Health and safety at work: the prevention model in Italy. WP C.S.D.L.E. “Massimo D’Antona”.IT – 408/2020

A research itinerary aimed at clarifying the substantive content and the type of prevention that shapes the rules for the protection of health and safety of workers in the Italian legal system. The focus will be on the difference between primary and secondary prevention in the warranty of fundamental right

One world connected: an assessment of Australia’s progress in suicide prevention

Overview: This paper provides a detailed assessment of Australia\u27s progress in suicide prevention. Written in response to the landmark World Health Organisation report Preventing Suicide: A global imperative, the National Coalition for Suicide Prevention, led by Suicide Prevention Australia, looks at the report findings in relation to Australia and suicide prevention, it explores what we are doing well and what we need to do differently. This paper offers a brief summary of points of interest from the WHO Report as well as a view on how Australia is performing against some of the criteria set out in this Report as important for a successful national suicide prevention strategy. For ease of reference, we have used a traffic light system so readers can easily identify where Australia is performing well, where we are heading in the right direction but have work to do; and where serious discussion and action is required

Beyond Paternalism: The Role of Counsel for Children in Abuse and Neglect Proceedings

[Excerpt] “Across the nation, lawyers routinely represent children who enter the juvenile court system. Juvenile court systems typically handle two types of cases: delinquency and dependency. Delinquency refers to those cases where children are accused of wrongdoing, which generally means a criminal offense. Dependency cases involve situations where the child is alleged to be mistreated, i.e. abused or neglected, by parents or guardians. Lawyers are involved in both types of proceedings most traditionally as representatives of the state. Lawyers represent the state and bring forth charges of criminal conduct against the child in delinquency proceedings. Lawyers represent the state and bring forth allegations of abuse and neglect against the parents or guardians of the child in dependency proceedings. In both types of proceedings, lawyers function as advocates for the state’s position. Lawyers are also appointed to represent parents in dependency matters and function as advocates for their clients, by protecting the fundamental rights and interests of parents in these cases where parental rights are directly at issue. The right to counsel for children in juvenile court proceedings is a relatively recent phenomenon. Prior to 1967, children did not have a right to counsel in juvenile court. In 1967, the U.S. Supreme Court in In re Gault held that children in juvenile delinquency proceedings have due process rights, including the right to counsel. A few years later in 1974, Congress enacted the Child Abuse Prevention and Treatment Act (“CAPTA”) which mandated that states appoint representatives for children in abuse and neglect proceedings in order to receive federal child abuse prevention and treatment funding. For over four decades, the roles, duties and responsibilities of the child’s attorney in juvenile court have been the subject of extensive debate and discussion among scholars, judges and practitioners. Currently, a general consensus exists that in delinquency matters, children have a right to counsel who functions as a legal advocate in the traditional sense. However, the right to counsel and the role of the counsel in dependency proceedings continues to be the subject of debate.

Systematic Analysis of Gene Expression Differences between Left and Right Atria in Different Mouse Strains and in Human Atrial Tissue

Background: Normal development of the atria requires left-right differentiation during embryonic development. Reduced expression of Pitx2c (paired-like homeodomain transcription factor 2, isoform c), a key regulator of left-right asymmetry, has recently been linked to atrial fibrillation. We therefore systematically studied the molecular composition of left and right atrial tissue in adult murine and human atria. Methods: We compared left and right atrial gene expression in healthy, adult mice of different strains and ages by employing whole genome array analyses on freshly frozen atrial tissue. Selected genes with enriched expression in either atrium were validated by RT-qPCR and Western blot in further animals and in shock-frozen left and right atrial appendages of patients undergoing open heart surgery. Results: We identified 77 genes with preferential expression in one atrium that were common in all strains and age groups analysed. Independent of strain and age, Pitx2c was the gene with the highest enrichment in left atrium, while Bmp10, a member of the TGFb family, showed highest enrichment in right atrium. These differences were validated by RT-qPCR in murine and human tissue. Western blot showed a 2-fold left-right concentration gradient in PITX2 protein in adult human atria. Several of the genes and gene groups enriched in left atria have a known biological role for maintenance of healthy physiology, specifically the prevention of atrial pathologies involved in atrial fibrillation, including membrane electrophysiology, metabolic cellular function, and regulation of inflammatory processes. Comparison of the array datasets with published array analyses in heterozygous Pitx2c+/2 atria suggested that approximately half of the genes with left-sided enrichment are regulated by Pitx2c. Conclusions: Our study reveals systematic differences between left and right atrial gene expression and supports the hypothesis that Pitx2c has a functional role in maintaining ‘‘leftness’’ in the atrium in adult murine and human hearts

