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Settimo G, Avino P. State-of-art of the legislation on odour emissions with a focus on the Italian studies. Environ Pollut 2024; 348:123525. [PMID: 38336139 DOI: 10.1016/j.envpol.2024.123525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
This review would like to point out the state-of-art of the European legislation for the odour pollution determination and management. Odour is generated by a mixture of more or less volatile and persistent compounds that surround us in daily life. European directives impose the use of corresponding technical standards for the application of the limits imposed. The different approaches (chemicals and/or olfactometries) and integrated evaluation methods for measuring and characterizing odour, even if in a very different way in the European territories, will be reviewed and commented. Specifically, the authors will describe and comment the main procedures for odour concentration determination (e.g., multigas sensors, electronic sensors for odour monitoring). It is important to note that the definition of odour does not take into account if an odour is "good" or "bad", but only if it exists. The limit value must guarantee a total equivalent level of environmental protection and does not involve a greater polluting load in the environment. Further, a deep revision of the Italian situation in terms of legislation and studies, will complete the paper.
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Affiliation(s)
- Gaetano Settimo
- Department of Environment and Health, Italian National Institute of Health, Viale Regina Elena 299, IT-00161, Rome, Italy.
| | - Pasquale Avino
- Department of Agricultural, Environmental and Food Sciences (DiAAA), University of Molise, Via De Sanctis 1, Campobasso, IT-86100, Italy; Institute of Atmospheric Pollution Research (IIA), National Research Council (CNR), Rome Research Area-Montelibretti, IT-00015, Monterotondo Scalo, Italy.
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Horteur C, Della Rosa T, Gaulin B, Morin V, Duval BR, Barth J, Pailhe R. The relevance of knee arthroscopy photographs in medicolegal proceedings. Int Orthop 2024; 48:1133-1138. [PMID: 38430224 DOI: 10.1007/s00264-024-06129-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE Whether photographs included in the operative report of knee arthroscopies can make the surgeon liable in the event of a legal investigation remains unknown. The main objective of this study was to establish inter-observer reliability in determining the presence or absence of lesions of the cartilage, meniscus and anterior cruciate ligament (ACL). Secondary objective was to assess the inter-observer reliability in classifying lesions. METHOD A retrospective observational study was conducted in a continuous serie of 60 patients who underwent knee arthroscopy from the same operator. The photographs of each patient's operative report were presented separately to three experts, blinded to each other. Each expert had to decide on the presence or absence of injuries to the following structures: meniscal, cartilage and ACL and then, classify it. Primary and secondary endpoints were evaluated using the Fleiss' kappa index. RESULTS Inter-observer reliability for lesion detection was between 0.4 and 0.61 for all structures with three exceptions: for cartilage, it was low (0.15) at the lateral tibial plateau and poor (-0.01) at the external condyle. On the contrary, the concordance was almost perfect (0.8) for the ACL. For classifying cartilaginous and meniscal lesions, inter-observer reliability was poor (from 0.03 to 0.14), except for at the lateral meniscus (0.65). CONCLUSION Inter-observer reliability of arthroscopic knee diagnoses is poor when photographs alone are used. In the event of a legal investigation following knee arthroscopy, the photographs included in the operative report should not be used alone to hold the surgeon liable.
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Affiliation(s)
- Clément Horteur
- Service de Chirurgie de L'Arthrose Et du Sport, Urgences Traumatiques Des Membres, Hôpital Sud - CHU de Grenoble, 38000, Biarritz, France.
| | - Thibault Della Rosa
- Service de Chirurgie de L'Arthrose Et du Sport, Urgences Traumatiques Des Membres, Hôpital Sud - CHU de Grenoble, 38000, Biarritz, France
| | - Benoit Gaulin
- Service de Chirurgie de L'Arthrose Et du Sport, Urgences Traumatiques Des Membres, Hôpital Sud - CHU de Grenoble, 38000, Biarritz, France
| | - Vincent Morin
- Clinique Aguiléra, 21 Rue de L'Estagnas, Service de Chirurgie Orthopédique, 64200, Biarritz, France
| | - Brice Rubens Duval
- Service de Chirurgie de L'Arthrose Et du Sport, Urgences Traumatiques Des Membres, Hôpital Sud - CHU de Grenoble, 38000, Biarritz, France
| | - Johannes Barth
- Service de Chirurgie de L'Arthrose Et du Sport, Urgences Traumatiques Des Membres, Hôpital Sud - CHU de Grenoble, 38000, Biarritz, France
| | - Régis Pailhe
- Hôpital Privé Médipole de Savoie, Challes-Les-Eaux, France
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Chavarría-Fernández SM, Jiménez-Alvarado R, Santos-López EM, Hernández-Hernandez AA, Cariño-Cortés R. Iron nanoparticles as food additives and food supplements, regulatory and legislative perspectives. Food Sci Biotechnol 2024; 33:1295-1305. [PMID: 38585565 PMCID: PMC10992046 DOI: 10.1007/s10068-024-01518-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 04/09/2024] Open
Abstract
Recently, the use of nanotechnology in food has gained great interest. Iron nanoparticles with unique chemical, physical and structural properties allow their potential use mainly as iron fortifiers, colorants and antimicrobial agents. However, in the market we can find only supplements and food colorants based on iron nanoparticles. Their use in food fortification has so far been focused only on in vitro and in vivo experimental studies, since the toxicological evaluation of these studies has so far been the basis for the proposals of laws and regulations, which are still in an early stage of development. Therefore, the aim of this work was to summarize the use of the different forms of iron nanoparticles (oxides, oxyhydroxides, phosphates, pyrophosphates and sulfates) as food additives and supplements and to resume the perspectives of legislation regarding the use of these types of nanoparticles in the food industry.
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Affiliation(s)
- Sara Madai Chavarría-Fernández
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Circuito Ex Hacienda la Concepción s/n, 42160 San Agustin Tlaxiaca, Hidalgo México
| | - Rubén Jiménez-Alvarado
- Instituto de Ciencias Agropecuarias, Universidad Autónoma del Estado de Hidalgo, Av Universidad km. 1. Ex Hacienda de Aquetzalpa AP 32, 43600 Tulancingo de Bravo, Hidalgo México
| | - Eva María Santos-López
- Instituto de Ciencias Básicas e Ingeniería, Universidad Autónoma del Estado de Hidalgo, Carretera Pachuca-Tulancingo km 4.5 Colonia Carboneras, 42184 Mineral de la Reforma, Hidalgo México
| | - Aldahir Alberto Hernández-Hernandez
- Instituto de Ciencias Agropecuarias, Universidad Autónoma del Estado de Hidalgo, Av Universidad km. 1. Ex Hacienda de Aquetzalpa AP 32, 43600 Tulancingo de Bravo, Hidalgo México
| | - Raquel Cariño-Cortés
- Instituto de Ciencias de la Salud, Universidad Autónoma del Estado de Hidalgo, Circuito Ex Hacienda la Concepción s/n, 42160 San Agustin Tlaxiaca, Hidalgo México
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Clark NL, Coe D, Newell N, Jones MNA, Robb M, Reaich D, Wroe C. "I am in favour of organ donation, but I feel you should opt-in"-qualitative analysis of the #options 2020 survey free-text responses from NHS staff toward opt-out organ donation legislation in England. BMC Med Ethics 2024; 25:47. [PMID: 38643137 PMCID: PMC11031982 DOI: 10.1186/s12910-024-01048-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding awareness and support of the change. This paper analyses the free-text responses from the survey. METHODS The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. RESULTS The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. CONCLUSIONS The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. TRIAL REGISTRATION National Institute of Health Research (NIHR) [IRAS 275992].
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Affiliation(s)
- Natalie L Clark
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, North Yorkshire, England, UK
| | - Dorothy Coe
- Newcastle-Upon-Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Tyne and Wear, England, UK
| | - Natasha Newell
- Centre for Process Innovation, Sedgefield, County Durham, England, UK
| | | | | | - David Reaich
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, North Yorkshire, England, UK
| | - Caroline Wroe
- Newcastle-Upon-Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, Tyne and Wear, England, UK.
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Rodríguez Valiente A, Vázquez Sasot A. Disability Degree Assessment: A Comprehensive Approach According to Royal Decree 888/2022. Med Clin (Barc) 2024:S0025-7753(24)00156-8. [PMID: 38632033 DOI: 10.1016/j.medcli.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/08/2023] [Accepted: 02/08/2024] [Indexed: 04/19/2024]
Abstract
BACKGORUND AND OBJECTIVE Royal Decree 888/2022 establishes that the evaluation of disability situations is carried out by multiprofessional teams responsible for assessing and recognizing the degree of disability. The participation of professionals in the healthcare and social fields can be valuable in providing reports from which the necessary data for the proper assessment of disability can be obtained, with the ultimate goal of providing comprehensive assistance to people with disabilities. MATERIALS AND METHODS An analysis and summary of Royal Decree 888/2022, which has recently come into effect, is performed, focusing on the most relevant aspects for professionals in the healthcare and social fields. RESULTS The recognition and classification of the degree of disability are the responsibility of the autonomous communities, and the assessments are issued by multiprofessional teams. To do this, four components are evaluated using the criteria outlined in the annexes of the Royal Decree itself. Each criterion generates a score that is combined to obtain a single score, the Final Disability Degree of the Person. CONCLUSIONS The pathology that causes the disability must have been previously diagnosed by the Healthcare System and considered permanent. Its evaluation is based on the evidence of objective clinical findings that are documented and supported by clinical reports. For this reason, it is important to maintain an accurate medical history, document reviews, and provide all relevant evidence.
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Ahmad MF, Ahmad FA, Alsayegh AA, Zeyaullah M, AlShahrani AM, Muzammil K, Saati AA, Wahab S, Elbendary EY, Kambal N, Abdelrahman MH, Hussain S. Pesticides impacts on human health and the environment with their mechanisms of action and possible countermeasures. Heliyon 2024; 10:e29128. [PMID: 38623208 PMCID: PMC11016626 DOI: 10.1016/j.heliyon.2024.e29128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024] Open
Abstract
Pesticides are chemical constituents used to prevent or control pests, including insects, rodents, fungi, weeds, and other unwanted organisms. Despite their advantages in crop production and disease management, the use of pesticides poses significant hazards to the environment and public health. Pesticide elements have now perpetually entered our atmosphere and subsequently contaminated water, food, and soil, leading to health threats ranging from acute to chronic toxicities. Pesticides can cause acute toxicity if a high dose is inhaled, ingested, or comes into contact with the skin or eyes, while prolonged or recurrent exposure to pesticides leads to chronic toxicity. Pesticides produce different types of toxicity, for instance, neurotoxicity, mutagenicity, carcinogenicity, teratogenicity, and endocrine disruption. The toxicity of a pesticide formulation may depend on the specific active ingredient and the presence of synergistic or inert compounds that can enhance or modify its toxicity. Safety concerns are the need of the hour to control contemporary pesticide-induced health hazards. The effectiveness and implementation of the current legislature in providing ample protection for human health and the environment are key concerns. This review explored a comprehensive summary of pesticides regarding their updated impacts on human health and advanced safety concerns with legislation. Implementing regulations, proper training, and education can help mitigate the negative impacts of pesticide use and promote safer and more sustainable agricultural practices.
