International Initiatives To Eliminate Corruption: Has Bribery Declined?

Bribery discriminates against honest companies by creating a barrier to entry in the form of a competitive disadvantage.  An important legal issue with significant implications is whether recent international anti-corruption laws have leveled the playing field for firms doing business abroad.  One of the first laws proscribing illicit payments to foreign public officials is the Foreign Corrupt Practices Act (FCPA), initially enacted by the U.S. Congress in 1977.  From its inception, the FCPA has been criticized for placing U.S. firms at a competitive disadvantage based on the fact that few countries outlawed bribery of foreign officials.  In the past ten years, several international treaties have been ratified that seek to criminalize bribery and eliminate the tax deductibility of corrupt payments made to foreign public officials.  This paper discusses anti-corruption laws and their effectiveness in creating a transparent business environment that discourages bribery.     

Monitoring E-Mail In The Workplace: Privacy Rights And Employer Responsibilities

Two important legal issues with significant implications for both employers and employees are whether employers have a right to access their employees’ e-mail correspondence and whether employers should monitor their e-mail systems.  Many people assume that e-mail messages sent and received at work are afforded the same legal protection from invasion of privacy afforded traditional letters.  This assumption could not be further from the truth. Privacy law, case law, and Title VII responsibilities are discussed.  Suggestions are made for procedures employers should follow to ensure the proper use of e-mail in the workplace

Student Use Of Technology In Class: Engaged Or Unplugged?

In recent years, there has been a great deal of discussion about the need for student engagement and a meaningful connection in the classroom. With the advent of cell phones, computers and the Internet, students are more connected to, and, at the same time, more disconnected from each other than ever before. We are living in the age of exponential change and technological convergence where forms of technology speak to each other. The omnipresent cell phone is a mini-computer and according to futurist Ray Kurzweil, “What now fits in your pocket 25 years from now will fit into a blood cell and will again be millions of times more cost effective.” (Greene, 2010) A survey of 211 undergraduates was conducted in an effort to determine whether student use of technology in the classroom enhances engagement or encourages disconnection. The results are discussed and suggestions are proposed

BLOGS: ANTI-FORENSICS and COUNTER ANTI-FORENSICS

Blogging gives an ordinary person the ability to have a conversation with a wide audience and has become one of the fastest growing uses of the Web. However, dozens of employee-bloggers have been terminated for exercising what they consider to be their First Amendment right to free speech and would-be consumer advocates face potential liability for voicing their opinions. To avoid identification and prevent retribution, bloggers have sought to maintain anonymity by taking advantage of various tools and procedures - anti-forensics. Unfortunately some anonymous bloggers also post content that is in violation of one or more laws. Some blogging content might be viewed as harassing others - an area known as cyber-bullying. Law enforcement and network forensics specialists are developing procedures called Counter Anti-forensics that show some promise to identify those who violate the law. However, these techniques must be used with caution so as not to violate the rights of others

Employee Blogs: Protected Speech Or Grounds For Discharge?

Posting and reading blogs is one of the fastest growing uses of the Web.  Blogging gives an ordinary person the ability to have a conversation with a wide audience.  Dozens of employee-bloggers have been “dooced” (terminated) for exercising what they consider to be their First Amendment right to free speech.  An important legal issue with significant implications for both employers and employees is to what extent are employee blogs a form of protected speech.  The First Amendment, employment at will, and laws protecting employee speech are discussed.  Suggestions are made for procedures employees should follow to safely blog.       &nbsp

Online Music Piracy: Are Lawsuits The Best Approach?

In the age of digital technology, perfect copies of sound recordings may be easily made and shared in violation of copyright law.  Music piracy in the form of illegal downloading is a worldwide phenomenon that has a significant impact on the music industry.   In response to the perceived threat to the music industry, lawsuits have been filed in the United States and abroad based on copyright infringement for illegally downloading music. This paper examines copyright law, case law, and recent litigation.  In the wake of legal efforts to curtail illegal downloading, a survey of 112 undergraduate students was conducted in an effort to determine whether the lawsuits filed by the music industry are a deterrent to downloading music.  Potential solutions are proposed and economic consequences discussed

INFOSEC: What Is The Legal Standard Of Care?

The convenience of conducting personal business in the comfort of one’s home attracts millions of individuals to shop, pay bills, and bank online. In the process, sensitive personal and financial information is disclosed and the exchange of this information creates a risk of identity theft. Providing effective cyber security is an issue with significant implications for companies.  Failure to provide adequate security for consumer information may subject a company to legal action by the Federal Trade Commission (FTC).  Information vulnerability, recent security failures and the standard of care are discussed

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe