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The article "Legal Innovations" provides information on various changes in the field of medical law and professional law. In medical law, changes have been made to the Narcotic Drug Quantity Regulation and the Psychotropic Substance Quantity Regulation. In professional law, changes have been made to the Occupational Diseases Modernization Act, the Health Reform Measures Financing Act, the Dental Practitioners Act Amendment 2023, and the Nursing Act Amendment 2023. Other changes concern the collective agreement of the Vorarlberg Social and Health Care Sector, the OTA-AV Amendment 2024, the Physicians Act 1998, the Federal Act on Hospitals and Health Resorts, the Pharmacopoeia, the Medical Device Reporting Regulation 2024, and the Health Target Control Act. Changes have also been made to the Pharmacy Act, the Pharmacy Chamber Act 2001, and the Salary Fund Act 2002, which aim to improve pharmaceutical supply. Pharmacies are now also allowed to conduct health tests and operate dispensing points in areas without their own pharmacies. [Extracted from the article]

The article "Legal Innovations" deals with various legal changes in the field of healthcare. Changes in the training regulations for veterinary office assistance and dental specialist assistance are presented. Furthermore, the distribution of medical contract positions is reported according to the Healthcare Reform Financing Act. Other topics include an increase in the endowment of the nursing care fund and the repeal of certain provisions in the Physicians Act 1998, Dental Chamber Act, and Veterinary Chamber Act. In addition, adjustments to the pharmacopoeia are presented. There are changes in the Veterinary Medicines Act as well as in the Medicines Act, Health and Nutrition Safety Act, Food Safety and Consumer Protection Act, Veterinary Act, Medicinal Products Import Act 2005, Biocidal Products Act, Chemicals Act 1996, Patent Act 1970, Pharmacy Act, Animal Welfare Act, Veterinary Chamber Act, Prescription Drug Act, and Pharmacopoeia Act 2012. There is a separate law on veterinary medicines and adjustments in various laws are necessary. There are also changes in the Medicines Act, Medicinal Products Import Act, Prescription Drug Act, and Veterinary Medicines Act regarding compensation for drug dealers. There are financial measures to ensure the availability of medicines and changes in the Health and Nutrition Safety Act. There are also changes in the Narcotics Regulation and Psychotropic Substances Regulation regarding the handling of narcotics and psychotropic substances. [Extracted from the article]

The article "Legal Innovations" in the Journal for Medical and Health Law reports on various legislative changes in the field of healthcare in Austria. Changes in professional law, medical products, social law, and sanitary law are presented. Among other things, new framework conditions for the competencies and qualification certificates of healthcare and nursing professionals are created, an apprenticeship for nursing assistance and nursing specialist assistance is introduced, and a federal law on the establishment of a federal crisis camp for the healthcare sector is enacted. Further changes concern the pharmacy and pharmaceutical law, primary care law, and the parent-child passport law. [Extracted from the article]

The article provides information on various legal innovations in social and labor law, as well as in COVID-19 and health law in Austria. Changes in various laws and regulations are listed, such as the General Social Security Act, the War Victims' Compensation Act, and the Federal Care Allowance Act. In COVID-19 and health law, extensions of provisions for the provision of antigen tests, vaccination against SARS-CoV-2, and the implementation of screening programs are mentioned. There are also changes in the field of health law, professional law, and medical products. Vietnam has withdrawn reservations to international agreements, and Greece has ratified the Convention on the International Protection of Adults. There is a revision of the International Private Law in the field of adult representation. [Extracted from the article]

The article deals with the tension between the duty of confidentiality of medical institutions and practitioners on one hand, and the right to information of the legal guardians on the other hand, in the treatment of minors. It is pointed out that the duty of confidentiality towards legal representatives of incapacitated minors may be breached and must be breached due to obligations to provide information. Capable minors have the right to keep sensitive information confidential, while legal guardians have the right to determine the whereabouts of minors, unless this contradicts the best interests of the child. Practitioners must inform the legal guardians of the whereabouts of minors and breach their duty of confidentiality in this case. [Extracted from the article]

