Med-Adept: A Lightweight Assessment Method for the Irish Medical Device Software Industry

In this paper we describe how a lightweight assessment method was developed to educate Irish software development organisations in relation to becoming medical device software suppliers

Cannabis; epidemiological, neurobiological and psychopathological issues: an update

This document is the Accepted Manuscript version of the following article: Maria Antonietta De Luca, Gaetano Di Chiara, Cristina Cadoni, Daniele Lecca, Laura Orsolini, Duccio Papanti, John Corkery, Fabrizio Schifano, 'Cannabis; Epidemiological, Neurobiological and Psychopathological Issues: An Update', CNS & Neurological Disorders - Drug Targets, Vol. 16, 2017. The published manuscript is available at EurekaSelect via https://doi.org/10.2174/1871527316666170413113246. Published by Bentham Science.Cannabis is the illicit drug with both the largest current levels of consumption and the highest reported lifetime prevalence levels in the world. Across different countries, the prevalence of cannabis use varies according to the individual income, with the highest use being reported in North America, Australia and Europe. Despite its ‘soft drug’ reputation, cannabis misuse may be associated with several acute and chronic adverse effects. The present article aims at reviewing several papers on epidemiological, neurobiological and psychopathological aspects of the use of cannabis. The PubMed database was here examined in order to collect and discuss a range of identified papers. Cannabis intake usually starts during late adolescence/early adulthood (15-24 years) and drastically decreases in adulthood with the acquisition of working, familiar and social responsibilities. Clinical evidence supports the current socio-epidemiological alarm concerning the increased consumption among youngsters and the risks related to the onset of psychotic disorders. The mechanism of action of cannabis presents some analogies with other abused drugs, e.g. opiates. Furthermore, it has been well demonstrated that cannabis intake in adolescence may facilitate the transition to the use and/or abuse of other psychotropic drugs, hence properly being considered a ‘gateway drug’. Some considerations on synthetic cannabimimetics are provided here as well. In conclusion, the highest prevalence of cannabis use and the social perception of a relatively low associated risk are in contrast with current knowledge based on biological and clinical evidence. Indeed, there are concerns relating to cannabis intake association with detrimental effects on both cognitive impairment and mental health.Peer reviewe

Market Analysis of Synthetic Drugs: Amphetamine-type Stimulants, New Psychoactive Substances

An estimated quarter of a billion people, or around 5 per cent of the global adult population, used drugs at least once in 2015. Even more worrisome is the fact that about 29.5 million of those drug users, or 0.6 per cent of the global adult population, suffer from drug use disorders. This means that their drug use is harmful to the point that they may experience drug dependence and require treatment.The magnitude of the harm caused by drug use is underlined by the estimated 28 million years of "healthy" life (disability-adjusted life years (DALYs)) lost worldwide in 2015 as a result of premature death and disability caused by drug use.Of those years lost, 17 million were attributable solely to drug use disorders across all drug types. DALYs attributable to morbidity and mortality resulting from all causes of drug use have increased overall in the past decade.Yet, with fewer than one in six persons with drug use disorders provided with treatment each year, the availability of and access to science-based services for the treatment of drug use disorders and related conditions remain limited

Introduction | Approaching Potent Substances in Medicine and Ritual across Asia

Introduction to themed research articles on Approaching Potent Substances in Medicine and Ritual across Asia

The use of synthetic cannabinoid receptor agonists (SCRAs) within the homeless population: Motivations, harms and the implications for developing an appropriate response

Synthetic cannabinoid receptor agonists (SCRAs) have become increasingly associated with a range of physical, mental health and societal harms. In response, several countries have introduced legislation aimed at restricting the supply and use of SCRAs. While these legislative changes have led to a decrease in SCRA use within the general population, SCRAs remain popular within vulnerable populations, in particular the homeless. Drawing on 84 face-to-face interviews (with 53 homeless users of SCRAs, and 31 key stakeholders), this article presents the first in-depth qualitative study of SCRA use within the homeless population. It highlights the distinct set of motivations for SCRA use within this population, along with the specific harms associated with their use. In doing so, this article makes an important and timely contribution to the current evidence base and discourse on how governments and service providers should respond to SCRA use within the homeless population. The article concludes by arguing that the most appropriate way to address the continued use of SCRAs within the homeless population is through the development of a more appropriate service response rather than further legislative change

Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools.