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Affiliation(s)
- Md Faruque Ahmad
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Fakhruddin Ali Ahmad
- Department of Basic and Applied Science, School of Engineering and Science, G.D Goenka University, Gururgram, Haryana, 122103, India
| | - Abdulrahman A. Alsayegh
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Md. Zeyaullah
- Department of Basic Medical Science, College of Applied Medical Sciences, Khamis Mushayt Campus, King Khalid University (KKU), Abha, Saudi Arabia
| | - Abdullah M. AlShahrani
- Department of Basic Medical Science, College of Applied Medical Sciences, Khamis Mushayt Campus, King Khalid University (KKU), Abha, Saudi Arabia
| | - Khursheed Muzammil
- Department of Public Health, College of Applied Medical Sciences, Khamis Mushayt Campus, King Khalid University (KKU), Abha, Saudi Arabia
| | - Abdullah Ali Saati
- Department of Community Medicine & Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Saudi Arabia
| | - Shadma Wahab
- Department of Pharmacognosy, College of Pharmacy, King Khalid University, Abha, 62529, Saudi Arabia
| | - Ehab Y. Elbendary
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Nahla Kambal
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Mohamed H. Abdelrahman
- College of Applied Medical Sciences, Medical Laboratory Sciences, Jazan University, Jazan, 45142, Saudi Arabia
| | - Sohail Hussain
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, 45142, Saudi Arabia
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Raycheva R, Kostadinov K, Mitova E, Iskrov G, Stefanov G, Vakevainen M, Elomaa K, Man YS, Gross E, Zschüntzsch J, Röttger R, Stefanov R. Landscape analysis of available European data sources amenable for machine learning and recommendations on usability for rare diseases screening. Orphanet J Rare Dis 2024; 19:147. [PMID: 38582900 PMCID: PMC10998425 DOI: 10.1186/s13023-024-03162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/30/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Patient registries and databases are essential tools for advancing clinical research in the area of rare diseases, as well as for enhancing patient care and healthcare planning. The primary aim of this study is a landscape analysis of available European data sources amenable to machine learning (ML) and their usability for Rare Diseases screening, in terms of findable, accessible, interoperable, reusable(FAIR), legal, and business considerations. Second, recommendations will be proposed to provide a better understanding of the health data ecosystem. METHODS In the period of March 2022 to December 2022, a cross-sectional study using a semi-structured questionnaire was conducted among potential respondents, identified as main contact person of a health-related databases. The design of the self-completed questionnaire survey instrument was based on information drawn from relevant scientific publications, quantitative and qualitative research, and scoping review on challenges in mapping European rare disease (RD) databases. To determine database characteristics associated with the adherence to the FAIR principles, legal and business aspects of database management Bayesian models were fitted. RESULTS In total, 330 unique replies were processed and analyzed, reflecting the same number of distinct databases (no duplicates included). In terms of geographical scope, we observed 24.2% (n = 80) national, 10.0% (n = 33) regional, 8.8% (n = 29) European, and 5.5% (n = 18) international registries coordinated in Europe. Over 80.0% (n = 269) of the databases were still active, with approximately 60.0% (n = 191) established after the year 2000 and 71.0% last collected new data in 2022. Regarding their geographical scope, European registries were associated with the highest overall FAIR adherence, while registries with regional and "other" geographical scope were ranked at the bottom of the list with the lowest proportion. Responders' willingness to share data as a contribution to the goals of the Screen4Care project was evaluated at the end of the survey. This question was completed by 108 respondents; however, only 18 of them (16.7%) expressed a direct willingness to contribute to the project by sharing their databases. Among them, an equal split between pro-bono and paid services was observed. CONCLUSIONS The most important results of our study demonstrate not enough sufficient FAIR principles adherence and low willingness of the EU health databases to share patient information, combined with some legislation incapacities, resulting in barriers to the secondary use of data.
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Affiliation(s)
- Ralitsa Raycheva
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria.
- Bulgarian Association for Promotion of Education and Science, Institute for Rare Disease, Plovdiv, Bulgaria.
| | - Kostadin Kostadinov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
- Bulgarian Association for Promotion of Education and Science, Institute for Rare Disease, Plovdiv, Bulgaria
| | - Elena Mitova
- Bulgarian Association for Promotion of Education and Science, Institute for Rare Disease, Plovdiv, Bulgaria
| | - Georgi Iskrov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
- Bulgarian Association for Promotion of Education and Science, Institute for Rare Disease, Plovdiv, Bulgaria
| | - Georgi Stefanov
- Bulgarian Association for Promotion of Education and Science, Institute for Rare Disease, Plovdiv, Bulgaria
| | - Merja Vakevainen
- Pfizer Biopharmaceuticals Group, Medical Affairs, Helsinki, Finland
| | | | - Yuen-Sum Man
- Global Medical Affairs Rare Disease, Novo Nordisk Health Care AG, Zurich, Switzerland
| | - Edith Gross
- EURORDIS - Rare Diseases Europe, 96 Rue Didot, Paris, 75014, France
| | - Jana Zschüntzsch
- Department of Neurology, University Medical Center, Göttingen, Germany
| | - Richard Röttger
- Department of Mathematics and Computer Science, University of Southern Denmark, Odense, Denmark
| | - Rumen Stefanov
- Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
- Bulgarian Association for Promotion of Education and Science, Institute for Rare Disease, Plovdiv, Bulgaria
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Ponce-Hernández DJ, Martínez-Regalado JA, Reynales-Shigematsu LM, Calderón-Villarreal A, Regidor E, Herrero L, Sordo L. Correlation between tobacco control policies and tobacco prevention in Mexico: a sub-national analysis. J Public Health Policy 2024:10.1057/s41271-024-00473-6. [PMID: 38575787 DOI: 10.1057/s41271-024-00473-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 04/06/2024]
Abstract
This study aims to determinate the correlation between tobacco control policies (TCP) and the prevalence of tobacco use in the 32 Mexican states during the 2016-2017 period. This is an ecological study that measured TCP by the Tobacco Control Scale (TCS) which assigns a score (0-100) based on the level of these component's implementation: price, prohibition in public spaces, expenditures of public information campaigns, publicity prohibitions, health warnings, and treatments. We analyzed the associations between the TCS scores and prevalence of tobacco use extracted from the National Survey of Drug, Alcohol and Tobacco Consumption using Spearman correlations. Prevalence of daily smokers is negatively correlated with global TCS scores for adolescents (p = 0.026). Price showed similar negative correlations with daily prevalence in adolescents (p = 0.003), adults (p = 0.040), men (p < 0.006), and women (p = 0.040). Many Mexican states need to improve on tobacco control policies, especially targeting a key population: adolescents.
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Affiliation(s)
- Delta Jeazul Ponce-Hernández
- Department of Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, P/ Ramón y Cajal s/n, 28040, Madrid, Spain
| | | | - Luz Myriam Reynales-Shigematsu
- Department of Tobacco Prevention and Control, Population Research Center, Instituto Nacional de Salud Publica de Mexico, Mexico City, Mexico
| | - Alhelí Calderón-Villarreal
- University of California, San Diego (UCSD), La Jolla, USA
- San Diego State University (SDSU), San Diego, USA
| | - Enrique Regidor
- Department of Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, P/ Ramón y Cajal s/n, 28040, Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Health Research Institute, Hospital Clínico de San Carlos (IdISSC), Madrid, Spain
| | | | - Luis Sordo
- Department of Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, P/ Ramón y Cajal s/n, 28040, Madrid, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- Health Research Institute, Hospital Clínico de San Carlos (IdISSC), Madrid, Spain.
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Echávarri de Miguel M, Riva de la Hoz B, Cuervas-Mons Vendrell M, Leal Pino B, Fernandez Romero L. Implementation of a traceability system and safe manufacturing medications in a clean room. Farm Hosp 2024:S1130-6343(24)00040-0. [PMID: 38575411 DOI: 10.1016/j.farma.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 03/04/2024] [Accepted: 03/08/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE To describe the process of implementing a traceability and safe drug manufacturing system in the clean room of a Pharmacy Service to increase patient safety, in accordance with current legislation. METHODS The process was carried out between September 2021 and July 2022. The software program integrated all the recommended stages of the manufacturing process outlined in the "Good Practices Guide for Medication Preparation in Pharmacy Services" (GBPP). The following sections were parameterized in the software program: personnel, facilities, equipment, starting materials, packaging materials, standardized work procedures, and quality controls. RESULTS A total of 50 users, 4 elaboration areas and 113 equipments were included. 435 components were parameterized (195 raw materials and 240 pharmaceutical specialties), 54 packaging materials, 376 standardized work procedures (123 of them corresponding to sterile medicines and 253 to non-sterile medicines, of which 52 non-sterile were dangerous), in addition 17 were high risk, 327 medium risk, 32 low risk, and 13 quality controls. CONCLUSIONS The computerization of the production process has allowed the implementation of a traceability and secure drug manufacturing system in a controlled environment in accordance with current legislation.
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Affiliation(s)
| | - Belén Riva de la Hoz
- Servicio de Farmacia, Hospital Infantil Universitario Niño Jesús, Madrid, España
| | | | - Beatriz Leal Pino
- Servicio de Farmacia, Hospital Infantil Universitario Niño Jesús, Madrid, España
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10
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Kelly BD. New technology, psychiatry, and the law: Panic, prudence, possibility. Int J Law Psychiatry 2024; 94:101984. [PMID: 38522125 DOI: 10.1016/j.ijlp.2024.101984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/01/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Abstract
Throughout human history, all new technology has been met with surprise, anxiety, panic, and - eventually - prudent adoption of certain aspects of specific technological advances. This pattern is evident in the histories of most technologies, ranging from steam power in the nineteenth century, to television in the twentieth century, and - now - 'artificial intelligence' (AI) in the twenty-first century. Each generation believes that the technological advances of its era are quantitatively and qualitatively different to those of previous generations, but the underlying phenomenon is the same: the shock of the new, followed by more gradual adjustment to (and of) new technology. These concerns are apparent today in relation to AI, which reflects interesting but incremental advances on existing technologies, rather than stand-alone developments. The usual concerns with all technologies (e.g., that they will replace certain aspects of human function) are, perhaps, more concerning in fields such as mental capacity law, which often applies to people with impaired decision-making capacity who might be especially vulnerable to technologies which appear capable of encroaching disproportionately on decision-making or other areas of core human function. This paper approaches this topic from an historical standpoint, noting both previous technological panics in the past and the possibilities offered by AI today, provided it is approached in a proportionate, prudent, and person-centered way, underpinned by appropriate ethical guidance and active ethical awareness in clinical and legal practice.
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Affiliation(s)
- Brendan D Kelly
- Department of Psychiatry, Trinity College Dublin, Trinity Centre for Health Sciences, Tallaght University Hospital, Tallaght, Dublin 24 D24 NR0A, Ireland.
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Brown J, Albanese B, Ho C, Elkington J, Koppel S, Charlton JL, Olivier J, Keay L, Bilston LE. Updated population-level estimates of child restraint practices among children aged 0-12 years in Australia, 10 years after introduction of age-appropriate restraint use legislation. Inj Prev 2024; 30:100-107. [PMID: 38050054 DOI: 10.1136/ip-2023-044994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/13/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVE Optimal child passenger protection requires use of a restraint designed for the age/size of the child (appropriate use) that is used in the way the manufacturer intended (correct use).This study aimed to determine child restraint practices approximately 10 years after introduction of legislation requiring correct use of age-appropriate restraints for all children aged up to 7 years. METHODS A stratified cluster sample was constructed to collect observational data from children aged 0-12 years across the Greater Sydney region of New South Wales (NSW). Methods replicated those used in a similar 2008 study. Population weighted estimates for restraint practices were generated, and logistic regression used to examine associations between restraint type, and child age with correct use accounting for the complex sample. RESULTS Almost all children were appropriately restrained (99.3%, 95% CI 98.4% to 100%). However, less than half were correctly restrained (no error=27.3%, 95% CI 10.8% to 43.8%, no serious error=43.8%, 95% CI 35.0% to 52.7%). For any error, the odds of error decreased by 39% per year of age (OR 0.61, 95% CI 0.46 to 0.81) and for serious error by 25% per year (OR 0.75, 95% CI 0.60 to 0.93). CONCLUSION The findings demonstrate high levels of appropriate restraint use among children across metropolitan Sydney approximately 10 years after introduction of legislation requiring age-appropriate restraint use until age 7, however, errors in the way restraints remain common. IMPLICATIONS FOR PUBLIC HEALTH Given the negative impact incorrect use has on crash protection, continuing high rates of incorrect use may reduce effectiveness of legislative change on injury reduction.
