Insights from analysis for harmful and potentially harmful constituents (HPHCs) in tobacco products.

PubMed

Oldham, Michael J; DeSoi, Darren J; Rimmer, Lonnie T; Wagner, Karl A; Morton, Michael J

2014-10-01

A total of 20 commercial cigarette and 16 commercial smokeless tobacco products were assayed for 96 compounds listed as harmful and potentially harmful constituents (HPHCs) by the US Food and Drug Administration. For each product, a single lot was used for all testing. Both International Organization for Standardization and Health Canada smoking regimens were used for cigarette testing. For those HPHCs detected, measured levels were consistent with levels reported in the literature, however substantial assay variability (measured as average relative standard deviation) was found for most results. Using an abbreviated list of HPHCs, statistically significant differences for most of these HPHCs occurred when results were obtained 4-6months apart (i.e., temporal variability). The assay variability and temporal variability demonstrate the need for standardized analytical methods with defined repeatability and reproducibility for each HPHC using certified reference standards. Temporal variability also means that simple conventional comparisons, such as two-sample t-tests, are inappropriate for comparing products tested at different points in time from the same laboratory or from different laboratories. Until capable laboratories use standardized assays with established repeatability, reproducibility, and certified reference standards, the resulting HPHC data will be unreliable for product comparisons or other decision making in regulatory science. Copyright © 2014 Elsevier Inc. All rights reserved.

Public attitudes towards gambling product harm and harm reduction strategies: an online study of 16-88 year olds in Victoria, Australia.

PubMed

Thomas, Samantha L; Randle, Melanie; Bestman, Amy; Pitt, Hannah; Bowe, Steven J; Cowlishaw, Sean; Daube, Mike

2017-07-25

Gambling has quickly emerged as an important global public health issue. With new technologies used to develop high intensity gambling products and promotions aimed at driving consumption, public health organisations and researchers, community groups, and politicians have argued for a range of regulatory and education measures aimed at reducing gambling harm. However, there has been limited research seeking to understand community perceptions of the harms associated with gambling products and environments, and the level of community support for strategies designed to prevent and reduce gambling harm. An online study of 500 adolescents and adults (aged 16 and over) was conducted with a representative sample (by age and gender) of individuals who were current residents in the state of Victoria, Australia. Participants were asked a range of questions about their own gambling behaviours, with the Problem Gambling Severity Index (PGSI) used as a measure of problem gambling. Participants were asked about their perceptions of harms associated with electronic gambling machines (EGMs), sports betting, horse betting, and casino gambling. They were also asked about the extent to which they agreed or disagreed with gambling harm reduction strategies related to marketing and promotions, restrictions on gambling products and venues, and public education campaigns. Quantitative data were analysed using descriptive statistics and paired t tests, with thematic analysis used to interpret qualitative responses to open-ended questionnaire items. More than one third (n = 201, 40.2%) of participants were at risk of experiencing some level of harm from gambling (PGSI ≥ 1), with 83 participants (16.6%) recording scores that indicated problem gambling (PGSI ≥ 8). One in five participants gambled on EGMs at least monthly (n = 100, 20.0%). Those who gambled on sports did so frequently, with nearly 1 in 5 gambling on sport at least once a month (n = 87, 17.4%). Over

9 CFR 105.3 - Notices re: worthless, contaminated, dangerous, or harmful biological products.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., dangerous, or harmful biological products. 105.3 Section 105.3 Animals and Animal Products ANIMAL AND PLANT... Notices re: worthless, contaminated, dangerous, or harmful biological products. (a) If at any time it...-Serum-Toxin Act, of any biological product by any person holding a license or permit may be dangerous in...

9 CFR 105.3 - Notices re: worthless, contaminated, dangerous, or harmful biological products.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., dangerous, or harmful biological products. 105.3 Section 105.3 Animals and Animal Products ANIMAL AND PLANT... Notices re: worthless, contaminated, dangerous, or harmful biological products. (a) If at any time it...-Serum-Toxin Act, of any biological product by any person holding a license or permit may be dangerous in...

9 CFR 105.3 - Notices re: worthless, contaminated, dangerous, or harmful biological products.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., dangerous, or harmful biological products. 105.3 Section 105.3 Animals and Animal Products ANIMAL AND PLANT... Notices re: worthless, contaminated, dangerous, or harmful biological products. (a) If at any time it...-Serum-Toxin Act, of any biological product by any person holding a license or permit may be dangerous in...

Minors, Moral Psychology, and the Harm Reduction Debate: The Case of Tobacco and Nicotine.

PubMed

Kozlowski, Lynn T

2017-12-01

Harm reduction debates are important in health policy. Although it has been established that morality affects policy, this article proposes that perspectives from moral psychology help to explain the challenges of developing evidence-based policy on prohibition-only versus tobacco/nicotine harm reduction for minors. Protecting youth from tobacco is critical, especially since tobacco/nicotine products are legal for adults, who usually begin using when young. Although cigarettes and other combustibles are the deadliest tobacco products, other products such as smokeless tobacco and electronic cigarettes, though unsafe, are upward of 90 percent less harmful than cigarettes. Disgust at contaminating the "purity" of youth, especially "good," low-risk youth, with any tobacco/nicotine products opposes harm reduction, as does contempt for violating so-called community values and disrespecting authority. Support for harm reduction arises from anger at failing to provide reduced harm to "bad," high-risk individuals and denying them the "liberty" to decide. Fast-thinking, moral-emotional intuitions are supported by rationalizations arising from slow-thinking processes. The recognition of such moral psychological influences and the efforts to minimize their impact may help lead to amelioration and compromise. This example from tobacco control, with divided concerns for low-risk and high-risk youth, can be applied to other harm reduction versus prohibition-only policies directed at minors. Copyright © 2017 by Duke University Press.

Harmful Cyanobacterial Material Production in the North Han River (South Korea): Genetic Potential and Temperature-Dependent Properties.

PubMed

Kim, Keonhee; Park, Chaehong; Yoon, Youngdae; Hwang, Soon-Jin

2018-03-03

Cyanobacteria synthesize various harmful materials, including off-flavor substances and toxins, that are regarded as potential socio-economic and environmental hazards in freshwater systems, however, their production is still not well understood. In this study, we investigated the potential and properties of harmful materials produced by cyanobacteria, depending on temperature, and undertook a phylogenetic analysis of cyanobacteria present in the North Han River (South Korea). Production potentials were evaluated using gene-specific probes, and the harmful material production properties of strains showing positive potentials were further characterized at different temperatures in the range 15 to 30 °C. We identified six cyanobacterial strains based on 16S rDNA analysis: two morphological types (coiled and straight type) of Dolichospermum circinale, Aphanizomenon flos-aquae, Oscillatoria limosa, Planktothricoides raciborskii, Pseudanabaena mucicola , and Microcystis aeruginosa . We confirmed that cyanobacterial strains showing harmful material production potential produced the corresponding harmful material, and their production properties varied with temperature. Total harmful material production was maximal at 20~25 °C, a temperature range optimal for cell growth. However, harmful material productivity was highest at 15 °C. These results indicate that the expression of genes related to synthesis of harmful materials can vary depending on environmental conditions, resulting in variable harmful material production, even within the same cyanobacterial strains.

Harm reduction as a strategy for supporting people who self-harm on mental health wards: the views and experiences of practitioners.

PubMed

James, Karen; Samuels, Isaac; Moran, Paul; Stewart, Duncan

2017-05-01

Harm reduction has had positive outcomes for people using sexual health and substance misuse services. Clinical guidance recommends these approaches may be appropriately adopted by mental health practitioners when managing some people who self-harm. There has, however, been very little research in this area. We explored practitioners' views of harm reduction as a strategy for supporting people who self-harm. The Self Harm Antipathy Scale (SHAS) was administered to a random sample of 395 mental health practitioners working on 31 wards in England, semi-structured interviews were then conducted with 18 survey respondents. Practitioners who had implemented the approach reported positive outcomes including a reduction in incidence and severity of self-harm and a perceived increase in empowerment of service users. Practitioners with no experience of using harm reduction were concerned that self-harm would increase in severity, and were unsure how to assess and manage risk in people under a harm reduction care plan. Some fundamentally disagreed with the principle of harm reduction for self-harm because it challenged their core beliefs about the morality of self-harm, or the ethical and potential legal ramifications of allowing individuals to harm themselves. This study was conducted solely with practitioners working on inpatient units. The majority of staff interviewed had no experience of harm reduction and so their concerns may not reflect challenges encountered by practitioners in clinical practice. Harm reduction is being used to support people who self-harm within inpatient psychiatry and some practitioners report potential benefits of this approach. However, this raises particularly complex practical, ethical and legal issues and further research is needed to assess the safety, acceptability and efficacy of the approach. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

US adult tobacco users' absolute harm perceptions of traditional and alternative tobacco products, information-seeking behaviors, and (mis)beliefs about chemicals in tobacco products.

PubMed

Bernat, Jennifer K; Ferrer, Rebecca A; Margolis, Katherine A; Blake, Kelly D

2017-08-01

Harm perceptions about tobacco products may influence initiation, continued use, and cessation efforts. We assessed associations between adult traditional tobacco product use and absolute harm perceptions of traditional and alternative tobacco products. We also described the topics individuals looked for during their last search for information, their beliefs about chemicals in cigarettes/cigarette smoke, and how both relate to harm perceptions. We ran multivariable models with jackknife replicate weights to analyze data from the 2015 administration of the National Cancer Institute's Health Information National Trends Survey (N=3376). Compared to never users, individuals reported lower perceived levels of harm for products they use. Among current tobacco users, ethnicity, thinking about chemicals in tobacco, and information-seeking were all factors associated with tobacco product harm perceptions. In the full sample, some respondents reported searching for information about health effects and cessation and held misperceptions about the source of chemicals in tobacco. This study fills a gap in the literature by assessing the absolute harm perceptions of a variety of traditional and alternative tobacco products. Harm perceptions vary among tobacco products, and the relationship among tobacco use, information seeking, thoughts about chemicals in tobacco products, and harm perceptions is complex. Data suggest that some individuals search for information about health effects and cessation and hold misperceptions about chemicals in tobacco products. Future inquiry could seek to understand the mechanisms that contribute to forming harm perceptions and beliefs about chemicals in tobacco products. Published by Elsevier Ltd.

The interim regulated legal market for NPS ('legal high') products in New Zealand: The impact of new retail restrictions and product licensing.

PubMed

Wilkins, Chris

2014-01-01

New Zealand has recently established the world's first regulated legal market for new psychoactive products (NPS) (i.e. 'legal highs'). While the new regime is currently in a transitional phase, a range of retail restrictions and an interim licensing regime for NPS products and operators has been introduced. A product safety assessment framework has been developed to determine if a product should receive an interim licence. As a result of the licensing requirements, the number of NPS retail outlets fell from 3000- 4000 largely convenience stores to 156 specialty stores, and the number of legally available NPS products fell from 200 to fewer than 46. Some of the licensed products contain potent cannabinoid compounds. The licensing system provided, for the first time, information on all the products and operators involved in the sector, and this will assist future monitoring. The effectiveness of the new product safety assessment framework will depend on the quality of the data available on adverse cases. This is a challenge as self-reported information from users is often unreliable, and some emergency department cases do not have all the information required to make an accurate assessment. These data limitations indicate the need for retrospective studies of NPS adverse cases and additional test data. While the new legislation initially reduced the number of NPS retailers by prohibiting convenience outlets, new specialized NPS retail outlets may emerge as the new sector expands. Empirical research is required to measure the impact of the reduction in retail outlets and products on NPS availability. Copyright © 2014 John Wiley & Sons, Ltd.

Research with Pregnant Women: New Insights on Legal Decision-Making

PubMed Central

Mastroianni, Anna C.; Henry, Leslie Meltzer; Robinson, David; Bailey, Theodore; Faden, Ruth R.; Little, Margaret O.; Lyerly, Anne Drapkin

2017-01-01

Although pregnant women rely on medical interventions to treat and prevent a wide variety of health conditions, they are frequently excluded or underrepresented in clinical research. The resulting dearth of pregnancy-specific evidence to guide clinical decisionmaking routinely exposes pregnant women, and their future offspring, to risk of uncertain harms for uncertain benefits. The two legal factors regularly cited as obstacles to such research are the federal regulatory scheme and fear of liability. This article reveals a far more nuanced and complex view of the legal context. First, legal professionals may—at any time from product conception to marketing—influence decisions about research with pregnant women. Second, factors not previously articulated in the literature may prompt legal professionals to slow or halt such research. They include: financial interests, regulatory ambiguity, obstacles to risk management, and site-specific laws unrelated to research. Any efforts to promote the ethical inclusion of pregnant women in research must acknowledge the role of legal decisionmakers and address their professional concerns. PMID:28543423

"Legal highs" on the net-Evaluation of UK-based Websites, products and product information.

PubMed

Schmidt, Martin M; Sharma, Akhilesh; Schifano, Fabrizio; Feinmann, Charlotte

2011-03-20

A vast array of substances are marketed as "legal highs" in the UK. These products are mainly marketed online and are packaged and produced to mimic illicit drugs. Little is known about the full range of products available at present and no studies have evaluated the product information provided to consumers. AIMS & HYPOTHESIS: To describe the available legal high products marketed by UK-based Internet retailers and evaluate the product information provided to consumers. Websites were identified using the terms "buy legal highs+UK" and two search engines. The first 100 hits and a random sample of 5% of the remaining results were screened. Websites based in the UK were included and all products were entered on a database. Information on product name, list price, claimed effects, side effects, contraindications and interactions was extracted. A descriptive analysis was conducted using SPSS v14. 115 Websites met the inclusion criteria but due to duplicate listings this was reduced to 39 unique Websites. 1308 products were found and evaluated. The average product price was 9.69 British pounds. Products took the form of pills (46.6%), smoking material (29.7%) and single plant material/extract (18.1%). Most products claimed to be stimulants (41.7%), sedatives (32.3%), or hallucinogens (12.9%). 40.1% of products failed to list ingredients, 91.9% failed to list side effects, 81.9% failed to list contraindications and 86.3% failed to list drug interactions. Top 5 products (with active ingredients in brackets) by frequency were Salvia divinorum (Salivinorin A), Kratom (Mitragynine), Hawaiian Baby Woodrose Seeds (Lysergic Acid Amide), Fly Agaric (Ibotenic Acid, Muscimol) and Genie (JWH018, CP47497). Products marketed as "legal highs" are easily available from UK-based Internet retailers and are reasonably affordable. Safety information provided to consumers is poor. Uninformed users risk serious adverse effects. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

A critical analysis of the implementation of a legal regulated market for new psychoactive substances ("legal highs") in New Zealand.

PubMed

Rychert, Marta; Wilkins, Chris

2018-05-01

In July 2013 New Zealand passed the Psychoactive Substances Act (PSA) to establish the world's first regulated legal market for new psychoactive substances (NPS) ("legal highs"). To critically analyse the implementation of the PSA. Synthesis of findings from interviews with 30 key informants (i.e. politicians, civil servants, legal high industry actors, toxicologists, NGO representatives and drug policy academics), analysis of relevant laws and policy documents, and a review of academic and grey literature on the PSA. Key challenges experienced during the implementation of the PSA included the harmfulness of interim approved products, the slowness in withdrawing products which caused adverse effects, enforcing retail restrictions, price competition by retailers, judicial challenges by the "legal high" industry, and growing opposition to the regime from local communities and key stakeholders (including local councils). The PSA lacks a tax on products and restrictions on retail opening hours which likely contributed to the problems above. The implementation of the PSA also appeared to suffer from a rushed legislative process and resource constraints on the regulatory agency which led to delays in the development of the full regulatory framework, including the product testing requirements, and issues with enforcing retail regulation, such as the minimum age of purchase. The decline in public support for the PSA regime reflected problems with communicating the aims of the policy to the general public. The troubled implementation of the PSA underlines a number of important lessons for consideration when developing a regulated legal drug market, including advanced development of regulatory systems, ensuring the sale of low risk products, adequately resourcing regulatory agencies and related enforcement activity, detailed regulation of retail outlets, establishing price controls, and ongoing engagement with stakeholders and the general public. Copyright © 2018 Elsevier B

Perceived harms and benefits of tobacco, marijuana, and electronic vaporizers among young adults in Colorado: implications for health education and research.

PubMed

Popova, Lucy; McDonald, Emily Anne; Sidhu, Sohrab; Barry, Rachel; Richers Maruyama, Tracey A; Sheon, Nicolas M; Ling, Pamela M

2017-10-01

To evaluate how young adults perceive and compare harms and benefits of marijuana and tobacco products in the context of a legal marijuana market in Colorado. Semi-structured qualitative interviews. Denver, CO, USA. Thirty-two young adults (aged 18-26 years) who used tobacco/marijuana/vaporizers. Semi-structured interviews addressed perceived harms and benefits of various tobacco and marijuana products and personal experiences with these products. Young adults evaluated harms and benefits using five dimensions: (1) combustion-smoking was considered more harmful than non-combustible products (e.g. e-cigarettes, vaporizers and edibles); (2) potency-edibles and marijuana concentrates were perceived as more harmful than smoking marijuana flower because of potential to receive too large a dose of tetrahydrocannabinol (THC); (3) chemicals-products containing chemical additives were seen as more harmful than 'pure' or 'natural' plant products; (4) addiction-participants recognized physiological addiction to nicotine, but talked primarily about psychological or life-style dependence on marijuana; and (5) source of knowledge-personal experiences, warning labels, campaigns, the media and opinions of product retailers and medical practitioners affected perceptions of harms and benefits. Among young adults in Colorado, USA, perceived harms and benefits of tobacco and marijuana include multiple dimensions. Health educational campaigns could benefit from addressing these dimensions, such as the potency of nicotine and cannabis concentrates and harmful chemicals present in the organic material of tobacco and marijuana. Descriptors such as 'natural' and 'pure' in the promotion or packaging of tobacco and marijuana products might be misleading. © 2017 Society for the Study of Addiction.

Legal Aspects of Internet Filtering in Public Libraries.

ERIC Educational Resources Information Center

Elsner, Edward J.

2001-01-01

Examines the legal issues surrounding Internet filtering in public libraries. Discusses First Amendment rights and responsibilities; recent court cases; legal problems with limiting Internet access; librarian intervention; less restrictive means to protect minors from harmful materials; and possible liability issues. (LRW)

An exploratory study of the health harms and utilisation of health services of frequent legal high users under the interim regulated legal high market in central Auckland.

PubMed

Wilkins, Chris; Prasad, Jitesh; Wong, K C; Rychert, Marta; Graydon-Guy, Thomas

2016-03-11

To explore health problems and the accessing of health services by frequent legal high users under an interim regulated legal market in central Auckland. Frequent legal high users (monthly+) were recruited from outside eight randomly-selected, licensed, legal high stores in central Auckland from 23 April-7 May, 2014. Eligible participants were emailed a unique invitation to complete an on-line survey; 105 completed the survey. Twenty-seven percent had suffered mental illness during their lifetimes. Eighty percent used synthetic cannabinoids (SC), and 20% 'party pills'. Forty-seven percent of SC users used daily or more often. Other drugs used included alcohol (80%), cannabis (59%), 'ecstasy' (18%) and methamphetamine (15%). Fifty-eight percent of SC users were classified as SC dependent. The most common problems reported from SC use were: insomnia (29%); 'vomiting/nausea' (25%); 'short temper/agitation' (21%); 'anxiety' (21%); 'strange thoughts' (16%); and 'heart palpitations' (14%). The health services most commonly accessed by SC users were: a 'doctor/GP' (9%); 'counsellor' (9%); 'DrugHelp/MethHelp' websites (7%); 'Alcohol & Drug Helpline' (4%); 'ambulance' (3%); 'A&E' (3%); and hospitalisation (3%). Frequent use of interim licensed SC products was associated with health problems, including dependency. Further research is required to determine the health risks of these products.

A critique of cannabis legalization proposals in Canada.

PubMed

Kalant, Harold

2016-08-01

An editorial in this issue describes a cannabis policy framework document issued by a major Canadian research centre, calling for legalization of non-medical use under strict controls to prevent increase in use, especially by adolescents and young adults who are most vulnerable to adverse effects of cannabis. It claims that such a system would eliminate the severe personal, social and monetary costs of prohibition, diminish the illicit market, and provide more humane management of cannabis use disorders. It claims that experience with regulation of alcohol and tobacco will enable a system based on public health principles to control access of youth to cannabis without the harm caused by prohibition. The present critique argues that the claims made against decriminalization and for legalization are unsupported, or even contradicted, by solid evidence. Early experience in other jurisdictions suggests that legalization increases use by adolescents and its attendant harms. Regulation of alcohol use does not provide a good model for cannabis controls because there is widespread alcohol use and harm among adolescents and young adults. Government monopolies of alcohol sale have been used primarily as sources of revenue rather than for guarding public health, and no reason has been offered to believe they would act differently with respect to cannabis. Good policy decisions require extensive unbiased information about the individual and social benefits and costs of both drug use and proposed control measures, and value judgments about the benefit/harm balance of each option. Important parts of the necessary knowledge about cannabis are not yet available, so that the value judgments are not yet possible. Therefore, a better case can be made for eliminating some of the harms of prohibition by decriminalization of cannabis possession and deferring decision about legalization until the necessary knowledge has been acquired. Copyright © 2016 Elsevier B.V. All rights reserved.

Do no harm: a defense of markets in healthcare.

PubMed

Kline, William

2010-09-01

This paper argues that the rules that constitute a market protect autonomy and increase welfare in healthcare. Markets do the former through protecting rights to self-ownership and a cluster of rights that protect its exercise. Markets protect welfare by organizing and protecting trades. In contrast, prohibition destroys legitimate markets, giving rise to so-called black markets that harm both the autonomy and well-being of agents. For example, a fee-for-service medical system is a highly developed and specialized market. It is individuals working together, through the division of labor, to provide mutual insurance. This coordination, and the benefits it makes possible, is not possible without injunctions against harm. Prohibitions on harm are not mere ethical niceties, they are practice rules for both healthcare and markets. Placing the doctor within a healthcare market actually reinforces the doctor's moral obligation, and the legal enforcement of that obligation, not to harm. Similarly, markets reinforce patient rights to self-determination through legal and institutional enforcement of the harm principle in the form of the protection of certain basic welfare rights to life, bodily integrity, property, trade, and contract. Since the establishment of markets protects agent autonomy and welfare, and prohibition directly harms the same, there are strong reasons for establishing markets to protect trade in precisely those areas where autonomy and well-being are most vulnerable to exploitation, for example, the trade in human kidneys.

How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products.

PubMed

Milcarz, Marek; Polańska, Kinga; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

2017-09-07

The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes ( p < 0.05). The smokers of traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers ( p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe.

How Social Care Beneficiaries in Poland Rate Relative Harmfulness of Various Tobacco and Nicotine-Containing Products

PubMed Central

Milcarz, Marek; Polańska, Kinga; Bak-Romaniszyn, Leokadia; Kaleta, Dorota

2017-01-01

The aim of the study was to examine how social care beneficiaries rate the relative harmfulness of tobacco/nicotine-containing products compared to traditional cigarettes. This information is crucial for the development of effective tobacco control strategies targeting disadvantaged populations. The cross-sectional study covered 1817 respondents who were taking advantage of social aid services offered by the local social care institutions in the Piotrkowski district, via face-to-face interviews. The linear regression analysis indicated that relative to women, men consider slim cigarettes, smokeless tobacco and e-cigarettes to be more harmful than traditional cigarettes (p < 0.05). The smokers of traditional cigarettes reported menthol cigarettes to be less harmful than traditional cigarettes, relative to the non-smokers (p = 0.05). The current results demonstrate that social care beneficiaries are not aware of the fact that some products are less harmful than others. Education concerning tobacco/nicotine products should include advice on how to reduce the adverse health effects of smoking (e.g., avoiding inhalation of combusted products), while driving the awareness that no nicotine-containing products are safe. PMID:28880223

The pattern of self-harm in Fars Province in South Iran: A population-based study.

PubMed

Gholamzadeh, Saeid; Zahmatkeshan, Mozhghan; Zarenezhad, Mohammad; Ghaffari, Elaheh; Hoseni, Sanaz

2017-10-01

Non-suicidal self-harm includes cutting, scratching, burning and minor overdosing. There have been few studies that have examined the rate and pattern of self-harm among different individuals of the society. We performed a population-based study to determine different aspects of non-suicidal self-harm in cases referred to legal medicine organization of Fars Province and south Iran. In a population-based longitudinal survey, we applied data from cases referred to legal medicine organization of Fars province. The survey included questions about the history, method, frequency, age of onset and help-seeking for non-suicidal self-harm. The data about non-suicidal self-harm were collected since 2007 to 2011 and analyzed using students' T-test for continuous data and χ 2 for binary or categorical data using SPSS ver. 21.0. Totally 2166 individuals were diagnosed who had ever harmed themselves. Self-injuries such as cutting, scratching and self-hitting were the most common forms of non-suicidal self-harm (83.2%). The mean age of onset was 25.7 ± 2.6 years. Self-injury was more frequent in males and individuals with lower education levels mostly unemployed. The most frequent injury site was posterior side of the body for example shoulders (157; 9.8%) and the most type of the injury was bruise in 398(55.26%) cases. Hard objects (1197; 55.26%) were the most used devices for self-injury followed by cutting and sharp devices. Among those who reported non-suicidal self-harm, 56% had sought help while self-injury. We found a high prevalence of non-suicidal self-harm in different individuals of the society in Fars province since 2007 to 2011. Many mental-health symptoms as well as legal and financial gains should be evaluated for any association with this behavior. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

[Migration of eight harmful elements from household products made with synthetic resin that infants may swallow by mistake].

PubMed

Isama, Kazuo; Kawakami, Tsuyoshi; Nishimura, Tetsuji

2011-01-01

Harmful elements are used as stabilizers and colorants in synthetic resin products. Accidental ingestion of harmful elements from such synthetic resins by infants is a dangerous health hazard. The Japanese Food Sanitation Law and the International Standard ISO 8124-3 "Safety of toys-Part 3: Migration of certain elements" control the levels of migrated harmful elements, such as lead or cadmium, from infants toys. However, the levels of migrated harmful elements from household products that are not infants toys are not controlled, since they are not covered by the law or standard. Therefore, we investigated the level of eight harmful elements (antimony, arsenic, barium, cadmium, chromium, lead, mercury and selenium) migrated from household products made of synthetic resin that infants may swallow by mistake. The extraction test of ISO 8124-3: 2010 was executed in 135 products (total 150 specimens), and the concentration of these elements was measured by inductively coupled plasma mass spectroscopy (ICP-MS). As a result, 1810 mg/kg and 1660 mg/kg of lead, exceeding the maximum acceptable level of the ISO standard, migrated from two products. In addition, lead and/or chromium at levels more than 1/10 of the maximum acceptable levels of the ISO standard migrated from four products. Household products that infants may swallow by mistake should ideally not release harmful elements such as lead and chromium.

HIV, drugs and the legal environment

PubMed Central

Strathdee, Steffanie A.; Beletsky, Leo; Kerr, Thomas

2014-01-01

A large body of scientific evidence indicates that policies based solely on law enforcement without taking into account public health and human rights considerations increase the health risks of people who inject drugs (PWIDs) and their communities. Although formal laws are an important component of the legal environment supporting harm reduction, it is the enforcement of the law that affects PWIDs' behavior and attitudes most acutely. This commentary focuses primarily on drug policies and policing practices that increase PWIDs' risk of acquiring HIV and viral hepatitis, and avenues for intervention. Policy and legal reforms that promote public health over the criminalization of drug use and PWID are urgently needed. This should include alternative regulatory frameworks for illicit drug possession and use. Changing legal norms and improving law enforcement responses to drug-related harms requires partnerships that are broader than the necessary bridges between criminal justice and public health sectors. HIV prevention efforts must partner with wider initiatives that seek to improve police professionalism, accountability, and transparency and boost the rule of law. Public health and criminal justice professionals can work synergistically to shift the legal environment away from one that exacerbates HIV risks to one that promotes safe and healthy communities. PMID:25265900

[Legalization of drugs--pro and con].

PubMed

Marjanović-Cengić, S

2001-01-01

This article deals with various opinions and assertions regarding drug legalization. Societal and clinical implication regarding the effect of decrease or increase in the use of psyhoactive substances, on public health, violence and criminal activities have been pointed out. The relation between legal and illegal drugs has been considered. Special attention has been paid to arguments on legalization and decriminalization of marihuana and possible consequences on the risk group-children and adolescents. Experiences from USA and some European countries have been presented. Having in mind the specific situation in BiH, the author of article gives her own view and suggest the introduction of harm reduction strategy into BiH drug policy, without changing the legal drug status.

Prevalence, Harm Perceptions, and Reasons for Using Noncombustible Tobacco Products Among Current and Former Smokers

PubMed Central

Pearson, Jennifer; Xiao, Haijun; Stalgaitis, Carolyn; Vallone, Donna

2014-01-01

Objectives. We provided estimates of noncombustible tobacco product (electronic nicotine delivery systems [ENDS]; snus; chewing tobacco, dip, or snuff; and dissolvables) use among current and former smokers and examined harm perceptions of noncombustible tobacco products and reasons for their use. Methods. We assessed awareness of, prevalence of, purchase of, harm perceptions of, and reasons for using noncombustible tobacco products among 1487 current and former smokers from 8 US designated market areas. We used adjusted logistic regression to identify correlates of noncombustible tobacco product use. Results. Of the sample, 96% were aware of at least 1 noncombustible tobacco product, but only 33% had used and 21% had purchased one. Noncombustible tobacco product use was associated with being male, non-Hispanic White, younger, and more nicotine dependent. Respondents used noncombustible tobacco products to cut down or quit cigarettes, but only snus was associated with a higher likelihood of making a quit attempt. Users of noncombustible tobacco products, particularly ENDS, were most likely to endorse the product as less harmful than cigarettes. Conclusions. Smokers may use noncombustible tobacco products to cut down or quit smoking. However, noncombustible tobacco product use was not associated with a reduction in cigarettes per day or cessation. PMID:24922154

Legal liability perspectives on abuse-deterrent opioids in the treatment of chronic pain.

PubMed

Brushwood, David B; Rich, Ben A; Coleman, John J; Bolen, Jennifer; Wong, Winston

2010-12-01

Abuse-deterrent opioid analgesic formulations can help reduce the risk of opioid diversion and abuse. Not all opioid analgesics are available as both extended- and immediate-release dosage forms in abuse-deterrent formulations. Clinicians may have to balance the clinical benefit of a product that does not use abuse-deterrent technology versus the regulatory benefit of using a product with this technology. There is the possibility that a health care professional may be held legally liable when a product without abuse-deterrent qualities is used and a person suffers harm that would not have occurred had an abuse-deterrent formulation been provided. This article reviews legal precedents that inform an understanding of the need to reduce malpractice exposure by identifying patients who are at high risk of opioid diversion and/or abuse and considering the use of an abuse-deterrent formulation for these patients.

Attitudes to legalizing cannabis use.

PubMed

Williams, Jenny; van Ours, Jan C; Grossman, Michael

2016-09-01

In this paper, we investigate the relationship between cannabis use and attitudes to legalizing the use of cannabis. Predictions from theory provide a means of learning about the roles of information, self interest and regret in explaining differences in attitudes to legalization between those who currently use, those who have used in the past and those who have never used. Our empirical investigation suggests that users have a greater awareness of cannabis not being as harmful as abstainers think it is. This may explain why individuals are more inclined to be in favor of legalizing cannabis once they have used it themselves. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The law isn't everything: The impact of legal and non-legal sanctions on motorists' drink driving behaviors.

PubMed

Freeman, James; Szogi, Elizabeth; Truelove, Verity; Vingilis, Evelyn

2016-12-01

The effectiveness of drink driving countermeasures (such as sanctions) to deter motorists from driving over the legal limit is extremely important when considering the impact the offending behavior has on the community. However, questions remain regarding the extent that both legal and non-legal factors influence drink driving behaviors. This is of particular concern given that both factors are widely used as either sanctioning outcomes or in media campaigns designed to deter drivers (e.g., highlighting the physical risk of crashing). This paper reports on an examination of 1,253 Queensland motorists' perceptions of legal and non-legal drink driving sanctions and the corresponding deterrent impact of such perceptions on self-reported offending behavior. Participants volunteered to complete either an online or paper version of the questionnaire. Encouragingly, quantitative analysis of the data revealed that participants' perceptions of both legal sanctions (e.g., certainty, severity and swiftness) as well as non-legal sanctions (e.g., fear of social, internal or physical harm) were relatively high, with perceptual certainty being the highest. Despite this, a key theme to emerge from the study was that approximately 25% of the sample admitted to drink driving at some point in time. Multivariate analyses revealed six significant predictors of drink driving, being: males, younger drivers, lower perceptions of the severity of sanctions, and less concern about the social, internal, and physical harms associated with the offense. However, a closer examination of the data revealed that the combined deterrence model was not very accurate at predicting drink driving behaviors (e.g., 21% of variance). A range of non-legal deterrent factors have the potential to reduce the prevalence of drink driving although further research is required to determine how much exposure is required to produce a strong effect. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights

Is multi-level marketing of nutrition supplements a legal and an ethical practice?

PubMed

Cardenas, Diana; Fuchs-Tarlovsky, Vanessa

2018-06-01

Multi-level marketing (MLM) of nutrition products has experienced dramatic growth in recent decades. 'Wellness' is the second most popular niche in the MLM industry and represents 35% of sales among all the products in 2016. This category includes dietary supplements, weight management and sports nutrition products. The aim of this paper is to analyse whether this practice is legal and ethical. An analysis of available documentary information about the legal aspects of Multi-level marketing business was performed. Ethical reflexion was based on the "principlism" approach. We argue that, while being a controversial business model, MLM is not fraudulent from a legal point of view. However, it is an unethical strategy obviating all the principles of beneficence, nonmaleficence and autonomy. What is at stake is the possible economic scam and the potential harm those products could cause due to unproven efficacy, exceeding daily nutrient requirements and potential toxicity. The sale of dietary and nutrition supplements products by physicians and dieticians presents a conflict of interests that can undermine the primary obligation of physicians to serve the interests of their patients before their own. While considering that MLM of dietary supplements and other nutrition products are a legal business strategy, we affirm that it is an unethical practice. MLM products that have nutritional value or promoted as remedies may be unnecessary and intended for conditions that are unsuitable for self-prescription as well. Copyright © 2018 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.

The changing nicotine products landscape: time to outlaw sales of combustible tobacco products?

PubMed

Hefler, Marita

2018-01-01

Combustible tobacco products are unique both for the extraordinary harm they cause, and the fact that more than 50 years after these harms became known, they continue to be widely and legally available globally. However, the rapid evolution of the nicotine product marketplace in recent years warrants a re-assessment of the viability of phasing out commercial sales of combustible tobacco, and presents an opportunity to end the exceptionalism of combustible tobacco being permitted for sale. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Who is 'Molly'? MDMA adulterants by product name and the impact of harm-reduction services at raves.

PubMed

Saleemi, Sarah; Pennybaker, Steven J; Wooldridge, Missi; Johnson, Matthew W

2017-08-01

Methylenedioxymethamphetamine (MDMA), often sold as 'Ecstasy' or 'Molly', is commonly used at music festivals and reported to be responsible for an increase in deaths over the last decade. Ecstasy is often adulterated and contains compounds that increase morbidity and mortality. While users and clinicians commonly assume that products sold as Molly are less-adulterated MDMA products, this has not been tested. Additionally, while pill-testing services are sometimes available at raves, the assumption that these services decrease risky drug use has not been studied. This study analyzed data collected by the pill-testing organization, DanceSafe, from events across the United States from 2010 to 2015. Colorimetric reagent assays identified MDMA in only 60% of the 529 samples collected. No significant difference in the percentage of samples testing positive for MDMA was determined between Ecstasy and Molly. Individuals were significantly less likely to report intent to use a product if testing did not identify MDMA (relative risk (RR) = 0.56, p = 0.01). Results suggest that Molly is not a less-adulterated substance, and that pill-testing services are a legitimate harm-reduction service that decreases intent to consume potentially dangerous substances and may warrant consideration by legislators for legal protection. Future research should further examine the direct effects of pill-testing services and include more extensive pill-testing methods.

Responsible and controlled use: Older cannabis users and harm reduction.

PubMed

Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

2015-08-01

Cannabis use is becoming more accepted in mainstream society. In this paper, we use Zinberg's classic theoretical framework of drug, set, and setting to elucidate how older adult cannabis users managed health, social and legal risks in a context of normalized cannabis use. We present selected findings from our qualitative study of Baby Boomer (born 1946-1964) cannabis users in the San Francisco Bay Area. Data collection consisted of a recorded, in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analyzed to discover the factors of cannabis harm reduction from the users' perspectives. Interviewees made harm reduction choices based on preferred cannabis derivatives and routes of administration, as well as why, when, where, and with whom to use. Most interviewees minimized cannabis-related harms so they could maintain social functioning in their everyday lives. Responsible and controlled use was described as moderation of quantity and frequency of cannabis used, using in appropriate settings, and respect for non-users. Users contributed to the normalization of cannabis use through normification. Participants followed rituals or cultural practices, characterized by sanctions that helped define "normal" or "acceptable" cannabis use. Users contributed to cannabis normalization through their harm reduction methods. These cultural practices may prove to be more effective than formal legal prohibitions in reducing cannabis-related harms. Findings also suggest that users with access to a regulated market (medical cannabis dispensaries) were better equipped to practice harm reduction. More research is needed on both cannabis culture and alternative routes of administration as harm reduction methods. Copyright © 2015 Elsevier B.V. All rights reserved.

Responsible and controlled use: Older cannabis users and harm reduction

PubMed Central

Lau, Nicholas; Sales, Paloma; Averill, Sheigla; Murphy, Fiona; Sato, Sye-Ok; Murphy, Sheigla

2015-01-01

Background Cannabis use is becoming more accepted in mainstream society. In this paper, we use Zinberg’s classic theoretical framework of drug, set, and setting to elucidate how older adult cannabis users managed health, social and legal risks in a context of normalized cannabis use. Methods We present selected findings from our qualitative study of Baby Boomer (born 1946–1964) cannabis users in the San Francisco Bay Area. Data collection consisted of a recorded, in-depth life history interview followed by a questionnaire and health survey. Qualitative interviews were analyzed to discover the factors of cannabis harm reduction from the users’ perspectives. Results Interviewees made harm reduction choices based on preferred cannabis derivatives and routes of administration, as well as why, when, where, and with whom to use. Most interviewees minimized cannabis-related harms so they could maintain social functioning in their everyday lives. Responsible and controlled use was described as moderation of quantity and frequency of cannabis used, using in appropriate settings, and respect for non-users. Users contributed to the normalization of cannabis use through normification. Conclusion Participants followed rituals or cultural practices, characterized by sanctions that helped define “normal” or “acceptable” cannabis use. Users contributed to cannabis normalization through their harm reduction methods. These cultural practices may prove to be more effective than formal legal prohibitions in reducing cannabis-related harms. Findings also suggest that users with access to a regulated market (medical cannabis dispensaries) were better equipped to practice harm reduction. More research is needed on both cannabis culture and alternative routes of administration as harm reduction methods. PMID:25911027

Seismic Activity: Public Alert and Warning: Legal Implications

NASA Astrophysics Data System (ADS)

Zocchetti, D.

2007-12-01

As science and technology evolve in ways that increase our ability to inform the public of potentially destructive seismic activity, there are significant legal issues for consideration. Even though countries and even states within the United States have differing legal tenets that could either change or at least re-shape the outcome of specific legal questions that this session will be pondering, there are fundamental legal principals that will permeate. It is often said that the law lags behind society and in particular its technological developments. No doubt in the area of warning the public of impending destructive forces of nature or society, the law will need to do some catching up. The law is probably adequately developed for at least some preliminary discussion of the key issues. No matter the legal scheme, if there is a failure or perceived failure in the system to warn people of a pending emergencies, albeit an earthquake, tsunami, or other predictable event, those who are harmed or believe they are harmed will seek relief under the law. Every day there are situations wherein the failure to warn or to adequately warn is key, such as with faulty or defective consumer products, escaped prisoners, and police high-speed vehicle chases. With alert and warning systems for disaster, however, we have a unique set of facts. Generally, the systems and their failures occur during emergencies or at least during situations under apparently exigent circumstances when the disaster's predictability is widely recognized as less than 100 percent. The law, in particular United States tort law, has been particularly lenient when people and organizations are operating during compressed timeframes and their actions are generally considered necessary to address circumstances relative to public safety. The legal system has been forgiving when the actor that failed or appeared to fail was government. The courts have liberally applied the principal of sovereign immunity to

Volunteer health professionals and emergencies: assessing and transforming the legal environment.

PubMed

Hodge, James G; Gable, Lance A; Cálves, Stephanie H

2005-01-01

Volunteer health professionals (VHPs) are essential in emergencies to fill surge capacity and provide needed medical expertise. While some VHPs are well-organized and trained, others arrive spontaneously at the site of a disaster. Lacking organization, training, and identification, they may actually impede emergency efforts. Complications involving medical volunteers in New York City after September 11, 2001, led Congress to authorize federal authorities to assist states and territories in developing emergency systems for the advance registration of volunteer health professionals (ESARVHP). Through advance registration, volunteers can be vetted, trained, and mobilized more effectively during emergencies. The use of VHPs, however, raises multiple legal questions: What constitutes an emergency, how is it declared, and what are the consequences? When are volunteers liable for their actions? When may volunteers who are licensed or certified in one state legally practice their profession in another state? Are volunteers entitled to compensation for harms they incur? This article examines the legal framework underlying the registration and use of volunteers during emergencies and offers recommendations for legal reform, including: (1) establish minimum standards to facilitate interjurisdictional emergency response, improve coordination, and enhance reciprocity of licensing and credentialing; (2) develop liability provisions for VHPs that balance their need to respond without significant fear of civil liability with patients' rights to legal recourse for egregious harms; and (3) provide basic levels of protections for VHPs harmed, injured, or killed while responding to emergencies.

Evaluating the public health impacts of legalizing recreational cannabis use in the United States.

PubMed

Hall, Wayne; Lynskey, Michael

2016-10-01

Since 2012 four US states have legalized the retail sale of cannabis for recreational use by adults, and more are likely to follow. This report aimed to (1) briefly describe the regulatory regimes so far implemented; (2) outline their plausible effects on cannabis use and cannabis-related harm; and (3) suggest what research is needed to evaluate the public health impact of these policy changes. We reviewed the drug policy literature to identify: (1) plausible effects of legalizing adult recreational use on cannabis price and availability; (2) factors that may increase or limit these effects; (3) pointers from studies of the effects of legalizing medical cannabis use; and (4) indicators of cannabis use and cannabis-related harm that can be monitored to assess the effects of these policy changes. Legalization of recreational use will probably increase use in the long term, but the magnitude and timing of any increase is uncertain. It will be critical to monitor: cannabis use in household and high school surveys; cannabis sales; the number of cannabis plants legally produced; and the tetrahydrocannabinol (THC) content of cannabis. Indicators of cannabis-related harms that should be monitored include: car crash fatalities and injuries; emergency department presentations; presentations to addiction treatment services; and the prevalence of regular cannabis use among young people in mental health services and the criminal justice system. Plausible effects of legalizing recreational cannabis use in the United States include substantially reducing the price of cannabis and increasing heavy use and some types of cannabis-related harm among existing users. In the longer term it may also increase the number of new users. © 2016 Society for the Study of Addiction.

Mull it over: cannabis vaporizers and harm reduction.

PubMed

Gartner, Coral E

2015-11-01

Legalization of cannabis is likely to lead to greater use. Balanced regulation of potentially less harmful modes of administration, such as vaporizers, is needed. Further research is warranted not only on the direct health effects of vaping cannabis, but also on its potential to decrease co-administration of tobacco with cannabis.

F141. DUTY TO WARN FOR POTENTIAL RISK OF PSYCHOLOGICAL HARM: A CASE REPORT

PubMed Central

Zhand, Naista; Attwood, David

2018-01-01

Abstract Background Under the current ethical and legal standards physicians are expected to breach confidentiality when a third party is at risk. However, the law has mainly focused on risk of bodily harm and there is no legal guidance on physicians’ responsibilty when it comes to risk of psychological harm to a potential targeted victim Methods This case report illustrates a clinical dilemma on duty to warn for mental health professionals. Results N/A Discussion This case report illustrates an unconventional perspective on a psychiatrist’s duty to warn: consideration of risk of psychological harm to the potential target of their patient. Psychological trauma can have a potential negative impact on victims, affecting their mental health and well being as well as their physical health. The ethicolegal dilemma discussed in this case has implications for policies related to the care of psychiatric patients.

Are Australian smokers interested in using low-nitrosamine smokeless tobacco for harm reduction?

PubMed

Gartner, C E; Jimenez-Soto, E V; Borland, R; O'Connor, R J; Hall, W D

2010-12-01

To determine (1) whether Australian smokers are aware of low-nitrosamine smokeless tobacco (LNSLT) products and (2) whether they would be interested in using LNSLT either as a long-term substitute for smoking or as an aid to quitting, if these products were to become legally available. 401 daily smokers were recruited by a market research company to complete an internet questionnaire about their smoking history, knowledge of smokeless tobacco and intentions to purchase LNSLT under different scenarios. Just under half (48%) indicated they were willing to buy an LNSLT product. Predictors of an interest in purchasing LNSLT were low income, poorer health, prior SLT use, belief that SLT is less harmful than cigarettes, switching to a lower tar cigarette in the past year, ever using nicotine replacement therapy products for quitting or other reasons, having made a failed cessation attempt in the previous year and not planning to quit smoking. Analysis of quitting and LNSLT purchasing intentions under different scenarios suggest that making LNSLT available at a much lower cost than smoked cigarettes while increasing taxes on cigarettes could provide a greater reduction in the number of smokers than the same tax increase alone. These results support further examination of the potential for LNSLT to reduce smoking-related harm in Australia.

Legal Preparedness

PubMed Central

Courtney, Brooke; Hodge, James G.; Toner, Eric S.; Roxland, Beth E.; Penn, Matthew S.; Devereaux, Asha V.; Dichter, Jeffrey R.; Kissoon, Niranjan; Christian, Michael D.; Powell, Tia

2015-01-01

contribute to protecting hospitals and practitioners who act in good faith from liability. Finally, to address anticipated staffing shortages during severe and prolonged disasters and pandemics, governments should develop approaches to formally expand the availability of qualified health-care workers, such as through using official foreign medical teams. CONCLUSIONS As a fundamental element of health-care and public health emergency planning and preparedness, the law underlies critical aspects of disaster and pandemic responses. Effective responses require comprehensive advance planning efforts that include assessments of complex legal issues and authorities. Recent disasters have shown that although law is a critical response tool, it can also be used to hold health-care stakeholders who fail to appropriately plan for or respond to disasters and pandemics accountable for resulting patient or staff harm. Claims of liability from harms allegedly suffered during disasters and pandemics cannot be avoided altogether. However, appropriate planning and legal protections can help facilitate sound, consistent decision-making and support response participation among health-care entities and practitioners. PMID:25144203

Getting out of (self-) harm's way: A study of factors associated with self-harm among asylum seekers in Australian immigration detention.

PubMed

Hedrick, Kyli

2017-07-01

The monitoring of self-harm among asylum seekers in Australian immigration detention has not occurred routinely or transparently. Thus whilst concerns regarding rates of self-harm among asylum seekers have been frequently raised, a paucity of systematic information regarding key factors associated with self-harm among asylum seekers exists. The present study was designed therefore to fill a number of gaps in government monitoring by examining the government's own archived self-harm data. Via a descriptive analysis of self-harm incident reports from all operational Australian immigration detention facilities over a 20-month period to May 2011, obtained under Freedom of Information, the present study identified that 959 incidents of self-harm occurred during this period. A gender bias towards men was also found. In addition to this, 10 different methods of self-harm were identified, the four most common being: cutting (47%), attempted hanging (19%), head hitting (12%) and self-poisoning by medication (6%). Seven different precipitating factors for self-harm were also identified, the four most common were: detention conditions (39%), processing arrangements (27%), negative decisions (24%) and family separation (3%). These findings point strongly to the health benefits of considering alternatives to held immigration detention, such as community based processing. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

"Legal Highs"--An Emerging Epidemic of Novel Psychoactive Substances.

PubMed

Zawilska, Jolanta B

2015-01-01

During the last decade, there has been an increase in the availability and use of novel psychoactive substances (NPS), also known as "legal highs," across the world. They include a wide range of products, from natural plant-originated substances to synthetic compounds, that can be purchased both online and from high street retailers. "Legal highs" mimic psychoactive effects of illicit drugs of abuse. However, they are claimed to consist of compounds that are legal to sell, possess, and use, often labeled as "not for human consumption" to circumvent drug abuse legislation. Based on the spectrum of their actions on cognitive processes, mood, and behavior, "legal highs" can be classified into four basis categories: amphetamine- and ecstasy-like stimulants, synthetic cannabinoids (SCs), hallucinogenic/dissociative, and opioid-like compounds. NPS may, however, exhibit a combination of these actions due to their designed chemical structure. Although the prevalence and pattern of NPS use differ between various countries, the most popular groups are SCs and psychostimulants, described in this chapter. Currently, there is limited information available on the potential acute toxicity (harms) associated with the use of these substances. However, the number of intoxicated people presenting with emergencies is constantly increasing, providing evidence that negative health and social consequences may indeed seriously affect recreational and chronic users. © 2015 Elsevier Inc. All rights reserved.

[The establishment of relationship between mental disorder of a victim and psychotraumatic effect of sexual character in the legal expertise of "health harm severity"].

PubMed

Iakovleva, E Iu

2009-01-01

Based on the analysis of 51 cases of sexual crimes committed against persons with mean age 11,1 years, main points of expert analysis of statement or exclusion of cause-effect relationship between mental disorder of a victim and psychogenic action of sexual infringement in the legal expertise of "health harm severity" are presented. The regularities of development of mental disorder in judicially significant situations with regard to the influence of different types of psychogenic factors (specific sexual traumatization, additional and concomitant factors, non-specific psychogenic factors) are described. Definitions of different variants of cause-effect relationships (directed, modified) are formulated. The author suggests the grounds for choosing a form (definite, probable) of expert conclusion.

The Olympics and harm reduction?

PubMed Central

2012-01-01

The current anti-doping policy (‘war on doping’) resembles the ‘war on drugs’ in several aspects, including a zero-tolerance approach, ideology encroaching on human rights and public health principles, high cost using public money for repression and control, and attempts to shape internationally harmonized legal frameworks to attain its aim. Furthermore, even if for different reasons, both wars seem not to be able to attain their objectives, and possibly lead to more harm to society than they can prevent. The Olympic buzz is mounting and we can expect multiple headlines in the media on doping and anti-doping stories related to this event. In this article we describe current anti-doping policy, reflect on its multiple unplanned consequences, and end with a discussion, if lessons learned from harm reduction experiences in the illicit drugs field could be applied to anti-doping. PMID:22788912

Perceptions of Harm to Children Exposed to Secondhand Aerosol From Electronic Vapor Products, Styles Survey, 2015.

PubMed

Nguyen, Kimberly H; Tong, Van T; Marynak, Kristy; King, Brian A

2017-05-25

The US Surgeon General has concluded that e-cigarette aerosol is not harmless and can contain harmful and potentially harmful chemicals, including nicotine. We assessed factors associated with adults' perceptions of harm related to children's exposure to secondhand aerosol from electronic vapor products (EVPs). Data came from the 2015 Styles, an Internet panel survey of US adults aged 18 years or older (n = 4,127). Respondents were asked whether they believe aerosol from other people's EVPs causes children harm. Harm perceptions were assessed overall and by cigarette smoking, EVP use, and sociodemographic characteristics. Multinomial logistic regression was used to assess odds of perceived harm. Overall, 5.3% of adults responded that secondhand EVP exposure caused "no harm" to children, 39.9% responded "little harm" or "some harm," 21.5% responded "a lot of harm," and 33.3% responded "don't know." Odds of "no harm" response were greater among men than among women, current and former cigarette smokers than among never smokers, and current and former EVP users than among never users; odds were lower among non-Hispanic blacks, Hispanics, and non-Hispanic other races than among non-Hispanic whites. Odds of responding "don't know" were greater among men, current cigarette smokers, and current and former EVP users; odds were lower among those aged 45 to 64 years than those aged 18 to 24 years and lower among non-Hispanic other races and Hispanics than non-Hispanic whites. Two-fifths of US adults believe that children's exposure to secondhand EVP aerosol causes some or little harm, while one-third do not know whether it causes harm. Efforts are warranted to educate the public about the health risks of secondhand EVP aerosol, particularly for children.

Legal Issues in Educational Technology: Implications for School Leaders.

ERIC Educational Resources Information Center

Quinn, David M.

2003-01-01

Discusses several legal issues involving the use of educational technology: Freedom of speech, regulation of Internet material harmful to minors, student-developed Web pages, harassment and hostile work environment, staff and student privacy, special education, plagiarism, and copyright issues. Includes recommendations for addressing technology…

Examining a home environmental strategy to reduce availability of legal products that can be misused by youth.

PubMed

Collins, David A; Johnson, Knowlton W; Shamblen, Stephen R

2012-10-01

This article presents results from a study of a home environmental strategy (HES) designed to reduce availability of harmful legal products (HLPs) in the home that can be used by youth to get high. HLPs include inhalants, prescription and nonprescription drugs, and household products that can be ingested to get high. Availability is one of the most consistent predictors of substance use among youth. Parents of 5th- to 7th-grade students in four Alaskan communities participated in telephone interviews as part of a larger study of a multicomponent community prevention model (CPM) that included a HES. The strategy was designed to encourage parents to reduce availability of HLPs by removing them from the home, and by locking up and monitoring the supplies of HLPs in the home. Data from 402 parents at Wave 1 and 371 parents at Wave 2 were analyzed using hierarchical non-Linear modeling (HNLM). Results show there was a significant decrease in HLPs in the home from Wave 1 to Wave 2, mostly inhalants and prescription and nonprescription drugs. Parents also reported a significant increase in locking up prescription and nonprescription drugs in the home. Parents' direct exposure to the HES was marginally associated with the change over time in HLP availability in the home. Indirect exposure through others and media was not associated with this change. Study lessons learned and conclusions are highlighted.

Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts.

PubMed

Hajizadeh, Mohammad

2016-05-25

Notwithstanding a century of prohibition, marijuana is the most widely used illicit substance in Canada. Due to the growing public acceptance of recreational marijuana use and ineffectiveness of the existing control system in Canada, the issue surrounding legalizing this illicit drug has received considerable public and political attentions in recent years. Consequently, the newly elected Liberal Government has formally announced that Canada will introduce legislation in the spring of 2017 to start legalizing and regulating marijuana. This editorial aims to provide a brief overview on potential economic, social, and public health impacts of legal marijuana in Canada. The legalization could increase tax revenue through the taxation levied on marijuana products and could also allow the Government to save citizens' tax dollars currently being spent on prohibition enforcement. Moreover, legalization could also remove the criminal element from marijuana market and reduce the size of Canada's black market and its consequences for the society. Nevertheless, it may also lead to some public health problems, including increasing in the uptake of the drug, accidents and injuries. The legalization should be accompanied with comprehensive strategies to keep the drug out of the hands of minors while increasing awareness and knowledge on harmful effects of the drug. In order to get better insights on how to develop an appropriate framework to legalize marijuana, Canada should closely watch the development in the neighboring country, the United States, where some of its states viz, Colorado, Oregon, Washington, and Alaska have already legalized recreational use of marijuana. © 2016 by Kerman University of Medical Sciences.

Legalizing and Regulating Marijuana in Canada: Review of Potential Economic, Social, and Health Impacts

PubMed Central

Hajizadeh, Mohammad

2016-01-01

Notwithstanding a century of prohibition, marijuana is the most widely used illicit substance in Canada. Due to the growing public acceptance of recreational marijuana use and ineffectiveness of the existing control system in Canada, the issue surrounding legalizing this illicit drug has received considerable public and political attentions in recent years. Consequently, the newly elected Liberal Government has formally announced that Canada will introduce legislation in the spring of 2017 to start legalizing and regulating marijuana. This editorial aims to provide a brief overview on potential economic, social, and public health impacts of legal marijuana in Canada. The legalization could increase tax revenue through the taxation levied on marijuana products and could also allow the Government to save citizens’ tax dollars currently being spent on prohibition enforcement. Moreover, legalization could also remove the criminal element from marijuana market and reduce the size of Canada’s black market and its consequences for the society. Nevertheless, it may also lead to some public health problems, including increasing in the uptake of the drug, accidents and injuries. The legalization should be accompanied with comprehensive strategies to keep the drug out of the hands of minors while increasing awareness and knowledge on harmful effects of the drug. In order to get better insights on how to develop an appropriate framework to legalize marijuana, Canada should closely watch the development in the neighboring country, the United States, where some of its states viz, Colorado, Oregon, Washington, and Alaska have already legalized recreational use of marijuana. PMID:27694657

Differences in harm from legal BZP/TFMPP party pills between North Island and South Island users in New Zealand: a case of effective industry self-regulation?

PubMed

Wilkins, Chris; Sweetsur, Paul

2010-01-01

'Party' pills containing benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP) were sold legally in New Zealand until early 2008. Prospective studies of hospital emergency department admissions appeared to suggest that the harm from party pills was greater among South Island than North Island users. The party pill industry association (the Social Tonics Association of New Zealand or STANZ) claimed these differences were due to the voluntary code of practice adopted by their members in the North Island. The aims of this study were to examine differences in harm from party pills between North and South Island users in New Zealand, and to investigate possible reasons for any differences in harm, including the impact of industry self-regulation. A national household survey of BZP/TFMPP party pill use was conducted in New Zealand. Information on the ingredients of party pills was provided by the National Poisons Centre. In a number of instances last year users of party pills from the South Island were more likely than last year users from the North Island to report harm from party pills. There were no differences between the North and South Island users with regard to the mean number of BZP/TFMPP party pills taken, mean total milligrams of BZP/TFMPP ingested or prevalence of use of other drug types in combination with party pills. A minority of users in the South Island reported using extremely high numbers of BZP/TFMPP party pills in a single session and using extremely high potency brands of party pills. Last year party pill users from the South Island were more likely than those from the North Island to be students. A number of factors may have contributed to the greater harm from BZP/TFMPP party pills among South Island users including a higher proportion of student users with higher consumption of alcohol and other drugs. Users from both Islands commonly exceeded the dosage of BZP/TFMPP recommended by STANZ suggesting the STANZ code of conduct was

"They're legal so they're safe, right?" What did the legal status of BZP-party pills mean to young people in New Zealand?

PubMed

Sheridan, Janie; Butler, Rachael

2010-01-01

The legislation on psychoactive substances has a role to play with regard to shaping social values and influencing the normalisation of drug use. In New Zealand from 2005 to 2008, benzylpiperazine-containing 'legal' party pills (BZP-party pills) were legally available for purchase, subject to controls around a minimum purchase age of 18 years, and prohibitions on free of charge distribution and advertising in certain media. This paper explores what their legal status communicated to young users. Interviews and group discussions with young people (n=58) who had used BZP-party pills in the preceding 6 months. Data were collected between June and December 2006 via a series of interviews with individuals, 'friendship' pairs, and groups comprised of participants known to each other. Young people saw BZP-party pills as 'safe' and of good quality as they were legal/government sanctioned, but also thus of inferior strength, suggesting they could take more of them. However, after using them they often reviewed their view of their safety and quality due to varied experiences. Being legal for some people meant they could use the substances without breaking the law, or having to go to 'dealers'. Their legal status also meant they were easily accessible and were seen to be 'socially acceptable', with some young people indicating they would be happy to discuss their use with their parents. However, social acceptability was, for some, a reason not to use them. These data provide a unique insight into the tension between positive and negative harm reduction messages relating to the legal nature of psychoactive drugs and as such begin to fill an information void in this area. The legal status of these 'party pills' conveys mixed messages to young people and whilst being seen as potentially safe and of good quality, this often leads to higher than 'recommended' doses being used. Nevertheless, not breaking the law or having to access BZP-party pills from 'dealers', and being able to

Cannabis, pesticides and conflicting laws: the dilemma for legalized States and implications for public health.

PubMed

Stone, Dave

2014-08-01

State laws on the legalization of medical and recreational cannabis are rapidly evolving. Similar to other crops, cannabis is susceptible to multiple pests during cultivation. Growers have an economic incentive to produce large yields and high quality plants, and may resort to pesticides to achieve these outcomes. Currently, there are no pesticides registered for cannabis in the United States, given its illegal status by the federal government. This discrepancy creates a regulatory vacuum and dilemma for States with legal medical and recreational cannabis that seek to balance lawful compliance with pesticides and worker or public health. Pesticide use presents occupational safety issues that can be mitigated through established worker protection measures. The absence of approved products for cannabis may result in consumer exposures to otherwise more hazardous pesticides or higher residue levels. While many legal and scientific hurdles exist to register conventional pesticides for use on cannabis, legalized States have explored other opportunities to leverage the present regulatory infrastructure. Stakeholder engagement and outreach to the cannabis industry from credible sources could mitigate pesticide misuse and harm. Copyright © 2014 Elsevier Inc. All rights reserved.

Communicating Tobacco Product Information to the Public.

PubMed

Berman, Micah L; Byron, M Justin; Hemmerich, Natalie; Lindblom, Eric N; Lazard, Allison J; Peters, Ellen; Brewer, Noel T

2017-01-01

The 2009 Family Smoking Prevention and Tobacco Control Act (TCA) requires tobacco companies to disclose information about the harmful chemicals in their products to the U.S. Food and Drug Administration (FDA). The law requires the FDA, in turn, to communicate this information to the public "in a format that is understandable and not misleading to a lay person." But how should the FDA comply with this requirement? What does it mean for information about complex chemicals to be "understandable and not misleading to a lay person"? These questions are not easy ones to answer. Disclosures about the amount of harmful chemicals (constituents) in different tobacco products may help to inform consumers, but may also conversely prompt consumers to reach incorrect or unsupported conclusions about products' relative health risks. This paper first analyzes the FDA's legal obligation to publish tobacco constituent information so that it is "understandable and not misleading to a layperson." Second, it discusses how that legal analysis has guided scientific research examining how members of the public interpret messages regarding tobacco constituents. Lastly, this paper concludes with policy recommendations for the FDA as it considers how to comply with the law's constituent disclosure requirement while still furthering its overall objective of promoting public health.

Alleviation of harmful effect in stillage reflux in food waste ethanol fermentation based on metabolic and side-product accumulation regulation.

PubMed

Ma, Hongzhi; Yang, Jian; Jia, Yan; Wang, Qunhui; Ma, Xiaoyu; Sonomoto, Kenji

2016-10-01

Stillage reflux fermentation in food waste ethanol fermentation could reduce sewage discharge but exert a harmful effect because of side-product accumulation. In this study, regulation methods based on metabolic regulation and side-product alleviation were conducted. Result demonstrated that controlling the proper oxidation-reduction potential value (-150mV to -250mV) could reduce the harmful effect, improve ethanol yield by 21%, and reduce fermentation time by 20%. The methods of adding calcium carbonate to adjust the accumulated lactic acid showed that ethanol yield increased by 17.3%, and fermentation time decreased by 20%. The accumulated glyceal also shows that these two methods can reduce the harmful effect. Fermentation time lasted for seven times without effect, and metabolic regulation had a better effect than side-product regulation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Denying Social Harm: Students' Resistance to Lessons about Inequality

ERIC Educational Resources Information Center

Kleinman, Sherryl; Copp, Martha

2009-01-01

Students share folk beliefs that make it difficult for them to understand inequality, especially the harmful consequences of social practices they routinely engage in, are attached to, and take for granted. Four of these beliefs include: (a) harm is direct, extreme, and the product of an individual's intentions; (2) harm is the product of the…

Legal highs on the Internet.

PubMed

Hillebrand, Jennifer; Olszewski, Deborah; Sedefov, Roumen

2010-02-01

This article describes the findings of a descriptive analysis of 27 online drug retailers selling legal alternatives to illegal drugs, commonly referred to as "herbal highs" and "legal highs" in 2008 . The study attempted to quantify the online availability of drug retailers, to describe common products and characteristics in EU-based retail sales. The findings highlight the concern about the lack of objective information about products offered, including potential risks to health. Systems should be developed to assess the contents of products and the accuracy of information provided on the Internet, alongside continued monitoring of this market for "legal high" substances.

78 FR 14079 - Legal Processes

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-04

... DEPARTMENT OF COMMERCE United States Patent and Trademark Office Legal Processes ACTION: Proposed... former employees of the United States Patent and Trademark Office (USPTO). The rules for these legal... employee testimony and production of documents in legal proceedings, reports of unauthorized testimony...

75 FR 3893 - Legal Processes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-25

... DEPARTMENT OF COMMERCE Patent and Trademark Office Legal Processes ACTION: Proposed collection... legal processes may be found under 37 CFR Part 104, which outlines procedures for service of process, demands for employee testimony and production of documents in legal proceedings, reports of unauthorized...

Development of a rational scale to assess the harm of drugs of potential misuse.

PubMed

Nutt, David; King, Leslie A; Saulsbury, William; Blakemore, Colin

2007-03-24

Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.

EXAMINING A HOME ENVIRONMENTAL STRATEGY TO REDUCE AVAILABILITY OF LEGAL PRODUCTS THAT CAN BE MISUSED BY YOUTH

PubMed Central

Collins, David A.; Johnson, Knowlton W.; Shamblen, Stephen R.

2013-01-01

This article presents results from a study of a home environmental strategy (HES) designed to reduce availability of harmful legal products (HLPs) in the home that can be used by youth to get high. HLPs include inhalants, prescription and non-prescription drugs, and household products that can be ingested to get high. Availability is one of the most consistent predictors of substance use among youth. Parents of 5th to 7th-grade students in four Alaskan communities participated in telephone interviews as part of a larger study of a multi-component Community Prevention Model that included a HES. The strategy was designed to encourage parents to reduce availability of HLPs by removing them from the home, and by locking up and monitoring the supplies of HLPs in the home. Data from 402 parents at Wave 1 and 371 parents at Wave 2 were analyzed using Hierarchical Non-Linear Modeling (HNLM). Results show there was a significant decrease in HLPs in the home from Wave 1 to Wave 2, mostly inhalants, prescription and non-prescription drugs. Parents also reported a significant increase in locking up prescription and non-prescription drugs in the home. Parents’ direct exposure to the HES was marginally associated with the change over time in HLP availability in the home. Indirect exposure through others and media was not associated with this change. Study lessons learned and conclusions are highlighted. PMID:22943304

Drug policy, harm and human rights: a rationalist approach.

PubMed

Stevens, Alex

2011-05-01

It has recently been argued that drug-related harms cannot be compared, so making it impossible to choose rationally between various drug policy options. Attempts to apply international human rights law to this area are valid, but have found it difficult to overcome the problems in applying codified human rights to issues of drug policy. This article applies the rationalist ethical argument of Gewirth (1978) to this issue. It outlines his argument to the 'principle of generic consistency' and the hierarchy of basic, nonsubtractive and additive rights that it entails. It then applies these ideas to drug policy issues, such as whether there is a right to use drugs, whether the rights of drug 'addicts' can be limited, and how different harms can be compared in choosing between policies. There is an additive right to use drugs, but only insofar as this right does not conflict with the basic and nonsubtractive rights of others. People whose freedom to choose whether to use drugs is compromised by compulsion have a right to receive treatment. They retain enforceable duties not to inflict harms on others. Policies which reduce harms to basic and nonsubtractive rights should be pursued, even if they lead to harms to additive rights. There exists a sound, rational, extra-legal basis for the discussion of drug policy and related harms which enables commensurable discussion of drug policy options. Copyright © 2011 Elsevier B.V. All rights reserved.

Assessment of the exposure to harmful and potentially harmful constituents in healthy Japanese smokers using a novel tobacco vapor product compared with conventional cigarettes and smoking abstinence.

PubMed

Yuki, Dai; Takeshige, Yuki; Nakaya, Kyoko; Futamura, Yasuyuki

2018-07-01

The objectives of this clinical study were to demonstrate a reduction in exposure to selected harmful and potentially harmful constituents (HPHCs), and to assess product use behavior, in Japanese healthy adult smokers who switched to a novel tobacco vapor product (NTV). 60 smokers were randomly assigned for 5 days to either (a) a group who switched to an NTV (n = 20), (b) a group who continued to smoke their own brand of conventional cigarettes (CC, n = 20) or (c) a smoking abstinence group (SA, n = 20). Fifteen biomarkers of exposure (BoEs) to 14 HPHCs and pyrene were measured at baseline, day 3 and 5. Product use behavior was assessed by measuring product consumption, nicotine uptake and puffing topography. During investigations, increases were observed in product consumption and total puff volume in NTV group subjects as compared to baseline. Additionally, nicotine uptake in the NTV group was approximately half that observed in the CC group. BoE values were significantly reduced in the NTV group as compared to those in the CC group. Significantly, the magnitude of the reduction in exposure to HPHCs observed in the NTV group (49-94%) was close to that observed for the SA group (39-95%). Copyright © 2018 Elsevier Inc. All rights reserved.

[Harm related to medical device use - legal and organisational risks].

PubMed

Hölscher, U M

2014-12-01

The effectiveness of the risk management systems established by medical device manufacturers and health-care facilities is clearly mitigated by European and national legal provisions. Laws, regulations and authorities prevent the systematic exchange of much safety-relevant information. The obligation to report adverse events is suspended for many relevant risks associated with medical device use. Reporting into the vigilance system is of little avail for users. Reporting even may endanger the information provider. The federal fragmentation of the German vigilance system poses a risk for patients. Risk management in health-care facilities without risk policy is dangerously incomplete. © Georg Thieme Verlag KG Stuttgart · New York.

'Legal highs'--novel and emerging psychoactive drugs: a chemical overview for the toxicologist.

PubMed

Gibbons, Simon

2012-01-01

'Legal highs' are psychoactive chemicals which are sold from 'head shops', the internet and from street suppliers and may be possessed without legal restriction. An increase in the marketing of these materials has resulted in a corresponding increase in published reports of their adverse effects. However, a lack of primary literature pertaining to their chemistry, pharmacology and toxicology, makes an evaluation of their harm difficult. This review covers the basic chemistry of these novel psychoactive compounds and relates them to endogenous neurotransmitters and existing drugs of abuse. A survey of the internet was used to identify websites that are marketing 'legal highs' in the UK. Trivial and systematic chemical compound names, for example methoxetamine, 4-methoxyphencycline, 4-fluorotropacocaine and ethyl phenidate were entered into PubMed to retrieve data on these compounds. This search elicited no citations. Other search terms which were more fruitful included desoxypipradrol, diphenylprolinol, methylenedioxy-2-amino-indane and methylenedioxy-2-amino-tetralin, alpha-methyltryptamine and 5-methoxy-N,N-diallyl-tryptamine. 'Legal highs' from the phenylethylamine, cocaine, tryptamine and phencyclidine classes are increasingly being marketed and, in the majority of cases, little is cited in the literature on their true chemical identity, pharmacology or toxicology. 'Legal highs' are gaining in popularity and present clear challenges to toxicologists and society as a whole. Whilst improved use of existing legislation and development of new legislation can be used to reduce the supply of these materials, investment in better education for young people on the harms associated with 'legal highs' is needed.

Denial of abortion in legal settings.

PubMed

Gerdts, Caitlin; DePiñeres, Teresa; Hajri, Selma; Harries, Jane; Hossain, Altaf; Puri, Mahesh; Vohra, Divya; Foster, Diana Greene

2015-07-01

Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Harmful Algal Blooms

USGS Publications Warehouse

Graham, Jennifer L.

2007-01-01

What are Harmful Algal Blooms (HABs)? Freshwater and marine harmful algal blooms (HABs) can occur anytime water use is impaired due to excessive accumulations of algae. HAB occurrence is affected by a complex set of physical, chemical, biological, hydrological, and meteorological conditions making it difficult to isolate specific causative environmental factors. Potential impairments include reduction in water quality, accumulation of malodorous scums in beach areas, algal production of toxins potent enough to poison both aquatic and terrestrial organisms, and algal production of taste-and-odor compounds that cause unpalatable drinking water and fish. HABs are a global problem, and toxic freshwater and (or) marine algae have been implicated in human and animal illness and death in over 45 countries worldwide and in at least 27 U.S. States (Yoo and others, 1995; Chorus and Bartram, 1999; Huisman and others, 2005).

Organ donation after cardiac death: legal and ethical justifications for antemortem interventions.

PubMed

Richards, Bernadette; Rogers, Wendy A

2007-08-06

Organ donation after cardiac death increases organ availability, but raises several legal and ethical issues, including consent. Medical interventions for people who are unconscious usually require guardian consent and must meet patients' best-interests standards. Antemortem procedures can improve the success of organ transplant after cardiac death, but do not serve the patient's medical interests, and it is contentious whether consent for antemortem interventions is legal under current Australian guardianship legislation. We argue that consent decisions should take patients' wishes as well as their medical interests into account. Antemortem interventions are ethically and legally justified if the interventions are not harmful and the person concerned wished to be an organ donor.

Medical-Legal Partnerships: Addressing Competency Needs Through Lawyers

PubMed Central

Paul, Edward; Fullerton, Danya Fortess; Cohen, Ellen; Lawton, Ellen; Ryan, Anne; Sandel, Megan

2009-01-01

Background Many low- and moderate-income individuals and families have at least one unmet legal need (for example, unsafe housing conditions, lack of access to food and/or income support, lack of access to health care), which, if left unaddressed, can have harmful consequences on health. Eighty unique medical-legal partnership programs, serving over 180 clinics and hospitals nationwide, seek to combine the strengths of medical and legal professionals to address patients' legal needs before they become crises. Each partnership is adapted to serve the specific needs of its own patient base. Intervention This article describes innovative, residency-based medical-legal partnership educational experiences in pediatrics, internal medicine, and family medicine at 3 different sites (Boston, Massachusetts; Newark, New Jersey; and Tucson, Arizona). This article addresses how these 3 programs have been designed to meet the Accreditation Council for Graduate Medical Education's 6 competencies, along with suggested methods for evaluating the effectiveness of these programs. Training is a core component of medical-legal partnership, and most medical-legal partnerships have developed curricula for resident education in a variety of formats, including noon conferences, grand rounds, poverty simulations and day-long special sessions. Discussion Medical-legal partnerships combine the skill sets of medical professionals and lawyers to teach social determinants of health by training residents and attending physicians to identify and help address unmet legal needs. Medical-legal partnership doctors and lawyers treat health disparities and improve patient health and well-being by ensuring that public programs, regulations, and laws created to benefit health and improve access to health care are implemented and enforced. PMID:21975996

76 FR 5387 - Guidance for Industry and Food and Drug Administration Staff; “`Harmful and Potentially Harmful...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville... harmful constituents, including smoke constituents, to health in each tobacco product by brand and by quantity in each brand and subbrand.'' The guidance discusses the meaning of the term ``harmful and...

Medical negligence. An overview of legal theory and neurosurgical practice: causation.

PubMed

Todd, Nicholas V

2014-06-01

This article discusses the principles of the law in relation to legal causation as applied to neurosurgical practice. Causation is a causal link between a breach of duty of care and the final harm. The fundamental "but-for" test for causation will be discussed, together with Chester v Afshar modified causation, prospective and retrospective probabilities of harm, loss of a chance, causation following breach of duty of care by omission, breaking the chain of causation, material contribution and the law in relation to multiple defendants, with neurosurgical examples.

Reefer madness: legal & moral issues surrounding the medical prescription of marijuana.

PubMed

Barnes, R E

2000-01-01

California, Arizona, and several other states have recently legalized medical marijuana. My goal in this paper is to demonstrate that even if one grants the opponents of legalization many of their contentious assumptions, the federal government is still obligated to take several specific steps toward the legalization of medical marijuana. I defend this claim against a variety of objections, including the claims: that marijuana is unsafe, that marijuana cannot be adequately tested or produced as a drug, that the availability of synthetic THC makes marijuana superfluous, and especially that legalizing medical marijuana will increase recreational use by 'sending the wrong message.' I then go on to argue that given the intransigent position of the federal government on this issue, state governments are justified in unilaterally legalizing medical marijuana as an act of civil disobedience. A large portion of this paper consists of an extensive response to the objection that legalizing medical marijuana will 'send the wrong message'--which I take to be the primary impediment to legalization. This objection basically claims that the consequences of withholding legalization (especially preventing increased recreational use) are superior to those of legalizing medical marijuana. I argue that legalization is justified even if one were to grant both that the harms of legalization outweighed its benefits and that utilitarianism is true. This requires a subtle and somewhat extended discussion of utilitarian moral and political theory.

Waiting for the opportune moment: the tobacco industry and marijuana legalization.

PubMed

Barry, Rachel Ann; Hiilamo, Heikki; Glantz, Stanton A

2014-06-01

In 2012, Washington State and Colorado legalized the recreational use of marijuana, and Uruguay, beginning in 2014, will become the first country to legalize the sale and distribution of marijuana. The challenge facing policymakers and public health advocates is reducing the harms of an ineffective, costly, and discriminatory "war on drugs" while preventing another public health catastrophe similar to tobacco use, which kills 6 million people worldwide each year. Between May and December 2013, using the standard snowball research technique, we searched the Legacy Tobacco Documents Library of previously secret tobacco industry documents (http://legacy.library.ucsf.edu). Since at least the 1970s, tobacco companies have been interested in marijuana and marijuana legalization as both a potential and a rival product. As public opinion shifted and governments began relaxing laws pertaining to marijuana criminalization, the tobacco companies modified their corporate planning strategies to prepare for future consumer demand. Policymakers and public health advocates must be aware that the tobacco industry or comparable multinational organizations (eg, food and beverage industries) are prepared to enter the marijuana market with the intention of increasing its already widespread use. In order to prevent domination of the market by companies seeking to maximize market size and profits, policymakers should learn from their successes and failures in regulating tobacco. © 2014 Milbank Memorial Fund.

Waiting for the Opportune Moment: The Tobacco Industry and Marijuana Legalization

PubMed Central

Barry, Rachel Ann; Hiilamo, Heikki; Glantz, Stanton A

2014-01-01

Context In 2012, Washington State and Colorado legalized the recreational use of marijuana, and Uruguay, beginning in 2014, will become the first country to legalize the sale and distribution of marijuana. The challenge facing policymakers and public health advocates is reducing the harms of an ineffective, costly, and discriminatory “war on drugs” while preventing another public health catastrophe similar to tobacco use, which kills 6 million people worldwide each year. Methods Between May and December 2013, using the standard snowball research technique, we searched the Legacy Tobacco Documents Library of previously secret tobacco industry documents (http://legacy.library.ucsf.edu). Findings Since at least the 1970s, tobacco companies have been interested in marijuana and marijuana legalization as both a potential and a rival product. As public opinion shifted and governments began relaxing laws pertaining to marijuana criminalization, the tobacco companies modified their corporate planning strategies to prepare for future consumer demand. Conclusions Policymakers and public health advocates must be aware that the tobacco industry or comparable multinational organizations (eg, food and beverage industries) are prepared to enter the marijuana market with the intention of increasing its already widespread use. In order to prevent domination of the market by companies seeking to maximize market size and profits, policymakers should learn from their successes and failures in regulating tobacco. PMID:24890245

Public health implications of smokeless tobacco use as a harm reduction strategy.

PubMed

Savitz, David A; Meyer, Roger E; Tanzer, Jason M; Mirvish, Sidney S; Lewin, Freddi

2006-11-01

Harm reduction strategies involve promoting a product that has adverse health consequences as a substitute for one that has more severe adverse health consequences. Smokeless tobacco low in nitrosamine content offers potential benefits in reducing smoking prevalence rates. Possible harm arises from the potential for such products to serve as a gateway to more harmful tobacco products, public misinterpretation of "less harmful" as "safe," distraction from the public health goal of tobacco elimination, and ethical issues involved in advising those marketing these harmful products. We offer a research agenda to provide a stronger basis for evaluating the risks and benefits of smokeless tobacco as a means of reducing the adverse health effects of tobacco.

78 FR 49975 - Energy Conservation Program for Consumer Products: Landmark Legal Foundation; Petition for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-16

... DEPARTMENT OF ENERGY 10 CFR Part 430 [Docket No. EERE-BT-PET-0043] Energy Conservation Program for Consumer Products: Landmark Legal Foundation; Petition for Reconsideration AGENCY: Office of Energy Efficiency and Renewable Energy, Department of Energy. ACTION: Petition for Reconsideration; Request for...

AREA RESTRICTIONS, RISK, HARM, AND HEALTH CARE ACCESS AMONG PEOPLE WHO USE DRUGS IN VANCOUVER, CANADA: A SPATIALLY ORIENTED QUALITATIVE STUDY

PubMed Central

McNeil, Ryan; Cooper, Hannah; Small, Will; Kerr, Thomas

2015-01-01

Area restrictions prohibiting people from entering drug scenes or areas where they were arrested are a common socio-legal mechanism employed to regulate the spatial practices of people who use drugs (PWUD). To explore how socio-spatial patterns stemming from area restrictions shape risk, harm, and health care access, qualitative interviews and mapping exercises were conducted with 24 PWUD with area restrictions in Vancouver, Canada. Area restrictions disrupted access to health and social resources (e.g., HIV care) concentrated in drug scenes, while territorial stigma prevented PWUD from accessing supports in other neighbourhoods. Rather than preventing involvement in drug-related activities, area restrictions displaced these activities to other locations and increased vulnerability to diverse risks and harms (e.g., unsafe drug use practices, violence). Given the harms stemming from area restrictions there is an urgent need to reconsider this socio-legal strategy. PMID:26241893

Assessing the public health impacts of legalizing recreational cannabis use in the USA.

PubMed

Hall, W; Weier, M

2015-06-01

A major challenge in assessing the public health impact of legalizing cannabis use in Colorado and Washington State is the absence of any experience with legal cannabis markets. The Netherlands created a de facto legalized cannabis market for recreational use, but policy analysts disagree about how it has affected rates of cannabis use. Some US states have created de facto legal supply of cannabis for medical use. So far this policy does not appear to have increased cannabis use or cannabis-related harm. Given experience with more liberal alcohol policies, the legalization of recreational cannabis use is likely to increase use among current users. It is also likely that legalization will increase the number of new users among young adults but it remains uncertain how many may be recruited, within what time frame, among which groups within the population, and how many of these new users will become regular users. © 2015 American Society for Clinical Pharmacology and Therapeutics.

Parents of minors who have sexually abused: legal liability and clinical interventions.

PubMed

Oz, Sheri

2013-01-01

While children and adolescents generally do not have the right to vote, marry, or sign contracts independently, they are often held responsible for their crimes. In spite of this, some parents of minor victims file civil suits against parents of the youth responsible for the harm. The courts must then decide to what extent, if any, parents are legally liable when their minor children commit offenses. Since parents are essential to the successful rehabilitation of minors who have sexually offended, the impact of legal liability on parental engagement in therapy must be examined. This article will explore the conflicting issues of age, legal responsibility, parental responsibility, and therapeutic effectiveness in the Israeli context and propose a means for resolution.

[Harm reduction interventions in drug users: current situation and recommendations].

PubMed

Bosque-Prous, Marina; Brugal, María Teresa

2016-11-01

Harm reduction encompasses interventions, programmes and policies that seek to reduce the negative consequences of the consumption of both legal and illegal drugs on the individual and public health. Harm reduction looks to mitigate the harm suffered by drug users through drug use monitoring and prevention, and promotes initiatives that respect and protect the human rights of this population. The harm reduction policies that have proven effective and efficient are: opioid substitution maintenance therapy (methadone); needle and syringe exchange programmes; supervised drug consumption rooms; and overdose prevention through peer-based naloxone distribution. In order to be effective, these policies must have comprehensive coverage and be implemented in areas where the target population is prevalent. Resident-based opposition to the implementation of these policies is known as the NIMBY (Not In My Back Yard) phenomenon, which is characterised by being against the implementation of new measures in a particular place, but does not question their usefulness. Given that any NIMBY phenomenon is a complex social, cultural and political phenomenon, it is important to conduct a thorough analysis of the situation prior to implementing any of these measures. Harm reduction policies must be extended to other substances such as alcohol and tobacco, as well as to other conditions beyond infectious/contagious diseases and overdose. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Public education about the relative harm of tobacco products: an intervention for tobacco control professionals.

PubMed

Biener, Lois; Nyman, Amy L; Stepanov, Irina; Hatsukami, Dorothy

2014-09-01

In the USA, new regulations require the collection of information on tobacco constituents by brand and variety and publication of this information in a way not likely to be misconstrued by consumers. Understanding of such information becomes increasingly important as new tobacco products are marketed and modifications are made to reduce the toxicity of some products. This pilot study assessed the current knowledge of tobacco control professionals regarding the relative harmfulness of several tobacco products, and evaluated an online educational intervention aimed at improving understanding of variations in nicotine and tobacco-specific N-nitrosamines (TSNAs). Fifty-two tobacco control professionals participated in an online intervention which presented and discussed the results of constituent analyses of Camel Snus and Marlboro Snus compared to several conventional smokeless tobacco products. Comparisons with cigarettes were also discussed. Pre- and post-intervention questions assessed understanding of the concepts. Pre-intervention responses demonstrated that 31% did not know that cigarettes are more harmful than smokeless tobacco, 67% did not know that smokeless products higher in nicotine are likely to be more effective substitutes for cigarettes, 52% did not know TSNAs are the major carcinogens in tobacco and 81% did not know new snus products tend to be lower in TSNAs than conventional spit tobacco. After intervention participation, knowledge increased on all points except one where pretest results were 100% correct. Public education campaigns are urgently needed for tobacco control professionals and consumers to increase awareness and understanding of the continuum of risk among tobacco products. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[The legal status of blood's therapeutic products and consequences].

PubMed

Thibert, J-B

2016-05-01

The first testimonies of humanity show a constant: blood was always surrounded with a sacred fascination. For years, it was not useful to define a legal status for blood, but healthy crisis, medical practices, had led to answer this question in a context of legal protection of human dignity and rights. Actually, the legal frame is moving and to know those statuses is helpful for a better understanding of the changes. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Premigration harm and depression: findings from the new immigrant survey, 2003.

PubMed

Montgomery, Michelle A; Jackson, Charlotte T; Kelvin, Elizabeth A

2014-10-01

Studies examining refugees from conflict areas have found that persecution in the place of origin is a risk factor for depression. No studies have looked at this association between mental health and the experience of premigration harm due to race, gender or religion in the general population of United States immigrants. The New Immigrant Survey baseline questionnaire was administered to a random sample of adults receiving legal permanent residency in the U.S. in 2003 (n = 8,573), including refugees, asylees and other immigrants. In multivariate analysis controlling for visa type, premigration harm was a predictor of general depression of borderline statistical significance [odds ratio (OR), 1.33; 95 % CI 0.98-1.80, p = 0.068] and a significant predictor of major depression with dysphoria (OR, 2.24; 95 % CI 1.48-3.38, p = 0.0001). These findings suggest that premigration harm is a risk factor for depression in the general immigrant population and not just among refugees.

Physician's error: medical or legal concept?

PubMed

Mujovic-Zornic, Hajrija M

2010-06-01

This article deals with the common term of different physician's errors that often happen in daily practice of health care. Author begins with the term of medical malpractice, defined broadly as practice of unjustified acts or failures to act upon the part of a physician or other health care professionals, which results in harm to the patient. It is a common term that includes many types of medical errors, especially physician's errors. The author also discusses the concept of physician's error in particular, which is understood no more in traditional way only as classic error in acting something manually wrong without necessary skills (medical concept), but as an error which violates patient's basic rights and which has its final legal consequence (legal concept). In every case the essential element of liability is to establish this error as a breach of the physician's duty. The first point to note is that the standard of procedure and the standard of due care against which the physician will be judged is not going to be that of the ordinary reasonable man who enjoys no medical expertise. The court's decision should give finale answer and legal qualification in each concrete case. The author's conclusion is that higher protection of human rights in the area of health equaly demands broader concept of physician's error with the accent to its legal subject matter.

Legal requirements and guidelines for the control of harmful laser generated particles, vapours and gases

NASA Astrophysics Data System (ADS)

Horsey, John

2015-07-01

This paper is a review of the Health and Safety laws and guidelines relating to laser generated emissions into the workplace and outside environment with emphasis on the differences between legal requirements and guideline advice. The types and nature of contaminants released by various laser processes (i.e. cutting, coding, engraving, marking etc) are discussed, together with the best methods for controlling them to within legal exposure limits. A brief description of the main extract air filtration techniques, including the principles of particulate removal and the action of activated carbon for gas/vapour/odour filtration, is given.

Lack of pregnancy warnings on over-the-counter dermatologic products containing potentially harmful hydroquinone.

PubMed

Bio, L L; Cies, J J

2017-07-01

To determine the presence of pregnancy warnings on over-the-counter (OTC) dermatologic products with hydroquinone, a potentially harmful ingredient. Data were obtained from the Food and Drug Administration National Drug Code Directory and Label Repository to identify OTC dermatologic products containing hydroquinone. Products were stratified based on pregnancy or general warning presence (WP) or absence (WA). Product characteristics were compared between groups: hydroquinone concentration, presence of external packaging, indication and warning statements. Of the 112 products studied, 21 had a pregnancy warning and 3 included a general warning against use: WP (n=24) and WA (n=88) group. External packaging was more prevalent in the WP group compared to WA (62.5% vs 29.5%, P=0.004). Majority of OTC dermatologic products containing hydroquinone did not have a pregnancy warning. This highlights the need for improved labeling and informs providers caring for pregnant women of OTC labeling limitations.

Monitoring indicators of harmful cyanobacteria in Texas

USGS Publications Warehouse

Kiesling, Richard L.; Gary, Robin H.; Gary, Marcus O.

2008-01-01

Harmful algal blooms can occur when certain types of microscopic algae grow quickly in water, forming visible patches that might harm the health of the environment, plants, or animals. In freshwater, species of Cyanobacteria (also known as bluegreen algae) are the dominant group of harmful, bloom-forming algae. When Cyanobacteria form a harmful algal bloom, potential impairments include restricted recreational activities because of algal scums or algal mats, potential loss of public water supply because of taste and odor compounds (for example, geosmin), and the production of toxins (for example, microcystin) in amounts capable of threatening human health and wildlife.

Effect of smokeless tobacco product marketing and use on population harm from tobacco use policy perspective for tobacco-risk reduction.

PubMed

Kozlowski, Lynn T

2007-12-01

This article presents policy perspectives on the marketing of smokeless tobacco products to reduce population harm from tobacco use. Despite consensus that smokeless tobacco products as sold in the United States are less dangerous than cigarettes, there is no consensus on how to proceed. Diverse factions have different policy concerns. While the tobacco industry is exempted from U.S. Food and Drug Administration (FDA) oversight, the pharmaceutical industry whose nicotine replacement therapy (NRT) medicines compete with smokeless tobacco as noncombustible nicotine-delivery systems are regulated by the FDA. Some public health experts support smokeless tobacco use to reduce population harm from tobacco; other public health experts oppose promoting smokeless tobacco for harm reduction. Adult consumers can freely purchase currently-marketed smokeless tobacco products and even more-deadly cigarettes. Concerns with and advantages of smokeless tobacco products are discussed. In that noncombustible medicinal nicotine-delivery systems have been proven to be effective smoking-cessation aids, smokeless tobacco, as another source of psychoactive doses of nicotine, could be used similarly, in a dose-response fashion as a smoking-cessation aid (consistent with FDA principles for evaluating generic versions of drugs). Price measures should be used on tobacco products to make costs to consumers proportional to product health risks (which would make smokeless tobacco much cheaper than cigarettes), and smokeless tobacco should be encouraged as an option for smoking cessation in adult smokers, particularly for those who have failed to stop smoking using NRT or other methods.

Evaluating the Legitimacy of Contemporary Legal Strategies for Obesity.

PubMed

Morain, Stephanie

2015-12-01

Contemporary legal strategies for obesity raise troubling questions regarding individual liberty and the legitimate scope of public health authority. This article argues that the predominant approach to assessing public health legitimacy--John Stuart Mill's "harm principle"--may be unsuitable for evaluating the legitimacy of legal strategies for obesity. The article proposes an alternative test for assessing the legitimate scope of public health authority: John Rawls's liberal principle of legitimacy. It outlines how Rawls's principle would evaluate obesity policies, and contrasts this evaluation to that of Mill. The alternative test avoids some of the limitations of the Millian approach, and may offer an improved mechanism for assessing the liberty effects of policies for obesity and other public health activities.

Supping with the devil? The role of law in promoting tobacco harm reduction using low nitrosamine smokeless tobacco products.

PubMed

Hall, W; Gartner, C

2009-03-01

In Sweden, male cigarette smoking has declined as snus, a smokeless tobacco product which is low in carcinogenic nitrosamines, has gained popularity among male tobacco users. Epidemiological modelling based on the Swedish experience indicates that there would be major public health gains if a substantial number of current smokers in other countries could also be persuaded to switch to this product. This form of 'tobacco harm reduction' is very controversial in the public health community for many reasons. These include: objections in principle to the use of less harmful but still addictive nicotine products; uncertainties about the long-term effects of these products on health; doubts about the likely interest in and uptake of these products among existing smokers; concerns that increasing the availability of these products will increase the number of new tobacco users and eventually the number of smokers in the population; and anxiety about how the tobacco industry may use these products to undermine current tobacco control policies. This paper concludes with suggestions for a graduated series of policies that may allow exploration of the public health costs and benefits of encouraging smokers to switch to snus.

U.S. cannabis legalization and use of vaping and edible products among youth.

PubMed

Borodovsky, Jacob T; Lee, Dustin C; Crosier, Benjamin S; Gabrielli, Joy L; Sargent, James D; Budney, Alan J

2017-08-01

Alternative methods for consuming cannabis (e.g., vaping and edibles) have become more popular in the wake of U.S. cannabis legalization. Specific provisions of legal cannabis laws (LCL) (e.g., dispensary regulations) may impact the likelihood that youth will use alternative methods and the age at which they first try the method - potentially magnifying or mitigating the developmental harms of cannabis use. This study examined associations between LCL provisions and how youth consume cannabis. An online cannabis use survey was distributed using Facebook advertising, and data were collected from 2630 cannabis-using youth (ages 14-18). U.S. states were coded for LCL status and various LCL provisions. Regression analyses tested associations among lifetime use and age of onset of cannabis vaping and edibles and LCL provisions. Longer LCL duration (OR vaping : 2.82, 95% CI: 2.24, 3.55; OR edibles : 3.82, 95% CI: 2.96, 4.94), and higher dispensary density (OR vaping : 2.68, 95% CI: 2.12, 3.38; OR edibles : 3.31, 95% CI: 2.56, 4.26), were related to higher likelihood of trying vaping and edibles. Permitting home cultivation was related to higher likelihood (OR: 1.93, 95% CI: 1.50, 2.48) and younger age of onset (β: -0.30, 95% CI: -0.45, -0.15) of edibles. Specific provisions of LCL appear to impact the likelihood, and age at which, youth use alternative methods to consume cannabis. These methods may carry differential risks for initiation and escalation of cannabis use. Understanding associations between LCL provisions and methods of administration can inform the design of effective cannabis regulatory strategies. Copyright © 2017 Elsevier B.V. All rights reserved.

Reduced Exposure to Harmful and Potentially Harmful Smoke Constituents With the Tobacco Heating System 2.1

PubMed Central

Baker, Gizelle; Magnette, John; Picavet, Patrick; Weitkunat, Rolf

2017-01-01

Introduction: Heating rather than burning tobacco reduces levels of harmful and potentially harmful constituents, and consumer products using this approach aim to reduce exposure to tobacco toxicants. The Tobacco Heating System (THS) version 2.1 has been enhanced from earlier prototypes with an improved heat control and sensorial experience and thereby user acceptance. Exposure measurements are required to determine whether it may be possible to reduce the individual health risk compared to smoking combustible cigarettes (CCs). Methods: This controlled clinical study randomly assigned 40 smokers to either a group continuing to use of their own CC brand (n = 20) or a group switching to THS 2.1 (n = 20) for 5 days. Biomarkers of exposure were measured at baseline and on day 1 through day 5. Product consumption, Human Puffing Topography, the occurrence of adverse events, and an assessment of subjective effects, such as smoking satisfaction and enjoyment of respiratory tract sensations, were also determined. Results: The group of smokers who switched to THS 2.1 adapted their puffing behavior initially through longer puff duration and more puffs. During the duration of the study, total puff volume returned to baseline levels and the mean daily product consumption increased but with similar nicotine exposure compared to baseline CC use. Biomarkers of exposure to tobacco smoke toxicants which inform product risk assessment were significantly reduced with THS use compared to the CC group. THS 2.1 users experienced less reinforcing effects with THS 2.1 than with their own cigarette brand. Conclusions: THS 2.1 is a promising alternative to smoking CCs. Notwithstanding possible use adaption through consumption or puffing behavior, the exposure to harmful smoke constituents was markedly reduced with the new heated tobacco platform. Implications: Exposure markers to harmful and potentially harmful smoke constituents were lowered with the THS 2.1. Heating tobacco instead of

Reduced Exposure to Harmful and Potentially Harmful Smoke Constituents With the Tobacco Heating System 2.1.

PubMed

Lüdicke, Frank; Baker, Gizelle; Magnette, John; Picavet, Patrick; Weitkunat, Rolf

2017-02-01

Heating rather than burning tobacco reduces levels of harmful and potentially harmful constituents, and consumer products using this approach aim to reduce exposure to tobacco toxicants. The Tobacco Heating System (THS) version 2.1 has been enhanced from earlier prototypes with an improved heat control and sensorial experience and thereby user acceptance. Exposure measurements are required to determine whether it may be possible to reduce the individual health risk compared to smoking combustible cigarettes (CCs). This controlled clinical study randomly assigned 40 smokers to either a group continuing to use of their own CC brand (n = 20) or a group switching to THS 2.1 (n = 20) for 5 days. Biomarkers of exposure were measured at baseline and on day 1 through day 5. Product consumption, Human Puffing Topography, the occurrence of adverse events, and an assessment of subjective effects, such as smoking satisfaction and enjoyment of respiratory tract sensations, were also determined. The group of smokers who switched to THS 2.1 adapted their puffing behavior initially through longer puff duration and more puffs. During the duration of the study, total puff volume returned to baseline levels and the mean daily product consumption increased but with similar nicotine exposure compared to baseline CC use. Biomarkers of exposure to tobacco smoke toxicants which inform product risk assessment were significantly reduced with THS use compared to the CC group. THS 2.1 users experienced less reinforcing effects with THS 2.1 than with their own cigarette brand. THS 2.1 is a promising alternative to smoking CCs. Notwithstanding possible use adaption through consumption or puffing behavior, the exposure to harmful smoke constituents was markedly reduced with the new heated tobacco platform. Exposure markers to harmful and potentially harmful smoke constituents were lowered with the THS 2.1. Heating tobacco instead of burning can offer a potentially lower risk of delivering

45 CFR 615.5 - Legal proceedings between private litigants: Testimony and production of documents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION TESTIMONY AND PRODUCTION OF RECORDS § 615.5 Legal... employee may testify as to facts within his or her personal knowledge, but, unless specifically authorized...) Testify as to facts when the General Counsel determines such testimony would not be in the best interest...

45 CFR 615.5 - Legal proceedings between private litigants: Testimony and production of documents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION TESTIMONY AND PRODUCTION OF RECORDS § 615.5 Legal... employee may testify as to facts within his or her personal knowledge, but, unless specifically authorized...) Testify as to facts when the General Counsel determines such testimony would not be in the best interest...

45 CFR 615.5 - Legal proceedings between private litigants: Testimony and production of documents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION TESTIMONY AND PRODUCTION OF RECORDS § 615.5 Legal... employee may testify as to facts within his or her personal knowledge, but, unless specifically authorized...) Testify as to facts when the General Counsel determines such testimony would not be in the best interest...

45 CFR 615.5 - Legal proceedings between private litigants: Testimony and production of documents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION TESTIMONY AND PRODUCTION OF RECORDS § 615.5 Legal... employee may testify as to facts within his or her personal knowledge, but, unless specifically authorized...) Testify as to facts when the General Counsel determines such testimony would not be in the best interest...

45 CFR 615.5 - Legal proceedings between private litigants: Testimony and production of documents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare (Continued) NATIONAL SCIENCE FOUNDATION TESTIMONY AND PRODUCTION OF RECORDS § 615.5 Legal... employee may testify as to facts within his or her personal knowledge, but, unless specifically authorized...) Testify as to facts when the General Counsel determines such testimony would not be in the best interest...

"First, do no harm": legal guidelines for health programmes affecting adolescents aged 10-17 who sell sex or inject drugs.

PubMed

Conner, Brendan

2015-01-01

entitled to judicial process. Legal guidelines also provide that these adolescents have influence over their placement, access to legal counsel to challenge the conditions of their detention and regular visitation from peers, friends and family, and that all facilities be subject to frequent and periodic review by independent agencies, including community-based groups led by KPs. Controlling international law specifies that protective interventions among KPs aged 10-17 must not only include low-threshold, voluntary services but also "protect" adolescent KPs from the harms attendant to law-enforcement-based interventions. Going forward, health practitioners must honour the right to health by adjusting programmes according to principles of minimum intervention, due process and proportionality, and duly limit juvenile justice and child protection involvement as a measure of last resort, if any.

On balance: weighing harms and benefits in fundamental neurological research using nonhuman primates.

PubMed

Arnason, Gardar; Clausen, Jens

2016-06-01

One of the most controversial areas of animal research is the use of nonhuman primates for fundamental research. At the centre of the controversy is the question of whether the benefits of research outweigh the harms. We argue that the evaluation of harms and benefits is highly problematic. We describe some common procedures in neurological research using nonhuman primates and the difficulties in evaluating the harm involved. Even if the harm could be quantified, it is unlikely that it could be meaningfully aggregated over different procedures, let alone different animals. A similar problem arises for evaluating benefits. It is not clear how benefits could be quantified, and even if they could be, values for different aspects of expected benefits cannot be simply added up. Sorting harms and benefits in three or four categories cannot avoid the charge of arbitrariness and runs the risk of imposing its structure on the moral decision. The metaphor of weighing or balancing harms and benefits is inappropriate for the moral decision about whether to use nonhuman primates for research. Arguing that the harms and benefits in this context are incommensurable, we suggest describing the moral consideration of harms and benefits as a coherent trade-off. Such a decision does not require commensurability. It must be well-informed about the suffering involved and the potential benefits, it must be consistent with the legal, regulatory and institutional framework within which it is made, and it must cohere with other judgments in relevant areas.

Substance abuse and developments in harm reduction.

PubMed

Cheung, Y W

2000-06-13

A drug is a substance that produces a psychoactive, chemical or medicinal effect on the user. The psychoactive effect of mood-altering drugs is modulated by the user's perception of the risks of drug use, his or her ability to control drug use and the demographic, socioeconomic and cultural context. The ability to control drug use may vary along a continuum from compulsive use at one end to controlled use at the other. The "drug problem" has been socially constructed, and the presence of a moral panic has led to public support for the prohibitionist approach. The legalization approach has severely attacked the dominant prohibitionist approach but has failed to gain much support in society because of its extreme libertarian views. The harm reduction approach, which is based on public health principles, avoids the extremes of value-loaded judgements on drug use and focuses on the reduction of drug-related harm through pragmatic and low-threshold programs. This approach is likely to be important in tackling the drug problem in the 21st century.

Substance abuse and developments in harm reduction

PubMed Central

Cheung, Y W

2000-01-01

A drug is a substance that produces a psychoactive, chemical or medicinal effect on the user. The psychoactive effect of mood-altering drugs is modulated by the user's perception of the risks of drug use, his or her ability to control drug use and the demographic, socioeconomic and cultural context. The ability to control drug use may vary along a continuum from compulsive use at one end to controlled use at the other. The "drug problem" has been socially constructed, and the presence of a moral panic has led to public support for the prohibitionist approach. The legalization approach has severely attacked the dominant prohibitionist approach but has failed to gain much support in society because of its extreme libertarian views. The harm reduction approach, which is based on public health principles, avoids the extremes of value-loaded judgements on drug use and focuses on the reduction of drug-related harm through pragmatic and low-threshold programs. This approach is likely to be important in tackling the drug problem in the 21st century. PMID:10870502

MEDICAL ERROR: CIVIL AND LEGAL ASPECT.

PubMed

Buletsa, S; Drozd, O; Yunin, O; Mohilevskyi, L

2018-03-01

The scientific article is focused on the research of the notion of medical error, medical and legal aspects of this notion have been considered. The necessity of the legislative consolidation of the notion of «medical error» and criteria of its legal estimation have been grounded. In the process of writing a scientific article, we used the empirical method, general scientific and comparative legal methods. A comparison of the concept of medical error in civil and legal aspects was made from the point of view of Ukrainian, European and American scientists. It has been marked that the problem of medical errors is known since ancient times and in the whole world, in fact without regard to the level of development of medicine, there is no country, where doctors never make errors. According to the statistics, medical errors in the world are included in the first five reasons of death rate. At the same time the grant of medical services practically concerns all people. As a man and his life, health in Ukraine are acknowledged by a higher social value, medical services must be of high-quality and effective. The grant of not quality medical services causes harm to the health, and sometimes the lives of people; it may result in injury or even death. The right to the health protection is one of the fundamental human rights assured by the Constitution of Ukraine; therefore the issue of medical errors and liability for them is extremely relevant. The authors make conclusions, that the definition of the notion of «medical error» must get the legal consolidation. Besides, the legal estimation of medical errors must be based on the single principles enshrined in the legislation and confirmed by judicial practice.

The gap between legal rules and practice in advertising non-registered pharmaceutical products. A new method of analysis.

PubMed

Wieringa, N F; de Meijer, A H; Schutjens, M D; Vos, R

1992-12-01

The market of non-registered pharmaceutical products is growing fast in number and overall costs, not only in the Netherlands, but also in other European countries. These products often give the impression that the consumer may expect 'an effect as from a drug'. Legally, there is a clear distinction between 'drugs' and 'commodities' in the Netherlands; the question is whether legislation and practice concur. In an investigation we analysed texts of advertisements for non-registered pharmaceutical products published in a popular magazine. A method was developed, based on the legal definition of a drug and jurisprudence, to determine in a qualitative and quantitative way the application of medicinal claims. It transpired that in 65% of the analysed advertisements explicit or implicit claims were made. These products should therefore be subject to drugs legislation. Thus, in the Netherlands there is a gap between legislation and practice in advertising non-registered pharmaceutical products.

Attorney work product privilege trumps mandated child abuse reporting law: The case of Elijah W. v. Superior Court.

PubMed

Lareau, Craig R

2015-01-01

Forensic psychologists and psychiatrists are licensed in their respective professions, but they perform most of their work with attorneys in the legal arena. Both attorneys and mental health professionals place high value on confidentiality of information, reflected in the ethics of their professions and codified into laws governing their work. In psychology and psychiatry, there are some well-known exceptions to confidentiality; two primary exceptions include the mandated reporting of suspected child abuse and various "Tarasoff" duty to warn or protect laws. Generally, however, the corresponding duty for attorneys to report suspected child abuse or to warn or protect intended victims of threatened harm is not as extensive. This difference in mandated reporting responsibilities can create significant difficulties when attorneys need to retain forensic psychologists and psychiatrists to evaluate their clients, especially in criminal contexts. If the retained psychologist or psychiatrist is required to report suspected abuse or threatened harm, the attorney may be harming his or her client's legal interests by using the forensic psychologist or psychiatrist to evaluate his or her client. This article will briefly review the development of mandated reporting laws for psychologists and psychiatrists and juxtapose those with the legal and ethical requirements of confidentiality for attorneys embodied in the attorney-client privilege and attorney work product privilege. The article will then discuss the California Court of Appeals case in Elijah W. v. Superior Court, where the court addressed the issue of whether retained mental health professionals must report suspected child abuse and threatened harm to others as required by law or if they do not need to report because they come under the umbrella of the attorney work product privilege. This California court ultimately concluded that retained psychologists and psychiatrists work under the attorney work product

Perceived Relative Harm of Selected Cigarettes and Non-Cigarette Tobacco Products-A Study of Young People from a Socio-Economically Disadvantaged Rural Area in Poland.

PubMed

Kaleta, Dorota; Polanska, Kinga; Bak-Romaniszyn, Leokadia; Wojtysiak, Piotr

2016-09-06

The perceived health risk of recently introduced nicotine and tobacco products may influence both their uptake and continued use. The aim of the study was to assess how adolescents rate relative harmfulness of slim and menthol cigarettes, water pipes, e-cigarettes, and smokeless tobacco compared to regular cigarettes. Cross-sectional survey data from students aged 13-19 years from Piotrkowski district, Poland were analyzed. Among the sample of 4050 students, 3552 respondents completed anonymous, confidential, self-administered questionnaire adapted from the Global Youth Tobacco Survey (GYTS). The study results indicate that the students perceived slim cigarettes and menthol cigarettes as less harmful, which is in line with the message created by tobacco companies. On the other hand, less popular products such as water pipes and smokeless tobacco were considered as more harmful. The current study indicates insufficient and misleading perception of harmfulness of different tobacco/nicotine products available on the Polish market. Simultaneously, there is insufficient countrywide public health education in this matter. Preventive measures are necessary to discourage young people from smoking uptake and to ensure that potential consumers can, based on objective data, make informed decisions about cigarettes and non-cigarette tobacco products.

Harm, hype and evidence: ELSI research and policy guidance

PubMed Central

2013-01-01

There has been much investment in research on the ethical, legal and social issues (ELSI) associated with genetic and genomic research. This research should inform the development of the relevant policy. So far, much of the relevant policy - such as in the areas of patents, genetic testing and genetic discrimination - seems to be informed more by speculation of harm and anecdote than by available evidence. Although a quest for evidence cannot always be allowed to delay policy choice, it seems axiomatic to us that policy options are improved by the incorporation of evidence. PMID:23534337

The Legal Implications of Report Back in Household Exposure Studies.

PubMed

Goho, Shaun A

2016-11-01

Scientists conducting research into household air or dust pollution must decide whether, when, and how to disclose to study participants their individual results. A variety of considerations factor into this decision, but one factor that has not received attention until now is the possibility that study participants' receipt of their results might create legal duties under environmental, property, landlord-tenant, or other laws. This article examines relevant laws and regulations and explores the scope of participants' legal duties and the resulting legal and ethical consequences for researchers. Participants could be required in some situations to disclose the presence of certain chemicals when selling or renting their homes or to frequent visitors. The article discusses hypothetical case studies involving the reporting back of results regarding lead, polychlorinated biphenyls, and phthalates. The potential legal duties of study participants have both ethical and legal implications for researchers. Issues include whether the legal consequences for participants should affect the decision whether to report back individual results, how researchers should disclose the legal risks to participants during the informed consent process, and whether researchers would be liable to study participants for legal or economic harm arising from reporting study results to them. The review provides recommendations for language that researchers could use in the informed consent process to disclose the legal risks. Researchers should still report back to participants who want to see their results, but they should disclose the risks of obtaining the information as part of the informed consent process. Citation: Goho SA. 2016. The legal implications of report back in household exposure studies. Environ Health Perspect 124:1662-1670; http://dx.doi.org/10.1289/EHP187.

Mine to market: The legal issues

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1985-01-01

The movement of mineral products from mine to market is the fundamental objective of every mining enterprise. However, the difficult and recurring legal problems encountered in these activities have been overlooked by legal scholars, and little literature is available. The manual from the Foundation's Special Institute on Mine to Market: The Legal Issues is intended to help cure this deficiency, and will be invaluable to individuals involved in any phase of the production and sale or purchase of minerals - from negotiating an initial lease to preparing an agreement for the purchase or sale of a refined product. Included inmore » the manual are discussions of: the mining process - from severance to saleable product; marketing strategy and the lawyer - methods of selling and hedging used in the mining industry; metal markets and pricing mechanisms; the impact of the uniform commercial code on contracts for the sale of minerals and other goods; contracts for the international sale of minerals; countertrade - commercial practices, legal issues, and policy dilemmas; commercial impracticability in mineral transactions; price and payment terms in mineral agreements; and mineral sales and processing agreements.« less

PREP advertisement features affect smokers’ beliefs regarding potential harm

PubMed Central

Strasser, Andrew A; Tang, Kathy Z; Tuller, Michael D; Cappella, Joseph N

2014-01-01

Background The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. Objective To determine the effect of altering advertisement features on smokers’ beliefs of the harm exposure from a PREP. Methods A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a “red” condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a “no text” condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using “incorrect,” “unsure” and “correct” as outcomes, and advertisement type and covariates as predictors, was used for analyses. Results Participants randomised to the “no text” advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, healthier and make smoking safer. Conclusions Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising. PMID:18768457

PREP advertisement features affect smokers' beliefs regarding potential harm.

PubMed

Strasser, A A; Tang, K Z; Tuller, M D; Cappella, J N

2008-09-01

The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation. To determine the effect of altering advertisement features on smokers' beliefs of the harm exposure from a PREP. A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a "red" condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a "no text" condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using "incorrect," "unsure" and "correct" as outcomes, and advertisement type and covariates as predictors, was used for analyses. Participants randomised to the "no text" advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer. Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

Killing us softly: the dangers of legalizing assisted suicide.

PubMed

Golden, Marilyn; Zoanni, Tyler

2010-01-01

This article is an overview of the problems with the legalization of assisted suicide as public policy. The disability community's opposition to assisted suicide stems in part from factors that directly impact the disability community as well as all of society. These factors include the secrecy in which assisted suicide operates today, in states where it is legal; the lack of robust oversight and the absence of investigation of abuse; the reality of who uses it; the dangerous potential of legalization to further erode the quality of the U.S. health care system; and its potential for other significant harms. Legalizing assisted suicide would augment real dangers that negate genuine choice and self-determination. In view of this reality, we explore many of the disability-related effects of assisted suicide, while also addressing the larger social context that inseparably impacts people with disabilities and the broader public. First, after addressing common misunderstandings, we examine fear and bias toward disability, and the deadly interaction of assisted suicide and our profit-driven health care system. Second, we review the practice of assisted suicide in Oregon, the first U.S. state to legalize it, and debunk the merits of the so-called Oregon model. Third and finally, we explore the ways that so-called "narrow" assisted suicide proposals threaten inevitable expansion. Copyright © 2010 Elsevier Inc. All rights reserved.

Perceptions of Harm and Addiction of Snus: An Exploratory Study

PubMed Central

Kaufman, Annette R.; Grenen, Emily; Grady, Meredith; Leyva, Bryan; Ferrer, Rebecca A.

2017-01-01

Tobacco companies in the United States are prohibited from making reduced harm claims without filing a modified risk tobacco product application with the Food and Drug Administration and obtaining an order to market as such. However, it is possible that product marketing may suggest reduced risk to individuals. This study examines perceptions, in particular those related to harm and addiction, of snus print advertisements using a combination of eye-tracking, survey, and semistructured interviews. Participants were 22 male smokers ages 19–29 (M = 26.64, SD = 2.92). Five snus advertisements were each displayed for 20 s and eye movements were tracked. Participants responded to questions about harm and addiction after each advertisement and interviews were conducted after seeing all advertisements. For each advertisement, descriptive statistics were calculated and regression analyses predicted harm and addiction perceptions from eye tracking areas of interest (e.g., warning label). Qualitative data were analyzed using inductive/deductive thematic analysis. For certain advertisements, areas of interest were significantly associated with harm and/or addiction perceptions. For example, higher total fixation duration on the graphic in the Smokeless for Smokers advertisement was associated with decreased perceptions of addiction (B = −.360, p = .048). Qualitative themes emerged and in many instances corroborated quantitative results. This study indicates that for some advertisements, attention on certain areas (measured through eye tracking) is associated with perceptions among young male smokers. Understanding how smokers perceive and understand products after viewing advertisements may inform regulations regarding claims about product harm and addiction and may guide public health efforts to educate smokers on the risks of emerging products. PMID:28068113

Perceptions of harm and addiction of snus: An exploratory study.

PubMed

Kaufman, Annette R; Grenen, Emily; Grady, Meredith; Leyva, Bryan; Ferrer, Rebecca A

2016-12-01

Tobacco companies in the United States are prohibited from making reduced harm claims without filing a modified risk tobacco product application with the Food and Drug Administration and obtaining an order to market as such. However, it is possible that product marketing may suggest reduced risk to individuals. This study examines perceptions, in particular those related to harm and addiction, of snus print advertisements using a combination of eye-tracking, survey, and semistructured interviews. Participants were 22 male smokers ages 19-29 (M = 26.64, SD = 2.92). Five snus advertisements were each displayed for 20 s and eye movements were tracked. Participants responded to questions about harm and addiction after each advertisement and interviews were conducted after seeing all advertisements. For each advertisement, descriptive statistics were calculated and regression analyses predicted harm and addiction perceptions from eye tracking areas of interest (e.g., warning label). Qualitative data were analyzed using inductive/deductive thematic analysis. For certain advertisements, areas of interest were significantly associated with harm and/or addiction perceptions. For example, higher total fixation duration on the graphic in the Smokeless for Smokers advertisement was associated with decreased perceptions of addiction (B = -.360, p = .048). Qualitative themes emerged and in many instances corroborated quantitative results. This study indicates that for some advertisements, attention on certain areas (measured through eye tracking) is associated with perceptions among young male smokers. Understanding how smokers perceive and understand products after viewing advertisements may inform regulations regarding claims about product harm and addiction and may guide public health efforts to educate smokers on the risks of emerging products. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Legal Implications of Report Back in Household Exposure Studies

PubMed Central

Goho, Shaun A.

2016-01-01

Background: Scientists conducting research into household air or dust pollution must decide whether, when, and how to disclose to study participants their individual results. A variety of considerations factor into this decision, but one factor that has not received attention until now is the possibility that study participants’ receipt of their results might create legal duties under environmental, property, landlord–tenant, or other laws. Objectives: This article examines relevant laws and regulations and explores the scope of participants’ legal duties and the resulting legal and ethical consequences for researchers. Participants could be required in some situations to disclose the presence of certain chemicals when selling or renting their homes or to frequent visitors. The article discusses hypothetical case studies involving the reporting back of results regarding lead, polychlorinated biphenyls, and phthalates. Discussion: The potential legal duties of study participants have both ethical and legal implications for researchers. Issues include whether the legal consequences for participants should affect the decision whether to report back individual results, how researchers should disclose the legal risks to participants during the informed consent process, and whether researchers would be liable to study participants for legal or economic harm arising from reporting study results to them. The review provides recommendations for language that researchers could use in the informed consent process to disclose the legal risks. Conclusions: Researchers should still report back to participants who want to see their results, but they should disclose the risks of obtaining the information as part of the informed consent process. Citation: Goho SA. 2016. The legal implications of report back in household exposure studies. Environ Health Perspect 124:1662–1670; http://dx.doi.org/10.1289/EHP187 PMID:27153111

Self-harm.

PubMed

Skegg, Keren

The term self-harm is commonly used to describe a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial cutting in response to intolerable tension. As with suicide, rates of self-harm vary greatly between countries. 5-9% of adolescents in western countries report having self-harmed within the previous year. Risk factors include socioeconomic disadvantage, and psychiatric illness--particularly depression, substance abuse, and anxiety disorders. Cultural aspects of some societies may protect against suicide and self-harm and explain some of the international variation in rates of these events. Risk of repetition of self-harm and of later suicide is high. More than 5% of people who have been seen at a hospital after self-harm will have committed suicide within 9 years. Assessment after self-harm includes careful consideration of the patient's intent and beliefs about the lethality of the method used. Strong suicidal intent, high lethality, precautions against being discovered, and psychiatric illness are indicators of high suicide risk. Management after self-harm includes forming a trusting relationship with the patient, jointly identifying problems, ensuring support is available in a crisis, and treating psychiatric illness vigorously. Family and friends may also provide support. Large-scale studies of treatments for specific subgroups of people who self-harm might help to identify more effective treatments than are currently available. Although risk factors for self-harm are well established, aspects that protect people from engaging in self-harm need to be further explored.

The development of peer educator-based harm reduction programmes in Northern Vietnam.

PubMed

Walsh, Nick; Gibbie, Tania M; Higgs, Peter

2008-03-01

Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.

What products are considered psychoactive under New Zealand's legal market for new psychoactive substances (NPS, 'legal highs')? Implications for law enforcement and penalties.

PubMed

Rychert, Marta; Wilkins, Chris

2016-08-01

The problem of defining what psychoactive products and substances should be covered by legislation aimed at controlling new psychoactive substances (NPS; 'legal highs') is central to the current debate on designing new legislative responses to NPS. In New Zealand, implementation of the Psychoactive Substances Act 2013 (PSA) revealed uncertainties about which psychoactive products are covered by the new regime, with important implications for legal penalties. We reviewed five pieces of legislation which can cover substances with psychoactive properties: PSA, Misuse of Drugs Act (MODA), Food Act, Dietary Supplements Regulations and Medicines Act. Our analysis revealed that a number of psychoactive substances which are not MODA-scheduled may potentially fall under more than one regulatory regime, including kava, Salvia divinorum, nitrous oxide, 25I-NBOMe, and 1,3-dimethylbutylamine (DMBA). For example, kava may be classified as a food, a dietary supplement, a herbal remedy, or a psychoactive substance, depending on how it is presented (including advertising and labelling). There are considerable differences in penalties and regulatory requirements between the different legislative regimes and these may result in unnecessary prosecutions or 'gaming' of the system. We discuss a number of ways to more clearly categorize products, including a public schedule of psychoactive substances and products, demarcation criteria based on the quantity of the active ingredient, and demarcation based on 'discernible intoxication'. Routine use of forensic testing is essential to ensure appropriate prosecutions and penalties. Robust safety standards are also required in legislative regimes exempted from psychoactive substances regime to prevent 'creative compliance'. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

A Legal Analysis and Contrarian View of the Syllabus-as-Contract Perspective

ERIC Educational Resources Information Center

Kaufmann, Kent D.

2015-01-01

Despite the claim made in the scholarship of teaching and learning (SoTL) literature for over two decades that a syllabus is a contract, the courts have uniformly ruled that it is not. While there is no harm in thinking one's syllabus is a contract, there may be legal risk in proclaiming it so. The author provides an analysis of the…

Gambling harms and gambling help-seeking amongst indigenous Australians.

PubMed

Hing, Nerilee; Breen, Helen; Gordon, Ashley; Russell, Alex

2014-09-01

This paper aimed to analyze the harms arising from gambling and gambling-related help-seeking behaviour within a large sample of Indigenous Australians. A self-selected sample of 1,259 Indigenous Australian adults completed a gambling survey at three Indigenous sports and cultural events, in several communities and online. Based on responses to the problem gambling severity index (PGSI), the proportions of the sample in the moderate risk and problem gambler groups were higher than those for the population of New South Wales. Many in our sample appeared to face higher risks with their gambling and experience severe gambling harms. From PGSI responses, notable harms include financial difficulties and feelings of guilt and regret about gambling. Further harms, including personal, relationship, family, community, legal and housing impacts, were shown to be significantly higher for problem gamblers than for the other PGSI groups. Most problem gamblers relied on family, extended family and friends for financial help or went without due to gambling losses. Nearly half the sample did not think they had a problem with gambling but the results show that the majority (57.7 %) faced some risk with their gambling. Of those who sought gambling help, family, extended family, friends and respected community members were consulted, demonstrating the reciprocal obligations underpinning traditional Aboriginal culture. The strength of this finding is that these people are potentially the greatest source of gambling help, but need knowledge and resources to provide that help effectively. Local Aboriginal services were preferred as the main sources of professional help for gambling-related problems.

Central venous catheters: legal issues.

PubMed

Gallieni, Maurizio; Martina, Valentina; Rizzo, Maria Antonietta; Gravellone, Luciana; Mobilia, Francesca; Giordano, Antonino; Cusi, Daniele; Genovese, Umberto

2011-01-01

In dialysis patients, both central venous catheter (CVC) insertion and CVC use during the dialysis procedure pose important legal issues, because of potentially severe, even fatal, complications. The first issue is the decision of the kind of vascular access that should be proposed to patients: an arteriovenous (AV) fistula, a graft, or a CVC. The second issue, when choosing the CVC option, is the choice of CVC: nontunneled versus tunneled. Leaving a temporary nontunneled CVC for a prolonged time increases the risk of complications and could raise a liability issue. Even when choosing a long-term tunneled CVC, nephrologists should systematically explain its potential harms, presenting them as "unsafe for long-term use" unless there is a clear contraindication to an AV native or prosthetic access. Another critical issue is the preparation of a complete, informative, and easy-to-understand consent form. The CVC insertion procedure has many aspects of legal interest, including the choice of CVC, the use of ECG monitoring, the use of ultrasound guidance for cannulation, and the use of fluoroscopy for checking the position of the metal guidewire during the procedure as well as the CVC tip before the end of the procedure. Use of insertion devices and techniques that can prevent complications should obviously be encouraged. Complications of CVC use are mainly thrombosis and infection. These are theoretically expected as pure complications (and not as malpractice effects), but legal issues might relate to inappropriate catheter care (in both the inpatient and outpatient settings) rather than to the event per se. Thus, in the individual case it is indeed very difficult to establish malpractice and liability with a catheter-related infection or thrombosis. In conclusion, we cannot avoid complications completely when using CVCs, but reducing them to a minimum and adopting safe approaches to their insertion and use will reduce legal liability.

Legal and medical aspects of body dysmorphic disorder.

PubMed

Nachshoni, Tali; Kotler, Moshe

2007-12-01

Body Dysmorphic Disorder (BDD), a preoccupation with an imagined defect in physical appearance has a rich clinical history, but officially appeared with diagnostic criteria only in the DSM-III-R classification system. Prevalence of BDD in plastic and cosmetic dermatology ranges between 7-15% due to the obsession with imagined imperfections. The emotional "defect" causes dissatisfaction with nonpsychiatric medical procedures, and often recourse into legal action. We present a case study of BDD developing after cosmetic surgery and debate whether this is an actual possibility and the legal consequences of this possibility. We question whether surgery was a traumatic event and its relationship to the patient's premorbid "eggshell personality". The difficulty in determining causation of psychiatric disorders for the purpose of deciding issues of compensation is discussed. A practical algorithm is offered in order to avoid litigation and to maintain the legitimate medical ideal of "first do no harm".

Surveillance of tobacco industry retail marketing activities of reduced harm products.

PubMed

Slater, Sandy; Giovino, Gary; Chaloupka, Frank

2008-01-01

With the introduction of potential reduced exposure products (PREPs) and the interest in studying tobacco harm reduction, sound research and surveillance are needed to examine and understand the distribution and availability of PREPs in communities, as well as the tobacco industry's marketing practices surrounding these products. We examined the availability and marketing of PREPs in a national sample of tobacco retail stores. We also compared the price of PREPs to those of premium brand cigarettes and examined the distribution of PREPs in comparison with premium brand cigarettes by store type, urbanization, region, and race/ethnicity. We found that PREPs are not widely available, are priced similarly to leading cigarette brands, and have few promotional offers. We also found some significant differences in the distribution of PREPs and cigarettes, as well as in the distribution of Ariva and Omni, by store type and community demographics. The fact that this study used data collected nationally emphasizes the importance of these findings and helps shed some light on the tobacco industry's PREP marketing strategies. This study's national sample provides a unique perspective that needs to be replicated if and when other PREPs are widely marketed.

16 CFR 1102.28 - Publication of reports of harm.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATIONS PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Procedural Requirements § 1102.28... publish reports of harm that meet the requirements for publication in the Database. The Commission will... Commission may publish a report of harm that meets the requirements of § 1102.10(d) in the Database beyond...

16 CFR 1102.28 - Publication of reports of harm.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Procedural Requirements § 1102.28... publish reports of harm that meet the requirements for publication in the Database. The Commission will... Commission may publish a report of harm that meets the requirements of § 1102.10(d) in the Database beyond...

The legal status of the fetus: an international review.

PubMed

Seymour, John

2002-08-01

The article examines the way that courts and legislatures in the United Kingdom, the United States of America, Canada and Australia have answered questions regarding the legal status of a fetus. These questions have arisen in a variety of legal situations: the article deals with succession, criminal, child protection and negligence law. The conclusion offered is that a fetus has a value and an existence that the law should recognise. This does not mean, however, that in all circumstances the law should protect the interests of the fetus. Law-makers will respond differently to claims made on behalf of a fetus, depending on the context. The fetus does not have a uniform value or character in the eyes of the law. The law makes choices as to the situations in which it will take account of actual or threatened antenatal harm.

The bereavement gap: grief, human dignity and legal personhood in the debate over Zoe's law.

PubMed

Robert, Hannah

2014-12-01

A Bill before the New South Wales Parliament attempted to re-frame harm to late-term fetuses as grievous bodily harm to the fetus itself rather than (under the existing law) grievous bodily harm to the mother. To achieve this, the Bill extended legal personhood to the fetus for a limited number of offences. The Bill was brought on behalf of Brodie Donegan, who lost her daughter Zoe at 32 weeks' gestation when Donegan was hit by a drug-affected driver. This article asks what the perspective of a grieving mother can bring to the debate, in terms of helping the criminal law accurately come to grips with the complexity of pregnancy and the specific harm of fetal loss. It assesses the likely impacts of a change to fetal personhood and suggests an alternative legislative approach which is less likely to result in an erosion of bodily autonomy for pregnant women.

What's the Harm? Harms in Research With Adults With Intellectual Disability.

PubMed

McDonald, Katherine E; Conroy, Nicole E; Olick, Robert S; Panel, The Project Ethics Expert

2017-01-01

Scientific advances can improve the lives of adults with intellectual disability, yet concerns that research participation may impose harm impede scientific progress. What counts as harmful can be subjective and perceptions of harm may vary among stakeholders. We studied perspectives on the harmfulness of research events among adults with intellectual disability, family members and friends, disability service providers, researchers, and Institutional Review Board members. We found considerable variance. For example, adults with intellectual disability see exclusion from research as more harmful, but most psychosocial harms as less significant than others. All stakeholders agree that having someone else make the participation decision is harmful. Findings provide insights into the concept of harm and ethical research with adults with intellectual disability.

Marijuana Legalization and Parents’ Attitudes, Use, and Parenting in Washington State

PubMed Central

Kosterman, Rick; Bailey, Jennifer A.; Guttmannova, Katarina; Jones, Tiffany M.; Eisenberg, Nicole; Hill, Karl G.; Hawkins, J. David

2016-01-01

Purpose The recent legalization of non-medical marijuana use in several US states has unknown implications for those who are actively parenting. This study examined parents’ reactions to marijuana legalization and changes in attitudes and behaviors over time. Methods Data were from a gender-balanced, ethnically diverse sample of 395 parents in Washington State who were participating in the longitudinal Seattle Social Development Project. Participants were interviewed 15 times between 1985 (age 10) and 2014 (age 39). Adult non-medical marijuana use was legalized in Washington in 2012 and retail outlets opened in 2014. Results Results showed (a) one third of parents incorrectly believed the legal age of non-medical marijuana use to be 18; (b) significant increase in approval of adult marijuana use and decrease in perceived harm of regular use; (c) wide opposition to teen use and use around one’s children; and (d) substantial increases in frequency of use and marijuana use disorder among parents who used. Conclusions Despite increased acceptance and frequency of adult use, parents remain widely opposed to teen use but need facts and strategies for talking with their children about marijuana. PMID:27523977

16 CFR 1102.10 - Reports of harm.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Content Requirements § 1102.10 Reports of harm. (a... they have a public safety purpose. (b) Manner of submission. To be entered into the Database, reports... Commission will publish in the Publicly Available Consumer Product Safety Information Database reports of...

16 CFR 1102.10 - Reports of harm.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Content Requirements § 1102.10 Reports of harm. (a... they have a public safety purpose. (b) Manner of submission. To be entered into the Database, reports... Commission will publish in the Publicly Available Consumer Product Safety Information Database reports of...

Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment.

PubMed

Salloum, Ramzi G; Louviere, Jordan J; Getz, Kayla R; Islam, Farahnaz; Anshari, Dien; Cho, Yoojin; O'Connor, Richard J; Hammond, David; Thrasher, James F

2017-07-13

The US Food and Drug Administration (FDA) has regulatory authority to use inserts to communicate with consumers about harmful and potentially harmful constituents (HPHCs) in tobacco products; however, little is known about the most effective manner for presenting HPHC information. In a discrete choice experiment, participants evaluated eight choice sets, each of which showed two cigarette packages from four different brands and tar levels (high vs low), accompanied by an insert that included between-subject manipulations (ie, listing of HPHCs vs grouping by disease outcome and numeric values ascribed to HPHCs vs no numbers) and within-subject manipulations (ie, 1 of 4 warning topics; statement linking an HPHC with disease vs statement with no HPHC link). For each choice set, participants were asked: (1) which package is more harmful and (2) which motivates them to not smoke; each with a 'no difference' option. Alternative-specific logit models regressed choice on attribute levels. 1212 participants were recruited from an online consumer panel (725 18-29-year-old smokers and susceptible non-smokers and 487 30-64-year-old smokers). Participants were more likely to endorse high-tar products as more harmful than low-tar products, with a greater effect when numeric HPHC information was present. Compared with a simple warning statement, the statement linking HPHCs with disease encouraged quit motivation. Numeric HPHC information on inserts appears to produce misunderstandings that some cigarettes are less harmful than others. Furthermore, brief narratives that link HPHCs to smoking-related disease may promote cessation versus communications that do not explicitly link HPHCs to disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ethical, legal, and social issues in the translation of genomics into health care.

PubMed

Badzek, Laurie; Henaghan, Mark; Turner, Martha; Monsen, Rita

2013-03-01

The rapid continuous feed of new information from scientific discoveries related to the human genome makes translation and incorporation of information into the clinical setting difficult and creates ethical, legal, and social challenges for providers. This article overviews some of the legal and ethical foundations that guide our response to current complex issues in health care associated with the impact of scientific discoveries related to the human genome. Overlapping ethical, legal, and social implications impact nurses and other healthcare professionals as they seek to identify and translate into practice important information related to new genomic scientific knowledge. Ethical and legal foundations such as professional codes, human dignity, and human rights provide the framework for understanding highly complex genomic issues. Ethical, legal, and social concerns of the health provider in the translation of genomic knowledge into practice including minimizing harms, maximizing benefits, transparency, confidentiality, and informed consent are described. Additionally, nursing professional competencies related to ethical, legal, and social issues in the translation of genomics into health care are discussed. Ethical, legal, and social considerations in new genomic discovery necessitate that healthcare professionals have knowledge and competence to respond to complex genomic issues and provide appropriate information and care to patients, families, and communities. Understanding the ethical, legal, and social issues in the translation of genomic information into practice is essential to provide patients, families, and communities with competent, safe, effective health care. © 2013 Sigma Theta Tau International.

Obsolete tobacco control themes can be hazardous to public health: the need for updating views on absolute product risks and harm reduction.

PubMed

Kozlowski, Lynn T; Abrams, David B

2016-05-24

Leading themes have guided tobacco control efforts, and these themes have changed over the decades. When questions arose about health risks of tobacco, they focused on two key themes: 1) how bad is the problem (i.e., absolute risk) and 2) what can be done to reduce the risk without cessation (i.e., prospects for harm reduction). Using the United States since 1964 as an example, we outline the leading themes that have arisen in response to these two questions. Initially, there was the recognition that "cigarettes are hazardous to health" and an acceptance of safer alternative tobacco products (cigars, pipes, light/lower-tar cigarettes). In the 1980s there was the creation of the seminal theme that "Cigarettes are lethal when used as intended and kill more people than heroin, cocaine, alcohol, AIDS, fires, homicide, suicide, and automobile crashes combined." By around 2000, support for a less-dangerous light/lower tar cigarette was gone, and harm reduction claims were avoided for products like cigars and even for smokeless tobacco which were summarized as "unsafe" or "not a safe alternative to cigarettes." The Surgeon General in 2014 concluded that by far the greatest danger to public health was from cigarettes and other combusted products. At the same time the evidence base for smokeless tobacco and alternative nicotine delivery systems (ANDS) had grown. Product innovation and tobacco/nicotine bio-behavioral, epidemiological and public health sciences demonstrate that low nitrosamine smokeless tobacco (e.g., Swedish snus), and ANDS have substantially lower harms than cigarettes. Going forward, it is important to sharpen themes and key messages of tobacco control, while continuing to emphasize the extreme lethality of the inhaled smoke from cigarettes or from use of any combusting tobacco product. Implications of updating the leading themes for regulation, policymaking and advocacy in tobacco control are proposed as an important next step. A new reframing can align

Criterion Validity of Measures of Perceived Relative Harm of E-Cigarettes and Smokeless Tobacco Compared to Cigarettes

PubMed Central

Persoskie, Alexander; Nguyen, Anh B.; Kaufman, Annette R.; Tworek, Cindy

2017-01-01

Beliefs about the relative harmfulness of one product compared to another (perceived relative harm) are central to research and regulation concerning tobacco and nicotine-containing products, but techniques for measuring such beliefs vary widely. We compared the validity of direct and indirect measures of perceived harm of e-cigarettes and smokeless tobacco (SLT) compared to cigarettes. On direct measures, participants explicitly compare the harmfulness of each product. On indirect measures, participants rate the harmfulness of each product separately, and ratings are compared. The U.S. Health Information National Trends Survey (HINTS-FDA-2015; N=3738) included direct measures of perceived harm of e-cigarettes and SLT compared to cigarettes. Indirect measures were created by comparing ratings of harm from e-cigarettes, SLT, and cigarettes on 3-point scales. Logistic regressions tested validity by assessing whether direct and indirect measures were associated with criterion variables including: ever-trying e-cigarettes, ever-trying snus, and SLT use status. Compared to the indirect measures, the direct measures of harm were more consistently associated with criterion variables. On direct measures, 26% of adults rated e-cigarettes as less harmful than cigarettes, and 11% rated SLT as less harmful than cigarettes. Direct measures appear to provide valid information about individuals’ harm beliefs, which may be used to inform research and tobacco control policy. Further validation research is encouraged. PMID:28073035

Political rape as persecution: a legal perspective.

PubMed

Kelly, N

1997-01-01

The use of rape as a tool of persecution is not new, but recognition of the political rape of women as a violation of internationally protected human rights and as a basis for political asylum is. Over the last several years, a number of advances have been made, including human rights instruments that recognize the need to protect women from rape and other sexual abuse; guidelines from the United Nations High Commission for Refugees and several countries that acknowledge the political nature of rape and the difficulties experienced by women attempting to assert claims to asylum based on rape or other sexual abuse; and a number of important decisions by individual governments to provide protection to survivors of rape. Legal advancements for women in this area have depended largely on the assistance of medical and psychological experts who have been able to educate adjudicators and advocates on the effects of sexual harm, provide expert testimony in individual asylum cases, and provide critical treatment and support to survivors as they work their way through the process of obtaining legal protection.

What's the Harm? Harms in Research with Adults with Intellectual Disability

ERIC Educational Resources Information Center

McDonald, Katherine E.; Conroy, Nicole E.; Olick, Robert S.

2017-01-01

Scientific advances can improve the lives of adults with intellectual disability, yet concerns that research participation may impose harm impede scientific progress. What counts as harmful can be subjective and perceptions of harm may vary among stakeholders. We studied perspectives on the harmfulness of research events among adults with…

Are "Legal Highs" users satisfied? Evidence from online customer comments.

PubMed

Bruneel, Christophe-Alain; Lakhdar, Christian Ben; Vaillant, Nicolas G

2014-03-01

This article describes the results of a clustering analysis of more than 2,100 comments posted by online purchasers of "Legal Highs" on five websites in 2012. The aim is to investigate the reasons for satisfaction/dissatisfaction on the part of legal highs users. Our results show that the reasons for satisfaction depend on the price/quality ratio and the real effects of the product (compared to illicit drugs). Dissatisfaction seems to stem from the disparity between the advertising of the product and its real quality. We conclude that online purchasers are certainly illicit drug users who consider legal highs as substitution products.

What’s the Harm? Harms in Research with Adults with Intellectual Disability

PubMed Central

McDonald, Katherine E.; Conroy, Nicole E.; Olick, Robert S.

2017-01-01

Scientific advances can improve the lives of adults with intellectual disability, yet concerns that research participation may impose harm impede scientific progress. What counts as harmful can be subjective and perceptions of harm may vary among stakeholders. We studied perspectives on the harmfulness of research events among adults with intellectual disability, family members and friends, disability service providers, researchers, and Institutional Review Board members. We found considerable variance. For example, adults with intellectual disability see exclusion from research as more harmful, but most psychosocial harms as less significant than others. All stakeholders agree that having someone else make the participation decision is harmful. Findings provide insights into the concept of harm and ethical research with adults with intellectual disability. PMID:28095059

Hedging bets: Applying New Zealand's gambling machine regime to cannabis legalization.

PubMed

Caulkins, Jonathan P

2018-03-01

Cannabis legalization is often falsely depicted as a binary choice between status quo prohibition and legalizing production and distribution by (regulated) for-profit industry. There are, however, many more prudent architectures for legalization, such as restricting production and distribution licenses to not-for-profit entities. Wilkins describes how New Zealand applied that concept to gambling machines and proposes a parallel for cannabis legalization. Greater investment in proposing good designs along these lines, including attending to governance structures, would be valuable. Copyright © 2017 Elsevier B.V. All rights reserved.

Thinking Like a Lawyer, Thinking Like a Legal System

ERIC Educational Resources Information Center

Stuart, Richard Clay

2013-01-01

The legal system is the product of lawyers. Lawyers are the product of a specific educational system. Therefore, to understand the legal system, we must first explore how lawyers are trained and conditioned to think. What does it mean to "Think Like a Lawyer?'' This dissertation makes use of autoethnography to explore the experience…

"Bitch, You Got What You Deserved!": Violation and Violence in Sex Buyer Reviews of Legal Brothels.

PubMed

Jovanovski, Natalie; Tyler, Meagan

2018-03-01

In this article, we use feminist critical discourse analysis to examine online brothel reviews (148 reviews and 2,424 reply posts) of sex buyers in the context of debates surrounding harm minimization. Our findings show that sex buyers actively construct and normalize narratives of sexual violation and violence against women in licensed brothels through their language, referencing objectification, unsafe sex practices, and, in more extreme cases, rape to create a sense of community with other punters. Through this analysis, we challenge existing assumptions about harm minimization in systems of prostitution, which are legalized or fully decriminalized.

Legal high industry business and lobbying strategies under a legal market for new psychoactive substances (NPS, 'legal highs') in New Zealand.

PubMed

Rychert, Marta; Wilkins, Chris

2016-11-01

The establishment of a regulated legal market for new psychoactive substances (NPS, 'legal highs') under New Zealand's Psychoactive Substances Act (PSA) 2013 created a new commercial sector for psychoactive products, previously limited to alcohol and tobacco. To explore how the newly-recognised 'legal high' industry (LHI) viewed and responded to the changing regulatory and market environment. In-depth interviews with six key informants (KI) from the LHI: a leading entrepreneur, chemist, industry spokesperson, retailer, product buyer and a researcher commissioned by the LHI - were conducted, transcribed and analysed thematically. Formative work for the study included review of official LHI documents (websites, public submissions, self-regulation documents). The LHI stakeholders espoused an idealistic mission of shifting recreational users of alcohol, tobacco and illegal drugs towards "safer alternatives". Passage of the PSA was viewed as a success after years of lobbying led by pioneering LHI actors. The growth and professionalisation of the LHI resulted in an increasingly commercial market which challenged idealistic views of the original operators. LHI KI reported the targeting of young and low income customers, price cutting and increasing the strength of products as business strategies. Attempts by the LHI to self-regulate did not prevent escalation in the strength of products and fall in retail prices. The LHI reported outsourcing of manufacturing and exporting of their products to other countries, demonstrating an international business model. There was a tension between profit and idealistic motivations within the LHI and this increased as the sector became more commercialised. While the LHI distanced itself from both alcohol and tobacco, they reported the use of similar marketing, business and political lobbying strategies. Rules for engagement with new 'addictive consumption industries' are required to clarify the role they are permitted to play in the

16 CFR § 1102.28 - Publication of reports of harm.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE Procedural Requirements § 1102.28... publish reports of harm that meet the requirements for publication in the Database. The Commission will... Commission may publish a report of harm that meets the requirements of § 1102.10(d) in the Database beyond...

Menthol cigarettes: moving toward a broader definition of harm.

PubMed

Gardiner, Phillip; Clark, Pamela I

2010-12-01

The current practice of the tobacco industry of primarily focusing on the extent that menthol cigarettes contribute or do not contribute to excess morbidity and mortality in various diseases does not, in and of itself, fully illuminate the harm caused by these products. In fact, this practice actually masks and obscures the public health harm associated with menthol cigarettes. Given this, this commentary develops and presents a broader definition of harm in which to view menthol cigarettes and as the necessary and underlying rationale of why this candy-flavored ingredient should be removed from all tobacco products. This paper relies on the scientific presentations of the 2nd Conference on Menthol Cigarettes, and the peer-reviewed literature on menthol cigarettes. A broader definition of harm from menthol cigarettes must be analyzed from a broad public health perspective and take into account youth uptake and initiation, menthol's ability to augment addiction through unique sensory properties, spurious health messages associated with these products, menthol's role in cessation inhibition and relapse promotion, and the blatant predatory marketing of these products to the most vulnerable sectors of society. The Food and Drug Administration (FDA) should apply the same logic that outlawed other candy flavorings and apply it to menthol cigarettes; in the end, all candy flavorings, including menthol, only serve to make the poisons inherent in tobacco smoke go down easier. Additionally, the mobilization of communities most affected by the menthol cigarettes, the FDA, and candy flavorings and the tobacco industry's machinations will be discussed.

Seeing the "Harm" in "Harmed" and "Harmful": Morphological Processing by Children in Grades 4, 6, and 8

ERIC Educational Resources Information Center

Deacon, S. Helene; Campbell, Emily; Tamminga, Meredith; Kirby, John

2010-01-01

This study examined morphological processing of inflected and derived words by children in Grades 4, 6, and 8. Participants were shown root forms and inflected, derived, and orthographic control items (e.g., "harm", "harmed", "harmful", or "harmony"), followed by a fragment completion task (e.g., completing "h a_ _"). Participants were equally…

A Legal Guide for the Software Developer.

ERIC Educational Resources Information Center

Minnesota Small Business Assistance Office, St. Paul.

This booklet has been prepared to familiarize the inventor, creator, or developer of a new computer software product or software invention with the basic legal issues involved in developing, protecting, and distributing the software in the United States. Basic types of software protection and related legal matters are discussed in detail,…

Implications of marijuana legalization for adolescent substance use.

PubMed

Hopfer, Christian

2014-01-01

Marijuana that is legally available for adults has multiple implications for adolescent substance use. One potential effect that legalization may have is an increase in adolescent use to due increased availability, greater social acceptance, and possibly lower prices. Legalization may also facilitate the introduction of new formulations of marijuana (edible, vaporized) and with potentially higher potencies. It is unknown what adolescent consumption patterns will be if marijuana is widely available and marketed in different forms, or what effects different patterns of adolescent use will have on cognition, the development of marijuana use disorders, school performance, and the development of psychotic illnesses. Also unclear is whether adolescent users will be experiencing higher levels of tetrahydrocannabinol (THC) compared with previous generations of users due to higher potencies. Although previous studies of the effects of adolescent marijuana use provide some guidance for current policy and public health recommendations, many new studies will be needed that answer questions in the context of use within a legal adult environment. Claims that marijuana has medicinal benefits create additional challenges for adolescent prevention efforts, as they contrast with messages of its harmfulness. Prevention and treatment approaches will need to address perceptions of the safety of marijuana, claims of its medicinal use, and consider family-wide effects as older siblings and parents may increasingly openly consume and advocate for marijuana use. Guidance for primary care physicians will be needed regarded screening and counseling. Widespread legalization and acceptance of marijuana implies that as law enforcement approaches for marijuana control decline, public health, medical, and scientific efforts to understand and reduce negative consequences of adolescent marijuana use need to be substantially increased to levels commensurate with those efforts for tobacco and alcohol.

The use of HPLC-Q-TOF-MS for comprehensive screening of drugs and psychoactive substances in hair samples and several "legal highs" products.

PubMed

Aszyk, Justyna; Kot-Wasik, Agata

Non-targeted screening of drugs present in herbal products, known as "legal high" drugs and in hair as a biological matrix commonly used in toxicological investigations was accomplished with the use of high pressure liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (HPLC-Q-TOF-MS). In total, 25 and 14 therapeutical drugs and psychoactive substances/metabolites were detected in investigated hair samples and herbal products, respectively. We demonstrate that the HPLC-Q-TOF methodology seems to be a powerful tool in the qualitative analysis applied in identification of these designer drugs, thus enabling a laboratory to stay-up-to-date with the drugs that are being sold as legal high products on black market.

The conflict between least harm and no-use tobacco policy for youth: ethical and policy implications.

PubMed

Pentz, M A; Sussman, S; Newman, T

1997-09-01

This paper examines policy and ethical implementation issues associated with local drug policies that are aimed at producing a "least harm" approach toward youth, with particular application to tobacco policy as an example of a legal, but addictive drug. Research is reviewed which shows the inconsistencies between federally mandated enforcement of zero tobacco use, the Synar Amendment and local community and school policies which appear to relax enforcement of no-use policies for the purpose of retaining youth in school. The inconsistencies are described from the perspective of a "least harm" approach, in that tobacco use may be considered less harmful than absence from school, or use of other substances. The conflict between law and intent to reduce harm is examined with implications for long-term enforcement of federal policy, and for effectiveness of tobacco and other drug abuse prevention programs and other drug policies. Several strategies for reducing the conflict are recommended. These include provision of support-orientated smoking cessation programs for youth on school campuses and in community organizations, and promoting consistent no-use norms across all drugs and across multiple channels that affect youth-mass media, school, point-of-purchase settings and public settings and events.

Understanding gambling related harm: a proposed definition, conceptual framework, and taxonomy of harms.

PubMed

Langham, Erika; Thorne, Hannah; Browne, Matthew; Donaldson, Phillip; Rose, Judy; Rockloff, Matthew

2016-01-27

Harm from gambling is known to impact individuals, families, and communities; and these harms are not restricted to people with a gambling disorder. Currently, there is no robust and inclusive internationally agreed upon definition of gambling harm. In addition, the current landscape of gambling policy and research uses inadequate proxy measures of harm, such as problem gambling symptomology, that contribute to a limited understanding of gambling harms. These issues impede efforts to address gambling from a public health perspective. Data regarding harms from gambling was gathered using four separate methodologies, a literature review, focus groups and interviews with professionals involved in the support and treatment of gambling problems, interviews with people who gamble and their affected others, and an analysis of public forum posts for people experiencing problems with gambling and their affected others. The experience of harm related to gambling was examined to generate a conceptual framework. The catalogue of harms experienced were organised as a taxonomy. The current paper proposes a definition and conceptual framework of gambling related harm that captures the full breadth of harms that gambling can contribute to; as well as a taxonomy of harms to facilitate the development of more appropriate measures of harm. Our aim is to create a dialogue that will lead to a more coherent interpretation of gambling harm across treatment providers, policy makers and researchers.

Legal highs - legal aspects and legislative solutions.

PubMed

Kapka-Skrzypczak, Lucyna; Kulpa, Piotr; Sawicki, Krzysztof; Cyranka, Małgorzata; Wojtyła, Andrzej; Kruszewski, Marcin

2011-01-01

In recent years the attention of society, the media and politicians has focused on the negative phenomenon of the occurrence of an enormous amount of new psychoactive substances flooding the European market. In Poland and in Europe they are known under the name 'legal highs' or 'smart drugs'. In many countries these compounds present a serious social and health problem. The core of the problem is the fact that in the light of the law these substances are legal, while actually they imitate the eff ect of illegal narcotics. Smart drugs are sold allegedly as 'products not intended for human consumption', under the cover of 'collector's commodities', 'incense sticks' or 'bath salts'. Efforts undertaken by many countries, including Poland, are biased towards gaining control over this pathological phenomenon by placing the subsequent substances on the list of prohibited agents. However, the resilient chemical and pharmaceutical industry still remains one step ahead by introducing new derivatives of already banned products, practically identical in action. The presented article is an attempt to bring closer the problem of smart drugs in Poland, from the occurrence of this alarming phenomenon, through the spread of sales in shops all over Poland, to a series of changes in the Polish anti-narcotic law, drastic actions of closing the shops throughout the entire country, and transferring the sale of smart drugs to the internet.

[Russian and foreign legal-standards bases for guaranteeing the parasitic safety of raw produce and food products].

PubMed

Lovgalev, A S

1998-01-01

The paper analyzes the standard legal and methodological assurance of the quality and safety of animal food raw materials and foodstuffs (meat, meat products, fish, shellfish, crayfish and their processing products) by the parasitic purity rates according the requirements under the Russian Federation's laws "On Sanitary and Epidemiological Well-Being of the Population", "On Protection of Consumer's Rights", "On Certification of Products and Services", those of SanPiN, such as 2.3.2.560-96 "Sanitary Requirements for the Quality and Safety of Food Raw Materials and Foodstuffs" and 3.2.569-96 "Prevention of Parasitic Diseases in the Russian Federation".

Harassment, Bullying, and Discrimination of Lesbian, Gay, Bisexual, and Transgender Students: Legal Issues for North Carolina Schools

ERIC Educational Resources Information Center

Hall, Will

2007-01-01

The purpose of the report is to inform students, parents, school personnel, and officials of the legal issues related to harassment, bullying, and discrimination of lesbian, gay, bisexual, and transgender (LGBT) students. This report describes existing research on the current school climate for LGBT youth as well as the harmful effects of…

[Self-harming behaviour].

PubMed

Kool, Nienke; Pollen, Wim; van Meijel, Berno

2010-01-01

To gain a better understanding of self-harm, a 28-year-old female patient and a 19-year-old female patient with self-harming behaviour are presented. The first patient refused treatment of cut wounds when the doctor enquired about the reason for self-harm. The second patient was referred for mental health care. These cases illustrate the complexity of this behaviour for the patient and the caregiver. Self-harm is often a symbol of underlying problems and serves multiple psychological functions. It is mostly used by patients to cope with unbearable emotions for which they have no other solution. The self-harm invokes different feelings in caregivers which tend to influence the attitude of the caregiver towards the patient. It is very important that caregivers are aware of their feelings and use them professionally. People who self-harm should not be judged, but treated respectfully and attention should be paid to their suffering.

Social and legal determinants for the marketing of GM products in Poland.

PubMed

Twardowski, Tomasz; Małyska, Aleksandra

2012-02-15

The development of biotechnology is influenced by many factors unique for a specific region. In Poland the lack of legislative solutions (to facilitate the promotion of the inventions) and the public resistance against certain sectors of biotechnology are significant factors limiting any further development. Although, science and technology are the front runners in any innovation, the significance of social and legal aspects is difficult to overestimate. In our opinion those factors are interconnected and crucial for marketing of innovative products, therefore, we indicate and explain the most important issues restraining the implementation of innovative biotechnology in the context of national specificity in Poland. Copyright © 2011 Elsevier B.V. All rights reserved.

Bricks without Straw: The Sorry State of American Legal Education

ERIC Educational Resources Information Center

Rounds, Charles E., Jr.

2011-01-01

While many law students and recent grads have come to feel that legal education is an expensive waste of time now that the job market for lawyers has collapsed, some seasoned law practitioners have their own concerns about the worth of a legal education. Their concerns, however, relate to product quality rather than product marketability.…

Deficiencies in public understanding about tobacco harm reduction: results from a United States national survey.

PubMed

Kiviniemi, Marc T; Kozlowski, Lynn T

2015-07-02

Tobacco products differ in their relative health harms. The need for educating consumers about such harms is growing as different tobacco products enter the marketplace and as the FDA moves to regulate and educate the public about different products. However, little is known about the patterns of the public's knowledge of relative harms. Data were analyzed from the Health Information National Trends Survey (HINTS) 4 Cycle 2, a population-representative survey of US adults conducted between October 2012 and January 2013 (N = 3630). Participants reported their perceptions of the relative risks of e-cigarettes, smokeless tobacco, and different types of cigarettes compared to "traditional" cigarettes. Relative risk perceptions for each product type, as well as the consistency and accuracy of harm reduction beliefs, were analyzed. About 65% of the respondents accurately reported that no cigarettes were less harmful than any others. Slightly more than half of U.S. adults perceived e-cigarettes to be safer than regular cigarettes, a belief in line with current scientific evidence. By contrast, only 9% of respondents perceived some smokeless tobacco products to be safer, a belief strongly supported by the evidence. Only 3.5% of respondents had patterns of relative risk perceptions in line with current scientific evidence for all three modalities. The discrepancy between current evidence and public perceptions of relative risk of various tobacco/nicotine products was marked; for most tobacco types, a large proportion of the population held inaccurate harm reduction beliefs. Although there was substantial awareness that no cigarettes were safer than any other cigarettes, there could be benefits from increasing the percentage of the public that appreciates this fact, especially among current smokers. Given the potential benefits of tobacco risk reduction strategies, public health education efforts to increase understanding of basic harm reduction principles are needed to

Self-Harm

MedlinePlus

... value. Skipping classes to change bandages or avoiding social occasions to prevent people from seeing your scars is a sign that your habit is negatively affecting work and relationships. Why People Self-harm Self-harm is not a mental illness, but ...

Use of imagery and text that could convey reduced harm in American Spirit advertisements.

PubMed

Moran, Meghan Bridgid; Pierce, John P; Weiger, Caitlin; Cunningham, Mary C; Sargent, James D

2017-03-01

In 2015, the US Food and Drug Administration issued warning letters to three tobacco companies regarding use of the terms 'natural' and/or 'additive-free' to describe their products, as these terms inaccurately convey reduced harm. Yet, tobacco companies engage in a variety of alternate techniques to attempt to convey the same 'natural' (and thus reduced harm) message. It is critical to monitor these practices to inform regulatory action. To describe the marketing techniques used in Natural American Spirit (American Spirit) ads that could convey a natural and less harmful product image. Trained coders content analysed 142 American Spirit ads from 2012 to 2016. In addition to use of the terms 'natural' and 'additive-free', American Spirit ads engage in a variety of other linguistic and iconic techniques that could convey reduced harm, such as references to small, local or organic farming, eco-friendly practices, and plant, farming and other nature-related imagery. American Spirit ads use a wide range of marketing techniques to convey a natural product image, which could subsequently communicate reduced harm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Ethical considerations of e-cigarette use for tobacco harm reduction.

PubMed

Franck, Caroline; Filion, Kristian B; Kimmelman, Jonathan; Grad, Roland; Eisenberg, Mark J

2016-05-17

Due to their similarity to tobacco cigarettes, electronic cigarettes (e-cigarettes) could play an important role in tobacco harm reduction. However, the public health community remains divided concerning the appropriateness of endorsing a device whose safety and efficacy for smoking cessation remain unclear. We identified the major ethical considerations surrounding the use of e-cigarettes for tobacco harm reduction, including product safety, efficacy for smoking cessation and reduction, use among non-smokers, use among youth, marketing and advertisement, use in public places, renormalization of a smoking culture, and market ownership. Overall, the safety profile of e-cigarettes is unlikely to warrant serious public health concerns, particularly given the known adverse health effects associated with tobacco cigarettes. As a result, it is unlikely that the population-level harms resulting from e-cigarette uptake among non-smokers would overshadow the public health gains obtained from tobacco harm reduction among current smokers. While the existence of a gateway effect for youth remains uncertain, e-cigarette use in this population should be discouraged. Similarly, marketing and advertisement should remain aligned with the degree of known product risk and should be targeted to current smokers. Overall, the available evidence supports the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking, while taking measures to protect vulnerable groups and individuals.

[Legal aspects of reuse and re-sterilization of disposable products in the hospital].

PubMed

Bohle, T

2000-06-01

What consequences may follow if the hospital administration decides to introduce recycling and resterilisation of disposable medical products? While some consider the chief executive administrators and doctors to be seriously endangered by the legal implications of the German Medical Products Act (MPG), others consider recycling and resterilisation to be clearly admissible. A closer look at what constitutes an offence as described in sec. 43, para 1 No. 1 of the MPG reveals that mere presumptions do not suffice to incur the respective penalties; rather, a concrete, scientifically sound basis for assuming an endangerment of safety or health are required for penal measures to be justified. The manufacturer's designation "for once-only use" may not be considered "intended purpose" as stipulated in sec. 4, para 1 No. 1 of the MPG. If recycling or resterilisation be confined to self-made disposables, there is no necessity for CE marking. Information of the patient and individual documentation must be extended to cover the use of recycled or resterilised disposable products only if the use of the latter may constitute a significant additional danger to the patient.

A Study of the Possible Harmful Effects of Cosmetic Beauty Products on Human Health.

PubMed

Kaličanin, Biljana; Velimirović, Dragan

2016-04-01

The origins of the usage of different substances in beauty, skin, body, hair, and nails care products can be found in ancient times. To achieve better quality and enhance their effects, some additives such as preservatives, stabilizers, mineral pigments, dye, and shine were added to these products. Some of these substances may also have allergic, irritating, and harmful effects on human health. The aim of this study was the optimization of the potentiometric stripping analysis (PSA) for the purpose of determining the content of heavy metals (lead, cadmium, zinc), in some commercial cosmetic beauty products (lipsticks, lip glosses, eye shadows, and henna hair dye). In addition, in order to monitor the potential adverse effects of henna dye on hair quality, as well as the total body burden of heavy metals (Pb, Cd), the paper analyzed hair samples before and after henna dye treatment. Beauty products used for cosmetic purposes can have adverse effects to human health due to the fact that they contain lead, a highly toxic metal. The lead content in the tested samples varied depending on the additives used along with the method of production. The cosmetic products that were analyzed in this study contained a certain amount of zinc, which is an essential element, although its content above the prescribed limit may lead to side effects. Highly toxic metal, cadmium, was not detected in the tested samples. The presence of these metals in cosmetic products certainly indicate that it is necessary to monitor and determinate the content of toxic heavy metals in these products, especially because they are in direct contact with skin or mucous membranes and are often used in daily life.

Harm, change, and time.

PubMed

Belshaw, Christopher

2012-10-01

What is harm? I offer an account that involves the victim's either suffering some adverse intrinsic change or being prevented from enjoying some beneficial intrinsic change. No one is harmed, I claim, in virtue of relational changes alone. Thus (excepting for contrived cases), there are neither posthumous harms nor, in life, harms of the undiscovered betrayal, slander, reputation-damaging variety. Further, two widespread moves in the philosophy of death are rejected. First, death and posthumous are not to be assimilated--death does bring about adverse internal change and harms us straightforwardly. Second, Pitcher-type accounts of posthumous harm are criticized--posthumous events can thwart the satisfaction of my interests, but I am not harmed either just when this occurs or, earlier, when I first acquire or invest in those interests. We have other ways of describing what is going on.

28 CFR 543.11 - Legal research and preparation of legal documents.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Legal research and preparation of legal... INSTITUTIONAL MANAGEMENT LEGAL MATTERS Inmate Legal Activities § 543.11 Legal research and preparation of legal... program or work assignment), to do legal research and to prepare legal documents. Where practical, the...

28 CFR 543.11 - Legal research and preparation of legal documents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Legal research and preparation of legal... INSTITUTIONAL MANAGEMENT LEGAL MATTERS Inmate Legal Activities § 543.11 Legal research and preparation of legal... program or work assignment), to do legal research and to prepare legal documents. Where practical, the...

28 CFR 543.11 - Legal research and preparation of legal documents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Legal research and preparation of legal... INSTITUTIONAL MANAGEMENT LEGAL MATTERS Inmate Legal Activities § 543.11 Legal research and preparation of legal... program or work assignment), to do legal research and to prepare legal documents. Where practical, the...

28 CFR 543.11 - Legal research and preparation of legal documents.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Legal research and preparation of legal... INSTITUTIONAL MANAGEMENT LEGAL MATTERS Inmate Legal Activities § 543.11 Legal research and preparation of legal... program or work assignment), to do legal research and to prepare legal documents. Where practical, the...

28 CFR 543.11 - Legal research and preparation of legal documents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Legal research and preparation of legal... INSTITUTIONAL MANAGEMENT LEGAL MATTERS Inmate Legal Activities § 543.11 Legal research and preparation of legal... program or work assignment), to do legal research and to prepare legal documents. Where practical, the...

The diverging trajectories of cannabis and tobacco policies in the United States: reasons and possible implications.

PubMed

Hall, Wayne; Kozlowski, Lynn T

2018-04-01

To examine briefly the (i) rationales for two policy proposals in the United States to make it mandatory for cigarettes to contain very low levels of nicotine and to legalize cannabis for recreational use by adults; and (ii) possible lessons that participants in each policy debate may learn from each other. We briefly describe the diverging policies towards cannabis and tobacco in the United States, explain and critically analyse their rationales and discuss possible policy lessons. Advocates of cannabis legalization have argued that prohibition has been an ineffective and expensive policy that penalizes ethnic minority users unjustly of a drug that is far less harmful than alcohol. The prohibition of traditional tobacco cigarettes has been advocated as a way to eliminate cigarette smoking. These proposals embody very different attitudes towards the harms of recreational adult drug use. Advocates of nicotine prohibition demand that alternative methods of nicotine delivery must be shown to be completely safe before adults are allowed to use them. Advocates of tobacco prohibition ignore evidence that smokers may not use these products and the likelihood of expanding the illicit tobacco market. Advocates of legalizing and regulating recreational cannabis ignore the need to tax and regulate sales in order to minimize the harms of heavy use. It is not clear that the prohibition of adult use has a useful role to play in the regulation of either cannabis or tobacco. If both products remain legal, the goals of regulating tobacco and cannabis products should be to restrict youth access, promote the use of the least harmful products, provide users with evidence-based information on both absolute and differential product risks of use and use differential taxes and marketing controls to promote ways of using these products that cause the least harm to their users. © 2017 Society for the Study of Addiction.

[Behavioral disorders in Parkinson's disease. Genetic, pharmacological and medico-legal aspects].

PubMed

Sobrido, M J; Dias-Silva, J J; Quintáns, B

2009-01-23

Patients with Parkinson's disease (PD) may present neuropsychiatric and conduct disorders at different stages of the development of the disease that make treatment even more difficult. The neurologist must be on the lookout for the possible appearance of alterations affecting impulse control, even from the early stages of the disease, so as to be able to prevent them or to plan a suitable adjustment of treatment. Some of the most common impulsivity disorders include hypersexuality, compulsive gambling and other addictive behaviours which, if left undetected and untreated, can end up having a destructive effect on the patient's socio-familial surroundings. Psychotic disorders (hallucinations, delusions) are often associated to advanced phases of PD and to the effect of dopamine therapy, and they are associated to a higher morbidity and mortality rate. Factors of a genetic or pharmacogenetic nature or a gene-environment interaction may account for the different individual susceptibility to disorders in the neuropsychiatric realm among patients with PD. It is wise to bear in mind the possible medico-legal implications that may stem from behavioral disorders, both for the patient and his or her family and for the physician, because situations could arise that trigger conflicts between confidentiality and preventing third parties from being harmed, as well as harm that can be attributed to the side effects of medicines. The specialist must be familiar with, foresee and propose suitable treatment for behavioral and neuropsychiatric disorders in PD with potential medico-legal implications.

The state of harm reduction in the Middle East and North Africa: A focus on Iran and Morocco.

PubMed

Himmich, Hakima; Madani, Navid

2016-05-01

HIV/AIDS and hepatitis C among people who inject drugs are on the rise in the Middle East and North Africa (MENA) region. But the regional response to the epidemic falls short both in terms of the quality and scale of response. From the threat of the death sentence for drug offenses to the burden of refugees fleeing conflict, there are many legal, political and social barriers that hinder the introduction and expansion of harm reduction in the region. However Iran and Morocco are two pioneering countries and over the last decade they have been providing evidence that harm reduction is feasible and acceptable in MENA. Using different approaches, these two countries have overcome various obstacles and encouraged discussion and collaboration among stakeholders, including government, health professionals, civil society and community-based organizations. In so doing they have created an enabling environment to endorse a national harm strategy. Copyright © 2016 Elsevier B.V. All rights reserved.

Legal Services: The Army Legal Assistance Program

DTIC Science & Technology

1996-02-21

Army Regulation 27–3 Legal Services The Army Legal Assistance Program Headquarters Department of the Army Washington, DC 21 February 1996 REPORT...1996 to xx-xx-1996 4. TITLE AND SUBTITLE The Army Legal Assistance Program Unclassified 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...Z39.18 SUMMARY of CHANGE AR 27–3 The Army Legal Assistance Program This change 2 corrects the title page of this regulation. This change 2-- o Corrects

Interprofessional Medical-Legal Education of Medical Students: Assessing the Benefits for Addressing Social Determinants of Health.

PubMed

Pettignano, Robert; Bliss, Lisa; McLaren, Susan; Caley, Sylvia

2017-09-01

Screening tools exist to help identify patient issues related to social determinants of health (SDH), but solutions to many of these problems remain elusive to health care providers as they require legal solutions. Interprofessional medical-legal education is essential to optimizing health care delivery. In 2011, the authors implemented a four-session didactic interprofessional curriculum on medical-legal practice for third-year medical students at Morehouse School of Medicine. This program, also attended by law students, focused on interprofessional collaboration to address client/patient SDH issues and health-harming legal needs. In 2011-2014, the medical students participated in pre- and postintervention surveys designed to determine their awareness of SDH's impact on health as well as their attitudes toward screening for SDH issues and incorporating resources, including a legal resource, to address them. Mean ratings were compared between pre- and postintervention respondent cohorts using independent-sample t tests. Of the 222 medical students who participated in the program, 102 (46%) completed the preintervention survey and 100 (45%) completed the postintervention survey. Postintervention survey results indicated that students self-reported an increased likelihood to screen patients for SDH issues and an increased likelihood to refer patients to a legal resource (P < .001). Incorporating interprofessional medical-legal education into undergraduate medical education may result in an increased likelihood to screen patients for SDH and to refer patients with legal needs to a legal resource. In the future, an additional evaluation to assess the curriculum's long-term impact will be administered prior to graduation.

Legal regulation of the production and trade of medical devices and medical equipment in the EU and US: experience for Ukraine.

PubMed

Pashkov, Vitalii; Kotvitska, Alla; Harkusha, Andrii

2017-01-01

The need for effective legal regulation of production and sale of medical products in Ukraine due to its social effect is obvious and requires a high level of clarity. The experience of more advanced countries in this area, given the way chosen by Ukraine to harmonize our laws with EU legislation, is certainly could be a useful source of information. The urgency of issues need further intensification of national legal reforms. Some key points on concept of legal regulation of abovementioned sphere is a base of this study. Legislation of Ukraine, European Union, United States of America, Guidelines, developed by European Commission & Food and Drug Administration's (FDA), recommendations represented by international voluntary group and scientific works. This article is based on dialectical, comparative, analytic, synthetic and comprehensive research methods. This study provide a possibility to state that main difference of regulatory systems in EU and US is that the legal framework of the EU is more flexible. This flexibility is grounded on main principle that only basic quality requirements for medical devices is defined by legislative acts however more detailed requirements are defined in standards, technical regulations, specifications, which are discretionary in nature. Contractors are free to choose any technical solution that provides compliance with the essential requirements, they can choose among different conformity assessment procedures and between accredited conformity assessment bodies to which they want to apply. The contractors themselves is interested to pass the conformity assessment procedure and have the right to put a conformity mark on their medical device because it will give them a real competitive advantage. In contrast, US State regulatory system provides strict control over business entities and law act establishes the quality requirements of medical products. The only body that can authorize the introduction of medical products and perform

Harmful excipients in medicines for neonates in Spain.

PubMed

Garcia-Palop, Beatriz; Movilla Polanco, Emma; Cañete Ramirez, Carmen; Cabañas Poy, Maria Jose

2016-04-01

Neonates may respond differently from adults to drug components. Hence, ingredients that seem safe in adults may not be safe in this age group. To describe the content of harmful excipients in drugs used in our neonatal wards and compare the daily dose a neonate may receive with the accepted daily intake (ADI) in adults. All drugs included in the hospital's neonatal treatment guide were reviewed, using information from the package inserts or the summary of product characteristics. Those containing at least one harmful excipient (e.g., metabisulfite, sorbitol) were analyzed. Minimum and maximum usual daily drug doses were determined, and excipient exposure was estimated by extrapolation of the minimum and maximum of excipient referred to the active ingredient. These amounts were compared with ADIs for each excipient in adults. In total, 32 % of intravenous and 62 % of oral formulations used in neonates contained at least one harmful excipient. On quantitative analysis, 25 % of intravenous and 19 % of oral drugs contained harmful excipients exceeding the ADI in adults. Several drugs commonly used to treat neonates contain harmful excipients in amounts that may exceed the ADI in adults. Clinicians should be aware of this to prescribe appropriate treatment in this population.

Attitudes of regular injecting drug users towards the legal status of the major illicit drugs.

PubMed

Darke, Shane; Torok, Michelle

2013-09-01

The study aimed to determine injecting drug users' (IDU) attitudes, and correlates of attitudes, towards continued prohibition, decriminalisation or legalisation of the major illicit drugs. This study used structured interview with 300 IDUs who had injected on at least a weekly basis over the preceding 12 months. Methamphetamine was rated the most harmful of the five illicit substances and cannabis the lowest. By far the highest level of support for legislative change was for cannabis, with only 8.7% supporting continued prohibition. While there was majority support for change to the legal status of heroin, the modal position was for decriminalisation. Support for changing the status of the three illicit psychostimulants was low, with the majority believing that methamphetamine (63.3%), cocaine (53.3%) and 3,4-methylenedioxy-N-methylamphetamine (53.3%) should remain illegal. Demographic characteristics were largely unrelated to attitudes. Lower levels of perceived harm were associated with increased likelihood of support for legalisation of all substances. Recent use was positively related to support for both decriminalisation and legality of heroin, but was not associated with views on other substances. Higher lifetime polydrug use was associated with support for the legalisation of heroin, methamphetamine, cocaine and 3,4-methylenedioxy-N-methylamphetamine. IDUs expressed nuanced views on different substances. In policy debates, care should be taken not to speak for IDUs by imputing their beliefs. It is clear that the fact that a group uses illegal drugs does not necessarily imply that they support changes to their legal status. © 2013 Australasian Professional Society on Alcohol and other Drugs.

[Self-harm vs. harming others: the lived experiences of a dysfunctional family].

PubMed

Wu, Hsiu-Chin; Lin, Mei-Feng; Yu, Shu-Hua

2007-10-01

The purpose of this study was to explore the lived experiences of self-harm and harm to others from the perspective of two adult offspring and a father, the latter of whom was prone to alcohol abuse and domestic violence and had attempted suicide. Written informed consents were obtained from the subjects after a detailed explanation of the research aims and procedures. A qualitative, phenomenological method was applied for the study. Three subjects were interviewed using a semi-structured interview guide designed by the researchers and based on the aims of the study over a six-month period of home care. A qualitative content analysis based on a phenomenological method was used to identify themes in the data. Two main categories emerged: (1) the mutual harm to the couple subsystem, (2) the misplaced parental-child subsystem. Subsequently, two to four themes were identified from each category. These results provide a better analysis and understanding of the perceived experiences of the harm to the spouse, parental, and sibling subsystems. They should also help health professionals to improve awareness of the lived experiences associated with the issues of self-harm and threats of harm to others. This study could serve as a valuable reference in promoting possible prevention strategies aiming at the reduction of self-harm and harm to others in dysfunctional families within the community.

‘Legal high’ associated Wallenberg syndrome

PubMed Central

Arora, Alok; Kumar, Anil; Raza, Muhammad Naeem

2013-01-01

‘Legal highs’ are substances of synthetic or natural origin having psychotropic properties. ‘Legal highs’ are often new and, in many cases, the actual chemical ingredients in a branded product can be changed without notifications and the risks are unpredictable. Acute recreational drug toxicity is a common reason for presentation to both hospital and prehospital medical services. It appears that, generally, the pattern of toxicity associated with ‘legal highs’ is broadly similar to that seen with classical stimulant recreational drugs such as cocaine, MDMA (3,4 methylenedioxy-N-methyl amphetamine) and amphetamine. Lack of clear literature pertaining to their chemical properties, pharmacology and toxicology makes an evaluation of their effects difficult. We describe a unique case in which consumption of such a substance led to hospital admission and a diagnosis of ‘lateral medullary stroke’ or ‘Wallenberg syndrome’. We believe that this is the first described case of a ‘legal high’ intake linked to a posterior circulation stroke. PMID:23709150

Forensic electrochemistry: the electroanalytical sensing of synthetic cathinone-derivatives and their accompanying adulterants in "legal high" products.

PubMed

Smith, Jamie P; Metters, Jonathan P; Irving, Craig; Sutcliffe, Oliver B; Banks, Craig E

2014-01-21

The production and abuse of new psychoactive substances, known as "legal highs" which mimic traditional drugs of abuse is becoming a global epidemic. Traditional analytical methodologies exist which can provide confirmatory analysis but there is a requirement for an on-the-spot analytical screening tool that could be used to determine whether a substance, or sample matrix contains such legal, or formally "legal highs". In this paper the electrochemical sensing of (±)-methcathinone and related compounds at a range of commercially available electrode substrates is explored. We demonstrate for the first time that this class of "legal highs" are electrochemically active providing a novel sensing protocol based upon their electrochemical oxidation. Screen-printed graphite sensing platforms are favoured due to their proven ability to be mass-produced providing large numbers of reliable and reproducible electrode sensing platforms that preclude the requirement of surface pre-treatment such as mechanical polishing as is the case in the use of solid/re-usable electrode substrates. Additionally they hold potential to be used on-site potentially being the basis of an on-site legal high screening device. Consequently the electroanalytical sensing of (±)-methcathinone (3a), (±)-4′-methylmethcathinone [3b, 4-MMC, (±)-mephedrone] and (±)-4′-methyl-N-ethylcathinone (3c, 4-MEC) is explored using screen-printed sensing platforms with the effect of pH explored upon the analytical response with their analytical efficiency evaluated towards the target legal highs. Interesting at pH values below 6 the voltammetric response quantitatively changes from that of an electrochemically irreversible response to that of a quasi-reversible signature which can be used analytically. It is demonstrated for the first time that the electroanalytical sensing of (±)-methcathinone (3a), (±)-mephedrone (3b) and 4-MEC (3c) are possible with accessible linear ranges found to correspond to 16�

Marijuana usage in relation to harmfulness ratings, perceived likelihood of negative consequences, and defense mechanisms in high school students.

PubMed

Como-Lesko, N; Primavera, L H; Szeszko, P R

1994-08-01

This study investigated high school students' marijuana usage patterns in relation to their harmfulness ratings of 15 licit and illicit drugs, perceived negative consequences from using marijuana, and types of defense mechanisms employed. Subjects were classified into one of five pattern-of-use groups based on marijuana usage: principled nonusers, nonusers, light users, moderate users, and heavy users. Principled nonusers (individuals who have never used marijuana and would not do so if it was legalized) rated marijuana, hashish, cocaine, and alcohol as significantly more harmful than heavy users. A cluster analysis of the drugs' harmfulness ratings best fit a three cluster solution and were named medicinal drugs, recreational drugs, and hard drugs. In general, principled nonusers rated negative consequences from using marijuana as significantly more likely to occur than other groups. Principled nonusers and heavy users utilized reversal from the Defense Mechanism Inventory, which includes repression and denial, significantly more than nonusers, indicating some trait common to the two extreme pattern-of-use groups.

49 CFR 9.9 - Legal proceedings between private litigants: General rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: General rules. 9.9 Section 9.9 Transportation Office of the Secretary of Transportation TESTIMONY OF EMPLOYEES OF THE DEPARTMENT AND PRODUCTION OF RECORDS IN LEGAL PROCEEDINGS § 9.9 Legal proceedings between... provided in §§ 9.13 and 9.15 of this part, not to serve a demand on the employee. Whenever, in a legal...

[Legal and illegal abortion in Switzerland].

PubMed

Stamm, H

1970-01-01

Aspects of legal and illegal abortion in Switzerland are discussed. About 110,000 births, 25,000 therapeutic abortions (75% for psychiatric indications) and an estimated 50,000 illegal abortions occur annually in Switzerland. Although the mortality and morbidity of therapeutic aborti on are similar to those of normal births (1.4 per 1000 and 11%, respectively) the mortality and morbidity of criminal abortions are far greater (3 per 1000 and 73%, respectively). In the author's view, too strict an interpretatiok of Swiss abortion law (which permits abortion to avoid serious harm to the mother's health) does not take into account the severe and lasting emotional and psychological damage which may be caused by unwanted pregnancy, birth, and childraising. In the present social situation, the social and psychological support required by these women is not available; until it is, abortion is to be preferred.

Nonsuicidal Self-Harm among Community Adolescents: Understanding the "Whats" and "Whys" of Self-Harm

ERIC Educational Resources Information Center

Laye-Gindhu, Aviva; Schonert-Reichl, Kimberly A.

2005-01-01

This study examines self-harm in a community sample of adolescents. More specifically, the study identifies the prevalence and types of self-harm, elucidates the nature and underlying function of self-harm, and evaluates the relation of psychological adjustment, sociodemographic, and health-risk variables to self-harm. Self-report questionnaires…

A critical first assessment of the new pre-market approval regime for new psychoactive substances (NPS) in New Zealand.

PubMed

Wilkins, Chris

2014-10-01

New Zealand has recently attempted to address the underlying drivers of the escalating new psychoactive substances (NPS) ('legal highs') problem by establishing the world's first pre-market approval regulatory regime for NPS. NPS products which can be shown with clinical trial data to pose a 'low risk' of harm will be approved for legal manufacture and sale. This paper critically assesses the new regime, drawing on experience of the pharmaceutical sector and legal BZP market. A number of characteristics of the recreational use of NPS may not be well addressed by standard medical clinical trials, including binge use, polydrug use, use by vulnerable groups and high-risk modes of administration. The overt advertising and covert promotion of approved NPS products on the internet may make them fairly visible to young people. The black market for unapproved NPS may be difficult to suppress given that unapproved NPS will be physically identical to approved NPS. If the legal market for NPS encourages the use of NPS, alcohol and other drugs there may be an increase in drug-related harm. Alternatively, if the legal NPS market reduces the use of more harmful drugs, there may be a considerable public health benefit. The clinical trials required for NPS products should address the characteristics of recreational NPS use. Enforcement resources and technical solutions are required to clearly distinguish legal NPS products. The impact the new NPS regime has on other drug use is a key issue and demands further study. © 2014 Society for the Study of Addiction.

Marijuana Legalization: Impact on Physicians and Public Health.

PubMed

Wilkinson, Samuel T; Yarnell, Stephanie; Radhakrishnan, Rajiv; Ball, Samuel A; D'Souza, Deepak Cyril

2016-01-01

Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health.

Argumentation in Legal Reasoning

NASA Astrophysics Data System (ADS)

Bench-Capon, Trevor; Prakken, Henry; Sartor, Giovanni

A popular view of what Artificial Intelligence can do for lawyers is that it can do no more than deduce the consequences from a precisely stated set of facts and legal rules. This immediately makes many lawyers sceptical about the usefulness of such systems: this mechanical approach seems to leave out most of what is important in legal reasoning. A case does not appear as a set of facts, but rather as a story told by a client. For example, a man may come to his lawyer saying that he had developed an innovative product while working for Company A. Now Company B has made him an offer of a job, to develop a similar product for them. Can he do this? The lawyer firstly must interpret this story, in the context, so that it can be made to fit the framework of applicable law. Several interpretations may be possible. In our example it could be seen as being governed by his contract of employment, or as an issue in Trade Secrets law.

Legal features of the drug advertising.

PubMed

Pashkov, Vitalii M; Olefir, Andrii A; Bytyak, Oleksiy Y

In the article discribed current trends of advertising in the pharmaceutical market and foreign experience of legal regulation of these relations. As for the advertising of medicines identified it's symptoms, types, basic rules and prohibitions. Modern pharmaceutical companies can not successfully carry out economic activities without advertising. Besides we can mention some fundamental changes in society (information overload, universal access to internet, social media, freedom of movement of goods, labor and finance), also self-medication becomes more popular. At the same time, the number of deaths after improper and uncontrolled use of drugs ranks fifth in the world among the causes of death. Investigate current trends of advertising on the pharmaceutical market, find advertising signs, basic restrictions and prohibitions on advertising of medicines, as well as foreign experience of legal regulation of these relations. Despite the fact that pharmaceutical advertising were studied by such scholars as M. Abraham, L. Bradley, C. Dunn, J. Donoh'yu, D. Castro, M. Lipski, K. Taylor and others, number of issues related features of drug advertising, remained without proper theoretical studies. Based on the analysis can come to the conclusion that advertising of medicinal products are the subject of special attention from the state. Drugs, unlike other products, are a group of specialized consumer products. Risks increase when patients under the influence of «aggressive» advertising resort to self-medication. If a complete ban on advertising of medicines is inappropriate, you should set stricter requirements for the content of advertising and product placement rules. That is, in the national legislation to implement regulatory requirements of Directive 2001/83 / EC. Legal regulation of drug advertising can be improved by such legal means: - should provide for a mechanism of public control over the observance of ethical standards in the advertising of medicinal products

Assessing changes in HIV-related legal and policy environments: Lessons learned from a multi-country evaluation.

PubMed

Ferguson, Laura; Nicholson, Alexandra; Henry, Ian; Saha, Amitrajit; Sellers, Tilly; Gruskin, Sofia

2018-01-01

There is growing recognition in the health community that the legal environment-including laws, policies, and related procedures-impacts vulnerability to HIV and access to HIV-related services both positively and negatively. Assessing changes in the legal environment and how these affect HIV-related outcomes, however, is challenging, and understanding of appropriate methodologies nascent. We conducted an evaluation of a UNDP project designed to strengthen legal environments to support the human rights of key populations, in particular LGBT populations, women and girls, affected by HIV in sub-Saharan Africa. We analyzed data on activities designed to improve legal environments through a systematic document review and 53 qualitative interviews. The project made substantial strides towards legal change in many places, and examples provide broader lessons for work in this area. Two core pillars appear fundamental: a government-led participatory assessment of the legal environment, and building the capacity of those impacted by and engaged in this work. Systematic attention to human rights is vital: it can help open new spaces for dialogue among diverse stakeholders, foster new collaborations, and ensure local ownership, nuanced understanding of the political landscape, attention to marginalized populations, and accountability for (in)action. Entry points for effecting legal change go beyond "HIV laws" to also include other laws, national policies and strategies. Conducting legal environment assessments, multi-stakeholder dialogues, action planning and related activities, alongside capacity building, can contribute to changes in knowledge and attitudes directly relevant to reforming laws that are found to be harmful. Shorter-term goals along the causal pathway to legal change (e.g. changes in policy) can constitute interim markers of success, and recognition of these can maintain momentum. Increasing understanding of progress towards changes in the legal environment

Minimising the harm from nicotine use: finding the right regulatory framework.

PubMed

Borland, Ron

2013-05-01

The tobacco problem can be usefully conceptualised as two problems: eliminating the most harmful forms of nicotine use (certainly cigarettes, and probably all smoked tobacco), and minimising the use and/or harms from use of lower-harm, but addictive forms of nicotine. A possible target would be to effectively eliminate use of the most harmful forms of nicotine within the next decade and then turn our focus to a long-term strategy for the low-harm forms. This paper focuses on the administrative framework(s) needed to accomplish these twin tasks. For a phase-out taking a long time and/or for dealing with residually net harmful and addictive products, there are severe limitations to allowing for-profit marketing of tobacco because such an arrangement (the current one in most countries) can markedly slow down progress and because of the difficulty of constraining marketing in ways that minimise undesirable use. A harm reduction model where the marketing is under the control of a non-profit entity (a regulated market) is required to curtail the incredible power of for-profit marketing and to allow tobacco marketing to be done in ways that further the goal of minimising tobacco-related harm. Countries with a nationalised industry can move their industry onto a harm minimisation framework if they have the political will. Countries with a for-profit industry should consider whether the time and effort required to reconstruct the market may, in the longer term, facilitate achieving their policy goals.

Self-harm and life problems: findings from the Multicentre Study of Self-harm in England.

PubMed

Townsend, Ellen; Ness, Jennifer; Waters, Keith; Kapur, Navneet; Turnbull, Pauline; Cooper, Jayne; Bergen, Helen; Hawton, Keith

2016-02-01

Self-harm is a major clinical problem and is strongly linked to suicide. It is important to understand the problems faced by those who self-harm to design effective clinical services and suicide prevention strategies. We investigated the life problems experienced by patients presenting to general hospitals for self-harm. Data for 2000-2010 from the Multicentre Study of Self-harm in England were used to investigate life problems associated with self-harm and their relationship to patient and clinical characteristics, including age, gender, repeat self-harm and employment status. Of 24,598 patients (36,431 assessed episodes), 57% were female and with a mean age of 33.1 years (SD 14.0 years), 92.6% were identified as having at least one contributing life problem. The most frequently reported problems at first episode of self-harm within the study period were relationship difficulties (especially with partners). Mental health issues and problems with alcohol were also very common (especially in those aged 35-54 years, and those who repeated self-harm). Those who repeated self-harm were more likely to report problems with housing, mental health and dealing with the consequences of abuse. Self-harm usually occurs in the context of multiple life problems. Clinical services for self-harm patients should have access to appropriate care for provision of help for relationship difficulties and problems concerning alcohol and mental health issues. Individualised clinical support (e.g. psychological therapy, interventions for alcohol problems and relationship counselling) for self-harm patients facing these life problems may play a crucial role in suicide prevention.

Suicide Following Deliberate Self-Harm.

PubMed

Olfson, Mark; Wall, Melanie; Wang, Shuai; Crystal, Stephen; Gerhard, Tobias; Blanco, Carlos

2017-08-01

The authors sought to identify risk factors for repeat self-harm and completed suicide over the following year among adults with deliberate self-harm. A national cohort of Medicaid-financed adults clinically diagnosed with deliberate self-harm (N=61,297) was followed for up to 1 year. Repeat self-harm per 1,000 person-years and suicide rates per 100,000 person-years (based on cause of death information from the National Death Index) were determined. Hazard ratios of repeat self-harm and suicide were estimated by Cox proportional hazard models. During the 12 months after nonfatal self-harm, the rate of repeat self-harm was 263.2 per 1,000 person-years and the rate of completed suicide was 439.1 per 100,000 person-years, or 37.2 times higher than in a matched general population cohort. The hazard of suicide was higher after initial self-harm events involving violent as compared with nonviolent methods (hazard ratio=7.5, 95% CI=5.5-10.1), especially firearms (hazard ratio=15.86, 95% CI=10.7-23.4; computed with poisoning as reference), and to a lesser extent after events of patients who had recently received outpatient mental health care (hazard ratio=1.6, 95% CI=1.2-2.0). Compared with self-harm patients using nonviolent methods, those who used violent methods were at significantly increased risk of suicide during the first 30 days after the initial event (hazard ratio=17.5, 95% CI=11.2-27.3), but not during the following 335 days. Adults treated for deliberate self-harm frequently repeat self-harm in the following year. Patients who use a violent method for their initial self-harm, especially firearms, have an exceptionally high risk of suicide, particularly right after the initial event, which highlights the importance of careful assessment and close follow-up of this group.

Design considerations for legalizing cannabis: lessons inspired by analysis of California's Proposition 19.

PubMed

Caulkins, Jonathan P; Kilmer, Beau; MacCoun, Robert J; Pacula, Rosalie Liccardo; Reuter, Peter

2012-05-01

No modern jurisdiction has ever legalized commercial production, distribution and possession of cannabis for recreational purposes. This paper presents insights about the effect of legalization on production costs and consumption and highlights important design choices. Insights were uncovered through our analysis of recent legalization proposals in California. The effect on the cost of producing cannabis is largely based on existing estimates of current wholesale prices, current costs of producing cannabis and other legal agricultural goods, and the type(s) of production that will be permitted. The effect on consumption is based on production costs, regulatory regime, tax rate, price elasticity of demand, shape of the demand curve and non-price effects (e.g. change in stigma). Removing prohibitions on producing and distributing cannabis will dramatically reduce wholesale prices. The effect on consumption and tax revenues will depend on many design choices, including: the tax level, whether there is an incentive for a continued black market, whether to tax and/or regulate cannabinoid levels, whether there are allowances for home cultivation, whether advertising is restricted, and how the regulatory system is designed and adjusted. The legal production costs of cannabis will be dramatically below current wholesale prices, enough so that taxes and regulation will be insufficient to raise retail price to prohibition levels. We expect legalization will increase consumption substantially, but the size of the increase is uncertain since it depends on design choices and the unknown shape of the cannabis demand curve. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Marijuana Legalization: Impact on Physicians and Public Health

PubMed Central

Wilkinson, Samuel T.; Yarnell, Stephanie; Radhakrishnan, Rajiv; Ball, Samuel A.; D'Souza, Deepak Cyril

2016-01-01

Marijuana is becoming legal in an increasing number of states for both medical and recreational use. Considerable controversy exists regarding the public health impact of these changes. The evidence for the legitimate medical use of marijuana or cannabinoids is limited to a few indications, notably HIV/AIDS cachexia, nausea/vomiting related to chemotherapy, neuropathic pain, and spasticity in multiple sclerosis. Although cannabinoids show therapeutic promise in other areas, robust clinical evidence is still lacking. The relationship between legalization and prevalence is still unknown. Although states where marijuana use is legal have higher rates of use than nonlegal states, these higher rates were generally found even prior to legalization. As states continue to proceed with legalization for both medical and recreational use, certain public health issues have become increasingly relevant, including the effects of acute marijuana intoxication on driving abilities, unintentional ingestion of marijuana products by children, the relationship between marijuana and opioid use, and whether there will be an increase in health problems related to marijuana use, such as dependence/addiction, psychosis, and pulmonary disorders. In light of this rapidly shifting legal landscape, more research is urgently needed to better understand the impact of legalization on public health. PMID:26515984

Economic consequences of legal and illegal drugs: The case of social costs in Belgium.

PubMed

Lievens, Delfine; Vander Laenen, Freya; Verhaeghe, Nick; Putman, Koen; Pauwels, Lieven; Hardyns, Wim; Annemans, Lieven

2017-06-01

Legal and illegal drugs impose a considerable burden to the individual and to society. The misuse of addictive substances results in healthcare and law enforcement costs, loss of productivity and reduced quality of life. A social cost study was conducted to estimate the substance-attributable costs of alcohol, tobacco, illegal drugs and psychoactive medication to Belgian society in 2012. The cost-of-illness framework with prevalence-based and human capital approach was applied. Three cost components were considered: direct, indirect and intangible costs related to substance misuse. The direct and indirect cost of addictive substances was estimated at 4.6 billion euros in Belgium (419 euros per capita or 1.19% of the GDP) and more than 515,000 healthy years are lost due to substance misuse. The Belgian social cost study reaffirms that alcohol and tobacco impose the highest cost to society compared to illegal drugs. Health problems are the main driver of the social cost of legal drugs. Law enforcement expenditure exceed the healthcare costs but only in the case of illegal drugs. Estimating social costs of addictive substances is complex because it is difficult to determine to what extent the societal harm is caused by substances. It can be argued that social cost studies take only a 'snapshot' of the monetary consequences of substance misuse. Nevertheless, the current study offers the most comprehensive analysis thus far of the social costs of substance misuse in Belgium. Copyright © 2017 Elsevier B.V. All rights reserved.

Harm reduction at the crossroads: the case of e-cigarettes.

PubMed

Maziak, Wasim

2014-10-01

The recent popularity of electronic (e)-cigarettes and their rapid uptake by youth has ignited the debate about their role as a harm-reduction strategy. Harm reduction in the context of tobacco control contends that in societies that have achieved considerable success in curbing smoking, leaving the remaining hard-to-quit smokers with an abstinence-only option is unfair, especially when less-harmful choices are available. On one side of the debate are those who call for caution in endorsing such products until critical pieces of evidence about their safety and potential become available, whereas the other side argues that waiting until all questions about e-cigarettes are answered is dogma driven. In this piece, I try to discuss the unresolvable contention between harm-reduction goals of offering safer options to smokers, and those of e-cigarette makers of being commercially viable and profitable. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Secondary harm mitigation: A more humanitarian framework for international drug law enforcement.

PubMed

Blaustein, Jarrett; McLay, Miki; McCulloch, Jude

2017-08-01

This article introduces the concept of 'secondary harm mitigation' as a framework for improving the humanitarian credentials of international drug law enforcement agencies. The concept is rooted in a critical analysis of the compatibility of the harm reduction philosophy with Australia's international drug law enforcement practices. On a utilitarian level, the net benefits of international drug law enforcement are determined to be, at best inconclusive, arguably counterproductive and in most cases, incalculable. On a humanitarian level, international drug law enforcement is also determined to be problematic from a criminological standpoint because it generates secondary harms and it is indifferent to the vulnerability of individuals who participate in illicit drug trafficking. Accordingly, the article concludes that a philosophy of harm reduction grounded in the public health perspective is inadequate for mitigating secondary harms arising from Australia's efforts to combat international illicit drug trafficking. A tentative list of secondary harm mitigation principles is presented and the article argues that secondary harm mitigation should replace supply reduction as a core tenet of Australia's National Drug Strategy. The article also concludes that secondary harm mitigation may provide a viable framework for stimulating a productive dialogue between those who advocate prohibition and those who call for decriminalisation at the global level. Copyright © 2017 Elsevier B.V. All rights reserved.

Use of potentially harmful skin-lightening products among immigrant women in Rome, Italy: a pilot study.

PubMed

Cristaudo, A; D'Ilio, S; Gallinella, B; Mosca, A; Majorani, C; Violante, N; Senofonte, O; Morrone, A; Petrucci, F

2013-01-01

Skin-lightening products are increasingly common in European cities. These products may contain substances that are banned under EU regulations as they can induce adverse effects, including cutaneous and systemic reactions (e.g., mercury, hydroquinone and topical corticosteroids). To assess the knowledge, attitudes and practices of women regarding skin-lightening products and to quantify the potentially harmful substances in the products used. We performed a cross-sectional study among 82 non-Italian women visiting an outpatient facility in Rome, Italy. The women completed a questionnaire on product use, side effects and risk awareness. We performed patch tests among a subgroup of 48 women who presented with contact dermatitis. We also quantified the allergenic and toxic substances in the 14 products reported, using dynamic reaction cell inductively coupled plasma mass spectrometry for metals and high-performance liquid chromatography for hydroquinone and topical corticosteroids. Out of the 82 women, 33 used skin-lightening products; about one fourth of these women were aware of potential risks. Three cosmetic creams and two soaps contained high concentrations of metals (Cr, Ni and Pb); hydroquinone was found in three creams and one oil. The only topical corticosteroid detected was dexamethasone, in one product. More than half of the women in the clinical evaluation had irritant contact dermatitis (i.e., negative response to patch test). Among immigrant women in Rome, the use of skin-lightening products seems to be fairly common, and some of these products contain potentially hazardous substances. Consumers must be informed of the potential risks, and EU regulations must be more strictly enforced. Copyright © 2013 S. Karger AG, Basel.

What is legal medicine--are legal and forensic medicine the same?

PubMed

Beran, Roy G

2010-04-01

Some consider the terms "forensic" and "legal" medicine to be synonymous but this is counter to the title of the Faculty of Forensic and Legal Medicine or the dual strands for progression to fellowship of the Australian College of Legal Medicine. The paper examines a very brief historical background to legal medicine and develops a definition of the strands thereof, namely legal and forensic medicine. It demonstrates that the two are different components of the application of medical knowledge upon the legal system. Legal medicine has greater relevance to civil and tort law, impacting upon patient care, whereas forensic medicine relates to criminal law and damage to, or by, patients.

Shortcomings of existing systems for registration and legal protection of software products and possible ways to overcome them

NASA Astrophysics Data System (ADS)

Liapidevskiy, A. V.; Petrov, A. S.; Zhmud, V. A.; Sherubneva, I. G.

2018-05-01

The paper reveals the shortcomings of the existing system of registration and legal protection of software products. The system has too many disadvantages and shortcomings. Explanatory examples are given. Possible ways of overcoming these shortcomings are discussed. The paper also gives possible prospects for the use of new digital technologies. Also in the paper, the information is provided about the modern software components for protecting intellectual property rights of State corporations

Minimising the harm from nicotine use: finding the right regulatory framework

PubMed Central

Borland, Ron

2013-01-01

The tobacco problem can be usefully conceptualised as two problems: eliminating the most harmful forms of nicotine use (certainly cigarettes, and probably all smoked tobacco), and minimising the use and/or harms from use of lower-harm, but addictive forms of nicotine. A possible target would be to effectively eliminate use of the most harmful forms of nicotine within the next decade and then turn our focus to a long-term strategy for the low-harm forms. This paper focuses on the administrative framework(s) needed to accomplish these twin tasks. For a phase-out taking a long time and/or for dealing with residually net harmful and addictive products, there are severe limitations to allowing for-profit marketing of tobacco because such an arrangement (the current one in most countries) can markedly slow down progress and because of the difficulty of constraining marketing in ways that minimise undesirable use. A harm reduction model where the marketing is under the control of a non-profit entity (a regulated market) is required to curtail the incredible power of for-profit marketing and to allow tobacco marketing to be done in ways that further the goal of minimising tobacco-related harm. Countries with a nationalised industry can move their industry onto a harm minimisation framework if they have the political will. Countries with a for-profit industry should consider whether the time and effort required to reconstruct the market may, in the longer term, facilitate achieving their policy goals. PMID:23591515

The harms of prostitution: critiquing Moen's argument of no-harm.

PubMed

Westin, Anna

2014-02-01

In this short critical analysis, the author examines the recent argument by Moen in his article 'Is Prostitution Harmful?' In highlighting why prostitution does not cause harm to either member involved in the act, Moen argues that prostitution is not an ethical concern. However, while Moen is able to clearly challenge contemporary objections to prostitution, the author of this review will suggest that Moen's argument is itself incomplete as it does not address essential key ontological issues. This critical analysis will briefly suggest why this omission weakens Moen's argument. Finally, it will conclude with examining why prostitution differs substantially from other professions through the type of harm that it causes to the moral agents involved.

Can the Brain-Dead Be Harmed or Wronged?: On the Moral Status of Brain Death and its Implications for Organ Transplantation.

PubMed

Nair-Collins, Michael

2017-01-01

The majority of transplantable human organs are retrieved from patients declared dead by neurological criteria, or "brain-dead." Since brain death is considered to be sufficient for death, the procurement of vital organs is not considered to harm or wrong such patients. In this essay I argue that this is not the case. After distinguishing welfare, experiential, and investment interests, and defining precedent autonomy and surviving interests, I argue that brain-dead patients can be, and many are, harmed and wronged by organ procurement as currently practiced. Indeed, with respect to precedent autonomy and surviving investment interests, the brain-dead are morally equivalent to patients with severe dementia, and thus can be harmed and wronged if and only if, and to the extent that, patients with severe dementia can. The "bright line" that separates brain death from all other conditions for clinical and legal purposes is not justified by any morally relevant distinctions.

When patients are harmed, but are not wronged: ethics, law, and history.

PubMed

Klaas, Paul B; Berge, Keith H; Klaas, Kelsey M; Klaas, James P; Larson, Annalise Noelle

2014-09-01

Iatrogenic injury-injury caused unintentionally by medical treatment-breaks the oldest and most famous rule of medical ethics: primum non nocere, or above all, do no harm. Medical malpractice law, however, focuses on whether an injury was caused by negligence, not on whether an injury was iatrogenic. Iatrogenic injury inflicted without negligence is a common pattern in medical malpractice lawsuits; it is likely the pattern of Jacobs v Cross (Minnesota, 1872), in which Dr W. W. Mayo testified as an expert witness. As a matter of law, the doctor defendants should win all those lawsuits, for iatrogenic injury inflicted without negligence is not a legal wrong in the United States and has not been considered a legal wrong for hundreds of years. However, the medical ethics applicable to doctors' duties to report incompetence in colleagues, including those who inflict excessive iatrogenic injury, have developed dramatically over time. In 1872, the ethical codes in the United States exhorted doctors not to criticize another doctor, even if incompetent. Today, doctors in the United States are ethically required to report an incompetent colleague. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Evaluation of the legal consequences of action affects neural activity and emotional experience during the resolution of moral dilemmas.

PubMed

Pletti, Carolina; Sarlo, Michela; Palomba, Daniela; Rumiati, Rino; Lotto, Lorella

2015-03-01

In any modern society killing is regarded as a severe violation of the legal codes that is subjected to penal judgment. Therefore, it is likely that people take legal consequences into account when deciding about the hypothetical killing of one person in classic moral dilemmas, with legal concerns contributing to decision-making. In particular, by differing for the degree of intentionality and emotional salience, Footbridge- and Trolley-type dilemmas might promote differential assignment of blame and punishment while implicating the same severity of harm. The present study was aimed at comparing the neural activity, subjective emotional reactions, and behavioral choices in two groups of participants who either took (Legal group) or did not take (No Legal group) legal consequences into account when deciding on Footbridge-type and Trolley-type moral dilemmas. Stimulus- and response-locked ERPs were measured to investigate the neural activity underlying two separate phases of the decision process. No difference in behavioral choices was found between groups. However, the No Legal group reported greater overall emotional impact, associated with lower preparation for action, suggesting greater conflict between alternative motor responses representing the different decision choices. In contrast, the Legal group showed an overall dampened affective experience during decision-making associated with greater overall action readiness and intention to act, reflecting lower conflict in responding. On these bases, we suggest that in moral dilemmas legal consequences of actions provide a sort of reference point on which people can rely to support a decision, independent of dilemma type. Copyright © 2015 Elsevier Inc. All rights reserved.

Cannabis use, attitudes, and legal status in the U.S.: A review.

PubMed

Carliner, Hannah; Brown, Qiana L; Sarvet, Aaron L; Hasin, Deborah S

2017-11-01

Cannabis is widely used among adolescents and adults. In the U.S., marijuana laws have been changing, and Americans increasingly favor legalizing cannabis for medical and recreational uses. While some can use cannabis without harm, others experience adverse consequences. The objective of this review is to summarize information on the legal status of cannabis, perceptions regarding cannabis, prevalence and time trends in use and related adverse consequences, and evidence on the relationship of state medical (MML) and recreational (RML) marijuana laws to use and attitudes. Twenty-nine states now have MMLs, and eight of these have RMLs. Since the early 2000s, adult and adolescent perception of cannabis use as risky has decreased. Over the same time, the prevalence of adolescent cannabis use has changed little. However, adult cannabis use, disorders, and related consequences have increased. Multiple nationally representative studies indicate that MMLs have had little effect on cannabis use among adolescents. However, while MML effects have been less studied in adults, available evidence suggests that MMLs increase use and cannabis use disorders in adults. While data are not yet available to evaluate the effect of RMLs, they are likely to lower price, increase availability, and thereby increase cannabis use. More permissive marijuana laws may accomplish social justice aims (e.g., reduce racial disparities in law enforcement) and generate tax revenues. However, such laws may increase cannabis-related adverse health and psychosocial consequences by increasing the population of users. Dissemination of balanced information about the potential health harms of cannabis use is needed. Copyright © 2017. Published by Elsevier Inc.

Reviewing harm reduction for people who inject drugs in Asia: the necessity for growth.

PubMed

Stone, Katie Alexandra

2015-10-16

There is an estimate of three to five million people who inject drugs living in Asia. Unsafe injecting drug use is a major driver of both the HIV and hepatitis C (HCV) epidemic in this region, and an increase in incidence among people who inject drugs continues. Although harm reduction is becoming increasingly accepted, a largely punitive policy remains firmly in place, undermining access to life-saving programmes. The aim of this study is to present an overview of key findings on harm reduction in Asia based on data collected for the Global State of Harm Reduction 2014. A review of international scientific and grey literature was undertaken between May and September 2014, including reports from multilateral agencies and international non-governmental organisations. A qualitative survey comprising open-ended questions was also administered to civil society, harm reduction networks, and organisations of people who use drugs to obtain national and regional information on key developments in harm reduction. Expert consultation from academics and key thinkers on HIV, drug use, and harm reduction was used to verify findings. In 2014, 17 countries in Asia provide needle and syringe programmes (NSP) provision and 15 opioid substitution therapy (OST). It is estimated that between 60 and 90 % of people who use drugs in Asia have HCV; however, treatment still remains out of reach due to cost barriers. TB testing and treatment services are yet to be established for key populations, yet nearly 15 % of the global burden of new cases of HIV-TB co-infection are attributed to southeast Asia. Eighteen percent of the total number of people living with HIV eligible for antiretroviral treatment (ART) accessed treatment. Only Malaysia and Indonesia provide OST in prison, with no NSP provision in prisons in the region. To reduce HIV and viral hepatitis risk among people who inject drugs, there is a necessity to significantly increase harm reduction service provision in Asia. Although

16 CFR 1110.15 - Legal responsibility for certificate information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Legal responsibility for certificate information. 1110.15 Section 1110.15 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION CONSUMER PRODUCT... statute and its availability in timely fashion. ...

Planetary protection - some legal questions

NASA Astrophysics Data System (ADS)

Fasan, E.

2004-01-01

When we legally investigate the topic of Planetary Protection, we have to realise that there are primarily two very distinct parts of our juridical work: We have to study lexlata, theexistingapplicableLaw, especially Space Law, and also lexferenda, whatshouldbethe law . With this in mind, we have to deliberate the legal meaning of the notions "Planetary", and "Protection". About " Planetary": Our own Earth is our most important planet. At present only here do exist human beings, who are sensu strictu the only legal subjects. We make the law, we have to apply it, and we are to be protected as well as bound by it. But what is further meant by "Planetary"? Is it planets in an astronomical sense only, the nine planets which revolve around our fixed star, namely the sun, or is it also satellites, moving around most of these planets, as our own Moon circles Earth. "The Moon and other Celestial Bodies (C.B.)" are subject to Space Law, especially to International Treaties, Agreements, Resolutions of the UN, etc. I propose that they and not only the planets in an strictly astronomical sense are to be protected. But I do not think that the said notion also comprises asteroids, comets, meteorites, etc. although they too belong to our solar system. Our investigation comes to the result that such bodies have a different (lesser) legal quality. Also we have to ask Protectionfrom what ? From: Natural bodies - Meteorites, NEO Asteroids, Comets which could hit Earth or C.B.Artificial Objects: Space Debris threatening especially Earth and near Earth orbits.Terrestrial Life - no infection of other celestial bodies. Alien life forms which could bring about "harmful contamination" of Earth and the life, above all human life, there, etc. Here, astrobiological questions have to be discussed. Special realms on C.B. which should be protected from electronic "noise" such as craters SAHA or Deadalus on the Moon, also taking into account the "Common Heritage" Principle. Then, we have to

Sex-work harm reduction.

PubMed

Rekart, Michael L

2005-12-17

Sex work is an extremely dangerous profession. The use of harm-reduction principles can help to safeguard sex workers' lives in the same way that drug users have benefited from drug-use harm reduction. Sex workers are exposed to serious harms: drug use, disease, violence, discrimination, debt, criminalisation, and exploitation (child prostitution, trafficking for sex work, and exploitation of migrants). Successful and promising harm-reduction strategies are available: education, empowerment, prevention, care, occupational health and safety, decriminalisation of sex workers, and human-rights-based approaches. Successful interventions include peer education, training in condom-negotiating skills, safety tips for street-based sex workers, male and female condoms, the prevention-care synergy, occupational health and safety guidelines for brothels, self-help organisations, and community-based child protection networks. Straightforward and achievable steps are available to improve the day-to-day lives of sex workers while they continue to work. Conceptualising and debating sex-work harm reduction as a new paradigm can hasten this process.

The Strategic Dialogue on Tobacco Harm Reduction: a vision and blueprint for action in the US

PubMed Central

Zeller, Mitchell; Hatsukami, Dorothy

2016-01-01

The issues related to tobacco harm reduction continue to challenge the tobacco control research and policy communities. The potential for combusting tobacco products to reduce exposure and risk remains largely unknown, but this has not stopped manufacturers from offering such products making these claims. The role of oral tobacco products in a harm reduction regimen has also been a source of dialogue and debate. Within the last few years, major cigarette manufacturing companies have begun selling smokeless products for the first time, claiming to target current cigarette smokers. Other cigarette manufacturers are also offering smokeless products in markets around the world. The harm reduction debate has at times been divisive. There has been no unifying set of principles or goals articulated to guide tobacco control efforts. In particular, the research needs are extraordinarily high in order to drive evidence-based policy in this area and avoid the mistakes made with “light” cigarettes. This paper discusses recommendations from a strategic dialogue held with key, mostly US-based tobacco control researchers and policy makers to develop a strategic vision and blueprint for research, policy and communications to reduce the harm from tobacco for the US. Short-term and long-term objectives are described. PMID:19240228

Environments, risk and health harms: a qualitative investigation into the illicit use of anabolic steroids among people using harm reduction services in the UK.

PubMed

Kimergård, Andreas; McVeigh, Jim

2014-06-04

The illicit use of anabolic steroids among the gym population continues to rise, along with the number of steroid using clients attending harm reduction services in the UK. This presents serious challenges to public health. Study objectives were to account for the experiences of anabolic steroid users and investigate how 'risk environments' produce harm. Qualitative face-to-face interviews with 24 users of anabolic steroids engaged with harm reduction services in the UK. Body satisfaction was an important factor when deciding to start the use of anabolic steroids. Many users were unaware of the potential dangers of using drugs from the illicit market, whereas some had adopted a range of strategies to negotiate the hazards relating to the use of adulterated products, including self-experimentation to gauge the perceived efficacy and unwanted effects of these drugs. Viewpoints, first-hand anecdotes, norms and practices among groups of steroid users created boundaries of 'sensible' drug use, but also promoted practices that may increase the chance of harms occurring. Established users encouraged young users to go to harm reduction services but, at the same time, promoted risky injecting practices in the belief that this would enhance the efficacy of anabolic steroids. Current steroid-related viewpoints and practices contribute to the risk environment surrounding the use of these drugs and may undermine the goal of current public health strategies including harm reduction interventions. The level of harms among anabolic steroid users are determined by multiple and intertwining factors, in addition to the harms caused by the pharmacological action or injury and illness associated with incorrect injecting techniques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Legally high? Legal considerations of Salvia divinorum.

PubMed

Griffin, O Hayden; Miller, Bryan Lee; Khey, David N

2008-06-01

The legal status of the hallucinogenic plant Salvia divinorum has been rapidly changing. Legal prohibitions on this plant native to Oaxaca, Mexico have emerged at the state level, a phenomenon that has not occurred since the passage of the Controlled Substances Act (CSA). Included will be a brief description of the plant that has only recently crept into the popular American consciousness, and a review of the different legal mechanisms through which states have controlled the plant and the pending legislation proposing controls. Lastly, the implications of various state laws are discussed.

Assessing the public health impact of cannabis legalization in Canada: core outcome indicators towards an 'index' for monitoring and evaluation.

PubMed

Fischer, Benedikt; Russell, Cayley; Rehm, Jürgen; Leece, Pamela

2018-05-30

The legalization of non-medical cannabis use and supply is impending in Canada. This constitutes a major policy change with the declared objective of improving public health outcomes, which requires rigorous monitoring and evaluation. While numerous different aspects associated with legalization will be examined, a focused perspective is required for effective policy evaluation purposes. To these ends, we have identified a set of 10 core indicators associated with cannabis-related risk/harm outcomes-based on current best evidence-that are expected to measure the primary impacts of legalization on public health outcomes. We briefly review these indicators, and their respective data availability in Canada. As ideally an integrated outcome assessment of cannabis legalization's impact on public health will be available, we further propose options to merge the individual indicators into an integrated, weighted 'index', considering their expected relative impact for public health. One possible approach to undertake this is 'multi-criteria decision analysis' as a method to weight the relative indicator impact on public health; alternative approaches are proposed. The integrated 'public health index' for cannabis legalization will allow for scientifically comprehensive, while focused, monitoring and evaluation of the effects of legalization in Canada for the benefits of science and evidence-based policy alike.

The cost of harmful alcohol use in South Africa.

PubMed

Matzopoulos, R G; Truen, S; Bowman, B; Corrigall, J

2014-02-01

The economic, social and health costs associated with alcohol-related harms are important measures with which to inform alcohol management policies and laws. This analysis builds on previous cost estimates for South Africa. We reviewed existing international best-practice costing frameworks to provide the costing definitions and dimensions. We sourced data from South African costing literature or, if unavailable, estimated costs using socio-economic and health data from secondary sources. Care was taken to avoid possible causes of cost overestimation, in particular double counting and, as far as possible, second-round effects of alcohol abuse. The combined total tangible and intangible costs of alcohol harm to the economy were estimated at 10 - 12% of the 2009 gross domestic product (GDP). The tangible financial cost of harmful alcohol use alone was estimated at R37.9 billion, or 1.6% of the 2009 GDP. The costs of alcohol-related harms provide a substantial counterbalance to the economic benefits highlighted by the alcohol industry to counter stricter regulation. Curtailing these costs by regulatory and policy interventions contributes directly and indirectly to social well-being and the economy. CONCLUSIONS; Existing frameworks that guide the regulation and distribution of alcohol frequently focus on maximising the contribution of the alcohol sector to the economy, but should also take into account the associated economic, social and health costs. Current interventions do not systematically address the most important causes of harm from alcohol, and need to be informed by reliable evidence of the ongoing costs of alcohol-related harms.

Tobacco harm reduction: an alternative cessation strategy for inveterate smokers

PubMed Central

Rodu, Brad; Godshall, William T

2006-01-01

According to the Centers for Disease Control and Prevention, about 45 million Americans continue to smoke, even after one of the most intense public health campaigns in history, now over 40 years old. Each year some 438,000 smokers die from smoking-related diseases, including lung and other cancers, cardiovascular disorders and pulmonary diseases. Many smokers are unable – or at least unwilling – to achieve cessation through complete nicotine and tobacco abstinence; they continue smoking despite the very real and obvious adverse health consequences. Conventional smoking cessation policies and programs generally present smokers with two unpleasant alternatives: quit, or die. A third approach to smoking cessation, tobacco harm reduction, involves the use of alternative sources of nicotine, including modern smokeless tobacco products. A substantial body of research, much of it produced over the past decade, establishes the scientific and medical foundation for tobacco harm reduction using smokeless tobacco products. This report provides a description of traditional and modern smokeless tobacco products, and of the prevalence of their use in the United States and Sweden. It reviews the epidemiologic evidence for low health risks associated with smokeless use, both in absolute terms and in comparison to the much higher risks of smoking. The report also describes evidence that smokeless tobacco has served as an effective substitute for cigarettes among Swedish men, who consequently have among the lowest smoking-related mortality rates in the developed world. The report documents the fact that extensive misinformation about ST products is widely available from ostensibly reputable sources, including governmental health agencies and major health organizations. The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in public policy, and to assist

Chemical elimination of the harmful properties of asbestos from military facilities.

PubMed

Pawełczyk, Adam; Božek, František; Grabas, Kazimierz; Chęcmanowski, Jacek

2017-03-01

This work presents research on the neutralization of asbestos banned from military use and its conversion to usable products. The studies showed that asbestos can be decomposed by the use of phosphoric acid. The process proved very effective when the phosphoric acid concentration was 30%, the temperature was 90°C and the reaction time 60min. Contrary to the common asbestos treatment method that consists of landfilling, the proposed process ensures elimination of the harmful properties of this waste material and its transformation into inert substances. The obtained products include calcium phosphate, magnesium phosphate and silica. Chemical, microscopic and X-ray analyses proved that the products are free of harmful fibers and can be, in particular, utilized for fertilizers production. The obtained results may contribute to development of an asbestos utilization technique that fits well into the European waste policy, regulated by the EU waste management law. Copyright © 2016 Elsevier Ltd. All rights reserved.

Dealing with difficult days: Functional coping dynamics in self-harm ideation and enactment.

PubMed

Nielsen, Emma; Sayal, Kapil; Townsend, Ellen

2017-01-15

Self-harm affords people a means of coping. However, little is known about how functional coping dynamics differ between stressful situations in which people self-harm (enactment), think about harming (ideation), or experience no self-harmful thoughts or behaviours. Participants (N = 1,157) aged 16-49 years (M = 18.21, SD = 3.24) with a recent history of self-harm (past 3 months) reported how they coped in response to their most significant recent stressor (3 months). Almost 40% of participants, all of whom had self-harmed in the last 3 months, had no self-harm experience (thoughts or behaviours) in response to their most significant stressor in that time frame. In multivariate analysis, adjusting for symptoms of depression and anxiety, reappraisal coping was predictive of self-harm thoughts. Approach, emotion regulation and reappraisal coping were predictive of self-harm behaviour. Emotion regulation coping differentiated self-harm ideation and enactment groups. The cross-sectional design of the study precludes the ability to make inferences regarding causality. Further, there is no agreed definition of 'recent' self-harm. Taken together, the findings suggest that functional coping dynamics may be differentially associated with self-harm ideation and enactment. This is important, given that understanding the transitions between ideation and enactment has been identified as a critical frontier in suicide prevention. Further, results indicate that seemingly innocuous events may have a profound impact as tipping points for enaction; this has implications for clinical practice, including the co-production of safety plans. Copyright © 2016. Published by Elsevier B.V.

Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the Multicentre Study of Self-harm in England.

PubMed

Hawton, Keith; Bergen, Helen; Kapur, Navneet; Cooper, Jayne; Steeg, Sarah; Ness, Jennifer; Waters, Keith

2012-12-01

Self-harm (intentional self-poisoning and self-injury) in children and adolescents is often repeated and is associated with increased risk of future suicide. We have investigated factors associated with these outcomes. We used data collected in the Multicentre Study of Self-harm in England on all self-harm hospital presentations by individuals aged 10-18 years between 2000 and 2007, and national death information on these individuals to the end of 2010. Cox hazard proportional models were used to identify independent and multivariable predictors of repetition of self-harm and of suicide. Repetition of self-harm occurred in 27.3% of individuals (N = 3920) who presented between 2000 and 2005 and were followed up until 2007. Multivariate analysis showed that repetition was associated with age, self-cutting, and previous self-harm and psychiatric treatment. Of 51 deaths in individuals who presented between 2000 and 2007 and were followed up to 2010 (N = 5133) half (49.0%) were suicides. The method used was usually different to that used for self-harm. Multivariate analysis showed that suicide was associated with male gender [Hazard ratio (HR) = 2.4, 95% CI 1.2-4.8], self-cutting (HR = 2.1, 95% CI 1.1-3.7) and prior psychiatric treatment at initial presentation (HR = 4.2, 95% CI 1.7-10.5). It was also associated with self-cutting and history of psychiatric treatment at the last episode before death, and history of previous self harm. Self-cutting as a method of self-harm in children and adolescents conveys greater risk of suicide (and repetition) than self-poisoning although different methods are usually used for suicide. The findings underline the need for psychosocial assessment in all cases. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

Recommendations for teaching upon sensitive topics in forensic and legal medicine in the context of medical education pedagogy.

PubMed

Kennedy, Kieran M; Scriver, Stacey

2016-11-01

Undergraduate medical curricula typically include forensic and legal medicine topics that are of a highly sensitive nature. Examples include suicide, child abuse, domestic and sexual violence. It is likely that some students will have direct or indirect experience of these issues which are prevalent in society. Those students are vulnerable to vicarious harm from partaking in their medical education. Even students with no direct or indirect experience of these issues may be vulnerable to vicarious trauma, particularly students who are especially empathetic to cases presented. Despite these risks, instruction relating to these topics is necessary to ensure the competencies of graduating doctors to respond appropriately to cases they encounter during their professional careers. However, risk can be minimised by a well-designed and thoughtfully delivered educational programme. We provide recommendations for the successful inclusion of sensitive forensic and legal medicine topics in undergraduate medical curricula. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Assessing changes in HIV-related legal and policy environments: Lessons learned from a multi-country evaluation

PubMed Central

Nicholson, Alexandra; Henry, Ian; Saha, Amitrajit; Sellers, Tilly; Gruskin, Sofia

2018-01-01

Introduction There is growing recognition in the health community that the legal environment—including laws, policies, and related procedures—impacts vulnerability to HIV and access to HIV-related services both positively and negatively. Assessing changes in the legal environment and how these affect HIV-related outcomes, however, is challenging, and understanding of appropriate methodologies nascent. Methods We conducted an evaluation of a UNDP project designed to strengthen legal environments to support the human rights of key populations, in particular LGBT populations, women and girls, affected by HIV in sub-Saharan Africa. We analyzed data on activities designed to improve legal environments through a systematic document review and 53 qualitative interviews. Results The project made substantial strides towards legal change in many places, and examples provide broader lessons for work in this area. Two core pillars appear fundamental: a government-led participatory assessment of the legal environment, and building the capacity of those impacted by and engaged in this work. Systematic attention to human rights is vital: it can help open new spaces for dialogue among diverse stakeholders, foster new collaborations, and ensure local ownership, nuanced understanding of the political landscape, attention to marginalized populations, and accountability for (in)action. Entry points for effecting legal change go beyond “HIV laws” to also include other laws, national policies and strategies. Conclusion Conducting legal environment assessments, multi-stakeholder dialogues, action planning and related activities, alongside capacity building, can contribute to changes in knowledge and attitudes directly relevant to reforming laws that are found to be harmful. Shorter-term goals along the causal pathway to legal change (e.g. changes in policy) can constitute interim markers of success, and recognition of these can maintain momentum. Increasing understanding of

Interpretations of legal criteria for involuntary psychiatric admission: a qualitative analysis.

PubMed

Feiring, Eli; Ugstad, Kristian N

2014-10-25

The use of involuntary admission in psychiatry may be necessary to enable treatment and prevent harm, yet remains controversial. Mental health laws in high-income countries typically permit coercive treatment of persons with mental disorders to restore health or prevent future harm. Criteria intended to regulate practice leave scope for discretion. The values and beliefs of staff may become a determinating factor for decisions. Previous research has only to a limited degree addressed how legal criteria for involuntary psychiatric admission are interpreted by clinical decision-makers. We examined clinicians' interpretations of criteria for involuntary admission under the Norwegian Mental Health Care Act. This act applies a status approach, whereby involuntary admission can be used at the presence of mental disorder and need for treatment or perceived risk to the patient or others. Further, best interest assessments carry a large justificatory burden and open for a range of extra-legislative factors to be considered. Deductive thematic analysis was used. Three ideal types of attitudes-to-coercion were developed, denoted paternalistic, deliberative and interpretive. Semi-structured, in-depth interviews with 10 Norwegian clinicians with experience from admissions to psychiatric care were carried out. Data was fit into the preconceived analytical frame. We hypothesised that the data would mirror the recent shift from paternalism towards a more human rights focused approach in modern mental health care. The paternalistic perspective was, however, clearly expressed in the data. Involuntary admission was considered to be in the patient's best interest, and patients suffering from serious mental disorder were assumed to lack decision-making capacity. In addition to assessment of need, outcome effectiveness and risk of harm, extra-legislative factors such as patients' functioning, experience, resistance, networks, and follow-up options were told to influence decisions

Naphyrone: a "legal high" not legal any more.

PubMed

Vardakou, Ioanna; Pistos, Constantinos; Dona, Artemis; Spiliopoulou, Chara; Athanaselis, Sotiris

2012-10-01

Naphyrone, also known as naphthylpyrovalerone and O-2482, is a cathinone derivative that has been recently advertized for purchase on a number of websites. Naphyrone belongs to a new class of "designer drugs" that has emerged on the drugs abuse market and has gained popularity as the new "legal high." Legal highs have been circulating for a number of years in Europe and are becoming popular in the United States. They are affordable, widely available, legal to use and possess, and legal to supply. This review presents any available information about safety profile, clinical data, analytical profile, and legislation of this legal high, which is not legal any more. Any available information has been collected by various literature search engines and the World Wide Web. The structure of naphyrone is similar to that of pyrovalerone, a monoamine uptake inhibitor. This new designer drug does not have a long history of use, so there is little evidence of its long-term effects or on the risks from its use. Because of its similarity to other cathinone derivatives, naphyrone is likely to share the same risks, such as anxiety, paranoia, and overstimulation of the heart and circulatory system. Naphyrone was classified as a controlled drug under the UK Misuse of Drugs Act of 1971 (Amendment No. 2) Regulation 2010.

Harm and the Boundaries of Disease.

PubMed

McGivern, Patrick; Sorial, Sarah

2017-08-01

What is the relationship between harm and disease? Discussions of the relationship between harm and disease typically suffer from two shortcomings. First, they offer relatively little analysis of the concept of harm itself, focusing instead on examples of clear cases of harm such as death and dismemberment. This makes it difficult to evaluate such accounts in borderline cases, where the putative harms are less severe. Second, they assume that harm-based accounts of disease must be understood normatively rather than naturalistically, in the sense that they are inherently value based. This makes such accounts vulnerable to more general objections of normative accounts of disease. Here we draw on an influential account of harm from the philosophy of law to develop a harm-based account of disease that overcomes both of these shortcomings. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Harm reduction principles for healthcare settings.

PubMed

Hawk, Mary; Coulter, Robert W S; Egan, James E; Fisk, Stuart; Reuel Friedman, M; Tula, Monique; Kinsky, Suzanne

2017-10-24

Harm reduction refers to interventions aimed at reducing the negative effects of health behaviors without necessarily extinguishing the problematic health behaviors completely. The vast majority of the harm reduction literature focuses on the harms of drug use and on specific harm reduction strategies, such as syringe exchange, rather than on the harm reduction philosophy as a whole. Given that a harm reduction approach can address other risk behaviors that often occur alongside drug use and that harm reduction principles have been applied to harms such as sex work, eating disorders, and tobacco use, a natural evolution of the harm reduction philosophy is to extend it to other health risk behaviors and to a broader healthcare audience. Building on the extant literature, we used data from in-depth qualitative interviews with 23 patients and 17 staff members from an HIV clinic in the USA to describe harm reduction principles for use in healthcare settings. We defined six principles of harm reduction and generalized them for use in healthcare settings with patients beyond those who use illicit substances. The principles include humanism, pragmatism, individualism, autonomy, incrementalism, and accountability without termination. For each of these principles, we present a definition, a description of how healthcare providers can deliver interventions informed by the principle, and examples of how each principle may be applied in the healthcare setting. This paper is one of the firsts to provide a comprehensive set of principles for universal harm reduction as a conceptual approach for healthcare provision. Applying harm reduction principles in healthcare settings may improve clinical care outcomes given that the quality of the provider-patient relationship is known to impact health outcomes and treatment adherence. Harm reduction can be a universal precaution applied to all individuals regardless of their disclosure of negative health behaviors, given that health

A Descriptive Literature Review of Harmful Leadership Styles: Definitions, Commonalities, Measurements, Negative Impacts, and Ways to Improve These Harmful Leadership Styles

ERIC Educational Resources Information Center

Burns, Wallace A., Jr.

2017-01-01

There are many harmful leadership styles--the egotistic leader, the incompetent leader, the ignorant leader, and leaders that are reckless, cruel, or even evil. To understand what ultimately are considered leadership traits that are contrary to good order, discipline and productivity, the author conducted a review of the literature to obtain a…

Legal Briefing: Mandated Reporters and Compulsory Reporting Duties.

PubMed

Pope, Thaddeus Mason

2016-01-01

This issue's "Legal Briefing" column, one product of a Greenwall Foundation grant, reviews recent developments concerning compulsory reporting duties. Most licensed clinicians in the United States are "mandated reporters." When these clinicians discover certain threats to the safety of patients or the public, they are legally required to report that information to specified government officials. Over the past year, several states have legislatively expanded the scope of these reporting duties. In other states, new court cases illustrate the vigorous enforcement of already existing duties. I have organized all these legal developments into the following eight categories: 1. Overview of Mandatory Reporting Duties 2. Controversy over the Benefits of Mandatory Reporting 3. New and Expanded Duties to Report 4. Criminal Penalties for Failing to Report 5. Civil Liability for Failing to Report 6. Disciplinary Penalties for Failing to Report 7. Legal Immunity for Good-Faith Reporting 8. Protection against Employers' Retaliation. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Withholding differential risk information on legal consumer nicotine/tobacco products: The public health ethics of health information quarantines.

PubMed

Kozlowski, Lynn T; Sweanor, David

2016-06-01

The United States provides an example of a country with (a) legal tobacco/nicotine products (e.g., snus, other smokeless tobacco, cigarettes) differing greatly in risks to health and (b) respected health information websites that continue to omit or provide incorrect differential risk information. Concern for the principles of individual rights, health literacy, and personal autonomy (making decisions for oneself), which are key principles of public health ethics, has been countered by utilitarian arguments for the use of misleading or limited information to protect public health overall. We argue that omitting key health relevant information for current or prospective consumers represents a kind of quarantine of health-relevant information. As with disease quarantines, the coercive effects of quarantining information on differential risks need to be justified, not merely by fears of net negative public health effects, but by convincing evidence that such measures are actually warranted, that public health overall is in imminent danger and that the danger is sufficient to override principles of individual autonomy. Omitting such health-relevant information for consumers of such products effectively blindfolds them and impairs their making informed personal choices. Moral psychological issues that treat all tobacco/nicotine products similarly may also be influencing the reluctance to inform on differential risks. In countries where tobacco/nicotine products are legally sold and also differ greatly in disease risks compared to cigarettes (e.g., smokeless tobacco and vape), science-based, comprehensible, and actionable health information (consistent with health literacy principles) on differential risks should be available and only reconsidered if it is established that this information is causing losses to population health overall. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Incidence of suicide, hospital-presenting non-fatal self-harm, and community-occurring non-fatal self-harm in adolescents in England (the iceberg model of self-harm): a retrospective study.

PubMed

Geulayov, Galit; Casey, Deborah; McDonald, Keltie C; Foster, Pauline; Pritchard, Kirsty; Wells, Claudia; Clements, Caroline; Kapur, Navneet; Ness, Jennifer; Waters, Keith; Hawton, Keith

2018-02-01

Little is known about the relative incidence of fatal and non-fatal self-harm in young people. We estimated the incidence of suicide, hospital-presenting non-fatal self-harm, and community-occurring non-fatal self-harm in adolescents in England. We used national mortality statistics (Jan 1, 2011, to Dec 31, 2013), hospital monitoring data for five hospitals derived from the Multicentre Study of Self-Harm in England (Jan 1, 2011, to Dec 31, 2013), and data from a schools survey (2015) to estimate the incidence of fatal and non-fatal self-harm per 100 000 person-years in adolescents aged 12-17 years in England. We described these incidences in terms of an iceberg model of self-harm. During 2011-13, 171 adolescents aged 12-17 years died by suicide in England (119 [70%] male and 133 [78%] aged 15-17 years) and 1320 adolescents presented to the study hospitals following non-fatal self-harm (1028 [78%] female and 977 [74%] aged 15-17 years). In 2015, 322 (6%) of 5506 adolescents surveyed reported self-harm in the past year in the community (250 [78%] female and 164 [51%] aged 15-17 years). In 12-14 year olds, for every boy who died by suicide, 109 attended hospital following self-harm and 3067 reported self-harm in the community, whereas for every girl who died by suicide, 1255 attended hospital for self-harm and 21 995 reported self-harm in the community. In 15-17 year olds, for every male suicide, 120 males presented to hospital with self-harm and 838 self-harmed in the community; whereas for every female suicide, 919 females presented to hospital for self-harm and 6406 self-harmed in the community. Hanging or asphyxiation was the most common method of suicide (125 [73%] of 171), self-poisoning was the main reason for presenting to hospital after self-harm (849 [71%] of 1195), and self-cutting was the main method of self-harm used in the community (286 [89%] of 322). Ratios of fatal to non-fatal rates of self-harm differed between males and females and between

Adolescent self-harm and risk factors.

PubMed

Zhang, Jixiang; Song, Jianwei; Wang, Jing

2016-12-01

This study aims to define the characteristics of adolescents who have engaged in self-harm behavior and ascertain the risk factors. From January 2013 to January 2014, 4,176 adolescents from senior middle schools in Linyi, China, were administered four questionnaire surveys to ascertain the following: incidence of self-harm behavior regarding the frequency of different self-harm behaviors by group (never/one to five times/greater than five times in the last 6 months) and then comparing the self-harm behavior of the different subgroups; symptom self-check, comparing the differences between the adolescents with self-harm behavior and without in nine subscales (somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, fear, paranoid, and psychosis); Adolescent Self-Rating Life Events Check List scores; and Egna Minnenav Barndoms Uppfostran (EMBU) scores. Multivariate logistic regression analysis was used to determine the risk factors of self-harm in adolescents. The incidence of adolescent self-harm was 27.60%; the occurrence of adolescent self-harm was closely related to their mental health status, stressful life events, and EMBU. Being female, an urban student, or an only child; having poor school performance or experiences of stressful life events, harsh parenting styles, or excessive interference; and poor mental health were the risk factors for adolescent self-harm. The incidence of adolescent self-harm was high, and their mental health status, stressful life events, and EMBU affected the occurrence of adolescent self-harm, which is an issue that needs greater attention. © 2016 John Wiley & Sons Australia, Ltd.

Ownership of Traditional Information: Moral and Legal Obligations to Compensate for Taking.

ERIC Educational Resources Information Center

McNeil, Richard J.; McNeil, Michael J.

1989-01-01

Argues that "indigenous" people transferring cultural information to other, more "developed" people should have legal protection from unfair transactions. Presents ethical and legal bases for such protection. Examples involve the knowledge of rain-forest tribes that has been used to produce valuable pharmaceutical products from…

Legal preparedness: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

PubMed

Courtney, Brooke; Hodge, James G; Toner, Eric S; Roxland, Beth E; Penn, Matthew S; Devereaux, Asha V; Dichter, Jeffrey R; Kissoon, Niranjan; Christian, Michael D; Powell, Tia

2014-10-01

hospitals and practitioners who act in good faith from liability. Finally, to address anticipated staffing shortages during severe and prolonged disasters and pandemics, governments should develop approaches to formally expand the availability of qualified health-care workers, such as through using official foreign medical teams. As a fundamental element of health-care and public health emergency planning and preparedness, the law underlies critical aspects of disaster and pandemic responses. Effective responses require comprehensive advance planning efforts that include assessments of complex legal issues and authorities. Recent disasters have shown that although law is a critical response tool, it can also be used to hold health-care stakeholders who fail to appropriately plan for or respond to disasters and pandemics accountable for resulting patient or staff harm. Claims of liability from harms allegedly suffered during disasters and pandemics cannot be avoided altogether. However, appropriate planning and legal protections can help facilitate sound, consistent decision-making and support response participation among health-care entities and practitioners.

Measuring costs of alcohol harm to others: a review of the literature.

PubMed

Navarro, Héctor José; Doran, Christopher M; Shakeshaft, Anthony P

2011-04-01

People other than the drinker experience harmful consequences from alcohol misuse, accounting for part of the economic burden to society. Little has been done on costing harm to others. A literature review was undertaken of various databases, government publications, dissertations, conference papers and reference materials. Publications were included for analysis if they reported costs on alcohol harm to others. Methodological adequacy of costing studies was assessed using a checklist modified from the Drummond 10-point checklist. In total, 25 publications including costs on alcohol harm to others were reviewed. Fetal alcohol syndrome (FAS) was the harm to others most frequently cost. The cost-of-illness (COI) framework was used in 24 of the publications, while 1 employed a cost-benefit analysis (CBA) serving as starting point for further studies estimating intangible costs (e.g. victim's quality-of-life (QoL) loss). Indirect costs (e.g. victim's lost productivity) were quantified most frequently with the human capital approach. The majority of publications critically assessed on costing received an average quality score (17/25). Few studies have reported costs on the magnitude from harm to people other than the drinker, therefore the overall economic burden of risky alcohol consumption across countries is underestimated. This review may be considered a starting point for future research on costing alcohol harm to others. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Perception of e-cigarette harm and its correlation with use among U.S. adolescents.

PubMed

Amrock, Stephen M; Zakhar, Joseph; Zhou, Sherry; Weitzman, Michael

2015-03-01

U.S. adolescents increasingly use e-cigarettes. The perceived harm of e-cigarettes has not been described, nor has the correlation between harm perception and e-cigarette use been assessed. This study examines correlates of e-cigarette harm perception and use of e-cigarettes in a national survey. We used cross-sectional nationally representative data from the 2012 National Youth Tobacco Survey (n = 24,658). Cross-tabulations and multivariate ordered probit and logistic regression models were employed to assess relative harm perception and e-cigarette use. Half of U.S. adolescents had heard of e-cigarettes. Of these, 13.2% (95% confidence interval [CI] = 11.7-14.9) and 4.0% (95% CI = 3.4-4.7) reported ever or currently using e-cigarettes, respectively. Of those aware of e-cigarettes, 34.2% (95% CI = 32.8-35.6) believed e-cigarettes were less harmful than cigarettes. Among those trying e-cigarettes, 71.8% (95% CI = 69.0-74.5) believed e-cigarettes were comparatively less harmful. Females and those ≥ 17 years old were more likely to perceive e-cigarettes as more harmful relative to cigarettes, while on average Whites, users of other tobacco products, and those with family members who used tobacco were more likely to perceive e-cigarettes as comparatively safer. Among cigarette-naive e-cigarette users, use of other tobacco products and perceived harm reduction by e-cigarettes were, respectively, on average associated with 1.6 and 4.1 percentage-point increases in e-cigarette use. Perception of e-cigarettes as less harmful than conventional cigarettes was associated with increased e-cigarette use, including among cigarette-naive e-cigarette users. These findings should prompt further scientific investigation and merit attention from regulators. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Measuring and preventing alcohol use and related harm among young people in Asian countries: a thematic review.

PubMed

Jiang, Heng; Xiang, Xiaojun; Hao, Wei; Room, Robin; Zhang, Xiaojie; Wang, Xuyi

2018-01-01

The paper reviews alcohol consumption patterns and alcohol-related social and health issues among 15-29-year old young people in Asian countries, and discusses strategies for preventing and controlling alcohol use and related harms. We searched Google Scholar, PubMed, and Web of Science for reports, reviews and journal articles published in English between 1st Jan 1990 and 31st August 2016. Forty-one reports, reviews and journal papers were identified and included in the final review. The current drinking levels and prevalence among young people are markedly different between eight included Asian countries, ranging from 4.2% in Malaysia to 49.3% in China. In a majority of the selected Asian countries, over 15% of total deaths among young men and 6% among young women aged 15-29 years are attributable to alcohol use. Alcohol use among young people is associated with a number of harms, including stress, family violence, injuries, suicide, and sexual and other risky behaviours. Alcohol policies, such as controlling sales, social supply and marketing, setting up/raising a legal drinking age, adding health warning labels on alcohol containers, and developing a surveillance system to monitor drinking pattern and risky drinking behaviour, could be potential means to reduce harmful use of alcohol and related harm among young people in Asia. The review reveals that drinking patterns and behaviours vary across eight selected Asian countries due to culture, policies and regional variations. The research evidence holds substantial policy implications for harm reduction on alcohol drinking among young people in Asian countries -- especially for China, which has almost no alcohol control policies at present.

Designer Drug (DD) abuse in Poland; a review of the psychoactive and toxic properties of substances found from seizures of illegal drug products and the legal consequences thereof. Part 1--cannabinoids and cathinones.

PubMed

Biliński, Przemysław; Hołownia, Piotr; Kapka-Skrzypczak, Lucyna; Wojtyła, Andrzej

2012-01-01

Faced with the rapidly growing increase of designer drug abuse, particularly amongst the younger generation, various legislative strategies are currently employed world-wide for tackling this problem - however with mixed results. The key issue is that the producers of DDs are able to either exploit existing legal substances intended for other uses, but which have been found to possess psychoactive properties, or to synthesise new psychoactive substances by introducing chemical modifications, often very minor ones, thereby avoiding the prohibited use of chemicals included on any banned lists. Some countries opt to ban new drugs as and when shown or considered to be harmful, while others introduce sweeping bans based on chemical structure. Nevertheless, an ever increasing diversity of new DDs are constantly appearing on domestic and Internet markets. Poland, together with the UK and Eire, has placed temporary bans on all DDs whenever they have been identified, thus enabling sufficient time for assessing their potential hazards to health. Part of this 'holding' strategy entails a thorough review of the scientific literature, including expert opinion when direct evidence is lacking, as well as information received from EU support organisations Europol and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). This paper, in two parts, therefore aims to provide an up-to-date summary review of available scientific evidence on the harm caused by the six main chemical groupings of DDs found in drug seizures of illegal products recently made in Poland. The first part is devoted to Cannabinoids and Cathinones derivatives. Ensuing legislation can therefore be rapidly formulated to make the bans permanent as appropriate.

The Canadian Cannabis Act legalizes and regulates recreational cannabis use in 2018.

PubMed

Cox, Chelsea

2018-03-01

Canada is on the cusp of an unprecedented change in its governmental approach to recreational cannabis consumption. By July of 2018 the country will legalize and regulate recreational cannabis use across the country via the implementation of the Cannabis Act, representing the second country in the world and the first in North America to do so. With almost half of Canadians having admitted to using the drug illegally, this change in policy has been long advocated. While medical cannabis has been legal since 2001 this represents the first time in recent history that recreational cannabis will be legal on a federal level. As the country moves away from criminal prohibition into a framework centered on harm minimization and public health and safety, the policy specifics are being worked out by a variety of stakeholders. With limited peer-reviewed research and similar regulatory schemes to shape the Cannabis Act off of, Canada is entering unchartered territory. As other countries around the world struggle with illegal cannabis consumption, the Canadian example and novel regulatory scheme could prove a useful guiding tool for future policy in other jurisdictions. The following paper discusses key areas to watch and a brief intro of how Canada got to where it is and the foundational need for a shift in policy. Copyright © 2018 Elsevier B.V. All rights reserved.

The globalization of ayahuasca: harm reduction or benefit maximization?

PubMed

Tupper, Kenneth W

2008-08-01

Ayahuasca is a tea made from two plants native to the Amazon, Banisteriopsis caapi and Psychotria viridis, which, respectively, contain the psychoactive chemicals harmala alkaloids and dimethyltryptamine. The tea has been used by indigenous peoples in countries such as Brazil, Ecuador and Peru for medicinal, spiritual and cultural purposes since pre-Columbian times. In the 20th century, ayahuasca spread beyond its native habitat and has been incorporated into syncretistic practices that are being adopted by non-indigenous peoples in modern Western contexts. Ayahuasca's globalization in the past few decades has led to a number of legal cases which pit religious freedom against national drug control laws. This paper explores some of the philosophical and policy implications of contemporary ayahuasca use. It addresses the issue of the social construction of ayahuasca as a medicine, a sacrament and a "plant teacher." Issues of harm reduction with respect to ayahuasca use are explored, but so too is the corollary notion of "benefit maximization."

Legal Knowledge as a Tool for Social Change

PubMed Central

González Vélez, Ana Cristina; Jaramillo, Isabel Cristina

2017-01-01

Abstract In May 2006, Colombia’s Constitutional Court liberalized abortion, introducing three circumstances under which the procedure would not be considered a crime: (1) rape or incest; (2) a risk to the woman’s health or life; and (3) fetal malformations incompatible with life. Immediately following the court’s ruling, known as Sentence C-355, members of La Mesa por la Vida y Salud de las Mujeres (hereinafter La Mesa) began to mobilize to ensure the decision’s implementation, bearing in mind the limited impact that the legal framework endorsed by the court has had in other countries in the region. We argue that La Mesa’s strategy is an innovative one in the field of legal mobilization insofar as it presumes that law can be shaped not just by public officials and universities but also by social actors engaged in the creation and diffusion of legal knowledge. In this regard, La Mesa has become a legal expert on abortion by accumulating knowledge about the multiple legal rules affecting the practice of abortion and about the situations in which these rules are to be applied. In addition, by becoming a legal expert, La Mesa has been able to persuade health providers that they will not risk criminal prosecution or being fired if they perform abortions. We call this effect of legal mobilization a “pedagogical effect” insofar as it involves the production of expertise and appropriation of knowledge by health professionals. We conclude by discussing La Mesa’s choice to become a legal expert on abortion as opposed to recruiting academics to do this work or encouraging women to produce and disseminate this knowledge. PMID:28630545

Validation of the Short Gambling Harm Screen (SGHS): A Tool for Assessment of Harms from Gambling.

PubMed

Browne, Matthew; Goodwin, Belinda C; Rockloff, Matthew J

2018-06-01

It is common for jurisdictions tasked with minimising gambling-related harm to conduct problem gambling prevalence studies for the purpose of monitoring the impact of gambling on the community. However, given that both public health theory and empirical findings suggest that harms can occur without individuals satisfying clinical criteria of addiction, there is a recognized conceptual disconnect between the prevalence of clinical problem gamblers, and aggregate harm to the community. Starting with an initial item pool of 72 specific harms caused by problematic gambling, our aim was to develop a short gambling harms scale (SGHS) to screen for the presence and degree of harm caused by gambling. An Internet panel of 1524 individuals who had gambled in the last year completed a 72-item checklist, along with the Personal Wellbeing Index, the PGSI, and other measures. We selected 10 items for the SGHS, with the goals of maximising sensitivity and construct coverage. Psychometric analysis suggests very strong reliability, homogeneity and unidimensionality. Non-zero responses on the SGHS were associated with a large decrease in personal wellbeing, with wellbeing decreasing linearly with the number of harms indicated. We conclude that weighted SGHS scores can be aggregated at the population level to yield a sensitive and valid measure of gambling harm.

16 CFR 1102.28 - Publication of reports of harm.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS PUBLICLY AVAILABLE CONSUMER PRODUCT SAFETY INFORMATION DATABASE (Eff. Jan. 10, 2011) Procedural..., the Commission will publish reports of harm that meet the requirements for publication in the Database...(d) in the Database beyond the 10-business-day time frame set forth in paragraph (a) of this section...

Inmetro - Metrologia Legal

Science.gov Websites

Ética Mapa do site English Version Inmetro Metrologia Legal Procurando algo? Inmetro no Facebook Metrologia Legal Introdução .: Introdução :. A Metrologia Legal é parte da metrologia relacionada às ambiente. No Brasil as atividades da Metrologia Legal são uma atribuição do Inmetro, que também

Harm reduction in U.S. tobacco control: Constructions in textual news media.

PubMed

Eversman, Michael H

2015-06-01

U.S. tobacco control has long emphasized abstinence, yet quitting smoking is hard and cessation rates low. Tobacco harm reduction alternatives espouse substituting cigarettes with safer nicotine and tobacco products. Policy shifts embracing tobacco harm reduction have increased media attention, yet it remains controversial. Discourse theory posits language as fluid, and socially constructed meaning as neither absolute nor neutral, elevating certain views over others while depicting "discursive struggle" between them. While an abstinence-based framework dominates tobacco policy, discourse theory suggests constructions of nicotine and tobacco use can change, for example by positioning tobacco harm reduction more favorably. Textual discourse analysis was used to explore constructions of tobacco harm reduction in 478 (308 original) U.S. textual news media articles spanning 1996-2014. Using keyword database sampling, retrieved articles were analyzed first as discrete recording units and then to identify emergent thematic content. Constructions of tobacco harm reduction shifted over this time, revealing tension among industry and policy interests through competing definitions of tobacco harm reduction, depictions of its underlying science, and accounts of regulatory matters including tobacco industry support for harm reduction and desired marketing and taxation legislation. Heightened salience surrounding tobacco harm reduction and electronic cigarettes suggests their greater acceptance in U.S. tobacco control. Various media depictions construct harm reduction as a temporary means to cessation, and conflict with other constructions of it that place no subjective value on continued "safer" tobacco/nicotine use. Constructions of science largely obscure claims of the veracity of tobacco harm reduction, with conflict surrounding appropriate public health benchmarks for tobacco policy and health risks of nicotine use. Taxation policies and e-cigarette pricing relative to

Will growth in cryptomarket drug buying increase the harms of illicit drugs?

PubMed

Aldridge, Judith; Stevens, Alex; Barratt, Monica J

2018-05-01

Cryptomarkets-on-line, anonymous market-places for illicit goods and services that specialize mainly in drugs-account for a small but rapidly growing share of the illicit drug market in many countries. Policy responses so far are based generally on the assumption that their rise will only increase drug harms. In this contribution for debate, we question this assumption. We provide a narrative review of the emerging literature connected to drug cryptomarkets. We use MacCoun & Reuter's formula to understand the effect of population-level increases in use on total harm as depending on the level of harm associated with each unit of use. We then consider the potential for cryptomarkets to increase or decrease the harms and benefits related to each unit of drug use, with specific attention to the quality of drugs sold and the non-drug-related harms and benefits for customers. It is likely that cryptomarkets will increase both the amount and the range of substances that are sold. However, we argue that the effects on harms will depend upon whether cryptomarkets also increase the quality and safety of products that are sold, provide harm-reducing information to consumers and reduce transactional conflict involved in drug purchasing. There is an emerging and rapidly growing evidence base connected to the macro and micro harms and benefits of cryptomarkets for drug users. Future researchers should use appropriately matched comparative designs to establish more firmly the differential harms and benefits of sourcing drugs both on- and off-line. While it is unlikely that the on-line drug trade can be eradicated completely, cryptomarkets will respond to regulation and enforcement in ways that have complex, and sometimes unanticipated, effects on both harms and benefits. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Digital Self-Harm Among Adolescents.

PubMed

Patchin, Justin W; Hinduja, Sameer

2017-12-01

Despite increased media and scholarly attention to digital forms of aggression directed toward adolescents by their peers (e.g., cyberbullying), very little research has explored digital aggression directed toward oneself. "Digital self-harm" is the anonymous online posting, sending, or otherwise sharing of hurtful content about oneself. The current study examined the extent of digital self-harm among adolescents. Survey data were obtained in 2016 from a nationally representative sample of 5,593 American middle and high school students (12-17 years old). Logistic regression analysis was used to identify correlates of participation in digital self-harm. Qualitative responses were also reviewed to better understand motivations for digital self-harm. About 6% of students have anonymously posted something online about themselves that was mean. Males were significantly more likely to report participation (7.1% compared to 5.3%). Several statistically significant correlates of involvement in digital self-harm were identified, including sexual orientation, experience with school bullying and cyberbullying, drug use, participation in various forms of adolescent deviance, and depressive symptoms. Digital self-harm is a new problem that demands additional scholarly attention. A deeper inquiry as to the motivations behind this behavior, and how it correlates to offline self-harm and suicidal ideation, can help direct mental health professionals toward informed prevention approaches. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Big data on a big new market: Insights from Washington State's legal cannabis market.

PubMed

Caulkins, Jonathan P; Bao, Yilun; Davenport, Steve; Fahli, Imane; Guo, Yutian; Kinnard, Krista; Najewicz, Mary; Renaud, Lauren; Kilmer, Beau

2018-07-01

Voters in eight U.S. states have passed initiatives to legalize large-scale commercial production of cannabis for non-medical use. All plan or require some form of "seed-to-sale" tracking systems, which provide a view of cannabis market activity at a heretofore unimagined level of detail. Legal markets also create a range of new matters for policy makers to address. Publicly available data were obtained on approximately 45 million individually priced items purchased in the 35 million retail transactions that took place during the first two and a half years of Washington State's legal cannabis market. Records include product type (flower, extract, lotion, liquid edible, etc.), product name, price, and potency with respect to multiple cannabinoids, notably THC and CBD. Items sold can be traced back up the supply chain through the store to the processor and producer, to the level of identifying the specific production batch and mother plant, the firm that tested the product, and test results. Data visualization methods are employed to describe spatial-temporal patterns of multiple correlated attributes (e.g., price and potency) broken down by product. Text-analytic methods are used to subdivide the broad category of "extracts for inhalation" into more homogeneous sub-categories. To understand the competitiveness of the legal cannabis market in Washington we calculate the Herfindahl-Hirschman index (HHI) for processors and retailers. Cannabis prices fell steadily and proportionally at the processor and retailer levels. Retail and wholesale price maintained a roughly 3:1 ratio for multiple product types after some initial fluctuations. Although a wide range of edibles are sold, they account for a modest share of consumer spending; extracts for inhalation are a larger and heterogeneous market segment. The HHI indicates the cannabis market is highly competitive at the processor level, but less so for retail markets at the county level. Washington's state-legal cannabis

Attitudes toward adolescent self-harm and its prevention: The views of those who self-harm and their peers.

PubMed

Doyle, Louise

2017-08-01

Adolescent self-harm is a common phenomenon; however, little is known about young peoples' attitudes toward self-harm and what they believe can be done to prevent it. This study aimed to identify adolescents' attitudes about self-harm and their perspectives on preventing it. A cross-sectional anonymous survey was administered to 856 post-primary school students across 11 schools in Dublin, Ireland. Attitudes toward self-harm were captured through a five-item scale and views on prevention of self-harm were captured through an open-ended survey question. Responses from those who self-harmed and those who did not were compared to identify differences. Significant differences were identified between those who self-harmed and their peers. Those who self-harmed were less likely to believe that self-harm was carried out to get attention or was a result of loneliness or depression; they were more likely to believe that self-harm was impulsive. Findings demonstrated that a majority of young people believed that self-harm could be prevented and a number of preventative strategies were identified. It is important that the views of adolescents are incorporated into the design and delivery of youth-friendly services and that there is a focus on increasing awareness of the youth-orientated services that currently exist. © 2018 Wiley Periodicals, Inc.

Balancing benefits and harm: Chemical use and bodily transformation among Indonesia's transgender waria

PubMed Central

Idrus, Nurul Ilmi; Hymans, Takeo David

2014-01-01

Background Members of Indonesia's diverse male-to-female transgender community often describe themselves as waria. Waria do not equate being feminine with being female. They do not want to be women; they aspire to be like women. It entails cultivating mannerisms and wearing make-up and women's clothes, shaving one's legs and styling one's hair. But some go further in their practices of self-administered, chemically assisted bodily transformation. Methods Field research took place in Makassar, the capital city of South Sulawesi; in a smaller town in the regency of Bulukumba on the south coast of Sulawesi; and in the special region of Yogyakarta in Java. Data were collected through repeated in-depth interviews with ten waria youths aged between 18 and 26 in each site; interviews with pharmacists, drug and cosmetics store clerks; three focus group discussions at each site; and participant observation. Results Our respondents saw their bodies as ‘projects’ they can manipulate with pharmaceutical products and cosmetics. To lighten their skin, they experimented with different brands of exfoliating liquid, whitening cream, powder, foundation, face soap and skin scrub. To grow breasts and reduce muscle mass, they experimented with different brands and dosages of contraceptive pills and injections in order to get faster, better and longer-lasting results. Conclusion Harm reduction programs often neglect chemicals that are not narcotics, not related to sexually transmitted infections, and which are legally and freely available. Safety issues arise when otherwise safe products are used off-label in large quantities. Drug policy-makers are paying insufficient attention to the safety of cosmetics. PMID:25091633

New legal requirements for submission of product information to poisons centres in EU member states.

PubMed

de Groot, Ronald; Brekelmans, Pieter; Desel, Herbert; de Vries, Irma

2018-01-01

In the past eight years, the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) has been intensively involved in a European Commission led process to develop EU legislation on the information of hazardous products that companies have to notify to EU Poisons Centres (or equivalent "appointed bodies"). As a result of this process, the Commission adopted Regulation (EU) No 2017/542, amending the CLP Regulation by adding an Annex on harmonised product submission requirements. Harmonised mixture information requirements: Detailed and consistent information on the composition of the hazardous product will become available to EU Poisons Centres (PC). The information will be submitted by companies to PCs (or equivalent "appointed bodies") using a web-based software application or in-house software. Two new important features are introduced. Firstly, to be able to rapidly identify the product formula, a Unique Formula Identifier (UFI) on the product label links to the submitted information. Secondly, for better comparability of reports on poisonings between EU member states, a harmonised Product Categorisation System will specify the intended use of a product. Rapid product identification and availability of detailed composition information will lead to timely and adequate medical intervention. This may lead to considerable reduction in healthcare costs. Additionally, for companies trading across the EU, costs of submission of this information will be reduced significantly. Next steps: From 2017, an implementation period has started, consisting of a three-year period for stakeholders to implement the new requirements, followed by a gradual applicability for consumer products (2020), professional products (2021) and industrial use-only products (2024). Technical tools to generate the electronic format and the UFI together with guidance documents are expected to be made available by the end of 2017 by the European Chemicals Agency (ECHA). Guidance on

Predictors for repeat self-harm and suicide among older people within 12 months of a self-harm presentation.

PubMed

Cheung, Gary; Foster, Gisele; de Beer, Wayne; Gee, Susan; Hawkes, Tracey; Rimkeit, Sally; Tan, Yu Mwee; Merry, Sally; Sundram, Frederick

2017-08-01

A past history of self-harm is a significant risk factor for suicide in older people. The aims of this study are to (i) characterize older people who present with self-harm to emergency departments (EDs); and (ii) determine the predictors for repeat self-harm and suicide. Demographic and clinical data were retrospectively collected on older people (age 65+ years), who presented to seven EDs in New Zealand following an episode of self-harm between 1st July 2010 and 30th June 2013. In addition, 12-month follow-up information on repeat self-harm and suicide was collected. The sample included 339 older people (55.2% female) with an age range of 65-96 years (mean age = 75.0; SD = 7.6). Overdose (68.7%) was the most common method of self-harm. 76.4% of the self-harm cases were classified as suicide attempts. Perceived physical illness (47.8%) and family discord (34.5%) were the most common stressors. 12.7% of older people repeated self-harm and 2.1% died by suicide within 12 months. Older people who had a positive blood alcohol reading (OR = 3.87, 95% Cl = 1.35-11.12, p = 0.012) and were already with mental health services at the index self-harm (OR = 2.73, 95% Cl = 1.20-6.25, p = 0.047) were more likely to repeat self-harm/suicide within 12 months. Older people who self-harm are at very high risk of repeat self-harm and suicide. Screening and assessment for alcohol use disorders should be routinely performed following a self-harm presentation, along with providing structured psychological treatment as an adjunct to pharmacological treatment for depression and interventions to improve the person's resilience resources.

A harm-reduction model of abortion counseling about misoprostol use in Peru with telephone and in-person follow-up: A cohort study.

PubMed

Grossman, Daniel; Baum, Sarah E; Andjelic, Denitza; Tatum, Carrie; Torres, Guadalupe; Fuentes, Liza; Friedman, Jennifer

2018-01-01

In Peru, abortion is legal only to preserve the life and health of the woman. A non-profit clinic system in Peru implemented a harm-reduction model for women with unwanted pregnancy that included pre-abortion care with instructions about misoprostol use and post-abortion care; they started offering telephone follow-up for clients in 2011. This study aimed to evaluate the effectiveness and safety of the harm-reduction model, and to compare outcomes by type of follow-up obtained. Between January 2012 and March 2013, 500 adult women seeking harm-reduction services were recruited into the study. Telephone surveys were conducted approximately four weeks after their initial harm-reduction counseling session with 262 women (response rate 52%); 9 participants were excluded. The survey focused on whether women pursued an abortion, and if so, what their experience was. Demographic and clinical data were also extracted from clinic records. Eighty-six percent of participants took misoprostol; among those taking misoprostol, 89% reported a complete abortion at the time of the survey. Twenty-two percent obtained an aspiration after taking misoprostol and 8% self-reported adverse events including hemorrhage without transfusion, infection, or severe pain. Among women who took misoprostol, 46% reported receiving in-person follow-up (in some cases both telephone and in-person), 34% received telephone only, and 20% did not report receiving any form of follow-up. Those who had in-person follow-up with the counselor were most likely to report a complete abortion (<0.001). Satisfaction with both types of follow-up was very high, with 81%-89% reporting being very satisfied. Liberalization of restrictive abortion laws is associated with improvements in health outcomes, but the process of legal reform is often lengthy. In the interim, giving women information about evidence-based regimens of misoprostol, as well as offering a range of follow-up options to ensure high quality post

A harm-reduction model of abortion counseling about misoprostol use in Peru with telephone and in-person follow-up: A cohort study

PubMed Central

Baum, Sarah E.; Andjelic, Denitza; Tatum, Carrie; Torres, Guadalupe; Fuentes, Liza; Friedman, Jennifer

2018-01-01

Background In Peru, abortion is legal only to preserve the life and health of the woman. A non-profit clinic system in Peru implemented a harm-reduction model for women with unwanted pregnancy that included pre-abortion care with instructions about misoprostol use and post-abortion care; they started offering telephone follow-up for clients in 2011. This study aimed to evaluate the effectiveness and safety of the harm-reduction model, and to compare outcomes by type of follow-up obtained. Methods Between January 2012 and March 2013, 500 adult women seeking harm-reduction services were recruited into the study. Telephone surveys were conducted approximately four weeks after their initial harm-reduction counseling session with 262 women (response rate 52%); 9 participants were excluded. The survey focused on whether women pursued an abortion, and if so, what their experience was. Demographic and clinical data were also extracted from clinic records. Results Eighty-six percent of participants took misoprostol; among those taking misoprostol, 89% reported a complete abortion at the time of the survey. Twenty-two percent obtained an aspiration after taking misoprostol and 8% self-reported adverse events including hemorrhage without transfusion, infection, or severe pain. Among women who took misoprostol, 46% reported receiving in-person follow-up (in some cases both telephone and in-person), 34% received telephone only, and 20% did not report receiving any form of follow-up. Those who had in-person follow-up with the counselor were most likely to report a complete abortion (<0.001). Satisfaction with both types of follow-up was very high, with 81%-89% reporting being very satisfied. Conclusions Liberalization of restrictive abortion laws is associated with improvements in health outcomes, but the process of legal reform is often lengthy. In the interim, giving women information about evidence-based regimens of misoprostol, as well as offering a range of follow

Hospitalised neonates in Estonia commonly receive potentially harmful excipients

PubMed Central

2012-01-01

Background Information on the neonatal exposure to excipients is limited. Our aim was to describe the extent of excipient intake by Estonian neonates; to classify the excipients according to potential neonatal toxicity and thereby to measure the extent of exposure of neonates to potentially harmful excipients. Methods A prospective cohort study that recorded all medicines prescribed to patients aged below 28 days admitted to Tartu University Hospital from 01.02-01.08 2008 and to Tallinn Children’s Hospital from 01.02- 01.08 2009 was conducted. Excipients were identified from Summaries of Product Characteristics and classified according to toxicity following a literature review. Results 1961 prescriptions comprising 107 medicines were written for 348/490 neonates admitted. A total of 123 excipients were found in 1620 (83%) prescriptions and 93 (87%) medicines. 47 (38%) of these excipients were classified as potentially or known to be harmful to neonates. Most neonates (97%) received at least one medicine (median number 2) with potentially or known to be harmful excipient. Parabens were the most commonly used known to be harmful excipients and sodium metabisulphite the most commonly used potentially harmful excipient, received by 343 (99%) and 297 (85%) of treated neonates, respectively. Conclusions Hospitalised neonates in Estonia are commonly receiving a wide range of excipients with their medication. Quantitative information about excipients should be made available to pharmacists and neonatologists helping them to take into account excipient issues when selecting medicines and to monitor for adverse effects if administration of medicines containing excipients is unavoidable. PMID:22931304

Characteristics of Self-Harm Behaviour among Identified Self-Harming Youth in Care

ERIC Educational Resources Information Center

Grenville, Jeffrey; Goodman, Deborah; Macpherson, Alison K.

2012-01-01

The objective of this study was to describe deliberate self-harming (DSH) characteristics in a child-welfare population identified as having threatened or completed self-harm. Secondary data from 621 serious occurrence reports (SOR) that documented 2004-2007 DSH incidents and DSH threats with 252 Canadian youth in care (Y-INC) of the Children's…

Harm is all you need? Best interests and disputes about parental decision-making.

PubMed

Birchley, Giles

2016-02-01

A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema's seminal paper as an example, this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on 'substandard' parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Making the cut: The production of 'self-harm' in post-1945 Anglo-Saxon psychiatry.

PubMed

Millard, Chris

2013-04-01

'Deliberate self-harm', 'self-mutilation' and 'self-injury' are just some of the terms used to describe one of the most prominent issues in British mental health policy in recent years. This article demonstrates that contemporary literature on 'self-harm' produces this phenomenon (to varying extents) around two key characteristics. First, this behaviour is predominantly performed by those identified as female. Second, this behaviour primarily involves cutting the skin. These constitutive characteristics are traced back to a corpus of literature produced in the 1960s and 1970s in North American psychiatric inpatient institutions; analysis shows how pre-1960 works were substantially different. Finally, these gendered and behavioural assertions are shown to be the result of historically specific processes of exclusion and emphasis.

Online E-cigarette Marketing Claims: A Systematic Content and Legal Analysis.

PubMed

Klein, Elizabeth G; Berman, Micah; Hemmerich, Natalie; Carlson, Cristen; Htut, SuSandi; Slater, Michael

2016-07-01

Electronic nicotine delivery systems (ENDS), or e-cigarettes, are heavily marketed online. The purpose of our study was to perform a systematic identification and evaluation of claims made within ENDS retailer and manufacturer websites, and the legal status of such claims. We employed a systematic search protocol with popular search engines using 6 terms: (1) e-cigarettes; (2) e-cigs; (3) e-juice; (4) e-liquid; (5) e-hookah; and (6) vape pen. We analyzed English-language websites where ENDS are sold for implicit and explicit health-related claims. A legal analysis determined whether such claims are permissible under the US Food and Drug Administration's regulations. The vast majority of ENDS manufacturer (N = 78) and retailer (N = 32) websites made at least one health-related claim (77% and 65%, respectively). Modified risk claims and secondhand smoke-related claims were most prevalent, with an average of 2 claims per site. Health-related claims are plentiful within ENDS manufacturer and retailer websites. Results demonstrate that these sites focus on potential benefits while minimizing or eliminating information about possible harmful effects of ENDS. These claims are subject to the current regulatory authority by the FDA, and pose a risk of misinforming consumers.

Over-the-Counter and Out-of-Control: Legal Strategies to Protect Youths From Abusing Products for Weight Control

PubMed Central

Taylor, Lisa M.; Austin, S. Bryn

2013-01-01

Abuse of widely available, over-the-counter drugs and supplements such as laxatives and diet pills for weight control by youths is well documented in the epidemiological literature. Many such products are not medically recommended for healthy weight control or are especially susceptible to abuse, and their misuse can result in serious health consequences. We analyzed the government’s role in regulating these products to protect public health. We examined federal and state regulatory authority, and referred to international examples to inform our analysis. Several legal interventions are indicated to protect youths, including increased warnings and restrictions on access through behind-the-counter placement or age verification. We suggest future directions for governments internationally to address this pervasive public health problem. PMID:23237149

The Legal Assistant.

ERIC Educational Resources Information Center

Steely, Robert D.

Following a review of the history of the legal assistant profession and the present status of legal assistant education, this document reports a study of the need for a legal assistant program at Kellogg Community College (KCC). A survey questionnaire was distributed to 106 private attorneys, financial institutions, businesses and industries,…

Civil Legal Services and Medical-Legal Partnerships Needed by the Homeless Population: A National Survey.

PubMed

Tsai, Jack; Jenkins, Darlene; Lawton, Ellen

2017-03-01

To examine civil legal needs among people experiencing homelessness and the extent to which medical-legal partnerships exist in homeless service sites, which promote the integration of civil legal aid professionals into health care settings. We surveyed a national sample of 48 homeless service sites across 26 states in November 2015. The survey asked about needs, attitudes, and practices related to civil legal issues, including medical-legal partnerships. More than 90% of the homeless service sites reported that their patients experienced at least 1 civil legal issue, particularly around housing, employment, health insurance, and disability benefits. However, only half of all sites reported screening patients for civil legal issues, and only 10% had a medical-legal partnership. The large majority of sites reported interest in receiving training on screening for civil legal issues and developing medical-legal partnerships. There is great need and potential to deploy civil legal services in health settings to serve unstably housed populations. Training homeless service providers how to screen for civil legal issues and how to develop medical-legal partnerships would better equip them to provide comprehensive care.

Will growth in cryptomarket drug buying increase the harms of illicit drugs?

PubMed Central

Stevens, Alex; Barratt, Monica J.

2017-01-01

Abstract Background and aim Cryptomarkets—on‐line, anonymous market‐places for illicit goods and services that specialize mainly in drugs—account for a small but rapidly growing share of the illicit drug market in many countries. Policy responses so far are based generally on the assumption that their rise will only increase drug harms. In this contribution for debate, we question this assumption. Methods We provide a narrative review of the emerging literature connected to drug cryptomarkets. We use MacCoun & Reuter's formula to understand the effect of population‐level increases in use on total harm as depending on the level of harm associated with each unit of use. We then consider the potential for cryptomarkets to increase or decrease the harms and benefits related to each unit of drug use, with specific attention to the quality of drugs sold and the non‐drug‐related harms and benefits for customers. Results It is likely that cryptomarkets will increase both the amount and the range of substances that are sold. However, we argue that the effects on harms will depend upon whether cryptomarkets also increase the quality and safety of products that are sold, provide harm‐reducing information to consumers and reduce transactional conflict involved in drug purchasing. Conclusions There is an emerging and rapidly growing evidence base connected to the macro and micro harms and benefits of cryptomarkets for drug users. Future researchers should use appropriately matched comparative designs to establish more firmly the differential harms and benefits of sourcing drugs both on‐ and off‐line. While it is unlikely that the on‐line drug trade can be eradicated completely, cryptomarkets will respond to regulation and enforcement in ways that have complex, and sometimes unanticipated, effects on both harms and benefits. PMID:28766792

Dementia and legal competency.

PubMed

Filaković, Pavo; Erić, Anamarija Petek; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven

2011-06-01

The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task

Anti-legal attitude toward abortion among abortion patients in the United States.

PubMed

Thomas, Rachel G; Norris, Alison H; Gallo, Maria F

2017-11-01

To measure the prevalence of believing that abortion should be illegal in all or most cases among women obtaining an abortion in the United States and to identify correlates of holding this belief. Study population was drawn from the nationally-representative 2008 Abortion Patient Survey. The primary outcome was having an anti-legal abortion attitude, defined as agreeing that abortion should be illegal in all or most cases. We assessed potential correlates in bivariable and multivariable analyses using weights to account for the complex sampling. A total of 4769 abortion patients completed the survey module containing the question on abortion legality, of which 4492 (94.2%) had non-missing data for the outcome. Overall, 4.1% of patients (N=183) reported an anti-legal abortion attitude. Correlates of having anti-legal attitude included being married, at <200% federal poverty level, fundamentalist, contraception non-use, no abortion history, perceiving the pregnancy with ambivalence or as unintended, and using misoprostol or another product on their own to bring back their period or end the pregnancy. Abortion patients who do not believe abortion should be legal appear to differ substantially from women who are more supportive of legality. Findings raise important questions about this subset of patients, including whether possible discordance between patient beliefs and behavior could influence their use of medical abortion or other products. Some abortion patients do not agree with abortion legality, and this subset could experience a degree of cognitive dissonance, which could influence the method by which they seek to abort. Copyright © 2017 Elsevier Inc. All rights reserved.

Why "do no harm"?

PubMed

Sharpe, V A

1997-01-01

Edmund Pellegrino has argued that the dramatic changes in American health care call for critical reflection on the traditional norms governing the therapeutic relationship. This paper offers such reflection on the obligation to "do no harm." Drawing on work by Beauchamp and Childress and Pellegrino and Thomasma, I argue that the libertarian model of medical ethics offered by Engelhardt cannot adequately sustain an obligation to "do no harm." Because the obligation to "do no harm" is not based simply on a negative duty of nonmaleficence but also on a positive duty of beneficence, I argue that it is best understood to derive from the fiduciary nature of the healing relationship.

[Current cases of falsified medicinal products within the competence of the Federal Institute for Drugs and Medical Devices (BfArM) : Case studies and extent].

PubMed

Wittstock, Marcus; Paeschke, Norbert

2017-11-01

The nature of a falsification of a medicinal product can vary a lot. Therefore the means to detect them and the potential risk to patient safety can also be very different. The whole range of falsification will be described using observed cases from the Federal Institute for Drugs and Medical Devices (BfArM).Based on the relatively low number of detected cases of falsified medicines, the legal supply chain can still be regarded as safe. It has to be assumed that in the illegal supply chain, e. g. illegal internet trade, the majority of the offered medicinal products are not only falsifications due to illegal trade but because they are completely falsified. Therefore there is an especially high risk for the consumer to be harmed by medicinal products that do not fulfil the required specifications.The trend indicates that increased efforts will be necessary to keep the legal supply chain safe and to contain illegal trade with falsifications. The higher federal authorities BfArM, PEI and BVL are involved in this task by coordinating and ensuring the flow of information to the concerned authorities and stakeholders as well as informing the public. Increased efforts are also necessary due to the rising involvement of organised crime in the falsification of medicinal products. A package of measures was enacted with the Falsified Medicines Directive 2011/62/EU to protect the legal supply chain from falsified medicinal products.

Alcohol and alcohol-related harm in China: policy changes needed

PubMed Central

Tang, Yi-lang; Xiang, Xiao-jun; Wang, Xu-yi; Cubells, Joseph F; Babor, Thomas F

2013-01-01

Abstract In China, alcohol consumption is increasing faster than anywhere else in the world. A steady increase in alcohol production has also been observed in the country, together with a rise in alcohol-related harm. Despite these trends, China’s policies on the sale and consumption of alcoholic beverages are weak compared with those of other countries in Asia. Weakest of all are its policies on taxation, drink driving laws, alcohol sale to minors and marketing licenses. The authors of this descriptive paper draw attention to the urgent need for public health professionals and government officials in China to prioritize population surveillance, research and interventions designed to reduce alcohol use disorders. They describe China’s current alcohol policies and recent trends in alcohol-related harm and highlight the need for health officials to conduct a thorough policy review from a public health perspective, using as a model the World Health Organization’s global strategy to reduce the harmful use of alcohol. PMID:23599550

Helping Self-Harming Students

ERIC Educational Resources Information Center

Selekman, Matthew D.

2009-01-01

Approximately 14 to 17 percent of adolescents today self-harm, deliberately cutting, burning, or bruising themselves. Most self-harming adolescents use the behavior as a coping strategy to get immediate relief from emotional distress or other stressors in their lives. Stressors include fitting in with peers, activity and homework overload, fears…

Legal requirements for human-health based appeals of wind energy projects in ontario.

PubMed

Engel, Albert M

2014-01-01

In 2009, the government of the province of Ontario, Canada passed new legislation to promote the development of renewable energy facilities, including wind energy facilities in the province. Throughout the legislative process, concerns were raised with respect to the effect of wind energy facilities on human health. Ultimately, the government established setbacks and sound level limits for wind energy facilities and provided Ontario residents with the right to appeal the approval of a wind energy facility on the ground that engaging in the facility in accordance with its approval will cause serious harm to human health. The first approval of a wind facility under the new legislation was issued in 2010 and since then, Ontario's Environmental Review Tribunal as well as Ontario's courts has been considering evidence proffered by appellants seeking revocation of approvals on the basis of serious harm to human health. To date, the evidence has been insufficient to support the revocation of a wind facility approval. This article reviews the legal basis for the dismissal of human-health based appeals.

Reefer madness or much ado about nothing? Cannabis legalization outcomes among young adults in the United States.

PubMed

Parnes, Jamie E; Smith, Joey K; Conner, Bradley T

2018-06-01

In 2012, Colorado became one of the first two U.S. States to legalize cannabis for recreational use for adults 21 and older. Given that cannabis use holds potential physical and mental health risks, particularly among adolescent users, concerns have grown regarding changes in use following this change in policy. Studies examining medical cannabis legalization have found inconsistent changes in cannabis use and prevalence of dependence following medical implementation. However, recreational legalization holds potential unique changes, such as increased availability and social acceptance, as well as decreased price and perceived harm of use. There also may be increased interest in moving to Colorado related to the changes in cannabis laws. Based on past literature, two hypotheses were made for this study. First, college student cannabis use would increase after recreational legalization, however just for those 21 years old and older. Second, there would be a positive relation between the influence of cannabis legislation on out-of-State student's decision to attend a Colorado university and their cannabis use. Data from 5241 undergraduate students was available to test study hypotheses using Pearson's Chi-square, negative binomial regressions, and path analysis. Results indicated that cannabis use increased since recreational legalization for all students, but more so for those over 21 years. No differences in past month use frequency were found between pre- and post-legalization. Influence of cannabis laws on non-resident student's decision to attend a Colorado college predicted lifetime and past 30-day use. Additionally, out-of-State students reported higher past 30-day use than in-State students. These findings may help inform other States considering recreational legalization of potential outcomes, as well as potential interventions. Copyright © 2018 Elsevier B.V. All rights reserved.

Legal Care as Part of Health Care: The Benefits of Medical-Legal Partnership.

PubMed

Murphy, Johnna S; Lawton, Ellen M; Sandel, Megan

2015-10-01

Many of the social determinants of health are rooted in legal problems. Medical-legal partnerships (MLPs) have the potential to positively change clinical systems. This change can be accomplished by integrating legal staff into health care clinics to educate staff and residents on social determinants of health and their legal origins. When the MLP team works directly with patients to identify and address legal needs that improve health outcomes, and incorporate legal insights and solutions into health care practice where the patient population is overwhelmingly impacted by social conditions, outcomes are beneficial to children and families. Copyright © 2015 Elsevier Inc. All rights reserved.

Constitutionally-Legal Policy as Base Type of Legal Policy of Russia

ERIC Educational Resources Information Center

Anichkin, Eugene S.

2016-01-01

The article deals with reasons for formation, nature and specifics of the constitutionally legal policy of modern Russia. The special attention is spared to the exposure of the aim, long-term and short-term tasks, and principles of national constitutionally legal policy. The functions of constitutionally legal policy are separately considered:…

Department of Legal Services

Science.gov Websites

The Department of Legal Services ("DLS") is a dependency of the Secretariat for Legal Affairs of the OAS General Secretariat. www.oas.org/en/sla DLS provides legal advice on: interpretation of Secretariat for Legal Affairs Inter-American Commission on Human Rights Inter-American Court of Human Rights

Analysis - what is legal medicine?

PubMed

Beran, Roy G

2008-04-01

Legal medicine addresses the interface between medicine and law in health care. The Australian College of Legal Medicine (ACLM) established itself as the peak body in legal and forensic medicine in Australia. It helped establish the Expert Witness Institute of Australia (EWIA), the legal medicine programme at Griffith University and contributes to government enquiries. Public health, disability assessment, competing priorities of privacy verses notification and determination of fitness for a host of pursuits are aspects of legal medicine. Complementing the EWIA, the ACLM runs training programmes emphasising legal medicine skills additional to clinical practice, advocating clinical relevance. Assessment of athletes' fitness and ensuring that prohibited substances are not inadvertently prescribed represent a growing area of legal medicine. Ethical consideration of health care should respect legal medicine principles rather than armchair commentary. International conventions must be respected by legal medicine and dictate physicians' obligations. The NSW courts imposed a duty to provide emergency medical care. Migration and communicable diseases are aspects of legal medicine. Police surgeons provide a face to legal medicine (which incorporates forensic medicine) underpinning its public perception of specialty recognition. Legal medicine deserves its place as a medical specialty in its own right.

Legal History Meets the Honors Program

ERIC Educational Resources Information Center

Bennett, Robert B., Jr.

2009-01-01

In this article, the author discusses the "Law and Culture" course that he developed to teach in the Butler University Honors Program. The course looks at some landmark periods or events in legal history and explores how those events were the product of their culture, and how they affected their culture. Among the events or periods that the author…

Changing Perceptions of Harm of E-Cigarettes Among U.S. Adults, 2012– 2015

PubMed Central

Majeed, Ban A.; Weaver, Scott R.; Gregory, Kyle R.; Whitney, Carrie F.; Slovic, Paul; Pechacek, Terry F.; Eriksen, Michael P.

2016-01-01

Introduction Although the impact of long-term use of electronic cigarettes (e-cigarettes) on health is still unknown, current scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes. The study examined whether perceived relative harm of e-cigarettes and perceived addictiveness have changed during 2012–2015 among U.S. adults. Methods Data were from Tobacco Products and Risk Perceptions surveys of probability samples representative of U.S. adults in 2012, 2014, and 2015. Changes over time in perceived harmfulness of e-cigarettes were examined using pairwise comparisons of proportions and multinomial logistic regression analysis. Analyses were conducted in January 2016. Results Whereas 11.5% and 1.3% of adults perceived e-cigarettes to have about the same level of harm and to be more harmful than cigarettes, respectively, in 2012, 35.7% and 4.1% did so in 2015. The proportion of adults who thought e-cigarettes were addictive more than doubled during 2012–2015 (32.0% in 2012 vs 67.6% in 2015). Compared with 2012, the odds of perceiving e-cigarettes to be equally or more harmful (than to be less harmful) doubled (95% CI=1.64, 2.41) in 2014, and tripled (95% CI=2.60, 3.81) in 2015. Conclusions There is an increase in the proportion of U.S. adults who misperceive the harm of e-cigarettes and consider them to be as harmful as combustible cigarettes. The study highlights the need to design public health messages that accurately interpret the scientific data on the potential harm of e-cigarettes and clearly differentiate the absolute from the relative harm of e-cigarettes. PMID:28341303

Is prostitution harmful?

PubMed

Moen, Ole Martin

2014-02-01

A common argument against prostitution states that selling sex is harmful because it involves selling something deeply personal and emotional. More and more of us, however, believe that sexual encounters need not be deeply personal and emotional in order to be acceptable--we believe in the acceptability of casual sex. In this paper I argue that if casual sex is acceptable, then we have few or no reasons to reject prostitution. I do so by first examining nine influential arguments to the contrary. These arguments purport to pin down the alleged additional harm brought about by prostitution (compared to just casual sex) by appealing to various aspects of its practice, such as its psychology, physiology, economics and social meaning. For each argument I explain why it is unconvincing. I then weight the costs against the benefits of prostitution, and argue that, in sum, prostitution is no more harmful than a long line of occupations that we commonly accept without hesitation.

Is there any legal and scientific basis for classifying electronic cigarettes as medications?

PubMed

Farsalinos, Konstantinos E; Stimson, Gerry V

2014-05-01

The rapid growth in the use of electronic cigarettes has been accompanied by substantial discussions by governments, international organisations, consumers and public health experts about how they might be regulated. In the European Union they are currently regulated under consumer legislation but new legislation will regulate them under the Tobacco Products Directive. However, several countries have sought to regulate them under medicines regulations. These claims have been successfully challenged in 6 court cases in European states. Under European legislation a product may be deemed to be a medicine by function if it is used in or administered to human beings either with a view to restoring, correcting or modifying physiological functions by exerting a pharmacological, immunological or metabolic action, or to making a medical diagnosis. It is a medicine by presentation if it is presented (e.g. by a manufacturer or distributor) as having properties for treating or preventing disease in human beings. We assess the legal and scientific basis for the claim that electronic cigarettes should be regulated as medicines. We conclude that they are neither medicine by function nor necessarily by presentation The main reason for their existence is as a harm reduction product in which the liking for and/or dependence on nicotine is maintained, and adoption of use is as a substitute for smoking and not as a smoking cessation product. In reality, they are used as consumer products providing pleasure to the user. They are not used to treat nicotine addiction or other disease, but to enable continued use of nicotine. Their use is adjusted individually by each consumer according to his or her perceived pleasure and satisfaction. Gaps in current regulation regarding safety and quality can be met by tailored regulations. Copyright © 2014 Elsevier B.V. All rights reserved.

Residential staff responses to adolescent self-harm: The helpful and unhelpful.

PubMed

Johnson, Dan R; Ferguson, Kirstin; Copley, Jennifer

2017-07-01

Adolescent self-harm is prevalent in residential and secure care and is the cause of distress to those harming themselves, to the staff caring for them and for other young people living with them. This article sought service user views on what staff supports were effective and what were counter-productive in order to improve the care offered to young people. Seven young people living in residential or secure care were interviewed. Thematic analysis was used to elicit key themes. Global themes of safety and care were elicited. The young people understood and accepted that the role of staff was to provide these. Within these themes, they noted numerous responses that had both helpful and unhelpful effects, including increased observation, removal of means and extra collaborative support. Service users made numerous recommendations to increase the helpful effects of staff support. Young people provided informed and helpful guidance on how best to care for them. Their views can help mental health professionals and care staff increase their helpful responses making them more effective and less counter-productive. This study is a rare representation of the views of young people in residential and secure care and how to respond to their self-harm behaviour.

Public Perceptions of Self-Harm: Perceived Motivations of (and Willingness to Help in Response to) Adolescent Self-Harm.

PubMed

Nielsen, Emma; Townsend, Ellen

2018-01-01

We investigated public perceptions of, and responses to, adolescent self-harm-an under-researched topic, given that the majority of self-harm in this group is not disclosed to formal support services. Participants (N = 355, aged 18-67 years) were presented with 1 of 10 vignettes and completed self-report measures assessing perceived motivations for self-harm and helping/rejecting responses. Vignettes were manipulated across conditions for stated motivation, controllability of stated cause, and presentation format. Results indicate that stated motivation for self-harm, controllability of stated cause, and presentation format affect perceived motivations. Further, participants demonstrate an understanding of the complex nature of self-harm, indicating an appreciation that an individual may hold multiple motivations simultaneously. Perceived motivations for self-harm are associated with the endorsement of helping/rejecting behaviors. These relationships are important to explore, given the critical importance of initial responses to self-harm on subsequent disclosures and help-seeking.

Self-harm in young offenders.

PubMed

Borschmann, Rohan; Coffey, Carolyn; Moran, Paul; Hearps, Stephen; Degenhardt, Louisa; Kinner, Stuart A; Patton, George

2014-12-01

The prevalence and correlates of self-harm and suicidal behavior in 515 young offenders (mean age 17.3 years, SD = 1.7) serving community-based orders (CBOs; n = 242) or custodial sentences (n = 273) in Victoria, Australia, are described. Results from structured interviews showed that 83 (16.1%) participants reported self-harming in the previous 6 months, and this was more common among those serving custodial sentences than those serving CBOs (19.4% vs. 12.4%; OR 3.10, 95% CI: 1.74-5.55). Multiple incidents were more common in females and 24% (95% CI: 19-39) of participants who had self-harmed reported having done so with suicidal intent. Self-harm was associated with recent bullying victimization, expulsion from school, past year violent victimization, cannabis dependence, and risk-taking behavior in the preceding year. The epidemiological profile of self-harm in this population appears to be distinct from that seen in the general population. Young offenders who self-harm are a vulnerable group with high rates of psychiatric morbidity, substance misuse problems, and social risk factors. They may benefit from targeted psychological interventions designed specifically to address impulsivity, delivered both within-and during the transition from-the youth justice system. © 2014 The American Association of Suicidology.

Legal Services: Judge Advocate Legal Services

DTIC Science & Technology

1996-09-30

14–14, page 41 Publicity • 14–15, page 41 Insignia • 14–16, page 41 Chapter 15 Contract Law Attorneys, page 43 General • 15–1, page 43 General...Duties • 15–2, page 43 Management • 15–3, page 43 Principles of contract law practice • 15–4, page 43 Contract disputes and litigation support • 15–5...legal matters; and (2) Resolving their personal legal problems whenever possible. m. Contract law responsibilities. TJAG will provide— (1) Technical

Substance Use and Self-Harm: Case Studies From Patients Admitted to an Urban Hospital Following Medically Serious Self-Harm.

PubMed

Breet, Elsie; Bantjes, Jason

2017-12-01

Few qualitative studies have explored the relationship between substance use and self-harm. We employed a multiple-case study research design to analyze data from 80 patients who were admitted to a hospital in South Africa following self-harm. Our analysis revealed, from the perspective of patients, a number of distinct ways in which substance use is implicated in self-harm. Some patients reported that substance intoxication resulted in poor decision making and impulsivity, which led to self-harm. Others said substance use facilitated their self-harm. Some participants detailed how in the past their chronic substance use had served an adaptive function helping them to cope with distress, but more recently, this coping mechanism had failed which precipitated their self-harm. Some participants reported that substance use by someone else triggered their self-harm. Findings suggest that there are multiple pathways and a host of variables which mediate the relationship between substance use and self-harm.

Planetary protection - some legal questions

NASA Astrophysics Data System (ADS)

Fasan, E.

When we legally investigate the topic of Planetary Protection, we have to realise that there are primarily two very distinct parts of our juridical work: We have to study lex lata, the existing applicable Law, especially Space Law, and also lex ferenda, what should be the law. With this in mind, we have to deliberate the legal meaning of "Planetary", and of "Protection". About "Planetary": Our own Earth is the most important planet. At present only here do exist human beings, who are sensu strictu the only legal subjects. We make the law, we have to apply it, and we are to be protected as well as bound by it. Then, we have to discuss what is further meant by "Planetary": Is it planets in an astronomical sense only, the nine planets which revolve around our fixed star, namely the sun, or is it also satellites, moving around most of these planets, as our own Moon circles Earth. "The Moon and other Celestial Bodies (C.B)" are subject to Space Law, especially to International Treaties, Agreements, Resolutions of the UN etc. I propose that they and not only the planets in an strictly astronomical sense are to be protected. But I do not think that the said notion also comprises asteroids, comets, meteorites etc. although they too belong to our solar system. Our investigation comes to the result that such bodies have a different (lesser) legal quality. Also we have to ask Protection from what? From: Natural bodies - Meteorites, NEO Asteroids, Comets which could hit Earth or C.B. Artificial Objects: Space Debris threatening especially Earth and near Earth orbits. Terrestrial Life - no infection of other celestial bodies. Alien life forms which could bring about "harmful contamination" of Earth and the life, above all human life, there etc. Here, astrobiological questions have to be discussed. Special realms on C.B. which should be protected from Electronic "Noise" such as craters SAHA or Deadalus on the Moon, also taking into account the "Common Heritage" Principle. Then

Medico legal issues.

PubMed

Mackenzie, Geraldine; Carter, Hugh

2010-01-01

This chapter gives an educational overview of: * An awareness of the legal issues involved in health informatics * The need for the privacy and security of the patient record * The legal consequences of a breach of the security of the patient record * The concept of privacy law and what precautions ought to be taken to minimize legal liability for a breach of privacy and/or confidentiality.

HTA and its legal issues: a framework for identifying legal issues in health technology assessment.

PubMed

Widrig, Daniel; Tag, Brigitte

2014-12-01

Legal analysis can highlight important issues that are relevant when deciding whether a medical technology should be implemented or reimbursed. Literature and studies show that even though the law is an acknowledged part of health technology assessment (HTA), legal issues are rarely considered in practice. One reason for this may be the lack of knowledge about the diversity of legal issues that are relevant for HTA. Therefore, this contribution aims primarily to identify and then explain the relevant legal issues in HTA. This study offers a framework for identifying the legal issues in HTAs in different jurisdictions and provides a basis for further research. After extensive literature search, the authors review Swiss health law to identify legal issues that are relevant to HTA. The authors then categorize these legal issues using a framework with an inside and outside perspective. Finally, they explain a selection of these legal issues with several examples. This study reveals numerous legal issues that are relevant for HTA and underlines the necessity of incorporating legal analysis in HTAs. The suggested perspectival framework in this study provides a basis to structure the legal analysis. The identified legal issues are relevant in other countries and the perspectival framework is transferable to other jurisdictions. The article underlines the importance of in-depth discussion about the role of law in HTA. It provides a structured overview of the legal issues in HTA and suggests a development of more concrete instruments toward a standardized legal technology assessment.

Policy designs for cannabis legalization: starting with the eight Ps.

PubMed

Kilmer, Beau

2014-07-01

The cannabis policy landscape is changing rapidly. In November 2012 voters in Colorado and Washington State passed ballot initiatives to remove the prohibition on the commercial production, distribution, and possession of cannabis. This paper does not address the question of whether cannabis should be legal; it instead focuses on the design considerations confronting jurisdictions that are pondering a change in cannabis policy. Indeed, whether or not cannabis legalization is net positive or negative for public health and public safety largely depends on regulatory decisions and how they are implemented. This essay presents eight of these design choices which all conveniently begin with the letter "P": production, profit motive, promotion, prevention, potency, purity, price, and permanency.

German law on circumcision and its debate: how an ethical and legal issue turned political.

PubMed

Aurenque, Diana; Wiesing, Urban

2015-03-01

The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the 'child as a child' and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany's unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues - as in the case of religious circumcision. © 2013 John Wiley & Sons Ltd.

[Ethical and legal implications of the determination of blood alcohol content in the emergency department].

PubMed

Real de Asúa, Diego; González-Cajal, Jesús

2012-01-01

Alcohol is the most widely consumed toxic in Spain. Excessive alcohol intake is responsible for a significant number of visits to emergency departments (EDs), and what occurs may not only have severe medical consequences, but also serious legal implications. Most Spanish EDs lack specific protocols concerning the correct determination of blood alcohol content (BAC). The present work aims to review the technical, ethical and legal problems surrounding this test. Since ethanol is metabolized in peripheral blood, blood extraction should be standardized in order to preserve the proper chain of custody. An emergency test for BAC should be performed in two scenarios: patients with an altered level of consciousness of unknown origin (when health-care professionals act for the good of the patient), and situations which may be penalized by law (when health-care professionals act for the good of the community). The latter would include traffic controls and traffic accidents, job-related accidents, criminal activities or harmful domestic behaviour. Health-care professionals are responsible for treating patients' clinical information with due respect and confidentiality. However, professional secrecy may be overridden by legal imperative in certain situations. It is necessary to promote conscious ethical decision-taking by the health-care professional, so that this responsibility does not solely depend on the juridical context.

[Marketability of food supplements - criteria for the legal assessment].

PubMed

Breitweg-Lehmann, Evelyn

2017-03-01

To be placed on the market legally, food supplements have to meet national and European food law regulations. This is true for all substances used as well as for the labeling on the packaging of and the advertising for food supplements. The food business operator is responsible for its compliance with all regulations. Therefore, in this article, a concise step-by-step assessment is presented, covering all necessary legal requirements to market food supplements. Additionally, all steps are visualized in a flow chart. All vitamins, minerals and other substances used have to meet the legal conditions. Food business operators have to make sure that their products do not contain medicinal ingredients based on their pharmacologic effect. It is prohibited to place medicinal products as food supplements on the market. Furthermore, food business operators have to make sure that their products are not non-authorized novel foods according to the novel food regulation (EC) no. 258/97. Also, food supplements have to meet the requirements of article 14 of Regulation (EC) No. 178/2002 concerning the safety of foodstuff. Food shall not be placed on the market if it is unsafe. For food supplements that fail the German food-related legal standards but are legally manufactured in another EU member state or are legally put into circulation, the importer requires the so-called general disposition, which must be applied for at the BVL according to § 54 of the German Food and Feed Act. Another possibility for food which fails to meet German food law is to apply for a certificate of exemption according to § 68 of the Food and Feed Act. The food business operator has to meet the harmonized regulations concerning maximum and minimum levels of additives, flavors and enzymes. The packaging has to meet the compulsory labeling as well the voluntary labeling, like health claims. The BVL is also the relevant authority for other tasks concerning food supplements. A figure shows all

A fresh look at tobacco harm reduction: the case for the electronic cigarette

PubMed Central

2013-01-01

Smokers of any age can reap substantial health benefits by quitting. In fact, no other single public health effort is likely to achieve a benefit comparable to large-scale smoking cessation. Surveys document that most smokers would like to quit, and many have made repeated efforts to do so. However, conventional smoking cessation approaches require nicotine addicted smokers to abstain from tobacco and nicotine entirely. Many smokers are unable – or at least unwilling – to achieve this goal, and so they continue smoking in the face of impending adverse health consequences. In effect, the status quo in smoking cessation presents smokers with just two unpleasant alternatives: quit or suffer the harmful effects of continuing smoking. But, there is a third choice for smokers: tobacco harm reduction. It involves the use of alternative sources of nicotine, including modern smokeless tobacco products like snus and the electronic cigarette (E-cig), or even pharmaceutical nicotine products, as a replacement for smoking. E-cigs might be the most promising product for tobacco harm reduction to date, because, besides delivering nicotine vapour without the combustion products that are responsible for nearly all of smoking’s damaging effect, they also replace some of the rituals associated with smoking behaviour. Thus it is likely that smokers who switch to E-cigs will achieve large health gains. The focus of this article is on the health effects of using an E-cig, with consideration given to the acceptability, safety and effectiveness of this product as a long-term substitute for smoking. PMID:24090432

The risks and benefits of disclosing psychotherapy records to the legal system: What psychologists and patients need to know for informed consent.

PubMed

Borkosky, Bruce; Smith, Deirdre M

2015-01-01

When psychologists release patient records to the legal system, the typical practice is to obtain the patient's signature on a consent form, but rarely is a formal informed-consent obtained from the patient. Although psychologists are legally and ethically required to obtain informed consent for all services (including disclosure of records), there are a number of barriers to obtaining truly informed consent. Furthermore, compared to disclosures to nonlegal third parties, there are significantly greater risks when records are disclosed to the legal system. For these reasons, true informed consent should be obtained from the patient when records are disclosed to the legal system. A model for informed consent is proposed. This procedure should include a description of risks and benefits of disclosing or refusing to disclose by the psychotherapist, an opportunity to ask questions, and indication by the patient of a freely made choice. Both psychotherapist and patient share decision making responsibilities in our suggested model. The patient should be informed about potential harm to the therapeutic relationship, if applicable. Several recommendations for practice are described, including appropriate communications with attorneys and the legal system. A sample form, for use by psychotherapists, is included. Copyright © 2015 Elsevier Ltd. All rights reserved.

Is Personality Associated with Secondhand Harm from Drinking?

PubMed

Davis MacNevin, Parnell; Thompson, Kara; Teehan, Michael; Stuart, Heather; Stewart, Sherry

2017-09-01

Prior research suggests more than 70% of undergraduates have experienced harm from other students' drinking. This study built on the literature by, first, investigating whether secondhand harm cluster into latent factors that reflect distinct but related types of harm. Second, given the paucity of research examining factors that increase students' vulnerability to secondhand harm, we examined dimensions from Castellanos-Ryan and Conrod's 4-factor personality model for alcohol disorders (impulsivity [IMP], sensation seeking [SS], hopelessness [HOP], anxiety sensitivity [AS]) as predictors of secondhand harm exposure. We also investigated the possible mediating role of students' own problematic alcohol use in explaining personality-secondhand harm relationships. An online survey was administered to 1,537 first-year Canadian undergraduates (68% women). Problematic alcohol use was measured by the Alcohol Use Disorders Identification Test, and personality was measured by the Substance Use Risk Profile Scale. Eleven secondhand harm items were included. The secondhand harm clustered into 3 distinct but related factors: "strains" (e.g., interruption of sleep or study), "threats" (e.g., harassment or assault), and "interpersonal harm" (e.g., arguments with peers). Sixty-eight percent of respondents reported strains, 44% threats, and 64% interpersonal harm, and 35% reported experiencing all 3 types of harm, in the last term. All 4 personality dimensions were independently associated with greater secondhand harm exposure. HOP was directly associated with threats and interpersonal harm, and AS was directly associated with all 3 types of harm. SS and IMP were both indirectly associated with all 3 types of harm through students' own problematic alcohol use. In addition, IMP was directly related to threats. The prevalence of secondhand harm from alcohol is high among undergraduates. Findings suggest that distinct personality risks may predispose students to experience secondhand

Uncovering key patterns in self-harm in adolescents: Sequence analysis using the Card Sort Task for Self-harm (CaTS).

PubMed

Townsend, E; Wadman, R; Sayal, K; Armstrong, M; Harroe, C; Majumder, P; Vostanis, P; Clarke, D

2016-12-01

Self-harm is a significant clinical issue in adolescence. There is little research on the interplay of key factors in the months, weeks, days and hours leading to self-harm. We developed the Card Sort Task for Self-harm (CaTS) to investigate the pattern of thoughts, feelings, events and behaviours leading to self-harm. Forty-five young people (aged 13-21 years) with recent repeated self-harm completed the CaTS to describe their first ever/most recent self-harm episode. Lag sequential analysis determined significant transitions in factors leading to self-harm (presented in state transition diagrams). A significant sequential structure to the card sequences produced was observed demonstrating similarities and important differences in antecedents to first and most recent self-harm. Life-events were distal in the self-harm pathway and more heterogeneous. Of significant clinical concern was that the wish to die and hopelessness emerged as important antecedents in the most recent episode. First ever self-harm was associated with feeling better afterward, but this disappeared for the most recent episode. Larger sample sizes are necessary to examine longer chains of sequences and differences in genders, age and type of self-harm. The sample was self-selected with 53% having experience of living in care. The CaTs offers a systematic approach to understanding the dynamic interplay of factors that lead to self-harm in young people. It offers a method to target key points for intervention in the self-harm pathway. Crucially the factors most proximal to self-harm (negative emotions, impulsivity and access to means) are modifiable with existing clinical interventions. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Deliberate self-harm in adolescents

PubMed Central

Lauw, Michelle; How, Choon How; Loh, Cheryl

2015-01-01

Deliberate self-harm refers to an intentional act of causing physical injury to oneself without wanting to die. It is frequently encountered in adolescents who have mental health problems. Primary care physicians play an important role in the early detection and timely intervention of deliberate self-harm in adolescents. This article aims to outline the associated risk factors and possible aetiologies of deliberate self-harm in adolescents, as well as provide suggestions for clinical assessment and appropriate management within the primary care setting. PMID:26106236

Harm mediates the disgust-immorality link.

PubMed

Schein, Chelsea; Ritter, Ryan S; Gray, Kurt

2016-09-01

Many acts are disgusting, but only some of these acts are immoral. Dyadic morality predicts that disgusting acts should be judged as immoral to the extent that they seem harmful. Consistent with this prediction, 3 studies reveal that perceived harm mediates the link between feelings of disgust and moral condemnation-even for ostensibly harmless "purity" violations. In many cases, accounting for perceived harm completely eliminates the link between disgust and moral condemnation. Analyses also reveal the predictive power of anger and typicality/weirdness in moral judgments of disgusting acts. The mediation of disgust by harm holds across diverse acts including gay marriage, sex acts, and religious blasphemy. Revealing the endogenous presence and moral relevance of harm within disgusting-but-ostensibly harmless acts argues against modular accounts of moral cognition such as moral foundations theory. Instead, these data support pluralistic conceptions of harm and constructionist accounts of morality and emotion. Implications for moral cognition and the concept of "purity" are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Legal restraints of pesticide effect on human organism and environment under international legislation.

PubMed

Pashkov, Vitalii; Batyhina, Olena; Trotska, Maryna

2017-01-01

Human health depends on many factors: a level of medicine, quality of medical preparations, state of the environment, food safety, lifestyle and others. Phytosanitary products including pesticides used by farmers to kill, control reproduction and prevent animal, microbial or plant pests in the cultivation of agricultural products, which are the basis of human food, are one of the factors that may have an unfavourable effect on human health. To analyze provisions of international legislation for presence of effective means to prevent a negative pesticide effect on human health and the environment. International acts, data of international organizations and conclusions of scientists have been examined and used in the study. The article also summarizes information from scientific journals and monographs from a medical and legal point of view with scientific methods. As a part of a systematic approach, issues of the pesticide effect in the course of their use on human health and the environment are analyzed. Based on the undertaken study, it has been found that developed countries take much better care of prevention and reduction of the negative pesticide effect on human health and the environment in the course of their use than developing countries. The pesticide effect has a dual nature. On the one hand, it is positive to ensure efficient development of agriculture, but on the other hand, it is negative that is expressed in potential possibilities of harm to humans and the environment.

[Self-harm in fiction literature].

PubMed

Skårderud, Finn

2009-04-16

European literature contains fictional descriptions of self-harm and self-punishment over a time span of almost 2 500 years. This article presents such descriptions, from Sofocles' tragedy about King Oedipus to contemporary literature. Particular interest is dedicated to the Austrian Nobel prize laureate Elfriede Jelinek and the Norwegian author Karl Ove Knausgård. In Jelinek's fictional universe, self-harm is particularly related to the topic of autonomy in a family context; while Knausgård describes the role of shame in triggering and sustaining self-harming behaviour.

Self-harm and ethnicity: A systematic review.

PubMed

Al-Sharifi, Ali; Krynicki, Carl R; Upthegrove, Rachel

2015-09-01

This review will focus on the rates, clinical characteristics, risk factors and methods of self-harm and suicide in different ethnic groups in the United Kingdom, providing an update synthesis of recent literature. Studies that met the inclusion criteria between 2003 and 2013 were reviewed using the following databases: MEDLINE, PsycINFO, EMBASE and CINAHL. The methodological quality of each study was then assessed using a structured scoring system. A total of 2,362 articles were retrieved, 10 of which matched the inclusion criteria were reviewed. Significant differences were found in the rates of self-harm between ethnic groups with Asian males being least likely to self-harm and Black females being most likely to self-harm. Also, Black and South Asian people were less likely to repeat self-harm. Factors that may help protect or predispose individuals to self-harm or attempt suicide (such as religion, mental health and coping styles) also differ between ethnic groups. There are clear ethnic differences in self-harm and suicide, which may be affected by factors such as cultural pressures and prevalence of mental illness. An awareness of these differences is vital to help prevent further attempts of self-harm and suicide. Further research into differences between ethnic and cultural groups and self-harm continues to be important. © The Author(s) 2015.

Self-harm

MedlinePlus

... have trouble stopping. Examples of self-harm include Cutting yourself (such as using a razor blade, knife, ... them a sense of relief. Some people use cutting as a means to cope with a problem. ...

Fish sound production in the presence of harmful algal blooms in the eastern Gulf of Mexico.

PubMed

Wall, Carrie C; Lembke, Chad; Hu, Chuanmin; Mann, David A

2014-01-01

This paper presents the first known research to examine sound production by fishes during harmful algal blooms (HABs). Most fish sound production is species-specific and repetitive, enabling passive acoustic monitoring to identify the distribution and behavior of soniferous species. Autonomous gliders that collect passive acoustic data and environmental data concurrently can be used to establish the oceanographic conditions surrounding sound-producing organisms. Three passive acoustic glider missions were conducted off west-central Florida in October 2011, and September and October 2012. The deployment period for two missions was dictated by the presence of red tide events with the glider path specifically set to encounter toxic Karenia brevis blooms (a.k.a red tides). Oceanographic conditions measured by the glider were significantly correlated to the variation in sounds from six known or suspected species of fish across the three missions with depth consistently being the most significant factor. At the time and space scales of this study, there was no detectable effect of red tide on sound production. Sounds were still recorded within red tide-affected waters from species with overlapping depth ranges. These results suggest that the fishes studied here did not alter their sound production nor migrate out of red tide-affected areas. Although these results are preliminary because of the limited measurements, the data and methods presented here provide a proof of principle and could serve as protocol for future studies on the effects of algal blooms on the behavior of soniferous fishes. To fully capture the effects of episodic events, we suggest that stationary or vertically profiling acoustic recorders and environmental sampling be used as a complement to glider measurements.

Fish Sound Production in the Presence of Harmful Algal Blooms in the Eastern Gulf of Mexico

PubMed Central

Wall, Carrie C.; Lembke, Chad; Hu, Chuanmin; Mann, David A.

2014-01-01

This paper presents the first known research to examine sound production by fishes during harmful algal blooms (HABs). Most fish sound production is species-specific and repetitive, enabling passive acoustic monitoring to identify the distribution and behavior of soniferous species. Autonomous gliders that collect passive acoustic data and environmental data concurrently can be used to establish the oceanographic conditions surrounding sound-producing organisms. Three passive acoustic glider missions were conducted off west-central Florida in October 2011, and September and October 2012. The deployment period for two missions was dictated by the presence of red tide events with the glider path specifically set to encounter toxic Karenia brevis blooms (a.k.a red tides). Oceanographic conditions measured by the glider were significantly correlated to the variation in sounds from six known or suspected species of fish across the three missions with depth consistently being the most significant factor. At the time and space scales of this study, there was no detectable effect of red tide on sound production. Sounds were still recorded within red tide-affected waters from species with overlapping depth ranges. These results suggest that the fishes studied here did not alter their sound production nor migrate out of red tide-affected areas. Although these results are preliminary because of the limited measurements, the data and methods presented here provide a proof of principle and could serve as protocol for future studies on the effects of algal blooms on the behavior of soniferous fishes. To fully capture the effects of episodic events, we suggest that stationary or vertically profiling acoustic recorders and environmental sampling be used as a complement to glider measurements. PMID:25551564

Algicidal Activity of Bacillamide Alkaloids and Their Analogues against Marine and Freshwater Harmful Algae.

PubMed

Wang, Bo; Tao, Yuanyuan; Liu, Qisheng; Liu, Na; Jin, Zhong; Xu, Xiaohua

2017-08-07

Harmful algal blooms have become a great challenge to global aquatic ecosystems over the past decades. Given their low toxicity, high selectivity, and environment-friendly properties, the use of natural products and their analogues as algicides has proven to be particularly efficient. In the present study, algicidal activity of naturally occurring bacillamides A-C, alkaloid ( 1 ), and neobacillamide A, as well as their synthetic analogues were investigated intensively. Bioassay results showed that, relative to natural bacillamide alkaloids, aniline-derived analogue ( 10d ) exhibited higher algicidal potential against three freshwater harmful algae Mycrocyctis aeruginosa, Scenedesmus obliquus, and Chlorella pyrenoidosa , suggesting that it could be used as a promising lead compound to develop novel algicide for controlling harmful algal blooms.

Crystal methamphetamine smoking among regular ecstasy users in Australia: increases in use and associations with harm.

PubMed

Kinner, Stuart A; Degenhardt, Louisa

2008-05-01

This study examined (a) changes in crystal methamphetamine use among regular ecstasy users (REU) in Australia and (b) associations of crystal use and smoking with demographics, drug use and harm. Cross-sectional surveys (2000-06) of REU in three Australian capital cities, and in 2006, 750 REU in all Australian capital cities. The interview included: demographics, drug use, risk behaviour, recent criminal activity and methamphetamine dependence using Severity of Dependence Scale. There was little change in overall methamphetamine use, but a marked increase in crystal methamphetamine smoking. Among recent methamphetamine users in 2006 (n = 606), crystal methamphetamine users (n = 364) reported more frequent methamphetamine use and higher levels of dependence. Compared with those who had used only other forms of methamphetamine, recent crystal methamphetamine users were more likely to 'binge' on drugs for > or = 48 hours, engage in crime and experience financial and legal problems related to drug use. Non-smoking crystal methamphetamine users (n = 78) more often reported recent injecting and heroin use. Recent smokers were more likely to have: greater polydrug use, recently overdosed on a 'party drug', and accessed medical services for their drug use. Many of these associations were accounted for by their injecting and heavier methamphetamine use, rather than smoking per se. Crystal methamphetamine smoking among REU has increased markedly and is associated with significant harm. This appears related to smokers' heavier levels of methamphetamine use. Effective harm reduction strategies should be tailored to these specific risks.

Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

PubMed Central

Dinh, Michael; Rodgers, Craig; Muscatello, David J.; McGuire, Rhydwyn; Ryan, Therese; Thackway, Sarah

2016-01-01

Abstract Introduction and Aims Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms. Design and Methods We selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the ‘alcohol syndrome’) in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free‐text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an ‘acute’ or ‘chronic’ harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression. Results The PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4–4.7], younger age (12–24 vs. 25–39 years: aOR = 3.4, 95% CI 2.2–5.3), not being admitted (aOR 2.2, 95% CI 1.5–3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5–2.8). PPV among 12 to 24‐year‐olds was 82%. Discussion and Conclusions The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis‐based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693–701] PMID:27786390

[Legal framework and strategy of the tobacco industry in relation to tobacco advertising in Spain].

PubMed

Elder, J; Cortés Blanco, M; Sarriá Santamera, A

2000-01-01

Publicity is legally regulated in Spain, in order to avoid its misuse. Tobacco publicity is also under those regulation, having had the companies operating in this sector to adapt themselves through new strategies. In this work, the legal restrictions existing in Spain regarding publicity are analyzed, together with some of the strategies developed by tobacco companies in order to elude them. In this sense, and despite of the existing legal framework, it should be noticed that tobacco companies are cleverly taking advantage of the existence of legal loopholes in tobacco publicity to promote their products.

Self-harm and suicide in adolescents.

PubMed

Hawton, Keith; Saunders, Kate E A; O'Connor, Rory C

2012-06-23

Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs. Copyright © 2012 Elsevier Ltd. All rights reserved.

Identifying environmental factors harmful to reproduction.

PubMed Central

Palmer, A K

1993-01-01

Reproduction is essential for the continuation of the species and for life itself. In biological terms, living and reproducing are essentially one and the same. There is, therefore, no sharp division between identifying factors harmful to reproduction and identifying factors harmful to life or vice versa. Detection of harmful factors requires balanced use of a variety of methodologies from databases on structure-activity relationships through in vitro and in vivo test systems of varying complexity to surveys of wildlife and human populations. Human surveys provide the only assured means of discriminating between real and imagined harmful factors, but they are time consuming and provide information after the harm has been done. Test systems with whole animals provide the best prospects for identifying harmful factors quickly, but currently available methods used for testing agrochemicals and drugs need a thorough overhaul before they can provide a role model. Whether there is a need for new methodology is doubtful. More certain is the need to use existing methodology more wisely. We need a better understanding of the environment--whatever it is--and a more thoughtful approach to investigation of multifactorial situations. PMID:8243390

Psychological characteristics, stressful life events and deliberate self-harm: findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

PubMed

Madge, Nicola; Hawton, Keith; McMahon, Elaine M; Corcoran, Paul; De Leo, Diego; de Wilde, Erik Jan; Fekete, Sandor; van Heeringen, Kees; Ystgaard, Mette; Arensman, Ella

2011-10-01

There is evidence to suggest that both psychological characteristics and stressful life events are contributory factors in deliberate self-harm among young people. These links, and the possibility of a dose-response relationship between self-harm and both psychological health and life events, were investigated in the context of a seven-country school-based study. Over 30,000, mainly 15 and 16 year olds, completed anonymous questionnaires at secondary schools in Belgium, England, Hungary, Ireland, the Netherlands, Norway and Australia. Pupils were asked to report on thoughts and episodes of self-harm, complete scales on depression and anxiety symptoms, impulsivity and self-esteem and indicate stressful events in their lives. Level and frequency of self-harm was judged according to whether they had thought about harming themselves or reported single or multiple self-harm episodes. Multinomial logistic regression assessed the extent to which psychological characteristics and stressful life events distinguished between adolescents with different self-harm histories. Increased severity of self-harm history was associated with greater depression, anxiety and impulsivity and lower self-esteem and an increased prevalence of all ten life event categories. Female gender, higher impulsivity and experiencing the suicide or self-harm of others, physical or sexual abuse and worries about sexual orientation independently differentiated single-episode self-harmers from adolescents with self-harm thoughts only. Female gender, higher depression, lower self-esteem, experiencing the suicide or self-harm of others, and trouble with the police independently distinguished multiple- from single-episode self-harmers. The findings reinforce the importance of psychological characteristics and stressful life events in adolescent self-harm but nonetheless suggest that some factors are more likely than others to be implicated.

"Word of mouse": indigenous harm reduction and online consumerism of the synthetic compound methoxphenidine.

PubMed

Van Hout, Marie Claire; Hearne, Evelyn

2015-01-01

Methoxphenidine (MXP) was one of several NMDA antagonists marketed in 2013 to replace the recently controlled compound Methoxetamine (MXE). A steep rise in user interest was recorded, despite vendor cautioning of limited user feedback. The study presented a phenomenological analysis of MXP experiences amongst recreational drug users as posted on public Internet fora. Internet searches were carried out using specific key words; "methoxphenidine," "MXP" and in combination with "experience," "report," "forum," and "trip." Seven self-reported experiences and 28 thread discussions relating sole use of MXP were analyzed using the Empirical Phenomenological Psychological method. Five themes and 61 categories emerged. MXP is marketed as a legal replacement for MXE, diphenidine, and ketamine, with a dissociative and stimulant wave outcome often lasting for days. Harm reduction tactics, awareness of prior tolerance to dissociative and optimal settings for use are discussed. Acute side-effects relate to hypertension and seizures. Chronic long-term memory loss and limb numbness is reported. Sense of empowerment occurs in the afterglow experience. Internet drug fora fuel information exchange and informed consumerism of synthetic compounds, and offer viable mechanisms for pre- and post-purchase decision making and indigenous harm reduction. Continued surveillance of synthetic market entries and user trends is warranted.

'Heads held high': an exploratory study of legal highs in pre-legislation Ireland.

PubMed

Van Hout, Marie Claire; Brennan, Rebekah

2011-01-01

The research aimed to present a unique 'snapshot' of legal psychoactive drug use prior to legislative control in Ireland, in relation to the types of products used; sourcings; consumptive practices and particular social settings for use; gauging of dosage; licit and illicit drug transitions, individualisation of drug decision-making and experiences; and future intentions regarding drug switching post legislation. Semi-structured in depth interviews (n = 32) were conducted with adults aged 18-33 years who had used legal highs in the 6 months prior to fieldwork. The findings indicate some support for 'differentiated' displacement consumptive patterns between illegal and legal drugs, with user pathways grounded in 'legal high' availability; perceived user effect, safety, legality, quality and price. Mephedrone emerged as most popular drug of choice. Internet sales, stockpiling and diversion of previously 'legal highs' onto the illegal street drug market remain of concern, against a background of emerging new designer drugs in Ireland.

Online E-cigarette Marketing Claims: A Systematic Content and Legal Analysis

PubMed Central

Klein, Elizabeth G.; Berman, Micah; Hemmerich, Natalie; Carlson, Cristen; Htut, SuSandi; Slater, Michael

2016-01-01

Objectives Electronic nicotine delivery systems (ENDS), or e-cigarettes, are heavily marketed online. The purpose of our study was to perform a systematic identification and evaluation of claims made within ENDS retailer and manufacturer websites, and the legal status of such claims. Methods We employed a systematic search protocol with popular search engines using 6 terms: (1) e-cigarettes; (2) e-cigs; (3) e-juice; (4) e-liquid; (5) e-hookah; and (6) vape pen. We analyzed English-language websites where ENDS are sold for implicit and explicit health-related claims. A legal analysis determined whether such claims are permissible under the US Food and Drug Administration’s regulations. Results The vast majority of ENDS manufacturer (N = 78) and retailer (N = 32) websites made at least one health-related claim (77% and 65%, respectively). Modified risk claims and secondhand smoke-related claims were most prevalent, with an average of 2 claims per site. Conclusions Health-related claims are plentiful within ENDS manufacturer and retailer websites. Results demonstrate that these sites focus on potential benefits while minimizing or eliminating information about possible harmful effects of ENDS. These claims are subject to the current regulatory authority by the FDA, and pose a risk of misinforming consumers. PMID:27446984

Associations between self-harm and distinct types of impulsivity

PubMed Central

Chamberlain, Samuel R; Leppink, Eric W.; Redden, Sarah A.; Grant, Jon E.

2017-01-01

Objective Self-harm is common and is of considerable public health concern. There is an ongoing debate regarding how self-harm should be classified. The aim of this study was to characterize associations between self-harm and impulsivity, including from the perspective of formal mental disorders and neuropsychological functioning. Method Total 333 adults (mean [SD] age 22.6 (3.6) years, 61% male) were recruited from the general community, and undertook detailed clinical and cognitive assessments. History of self-harm was quantified using the Self-Harm Inventory (SHI), which asks about 22 self-harm behaviors (classic self-harm behaviors as well as broader types of behavior that may be relevant, such as engaging in emotionally abusive relationships). Principal components analysis was used to identify latent dimensions of self-harming behaviors. Relationships between self-harm dimensions and other measures were characterized using ordinary least squares regression. Results Principal Components Analysis yielded a three factor solution, corresponding to self-injurious self-harm (e.g. cutting, overdoses, burning), interpersonal related self-harm (e.g. engaging in emotionally or sexually abusive relationships), and reckless self-harm (e.g. losing one’s job deliberately, driving recklessly, abusing alcohol). Regression modelling showed that all three dimensions of self-harm were associated with lower quality of life. Classic and interpersonal self-harm dimensions were associated with impulse control disorders (ICDs) whereas reckless self-harm was associated with other mainstream mental disorders besides ICDs. Only interpersonal self-harm was significantly associated with other impulsive measures ( less risk adjustment on the Cambridge Gambling Task). Conclusions This study suggests the existence of three distinct subtypes or ‘latent factors’ of self-harm: all three appear clinically important in that they are linked with worse quality of life. Clinicians should

Trends in Self-Harm in Kuala Lumpur, 2005-2011.

PubMed

Armitage, Christopher J; Abdul Rahim, Wirda; Rowe, Richard; O'Connor, Rory C

2016-01-01

Acts of self-harm are not routinely tracked in Malaysia. The present study investigates the prevalence of self-harm in Kuala Lumpur, Malaysia, over a 7-year period. The aims were to: (a) assess the prevalence of self-harm; (b) examine any changes over a period of 7 years, and (c) identify correlates of methods of self-harm. Data were extracted from the hospital records of Kuala Lumpur Hospital to review trends in self-harm between 2005 and 2011. There were 918 episodes of self-harm across the 7-year period, with a significant peak in 2007-2009. The average rate of self-harm (7.7 per 100,000 population per year) was similar or lower than the rate of suicide (6-8 or 8-13 per 100,000) suggesting that genuine cases of self-harm are often attributed to other causes. Nevertheless, over-representation of young people, women and Indians suggest areas in which resources to prevent self-harm might usefully be targeted. Estimating rates of self-harm are fraught with problems and further research is needed to understand the economic and cultural barriers around seeking treatment for self-harm, reporting self-harm and classifying self-harm.

Applied Use of Safety Event Occurrence Control Charts of Harm and Non-Harm Events: A Case Study.

PubMed

Robinson, Susan N; Neyens, David M; Diller, Thomas

Most hospitals use occurrence reporting systems that facilitate identifying serious events that lead to root cause investigations. Thus, the events catalyze improvement efforts to mitigate patient harm. A serious limitation is that only a few of the occurrences are investigated. A challenge is leveraging the data to generate knowledge. The goal is to present a methodology to supplement these incident assessment efforts. The framework affords an enhanced understanding of patient safety through the use of control charts to monitor non-harm and harm incidents simultaneously. This approach can identify harm and non-harm reporting rates and also can facilitate monitoring occurrence trends. This method also can expedite identifying changes in workflow, processes, or safety culture. Although unable to identify root causes, this approach can identify changes in near real time. This approach also supports evaluating safety or policy interventions that may not be observable in annual safety climate surveys.

Bundling occupational safety with harm reduction information as a feasible method for improving police receptiveness to syringe access programs: evidence from three U.S. cities

PubMed Central

Davis, Corey S; Beletsky, Leo

2009-01-01

Introduction In light of overwhelming evidence that access to sterile injection equipment reduces incidence of injection-attributable bloodborne disease without encouraging drug use, many localities have authorized sterile syringe access programs (SAPs), including syringe exchange and pharmacy-based initiatives. Even where such interventions are clearly legal, many law enforcement officers are unaware of the public health benefits and legal status of these programs and may continue to treat the possession of injection equipment as illegal and program participation as a marker of illegal behavior. Law enforcement practice can impede SAP utilization and may increase the risk of needlestick injury (NSI) among law enforcement personnel. Many SAPs conduct little or no outreach to law enforcement, in part because they perceive law enforcement actors as unreceptive to health-promotion programs targeting drug users. Case description We report on a brief training intervention for law enforcement personnel designed to increase officer knowledge of and positive attitudes towards SAPs by bundling content that addresses officer concerns about infectious disease and occupational safety with information about the legality and public health benefits of these programs. Pilot trainings using this bundled curriculum were conducted with approximately 600 officers in three US cities. Discussion and evaluation Law enforcement officers were generally receptive to receiving information about SAPs through the bundled curriculum. The trainings led to better communication and collaboration between SAP and law enforcement personnel, providing a valuable platform for better harmonization of law enforcement and public health activities targeting injection drug users. Conclusion The experience in these three cities suggests that a harm reduction training curriculum that bundles strategies for increasing officer occupational safety with information about the legality and public health benefits of

Communicating tobacco product harm: Compared to what?

PubMed

Kaufman, Annette R; Suls, Jerry M; Klein, William M P

2016-01-01

With the expansion of tobacco product options, a better understanding is needed of how information about the known and unknown risks of products is communicated to the public. Engaging in comparative processes is an common way for people to understand novel products, but the referent of comparison matters and can influence perceptions and behavior. This paper builds awareness of research from other disciplines, including decision science, marketing, and psychology, which can help inform research and tobacco control efforts. Published by Elsevier Ltd.

Thermal acclimation affects growth and lipophilic toxin production in a strain of cosmopolitan harmful alga Dinophysis acuminata.

PubMed

Basti, Leila; Suzuki, Toshiyuki; Uchida, Hajime; Kamiyama, Takashi; Nagai, Satoshi

2018-03-01

Species of the harmful algal bloom (HAB) genera Dinophysis are causative of one of the most widespread and expanding HAB events associated with the human intoxication, diarrheic shellfish poisoning (DSP). The effects of warming temperature on the physiology and toxinology of these mixotrophic species remain intractable due to their low biomass in nature and difficulties in establishing and maintaining them in culture. Hence, the present study investigated the influence of warming temperature, encompassing present and predicted climate scenarios, on growth and toxin production in a strain of the most cosmopolitan DSP-causative species, Dinophysis acuminata. The strain was isolated from western Japan, acclimated, and cultured over extended time spans. The specific growth and toxin production rates were highest at 20-26 °C and 17-29 °C, respectively, and had significant linear relationships during exponential phase. The cellular toxin production of okadaic acid and pectenotoxin-2 were highest during early exponential growth phase at temperatures ≤17 °C but highest during late stationary phase at temperatures ≥20 °C. The cellular toxin production of Dinophysistoxin-1, however, increased from early exponential to late stationary growth phase independently from temperature. The net toxin productions were not affected by acclimation temperature but significantly affected by growth and were highest during early exponential growth phase. Warming water temperatures increase growth and promote toxin production of D. acuminata, potentially increasing incidence of diarrheic shellfish poisoning events and closures of shellfish production. It is likely that D. acuminata is more toxic at low cell densities during bloom initiation in winter, and at high cell densities during bloom termination in spring-autumn. The results of the present research are also of importance for the mass production of D. acuminata for subsequent studies of the toxicological and

Clarifying self-harm through evolutionary concept analysis.

PubMed

Tofthagen, Randi; Fagerstrøm, Lisbeth

2010-09-01

Clarification of the concept self-harm is needed in order to enable research and theory development and facilitate the development and evaluation of medical interventions and nursing care for individuals who self-harm. This study presents such a conceptual analysis. Articles from 1997 to 2007 were sought from the Medline, PubMed, Cinahl, and PsychINFO search engines by entering the search words 'self-harm', 'self-harming', and 'psychiatric care'. 25 medicine and 23 nursing science articles were chosen for inclusion and analysed. Rodgers' evolutionary concept analysis process was used to delineate and clarify the concept's context, surrogate terms, antecedents, attributes, and consequences, as well as to determine implications for further research. Attributes of self-harm may include repetitive injury of mouth or exterior body, that is to say the infliction of physical pain to alleviate mental pain, and time spent self-harming. Antecedents may be gender, mental pain, substance abuse and relational problems. Consequences often include the need for medication and help with altering coping behaviour. Some self-harm patients met with negative attitudes from nurses. Individualized care and treatment is recommended. Accordingly, inter-professional collaboration and postgraduate education is needed in order to provide better care and treatment for self-harm patients. Furthermore, better understanding is needed to help enable health care personnel understand why individuals self-harm. The conceptual analysis presented in this study may be helpful as regards theory development within this still rather unexplored field. © 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science.

High-Volume Repeaters of Self-Harm.

PubMed

Ness, Jennifer; Hawton, Keith; Bergen, Helen; Waters, Keith; Kapur, Navneet; Cooper, Jayne; Steeg, Sarah; Clarke, Martin

2016-11-01

Repetition of self-harm is common and is strongly associated with suicide. Despite this, there is limited research on high-volume repetition. To investigate individuals with high-volume repeat self-harm attendances to the emergency department (ED), including their patterns of attendance and mortality. Data from the Multicentre Study of Self-Harm in England were used. High-volume repetition was defined as ⩾15 attendances within 4 years. An attendance timeline was constructed for each high-volume repeater (HVR) and the different patterns of attendance were explored using an executive sorting task and hierarchical cluster analysis. A small proportion of self-harm patients are HVRs (0.6%) but they account for a large percentage of self-harm attendances (10%). In this study, the new methodological approach resulted in three types of attendance patterns. All of the HVRs had clusters of attendance and a greater proportion died from external causes compared with non-HVRs. The approach used in this study offers a new method for investigating this problem that could have both clinical and research benefits. The need for early intervention is highlighted by the large number of self-harm episodes per patient, the clustered nature of attendances, and the higher prevalence of death from external causes.

Causes of drug shortages in the legal pharmaceutical framework.

PubMed

De Weerdt, Elfi; Simoens, Steven; Hombroeckx, Luc; Casteels, Minne; Huys, Isabelle

2015-03-01

Different causes of drug shortages can be linked to the pharmaceutical legal framework, such as: parallel trade, quality requirements, economic decisions to suspend or cease production, etc. However until now no in-depth study of the different regulations affecting drug shortages is available. The aim of this paper is to provide an analysis of relevant legal and regulatory measures in the European pharmaceutical framework which influence drug shortages. Different European and national legislations governing human medicinal products were analyzed (e.g. Directive 2001/83/EC and Directive 2011/62/EU), supplemented with literature studies. For patented drugs, external price referencing may encompass the largest impact on drug shortages. For generic medicines, internal or external reference pricing, tendering as well as price capping may affect drug shortages. Manufacturing/quality requirements also contribute to drug shortages, since non-compliance leads to recalls. The influence of parallel trade on drug shortages is still rather disputable. Price and quality regulations are both important causes of drug shortages or drug unavailability. It can be concluded that there is room for improvement in the pharmaceutical legal framework within the lines drawn by the EU to mitigate drug shortages. Copyright © 2015 Elsevier Inc. All rights reserved.

A Critical Review of the Harm-Minimisation Tools Available for Electronic Gambling.

PubMed

Harris, Andrew; Griffiths, Mark D

2017-03-01

The increasing sophistication of gambling products afforded by electronic technologies facilitates increased accessibility to gambling, as well as encouraging rapid and continuous play. This poses several challenges from a responsible gambling perspective, in terms of facilitating player self-awareness and self-control. The same technological advancements in gambling that may facilitate a loss of control may also be used to provide responsible gambling tools and solutions to reduce gambling-related harm. Indeed, several harm-minimisation strategies have been devised that aim to facilitate self-awareness and self-control within a gambling session. Such strategies include the use of breaks in play, 'pop-up' messaging, limit setting, and behavioural tracking. The present paper reviews the theoretical argument underpinning the application of specific harm-minimisation tools, as well as providing one of the first critical reviews of the empirical research assessing their efficacy, in terms of influencing gambling cognitions and behaviour.

Legal Issues in Higher Education.

ERIC Educational Resources Information Center

Branton, Wiley A.

1984-01-01

Legal problems that colleges and universities might avoid are identified. Colleges are being sued over a broad range of legal issues and are expending money for legal and court fees, settlements, and judgments. Legal problems include right of admission to particular colleges, the right to stay in school, questions of faculty promotion and tenure,…

Prevention, early intervention, harm reduction, and treatment of substance use in young people.

PubMed

Stockings, Emily; Hall, Wayne D; Lynskey, Michael; Morley, Katherine I; Reavley, Nicola; Strang, John; Patton, George; Degenhardt, Louisa

2016-03-01

We did a systematic review of reviews with evidence on the effectiveness of prevention, early intervention, harm reduction, and treatment of problem use in young people for tobacco, alcohol, and illicit drugs (eg, cannabis, opioids, amphetamines, or cocaine). Taxation, public consumption bans, advertising restrictions, and minimum legal age are effective measures to reduce alcohol and tobacco use, but are not available to target illicit drugs. Interpretation of the available evidence for school-based prevention is affected by methodological issues; interventions that incorporate skills training are more likely to be effective than information provision-which is ineffective. Social norms and brief interventions to reduce substance use in young people do not have strong evidence of effectiveness. Roadside drug testing and interventions to reduce injection-related harms have a moderate-to-large effect, but additional research with young people is needed. Scarce availability of research on interventions for problematic substance use in young people indicates the need to test interventions that are effective with adults in young people. Existing evidence is from high-income countries, with uncertain applicability in other countries and cultures and in subpopulations differing in sex, age, and risk status. Concerted efforts are needed to increase the evidence base on interventions that aim to reduce the high burden of substance use in young people. Copyright © 2016 Elsevier Ltd. All rights reserved.

The legal status of cannabis (marijuana) and cannabidiol (CBD) under U.S. law.

PubMed

Mead, Alice

2017-05-01

In the United States, federal and state laws regarding the medical use of cannabis and cannabinoids are in conflict and have led to confusion among patients, caregivers, and healthcare providers. Currently, cannabis is legal for medical purposes in 50% of the states, and another seventeen states allow products that are high in cannabidiol (CBD) and low in THC (tetrahydrocannabinol) for medical use. Many of these artisanal products are sold in dispensaries or over the internet. However, none of these products has been approved by the Food and Drug Administration (FDA). Understanding how federal laws apply to clinical research and practice can be challenging, and the complexity of these laws has resulted in particular confusion regarding the legal status of CBD. This paper provides an up-to-date overview (as of August 2016) of the legal aspects of cannabis and cannabidiol, including cultivation, manufacture, distribution, and use for medical purposes. This article is part of a Special Issue title, Cannabinoids and Epilepsy. Copyright © 2017 The Author. Published by Elsevier Inc. All rights reserved.

The Principal's Legal Handbook.

ERIC Educational Resources Information Center

Camp, William E., Ed.; And Others

The principal is faced with myriad legal issues on a daily basis, making it imperative that he or she keep abreast with developing legal issues. The first of four sections, "Students and the Law," surveys federal statutes and landmark Supreme Court decisions pertaining to the rights of students. It addresses legal issues regarding search and…

Working with cognitively impaired drivers: legal issues for mental health professionals to consider.

PubMed

Love, Christopher M; Welsh, Robert K; Knabb, Joshua J; Scott, Sheryn T; Brokaw, David W

2008-01-01

Mental health professionals are gatekeepers of patient confidentiality. Yet, confidentiality held too strictly, by allowing a potentially dangerous driver to assume control of a car, endangers society. Recent court cases have mandated that mental health professionals must warn those who may be potentially harmed by patients. In spite of this, disagreements linger as to whether it is the responsibility of governmental agencies or mental health professionals to decide who is unfit to operate a vehicle because of cognitive impairment. This article addresses the legally relevant considerations when working with cognitively compromised individuals who operate a motor vehicle. Legal issues surrounding confidentiality, patient rights, foreseeable risk, and the duty to warn and protect are presented in order to understand their relationship to recent court rulings. The impact on the mental health care industry includes not only concerns about increased insurance premiums or costs due to alleged negligence or litigation expenses secondary to failure to ensure the safety of an impaired client under their care. Mental health care providers are aware that the welfare of clients with impairment to cognitive decision making ability may require unique considerations for safety such as ensuring safe and appropriate transportation.

20 CFR 404.733 - Evidence you are the legally adopting parent or legally adopted child.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Evidence you are the legally adopting parent or legally adopted child. 404.733 Section 404.733 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... Benefits § 404.733 Evidence you are the legally adopting parent or legally adopted child. If you are the...

Prevention. How much harm? How much benefit? 3. Physical, psychological and social harm.

PubMed Central

Marshall, K G

1996-01-01

Harm caused by preventive programs may be physical, psychological, social or, if informed consent has not been obtained, ethical. Adverse effects of preventive screening programs may occur at any of the three levels of the "screening cascade", the screening procedure itself, the investigation of abnormal results of screening tests or the treatment of detected abnormalities or diseases. The greatest harm occurs at the second and third levels. Examples of procedures that may cause physical harm are venipuncture, mammography, colonoscopy, breast biopsy, transrectal ultrasonography, prostate biopsy, weight-reducing and cholesterol-lowering diets and radical prostatectomy. The psychological and social harm of preventive programs involves anticipated discomfort or perception of adverse effects of preventive interventions; unpleasant interactions with health care workers, time required for preventive programs, excessive overall awareness of health, anxiety over the results of a screening test implications of a positive screening test, consequences of being labelled as "sick" or "at risk," psychopathologic effects induced directly by preventive programs and, in the case of a false-negative test result, false assurance of disease-free status. Since the positive predictive value of screening tests in the general population is always low, most abnormal test results are "false-positive," these engender a great deal of psychological discuss among patients. PMID:8800074

Algicidal Activity of Bacillamide Alkaloids and Their Analogues against Marine and Freshwater Harmful Algae

PubMed Central

Wang, Bo; Tao, Yuanyuan; Liu, Qisheng; Liu, Na; Jin, Zhong; Xu, Xiaohua

2017-01-01

Harmful algal blooms have become a great challenge to global aquatic ecosystems over the past decades. Given their low toxicity, high selectivity, and environment-friendly properties, the use of natural products and their analogues as algicides has proven to be particularly efficient. In the present study, algicidal activity of naturally occurring bacillamides A–C, alkaloid (1), and neobacillamide A, as well as their synthetic analogues were investigated intensively. Bioassay results showed that, relative to natural bacillamide alkaloids, aniline-derived analogue (10d) exhibited higher algicidal potential against three freshwater harmful algae Mycrocyctis aeruginosa, Scenedesmus obliquus, and Chlorella pyrenoidosa, suggesting that it could be used as a promising lead compound to develop novel algicide for controlling harmful algal blooms. PMID:28783131

Notifying patients exposed to blood products associated with Creutzfeldt-Jakob disease: integrating science, legal duties and ethical mandates

PubMed Central

Caulfield, T; Dossetor, J; Boshkov, L; Hannon, J; Sawyer, D; Robertson, G

1997-01-01

The issue of notifying people who have been exposed to blood products that have been associated with Creutzfeldt-Jakob disease (CJD) has arisen at a time when the Canadian blood system is under intense scrutiny. As a result, the Canadian Red Cross Society issued a recommendation to health care institutions that recipients of CJD-associated blood products be identified, notified and counselled. Although Canadian jurisprudence in the realm of informed consent may support a policy of individual notification, a review of the scientific evidence and the applicable ethical principles arguably favours a policy of a more general public notification. Indeed, situations such as this require a unique approach to the formation of legal and ethical duties, one that effectively integrates all relevant factors. As such, the authors argue that individual notification is currently not justified. Nevertheless, if a system of general notification is implemented (e.g., through a series of public health announcements), it should provide, for people who wish to know, the opportunity to find out whether they were given CJD-associated products. PMID:9371070

Account-giving for a corporate transgression influences moral judgment: when those who "spin" condone harm-doing.

PubMed

Folkes, Valerie S; Whang, Yun-Oh

2003-02-01

Generating some types of accounts-justifications, excuses, or apologies--for an organization's harm-doing increases condoning of a transgression compared with generating denials or not having to explain a transgression. In Experiment 1. students (N = 324) were required either to explain a corporation's use of child labor to manufacture its products or merely to read about it. Explaining decreased condemnation of the offense compared with when no explanation was required. In Experiment 2, students (N = 101) either justified the corporation's harm-doing or denied that the corporation had harmed employees, with justifications increasing condoning more than denials. In Experiment 3, students (N = 113) either wrote an apology or wrote a denial, with apologizers condoning harm-doing more than deniers. Differences appear to be due to some accounts eliciting cognitive elaboration on the misdeed.

Brief Report: The Self Harm Questionnaire--A New Tool Designed to Improve Identification of Self Harm in Adolescents

ERIC Educational Resources Information Center

Ougrin, Dennis; Boege, Isabel

2013-01-01

The Self Harm Questionnaire (SHQ) aiming at identification of self-harm in adolescents has been developed and piloted in a sample of 12-17 year olds (n = 100). The adolescents were recruited from both in- and outpatient psychiatric services. Concurrent validity of the SHQ was evaluated by comparing the SHQ results with recorded self harm in the…

Trafficking in Human Beings for the Purpose of Organ Removal and the Ethical and Legal Obligations of Healthcare Providers

PubMed Central

Caulfield, Timothy; Duijst, Wilma; Bos, Mike; Chassis, Iris; Codreanu, Igor; Danovitch, Gabriel; Gill, John; Ivanovski, Ninoslav; Shin, Milbert

2016-01-01

Abstract Physicians and other health care professionals seem well placed to play a role in the monitoring and, perhaps, in the curtailment of the trafficking in human beings for the purpose of organ removal. They serve as important sources of information for patients and may have access to information that can be used to gain a greater understanding of organ trafficking networks. However, well-established legal and ethical obligations owed to their patients can create challenging policy tensions that can make it difficult to implement policy action at the level of the physician/patient. In this article, we explore the role—and legal and ethical obligations—of physicians at 3 key stages of patient interaction: the information phase, the pretransplant phase, and the posttransplant phase. Although policy challenges remain, physicians can still play a vital role by, for example, providing patients with a frank disclosure of the relevant risks and harms associated with the illegal organ trade and an honest account of the physician's own moral objections. They can also report colleagues involved in the illegal trade to an appropriate regulatory authority. Existing legal and ethical obligations likely prohibit physicians from reporting patients who have received an illegal organ. However, given the potential benefits that may accrue from the collection of more information about the illegal transactions, this is an area where legal reform should be considered. PMID:27500253

Genetic harm: bitten by the body that keeps you?

PubMed

Kahn, Jeffrey P

1991-10-01

... We must attempt to explain, how, if ever, our existence may harm us. To address this and the other questions raised, I propose to examine what constitutes harm and whether it makes sense to say that our genetic makeup may harm us. To do this I will describe three approaches to the problem of describing the status of negative effects our genes have upon us, which I have named the "technical harm" view, the "constitutive" view, and the "harmful conditions" view. On the technical harm view, the standard definitions of harm are applied to genetic disposition in an attempt to couch genetic defects or flaws in terms of harming. The constitutive view rejects applying the concept of harm to genetic disposition on the grounds that it is impossible to separate genetic disposition from individual identity. Lastly, the harmful conditions view, which I conclude is the most successful of the three, focuses on the tendency of certain genetic dispositions to cause harm in the future and thus avoids what I will argue are the "context" shortcomings of the other two approaches. To conclude the discussion I will very briefly analyze the ramifications of a harmful conditions view for the concept of genetic disease and the prospects for genetic counseling, gene therapy, and reproductive decision making.

E-Cigarette Awareness and Perceived Harmfulness

PubMed Central

Tan, Andy S.L.; Bigman, Cabral A.

2014-01-01

Background Electronic cigarettes, or e-cigarettes, are increasingly advertised as replacements for regular cigarettes or cessation aids for smokers. Purpose To describe the prevalence and correlates of e-cigarette awareness and perceived harmfulness among U.S. adults and analyze whether these variables are associated with smokers’ past year quit attempts and intention to quit. Methods Data were obtained from the Health Information National Trends Survey (HINTS 4 Cycle 2), conducted from October 2012 to January 2013. Data analyses were performed from June to August 2013. Results Overall, 77% of respondents were aware of e-cigarettes. Of these, 51% believed e-cigarettes were less harmful than cigarettes. Younger, white (compared with Hispanic), more educated respondents, and current or former smokers (compared with non-smokers) were more likely to be aware of e-cigarettes. Among those who were aware of e-cigarettes, younger, more educated respondents and current smokers (compared with former and non-smokers) were more likely to believe that e-cigarettes were less harmful. Awareness and perceived harm were not associated with smokers’ past year quit attempts or intention to quit. Conclusions Overall e-cigarette awareness increased while smokers’ perceived harm of e-cigarettes declined compared with earlier surveys. However, awareness and perceived harm of e-cigarettes did not show evidence of promoting smoking cessation at the population level. PMID:24794422

Violent Self-Harm in Schizophrenia

ERIC Educational Resources Information Center

Symonds, Catherine S.; Taylor, Steve; Tippins, Val; Turkington, Douglas

2006-01-01

Patients with schizophrenia have a substantial lifetime suicide risk, especially by violent means. Little published work exists on self-harm (SH) in this population. The goal of this study was to examine whether patients with schizophrenia were also more likely to self-harm in a violent manner. A retrospective analysis performed on method, motive,…

Alcohol Involvement in Suicide and Self-Harm.

PubMed

Larkin, Celine; Griffin, Eve; Corcoran, Paul; McAuliffe, Carmel; Perry, Ivan J; Arensman, Ella

2017-11-01

Alcohol misuse and alcohol consumption are significant risk factors for suicidal behavior. This study sought to identify factors associated with alcohol consumption in cases of suicide and nonfatal self-harm presentations. Suicide cases in Cork, Ireland, from September 2008 to June 2012 were identified through the Suicide Support and Information System. Emergency department presentations of self-harm in the years 2007-2013 were obtained from the National Self-Harm Registry Ireland. Alcohol consumption was detected in the toxicology of 44% out of 307 suicide cases. Only younger age was significantly associated with having consumed alcohol among suicides. Alcohol consumption was noted in the case notes in 21% out of 8,145 self-harm presentations. Logistic regression analyses indicated that variables associated with having consumed alcohol in a self-harm presentation included male gender, older age, overdose as a method, not being admitted to a psychiatric ward, and presenting out-of-hours. Data was limited to routinely collected variables by the two different monitoring systems. Alcohol consumption commonly precedes suicidal behavior, and several factors differentiated alcohol-related suicidal acts. Self-harm cases, in particular, differ in profile when alcohol is consumed and may require a tailored clinical approach to minimize risk of further nonfatal or fatal self-harm.

Patterns of Use and Perceptions of Harm of Smokeless Tobacco in Navi Mumbai, India and Dhaka, Bangladesh.

PubMed

Mutti, Seema; Reid, Jessica L; Gupta, Prakash C; Pednekar, Mangesh S; Dhumal, Gauri; Nargis, Nigar; Hussain, Akm Ghulam; Hammond, David

2016-01-01

Globally, smokeless tobacco use is disproportionately concentrated in low-income and middle-income countries like India and Bangladesh. The current study examined comparative patterns of use and perceptions of harm for different smokeless tobacco products among adults and youth in Navi Mumbai, India, and Dhaka, Bangladesh. Face-to-face interviews were conducted on tablets with adult (19 years and older) smokeless tobacco users and youth (16-18 years) users and non-users in Navi Mumbai ( n = 1002), and Dhaka ( n = 1081). A majority (88.9%) of smokeless tobacco users reported daily use. Approximately one-fifth (20.4%) of the sample were mixed-users (used both smoked and smokeless tobacco), of which about half (54.4%) reported that they primarily used smokeless over smoked forms like cigarettes or bidis. The proportion of users planning to quit was higher in India than in Bangladesh (75.7% vs. 49.8%, p < 0.001). Gutkha was the most commonly used smokeless product in India, and pan masala in Bangladesh. Among users in Bangladesh, the most commonly reported reason for using their usual product was the belief that it was "less harmful" than other types. Perceptions of harm also differed with respect to a respondent's usual product. Bangladeshi respondents reported more negative attitudes toward smokeless tobacco compared to Indian respondents. The findings highlight the high daily use of smokeless tobacco, and the high prevalence of false beliefs about its harms. This set of findings reinforces the need to implement effective tobacco control strategies in low and middle-income countries like India and Bangladesh.

An analysis of legal warnings after drug approval in Thailand.

PubMed

Sriphiromya, Pakawadee; Theeraroungchaisri, Anuchai

2015-02-01

Drug risk management has many tools for minimizing risk and black-boxed warnings (BBWs) are one of those tools. Some serious adverse drug reactions (ADRs) emerge only after a drug is marketed and used in a larger population. In Thailand, additional legal warnings after drug approval, in the form of black-boxed warnings, may be applied. Review of their characteristics can assist in the development of effective risk mitigation. This study was a cross sectional review of all legal warnings imposed in Thailand after drug approval (2003-2012). Any boxed warnings for biological products and revised warnings which were not related to safety were excluded. Nine legal warnings were evaluated. Seven related to drugs classes and two to individual drugs. The warnings involved four main types of predictable ADRs: drug-disease interactions, side effects, overdose and drug-drug interactions. The average time from first ADRs reported to legal warnings implementation was 12 years. The triggers were from both safety signals in Thailand and regulatory measures in other countries outside Thailand. Copyright © 2014 Elsevier Inc. All rights reserved.

Legality Principle of Crimes and Punishments in Iranian Legal System

ERIC Educational Resources Information Center

Habibzadeh, Mohammad Ja'far

2006-01-01

The Principle of legality of crimes and punishments (nullum crimen, nulla poena sine lege) refers to the fact that an act is not considered a crime and deserves no punishment, unless the Legislator determines and announces the criminal title and its penalty before. The legality principle protects individual security by ensuring basic individual…

[Is the legally responsible party indeed responsible? An ethical-legal question on the term].

PubMed

Fontana-Rosa, Júlio César; Oliveira, Reinaldo Ayer de

2008-01-01

The authors discuss the legal and ethical meaning of the expression "Third-Party Consent" by questioning its limits. It is indeed shown that it does not satisfactorily meet what is called third-party consent because this would require legal endorsement by legal codes and norms which, in fact does not occur. As such, the expression "third-party consent", whenever used, may not provide the professional with the normative, ethical and legal support needed for professional performance.

Method Choice in Nonfatal Self-Harm as a Predictor of Subsequent Episodes of Self-Harm and Suicide: Implications for Clinical Practice

PubMed Central

Hempstead, Katherine; Nguyen, Tuan; Barber, Catherine; Rosenberg-Wohl, Sarah; Azrael, Deborah

2013-01-01

Objectives. We examined time-varying and time-invariant characteristics of nonfatal intentional self-harm episodes in relation to subsequent episodes of self-harm and suicide. Methods. We conducted a follow-up cohort study through 2007 of 3600 patients discharged from hospitals in New Jersey with a primary diagnosis of intentional self-harm in 2003. We determined repetition of self-harm from hospital records and suicide from state registers. Results. Use of methods other than drug overdose and cutting in self-harm events, greater medical severity of nonfatal episodes, and a history of multiple self-harm episodes increased the risk of suicide. However, most suicides occurred without these risk factors. Most suicides took place without intervening episodes of self-harm, and most persons used a low-lethality method (drug overdose or cutting) in their index episode, but switched to a more lethal method in their fatal episode. Conclusions. Our findings suggest that preventing suicide among persons with a history of self-harm must account for the possibility that they will adopt methods with higher case-fatality ratios than they previously tried. PMID:23597351

Authority dependence and judgments of utilitarian harm.

PubMed

Piazza, Jared; Sousa, Paulo; Holbrook, Colin

2013-09-01

Three studies tested the conditions under which people judge utilitarian harm to be authority dependent (i.e., whether its right or wrongness depends on the ruling of an authority). In Study 1, participants judged the right or wrongness of physical abuse when used as an interrogation method anticipated to yield useful information for preventing future terrorist attacks. The ruling of the military authority towards the harm was manipulated (prohibited vs. prescribed) and found to significantly influence judgments of the right or wrongness of inflicting harm. Study 2 established a boundary condition with regards to the influence of authority, which was eliminated when the utility of the harm was definitely obtained rather than forecasted. Finally, Study 3 replicated the findings of Studies 1-2 in a completely different context-an expert committee's ruling about the harming of chimpanzees for biomedical research. These results are discussed as they inform ongoing debates regarding the role of authority in moderating judgments of complex and simple harm. Copyright © 2013 Elsevier B.V. All rights reserved.

Characterizing Young Adults' Susceptibility to Waterpipe Tobacco Use and Their Reactions to Messages About Product Harms and Addictiveness.

PubMed

Lipkus, Isaac M; Mays, Darren; P Tercyak, Kenneth

2017-10-01

There is very little insight into the psychosocial characteristics of young adults susceptible to waterpipe tobacco use and their reactions to messages about harms of waterpipe tobacco smoking (WTS). We investigated how young adults who were or were not susceptible to WTS differed on various characteristics and their reactions to messages about WTS harms. Young adults ages 18 to 30 who had never used waterpipe tobacco were recruited through an online crowdsourcing site. Participants were stratified on susceptibility status (susceptible or not) and randomized to receive messages about harms and addictiveness of WTS or a control condition that received no messages. Participants' perceptions of risk and worry, their attitudes toward, and willingness/curiosity to try WTS were assessed. Compared to nonsusceptible participants, susceptible participants perceived themselves to be at lower risk and worried less about harms and addictiveness of WTS, had more positive attitudes toward use, and expressed a greater willingness and curiosity to try it. Among susceptible participants, messages decreased willingness/curiosity to try WTS; messages had no effect on nonsusceptible participants. The message effects among susceptible participants were explained by more negative attitudes and less ambivalence toward WTS. Susceptible young adults' psychosocial characteristics place them at high risk for future uptake of WTS. Brief public health messages about harm and addiction may deter susceptible young adults' willingness to try WTS and prevent WTS initiation and progression. Findings suggest that in order to curb the initiation of WTS among susceptible young adults, interventions should target risk appraisals and attitudes toward WTS. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Review of Body Dysmorphic Disorder in Aesthetic Surgery Patients and the Legal Implications.

PubMed

Sweis, Iliana E; Spitz, Jamie; Barry, David R; Cohen, Mimis

2017-08-01

Body dysmorphic disorder (BDD) is an often under-recognized yet severe psychiatric illness. There is limited guidance for plastic surgeons in the USA in how to recognize and manage patients with BDD and protect themselves from potential litigation and harm. Therefore, in collaboration with legal counsel, we remind our profession of the serious nature of patients with BDD, provide warning signs for recognizing BDD, and critically evaluate the validity of informed consent and the legal ramifications of operating on such patients in the USA. A literature review was performed to clearly define the psychopathology of BDD and identify cases of patients with BDD who underwent cosmetic surgery resulting in potential threats to the surgeon. An additional search of the legal literature was performed in collaboration with legal counsel to identify key cases of patients with BDD attempting litigation following cosmetic surgery procedures. The diagnostic criteria and psychopathology of BDD are presented. Warning signs are highlighted to alert the plastic surgeon to patients at high risk for BDD. Strategies for legal protection include a pre-procedure checklist for patients that are suspected of having a BDD diagnosis. Body dysmorphic disorder is prevalent in the cosmetic surgery population. Patients with BDD often have a poor outcome following aesthetic surgery, which can result in a dangerous or even deadly situation for the surgeon. We aim to remind aesthetic plastic surgeons of the psychopathology, severity, and specific risks associated with operating on patients with BDD while suggesting specific protective strategies. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please

Pilot study of medical-legal partnership to address social and legal needs of patients.

PubMed

Weintraub, Dana; Rodgers, Melissa A; Botcheva, Luba; Loeb, Anna; Knight, Rachael; Ortega, Karina; Heymach, Brooke; Sandel, Megan; Huffman, Lynne

2010-05-01

As a preliminary investigation of the effectiveness of medical-legal partnership in pediatrics, we conducted a 36-month prospective cohort study of the impact of clinic- and hospital-based legal services. We hypothesized that integration of legal services into pediatric settings would increase families' awareness of and access to legal and social services, decrease barriers to health care for children, and improve child health. Health care providers referred families with legal or social needs to the Peninsula Family Advocacy Program (FAP). Fifty four families completed both baseline and six-month follow-up assessments. Comparison of follow-up with baseline demonstrated significantly increased proportions of families who utilized food and income supports and significantly decreased proportions of families avoiding health care due to lack of health insurance or concerns about cost. Two-thirds of respondents reported improved child health and well-being. This study suggests that adding an attorney to the medical team increases awareness of and access to social and legal services.

77 FR 39654 - Proposed Legal Interpretation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

...-0670] Proposed Legal Interpretation AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... legal interpretation in which the agency considered clarifying prior legal interpretations regarding... inadvertently assigned an incorrect docket number to the proposed legal interpretation. This document corrects...

Are psychiatrists affecting the legal process by answering legal questions?

PubMed

Hardie, Timothy; Elcock, Susan; Mackay, R D

2008-01-01

Psychiatrists are often asked to answer legal questions. The extent to which they answer strictly legal rather than medical matters is not known. To investigate how strongly psychiatrists in England and Wales express opinions on one legal question - that of diminished responsibility in respect of a murder charge, and how this is related to outcome in court. METHOD Our data were extracted from psychiatric reports and case files supplied by the then Department of Constitutional Affairs (now the Ministry of Justice) on cases heard in the Crown Courts between 1 January 1997 and 31 December 2001 in which the defence of diminished responsibility had been raised. The cases had been selected by the Law Commission in their earlier review of partial defences to murder. We devised a reliable system of rating the presence/absence and strength of expression of a legal opinion in the medical reports. We tested the data for relationship between nature and strength of opinion and progression to trial and verdict. RESULTS Psychiatric reports were available on 143 of 156 cases in which diminished responsibility was considered. They yielded 338 opinions on at least one aspect of diminished responsibility. In 110 (93%) of the 118 cases in which there was a diminished verdict, this was made without trial and, therefore, without reference to a jury. In only eight (27%) out of the 30 cases that went to trial, was a diminished responsibility verdict made. Half of the reports (169) gave a clear opinion on diminished responsibility, a third (121) invited the court to draw a particular conclusion and only 11% (36) provided relevant evidence without answering the legal questions. When there was an opinion or an invitation to make a finding on the legal question, a trial was less likely. A trial was also less likely if reports agreed on what the verdict should be. CONCLUSIONS Psychiatrists frequently answer the legal question of diminished responsibility. The judiciary and medical experts

Legal assessment of current situation on orphan patients in Lithuania.

PubMed

Spokiene, Indre

2008-01-01

After Lithuania joined the European Union, the Regulation (EC) No. 141/2000 on orphan medicinal products and Commission Regulation (EC) No. 847/2000 came into force as part of national legislation. Member States must adopt specific measures to increase knowledge on rare diseases and to improve their detection, diagnosis, and treatment. The aim of this article was to present and to assess the current legal situation on orphan patients and their treatment in Lithuania, to identify legislation gaps, and to propose some ideas how to facilitate the solution of the existing problems in this field. For this purpose, European Union and Lithuanian legal documents on rare medicinal products are examined using a comparative method. With reference to inventory of Member States' incentives for rare diseases in national level, the most important issues, which orphan patients face to in Lithuania, are singled out. In Lithuania, the situation of orphan patients in terms of protection of patient rights is insufficiently determined. The access to effective health care services or approved therapies in some cases is restricted. Working relationships between genetic services and various clinical specialists as well as with those in primary care are not legally determined; the number of clinical trials aimed at orphan medicinal products is low. These results suggest a need for awareness raising among Lithuanian Government, health care specialists, patient organizations about the importance to improve practical implementation of European Union legislation and progressive experience of some European countries in this field.

Legal Support for Palliative Care Patients.

PubMed

Ezer, Tamar; Burke-Shyne, Naomi; Hepford, Kiera

2018-02-01

Palliative care patients face legal issues that impact their quality of life. Legal support, embedded in holistic palliative care services, has developed globally over the last decade to address this. This article aims to trace the origins of legal support for palliative care patients, detail models of legal support, and describe achievements and challenges. The article draws on years of work in this area and the available literature. Common legal issues include disposing of property and drafting wills, planning for children, dealing with debt and securing social benefits, and addressing discrimination. Diverse approaches to integrating legal support include developing paralegal skills, accessing skilled legal advice, empowering patients and families, and building awareness of rights among health care workers. There is robust and growing acceptance of legal support as a key component of holistic palliative care, and many palliative care professionals are identifying and addressing the legal needs they encounter through mediation, guidance on basic rights, or referrals to a lawyer. Addressing legal problems can contribute to peace of mind, well-being, and the health of patients. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Assessing the harms of cannabis cultivation in Belgium.

PubMed

Paoli, Letizia; Decorte, Tom; Kersten, Loes

2015-03-01

Since the 1990s, a shift from the importation of foreign cannabis to domestic cultivation has taken place in Belgium, as it has in many other countries. This shift has prompted Belgian policy-making bodies to prioritize the repression of cannabis cultivation. Against this background, the article aims to systematically map and assess for the first time ever the harms associated with cannabis cultivation, covering the whole spectrum of growers. This study is based on a web survey primarily targeting small-scale growers (N=1293) and on three interconnected sets of qualitative data on large-scale growers and traffickers (34 closed criminal proceedings, interviews with 32 criminal justice experts, and with 17 large-scale cannabis growers and three traffickers). The study relied on Greenfield and Paoli's (2013) harm assessment framework to identify the harms associated with cannabis cultivation and to assess the incidence, severity and causes of such harms. Cannabis cultivation has become endemic in Belgium. Despite that, it generates, for Belgium, limited harms of medium-low or medium priority. Large-scale growers tend to produce more harms than the small-scale ones. Virtually all the harms associated with cannabis cultivation are the result of the current criminalizing policies. Given the spread of cannabis cultivation and Belgium's position in Europe, reducing the supply of cannabis does not appear to be a realistic policy objective. Given the limited harms generated, there is scarce scientific justification to prioritize cannabis cultivation in Belgian law enforcement strategies. As most harms are generated by large-scale growers, it is this category of cultivator, if any, which should be the focus of law enforcement repression. Given the policy origin of most harms, policy-makers should seek to develop policies likely to reduce such harms. At the same time, further research is needed to comparatively assess the harms associated with cannabis cultivation (and

The challenge of a ban on animal testing for the development of a regulated legal market for new psychoactive substances (NPS) ('legal highs') in New Zealand: Issues and options for resolution.

PubMed

Rychert, Marta; Wilkins, Chris

2015-12-01

In mid-July 2013, New Zealand passed the Psychoactive Substances Act (PSA), which allowed 'low risk' psychoactive products ('legal highs') to be approved for legal sale. In early May 2014, following public protest, the Psychoactive Substances Amendment Act (PSAA) was passed banning animal testing of psychoactive products, potentially making the new regime unworkable. To investigate strategies to overcome the impasse created by the animal testing ban. Solutions to the impasse were investigated using 'scenario' and 'stakeholder' analysis. Legislation, parliamentary debates, and regulatory statements related to the PSA and animal testing were reviewed. Strategies to resolve the impasse were discussed with stakeholders including the Psychoactive Substances Regulatory Authority (PSRA) officials, health officials, a legal high industry lawyer, and a leading legal highs manufacturer. This process generated six possible scenarios and five decision-making criteria of key importance to major stakeholders. Scenarios were then evaluated based on feedback from the industry and regulators. The six scenarios were: (1) pragmatic modification of the animal testing ban; (2) waiting until new non-animal test models are internationally accepted; (3) use of non-validated replacement test methods; (4) judicial challenge of the animal testing ban; (5) 'creative compliance' by only presenting human clinical trial results; and (6) philosophical re-conceptualisation of the 'benefits' from psychoactive products. Options 1 and 5 appear to be the most attractive overall solutions. However, both rely on a new political consensus and astute framing of the issues by political communicators. Political decision makers may be happy to accept Scenario 2 which would impose significant delays. A 'failed' pharmaceutical product with psychoactive effects may have the test data required to be approved under Scenarios 1 and 5. Ultimately, the pleasurable benefits from psychoactive products may need to be

Deliberate self-harm in 15-year-old adolescents: a pilot study with a modified version of the Deliberate Self-Harm Inventory.

PubMed

Lundh, Lars-Gunnar; Karim, Jessica; Quilisch, Eva

2007-02-01

The purpose of the present study was to investigate the rate of deliberate self-harm in 15-year-old Swedish adolescents, gender differences in this behavior, and possible associations with self-esteem and mindfulness. For this purpose, we developed a simplified version of Gratz's (2001) Deliberate Self-Harm Inventory (DSHI), and carried out a pilot study with 123 adolescents from three different schools in southern Sweden. The results showed that 65.9% of the adolescents reported having engaged in some kind of deliberate self-harm at least once; 41.5% reported at least one kind of self-harm more than once; and 13.8% reported at least one kind of deliberate self-harm behavior "many times". Although there were no overall gender differences in self-harm, the girls reported significantly more of cutting wrists, arms and other body areas than the boys. High rates of deliberate self-harm were associated with low self-esteem and low mindfulness.

Routine hospital management of self-harm and risk of further self-harm: propensity score analysis using record-based cohort data.

PubMed

Steeg, S; Emsley, R; Carr, M; Cooper, J; Kapur, N

2018-01-01

The care received by people presenting to hospital following self-harm varies and it is unclear how different types of treatment affect risk of further self-harm. Observational cohort data from the Manchester Self-Harm Project, UK, included 16 456 individuals presenting to an Emergency Department with self-harm between 2003 and 2011. Individuals were followed up for 12 months. We also used data from a smaller cohort of individuals presenting to 31 hospitals in England during a 3-month period in 2010/2011, followed up for 6 months. Propensity score (PS) methods were used to address observed confounding. Missing data were imputed using multiple imputation. Following PS stratification, those who received a psychosocial assessment had a lower risk of repeat hospital attendance for self-harm than those who were not assessed [RR 0.87, 95% confidence interval (CI) 0.80-0.95]. The risk was reduced most among people less likely to be assessed. Following PS matching, we found no associations between risks of repeat self-harm and admission to a medical bed, referral to outpatient psychiatry or admission to a psychiatric bed. We did not find a relationship between psychosocial assessment and repeat self-harm in the 31 centre cohort. This study shows the potential value of using novel statistical techniques in large mental health datasets to estimate treatment effects. We found that specialist psychosocial assessment may reduce the risk of repeat self-harm. This type of routine care should be provided for all individuals who present to hospital after self-harm, regardless of perceived risk.

Quantitative approach for the risk assessment of African swine fever and Classical swine fever introduction into the United States through legal imports of pigs and swine products.

PubMed

Herrera-Ibatá, Diana María; Martínez-López, Beatriz; Quijada, Darla; Burton, Kenneth; Mur, Lina

2017-01-01

The US livestock safety strongly depends on its capacity to prevent the introduction of Transboundary Animal Diseases (TADs). Therefore, accurate and updated information on the location and origin of those potential TADs risks is essential, so preventive measures as market restrictions can be put on place. The objective of the present study was to evaluate the current risk of African swine fever (ASF) and Classical swine fever (CSF) introduction into the US through the legal importations of live pigs and swine products using a quantitative approach that could be later applied to other risks. Four quantitative stochastic risk assessment models were developed to estimate the monthly probabilities of ASF and CSF release into the US, and the exposure of susceptible populations (domestic and feral swine) to these introductions at state level. The results suggest a low annual probability of either ASF or CSF introduction into the US, by any of the analyzed pathways (5.5*10-3). Being the probability of introduction through legal imports of live pigs (1.8*10-3 for ASF, and 2.5*10-3 for CSF) higher than the risk of legally imported swine products (8.90*10-4 for ASF, and 1.56*10-3 for CSF). This could be caused due to the low probability of exposure associated with this type of commodity (products). The risk of feral pigs accessing to swine products discarded in landfills was slightly higher than the potential exposure of domestic pigs through swill feeding. The identification of the months at highest risk, the origin of the higher risk imports, and the location of the US states most vulnerable to those introductions (Iowa, Minnesota and Wisconsin for live swine and California, Florida and Texas for swine products), is valuable information that would help to design prevention, risk-mitigation and early-detection strategies that would help to minimize the catastrophic consequences of potential ASF/CSF introductions into the US.

Quantitative approach for the risk assessment of African swine fever and Classical swine fever introduction into the United States through legal imports of pigs and swine products

PubMed Central

Herrera-Ibatá, Diana María; Martínez-López, Beatriz; Quijada, Darla; Burton, Kenneth

2017-01-01

The US livestock safety strongly depends on its capacity to prevent the introduction of Transboundary Animal Diseases (TADs). Therefore, accurate and updated information on the location and origin of those potential TADs risks is essential, so preventive measures as market restrictions can be put on place. The objective of the present study was to evaluate the current risk of African swine fever (ASF) and Classical swine fever (CSF) introduction into the US through the legal importations of live pigs and swine products using a quantitative approach that could be later applied to other risks. Four quantitative stochastic risk assessment models were developed to estimate the monthly probabilities of ASF and CSF release into the US, and the exposure of susceptible populations (domestic and feral swine) to these introductions at state level. The results suggest a low annual probability of either ASF or CSF introduction into the US, by any of the analyzed pathways (5.5*10−3). Being the probability of introduction through legal imports of live pigs (1.8*10−3 for ASF, and 2.5*10−3 for CSF) higher than the risk of legally imported swine products (8.90*10−4 for ASF, and 1.56*10−3 for CSF). This could be caused due to the low probability of exposure associated with this type of commodity (products). The risk of feral pigs accessing to swine products discarded in landfills was slightly higher than the potential exposure of domestic pigs through swill feeding. The identification of the months at highest risk, the origin of the higher risk imports, and the location of the US states most vulnerable to those introductions (Iowa, Minnesota and Wisconsin for live swine and California, Florida and Texas for swine products), is valuable information that would help to design prevention, risk-mitigation and early-detection strategies that would help to minimize the catastrophic consequences of potential ASF/CSF introductions into the US. PMID:28797058

Did Legalized Abortion Lower Crime?

ERIC Educational Resources Information Center

Joyce, Ted

2004-01-01

Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.

Developing and Evaluating an Automated All-Cause Harm Trigger System.

PubMed

Sammer, Christine; Miller, Susanne; Jones, Cason; Nelson, Antoinette; Garrett, Paul; Classen, David; Stockwell, David

2017-04-01

From 2009 through 2012, the Adventist Health System Patient Safety Organization (AHS PSO) used the Global Trigger Tool method for harm identification and demonstrated harm reduction. Although the awareness of harm demonstrated opportunities for improvement across the system, leaders determined that the human and fiscal resources required to continue with a retrospective manual harm identification process were unsustainable. In addition, there was growing concern that the identification of harm after the patient's discharge did not allow for intervention during the hospital stay. Therefore, the AHS PSO decided to seek an alternative method for patient harm identification. The AHS PSO and another PSO jointly developed a novel automated all-cause harm trigger identification system that allowed for real-time bedside intervention, real-time trend analysis affecting patient safety, and continued learning about harm measurement. A sociotechnical approach of people, process, and technology was used at two pilot hospitals sharing the same electronic health record platform. Automated positive harm triggers and work-flow models were developed and evaluated. Combined data from the two hospitals in a period of 11 consecutive months indicated (1) a total of 2,696 harms (combined hospital-acquired and outside-acquired); (2) that hypoglycemia (blood glucose ≤ 40 mg/dL) was the most frequently identified harm; (3) 256 harms related to the Patient Safety Indicator 90 (PSI 90) Composite descriptions versus 77 harms reported to regulatory harm reduction programs; and (4) that almost one third (32%) of total harms were classified as outside-acquired. The automated harm trigger system revealed not only more harm but a broader scope of harm and led to a deeper understanding of patient safety vulnerabilities. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

How do drug users define their progress in harm reduction programs? Qualitative research to develop user-generated outcomes

PubMed Central

Ruefli, Terry; Rogers, Susan J

2004-01-01

Background Harm reduction is a relatively new and controversial model for treating drug users, with little formal research on its operation and effectiveness. In order to advance the study of harm reduction programs and our understanding of how drug users define their progress, qualitative research was conducted to develop outcomes of harm reduction programming that are culturally relevant, incremental, (i.e., capable of measuring change), and hierarchical (i.e., capable of showing how clients improve over time). Methods The study used nominal group technique (NGT) to develop the outcomes (phase 1) and focus group interviews to help validate the findings (phase 2). Study participants were recruited from a large harm-reduction program in New York City and involved approximately 120 clients in 10 groups in phase 1 and 120 clients in 10 focus groups in phase 2. Results Outcomes of 10 life areas important to drug users were developed that included between 10 to 15 incremental measures per outcome. The outcomes included ways of 1) making money; 2) getting something good to eat; 3) being housed/homeless; 4) relating to families; 5) getting needed programs/benefits/services; 6) handling health problems; 7) handling negative emotions; 8) handling legal problems; 9) improving oneself; and 10) handling drug-use problems. Findings also provided insights into drug users' lives and values, as well as a window into understanding how this population envisions a better quality of life. Results challenged traditional ways of measuring drug users based solely on quantity used and frequency of use. They suggest that more appropriate measures are based on the extent to which drug users organize their lives around drug use and how much drug use is integrated into their lives and negatively impacts other aspects of their lives. Conclusions Harm reduction and other programs serving active drug users and other marginalized people should not rely on institutionalized, provider

Defining Legal Writing: An Empirical Analysis of the Legal Memorandum. LSAC Research Report Series.

ERIC Educational Resources Information Center

Breland, Hunter M.; Hart, Frederick M.

This study examined legal writing as it was represented in legal memoranda prepared by first-semester law students at 12 different law schools. The study was based on the cumulative judgments of the instructors and professors of law in those institutions, humanities specialists at the Educational Testing Service, and two legal consultants. A…

Caring for self-harming patients in general practice.

PubMed

Rowe, Joanne; Jaye, Chrystal

2017-12-01

INTRODUCTION Intentional self-harm is an international public health issue with high personal, social and financial costs to society. Poor relationship dynamics are known to have a negative influence on the psyche of people who self-harm, and this can increase anxiety and decrease self-esteem, both shown to be significant contributors to self-harm behaviours. Positive and functional social supports have been proposed as a cost-effective and constructive approach in diminishing self-harming behaviours. AIM This qualitative study investigated the aspects of professional, social, familial and romantic relationships that people who have self-harmed identified as having a positive and constructive effect on their self-harm behaviour. METHODS Twelve participants with a history of self-harming behaviours were recruited through free press advertising in primary care and interviewed. The participants ranged in age from 19 to 70 years, and represented New Zealand (NZ) European and Māori from across the Southern region of NZ. RESULTS This study shows that constructive relationships that inhibit self-harm behaviours are characterised by participants' perceptions of authenticity in their relationships, and knowing that other people genuinely care. Feeling cared for within an authentic therapeutic relationship enabled participants to overcome their perception of being damaged selves and gave them the skills and confidence to develop functional relationships within their communities. A relationship-centred care approach may be useful for general practitioners seeking to develop more effective therapeutic relationships with patients who deliberately self-harm.

Alcohol policy and harm reduction in Australia.

PubMed

Loxley, Wendy; Gray, Dennis; Wilkinson, Celia; Chikritzhs, Tanya; Midford, Richard; Moore, David

2005-11-01

With consultations having been held across Australia this year as part of the process of developing a new National Alcohol Strategy, it seemed timely to invite my colleagues from the National Drug Research Institute who are experts in the alcohol field to write this Harm Reduction Digest. The authors have canvassed a range of alcohol policy options and discussed their effectiveness in reducing harm for what is arguably Australia's number one drug problem. Australia's response to alcohol and other drug problems has, historically, been based on 'harm minimization--incorporating supply reduction, demand reduction and harm reduction'. At this time where the policy options for alcohol are being set for the next 5 years in a climate of 'small government', removing restrictions of 'fair competition' in business and a belief in the free market, what does the research have to say about recommended policies and strategies to reduce alcohol-related harm?

Tobacco harm perceptions and use among sexual and gender minorities: findings from a national sample of young adults in the United States.

PubMed

Ganz, Ollie; Johnson, Amanda L; Cohn, Amy M; Rath, Jessica; Horn, Kimberly; Vallone, Donna; Villanti, Andrea C

2018-06-01

In the United States, the prevalence of tobacco use among sexual and gender minorities (SGM) is higher compared to their non-SGM counterparts. Tobacco harm perceptions have gone largely unexamined as a potential mechanism supporting disproportionate tobacco use among this population. The purpose of this study was to examine differences between SGM and non-SGM young adults in harm perceptions of various tobacco products and tobacco use behavior and whether low tobacco-related harm perceptions moderate the relationship between identifying as a SGM and tobacco use behavior. This study used data from Wave 10 of the Truth Initiative Young Adult Cohort Study, a sample of U.S. young adults (ages 18-34). Data were collected from September to October 2016 and the study sample included 3089 individuals. Demographics, past 30-day use of cigarettes, little cigars/cigarillos/bidis and electronic cigarettes were assessed. Absolute and relative harm perceptions of these products were also examined. Identifying as a SGM and low tobacco harm perceptions were found to be positively associated with past 30-day tobacco use. There was no interaction between SGM status and harm perceptions on past 30-day tobacco use CONCLUSIONS: Findings confirm that SGM young adults continue to disproportionately use tobacco products, compared to non-SGM young adults. More research is needed to understand moderators of the relationship between SGM status and tobacco use in young adults. Copyright © 2018 Elsevier Ltd. All rights reserved.

Self-harm in patients with schizophrenia spectrum disorders.

PubMed

Mork, Erlend; Mehlum, Lars; Barrett, Elizabeth A; Agartz, Ingrid; Harkavy-Friedman, Jill M; Lorentzen, Steinar; Melle, Ingrid; Andreassen, Ole A; Walby, Fredrik A

2012-01-01

This study describes the prevalence, clinical characteristics, and gender profile of self-harm in a cross-sectional sample of 388 patients with schizophrenia spectrum disorders. All patients were interviewed and assessed with respect to lifetime self-harm and relevant clinical variables. An overall of 49% of the patients reported self-harm which was associated with female gender, having had a depressive episode, younger age at psychosis onset, alcohol abuse or dependence, current suicidality, awareness of illness, and low adherence to prescribed medication. Higher awareness of having a mental disorder was associated with self-harm in men only, while emotional dysregulation was associated with self-harm in women only. We conclude that while self-harm in patients with schizophrenia spectrum disorders is highly prevalent in both genders, risk factors in men and women differ in several important ways.

Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol.

PubMed

Anderson, Peter; Chisholm, Dan; Fuhr, Daniela C

2009-06-27

This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.

The legal framework governing the quality of (traditional) herbal medicinal products in the European Union.

PubMed

Kroes, Burt H

2014-12-02

In the European Union a complex regulatory framework is in place for the regulation of (traditional) herbal medicinal products. It is based on the principle that a marketing authorisation granted by the competent authorities is required for placing medicinal products on the market. The requirements and procedures for acquiring such a marketing authorisation are laid down in regulations, directives and scientific guidelines. This paper gives an overview of the quality requirements for (traditional) herbal medicinal products that are contained in European pharmaceutical legislation. Pharmaceutical quality of medicinal product is the basis for ensuring safe and effective medicines. The basic principles governing the assurance of the quality of medicinal products in the European Union are primarily defined in the amended Directive 2001/83/EC and Directive 2003/63/EC. Quality requirements of herbal medicinal products are also laid down in scientific guidelines. Scientific guidelines provide a basis for practical harmonisation of how the competent authorities of EU Member States interpret and apply the detailed requirements for the demonstration of quality laid down in regulations and directives. Detailed quality requirements for herbal medicinal products on the European market are contained in European Union (EU) pharmaceutical legislation. They include a system of manufacturing authorisations which ensures that all herbal medicinal products on the European market are manufactured/imported only by authorised manufacturers, whose activities are regularly inspected by the competent authorities. Additionally, as starting materials only active substances are allowed which have been manufactured in accordance with the GMP for starting materials as adopted by the Community. The European regulatory framework encompasses specific requirements for herbal medicinal products. These requirements are independent from the legal status. Thus, the same quality standards equally apply

The Development And Implementation Of A Concept To Permanent Reduction Of Noise Pollution In Production Taking Into Account The Legal And Economic Framework Conditions

NASA Astrophysics Data System (ADS)

Zaušková, Lucia; Czán, Andrej; Babík, Ondrej; Piešová, Marianna

2015-12-01

Article deals with the issue of reducing noise impact in real conditions of industrial production. The solution includes measurements and calculations of noise level the person is exposed to and developing proposals for effective reduction of noise levels at the specific workplace. When assessing noise levels and design to reduce it to an acceptable level we will consider the legal, safety and economic conditions.

To 'enable our legal product to compete effectively with the transit market': British American Tobacco's strategies in Thailand following the 1990 GATT dispute.

PubMed

MacKenzie, Ross; Lee, Kelley; LeGresley, Eric

2015-08-21

The opening of the Thai tobacco market, following action brought by the US Trade Representative under the General Agreement on Tariffs and Trade, is seen as a key case study of the tensions between trade and health policy. Interpretations of the dispute cast it, either as an example of how trade agreements undermine national policy-making, or how governments can adopt effective public health protections compliant with international trade rules. As a UK-based company, British American Tobacco has been regarded as peripheral to this dispute. This paper argues that its close monitoring of the illegal trade during this period, the role of smuggling in the company's global business strategy, and its management of the relative supply and pricing of legal and illegal products after market opening provide a fuller understanding of the interests and roles of transnational tobacco companies and the government in this dispute. The findings have important policy implications, notably the role of effective governance in countries facing pressure to open their tobacco sectors, need to better understand corporate-level activities within an increasingly globalised tobacco industry, and need to address the intertwined legal and illegal trade in implementing the WHO Framework Convention on Tobacco Control Protocol to Eliminate Illicit Trade in Tobacco Products.

Resolving legal, ethical, and human rights challenges in HIV vaccine research.

PubMed

Patterson, D

2000-01-01

In the absence of a cure for AIDS, attention has turned to the possibility of developing a preventive vaccine for HIV infection. Yet many scientific, ethical, legal, and economic obstacles remain. At the current rate, the development and production of an effective vaccine could take 15 to 20 years or longer. If tens of millions more HIV infections and deaths are to be avoided in the coming decades, vaccine research needs to be greatly expedited. Furthermore, it must be undertaken ethically, and the products of this research must benefit people in developing countries. This article, an edited and updated version of a paper presented at "Putting Third First," addresses challenges arising in HIV preventive vaccine research in developing countries. It does not address clinical research in developing countries relating to treatments or therapeutic vaccines. Nor does it address legal and ethical issues relating to HIV vaccine research in industrialized countries, although similar issues arise in both contexts. The article concludes that while ethical codes are silent on the obligation to undertake research and development, international law provides strong legal obligations--particularly with regard to industrialized states--that should be invoked to accelerate HIV vaccine development, and distribution.

What's the Harm? The Coverage of Ethics and Harm Avoidance in Research Methods Textbooks

ERIC Educational Resources Information Center

Dixon, Shane; Quirke, Linda

2018-01-01

Methods textbooks play a role in socializing a new generation of researchers about ethical research. How do undergraduate social research methods textbooks portray harm, its prevalence, and ways to mitigate harm to participants? We conducted a content analysis of ethics chapters in the 18 highest-selling undergraduate textbooks used in sociology…

Is incest harmful?

PubMed

Henderson, J

1983-02-01

Classically, incest has been considered from both a psychological and sociological point of view to have harmful consequences. Genetic research, though by no means lacking controversy of its own, generally supports the notion that inbreeding has untoward genetic consequences. The psychodynamics of all three parties to father-daughter incest seem to indicate that people who become involved in incestuous behaviour are often psychologically damaged before the fact, so that if they show subsequent evidence of psychological impairment the incestuous behaviour can be as plausibly viewed as a dysfunctional attempt at solving problems as it can a cause of subsequent psychopathology. Girls involved in the father-daughter incest present in one of half a dozen frequent clinical syndromes. The presentation is influenced by the degree to which the girl may have participated in ongoing incestuous behaviour as opposed to being the presumed victim of an older adult's coercive actions or her own temporary suspension of a behavioural taboo. Research is inconclusive as to the psychological harmfulness of incestuous behaviour, and evidence is reviewed on both sides of this complicated and controversial question. Quite apart from the general issue of the harmfulness of incest, a number of indicators can be derived from the nature of the incestuous episode and the early response to therapeutic assessment which aid in the clinical forecasting of probable outcome.

Legal capacity of persons with disabilities in Ethiopia: The need to reform existing legal frameworks.

PubMed

Marishet, Mohammed Hamza

The Convention on the Rights of Persons with Disabilities (CRPD) prohibited deprivation legal capacity of persons with disability based on assessment of mental capacity. The assertion is that, persons with disabilities shall exercise their legal capacity in all aspects of life without any restrictions that are based on mental incapacity (such as, unsoundness of mind, deficit in mental capacity, dotage, etc. This approach signifies a shift from substituted decision making, where another person act on behalf of persons with mental disabilities, to supported decision making where the person with mental disability is assisted in decision making. The rationale for the move lies on the recognition that the right to legal capacity embodies the inherent meaning of what it meant to be human. Without legal capacity a person cannot exercise all other rights and entitlements. Accordingly, States parties to CRPD are required to reform domestic legislations that are based on substituted decision making model and recognize full legal capacity of persons with disabilities in line with supported decision making model. As a Sate party to CRPD, Ethiopia assumed the same obligation. Nonetheless, in its initial report to the Committee on CRPD, the country denies existence of legislation that restricts legal capacity on the grounds of mental incapacity. This research found out that there are restrictions imposed on legal capacity of persons with disabilities on the basis of mental incapacity/disability. The research analyzed the approach employed to restrict legal capacity under the existing legal frameworks of Ethiopia vis-à-vis supported decision-making regime under CRPD. The research is doctrinal and, as such, limited to content analysis of general and specific legal capacity laws of the country (such as, marriage, divorce, will, work and employment, political participation, access to justice and others). Copyright © 2017 Elsevier Ltd. All rights reserved.

Do immigrants working illegally reduce the natives' legal employment? Evidence from Italy.

PubMed

Venturini, A

1999-01-01

This paper examines how immigrants working illegally in the shadow economy affect the legal employment of native and foreign workers in the official economy of Italy. The data set used was provided by the Central Statistical Office and includes information regarding the units of labor employed both in official production and in underground production; employment in the latter is subdivided into native workers and foreign workers. Estimates were then made as to how "legal employment" has reacted to changes in "illegal employment", with special reference to the effect of the foreign component of "illegal labor". The results of the cross sector-time series analysis of the demand for legal labor in the Italian economy from 1980 to 1995 showed that the increase of illegal units of labor produces a reduction in the use of legal labor, albeit a very limited one. An analysis by sectors shows that the competitive effects of illegal foreign workers is not homogeneous and is strongest in the agricultural sector while complementarity between the two categories of labor is evident in the nontradable services sector. When comparing the number of effects of illegal foreign and illegal native workers, illegal native workers are lower than the illegal foreign workers. Despite regularization in Italy and the lack of flexibility in the labor market, neither regular nor nonregular foreign workers have begun to openly displace native workers.

Patients with lung cancer: Are electronic cigarettes harmful or useful?

PubMed

Dautzenberg, Bertrand; Garelik, Daniel

2017-03-01

E-cigarettes remain controversial because the scientific evidence of short term and long term effects on tolerance and the health value of a switch from tobacco to e-cigarettes is contested and controversial. Nevertheless the quality of e-cigarettes and e-liquids has improved. The main ingredients, propylene glycol, vegetable glycerine and nicotine are pharmaceutical-grade quality in most e-liquids. Flavors are almost all food grade. The high quality of ingredients has decreased the presence of impurities in e-liquids. The emissions of e-cigarettes do not contain solid particles or carbon monoxide. Nitrosamine content is at least one hundred times lower than in tobacco smoke. E-cigarette emissions in normal use do not contain any harmful constituents at significant levels except nicotine. UK public health authorities have stated that e-cigarette use is likely to be at least 95% less toxic than cigarette use. There are benefits from having a well-regulated legal market. In countries where e-liquid containing nicotine is not allowed, "do-it-yourself" liquids are common and have handling risks and may sometimes contain toxic impurities. Though e-cigarettes should never be assumed safe products for non-smokers, for smokers, the e-cigarette is at least 20 times less dangerous than the cigarette. Tobacco cessation specialists in countries where nicotine containing e-cigarettes are available increasingly provide counselling for e-cigarette use to stop smoking or to reduce smoking at the request of patients. Based on current knowledge, for patients with lung or other forms of cancer who would otherwise continue to smoke, e-cigarettes offer an alternative way to quit smoking while they undergo medical treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

38 CFR 13.58 - Legal custodian.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Legal custodian. 13.58... ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.58 Legal custodian. (a) Authority. The Veterans Service Center Manager is authorized to make determinations as to the person or legal entity to be appointed legal custodian...

38 CFR 13.58 - Legal custodian.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Legal custodian. 13.58... ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.58 Legal custodian. (a) Authority. The Veterans Service Center Manager is authorized to make determinations as to the person or legal entity to be appointed legal custodian...

38 CFR 13.58 - Legal custodian.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Legal custodian. 13.58... ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.58 Legal custodian. (a) Authority. The Veterans Service Center Manager is authorized to make determinations as to the person or legal entity to be appointed legal custodian...

38 CFR 13.58 - Legal custodian.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Legal custodian. 13.58... ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.58 Legal custodian. (a) Authority. The Veterans Service Center Manager is authorized to make determinations as to the person or legal entity to be appointed legal custodian...

38 CFR 13.58 - Legal custodian.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Legal custodian. 13.58... ADMINISTRATION, FIDUCIARY ACTIVITIES § 13.58 Legal custodian. (a) Authority. The Veterans Service Center Manager is authorized to make determinations as to the person or legal entity to be appointed legal custodian...

Perceived harm as a mediator of the relationship between social norms and marijuana use and related consequences among American Indian youth.

PubMed

Prince, Mark A; Swaim, Randall C; Stanley, Linda R; Conner, Bradley T

2017-12-01

American Indian (AI) youth are at increased risk for marijuana use with marijuana use rates on or near reservations 1.6-4.8 times higher compared to non-AI youth in the same regions (Stanley et al., 2014). One outcome of the changing social and legal acceptance of marijuana is a decrease in perceived risk among adolescents. It is unknown whether these changes in perceptions of marijuana-related harm will presage higher rates of use among AI youth. Perceptions of others use (i.e., descriptive norms) and approval (i.e., injunctive norms) are consistent predictors of marijuana use and consequences. Moreover, large scale surveys have shown that gender is an important moderator of the relationship between norms and marijuana use in AI samples. The current study is a large epidemiologic study of 7th-12th grade self-identified American Indian students (N=3050). We examined the direct relations between descriptive and injunctive norms and marijuana use/consequences among AI youth, as well as the mediating role of perceived harm and the moderating role of gender. Results of a multi-group path analysis revealed a similar pattern of findings for males and females. In addition, there were direct effects for descriptive but not injunctive norms on marijuana use/consequences, and the sequential pathway from norms to use/consequences via perceived harm held. Findings suggest that normative perceptions and perceived harm are antecedents of marijuana use/consequences and are prime targets for large scale interventions on AI reservations. Copyright © 2017 Elsevier B.V. All rights reserved.

The legalization of cannabis derivatives in Spain: Hypothesis on a potential emerging market.

PubMed

Álvarez, Arturo; Gamella, Juan F; Parra, Iván

2017-06-28

First, this paper estimates the dimensions of the market for cannabis in Spain using data on the extent of consumption and the main patterns of use of consumers. Then the paper reviews the hypothetical production and distribution costs of these drugs in different production regimes under different legal conditions. The review shows that current prices of cannabis in the illegal market could be notably reduced if production and distribution of cannabis were decriminalized and even more if they were performed by legal enterprises. Thirdly, we examine the relationship between prices and consumption levels by analysing the price elasticity of demand. A fall in the prices of cannabis products will likely result in an increase in the number of users and in the total amount consumed. Lastly we consider several alternatives for the taxation of cannabis derivatives to counteract the likely fall in prices, and their pros and cons.

Impulsivity and self-harm in adolescence: a systematic review.

PubMed

Lockwood, Joanna; Daley, David; Townsend, Ellen; Sayal, Kapil

2017-04-01

Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.

A Legal Handbook.

ERIC Educational Resources Information Center

Cincinnati Public Schools, OH.

This publication was developed by the Cincinnati (Ohio) Public Schools for use as a resource in adult basic education classes. It presents, in simple format, the basic legal rights of citizens of the United States and points out legal problem areas that average adults may encounter in daily life. The book is organized into nine parts containing 2…

Accreditation's Legal Landscape

ERIC Educational Resources Information Center

Graca, Thomas J.

2009-01-01

Like most issues in higher education, the accreditation paradigm in the United States is defined in large measure by the legal and political climate in which the academy finds itself. In the case of accreditation in particular, the legal substrate is of particular importance given the central role of accreditation in a college's ability to receive…

32 CFR 724.703 - Legal counsel.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 5 2012-07-01 2012-07-01 false Legal counsel. 724.703 Section 724.703 National... Organization of the Naval Discharge Review Board § 724.703 Legal counsel. Normally, the NDRB shall function without the immediate attendance of legal counsel. In the event that a legal advisory opinion is deemed...

32 CFR 724.703 - Legal counsel.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 5 2010-07-01 2010-07-01 false Legal counsel. 724.703 Section 724.703 National... Organization of the Naval Discharge Review Board § 724.703 Legal counsel. Normally, the NDRB shall function without the immediate attendance of legal counsel. In the event that a legal advisory opinion is deemed...

32 CFR 724.703 - Legal counsel.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 5 2011-07-01 2011-07-01 false Legal counsel. 724.703 Section 724.703 National... Organization of the Naval Discharge Review Board § 724.703 Legal counsel. Normally, the NDRB shall function without the immediate attendance of legal counsel. In the event that a legal advisory opinion is deemed...

32 CFR 724.703 - Legal counsel.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 5 2014-07-01 2014-07-01 false Legal counsel. 724.703 Section 724.703 National... Organization of the Naval Discharge Review Board § 724.703 Legal counsel. Normally, the NDRB shall function without the immediate attendance of legal counsel. In the event that a legal advisory opinion is deemed...

32 CFR 724.703 - Legal counsel.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 5 2013-07-01 2013-07-01 false Legal counsel. 724.703 Section 724.703 National... Organization of the Naval Discharge Review Board § 724.703 Legal counsel. Normally, the NDRB shall function without the immediate attendance of legal counsel. In the event that a legal advisory opinion is deemed...

Legal and Regulatory Barriers to Reverse Innovation.

PubMed

Rowthorn, Virginia; Plum, Alexander J; Zervos, John

Reverse innovation, or the importation of new, affordable, and efficacious models to high-income countries from the developing world, has emerged as a way to improve the health care system in the United States. Reverse innovation has been identified as a key emerging trend in global health systems in part because low-resourced settings are particularly good laboratories for low-cost/high-impact innovations that are developed out of necessity. A difficult question receiving scant attention is that of legal and regulatory barriers. The objective of this paper is to understand and elucidate the legal barriers faced by innovators bringing health interventions to the United States. Semistructured qualitative interviews were conducted with 9 key informants who have directly participated in the introduction of global health care approaches to the United States health system. A purposive sampling scheme was employed to identify participants. Phone interviews were conducted over one week in July 2016 with each participant and lasted an average of 35 minutes each. Purely legal barriers included questions surrounding tort liability, standard of care, and concerns around patient-administered self-care. Regulatory burdens included issues of international medical licensure, reimbursement, and task shifting and scope of work challenges among nonprofessionals (e.g. community health workers). Finally, perceived (i.e. not realized or experienced) legal and regulatory barriers to innovative modalities served as disincentives to bringing products or services developed outside of the United States to the United States market. Conflicting interests within the health care system, safety concerns, and little value placed on low-cost interventions inhibit innovation. Legal and regulatory barriers rank among, and contribute to, an anti-innovation atmosphere in healthcare for domestic and reverse innovators alike. Reverse innovation should be fostered through the thoughtful development of

Potentially harmful excipients in neonatal medicines: a pan-European observational study.

PubMed

Nellis, Georgi; Metsvaht, Tuuli; Varendi, Heili; Toompere, Karolin; Lass, Jana; Mesek, Inge; Nunn, Anthony J; Turner, Mark A; Lutsar, Irja

2015-07-01

We aimed to describe administration of eight potentially harmful excipients of interest (EOI)-parabens, polysorbate 80, propylene glycol, benzoates, saccharin sodium, sorbitol, ethanol and benzalkonium chloride-to hospitalised neonates in Europe and to identify risk factors for exposure. All medicines administered to neonates during 1 day with individual prescription and demographic data were registered in a web-based point prevalence study. Excipients were identified from the Summaries of Product Characteristics. Determinants of EOI administration (geographical region, gestational age (GA), active pharmaceutical ingredient, unit level and hospital teaching status) were identified using multivariable logistical regression analysis. Overall 89 neonatal units from 21 countries participated. Altogether 2095 prescriptions for 530 products administered to 726 neonates were recorded. EOI were found in 638 (31%) prescriptions and were administered to 456 (63%) neonates through a relatively small number of products (n=142; 27%). Parabens, found in 71 (13%) products administered to 313 (43%) neonates, were used most frequently. EOI administration varied by geographical region, GA and route of administration. Geographical region remained a significant determinant of the use of parabens, polysorbate 80, propylene glycol and saccharin sodium after adjustment for the potential covariates including anatomical therapeutic chemical class of the active ingredient. European neonates receive a number of potentially harmful pharmaceutical excipients. Regional differences in EOI administration suggest that EOI-free products are available and provide the potential for substitution to avoid side effects of some excipients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Perceived intent motivates people to magnify observed harms

PubMed Central

Ames, Daniel L.; Fiske, Susan T.

2015-01-01

Existing moral psychology research commonly explains certain phenomena in terms of a motivation to blame. However, this motivation is not measured directly, but rather is inferred from other measures, such as participants’ judgments of an agent’s blameworthiness. The present paper introduces new methods for assessing this theoretically important motivation, using tools drawn from animal-model research. We test these methods in the context of recent “harm-magnification” research, which shows that people often overestimate the damage caused by intentional (versus unintentional) harms. A preliminary experiment exemplifies this work and also rules out an alternative explanation for earlier harm-magnification results. Exp. 1 asks whether intended harm motivates blame or merely demonstrates the actor’s intrinsic blameworthiness. Consistent with a motivational interpretation, participants freely chose blaming, condemning, and punishing over other appealing tasks in an intentional-harm condition, compared with an unintentional-harm condition. Exp. 2 also measures motivation but with converging indicators of persistence (effort, rate, and duration) in blaming. In addition to their methodological contribution, these studies also illuminate people’s motivational responses to intentional harms. Perceived intent emerges as catalyzing a motivated social cognitive process related to social prediction and control. PMID:25733850

14 CFR 77.47 - Legal officer.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Legal officer. 77.47 Section 77.47... § 77.47 Legal officer. The Chief Counsel designates a member of his staff to serve as legal officer at each hearing under this subpart. The legal officer may examine witnesses and assist and advise the...

40 CFR 60.26 - Legal authority.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 7 2014-07-01 2014-07-01 false Legal authority. 60.26 Section 60.26... Legal authority. (a) Each plan shall show that the State has legal authority to carry out the plan... designated pollutant(s) for which the plan is submitted. (c) The plan shall show that the legal authorities...

40 CFR 60.26 - Legal authority.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Legal authority. 60.26 Section 60.26... Legal authority. (a) Each plan shall show that the State has legal authority to carry out the plan... designated pollutant(s) for which the plan is submitted. (c) The plan shall show that the legal authorities...

40 CFR 60.26 - Legal authority.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 7 2012-07-01 2012-07-01 false Legal authority. 60.26 Section 60.26... Legal authority. (a) Each plan shall show that the State has legal authority to carry out the plan... designated pollutant(s) for which the plan is submitted. (c) The plan shall show that the legal authorities...

40 CFR 60.26 - Legal authority.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 7 2013-07-01 2013-07-01 false Legal authority. 60.26 Section 60.26... Legal authority. (a) Each plan shall show that the State has legal authority to carry out the plan... designated pollutant(s) for which the plan is submitted. (c) The plan shall show that the legal authorities...

40 CFR 60.26 - Legal authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false Legal authority. 60.26 Section 60.26... Legal authority. (a) Each plan shall show that the State has legal authority to carry out the plan... designated pollutant(s) for which the plan is submitted. (c) The plan shall show that the legal authorities...

44 CFR 206.164 - Disaster legal services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Disaster legal services. 206... § 206.164 Disaster legal services. (a) Legal services, including legal advice, counseling, and... adequate legal services, whether the insufficiency existed prior to or results from the major disaster. In...

44 CFR 206.164 - Disaster legal services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Disaster legal services. 206... § 206.164 Disaster legal services. (a) Legal services, including legal advice, counseling, and... adequate legal services, whether the insufficiency existed prior to or results from the major disaster. In...

44 CFR 206.164 - Disaster legal services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Disaster legal services. 206... § 206.164 Disaster legal services. (a) Legal services, including legal advice, counseling, and... adequate legal services, whether the insufficiency existed prior to or results from the major disaster. In...

Against Harmful Research on Non-Agreeing Children.

PubMed

Chwang, Eric

2015-07-01

The Code of Federal Regulations permits harmful research on children who have not agreed to participate, but I will argue that it should be no more permissive of harmful research on such children than of harmful research on adults who have not agreed to participate. Of course, the Code permits harmful research on adults. Such research is not morally problematic, however, because adults must agree to participate. And, of course, the Code also permits beneficial research on children without needing their explicit agreement. This sort of research is also not problematic, this time because paternalism towards children may be justifiable. The moral problem at the center of this paper arises from the combination of two potential properties of pediatric research, first that it might be harmful and second that its subjects might not agree to participate. In Section 2 of this article I explain how the Code permits harmful research on non-agreeing children. Section 3 contains my argument that we should no more permit harmful research on non-agreeing children than on non-agreeing adults. In Section 4, I argue that my thesis does not presuppose that pediatric assent has the same moral force that adult consent does. In Section 5, I argue that the distinction between non-voluntary and involuntary research is irrelevant to my thesis. In Section 6, I rebut an objection based on the power of parental permission. In Section 7 I suggest how the Code of Federal Regulations might be changed. © 2014 John Wiley & Sons Ltd.

42 CFR 425.104 - Legal entity.

Code of Federal Regulations, 2012 CFR