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It remains unclear if mandatory reporting (MR) of sexual violence (SV) in universities impacts student reports of SV. MR may deter students from disclosing SV under certain circumstances (e.g., alcohol, perpetrator). This study evaluated students' likelihood of reporting SV under MR policy across perpetrators, violence, and alcohol use. Female students received instructional manipulations describing either confidential or mandatory reporting policies before reading four vignettes describing SV. They rated their likelihood of reporting each vignette. Significant differences arose across vignettes, conditions, and alcohol consumption. This indicates MR can significantly decrease reporting likelihood in some cases, while alcohol consumption may increase the likelihood.

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AIM: To explore internationally qualified nurses' perceptions regarding the facilitators and barriers to specialty skill transfer in Australia. DESIGN: The study utilised a descriptive research design with a cross-sectional survey. Data were collected from July to September 2022. METHODS: A self-designed survey was distributed through social media, snowballing and nursing professional organisations. The survey included six open-ended questions which were analysed using thematic content analysis. RESULTS: Sixty-three participants completed the open-ended questions in the survey. The findings identified a range of facilitators (support, previous experience, self-agency) and barriers (systems barriers, bias/discrimination, being undervalued, lack of trust) to skill transition. CONCLUSION: Recognising and addressing facilitators and barriers, coupled with creating customised pathways for specialty skill integration, are essential for optimising the utilisation of specialised skills in internationally qualified nurses. IMPACT: This study aims to explore the barriers and facilitators involved in maximising skill utilisation among internationally qualified nurses in Australia. Identifying these barriers and facilitators is essential for improving patient care, as it will guide the development of strategies for safe nursing service delivery and the optimisation of skill usage. These findings hold significant implications for policymakers, healthcare organisations and nurses, providing valuable insights into how to address these obstacles and capitalise on the factors that make skill transfer smoother and more effective. PATIENT OR PUBLIC CONTRIBUTION: Sixty-three internationally qualified nurses shared their experiences and opinions.

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How everyday self-control conflicts are resolved can have significant long-term personal and societal consequences, as readily illustrated by obesity, smoking, and unsustainable consumption. Here, we delineate connections between current self-control research and policymaking. We first discuss the achievements and shortcomings of the prevailing individual-level focus in self-control research. Next, we propose a multilevel perspective that incorporates structural factors operating at the micro, meso, and macro levels as the root cause of many issues framed as self-control problems. We then introduce a comprehensive framework (4LP) synthesizing four key levers for public policymaking. We conclude that future policy research may benefit from closer, interdisciplinary collaboration to better represent the complex interplay between individual agency and structural factors regarding self-control outcomes.

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The American Transplant Congress (ATC) is the largest national transplant meeting in the United States jointly sponsored by the American Society of Transplantation and the American Society of Transplant Surgeons. The 2024 ATC was held in Philadelphia, Pennsylvania during which a number of peer-reviewed scientific abstracts were censored from the program by the Health Resources and Services Administration (HRSA). These abstract presentations were redacted from the program for perceived conflict with current government policy effectively restricting dissemination of highly rated findings and discussion in a scientific forum. In this viewpoint we describe the content of the abstracts that were withdrawn from the annual ATC meeting and the implications of this censorship by HRSA. We further consider the ramifications of this action for prospective evaluation of government policy and the relationship of the contract agency with the transplant community in the context of ongoing discussions of modernizing the transplant system which has previously been critiqued for lack of transparency.

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BACKGROUND: A national policy in Norway demanding certificates for medical absences in upper secondary school was implemented in 2016, leading to an increase in general practitioner (GP) visits in this age group. OBJECTIVES: To assess the policy's effect on the use of primary and specialist healthcare. METHODS: A cohort study following all Norwegian youth aged 14-21 in the years 2010-2019 using a difference-in-differences approach comparing exposed cohorts expected to attend upper secondary school after the policy change in 2016 with previous unexposed cohorts. Data were collected from national registries. RESULTS: The absence policy led to the increased number of contacts with GPs for exposed cohorts during all exposed years, with estimated incidence rate ratios (IRRs) in the range from 1.14 (95% confidence intervals [CI] 1.11-1.18) to 1.25 (95% CI 1.21-1.30). Consultations for respiratory tract infections increased during exposed years. However, there was no conclusive policy-related difference in mental health consultations with GPs. In specialist healthcare we did not find conclusive evidence of an effect of absence policy on the risk of any contact per school year, but there was a slightly increased risk of contacts with ear-nose-throat specialist services. CONCLUSIONS: We found an increase in general practice contacts attributable to the school absence policy. Apart from a possible increase in ear-nose-throat contacts, increased GP attention did not increase specialized healthcare.

