Conflicts of Interest in Self-Regulating Health Professions Regulators

This article analyzes a set of related complaints and informal reports made to the Nova Scotia College of Chiropractors with respect to an alleged breach of the College’s advertising policy. This analysis assessed situational elements of conflicts of interest in the complaint process, particularly dual roles and competing professional interests, against the Childress et al framework of ethical public health decision-making and the conflict-of-interest standards in the Nova Scotia Chiropractic Act and Regulations. The analysis concludes that the legislative scheme fails to adequately regulate conflicts of interest and bias in the College’s disciplinary decision-making processes through weak or unarticulated standards and high levels of discretion devolved to the College. Conflicts of interest within complaint processes threaten patients’ health and well-being and diminish public trust in professional self-regulation. This case study identifies a need for legislative and policy reforms to better protect procedural justice and public accountability in health professional regulation. Dans cet article, nous analysons un ensemble de plaintes et de rapports informels connexes adressés au Nova Scotia College of Chiropractors (collège des chiropraticiens de la Nouvelle Écosse) relativement à une violation présumée de la politique du collège en matière de publicité. Cette analyse évalue les éléments situationnels des conflits d\u27intérêts dans le processus de plainte, en particulier les doubles rôles et les intérêts professionnels concurrents, par rapport au cadre de prise de décision éthique en matière de santé publique élaboré par Childress et aux normes relatives aux conflits d\u27intérêts de la Chiropractic Act and Regulations de la Nouvelle Écosse. L\u27analyse conclut que le régime législatif ne parvient pas à réglementer adéquatement les conflits d\u27intérêts et la partialité dans les processus de prise de décisions disciplinaires du collège, en raison de normes faibles ou non articulées et des niveaux élevés de discrétion dévolus au collège. Les conflits d\u27intérêts dans les processus de plainte menacent la santé et le bien-être des patients et diminuent la confiance du public dans l\u27autorégulation professionnelle. Cette étude de cas identifie un besoin de réformes législatives et politiques pour mieux protéger la justice procédurale et la responsabilité publique dans la réglementation des professionnels de la santé. *This contribution has not been peer-reviewed. *This file was updated with a revised version on 23/07/21

Who Knows What, When? Current and Desired Capacities for Online Journal Statistics Gathering and Dissemination

As part of the national Synergies project, the Statistics Working Group was formed to investigate statistical reporting mechanisms used by participating institutions, to research online journal-specific reporting needs, and to form a common model for statistical reporting and the sharing of usage data across Canada. The working group informally compared the statistics-gathering range of Open Journal Systems (ojs) and the Érudit Consortium publishing platform; they also surveyed Canadian and international scholarly journal stakeholders to obtain a better understanding of their needs. Respondents were asked about desired types of statistics captured, preferred groupings, preferred harvesting frequency, and their level of satisfaction with available tools. This article describes the results of the platform comparison and the survey, and it provides a set of recommendations intended for the Synergies project but applicable elsewhere

Barriers and Contradictions in the Resettlement of Single Homeless People

Research in one local authority area suggests that a number of social policy difficulties and contradictions need to be resolved if single homeless people are to be resettled effectively. In particular, there are competing pressures on social housing providers, who are expected to meet the needs of socially excluded individuals while also creating sustainable communities and operating in a cost efficient manner. The government needs to clarify that meeting housing need is a priority for social landlords, and provide adequate funding for long-term support, if single homeless people are to find appropriate permanent accommodation

Generosity of spirit sustains caseloading Lead Maternity Carer midwives in New Zealand.

Background: This article is the third in a series reporting on original research exploring the sustainability of Lead Maternity Carer (LMC) midwifery. Previous publications have described sustainable practice arrangements and the way that partnership and reciprocity with women sustain LMC midwives. Research about sustainable caseload practice is important because lessons can be learnt that ensure this model of care, with its excellent outcomes and high levels of maternal satisfaction, continues. Aim: The aim of this paper is to provide stand-alone data in relation to what sustains LMC midwives in midwifery practice over time. The final theme to emerge from our original research arose from data which support the strong relationship between the midwives' generosity of spirit alongside professional boundaries that is critical to sustaining caseloading practice. Method: A qualitative descriptive study was conducted in New Zealand. Eleven LMC midwives with between 8-20 years of practice experience were interviewed. Interviews were transcribed and the data thematically analysed. The researchers within the group undertook the analysis together in a reciprocal fashion between the individual interviews and all the data as a whole. Themes were clustered into groups and excerpts from the data used to illustrate the agreed themes. Ethics approval was obtained from Auckland University of Technology Ethics Committee. Conclusion: This paper draws attention to the significance of generosity of spirit in LMC practice and how this acts synergistically with personal and professional boundaries. Reciprocity and partnership work well when generosity of spirt is enabled to flourish, and this, in turn, supports joy of practice. This paper provides further insight into how LMC practice is sustained over time and provides direction for midwives in LMC practice, and those planning to enter LMC practice, in New Zealand and elsewhere