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Affiliation(s)
- Julie Brown
- The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bianca Albanese
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Catherine Ho
- The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia
| | - Jane Elkington
- The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia
| | - Sjaan Koppel
- Monash University Accident Research Centre, Clayton, Victoria, Australia
| | - Judith L Charlton
- Monash University Accident Research Centre, Clayton, Victoria, Australia
| | - Jake Olivier
- School of Mathematics and Statistics, UNSW, Sydney, New South Wales, Australia
| | - Lisa Keay
- The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Lynne E Bilston
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
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12
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Petrovic N. Reassessing the VaxTax. J Med Ethics 2024; 50:222-225. [PMID: 37673670 DOI: 10.1136/jme-2023-109045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/12/2023] [Indexed: 09/08/2023]
Abstract
To counter the imbalance in vaccine distribution during the COVID-19 pandemic, Albertsen and more recently Germani et al have suggested a new system of taxation coined as 'VaxTax' that would force higher-income countries to fund the access of low-income and middle-income countries (LMICs) to new vaccines in times of pandemic. I will argue that this idea faces numerous challenges of ethical, sociopolitical and economical nature that may hinder any effort to solve the numerous health challenges that LMICs face. I argue that while it is an interesting idea, it is neither sufficient nor will it ever be easily implemented because of socioeconomic or practical reasons.
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13
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Zatovkaňuková P, Slíva J. Diverse pharmacovigilance jurisdiction-The right way for global drug safety? Eur J Clin Pharmacol 2024; 80:305-315. [PMID: 38135821 DOI: 10.1007/s00228-023-03608-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE The purpose of this narrative review is to provide a comparison of several countries with different legislation and approaches to pharmacovigilance and to point out how these impact the number of adverse drug reactions (ADRs) that are reported to national competent authorities. METHODS Legislative and statistical data regarding ADR reporting from various national competent authorities' websites, databases, and pharmacovigilance centers were used. In combination with the WHO pharmacovigilance quantitative indicator that was applied to evaluate the effectiveness of particular national pharmacovigilance systems in our scope. RESULTS The study compared pharmacovigilance systems in six countries, focusing on ADR reporting from 2010 onwards. All countries required MAHs to report ADRs, while healthcare professionals' obligations varied. Per-capita ADR reports increased in all countries with available data, with the United States having a significantly higher reporting rate, possibly due to FDA campaigns. Despite starting later, China's per-capita reporting rate surpassed that of the Czech Republic and Japan. The study highlighted various measures taken by countries to enhance ADR reporting systems since the inception of their programs, contributing to the overall increase in reporting rates. CONCLUSIONS ADR reporting is a global priority, with efforts made by different countries to strengthen their pharmacovigilance systems. Some success can be seen in gradually improving per-capita ADR reporting rates. The varying reporting rates and measures taken by each country may serve as a basis for further research and exchange of best practices to improve drug safety monitoring worldwide.
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Affiliation(s)
- Petra Zatovkaňuková
- Department of Pharmacology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague 10, Czech Republic.
| | - Jiří Slíva
- Department of Pharmacology, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague 10, Czech Republic
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14
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Silva AMD, Benites PT, Zulin MEG, Ferreira Júnior MA, Cardoso AIDQ, Cury ERJ. Global legislation regulating the donation, procurement and distribution processes of organs and tissues from deceased donors for transplants: A scoping review. Heliyon 2024; 10:e26313. [PMID: 38375299 PMCID: PMC10875591 DOI: 10.1016/j.heliyon.2024.e26313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Organ transplantation is one of the most successful advances in modern medicine. However, a legal system is necessary for its practice to be free from ethical flaws and to respect donors, recipients, and family members. Objective To map the global legislation regulating the donation, capture and distribution processes of organs and tissues from deceased donors for transplants. Method A scoping review according to the Joanna Briggs Institute was conducted in the following databases: Medline, CINAHL, Virtual Health Library, SCOPUS, Web of Science, Science Direct, and EMBASE, as well as gray literature, and reported according to the PRISMA extension for scoping reviews. Results We identified 3302 records, of which 77 were analyzed which enabled mapping the type of consent adopted and the existence of current legislation for harvesting organs and tissues after circulatory and brain death. Conclusion Opt-out consent predominates in Europe, and there is harvesting after brain and circulatory death. Opt-out predominates in the Americas, while Opt-in and harvesting of organs and tissues after brain death predominate in Asia and Oceania. The procurement of organs and tissues from deceased donors is practically non-existent in Africa.
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Affiliation(s)
- Aline Moraes da Silva
- Doctoral student in Health and Development of the Midwest Region at the Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | | | - Marcos Antonio Ferreira Júnior
- Graduate and Post-Graduation Program in Nursing, Integrated Health Institute, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | | | - Elenir Rose Jardim Cury
- Post-Graduation Program in in Health and Development of the Midwest Region at the Federal University of Mato Grosso do Sul, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
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Álvarez de la Cadena-Sillas J, Asensio-Lafuente E, Martínez-Dunker D, Urzúa-Gonzalez A, Celaya-Cota M, Aguilera-Mora LF, Lainez-Zelaya J, Hernández-Garcia L, González-Cruz EH. Out of hospital cardiac arrest, first steps to know and follow in Mexico to have cardioprotected territories. A point of view of a group of experts. Arch Cardiol Mex 2024; 94:174-180. [PMID: 38306447 DOI: 10.24875/acm.23000072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/28/2023] [Indexed: 02/04/2024] Open
Abstract
Sudden cardiac death is a common occurrence. Out-of-hospital cardiac arrest is a global public health problem suffered by ≈3.8 million people annually. Progress has been made in the knowledge of this disease, its prevention, and treatment; however, most events occur in people without a previous diagnosis of heart disease. Due to its multifactorial and complex nature, it represents a challenge in public health, so it led us to work in a consensus to achieve the implementation of cardioprotected areas in Mexico as a priority mechanism to treat these events. Public access cardiopulmonary resuscitation (CPR) and early defibrillation require training of non-medical personnel, who are usually the first responders in the chain of survival. They should be able to establish a basic and efficient CPR and use of the automatic external defibrillator (AED) until the emergency services arrive at the scene of the incident. Some of the current problems in Mexico and alternative solutions for them are addressed in the present work.
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Affiliation(s)
- Jorge Álvarez de la Cadena-Sillas
- Práctica Privada San Miguel Allende, San Miguel Allende, Guanajuato, México
- Servicio de Cardiología, de Corazón de Querétaro, Querétaro, México
| | | | | | - Agustín Urzúa-Gonzalez
- Servicio de Cardiología, Unidades Médicas de Alta Especialidad T1, Instituto Mexicano del Seguro Social, León, Guanajuato, México
| | | | | | - José Lainez-Zelaya
- Servicio de Cardiología, Hospital Alta Especialidad, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado, Zapata, Morelos, México
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Ventsislavova P, Baguley T, Antonio J, Byrne D. E-scooters: Still the new kid on the transport block. Assessing e-scooter legislation knowledge and illegal riding behaviour. Accid Anal Prev 2024; 195:107390. [PMID: 37995527 DOI: 10.1016/j.aap.2023.107390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/29/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023]
Abstract
The use of e-scooters is rapidly increasing in cities, leading to their integration into the transportation system. However, numerous collisions involving e-scooters, including some resulting in fatalities, have been reported since their introduction. These incidents indicate that the potential dangers posed by e-scooters may be underestimated. Research suggests that a significant factor contributing to these collisions is the prevalence of illegal riding behaviour exhibited by many riders. This paper presents three studies that aimed to assess the understanding of e-scooter riders and non-riders of the current legislation across various riding scenarios and link it to their profile, riding habits, and their proneness to engage in illegal riding behaviours. Study 1 utilised questionnaires to survey participants and gather information about their profiles and self-reported illegal riding behaviour. Study 2 focused on assessing participants' knowledge of the current e-scooter legislation through different everyday riding scenarios. Study 3 featured short video clips from the rider's perspective to determine the proneness of participants to engage in illegal riding behaviour and explore the potential relationship between these behaviours and their understanding of e-scooter rules. The findings revealed that e-scooter riders were generally younger and exhibited a higher propensity for engaging in illegal riding behaviour than non-users. Both groups demonstrated limited knowledge regarding various aspects of the current e-scooter legislation, particularly related to parking, speeding, and designated infrastructure. While e-scooter riders demonstrated relatively greater knowledge of the e-scooter rules, this was not consistently observed across all areas, particularly in relation to riding on pavements (pedestrian footpaths). Furthermore, Study 3 revealed that participants with better knowledge of the current legislation were less likely to engage in illegal riding behaviour. These findings suggest a need for targeted interventions and educational campaigns to improve riders' understanding of regulations and promote safer riding practices. Implementing training programs for e-scooter safety could significantly enhance riders' awareness of the associated dangers, fostering responsible e-scooter use.
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Affiliation(s)
- Petya Ventsislavova
- Department of Psychology School of Social Sciences, Nottingham Trent University, UK.
| | - Thom Baguley
- Department of Psychology School of Social Sciences, Nottingham Trent University, UK
| | - Josceline Antonio
- Department of Psychology School of Social Sciences, Nottingham Trent University, UK
| | - Daniel Byrne
- Department of Psychology School of Social Sciences, Nottingham Trent University, UK
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Carrillo V, Castillo R, Magrí A, Holzapfel E, Vidal G. Phosphorus recovery from domestic wastewater: A review of the institutional framework. J Environ Manage 2024; 351:119812. [PMID: 38100865 DOI: 10.1016/j.jenvman.2023.119812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
Phosphorus (P) is an essential element for life that must be managed sustainably. The institutional framework for P recovery from wastewater includes policies, regulations, plans, and actions that promote the recovery, recycling, and safe use of this element, aimed at moving toward more sustainable nutrient management and environmental protection. This review analyzes the status of the institutional framework for P recovery from wastewater in different countries around the world. Europe is the continent where the most progress has been made in terms of legislation. Countries such as Germany, the Netherlands, Austria, and Denmark have already implemented policies and regulations that promote environmental protection, as well as P recovery and reuse. In other parts of the world, such as the United States, China, and Japan, there have also been significant advances in promoting the closure of the P cycle, with the implementation of advanced recovery technologies in wastewater treatment plants and regional/national action plans. By contrast, in Latin America there has been little progress in P treatment and recovery, with a weak regulatory framework, unclear goals, and insufficient allocation of techno-economic resources. In this context, it is necessary to reinforce the comprehensive institutional framework, which covers technological aspects, economic incentives, political agreements, and regulations, to promote the sustainable management of this valuable resource.
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Affiliation(s)
- Valentina Carrillo
- Water Research Center for Agriculture and Mining (CRHIAM), ANID Fondap Center, Victoria, 1295, Concepcion, Chile; Engineering and Environmental Biotechnology Group (GIBA-UDEC), Environmental Sciences Faculty and Center EULA-Chile, Universidad de Concepción, Concepción, Chile
| | - Rodrigo Castillo
- Water Research Center for Agriculture and Mining (CRHIAM), ANID Fondap Center, Victoria, 1295, Concepcion, Chile; Faculty of Legal and Social Sciences, Universidad Austral de Chile, Puerto Montt, Chile
| | - Albert Magrí
- LEQUIA, Institute of the Environment, University of Girona, Campus Montilivi, Carrer Maria Aurèlia Capmany 69, E-17003, Girona, Catalonia, Spain
| | - Eduardo Holzapfel
- Water Research Center for Agriculture and Mining (CRHIAM), ANID Fondap Center, Victoria, 1295, Concepcion, Chile
| | - Gladys Vidal
- Water Research Center for Agriculture and Mining (CRHIAM), ANID Fondap Center, Victoria, 1295, Concepcion, Chile; Engineering and Environmental Biotechnology Group (GIBA-UDEC), Environmental Sciences Faculty and Center EULA-Chile, Universidad de Concepción, Concepción, Chile.
