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Background: The Framework Convention on Tobacco Control makes a number of recommendations aimed at restricting the marketing of tobacco products. Tobacco industry political activity has been identified as an obstacle to Parties’ development and implementation of these provisions. This study systematically reviews the existing literature on tobacco industry efforts to influence marketing regulations and develops taxonomies of 1) industry strategies and tactics and 2) industry frames and arguments. Methods: Searches were conducted between April-July 2011, and updated in March 2013. Articles were included if they made reference to tobacco industry efforts to influence marketing regulations; supported claims with verifiable evidence; were written in English; and concerned the period 1990–2013. 48 articles met the review criteria. Narrative synthesis was used to combine the evidence. Results: 56% of articles focused on activity in North America, Europe or Australasia, the rest focusing on Asia (17%), South America, Africa or transnational activity. Six main political strategies and four main frames were identified. The tobacco industry frequently claims that the proposed policy will have negative unintended consequences, that there are legal barriers to regulation, and that the regulation is unnecessary because, for example, industry does not market to youth or adheres to a voluntary code. The industry primarily conveys these arguments through direct and indirect lobbying, the promotion of voluntary codes and alternative policies, and the formation of alliances with other industrial sectors. The majority of tactics and arguments were used in multiple jurisdictions. Conclusions: Tobacco industry political activity is far more diverse than suggested by existing taxonomies of corporate political activity. Tactics and arguments are repeated across jurisdictions, suggesting that the taxonomies of industry tactics and arguments developed in this paper are generalisable to multiple jurisdictions and can be used to predict industry activity. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Public Policy is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Canadian reports have recommended that health as a human right must be Canada's overarching global commitment and that the primacy of human rights should be prioritized over other elements of international law including international trade and investment law as it applies to access to pharmaceuticals. This paper uses a series of case reports to examine Canada's commitment to this goal. Specifically it examines cases where improved access has been in conflict with increased intellectual property rights. The 6 cases are: Canada's position when 39 pharmaceutical companies took South Africa to court in 1998 over its legislation to allow parallel importation of patented medicines and to regulate the price of medications; the stance that Canada took in the negotiations around the Doha Declaration in 2001; the passage of Canada's Access to Medicines Regime in 2004 and subsequent attempts to amend the legislation in 2011 and 2012; Canada's involvement in the final declaration at the United Nations High-Level meeting on non-communicable diseases in 2012; Canada's views about the terms in the Anti-Counterfeiting Trade Agreement as expressed in 2009; and Canada's 2013 position on the extension of the exemption for least developed countries from having to comply with the terms of the Trade Related Aspects of Intellectual Property Rights Agreement. In the first case Canada was neutral but in the remaining 5 cases Canada prioritized intellectual property rights over access. This position is consistent with how Canada has acted around domestic issues involving intellectual property rights for pharmaceutical products. Canada has supported strengthened rights despite the fact that their touted benefits have not been realized either domestically or in developing countries. As a result Canada has failed in its humanitarian duty to protect the human right to health in the form of safe and low cost medicines for the people in developing countries. [ABSTRACT FROM AUTHOR]

