Regulatory Barriers Research Articles

Bridging the gap: opportunities, challenges, and future directions for teleradiology in rural healthcare

Teleradiology, the electronic transmission of radiological images and data for diagnostic purposes, holds significant promise for improving healthcare access in rural and underserved regions. This review explores the opportunities and challenges of implementing teleradiology in rural settings, where limited access to radiology services exacerbates healthcare disparities. Teleradiology offers multiple benefits, including improved access to timely diagnostics, enhanced decision-making, and cost savings for rural patients who would otherwise need to travel to urban centers for radiology services. It has shown positive outcomes globally, with examples in India, Mali, the Democratic Republic of Congo, and Brazil, demonstrating its feasibility and potential to reduce geographic health inequities. However, implementing teleradiology in these settings faces several challenges, such as technological limitations, workforce shortages, regulatory and legal barriers, data security concerns, and cultural acceptance issues. Solutions and recommendations include investments in infrastructure, workforce training, supportive regulatory frameworks, secure data management, and adaptable telehealth models that consider socioeconomic factors in rural areas. By addressing these challenges, stakeholders can enhance the impact of teleradiology in rural healthcare systems, ultimately contributing to reduced disparities and improved healthcare outcomes. This review provides a comprehensive overview of the current landscape and suggests actionable pathways for advancing teleradiology in rural settings worldwide.

Barriers to opioid use in the Arab world.

The Arab world consists of 22 countries, representing 5.5% of the world's population. Morphine consumption accounts for less than 1% of the world's consumption. This is the first study to identify barriers to opioid use in the Arab world. This study aimed to investigate the barriers to opioid use in pain management in the Arab world. Online survey was developed to investigate barriers to governance, prescribing, distributing, dispensing and administering, as well as educational barriers in the Arab world. The questionnaire was sent via email and a mobile app to one expert physician in pain management and one licensed pharmacist from each Arab country. With the exception of Tunisia, Djibouti and Comoros, 34(77%) participants from 19 Arab countries answered the survey. Most countries lack local opioid production, necessitate special licenses for physicians, and restrict opioid prescribing to medical specialists. Special prescription forms are mandated, and pharmacists lack the authority to correct prescription errors or accept refill or verbal orders on opioids. Storage requirements for empty ampoules and prescriptions are enforced. Nurses are not allowed to carry opioids during home visits, and only first degree relatives can collect opioids for patients. Furthermore, the integration of palliative care and pain management curricula into pharmacies and medical schools is lacking. There is a wide range of regulatory and other barriers to opioid use in the Arab world. There is a substantial need for regulatory review and reform, as well as for educational initiatives, in most Arab countries.

PROSPECTS FOR UKRAINIAN PRODUCERS TO ENTER THE EU MARKET OF CABLE AND WIRE PRODUCTS

This article investigates the potential for Ukrainian cable and wire manufacturers to access the European Union market, where a growing demand for energy-efficient and sustainable solutions is driven by the rapid expansion of renewable energy sources and an accelerated pace of digitalization across industries. The research provides an analysis of the European cable and wire market's current state and development trends, identifying the primary drivers of growth, including the expansion of smart grids and renewable energy projects. Emphasis is placed on the competitive landscape, detailing key industry players who lead the sector by meeting stringent EU regulations and embracing innovation to provide advanced cable solutions. The study examines the economic and regulatory barriers Ukrainian manufacturers face to penetrate the EU market, highlighting the rigorous product certification standards required for compliance, such as CE, CPR, RoHS, and REACH certifications. These standards ensure that products meet high requirements for quality, safety, and environmental impact, which are essential for market access but present significant challenges for companies unfamiliar with EU compliance processes. The article illustrates the strategic approaches, adjustments, and resource investments required to establish a foothold in this competitive environment by analyzing a successful case of a Ukrainian company entering the European cable and wire market. Furthermore, the article evaluates the export potential for Ukrainian cable products, noting the unique competitive advantages that Ukrainian manufacturers may leverage, such as cost-effective production and geographical proximity to the EU. The findings emphasize that Ukrainian producers can enhance their competitive position with targeted state support, a focus on meeting EU standards, and engagement in strategic partnerships with European companies. By developing these capabilities, Ukrainian cable manufacturers have the potential to meet the EU market's increasing demand and contribute to sustainable infrastructure projects that align with Europe's environmental goals. Thus, this research highlights the importance of an integrated approach that combines regulatory compliance, strategic partnerships, and innovation as Ukrainian manufacturers aim to capitalize on the growing opportunities within the European Union's dynamic cable and wire sector.

