Designing Implementation Strategies for the Inclusion of Lesbian, Gay, Bisexual, Transgender, Intersex, Queer, and Allied and Key Populations' Content in Undergraduate Nursing Curricula in KwaZulu-Natal, South Africa: Protocol for a Multimethods Research Project.

BACKGROUND: Lesbian, gay, bisexual, transgender, intersex, queer, and allied (LGBTQIA+) individuals encounter challenges with access and engagement with health services. Studies have reported that LGBTQIA+ individuals experience stigma, discrimination, and health workers' microaggression when accessing health care. Compelling evidence suggests that the LGBTQIA+ community faces disproportionate rates of HIV infection, mental health disorders, substance abuse, and other noncommunicable diseases. The South African National Strategic Plan for HIV or AIDS, tuberculosis, and sexually transmitted infections, 2023-2028 recognizes the need for providing affirming LGBTQIA+ health care as part of the country's HIV or AIDS response strategy. However, current anecdotal evidence suggests paucity of LGBTQIA+ and key populations' health content in the undergraduate health science curricula in South Africa. Moreover, literature reveals a general lack of health worker training regarding the health needs of LGBTQIA+ persons and other key populations such as sex workers, people who inject drugs, and men who have sex with men. OBJECTIVE: This study aimed to describe the design of a project that aims at facilitating the inclusion of health content related to the LGBTQIA+ community and other key populations in the undergraduate nursing curricula of KwaZulu-Natal, South Africa. METHODS: A multimethods design encompassing collection of primary and secondary data using multiple qualitative designs and quantitative approaches will be used to generate evidence that will inform the co-design, testing, and scale-up of strategies to facilitate the inclusion of LGBTQIA+ and key populations content in the undergraduate nursing curricula in KwaZulu-Natal, South Africa. Data will be collected using a combination of convenience, purposive, and snowball sampling techniques from LGBTQIA+ persons; academic staff; undergraduate nursing students; and other key populations. Primary data will be collected through individual in-depth interviews, focus groups discussions, and surveys guided by semistructured and structured data collection tools. Data collection and analysis will be an iterative process guided by the respective research design to be adopted. The continuous quality improvement process to be adopted during data gathering and analysis will ensure contextual relevance and sustainability of the resultant co-designed strategies that are to be scaled up as part of the overarching objective of this study. RESULTS: The proposed study is designed in response to recent contextual empirical evidence highlighting the multiplicity of health challenges experienced by LGBTQIA+ individuals and key populations in relation to health service delivery and access to health care. The potential findings of the study may be appropriate for contributing to the education of nurses as one of the means to ameliorate these problems. Data collection is anticipated to commence in June 2024. CONCLUSIONS: This research has potential implications for nursing education in South Africa and worldwide as it addresses up-to-date problems in the nursing discipline as it pertains to undergraduate students' preparedness for addressing the unique needs and challenges of the LGBTQIA+ community and other key populations. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52250.

Iron nanoparticles as food additives and food supplements, regulatory and legislative perspectives.

Recently, the use of nanotechnology in food has gained great interest. Iron nanoparticles with unique chemical, physical and structural properties allow their potential use mainly as iron fortifiers, colorants and antimicrobial agents. However, in the market we can find only supplements and food colorants based on iron nanoparticles. Their use in food fortification has so far been focused only on in vitro and in vivo experimental studies, since the toxicological evaluation of these studies has so far been the basis for the proposals of laws and regulations, which are still in an early stage of development. Therefore, the aim of this work was to summarize the use of the different forms of iron nanoparticles (oxides, oxyhydroxides, phosphates, pyrophosphates and sulfates) as food additives and supplements and to resume the perspectives of legislation regarding the use of these types of nanoparticles in the food industry.

Efficacy of point source legislation quantified for a 64-year river water quality trajectory of phosphorus loading.

