Promoting Public Health through Clinical Legal Education: Initiatives in South Africa, Thailand, and Ukraine

The law can be a powerful tool in protecting public health. Studies reveal both the impact of human rights violations on health and the importance of interdisciplinary partnerships for the law to achieve its full potential and lead to justice. As one scholar describes, “Human rights are increasingly recognized as important to providing social conditions in which people can be healthy.” Additionally, as one law clinic instructor explains, “A multidisciplinary model can respond to the myriad needs of those who are poor or marginalized by their social, medical, or psychological circumstances.” Clinical legal education has a critical role to play in training advocates capable of working at the intersection of law and health

The Guillain-Barre syndrome and the 1992-1993 and 1993-1994 influenza vaccines

BackgroundThe number of reports of influenza-vaccine-associated Guillain-Barré syndrome to the national Vaccine Adverse Event Reporting System increased from 37 in 1992-1993 to 74 in 1993-1994, arousing concern about a possible increase in vaccine-associated risk. MethodsPatients given a diagnosis of the Guillain-Barré syndrome in the 1992-1993 and 1993-1994 influenza-vaccination seasons were identified in the hospital-discharge data bases of four states. Vaccination histories were obtained by telephone interviews during 1995-1996 and were confirmed by the vaccine providers. Disease with an onset within six weeks after vaccination was defined as vaccine-associated. Vaccine coverage in the population was measured through a random-digit-dialing telephone survey. ResultsWe interviewed 180 of 273 adults with the Guillain-Barré syndrome; 15 declined to participate, and the remaining 78 could not be contacted. The vaccine providers confirmed influenza vaccination in the six weeks before the onset of Guillain-Barré syndrome for 19 patients. The relative risk of the Guillain-Barré syndrome associated with vaccination, adjusted for age, sex, and vaccine season, was 1.7 (95 percent confidence interval, 1.0 to 2.8; P=0.04). The adjusted relative risks were 2.0 for the 1992-1993 season (95 percent confidence interval, 1.0 to 4.3) and 1.5 for the 1993-1994 season (95 percent confidence interval, 0.8 to 2.9). In 9 of the 19 vaccine-associated cases, the onset was in the second week after vaccination, all between day 9 and day 12. ConclusionsThere was no increase in the risk of vaccine-associated Guillain-Barré syndrome from 1992-1993 to 1993-1994. For the two seasons combined, the adjusted relative risk of 1.7 suggests slightly more than one additional case of Guillain-Barré syndrome per million persons vaccinated against influenza

Computer Kiosks to Deliver Medication Information in the Pharmacy

The feasibility of using a computer kiosk to deliver medication information to patients was tested in a community pharmacy environment. Viewers used a computer kiosk to access the National Library of Medicine (NLM) MedlinePlus® website. In four weeks, 198 pharmacy patients viewed the website and completed brief questionnaires about their experiences. The majority of patients (63%) were female and between 46 and 65 years of age (48%). Few (8%) had used the NLM website before. Patient age was associated with access to the Internet, previous use of the NLM website, and other habits regarding medication information sources; however, the differences were not as great as anticipated. © 2011 Copyright Taylor and Francis Group, LLC