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18
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Vijayvergiya DH, Christiansen-Lindquist L. Fusing stillbirth parent advocacy and epidemiology to address the US stillbirth crisis. Semin Perinatol 2024; 48:151874. [PMID: 38238215 DOI: 10.1016/j.semperi.2023.151874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
This narrative describes how a stillbirth advocate and an epidemiologist have worked together to advocate for federal legislation to address stillbirth in the United States. It alternates between each of their perspectives to illustrate how they have leveraged their complementary skills and experiences with the hope that fewer families will experience the tragedy of stillbirth.
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Korde A, Patt M, Selivanova SV, Scott AM, Hesselmann R, Kiss O, Ramamoorthy N, Todde S, Rubow SM, Gwaza L, Lyashchenko S, Andersson J, Hockley B, Kaslival R, Decristoforo C. Position paper to facilitate patient access to radiopharmaceuticals: considerations for a suitable pharmaceutical regulatory framework. EJNMMI Radiopharm Chem 2024; 9:2. [PMID: 38165504 PMCID: PMC10761641 DOI: 10.1186/s41181-023-00230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/13/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Nuclear medicine has made enormous progress in the past decades. However, there are still significant inequalities in patient access among different countries, which could be mitigated by improving access to and availability of radiopharmaceuticals. MAIN BODY This paper summarises major considerations for a suitable pharmaceutical regulatory framework to facilitate patient access to radiopharmaceuticals. These include the distinct characteristics of radiopharmaceuticals which require dedicated regulations, considering the impact of the variable complexity of radiopharmaceutical preparation, personnel requirements, manufacturing practices and quality assurance, regulatory authority interfaces, communication and training, as well as marketing authorisation procedures to ensure availability of radiopharmaceuticals. Finally, domestic and regional supply to ensure patient access via alternative regulatory pathways, including in-house production of radiopharmaceuticals, is described, and an outlook on regulatory challenges faced by new developments, such as the use of alpha emitters, is provided. CONCLUSIONS All these considerations are an outcome of a dedicated Technical Meeting organised by the IAEA in 2023 and represent the views and opinions of experts in the field, not those of any regulatory authorities.
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Affiliation(s)
- Aruna Korde
- Division of Physical and Chemical Sciences, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Marianne Patt
- Section Radiopharmacy, Department of Nuclear Medicine, University Hospital Augsburg, Augsburg, Germany
| | - Svetlana V Selivanova
- Canadian Nuclear Laboratories, Chalk River, ON, Canada
- Faculty of Pharmacy, Universite Laval, Quebec City, QC, Canada
| | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, and Faculty of Medicine, University of Melbourne, Melbourne, Australia
- Olivia Newton-John Cancer Research Institute, and School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Rolf Hesselmann
- Health Protection Directorate, Radiation Protection Division, Section for Research Facilities and Nuclear Medicine, Federal Office of Public Health, Bern, Switzerland
| | - Oliver Kiss
- Department of Targetry, Target Chemistry and Radiopharmacy, Institute for Radipopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | | | - Sergio Todde
- Department of Medicine and Surgery, University of Milano-Bicocca, Tecnomed Foundation, Via Pergolesi, 33, 20900, Monza, Italy
| | - Sietske M Rubow
- Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Luther Gwaza
- Health Products Policy and Standards Department, World Health Organization, Geneva, Switzerland
| | - Serge Lyashchenko
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jan Andersson
- Edmonton Radiopharmaceutical Centre, Alberta Health Services, Edmonton, Canada
- Department of Oncology, University of Alberta, Edmonton, Canada
| | - Brian Hockley
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Ravindra Kaslival
- Office of New Drug Products, Office of Pharmaceutical Quality, CDER, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
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Schmeling J, Martins-Correia J, Pinto da Costa M. Compulsory treatment in Portuguese-speaking countries: An analysis and comparison of the legal framework. Int J Law Psychiatry 2024; 92:101950. [PMID: 38181487 DOI: 10.1016/j.ijlp.2023.101950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Compulsory treatment involves the hospital admission of individuals with mental disorders in appropriate facilities through judicial decisions. However, limited information is available regarding the similarities and differences in compulsory treatment legislation in Portuguese-speaking countries. AIMS To analyse the commonalities and differences in compulsory treatment legislation in Portuguese-speaking countries, where Portuguese is the primary official language, including Angola, Brazil, Cape Verde, East Timor, Guinea-Bissau, Mozambique, Portugal, and São Tomé and Príncipe. METHODS A comparative analysis of the specific legislation on compulsory treatment in Portuguese-speaking countries was conducted. National development plans were analysed in countries lacking legislation. A purposive sampling of mental health professionals was contacted to gather information on the countries under study. RESULTS Among the eight Portuguese-speaking countries examined, specific legislation regarding compulsory treatment was found only in Brazil, Cape Verde, and Portugal. These countries, with the lowest poverty rates, exhibited a notable degree of homogeneity in the criteria supporting compulsory treatment, ensuring the protection of individual rights. In contrast, in Angola, East Timor, Guinea-Bissau, Mozambique, and São Tomé and Príncipe, compulsory treatment primarily relies on mental health development plans, resulting in significant variations in the presented criteria. CONCLUSIONS The significant disparities in compulsory treatment policies among Portuguese-speaking countries, with only Brazil, Cape Verde, and Portugal having specific legislation, underscore the need for a collective effort to establish more consistent procedures and safeguard individual rights.
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Affiliation(s)
- Jéssica Schmeling
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - João Martins-Correia
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Mariana Pinto da Costa
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
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Ben Abderrahim S, Turki E, Zemni Z, Zemni M. [Gametes self-preservation: Tunisian regulatory framework and comparative law]. Gynecol Obstet Fertil Senol 2024; 52:57-59. [PMID: 37918687 DOI: 10.1016/j.gofs.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/04/2023]
Affiliation(s)
- Sarra Ben Abderrahim
- Faculté de médecine Ibn-El-Jazzar de Sousse, avenue Mohamed-Karoui, 4002 Sousse, Tunisie; Service de médecine légale, hôpital universitaire Ibn-El-Jazzar, unité chirurgicale les Aghlabites, rue Ibn-El-Jazzar, 3100 Kairouan, Tunisie.
| | - Elyes Turki
- Faculté de médecine Ibn-El-Jazzar de Sousse, avenue Mohamed-Karoui, 4002 Sousse, Tunisie; Service de médecine légale, hôpital universitaire Ibn-El-Jazzar, unité chirurgicale les Aghlabites, rue Ibn-El-Jazzar, 3100 Kairouan, Tunisie
| | - Zeineb Zemni
- Faculté de médecine Ibn-El-Jazzar de Sousse, avenue Mohamed-Karoui, 4002 Sousse, Tunisie; Service de gynécologie obstétrique, hôpital universitaire Aziza-Othmana, place du gouvernement la Kasba, 1008 Tunis, Tunisie
| | - Majed Zemni
- Faculté de médecine Ibn-El-Jazzar de Sousse, avenue Mohamed-Karoui, 4002 Sousse, Tunisie; Service de médecine légale, hôpital universitaire Farhat-Hached, rue Ibn-El-Jazzar, 4000 Sousse, Tunisie
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Kuhn AV, Pont GD, Cozer N, Sadauskas-Henrique H. The concentrations of polycyclic aromatic hydrocarbons in fish: A systematic review. Mar Pollut Bull 2024; 198:115778. [PMID: 38016205 DOI: 10.1016/j.marpolbul.2023.115778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/30/2023]
Abstract
This study was conducted on the concentrations of PAHs, including benzo[a]pyrene and the sum of four PAHs (benz[a]anthracene, chryseno, benzo[b]fluoranthene, and benzo[a]pyrene), in unsmoked fish tissues. The values were related to the time period, locality (country and region), living habits, eating habits, and types of environments of the fish species. The data obtained has been also compared with the limits established by the United States Environmental Protection Agency (U.S. EPA) and European Union (E.U.) legislation. The data were collected through a PRISMA systematic review (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) from 1982 to 2020. Only documents that presented the PAHs concentration values were selected. China, Nigeria, and Iran had the highest number of studies. The species Coptodon zillii, Siganus punctatus, and Liza abu were the most commonly used bioindicators. Fish inhabiting demersal and pelagic environments showed the highest concentrations of PAHs. The majority of PAH concentrations of the analyzed documents fell within permissible limits for human consumption, representing a total percentage of 79.49 % for benzo[a]pyrene and 82.86 % for the sum of the 4 PAHs. Although some studies identified concentrations of benzo[a]pyrene alone and benzo[a]pyrene, benz[a]anthracene, chryseno, benzo[b]fluoranthene above the legislation limits, in most of them, the concentrations reported in fish tissue were below the limits defined by European Legislation for human consumption.
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Affiliation(s)
- André Vieira Kuhn
- Laboratório de Ecofisiologia e Bioquímica de Organismos Aquáticos, Universidade Santa Cecília, Rua Oswaldo Cruz, 11045-907 Santos, Brazil.
| | - Giorgi Dal Pont
- Grupo Integrado de Aquicultura e Estudos Ambientais, Departamento de Zootecnia, Universidade Federal do Paraná, Rua dos Funcionários, 1540, Juvevê, 80035-050 Curitiba, PR, Brazil
| | - Nathieli Cozer
- Grupo Integrado de Aquicultura e Estudos Ambientais, Departamento de Zootecnia, Universidade Federal do Paraná, Rua dos Funcionários, 1540, Juvevê, 80035-050 Curitiba, PR, Brazil
| | - Helen Sadauskas-Henrique
- Laboratório de Ecofisiologia e Bioquímica de Organismos Aquáticos, Universidade Santa Cecília, Rua Oswaldo Cruz, 11045-907 Santos, Brazil
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Laasri I, Bakkali M, Mejias L, Laglaoui A. Marine collagen: Unveiling the blue resource-extraction techniques and multifaceted applications. Int J Biol Macromol 2023; 253:127253. [PMID: 37806417 DOI: 10.1016/j.ijbiomac.2023.127253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/31/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
Marine organisms such as fish and shellfish are composed of compounds with properties and characteristics that have been proven useful in a variety of sectors such as cosmetics, healthcare (wound healing), food industries, and tissue engineering. Collagen extraction from fish waste as a "blue resource" has attracted research attention over the past decade. Around 75 % of fish waste contains a high concentration of collagen. This has driven research in the conversion of these low-cost by-products into valuable products. Collagen extracted by acidic or/and enzymatic methods is gaining a lot of attention today due to its low cost and high yield. Fermentation and enzymatic hydrolysis stand out as one of the most environmentally sustainable and ecologically friendly methods for collagen extraction. Because of its great biocompatibility, excellent bioactivity, and low antigenicity, marine collagen is receiving more attention. Furthermore, collagen-derived peptides may exhibit interesting antioxidant activity, potent antihypertensive activity, and antimicrobial activity against different strains of bacteria. This review focuses on the advancements in extraction and detection methods of marine collagen, both from a technological and legislative standpoint, in addition to exploring its diverse range of application domains.
