Dick van Velzen and the Burnside warehouse organ scandal in Nova Scotia, Canada.

Dick van Velzen practiced as a pediatric pathologist at Alder Hey Children's Hospital in Liverpool, England from September 1988 until December 1995; he then relocated to the IWK-Grace Health Centre, a children's and maternity hospital in Halifax, Nova Scotia, Canada, where he practiced until he was fired for cause in January 1998. About a year and a half later, his practice in Liverpool came under increasing scrutiny, with the initial focus on the massive collection of post-mortem pediatric organs he had accumulated for planned future research on sudden infant death syndrome. Soon, a Parliamentary Inquiry began investigating the full scope of his Liverpool practice. During the Inquiry, another organ-hoarding scandal erupted; van Velzen, when leaving Halifax after his dismissal, had put his family's personal belongings into a storage facility at Burnside Industrial Park and then did not pay bills. As his belongings were being prepared for auction, formalin-fixed organs were found, and a Canada-wide arrest warrant for disrespect for human remains was issued by the Halifax Police. While the Alder Hey scandal resulted in a 535-page-long Parliamentary Report and the Human Tissue Act, van Velzen was never charged criminally in the UK. The largely unknown story of his second organ scandal in Halifax, is related here. Although he had obtained the body parts with the consent of the parents of the child to which they had belonged, his failure to properly identify and store them traumatized parents already impacted by his organ-hoarding in the UK, traumatized additional parents in Halifax, and resulted in significant waste of public resources in investigating the case. He pled guilty to "indignity to a human body" in Canada and was fined and placed on 12 months' probation.

Changes in Drug Utilization After Publication of Clinical Trials and Drug-Related Scandals in Japan: An Interrupted Time Series Analysis, 2005-2017.

BACKGROUND: Breaches of ethics undermine the practice of medicine. In Japan, two major scandals involving clinical research and drug marketing occurred after the publication of clinical trials. To study the effects of those scandals, we evaluated changes in the use of first-generation angiotensin II receptor blockers (ARBs) after publication of relevant clinical trials and also after the subsequent scandals. METHODS: We conducted a quasi-experimental design of an interrupted time series analysis (ITSA) on nationwide monthly drug-market data covering 12 years (2005 to 2017) in Japan. The main outcome was the use of first-generation ARBs (valsartan, candesartan, and losartan). The two exposures were the publication of ARB-related clinical-trial results (October 2006) and subsequent ARB-related scandals involving research and marketing (February 2013). A generalized estimating equation model was fitted for ITSA with a log link, Poisson distribution, robust variance estimators, and seasonality adjustment. RESULTS: The publication of clinical trials was associated with 12% increase in the use of first-generation ARBs in Japan, and the subsequent ARB-related scandals was associated with 19% decrease. The decrease in the use of first-generation ARBs after the scandals was greater than the increase in their use after the publication of clinical-trial results. The net effect of the two exposures was a 9% decrease in the use of first-generation ARBs. CONCLUSIONS: The scandals were associated with decrease in the use of first-generation ARBs, and that decrease was greater than the increase associated with the publication of "successful" clinical trials, making the net effect not zero but negative.

Consumer trust in the dairy value chain in China: The role of trustworthiness, the melamine scandal, and the media.

This study provides a deep insight into Chinese consumer trust in the Chinese dairy value chain, as a lack of trust due to the 2008 melamine scandal has been widely recognized as a barrier to the development of the domestic dairy industry in China. Based on face-to-face interviews with 954 Chinese consumers in Beijing, Shanghai, and Shijiazhuang, this study measured consumer trust in farmers, manufacturers, retailers, the government, and third parties. Consumer trust was studied by measuring the effect of beliefs on the trustworthiness of actors (i.e., competence, benevolence, integrity, credibility, and openness), and current experiences regarding the melamine scandal and the media. The results showed that the level of trust in dairy chain actors varied. The government and third parties were relatively highly trusted, whereas retailers were considered less trustworthy. The importance of consumer beliefs about trustworthiness are different among actors. Consumer belief of competence determines trust in farmers and manufacturers. For retailers, the government, and third parties, respectively, benevolence, credibility, and openness are the most important factors. Trust in dairy chain actors is still strongly negatively affected by current experiences regarding the melamine scandal, even though it occurred more than 10 years ago. Using social media to directly provide more information and establish continuous daily communication with consumers could help manufacturers and third parties to strengthen consumer trust.

Scandals in health-care: their impact on health policy and nursing.

