Using Advocacy to Address the Crisis of Children's Mental Health.

Children and youth in the United States are experiencing a mental health crisis that predates the COVID-19 pandemic. Child and adolescent psychiatrists have the knowledge and skillset to advocate for improving the pediatric mental health care system at the local, state, and federal levels. Child psychiatrists can use their knowledge and expertise to advocate legislatively or through regulatory advocacy to improve access to mental health care for youth. Further, including advocacy education in psychiatry and child psychiatry graduate medical education would help empower child psychiatrists to make an impact through their advocacy efforts.

The Development of the Urban-Rural Cleavage in Anglo-American Democracies.

We provide a mixed-methods, comparative analysis of the development of the urban-rural electoral cleavage in Canada, Great Britain, and the United States from the early 20th century to the present. Using aggregate election results, electoral district boundary files, and electoral district population measures, we construct a new comparable dataset of district election results and urbanity for the lower house of the legislature in each country. We use this dataset to measure the importance of the urban-rural divide for election outcomes across countries and time. We find that the cleavage has widened over time in each country, each arrived at its current urban-rural divide via a distinct developmental trajectory, which we interpret with reference to secondary literature. We conclude by discussing the significance of our findings for theories of both the causes and consequences of urban-rural divides and discuss the implications of our work for the comparative study of urban-rural cleavages.

Exploring the Threefold Viewpoint on Children's Oral Health in a Cross-Sectional Study.

Oral health is situated within the framework of the global health agenda, addressing facets pertaining to well-being and quality of life. The research is based on the need to address variables at the community level to improve schoolchildren's oral health and promote healthy behaviors and aims to carry out an in-depth analysis from the perspective of the factors that influence children's oral health. Step 1, designed by the World Health Organization, was utilized. An easy-to-use web interface was created for data collection. The statistical analysis consisted of using multinomial and binominal logistic regression models. The level of education of the adult has a high probability of influencing the consumption of unhealthy or healthy foods, it has a significant probability of exerting influence on social or medical problems and a correlation was found between the level of academic education and the pattern of dental visits. The development of health-promoting behaviors begins in childhood and involves parents, who have an essential role in the education of their children. Oral health promotion programs in schools need to target the child-adult-teacher-dentist relationships. Taking into consideration the aforementioned, a threefold viewpoint is necessary for the development of a national program aimed at promoting the oral health of schoolchildren in Romania.

Assessing Growth of BACB Certificants (1999-2019).

Geographic distribution patterns of board certified behavior analysts may be useful in analyzing the growth of the field. First, we present an international snapshot of Behavior Analyst Certification Board (BACB) certificants, then analyze relative growth rates between countries from 1999 to 2019. This is followed by an in depth review of certificant distribution patterns in the United States and Canada, as well as the ratios of experienced behavior analysts to new certificants. These data highlight regions with a potential deficit of qualified supervisors. There are factors that influence different dispersal patterns, and without drilling deeper into the data we may be unable to effectively identify or influence them in order meet the specific needs of a geographic region. Supplementary Information: The online version contains supplementary material available at 10.1007/s40614-023-00370-5.

The use of arguments and justifications in Westminster parliamentary debates on assisted dying.

Assisted dying, the practice whereby healthcare professionals provide lethal drugs to end the life of patients at their voluntary request, remains unlawful in the United Kingdom, despite multiple attempts to change the law during the past two decades. Using qualitative and quantitative research methods, our research analysed eight debates on this topic that have taken place in the Westminster Parliament between 2014 and 2022, with a view to (a) providing a detailed classification of the arguments used by Parliamentarians (b) establishing the range and balance of anecdotes, evidence and authority statements underpinning those arguments and (c) generating insights into relationships between these argumentative strategies and the stances and characteristics of the speakers. Supporters of change emphasise principles such as autonomy and compassion and make extensive use of anecdotes that describe awful deaths under the current arrangements. Opponents contend that vulnerable individuals will suffer pressure and abuse, that the health and social care system will be adversely affected, and that legalisation will inevitably lead to expansion in the eligibility criteria and the numbers ending their lives in this way. By promoting evidence-informed debate and closer scrutiny of the arguments deployed, the findings and discussion should be of interest to any legislative (or executive) bodies around the world that are contemplating a change in the law with respect to assisted dying.