The summary of the text is as follows: The article "Legal Innovations" deals with various changes in legislation in the field of social law, medical law, professional law, medical products, and e-health. In social law, amendments were made to the Federal Care Allowance Act, including an increase in the hardship supplement for people with dementia-related impairments. In medical law, regulations on vaccination in outpatient settings were maintained, and further allowances for tests and treatments for COVID-19 were introduced. In professional law, special regulations were introduced for the vocational training occupations of nursing assistant and nursing care assistant. In the field of medical products and e-health, adjustments were made in connection with the introduction of a digital prescription process (e-prescription). [Extracted from the article]

The article "LVwG Tirol: Unauthorized practice of healthcare and nursing" deals with administrative offenses related to the exercise of the advanced service for healthcare and nursing. It is stated that an administrative offense occurs when someone carries out this activity without recognition of their foreign acquired education or when someone employs someone for this activity without recognition of their foreign acquired education. It is also pointed out that an administrative offense occurs when the reservation of operation form according to the ÄrzteG (Physicians Act) is violated. The decision of the LVwG Tirol from March 17, 2022 refers to the administrative offenses committed by the complainant and the complainant. The fines imposed on the complainants were considered appropriate to their guilt and the decision has a general preventive effect. [Extracted from the article]

The article "Legal Innovations" deals with various legal changes in the field of medical and health law. In connection with COVID-19 and medical law, a 3rd amendment to the COVID-19 Entry Ordinance and a 5th amendment to the 2nd COVID-19 Basic Measures Ordinance are mentioned. There are also changes in professional law, such as an amendment to the Physicians Act 2022, which concerns the composition and activities of the "Article 44 Commission for Medical Education". Further changes concern the Specialist Dentist Orthodontics Act and the Medical Devices Act. Changes regarding medical products and e-health are also mentioned, such as the implementation of the requirements of EU Regulation 2022/112 and the amendment of the New Psychoactive Substances Regulation. [Extracted from the article]

The article deals with the sanctioning of professional misconduct in non-medical healthcare professions. Similarities and differences in the sanctioning system are highlighted, problems are identified, and suggestions for improvement are made. The professional duties are presented in a table, and it is pointed out that behavioral norms are reinforced by sanctioning norms in order to protect the rights of patients. It is also noted that simultaneous criminal liability cannot be disregarded. The article addresses the sanctioning of professional misconduct in the healthcare sector. It is pointed out that unauthorized medical treatments, violations of disclosure obligations, lack of expert assistance, violations of documentation obligations, violations of confidentiality obligations, violations of disclosure obligations, violations of reporting obligations, violations of the obligation to personally and directly practice the profession, violations of the obligation to report the professional address, violations of advertising restrictions, and the hygienic condition of the professional address can be sanctioned differently. It is noted that professional liability is structured differently in different professions. The article discusses the differences in the sanctioning of professional misconduct in the professional laws for medical-technical services (MTD-G), midwives (HebG), and healthcare and nursing professionals (GuKG) in Austria. While almost all professional misconduct is criminally sanctioned in MTD-G and HebG, this is the exception in GuKG. It is argued that there is no rational justification for these differences and that harmonization of the sanctioning is politically necessary. It is suggested to include certain professional misconduct, such as violations of the prohibition of discrimination and the obligation for further education, in the criminal offenses of GuKG. Furthermore, the importance of reporting obligations for healthcare professions in violence prevention is emphasized, and corresponding sanctions for violations of this obligation are recommended. [Extracted from the article]