Through an analysis of several high-profile scandals in health-care in the UK, this article discusses the nature of scandal and its impact on policy reform. The nursing profession is compared to social work and medicine, which have also undergone considerable examination and change as a result of scandals. The author draws on reports from public inquiries from 1945 to 2013 to form the basis of the discussion about policy responses following scandals in health-care. In each case, the nature of the scandal, the public and government discourses generated by events and the policy response to those failings are explored. These scandals are compared to the recent scandal at Mid Staffordshire Hospital. Conclusions are drawn about the impact of these events on the future of the profession and on health policy directions. Recent events have raised public anxieties about caring practices in nursing. Health policy reform driven by scandal may obscure the effect of under resourcing in health services and poses a very real threat to the continued support for state-run services. Understanding the socially constructed nature of scandal enables the nurse to develop a greater critical awareness of policy contexts in order that they can influence health service reform.

Justice and health care: When "ordinary" is extraordinary.

In some Asian countries, the poor are often denied access to health care. In the Philippines, we have thousands of Catholic doctors, Catholic nurses, even Catholic administrators, but not a Catholic, understood as "universal," healthcare system available to all. This is a scandal and places heavy emotional and financial burdens on many families who need to pay the healthcare costs of sick loved ones. The Church teaches the principles of ordinary and extraordinary care, with only the former being morally obligatory. Extraordinary care, that involving excessive burden or cost may be foregone. Many families and healthcare professionals are uncertain about these principles and their application in practice. It would be helpful to more widely disseminate the Catholic Church teaching regarding ordinary and extraordinary care, especially in poor countries, to also avoid unnecessary or futile treatments, especially in critical or end-of-life situations. Lay Summary: The poor have limited access to health care in many countries. Even one episode of sickness often places the patient and their family under considerable financial strain. Many times they simply cannot afford even basic treatments. This is a scandal and an injustice which is the concern of us all. The Church teaches that when a treatment becomes very expensive it may be considered "extraordinary care" and not morally obligatory. It would be helpful to more widely disseminate this Catholic Church teaching, helping families to avoid unnecessary treatments especially in critical or end-of-life situations.

Infant formula crisis in china: a cohort study in sichuan province.

China has become the largest market of infant formula in the world. The consumption of infant formula is widespread across the country. This study investigated the opinions of Chinese mothers on infant formula. A prospective cohort study (n=695) was undertaken in 2011 in Sichuan province of China two years after the melamine scandal. Infant-feeding practices and mothers' opinions on infant formula-use were documented in detail. A total of 674 mothers (97%) had initiated breastfeeding by discharge. Of the 21 mothers who did not commence breastfeeding, 13 made a decision to exclusively feed their babies with infant formula because of hepatitis B virus infection. Nearly 70% of newborns received infant formula as their first feed, and the prevalence increased to 88% within one month. Having insufficient breastmilk was perceived by the majority (77%) of mothers as the reason behind infant formula feeding. About half (46%) of the mothers agreed with or were ambivalent that infant formula feeding does not reduce their breastmilk production. More than one-third (38%) of women thought that formulafed infants sleep longer at night than those who are breastfed. In addition, this perception was positively associated with the use of formula within one month postpartum (p=0.003). In conclusion, mothers' opinions appear to influence the use of infant formula in China. There is a need for further education on breastfeeding and infant-feeding options to maintain and improve breastfeeding outcomes in China.

Widespread usage of infant formula in China: a major public health problem.

BACKGROUND: The potential health risks of infant formula feeding are well established. This study investigated the opinions and perceptions of mothers and recommendations by hospital staff with respect to infant formula usage in China. METHODS: A cross-sectional survey of 726 mothers within 6 months postpartum and 241 hospital staff, using structured questionnaires, was conducted in Hangzhou and Shenzhen, China. RESULTS: Overall, 474 of 726 (65.3%) infants aged within 6 months had consumed some infant formula. About 40.0 percent of mothers chose a hybrid brand of formula (manufactured in China but owned by a foreign company), over imported (< 32.0%) and domestic brands (< 28.0%), despite their higher level of confidence on the quality of imported brands. Perceived insufficient breastmilk production (86.2%) was the most common reason for giving infant formula, followed by return to work (24.6%). Of the 241 hospital staff, 97 (40.2%) gave no recommendation about infant formula brand for infants at any age. However, 47.2 percent of the remaining staff recommended a hybrid brand in combination with an imported and/or a domestic product. CONCLUSIONS: Perceptions by mothers and recommendations from hospital staff appear to contribute to the widespread usage of infant formula in China. It is important to ensure breastmilk substitutes are prescribed to Chinese infants strictly for medical reasons. Maternal education programs incorporating information on food safety issues and establishment of breastfeeding-friendly workplaces could curtail the common practice of formula feeding in China.