Advancing financial inclusion through digital payment platforms in emerging markets

Advancing financial inclusion in emerging markets has become a critical focus for economic development, and digital payment platforms are playing a transformative role in this process. These platforms offer a scalable solution to bridge the gap between the unbanked population and formal financial services, enabling individuals and businesses to access affordable and secure financial products. The rise of mobile technology and widespread internet penetration have provided the infrastructure for digital payments to thrive, particularly in regions where traditional banking systems are underdeveloped. Key enablers include mobile money services, fintech innovations, and supportive regulatory frameworks that promote adopting digital financial solutions. Digital payment platforms facilitate faster, more efficient transactions, reduce the reliance on cash, and open up opportunities for marginalized groups, including women and small business owners, to participate in the formal economy. They also enhance financial literacy by offering accessible financial education tools, which empower users to manage their finances more effectively. However, challenges such as limited digital literacy, regulatory barriers, cybersecurity risks, and the digital divide must be addressed to maximize the potential of these platforms. Emerging markets have witnessed significant success stories, particularly in Africa and Southeast Asia, where mobile money platforms like M-Pesa and GCash have expanded financial access to millions. These platforms contribute to financial inclusion and stimulate economic growth by integrating more people into the financial system. Moving forward, collaborative efforts between governments, private sector stakeholders, and development organizations are essential to ensuring that digital payment platforms continue to drive financial inclusion sustainably and equitably.. Keywords: Financial Inclusion, Digital Payment Platforms, Emerging Markets, Mobile Money, Fintech, Unbanked Population, Economic Development, Financial Literacy, Digital Financial Services, Mobile Technology.

A review on Biofortification of Crops: A Nutritional Strategy for Combating Malnutrition

Biofortification is an innovative agricultural approach aimed at reducing global micronutrient deficiencies, often referred to as "hidden hunger," by enhancing the nutritional quality of staple crops through breeding, genetic engineering, and agronomic practices. This strategy targets essential micronutrients such as iron, zinc, and provitamin A, particularly in regions where diets are predominantly based on nutrient-poor staple foods. Biofortified crops, such as vitamin A-enriched sweet potatoes and iron-rich beans, have demonstrated significant improvements in nutrient intake and health outcomes, including reduced anemia and enhanced child growth. Despite its promise, the adoption and widespread implementation of biofortified crops face multiple challenges, including technical constraints in breeding for nutrient stability and bioavailability, regulatory barriers for genetically modified varieties, and socio-cultural resistance due to consumer preferences and lack of awareness. Moreover, environmental factors, such as soil nutrient content and agro-ecosystem dynamics, can influence the success and sustainability of biofortification. Addressing these issues requires advancing research in nutrient bioavailability, developing more resilient crop varieties, and incorporating biofortification into broader food and nutrition policies. Scaling up biofortified crops will depend on effective community engagement, public-private partnerships, and integration into existing agricultural extension systems. Successful examples, such as the widespread adoption of orange-fleshed sweet potatoes in Sub-Saharan Africa, highlight the potential of biofortification to improve nutritional security and livelihoods when supported by targeted advocacy and policy initiatives. Thus, while challenges persist, biofortification remains a valuable, cost-effective solution to addressing micronutrient malnutrition and improving global food security, especially when implemented in tandem with other nutrition and health interventions.