Paediatric non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease in childhood. Obesity is the main risk factor. Nutrition and lifestyle are the key elements in preventing and treating NAFLD in the absence of approved drug therapy. Whilst recommendations and studies on macronutrients (carbohydrates, fat and protein) in adult NAFLD exist, the discussion of this topic in paediatric NAFLD remains contradictory. The purpose of this review is to provide state-of-the-art knowledge on the role of macronutrients in paediatric NAFLD regarding quality and quantity. PubMed was searched and original studies and review articles were included in this review. Fructose, sucrose, saturated fatty acids, trans-fatty acids and ω-6-fatty-acids are strongly associated with paediatric NAFLD. High consumption of fibre, diets with a low glycaemic index, mono-unsaturated-fatty-acids and ω-3-fatty-acids reduce the risk of childhood-onset NAFLD. Data regarding the role of dietary protein in NAFLD are contradictory. No single diet is superior in treating paediatric NAFLD, although the composition of macronutrients in the Mediterranean Diet appears beneficial. Moreover, the optimal proportions of total macronutrients in the diet of paediatric NAFLD patients are unknown. Maintaining a eucaloric diet and avoiding saturated fatty acids, simple sugars (mainly fructose) and a high-caloric Western Diet are supported by literature. [ABSTRACT FROM AUTHOR]

The Journal for Medical and Health Law (JMG) presents interesting articles on the topic of health and medical law in its second issue of the year. One focus is on the decision of the Supreme Court regarding "wrongful birth" and "wrongful conception". Other articles address topics such as the recognition of foreign degrees in the healthcare sector, the recruitment of nursing staff from third countries, and the assumption of costs by the Austrian Integration Fund. In addition, the journal offers contributions on various legal aspects in the medical field. One article deals with the health function of forests. [Extracted from the article]

The article "Legal Innovations" in the Journal for Medical and Health Law summarizes various legislative changes in the period from July 1 to August 31, 2022. Changes in the Health Target Control Act, the Drug Tax, the Cost Reimbursement for the Umbrella Organization of Social Insurance Institutions, and the Federal Care Allowance Act are mentioned. In connection with COVID-19, regulations on the dispensing of drugs and vaccines, as well as school organizational measures to prevent the spread of the virus, are implemented. Decisions of the Constitutional Court regarding the COVID-19 Protection Measures Ordinance and the COVID-19 Emergency Measures Ordinance are also mentioned. Furthermore, changes related to notifiable diseases, the COVID-19 Fund, the isolation of the sick and suspected cases, the entry regulation, recommended vaccinations, and the Health Telematics Act are described. [Extracted from the article]

The article "Legal Innovations" in the Journal for Medical and Health Law reports on various legislative changes in the period from April 1 to June 30, 2022. It mentions various laws and regulations that affect changes in social law, medical law, health telematics law, epidemic law, administrative law, drug pricing, and other areas. It also mentions extensions of regulations related to COVID-19 and pandemic regulations. The article includes a list of laws and regulations with their short titles and notes on the changes. [Extracted from the article]

In the editorial of the Journal for Medical and Health Law (JMG), reference is made to the upcoming regional, national, and European elections, which also have implications for the healthcare system. It is mentioned that the Austrian healthcare reform still requires many steps. Two articles in this issue address changes in pharmacy law and the benefits of the new electronic parent-child pass. Another article deals with the Supreme Court's case law on claims for damages in cases of unintended pregnancy despite the use of a spiral contraceptive. It also highlights the legal entitlement to an advance healthcare directive and other less dramatic topics in health law. [Extracted from the article]

The article offers information on Austrian legal situation regarding the SARS-CoV-2 pandemic. Topics discusses include segregation and traffic restrictions and legal protection against te pandemic; legal instruments for containing infectious diseases regulated by the Epidemic Act 1950; and critical care health and key personnel and management of contact persons diverges according to category such as isolation, traffic restriction, self-monitoring and registration.