European perspectives of food safety.

Food safety has been a growing concern among European Union (EU) citizens over the last decades. Despite the fact that food has never been safer, consumers are considerably uncertain and increasingly critical about the safety of their food. The introduction of new principles, such as the primary responsibility of producers, traceability, risk analysis, the separation of risk assessment and risk management provided a more transparent, science-based system in Europe, which can help to restore consumers' lost confidence. The present EU integrated approach to food safety 'from farm to fork' aims to assure a high level of food safety within the EU.

On the Defensive: Identity, Language, and Partisan Reactions to Political Scandal.

We investigated how individuals judge politicians embroiled in scandal. Drawing on social identity and realistic group conflict theory, we predicted that beyond an overall ingroup bias, partisans would be particularly forgiving of in-party politicians who denied or justified their misconduct rather than apologize for it. By insisting that they did nothing wrong, these politicians defend the public image of their party and signal their commitment to partisan goals. We find qualified support for this prediction across three experiments. Participants did not respond negatively to in-party politicians who apologized but did react more positively to those who denied or justified wrongdoing (relative to silence). These accounts worked only for in-party politicians and were more effective for those whose misconduct furthered their party's agenda or whose seat was high-status or pivotal for party goals. In intergroup contexts like politics, people may accept explanations for misconduct that they would otherwise find offensive.

Denotation and connotation in public representation: Semantic network analysis of Hwang supporters' internet dialogues.

This article analyzes the internet discourses of Korean people who supported Hwang Woo Suk despite the disclosure of his scientific misconduct. During the controversial period, those who supported Hwang constructed a narrative of a fallen hero trapped by jealous rivals and an "unjust" society. The supporters' dramatized discourses compete with expert opinions of Seoul National University's Audit Board and prosecutors that investigated the scientific fraud. By introducing and applying an innovative method of semantic network analysis, this study explores how the supporters represent their personal concerns in daily life and latent social problems in South Korea, as well as the failure of science communication. In short, the supporters' internet representations connote concerns in daily life that motivated their sympathy and activism for Hwang.

Representative misconduct, voter perceptions and accountability: Evidence from the 2009 House of Commons expenses scandal.

This paper examines electoral accountability after the 2009-10 UK expenses scandal. Existing research shows that Members of Parliament (MPs) implicated in the scandal fared only marginally worse in the election than non-implicated colleagues. This lack of electoral accountability for misconduct could have arisen either because voters did not know about their representative's wrongdoing or because they chose not to electorally sanction them. We combine panel survey data with new measures of MP implication in the expenses scandal to test where electoral accountability failed. We find that MP implication influenced voter perceptions of wrongdoing more than expected. In contrast, constituents were only marginally less likely to vote for MPs who were implicated in the scandal. Electoral accountability may therefore be constrained even when information about representative misconduct is easily available and clearly influences voter perceptions.

Considering respect for the donated body: lessons from the scandal in France.

Cadaver surgical training (CST) has been developing in Japan in the past 10 years. To perform ethically adequate CST program, sincere respect for the donated body is required. To understand this better, we reviewed the recent scandal at a body donation center in Paris, France. This scandal revealed the disrespectful treatment of donated bodies happening for several years. Therefore, legal regulation over the body donation center has been reinforced. We believe that serious action against disrespectful handling of donated bodies is warranted in Japan.

Discursive Strategies of Blaming: The Language of Judgment and Political Protest Online.

Modern politics is permeated by blame games-symbolic struggles over the blameworthiness or otherwise of various social actors. In this article, we develop a framework for identifying different strategies of blaming that protesters use on social media to criticize and delegitimize governments and political leaders. We draw on the systemic functional linguistic theory of Appraisal to distinguish between blame attributions based on negative judgments of the target's (1) capacity, such as references to their incompetence and policy failures; (2) veracity, questioning their truthfulness or honesty via references to deceitful character or dishonest acts and utterances; (3) propriety, questioning their moral standing by references to, for instance, corruption; and (4) tenacity, suggesting that the politicians are not dependable due to, for example, dithering. We add to this a further threefold distinction based on whether blaming is focused on the target's (1) bad character, (2) bad behavior, or (3) negative outcomes that the target either caused or did not prevent from happening. To illustrate the approach, we analyze a corpus of replies by Twitter users to tweets by British government ministers about two highly contentious issues, Covid-19 and Brexit, in 2020-2021. We suggest that the methodology outlined here could provide a useful avenue for systematically revealing and comparing a variety of realizations of blaming in large datasets of online conflict talk, thereby providing a more fine-grained understanding of the practices of protest and delegitimation in modern politics.

