Framing and scientific uncertainty in nicotine vaping product regulation: An examination of competing narratives among health and medical organisations in the UK, Australia and New Zealand

Aims To compare the policy positions of health and medical organisations across Australia, New Zealand, and the UK as they relate to sale and supply of nicotine vaping products (NVPs) and evaluate factors that have informed the differences in policy recommendations among these countries. Methods We used mixed methods to analyse data from position or policy statements published by health and medical organisations regarding NVPs (n = 30) and consultation documents submitted to government committees regarding policy options for the regulation of NVPs (n = 26). Quality assessment of included documents was conducted using the six-item Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers, and findings were presented narratively. Qualitative data were coded using NVivo 12 software and analysed using thematic analysis. Results An overwhelming majority of health bodies, charities and government agencies in the UK and New Zealand portrayed NVPs as a life-saving harm reduction tool. In contrast, concerns about addicting non-smoking youth to nicotine, a perceived lack of clear and convincing evidence of safety and efficacy and the potential to undermine tobacco control progress continues to define attitudes and recommendations towards NVPs among Australian health and medical organisations. Although the profoundly divided views among stakeholders seem to arise from empirical uncertainties and disagreements over the level and credibility of evidence, the source of most of these disagreements can be traced back to the fundamental and irreconcilable differences in the framing of the NVP debate, and varied tolerability of risk trade-offs associated with NVPs. Conclusion Progress in resolving the controversy surrounding NVP policy requires stakeholders to be frame-reflective and engage in a meaningful dialogue of risk trade-offs, as well as both intended and unintended consequences of proposed policies

Nicotine vaping product use, harm perception and policy support among pharmacy customers in Brisbane, Australia

Despite regulatory barriers for accessing nicotine liquid, use of nicotine vaping products (NVPs) has increased rapidly in Australia. Legal use of NVPs to aid smoking cessation requires a prescription, and pharmacies report receiving enquiries about the use of and access to NVPs. In this study, we assessed vaping product use, harm perception and policy support among community pharmacy customers.A cross-sectional survey was conducted among customers (n = 470) from a large community pharmacy chain in Brisbane, Australia. Multivariable logistic regression was used to examine perception of NVPs as less harmful than combustible cigarettes and regulatory recommendations in relation to demographics, smoking status and NVP use.Almost one-third of the sample (31%) had either tried NVPs in the past (16%) or were current vapers (15%), the majority of them being current smokers (67%) who are trying to quit (31%) or substitute smoking (41%). Vapers primarily depended on family/friends as a source of information (76%). Current smokers and vapers were more likely to perceive NVPs as less harmful than cigarettes than non-smokers and non-vapers. Perceiving NVPs as safer than cigarettes was correlated with a recommendation to regulate as a tobacco product.There was widespread misperception about relative risk of nicotine-containing products, with 37% of respondents perceiving nicotine-containing NVPs to be as harmful as combustible cigarettes. Community pharmacies represent an ideal setting for educating smokers about smoking and vaping. Thus, pharmacy staff needs educational support to ensure that they are equipped to provide current evidence-based information to customers

Imaging ancient and mummified specimens: dual-energy CT with effective atomic number imaging of two ancient Egyptian cat mummies

In mummified animals and humans, soft tissues like skin and muscle become more dense over time due to dehydration. At the same time, bone becomes less dense as marrow is replaced by air. This is a problem for the radiological examination of ancient specimens, as currently used methods such as single-energy CT and MRI rely on density and water content to produce tissue contrast in an image. Dual energy CT with effective atomic number imaging overcomes this problem, as the elemental constituents and consequently effective atomic number of a specimen remain relatively constant over time. This case study of two ancient Egyptian cat mummies demonstrates that effective atomic number imaging can differentiate desiccated soft tissues from low-density bone in ancient remains. Effective atomic number imaging has the potential for superior tissue contrast resolution when compared to single energy CT and can be used to provide new paleoradiological perspectives.James M. Bewes, Antony Morphett, F. Donald Pate, Maciej Henneberg, Andrew J. Low, Lars Kruse, Barry Craig, Aphrodite Hindson, Eleanor Adam

What does 'acceptance' mean? Public reflections on the idea that addiction is a brain disease

Public responses to the dissemination of neuroscientific explanations of addiction and other mental disorders are an interesting sociocultural phenomenon. We investigated how 55 members of the Australian public deliberated on the idea that 'addiction is a brain disease'. Our findings point to the diverse ways in which the public understands and utilises this proposition. Interviewees readily accepted that drugs affect brain functioning but were ambivalent about whether to label addiction as a 'disease'. Contrary to the prediction of neuroscientific advocates and social science critics, acceptance of a neurobiological conception of addiction did not necessarily affect beliefs about addicted persons' responsibility for their addiction. We discuss the theoretical and applied implications of these findings. Theoretically, we examine the complexity surrounding how people adopt new knowledge and its role in reshaping ethical beliefs. We also discuss the implications of these findings for the ethics of communication of neuroscientific information to reduce stigma and enhance social support for the treatment of addicted individuals

