Prevention Of Harm Research Articles

Making salient ethics arguments about vaccine mandates: A California case study.

Vaccine mandates can take many forms, and different kinds of mandates can implicate an array of values in diverse ways. It follows that good ethics arguments about particular vaccine mandates will attend to the details of individual policies. Furthermore, attention to particular mandate policies-and to attributes of the communities they aim to govern-can also illuminate which ethics arguments may be more salient in particular contexts. If ethicists want their arguments to make a difference in policy, they should attend to these kinds of empirical considerations. This paper focuses on the most common and contentious vaccine mandate reform in the contemporary United States: the elimination of nonmedical exemptions (NMEs) to school and daycare vaccine mandates. It highlights, in particular, debates about California's Senate Bill 277 (SB277), which was the first successful recent effort to eliminate NMEs in that country. We use media, secondary sources, and original interviews with policymakers and activists to identify and evaluate three ethics arguments offered by critics of SB277: parental freedom, informed consent, and children's rights to care and education. We then turn to one ethics argument often offered by advocates of SB277: harm prevention. We note, however, that three arguments for mandates that are common in the immunization ethics literature-fairness/free-riding, children's rights to vaccination, and utilitarianism-did not play a role in debates about SB277.

Community voices on alcohol harm in Sierra Leone: Perceptions of prevention needs

ObjectiveThe research purpose is to determine alcohol prevention needs in Sierra Leone. MethodsWe analyzed a cross-sectional survey from fall 2020, distributed by the West African Alcohol Policy Alliance to their partners across nine West African countries. The survey included questions on perceptions of alcohol harm, research priorities, and capacity and reach of the organizations represented. Only participants from Sierra Leone were included (n = 33). ResultsWhen asked if they thought measures taken to prevent alcohol-related harm in their country have been adequate, 66% answered inadequate (n = 32). Asked if heavy drinking of commercial alcohol is a concern in their community, 96% said yes (n = 25), and 92% said heavy drinking of traditional brew or distilled spirits is a concern in their community (n = 24). Finally, 91% said that their organization would be interested in implementing an alcohol counter-marketing campaign (n = 23). ConclusionsBased on the perception of survey participants, efforts to prevent alcohol-related harm thus far are inadequate in Sierra Leone where heavy drinking is a critical concern. CBOs and NGOs already engaged in alcohol harm prevention are eager to support and adopt new strategies. InnovationThis is the first research to seek direct input from CBOS and NGOs about alcohol harm prevention in Sierra Leone.

Development of the Harm Prevention Partners Clinical Model: An Academic-Practice Partnership for Prevention of Patient Harm Events.

This innovative academic-practice partnership applied user-centered design, resulting in a new clinical model, the "Harm Prevention Partners Program." The model engaged students working as teams with faculty to intervene on nurse-sensitive indicators by documenting care on a novel smartphone tool and generating an intervention dashboard to visualize impact. Faculty utilized the dashboard to guide postclinical debriefing and highlight students' impact on patient outcomes.

Optical illusions: The vital importance of instructions for use and intentionally approaching eye device processing

The purpose of this process and quality improvement activity was to address opportunities identified with cleaning, disinfection, and sterilization requirements for eye devices, and implement a robust and sustainable processing system to support safe patient care. Through the lean 6 Sigma methodology, the evaluation of noncritical, semicritical and critical device processing was conducted. A hierarchal approach to law, regulation, manufacturer's instructions for use, evidence-based guidelines, consensus documents, facility risk assessments, policy, and procedure was conducted. Over 15 diverse clinical areas within a large health care network were assessed for utilization of ophthalmic and optometric devices, with the review of inventory for manufacturer-instructed cleaning, disinfection and sterilization compliance. An interdepartmental multidisciplinary team with oversight of over 10 service lines led the implementation of point-of-use treatment, transport, high-level disinfection, sterilization, storage, and documentation based on intended use. During this experience, infection Preventionists performed a vital role in supporting a highly reliable cleaning, disinfection, and sterilization process. This undertaking required a team approach to apply instructions for uses and evidence-based practice that promoted sustainability and ultimately led to supporting the prevention of health care-associated infections and patient harm.

