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Background and aims Prohibitions on producing, distributing and selling cannabis are loosening in various jurisdictions around the world. This paper describes the diversification of cannabis supply laws and discusses the challenges to and opportunities for learning from these changes. Methods We document changes in cannabis supply laws that de jure legalized cannabis production for medical and/or non-medical purposes (excluding industrial hemp) in Australasia, Europe, North America and South America. We also highlight challenges to evaluating these legal changes based on our experiences studying cannabis laws and policies in the United States. Findings As of August 2016, two countries have passed laws to legalize large-scale cannabis production for non-medical purposes at the national (Uruguay) or subnational level (four US states). At least nine other countries legally allow (or will soon allow) cannabis to be supplied for medicinal purposes. Most of the changes in cannabis supply laws have occurred since 2010. The data available in most countries are inadequate for rigorously evaluating the changes in cannabis supply laws. Conclusion The evidence base for assessing changes in cannabis supply laws remains weak. Efforts should focus upon collecting information about quantities consumed and market transactions as well as validating self-report surveys. [ABSTRACT FROM AUTHOR]

Background: Non‐pharmacologic interventions might be effective to reduce the incidence of delirium in pediatric intensive care units (PICU). Aim: To explore expert opinions and generate informed consensus decisions regarding the content of a non‐pharmacologic delirium bundle to manage delirium in PICU patients. Study design: A two‐round online Delphi study was conducted from February to April 2021. PICU experts (nurses, physicians, researchers, physical therapists, play specialists, and occupational therapists) located in Europe, North America, South America, Asia, and Australia participated. Results: We developed a questionnaire based on the outcomes of a comprehensive literature search in the domains: 1) cognition support; 2) sleep support; and 3) physical activity support. Under these domains, we listed 11 strategies to promote support with 61 interventions. Participants rated the feasibility of each intervention on a 9‐point Likert scale (ranging from 1 strongly disagree to 9 strongly agree). A disagreement index and panel median were calculated to determine the level of agreement among experts. In the second round, participants reassessed the revised statements and ranked the interventions in each domain in order of importance for age groups: 0–2, 3–5, and 6–18 years of age. During the first Delphi round, 53 of 74 (72%) questionnaires were completed, and in the second round 45 of 74 (61%) were completed. Five of the highest ranked interventions across the age groups were: 1) developing a daily routine, 2) adjusting light exposure according to the time of day, 3) scheduling time for sleep, 4) providing eyeglasses and hearing aids if appropriate, 5) encouraging parental presence. Conclusions: Based on expert consensus, we developed an age‐specific non‐pharmacologic delirium bundle of interventions to manage delirium in PICU patients. Relevance to Clinical Practice: An age‐specific Non‐Pharmacological Delirium bundle is now ready to be tested in the PICU and will hopefully reduce pediatric delirium. [ABSTRACT FROM AUTHOR]

International Journal of Paediatric Dentistry 2011 Background. Paediatric dentists receive training in sedation during their advanced education training, but evidence suggests that this training varies widely. Aim. The purpose of this study was to survey members of the International Association of Paediatric Dentistry (IAPD) and the European Academy of Paediatric Dentistry (EAPD) on their opinion on pharmacological and other behavioural management techniques and their training related to provision of oral health care of paediatric patients in the dental setting. Methods. A request was made for access to the IAPD and EAPD membership email addresses. The responses were recorded anonymously and data uploaded into spss (version 9) and analysed using descriptive analysis and chi-square with and without tabulation processes. Results. A total of 311 respondents of 1973 targeted individuals answered the survey. The response rate was 16%. The majority of the respondents came from the continent of Europe, Asia, and the Americas. The most frequent type of sedation was general anaesthesia (52% of the respondents), followed by nitrous oxide (46%) and then oral sedation (44%). At least 91% of the respondents indicated that they were interested in the development of continuing education on the topic of sedation. Conclusions. Paediatric dentists around the world use relatively few behaviour management techniques, including pharmacological management. There is a definite interest in continuing education in the area of sedation. [ABSTRACT FROM AUTHOR]

The purpose of this study was to review documented outbreaks of gastrointestinal illness in schools, published in the last 10 years, to identify etiology, mode of transmission, the number of children affected, morbidity and mortality patterns, and interventions for control and prevention. Searches of electronic databases, public health publications, and federal, state, and provincial public health Web sites were completed. Of the 121 outbreaks that met the inclusion criteria, 51% were bacterial, 40% viral, 7% were from Cryptosporidium, and 2% from multiple organisms. Transmission routes recorded in 101 reports included foodborne (45%), person-to-person (16%), waterborne (12%), and animal contact (11%). Actions to control outbreaks included alerting medical and public health authorities or the community to the outbreak (13%), treating cases (12%), enhancing hand washing (11%), and increased vigilance during food preparation (8%). Recommendations to prevent future outbreaks were compared with previously published studies that demonstrated effectiveness. The risk of foodborne illness was reduced when food handlers practiced effective hand washing technique and received food safety training and certification. Student training programs on hand hygiene, enhanced cleaning and disinfection of the school, and hepatitis A vaccination were found effective. Children should be supervised on farm visits, hand washing strictly enforced, and food eaten in an area separated from the animals. Staff and students should have a positive, continuous communication with public health authorities including educational sessions and immediate reporting of possible outbreaks. [ABSTRACT FROM AUTHOR]

Aims: For the first time, the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduces non-substance addictions as psychiatric diagnoses. The aims of this paper are to (i) present the main controversies surrounding the decision to include internet gaming disorder, but not internet addiction more globally, as a non-substance addiction in the research appendix of the DSM-5, and (ii) discuss the meaning behind the DSM-5 criteria for internet gaming disorder. The paper also proposes a common method for assessing internet gaming disorder. Although the need for common diagnostic criteria is not debated, the existence of multiple instruments reflect the divergence of opinions in the field regarding how best to diagnose this condition., Methods: We convened international experts from European, North and South American, Asian and Australasian countries to discuss and achieve consensus about assessing internet gaming disorder as defined within DSM-5., Results: We describe the intended meaning behind each of the nine DSM-5 criteria for internet gaming disorder and present a single item that best reflects each criterion, translated into the 10 main languages of countries in which research on this condition has been conducted., Conclusions: Using results from this cross-cultural collaboration, we outline important research directions for understanding and assessing internet gaming disorder. As this field moves forward, it is critical that researchers and clinicians around the world begin to apply a common methodology; this report is the first to achieve an international consensus related to the assessment of internet gaming disorder., (© 2014 Society for the Study of Addiction.)