In 2016, a national policy was introduced for upper secondary students demanding certificates for medical absences. This was followed by an increase in general practitioner (GP) contacts, and consultations for respiratory tract infections doubled. We wanted to examine youth contacts with general practice, and also to look into contacts with specialist health care and for specific diagnoses. We chose to compare the age trends among birth cohorts affected by the policy to earlier, unaffected cohorts to minimize the impact of time trends. We found a 14%­25% increase in contacts with general practice offices attributable to the policy and a doubling of consultations for respiratory tract infections. Mental health consultations were minimally affected. Overall, specialist somatic or mental healthcare was seemingly not affected, but selected ear­nose­throat diagnoses increased somewhat among cohorts affected by the policy. Thus, the GPs' gatekeeping role seems to have worked in most cases. The policy did not appear to affect health care seeking substantially after upper secondary school.

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To inform regulatory policy, this article summarises findings on inhalation facilitation from the ninth report of the WHO Study Group on Tobacco Product Regulation. Some additives counteract the harshness and bitterness of tobacco and nicotine product aerosols, making them easier to inhale. Additives that promote inhalability may perpetuate and increase the use of inhaled tobacco and nicotine products, especially by young people. Thus, as a class, additives that facilitate inhalation are an important regulatory target to prevent tobacco and nicotine product uptake. We defined inhalation facilitation as modifications to products during manufacturing that enhance the sensory experience and (potentially) behaviours associated with inhalation (eg, deeper puffs, faster inhalation, larger puff volume, shorter intervals in between puffs and use episodes). Evidence review showed that: (a) menthol and synthetic coolants decrease irritation caused by aerosol constituents by activating sensory perception receptors (eg, cooling receptors) and may promote dependence in inexperienced users; (b) acid additives and sugars, which lower the pH of aerosols and shift nicotine from free-base to protonated salt forms, reduce harshness and increase blood nicotine yield; (c) e-cigarette flavourings perceived as sweet or fruity reduce subjective bitterness, increase attractiveness and may escalate use, although their effects on perceived harshness are inconclusive; (d) sugars in tobacco impart sweet sensations, but limited industry-independent data preclude strong conclusions for sugars' roles in inhalation facilitation. Given these findings, WHO policy recommendations suggest that regulators might consider banning ingredients that facilitate inhalation in all commercial inhaled tobacco and nicotine products.

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BACKGROUND: Following California's statewide law prohibiting the sale of flavoured tobacco products, some cigarette brands introduced new variants advertised as non-menthol, yet featuring design and text commonly found in menthol cigarette marketing. METHODS: Data are from the February-May 2023 wave of the Tobacco Epidemic Evaluation Network (TEEN+) national probability-based survey (aged 13-25 years). Respondents (N=10 217) were shown images of two (of four) 'new non-menthol' brand ads or packaging and two comparators ('classic' non-menthol and menthol cigarette brands). Respondents reported expected taste of each (no or any minty/menthol taste; 'don't know'). Multinomial regression models tested associations between predictors (age, gender identity, race and ethnicity, perceived financial situation, smoking status) and expectation of minty/menthol taste. RESULTS: Younger age was associated with expectations of minty/menthol taste, controlling for covariates. Respondents aged 13-17 years had greater odds of expecting minty/menthol taste than no minty/menthol taste for all tested new non-menthol brands (Camel Crush Oasis adjusted OR (aOR): 1.30, p<0.05; Camel Crisp aOR: 1.47, p<0.001; Kool Non-Menthol Blue aOR: 1.27, p<0.05; Kool Non-Menthol Green aOR: 1.43, p<0.01), compared to respondents aged 21 and older. Respondents aged 18-20 years had greater odds of reporting minty/menthol expectancies than no minty/menthol expectancies for Camel Crush Oasis (aOR: 1.35, p<0.05) and Kool Non-Menthol Green (aOR: 1.29, p<0.05) compared to those aged 21-25 years. Compared to non-Hispanic white respondents, non-Hispanic Asian respondents had greater odds of expecting minty/menthol taste than no minty/menthol taste for Camel Crush Oasis (aOR: 1.89, p<0.01), Kool Non-Menthol Blue (aOR: 1.88, p<0.01) and Kool Non-Menthol Green (aOR: 1.72, p<0.05). DISCUSSION: Younger age was associated with expectations of new non-menthol cigarettes having a minty/menthol taste. Results raise concerns regarding the potential appeal of these products to youth and young adults.

