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Zimba B, Mpinganjira S, Msosa T, Bickton FM. The urban-poor vaccination: Challenges and strategies in low-and-middle income countries. Hum Vaccin Immunother 2024; 20:2295977. [PMID: 38166597 PMCID: PMC10766387 DOI: 10.1080/21645515.2023.2295977] [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: 10/23/2023] [Accepted: 12/09/2023] [Indexed: 01/05/2024] Open
Abstract
Vaccination is one of the success stories of public health. The benefit of vaccination goes beyond individual protection to include promoting population well-being, improving cognitive development, and increasing economic productivity. However, the existing inequalities in the access to vaccination undermines its impact. There are significant variations in the coverage of vaccination between and within countries. Despite that urban populations have better access to health services; evidence has shown that the urban poor have the worst health indicators including vaccination uptake. Additionally, there are unique challenges affecting vaccination in urban settings, especially in urban slums. This paper has discussed key challenges some of the proposed interventions that can improve urban vaccination service delivery.
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Affiliation(s)
- Boston Zimba
- Department of Public Health, University of Glasgow, Glasgow, UK
| | - Samuel Mpinganjira
- Department of Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Takondwa Msosa
- Department of Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Fanuel Meckson Bickton
- Lung Health Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Department of Rehabilitation Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
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2
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Rockman M. Capacity of the U.S. federal system for cultural heritage to meet challenges of climate change. Proc Natl Acad Sci U S A 2024; 121:e2317158121. [PMID: 38527215 DOI: 10.1073/pnas.2317158121] [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: 10/03/2023] [Accepted: 02/16/2024] [Indexed: 03/27/2024] Open
Abstract
The U.S. federal government is unbalanced in its capacity to recognize, manage, and engage cultural heritage as part of its response to climate change. Legislation from the 1906 Antiquities Act to Executive Order (EO) 13990 signed in 2021 has set an overarching approach in which heritage is understood to be primarily tangible places and things that should be conserved, foremost through monument and park boundaries and significance designations. Such conservation, however, does not protect heritage from impacts of climate change and how to manage these components of heritage is nearly invisible in recent climate-focused publications of the two agencies assigned by legislation to serve as leads for cultural heritage in the U.S. government. Yet further, the long-standing tangible approach to heritage does not incorporate emerging understandings of its intangible components and the diverse connections of all forms of heritage to place, meaning, identity, and global change goals of sustainability and equity. In contrast, analysis of 27 federal agency climate adaptation plans prepared in response to 2021 EO 14008 shows that multiple agencies not assigned lead roles for heritage recognize a range of responsibilities that include heritage as part of climate adaptation, mitigation, equity, and coordination with Indigenous communities. This paper explores U.S. heritage legislative history, the definition it helped create for heritage, more recent understandings of heritage, and relationships of these to climate change and how these are represented in climate work and plans across U.S. federal agencies. On these bases, recommendations are provided for research and policy steps.
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Affiliation(s)
- Marcy Rockman
- Department of Anthropology, University of Maryland, College Park, MD 20742
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3
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Liu C, Wang N, Liu LX, Zhang YY, Liu YG. An analytical overview of the composition and characteristics of China's food safety standards. J Sci Food Agric 2024; 104:3197-3205. [PMID: 38233355 DOI: 10.1002/jsfa.13262] [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: 09/17/2023] [Revised: 11/06/2023] [Accepted: 01/04/2024] [Indexed: 01/19/2024]
Abstract
This paper discusses the framework of China's food safety standards and provides a brief overview of the problems and developmental characteristics of food safety in China. The composition and characteristics of China's food safety standards are revealed by an analysis of the changes in China's general food standards, an overview of the characteristics of the hygiene requirements in the production and operation process, and an introduction to food product and test method standards. In conclusion, Chinese food safety standards are still being improved, but they must also be effectively implemented and followed up in real time in order to continuously improve the quality of food and reduce food safety incidents. © 2024 Society of Chemical Industry.
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Affiliation(s)
- Chen Liu
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin, China
- College of Life Sciences, Linyi University, Linyi, China
- Shandong (Linyi) Institute of Modern Agriculture, Zhejiang University, Linyi, China
| | - Nan Wang
- College of Biotechnology, Tianjin University of Science and Technology, Tianjin, China
| | - Ling-Xiao Liu
- Linyi Academy of Agricultural Sciences, Linyi, China
| | | | - Yun-Guo Liu
- College of Life Sciences, Linyi University, Linyi, China
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4
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Andraka-Christou B, Golan OK, Williams M, Buksbaum S, Gordon AJ, Stein BD. A Systematic Review of State Office-Based Buprenorphine Treatment Laws Effective During 2022: Counseling, Dosage, and Visit Frequency Requirements. Subst Use Addctn J 2024; 45:278-291. [PMID: 38288697 DOI: 10.1177/29767342231223721] [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] [Indexed: 03/14/2024]
Abstract
BACKGROUND Buprenorphine is among the most effective treatments for opioid use disorder. Even though the federal government recently eliminated the waiver requirement and patient limits applicable to office-based buprenorphine treatment (OBBT), among other settings, some states may still have policies imposing requirements on OBBT providers not required by federal law. METHODS We collected statutes and regulations from 50 US states and the District of Columbia (ie, 51 jurisdictions) between August 11 and November 30, 2022 using the Nexis Uni legal database and search terms related to OBBT counseling, dosage, and/or frequency of visits. We then used template analysis, a mixed deductive-inductive qualitative method, to analyze legal content. RESULTS Ten jurisdictions (20%) in 2022 had an OBBT counseling, dosage, and/or visit frequency requirement. Four jurisdictions had at least one law in each OBBT policy category examined. One-fifth of jurisdictions have OBBT policies not required under federal law. Five of these jurisdictions are among those with the highest overdose death rates per capita, according to publicly available data from 2021. Some OBBT requirements could potentially limit clinician interest in offering buprenorphine treatment or result in inadequate care (eg, if dosage limitations are too low.). CONCLUSIONS Even though a federal waiver is no longer required for OBBT, our results suggests that at least some jurisdictions have other OBBT requirements, such as counseling, dosage, and/or frequency requirements. Given the severity of the ongoing opioid overdose crisis, policymakers should carefully consider the extent to which OBBT requirements are evidence based.
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Affiliation(s)
- Barbara Andraka-Christou
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA
- Department of Internal Medicine, University of Central Florida, Orlando, FL, USA
| | | | - Michelle Williams
- Legal Studies Department, University of Central Florida, Orlando, FL, USA
| | - Scott Buksbaum
- Legal Studies Department, University of Central Florida, Orlando, FL, USA
| | - Adam J Gordon
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
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5
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Cummins MR, Ivanova J, Ong T, Soni H, Barrera JF, Wilczewski H, Welch BM, Bunnell BE. Will the United States pass on telemedicine progress? JAMIA Open 2024; 7:ooae016. [PMID: 38410742 PMCID: PMC10896640 DOI: 10.1093/jamiaopen/ooae016] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 10/04/2023] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
Background During the COVID-19 pandemic, federal and state health policies allowed temporary flexibilities for Medicare and Medicaid beneficiaries, leading to a sharp increase in telemedicine use. However, many of the flexibilities that enabled innovation and growth in telemedicine continue temporarily since the federal emergency declaration ended in May 2023, and the United States has not made permanent decisions about telemedicine policy. Analysts have raised concerns about increased spending, program integrity, safety, and equity, and recommend strengthening oversight. Methods Here, we argue that we must continue the flexibilities to better understand telemedicine's quality, safety, and outcomes, and until the United States can develop an evidence-based digital health strategy. A premature regression to pre-pandemic telemedicine policies risks unintended consequences. Conclusion We must continue the current policy flexibilities, safeguard against fraud and abuse, and immediately prioritize research and evaluation of telemedicine's quality, safety, and outcomes, to avoid unintended consequences and support more permanent policy decision-making.
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Affiliation(s)
- Mollie R Cummins
- College of Nursing, University of Utah, Salt Lake City, UT 84112-5880, United States
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT 84112-5880, United States
- Doxy.me Research, Doxy.me Inc, Rochester, NY 14623, United States
| | - Julia Ivanova
- Doxy.me Research, Doxy.me Inc, Rochester, NY 14623, United States
| | - Triton Ong
- Doxy.me Research, Doxy.me Inc, Rochester, NY 14623, United States
| | - Hiral Soni
- Doxy.me Research, Doxy.me Inc, Rochester, NY 14623, United States
| | - Janelle F Barrera
- Doxy.me Research, Doxy.me Inc, Rochester, NY 14623, United States
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL 33613, United States
| | | | - Brandon M Welch
- Doxy.me Research, Doxy.me Inc, Rochester, NY 14623, United States
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC 29425, United States
| | - Brian E Bunnell
- Doxy.me Research, Doxy.me Inc, Rochester, NY 14623, United States
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL 33613, United States
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6
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McCafferty R, Cembrowski G, de la Salle B, Peng M, Urrechaga E. ICSH review of internal quality control policy for blood cell counters. Int J Lab Hematol 2024; 46:216-226. [PMID: 38214063 DOI: 10.1111/ijlh.14220] [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: 01/08/2023] [Accepted: 11/24/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION This paper is a report of an ICSH review of policies and practices for internal quality control (IQC) policy for haematology cell counters among regulatory bodies, cell counter manufacturers and diagnostic laboratories. It includes a discussion of the study findings and links to separate ICSH guidance for such policies and practices. The application of internal quality control (IQC) methods is an essential pre-requisite for all clinical laboratory testing including the blood count (Full Blood Count, FBC, or Complete Blood Count, CBC). METHODS The ICSH has gathered information regarding the current state of practice through review of published guidance from regulatory bodies, a questionnaire to six major cell counter manufacturers (Abbott Diagnostics, Beckman Coulter, Horiba Medical Diagnostic Instruments & Systems, Mindray Medical International, Siemens Healthcare Diagnostics and Sysmex Corporation) and a survey issued to 191 diagnostic laboratories in four countries (China, Republic of Ireland, Spain and the United Kingdom) on their IQC practice and approach to use of commercial IQC materials. RESULTS This has revealed diversity both in guidance and in practice around the world. There is diversity in guidance from regulatory organizations in regard to IQC methods each recommends, clinical levels to use and frequency to run commercial controls, and finally recommended sources of commercial controls. The diversity in practice among clinical laboratories spans the areas of IQC methods used, derivation of target values and action limits used with control materials, and frequency of running commercial controls materials. CONCLUSIONS These findings and their implications for IQC Practice are discussed in this paper. They are used to inform a separate guidance document, which proposes a harmonized approach to address the issues faced by diagnostic laboratories.