Numerous recent deaths have been linked to government-approved prescription medicines which revealed no toxic effects during pre-market tests. Governments want to mandate a legal post-marketing surveillance program which would monitor and scrutinize individual drugs over their life cycle. The industry is divided in its response. Some executives refer to the proposed action as ‘overkill’ while others simply anticipate more government regulations. A third group endorses the efforts of government as a positive step in mitigating public fears before they become epidemic. This paper focuses on this struggle within the industry and between the industry and government. Research was undertaken to examine industry reaction to government surveillance systems and to analyze the results within a framework of coping behavior. In addition, relationships are drawn between market structure and corporate response, and between government-mandated responsibility to consumer concerns and industry's numerous stakeholders. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims Since the beginning of the coronavirus disease 2019 (COVID‐19), a large number of government policies have been implemented worldwide in response to the global spread of COVID‐19. This paper aims at developing a data‐driven analysis to answer the three research questions: (a) Compared to the pandemic development, are the global government COVID‐19 policies sufficiently active? (b) What are the differences and characteristics in the policy activity levels at the country level? (c) What types of COVID‐19 policy patterns are forming? Methods Using the Oxford COVID‐19 Government Response Tracker data set, we present a global analysis of the COVID‐19 policy activity levels and evolution patterns from January 1, 2020 to June 30, 2022, based on the differential expression‐sliding window analysis (DE‐SWAN) algorithm and the clustering ensemble algorithm. Results Within the period under study, the results indicate that (a) the global government policy responses to COVID‐19 are very active, and the policy activity levels are significantly higher than those of global pandemic developments; (b) a high activity of policy is positively correlated to pandemic prevention at the country level; and (c) a high human development index (HDI) score is negatively correlated to the country policy activity level. Furthermore, we propose to categorize the global policy evolution patterns into three categories: (i) Mainstream (152 countries); (ii) China; and (iii) Others (34 countries). Conclusion This work is one of the few studies that quantitatively explores the evolutionary characteristics of global government policies on COVID‐19, and our results provide some new perspectives on global policy activity levels and evolution patterns.

The labour market for care professionals has experienced significant changes, resulting in critical shortages globally. Nurses represent the largest share of health workers worldwide; nonetheless, an estimated 13 million more nurses will be needed over the next 10 years. Prior to the pandemic, the domestic supply of nurses in Canada had not kept pace with the ever-increasing demand for services. Pre-pandemic age- and needs-based forecasting models have estimated shortages in an excess of 100,000 nurses nationwide by 2030. While COVID-19 has accelerated the demand for and complexity of service requirements, it has also resulted in losses of healthcare professionals due to an increased sick leave, unprecedented burnout and retirements. This paper examines key factors that have contributed to nursing supply issues in Canada over time and provides examples of policy responses to the present shortage facing the healthcare system. To provide adequate care, the nursing workforce must be stabilized and—more importantly—recognized as critical to the health of the population.

In the USA, the relationship between the legal availability of guns and the firearm-related homicide rate has been debated. It has been argued that unrestricted gun availability promotes the occurrence of firearm-induced homicides. It has also been pointed out that gun possession can protect potential victims when attacked. This paper provides a first mathematical analysis of this tradeoff, with the goal to steer the debate towards arguing about assumptions, statistics, and scientific methods. The model is based on a set of clearly defined assumptions, which are supported by available statistical data, and is formulated axiomatically such that results do not depend on arbitrary mathematical expressions. According to this framework, two alternative scenarios can minimize the gun-related homicide rate: a ban of private firearms possession, or a policy allowing the general population to carry guns. Importantly, the model identifies the crucial parameters that determine which policy minimizes the death rate, and thus serves as a guide for the design of future epidemiological studies. The parameters that need to be measured include the fraction of offenders that illegally possess a gun, the degree of protection provided by gun ownership, and the fraction of the population who take up their right to own a gun and carry it when attacked. Limited data available in the literature were used to demonstrate how the model can be parameterized, and this preliminary analysis suggests that a ban of private firearm possession, or possibly a partial reduction in gun availability, might lower the rate of firearm-induced homicides. This, however, should not be seen as a policy recommendation, due to the limited data available to inform and parameterize the model. However, the model clearly defines what needs to be measured, and provides a basis for a scientific discussion about assumptions and data. [ABSTRACT FROM AUTHOR]

The article reflects on bringing clarity to the reporting of health equity. It is said that health equity is relevant to virtually the whole of medicine and public health and encompasses much more than inequality alone. It is also said that the guidelines may not fit into the usual technical reasons for the development of reporting guidelines.

The article presents information on the effects of increased clinical trial complexes and protocol design on drug development activity, and data management. Topics discussed include the spread of diversity in the data management cycles, the importance of medical protocols in the medical industry, and optimization in the protocol designing.

