Impact of a community pharmacy led antibiotic amnesty in the Midlands region of England.

OBJECTIVES: Antimicrobial resistance is a recognised threat to human health and may be driven by the unsafe disposal of antibiotics via domestic waste streams, contaminating the environment. A community pharmacy based antibiotic amnesty could address this. METHODS: We evaluated the impact of an antibiotic amnesty promoting the return of unused antibiotics to community pharmacies in the Midlands region of England during World Antibiotic Awareness Week in November 2021. RESULTS: Two hundred and thirty nine pharmacies participated voluntarily and held amnesty conversations with 7399 people, 369 part used and 126 full packs of antibiotics were returned. CONCLUSIONS: This is an important public health initiative that could be replicated more widely.

Have Indian Surrogates Been Harmed by Commercial Surrogacy Transactions?

Draft legislation has been approved by the Union Cabinet in India seeking to limit surrogacy to altruistic arrangements with intended parents who are either Indian citizens or couples residing outside the country but of Indian origin. This follows longstanding debates as to whether commercial surrogacy should be permitted. The primary argument against such arrangements has been the potential to exploit and cause harm to surrogate women. There is considerable literature on the exploitation debate, but little has been written about whether these transactions cause harm to surrogate women. Our article addresses this gap in the literature and develops a three-step framework using Mill's harm principle through which to assess whether harm has occurred. We apply this framework to a sample of women who provided surrogacy services in India between 2006 and 2015, the period just before the government moved to ban overseas couples from accessing commercial surrogacy.

An Electronic Strategy for Eliminating Unnecessary Duplicate Genetic Testing.

OBJECTIVES: To determine the impact of an electronic intervention designed to block duplicate constitutional genetic tests. METHODS: We constructed, implemented, and studied an electronic intervention that stopped duplicate genetic tests. The activation frequency, types of tests affected, and cost savings achieved with this intervention were determined. The frequency and justification of override requests were also studied. RESULTS: This intervention stopped 710 unnecessary duplicate genetic tests over a 3-year period and saved $98,596. The tests with the highest numbers of alerts were those used for screening presurgical or transplant patients and were commonly part of an order set or test panel. Most override requests were justified because of the lack of exclusion codes in the initial programming. CONCLUSIONS: Electronic interventions that stop duplicate genetic testing, if properly constructed, can reduce waste, save health care dollars, and facilitate patient care by directing the provider to a test that has already been performed.

The Agony and the Ecstasy: Sacrifice and Pain for Financial Gain: Have Indian Surrogate Mothers Been Exploited by Their Intended Parents in Commercial Surrogacy Arrangements?

This article investigates whether a sample of Indian women involved in commercial surrogacy arrangements were exploited by their intended parents. This issue is topical as the Indian parliament is currently considering a ban on commercial surrogacy. This is due to a range of concerns, including that such arrangements are unethical and exploitative of illiterate women from low socio-economic backgrounds. We define the term exploitation and identify from the literature the three key elements that we argue provide a conceptual framework through which to analyse whether exploitation has occurred. We conclude that there are indications that many of the women were exploited. However, we contend that the practice should not be banned as this would mean that the commercial surrogacy industry in India would no longer be regulated and women who become surrogate mothers may be exposed to greater risk.

ABCC6 and Pseudoxanthoma Elasticum: The Face of a Rare Disease from Genetics to Advocacy.

Pseudoxanthoma elasticum (PXE) is an autosomal recessive disorder characterized by the mineralization of connective tissues in the body. Primary manifestation of PXE occurs in the tissues of the skin, eyes, and cardiovascular system. PXE is primarily caused by mutations in the ABCC6 gene. The ABCC6 gene encodes the trans-membrane protein ABCC6, which is highly expressed in the kidneys and liver. PXE has high phenotypic variability, which may possibly be affected by several modifier genes. Disease advocacy organizations have had a pivotal role in bringing rare disease research to the forefront and in helping to sustain research funding for rare genetic diseases in order to help find a treatment for these diseases, pseudoxanthoma elasticum included. Because of these initiatives, individuals affected by these conditions benefit by being scientifically informed about their condition, having an effective support mechanism, and also by contributing to scientific research efforts and banking of biological samples. This rapid progress would not have been possible without the aid of disease advocacy organizations such as PXE International.

Risk-based immunization policies and tuberculosis screening practices for animal care and research workers in the United States: survey results and recommendations.

A national survey was conducted to assess immunization practices and tuberculosis screening methods for animal care and research workers in biomedical settings throughout the United States. Veterinarians (n = 953) were surveyed via a web-based mechanism; completed surveys (n = 308) were analyzed. Results showed that occupational health and safety programs were well-developed, enrolling veterinary, husbandry, and research staff at rates exceeding 90% and involving multiple modalities of health assessments and risk communication for vaccine-preventable diseases. Most (72.7%) institutions did not store serum samples from animal research personnel. More than half of the institutions housed nonhuman primates and maintained tuberculosis screening programs, although screening methods varied. Immunization protocols included various recommended or required vaccines that differed depending on job duties, type of institution, and nature of scientific programs. A single case of an identified vaccine-preventable illness in a laboratory worker was noted. Tetanus toxoid was the predominant vaccine administered (91.7%) to animal care and research workers, followed by hepatitis B (54.8%), influenza (39.9%), and rabies (38.3%). For some immunization protocols, an inconsistent rationale for administration was evident. Indications that animal care and research workers are unprotected from work-related etiologic agents did not emerge from this survey; rather, existing guidelines from the Advisory Committee on Immunization Practices and available biologics seem sufficient to address most needs of the laboratory animal research community. Institutions should commit to performance-based standards in parallel with context-specific risk assessment methods to maintain occupational health and safety programs and practices appropriate to their needs.

The Lockhart Review: where now for Australia?

In 2005 a Legislation Review Committee, known as the Lockhart Review, undertook a review of the Commonwealth legislation regulating human embryo research. The report that emanated from the review was released in December 2005. If the report recommendations are implemented by the Federal Government, Australian scientists will be permitted to create human embryo entities currently known as "human embryo clones" by the process known as somatic cell nuclear transfer to develop stem cell lines for research purposes. Many argue that stem cells have the potential to be developed into valuable medical therapies that could assist with, or cure, serious diseases such as Type 1 diabetes and Parkinson's disease. This article analyses the evidence presented to the Lockhart Review and the report recommendations. It assesses where the Lockhart recommendations would place Australia in terms of worldwide embryo research. It is argued that the Federal Government should fully embrace the recommendations so that Australia can progress stem cell research to its fullest potential.