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Affiliation(s)
- Ikhlas Laasri
- Abdelmalek Essaadi university, Faculty of Sciences and Technology, Tangier, Morocco; BETA Technological Centre, University of Vic-UCC, Vic, Barcelona 08500, Spain.
| | - Mohammed Bakkali
- Abdelmalek Essaadi university, Faculty of Sciences and Technology, Tangier, Morocco
| | - Laura Mejias
- BETA Technological Centre, University of Vic-UCC, Vic, Barcelona 08500, Spain
| | - Amin Laglaoui
- Abdelmalek Essaadi university, Faculty of Sciences and Technology, Tangier, Morocco
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Abstract
The overwhelming weight of legal authority in the USA and Canada holds that consent is not required for brain death testing. The situation in England and Wales is similar but different. While clinicians in England and Wales may have a prima facie duty to obtain consent, lack of consent has not barred testing. In three recent cases where consent for brain death testing was formally presented to the court, lack of consent was not determinative, and in one case the court questioned whether the clinicians were even required to seek consent from the parents of a child at all.
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Affiliation(s)
| | - Alexander Ruck Keene
- 39 Essex Chambers, London, UK
- Dickson Poon School of Law, Kings College London, London, UK
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Xu J, Liu Z, Shi J, Wang Y. How should China set ethical guardrails for medical research? J Med Ethics 2023:jme-2023-109621. [PMID: 38124192 DOI: 10.1136/jme-2023-109621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
'Ethics first' reform in China significantly changes the governance framework for the research of emerging technologies. The misapplication of human genome editing technology reflects the urgent need to reform the governance framework. Strengthening ethics governance in medical research has become a consensus in China, where legal and ethical reforms are proceeding in parallel. The protection of human dignity, the prevention of biosafety risks, as well as the regulation of technological crimes are at the core of the legal system, which has been embodied in numerous fundamental legislations following the CRISPR-babies incident. Establishing a national ethics committee to coordinate ethics governance, and reinforcing ethics review and external oversight are significant steps in ethical reform. Essentially, ethics governance requires implementing the basic concept of 'ethics first', focusing on forward-looking and preventive governance rather than delayed intervention, while maintaining openness and collaboration.
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Affiliation(s)
- Jingyi Xu
- Department of Medical Ethics and Law, School of Health Humanities, Peking University, Beijing, China
| | - Zhongxuan Liu
- Law School, Sichuan University, Chengdu, Sichuan, China
| | - Jiayou Shi
- Law School, Renmin University of China, Beijing, China
| | - Yue Wang
- School of Health Humanities, Peking University, Beijing, China
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Wang H. Single women's access to egg freezing in mainland China: an ethicolegal analysis. J Med Ethics 2023; 50:50-56. [PMID: 37147115 DOI: 10.1136/jme-2023-108915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/12/2023] [Indexed: 05/07/2023]
Abstract
In the name of safeguarding public interests and ethical principles, China's National Health Commission bans unmarried women from using assisted reproductive technology (ART), including egg freezing. Supported by local governments, the ban has restricted single women's reproductive rights nationwide. Although some courts bypassed the ban to allow widowed single women to use ART, they have not adopted a position in favour of single women's reproductive autonomy, but quite the contrary. Faced with calls to relax the ban and allow single women to freeze eggs electively, the National Health Commission refused to amend their policy, partly to protect women's well-being paternalistically and partly to implement the central government's policies to boost the birthrate and maintain traditional family structures. While the government's concerns about elective egg freezing are not entirely unfounded, they have failed to demonstrate that banning single women's egg freezing is a suitable, necessary and proportionate means to safeguard societal interests and ethical principles. The authority's assumptions that women cannot make rational decisions for their health even with adequate informed consent procedures, that banning egg freezing by single women promotes a culture of having children 'at a proper age', and that egg freezing by single women offends China's public moralities have not been substantiated.
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Affiliation(s)
- Hao Wang
- Shen Junru Law School, Hangzhou Normal University, Hangzhou, Zhejiang, China
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Culyba AJ, Fleegler EW, Pratt AH, Lee LK. Violence Prevention in Pediatrics: Advocacy and Legislation. Pediatr Clin North Am 2023; 70:1225-1238. [PMID: 37865442 DOI: 10.1016/j.pcl.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Given the complexities of youth violence prevention and longstanding violence inequities, advocacy by pediatric clinicians provides a critical voice to represent youth at multiple levels to address the myriad contributors and effects of youth violence. Institutional, community, state, and federal programs, policies, and legislation are required to support a public health approach to the amelioration of youth violence. This article focuses on the role of pediatric clinicians in advocating for youth and families, promoting change within clinical and hospital systems, partnering with communities to advance evidence-informed prevention and intervention, and legislative advocacy to advance violence prevention policy, research, and practice.
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Affiliation(s)
- Alison J Culyba
- Division of Adolescent and Young Adult Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, 120 Lytton Avenue, Suite 302, Pittsburgh, PA 15217, USA.
| | - Eric W Fleegler
- Division of Emergency Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Abdullah H Pratt
- Section of Emergency Medicine, The University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637, USA
| | - Lois K Lee
- Division of Emergency Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
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Kim EJ, Ganga A, Kim LA. The forgotten protection factor: A nationwide score-based assessment of motorcycle eye protection legislation. J Safety Res 2023; 87:407-415. [PMID: 38081713 DOI: 10.1016/j.jsr.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 05/20/2023] [Accepted: 08/15/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Motorcycle accidents cause millions of deaths and injuries globally. It is estimated that billions of dollars would be saved in the United States alone if safety equipment, such as helmets and eye protection, was ubiquitously worn. Legislation concerning eye protection specifically is understudied and poorly characterized. METHOD We reviewed all motorcycle-related safety equipment laws in all 50 states of the United States for information regarding eye protection. We graded the rigor of each statute using our six-category Eye Safety Metric and performed a comparative analysis of statutes across all jurisdictions. RESULTS Fourteen states did not have any statutes regarding eye protection. Among states that did, 23 states had weak statutes (0-2 points), 20 states had moderately stringent statutes (3-4 points), and 7 states had strong statutes (5-6 points). States in western United States tended to have less strict eye protection laws. Twenty-six states had eye protection exemptions for windshields, which are a poor form of eye protection. Six states that had universal helmet laws had no laws requiring eye protection. CONCLUSIONS We characterized eye protection legislation across the country and found great diversity in the stringency of laws across all jurisdictions. Despite only two states lacking helmet laws, we found that 14 states lacked eye protection laws. These findings from our Eye Safety Metric can be used as a springboard for future research, which can be used to determine the need for and significance of eye safety legislation for motorcyclists and to inform legislative decision-making. PRACTICAL APPLICATIONS With this research, we hope to further the understanding of legislation regarding eye protection for motorcyclists and help policymakers identify states that need improved eye safety standards.
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Affiliation(s)
- Eric J Kim
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, USA; Schepens Eye Research Institute of Mass Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, MA 02114, USA
| | - Arjun Ganga
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, USA
| | - Leo A Kim
- Schepens Eye Research Institute of Mass Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, MA 02114, USA.
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Prictor M. Data Breach Notification Laws-Momentum Across the Asia-Pacific Region. J Bioeth Inq 2023; 20:567-570. [PMID: 38082137 DOI: 10.1007/s11673-023-10324-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/17/2023] [Indexed: 03/16/2024]
Affiliation(s)
- Megan Prictor
- Melbourne Law School, The University of Melbourne, Carlton, 3053, VIC, Australia.
- Centre for Digital Transformation of Health, The University of Melbourne, Carlton, VIC, 3053, Australia.
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Olsson B. Increased bicycle helmet use in the absence of mandatory bicycle helmet legislation: Prevalence and trends from longitudinal observational studies on the use of bicycle helmets among cyclists in Denmark 2004-2022. J Safety Res 2023; 87:54-63. [PMID: 38081723 DOI: 10.1016/j.jsr.2023.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/23/2023] [Accepted: 09/05/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Using a bicycle helmet reduces the risk of serious head injuries among cyclists substantially. This makes it highly relevant to increase the use of helmets and to measure the prevalence of bicycle helmet use over time and across different groups. METHOD Since 2004, the use of bicycle helmets in Denmark has been measured observationally in two nationwide time series: one among cyclists in city traffic across all age groups, and one among cycling school children (aged 6-16) around schools. The observations have been conducted on a regular basis in different parts of the country following the same methodology over the years. RESULTS Bicycle helmet use among cyclists in city traffic in Denmark has increased from 6% in 2004 to 50% in 2022. Among cycling school children, helmet use has increased from 33% in 2004 to 79% in 2022. Throughout the years, helmet wearing rates have been highest among young children and lowest among young adults. Since 2015, female cyclists in city traffic have had a slightly higher helmet use than male cyclists. DISCUSSION Several factors might have affected bicycle helmet use in Denmark. One possible factor is a nationwide focus on traffic safety education and behavior change campaigns to encourage helmet wearing. Furthermore, among stakeholders on cycling safety there has been consensus on recommending bicycle helmet use and supporting the promotion of helmets while not recommending or promoting helmet legislation. Finally, more safety-oriented behavior in road traffic in general, and self-reinforcing effects of increased helmet use have plausibly been important factors. PRACTICAL APPLICATIONS Increasing bicycle helmet use in a country where cycling is popular is possible in the absence of mandatory bicycle helmet legislation. Persistent behavior change campaigning and education, stakeholder consensus, higher levels of road safety-oriented behaviors, and self-reinforcing processes could potentially be important factors.
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Affiliation(s)
- Bjørn Olsson
- The Danish Road Safety Council, Lersø Park Allé 111, 2100 Copenhagen Ø, Denmark.
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31
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Simana S, Ravitsky V, Cohen IG. The misplaced embryo: legal parenthood in 'embryo mix-up' cases. J Med Ethics 2023:jme-2023-109401. [PMID: 38050118 DOI: 10.1136/jme-2023-109401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Abstract
Recently in Israel, a woman was mistakenly implanted with an embryo that is genetically related to another couple. Unfortunately, this case is not an isolated occurrence, as other cases of embryo mix-ups have been reported in several countries, including the USA, China, the UK and various other countries within the European Union. Cases of mixed-up embryos are ethically and legally complex: the woman who carried the pregnancy and the woman who is genetically related to the resulting child-both of whom endured emotionally and physically demanding infertility treatments-along with their partners, may be unwilling to relinquish parental rights over the child.This article explores four possible approaches, found in numerous common law jurisdictions, which can be used to address cases involving embryo mix-ups. Our analysis reveals several avenues through which legal parentage can be established. It can be done through gestation and the marital presumption, genetic connections, by adhering to the principle of the best interests of the child, or by recognising multiple individuals as legal parents. We review the advantages and disadvantages of each approach, but we have one clear recommendation: resolving embryo mix-up cases should be done proactively through the establishment of legislation and guidelines, rather than relying on post hoc individual court decisions. Such legislation and guidelines should guarantee the consistency of values throughout diverse reproductive contexts and mandate that fertility clinics and medical professionals provide individuals with comprehensive information regarding the potential risks associated with assisted reproductive treatments.
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Affiliation(s)
- Shelly Simana
- Stanford Law School, Stanford University, Stanford, California, USA
| | | | - I Glenn Cohen
- Harvard Law School, Harvard University, Cambridge, Massachusetts, USA
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32
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Saunders B. Healthcare strikes and the ethics of voting in ballots. J Med Ethics 2023:jme-2023-109502. [PMID: 38050162 DOI: 10.1136/jme-2023-109502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/24/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Ben Saunders
- Politics and IR, University of Southampton, Southampton, UK
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33
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Scheibner J, Kroesche N, Wakefield L, Cockburn T, McPhail SM, Richards B. Does Legislation Impede Data Sharing in Australia Across Institutions and Jurisdictions? A Scoping Review. J Med Syst 2023; 47:116. [PMID: 37962613 DOI: 10.1007/s10916-023-02009-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023]
Abstract
In Australia, regulations governing data, including formal legislation and policies promulgated by private and public agencies, are often seen as a barrier to data sharing. This sharing can include between institutions, as well as across jurisdictional borders in a federated jurisdiction such as Australia. In some cases, these regulations place a barrier to sharing data across borders or between institutions without a prerequisite requirement. In other cases, these regulations may be perceived as a justification not to share data. The objective of this review was to analyse published literature from Australia to see what regulations were used to justify not sharing data, along with any other factors that might discourage data sharing. We searched PubMed, Scopus and Web of Science for empirical and policy articles discussing data sharing in Australia. We then filtered these results via abstract and conducted a full text assessment to include 33 articles for analysis. Although there are a few areas of notable regulatory divergence with respect to legislation governing health data, most regulations in Australia are relatively consistent. Further, the absence of uniform ethics approval between sites in different states was frequently cited as a barrier to data sharing.