Objective: The aim of this study was to use routinely collected electronic medicines administration (eMAR) data in residential aged care (RAC) to investigate the quality use of medicines.Design: A cross-sectional analysis of eMAR data.Setting: 71 RAC facilities in New South Wales and the Australian Capital Territory, Australia.Participants: Permanent residents living in a participating facility on 1 October 2015.Intervention: None.Main Outcome Measures: Variation in polypharmacy (≥5 medications), hyper-polypharmacy (≥10 medications) and antipsychotic use across facilities was examined using funnel plot analysis.Results: The study dataset included 4775 long-term residents. The mean resident age was 85.3 years and 70.6% of residents were female. The median facility size was 60 residents and 74.3% were in metropolitan locations. 84.3% of residents had polypharmacy, 41.2% hyper-polypharmacy and 21.0% were using an antipsychotic. The extent of polypharmacy (69.75-100% of residents), hyper-polypharmacy (38.81-76.19%) and use of antipsychotic medicines (0-75.6%) varied considerably across the 71 facilities.Conclusions: Using eMAR data we found substantial variation in polypharmacy, hyper-polypharmacy and antipsychotic medicine use across 71 RAC facilities. Further investigation into the policies and practices of facilities performing above or below expected levels is warranted to understand variation and drive quality improvement. [ABSTRACT FROM AUTHOR]

This study assesses the impact of proprietary medicine advertising on children. Only limited support is found for a direct link between exposure to medicine commercials and a child's beliefs, attitudes, and requests to parents regarding medicine. There is no evidence of a link between medicine advertising and a child's use of proprietary medicines. [ABSTRACT FROM AUTHOR]

Introduction: In 2015, the UK health secretary made public an intention to include the value of medicines costing over £20 on dispensing labels as an attempt to reduce wastage attributable to patient behavior. However, there is a lack of evidence investigating the potential effect or feasibility of this proposal, and concerns have been raised that it may introduce new problems in vulnerable groups. This pilot study aimed to gather views of the Welsh general public on this subject. Methods: Six focus groups from within key population groups were conducted. A snowball sampling strategy was employed with participants recruited via a neutral gatekeeper. Focus groups session were audio recorded and transcribed verbatim and iterative thematic analysis was used to identify emergent themes. Results: Six focus groups were conducted. Three key themes were identified: "influence of cost" - whereby participants expressed concern about cost linking to their perceived value, guilt for needing prescribed medication and irrelevance of cost if the medication was considered necessary; "knowledge is power" - whereby participants expressed a desire to know more about their medicines and engage with health care professionals about them, and felt information on dispensing labels alone would be insufficient to support this and "blame the system" - whereby participants felt responsibility for wastage should be shared by both system and patient and identified existing wasteful practices such as inappropriate prescribing, ordering and disposal of returned medicines. Conclusion: Findings were largely consistent with criticisms publicized by professional bodies that introducing cost may serve to make patients feel guilty or unworthy rather than encourage them to use their medicines appropriately. Similarly, providing cost information on labels alone was considered insufficient and therefore additional counseling or education would be necessary to prevent misunderstanding. The acknowledgment of system factors contributing to wastage highlights an important role for pharmacists to become involved in using medicines more cost-effectively. However, cost was considered irrelevant if the medicine was deemed necessary by the patient, and therefore more mindful prescribing of superfluous items should be promoted. [ABSTRACT FROM AUTHOR]

Copyright of Universum is the property of Instituto de Estudios Humanisticos Juan Ignacio Molina, Universidad de Talca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: To support policy making, we developed an initial model to assess the cost-effectiveness of potential strategies to increase influenza vaccination rates among children in China. Methods: We studied on children aged 6 months to 14 years in four provinces (Shandong, Henan, Hunan, and Sichuan), with a health care system perspective. We used data from 2005/6 to 2010/11, excluding 2009/10. Costs are reported in 2010 U.S. dollars. Results: In comparison with no vaccination, the mean (range) of Medically Attended Cases averted by the current self-payment policy for the two age groups (6 to 59 months and 60 months to 14 years) was 1,465 (23∼11,132) and 792 (36∼4,247), and the cost effectiveness ratios were $ 0 (-11-51) and $ 37 (6-125) per case adverted, respectively. In comparison with the current policy, the incremental cost effectiveness ratio (ICER) of alternative strategies, OPTION One-reminder and OPTION Two-comprehensive package, decreased as vaccination rate increased. The ICER for children aged 6 to 59 months was lower than that for children aged 60 months to 14 years. Conclusions: The model is a useful tool in identifying elements for evaluating vaccination strategies. However, more data are needed to produce more accurate cost-effectiveness estimates of potential vaccination policies. [ABSTRACT FROM AUTHOR]