Clinimetric evaluation of active range of motion measures in patients with non-specific neck pain: a systematic review

The study is to provide a critical analysis of the research literature on clinimetric properties of instruments that can be used in daily practice to measure active cervical range of motion (ACROM) in patients with non-specific neck pain. A computerized literature search was performed in Medline, Cinahl and Embase from 1982 to January 2007. Two reviewers independently assessed the clinimetric properties of identified instruments using a criteria list. The search identified a total of 33 studies, investigating three different types of measurement instruments to determine ACROM. These instruments were: (1) different types of goniometers/inclinometers, (2) visual estimation, and (3) tape measurements. Intra- and inter-observer reliability was demonstrated for the cervical range of motion instrument (CROM), Cybex electronic digital instrument (EDI-320) and a single inclinometer. The presence of agreement was assessed for the EDI-320 and a single inclinometer. The CROM received a positive rating for construct validity. When clinical acceptability is taken into account both the CROM and the single inclinometer can be considered appropriate instruments for measuring the active range of motion in patients with non-specific neck pain in daily practice. Reliability is the aspect most frequently evaluated. Agreement, validity and responsiveness are documented less frequently

Peer-to-peer session initiation protocol in highly volatile environments

The session initiation protocol (SIP) is an IETF standardised protocol for multimedia signalling and communication over the internet. SIP has been used in many deployments in client-server architecture. However, this configuration potentially possesses various scalability and redundancy limitations because its architecture relies on various centralised components. To overcome some of these limitations, there has been various proposed architectures for using SIP in a fully decentralised manner with minimal or no centralised authorities. One of these proposed architectures is known as peer-to-peer SIP (P2P-SIP), which uses structured p2p overlay networks to lookup and locate SIP resources over the Internet. In this paper we investigate P2P-SIP in a broader perspective beyond the Internet, focusing on the effects of mobility on this approach especially in highly volatile environments in which the underlying p2p overlay never fully converges or stabilises. Our experimental results shows that P2P-SIP systems using CHORD deployed in these environments are highly scalable. But more interestingly, we also show that as the number of peers in the system increases, the signalling overheads per peer in the overlay tends to decrease

An Attention Based Approach to Content Based Image Retrieval

Mark Weiser’s vision that ubiquitous computing will overcome the problem of information overload by embedding computation in the environment is on the verge of becoming a reality. Nevertheless today’s technology is now capable of handling many different forms of multimedia that pervade our lives and as a result is creating a healthy demand for new content management and retrieval services. This demand is everywhere; it is coming from the mobile video phone owners, the digital camera owners, the entertainment industry, medicine, surveillance, the military, and virtually every library and museum in the world where multimedia assets are lying unknown, unseen, and unused. The volume of visual data in the world is increasing exponentially through the use of digital camcorders and cameras in the mass market. These are the modern day consumer equivalents of ubiquitous computers. And, although storage space is in plentiful supply, access and retrieval remain a severe bottleneck both for the home user and for industry. This paper describes an approach, which makes use of a visual attention model together with a similarity measure, to automatically identify salient visual material and generate searchable metadata that associates related items in a database. Such a system for content classification and access will be of great use in current and future pervasive environments where static and mobile content retrieval of visual imagery is required. 1

Policy debates regarding nicotine vaping products in Australia: a qualitative analysis of submissions to a government inquiry from health and medical organisations

Australia has maintained a highly restrictive regulatory framework for nicotine vaping products (NVPs) and the regulatory approach differs from most other high income countries. This paper employed a thematic analysis to assess policy consultation submissions made to a government inquiry regarding use and marketing of NVPs. We included in the analysis submissions ( = 40) made by Australian institutions that influence or contribute to health policy-making including government agencies, health bodies and charities ( = 23), and public health academics and healthcare professionals ( = 18). Submissions from commercial entities and consumers were excluded. The majority of submissions from representatives of government agencies, health bodies and charities recommended maintaining current restrictions on NVPs. Arguments against widening access to NVPs included the demand for long-term evidence on safety and efficacy of an unusually high standard. There was widespread support for restrictions on sales, advertising and promotion, with most submissions supporting similar controls as for tobacco products. In contrast, the majority of individual submissions from healthcare professionals and public health academics advocated for widening access to NVPs for smokers and emphasized the potential benefits of smokers switching to vaping and the policy incoherence of regulating less harmful nicotine products more strictly than tobacco cigarettes. Progress in resolving the policy debate concerning NVP regulation in Australia will require policy makers, clinicians and the public health community to engage in a meaningful dialogue which gives due consideration to both intended and unintended consequences of proposed policies