[Clinical, diagnostic and forensic features of a REMS patient's sample]. / Caratteristiche cliniche, diagnostiche e forensi di un campione di pazienti di una REMS.

INTRODUCTION: Residential Services for the Execution of Security Measures (REMS) are specialist psychiatric units for forensic patients created in 2015 after OPG (Italian Security Psychiatric Forensic Hospitals) have been closed. AIMS: to describe the clinical, diagnostic and forensic features of patients and evaluate the relevance of 3 elements: use of alcohol and substance, antisociality, cognitive disability. A further aim is the evaluation of the level of pre and post admission diagnostic concordance. METHODS: A specific database has been set for the purpose of the study, which collects data of patients admitted in 5 years of activity of the unit. Data have been analysed through a descriptive approach. RESULTS: 4 main clusters have been identified: Psychosis, Use of Alcohol/Substance Disorder, Personality Disorder, Cognitive Disability. Alcohol/substance use, antisociality, cognitive disability elements are relevant in the sample. Diagnostic concordance level pre- and post- admission is overall good, sometimes partial. CONCLUSIONS: alcohol/substance use, antisociality and cognitive disability, often in comorbidity mode, represent core features in part of the sample. This finding emphasizes a complexity level which is linked to social and judicial aspects, in addition to the health component.

Aspectos éticos del uso de identificadores biométricos / Bioethical aspects of the use of biometric identifiers / Aspectos éticos do uso de identificadores biométricos

La biometría ha tenido una rápida expansión como tecnología, siendo cada vez más accesible para el público general, prestando utilidad a los gobiernos y a la sociedad en el manejo de la seguridad ciudadana. Se aplica para la verificación o la identificación de la identidad de un individuo y, desde un punto de vista puramente técnico, constituye un problema de reconocimiento de patrones. En Chile, el marco legal acerca del manejo de datos personales no incluye específicamente a la biometría. A la fecha, se encuentra en trámite un nuevo proyecto de ley que considera tanto los datos biométricos como los perfiles biológicos. En otros países, los informes de las últimas dos décadas, que analizan el uso de biometría, plantean como principal foco de preocupación, desde el punto de vista ético, el derecho a la privacidad de los individuos, entregándose orientaciones prácticas acerca de la aplicación apropiada de estas tecnologías. Finalmente, desde un breve análisis de la biopolítica, se contextualiza el papel que cumple la biometría y los requerimientos éticos básicos para su desarrollo en dicho marco.

Biometrics has had a rapid expansion as a technology, being increasingly accessible to the public, and lending utility to governments and society in the management of citizen security. It is applied either for verification or for identification of an individual's identity and technically constitutes a problem of pattern recognition. In Chile, the existing legal framework regarding the handling of personal data does not include specific biometrics in its regulation. A new bill that considers both biometric data and Biological profiles is in process. In addition, we revised the international reports of the last two decades that analyze the use of biometrics. The primary focus of concern of these documents, from the ethical point of view, is the right to privacy of individuals, giving practical guidance and discussion regarding the elements necessary for the application of these novel technologies in an appropriate ethically manner. Finally, we contextualize from a brief analysis of biopolitics the role of biometrics and the basic ethical requirements for its development in that framework.

A biometria teve uma rápida expansão como tecnologia, sendo cada vez mais acessível para o público geral, sendo de utilidade para os governos e à sociedade no manejo da segurança cidadã. Ela pode ser aplicada para a verificação ou estabelecimento da identidade de um indivíduo e, desde um ponto de vista puramente técnico, constitui um problema de reconhecimento de padrões. No Chile, o contexto legal acerca do manejo de dados pessoais não inclui especificamente a biometria. Atualmente, encontra-se tramitando um novo projeto de lei que considera tanto os dados biométricos como os perfis biológicos. Em outros países, os informes das últimas duas décadas que analisam o uso da biometria, propõem como principal foco de preocupação, do ponto de vista ético, o direito à privacidade dos indivíduos, entregando-se orientações práticas acerca da aplicação apropriada destas tecnologias. Finalmente, desde uma breve análise da bio-política, contextualiza-se o papel que cumpre a biometria e os requerimentos éticos básicos para seu desenvolvimento em tal contexto legal.

Prevalence of zolpidem use in France halved after secure prescription pads implementation in 2017: A SNDS database nested cohort study.