Pneumococcal disease prevention: Arewe on the right track?

The history of Streptococcus pneumoniae diseases dramatically changed with the introduction into the immunization schedule of infants and children of the first pneumococcal conjugate vaccine, the one containing 7 (PCV7) of the most common pneumococcal serotypes (STs) causing invasive pneumococcal diseases (IPDs). Where PCV7 was largely used, incidence of both IPDs and non-invasive pneumococcal diseases (nIPDs) in vaccinated children and in unvaccinated subjects of any age, mainly the elderly, significantly decreased. Unfortunately, the impact of PCV7 administration was slightly lower than expected, as the reduction in infections due to vaccine serotypes (STs) was accompanied by a significant increase in the number of IPDs and nIPDs due to STs not included in the vaccine. To overcome this problem, two PCVs containing 10 (PCV10) and 13 (PCV13) STs, chosen among those emerging, were developed and licensed. However, ST replacement occurred again. Moreover, the new PCVs showed little effectiveness in the prevention of infection due to nonencapsulated STs and to ST3. Next-generation S. pneumoniae vaccines able to prevent pneumococcal infections regardless of infecting ST are urgently needed. For the moment, the use of available PCVs remains fundamental because their benefits far outweigh any concerns for emerging STs

The ENERGY club: A diabetes prevention project for Monterey Elementary School

The Monterey School Diabetes Prevention Project\u27s (MSDPP) ENERGY Club is a pilot project for school-based health prevention curriculum targeting students with risk factors for diabetes. ENERGY is an acronym for Exercise \u27n Eating Right is Good for You

Early Clinical and Subclinical Visual Evoked Potential and Humphrey's Visual Field Defects in Cryptococcal Meningitis.

Cryptococcal induced visual loss is a devastating complication in survivors of cryptococcal meningitis (CM). Early detection is paramount in prevention and treatment. Subclinical optic nerve dysfunction in CM has not hitherto been investigated by electrophysiological means. We undertook a prospective study on 90 HIV sero-positive patients with culture confirmed CM. Seventy-four patients underwent visual evoked potential (VEP) testing and 47 patients underwent Humphrey's visual field (HVF) testing. Decreased best corrected visual acuity (BCVA) was detected in 46.5% of patients. VEP was abnormal in 51/74 (68.9%) right eyes and 50/74 (67.6%) left eyes. VEP P100 latency was the main abnormality with mean latency values of 118.9 (±16.5) ms and 119.8 (±15.7) ms for the right and left eyes respectively, mildly prolonged when compared to our laboratory references of 104 (±10) ms (p<0.001). Subclinical VEP abnormality was detected in 56.5% of normal eyes and constituted mostly latency abnormality. VEP amplitude was also significantly reduced in this cohort but minimally so in the visually unimpaired. HVF was abnormal in 36/47 (76.6%) right eyes and 32/45 (71.1%) left eyes. The predominant field defect was peripheral constriction with an enlarged blind spot suggesting the greater impact by raised intracranial pressure over that of optic neuritis. Whether this was due to papilloedema or a compartment syndrome is open to further investigation. Subclinical HVF abnormalities were minimal and therefore a poor screening test for early optic nerve dysfunction. However, early optic nerve dysfunction can be detected by testing of VEP P100 latency, which may precede the onset of visual loss in CM