BACKGROUND: There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment. METHODS: We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach. RESULTS: We retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a 'gold standard' significantly hinders the evaluation of tools' validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations. CONCLUSIONS: There are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence

Effect of pepper and salt blends on microbial quality of quanta: Ethiopian dried red meat

This study was conducted to assess the effect of spice blends varying in salt and pepper concentrations on the microbial quality of Quanta: Ethiopian dried red meat. The experiment had seven treatments: 25% spices, 25% salt, and 50% pepper (T1); 25% spices, 20% salt, and 55% pepper (T2); 25% spices, 15% salt, and 60% pepper (T3); 25% spices, 10% salt, and 65% pepper (T4); 25% spices, 5% salt, and 70% pepper (T5); 100% spices (without salt and pepper), a positive control (T6); a negative control without any added ingredient (T7). Microbiological analyses were performed initially on the raw sliced meat and spice blends, and after application of the treatments on the 10th and 20th days of drying. High initial loads of total bacteria (APC) and Enterobacteriaceae (EC) were observed in the raw meat samples and spice blends and increased over the drying periods (10 and 20 days) in all treatments. No significant difference (p>0.05) was observed among the treatments (T1-T7) for APC and EC at a given drying period and between the drying periods. Salmonella spp. was not detected in any of the seven treatments either on the 10th and 20th days of drying. However, Escherichia coli was detected in six (T1-T6) of the dry meat samples except in T7 both on the 10th and 20th days of drying suggesting that the spice blends served as a source of contamination of the dried meat samples with E. coli. However, the spice blends used in combination with drying were effective in inhibiting the growth of Salmonella species in the dry meat samples. Spices as well as the raw meat used for Quanta preparation should be produced and handled under hygienic conditions to minimize the microorganisms that they harbor

Four examples demonstrating the impact of Applied Botany on plant-based industrial processes

Currently, many producers of plant-derived commodities indicate a scarcity of associates whose skills cover the entire field of plant biology and who bolster industrial research by linking it to basic plant biology. This scarcity is of particular concern to small and medium sized companies.To illustrate the benefit of appropriate mediation between basic science and product-oriented research, four innovative examples of collaborative research are presented here. The examples cover a broad range of economically relevant issues, including green coffee processing, malting, production of spice and medicinal plants, and prevention of contamination with toxic natural products, such as nicotine or pyrrolizidine alkaloids. These examples illustrate that Applied Botany has the potential to improve even well-established production processes.This article argues that innovative product-oriented research must focus on the relevant physiological processes occurring in the plants. In particular, the impact of cultivation and post-harvest processes on related metabolic processes should be considered, rather than placing continued focus on physical parameters or on economic aspects. In order to achieve practical and feasible solutions that also meet economic demands, interdisciplinary and cross-functional approaches between partners are essential

Using cost-effectiveness analyses to inform policy: the case of antiretroviral therapy in Thailand.

BACKGROUND: Much emphasis is put on providing evidence to assist policymakers in priority setting and investment decisions. Assessing the cost-effectiveness of interventions is one technique used by policymakers in their decisions around the allocation of scarce resources. However, even where such evidence is available, other considerations may also be taken into account, and even over-ride technical evidence. Antiretroviral therapy (ART) is the most effective intervention to reduce HIV-related morbidity and prolong mortality. However, treatment provision in the developing world has been hindered by the high costs of services and drugs, casting doubts on its cost-effectiveness. This paper looks at Thailand's publicly-funded antiretroviral initiative which was first introduced in 1992, and explores the extent to which cost-effectiveness evidence influenced policy. METHODS: This article reviews the development of the national ART programme in Thailand between 1992 and 2004. It examines the roles of cost-effectiveness information in treatment policy decisions. Qualitative approaches including document analysis and interview of key informants were employed. RESULTS: Two significant policy shifts have been observed in government-organised ART provision. In 1996, service-based therapy for a few was replaced by a research network to support clinical assessments of antiretroviral medication in public hospitals. This decision was taken after a domestic study illustrated the unaffordable fiscal burden and inefficient use of resources in provision of ART. The numbers of treatment recipients was maintained at 2,000 per year throughout the 1990s. It was not until 2001 that a new government pledged to extend the numbers receiving the service, as part of its commitment to universal coverage. Several elements played a role in this decision: new groups of dominant actors, drug price reductions, a pro-active civil society movement, lessons from experience on treatment benefits, and global treatment advocacy. Unlike previous policy discourse, human rights, ethics and equity notions were explicitly raised to support therapy extension. CONCLUSION: In the early decision, moving from a relatively limited ART service to a research network was clearly influenced by cost-effectiveness data. But in the 2001 decision to include ART in the universal coverage package, cost-effectiveness arguments were over-ruled by other considerations. Thai ART policy was shaped by many factors, and was not a simple rational process which relied on evidence