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7
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Moore M, Balascio P, Bonner-Johnson T, Garth J, Brinkman B, Hill AV. Implementing Comprehensive Sex and Sexuality Education in Kindergarten-Grade 12 Schools: Guiding Practices and Examples. J Sch Health 2024; 94:374-379. [PMID: 38351584 DOI: 10.1111/josh.13431] [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: 03/22/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Comprehensive sex and sexuality education (CSE) is an evidence-based intervention associated with improved sexual and reproductive health outcomes. Currently, there are no standardized requirements for sex and sexuality education in the United States, despite expert recommendations. CONTRIBUTIONS TO THEORY In the United States, a Whole School, Whole Community, Whole Child theoretical model proposed by the Centers for Disease Control, and current examples of school sex education policy is used to make recommendations for the standardization of comprehensive sexual health education in K-12 schools. This article describes the necessary components to adopt CSE equitably, and provides an example of the process implemented to improve CSE in 1 school district in Pittsburgh, PA. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY Understanding the key components of legislation that align with recommended standards, and the process of advocating for school policy change, allows local advocacy groups and education policymakers to create and pass feasible legislation that will ensure appropriate instruction. There is additional room for improvement in states and local districts that have current CSE legislation, to adopt approaches grounded in frameworks that critically evaluate social determinants of health and amend legislation to further improve health equity. CONCLUSIONS Several states and local districts have passed CSE regulations, and are implementing and evaluating their efficacy, providing support and examples for other regions interested in adopting similar policies and processes. Pittsburgh Public Schools can be used as an example adapting current legislation and adopting more comprehensive language.
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Affiliation(s)
- Mikaela Moore
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Phoebe Balascio
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Tausha Bonner-Johnson
- Health & Wellness Workgroup, Black Girls Equity Alliance, New Voices for Reproductive Heath, Pittsburgh, PA
| | - José Garth
- Health & Wellness Workgroup, Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, PA
| | - Britney Brinkman
- Black Girls Equity Alliance, Gwen's Girls, Pittsburgh, Pennsylvania; Department of Psychology, Point Park University, Pittsburgh, PA
| | - Ashley V Hill
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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8
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Lucchese E. How important are delays in treatment for health outcomes? The case of ambulance response time and cardiovascular events. Health Econ 2024; 33:652-673. [PMID: 38148482 DOI: 10.1002/hec.4791] [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: 04/21/2023] [Revised: 10/31/2023] [Accepted: 12/01/2023] [Indexed: 12/28/2023]
Abstract
The cost effectiveness of medical treatments is not precisely known due to the compounding effect of multiple determining factors. Ambulance response time (RT) to emergency calls is exploited to learn more about the effect of the timing of treatment on health outcomes. This causal relation is identified by exploiting rainfall at the time of the ambulance run as a shock to RT. The analysis focuses on patients who have undergone a cardiac event and shows that a one-minute increase in average RT leads to 105 more deaths each year in one Italian region. Finally, the economic value of the lives that would be saved by reducing RT is quantified to facilitate policymaking.
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Affiliation(s)
- Elena Lucchese
- Department of Economics, Management and Statistics, University of Milan Bicocca, Milano, Italy
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9
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Cygan HR, Dombrowski RD, Moore EWG, Tully J, Kin K, Hansen E. Development of a School Health Policy Implementation Survey: A Delphi Study. J Sch Nurs 2024; 40:135-143. [PMID: 34882017 DOI: 10.1177/10598405211057588] [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: 11/15/2022] Open
Abstract
Data on school health policy implementation are limited due to the absence of a validated measurement tool. The purpose of this study was to create and pilot a school health policy implementation survey. A modified, four-round Delphi process was used to achieve consensus on content and format of the survey. The final 76-item survey was piloted in 655 schools with a return rate of 57.1% (n = 378). Seven schools participated in environmental audits. Based on the audits, survey responses represented an accurate description of school practices for 84.2% (n = 64) of questions. The remaining 15.8% (n = 12) of survey items were eliminated or revised. This measurement tool begins to fill the research gap between the evaluation of written school health policy and implementation. Further, this tool may be used by school nurses in alignment with the Framework for 21st Century School Nursing Practice.
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Affiliation(s)
- Heide R Cygan
- Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, IL
| | - Rachael D Dombrowski
- Division of Kinesiology Health and Sport Studies, College of Education, Wayne State University, Detroit, MI
| | - E Whitney G Moore
- Kinesiology, Health & Sport Studies, Achievement Motivation Theory Specialist, College of Education, Wayne State University, Detroit, MI
| | - Jamie Tully
- Office of Student Health and Wellness, Chicago Public Schools, Chicago, IL
| | - Kimberly Kin
- Kinesiology, Health & Sport Studies, College of Education, Wayne State University, Detroit, MI
| | - Elizabeth Hansen
- Office of Student Health and Wellness, Chicago Public Schools, Chicago, IL
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10
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Morgenroth T, Axt JR, Westgate EC. What Underlies the Opposition to Trans-Inclusive Policies? The Role of Concerns About Male Violence Versus Attitudes Toward Trans People. Pers Soc Psychol Bull 2024; 50:533-549. [PMID: 36511579 DOI: 10.1177/01461672221137201] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/22/2023]
Abstract
Transgender women's access to women-only spaces is controversial. Arguments against trans-inclusive policies often focus on cisgender women's safety from male violence, despite little evidence to suggest that such policies put cisgender women at risk. Across seven studies using U.S. and U.K. participants (N = 3,864), we investigate whether concerns about male violence versus attitudes toward trans people are a better predictor of support for trans-inclusive policies and whether these factors align with the reasons given by opponents and supporters regarding their policy views. We find that opponents of these policies do not accurately report their reasons for opposition: Specifically, while opponents claim that concerns about male violence are the primary reason driving their opposition, attitudes toward transgender people more strongly predicted policy views. These results highlight the limitations of focusing on overt discourse and emphasize the importance of investigating psychological mechanisms underlying policy support.
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11
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McCollister KE, Gordon AJ, Acevedo A, Voshtina D, Li JM, Tse B, Murphy SM. The 2023 Addiction Health Services Research Conference: Back in Person and Taking a Bite of the Big Apple. Subst Use Addctn J 2024; 45:163-167. [PMID: 38288727 DOI: 10.1177/29767342231225577] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
The Addiction Health Services Research (AHSR) Conference has been held since 2002. This Conference brings together researchers, graduate students, policymakers, and treatment providers to focus improving the organization, distribution, and financing of healthcare resources for prevention/care of SUD. The AHSR 2023 Conference took place in New York City, October 18-20th, and was hosted by the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH; cherishresearch.org). Attended by more than 300 participants, the Conference comprised several themes relating to the latest research on addiction health services delivery, financing, and impact. The agenda also included pre-conference workshops, distinguished plenary speakers, a multitude of networking opportunities, and career support for early-stage and minority investigators. AHSR 2023 featured 3 plenary sessions, 120 oral presentations, and 143 poster presentations from academics throughout the world. Overall, AHSR 2023 provided numerous opportunities to advance the field of addiction health services research. The state-of-the-art techniques and insights gained by attending scholars will position them to be change-agents in the addiction field going forward.
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Affiliation(s)
- Kathryn E McCollister
- Division of Health Services Research and Policy, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
- Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH), Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Adam J Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
| | | | - Dorela Voshtina
- Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH), Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Jazmine M Li
- Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH), Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Bonnie Tse
- Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH), Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
| | - Sean M Murphy
- Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV (CHERISH), Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA
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12
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Roberts E. What impact could the legalisation of recreational cannabis have on the health of the UK? Lessons from the rest of the world. Br J Psychiatry 2024; 224:117-118. [PMID: 38268114 PMCID: PMC7615739 DOI: 10.1192/bjp.2024.4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Several jurisdictions across the globe have introduced legislation to legally permit the sale and consumption of recreational cannabis. This editorial considers current evidence from the rest of the world and asks how this might inform the possible consequences of 'legalisation' models in the UK.
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Affiliation(s)
- Emmert Roberts
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and South London and the Maudsley NHS Foundation Trust, London, UK
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13
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Shaw J, Glover W. The Political Economy of Digital Health Equity: Structural Analysis. J Med Internet Res 2024; 26:e46971. [PMID: 38530341 DOI: 10.2196/46971] [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: 03/03/2023] [Revised: 06/30/2023] [Accepted: 02/27/2024] [Indexed: 03/27/2024] Open
Abstract
Digital technologies have produced many innovations in care delivery and enabled continuity of care for many people when in-person care was impossible. However, a growing body of research suggests that digital health can also exacerbate health inequities for those excluded from its benefits for reasons of cost, digital literacy, and structural discrimination related to characteristics such as age, race, ethnicity, and socioeconomic status. In this paper, we draw on a political economy perspective to examine structural barriers to progress in advancing digital health equity at the policy level. Considering the incentive structures and investments of powerful actors in the field, we outline how characteristics of neoliberal capitalism in Western contexts produce and sustain digital health inequities by describing 6 structural challenges to the effort to promote health equity through digital health, as follows: (1) the revenue-first incentives of technology corporations, (2) the influence of venture capital, (3) inequitable access to the internet and digital devices, (4) underinvestment in digital health literacy, (5) uncertainty about future reimbursement of digital health, and (6) justified mistrust of digital health. Building on these important challenges, we propose future immediate and long-term directions for work to support meaningful change for digital health equity.
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Affiliation(s)
- James Shaw
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Joint Centre for Bioethics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Wiljeana Glover
- Technology, Operations, and Information Management Division, Babson College, Wellesley, MA, United States
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14
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Simoens S, Lacosta TB, Inotai A. Learnings from cross-border biosimilar pricing policies in Europe. Expert Rev Pharmacoecon Outcomes Res 2024:1-4. [PMID: 38530083 DOI: 10.1080/14737167.2024.2334343] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 03/20/2024] [Indexed: 03/27/2024]
Affiliation(s)
- Steven Simoens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | | | - András Inotai
- Centre for Health Technology Assessment, Semmelweis University, Budapest, Hungary
- Syreon Research Institute, Budapest, Hungary
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15
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Moffatt C, Leshin J. Best Practices in Evolving Privacy Frameworks for Patient Age Data: Census Data Study. JMIR Form Res 2024; 8:e47248. [PMID: 38526530 DOI: 10.2196/47248] [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: 03/13/2023] [Revised: 10/17/2023] [Accepted: 11/27/2023] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Over the previous 4 decennial censuses, the population of the United States has grown older, with the proportion of individuals aged at least 90 years old in the 2010 census being more than 2 and a half times what it was in the 1980 census. This suggests that the threshold for constraining age introduced in the Safe Harbor method of the HIPAA (Health Insurance Portability and Accountability Act) in 1996 may be increased without exceeding the original levels of risk. This is desirable to maintain or even increase the utility of affected data sets without compromising privacy. OBJECTIVE In light of the upcoming release of 2020 census data, this study presents a straightforward recipe for updating age-constrained thresholds in the context of new census data and derives recommendations for new thresholds from the 2010 census. METHODS Using census data dating back to 1980, we used group size considerations to analyze the risk associated with various maximum age thresholds over time. We inferred the level of risk of the age cutoff of 90 years at the time of HIPAA's inception in 1996 and used this as a baseline from which to recommend updated cutoffs. RESULTS The maximum age threshold may be increased by at least 2 years without exceeding the levels of risk conferred in HIPAA's original recommendations. Moreover, in the presence of additional information that restricts the population in question to a known subgroup with increased longevity (for example, restricting to female patients), the threshold may be increased further. CONCLUSIONS Increasing the maximum age threshold would enable the data user to gain more utility from the data without introducing risk beyond what was originally envisioned with the enactment of HIPAA. Going forward, a recurring update of such thresholds is advised, in line with the considerations detailed in the paper.