Wearable sensors for cardiological monitoring in the SUS: regulatory challenges and impacts on Brazilian Public Health

Cardiovascular diseases are the leading cause of death in Brazil, with approximately 400,000 deaths annually, which corresponds to almost 30% of all deaths in the country. In addition to the impact on mortality, these conditions generate an enormous economic burden for the health system, with costs associated with the treatment of diseases such as heart attack and heart failure exceeding R$50 billion per year. In this context, the use of wearable devices for continuous monitoring of cardiovascular parameters emerges as an opportunity to improve the management and prevention of these diseases. This study conducts a scoping review of the regulatory challenges involved in the incorporation of wearables into the Unified Health System (SUS), with a focus on cardiological monitoring. Articles published between 2019 and 2024 were analyzed, discussing issues such as data accuracy, interoperability between systems, protection of sensitive data, and training of health professionals. In addition, the study examines the economic and social implications of the adoption of these technologies in a context of profound socioeconomic inequalities. The results indicate that, although wearables have the potential to transform cardiovascular care in Brazil, regulatory and technical barriers still limit their large-scale adoption in the SUS. Adequate regulation, aligned with the General Data Protection Law (LGPD), and investments in infrastructure and training are essential for the safe and effective integration of these technologies into public health.

Translating Priorities Into Practice: Midwifery Care for Uninsured Migrant Populations Across Canada.

Immigrants and newcomers are identified by many provincial midwifery associations as "priority populations." Recently, newcomer populations have shifted considerably, with more people coming to Canada with precarious immigration status who are increasingly ineligible for public healthcare insurance and facing barriers to accessing care. Our aims were to: (1) gain an understanding of the policies related to equitable access to midwifery care and how they may apply to migrant groups without public healthcare insurance and (2) identify existing policy themes, gaps, and regulatory barriers that limit access for this vulnerable population in Canada. We conducted a high-level document content analysis using a health equity framework. We aimed to identify language related to equitable access in midwifery services, with particular emphasis on uninsured populations. A total of 64 documents were analyzed, including legislation and publicly available statements from midwifery regulatory bodies and associations. Midwifery regulatory authorities and associations across Canada are consistent in establishing an expectation that midwives will provide accessible care to diverse clientele. However, how these commitments are put into practice varies considerably between jurisdictions. We compared the cases of Manitoba and Ontario to illustrate the disconnect between commitments to priority populations and implementation. While there is a clearly demonstrated intention to provide equitable access to midwifery care to all people, including "priority populations" like migrants and newcomers, in practice, these commitments have not been fully realized. Equity is encumbered by broader structural issues, such as the growth in the number of newcomers without access to public health insurance. Moves toward equity within midwifery and healthcare more broadly need to meaningfully engage with other policy sectors, such as immigration, to be able to adapt to emerging issues affecting reproductive care, such as the growing precarity of newcomer populations in Canada.

USING ARTIFICIAL INTELLIGENCE FOR BIOMARKER ANALYSIS IN CLINICAL DIAGNOSTICS

Introduction. Artificial intelligence (AI) technologies are becoming crucial in clinical diagnostics due to their ability to process and interpret large volumes of data. The implementation of AI for biomarker analysis opens new opportunities in personalized medicine, offering more accurate and individualized approaches to disease diagnosis and treatment. The relevance of this review stems from the need to systematize recent advances in AI application for biomarker analysis, which is critical for early diagnosis and prediction of chronic non-communicable diseases (NCDs). Material and methods. The analysis of peer-reviewed scientific publications and reports from leading research centers over the past five years was conducted. Studies on the application of AI algorithms for analyzing genomic, proteomic, and metabolomic biomarkers were reviewed, including machine learning methods and deep neural networks. Special attention was paid to the integration of multi-marker panels for improving the accuracy of diagnosis and prediction of cardiovascular, digestive, respiratory, endocrine system diseases, as well as oncological and neurodegenerative pathologies. Results. The application of AI has significantly increased the sensitivity and specificity of diagnostics, especially in complex cases requiring analysis of multiple disease parameters. The effectiveness of AI has been demonstrated in early diagnosis of lung, breast, and colorectal cancer, prediction of cardiovascular complications and NCDs progression, including diabetes mellitus and Alzheimer’s disease. AI’s significant contribution to the discovery of new biomarkers, optimization of personalized treatment, and improvement of therapeutic strategies has been noted. Conclusion. The use of AI in biomarker analysis has become a significant breakthrough in medical diagnostics, particularly in oncology, cardiology, and neurodegenerative diseases. The technology allows integration of data about various biomarkers and contributes to creating more accurate models for disease diagnosis and prediction. Further development is associated with technology advancement and overcoming ethical and regulatory barriers, which will expand AI capabilities in clinical practice.