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Affiliation(s)
- James Scheibner
- College of Business, Government and Law, Flinders University, Adelaide, Australia.
| | - Nicole Kroesche
- Australian Centre for Health Law Research (ACHLR), School of Law, Faculty of Business and Law, Queensland University of Technology, Brisbane, Australia
| | - Luke Wakefield
- Australian Centre for Health Law Research (ACHLR), School of Law, Faculty of Business and Law, Queensland University of Technology, Brisbane, Australia
| | - Tina Cockburn
- Australian Centre for Health Law Research (ACHLR), School of Law, Faculty of Business and Law, Queensland University of Technology, Brisbane, Australia
| | - Steven M McPhail
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
- Digital Health and Informatics Directorate, Metro South Health, Brisbane, Australia
| | - Bernadette Richards
- Associate Professor of Ethics and Professionalism, Medical School, Academy for Medical Education, University of Queensland, Brisbane, Australia
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Thom R, Ayares D, Cooper DKC, Dark J, Fovargue S, Fox M, Gusmano M, Locke J, McGregor C, Parent B, Ravanan R, Shaw D, Dorling A, Cronin AJ. Update on the ethical, legal and technical challenges of translating xenotransplantation. J Med Ethics 2023:jme-2023-109298. [PMID: 37949649 DOI: 10.1136/jme-2023-109298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/01/2023] [Indexed: 11/12/2023]
Abstract
This manuscript reports on a landmark symposium on the ethical, legal and technical challenges of xenotransplantation in the UK. King's College London, with endorsement from the British Transplantation Society (BTS), and the European Society of Organ Transplantation (ESOT), brought together a group of experts in xenotransplantation science, ethics and law to discuss the ethical, regulatory and technical challenges surrounding translating xenotransplantation into the clinical setting. The symposium was the first of its kind in the UK for 20 years. This paper summarises the content of the expert lectures showcasing the progress which has been made in xenotransplantation including-the history of xenotransplantation, advances in gene edited animals and progress towards clinical xenotransplantation. We then set out the ethical and legal issues still to be resolved. Finally, we report the themes of the roundtable discussion highlighting areas of consensus and controversy. While the detail of the legal discussion was directed towards the UK, the principles and summary reported here are intended to be applicable to any jurisdiction seeking to implement clinical xenotransplantation.
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Affiliation(s)
- Rebecca Thom
- Department of Nephrology and Transplantation, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | | | - David K C Cooper
- Centre for Transplantation Sciences, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - John Dark
- Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Sara Fovargue
- School of Law, The University of Sheffield, Sheffield, UK
| | - Marie Fox
- School of Law and Social Justice at the University of Liverpool, Liverpool, Merseyside, UK
| | - Michael Gusmano
- Community and Population Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Jayme Locke
- Division of Transplantation, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chris McGregor
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Brendan Parent
- Medical Ethics, New York University School of Medicine, New York, New York, USA
| | | | - David Shaw
- Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
| | - Anthony Dorling
- Department of Nephrology and Transplantation, Guy's and St Thomas' Hospitals NHS Trust, London, UK
- Centre for Nephrology, Urology and Transplantation, King's College, London, UK
| | - Antonia J Cronin
- Department of Nephrology and Transplantation, Guy's and St Thomas' Hospitals NHS Trust, London, UK
- Centre for Nephrology, Urology and Transplantation, King's College, London, UK
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Rocha LL, Cordeiro NG, Jardim MZ, Kurihayashi AY, Gentil PC, Russo GC, Mendes LL. Do Brazilian regulatory measures promote sustainable and healthy eating in the school food environment? BMC Public Health 2023; 23:2166. [PMID: 37932690 PMCID: PMC10626708 DOI: 10.1186/s12889-023-17111-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Regulatory measures regarding food in the school environment aim to promote a healthier food environment in public and private schools. In Brazil, implementing regulations in the school food environment does not occur the same way across states and cities, and no national regulation covers public and private schools. The present study aims to analyze regulatory measures for school food environments in Brazilian states and cities and develop a score to evaluate them. METHODS A systematic search of the regulatory measures in force and implemented until 2021 was conducted. The score was developed based on the Model Law Project prepared by the Brazilian Institute for Consumer Protection. It considered food and nutrition education actions, restrictions on the sale and distribution of food, a ban or restriction on food advertising and marketing, and points of excellence. These points included regulations that addressed the importance of supervision and social control, laws regulated by decree, the mention of a ban on ultra-processed foods, and whether the regulatory measures covered public and private schools. RESULTS Sixty-five cities and states regulatory measures in force were found to be evaluated jointly by a federal entity (n = 43). Among the federal entities evaluated, only 13.95% fulfilled the function of promoting sustainable and healthy eating (8-12 points). CONCLUSIONS Brazilian children and adolescents are exposed to a school food environment with regulations that partially fulfill the function of promoting an adequate, healthy, and sustainable diet. In this sense, it is necessary to improve regulatory measures or to encourage states and cities to develop effective legal provisions that are in line with the food guide for the Brazilian population and with the perspective of a healthy school food environment for the effective promotion of adequate, healthy and sustainable and healthy food in schools.
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Affiliation(s)
- Luana Lara Rocha
- Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | | | | | - Larissa Loures Mendes
- Departamento de Nutrição, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
- , Av. Alfredo Balena 190 Santa Efigênia, Belo Horizonte, 30130-100, Brazil.
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Zargaran D, Zargaran A, Terranova T, Khaledi H, Robinson A, Davies J, Weyrich T, Mosahebi A. Profiling UK injectable aesthetic practitioners: A national cohort analysis. J Plast Reconstr Aesthet Surg 2023; 86:150-154. [PMID: 37717299 DOI: 10.1016/j.bjps.2023.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION The United Kingdom (UK) injectables market has been growing rapidly with a lack of robust regulation and to date, no information regarding the profile of practitioners has been published. AIM We aim to provide a descriptive and qualitative analysis of the advertised practitioners in the United Kingdom. METHODS We performed a systematic search using the internet search engine Google to perform a qualitative descriptive analysis of aesthetic practitioners in the UK. For each contiguous country in the UK: England, Scotland, and Wales, five searches were performed. The list of practitioners was then cross-referenced with professional regulatory bodies, with extraction of registration number, date of registration and presence or absence from the Specialist Register or General Practitioner Register. RESULTS 3000 websites were visited and evaluated. 1224 independent clinics with 4405 practitioners were identified. 738 were identified as those in business support functions and the remaining 3667 practitioners were undertaking injectable practice. The profile of professions were doctors 32%, nurses 13%, dentists 24% and dental nurses 8%. Of the 1163 doctors identified 481 were on the specialist register (41%) and 219 were on the GP register (19%). 27 specialties were represented in this cohort analysis. Plastic Surgery formed the majority of those who were on the specialist register at 37%, followed by Dermatology at 18%. CONCLUSION This paper is the first to describe the range of practitioners, their professional backgrounds and experience who perform non-surgical aesthetic interventions. The range of backgrounds may have an impact on the potential risks to patients and will be an important consideration in proposed legislation to introduce licensing to the industry.
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Affiliation(s)
- David Zargaran
- Department of Plastic Surgery, University College London, London, UK.
| | | | - Tom Terranova
- QUAD A - American Association for the Accreditation of Ambulatory Plastic Surgery Facilities (AAAAPSF), IL, USA
| | - Helia Khaledi
- Department of Plastic Surgery, University College London, London, UK
| | | | - Julie Davies
- UCL Global Business School for Health, University College London, London, UK
| | - Tim Weyrich
- Department of Computer Science, University College London, London, UK; Friedrich-Alexander University (FAU) Erlangen-Nürnberg, Germany
| | - Afshin Mosahebi
- Department of Plastic Surgery, University College London, London, UK
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Newton-Howes G, Walker S, Pickering NJ. Epistemic problems with mental health legislation in the doctor-patient relationship. J Med Ethics 2023; 49:727-732. [PMID: 36697216 DOI: 10.1136/jme-2022-108610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Mental health legislation that requires patients to accept 'care' has come under increasing scrutiny, prompted primarily by a human rights ethic. Epistemic issues in mental health have received some attention, however, less attention has been paid to the possible epistemic problems of mental health legislation existing. In this manuscript, we examine the epistemic problems that arise from the presence of such legislation, both for patients without a prior experience of being detained under such legislation and for those with this experience. We also examine how the doctor is legally obligated to compound the epistemic problems by the knowledge they prioritise and the failure to generate new knowledge. Specifically, we describe the problems of testimonial epistemic injustice, epistemic silencing, and epistemic smothering, and address the possible justification provided by epistemic paternalism. We suggest that there is no reasonable epistemic justification for mental health legislation that creates an environment that fundamentally unbalances the doctor-patient relationship. Significant positive reasons to counterbalance this are needed to justify the continuation of such legislation.
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Affiliation(s)
- Giles Newton-Howes
- Department of Psychological Medicine, University of Otago Medical School, Wellington, New Zealand
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Smothers M, Hill C, Lawrence D, Bagshaw R, Watt A. Predictors of recovery in a medium secure service: Influence of the Welsh Government's Mental Health (2010) Measure. Int J Law Psychiatry 2023; 91:101935. [PMID: 37717488 DOI: 10.1016/j.ijlp.2023.101935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Research to date has failed to examine the effectiveness of MSUs in facilitating recovery, or the influence that mental health policy may have on this process. Examining predictors of short-term clinical outcomes during inpatient admission and the effects of policy changes may inform future policy, treatment planning and may improve service user outcomes. AIMS To examine whether service user admission characteristics and length of stay predicted recovery status at discharge from medium secure care and whether a recovery-focused change in policy (introduction of the Mental Health (Wales) Measure (2010)) impacted either on recovery or the relationship between service user characteristics and recovery. METHODS The study adopted a retrospective analysis of quantitative data obtained from healthcare records from a Welsh MSU between 2007 and 2017 (n = 198). The DUNDUM-4 scale assessed recovery whilst DUNDRUM-2 assessed security need at admission. Service user admission characteristics included HCR-20 subscale scores, previous security-level transitions, adverse childhood experiences, substance misuse histories. RESULTS Shorter inpatient stays and higher scores on the dynamic HCR-20 clinical subscale were associated with poorer recovery outcomes. The relationship between admission characteristics and recovery endured despite changes in policy. Implementation of recovery focused legislation was associated with improved recovery. CONCLUSIONS The findings suggest that treatment should focus on dynamic risk factors to improve service user outcomes and highlights the need for long-term medium-secure provision for some. Further research is needed to evaluate the success of MSUs and the validity of the DUNDRUM-4 across UK secure services.
