Policy Initiatives to Address the Challenges of an Older Population in the Workforce

Today's working population is expected to experience a longer and healthier life than previous generations did. This, combined with a currently shrinking workforce, means the participation of older adults in the labor market is expected to positively contribute to national economic and social development. Policymakers have therefore implemented a series of reforms to motivate and encourage both employers and employees to embrace the prospect of an aging workforce and to respond to the associated challenges of such a demographic change in the workplace. This paper aims to provide an overview of recent policy initiatives in this context and to identify the role of technology in major international initiatives in overcoming the key challenges faced by developed countries. We have conducted a scoping review to obtain large volumes of peer-reviewed and gray literature. Our findings suggest that the stakeholders (researchers, government agencies, employers, and communities) are not only aware of the current issues relating to the aging population but also understand the importance of policies in terms of retaining older people in the workforce. In particular, our results indicate that technology, in both the public and private sectors, can be leveraged as a tool to facilitate older adults' participation in the workforce.

Assessment of the potential impact of resolving drug-related problems by clinical pharmacists in Japan: a retrospective observational study

Background

Clinical pharmacists play a role in limiting the disadvantages of pharmacotherapy for patients by detecting and resolving drug-related problems (DRPs) through medication reviews. Although their contributions to patient care have been analyzed and understood in various countries, the role of Japanese clinical pharmacists in this context remains to be clearly elucidated. Thus, in this study, we aimed to elucidate the detection of DRPs by clinical pharmacists and determine the potential impact of pharmacist interventions in Japan.

Methods

This study was conducted in a 273-bed hospital and targeted hospitalized patients over a period of 6 months. DRPs detected by clinical pharmacists during the study period were investigated and classified into 10 types. Furthermore, medications were categorized according to the Anatomical Therapeutic Chemical classification. A review committee consisting of two pharmacists independently reviewed the pharmacist interventions on a six-point scale (extremely significant, very significant, significant, somewhat significant, no significance, adverse significance) according to the potential impact on patient care.

Results

During the study period, 1711 patients (mean age: 71.2 years, 54.1% male) were included, and 2149 DRPs were detected (1.26 DRPs/patient). Pharmacists intervened in all the DRPs detected. The most common DRP was supratherapeutic dosage (19.3%), followed by untreated indication (18.1%). The most common medication classification causing DRPs was “Antiinfectives for Systemic Use” (25.1%), followed by “Alimentary Tract and Metabolism” (19.9%). Most of the pharmacist interventions (99.6%) were rated “somewhat significant” or more significant, of which 1.1% were rated “extremely significant,” and none were rated as “adverse significance.”

Conclusions

Our results show that in Japan, as in other countries, clinical pharmacists detect and resolve DRPs in hospitalized patients through medication review. Our findings also show that clinical pharmacists have a positive impact on patient care and suggest the need for their involvement.

COVID-19 PANDEMIC AND ITS POTENTIAL IMPACT ON SEXUAL AND REPRODUCTIVE HEALTH INDICATORS IN NIGERIA

The impact of the novel corona virus disease (COVID-19) pandemic cuts across all sectors and has brought to the fore the true realities and status of health systems globally, revealing the gaps and cracks even in seemingly perfect health systems. The fragile and weak health system in the country is also riddled with a lot of sub-optimal health indicators including reproductive health. It is important to anticipate and look out for these effects in order to plan for and ensure early detection and necessary intervention to mitigate such. This paper discusses the potential effect of COVID-19 on reproductive health indicators in Nigeria. The reproductive health indices of a population have far and wide reaching impact on the health status of the population. However, reproductive health indicators are usually among the worst hit during health emergencies or disasters as seen in the Ebola pandemic in sub-Saharan Africa. Interventions must be put in place so that the pandemic does not set Nigeria back from the marginal gains made in reproductive health over the years.

A review of sources, multimedia distribution and health risks of novel fluorinated alternatives

Per- and polyfluoroalkyl substances (PFASs) are a class of emerging persistent organic pollutants (POPs). They are widely used in industrial and consumer applications. Due to their persistence, bioaccumulation, long-distance migration and toxicity, it is important to find new compounds that can replace PFASs. The present review investigated the sources, fates and environmental effects of alternative PFAS compounds using surveys have been conducted over the past several years. Concentrations of PFAS alternatives in various environmental media, as well as human tissues, are summarized based on the available data. The results showed that hexafluoropropylene oxide dimer (HFPO-DA), hexafluoropropylene trimer acids (HFPO-TA), and 6:2 chlorinated polyfluorinated ether sulfonic acid (6:2 Cl-PFESA) have become the dominant global perfluorinated pollutants. Currently, there are a few toxicity assessments of these novel fluorinated alternatives, showing that they have systemic multiple organ toxicities. PFAS alternatives exhibited comparable or even more serious potential toxicity than legacy PFASs, indicating that these fluorinated alternatives are also harmful to the environment. Therefore, these alternatives require additional toxicological studies to confirm whether they can be used for a long time.

