Leaving No One Behind: Human Rights and Gender as Critical Frameworks for U=U

Experience has shown the need to explicitly address human rights and gender-related barriers in the rollout of HIV-related biomedical innovations, including “undetectable equals untransmittable” (U=U). This paper brings to light rights and gender considerations relevant to supporting U=U, recognizing a range of barriers that remain to be addressed for all people to benefit equally from U=U. We conducted a literature review to ascertain how human rights and gender were addressed in relevant publications, including peer-reviewed articles published between 2006 and 2020, relevant nongovernmental and global organizations’ publications, and abstracts presented at the 2019 International AIDS Conference, that explicitly addressed U=U or “treatment as prevention.” Despite evidence to illustrate the importance of attention to human rights and gender within U=U policies and interventions, there remains a lack of explicit attention to human rights and gender considerations in research and programming, particularly with regard to the rights principles of participation and accountability. Explicitly engaging all of these dimensions is key to informing interventions and improving people’s lives, health, and well-being.     

Nutritional Support Indications in Gastroesophageal Cancer Patients: From Perioperative to Palliative Systemic Therapy. A Comprehensive Review of the Last Decade

Gastric cancer treatments are rapidly evolving, leading to significant survival benefit. Recent evidence provided by clinical trials strongly encouraged the use of perioperative chemotherapy as standard treatment for the localized disease, whereas in the advanced disease setting, molecular characterization has improved patients’ selection for tailored therapeutic approaches, including molecular targeted therapy and immunotherapy. The role of nutritional therapy is widely recognized, with oncologic treatment’s tolerance and response being better in well-nourished patients. In this review, literature data on strategies or nutritional interventions will be critically examined, with particular regard to different treatment phases (perioperative, metastatic, and palliative settings), with the aim to draw practical indications for an adequate nutritional support of gastric cancer patients and provide an insight on future directions in nutritional strategies. We extensively analyzed the last 10 years of literature, in order to provide evidence that may fit current clinical practice both in terms of nutritional interventions and oncological treatment. Overall, 137 works were selected: 34 Randomized Clinical Trials (RCTs), 12 meta-analysis, 9 reviews, and the most relevant prospective, retrospective and cross-sectional studies in this setting. Eleven ongoing trials have been selected from clinicaltrial.gov as representative of current research. One limitation of our work lies in the heterogeneity of the described studies, in terms of sample size, study procedures, and both nutritional and clinical outcomes. Indeed, to date, there are no specific evidence-based guidelines in this fields, therefore we proposed a clinical algorithm with the aim to indicate an appropriate nutritional strategy for gastric cancer patients.     

Evidence-Based Training for Clinical Supervisors: A Systematic Review of 11 Controlled Studies

Clinical supervision training is now considered essential, but has not been given serious attention. Therefore, in this study a systematic review of the research literature on clinical supervision training is undertaken. Eleven controlled studies were located and assessed to identify evidence-based practices in supervisor training. Addressing the two questions posed by Whitman, Ryan, and Rubinstein (2001), we found that these 11 studies provided empirical support for supervisor training (i.e., 15 specific elements of training had empirical support: primarily corrective feedback, educational role-play, and observational learning). Recommendations are outlined, based on these 11 studies, combined with narrative reviews, surveys, and expert consensus.     

Involuntary Civil Commitment for Substance Use Disorders in Puerto Rico: Neglected Rights Violations and Implications for Legal Reform

Laws facilitating the involuntary civil commitment (ICC) of people with substance use disorders vary considerably internationally and across the United States. Puerto Rico, a colonial territory of the United States since 1898, currently harbors the most punitive ICC legislation in the country. It is the only place in the United States where self-sufficient adults who pose no grave danger to themselves or others can be involuntarily committed to restrictive residential facilities for over a year at a time without ever being assessed by a health care professional. The involuntary commitment of otherwise-able citizens—many of whom have never been diagnosed with a substance use disorder—continues to be ignored nationally and internationally. In this paper, we specify how Puerto Rican ICC law and procedures systematically violate rights and liberties that are supposed to be guaranteed by Puerto Rico’s Mental Health Act, the US Federal Supreme Court, and the Universal Declaration of Human Rights. To ensure that Puerto Rico’s ICC procedures conform to prevailing local, national, and international standards, we propose a series of legislative reforms. Finally, we highlight the importance of addressing the preponderance of poorly constructed ICC laws both within the United States and internationally.