Changes in river water quality often follow typical trajectories characterized by sequential phases of degradation and recovery induced by management measures, typically achieved with combinations of legislative and technological interventions. However, the key question about the effectiveness of the different types of legal interventions - source control, use-related, and end-of-pipe - remains poorly understood. With the case of phosphorus (P), which is a valuable indicator of surface water quality and a widespread target of legislation at various governance levels in order to control eutrophication of water bodies, we quantified the relation between point source loading of P and resulting river water quality for a multidecadal trajectory of the river Ruhr (Germany). In particular, we analysed P-related legislation targeting point source pollution enforced at EU, national, state, and local level and linked their development with measured total phosphorus (TP) concentrations in the river Ruhr (Germany). To this end, we combined archival data with information in the literature and conducted interviews with contemporary witnesses to describe and quantify the efficacy of each legislative approach. Although not specifically targeted at P reduction, end-of-pipe measures (sewer systems and wastewater treatment plants (WWTP)) reduced TP inputs to surface waters already in the 1960s and 1970s, curbing TP inputs to the Ruhr by 38% in 1980. The first targeted source control legislation - the banning of phosphates in textile detergents in 1981 - effectively reduced TP concentrations in WWTP influents by 36% since 1990. In combination with stronger end-of-pipe legislation focusing on P elimination in WWTP since the 1990s, TP concentrations in WWTP effluents were reduced by 86% at the end of the 1990s and by 92% in 2021. Complete and successful source control for textile detergents made use-related legislation redundant. Our study demonstrates that source control measures should be prioritized, because they are the fastest way to curb emissions. These findings provide insights that can inform efficient decision-making regarding water quality in a trajectory perspective of hierarchical governance and technological needs, as well as effective policy-making and management for other pollutants requiring control from point sources.

Phosphorus recovery from domestic wastewater: A review of the institutional framework.

Phosphorus (P) is an essential element for life that must be managed sustainably. The institutional framework for P recovery from wastewater includes policies, regulations, plans, and actions that promote the recovery, recycling, and safe use of this element, aimed at moving toward more sustainable nutrient management and environmental protection. This review analyzes the status of the institutional framework for P recovery from wastewater in different countries around the world. Europe is the continent where the most progress has been made in terms of legislation. Countries such as Germany, the Netherlands, Austria, and Denmark have already implemented policies and regulations that promote environmental protection, as well as P recovery and reuse. In other parts of the world, such as the United States, China, and Japan, there have also been significant advances in promoting the closure of the P cycle, with the implementation of advanced recovery technologies in wastewater treatment plants and regional/national action plans. By contrast, in Latin America there has been little progress in P treatment and recovery, with a weak regulatory framework, unclear goals, and insufficient allocation of techno-economic resources. In this context, it is necessary to reinforce the comprehensive institutional framework, which covers technological aspects, economic incentives, political agreements, and regulations, to promote the sustainable management of this valuable resource.

First foods in a packaged world: Results from the COMMIT consortium to protect young child diets in Southeast Asia.

Although commercially produced complementary foods (CPCFs) are increasingly sold throughout Southeast Asia, concerns have been raised about CPCFs nutritional quality, labelling practices and the strength and scope of national CPCF regulations. The Consortium for Improving Complementary Foods in Southeast Asia (COMMIT), composed of UN agencies and civil society organizations, was formed to assess the nutrient gap in the diets of young children and the consumer, product and policy landscapes for CPCFs in seven Southeast Asian countries. Results from a nutrient gap assessment indicate that the diets of children aged 6-23 months are suboptimal and deficient in micronutrients. A consumer survey revealed that caretakers commonly use CPCFs, are conscious of the importance of nutrition and are influenced by label claims. Results from a CPCF benchmarking showed that many products sold in Southeast Asia contained added sugar or sweeteners, had a high total sugar and/or high sodium content and that no CPCF product adhered to all recommended labelling practices. Further, a legal review of national binding legal measures relevant to CPCFs showed minimal alignment with available global guidance. Urgent actions are necessary to strengthen national regulations related to CPCF nutrient composition and labelling practices. To speed progress, COMMIT developed a compendium of existing standards and global guidance to help countries align their national regulations with CPCF composition, labelling and production recommendations. Advocacy to garner public support for new or improved CPCF regulations, as well as strong government monitoring and enforcement of regulations, is crucial to support efforts to safeguard and improve the diets of older infants and young children in Southeast Asia.

Micronutrients in Food Supplements for Pregnant Women: European Health Claims Assessment.