In 2011, the American Institute for Medical and Biological Engineering (AIMBE) (www.aimbe.org) celebrated its 20th anniversary by undertaking to identify major societal challenges to which medical and biological engineers can contribute solutions in the next 20 years. This report is a summary of the six major challenges that were identified. The report also discusses some specific areas within these high-level challenges that can form the basis for policy action, provides a brief rationale for pursuing those areas, and discusses roadblocks to progress. The six overarching challenges are: 1) engineering safe and sustainable water and food supply, 2) engineering personalized health care, 3) engineering solutions to injury and chronic diseases, 4) engineering global health through infectious disease prevention and therapy, 5) engineering sustainable bioenergy production, and 6) engineering the 21st century US economy. While arrived at independently by AIMBE, many of the elements overlap with similar challenges identified by other bodies. The similarities highlight the central mission of medical and biological engineers, working with other experts, which is to solve important problems central to human health and welfare. [ABSTRACT FROM PUBLISHER]

Background: India is unlikely to meet the Millennium Development Goal for child mortality. As public policy impacts child mortality, we assessed the association of social sector expenditure with child mortality in India. Methods and Findings: Mixed-effects regression models were used to assess the relationship of state-level overall social sector expenditure and its major components (health, health-related, education, and other) with mortality by sex among infants and children aged 1–4 years from 1997 to 2009, adjusting for potential confounders. Counterfactual models were constructed to estimate deaths averted due to overall social sector increases since 1997. Increases in per capita overall social sector expenditure were slightly higher in less developed than in more developed states from 1997 to 2009 (2.4-fold versus 2-fold), but the level of expenditure remained 36% lower in the former in 2009. Increase in public expenditure on health was not significantly associated with mortality reduction in infants or at ages 1–4 years, but a 10% increase in health-related public expenditure was associated with a 3.6% mortality reduction (95% confidence interval 0.2–6.9%) in 1–4 years old boys. A 10% increase in overall social sector expenditure was associated with a mortality reduction in both boys (6.8%, 3.5–10.0%) and girls (4.1%, 0.8–7.5%) aged 1–4 years. We estimated 119,807 (95% uncertainty interval 53,409 – 214,662) averted deaths in boys aged 1–4 years and 94,037 (14,725 – 206,684) in girls in India in 2009 that could be attributed to increases in overall social sector expenditure since 1997. Conclusions: Further reduction in child mortality in India would be facilitated if policymakers give high priority to the social sector as a whole for resource allocation in the country’s 5-year plan for 2012–2017, as public expenditure on health alone has not had major impact on reducing child mortality. [ABSTRACT FROM AUTHOR]

Background: On November 24th 2005, the Government of England and Wales removed regulatory restrictions on the times at which licensed premises could sell alcohol. This study tests availability theory by treating the implementation of Licensing Act (2003) as a natural experiment in alcohol policy. Methods: An interrupted time series design was employed to estimate the Act’s immediate and delayed impact on violence in the City of Manchester (Population 464,200). We collected police recorded rates of violence, robbery, and total crime between the 1st of February 2004 and the 31st of December 2007. Events were aggregated by week, yielding a total of 204 observations (95 pre-, and 109 post-intervention). Secondary analysis examined changes in daily patterns of violence. Pre- and post-intervention events were separated into four three-hour segments 18∶00–20∶59, 21∶00–23.59, 00∶00–02∶59, 03∶00–05∶59. Results: Analysis found no evidence that the Licensing Act (2003) affected the overall volume of violence. However, analyses of night-time violence found a gradual and permanent shift of weekend violence into later parts of the night. The results estimated an initial increase of 27.5% between 03∶00 to 06∶00 (ω = 0.2433, 95% CI = 0.06, 0.42), which increased to 36% by the end of the study period (δ = −0.897, 95% CI = −1.02, −0.77). Conclusions: This study found no evidence that a national policy increasing the physical availability of alcohol affected the overall volume of violence. There was, however, evidence suggesting that the policy may be associated with changes to patterns of violence in the early morning (3 a.m. to 6 a.m.). [ABSTRACT FROM AUTHOR]