When Public Will Meets Legislative Resistance: Five Lessons from Ohio's Issue 2 Cannabis Legalization Controversy.

In this paper, I explore the challenges of legalizing cannabis in Ohio, focusing on the passing of the Issue 2 Bill, legislative resistance, and public response. I propose five strategies for effective policy change: persistent advocacy post policy change success, establishing strong coalitions, empowering grassroots movements, promoting rigorous data-driven research, and launching public education campaigns. I offer a detailed analysis of the interaction between public opinion and legislative action in cannabis legalization and its implications for substance-related policy change.

Effects of stricter legislation on coercive measures in child and adolescent psychiatric care: a qualitative interview study with staff.

BACKGROUND: Legislators often want to positively affect psychiatric inpatient care and reduce coercion by a stricter judicial regulation. However, staff experiences and comprehension of such legal changes are largely unknown, yet essential in obtaining the intended outcomes. We examined staff understanding and implementation of a July 1, 2020 legal change in Sweden regarding the use of coercive measures (e.g., restraint, seclusion, and forced medication) in child and adolescent psychiatric inpatient care. METHODS: During 2021, semi-structured interviews were conducted with nine child and adolescent psychiatric inpatient staff (nurses, senior consultants, and head of units). Interviews were transcribed verbatim and analysed using reflexive thematic analysis. We used an implementation outcomes framework to relate data to a wider implementation science context. RESULTS: The legislative change was viewed as both positive and negative by participating staff. They reported mixed levels of preparedness for the legislative change, with substantial challenges during the immediate introduction, including insufficient preparations and lack of clear guidelines. A knowledge hierarchy was evident, affecting various professional roles differently. While the law was positively viewed for its child-centred approach, we found notable distrust in legislators' understanding of the clinical reality, leading to practical difficulties in implementation. Care practices after the legal change varied, with some participants reporting little change in the use of coercive measures, while others noted a shift towards more seclusion and sedative medication usage. The work environment for consultants was described as more challenging due to increased bureaucratic procedures and a heightened pressure for accuracy. CONCLUSIONS: The study highlights the complexities and challenges in implementing legislative changes in psychiatric care, where stricter legislation does not necessarily entail reduced use of coercion.

Experiences and Suggestions of Nurses Involved in Caring for Migrant Populations in Italy: A Qualitative Study.

The aim of this research is to explore nurses' experiences in caring for migrants, regular and non-regular, within outpatient clinics in Italy. MATERIALS AND METHODS: Thirteen nurses have been interviewed through online semi-structured interviews, conducted with the support of a questionnaire, made by researchers, consisting of open-ended questions on legislative issues, cultural issues, and regarding best practices. Purposive sampling has been used, along with phone and email recruitment. The audio recordings of the interviews were verbatim transcribed, then examined. This study is a qualitative descriptive fundamental research project. RESULTS: Interviewees highlight migrants' difficulties in accessing care, critical points of legislation, transcultural skills crucial to nurses, and good practices. A total of 105 labels were developed and grouped into 23 categories under 7 themes (Italian legislation and migrants; structural difficulties in assistance; the influence of politics; the work of NGOs and associations; nursing care; winning strategies; and the role of the Family and Community Nurse). CONCLUSION: The research highlights how access to care for migrants is hindered by legislative, structural, and cultural barriers, with consequences on the NHS (improper accesses to the emergency room, increased workload, and economic expenditure). For the full realization of the right to health, as enshrined by Art. 32 of the Constitution, changes are needed with respect to regulations and professionals' training.

Market assessment to improve fibre recycling within the EU textile sector.