Micronutrients play a critical role in pregnant women, a vulnerable group with higher nutritional requirements. The first strategy to achieve adequate micronutrients intake should always be through a healthy and balanced diet. In the case where the diet is not enough to meet these requirements, food supplements should be prescribed under supervision to complement the diet, and these products must bear reliable information about the declared nutritional contents and health benefits. Based on the data provided by the Coordinated System of Fast Interchange of Information (SCIRI) and to know the current national situation, this work addresses the assessment of the content and the adequacy of health claims related to some micronutrients (vitamin C, vitamin B9, iron, copper, manganese, zinc, calcium, magnesium) contained in food supplements for pregnant women commercialized in Spain. Analytical results coincided with the declared values and were covered by the ranges of tolerances, and samples met the requirements to use health claims. Although the samples could even include more claims, manufacturers could have selected those which either best addressed pregnant women's conditions or best aligned with marketing intentions. This study confirms an adequate use of health claims in food supplement samples, which could be interesting for strengthening consumers' confidence in the benefits shown in the labeling and for encouraging the use of health claims as a useful tool for making better-informed purchasing decisions.

Smoothies Marketed in Spain: Are They Complying with Labeling Legislation?

There is no legal definition of a smoothie, so the European legislation applicable to its labeling is that of fruit juice. The smoothie market has grown in recent years, as it can include a wide variety of ingredients: fruits, fruit purees, honey, milk and vegetable milks, vegetables, herbs, cereals, cereal flours, seaweed, and crushed ice. In this study, 57 smoothies were reviewed. All of them were purchased in supermarkets and classified into eight types according to the main ingredients. Fifteen legal statements/items were reviewed on the pack labels: eleven mandatory and three optional. Moreover, nutrition labels, nutritional claims, images, marks, and other symbols were also reviewed. Only 22.8% of the samples complied with EU and Spanish labeling legislation. More incorrectness was related to the name of the food and the fruits included as main ingredients; other errors related to the allergy/intolerance statements, and some nutritional claims concerning vitamin C were also detected to a lesser extent. General advice is provided for consumers to interpret smoothie labels correctly. Lawmakers should amend legislation to accept the term "smoothie" as a legal name.

Phosphorus recovery from sewage sludge ash (SSA): An integrated technical, environmental and economic assessment of wet-chemical and thermochemical methods.

Incineration is a promising disposal method for sewage sludge (SS), enriching more than 90% of phosphorus (P) in the influent into the powdered product, sewage sludge ash (SSA), which is convenient for further P recovery. Due to insufficient bioavailable P and enriched heavy metals (HMs) in SSA, it is limited to be used directly as fertilizer. Hence, this paper provides an overview of P transformation in SS incineration, characterization of SSA components, and wet-chemical and thermochemical processes for P recovery with a comprehensive technical, economic, and environmental assessment. P extraction and purification is an important technical step to achieve P recovery from SSA, where the key to all technologies is how to achieve efficient separation of P and HMs at a low economic and environmental cost. It can be clear seen from the review that the economics of P recovery from SSA are often weak due to many factors. For example, the cost of wet-chemical methods is approximately 5∼6 €/kg P, while the cost of recovering P by thermochemical methods is about 2∼3 €/kg P, which is slightly higher than the current P fertilizer (1 €/kg P). So, for now, legislation is significant for promoting P recovery from SSA. In this regard, the relevant experience in Europe is worth learning from countries that have not yet carried out P recovery from SSA, and to develop appropriate policies and legislation according to their own national conditions.

Skin Cancer Prevention across the G7, Australia and New Zealand: A Review of Legislation and Guidelines.

Incidence rates of melanoma and keratinocyte skin cancers have been on the rise globally in recent decades. While there has been a select focus on personal sun protection awareness, to our knowledge, there is a paucity of legislation in place to help support citizens' efforts to protect themselves from the harmful effects of ultraviolet radiation (UVR). Given this, we conducted a comprehensive review of legislation and guidelines pertaining to a variety of sun protection-related topics in countries of the Group of Seven (G7), Australia and New Zealand. Australia was the only country to have banned tanning beds for individuals of all ages, while other select countries have instituted bans for minors. In workplace policy, there is very little recognition of the danger of occupational UVR exposure in outdoor workers, and thus very few protective measures are in place. With regard to sports and recreation, certain dermatological/professional associations have put forward recommendations, but no legislation was brought forward by government bodies outside of Australia and New Zealand. With regard to youth, while there are various guidelines and frameworks in place across several countries, adherence remains difficult in the absence of concrete legislation and standardization of procedures. Finally, only Australia and a few select jurisdictions in the United States have implemented sales tax exemptions for sunscreen products. In light of our findings, we have made several recommendations, which we anticipate will help reduce the rates of melanoma and keratinocyte cancers in years to come. However, minimizing UVR exposure is not without risk, and we, therefore, suggest the promotion of vitamin D supplementation in conjunction with sun protective practices to limit potential harm.