Fraction of high-grade cervical intraepithelial lesions attributable to genotypes targeted by a nonavalent HPV vaccine in Galicia, Spain

Background

Human papillomavirus (HPV) bivalent and quadrivalent vaccines have been widely implemented in worldwide organized immunization programs. A nonavalent HPV vaccine is now available in several countries. The objective was to describe the fraction of squamous non-invasive high-grade cervical intraepithelial lesions attributable to genotypes targeted by bi-quadrivalent vaccines and by nonavalent vaccine according to age and diagnosis in women living in the city of Vigo (Galicia, Spain).

Methods

Cervical scrapings (2009–2014) of women with histological diagnosis of cervical intraepithelial neoplasia grade 2 (CIN2, n = 145) and grade 3-carcinoma in situ (CIN3-CIS, n = 244) were tested with Linear Array HPV Genotyping test (Roche diagnostics, Mannheim, Germany). Hierarchical estimation of the fraction attributable to HPV 16/18 or HPV 31/33/45/52/58 detected alone or in combination was calculated. Absolute additional fraction attributable to genotypes targeted by nonavalent vaccine compared to genotypes targeted by bi-quadrivalent vaccines was calculated as the increment of attributable cases with respect to all studied cases. Age group 1, 2 and 3 included women 18 to 34, 35–44 and ≥45 years old, respectively. EPIDAT 3.1 was used.

Results

Fraction attributable to genotypes targeted by bi-quadrivalent vaccines was 59% CIN2 vs. 69% CIN3-CIS (p < 0.001). It was 63/51/50% of CIN2 and 78/66/45% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by nonavalent vaccine was 86% CIN2 and 86% CIN3-CIS. It was 87/91/75% of CIN2 and 90/86/76% of CIN3-CIS in age group 1, 2, 3, respectively. Fraction attributable to genotypes targeted by these vaccines tended to decrease as age increased (p-trend <0.05). Globally, absolute additional attributable fraction was 16%, 26% and 29% in age group 1, 2 and 3, respectively (p < 0.005).

Conclusions

Absolute additional fraction of CIN2 and CIN3-CIS attributable to genotypes targeted by nonavalent vaccine was observed in women of any age, especially in those over 35 years old.

A review of status of tetrabromobisphenol A (TBBPA) in China

Tetrabromobisphenol A (TBBPA), a currently intensively used brominated flame retardant (BFR), is employed primarily as a reactive flame retardant in printed circuit boards but also has additive applications in several types of polymers. TBBPA is a ubiquitous environmental contaminant that is observed in both abiotic and biotic matrices. This paper summarizes and critically reviews the published scientific data concerning the current pollution status of TBBPA in China. To provide an indication of the seriousness of the pollution levels of TBBPA in China, the data are compared with available existing data from other countries of the world. According to the available data, the sources of TBBPA in China are mainly derived from the primitive e-waste dismantling, TBBPA manufacturing and processing of TBBPA-based materials. The most serious cases of TBBPA pollution in China are in Guiyu, Guangdong (primitive e-waste dismantling site) with concentrations of TBBPA reaching 66,010-95,040 pg m(-3) in air, Shouguang, Shandong (TBBPA manufacturing site) with concentrations of TBBPA reaching 1.64-7758 ng g(-1) dry weight in soil, and Chaohu Lake, Anhui (industry concentration site) with concentrations of TBBPA reaching 850-4870 ng L(-1) in water. In general, China is the most polluted region as affected by TBBPA compared with other countries. The present review preliminarily reveals the research status of TBBPA in China.

EARLY ASSESSMENT AND PREDICTION OF POTENTIAL IMPACT OF THE IMPLANTATION OF POLYURETHANE SCAFFOLD IN PARTIAL MENISCAL LESIONS: A PILOT HORIZON SCANNING ACTIVITY IN SOUTH KOREA

OBJECTIVES

The aim of this study was to predict the potential impact of the introduction of implantation of polyurethane scaffold for the treatment of partial meniscal lesions in the South Korean healthcare system.

METHODS

The horizon scanning process was used to select a target technology and assess its potential impacts on patients and the Korean healthcare system. We identified and filtered research-phase health technologies that are not listed yet in Korean, but appear promising. After a process of prioritization, we chose the implantation of polyurethane scaffolds as a target technology. Then, through the procedures of assessment and peer review, we analyzed current evidence and its predicted potential impacts.

RESULTS

There were eight studies included in the review: one prospective cohort and seven case-series studies. Six revealed significant improvements in function and pain relief. Of the six studies, which reported safety endpoints, four stated no major postoperative complications related to scaffold, and two reported adverse events and serious adverse events such as pain, joint swelling, et cetera. We also included the potential impact of this technology based on the experts' consultation. They all agreed that it would satisfy the diverse needs of patients and fulfill clinical needs. However, the majority of related clinical studies were based on short-term follow-up observations without any validation process involving comparison with control groups.

CONCLUSIONS

Through a horizon scanning activity, we found that the implantation of polyurethane scaffolds is a promising technology to resolve articular cartilage defects; however, long-term evidence with comparison groups for safety and effectiveness is required.