Tipping points of nitrogen use efficiency in freshwater phytoplankton along trophic state gradient

Eutrophication and harmful algal blooms have severe effects on water quality and biodiversity in lakes and reservoirs. Ecological regime shifts of phytoplankton blooms are generally thought to be driven by the rapidly rising nutrient use efficiency of bloom-forming species over short periods, and often exhibit nonlinear dynamics. Regime shifts of trophic state, eutrophication, stratification, and clear or turbid waters are well-studied topics in aquatic ecology. However, information on the prevalence of regime shifts in relationships between trophic states and phytoplankton resource transfer efficiencies in ecosystems is still lacking. Here, we provided a first insight into regime shifts in nitrogen use efficiency of phytoplankton along the trophic state gradient. We explored the regime shifts of phytoplankton resource use efficiency and detected the tipping points by combining four temporal or spatial datasets from tropical to temperate zones in Asia and Europe. We first observed significant abrupt transitions (abruptness > 1) in phytoplankton nitrogen use efficiency along the trophic state gradient. The tipping point values were lower in subtropical/tropical waterbodies (mesotrophic states; TSIc: around 50) than those in temperate zones (eutrophic states; TSIc: 60–70). The regime shifts significantly reduced the primary production transfer efficiency via zooplankton (from 0.15 ± 0.03 to 0.03 ± 0.01; mean ± standard error) in the aquatic food web. Nitrogen-fixing filamentous cyanobacteria can drive eutrophication under mesotrophic state. Our findings imply that the time-window of opportunity for harmful algae prevention and control in lakes and reservoirs is earlier in subtropical/tropical regions.

Reviewing the devices of those subject to Sexual Harm Prevention Orders (SHPOs): iOS opportunities, limitations and strategies

ABSTRACT In England and Wales, Management of Sexual or Violent Offenders (MOSOVO) teams are often tasked with managing offenders that are subject to Sexual Harm Prevention Orders SHPOs. These orders are put in place to protect the public and contain a series of prohibitions that allow for an offender’s conduct to be regulated and reviewed. SHPOs can be used to govern how offenders use their digital devices, particularly with regard to accessing the internet and the sending of electronic communications. To ensure SHPO compliance, officers frequently conduct reviews of any offender’s devices, sometimes manually by traversing a device’s menus and screens. These device manual reviews are not easy to conduct, often done under time pressures and in the knowledge that any missed evidence of misconduct may facilitate an offender to continue any wrongdoing and potentially increase the risk of harm to members of the public. Further, it is not always technical specialists undertaking this role. This work outlines a manual review strategy for devices running the operating system iOS (Apple products) to support officers in this role. Guided by commonly included SHPO prohibitions, relevant digital traces for evaluating SHPO compliance are highlighted, and limitations surrounding determining user behaviour are also discussed.

The Need for a Standard Outcome for Clinical Deterioration in Children's Hospitals.

Unrecognized clinical deterioration is a common and significant source of preventable harm to hospitalized children. Yet, unlike other sources of preventable harm, clinical deterioration outside of the ICU lacks a clear, "gold standard" outcome to guide prevention efforts. This gap limits multicenter learning, which is crucial for identifying effective and generalizable interventions for harm prevention. In fact, to date, no coordinated safety/quality initiative currently exists targeting prevention of harm from unrecognized clinical deterioration in hospitalized pediatric patients, which is startling given the morbidity and mortality risk patients incur. In this article, we compare existing outcomes for evaluating clinical deterioration outside of the ICU, highlighting sources of variation and vulnerability. The broader aim of this article is to highlight the need for a standard, consensus outcome for evaluating clinical deterioration outside of the ICU, which is a critical first step to preventing this type of harm.

An experimental study to examine whether and how Flemish and Dutch harm prevention messages on gambling advertising affect consumers' gambling-related beliefs and intentions.

Despite the widespread use of harm prevention messages on gambling advertising, it is unclear whether such messages achieve their goal of encouraging safer gambling behavior and preventing gambling harms. The current research therefore investigates whether and how existing harm prevention messages implemented on gambling advertisements in Belgium and the Netherlands affect consumers' gambling-related beliefs and intentions. Two experimental studies (Nexperiment 1 = 169; Nexperiment 2 = 212) investigate (a) the influence of message prominence and (b) the impact of message framing by comparing the effectiveness of the message "Gamble in moderation" with different types of Flemish and Dutch harm prevention messages (that are currently used in Belgium and the Netherlands) on people's gambling-related beliefs and intentions. The results of the first experiment show that although the size of a harm prevention message may increase message recognition, it does not affect the message's efficacy. In addition, the second experiment shows that the harm prevention message "Gamble in moderation" increases normative perceptions of gambling (vs. no message), and even enhances gambling intentions among at-risk gamblers compared to no message and other commonly used harm prevention messages. In contrast, exposure to the harm prevention message "What does gambling cost you? Stop in time" makes at-risk gamblers think most about the harms of gambling. Current harm prevention messages on gambling advertising often promote the concept of responsible gambling, but can have opposite effects than intended, especially among at-risk gamblers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