Agricultural Drones in Africa: Exploring Adoption, Applications, and Barriers

The adoption of drone technology in agriculture is transforming farming practices across Africa by enhancing resource efficiency, reducing operational costs, and promoting environmental sustainability. This paper explores the various applications of drones in African agriculture, including precision farming, crop monitoring, pest control, and livestock management. Drones enable farmers to optimize the use of water, fertilizers, and pesticides, leading to increased yields and improved profitability. Despite the potential benefits, the deployment of drones faces challenges such as high costs, lack of technical expertise, and regulatory barriers. This study highlights the importance of addressing these obstacles to facilitate the widespread adoption of drone technology among both small and large-scale farmers. By leveraging drones, African agriculture can improve food security, scale up operations, and contribute to the continent’s sustainable development goals. The findings of the review include case studies from Ghana, Kenya, and Nigeria which show that government intervention and private-sector partnerships are crucial for overcoming these barriers. This paper highlights the need for targeted training programs and policy reforms to enhance accessibility for smallholder farmers. By leveraging drones, African agriculture can improve food security, scale up operations, and contribute to the continent’s sustainable development goals.

Assessing the Effectiveness of India's Free Trade Agreements (Ftas): A Comparative Analysis

This study, titled "Assessing the Effectiveness of India’s Free Trade Agreements (FTAs): A Comparative Analysis," explores the economic impact, sectoral outcomes, and implementation challenges of India’s FTAs. With an increasing number of trade agreements aimed at enhancing market access, boosting exports, and promoting economic growth, India has pursued FTAs with various countries and regional blocs, including ASEAN, Japan, and South Korea. However, these agreements have produced mixed results, with significant trade imbalances, limited export growth, and sectorial disparities, raising questions about their overall effectiveness. The study employs a comparative analysis framework, combining quantitative and qualitative methods. By analysing trade data, the study assesses changes in trade volumes, trade balances, and GDP growth post-FTA implementation. Additionally, sector-specific analyses examine the differential impact on agriculture, manufacturing, and services, revealing both gains in certain industries and challenges faced by others. Findings indicate that while FTAs have increased India's trade volume, they often disproportionately favour imports over exports, leading to trade deficits with key partners. Sectors such as IT and services have benefited from liberalized trade, while traditional industries like agriculture face competitive pressures from imports, limiting broader economic gains. Moreover, implementation challenges such as regulatory and non-tariff barriers in partner countries, low FTA utilization by Indian businesses, and limited awareness have hindered the agreements' potential benefits. Interviews with stakeholders, including policymakers and industry representatives, further highlight the need for enhanced support and strategic adjustments to maximize FTA advantages. India’s FTAs have contributed to economic integration, their effectiveness in achieving balanced trade and sustainable growth requires improvement. Recommendations include negotiating favourable terms, addressing non-tariff barriers, and increasing awareness among Indian businesses. This study’s findings provide valuable insights for policymakers to refine India’s FTA strategy, fostering more equitable and beneficial trade relationships in the future.

Teamworking in Dentistry: The Importance for Dentists, Dental Hygienists and Dental Therapists to Work Effectively Together-A Narrative Review.

To consider teamworking in dentistry, focusing especially on the role of dental hygienists (DHs) and dental therapists (DTs) as part of the dental team. A narrative review of studies that have investigated teamworking in periodontology and dentistry in general together with consideration of examples of relevant regulatory and governmental policy documents. The inclusion of DHs and DTs as key members of the dental team yields significant patient benefits in terms of access to care (particularly among under-served populations), efficient and effective treatment and improved healthcare outcomes for patients. However, barriers can exist to full implementation of effective working in dental teams, including both systemic and regulatory barriers, as well as attitudinal barriers. Furthermore, DHs and DTs are not always working to their full scope of practice, thereby limiting the care that these team members can provide. Mutual respect between dental team members, high-quality communication and a common ethos and shared clinical standards are all essential for effective teamworking. DHs and DTs have a clear role to play in achieving sustainable improvements in oral and dental health for patient populations globally. Full and effective integration of DHs and DTs into healthcare teams will benefit not only the dental team, but also healthcare systems and patient populations, via more effective teamworking, improved access to care and enhanced treatment outcomes.