Using data collected from surgeons working in a transplantation unit in Portugal this article aims to identify how medical knowledge is constructed within the context of surgery. The key theoretical guidelines are drawn from the sociology of professions and medical sociology, particularly social constructivist studies. A qualitative methodological approach was adopted, in which we opted for a participant observation and on-site interviews. Three hypotheses are addressed: 1) the recent shift towards Evidence-Based-Medicine (EBM) influences the primacy of clinical experience in the construction of medical knowledge; 2) medical experience does not strongly links with EBM principles; 3) personal experience is central in the construction of medical knowledge and discourse. This article provides a new window into the study of medical profession, a step forward in the research field. Conclusions show new understanding about EBM practice, insofar as it ties the production of medical knowledge to professional dynamics and autonomy. [ABSTRACT FROM AUTHOR]

Anthropologists have become increasingly concerned about the discipline's lack of ‘public engagement’ with contemporary issues of late, but a key underlying problem - anthropology's unwillingness to address the nature and evidentiary status of anthropological knowledge itself - has remained largely unacknowledged. Here I approach this problem initially through an analysis of the rise of ‘evidence’ as a central concept in public policy and practice. Using the exemplar of ‘evidence-based’ medicine, I analyse anthropological responses to these evidentiary requirements, arguing that this turn to evidence can be seen in many other arenas of research and public policy and presents a fundamental challenge for the credibility and legitimacy of anthropology as a discipline. In the second part of the article comparison with anthropological work on legal issues provides a reflexive opening through which to begin to consider the nature of anthropological ‘evidence’ itself. [ABSTRACT FROM AUTHOR]

In both African and Asian colonies until the late 19th century, colonial medicine operated pragmatically to meet the medical needs first of colonial officers and troops, immigrant settlers, and laborer responsible for economic development, then of indigenous populations when their ill health threatened the well-being of the expatriate population. Since the turn of the century, however, the consequences of colonial expansion and development for indigenous people's health had become increasingly apparent, and disease control and public health programs were expanded in this light. These programs increased government surveillance of populations at both community and household levels. As a consequence, colonial states extended institutional oversight and induced dependency through public health measures. Drawing on my own work on colonial Malaya, I illustrate developments in public health and their links to the moral logic of colonialism and its complementarity to the political economy. [ABSTRACT FROM AUTHOR]

The article focuses on the perspective provided to the directions that legislatures have taken and will take in removing hindrances imposed by licensure in medicine. It has been inferred that no realignment of manpower can take place without significant legislative change, and the graduates of Type A assistant training programs will be left without statutory support for their roles. Furthermore, the next step will be the implementation of these statutes within the guidelines established by the legislatures, guaranteeing quality of health care while assuring flexibility in manpower utilization.

Focuses on the drug development regulations of the European Agency for the Evaluation of Medicinal Products (EMEA) in Europe. Conflicts on the revision of the Declaration of Helsinki; Guidance provided by EMEA for clinical investigations of Crohn's disease treatments; Advice on testing procedures of medical products during pregnancy. INSET: The EU's Rules on Clinical Trials..

The article focuses on issues regarding the Pakistan Medical and Dental Council (PMDC) Ordinance 2014 which aims to dissolve the PMDC set up and establishes a Seven Member Management Committee to run the affairs of the Council. During a press conference, Minister of State for National Health Services Saira Afzal Tarar states the committee members will be selected from the field of medicine, law, and finance.

Presents news briefs related to medical ethics as of April 2000. Publication of a parliamentary bill entitled Medical Treatment by the Great Britain government on January 18, 2000; Joint consultation document on preimplantation genetic diagnosis issued by the Human Fertilisation and Embryology and Advisory Committee on Genetic Testing on November 1999; Revision of the World Medical Association's Declaration of Helsinki for the ethics of medical research on humans.