Clothing is one of the primary human needs, but today's business models turned most apparel into a disposable product. As a matter of fact, the rising demand results in the production of Millions of tons of textile waste every year which is either landfilled, incinerated or exported, with only small amounts being recycled. One promising recycling attempt towards a circular economy in the apparel sector is fibre-to-fibre recycling, where end-of-use clothes serve as input material for the production of new fibres and, eventually, new apparel. In this work, together with fashion brands and a textile research organisation, a mapping of the market situation and the economic boundary conditions regarding textile fibre recycling are presented. Generally, fibre-to-fibre recycling technologies need more public attention and intensive research, and development is necessary as well as legislative instruments that encourage interest in textile recycling. The market situation for recycled fibres is promising and will tend to an increased demand in recycled fibres in the future. Mandatory certification ensures a sustainable product and fast fashion should be held back. Textile waste landfilling, export regulations as well as sustainable lifestyle education shall be considered by EU legislature to ensure that recycling materials are actually used and create a market pull for textile waste back into the industry.

By Design: How People Adapt to Cognitive Limitations in Politics.

Elections, jury deliberations, lawmaking, high-stakes negotiations and related activities are human attempts to answer the question "How should we live?" Collectively, we know these activities as politics. Politics are how societies attempt to reconcile diverse individual needs with potential benefits of social coordination. People's beliefs about what others will do ainfluence many political strategies and outcomes. This article reviews how properties of cognition affect these political phenomena. Contrary to the common belief that many citizens are too ignorant to make competent political decisions, we focus on a central finding of social science-how societies can design contexts and environments to overcome individual cognitive limitations. These adaptations expand societal capacities to provide essential goods, services, and protections. In addition to explaining these adaptations, we also show how greater collaborations between cognitive science and the social sciences can help societies do even better.

Challenges for the Pro-Life Movement in a Post-Roe Era.

This article argues that state laws banning abortions for disability violate reproductive justice for parents with disabilities. These bans deprive people with disabilities of choices that may be important to their possibilities of becoming parents, including possibilities for abortion of pregnancies that have become risky to continue. Far from protecting disability civil rights, these state law bans restrict the abilities of people with disabilities to choose to have children and to parent.

Preventive use of eye drops to stabilize the tear film in video display terminal workers: preliminary notes.

Abstract: In this work, he presents the results of preliminary work concerning the protective use of eye drops stabilizing all three layers that make up the tear film. Infact, video display terminals (VDT) are today an essential element in almost all work environments, from offices where they represent the fundamental work tool to production environments where they are indispensable for carrying out control functions (control stations, management of quantities and flows, etc.) or design. The risk due to VDTs is one of the factors considered by Legislative Decree 81/08, therefore its assessment falls within the employer's obligations and at the same time requires health surveillance by the occupational doctor.

A Bayesian spatial voting model to characterize the legislative behavior of the Colombian Senate 2010-2014.

This paper characterizes the legislators voting behavior in the Colombian Senate 2010-2014, by implementing a one-dimensional standard Bayesian ideal point estimator via Markov chain Monte Carlo algorithms. Our main goal is to retrieve the political preferences of legislators from their roll-call voting records, which individualizes the electoral behavior of the legislative chamber. Furthermore, we conclude about the nature of the latent trait underlying the deputies voting decisions and the legislators locations in political space. Finally, we also offer several methodological and theoretical tools to guide the analysis of nominal voting data in the context of unbalanced parliaments (multi-party systems), taking as reference the particular case of the Colombian Senate.

The Impact of Ex-Post Legislative Evaluations in Healthcare: A Mixed Methods Realist Evaluation Study Protocol for Conducting Case Studies.