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Affiliation(s)
- Marie Smothers
- Department of Applied Psychology, Cardiff Metropolitan University, Western Avenue, Cardiff, UK
| | - Charlotte Hill
- Department of Applied Psychology, Cardiff Metropolitan University, Western Avenue, Cardiff, UK; South Wales Forensic Psychiatry Service, Swansea Bay University Health Board, Pen-Y-Fai, Bridgend, UK
| | - Daniel Lawrence
- Department of Applied Psychology, Cardiff Metropolitan University, Western Avenue, Cardiff, UK; Psychology Department, Priory Healthcare, Llanarth Court, Monmouthshire, UK.
| | - Ruth Bagshaw
- Department of Applied Psychology, Cardiff Metropolitan University, Western Avenue, Cardiff, UK; South Wales Forensic Psychiatry Service, Swansea Bay University Health Board, Pen-Y-Fai, Bridgend, UK
| | - Andrew Watt
- Department of Applied Psychology, Cardiff Metropolitan University, Western Avenue, Cardiff, UK
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Xu Y, Zhang L, Chen J, Liu T, Li N, Xu J, Yin W, Li D, Zhang Y, Zhou X. Phosphorus recovery from sewage sludge ash (SSA): An integrated technical, environmental and economic assessment of wet-chemical and thermochemical methods. J Environ Manage 2023; 344:118691. [PMID: 37536239 DOI: 10.1016/j.jenvman.2023.118691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/12/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023]
Abstract
Incineration is a promising disposal method for sewage sludge (SS), enriching more than 90% of phosphorus (P) in the influent into the powdered product, sewage sludge ash (SSA), which is convenient for further P recovery. Due to insufficient bioavailable P and enriched heavy metals (HMs) in SSA, it is limited to be used directly as fertilizer. Hence, this paper provides an overview of P transformation in SS incineration, characterization of SSA components, and wet-chemical and thermochemical processes for P recovery with a comprehensive technical, economic, and environmental assessment. P extraction and purification is an important technical step to achieve P recovery from SSA, where the key to all technologies is how to achieve efficient separation of P and HMs at a low economic and environmental cost. It can be clear seen from the review that the economics of P recovery from SSA are often weak due to many factors. For example, the cost of wet-chemical methods is approximately 5∼6 €/kg P, while the cost of recovering P by thermochemical methods is about 2∼3 €/kg P, which is slightly higher than the current P fertilizer (1 €/kg P). So, for now, legislation is significant for promoting P recovery from SSA. In this regard, the relevant experience in Europe is worth learning from countries that have not yet carried out P recovery from SSA, and to develop appropriate policies and legislation according to their own national conditions.
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Affiliation(s)
- Yao Xu
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | - Longlong Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | - Jiabin Chen
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China.
| | - Tongcai Liu
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | - Nan Li
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | - Jiao Xu
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | - Wenjun Yin
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | - Dapeng Li
- School of Environmental Science and Engineering, Suzhou University of Science and Technology, Suzhou, 215000, China
| | - Yalei Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China
| | - Xuefei Zhou
- State Key Laboratory of Pollution Control and Resource Reuse, College of Environmental Science and Engineering, Tongji University, Shanghai, 200092, China.
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Law M, Couturier DL, Choodari-Oskooei B, Crout P, Gamble C, Jacko P, Pallmann P, Pilling M, Robertson DS, Robling M, Sydes MR, Villar SS, Wason J, Wheeler G, Williamson SF, Yap C, Jaki T. Medicines and Healthcare products Regulatory Agency's "Consultation on proposals for legislative changes for clinical trials": a response from the Trials Methodology Research Partnership Adaptive Designs Working Group, with a focus on data sharing. Trials 2023; 24:640. [PMID: 37798805 PMCID: PMC10552399 DOI: 10.1186/s13063-023-07576-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 08/04/2023] [Indexed: 10/07/2023] Open
Abstract
In the UK, the Medicines and Healthcare products Regulatory Agency consulted on proposals "to improve and strengthen the UK clinical trials legislation to help us make the UK the best place to research and develop safe and innovative medicines". The purpose of the consultation was to help finalise the proposals and contribute to the drafting of secondary legislation. We discussed these proposals as members of the Trials Methodology Research Partnership Adaptive Designs Working Group, which is jointly funded by the Medical Research Council and the National Institute for Health and Care Research. Two topics arose frequently in the discussion: the emphasis on legislation, and the absence of questions on data sharing. It is our opinion that the proposals rely heavily on legislation to change practice. However, clinical trials are heterogeneous, and as a result some trials will struggle to comply with all of the proposed legislation. Furthermore, adaptive design clinical trials are even more heterogeneous than their non-adaptive counterparts, and face more challenges. Consequently, it is possible that increased legislation could have a greater negative impact on adaptive designs than non-adaptive designs. Overall, we are sceptical that the introduction of legislation will achieve the desired outcomes, with some exceptions. Meanwhile the topic of data sharing - making anonymised individual-level clinical trial data available to other investigators for further use - is entirely absent from the proposals and the consultation in general. However, as an aspect of the wider concept of open science and reproducible research, data sharing is an increasingly important aspect of clinical trials. The benefits of data sharing include faster innovation, improved surveillance of drug safety and effectiveness and decreasing participant exposure to unnecessary risk. There are already a number of UK-focused documents that discuss and encourage data sharing, for example, the Concordat on Open Research Data and the Medical Research Council's Data Sharing Policy. We strongly suggest that data sharing should be the norm rather than the exception, and hope that the forthcoming proposals on clinical trials invite discussion on this important topic.
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Affiliation(s)
- Martin Law
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
| | - Dominique-Laurent Couturier
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | - Phillip Crout
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Carrol Gamble
- Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK
| | - Peter Jacko
- Lancaster University Management School, Lancaster University, Lancaster, UK
- Berry Consultants, Abingdon, UK
| | | | - Mark Pilling
- Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - David S Robertson
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Matthew R Sydes
- University College London, London, UK
- British Heart Foundation Data Science Centre, Health Data Research UK, London, UK
| | - Sofía S Villar
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - James Wason
- Biostatistics Research Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Graham Wheeler
- Imperial Clinical Trials Unit, Imperial College London, London, W12 7RH, UK
| | - S Faye Williamson
- Biostatistics Research Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Christina Yap
- Clinical Trials and Statistics Unit, The Institute of Cancer Research, London, UK
| | - Thomas Jaki
- Medical Research Council Biostatistics Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Faculty for Informatics and Data Science, University of Regensburg, Regensburg, Germany
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Council ML, Hruza GJ. Political Activism and the Dermatologist. Dermatol Clin 2023; 41:653-658. [PMID: 37718023 DOI: 10.1016/j.det.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
The practice of medicine is governed by legislation and regulation at the state and national level. It is crucial, therefore, that dermatologists become and remain involved in the process to advocate for their patients, their practices, and the specialty itself. Maintaining a relationship with one's state and federal senators and representatives is critical for physicians to have a voice in the shaping of health care policy. Local, state, and national medical and specialty societies are a tremendous resource for physicians to remain abreast of policies affecting the practice of medicine.
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Affiliation(s)
- Martha Laurin Council
- Washington University in St. Louis, 969 North Mason Road, Suite 200, St Louis, MO 63141, USA
| | - George J Hruza
- Laser & Dermatologic Surgery Center, 1001 Chesterfield Parkway East, Suite 101, Chesterfield, MO 63017, USA; St. Louis University.
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Martinez P, de Lourdes Saturnino Gomes M, Marini FS. Public policies strengthen the relationship between family farming and food security in Brazilian schools - A case study of Paraíba state. Heliyon 2023; 9:e20482. [PMID: 37810807 PMCID: PMC10556778 DOI: 10.1016/j.heliyon.2023.e20482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/18/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023] Open
Abstract
We reviewed the historical pathway that paved the way for the creation and implementation of public policies for food security in Brazilian schools. We then analyzed the implementation of such policies in Paraíba state (northeastern Brazil) in terms of the investment in purchasing food from familiar agriculture, i.e. agricultural production in small farm units where the labor comes from the owner's family that lives on the farm and receives gross income from agriculture. We conducted this study to determine the extent to which public policies for food security in schools promote income to family farmers in Paraíba state. We obtained data from the Management and Accountability System (SIGPC) to quantify the municipalities in Paraíba state that comply with the national school feeding program denominated Programa Nacional de Alimentação Escolar (PNAE). The fiscal years from 2015 to 2017 were used as a reference period because no data is available for the upcoming years. PNAE has been created to underpin programs offering free meals to school-age children, thus allowing for basic learning conditions while tackling hunger among social groups in poverty. PNAE became a public policy subsidiary of familiar agriculture through the Law 11,947 of 2009 which requires the minimal investment of 30% of PNAE funds to purchase food from family farmers. In Paraíba state, 80% of the municipalities buy food through PNAE. However, nearly 40% of the municipalities do not apply the minimum investment to purchase food from family farmers during the evaluated period (2011-2017). We identified that logistics and transportation of food coordinated by the school feeding councils are the main constraints for greater efficiency of the program. Despite such constraints, PNAE offers a unique opportunity to enhance human wellbeing by fostering family farmers to adopt conservation practices and provide healthy, local food to school-aged children.
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Affiliation(s)
- Pedro Martinez
- New Mexico State University, Las Cruces (NM), United States
| | | | - Fillipe Silveira Marini
- Department of Geosciences, Agroecology Graduate Program, Federal University of Paraíba, João Pessoa (PB), Brazil
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Solis Sánchez G, Alcalde Bezhold G, Alfonso Farnós I. Research ethics: From principles to practical aspects. An Pediatr (Barc) 2023; 99:195-202. [PMID: 37598083 DOI: 10.1016/j.anpede.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 08/21/2023] Open
Abstract
Any research conducted on human beings or human biological samples requires a prior ethical assessment to avoid risks and problems for all involved parties. The legislation in this regard is very broad and emphasizes the safeguarding of patient rights in relation to the universal principles of autonomy, beneficence and justice. The present article reviews the regulations applicable to clinical trials, observational studies with drugs, biobank projects or any other type of study that may be conducted in the health care field. It also addresses the role of research ethics committees, data protection and the foundations of scientific integrity.
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Affiliation(s)
- Gonzalo Solis Sánchez
- Hospital Universitario Central de Asturias, Universidad de Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain.
| | - Guillermo Alcalde Bezhold
- CEI OSI Araba, Universidad del País Vasco, Servicio de Nefrología, Hospital Universitario Araba, Vitoria, Vizcaya, Spain
| | - Iciar Alfonso Farnós
- Comité de Ética de la Investigación de Euskadi, Asociación Nacional de Comités de Ética en Investigación, Vitoria, Vizcaya, Spain
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44
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Pouyamanesh S, Kowsari E, Ramakrishna S, Chinnappan A. A review of various strategies in e-waste management in line with circular economics. Environ Sci Pollut Res Int 2023; 30:93462-93490. [PMID: 37572248 DOI: 10.1007/s11356-023-29224-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 08/04/2023] [Indexed: 08/14/2023]
Abstract
Waste management of electrical and electronic equipment has become a key challenge for electronics manufacturers due to globalization and the rapid expansion of information technology. As the volume of e-waste grows, legal departments lack the infrastructure, technology, and ability to collect and manage it environmentally soundly. Government laws, economic reasons, and social issues are important considerations in e-waste management. The circular economy concept is built on reusing and recycling goods and resources. A novel idea called the circular economy might prevent the negative consequences brought on by the exploitation and processing of natural resources while also having good effects such as lowering the demand for raw materials, cutting down on the use of fundamental resources, and creating jobs. To demonstrate the significance of policy implementation, the necessity for technology, and the need for societal awareness to build a sustainable and circular economy, the study intends to showcase international best practices in e-waste management. This study uses circular economy participatory implementation methods to provide a variety of possible approaches to assist decision-makers in e-waste management. The purpose of this article is to review the most accepted methods for e-waste management to emphasize the importance of implementing policies, technology requirements, and social awareness in creating a circular economy. To conclude, this paper highlights the necessity of a common legal framework, reform of the informal sector, the responsibility of different stakeholders, and entrepreneurial perspectives.