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Karvanen M, Cars O. The language of antimicrobial and antibiotic resistance is blocking global collective action. Infect Dis (Lond) 2024:1-9. [PMID: 38520678 DOI: 10.1080/23744235.2024.2332455] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 03/25/2024] Open
Abstract
Sustainable access to effective antibiotics is a foundational need for functioning health care that is increasingly threatened by antibiotic resistance. Although resistance has been known as long as antibiotics have been in clinical use, there are still multiple gaps in the global and local responses. One often cited cause for this complacency is the language that is used to describe the problem and its consequences. In this paper, we survey some examples of the current discussions around antibiotic resistance and seek to offer a path towards unified and understandable messaging that is relevant both to the public and policymakers by using narratives that highlight the individual and societal consequences of antibiotic resistance. Major shortcomings in the current language that hamper both the understanding of antibiotic resistance and needed behaviour change have been identified in scientific papers and special reports. These shortcomings range from terminology that is difficult to understand, through a lack of personal relevance, to a fragmented response in the policy field. We propose that scientists, including behaviour change experts, and other key stakeholders that are engaged in the issue take lead to agreement on the core scientific facts and to formulate a vision that can be a foundation for creation of consistent global narratives. These narratives must in turn be adapted to local contexts. Development of such narratives should be viewed as an essential component in national action plans on AMR to raise awareness, empower citizens and incentivise societal behaviour change, policy development and implementation of governance structures.
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Affiliation(s)
- Matti Karvanen
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Otto Cars
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Grasso D, Raissian KM, Doucette L, McGuire AB, Dineen JN. Harms and Benefits Inventory (HBI): initial validation of a novel assessment of perceived harms and benefits of firearm policies and practices. Inj Prev 2024:ip-2023-045073. [PMID: 38519144 DOI: 10.1136/ip-2023-045073] [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: 08/09/2023] [Accepted: 02/02/2024] [Indexed: 03/24/2024]
Abstract
INTRODUCTION Understanding gun owners' perceptions of potential firearm policies' harms and benefits is critical to successful policy development and implementation. We used national survey data to develop and validate a novel instrument, the Harms and Benefits Inventory (HBI), for policy-makers and advocates to better consider the citizen perspective. METHOD We conducted a nationally representative survey of American gun owners and non-owners (N=2007) using the Social Science Research Solutions probability panel. The survey included 31 candidate HBI items and questions about gun ownership and exposure, storage and carry behaviours, policy positions, and sociodemographic characteristics. Exploratory factor analyses (EFAs) were conducted on HBI items from a randomly selected subsample (N=1003) and then tested with a confirmatory factor analysis (CFA) on data from the second half of the sample (N=1004). RESULTS The best-fitting EFA model was upheld in the CFA and included 21 items with 5 underlying factors. Underlying factors included: (1) firearm regulation, cost and accessibility, (2) special restrictions, (3) permit and education, (4) relaxed restrictions and (5) and hobby and sport. Internal consistency was good to excellent within each of the five scales. Validity was supported by correlations between HBI scales and survey questions. DISCUSSION Findings support the validity of the HBI in assessing perceptions of potential harms and benefits of firearm policies and practices. Understanding perceptions of potential harms and benefits of gun policies at the time of development or implementation can improve uptake and reduce unintended consequences of these policies.
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Affiliation(s)
- Damion Grasso
- School of Public Policy, University of Connecticut, Hartford, Connecticut, USA
| | - Kerri M Raissian
- School of Medicine, University of Connecticut, Farmington, Connecticut, USA
| | - L Doucette
- Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Chiu P, Limoges J, Pike A, Calzone K, Tonkin E, Puddester R, Gretchev A, Dewell S, Newton L, Leslie K. Integrating genomics into Canadian oncology nursing policy: Insights from a comparative policy analysis. J Adv Nurs 2024. [PMID: 38509799 DOI: 10.1111/jan.16099] [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: 09/15/2023] [Revised: 01/16/2024] [Accepted: 02/06/2024] [Indexed: 03/22/2024]
Abstract
AIM To learn from two jurisdictions with mature genomics-informed nursing policy infrastructure-the United States (US) and the United Kingdom (UK)-to inform policy development for genomics-informed oncology nursing practice and education in Canada. DESIGN Comparative document and policy analysis drawing on the 3i + E framework. METHODS We drew on the principles of a rapid review and identified academic literature, grey literature and nursing policy documents through a systematic search of two databases, a website search of national genomics nursing and oncology nursing organizations in the US and UK, and recommendations from subject matter experts on an international advisory committee. A total of 94 documents informed our analysis. RESULTS We found several types of policy documents guiding genomics-informed nursing practice and education in the US and UK. These included position statements, policy advocacy briefs, competencies, scope and standards of practice and education and curriculum frameworks. Examples of drivers that influenced policy development included nurses' values in aligning with evidence and meeting public expectations, strong nurse leaders, policy networks and shifting healthcare and policy landscapes. CONCLUSION Our analysis of nursing policy infrastructure in the US and UK provides a framework to guide policy recommendations to accelerate the integration of genomics into Canadian oncology nursing practice and education. IMPLICATIONS FOR THE PROFESSION Findings can assist Canadian oncology nurses in developing nursing policy infrastructure that supports full participation in safe and equitable genomics-informed oncology nursing practice and education within an interprofessional context. IMPACT This study informs Canadian policy development for genomics-informed oncology nursing education and practice. The experiences of other countries demonstrate that change is incremental, and investment from strong advocates and collaborators can accelerate the integration of genomics into nursing. Though this research focuses on oncology nursing, it may also inform other nursing practice contexts influenced by genomics.
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Affiliation(s)
- Patrick Chiu
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jacqueline Limoges
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - April Pike
- Faculty of Nursing, Memorial University of Newfoundland, St. Johns, Newfoundland, Canada
| | - Kathleen Calzone
- Genetics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Emma Tonkin
- Faculty of Life Sciences and Education, University of South Wales, Wales, UK
| | - Rebecca Puddester
- Faculty of Nursing, Memorial University of Newfoundland, St. Johns, Newfoundland, Canada
| | - Andrea Gretchev
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
| | - Sarah Dewell
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Lorelei Newton
- School of Nursing, University of Victoria, Victoria, British Columbia, Canada
| | - Kathleen Leslie
- Faculty of Health Disciplines, Athabasca University, Athabasca, Alberta, Canada
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Humphreys A, Stevenson AJ, Yeatman S. Changes in Contraceptive Method Mix Following the Colorado Family Planning Initiative. Contraception 2024:110422. [PMID: 38521456 DOI: 10.1016/j.contraception.2024.110422] [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: 12/04/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVE To describe the changes in contraceptive method use and mix among Colorado Title X clients following the 2009 Colorado Family Planning Initiative (CFPI), which allowed Colorado Title X providers to offer all contraceptive methods without medically unnecessary barriers. STUDY DESIGN Using data on all visits to Colorado Title X clinics between 2007 and 2016 for women aged 10-49 years, we described trends in contraceptive method use by age group and race/ethnicity prior to and following the implementation of CFPI. RESULTS The implementation of CFPI saw an abrupt increase in Title X visits. Visits subsequently declined steeply for non-Hispanic White clients while visits by Hispanic clients remained at elevated levels. During CFPI, use of long-acting reversible contraceptives (LARCs) increased while use of oral contraceptive pills (OCPs) decreased. Nonetheless, OCPs remained the most common method used by Title X clients throughout the study period. Changes in method mix varied by age and race/ethnicity. Method switching was relatively uncommon among established Title X clinic users. CONCLUSION CFPI, which removed financial barriers to the most expensive methods, was associated with increases in the use of LARCs and changes in method mix that varied by age group and race/ethnicity. IMPLICATIONS CFPI removed barriers to previously inaccessible methods that contributed to changes in the method mix at Title X clinics. That these changes were not uniform across ages and race/ethnicities emphasizes that subgroup variation in family planning policy impact stems from heterogeneity in barriers to care and method-specific unmet demand.
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Affiliation(s)
- Abigail Humphreys
- University of Colorado Denver, Department of Economics, Campus Box 181, University of Colorado Denver, PO Box 173364, Denver, CO 80217-3364; University of Colorado Population Center, University of Colorado Boulder, Institute of Behavioral Science (IBS), University of Colorado Boulder, 483 UCB, Boulder, CO 80309-0483.
| | - Amanda Jean Stevenson
- University of Colorado Population Center, University of Colorado Boulder, Institute of Behavioral Science (IBS), University of Colorado Boulder, 483 UCB, Boulder, CO 80309-0483; University of Colorado Boulder, Department of Sociology, UCB 327 Ketchum 195, Boulder, CO 80309.
| | - Sara Yeatman
- University of Colorado Population Center, University of Colorado Boulder, Institute of Behavioral Science (IBS), University of Colorado Boulder, 483 UCB, Boulder, CO 80309-0483; Department of Health and Behavioral Sciences, University of Colorado Denver, College of Liberal Arts and Sciences, Campus Box 188, PO Box 173364, Denver, CO 80217-3364 USA.
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Gamertsfelder E, Delgado Figueroa N, Keestra S, Silva AR, Borana R, Siebert M, Bruckner T. Towards transparency: adoption of WHO best practices in clinical trial registration and reporting among top medical research funders in the USA. BMJ Evid Based Med 2024; 29:79-86. [PMID: 37932014 DOI: 10.1136/bmjebm-2023-112395] [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] [Accepted: 09/25/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE To assess to what extent the clinical trial policies of the largest public and philanthropic funders of clinical research in the United States meet WHO best practices in trial registration and reporting. METHODS Public and philanthropic funders of clinical trials in the USA with >US$50 million annual spend were selected. The funders were assessed using an 11-item scoring tool based on WHO Joint Statement benchmarks. These 11 items fell into 4 categories, namely: trial registration, academic publication, monitoring and sanctions. An additional item captured whether and how funders referred to Consolidated Standards of Reporting Trials (CONSORT) within their trial policies. Each funder was independently assessed by two or three researchers. Funders were contacted to flag possible errors and omissions. Ambiguous or difficult-to-score items were settled by an independent adjudicator. RESULTS Fourteen funders were assessed. Our cross-sectional study found that, on average, funders have only implemented 4.1/11 (37%) of WHO best practices in clinical trial transparency. The most frequently adopted requirement was open access publishing (14/14 funders). The least frequently adopted were (1) requiring trial ID to appear in all publications (2/14 funders, 14%) and (2) making compliance reports public (2/14 funders, 14%). Public funders, on average, adopted more policy elements (5.2/11 items, 47%) than philanthropic funders (2.8/11 items, 25%). Only one funder's policy documents mentioned the CONSORT statement. CONCLUSIONS There is a significant variation between the number of best practice policy items adopted by medical research funders in the USA. Many funders fell significantly short of WHO Joint Statement benchmarks. Each funder could benefit from policy revision and strengthening.