범죄피해자의 형사절차 참여 강화 방안

Despite ongoing discussions regarding the guarantee of victims' participation rights in criminal proceedings, the legal status of victims remains inadequate. Meaningful discussions on strengthening victims' participation in criminal proceedings can only take place when shifting away from a state-centric approach to a victim-centered approach. Victims can demand prevention of harm to their lives or bodies by participating in criminal proceedings, and they can also assert their right to seek recovery for the harm they have suffered as a result of the crime.
 However, the current system is far from victim-centered and fails to be victim-friendly. Victims are being treated as unwelcome guests by investigative agencies, and concerns regarding harm to victims are not properly taken into account in the criminal proceedings. The victim attorney system, which can make significant contributions to the exercise of participation rights, remains inadequate. Furthermore, victims are unable to provide proper statements in criminal proceedings, and they are not adequately guaranteed their right to information about their own cases.
 To address these issues, measures such as operating investigative procedures that consider the rights of victims and the perspective of recovery, prioritizing the protection of victims' right to life, expanding the victim attorney system, granting victims a quasi-party status in criminal trials, and ensuring proper guarantees of the right to information are necessary.

Differing perceptions of risk and the implications for the delivery of harm prevention programmes in Cambodia

ABSTRACT In 2005, Cambodia implemented harm prevention as a guiding principle in their National Strategic approach. In this practice-based research, social and community work practitioners at a community-based non-government organisation (NGO) delivered harm prevention workshops to 18 villages in rural Cambodia. Findings indicated that traditional expert understanding of risk did not always match how communities perceived risk. By engaging with the community utilising a Participation Action Research approach, Children’s Future International (CFI) found their expert position shifted to one where the communities became the experts, empowering them to be actively engaged in risk reduction strategies. These findings have implications for community engagement, development and targeting of harm prevention workshops.

Betting on Australian Rules Football: Can Expert Tipsters beat Randomness?

Betting on the various codes of football in Australia accounts for the majority of sports betting, with Australian rules football (AFL) by far the most popular sport in Australia. Several studies have revealed the heavy presence of gambling advertising during AFL broadcasts, and a frequently used advertising strategy involves the use of well-known AFL commentators outlining their tips and betting suggestions. To date, no research has examined the hypotheses that skill may help in predicting AFL matches and monetary outcomes from AFL betting. Rather than merely discounting such ideas, it is important to test them empirically. The aims of this study were therefore, to examine if (1) expert AFL tipsters made better predictions than random picks, (2) expert AFL tipsters gained greater monetary reward than random selection, and (3) expert tipsters’ prediction accuracy improved with betting experience. To this end, six seasons of AFL matches, odds data, and expert tipster data were analysed retrospectively, totalling 1141 matches. Random selections were calculated for each match using an inbuilt random number generator within Microsoft Excel and a $2 simulated wager was applied for each AFL match. The results of mixed-effects modelling showed that experts picked more correct outcomes than random selection; experts’ correct predictions were partially mediated by home-game selections; no difference in monetary outcome was observed for experts compared to random selection; experts’ predictions did not improve over time. The results of this study may be used to inform both psychological interventions that target gamblers’ illusions of control, and public health gambling harm prevention messaging.

Types of gambling: finnish gambling narratives under the lens of systems theory.

There seems to be no shortage of gambling and problem gambling typologies. At a closer look, however, previous research identified types of problem gamblers and not of problem gambling. While correct typologies of gamblers are important for developing treatment, they are less useful for harm prevention. The current study uses a system theoretical approach to investigate gambling communication in order to develop a genuine typology of gambling. Snowball sampling of Finnish gamblers resulted in 56 participants, who wrote 48 narratives about their ordinary gambling, 43 narratives about their most remarkable gambling event, and 28 about their worst gambling experience. The approach is informed by systems theory: communication on gambling is understood as a result of the reduction of contingency. Rather than focusing on the meaning of gambling or why people gamble, the analysis investigates what is included and what is excluded to make gambling discussable, i.e., the contextures of gambling. Economic and family/intimate contexture were the most prominent. The latter appeared most often in the most memorable gambling experiences. The economic contexture was more common in narrating ordinary and worst gambling situations. In all, four types of gambling could be identified: genuine monetary gambling, resonating monetary gambling, commensal gambling, and liminal gambling. When comparing the previously identified types of gamblers with the types of gambling discovered in the present study, it becomes obvious that a shift from the gamblers, their background, their personality, and their motives to the gambling activity provides novel insights. The constant appearance of the familial/intimate dimension in the narratives indicates that, beside the financial harms, societal harms also need to be treated as a category of harm in its own right, not just as a consequence of personality disorders, psychological distress, or social deprivation.