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Cancer universally represents one of the largest public health concerns, substantially contributing to global disease burden and mortality. The multifaceted interplay of environmental and genetic factors in the disease aetiology and progression has required comprehensive research to elucidate modifiable elements which can reduce the risk of incidence and improve prognosis. Among these factors, diet and nutrition have emerged as the most fundamental with a significant potential for influence and effect. Nutrition is not only an essential part of human survival, but also a vital determinant of overall health. Certain dietary requirements are necessary to support normal physiology. This includes individualised levels of macronutrients (proteins, carbohydrates and fats) and specific micronutrients (vitamins and minerals). Extensive research has demonstrated that diet plays a role in cancer pathogenesis at the genetic, epigenetic and cellular level. Therefore, its potential as a modifiable determinant of cancer pathogenesis for the purpose of prevention and improving management of disease must be further explored and implemented. The ability to influence cancer incidence and outcomes through dietary changes is underutilised in clinical practice and insufficiently recognised among the general public, healthcare professionals and policy-makers. Dietary changes offer the opportunity for autonomy and control over individuals health outcomes. Research has revealed that particular dietary components, as well as cultural behaviours and epidemiological patterns may act as causative or protective factors in cancer development. This review aims to comprehensively synthesise this research to further explore how to best utilise this knowledge within the community and clinical environment for more effective cancer prevention and therapeutic strategies. The identified key areas for improvement include the development of more specific, widely accepted guidelines, promoting increased involvement of dieticians within cancer multidisciplinary teams, enhancing nutritional education for healthcare professionals and exploring the potential implementation of personalised nutrition tools. A greater understanding of the complex interactions between diet and cancer will facilitate informed clinical interventions and public health policies to reduce global cancer burden and improve care for cancer patients and survivors.

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Background: The volume-outcome relationship is well-known in health care. The Experience Curve, initially developed by the Boston Consulting Group for manufacturing, offers insight on this relationship and has never before been applied to health care. Objectives: The purpose of this study was to determine the effect of experience on cost and resource utilization for the Cone procedure. Methods: We performed a retrospective review of patients who underwent Cone reconstruction for Ebstein's anomaly at Boston Children's Hospital between October 2010 and October 2021. Cardiopulmonary bypass time and aortic cross clamp time over time were evaluated using exponential regression to assess the surgeon-level learning curve. At the hospital level, length of stay and cost over time were assessed using exponential regression. Results: There were 115 patients included in the study. Median hospital length of stay was 7.9 days (IQR: 6.4-10.2 days) with a decline of 3.3% per year. Median intensive care unit [ICU] length of stay was 3.2 days (IQR: 2-5.7 days) with a decline of 10.5% per year. Adjusted direct costs indexed to 2020 prices fell by 4% per year. There was no statistically significant change in cardiopulmonary bypass or aortic cross clamp time. In mediation analysis, the reduction in cost was completely accounted for in the decline in ICU length of stay. ICU length of stay was correlated with duration of intubation. Conclusions: Increasing familiarity with Ebstein's anomaly and Cone reconstruction led to a reduction in resource utilization.

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Migration, from rural to urban settings is a common phenomenon in Latin America, due to social, economic, political, and other factors. Young people in search of economic and educational opportunities, financial, and social stability, have been migrating to larger urban centers, thus crafting important shifts in rural labor, generational transfer, and domestic economies. Through a systematic literature review of scientific literature, and documents from public institutions and international organizations, published between 2012 and 2022, this article addresses rural-urban migration of youth in Colombia and Guatemala's cattle sector, particularly identifying (i) driving factors, (ii) their impacts on cattle farming, and (iii) public policies implemented to counteract prejudicial effects. Results show that unemployment, lack of educational opportunities, and insecurity are the main reasons for youth migration to cities or abroad, with Mexico, the United States, and Spain being the most common destinations. Additionally, impacts on the cattle sector include shortage of labor and a perfectible generational transfer, hindering the modernization of the industry and investments in climate change adaptation and mitigation strategies. Despite various implemented public policies, the results are partial, and the issue of accelerated youth migration remains relevant. Consequently, without more effective measures adopted by national governments, the cattle sector will lag behind its regional and international competitors, deterring the achievement of the Sustainable Development Goals. As the main contribution of the study, the analysis of migration is highlighted based on its effects on a specific economic sector and not focused on its causes, as evidenced in a wide range of literature.