Background: Recent studies on the impact of ex-post legislative evaluations show that there are different types of impact and different factors that can influence it. These include the context of a legislative evaluation, research quality, and interactions between researchers and other actors within the evaluation process. However, thorough empirical research in this area is lacking. This warrants empirical research into the factors that influence the impact of ex-post legislative evaluations, so these insights can be used to increase the likelihood of ex-post legislative evaluations having an impact. Methods and analysis: In this protocol, we report on the realist evaluation methodology that will be used to evaluate the impact of three ex-post legislative evaluations in the Dutch healthcare sector. The mixed methods realist evaluation approach will facilitate this theory-driven, qualitative research. The study will consist of the following three steps: (1) Initial programme theory development, (2) theory validation, and (3) theory refinement. Knowledge from two scoping reviews conducted previously, and two subsequent expert meetings will form the basis for developing the initial programme theory. During this study, three case studies will be conducted, in which three individual ex-post legislative evaluations will be examined. Specificmethods for data collection will include: documentary review, observation, structured questionnaires and focus group discussions with purposefully identified key stakeholders. Using the framework approach, the data will be analysed thematically in a within-case analysis followed by a cross-case analysis. Discussion: This protocol provides insight into how the study will be conducted. As this study uses multiple qualitative researchmethods to answer one question, this protocol supports refining data collection procedures. Careful consideration of the approach beforehand can minimise pitfalls, reduce publication bias and improve reproducibility. The protocol therefore specifies how the research question will be answered in detail, and this provides solid guidance for the research process.

What are the experiences of team members involved in root cause analysis? A qualitative study.

BACKGROUND: Conducting root cause analysis (RCA) is complex and challenging. The aim of this study was to better understand the experiences of RCA team members and how they value their involvement in the RCA to inform future recruitment, conduct and implementation of RCA findings into clinical practice. METHODS: The study was set in a health network in Adelaide, South Australia. A qualitative exploratory descriptive approach was undertaken to provide an in-depth understanding of team member's experience in participating in an RCA. Eight of 27 RCA team members who conducted RCAs in the preceding 3-year period were included in one of three semi-structured focus groups. Thematic analysis was used to synthesise the transcribed data into themes. RESULTS: We derived four major themes: Experiences and perceptions of the RCA team, Limitations of RCA recommendations, Facilitators and barriers to conducting an RCA, and Supporting colleagues involved in the adverse event. Participants' mixed experience of RCAs ranged from enjoyment and the perception of worth and value to concerns about workload and lack of impact. Legislative privilege protecting RCAs from disclosure was both a facilitator and a barrier. Concern and a desire to better support their colleagues was widely reported. CONCLUSIONS: Clinicians perceived value in reviewing significant adverse events. Improvements can be made in sharing learnings to make effective improvements in health care. We have proposed a process to better support interviewees and strengthen post interview follow up.

Egg producer attitudes and expectations regarding the transition to cage-free production: a mixed-methods approach.

Several cage-free egg mandates and retailer pledge deadlines are set to take effect in January 2026. Yet it is unknown whether producers can transition to cage-free production at a rate commensurate with these goals. This study uses qualitative and quantitative data from 2 U.S. egg producer surveys to evaluate the operational activities of conventional and cage-free facilities, identify market challenges, and assess the expected transition timeline. Across both studies, producers indicated higher fixed and variable costs in cage-free housing systems, with capital and labor being 2 of the central drivers of the cost increase. While several producers are willing to adopt cage-free production, they are hesitant to view the market shift as an opportunity. Among the most commonly cited barriers are limited customer demand, high capital costs, and a contradiction to environmental sustainability and food security efforts. With the current challenges, respondents are skeptical that the industry will meet the January 2026 voluntary pledge deadlines. The results from this study offer a holistic view of the potential ramifications of the cage-free transition on the egg market and can be used to inform marketing strategies and policy discussions.

Video display terminal use and limitations according to italian legislative decree: occupational and forensic perspective.

Abstract: In this paper, the authors conduct a review inherent in the use of video display units considering the laws currently in force in Italy, with emphasis on critical legislative and operational issues. Video Display Terminal (VDTs) are today an essential element in almost all work environments, from offices where they represent the fundamental work tool to production environments where they are indispensable for carrying out control functions (command stations, quantity management and flows, etc.) or for design work. The risk due to VDTs is one of the factors considered by the Italian Legislative Decree 81/08, so its assessment is part of the employer's obligations and at the same time requires health surveillance by the occupational physician. The new workstations have certainly not reduced visual postural demands, but they have changed them, opening the door to new disor-ders and imposing greater flexibility on the activity of the occupational physician, who often cannot limit himself to an annual inspection of the workplace. The aim of this work is to examine the current critical issues and future prospects of ergophthalmology.