Adverse reactions of herbal drug: a case report of hepatitis, oral mucositis, and lichenoid reactions

Herbal medicine products are widely used as a popular therapeutic option worldwide. However, it is unfounded to assume that they are entirely free from side effects. In this particular case report, we are discussing a 40-year-old male patient who was diagnosed with herbal drug-induced hepatitis and oral mucositis, along with lichenoid reactions secondary to drug reaction. The patient was advised to take oral steroids and moisturizing cream. Initially, the patient was admitted under the Department of ENT and was later transferred to the Department of Medicine due to severe thrombocytopenia. Necessary investigations were conducted, which revealed leukocytopenia, thrombocytopenia, and deranged LFT. Two pints of RDP were transfused to address the thrombocytopenia, and the platelet count gradually improved. Subsequently, the patient was shifted to the general ward. Repeated LFT results returned to normal, and the patient was discharged. By reporting such cases, healthcare professionals and the public become more aware of the potential risks associated with herbal drugs. This facilitates the identification of adverse effects, thereby aiding in the prevention of additional harm to patients.

Ethical Challenges in the Development of Virtual Assistants Powered by Large Language Models

Virtual assistants (VAs) have gained widespread popularity across a wide range of applications, and the integration of Large Language Models (LLMs), such as ChatGPT, has opened up new possibilities for developing even more sophisticated VAs. However, this integration poses new ethical issues and challenges that must be carefully considered, particularly as these systems are increasingly used in public services: transfer of personal data, decision-making transparency, potential biases, and privacy risks. This paper, an extension of the work presented at IberSPEECH 2022, analyzes the current regulatory framework for AI-based VAs in Europe and delves into ethical issues in depth, examining potential benefits and drawbacks of integrating LLMs with VAs. Based on the analysis, this paper argues that the development and use of VAs powered by LLMs should be guided by a set of ethical principles that prioritize transparency, fairness, and harm prevention. The paper presents specific guidelines for the ethical use and development of this technology, including recommendations for data privacy, bias mitigation, and user control. By implementing these guidelines, the potential benefits of VAs powered by LLMs can be fully realized while minimizing the risks of harm and ensuring that ethical considerations are at the forefront of the development process.

Family role in paediatric safety incidents: a retrospective study protocol

IntroductionHealthcare-associated harm is an international public health issue. Children are particularly vulnerable to this with 15%–35% of hospitalised children experiencing harm during medical care. While many factors increase the risk...

Self-transcendent experience and prosociality: Connecting dispositional awe, compassion, and the moral foundations

Self-transcendent experiences are characterized by a reduced sense of self and an enhanced sense of connection which has led theorists to suggest them as a source of moral wisdom. This speculation has yet to be supported by empirical work that connects self-transcendent experience to moral psychology. Therefore, this cross-sectional study explored how a tendency toward awe, a self-transcendent experience, is associated with prosociality. Participants (N = 331; 73 % women) completed an online survey that assessed dispositional awe, moral foundations, and a compassionate view of others. As hypothesized, dispositional awe was positively associated with the moral foundations of harm prevention and fairness. An exploratory path analysis using structural equation modeling showed dispositional awe to positively predict these same foundations while controlling for political leaning and gender. The paths from dispositional awe to harm prevention and fairness were mediated by a compassionate view of others. These findings are the first to connect self-transcendent experience with moral foundations and are aligned with previous research. Implications of our results for future research and potential interventions that target prosocial behavior are discussed.