The Effect of Medical Cannabis on Anxiety and Depression

In December 2020, the United Nations removed medical cannabis (MC) from Schedule 4 of the 1961 UN Convention on Narcotic Drugs following a recommendation by the World Health Organization (WHO) on its medical potential to pave the way for the reduction of regulatory barriers for research (United Nations, 2020). Some of the medical indications for MC include but are not limited to rare seizure disorders, symptomatic treatment of nausea and vomiting, insomnia, pain, loss of appetite, anxiety, and post-traumatic stress disorder (PTSD), as well as glaucoma, Huntington’s Disease, dystonia, and Parkinson’s Disease (Klumpers & Thacker, 2019). In countries like the United States, MC prescriptions are on the rise for various medical indications, especially in symptomatic treatment of nausea and vomiting, loss of appetite, and pain among oncology patients (Corroon et al., 2019; Vinette et al., 2022).

Barriers to the Effective Selection of Sustainable Materials for Residential Building Projects: A Qualitative Study

Although sustainability in Tanzania’s construction sector has been explored in areas such as energy efficiency and green building practices, little attention has been given to understanding the specific barriers to the selection of SBMs in residential projects. This study fills that gap by identifying and analyzing the critical barriers hindering the effective selection of SBMs in Tanzania’s residential construction sector. Through qualitative interviews with experts from regulatory bodies, public developers, and academic researchers, this research provides a comprehensive examination of these barriers. Using Atlas.ti 23 software for a qualitative data analysis, six key categories of barriers were identified: (1) Regulatory and Policy Barriers, (2) Financial Barriers, (3) Knowledge and Awareness Barriers, (4) Technical Barriers, (5) Market and Supply Chain Issues, and (6) Cultural and Social Barriers. Among these, lack of awareness and limited knowledge emerged as particularly significant, alongside regulatory and policy barriers, in hindering the effective selection of SBMs. This study’s novelty lies in its focus on the Tanzanian context, depth of the analysis of the unique challenges, and categorization of the barriers. The findings underscore the need for targeted policy interventions, particularly in raising awareness, offering financial incentives, and establishing comprehensive regulatory frameworks. Furthermore, this study presents a graphical representation to illustrate the categories and constructs of these barriers, adding a visual dimension to the understanding of the issues. Future research should expand the scope to include private developers and material suppliers, whose roles are critical in enhancing the availability and adoption of SBMs in Tanzania’s construction industry.

From Cord to Cure: Repurposing Biological Waste for UAE's Health Revolution with Umbilical Cord Stem Cell Therapy

In the UAE, current hospital policies mandate the disposal of biological waste, such as umbilical cords. However, this tissue represents a valuable source of therapeutic material like mesenchymal stem cells (MSCs) and their secretome. The disposal of this valuable therapeutic material imposes a significant burden on public health. In the United States alone, approximately 18,000 people per year are diagnosed with diseases that could be ameliorated with stem cell therapy. These individuals often remain untreated due to the lack of available stem cells, as current methods for MSC obtention, such as Bone Marrow-MSCs, require an invasive bone marrow aspirate procedure, which is painful and can pose risks to donors, including infection and prolonged recovery times. This paper advocates for policy reform to facilitate the collection, storage, and utilization of umbilical cords. By addressing regulatory barriers and implementing standardized protocols, hospitals in the UAE can not only contribute to advancements in regenerative medicine but also solidify the nation’s position as a leader in this emerging field, ultimately improving patient outcomes and reducing the disease burden both locally and regionally. This is particularly relevant given the significant burden of cardiovascular diseases and type 2 diabetes mellitus (T2DM) in the UAE, where 17.3% of the population aged 20 to 79 is affected with T2DM. Cardiovascular diseases and T2DM are few of the many disorders that can benefit from MSC therapy. Utilizing umbilical cord biowaste for such diseases can further build the UAE’s status as a hub for medical tourism and accentuate it’s growing prominence in the field of regenerative medicine.