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Affiliation(s)
- Elise Gamertsfelder
- Department of Health Policy, The London School of Economics and Political Science, London, UK
- Consilium Scientific, London, UK
| | | | - Sarai Keestra
- Department for Epidemiology & Data Science, University of Amsterdam, Amsterdam, The Netherlands
| | - Alan Rossi Silva
- Faculty of Law, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | | | - Maximilian Siebert
- Meta-Research Innovation Center at Stanford, Stanford University, Stanford, California, USA
| | - Till Bruckner
- Consilium Scientific, London, UK
- TranspariMED, Bristol, UK
- UiT The Arctic University of Norway, Tromsø, Norway
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Moges M, Rodland EK, Argaw A. Ethiopian Street Foods: Working Conditions and Governance Perspectives. A Qualitative Study. Environ Health Insights 2024; 18:11786302241241414. [PMID: 38525296 PMCID: PMC10958792 DOI: 10.1177/11786302241241414] [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] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
Introduction Street foods are foods and beverages as either ready for direct consumption or minimally processed, prepared, and/or sold by vendors and handlers. The objective of this study was to explore the condition and governance of street foods in Ethiopia. Method A qualitative exploratory study was employed from December 2022 to January 2023 in Addis Ababa, Hawassa, Dire Dawa, and Jimma, cities of Ethiopia. Twelve respondents comprised key informants from selected governmental sectors were interviewed. The purposive sampling method was used to recruit study participants. The number of participants interviewed was determined by the information saturation criterion, and data were collected at the interviewee's offices. Data were collected by using key informant interview technique and audio recorded. An interview guide was used to facilitate interviews and thematic analysis was employed. The Overall data management process was conducted using Atlas-ti V 8 software. Result The result revealed there were 4 thematic areas these were street food vendors and vending process, policy content and implementation, integration and coordination of sectors, and the way forward. The street food vendors prepared their food in an insanitary manner, absence of common working places for the vendors, lack of due emphasis for the street food vendors in the national food and nutrition policy, lack of formalization and legalization of street food vendors, poor coordination among sectors and institutions work on street food governance, and weakness on the implementation of rules and regulations in controlling street food vendors were the prominent gaps that were identified in the policy. Conclusion Though Ethiopia has a national food and nutrition policy, the policy doesn't adequately address the street food vending sector. Besides, it is not well communicated to the implementers resulting in poor policy implementation. Quantifying socio-economic benefits of street food vending activities in Ethiopia needs further investigation.
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Affiliation(s)
- Mathewos Moges
- Environmental Health Science and Technology Department, Jimma University, Jimma, Ethiopia
| | | | - Ambelu Argaw
- Division of Water and Health, Ethiopian Institute of Water Resources, Addis Abeba University, Addis Ababa, Ethiopia
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Baek J, Lawson J, Rahimzadeh V. Investigating the Roles and Responsibilities of Institutional Signing Officials After Data Sharing Policy Reform for Federally Funded Research in the United States: National Survey. JMIR Form Res 2024; 8:e49822. [PMID: 38506894 DOI: 10.2196/49822] [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: 06/10/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND New federal policies along with rapid growth in data generation, storage, and analysis tools are together driving scientific data sharing in the United States. At the same, triangulating human research data from diverse sources can also create situations where data are used for future research in ways that individuals and communities may consider objectionable. Institutional gatekeepers, namely, signing officials (SOs), are therefore at the helm of compliant management and sharing of human data for research. Of those with data governance responsibilities, SOs most often serve as signatories for investigators who deposit, access, and share research data between institutions. Although SOs play important leadership roles in compliant data sharing, we know surprisingly little about their scope of work, roles, and oversight responsibilities. OBJECTIVE The purpose of this study was to describe existing institutional policies and practices of US SOs who manage human genomic data access, as well as how these may change in the wake of new Data Management and Sharing requirements for National Institutes of Health-funded research in the United States. METHODS We administered an anonymous survey to institutional SOs recruited from biomedical research institutions across the United States. Survey items probed where data generated from extramurally funded research are deposited, how researchers outside the institution access these data, and what happens to these data after extramural funding ends. RESULTS In total, 56 institutional SOs participated in the survey. We found that SOs frequently approve duplicate data deposits and impose stricter access controls when data use limitations are unclear or unspecified. In addition, 21% (n=12) of SOs knew where data from federally funded projects are deposited after project funding sunsets. As a consequence, most investigators deposit their scientific data into "a National Institutes of Health-funded repository" to meet the Data Management and Sharing requirements but also within the "institution's own repository" or a third-party repository. CONCLUSIONS Our findings inform 5 policy recommendations and best practices for US SOs to improve coordination and develop comprehensive and consistent data governance policies that balance the need for scientific progress with effective human data protections.
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Affiliation(s)
| | | | - Vasiliki Rahimzadeh
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, United States
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Ehsani JP, Eshragi AC, Hellinger A. Electric scooters: a crisis and opportunity. Trauma Surg Acute Care Open 2024; 9:e001396. [PMID: 38510533 PMCID: PMC10953031 DOI: 10.1136/tsaco-2024-001396] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Affiliation(s)
- Johnathon P Ehsani
- Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ava Clara Eshragi
- Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrew Hellinger
- Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Holl F, Kircher J, Hertelendy AJ, Sukums F, Swoboda W. Tanzania's and Germany's Digital Health Strategies and Their Consistency With the World Health Organization's Global Strategy on Digital Health 2020-2025: Comparative Policy Analysis. J Med Internet Res 2024; 26:e52150. [PMID: 38498021 DOI: 10.2196/52150] [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: 08/26/2023] [Revised: 11/28/2023] [Accepted: 01/31/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND In recent years, the fast-paced adoption of digital health (DH) technologies has transformed health care delivery. However, this rapid evolution has also led to challenges such as uncoordinated development and information silos, impeding effective health care integration. Recognizing these challenges, nations have developed digital health strategies (DHSs), aligning with their national health priorities and guidance from global frameworks. The World Health Organization (WHO)'s Global Strategy on Digital Health 2020-2025 (GSDH) guides national DHSs. OBJECTIVE This study analyzes the DHSs of Tanzania and Germany as case studies and assesses their alignment with the GSDH and identifies strengths, shortcomings, and areas for improvement. METHODS A comparative policy analysis was conducted, focusing on the DHSs of Tanzania and Germany as case studies, selected for their contrasting health care systems and cooperative history. The analysis involved a three-step process: (1) assessing consistency with the GSDH, (2) comparing similarities and differences, and (3) evaluating the incorporation of emergent technologies. Primary data sources included national eHealth policy documents and related legislation. RESULTS Both Germany's and Tanzania's DHSs align significantly with the WHO's GSDH, incorporating most of its 35 elements, but each missing 5 distinct elements. Specifically, Tanzania's DHS lacks in areas such as knowledge management and capacity building for leaders, while Germany's strategy falls short in engaging health care service providers and beneficiaries in development phases and promoting health equity. Both countries, however, excel in other aspects like collaboration, knowledge transfer, and advancing national DHSs, reflecting their commitment to enhancing DH infrastructures. The high ratings of both countries on the Global Digital Health Monitor underscore their substantial progress in DH, although challenges persist in adopting the rapidly advancing technologies and in the need for more inclusive and comprehensive strategies. CONCLUSIONS This study reveals that both Tanzania and Germany have made significant strides in aligning their DHSs with the WHO's GSDH. However, the rapid evolution of technologies like artificial intelligence and machine learning presents challenges in keeping strategies up-to-date. This study recommends the development of more comprehensive, inclusive strategies and regular revisions to align with emerging technologies and needs. The research underscores the importance of context-specific adaptations in DHSs and highlights the need for broader, strategic guidelines to direct the future development of the DH ecosystem. The WHO's GSDH serves as a crucial blueprint for national DHSs. This comparative analysis demonstrates the value and challenges of aligning national strategies with global guidelines. Both Tanzania and Germany offer valuable insights into developing and implementing effective DHSs, highlighting the importance of continuous adaptation and context-specific considerations. Future policy assessments require in-depth knowledge of the country's health care needs and structure, supplemented by stakeholder input for a comprehensive evaluation.
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Affiliation(s)
- Felix Holl
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Jennifer Kircher
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Attila J Hertelendy
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, United States
| | - Felix Sukums
- MUHAS Digital Health and Innovation Research Group, Muhimbili University of Health & Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Walter Swoboda
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
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Buck A, Hurewitz S, Franklin MS. Workforce perspective on racial and ethnic equity in early childhood autism evaluation and treatment: "The cornerstone of everything we do". Autism 2024:13623613241235522. [PMID: 38477296 DOI: 10.1177/13623613241235522] [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] [Indexed: 03/14/2024]
Abstract
LAY ABSTRACT Black and non-White Latinx children tend to receive autism diagnoses later in life and with a higher degree of impairment than White children. The purpose of this study was to learn what is currently helping as well as preventing Black and non-White Latinx children from getting access to autism evaluation and services. We held virtual interviews with 26 experts who work with autistic children and their families, including clinical providers, researchers, advocates, and policymakers/government representatives. From these interviews, we identified four themes that have an impact on equity in autism services: (1) who makes up the workforce, (2) workforce capacity and accessibility, (3) workforce payment structure, and (4) changes due to the COVID-19 pandemic. These findings show the need for improved workforce diversity, autism-specific education, payment structures, and additional support for workforce members to avoid burnout. To make childhood autism services more equitable, diversity in recruitment across training levels, cultural awareness, increased autism education for all pediatric providers, and partnerships with caregivers as experts must be prioritized. These investments in the autism workforce will allow professionals in the field to better meet the needs of children and families from Black and non-White Latinx communities and achieve equity in early childhood autism services.
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Crespi E, Hardesty JJ, Nian Q, Cohen JE. Decisions of the FDA on premarket tobacco product applications: Changes in the number of unique devices and liquids used by US adults who frequently use electronic nicotine delivery systems, 2020-2023. Tob Induc Dis 2024; 22:TID-22-52. [PMID: 38482508 PMCID: PMC10936557 DOI: 10.18332/tid/184240] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 02/17/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION The majority of decisions on electronic nicotine delivery system (ENDS) premarket tobacco product applications (PMTAs) were made from October 2020 to February 2023; 99% (>25 million) had determinations by March 2023 and just twenty-three received marketing granted orders. We examined the unique devices and liquids used among US adults frequently using ENDS before, during, and after a majority of PMTA decisions were made. METHODS Data are from waves 1-5 (W1: May-Oct 2020, n=1179; W5: Feb-Apr 2023, n=1290) of a longitudinal survey of US adults (≥21 years) using ENDS ≥5 days/week. User-submitted photos of participants' most used devices and liquids were coded. Descriptive analyses and Wilcoxon signed-rank tests were used to understand the number and types of unique devices and liquids used in W1-W5, and the top brands in each wave. RESULTS From W1-W5, the number of unique ENDS device models and liquid products used by participants increased from 279 to 357 (p<0.001) and 546 to 695 (p<0.001), respectively. More unique devices in W5 versus W1 were disposable (W1: 16.5%; W5: 36.1%); fewer were disposable pod (W1: 6.5%; W5: 3.1%) or tank (W1: 53.8%; W5: 30.8%) devices. Liquids were primarily sweet-flavored (W1: 81.1%; W5: 82.0%). The median liquid nicotine concentration increased from 12 to 50 mg/mL. In W5, few participants used FDA-approved devices (n=17; 1.3%) or liquids (n=6; 0.5%), and Elf Bar was the most commonly used device and liquid brand. Results for all waves are reported. CONCLUSIONS Despite PMTA decisions, an increase in the number of unique device models and liquid products used among adults who frequently use ENDS was observed from 2020 to 2023. Few participants in 2023 were using FDA-approved devices or liquids. Further research and monitoring are needed to inform how FDA prioritizes enforcement actions and what types of enforcement actions are effective.