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BACKGROUND: Nicotine products increasingly contain synthetic nicotine made in a lab (NML), not from tobacco. 'Tobacco-free nicotine' is most often used to describe NML commercially, but other descriptors are emerging (eg, 'non-tobacco,' 'zero-tobacco'). We examined whether terms for NML differentially impact public understanding of nicotine source or risk perceptions relative to each other and to terms for describing nicotine from tobacco (NFT) as 'tobacco-derived.' METHODS: From December 2022 to April 2023, 1000 participants aged 13 and older completed an online survey (mean age: 33.02 (SD=18.15) years, 50.5% female, 16.6% Hispanic, 67.4% White and 79.8% with current tobacco use). Participants read 11 terms describing nicotine and reported on perceived nicotine source (ie, NML, NFT) and addictiveness. Rank-ordered harm was included as a sensitivity analysis. RESULTS: Significant differences were observed among terms (eg, 'zero tobacco nicotine' and 'no tobacco nicotine' were rated as least addictive overall). 'NML' and 'NFT' adequately conveyed nicotine source and were rated as conveying comparable, yet high addictiveness, making them the optimal terms. CONCLUSIONS: Many terms for NML and NFT are differentially related to understanding nicotine source and risk perceptions even though no existing research indicates that NML and NFT differ meaningfully from each other on characteristics like addictiveness. In the absence of prohibiting product differentiation by nicotine source, regulatory agencies should promote using the terms 'Nicotine from Tobacco' and 'Nicotine Made in a Lab' and investigate whether products using descriptors conveying reduced harm (eg, 'zero-tobacco,' 'no-tobacco,' 'non-tobacco') should require review as Modified Risk Tobacco Products.

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INTRODUCTION: This study investigated exposures involving ∆8-tetrahydrocannabinol (∆8-THC) reported to US poison centers (PCs), including variation among states and regions. It evaluated whether the ∆8-THC exposure rate was lower among states with ∆8-THC regulations and states where cannabis (∆9-THC) use was legal. METHODS: National Poison Data System data for ∆8-THC exposures in 2021-2022 were analyzed, including comparisons of state and regional population-based exposure rates. RESULTS: There were 4,925 exposures involving ∆8-THC as the primary substance reported to US PCs from January 1, 2021, to December 31, 2022, with 69.8% of these reported in the US South. The rate of exposure per 100,000 US population increased by 79.2% from 0.53 in 2021 to 0.95 in 2022. In 2022, the mean rate of ∆8-THC exposures in states where cannabis use was illegal was 1.64 per 100,000 population (95% CI: 1.08-2.20) compared with 0.52 (95% CI: 0.29-0.76) in states where cannabis use was legal (P = 0.0010). In 2022, the mean rate of ∆8-THC exposures in states where ∆8-THC was unregulated was 1.36 per 100,000 population (95% CI: 0.95-1.77) compared with 0.17 (95% CI: 0.06-0.27) in states where ∆8-THC was banned (P < 0.0001). CONCLUSIONS: The rate of ∆8-THC exposures reported to US PCs increased by 79% from 2021 to 2022, with the US South accounting for more than two-thirds of exposures. The rate of ∆8-THC exposures reported to PCs was significantly lower among states where ∆8-THC was banned and among states where cannabis use was legal. Consistent regulation of ∆8-THC across all states should be adopted.

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A concerning number of hospitals have closed in the US in recent years and there are many other hospitals that are at significant risk of closure in the coming years. The COVID-19 pandemic magnified the trend of hospital closures, raising further concerns about the potential impacts of hospital closures and the important need for devising policies that can mitigate them. To devise such policies, however, we first need to better understand the main drivers, potential adaptations by providers, and the widespread public impacts of hospital closures. We also need to recognize various changes in care delivery modes and related practices. Understanding these complex issues can allow policymakers to shift their focus from the narrow scope of "access to care," and instead take into account various other consequences of hospital closures that are currently largely overlooked but need to be part of policy discussions.

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Over the past 20 years, plasma has become a medical treatment characterized as "liquid gold" to signal its lifesaving potential. Through a manufacturing process termed fractionation, plasma, collected through blood donation, is turned into Plasma Derived Medical Products (PDMPs). The World Health Organization (WHO) has underlined the importance of PDMPs for global health care, including a number of PDMPs on the WHO Model List of Essential Medicines. The process of collecting plasma from a donor, manufacturing plasma derived treatments, and distributing those treatments globally requires the coordination of multiple social actors operating in different social, political and economic contexts, but has received little attention in scholarly literature on public policy or the social sciences. This paper will introduce a set of analytic questions and concepts that can direct a sociology of plasma products. We build on the behavioral turn in the policy sciences to identify relevant policy questions emerging from this field and offer the analytic tools necessary to investigate how different social actors in this space make meaning of plasma. To do this, we will draw on key concepts in the sociology of health and illness.