The impact of the CervicalCheck controversy on provision of colposcopy services in Ireland: A cohort study.

OBJECTIVES: In 2018, an inquiry into the Irish Cervical Cancer screening programme (CervicalCheck) was initiated, following publicised cases of non-disclosure regarding internal audit results of cytology screening in women diagnosed with cervical cancer. The inquiry attracted widespread media coverage and the government offered women free, out of programme screening. We investigated whether the controversy led to an increase in referrals based on clinical suspicion and the impact on waiting times for abnormal cytology. STUDY DESIGN: A retrospective cross-sectional analysis was performed, including all colposcopy referrals to The National Maternity Hospital, Dublin, before (March 2016-2018) and after (March 2018-2020) the media coverage. Chi-squared (χ2) and independent one-tailed t-tests were used to perform between-group analyses. RESULTS: Post-controversy, suspicious cervix referrals increased (10.1 %-14.2 %; p = 0.037 × 10-27), as did colposcopic impression of CIN (p = 0.000000016). While an increase in CIN1 histology (18.5 %-30.3 %) was diagnosed, a decrease in high-risk CIN2 (10 % to 8.6 %), CIN3 (6.2 % to 2.9 %), AIS (1.2 % to 0.3 %) and invasive cancer (2.8 % to 1.2 %; p = 0.0058 × 10-9) were diagnosed. Across all grades of cytological abnormality, significantly fewer patients were reviewed in the recommended waiting time post-controversy. Half of delayed abnormal cytology referrals had high-grade changes. CONCLUSIONS: This study highlights the profound impact that the CervicalCheck Controversy had on the women attending colposcopy and clinicians performing the screening tests, and the direct impact on women with confirmed cytological abnormalities. The increase in suspicious cervix referrals reflects a lack of confidence in both clinical practice and screening test results. The importance of public trust in the effective delivery of screening services cannot be ignored. Increased resources are required to ensure all women are seen within recommended time frames. Heightened anxiety and increased surveillance does not necessarily lead to better clinical outcomes for patients but can result in unnecessary distress for low-risk patients and delays to diagnosis for high-risk patients with concerning abnormalities.

Scandalous decisions: explaining shifts in UK medicinal cannabis policy.

BACKGROUND AND AIMS: Opening up access to scheduled drugs such as cannabis in the United Kingdom rarely happens, yet on 1 November 2018 the United Kingdom changed the law to allow cannabis-derived products to be prescribed for medicinal purposes, albeit in tightly controlled circumstances. This followed substantial media interest in the cases of two children with epilepsy. This article focuses upon the role of scandal in bringing about legislative change. METHODS: We used political science and social policy theories (punctuated equilibrium theory and scandal theory) to guide a qualitative content analysis of media articles published in 2018 in UK national newspapers. We focused in particular on the 6-month period prior to the policy change. RESULTS: The concentrated attention by the media given to the suffering of children with epilepsy appears to have prompted the rapid change in policy by the UK government. A variety of strategies were used to develop a highly emotive response to garner support for reform. Media stories emphasized the injustice of two extremely sick children being unable to access the medicine they apparently needed to enable them to have a 'normal' childhood. Three groups of 'claim-makers' were identified as important in influencing public opinion: families, high-profile individuals and campaigning groups. CONCLUSIONS: The case of medicinal cannabis in the United Kingdom suggests that policy reform can occur when a scandal is successfully manufactured. We must be cautious, however, about over-emphasizing the role of scandal as a driver of policy change in this context: only a limited set of circumstances will permit a prescription for cannabis-based medicine to be issued in the United Kingdom.

Changes in parents' decisions pertaining to vaccination of their children after the Changchun Changsheng vaccine scandal in Guangzhou, China.