Our objective was to quantify the impact on the use of zolpidem of the obligation implemented in France in 2017 to use secure prescription pads to prescribe it. We conducted a cohort study within the French SNDS healthcare database. Patients aged over 18 years of age were considered for inclusion. The number of prevalent users and incident episodes of zolpidem use were compared before the change in law (July 1, 2016 to January 1, 2017) and after (July 1, 2017 to January 1, 2018). A prevalent user was a patient who has been reimbursed for zolpidem at least once. An incident episode of zolpidem use was defined by a first administration of zolpidem without any prior administration within the previous six months. Regarding prevalence of zolpidem users, we observed a decrease from 2.79% (CI95%:2.75-2.83) to 1.48% (1.44-1.51), with a number of patients who stopped taking it after the change in law being approximately 4.3 times higher than the number of patients who started. We observed a negative association between the post-law change period (OR = 0.52 (0.51-0.53)) and the probability of receiving zolpidem, adjusting for sex, aging, low income and chronic disease. We observed a decrease from 183 treatment episodes per 100,000 insured months on average to 79 episodes per 100,000 insured months, with an incidence rate ratio (IRR) equal to 0.43 (0.38-0.49). The use of secure prescription pads seems to have reduced the exposure of the French population to zolpidem.

Towards a reformed policy for immigrant DNA tests, a commentary.

DNA can be useful corroborative evidence in establishing familial relationship in immigration cases. Presently, there is no specific law in the UK regulating the use of DNA in this domain. This has led to inconsistencies in policy guidance and the rejection of some immigrant applications solely or partly due to a lack of DNA evidence. This commentary draws on the DNA regulatory regime in law enforcement to make a case for a specific DNA immigration law to protect individual rights, assure fairness and trust in the treatment of applicants. In addition to a specific law, consistency in operations should be ensured by developing a central point of contact for guidance including a central IT system, and a custodian of the DNA application process. Further, a single code of practice and conduct is proposed to ensure that guidance products are in line with the law and practice. An independent multi-stakeholder board is also recommended to ensure that policies are representative of the views of applicants and their relatives; policy officers and operational staff; and policymakers and the public.

Biodefense Policy Analysis-A Systems-based Approach.

Understanding the overall biosecurity and biodefense policy landscape, the relationships between policies and their effects on each other, and the mechanisms for leveraging advances in science and technology to enhance defensive capabilities is crucial for ensuring that policy strategies address long-standing gaps and challenges. To date, policy analyses have been conducted primarily on single issues, which limits analyses of broader effects of policies, particularly after implementation. Here we describe the first-ever systems-based analysis of the US biosecurity and biodefense policy landscape to analyze functional relationships between policies, including examination of the unintended positive or negative consequences of policy actions. This analysis revealed a striking bifurcation of the US policy landscape for countering biological threats, with one grouping of policies focused on prevention of theft, diversion, or deliberate malicious use of biological sciences knowledge, skills, materials, and technologies (ie, biosecurity) and a second grouping on development of capabilities and knowledge to assess, detect, monitor, respond to, and attribute biological threats (ie, biodefense). An analysis of indirect effects demonstrated that policies within groups may result in mutual benefit, but policies in different groups may counteract each other, limiting achievement of the policy objectives in either group. The current policy landscape predominantly focuses on pathogens and toxins, having limited focus on rapidly changing biotechnologies with potential to positively contribute to biodefense capabilities or introduce unknown and/or unacceptable security risk. Based on our analyses, we present actions for implementing biosecurity and biodefense policy in the United States that intends to harness the benefits of science and technology while also minimizing potential risks. This article synthesizes and highlights the major findings and conclusions from the detailed analyses, which can be found in the full report ( http://www.gryphonscientific.com/biosecurity-policy/ ).

Analysis of Australia's New Biosecurity Legislation.

On 16 June 2016 the Biosecurity Act 2015 Cth came into force. This legislation replaced the Quarantine Act 1908 Cth which had regulated biosecurity in Australia for over a century. Impetus for the change arose from a number of reviews (the Nairn Report and later Beale Review) into Australia's biosecurity system. These identified systemic flaws that were causing the country to be vulnerable to incursions of foreign pests and diseases through the administration of an archaic regulatory regime. The Biosecurity Act 2015 Cth includes new terminology, increased powers for the regulator and additional requirements for industry. The responsible agency, the Department of Agriculture and Water Resources, has stated that the new biosecurity laws are designed to be user-friendly, to be flexible and responsive to changes in technology and future challenges, to remove cluttered and confusing sections of the Quarantine Act 1908 Cth and to achieve the difficult balance of making biosecurity regulation risk-based and equipping the regulator with strong enforcement powers while also being economically prudent and supportive of increasing Australian trade and market access. This column analyses such claims, including the short, and long-term implications of providing biosecurity officers with two sets of authorising legislative powers and sharing the responsibility of biosecurity emergencies with the Department of Health.