Extraversion and low introversion more equivalent to high introversion in depression during COVID-19.

OBJECTIVE: This study investigated whether forms of extraversion-introversion produced different depression-related outcomes before and during the COVID-19 pandemic. METHOD: One-way MANCOVAs were conducted to investigate the relationship between extraversion-introversion and depressive symptoms. These data were sourced from the NLSY97, consisting of 4846 individuals born between 1980 and 1984. RESULTS: During pre-pandemic periods, high introversion increased the risk of depressive symptoms. During the pandemic, the risk for depressive symptoms was more equivalent, or less predominately high-introvert-based, among extraverted/low introverted and high introverted subjects. CONCLUSIONS: Extraversion/low introversion was linked with increased depression, relative to high introversion, during the pandemic. The findings raise significant questions about how individuals with distinct personality traits may experience changes in their psychological well-being during challenging public health events.

Delayed and unmet prescription drug access linked to elevated anxiety symptoms during COVID-19: Retrospective findings from the NLSY79 child and young adult cohort.

Background: The COVID-19 pandemic produced substantial challenges to pharmacy systems worldwide and provoked concerns about a wider influence on mental health. While various studies have investigated the relationship between disruptions in access to healthcare and mental health, the effects of delayed and unmet access to prescription drugs on anxiety-related outcomes have been underexamined. Objective: This study analyzed the impact of delayed and unmet access to prescription drugs on anxiety-related outcomes, including anxiety, inability to stop or control worrying, worrying too much, trouble relaxing, trouble sitting still, being annoyed or irritable, and fear of future events, before and during the COVID-19 pandemic. Methods: A retrospective observational study was performed using the National Longitudinal Survey of Youth 79 Child and Young Adult dataset, encompassing 2193 individuals. One-way multivariate analysis of covariance (MANCOVA) analyses were conducted to examine the relationship between access to prescription drugs and anxiety-related symptoms. Results: The findings show that, before the pandemic, instances of delayed/unable to access prescription drugs were either not linked to anxiety symptoms or, in some cases, were linked to anxiety symptoms but no different than during the pandemic. Delayed access to prescription drugs amid the pandemic was significantly linked with increases in anxiety symptoms not found pre-pandemic, including worrying too much (F = 18.433, p < .001, η2p = 0.017), trouble relaxing (F = 11.423, p < .001, η2p = 0.010), and being easily annoyed or irritable (F = 3.881, p = .021, η2p = 0.004). Similarly, unmet access to prescription drugs amid the pandemic was significantly linked with increases in anxiety-related symptoms not found pre-pandemic, including an inability to stop or control worrying (F = 14.666, p < .001, η2p = 0.013) and worrying too much (F = 18.433, p < .001, η2p = 0.017). Conclusions: These results have implications for pharmacy administrators and policymakers seeking to understand and limit adverse mental health outcomes within pharmacy during times of crisis.

Strengthening pill press control to combat fentanyl: Legislative and law enforcement imperatives.

Background: Fentanyl has garnered significant focus from governments, academics, and the media due to the unparalleled increase in overdose fatalities it has triggered in North America. However, the pill presses, dies, and molds used to tablet counterfeit fentanyl-laced pills in Mexico and the United States (U.S.) have gone largely unstudied despite their substantial influence on fentanyl production. The Biden-Harris administration's recent initiative to intensify the prosecution of illicit fentanyl supply chains and the U.S. Treasury Department's decision to impose sanctions on numerous Chinese entities for illicit pill press production and distribution highlights the need to increase controls on pill-press proliferation. Objective: Review the existing legislative frameworks and enforcement in the U.S., China, and Mexico that pertain to pill press control and provide recommendations for improvement. Methods: A literature review was conducted to gather information on counterfeit fentanyl-laced pill production, pill press control, and related legislative frameworks and enforcement in the U.S., China, and Mexico. Federal and state laws, policies, and enforcement mechanisms were reviewed to identify gaps, limitations, and potential for improvement. A comparative study was then performed to determine the strengths and weaknesses of these states' prevailing legislative structures and enforcement mechanisms. Results: In the U.S., pill press laws at the federal level are limited, and state laws are generally weak or nonexistent. The U.S. Controlled Substances Act should be amended to include harsher penalties for the unregistered possession of pill presses with or without the intent to tablet illicit substances. China, the primary source of illicitly distributed pill presses, does not have laws regulating pill presses and should enact strong pill press legislation and engage in rigorous enforcement. Conclusions: As pill presses are integral to the final and crucial step in counterfeit fentanyl-laced pill production, pill press control should receive more legislative and law enforcement attention in the U.S., China, and Mexico.

Privacy Protection in Using Artificial Intelligence for Healthcare: Chinese Regulation in Comparative Perspective.

Advanced artificial intelligence (AI) technologies are now widely employed in China's medical and healthcare fields. Enormous amounts of personal data are collected from various sources and inserted into AI algorithms for medical purposes, producing challenges to patient's privacy. This is a comparative study of Chinese, United States, and European Union operational rules for healthcare data that is collected and then used in AI functions, particularly focusing on legal differences and deficiencies. The conceptual boundaries of privacy and personal information, the influence of technological development on the informed consent model, and conflicts between freedom and security in rules of cross-border data flow were found to be key issues requiring consideration when regulating healthcare data used for AI purposes. Furthermore, the results indicate that the appropriate balance between privacy protections and technological development, between individual and group interests, and between corporate profits and the public interest should be identified and observed. In terms of specific rule-making, it was found that China should establish special regulations protecting healthcare information, provide clear definitions and classification schemas for different types of healthcare information, and enact stricter accountability mechanisms. Examining and contrasting operational rules for AI in health care promotes informed privacy governance and improved privacy legislation.

Combating illicit fentanyl: Will increased Chinese regulation generate a public health crisis in India?

This study examines how Chinese drug regulations are shifting illicit fentanyl production from China to India. This change has implications for the law, drug enforcement, pharmaceutical industry, and public health, as domestic production increases domestic access to fentanyl, in India. An empirical examination of current trends in fentanyl production and use in the region is conducted, along with an exegesis of the legal and regulatory systems in China and India. There is an accounting of the chemical and pharmaceutical industries, the strengths and weaknesses of drug legislation, and the public health consequences of increased production, distribution, and use of fentanyl in India. This study also details how the Indian government meets this challenge through legislative mechanisms, foremost through class-wide legislative control over fentanyl and its precursors. Class-wide control prohibits the unlawful production and distribution of all current and future fentanyl analogs and their precursors, disincentivizing and disrupting their development and production. The Indian government should also reduce domestic demand by promoting harm reduction measures such as opioid substitution therapy, evidence-based treatment, fentanyl test strip and naloxone distribution, and needle exchange programs.

The Evolving Regulatory Landscape for Fentanyl: China, India, and Global Drug Governance.

The rise of the synthetic opioid epidemic has time and time again brought criticism on China and India, the world's two main producers of fentanyl and its chemical precursors. In the past few years, the two countries have attempted to strengthen regulations over fentanyl production and distribution, though its effects on global drug governance remain under scrutiny. This study used qualitative and comparative methods to investigate the current regulatory landscape for fentanyl, including its efficiency and potential loopholes in China and India. It concludes that although both China and India are actively and significantly attempting to step away from the global fentanyl supply chain, these efforts remain ineffective due to institutional loopholes, namely inadequate legislation and fragmented regulatory structures. From insights gained on global drug governance, we recommend a binding international convention concentrated on controlling fentanyl and its related substances, with further bilateral and multilateral cooperation among states as necessary complementation.