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Affiliation(s)
- Soudabeh Pouyamanesh
- Department of Chemistry, Amirkabir University of Technology, No. 424, Hafez Avenue, Tehran, 1591634311, Iran
| | - Elaheh Kowsari
- Department of Chemistry, Amirkabir University of Technology, No. 424, Hafez Avenue, Tehran, 1591634311, Iran.
| | - Seeram Ramakrishna
- Department of Mechanical Engineering, Center for Nanofibers and Nanotechnology, National University of Singapore, Singapore, 119260, Singapore
| | - Amutha Chinnappan
- Department of Mechanical Engineering, Center for Nanofibers and Nanotechnology, National University of Singapore, Singapore, 119260, Singapore
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van der Storm SL, Jansen M, Meijer HAW, Barsom EZ, Schijven MP. Apps in healthcare and medical research; European legislation and practical tips every healthcare provider should know. Int J Med Inform 2023; 177:105141. [PMID: 37419042 DOI: 10.1016/j.ijmedinf.2023.105141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/27/2023] [Accepted: 07/02/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND The use of apps in healthcare and medical research is increasing. Apps in healthcare may be beneficial to patients and healthcare professionals, but their use comes with potential risks. How to use apps in clinical care is not standard part of medical training, resulting in a lack of knowledge. As healthcare professionals and their employers can be held accountable for the wrongful use of medical apps, this situation is undesirable. This article addresses the most important European legislation regarding medical apps from the perspective of healthcare providers. METHODS This review provides an overview of current and changing regulations, focusing on apps used in healthcare and medical research. Three topics are discussed: 1) the relevant European legislation and its enforcement, 2) the responsibilities and liability of the medical professional when using these apps, and 3) an overview of the most practical considerations medical professionals should know when using or building a medical app. RESULTS When using and developing medical apps, data privacy must be guaranteed according to the GDPR guidelines. Several international standards make it easier to comply with the GDPR, such as ISO/IEC 27001 and 27002. Medical Devices Regulation was implemented on May 26, 2021, and as a result, medical apps will more often qualify as medical devices. The important guidelines for manufacturers to comply with Medical Devices Regulation are ISO 13485, ISO 17021, ISO 14971 and ISO/TS 82304-2. CONCLUSION The use of medical apps in healthcare and medical research can be beneficial to patients, medical professionals, and society as a whole. This article provides background information on legislation and a comprehensive checklist for anyone wanting to start using or building medical apps.
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Affiliation(s)
- Sebastiaan L van der Storm
- Amsterdam UMC location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands.
| | - Marilou Jansen
- Amsterdam UMC location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Henriëtte A W Meijer
- Amsterdam UMC location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Esther Z Barsom
- Amsterdam UMC location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands
| | - Marlies P Schijven
- Amsterdam UMC location University of Amsterdam, Surgery, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Gastroenterology and Metabolism, Amsterdam, the Netherlands; Amsterdam Public Health, Digital Health, Amsterdam, the Netherlands.
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Sanchez Martinez DA, Carrasco Picazo JP, Estrella Porter PD, Ruiz-Montero R, Aginagalde Llorente AH, García-Camacho E, Navarro J, Cerame Del Campo A. Resident physician duty hours, resting times and European Working Time Directive compliance in Spain: a cross-sectional study. Hum Resour Health 2023; 21:70. [PMID: 37620869 PMCID: PMC10463816 DOI: 10.1186/s12960-023-00857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND There is a growing interest in understanding the impact of duty hours and resting times on training outcomes and the well-being of resident physicians. However, to this date no state-wide analysis exists in any European country. OBJECTIVES Our aim is to describe the shift work scheduling and to detail the degree of compliance with the Spanish legislation and the European Working Time Directive (EWTD) of Spanish resident physicians, focusing on territorial and specialty distribution. MATERIAL AND METHODS A descriptive cross-sectional analytical study was designed through an online survey adapted from the existing literature. RESULTS Out of the 2035 surveyed resident physicians undergoing PGT in Spain, 80.49% exceeded the 48 h per week limit set by the EWTD and 13% of them did not rest after a 24-h on-call shift. The mean number of on-call shifts in the last 3 months was 15.03, with the highest mean reported in Asturias, La Rioja, and Extremadura. 51.6% of respondents had a day-off after a Saturday on-call shift. Significant differences are observed by region and type of specialty. CONCLUSION Resident physicians in Spain greatly exceed the established 48 h/week EWTD limit. Likewise, non-compliance with labor regulations regarding mandatory rest after on-call duty and minimum weekly rest periods are observed.
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Affiliation(s)
- D A Sanchez Martinez
- Consejo General Colegios Oficiales de Médicos de España, Madrid, Spain.
- Department of Medical Oncology, IMIB-Arrixaca, Murcia, Región de Murcia, Spain.
| | - J P Carrasco Picazo
- Department of Psychiatry, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - P D Estrella Porter
- Department of Preventive Medicine, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - R Ruiz-Montero
- Department of Medical and Surgical Sciences, University of Cordoba, Cordoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
| | - A H Aginagalde Llorente
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
| | - E García-Camacho
- Department of Cardiology, Complejo Hospitalario Universitario Toledo, Toledo, Spain
| | - J Navarro
- Intensive Care Department, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - A Cerame Del Campo
- Plan de Atención Integral al Profesional Sanitario Enfermo, Servicio Madrileño de Salud, Madrid, Spain
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van Amsterdam J, Burgess N, van den Brink W. Legal Approaches to New Psychoactive Substances: First Empirical Findings. Eur Addict Res 2023; 29:363-372. [PMID: 37557091 DOI: 10.1159/000531503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/08/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Generic drug legislation, i.e., simultaneously banning groups of drugs, has been introduced worldwide to counteract the trade and use of emerging "new psychoactive substances" (NPSs) more effectively. SUMMARY The potential and de facto positive and negative effects of generic drug legislation have been described using an analysis based on documented evaluations of the experiences in the UK and Germany, supplemented with data from other publicly available sources. In particular, the effects of generic drug legislation on availability, use, sales, and overall health harms of NPS, and switches from NPS to traditional (classical) drugs are addressed. The results show that the introduction of generic drug legislation in the UK and Germany has enabled stricter regulation of NPS but has also led to some major harms within the domain of public health. Depending on the population considered, the rate of NPS use remained stable, slightly declined, or increased following the banning of NPS. Once banned, NPSs were more often purchased on the black market, often together with other (more harmful) drugs. Moreover, NPS-related harms did not reduce following the ban, and in some cases even increased. Finally, when harmful NPS, like potent synthetic opioids and cannabinoids, become substantially used and endanger public health, legislators already have the legal means to ban the problem drug, thus overruling the need for a generic ban. KEY MESSAGES Generic drug legislation may facilitate drug law enforcement, but it is not (very) effective in counteracting NPS use and it may increase NPS-related public health problems. It is concluded that, overall, the advantages of generic drug legislation are overshadowed by its serious disadvantages.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, Amsterdam Neuroscience, Research Program Compulsivity, Impulsivity & Attention, Amsterdam, The Netherlands
| | - Nicholas Burgess
- School of Law, College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Center, Amsterdam Neuroscience, Research Program Compulsivity, Impulsivity & Attention, Amsterdam, The Netherlands
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Lee SH, Joo MH. [Analysis of Media Trends and Social Perceptions on Nursing Law Legislation]. J Korean Acad Nurs 2023; 53:439-452. [PMID: 37673818 DOI: 10.4040/jkan.23030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/14/2023] [Accepted: 07/12/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE This study aimed to derive considerations for the enactment of nursing law by analyzing the trends and social perceptions of nursing law mentioned in major daily newspapers, cafes, and blogs. METHODS Main texts and comments that included nursing law as a keyword were collected from major daily news and online postings from January 2021 to August 2022. The data collected through web crawling were analyzed using a TousFlux program used for big data analysis. RESULTS During the period of study, the awareness level around nursing law enactment increased. In particular, public concern over nursing law enactment intensified due to the two political parties' policy pledges related to nursing law in January 2022 and the failure to introduce the nursing law to the national assembly judiciary committee in May 2022. Except in December 2021, public perception of nursing law enactment was generally favorable, with public opinion tilting more in favor of than against enactment. CONCLUSION Public opinion should be considered when drafting and implementing the nursing law to make it easier for the people to understand what the law constitutes. In addition, it is necessary to pay attention to and continuously promote the relationship between medical care and nursing in the nursing law system of developed nations. Lastly, nursing law enactment can enhance nurses' retention intention and provide a sense of efficacy to medical services.
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Affiliation(s)
- Seung-Hee Lee
- Post Anesthesia Care Unit 2, Seoul National University Hospital, Seoul, Korea
| | - Min-Ho Joo
- Department of Educational Technology, Konkuk University, Seoul, Korea.
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Borenko C, Simon J, Myers J, Diedrich K, Stajduhar K, Cash C, Wikjord N, Cory S, Schock B. Evolution and current state of Advance Care Planning in Canada. Z Evid Fortbild Qual Gesundhwes 2023; 180:36-42. [PMID: 37537087 DOI: 10.1016/j.zefq.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/18/2023] [Indexed: 08/05/2023]
Abstract
Canada is one of the early pioneers of Advance Care Planning concepts, processes, programs and initiatives. The evolution of national messages, models and frameworks is shaped by our publicly funded healthcare system and culturally diverse populations. Our Pan-Canadian Community Framework highlights the importance of individuals, those that matter to them, communities, organizations, and healthcare professionals collaborating, integrating, sharing, and building upon each other's strengths and successes. This framework describes Canada's priority actions at national, provincial and local levels. Our collective vision is for Advance Care Planning to be a part of the life journey.
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Affiliation(s)
- Cari Borenko
- Fraser Health Authority, Surrey, British Columbia, Canada.
| | - Jessica Simon
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Jeff Myers
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Karine Diedrich
- Canadian Hospice Palliative Care Association, Ottawa, Ontario, Canada
| | - Kelli Stajduhar
- School of Nursing and Institute on Aging & Lifelong Health, University of Victoria, Victoria, British Columbia, Canada
| | - Colleen Cash
- Nova Scotia Hospice Palliative Care Association, Nova Scotia, Canada
| | - Nicole Wikjord
- First Nations Health Authority, Vancouver, British Columbia, Canada
| | - Shelly Cory
- Canadian Virtual Hospice, Winnipeg, Manitoba, Canada
| | - Bren Schock
- Saskatchewan Health Authority, Regina, Saskatchewan, Canada
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Thomas VG, Kanstrup N. Promoting enforcement of non-lead hunting ammunition regulations and compliance in Europe and North America. Ambio 2023; 52:1350-1358. [PMID: 37079207 PMCID: PMC10272061 DOI: 10.1007/s13280-023-01863-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/21/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023]
Abstract
The direct regulation of lead ammunition in North America and Europe has been mainly for hunting in wetlands. Little support among hunters and the ammunition makers exists for further regulation despite suitable lead substitutes and much education about the known risks to wildlife and human health from ingested lead. In the absence of personnel to detect use of lead ammunition and enforce regulations, hunter compliance is low. Identification of non-lead ammunition using existing electronic technology and an international protocol on the identification of non-lead rifle bullets is proposed to aid enforcement. An explicit definition of the chemical composition of lead substitutes is required in European Union legislation together with a more enforceable distinction between 'possession during hunting' and 'ownership' of lead ammunition. A more transdisciplinary regulatory approach to transitioning to non-lead ammunition is advised. It comprises widespread public health advisories, setting a maximum allowable lead level in commercial game meats in EU legislation, and public communication that emphasizes the benefits of non-lead ammunition use to all categories of wildlife and the public perception of hunting, whether in North America or Europe.
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Affiliation(s)
- Vernon G. Thomas
- Department of Integrative Biology, College of Biological Science, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Niels Kanstrup
- Department of Ecoscience, Aarhus University, C.F. Møllers Allé 8, 8000 Aarhus C, Denmark
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