Involuntary civil commitment (ICC) for substance use disorder is a legal provision used in many countries to forcibly remand individuals who use alcohol or psychoactive substances into some form of treatment. Ostensibly, ICC laws are designed to protect those at risk of substance-related harm by facilitating their temporary commitment into care, with those who support the procedure usually considering it a lifesaving measure that empowers families to protect their loved ones before they overdose or otherwise harm themselves or others.¹ But in practice, many local and national health care systems lack sufficient services for effectively treating the substance use disorders of citizens who voluntarily seek care.² As a result, citizens subject to ICC are often channeled into prisons or jails instead, or into various paraprofessional services such as self-help groups run by nonprofit organizations that lack the necessary resources and expertise to employ effective, evidence-based treatments.³ Unsurprisingly, reviews of ICC conclude that there is no evidence ICC reduces substance-related harm.⁴ Quite the contrary, studies of ICC suggest that it damages family relationships, inflicts trauma on patients, and even places patients at greater risk of overdose death relative to voluntary treatment.⁵ A systematic review of compulsory treatment evaluations did not detect significant positive effects on drug use or criminal recidivism, whereas negative impacts on criminal recidivism was reported in two studies.⁶ Beyond these failures of clinical efficacy, studies of drug treatment in Latin America and the Caribbean have linked ICC to human trafficking, kidnapping, torture, and forced labor. ⁷Given all this, it is especially damning that four decades of professional handwringing and alarm-sounding on the part of professionals charged with implementing ICC have had so little impact on policy making.⁸ In the United States, several states that currently lack ICC statutes for psychoactive substances and alcohol are now considering introducing them, with ICC actually gaining popularity nationally since the onset of the US opioid epidemic.⁹ Currently, 37 US states, the District of Columbia, and Puerto Rico each have statutes in place that allow for the ICC of people diagnosed with substance or alcohol use disorder, alone or in combination with mental health disorders. The maximum duration of ICC varies significantly between US jurisdictions, from 48 hours in New York State to 180 days in North Carolina to open-ended commitment in Puerto Rico. In 17 states, the maximum time a candidate for ICC may be held in custody for evaluation is 72 hours.¹⁰ As ICC gains broader attention, it is important to assess the unintended consequences of emerging variation in ICC laws, including laxity in procedural guarantees and existing gaps in the availability of evidence-based effective treatment modalities to provide appropriate patient-centered care.In this paper, we stress the importance of documenting how ICC law and procedure is undermining human rights and civil liberties that are supposed to be guaranteed by prevailing local, national, and international laws. Much recent ICC research in the United States has focused on Massachusetts.¹¹ Our account, in contrast, is based in Puerto Rico, a colonial territory of the United States since 1898, and a place where ICC has never been studied academically. In fact, except for two brief mentions in reports by treatment activists and a short lay summary published online (and pro bono) by a Puerto Rican law school, no studies of ICC for substance use disorder in Puerto Rico have been published in either English or Spanish.