The editorial of the Journal for Medical and Health Law (JMG) refers to various crises in the year 2023, including the Corona pandemic, Russia's attack on Ukraine, and the climate crisis. It also addresses the "personnel crisis" in the healthcare sector and discusses solutions such as the implementation of nursing education. Other topics of the editorial include decision-making capacity in mental illnesses, professional legal issues of first responders and medical disciplinary law, liability of medical device manufacturers and authorities, as well as the temporary employment directive in outsourced hospitals. Recommendations are also given for ethically responsible medical practice in the use of artificial intelligence and the efficiency of the Austrian healthcare system compared internationally. The editorial also includes glosses on various court decisions regarding topics such as the discriminatory exclusion from participating in an entrance examination for military doctors, the social security number as health data, the requirements for medical expert opinions, the limits of freedom of speech in relation to a doctor's statement, as well as loss of earnings under the Crime Victims Compensation Act and the right to a decision within reasonable time limits in proceedings for granting a pharmacy concession. The editorial concludes with Christmas and New Year's greetings from the editorial board. [Extracted from the article]

The editorial of the Journal for Medical and Health Law (JMG) reports on various topics in the healthcare sector. The focus of this issue is on mental illnesses. It covers, among other things, the re-regulation of measures for the execution of sentences, the amendment of the law on placement, and the basic principles of psychiatry. Furthermore, contributions on other topics such as drug testing, assessment of compensation for pain and criminal liability are presented. Therefore, the journal offers a variety of specialized reading material for the autumn. [Extracted from the article]

The article focuses on liability in relation to surgical robots. It mentions surgical robots is the cause of death in cases on the technique or the intervention and basically a costly treatment method acts whose justification is lower evidence seems questionable. It also mentions liability regime failure and therefore no adequate risk allocation through artificial intelligence with features assistant liability and strict liability.

The second issue of the Journal for Medical and Health Law in the year 2023 contains a mixture of current topics. It addresses, among other things, the reform of nursing and health insurance, cross-border treatments, and questions of product liability. It also discusses topics such as the collaboration between medical and non-medical health professions, the basis for consent in cross-border medical treatments, and the protective effects of nursing home contracts. Another focus is the introduction of e-prescriptions and the legal regulation of triage in Germany. The issue offers a variety of interesting articles for readers. [Extracted from the article]

The article criticizes a change in the University of Applied Sciences Act that makes it more difficult for qualified health and nursing professionals to upgrade to a bachelor's degree. According to the amendment, students who have obtained their professional qualification as qualified health and nursing professionals through a qualification according to the GuK-AV must complete at least 90 ECTS credits to obtain the academic degree of "Bachelor". Specializations and further education courses cannot be credited either. The article discusses the recognition of professional qualifications for qualified health and nursing professionals and suggests creating a special regulation to obtain the bachelor's degree. However, this regulation should be temporary. [Extracted from the article]

The Journal for Medical and Health Law (JMG) dedicates its current issue to the medical and legal peculiarities concerning children and adolescents. The magazine covers topics such as the medical treatment of children, research on them, and their rights. It also addresses the impact of the COVID-19 pandemic on children and adolescents. Other topics include reproductive medicine, the limits of therapy for children and adolescents, confidentiality obligations for minors, and other relevant subjects. The magazine also provides an overview of legislative innovations and current literature. [Extracted from the article]

The fourth and final issue of the Journal for Medical and Health Law in the year 2022 contains an up-to-date overview article on the amendment of the Detention Act (Toyooka). Other articles deal with the mandatory vaccination against the Corona virus, assisted suicide in prison, and changes to pharmaceutical law due to EU legal developments. Topics such as patient rights and patient safety, telemedicine as telework, and the shortage of personnel in the healthcare sector are also addressed. The issue also provides information on current literature and wishes the readers a Merry Christmas and a Happy New Year 2023. [Extracted from the article]

The Journal for Medical and Health Law (JMG) presents itself in a new design and with a new content structure in order to be more current and relevant to practice. The editorial team has been expanded and the journal is now edited by Michael Ganner and Markus Grimm. The new focus of the JMG is on the perspective of the actors in the healthcare sector, both patients and service providers. This issue covers various topics, including nursing reform, the vaccine damage law, and the impact of the COVID-19 pandemic on patient data security. Articles on patient safety, patient rights, and medical research are also presented. [Extracted from the article]

Introduction: Image interpretation during ultrasound guided interscalene nerve blocks might be difficult and misleading due to rare anatomical variations of the sternocleidomastoid muscle. Case report: During a routine dissection, we found a cleidoatlanticus muscle, which originated lateral to the regular cleidomastoid portion of the sternocleidomastoid muscle. This muscle separated from the sternocleidomastoid muscle at level of the dorsally crossing omohyoid muscle to fuse with the levator scapulae muscle's origin at the transverse process of the atlas. Conclusion: As this muscle crosses at a level, where ultrasound guided interscalene blocks are performed, this unusual structure might lead to misinterpretation of the confusing ultrasound image, resulting in misguided needle positioning and consecutive inefficiency of the block technique. [ABSTRACT FROM AUTHOR]

To compare patterns of sedentary (SED) time (more sedentary, SED + vs less sedentary, SED-), moderate to vigorous physical activity (MVPA) time (more active, MVPA + vs less active, MVPA-), and combinations of behaviors (SED-/MVPA + , SED-/MVPA-, SED + /MVPA + , SED + /MVPA-) regarding nonalcoholic fatty liver diseases (NAFLD) markers. This cross-sectional study included 134 subjects (13.4 ± 2.2 years, body mass index (BMI) 98.9 ± 0.7 percentile, 48.5% females) who underwent 24-h/7-day accelerometry, anthropometric, and biochemical markers (alanine aminotransferase (ALT) as first criterion, and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), AST/ALT ratio as secondary criteria). A subgroup of 39 patients underwent magnetic resonance imaging-liver fat content (MRI-LFC). Hepatic health was better in SED- (lower ALT, GGT, and MRI-LFC (p < 0.05), higher AST/ALT (p < 0.01)) vs SED + and in MVPA + (lower ALT (p < 0.05), higher AST/ALT (p < 0.01)) vs MVPA- groups after adjustment for age, gender, and Tanner stages. SED-/MVPA + group had the best hepatic health. SED-/MVPA- group had lower ALT and GGT and higher AST/ALT (p < 0.05) in comparison with SED + /MVPA + group independently of BMI. SED time was positively associated with biochemical (high ALT, low AST/ALT ratio) and imaging (high MRI-LFC) markers independently of MVPA. MVPA time was associated with biochemical markers (low ALT, high AST/ALT) but these associations were no longer significant after adjustment for SED time. Conclusion: Lower SED time is associated with better hepatic health independently of MVPA. Reducing SED time might be a first step in the management of pediatric obesity NAFLD when increasing MVPA is not possible. What is Known: • MVPA and SED times are associated with cardiometabolic risks in youths with obesity. • The relationships between NAFLD markers and concomitant MVPA and SED times have not been studied in this population. What is New: • Low SED time is associated with healthier liver enzyme profiles and LFC independent of MVPA. • While low SED/high MVPA is the more desirable pattern, low SED/low MVPA pattern would have healthier liver enzyme profile compared with high MVPA/high SED, independent of BMI, suggesting that reducing SED time irrespective of MVPA is needed to optimize liver health. [ABSTRACT FROM AUTHOR]

Summary: Background: Relationships between movement‐related behaviours and metabolic health remain underexplored in adolescents with obesity. Objectives: To compare profiles of sedentary time (more sedentary, SED+ vs. less sedentary, SED−), moderate to vigorous physical activity (MVPA) time (more active, MVPA+ vs. less active, MVPA−) and combinations of behaviours (SED−/MVPA+, SED−/MVPA−, SED+/MVPA+, SED+/MVPA−) in regard to metabolic health. Methods: One hundred and thirty‐four subjects (mean age 13.4 ± 2.2 yrs, mean body mass index [BMI] 98.9 ± 0.7 percentile, 48.5% females) underwent 24 h/7 day accelerometry, anthropometric, body composition, blood pressure (BP), lipid profile and insulin resistance (IR) assessments. Results: Metabolic health was better in SED− [lower fat mass (FM) percentage (p < 0.05), blood pressure (BP) (p < 0.05), homeostasis model assessment of insulin resistance (HOMA‐IR) (p < 0.001) and metabolic syndrome risk score (MetScore) (p < 0.001), higher high‐density lipoprotein‐cholesterol (HDL‐c) (p = 0.001)] vs. SED+ group and in MVPA+ [lower triglyceridemia (TG), (p < 0.05), HOMA‐IR (p < 0.01) and MetScore (p < 0.001), higher HDL‐c (p < 0.01)] vs. MVPA− group after adjustment with age, gender, maturation and BMI. SED−/MVPA+ group had the best metabolic health. While sedentary (p < 0.001) but also MVPA times (p < 0.001) were lower in SED−/MVPA− vs. SED+/MVPA+, SED−/MVPA− had lower FM percentage (p < 0.05), HOMA‐IR (p < 0.01) and MetScore (p < 0.05) and higher HDL‐c (p < 0.05), independently of BMI. Sedentary time was positively correlated with HOMA‐IR and Metscore and negatively correlated with HDL‐c after adjustment with MVPA (p < 0.05). MVPA was negatively correlated with HOMA‐IR, BP and MetScore and positively correlated with HDL‐c after adjustment with sedentary time (p < 0.05). Conclusion: Lower sedentary time is associated with a better metabolic health independently of MVPA and might be a first step in the management of pediatric obesity when increasing MVPA is not possible. [ABSTRACT FROM AUTHOR]

Background: Nonalcoholic fatty liver disease (NAFLD) is the leading hepatic disease in children, ranging from steatosis to steatohepatitis and fibrosis. Age, sex, hormonal levels, pubertal stages, genetic risk- and epigenetic factors are among the many influencing factors. Appearing predominantly in children with obesity, but not exclusively, it is the liver's manifestation of the metabolic syndrome but can also exist as an isolated entity. Summary: Pediatric NAFLD differs from the adult phenotype. This narrative review on NAFLD in children with obesity provides an overview of the current knowledge on risk factors, screening, and diagnostic methods, as well state-of-the-art treatment. The recent discussion on the proposition of a new nomenclature – Metabolic [Dysfunction-] Associated Liver Disease – is featured, and current gaps of knowledge are discussed. Key Messages: Currently, there is no international consensus on screening and monitoring of pediatric NAFLD. With lifestyle interventions being the cornerstone of treatment, no registered pharmacological treatment for pediatric NAFLD is available. Development and validation of additional noninvasive biomarkers, scores and imaging tools suitable to subcategorize, screen and monitor pediatric patients are necessary. With a variety of upcoming and promising agents, clear recommendations for pediatric nonalcoholic steatohepatitis trials are urgently needed. [ABSTRACT FROM AUTHOR]

Objective: The lumbar sympathetic trunk's (LST) distance to two anatomical landmarks, the costal process and medial margin of the psoas muscle, was assessed due to its use as landmarks for lumbar sympathetic blocks: the costal process for fluoroscopic guided techniques and the psoas major for CT- and MRI-guided techniques. Based on the measurements, we evaluate the trunk's visibility in MR and CT images for accurate positioning of the needle. Methods: A total of 54 cadavers embalmed with Thiel's method were investigated. The LST's distances to the psoas major's medial margin and to the base of the lumbar vertebrae's costal process were measured on the levels L2/3, L3/4 and L4/5. The measurements were compared to MR and CT images of 20 anonymous patients to identify the LST. Results: LST's mean distance to the psoas major was 0.3 mm at L2/3, 3.1 mm at L3/4 and 4.6 mm at L4/5. The mean distance to the costal process was 31 mm at L2/3, 34 mm at L3/4 and 32.6 mm at L4/5. In both MR and CT imaging, a structure could be determined as the LST correlating to the measurements with decreasing possible identification from cephalad to caudad levels. Conclusions: The costal process is a usable landmark for fluoroscopic guidance and the psoas major for CT- and MRI-guided techniques. The LST is clearly visible in MR and CT images, which gives both techniques a decisive advantage over fluoroscopy concerning the block of the LST due to a visible target. [ABSTRACT FROM AUTHOR]