Understanding the Role of Therapy Dogs in Human Health Promotion.

Dogs may provide humans with a range of physical, mental and social benefits. Whilst there is growing scientific evidence of benefits to humans, there has been less focus on the impact to canine health, welfare and ethical considerations for the dogs. The importance of animal welfare is increasingly acknowledged, indicating that the Ottawa Charter should be extended to include the welfare of non-human animals supporting the promotion of human health. Therapy dog programmes are delivered across a variety of settings including hospitals, aged care facilities and mental health services, highlighting the important role they play in human health outcomes. Research has shown that that there are biomarkers for stress in humans and other animals engaged in human-animal interactions. This review aims to assess the impact of human-animal interactions on therapy dogs engaged in providing support to human health. While challenging, it is paramount to ensure that, within the framework of One Welfare, the welfare of therapy dogs is included, as it is a key factor for future sustainability. We identified a range of concerns due to the lack of guidelines and standards to protect the wellbeing of the dogs engaged in these programmes. Extension of the Ottawa Charter to include the welfare of non-human animals with leveraging through a One Welfare approach would promote animal and human health beyond current boundaries.

Insights into Current Education of Acupuncture as a Non-Conventional Therapy in Portugal.

Acupuncture, as an ancient practice for healthcare in China, is now widely used in the world and regarded as a non-conventional therapy (NCT) in many Western countries. In Portugal, acupuncture has been structured and well regulated for the market of teaching and clinical practice, but little effort has been put in to explore it in depth. This article aims to disclose the current education of acupuncture as a NCT in Portugal through investigation of acupuncture laws, field surveys, teaching work, and interviews with people from the NCT field. We found that according to the academic norms and rules of education in Portugal, there is a gradual difficulty in the progression and maintenance of the degree training dynamics. The reasons are the lack of more tolerant transitional measures and many practical difficulties confronted by the institutions that embark on these complementary programs. Therefore, it will be necessary to promote additional programs and measures to avoid a total emptiness of the teaching of acupuncture and at the same time losses of clinicians, competencies, and quality of information that are difficult to recover. It could be very meaningful and thought provoking to the future development and improvement of acupuncture in Portugal and in other countries that welcome acupuncture and intend to have better legislation and application.

Nursing and midwifery education, regulation and workforce in Kenya: A scoping review.

AIM: To explore contextual literature on nursing and midwifery education, regulation and workforce in Kenya to develop an understanding of the current state and inform opportunities to strengthen the nursing and midwifery professions. INTRODUCTION: Kenya has yet to achieve the minimum nursing and midwifery workforce threshold, despite the exponential increase in population and epidemiologic disease transitions. BACKGROUND: There are glaring health gaps and inequities in sub-Saharan African countries. Health systems are evolving into complex and costly utilities, increasing the demand for nurses and midwives. It is, therefore, necessary to re-examine systems that educate, deploy and retain the nursing workforce, especially given the ongoing COVID-19 pandemic and increase in non-communicable diseases. METHODS: This scoping review was guided and reported following the PRISMA-ScR guidelines. Four electronic databases (PubMed, Scopus, CINAHL and Web of Science) were probed for relevant studies conducted in Kenya between 1963 and 2020. The search was supplemented using Google Scholar. Findings from selected studies were extracted and analysed thematically. RESULTS: Of the 238 retrieved studies, 37 were included in this review: 10 articles on nursing and midwifery education, 11 on regulation and 16 on the workforce. DISCUSSION: There have been changes in regulation and an increase in nursing and midwifery enrolment and graduates. However, maldistribution and shortage of nurses and midwives persist. CONCLUSIONS: Kenya's nursing and midwifery professions have undergone significant changes to meet the demand for a skilled workforce. However, the shortage of qualified and specialised nurses and midwives persists. Moreover, this shortage is exacerbated by underinvestment, outmigration and a need for more reforms to expand the nursing and midwifery workforce. IMPLICATION FOR NURSING AND MIDWIFERY POLICY: Investment in nurse and midwifery education, mentorship and legislation is needed to build the capacity of the profession to provide quality health services. Several nursing and midwifery policy changes utilising a multipronged approach involving stakeholders' collaboration are suggested to address the bottlenecks from education to deployment.

