The impact of COVID-19 on access to canine integrative medical care in Michigan, USA, and Ontario and British Columbia, Canada.

OBJECTIVE: To determine the effects of the COVID-19 associated restrictions on the ability of owners in Michigan (MI), USA versus Ontario (ON) and British Columbia (BC), Canada, to obtain care for their chronically painful dogs. STUDY DESIGN: Cross-sectional survey. POPULATION: A total of 90 owners met the inclusion criteria for the study. METHODS: An anonymous electronic survey was distributed to owners at four veterinary integrative medicine (IM) clinics during July and August 2020. Two clinics in MI and one each in ON and BC were recruited. Owners were asked about availability of IM care preceding and during COVID-19 restrictions and their opinions of the impact of COVID-19 on their dog's health. The survey asked where owners sought care for their dogs, types of chronic conditions treated, therapeutic modalities used, and if owners had a medical background. Comparisons were made within and between groups. Thematic analysis, Fisher's exact test, chi-square analyses, McNemar's and Wilcoxon signed-rank tests for paired comparisons were performed (p < 0.05). RESULTS: During COVID-19 restrictions, access to IM care was better for dogs in ON and BC than in MI (p < 0.001). The negative effect of the pandemic restrictions to IM care on quality of life was perceived greater by owners in MI than those in ON and BC (p < 0.001). The owners' medical backgrounds had no effect on attempts to access care during this time (p = 0.76). CONCLUSIONS AND CLINICAL RELEVANCE: The results suggest that a widespread disease in humans had an adverse impact on animal welfare. Providers of veterinary care should use this experience to establish protocols to ensure continuity of care for chronically painful animals in the event of a similar situation in the future.

The downstream effects of state tobacco control policies on maternal smoking during pregnancy and birth outcomes.

BACKGROUND: Research has demonstrated that the implementation of tobacco control policies is associated with improved birth outcomes. Ascertainment of prenatal smoking on the US birth certificate has changed over the past decade to record smoking across each trimester. METHODS: Using 2005-2015 birth certificate data on 26,436,541 singletons from 47 states and DC linked to state-level cigarette taxes and smoke-free legislation, we conducted conditional mixed-process models to examine the impact of tobacco control policies on prenatal smoking and quitting, then on the associated changes in birth outcomes. We included interactions between race/ethnicity, education, and taxes and present average marginal effects. RESULTS: Among white and black mothers with less than a high school degree, 36.0% and 14.1%, respectively, smoked during the first trimester and their babies had the poorest birth outcomes. However, they were the most responsive to cigarette taxes. Every $1.00 increase in taxes was associated with a 3.45 percentage point decrease in prenatal smoking among white mothers and a 1.20 percentage point decrease among black mothers. These reductions translated to increases in birth weight by 4.19 g for babies born to white mothers and 0.89 g for babies born to black mothers. Among smokers, there was some evidence that taxes increased quitting and improved birth outcomes, although most associations were not statistically significant. We found limited effects of smoke-free legislation on smoking, quitting or birth outcomes. CONCLUSIONS: Cigarette taxes continue to have important downstream effects on reducing prenatal smoking and improving birth outcomes among the most vulnerable mothers and infants.

Suicide by firearm in Switzerland: who uses the army weapon? Results from the national survey between 2000 and 2010.

AIMS: In comparison with other central European countries, Switzerland has a high prevalence of gun ownership and a high rate of suicide by shooting. After the Army XXI reform in 2003, which reduced personnel from about 400,000 to approximately 200,000, a decline in suicides by firearms and a decline in the total number of suicides was observed in national data spanning the period from 2000 to 2010. It is, however, unclear whether this decline can be linked to the reduced availability of military guns. This study explored whether the decline in suicide by firearms is related to the decline of suicides by army weapons. METHODS: In 83.1% (n = 1112) of the 1338 suicides by firearm between 2000 and 2010 in Switzerland, the firearm could be categorised as an army weapon or a non-army weapon. The army weapon was used in 39.1% of these suicides. In comparison with other firearms, those who used army weapons tended to be younger and more likely to have a university degree. A prior suicide attempt was found less often in cases using a military weapon than other firearms. After the Army XXI reform, there was a significant drop in suicides by males aged 18 to 43 years using an army weapon, but no change in male suicide rates in the same age group who used a non-army weapon. The drop was statistically linked to a reduction of suicide by the army gun. RESULTS: The army weapon was used in 39.1% of suicides by firearm between 2000 and 2010 in Switzerland. In comparison with other methods, those who used army weapons tended to be younger and more likely to have a university degree. A prior suicide attempt was found less often in cases using a military weapon than other methods. After the Army XXI reform, there was a significant drop in suicides by males aged 18 to 43 years using an army weapon, but no change in males' suicide rates in the same age group who used a non-army weapon. The drop was statistically linked to a reduction of suicide by the army gun. CONCLUSIONS: Males who use army weapons differ from those who use other types of weapons. The significant drop in suicides was found in males aged 18 to 43 but there was no change in males of the same age group who used a non-army weapon. These results support the hypotheses that the observed drop in suicides is linked to the Army XXI reform and that restriction of access to guns is essential for reducing suicides by firearm.