Appraisal of existing evidences of competition law and policy: Bilateral legislative developments of Sino-Pak.

Developing nations use contemporary competition laws based on international models for reasons ranging from achieving international legitimacy to achieving domestic economic objectives. Although passing such laws gives these nations competition regimes more legitimacy, doing so does not guarantee that their economic goals will be met unless the laws are also effectively implemented. Comparative legal scholarship suggests that effective enforcement requires, among other things, a positive link between the passed laws and the nation's pre-existing legal systems in light of development economics. The globalization of national competition laws, particularly the application of international soft law, is responsible for the existence of modern competition law. Secondly, the competition regimes in Pakistan and China face a number of long-term difficulties, many of which are the product of globalization, which must be addressed as soon as possible. In order to examine the aims and objectives, this study employs qualitative data analysis. The results of this research suggest that for both nations to successfully implement competition law, innovation and unconventionality are required. Although the goal of competition law is to prevent anti-competitive activities and practices by promoting fair and open market competition, this goal is achieved through protecting consumers from businesses' use of unfair business practices. Because of this, the act encourages the formation of agreements that limit and restrict market dominance. In addition, the law specifies how investigations, acquisitions, mergers, penalties, leniency, and other aspects of law enforcement should be handled. As a result, this law can be seen as extremely important for regulating firms while maintaining consumer and producer welfare. It eventually supports economic growth and social justice. As a result, Voluntary adherence to competition law, rules, and regulations is essential since doing so would significantly lower the societal costs of enforcing the law.

Transition between social protection systems for workers with long term health problems: A controlled retrospective cohort study.

Many nations have established workers' compensation systems as a feature of their social protection system. These systems typically provide time-limited entitlements such as wage replacement benefits and funding for medical treatment. Entitlements may end for workers with long-term health conditions before they have returned to employment. We sought to determine the prevalence of transitions to alternative forms of social protection, specifically social security benefits, among injured workers with long-term disability, when workers' compensation benefits end. We linked Australian workers' compensation and social security data to examine receipt of social security payments one year before and after workers' compensation benefit cessation. Study groups included (1) injured workers whose workers' compensation benefits ceased due to reaching a 260-week limit introduced by legislative reform (N = 2761), (2) a control group of injured workers with at least 104 weeks workers compensation income support (N = 3890), and (3) a matched community control group (N = 10,114). Adjusted binary logistic regression examined the odds of transitions to social security in the injured worker groups relative to the community control group. Within 12 months of workers' compensation benefit cessation, 60% (N = 1669) of the exposed group received social security payments, of which 41% (N = 1120) received the unemployment allowance and 19% (N = 516) the disability pension. Among the work injured control group, 42% (N = 1676) received social security payments after workers compensation benefits ceased. Transitions to social security payments were significantly more common than community levels for both exposed (OR 25.0, 95%CI = 20.7, 30.1) and work injured control groups (OR 4.7, 95%CI = 4.2, 5.3). Many injured workers with long-term health problems transition to social security when their workers' compensation benefits cease. Transitions were more common among workers whose claims ended due to legislative reform which time-limited benefits. Design and implementation of system level policy reform should consider the social and economic impacts of transitions between separate social protection systems.

Plastics today: Key challenges and EU strategies towards carbon neutrality: A review.

Never as today the need for collaborative interactions between industry, the scientific community, NGOs, policy makers and citizens has become crucial for the development of shared political choices and protection of the environment, for the safeguard of future generations. The complex socio-economic and environmental interconnections that underlie the EU strategy of the last years, within the framework of the Agenda 2030 and the green deal, often create perplexity and confusion that make difficult to outline the definition of a common path to achieve carbon neutrality and "net zero emissions" by 2050. Scope of this work is to give a general overview of EU policies, directives, regulations, and laws concerning polymers and plastic manufacturing, aiming to reduce plastic pollution, allowing for a better understanding of the implications that environmental concern and protection may generate from a social-economical point of view.