Analysis of labeling infant's formulas to children allergic to the protein in cow's milk / Análise da rotulagem de fórmulas infantis para lactentes com alergia a proteína do leite de vaca

Introduction: breastfeeding is the most effective way to feed the child in the first six months of life exclusively and up to two years as a complementary form, as it provides a healthy development. However, in some situations it is impossible among them in children with food allergies such as Cow's Milk Protein Allergy (APLV). This condition can be defined as an adverse reaction of the immune system, caused by antigens present in the food that triggers the allergy.Objective: analyze the information on the labeling of infant formulas for infants with allergies to cow's milk protein (APLV), sold in pharmacies in Sobral/CE.Methods: cross-sectional, exploratory, quantitative and qualitative study. After data collection, the labels were analyzed based on a check list composed by the current legislation in accordance with RDC 45/2011, measuring the number of adjustments and inadequacies.Results: of the seven formulas analyzed, five were 100% adequate, when considering all the provisions that made up the check list. Of these were FAB-1 B, FAB-1 C, FAB-1 E, FAB-1 F, FAB-2 A, they were all in accordance with the dimensions established by RDC 45/2011, it is already in relation to formulas with inadequacy we observed that FAB-1 A was 2.22% in dimension two in which the micronutrient riboflavin was above the recommended range and FAB-1 D was 2.22% in dimension two, the carbohydrate macronutrient above the recommended range. In view of this, what we observed was that most of the formulas analyzed were within the labeling standards specified in Resolution RDC 45/2011, despite the many regulatory standards that govern the labeling and marketing of infant foods, it was realized that there is still a need for regulation stricter in this regard so that the legislation is fully complied with.Conclusion: according to what was evaluated about formulas for infants with APLV in relation to the labeling standards of the current legislation, some inadequacies were found. Therefore, this study showed a greater number of non-conformities in relation to the essential characteristics of composition and quality, despite the many regulatory standards that govern the labeling and marketing of infant foods, it is clear that they are still not fully complied with. It was found that we still need to evolve in the Elaboration, execution and inspection of the labels of formulas for infants with Allergy to Cow's Milk Protein (APLV), in order to minimize these non-conformities and offer the best food within the recommended standard, however these studies are necessary in order to better show and discuss the legislation referring to these products.

Introdução: a amamentação é a forma mais eficaz de alimentar a criança nos primeiros seis meses de vida exclusivamente e até os dois anos como forma complementar, pois proporciona um desenvolvimento saudável. No entanto, em algumas situações, é impossível entre eles em crianças com alergia alimentar, como a alergia à proteína do leite de vaca (APLV). Essa condição pode ser definida como uma reação adversa do sistema imunológico, causada por antígenos presentes nos alimentos que desencadeiam a alergia.Objetivo: analisar as informações sobre a rotulagem de fórmulas infantis para lactentes com alergia à proteína do leite de vaca (APLV), comercializadas em farmácias de Sobral/CE.Método: estudo transversal, exploratório, quantitativo e qualitativo. Após a coleta de dados, os rótulos foram analisados com base em um check list composto pela legislação vigente de acordo com a RDC 45/2011, mensurando o número de adequações e inadequações.Resultados: das sete fórmulas analisadas, cinco foram 100% adequadas, quando consideradas todas as disposições que compunham o check list. Destes eram FAB -1 B, FAB -1 C, FAB -1 E, FAB -1 F, FAB -2 A, todos estavam de acordo com as dimensões estabelecidas pela RDC 45/2011, já está em relação às fórmulas com inadequação observamos que FAB-1 A foi de 2,22% na dimensão dois em que a micronutriente riboflavina estava acima da faixa recomendada e FAB-1 D foi de 2,22% na dimensão dois, o macronutriente carboidrato acima da faixa recomendada. Diante disso, o que observamos foi que a maioria das fórmulas analisadas estava dentro dos padrões de rotulagem especificados na Resolução, apesar das inúmeras normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebeu-se que ainda existe necessidade de regulamentação mais rigorosa nesse sentido, para que a legislação seja integralmente cumprida.Conclusão: de acordo com o que foi avaliado sobre as fórmulas para lactentes com APLV em relação aos padrões de rotulagem da legislação vigente foram encontradas algumas inadequações. Portanto esse estudo apresentou maior número de inconformidades em relação as características essênciais de composição e qualidade, apesar das muitas normas regulamentadoras que regem a rotulagem e comercialização de alimentos infantis, percebe-se que ainda não são totalmente cumpridas. Verificou-se que ainda precisamos evoluir na Elaboração, execussão e fiscalização dos rótulos das fórmulas para lactentes com Alergia a Proteína do Leite de Vaca (APLV), a fim de minimizar essas não conformidades e ofererer o melhor alimento dentro do padrão preconizado, no entanto faz-se necessários estes estudos a fim de mostrar e discutir melhor as legislações referentes a esses produtos.