A series of scandals involving the rabies vaccine and the diphtheria, tetanus, and pertussis combined vaccine (DTP) were reported in July 2018, in China. Our goal was to assess the effects of the vaccine scandal on parents' attitudes and decisions regarding vaccination. A cross-sectional study was conducted by contacting kindergarteners' parents through an online questionnaire from March 1 to 8, 2019. In total, 14,300 valid questionnaire responses were received, and 92.53% of respondents were aware of the recent vaccine scandal. Among parents who were aware of the vaccine scandal, 13.62% preferred that their children receive optional vaccines (optional vaccine group) or delay, stop or reject vaccinations (hesitate group) instead of receiving mandatory vaccines (mandatory vaccine group). Awareness of the vaccine scandal and self-reporting of vaccine-associated side effects in their children were more common among respondents in the optional vaccine and the hesitate groups (P < 0.001). Compared with the mandatory vaccine group, parents in the hesitate group were more likely to report having attempted to dissuade others from vaccinating their children (P < 0.001). Because the scandal changed parents' decisions regarding vaccination of their children, efforts should be made to restore public confidence in vaccines and to boost immunization rates.

Has the public lost confidence in vaccines because of a vaccine scandal in China.

BACKGROUND: A vaccine manufacturer in China and regulatory authorities have been the focus of widespread outrage due to a vaccine scandal. We conducted a rapid survey during a time of intense mainstream and social media attention to determine whether the public's confidence in vaccines was affected. METHODS: We selected 7 cities that were not involved in the scandal as the setting for the survey, which was conducted in August 2018. We used a convenience sampling strategy to select subjects in urban streets and rural villages for a face-to-face questionnaire-based survey. Subjects were asked to describe their levels of confidence on a scale from 0 to 9, in which 0 means no confidence, and 9 means very confident. Respondents were asked to assess confidence for two points in time - recollection of their level of confidence before hearing about the scandal and their level of confidence at the time of the survey. RESULTS: In total, 683 individuals were invited to participate and 591 questionnaires were completed, for a response rate of 86.5%. Among respondents, 86.80% had heard of the vaccine scandal. The most common channel for hearing about the scandal was social media (e.g., WeChat), 40.6% of respondents. Regardless of gender, age, education level, province, town or country, or having children under 15 years old, respondents reported a significant decrease in confidence in domestically-produced vaccines. The mean pre-scandal confidence level recalled by respondents was 6.7, and the mean confidence level at the time of the survey was 3.2. Confidence in vaccine manufacturers, institutes for drug control, and drug supervision authorities decreased from 5.6 to 6.0 before the vaccine scandal to 2.0-3.2 at the time of the survey. Confidence in vaccine manufacturers decreased the most, from 5.6 before the scandal to 2.0; confidence in institutes for drug control decreased from 5.8 before the scandal to 2.6 at the time of the survey. CONCLUSION: This study demonstrated that public confidence was significantly affected by the vaccine scandal, particularly for vaccine producers and drug regulators. The decline in confidence is a reminder to governments that in order to build public confidence for vaccination, regulators have to reform regulatory practices and manufacturers have to ensure vaccine quality.

The Brand Scandal Spillover Effect at the Country Level: Evidence From Event-Related Potentials.

The spillover effect of brand scandals commonly exists, and this effect will damage the image of the company, industry or even country in which the scandal occurred. Most previous studies on the brand scandal spillover effect have mainly focused on the corporate and industry levels. However, with the development of brand internalization and media technology, the spillover effect at the country level is becoming increasingly common. In the current study, we conducted an event-related potentials study to explore the spillover effect of brand scandals on the country level as well as its underlying neural basis. Specifically, we compared consumers' attitudes toward countries of origin with different stereotypes during different types of brand scandals. When a competence scandal took place in a competence stereotype country, a larger P2 mean amplitude was elicited compared to a warmth stereotype country. When a morality scandal took place in a warmth stereotype country, a larger LPP mean amplitude was induced compared to a competence stereotype country. We explain the current results based on expectancy violations theory. When competence scandals take place in competence stereotype countries, there will be a greater degree of violation of expectations compared with that in warmth stereotype countries, which leads to a negative evaluation of the country of origin. When morality scandals take place in warmth stereotype countries, people had a stronger negative emotional arousal when morality scandals happened in the warmth stereotype country.

Judging scandal: Standards or bias in politics.

As the number of political scandals rises, we examined the circumstances that might influence how a politician would be judged as a result of a scandal. Specifically, we hypothesized that ingroup bias theory and shifting standards theory would produce different patterns of judgements. In two studies, we found support for the ingroup bias theory, such that participants rated the fictitious politician's public approval and perceived character as higher if the politician was a member of their own political party (i.e. their ingroup) than if the politician was a member of the another political party (i.e. their outgroup). These results may explain, in part, why people may judge politicians involved in scandal more or less harshly depending on whether they are an ingroup member or outgroup member.