Revolutionizing Eye Care: Exploring the Potential of Microneedle Drug Delivery

Microneedle technology revolutionizes ocular drug delivery by addressing challenges in treating ocular diseases. This review explores its potential impact, recent advancements, and clinical uses. This minimally invasive technique offers precise control of drug delivery to the eye, with various microneedle types showing the potential to penetrate barriers in the cornea and sclera, ensuring effective drug delivery. Recent advancements have improved safety and efficacy, offering sustained and controlled drug delivery for conditions like age-related macular degeneration and glaucoma. While promising, challenges such as regulatory barriers and long-term biocompatibility persist. Overcoming these through interdisciplinary research is crucial. Ultimately, microneedle drug delivery presents a revolutionary method with the potential to significantly enhance ocular disease treatment, marking a new era in eye care.

Designing circular supply chains with digital technologies for competitive sustainability: An operation management perspective

The objective of this research is to investigate how digital technologies, specifically blockchain, artificial intelligence (AI), and the Internet of Things (IoT), can be integrated into circular supply chains to enhance sustainability and preserve a competitive advantage. The goals of circular supply chains, which are founded on the ideas of the circular economy, are to reduce waste, promote resource regeneration, and lessen their negative effects on the environment. The study highlights the critical role that digital technologies play in guaranteeing transparency, promoting real-time monitoring, and optimizing resource distribution. Blockchain offers traceability and trust, IoT boosts visibility and operational efficiency within supply chains, and AI improves demand forecasting and resource efficiency. Though the benefits are obvious, there are significant obstacles to overcome, including high implementation costs, complex technological issues, scalability issues, and regulatory barriers. The research demonstrates how these digital technologies can effectively promote sustainability while enhancing operational efficiency through case studies of well-known companies like HP, Walmart, and Philips. The report also highlights important future trends and makes suggestions for companies looking to develop their workforces, invest in digital technologies, and work together on circular economy platforms. In the end, digital tool adoption is essential for creating supply chains that are more sustainable and competitive in the modern global economy.

Three-Dimensional Printing Technology in Drug Design and Development: Feasibility, Challenges, and Potential Applications

Background/Objectives: The present investigation evaluates the impact of 3D-printing technology on the design of pharmaceutical drugs, considering the feasibility issues and problems concerning technological, pharmaceutical, and clinical matters. This paper aims to review how 3D printing can modify the traditional manufacturing of drugs with personalized medicine-therapy outcomes being individualized and optimized, hence improving patients’ compliance. Methods: The historical development of 3D printing from rapid prototyping to advanced pharmaceutical applications is discussed. A comparison is then made between traditional drug manufacturing approaches and the different techniques of 3D printing, including stereolithography, material extrusion, and binder jetting. Feasibility is assessed based on clinical trials and studies evaluating the efficacy, safety, bioavailability, and cost-effectiveness of 3D-printed drugs. Results: Current evidence indicates that material selection, regulatory barriers, and scalability issues are some of the major challenges to be overcome for wider acceptance. Other matters, such as ethical issues concerning patient data privacy, the misuse of 3D-printing technology, and technical complexities related to pharmaceutical 3D printing, are discussed further. Future applications also include bioprinting and in situ printing together with their implications for personalized drug delivery, which will also be discussed. Conclusions: This review stresses that intersectoral collaboration and the updating of regulatory frameworks are a must to overcome the barriers that confront 3D-printing applications in drug development. can could be an opportunity for innovative licensing and manufacturing techniques in pharmaceutical product development that can change the paradigm of personalized medicine through modern printing techniques.

