Endorsed by the American Association of Critical-Care Nurses and the Society of Critical Care Medicine Public health emergencies have the potential to place enormous strain on health systems. The current pandemic of the novel 2019 coronavirus disease has required hospitals in numerous countries to expand their surge capacity to meet the needs of patients with critical illness. When even surge capacity is exceeded, however, principles of critical care triage may be needed as a means to allocate scarce resources, such as mechanical ventilators or key medications. The goal of a triage system is to direct limited resources towards patients most likely to benefit from them. Implementing a triage system requires careful coordination between clinicians, health systems, local and regional governments, and the public, with a goal of transparency to maintain trust. We discuss the principles of tertiary triage and methods for implementing such a system, emphasizing that these systems should serve only as a last resort. Even under triage, we must uphold our obligation to care for all patients as best possible under difficult circumstances.

President Trump announced his intention to declare a national emergency following the recommendation of the President's Commission on Combating Drug Addiction and the Opioid Crisis. 1 Opioid abuse is among the most consequential preventable public health threats facing the nation. More than 600 000 deaths have occurred to date, with 180 000 more predicted by 2020. 2 Of the 20.5 million US residents 12 years or older with substance use disorders in 2015, 2 million were addicted to prescription pain relievers. 3 A declaration of a national emergency authorizes public health powers, mobilizes resources, and facilitates innovative strategies to curb a rapidly escalating public health crisis.

Personally identifiable health information about individuals and general medical information is increasingly available in electronic form in health databases and through online networks. The proliferation of electronic data within the modern health information infrastructure presents significant benefits for medical providers and patients, including enhanced patient autonomy, improved clinical treatment, advances in health research and public health surveillance, and modern security techniques. However, it also presents new legal challenges in 3 interconnected areas: privacy of identifiable health information, reliability and quality of health data, and tortbased liability. Protecting health information privacy (by giving individuals control over health data without severely restricting warranted communal uses) directly improves the quality and reliability of health data (by encouraging individual uses of health services and communal uses of data), which diminishes tort-based liabilities (by reducing instances of medical malpractice or privacy invasions through improvements in the delivery of health care services resulting in part from better quality and reliability of clinical and research data). Following an analysis of the interconnectivity of these 3 areas and discussing existing and proposed health information privacy laws, recommendations for legal reform concerning health information privacy are presented. These include (1) recognizing identifiable health information as highly sensitive, (2) providing privacy safeguards based on fair information practices, (3) empowering patients with information and rights to consent to disclosure (4) limiting disclosures of health data absent consent, (5) incorporating industry-wide security protections, (6) establishing a national data protection authority, and (7) providing a national minimal level of privacy protections.

Labour market research in South Africa has typically focused on issues around either the supply of labour or the general level of demand for labour. An area that has received little attention is the structure of labour demand in the firm and its changing pattern over time. The process of economic growth and development never treats all occupational groups equally and the proportions with which different occupational groups are used to produce total output will change dramatically over time. These shifts in the structure of labour demand may occur as a result of two factors -changes in production methods used within each sector of the economy, and changes in the structure of the economy itself. The aim of this paper is to begin to fill the research gap by measuring -through a simple decomposition technique -the extent to which these two factors help explain shifts in the structure of labour demand for the South African economy from 1970 to 1995*(2). SAJE v67(3) p349The paper begins with a brief discussion of how production method and structural changes influence the structure of labour demand, followed by an outline of the main trends in South African production methods and structural change since 1970. The labour demand shifts and their decomposition to reflect the influence of these two variables are then measured. Finally, this analysis is extended to estimate the demand shifts by race and gender before some conclusions are drawn. 157