Anti-bullying Policies and Disparities in Bullying: A State-Level Analysis.

INTRODUCTION: Recent research suggests that anti-bullying laws may be effective in reducing risk of bullying victimization among youth, but no research has determined whether these laws are also effective in reducing disparities in bullying. The aim of this paper was to evaluate the effectiveness of anti-bullying legislation in reducing disparities in sex- and weight-based bullying and cyberbullying victimization. METHODS: Data on anti-bullying legislation were obtained from the U.S. Department of Education, which commissioned a systematic review of 16 key components of state laws in 2011. States were also categorized based on whether their legislation enumerated protected groups and, if so, which groups were enumerated. These policy variables from 28 states were linked to individual-level data on bullying and cyberbullying victimization from students in 9th through 12th grade participating in the 2011 Youth Risk Behavior Surveillance System study (N=79,577). Analyses were conducted in 2016. RESULTS: There was an absence of any kind of moderating effect of anti-bullying legislation on weight-based disparities in bullying and cyberbullying victimization. Only state laws with high compliance to Department of Education enumeration guidelines were associated with lower sex-based disparities in bullying victimization. CONCLUSIONS: Anti-bullying policies were not associated with lower weight-based disparities in bullying and cyberbullying victimization among youth, and only one form of policies (high compliance to Department of Education enumeration guidelines) was associated with lower sex-based disparities in bullying victimization. Results therefore suggest that anti-bullying legislation requires further refinement to protect youth who are vulnerable to bullying victimization.

Change in suicide rates in Switzerland before and after firearm restriction resulting from the 2003 "Army XXI" reform.

OBJECTIVE: Firearms are the most common method of suicide among young men in Switzerland. From March 2003 through February 2004, the number of Swiss soldiers was halved as a result of an army reform (Army XXI), leading to a decrease in the availability of guns nationwide. The authors investigated the patterns of the overall suicide rate and the firearm suicide rate before and after the reform. METHOD: Using a naturalistic study design, the authors compared suicide rates before (1995­2003) and after the intervention (2004­2008) in the affected population (men ages 18­43) and in two comparison groups (women ages 18­44 and men ages 44­53). Data were received from the Swiss Federal Statistical Office. Interrupted time series analysis was used to control for preexisting temporal trends. Alternative methods (Poisson regression, autocorrelation analysis, and surrogate data tests) were used to check validity. RESULTS: The authors found a reduction in both the overall suicide rate and the firearm suicide rate after the Army XXI reform. No significant increases were found for other suicide methods overall. An increase in railway suicides was observed. It was estimated that 22% of the reduction in firearm suicides was substituted by other suicide methods. The attenuation of the suicide rate was not compensated for during the follow-up years. Neither of the comparison groups showed statistically significant changes in firearm suicide rate and overall suicide rate. CONCLUSIONS: The restriction of firearm availability in Switzerland resulting from the Army XXI reform was followed by an enduring decrease in the general suicide rate.

Capital social e qualidade de vida em adolescentes trabalhadores em um município de médio porte de Minas Gerais, Brasil / Social capital and the quality of life in adolescents workers in a medium size city of Minas Gerais, Brazil

Considerando-se a escassez na produção científica de temas sobre os adolescentes trabalhadores, a presente pesquisa objetivou mensurar o capital social e sua possível relação com a qualidade de vida entre adolescentes trabalhadores. Realizou-se um estudo transversal analítico com 363 adolescentes trabalhadores assistidos por uma Entidade Filantrópica de Apoio ao adolescente em Sete Lagoas, Minas Gerais. A caracterização sócio-demográfica foi obtida por meio de questões referentes a sexo, idade, cor de pele, e saneamento básico (abastecimento de água, presença de sanitário no interior do domicílio, rede de esgoto, coleta de lixo). As informações sobre acess0/uso de serviços de saúde diziam respeito à posse de plano de saúde, uso regular do serviço público de saúde...

[Impact of increasing number of road alcohol controls on the prevalence of driving under the influence in Italy]. / L'aumento del numero dei controlli alcolemici su strada e i suoi effetti sulla prevalenza della guida in stato di ebbrezza in Italia.