¹²There is no centralized surveillance system for counting ICC in Puerto Rico, which is adjudicated by 15 distinct municipal courts across the island. That said, some sporadic (if not necessarily reliable) figures can be obtained from individual municipal courts. According to hand-written logs we accessed, three municipal courts out of a total of fifteen that currently oversee ICC cases collectively processed 721 ICC cases via Law 67 between 2014 and 2017. The remaining 12 courts either did not keep records or declined to share their records with us on the day we visited. The only other source of government information on ICC prevalence in Puerto Rico comes from the Puerto Rican Administration of Mental Health and Addiction Services (ASSMCA). As part of its annual provider survey, distributed to all licensed drug treatment centers, ASSMCA is supposed to receive a basic count from its drug treatment providers regarding the number of people admitted to each facility via ICC (via either Law 67 or the Mental Health Act). Unfortunately, due to widespread problems of underreporting, ASSMCA representatives consulted over the course of this research reported that these figures were unavailable. Consequently, basic questions regarding ICC’s overall prevalence and its distribution across institutional settings and treatment modalities— including the number of people who are being held in restrictive residential facilities—is unknown.As we show in this paper, Puerto Rico has some of the most draconian ICC legislation in the United States, legislation that is arguably unconstitutional. Under Puerto Rico’s current legal framework for ICC, citizens who pose no imminent threat of harm to themselves or others, who are otherwise able to meet their basic needs, and who have never been diagnosed with a substance use disorder may be committed to restrictive residential facilities for over a year at a time without receiving legal representation and without ever seeing a health care professional. The data shared here will help practitioners, researchers, and policy makers in the United States and elsewhere evaluate existing ICC regulations and the extent to which they safeguard patients’ rights and assess patients’ treatment outcomes, thereby informing future policymaking.Our findings derive from two long-term fieldwork projects examining rights-based issues in Puerto Rican drug treatment, and from the subsequent dialogue undertaken by the three of us—Caroline Parker (a British anthropologist), Oscar Miranda-Miller (a Puerto Rican legal scholar), and Carmen Albizu-García (a Puerto Rican physician and health services researcher).¹³Parker’s 18 months of ethnographic research (2016–2017) explored the nature and content of residential drug treatment and included 255 days of participant observation in 15 residential drug treatment centers; 20 days of participant observation conducted in ICC hearings across five municipal courts; and interviews with residents, their families, paraprofessional counselors, and policy makers. The full findings and methodology of Parker’s study are published elsewhere.¹⁴ The present analysis is restricted to the 31 interviews conducted with men living in six different residential drug treatment centers who reported a history of ICC, and to participant observation conducted at participants’ ICC hearings. Albizu-García and Miranda-Miller’s study examined the experiences of persons who had been relocated from Puerto Rico to the US mainland with the understanding that they would receive drug treatment for opioid use disorder. The aim of this larger study was to assess whether these relocation practices might meet the legal definition of human trafficking. The full findings and methodology are published elsewhere.¹⁵ The present analysis draws primarily on the legal component of this research and on the experiences of male participants who reported being subject to ICC.In the summer of 2019, the three of us began convening digitally to exchange findings and analyses, with the goal of collating and comparing the experiences of participants subject to ICC. Parker compiled and analyzed qualitative findings relating to ICC from both studies (interviews and field-notes). Here, we sum up what we have collectively learned about ICC in Puerto Rico through our sustained, iterative dialogue.     