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Affiliation(s)
- Elizabeth Crespi
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Jeffrey J. Hardesty
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Qinghua Nian
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
| | - Joanna E. Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States
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Bold KW, Sharma A, Haeny A, Gueorguieva R, Buta E, Baldassarri S, Lempert L, Krishnan-Sarin S, O'Malley S. A randomized controlled trial of potential tobacco policies prohibiting menthol flavor in cigarettes and e-cigarettes: a study protocol. BMC Psychiatry 2024; 24:201. [PMID: 38475757 DOI: 10.1186/s12888-024-05619-0] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Menthol cigarette use remains a large public health problem and disproportionately affects Black adults in the United States. The Food and Drug Administration has proposed prohibiting menthol flavor in cigarettes to protect public health. However, e-cigarettes are available in menthol flavor and are a popular alternative product adults might switch to if menthol is prohibited in cigarettes. Research is needed to understand how availability of menthol (vs. tobacco) flavored e-cigarettes could impact cigarette use among adults who smoke menthol cigarettes. METHODS We will recruit 150 adults who currently smoke menthol cigarettes and will randomize them to 1 of 3 conditions modeling different regulatory scenarios. We will recruit equal numbers of participants identifying as Black vs. non-Black and will stratify randomization by race. To promote standardization and adherence, cigarette and e-cigarette products will be provided for 8 weeks based on the assigned condition: (A) no menthol restriction (menthol cigarette and menthol flavored e-cigarette), (B) menthol prohibited in cigarettes only (non-menthol cigarette and menthol flavored e-cigarette), (C) menthol prohibited in both cigarettes and e-cigarettes (non-menthol cigarette and tobacco flavored e-cigarette). A follow-up visit will occur at week 12 to assess tobacco use status. The study aims are to (1) examine the impact of prohibiting menthol flavor in cigarettes and e-cigarettes on smoking behavior and (2) investigate whether outcomes differ by race to understand the impact of menthol policies on Black (vs. non-Black) individuals given high rates of menthol cigarette use in this population. The primary outcome will evaluate changes in the number of cigarettes smoked per day during the 8-week study period and will examine differences by regulatory scenario. Secondary outcomes will compare percent days smoke-free, changes in nicotine dependence, and motivation, confidence, and intentions to quit smoking by the regulatory scenarios. We will examine whether changes in the outcomes differ by Black vs. non-Black participants to compare the magnitude of the effect of the various menthol policy scenarios by race. DISCUSSION Results will contribute critical information regarding menthol in cigarettes and e-cigarettes to inform regulatory policies that maximize reductions in cigarette smoking and reduce tobacco-related health disparities. TRIAL REGISTRATION NCT05259566. Yale IRB protocol #2000032211, last approved 12/8/2023.
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Affiliation(s)
- Krysten W Bold
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA.
- Yale Cancer Center, New Haven, CT, USA.
| | - Akshika Sharma
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Angela Haeny
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Eugenia Buta
- Yale Center for Analytical Sciences, Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Stephen Baldassarri
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
- Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Lauren Lempert
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, CT, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
| | | | - Stephanie O'Malley
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
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Berridge V, Fairchild AL, Morphett K, Gartner C, Hall W, Bayer R. E-cigarettes: A framework for comparative history and policy. Addiction 2024. [PMID: 38467572 DOI: 10.1111/add.16462] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/31/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND England, Australia and the United States have approached the regulation of e-cigarettes in very different ways, yet all three countries have appealed to the concept of evidence as underpinning policy responses. We compared these policy responses using a combination of the methodologies of historians and policy scientists in order to elucidate the factors that had influenced policy in each country. ARGUMENT/ANALYSIS Each country's evidence and values intersected in different ways, producing very different responses within specific national contexts and histories. Our analysis accordingly emphasized the historical precursors of the policy issues raised by e-cigarettes and placed the policy debate within the context of regulatory bodies and the networks of researchers and advocates who influenced policy. Issues also of importance were the nature of the state; political context; the pre-history of nicotine for smoking cessation; the role of activism and its links with government; the influence of harm reduction ideas from drugs and HIV; and finally, whom policy was perceived to benefit. In the United Kingdom, based on this pre-history of the smoking issue, it was the existing smoker, while in the United States and Australia, protecting children and adolescents has played a central role. CONCLUSIONS Structural and historical factors appear to underpin differences in e-cigarette policy development in England, Australia and the United States.
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Affiliation(s)
- Virginia Berridge
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Kylie Morphett
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Coral Gartner
- School of Public Health, The University of Queensland, Herston, QLD, Australia
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, The University of Queensland, Herston, QLD, Australia
| | - Ronald Bayer
- Mailman School of Public Health, Columbia University, New York, NY, USA
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Sisk B, Antes AL, Bereitschaft C, Enloe M, Bourgeois F, DuBois J. Guiding Principles for Adolescent Web-Based Portal Access Policies: Interviews With Informatics Administrators. JMIR Pediatr Parent 2024; 7:e49177. [PMID: 38466976 DOI: 10.2196/49177] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 11/17/2023] [Accepted: 02/14/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Web-based patient portals are tools that could support adolescents in managing their health and developing autonomy. However, informatics administrators must navigate competing interests when developing portal access policies for adolescents and their parents. OBJECTIVE We aimed to assess the perspectives of informatics administrators on guiding principles for the development of web-based health care portal access policies in adolescent health care. METHODS We interviewed informatics administrators from US hospitals with ≥50 dedicated pediatric beds. We performed a thematic analysis of guiding principles for developing and implementing adolescent portal access policies. RESULTS We interviewed 65 informatics leaders who represented 63 pediatric hospitals, 58 health care systems, 29 states, and 14,379 pediatric hospital beds. Participants described 9 guiding principles related to three overarching themes: (1) balancing confidentiality and other care needs, (2) balancing simplicity and granularity, and (3) collaborating and advocating. Participants described the central importance of prioritizing the health and safety of the adolescent while also complying with state and federal laws. However, there were differing beliefs about how to prioritize health and safety and what role parents should play in supporting the adolescent's health care. Participants also identified areas where clinicians and institutions can advocate for adolescents, especially with electronic health record vendors and legislators. CONCLUSIONS Informatics administrators provided guiding principles for adolescent portal access policies that aimed to balance the competing needs of adolescent confidentiality and the usefulness of the portal. Portal access policies must prioritize the adolescent's health and safety while complying with state and federal laws. However, institutions must determine how to best enact these principles. Institutions and clinicians should strive for consensus on principles to strengthen advocacy efforts with institutional leadership, electronic health record vendors, and lawmakers.
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Affiliation(s)
- Bryan Sisk
- Bioethics Research Center, Department of Medicine, Washington University School of Medicine, St Louis, MO, United States
- Division of Hematology and Oncology, Department of Pediatrics, Washington University, St Louis, MO, United States
| | - Alison L Antes
- Bioethics Research Center, Department of Medicine, Washington University School of Medicine, St Louis, MO, United States
| | - Christine Bereitschaft
- Division of Hematology and Oncology, Department of Pediatrics, Washington University, St Louis, MO, United States
| | - Madi Enloe
- Division of Hematology and Oncology, Department of Pediatrics, Washington University, St Louis, MO, United States
| | - Fabienne Bourgeois
- Boston Children's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - James DuBois
- Bioethics Research Center, Department of Medicine, Washington University School of Medicine, St Louis, MO, United States
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30
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Carey RN, Crawford G, Jancey J, Lam T, Nimmo L, Trapp G, Pollard C, Hooper P, Leavy JE. Young people's alcohol use in and around water: A scoping review of the literature. Drug Alcohol Rev 2024. [PMID: 38461491 DOI: 10.1111/dar.13831] [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: 09/06/2023] [Revised: 01/29/2024] [Accepted: 02/12/2024] [Indexed: 03/12/2024]
Abstract
ISSUES The surrounding social and commercial context, including alcohol advertising, heavily influences alcohol consumption. Alcohol use is a major risk factor for both fatal and non-fatal drowning, particularly for young people. APPROACH We conducted a scoping review to explore the peer-reviewed literature on the use of alcohol by young people (aged 15-34 years) in the context of aquatic environments. Five electronic academic databases were searched for English-language studies conducted in high-income countries and published in the last 15 years (since 2008). The MetaQAT framework was used to assess methodological quality of included studies. KEY FINDINGS The review included a total of 24 studies, including those addressing the prevalence of and/or risk factors for alcohol use in aquatic environments among young people (n = 13); the epidemiology of alcohol-related unintentional drowning in young people (n = 9); and interventions to reduce alcohol-related harm around water (n = 3). Findings suggest that young people commonly consume alcohol around water, particularly young men. We found multiple influences on this behaviour, including the perception of risk, location of aquatic activity and presence of others, particularly peers. IMPLICATIONS Understanding the literature addressing alcohol use around water among young people will assist in identifying and setting priorities for drowning prevention, including the need to mitigate the effects of alcohol advertising which promotes drinking in and around water. CONCLUSION There is a clear imperative to address the use of alcohol by young people in aquatic environments. These findings have key implications for public health policy, advocacy and practice.
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Affiliation(s)
- Renee N Carey
- School of Population Health, Curtin University, Perth, Australia
| | - Gemma Crawford
- Collaboration for Evidence Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Jonine Jancey
- Collaboration for Evidence Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
| | - Tina Lam
- Monash Addiction Research Centre, Monash University, Melbourne, Australia
| | - Lauren Nimmo
- Research, Media and Communications, Royal Life Saving Society Western Australia, Perth, Australia
| | - Gina Trapp
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | | | - Paula Hooper
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia
| | - Justine E Leavy
- Collaboration for Evidence Research and Impact in Public Health, School of Population Health, Curtin University, Perth, Australia
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Constantino H, Pistollato F, Seidle T. Transitioning biomedical research toward human-centric methodologies: systems-based strategies. Drug Discov Today 2024; 29:103947. [PMID: 38460569 DOI: 10.1016/j.drudis.2024.103947] [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: 11/14/2023] [Revised: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
Human-centric methodologies like microphysiological systems and in silico methods have shown promise in addressing the limitations of animal models in understanding human biology and responding to public health priorities. However, the prevailing paradigm based on animal research persists. The article proposes a systemic thinking approach, endorsed by the OECD and the EU, as a tool to leverage innovation to reframe the issue and achieve transformative policies. By identifying the complex factors shaping method selection in basic and biomedical research, a simplified model is presented to illuminate the systemic nature of this decision-making process. The goal is not to prescribe solutions but to offer policymakers a new framework for more-effective strategies, emphasizing collaboration among stakeholders and the need for robust data.