Children’s Health in a Legal Framework

The interdisciplinary periodical Future of Children has dedicated an issue to children’s health policy. This contribution to the issue maps the legal landscape influencing policy choices. The authors demonstrate that in the U.S. legal system, parents have robust rights, grounded in the Constitution, to make decisions concerning their children’s health and medical treatment. Following from its commitment to parental rights, the system typically assumes the interests of parents and children are aligned, even when that assumption seems questionable. Thus, for example, parents who would limit their children’s access to health care on the basis of the parents’ religious belief have considerable latitude to do so, unless the child’s life is imminently threatened. There are some exceptions to this legal regime. Adolescents have the right to obtain some health services independently; in these contexts, social welfare needs such as pregnancy prevention trump parental rights. Minors also have access to abortion (although this right is more restricted than for adults). Moreover, the state has the power to intervene when parents place their children’s health at risk through abuse or neglect. A hallmark feature of the legal regime based on parental rights is that the state has no affirmative obligation to help parents care for their children’s health needs. This libertarian framing of the family-state relationship has profound implications for the development of public policy. To the extent the state provides support for families and children, it is doing so as a matter of policy choice (as with Medicaid and the Children’s Health Insurance Program) and not enforceable legal obligation. The importance of family autonomy thus results in a weak conception of shared responsibility for children. The framework also means that the state often takes a reactive approach to child wellbeing, intervening primarily when families have broken down or parents have seriously defaulted on their duties. Appreciation of the legal framework underscores the need to develop political support for any initiative to improve health services for children. Often, as this article shows, the state intervenes to promote children’s health only in response to compelling social welfare needs such as crime or disease prevention, or to crises in which parents abuse their children or fail to provide adequate care

The legal framework for groundwater allocation in Quebec: towards integrated water management

This paper aims at providing a model of the legal framework for groundwater allocation in the province of Quebec (Canada), identifying its potential deficiencies and suggesting possible improvements. In Quebec, groundwater is a res communis. The right to use it is tied to real estate property. This right forms the basis of the legal framework for the management of groundwater quantity. However, according to statutory law, the actual use of groundwater also depends on governmental authorisations that limit quantities used. The main statutory instrument for managing the resource is the Groundwater Catchment Regulation (GWCR), which aims at conflict prevention between first users and new users by means of governmental authorisations. In agricultural areas, an additional authorisation regime indirectly prioritises agricultural groundwater uses. Finally, legal mechanisms addressing conflicts between water users rely on the general litigation framework provided by Quebec law without establishing an order of priority for the different uses of the resource. According to Integrated Water Resources Management, four aspects of the legal framework for groundwater quantity management can be modified to increase the efficiency of the allocation regime: 1) provisions should be made to preserve a residual environmental flow; 2) an order of priority should be established between the different uses to minimise conflict; 3) the scope of the regime should be extended to all groundwater users to increase its efficiency; 4) stakeholders should participate in the management of the resource

A former right-wing extremist in school-based prevention work: Research findings from Germany

This paper summarizes the findings of a pioneer process and impact evaluation of a school-based Preventing Violent Extremism (PVE) measure conducted by a former right-wing extremist. The goal of the primary prevention measure was, inter alia, to attain positive effects on extreme right-wing attitudes and delinquent behavior among juveniles. This goal was evaluated using an impact assessment with a post intervention screening after approximately half a year. The sample comprised 564 pupils from 50 school classes, which were randomly assigned to a treatment and a control group. Additionally, we gained further data on the prevention measure using participant observations and by surveying the participating pupils. This is the first empirical study to evaluate a school-based PVE measure conducted by a former in such a manner. The results of the study do not suggest that the prevention measure influenced right-wing extremist attitudes and delinquency. The predominantly positive responses of the pupils suggest that this approach can be a tool to facilitate access to pupils in a period of life where adults have difficulties with accessing juveniles. However, the pupils’ statements also highlight critical aspects, which signify that some contents and their illustration do not seem to be adequate for this target group