[Analysis of the legal framework on food supplements for menopause in Spanish community pharmacies]. / Análisis del marco legal sobre complementos alimenticios para la menopausia en farmacias comunitarias españolas.

OBJECTIVE: To analyze the legal framework for the marketing of specific food supplements prescribed and indicated for menopause symptoms, so that it is verified if according to the effects on health that they produce, should be considered in the category of food supplements, or in others included in our legal system. METHOD: An exhaustive review of the legal frameworks applicable to food supplements used both in Spain and in Europe, collecting those aspects that are related to legal concepts such as the definition of medicine for human use, medicine based on medicinal plants, or the so-called "frontier products". RESULTS: There is a large number of products that can be called "frontier products", they can fit into different product categories, they can fit into different product categories, since some of the plants in their formulation are also authorized for use as industrial medicines or medicines based on traditional medicinal plants. CONCLUSIONS: There are currently specific food supplements for menopause that raise reasonable doubts about their inclusion in other legal categories, both as medicines for human use, or as herbal medicines, so the legislator would need to enable more agile mechanisms and more frequent reviews of the new certainties that science finds, and that can change the status of these products.

As informações sobre os direitos sociais estão acessíveis aos pacientes oncológicos? / Is information on social rights accessible to cancer patients? / ¿Es accesible la información de los derechos sociales para los pacientes con cáncer?

A legislação brasileira assegura aos pacientes com câncer direitos que auxiliam no tratamento e atenuam os gastos despendidos na jornada de adoecimento. O objetivo do estudo foi calcular a proporção de indivíduos em tratamento oncológico de um centro de referência do Sistema Único de Saúde (SUS) que referiram conhecer 15 direitos específicos previstos em lei, segundo o subgrupo populacional elegível para solicitar cada direito. Foram entrevistados todos os pacientes oncológicos adultos em início de tratamento no Hospital Associação Feminina de Prevenção e Combate ao Câncer de Juiz de Fora (ASCOMCER), Minas Gerais, entre março e julho de 2022 (n = 62). Cerca de 60% desses pacientes eram analfabetos ou não tinham completado o ensino fundamental, aproximadamente 75% viviam em domicílios em que a renda per capita era de no máximo um salário mínimo e 91,9% eram atendidos pelo SUS. Para nove dos 15 direitos selecionados, a proporção de pacientes elegíveis foi superior a 10%, variando de 17,7% para "saque do Fundo de Garantia por Tempo de Serviço (FGTS)" a 100% para "prioridade na tramitação de processos". No entanto, o único desses direitos conhecido por pelo menos 50% dos pacientes elegíveis foi o "auxílio-doença" (70,6%), sendo que para três direitos as respectivas proporções não chegaram a 5% (isenção de imposto sobre propriedade predial e territorial urbana, isenção do imposto de renda na aposentadoria, pensão e reforma e prioridade na tramitação de processos). Os pacientes oncológicos necessitam ter seus cuidados integrais fortalecidos. Dessa forma, é fundamental aumentar o acesso à informação sobre os benefícios que eles podem obter de um Estado democrático de direito.