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Affiliation(s)
| | | | - Troy Seidle
- Research & Toxicology, Humane Society International, Toronto, Canada
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32
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Jakubowski S, Kawalec P, Holko P, Kowalska-Bobko I, Kamusheva M, Petrova G, Draganić P, Fuksa L, Männik A, Ispán F, Briedis V, Bianchi I, Paveliu MS, Tesar T. Clinical aspects of reimbursement policies for orphan drugs in Central and Eastern European countries. Front Pharmacol 2024; 15:1369178. [PMID: 38523639 PMCID: PMC10957562 DOI: 10.3389/fphar.2024.1369178] [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: 01/11/2024] [Accepted: 02/16/2024] [Indexed: 03/26/2024] Open
Abstract
Objectives: The aim of this study was to characterize the reimbursement policy for orphan drugs (ODs) in Central and Eastern European (CEE) countries in relation to the availability and impact of clinical evidence, health technology assessment (HTA) procedure, selected economic indicators, and the drug type according to indications. Materials and methods: A list of authorized medicines with orphan designation and information about active substance, Anatomical Therapeutic Chemical (ATC) classification, and therapeutic area was extracted from the web-based register of the European Medicines Agency (EMA). A country-based questionnaire survey was performed between September 2021 and January 2022 in a group of selected experts from nine CEE countries (an invitation was sent to 11 countries). A descriptive and statistical analysis was conducted to determine statistical significance, correlations, between the drug or country characteristic and the positive recommendation or reimbursement of ODs. Results: The proportion of reimbursed orphan drugs differed between countries, ranging from 17.7% in Estonia to 49.6% in Hungary (p < 0.001). The odds that ODs were reimbursed were reduced in countries with a "strong" level of impact of drug safety and efficacy on reimbursement decisions (p=0.018), the presence of other additional specific clinical aspects (e.g., genomic data) considered in the reimbursement decision (p < 0.001) and mandatory (without exception) safety assessments (p=0.004). The probability that ODs were reimbursed was increased in countries with a "moderate" level of impact of drug safety and efficacy on reimbursement decisions (p=0.018), when reimbursement decisions are dependent on the EMA registration status and orphan drug designation (p < 0.001), the presence of the "positive HTA recommendation guarantees reimbursement" policy (p < 0.001), higher GDP per inhabitant (p=0.003), and higher healthcare expenditure (p < 0.001). Conclusion: We found that there are differences among CEE countries in the reimbursement of orphan drugs, and we identified aspects that may influence these differences. Safety, efficacy, and specific clinical aspect issues significantly influenced reimbursement decisions. Antineoplastic and immunomodulating agents drugs were the largest group of ODs and increased the chance of getting a positive recommendation. The higher GDP per inhabitant and healthcare expenditures per inhabitant were positively linked to the chance that an OD receives reimbursement.
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Affiliation(s)
- Szczepan Jakubowski
- Department of Health Promotion and e-Health, Faculty of Health of Science, Jagiellonian University Medical College, Kraków, Poland
| | - Pawel Kawalec
- Department of Nutrition and Drug Research, Faculty of Health of Science, Jagiellonian University Medical College, Kraków, Poland
| | - Przemyslaw Holko
- Department of Nutrition and Drug Research, Faculty of Health of Science, Jagiellonian University Medical College, Kraków, Poland
| | - Iwona Kowalska-Bobko
- Health Policy and Management Department, Faculty of Health of Science, Jagiellonian University Medical College, Kraków, Poland
| | - Maria Kamusheva
- Department of Organization and Economics of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Guenka Petrova
- Department of Organization and Economics of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Pero Draganić
- Agency for Medicinal Products and Medical Devices of Croatia, Zagreb, Croatia
- Department of Biotechnology, University of Rijeka, Rijeka, Croatia
| | - Leos Fuksa
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University in Prague, Prague, Czechia
| | - Agnes Männik
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Fanni Ispán
- Department of Reimbursement, National Institute of Health Insurance Fund Management, Budapest, Hungary
| | - Vitalis Briedis
- Department of Clinical Pharmacy of Lithuanian, University of Health Sciences, Kaunas, Lithuania
| | - Ioana Bianchi
- The Romanian Association of International Medicine Manufacturers. ARPIM, Bucharest, Romania
| | | | - Tomas Tesar
- Department of Organisation and Management in Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Bratislava, Slovakia
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Mago J, Tandon M, Koizumi N, Firlie M, Fang L, Serpico S, Ortiz AC, Inoue M, Baxter PR, Yu Y, John M, Abbas KAJ, Dinka L, Ekwenna O, Li MH, Ortiz J. A Comprehensive Analysis of Litigation in Organ Transplantation for Allegations of Insufficient Policy Coverage, Discrimination and Malpractice. Prog Transplant 2024:15269248241237822. [PMID: 38454748 DOI: 10.1177/15269248241237822] [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] [Indexed: 03/09/2024]
Abstract
Introduction: Transplantation is a field with unique medical and administrative challenges that involve an equally diverse array of stakeholders. Expectantly, the litigation stemming from this field should be similarly nuanced. There is a paucity of comprehensive reviews characterizing this medicolegal landscape. Design: The Caselaw Access Project Database was used to collect official court briefs of 2053 lawsuits related to kidney, liver, heart, lung, and pancreas transplantation. A thematic analysis was undertaken to characterize grounds for litigation, defendant type, and outcomes. Cases were grouped into policy, discrimination, poor or unsuccessful outcome, or other categories. Results: One hundred sixty-four court cases were included for analysis. Cases involving disputes over policy coverage were the most common across all organ types (N = 55, 33.5%). This was followed by poor outcomes (N = 51, 31.1%), allegations of discrimination against prison systems and employers (N = 37, 22.6%) and other (N = 21, 12.8%). Defendants involved in discrimination trials won with the greatest frequency (N = 29, 90.62%). Defendants implicated in policy suits won 65.3% (N = 32), poor outcomes 62.2% (N = 28), and other 70% (N = 14). Of the 51 cases involving poor outcomes, plaintiffs indicated lack of informed consent in 23 (45.1%). Conclusion: Reconsidering the informed consent process may be a viable means of mitigating future legal action. Most discrimination suits favoring defendants suggested previous concerns of structural injustices in transplantation may not be founded. The prevalence of policy-related cases could be an indication of financial burden on patients. Future work and advocacy will need to substantiate these concerns and address change where legal recourse falls short.
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Affiliation(s)
| | | | | | | | - Lauren Fang
- University of Toledo Medical Center, OH, USA
| | - Scott Serpico
- Pennsylvania College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | | | | | - Yang Yu
- George Mason University, Fairfax, VA, USA
| | | | | | | | - Obi Ekwenna
- University of Toledo Medical Center, OH, USA
| | | | - Jorge Ortiz
- Erie County Medical Center, Buffalo, NY, USA
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Vitagliano J, Shalev T, Saunders JB, Mason E, Stang J, Shlafer R, Kotlar B. Forgotten Fundamentals: A Review of State Legislation on Nutrition for Incarcerated Pregnant and Postpartum People. J Correct Health Care 2024. [PMID: 38442320 DOI: 10.1089/jchc.23.07.0063] [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] [Indexed: 03/07/2024]
Abstract
Adequate nutritional intake during pregnancy is critical to infant health and development. People with the capacity for pregnancy who are incarcerated have limited control over their diets and rely on prisons and jails to meet their nutritional needs. This study examined state and federal statutes pertaining to nutrition care for pregnant people while incarcerated. Following a systematic search and review, we identified four qualitative codes relating to access to vitamins, supplemental food, additional hydration, and prenatal nutrition education. Summaries of state and federal statutes pertaining to nutrition were developed and compared with current prenatal nutrition recommendations. Less than a third of states had nutrition-related mandates and no states had statutes that included all key nutrition recommendations. No federal statutes addressed nutrition during pregnancy. Additionally, our review found no provisions for enforcement of the limited nutritional statutes that do exist. To mitigate adverse health consequences for pregnant people and their fetuses, policymakers should enact or amend legislation to align nutrition standards in all prisons and jails with national policy recommendations and provide mechanisms to oversee compliance.
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Affiliation(s)
- Julia Vitagliano
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Talia Shalev
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jennifer B Saunders
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Ellen Mason
- University of Illinois Chicago School of Public Health, Chicago, Illinois, USA
| | - Jamie Stang
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Rebecca Shlafer
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Bethany Kotlar
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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35
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Caldwell HAT, Arthur M, Simms A, Mawhinney H, Hancock Friesen CL, Kirk SFL. Development and implementation of a municipal outdoor play policy for children and youth in Nova Scotia, Canada: a community case study. Front Public Health 2024; 12:1334767. [PMID: 38510347 PMCID: PMC10950929 DOI: 10.3389/fpubh.2024.1334767] [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: 11/10/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
Background: Children and youth benefit from outdoor play; however, environments and policies to support outdoor play are often limited. The purpose of this paper is to describe a case study of the development of a municipal outdoor play policy in Nova Scotia, Canada. The outdoor play policy was developed by the Town of Truro with support from the UpLift Partnership, a School-Community-University Partnership in Nova Scotia, Canada. UpLift supports the health and well-being of school-aged children and youth using a Health Promoting Schools approach which identifies the important role of municipal government in creating healthy school communities. The UpLift Partnership and the municipality hosted online workshops for municipal staff, community leaders and partners that included content about the importance of outdoor play, barriers and facilitators to outdoor play, best practices for youth engagement, the policy development process, and how policy actions can support outdoor play. Workshop participants developed policy actions for their community of Truro, Nova Scotia to increase opportunities for outdoor play for children and youth. Following the workshops, a small team from the municipality and UpLift drafted an outdoor play policy and submitted it to Truro town council for approval. The outdoor play policy was adopted in Fall 2021 and has since informed recreation and municipal planning decisions. By presenting a case study of the development of this outdoor play policy, we hope other communities may be inspired to develop and adopt their own outdoor play policies to benefit children and youth in their communities.
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Affiliation(s)
| | - Mike Arthur
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | | | - Hannah Mawhinney
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Camille L. Hancock Friesen
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- Children’s Nebraska and University of Nebraska Medical Center, Omaha, NE, United States
| | - Sara F. L. Kirk
- Healthy Populations Institute, Dalhousie University, Halifax, NS, Canada
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
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Anand H, Alemazkoor N, Shafiee-Jood M. HEvOD: A database of hurricane evacuation orders in the United States. Sci Data 2024; 11:270. [PMID: 38443468 PMCID: PMC10914785 DOI: 10.1038/s41597-024-03100-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/28/2024] [Indexed: 03/07/2024] Open
Abstract
Assessing and improving the effectiveness of evacuation orders is critical to improving hurricane emergency response, particularly as the frequency of hurricanes increases in the United States. However, our understanding of causal relationships between evacuation orders and evacuation decision-making is still limited, in large part due to the lack of standardized, high-temporal-resolution data on historical evacuation orders. To overcome this gap, we developed the Hurricane Evacuation Order Database (HEvOD) - a comprehensive database of hurricane evacuation orders issued in the United States between 2014 and 2022. The database features evacuation orders that were systematically retrieved and compiled from a wide range of resources and includes information on order type, announcement time, effective time, and evacuation area. The rich collection of attributes and the resolution of the data in the database will allow researchers to systematically investigate the impact of evacuation orders, as a vital public policy instrument, and can serve as an important resource to identify gaps in current policies, leading to more effective policy design in response to hurricanes.
