ABSTRACT
BACKGROUND: There has been a precipitous decline in authorizations for medical cannabis since non-medical cannabis was legalized in Canada in 2018. This study examines the demographic and health- and medical cannabis-related factors associated with authorization as well as the differences in medical cannabis use, side effects, and sources of medical cannabis and information by authorization status. METHODS: Individuals who were taking cannabis for therapeutic purposes completed an online survey in early 2022. Multivariable logistic regression was used to determine odds ratios (OR) and 95% confidence intervals (CI) of demographic and health- and medical cannabis-related variables associated with holding medical cannabis authorization. The differences in medical cannabis use, side effects, and sources of information by authorization status were determined via t-tests and chi-squared analysis. RESULTS: A total of 5433 individuals who were currently taking cannabis for therapeutic purposes completed the study, of which 2941 (54.1%) currently held medical authorization. Individuals with authorization were more likely to be older (OR ≥ 70 years vs. < 30 years, 4.85 (95% CI, 3.49-6.76)), identify as a man (OR man vs. woman, 1.53 (1.34-1.74)), have a higher income (OR > $100,000/year vs. < $50,000 year, 1.55 (1.30-1.84)), and less likely to live in a small town (OR small town/rural vs. large city, 0.69 (0.59-0.81)). They were significantly more likely to report not experiencing any side effects (29.9% vs. 23.4%; p < 0.001), knowing the amount of cannabis they were taking (32.1% vs. 17.7%; p < 0.001), obtaining cannabis from regulated sources (74.1% vs. 47.5%; p < 0.001), and seeking information about medical cannabis from healthcare professionals (67.8% vs. 48.2%; p < 0.01) than individuals without authorization. CONCLUSIONS: These findings offer insight into the possible issues regarding equitable access to medical cannabis and how authorization may support and influence individuals in a jurisdiction where recreational cannabis is legalized, highlighting the value of a formal medical cannabis authorization process.
Subject(s)
Cannabis , Medical Marijuana , North American People , Male , Female , Humans , Medical Marijuana/adverse effects , Cross-Sectional Studies , Canada/epidemiologyABSTRACT
Newborn screening for congenital hypothyroidism (CH) has dramatically improved the neurocognitive outcomes for newborns with a confirmed positive screening test result. However, screening yields a small number of false positive and false negative results. This report describes the first known case of familial dysalbuminaemic hyperthyroxinaemia presenting with a positive newborn thyroid stimulating hormone screen. This condition is characterized by artefactually elevated free tetraiodothyronine (T4) and triiodothyronine (T3) levels due to increased albumin binding and subsequent dissociation during laboratory assays but normal true free thyroid hormone and thyroid stimulating hormone (TSH) levels in a clinically euthyroid subject. This highlights the need to take care when attributing clinical significance to discordant results.
ABSTRACT
Equestrian sports, including racing (e.g., flat, steeple-chasing, harness or donkey derby); show-jumping; cross-country; dressage; polo; polocrosse; endurance; carriage driving; vaulting and hunting; are hugely popular in the UK, and they involve a significant number of people, both as participants and spectators, and tens of thousands of equids. In this paper, we discuss animal welfare as a complex and disputed issue, clarifying what the term means and how it can be measured. We review many aspects of welfare risk to equids used for sport, addressing issues encountered throughout their lives, including housing, feeding, veterinary intervention, shoeing, handling, training, breeding and equipment. This is followed by a unique exploration of the institutions and social processes influencing equine welfare. The institutional components comprise the rules of competition, the equids, attributes of the stakeholders and the space where participants strive to achieve a common purpose. We endeavour to untangle the most significant elements that create barriers or provide opportunities for equine welfare improvement. We expose the challenges faced by a broad range of stakeholders with differing ethics, attitudes and values. Evidently, there are many welfare risks to which equids used in sports continue to be exposed. It is also evident that significant improvements have occurred in recent times, but there remains a barrier to reducing the risks to an acceptable level. We conclude with recommendations regarding a process for change, involvement of stakeholders and management of knowledge to improve equine welfare that involves identifying and prioritising the risk factors and ultimately leading to interventions, further research and/or education.
ABSTRACT
Bits used for cart horses in Senegal are typically made of recovered construction iron and often have defects related to design, shape, fit and metal quality. Consequently, there is widespread presence of bit-related oral injury amongst these equids. It was hypothesised that improving bit design would ameliorate bit-related welfare issues for working cart horses. This study aimed to develop locally made alternative bit prototypes and test their efficacy as less harmful to working horses, and their acceptability to their drivers. Eight animal-based welfare indicators (four physical and four behavioural) were designed to measure positive or negative effects of the new bits. Following a testing phase to appraise and mitigate potential animal welfare risk associated with the alternative bit designs, a total of 540 driver/horse combinations were opportunistically selected across five municipalities in Senegal. Welfare indicators were observed when new bits were introduced and again after 21 weeks of daily use. The results indicated statistically significant improvements in all welfare indicators measured (i.e., lesions on lip commissures, tongue, buccal mucosa and bars; and open mouth, tongue loll, head toss/shake, and head tilt/turn behaviours). None of the drivers reported any difficulty with horse control, nor chose to revert back to their original bits. Whilst acknowledging the limitation of inability to control all potential confounding variables, these preliminary findings suggest the bit itself as an important contributor to oral injury, and the possibility to improve this through alternative bit design that is low-cost, locally produced and acceptable to drivers.
ABSTRACT
The majority of horses, donkeys and mules (equids) are in low- and middle-income countries, where they remain a key source of labour in the construction, agriculture and tourism industries, as well as supporting households daily through transporting people and staple goods. Globally, approximately 600 million people depend on working equids for their livelihood. Safeguarding the welfare of these animals is essential for them to work, as well as for the intrinsic value of the animal's quality of life. In order to manage animal welfare, it must be measured. Over the past decade, welfare assessment methodologies have emerged for different species, more recently for equids. We present the Standardised Equine-Based Welfare Assessment Tool (SEBWAT) for working equids. The tool is unique, in that it has been applied in practice by a non-governmental organisation (NGO) for six years across Low-Middle-Income Countries (LMICs). We describe the revision of the tool from an original to a second version, the tool methodology and user training process and how data collection and analysis have been conducted. We describe its application at scale, where it has been used more than 71,000 times in 11 countries. Case study examples are given from the tool being used for a needs assessment in Guatemala and monitoring welfare change in Jordan. We conclude by describing the main benefits and limitations for how the tool could be applied by others on working equids in LMICs and how it may develop in the future.