In Italy the number of road controls for the driving under the influence of alcohol is significantly grown in the last years. In 2006 these controls have been around 250,000; in 2007, around 800,000. On the grounds of the data currently available one can estimate around 1,500,000 controls in 2008. At the same time a lowering percentage of drivers with blood alcohol concentration greather than the legal limit (equal to 0.5 g/l in Italy) has been recorded. Aforesaid percentage amounted to 15% and 6% in 2006 and 2007 respectively, with a lessening of 9 percent points. This reduction could plausibly be the outcome of the increased controls number on the italian roads. Likely, increased perception to be checked by the police has induced to a greater caution the drivers. However the controls are not random controls, but based on a 'well-founded suspicion', that is when the police is right to hold by their behavior that the drivers can be in state of drunkenness. This procedure prevents us from properly estimating the true effect. Therefore, carry out a suitable number of random controls besides the well-founded controls seems needed to quantify in accurate statistical way the proportion of drivers in state of drunkenness as well as its temporal trend.

The role of tobacco control policies in reducing smoking and deaths in a middle income nation: results from the Thailand SimSmoke simulation model.

OBJECTIVES: With the male smoking prevalence near 60% in 1991, Thailand was one of the first Asian nations to implement strict tobacco control policies. However, the success of their efforts has not been well documented. METHODS: The role of tobacco control policies are examined using the "SimSmoke" tobacco control model. We first validated the model against survey data on smoking prevalence. We then distinguished the effect of policies implemented between 1991 and 2006 from long-term trends in smoking rates. We also estimated smoking attributable deaths and lives saved as a result of the policies. RESULTS: The model validates well against survey data. The model shows that by the year 2006, policies implemented between 1991 and 2006 had already decreased smoking prevalence by 25% compared to what it would have been in the absence of the policies. Tax increases on cigarettes and advertising bans had the largest impact, followed by media anti-smoking campaigns, clean air laws and health warnings. The model estimates that the policies saved 31 867 lives by 2006 and will have saved 319,456 lives by 2026. CONCLUSIONS: The results document the success of Thailand in reducing smoking prevalence and reducing the number of lives lost to smoking, thereby showing the potential of tobacco control policies specifically in a middle-income country. Additional improvements can be realised through higher taxes, stronger clean air policies, comprehensive cessation treatment policies, and targeted media campaigns.

Domestic violence in Israel: changing attitudes.

For many years, knowledge of the prevalence of violence against women in Israel was marginalized in such a way that it never figured in public discourse. Elite groups of academics and feminist activists with a Western background, together with human rights groups, delivered subversive messages that gradually infiltrated into larger circles and ultimately changed public policies. The issue is now central in public affairs. This article discusses the extent of violence against women in Israel and suggests explanations for the shift from denial to greater public awareness.

Epidemiological analysis of tuberculosis treatment outcome as a tool for changing TB control policy in Israel.

BACKGROUND: Sensing an inadequacy of tuberculosis control due to an influx of TB associated with immigration, we analyzed TB treatment outcome in Israel by population groups. OBJECTIVES: To provide an epidemiological basis necessary for any new national TB control policy, and to bring it to the attention of the medical profession in Israel and abroad since its results led to a change in Israel's TB control policy. METHODS: We reviewed all TB cases notified during the period 1990 to September 1992. "New cases" (820 cases, 93.5%) and "re-treatment cases" (57 cases, 6.5%) were analyzed according to three mutually exclusive groups: "successful outcome," "death," and "potentially unsatisfactory outcome" (according to WHO/IUATLD definitions). RESULTS: Of 820 "new cases," 26.6% had a "satisfactory outcome," 68.5% had a "potentially unsatisfactory outcome" and 4.9% died; compared to 47.4%, 45.6% and 7% among 57 "re-treatment cases," respectively. Using logistic regression analysis, outcome was associated with the district health office (P < 0.0001), the TB "experience" of the notifying clinic (P < 0.0001), and the form of TB (P = 0.02). No significant relationships were obtained for population groups, gender and age, interval between arrival in Israel and TB notification, and bacteriological results. CONCLUSIONS: Non-supervised TB treatment resulted in poor outcomes regardless of population groups. Better outcomes occurred in the larger TB clinics. Therefore, in addition to measures such as adequate drug supplies, reorganization of TB laboratories and training of TB personnel, we recommend the "directly observed treatment short-course" for all cases as well as reducing the number of treatment centers thereby increasing their case load.

Temas de politica social

Contiene: Narcotrafico y problemas sociales; el consumo de la pasta de cocaina, movilidad espacial y movilidad social generada por el narcotrafico; efectos del narcotrafico en la salud y la educacion; debate