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Affiliation(s)
- Harsh Anand
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, 22903, USA
| | - Negin Alemazkoor
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, 22903, USA
- Department of Civil and Environmental Engineering, University of Virginia, Charlottesville, 22903, USA
| | - Majid Shafiee-Jood
- Department of Systems and Information Engineering, University of Virginia, Charlottesville, 22903, USA.
- Department of Civil and Environmental Engineering, University of Virginia, Charlottesville, 22903, USA.
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37
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Hurst DJ. Xenotransplantation and Future Equitable Access. Prog Transplant 2024:15269248241237817. [PMID: 38433723 DOI: 10.1177/15269248241237817] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Affiliation(s)
- Daniel J Hurst
- Department of Family Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
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38
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Khan MAA, Rauf A. Promoting local production and active pharmaceutical ingredient (API) industry in low and middle income countries (LMICs): impact on medicines access and policy. J Pharm Policy Pract 2024; 17:2323683. [PMID: 38444526 PMCID: PMC10913693 DOI: 10.1080/20523211.2024.2323683] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
The success of universal coverage depends on ensuring that patients have access to medicine. Encouraging local production of medicines in developing countries can provide better access to medicines. In addition to determining the quality of pharmaceutical goods, Active Pharmaceutical Ingredients (APIs) also determine their cost. According to market forecasts, the active pharmaceutical ingredients market is expected to increase from USD 193.15 billion in 2023 to USD 285.29 billion by 2028. Pakistan largely depends on India and China for its Active Pharmaceutical Ingredient requirements. It was feared that a shortage of medicines would result from Pakistan's government suspending all trade with India on August 9, 2019. To improve health security in Pakistan, the Government of Pakistan has introduced an API promotion Policy in 2022. Financial and non-financial incentives have helped many countries develop their API industries like China, India, and Bangladesh. The current domestic API market of Pakistan is around 150 million $. After the introduction of the policy, the existing units are increasing their capacity while eight new API units are in the process of establishment. Through local production of APIs and intermediates, Pakistan can improve its health security by learning from the experiences of neighbouring countries, especially China.
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Affiliation(s)
| | - Asim Rauf
- Drug Regulatory Authority of Pakistan, Islamabad, Pakistan
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Rajagopalan S, Ramaswami A, Bhatnagar A, Brook RD, Fenton M, Gardner C, Neff R, Russell AG, Seto KC, Whitsel LP. Toward Heart-Healthy and Sustainable Cities: A Policy Statement From the American Heart Association. Circulation 2024. [PMID: 38436070 DOI: 10.1161/cir.0000000000001217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Nearly 56% of the global population lives in cities, with this number expected to increase to 6.6 billion or >70% of the world's population by 2050. Given that cardiometabolic diseases are the leading causes of morbidity and mortality in people living in urban areas, transforming cities and urban provisioning systems (or urban systems) toward health, equity, and economic productivity can enable the dual attainment of climate and health goals. Seven urban provisioning systems that provide food, energy, mobility-connectivity, housing, green infrastructure, water management, and waste management lie at the core of human health, well-being, and sustainability. These provisioning systems transcend city boundaries (eg, demand for food, water, or energy is met by transboundary supply); thus, transforming the entire system is a larger construct than local urban environments. Poorly designed urban provisioning systems are starkly evident worldwide, resulting in unprecedented exposures to adverse cardiometabolic risk factors, including limited physical activity, lack of access to heart-healthy diets, and reduced access to greenery and beneficial social interactions. Transforming urban systems with a cardiometabolic health-first approach could be accomplished through integrated spatial planning, along with addressing current gaps in key urban provisioning systems. Such an approach will help mitigate undesirable environmental exposures and improve cardiovascular and metabolic health while improving planetary health. The purposes of this American Heart Association policy statement are to present a conceptual framework, summarize the evidence base, and outline policy principles for transforming key urban provisioning systems to heart-health and sustainability outcomes.
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Dowie I. Respecting patient autonomy: legal and professional considerations. Br J Community Nurs 2024; 29:110-111. [PMID: 38421894 DOI: 10.12968/bjcn.2024.29.3.110] [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: 03/02/2024]
Abstract
In this month's Policy column, Iwan Dowie explores patient autonomy - a concept largely embedded within the community nursing setting. Through legal cases, a history of laws relating to patient autonomy are presented and its implications for community nurses discussed.
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Affiliation(s)
- Iwan Dowie
- Head of Subject, Adult Nursing; Faculty of Life Sciences and Education
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Paulden M, Sampson C, O'Mahony JF, Spackman E, McCabe C, Round J, Snowsill T. Logical Inconsistencies in the Health Years in Total and Equal Value of Life-Years Gained. Value Health 2024; 27:356-366. [PMID: 38048985 DOI: 10.1016/j.jval.2023.11.009] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/07/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVES This study aimed to assess whether recently proposed alternatives to the quality-adjusted life-year (QALY), intended to address concerns about discrimination, are suitable for informing resource allocation decisions. METHODS We consider 2 alternatives to the QALY: the health years in total (HYT), recently proposed by Basu et al, and the equal value of life-years gained (evLYG), currently used by the Institute for Clinical and Economic Review. For completeness we also consider unweighted life-years (LYs). Using a hypothetical example comparing 3 mutually exclusive treatment options, we consider how calculations are performed under each approach and whether the resulting rankings are logically consistent. We also explore some further challenges that arise from the unique properties of the HYT approach. RESULTS The HYT and evLYG approaches can result in logical inconsistencies that do not arise under the QALY or LY approaches. HYT can violate the independence of irrelevant alternatives axiom, whereas the evLYG can produce an unstable ranking of treatment options. HYT have additional issues, including an implausible assumption that the utilities associated with health-related quality of life and LYs are "separable," and a consideration of "counterfactual" health-related quality of life for patients who are dead. CONCLUSIONS The HYT and evLYG approaches can result in logically inconsistent decisions. We recommend that decision makers avoid these approaches and that the logical consistency of any approaches proposed in future be thoroughly explored before considering their use in practice.
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Affiliation(s)
- Mike Paulden
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | | | | | - Eldon Spackman
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Christopher McCabe
- Centre for Public Health and Queens Management School, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jeff Round
- Institute of Health Economics, Edmonton, AB, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Tristan Snowsill
- Health Economics Group, University of Exeter, Exeter, England, UK
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Dzikowicz DJ, Saoji SB, Tam WC, Brunner WM, Carey MG. The Effect of Mandatory Fitness Requirements on Cardiovascular Events: A State-by-State Analysis Using a National Database. Workplace Health Saf 2024; 72:101-107. [PMID: 38217417 DOI: 10.1177/21650799231221575] [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: 01/15/2024]
Abstract
BACKGROUND Cardiovascular events are known to be the leading cause of death among on-duty firefighters. Implementing fitness standards may help reduce the incidence of cardiovascular deaths; however, standards vary between firefighter type and states. We aimed to investigate the rate of cardiovascular events among firefighters across states. METHODS Using publicly available data from the United States Fire Administration, we explored the rates of cardiovascular deaths between firefighter type (e.g., career, volunteer, and wildland) and state. Specifically, we examined rates of cardiovascular deaths between California and Tennessee, which have fitness standards for all firefighters, and New York, which does not have fitness standards for volunteer firefighters. We used descriptive statistics and trend analysis to examine the data. FINDINGS Most cardiovascular events occur among volunteer firefighters (60.6%, n = 877). Volunteer firefighters had 7.5 (95% CI = [4.8, 11.7], p < .001) greater odds of cardiovascular events compared to wildland firefighters, who had the lowest incidence of cardiovascular events (1.7%, n = 24). New York reported the most cardiovascular events (n = 161), primarily among volunteer firefighters (73.9%, n = 119). After the passage of legislation mandating fitness standards in California, a downtrend in the number of volunteer firefighter fatalities is observed. However, a null effect was observed in Tennessee after the passage of similar fitness standards as in California. CONCLUSIONS/APPLICATIONS TO PRACTICE Volunteer firefighters are significantly more likely to die of a cardiovascular event than career and wildland firefighters, both of which have stricter fitness standards. However, the effect of legislation mandating stricter fitness standards among volunteers did not produce a clear benefit for preventing fatalities. Nurses need to promote cardiovascular health among volunteer firefighters.
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Affiliation(s)
- Dillon J Dzikowicz
- School of Nursing, University of Rochester
- University of Rochester Medical Center
- Clinical Cardiovascular Research Center
| | | | - Wai Cheong Tam
- Fire Research Division, National Institute of Standards and Technology
| | | | - Mary G Carey
- School of Nursing, University of Rochester
- University of Rochester Medical Center
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CLARK DUNCANA, MACINKO JAMES, PORFIRI MAURIZIO. Modeling State Firearm Law Adoption Using Temporal Network Models. Milbank Q 2024; 102:97-121. [PMID: 37818775 PMCID: PMC10938934 DOI: 10.1111/1468-0009.12677] [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: 02/21/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
Policy Points Promoting healthy public policies is a national priority, but state policy adoption is driven by a complex set of internal and external factors. This study employs new social network methods to identify underlying connections among states and to predict the likelihood of new firearm-related policy adoption given changes to this interstate network. This approach could be used to assess the likelihood that a given state will adopt a specific new firearm-related law and to identify points of influence that could either inhibit or promote wider diffusion of specific laws. CONTEXT US states are largely responsible for the regulation of firearms within their borders. Each state has developed a different legal environment with regard to firearms based on different values and beliefs of citizens, legislators, governors, and other stakeholders. Predicting the types of firearm laws that states may adopt is therefore challenging. METHODS We propose a parsimonious model for this complex process and provide credible predictions of state firearm laws by estimating the likelihood they will be passed in the future. We employ a temporal exponential-family random graph model to capture the bipartite state law-state network data over time, allowing for complex interdependencies and their temporal evolution. Using data on all state firearm laws over the period 1979-2020, we estimate these models' parameters while controlling for factors associated with firearm law adoption, including internal and external state characteristics. Predictions of future firearm law passage are then calculated based on a number of scenarios to assess the effects of a given type of firearm law being passed in the future by a given state. FINDINGS Results show that a set of internal state factors are important predictors of firearm law adoption, but the actions of neighboring states may be just as important. Analysis of scenarios provide insights into the mechanics of how adoption of laws by specific states (or groups of states) may perturb the rest of the network structure and alter the likelihood that new laws would become more (or less) likely to continue to diffuse to other states. CONCLUSIONS The methods used here outperform standard approaches for policy diffusion studies and afford predictions that are superior to those of an ensemble of machine learning tools. The proposed framework could have applications for the study of policy diffusion in other domains.