Brazilian legislation provides for rights for cancer patients in order to assist with their treatment and mitigate the expenses they face during their illness. This study aimed to calculate the proportion of individuals undergoing cancer treatment at a Brazilian Unified National Health System (SUS) referral center who reported being aware of 15 specific legal rights, according to the population subgroup eligible to request each right. All adult cancer patients starting treatment at the Juiz de Fora Women's Association for Preventing and Fighting Cancer Hospital (ASCOMCER), Minas Gerais State, from March to July 2022, were interviewed (n = 62). About 60% of these patients had incomplete primary education or were illiterate, around 75% lived in households with a per capita income below one minimum wage, and 91.9% received treatment from the SUS. For nine of the 15 selected rights, the proportion of eligible patients was higher than 10%, ranging from 17.7% for "Withdrawal from the Severance Pay Fund (FGTS)" to 100% for "priority in the processing of procedures". However, the only one of these rights known to at least 50% of eligible patients was "sickness benefit" (70.6%). The respective proportions were below 5% in three rights, including "exemption from property tax", "exemption from income tax on retirement, pension, and retirement", and "priority in the processing of cases". Cancer patients need to have their comprehensive care strengthened. Therefore, it is crucial to enhance the availability of information regarding the benefits cancer patients may receive from a democratic state that respects the rule of law.

La legislación brasileña garantiza a los pacientes con cáncer derechos que les ayudan en el tratamiento y mitigan los gastos que tienen a lo largo de la enfermedad. El objetivo de este estudio fue calcular la proporción de individuos sometidos al tratamiento oncológico en un centro de referencia del Sistema Único de Salud (SUS) brasileño que informaron conocer 15 derechos específicos previstos por la ley, según el subgrupo de población elegible para solicitar cada derecho. Se entrevistó a todos los pacientes adultos con cáncer que comenzaron el tratamiento en el Hospital Asociación de Mujeres para la Prevención y Lucha contra el Cáncer de Juiz de Fora (ASCOMCER), Minas Gerais, entre marzo y julio de 2022 (n = 62). Cerca del 60% de estos pacientes eran analfabetos o no habían completado la escuela primaria, aproximadamente el 75% vivía en hogares con ingreso per cápita de un salario mínimo y el 91,9% eran tratados por el SUS. Para 9 de los 15 derechos seleccionados, la proporción de pacientes elegibles para ellos fue superior al 10%, oscilando del 17,7% para el "retirada del Fondo de Garantía por Duración del Servicio" al 100% para "prioridad en la tramitación de procedimientos". Sin embargo, de estos derechos el único conociodo por al menos el 50% de los pacientes elegibles conocía fue el "beneficio por enfermedad" (70,6%), y en 3 derechos las proporciones respectivas no alcanzaron ni siquiera el 5% ("exención del impuesto sobre bienes inmuebles y territorial urbano", "exención del impuesto sobre la renta por jubilación, pensión y retiro" y "prioridad en la tramitación de procedimientos"). Los pacientes con cáncer requieren el fortalecimiento de una atención integral. Por lo tanto, es esencial incrementar el acceso a la información sobre los beneficios que los pacientes con cáncer pueden obtener de un Estado de derecho democrático.

Historical Aspects of Herbal Use and Comparison of Current Regulations of Herbal Products between Mexico, Canada and the United States of America.

Increased life expectancy and high costs of medicines and medical care have led to the use of herbal products. However, these items may contain toxic compounds that have an impact on public health. We will focus on the regulatory aspects and differences of these products marketed in the North American region (USA-Mexico-Canada) from government websites and selected literature. Mexico has an ancestral tradition of using plants for the treatment, improvement, and maintenance of human health as compared with Canada and the USA Currently, the use of herbal products in this region has a regulatory framework. The legal framework in these three countries is related to their history, idiosyncrasies, socio-economic and cultural aspects. Therefore, there are different public policies for herbal products consumed in the region. Mexico has a more specific classification of these products. In Canada, all herbal products are classified as natural health products and the safety and efficacy must be scientifically proven. In the USA, the development of botanical drugs is very recent. In particular, both herbal products classified as food supplements in Mexico and dietary supplements in the USA may have risks in both safety and efficacy.

Better Regulation of End-Of-Life Care: A Call For A Holistic Approach.

Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to focus on a single regulatory instrument (e.g., just law or just ethical codes). As a result, there has been a failure to capture holistically the various forces that guide end-of-life care. This article proposes a response to address this, identifying "regulatory space" theory as a candidate to provide the much-needed holistic insight into improving regulation of end-of-life care. The article concludes with practical implications of this approach for regulators and researchers.

Midwives in Health Sciences as a Sociocultural Phenomenon: Legislation, Training and Health (XV-XVIII Centuries).

Background and Objectives: The first inquisitorial processes were developed against Muslims and Jews. Then, they focused on women, especially those dedicated to care. Progressively, they were linked to witchcraft and sorcery due to their great assistance, generational and empirical knowledge. The health historiography of the 15th-18th centuries still has important bibliographic and interpretive gaps in the care provided by women. The main objective was to analyse the care provided by midwives in the legislative and socio-sanitary context of New Castile, in the inquisitorial Spain of the 15th-18th centuries. Materials and Methods: A historical review was conducted, following the Dialectical Structural Model of Care. Historical manuals, articles and databases were analysed. Results: The Catholic Monarchs established health profession regulations in 1477, including midwives. However, all legislations were annulled by Felipe II in 1576. These were not resumed until 1750. Midwives assumed a huge range of functions in their care commitment (teaching, care and religion) and were valued in opposing ways. However, many of them were persecuted and condemned by the Inquisition. They used to accompany therapeutic action with prayers and charms. Midwives were usually women in a social vulnerability situation, who did not comply with social stereotypes. Conclusions: Midwives, forerunners of current nursing and health sciences, overcame sociocultural difficulties, although they were condemned for it. Midwives achieved an accredited title, which was taken from them for two centuries. They acted as health agents in a society that demanded them while participating in a "witch hunt".

Antipodean Perspectives-Aged Care Nursing and the Multifaceted Role of the Aged Care Nurse.

Healthy ageing refers to the development and maintenance of the functional ability of ageing individuals. Aged care nurses provide nursing care to elderly individuals and usually work in aged care residential facilities, nursing homes, home care services, and/or hospital departments. The registered nurse working in the aged care sector has several important roles. Key roles cover both therapeutic and preventative paradigms, as discussed in this paper. The aged care nurse is also "tasked with" holistic patient-centred care and the promotion of healthy ageing via advocacy and sociocultural roles. This paper examined, described, and analysed the multifaceted role of an aged care nurse from an Australian perspective. We conducted meticulous searches using PubMed, Google Scholar, government guidelines, authoritative body regulations, quality control guidelines, and government portals pertaining to aged care nursing in Australia. This paper relied upon the information garnered from publications, reports, and guidelines resulting from these searches and analyses. Multiple aspects of healthy ageing and holistic aged care nursing are discussed. The key roles of the aged care nurse are enumerated next, in accordance with the code of conduct from the Nursing and Midwifery Board of Australia (NMBA). The NMBA promotes evidence-based, culturally sensitive, consultative, holistic aged care clinical practice that includes input from care recipients, their decision makers, and/or their health care providers. The difficult issue of loneliness is discussed with strategies to ameliorate aspects of this. Good social networks, community interactions, meaningful friendships, and participation in personalised spiritual/religious practices improve the quality of aged care. The key topic of elder abuse and its forms are discussed apropos of aged care nursing. Healthy ageing is promoted by identifying and reporting elder abuse at the earliest. Current Australian law and recent federal legislation changes pertaining to aged care nursing are discussed next. As a result of these legislation changes, several new quality control imperatives (for aged care organisations/facilities) under the Aged Care Quality and Safety Commission (ACQSC) have been implemented. Residential and flexible aged care providers should now have robust ongoing documentation and a well-developed behaviour support plan (BSP) for each care recipient who currently requires or may require restrictive practices, which must be reported under the new serious incident reporting scheme (SIRS). Various strategies to promote healthy ageing and approaches to communicate effectively with aged care recipients are also discussed. Healthy ageing is promoted when age care recipients are empowered with making their own autonomous choices in "major and minor" aspects of life. Finally, approaches to optimise quality aged care nursing care are discussed. The Roper-Logan-Tierney model is one of the models used to assess and optimise nursing care. This is premised on the capability of an ageing individual to accomplish 12 basic activities of daily living.