. The denial of equal rights for lesbians and gay men was subscribed to more strongly by social categories that have been exposed to traditional socializing agents and socializing circumstances in which traditional norms prevailed:members of denominations, people who frequently attend church, and older cohorts, especially the ones born before 1948, as well as by those who have presumably not dissociated themselves from these traditional norms, i.e., the lower educated.

Much of modern western law now presupposes opposition to discrimination based on race, religion, sex, national origin, and other factors. However, ancient religious Scriptures may have sanctioned certain types of discrimination. Whether those who are inclined to accept literal interpretations of their Scriptures will condone certain forms of discrimination could be evaluated to contrast the effects of modernization versus religious indoctrination on various kinds of prejudice.

Doctors have an ethical and legal duty to respect patient confidentiality. We consider the basis for this duty, looking particularly at the meaning and value of autonomy in health care. Enabling patients to decide how information about them is disclosed is an important element in autonomy and helps patients engage as active partners in their care. Good quality data is, however, essential for research, education, public health monitoring, and for many other activities essential to provision of health care. We discuss whether it is necessary to choose between individual rights and the wider public interest and conclude that this should only rarely be necessary. The paper makes some recommendations on practical steps which could help ensure that good quality information is available for work which benefits society and the public health, while still enabling patients' autonomy to be respected.

Based on reviews of hundreds of loan and project documents from the International Monetary Fund (IMF) and World Bank, this article provides detailed evidentiary support for critics who have long claimed that the international financial institutions require Third World countries to adopt policies that harm the interests of working people. After reviewing loan documents between the IMF and World Bank and 26 countries, the authors show that the institutions' loan conditionalities include a variety of provisions that undermine labor rights, labor power, and tens of millions of workers' standard of living. These include downsizing of the civil service and privatization of government-owned enterprises; promotion of labor flexibility: the notion that firms should be able to hire and fire workers, or change terms and conditions of work, with minimal regulatory restrictions; mandated wage rate reductions, minimum-wage reductions or containment, and spreading the wage gap between government employees and managers; and pension reforms, including privatization, that cut social security benefits. These labor-related policies take place in the context of broader IMF and World Bank structural adjustment packages that emphasize trade liberalization, with macroeconomic policies that further advance corporate interests at the expense of labor.

Purpose: It has been widely argued that community based programmes offer considerable advantages to the classical institutional forms of health and rehabilitation services delivery. With about 10 years of experience in operating community based rehabilitation projects (CBR) for the disabled, the Palestinian experience points to potentially serious problems relating to the conception and operationalization of such programmes in real life situations., Issues: Of importance is the issue of the impact of communal care on the already burdened lives of women, especially when such care is expected to be voluntary in nature. Caretaking in the Palestinian context, especially of the disabled, elderly and the sick, is a pre-defined sex linked role dictated by a patriarchal society and system of policy making that excludes women from economic and social life. The voluntary care aspect entailed in the CBR conception and practice, can and does contribute further to the exclusion of women not only from the labour force, but from most other aspects of life as well. This represents an apparent contradiction between the needs of two excluded groups, the disabled and women. The other problematic entailed in the communal model of caring for the disabled is the strategic and operational bias focusing on community, to the exclusion of the notion of social rights of all citizens, and the role and duty of state structures in the fulfilment of the disabled basic needs. Such an approach can only relegate the disabled rights back to their original place as charity. On the other hand, when CBR projects are operated holistically, in the context of social movements existing within power relation and with a broader democratic agenda engaging different groups-including a disability movement-as is currently taking place in Palestine, CBR projects can also turn into a mobilizing force for the social rights of all excluded groups., Conclusion: Thus the question is not merely one of governmental involvement as opposed to the involvement of non-governmental organizations and charitable societies in community based projects. Rather, it is a question of the right to a decent life for all, in dignity and security, that citizenship and statehood promise, but have yet to deliver in many developing countries, especially in Palestine.

Large racial inequities in health care use continue to be reported, raising concerns about discrimination. Historically, the health system, with its professionally dominated, autonomous, voluntary organizational structure, has presented special challenges to civil rights efforts. De jure racial segregation in the United States gave way to a period of aggressive litigation and enforcement from 1954 until 1968 and then to the current period of relative inactivity. A combination of factors--declining federal resources and organizational capacity to address more subtle forms of discriminatory practices in health care settings, increasingly restrictive interpretations by the courts, and the lack of any systematic mechanisms for the statistical monitoring of providers--offers little assurance that discrimination does not continue to play a role in accounting for discrepancies in use. The current rapid transformation of health care into integrated delivery systems driven by risk-based financing presents both new opportunities and new threats. Adequate regulation, markets, and management for such systems impose new requirements for comparative systematic statistical assessment of performance. My conclusion illustrates ways that current "report card" approaches to monitoring performance of such systems could be used to monitor, correct, and build trust in equitable treatment.

HSL talks to leaders of four healthcare organizations in various states of developing programs for ensuring a workforce representative of the communities they serve. Programs range from internships for future leaders to creating diversity ambassadors among the workforce.

There has been a great deal of speculation that deinstitutionalization has resulted in the criminalization of the mentally ill. Using two samples of defendants found incompetent to stand trial (IST) and two samples of civil patients randomly selected from five states, pre and post deinstitutionalization, this research compares changes in their mental health and arrest histories. After deinstitutionalization, fewer and less dramatic differences in the arrest and mental health histories were evident between ISTs and civil patients. Both patient samples displayed significant increases in prior hospitalization and arrest histories. Among the civil patients there was a significant increase in the frequency and seriousness of criminal activity. There was no evidence that IST commitments are being expanded to hospitalize the nondangerous mentally ill no longer subject to civil commitment.