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Affiliation(s)
- DUNCAN A. CLARK
- Fielding School of Public HealthUniversity of CaliforniaLos Angeles
| | - JAMES MACINKO
- Fielding School of Public HealthUniversity of CaliforniaLos Angeles
| | - MAURIZIO PORFIRI
- Center for Urban Science and ProgressTandon School of EngineeringNew York University
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Bae SH. Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review. Int Nurs Rev 2024; 71:168-179. [PMID: 37216655 DOI: 10.1111/inr.12849] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 04/26/2023] [Indexed: 05/24/2023]
Abstract
AIM This study aimed to investigate and synthesize the impacts of nurse staffing and work schedules on nurse turnover in acute hospitals. BACKGROUND The retention of nurses during the COVID-19 pandemic was critical due to the increased demand for nurses. Among the multifaceted factors contributing to nurse turnover, it is worth examining nurse staffing and work schedules while considering policy intervention. METHODS The findings of this systematic literature review were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Using eight databases, including CINAHL and PubMed, research articles published from January 2000 until June 2021 were reviewed. The inclusion criteria were original peer-reviewed research, nonexperimental studies published in English or Korean languages, and studies examining the impacts of nurse staffing and work schedules on nurses' actual turnover. RESULTS Fourteen articles were reviewed. Among them, 12 studies investigated the relationship between nurse staffing and turnover, and four examined the impact of work schedules on nurse turnover. Nurse staffing levels are strongly related to nurse turnover in the expected direction. However, few studies have found that work schedules are significantly related to nurse turnover. CONCLUSION Inadequate and unsafe nurse staffing leads to increased nurse turnover rates. More studies are needed to investigate the impacts of work schedules on nurse turnover. IMPLICATIONS FOR NURSING, HEALTH, AND SOCIAL POLICY Several states in the United States have adopted the nurse staffing policy during the COVID-19 pandemic. More hospitals and the government should adopt and implement policies to regulate nurse staffing, reduce nurse turnover, and increase retention. Policy intervention in nurse work schedules should also be considered to prevent nurse turnover.
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Affiliation(s)
- Sung-Heui Bae
- College of Nursing, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Republic of Korea
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Ray K, Cooper JF. The Bioethics of Environmental Injustice: Ethical, Legal, and Clinical Implications of Unhealthy Environments. Am J Bioeth 2024; 24:9-17. [PMID: 37104666 DOI: 10.1080/15265161.2023.2201192] [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] [Indexed: 06/19/2023]
Abstract
Environmental health remains a niche topic in bioethics, despite being a prominent social determinant of health. In this paper we argue that if bioethicists are to take the project of health justice as a serious one, then we have to address environmental injustices and the threats they pose to our bioethics principles, health equity, and clinical care. To do this, we lay out three arguments supporting prioritizing environmental health in bioethics based on bioethics principles including a commitment to vulnerable populations and justice. We also highlight and advocate for environmental law efforts that align with these priorities, focusing specifically on the need for a right to a healthy environment. Our intention is to draw attention to the legal and ethical concepts that underlie the importance of a healthy environment, and urge bioethicists to prioritize both legal and ethical advocacy against environmental injustices in their practice.
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Affiliation(s)
- Keisha Ray
- University of Texas Health Science Center at Houston
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Henning-Smith C, Swendener A, Rydberg K, Lahr M, Yam H. Rural/urban differences in receipt of governmental rental assistance: Relationship to health and disability. J Rural Health 2024; 40:394-400. [PMID: 37817344 PMCID: PMC10954423 DOI: 10.1111/jrh.12800] [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: 05/17/2023] [Revised: 09/12/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE Housing is essential to health. Governmental rental assistance is one way to increase access to affordable housing, but little is known about how it varies by rural/urban location. This paper seeks to address that gap by examining rural/urban and within-rural differences in receipt of rental assistance, with particular attention differences by health and disability. METHODS We used data from the 2021 National Health Interview Survey (n = 28,254) to conduct bivariate analyses to identify significant differences in receipt of rental assistance by rural/urban location. We then conducted logistic regression analyses to generate odds ratios of receiving rental assistance, adjusting for self-rated health, disability, sociodemographic characteristics, and the US Census region. FINDINGS When limiting the sample to those who rent (20.6% of rural residents and 29.6% of urban residents), rural residents were nearly 5 percentage points more likely to receive rental assistance (13.1% vs 8.2%, P<.001). Rural recipients of rental assistance were more likely to have a disability than urban residents (27.9% vs 20.3%, P<.05) and were more likely to report fair/poor health (41.6% vs 31.4%, P<.05). CONCLUSIONS Rural residents are less likely to rent their homes, but, among those who rent, they are more likely to receive governmental rental assistance. This may be reflective of the greater need for rental assistance among rural residents, who were in poorer health and of lower socioeconomic status than urban renters. As housing is essential to good health, policy attention must prioritize addressing a persistent and growing need for affordable housing in rural and urban areas alike.
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Affiliation(s)
- Carrie Henning-Smith
- Rural Health Research Center, University of Minnesota School of Public Health, Division of Health Policy and Management, Minneapolis, Minnesota
| | - Alexis Swendener
- Rural Health Research Center, University of Minnesota School of Public Health, Division of Health Policy and Management, Minneapolis, Minnesota
| | - Katie Rydberg
- Rural Health Research Center, University of Minnesota School of Public Health, Division of Health Policy and Management, Minneapolis, Minnesota
| | - Megan Lahr
- Rural Health Research Center, University of Minnesota School of Public Health, Division of Health Policy and Management, Minneapolis, Minnesota
| | - Hawking Yam
- Rural Health Research Center, University of Minnesota School of Public Health, Division of Health Policy and Management, Minneapolis, Minnesota
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Hamad R. Immigrants to the United States contribute to society: Here are 3 ways to support their transition. Health Aff Sch 2024; 2:qxae019. [PMID: 38435810 PMCID: PMC10906102 DOI: 10.1093/haschl/qxae019] [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] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
The number of migrants entering the United States in 2023 shattered records. Despite prevailing narratives, immigrants, on average, contribute substantially to US society. Rather than slamming the door in the faces of newcomers, federal, state, and local policymakers should provide services to these individuals to ensure they have the maximum opportunity to thrive, both for their own benefit and for the greater social good. Public health and social science research provides ample rigorous evidence on the benefits of different types of investments in these vulnerable individuals upon their arrival in our country. In this Commentary, I review 3 examples of potential evidence-based investments: social inclusion, meeting basic needs, and supportive neighborhoods.
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Affiliation(s)
- Rita Hamad
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA 02115, United States
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Davies J, Remington A, Buckley C, Crane L, Smalley K. 'It seems like a luxury to be able to offer that': Factors influencing the implementation of annual health checks for autistic people in England. Autism 2024; 28:656-673. [PMID: 37431819 PMCID: PMC10913342 DOI: 10.1177/13623613231182011] [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] [Indexed: 07/12/2023]
Abstract
LAY ABSTRACT Autistic people are more likely to have mental and physical health problems than non-autistic people. Annual health checks could reduce these problems by finding and treating them early. Annual health checks are yearly medical appointments where a primary healthcare provider (such as a doctor or nurse) can check things like a patient's weight and heart rate and ask if they have any worries about their health. In this study, we wanted to understand what might encourage primary healthcare providers to use annual health checks with their autistic patients. First, we spoke to 10 autistic people and 11 primary healthcare providers. Using the findings from these conversations, we created an online survey for primary healthcare providers in England. We used the findings from the interviews and survey to help us understand what would encourage primary healthcare providers to offer annual health checks for autistic people. Our participants said that a lack of time and staff would make it hard to provide health checks. To help, they said other members of staff (such as nurses and healthcare assistants) could do the health checks, rather than doctors. They also said parts of the process could be made automatic to save time (e.g. sending automatic reminders). Knowledge about autism was important too (e.g. knowing about the common conditions autistic people have, and how to best support autistic patients). Participants said training on these topics, produced and delivered with autistic people, could encourage them to use annual health checks with their autistic patients.
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Affiliation(s)
| | | | | | | | - Katelyn Smalley
- University College London, UK
- University of Plymouth, UK
- Imperial College London
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Dewinter J, Onaiwu MG, Massolo ML, Caplan R, Van Beneden E, Brörmann N, Crehan ET, Croen LA, Faja S, Gassner DL, Graham Holmes L, Hughes C, Hunter M, Huysamen M, Jelonche P, Lai MC, Noens I, Pukki H, Stokes MA, Strang JF, van der Miesen AIR. Short report: Recommendations for education, clinical practice, research, and policy on promoting well-being in autistic youth and adults through a positive focus on sexuality and gender diversity. Autism 2024; 28:770-779. [PMID: 37530121 PMCID: PMC10913304 DOI: 10.1177/13623613231188349] [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] [Indexed: 08/03/2023]
Abstract
LAY ABSTRACT In this article, we propose recommendations on what we can do to promote that autistic people can enjoy their sexuality and gender identity, because that contributes to overall well-being.First, we briefly summarize the existing research on sexuality and gender diversity in autistic individuals.Next, we propose recommendations for how to promote sexual and gender diversity-related health and well-being. Based on what is known about sexuality, gender diversity, and relationships in autistic adolescents and adults, we convened an international group of autistic and non-autistic researchers, advocates, parents, and professionals to develop recommendations to promote sexual and gender health in autistic people.The resulting recommendations were checked through an online survey distributed to autistic people across the world. The online participants endorsed the importance of eight final recommendations related to:1. Providing education and information on sexuality, relationships, and gender diversity to autistic individuals and their families;2. Improving expertise in and accessibility to healthcare for sexuality, relationships, and gender-related questions, with specific attention to prevention of and support after sexual victimization; and3. Meaningfully including the autism community in future research that addresses well-being relating to sexuality, relationships, and gender diversity.These community-driven recommendations aim to promote sexual health and well-being in autistic individuals internationally.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Susan Faja
- Boston Children’s Hospital/Harvard Medical School, USA
| | | | | | | | | | | | | | | | | | - Heta Pukki
- European Council of Autistic People, Finland
| | | | - John F Strang
- George Washington University School of Medicine, USA
| | - Anna IR van der Miesen
- Centre for Addiction and Mental Health, Canada
- Amsterdam University Medical Centers, Location Vrije Universiteit, The Netherlands
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Salvetti B, Gallagher M, Schapiro NA, Daley AM. Prioritizing Gender-Affirming Care for Youth: The Role of Pediatric-Focused Clinicians. J Pediatr Health Care 2024; 38:253-259. [PMID: 38429038 DOI: 10.1016/j.pedhc.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/29/2023] [Accepted: 12/03/2023] [Indexed: 03/03/2024]
Abstract
Gender-affirming care (GAC) acknowledges the right of each individual to live in the gender that is most authentic to them and to receive nonjudgmental, developmentally appropriate care. For transgender and gender-diverse (TGD) individuals, this care may include transition-related care, such as puberty blockers, gender-affirming hormones, and therapies, including surgery. All youth, including TGD youth, deserve confidential, adolescent-friendly care. However, recent legislation in many states seeks to limit access and/or ban GAC for TGD youth. This article reviews the evidence supporting GAC for adolescents, the risk of denying this care, and recommendations for advocacy from all pediatric-focused clinicians.
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