A Systematic Review of the Epidemiology of Nonfatal Strangulation,a Human Rights and Health Concern

We reviewed the literature on the epidemiology of nonfatal strangulation (also, albeit incorrectly, called choking) by an intimate partner.We searched 6 electronic databases to identify cross-sectional, primary research studies from 1960 to 2014 that reported national prevalence estimates of nonfatal strangulation by an intimate partner among community-residing adults. Of 7260 identified references, 23 articles based on 11 self-reported surveys in 9 countries met the inclusion criteria. The percentage of women who reported ever having been strangled by an intimate partner ranged from 3.0% to 9.7%; past-year prevalence ranged from 0.4% to 2.4%, with 1.0% being typical.Although many epidemiological surveys inquire about strangulation, evidence regarding its prevalence is scarce. Modifying or adding a question to ongoing national surveys, particularly the Demographic and Health Surveys, would remedy the lack of data for low- and middle-income countries. In addition, when questions about strangulation are asked, findings should be reported rather than only combined with other questions to form broader categories (e.g., severe violence). Such action is merited because of the multiple negative short- and long-term sequelae of strangulation.Intimate partners hurt one another in many ways. Few specific acts of nonfatal abuse, however, are associated with as wide of a range of health problems or are as difficult to detect as strangulation.Strangulation is defined by reduced blood flow to or from the brain via the external compression of blood vessels in the neck. Manual strangulation (i.e., gripping the throat with one’s hands) appears to be the most common method of strangulation in intimate partner violence (IPV), although ligatures (e.g., belts, scarves) are sometimes used. The application of 4 pounds of pressure is required to occlude jugular veins, and 5 to 11 pounds (roughly the pressure required to can vegetables or the recommended pressure for very light polishing of a motor vehicle) are required to occlude carotid arteries.1 Consciousness is lost in 10 to 15 seconds, and death can occur within 3 to 5 minutes.1Being strangled is extremely painful,2 and not being able to breathe is frightening even in controlled laboratory experiments.3 In addition to the psychological implications of such intimidation, a uniquely wide range of neurological and physical outcomes are associated with strangulation. Nonfatal intentional strangulation causes immediate symptoms (e.g., loss of consciousness, which recedes quickly; loss of sphincter control; a raspy voice, which sometimes becomes chronic), symptoms that appear a few hours later (e.g., petechiae on the face and eyes), symptoms that appear a few days afterward (e.g., ear bleeding; bruises, the immediate lack of which decreases acknowledgment of the injury event by police and others), and sometimes mental and physical health problems (e.g., stroke) that are manifested months later. In addition, strangulation with a loss of consciousness can result in mild brain injury. Multiple strangulations are reported among one third to as many as three fourths of women in domestic violence emergency shelters.4,5Strangulation is a relatively common cause of homicide death, particularly for women. We compiled data available through the World Health Organization6 to document the risk of homicide by asphyxiation among women around the globe and to illustrate gender differences in the risk of homicide by asphyxiation. As shown in Figure 1, rates vary widely, and many countries, particularly low-income countries, report no cases or have no data. Figure 2 documents that asphyxiation accounts for a higher percentage of homicides of women than of men. These mortality data are, as will be seen, paralleled by self-reported data. Moreover, as was found in a recent systematic review of intimate partner homicide in 66 countries, 6 times as many homicides of women (vs men) are by an intimate partner.7 Unfortunately, most mortality data, regardless of country, do not routinely include both means of death and the victim–suspect relationship.Open in a separate windowFIGURE 1—Homicide by asphyxiation, per 100 000 women aged ≥15 years old.Note. Rates shown are the average of up to five of the most recent years of data available for each country. Data were obtained from the World Health Organization’s Detailed Mortality Database. Mortality, ICD 10. Available at: http://www.who.int/healthinfo/statistics/mortality_rawdata/en/index.html. Accessed February 14, 2013.Open in a separate windowFIGURE 2—Percentage of homicides by asphyxiation among those aged ≥15 years old by (a) women and (b) men: Systematic Review of the Epidemiology of Nonfatal Strangulation, 1960–2014.Note. Rates shown are the average of up to five of the most recent years of data available for each country. Data were obtained from the World Health Organization’s Detailed Mortality Database. Mortality, ICD 10. Available at: http://www.who.int/healthinfo/statistics/mortality_rawdata/en/index.html. Accessed February 14, 2013.The unique nature of and the wide-ranging health outcomes following strangulation are broadly acknowledged. Such acknowledgment has extended to policy in some locales. For example, as of May 2012, approximately 30 US states had enacted separate statutes regarding strangulation.8 The federal government’s funding of the recently established National Strangulation Training Institute9 is further evidence of the growing acknowledgment of the importance of strangulation in IPV.We conducted the present systematic review to estimate the scope of nonfatal strangulation in intimate relationships, to describe key findings, and to offer suggestions for future research.     

Identifying Profiles of Support for Legal Abortion Services in Zambia: A Latent Class Analysis

Relative to neighboring countries, Zambia has among the most progressive abortion policies, but numerous sociopolitical constraints inhibit knowledge of pregnancy termination rights and access to safe abortion services. Multistage cluster sampling was used to randomly select 1,486 women aged 15–44 years from households in three provinces. We used latent class analysis (LCA) to partition women into discrete groups based on patterns of endorsed support for legalized abortion on six socioeconomic and health conditions. Predictors of probabilistic membership in latent profiles of support for legal abortion services were identified through mixture modeling. A three-class solution of support patterns for legal abortion services emerged from LCA: (1) legal abortion opponents (∼58 percent) opposed legal abortion across scenarios; (2) legal abortion advocates (∼23 percent) universally endorsed legal protections for abortion care; and (3) conditional supporters of legal abortion (∼19 percent) only supported legal abortion in circumstances where the pregnancy threatened the fetus or mother. Advocates and Conditional supporters reported higher exposure to family planning messages compared to opponents. Relative to opponents, advocates were more educated, and Conditional supporters were wealthier. Findings reveal that attitudes towards abortion in Zambia are not monolithic, but women with access to financial/social assets exhibited more receptive attitudes towards legal abortion.     