Transparency Too Little, Too Late? Why and How Health Canada Should Make Clinical Data and Regulatory Decision-Making Open to Scrutiny in the Face of COVID-19

Hard-won gains in the transparency of therapeutic product data in recent years1 have occurred alongside growing reliance by regulators upon expedited review processes.2 The concurrence of these two trends raises fundamental questions for the future of pharmaceutical regulation about whether the institutionalization of transparency will foster improved oversight of drugs, biologics, vaccines, and other interventions, or else, provide cover for a relaxing of regulatory standards of safety, effectiveness, and quality.3 The urgency of the COVID-19 pandemic, however, has brought this tension into immediate and sharp relief. During the course of the global health crisis, regulatory bodies have markedly expanded the number and use of expedited review processes for COVID-19 therapies, and at the same time, the proliferation of misinformation about any potential SARS-CoV-2 intervention4 reveals the limitations of recently implemented transparency measures

Evaluating the Association Between Keratoconus and the Corneal Thickness Genes in an Independent Australian Population

PURPOSE. A recent genome-wide association study (GWAS) identified six loci associated with central corneal thickness that also conferred associated risk of keratoconus (KC). We aimed to assess whether genetic associations existed for these loci with KC or corneal curvature in an independent cohort of European ancestry. METHODS. In total, 157 patients with KC were recruited from public and private clinics in Melbourne, Australia, and 673 individuals without KC were identified through the Genes in Myopia study from Australia. The following six single-nucleotide polymorphisms (SNPs) that showed a statistically significant association with KC in a recent GWAS study were selected for genotyping in our cohort: rs4894535 (FNDC3B), rs1324183 (MPDZ-NF1B), rs1536482 (RXRA-COL5A1), rs7044529 (COL5A), rs2721051 (FOXO1), and rs9938149 (BANP-ZNF469). The SNPs were assessed for their association with KC or corneal curvature using logistic or linear regression methods, with age and sex included as covariates. Bonferroni corrections were applied to account for multiple testing. RESULTS. Genotyping data were available for five of the SNPs. Statistically significant associations with KC were found for the SNPs rs1324183 (P ¼ 0.001; odds ratio [OR], 1.68) and rs9938149 (P ¼ 0.010; OR, 1.47). Meta-analysis of previous studies yielded genomewide significant evidence of an association for rs1324183, firmly establishing it as a KC risk variant. None of the SNPs were significantly associated with corneal curvature. CONCLUSIONS. The SNPs rs1324183 in the MPDZ-NF1B gene and rs9938149 (between BANP and ZNF4659) were associated with KC in this independent cohort, but their association was via a non-corneal curvature route

Impact of the timing of hepatitis B virus identification and antiâ hepatitis B virus therapy initiation on the risk of adverse liver outcomes for patients receiving cancer therapy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138209/1/cncr30729_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138209/2/cncr30729.pd

A single dose of antibody-drug conjugate cures a stage 1 model of African trypanosomiasis.

Infections of humans and livestock with African trypanosomes are treated with drugs introduced decades ago that are not always fully effective and often have severe side effects. Here, the trypanosome haptoglobin-haemoglobin receptor (HpHbR) has been exploited as a route of uptake for an antibody-drug conjugate (ADC) that is completely effective against Trypanosoma brucei in the standard mouse model of infection. Recombinant human anti-HpHbR monoclonal antibodies were isolated and shown to be internalised in a receptor-dependent manner. Antibodies were conjugated to a pyrrolobenzodiazepine (PBD) toxin and killed T. brucei in vitro at picomolar concentrations. A single therapeutic dose (0.25 mg/kg) of a HpHbR antibody-PBD conjugate completely cured a T. brucei mouse infection within 2 days with no re-emergence of infection over a subsequent time course of 77 days. These experiments provide a demonstration of how ADCs can be exploited to treat protozoal diseases that desperately require new therapeutics