CANNABIS: USO TERAPÊUTICO E DESAFIOS PARA SUA APLICABILIDADE MEDICINAL NO BRASIL

Introduction: The legalization of medicinal marijuana use has been a controversial and constantly debated topic in recent years worldwide. Marijuana, also known as cannabis, is a plant that contains various chemical components, including THC (tetrahydrocannabinol) and CBD (cannabidiol), which are the main compounds responsible for its medicinal effects. Although many countries have already established regulations for the therapeutic use of cannabis, there are still many barriers to overcome. Objective: To explore the methodology of therapeutic use and the challenges for the application of cannabis, focusing on its medicinal use, identifying notable challenges and the regulatory aspects involved. Methodology: This study is based on a bibliographic review with a qualitative methodology, centered on the subjective nature of the verified bibliography through literary studies. The works reviewed were published between 2020 and 2023, collected from three main sources: LILACS and PUBMED databases. Results: The review identified significant evidence pointing to the therapeutic potential of Cannabis sativa L., particularly in the treatment of neurological conditions such as epilepsy, multiple sclerosis, and anxiety disorders. However, it also highlighted the major regulatory challenges faced in countries like Brazil, where the cultivation of cannabis for medicinal purposes remains prohibited. This prohibition increases treatment costs and limits accessibility for patients. Additionally, the results revealed a growing acceptance among healthcare professionals and patients, suggesting a likely increase in the demand for medicinal cannabis in the coming years. Conclusion: Although there is robust evidence supporting the efficacy of cannabis for medicinal purposes, significant regulatory and legal barriers remain, particularly in countries with restrictive policies. A reformulation of regulatory frameworks is urgently needed to expand patient access and promote the development of local medicinal cannabis industries. Further investment in scientific research is also essential to ensure that regulatory decisions are based on comprehensive and context-specific data.

Integrated care in the Baltic states over a 5-year period: progress, challenges and future directions

Abstract Person-centered, multidisciplinary care is key to addressing evolving complex health needs. In Estonia, Latvia, and Lithuania, this pursuit of integrated care has gained momentum as an innovative approach to allocate resources more efficiently and improve patient outcomes. This study investigates the progress of integrating care in the Baltic countries from 2019 to 2024. It details key learnings, particularly for small European countries with limited resources. The Health Systems and Policy Monitor Network of the European Observatory on Health Systems and Policies undertook a cross-country study to better understand the progress in care integration in the Baltics. The Network’s Baltic country experts completed a 21-item questionnaire on the adoption of integrated care reforms. Responses were analyzed to capture reform characteristics and commonalities, countries’ political environments and their conduciveness to the uptake of integrated care. Country-specific experiences with the implementation of integrated care were further explored via case studies of pilot programs over the five years. The pace of implementing integrating care reforms varied in each country. Existing regulatory barriers, workforce challenges and payment schemes have impeded integration efforts across health and social care. Despite these obstacles, the political commitment to new and innovative service delivery and collaboration for chronic care management underscores an important prerequisite toward achieving more integrated and person-centered healthcare. The three case studies illustrate the hurdles that come with shifting care settings and expanding roles for some workers. Findings stress the role for integrated care to address organisational challenges in the Baltics. This study highlights innovative approaches and long-running efforts to provide multidisciplinary care for complex-needs patients and the implications of their results for broader health system adoption. Key messages • Small countries like the Baltics face structural challenges in integrating care to improve outcomes and efficiency. • Investment and innovative care approaches are key to further advancements.

Designing comprehensive workforce safety frameworks for high-risk environments: A strategic approach

High-risk industries such as oil and gas, construction, and manufacturing face significant challenges in safeguarding their workforce due to the inherent dangers of their operations. This paper presents a strategic approach to designing comprehensive workforce safety frameworks that address both personal and process safety. Personal safety focuses on the use of personal protective equipment (PPE), behavior-based safety programs, and training, while process safety aims to manage operational risks such as equipment malfunctions and hazardous materials. The interdependency of these two safety pillars is essential in reducing workplace accidents and ensuring a safer operational environment. Challenges in implementing safety frameworks, such as complex operations, human factors, and technological and regulatory barriers, are also discussed. To overcome these challenges, the paper proposes a series of strategic solutions, including risk assessment, technology integration, continuous improvement, and stakeholder collaboration. By adopting these recommendations, industries can develop customized safety frameworks that protect their workforce and enhance operational efficiency. Keywords: High-Risk Industries, Workforce Safety, Personal Safety, Process Safety, Risk Assessment, Safety Frameworks.