Establishing Core Content for Culturally Grounded Harm Reduction Intervention for Urban Indigenous After-School Youth in the Pacific Northwest

Indigenous adults (18 years or older) including parents, staff, and volunteers of an urban Indigenous youth after-school program participated in individual interviews (n = 10) as part of a community-based participatory research (CBPR) Indigenous harm reduction study to identify alcohol and other drug (AOD) content to include in prevention programming for youth participants. Adult findings were organized using a risk environment framework to identify culturally relevant social, physical, policy, and economic AOD risk factors for youth. We report where adult findings intersect with previously described youth results to establish a list of core content (i.e., culturally relevant AOD prevention activities and discussion topics) to guide program implementation. Core content includes intergenerational Indigenous perspectives (i.e., youth, adult, and elder) to reflect Indigenous cultural lifeways and values of protecting future generations. Findings may be highly relevant to other Indigenous after-school groups or others who wish to develop harm reduction prevention programming for urban Indigenous youth in the Pacific Northwest or beyond.

Community-based respondent-driven sampling as a strategy for drug use surveillance in a large French urban area

BackgroundUnderstanding drug use and behavior within the PWUD population is crucial to adapt harm reduction and prevention strategies, and provide improved addiction and medical treatment. However, in most countries such as France, the knowledge of drug use behaviors is likely biased as it originates from addiction centers which are attended by only an unknown proportion of PWUD. The objectives of this study were to describe drug use behavior in a population of active PWUD in the urban area of Montpellier, South of France.MethodsWe implemented a community-based respondent-driven sampling survey (RDSS), a validated strategy to obtain a representative sample of a population, to recruit PWUD in the city. Adult individuals reporting frequent psychoactive drug use other than cannabis, with confirmation by urine test, were eligible. Beside HCV and HIV testing, trained peers interviewed participants on their drug consumption and behavior using standardized questionnaires. Fifteen seeds launched the RDSS.ResultsDuring the 11 weeks of the RDSS, 554 actives PWUD were consecutively included. They were mostly men (78.8%), had a median age of 39 years, and only 25.6% had a stable living place. On average, participants consumed 4.7 (± 3.1) different drugs, and 42.6% smoked free-base cocaine. Unexpectedly, heroin and methamphetamine were consumed by 46.8% and 21.5% of participants, respectively. Among the 194 participants injecting drugs, 33% declared sharing their equipment.ConclusionThis RDSS highlighted a high consumption of heroin, crack and methamphetamine in this PWUD population. These unexpected results can be explained by low attendance to addiction centers, the source of drug use reports. Despite free care and risk reduction equipment in the city, sharing was very frequent among injectors, challenging the current program of harm reduction.

Gambling, social integration and sources of strain in cases of suicide: exploring police investigation reports

In this qualitative sociological study we explore the significance of social integration and social strain in gambling suicides. There is evidence that gambling and suicidality are associated. Mental distress is common among people experiencing gambling harm. Indebtedness and financial losses are also associated with suicidality among people experiencing gambling harm. The significance of social factors and social context on gambling suicides is understudied. Social integration theory proposes that social ties, such as marriage, can protect people from suicide. Strain theory explains suicide by social factors causing strain. Our research question is: How are social integration and different sources of strain related to cases of gambling suicides? The data consists of police investigation reports of 21 suicide cases. The data was analyzed with thematic content analysis. The results show variation in the social integration and strain the deceased experienced before their deaths. None of the deceased were without social ties. The entanglement of different sources of strain was manifest. The results suggest that a typology consisting of four categories of suicide contexts can be distinguished by the respective strength of integration and the number of different strains. We conclude that gambling policy with a focus on harm prevention is also a matter of suicide prevention.

COVID-19 and healthcare worker mental well-being: Comparative case studies on interventions in six countries

Healthcare worker (HCW) mental well-being has become a global public health priority as health systems seek to strengthen their resilience in the face of the COVID-19 pandemic. Analysing data from the Health System Response Monitor, we present six case studies (Denmark, Italy, Kyrgyzstan, Lithuania, Romania, and the United Kingdom) as a comparative review of policy interventions supporting HCW mental health during the pandemic. The results illustrate a wide range of interventions. While Denmark and the United Kingdom built on pre-existing structures to support HCW mental wellbeing during the pandemic, the other countries required new interventions. Across all cases, there was a reliance on self-care resources, online training tools, and remote professional support.Based on our analysis, we develop four policy recommendations for the future of HCW mental health supports. First, HCW mental health should be seen as a core facet of health workforce capacity. Second, effective mental health supports requires an integrated psychosocial approach that acknowledges the importance of harm prevention strategies and organisational resources (psychological first aid) alongside targeted professional interventions. Third, personal, professional and practical obstacles to take-up of mental health supports should be addressed. Fourth, any specific support or intervention targeting HCW's mental health is connected to, and dependent on, wider structural and employment factors (e.g. system resourcing and organisation) that determine the working conditions of HCWs.