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Objectives: Aiming to disseminate information related to suicide prevention in Brazil, the "Setembro Amarelo" campaign has been conducted since 2015. The objective of this study is to assess the association between this campaign and elderly suicide rates over a 12-year period. Methods: Data were gathered from the Mortality Information System and the Notifiable Diseases Information System, established by public institutions in Brazil. An interrupted time-series framework was applied to assess the association between the "Setembro Amarelo" campaign and suicide mortality rates in the elderly population (60 et plus) in the southeastern region of Brazil. We consider three monthly outcomes: all suicides, suicides in males and suicide in females. We operationalize the campaign assuming three effects: short-term, declining and sustained. The period of analysis was from 2011-2022. Results: The suicide-mortality rate over time has remained stable; the average rate in the pre-campaign period was 0.028 and increased slightly to 0.035. Regardless of the campaign's operationalization and the outcome used, results show no significant associations between the campaign and elderly suicide rates. The campaign was associated with non-significant decreased effects of 15% (P=0.532) in the short term, and 16% (P=0.446) assuming the campaign was sustained. Conclusions: There is a lack of association between the campaign and suicide rates, among the elderly in Brazil's southeastern region. As suicide is complex and multifactorial, more research is needed. The campaign, while raising awareness and reducing stigma, may not reduce suicides. To reduce the suicide rate in the elderly requires addressing social, economic and cultural factors, multisectoral interventions, and upholding basic human rights.

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The article considers issues of how population behavior impacts realization of state anti-epidemic measures and efforts to control pandemic. Materials and Methods. The methodology of the study is based on such methods as text analysis, elastic network and construction of regression equations. The analysis of indicators characterizing state policy measures controlling pandemic was applied according to data from The Oxford COVID-19 Government Response Tracker portal. The behavioral reactions of population were assessed by text analysis of messages in Twitter and VKontakte social networks using the Rulexicon, tonalities dictionary of Russian language. The analysis of mobility was implemented on basis of data from Google Community Mobility Reports (GCMR). The study base includes data of March 12, 2020 - August 1, 2021. It is established that in controlling pandemic the most effective is to apply combination of measures implemented at state level of the Ministry of Health and the Ministry of Economic Development of the Russian Federation that permits to compensate negative effect of quarantine regimen. In the Russian Federation,effect of self-isolation measures, organization of remote work of employees of enterprises, closure of schools, wearing masks is controversial and their incorrect application can contribute to virus propagation. The vaccination measures are also effective in reducing morbidity of disease, but they are characterized by lagging effect. The approval and acceptance by population anti-epidemic measures significantly impact efficiency of pandemic control. The study results can be applied in practice of implementation of anti-epidemic measures as a tool preventing excessive risks of population morbidity and mortality.

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Introduction: The COVID-19 pandemic had a great impact on several public sectors worldwide, requiring the implementation of public policies in an organized way to contain and control the disease. Thus, this study aimed to analyze public policies to face the COVID-19 pandemic in the State of Paraná, Brazil. Methods: This was a cross-sectional, retrospective, quantitative survey carried out with data from March 2020 to March 2022 in the twenty-two municipalities that host the local health regions. Data collection was documentary, carried out from the municipal Portal da Transparência website, which is dedicated to making public all expenditures, and epidemiological bulletins released by the Health Department of the state of Paraná. The variables analyzed were New Cases and Deaths, Mortality and Lethality Coefficient, Incidence Rate, Vaccination Coverage, Number of Hospital and ICU beds exclusive to COVID-19, Settled Expenses destined for COVID-19 and coping measures, namely, the Declaration of Public Health Emergency, Curfew, Mandatory use of masks, Businesses closure, Teleworking of risk groups, and Suspension of activities with crowds and of classes. After collection, data underwent descriptive analysis, and subsequently, the correlation of variables was analyzed using the Spearman test. Multiple linear regression was applied using the variable selection method called best subset selection (BSS). The dependent variables listed were incidence rate, new cases and new deaths. Results: The results showed that coping measures, as well as the application of resources for the pandemic, were implemented heterogeneously in the municipalities studied, and the progression of the disease, the distribution of beds and vaccination occurred unevenly and may be a reflection of the limited Brazilian national governance. An important correlation was observed between the incidence rate and new deaths with vaccination coverage. In addition, the regression model showed that measures such as mandatory use of masks, closure of shops, suspension of classes, and curfew showed important correlations with the variables incidence rate, cases, and new deaths. Discussion: The study highlighted the importance of carrying out a robust analysis of public policies to face emergencies of global importance so that government entities are prepared for future crises of great repercussions, such as the COVID-19 pandemic.

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