对医院产权制度改革的思考

通过诠释科斯定理的3种表述方式并引用部分国际经验，说明国有医院产权制度改革的关键是产权清晰和减少交易成本，产权改革并不必然导致私有化。而国有医院因为多级委托-代理，使责任不能具体落实。导致产权不清晰。建议通过市场微观调控和政府宏观调控两方面来进行产权改革。政府应该根据区域卫生规划来确定医疗机构设置规划和布局，搞好医院分类管理改革，并逐步完善相应的配套政策与法规。     

An Annotated Checklist of the Human and Animal Entamoeba (Amoebida: Endamoebidae) Species- A Review Article

Background:

The number of valid of pathogen and non-pathogen species of Entamoeba has continuously increased in human and animals. This review is performed to provide an update list and some summarized information on Entamoeba species, which were identified up to the 2014.

Methods:

We evaluated the Entamoeba genus with a broad systematic review of the literature, books and electronic databases until February 2014. The synonyms, hosts, pathogenicity and geographical distribution of valid species were considered and recorded. Repeated and unrelated cases were excluded.

Results:

Totally 51 defined species of Entamoeba were found and arranged by the number of nuclei in mature cyst according to Levin’s grouping. Seven of these species within the 4 nucleate mature cysts group and 1 species with one nucleate mature cyst are pathogen. E. histolytica, E. invadence, E. rananrum and E. anatis causes lethal infection in human, reptiles, amphibians and brides respectively, four species causes non-lethal mild dysentery. The other species were non-pathogen and are important to differential diagnosis of amoebiasis.

Conclusion:

There are some unknown true species of Entamoeba that available information on the morphology, hosts, pathogenicity and distribution of them are still very limited and more considerable investigation will be needed in order to clarify the status of them.     

人巨细胞病毒感染与自然流产关系的研究

目的 探讨人巨细胞病毒(HCMV)感染与自然流产之间的关系。方法 应用酶联免疫吸附试验(ELISA)及聚合酶链试验(PCR)检测39例自然流产患者(流产组)血清中HCMV-IgM及外周血、胎儿组织中HCMV-DNA,并选择23例人工流产孕妇做对照组。结果 流产组患者血清中HCMV-IgM、外周血、胎儿组织HCMV-DNA阳性率分别为38.46%、43.58%、33.33%.对照组分别是8.69%、8.69%、4.31%.两者比较差别有显着性意义(P<0.05).结论 HCMV感染是引起自然流产的重要原因之一。     

Effectiveness of Contact Tracing for Viral Disease Mitigation and Suppression: Evidence-Based Review

BackgroundContact tracing in association with quarantine and isolation is an important public health tool to control outbreaks of infectious diseases. This strategy has been widely implemented during the current COVID-19 pandemic. The effectiveness of this nonpharmaceutical intervention is largely dependent on social interactions within the population and its combination with other interventions. Given the high transmissibility of SARS-CoV-2, short serial intervals, and asymptomatic transmission patterns, the effectiveness of contact tracing for this novel viral agent is largely unknown.ObjectiveThis study aims to identify and synthesize evidence regarding the effectiveness of contact tracing on infectious viral disease outcomes based on prior scientific literature.MethodsAn evidence-based review was conducted to identify studies from the PubMed database, including preprint medRxiv server content, related to the effectiveness of contact tracing in viral outbreaks. The search dates were from database inception to July 24, 2020. Outcomes of interest included measures of incidence, transmission, hospitalization, and mortality.ResultsOut of 159 unique records retrieved, 45 (28.3%) records were reviewed at the full-text level, and 24 (15.1%) records met all inclusion criteria. The studies included utilized mathematical modeling (n=14), observational (n=8), and systematic review (n=2) approaches. Only 2 studies considered digital contact tracing. Contact tracing was mostly evaluated in combination with other nonpharmaceutical interventions and/or pharmaceutical interventions. Although some degree of effectiveness in decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality was observed, these results were highly dependent on epidemic severity (R0 value), number of contacts traced (including presymptomatic and asymptomatic cases), timeliness, duration, and compliance with combined interventions (eg, isolation, quarantine, and treatment). Contact tracing effectiveness was particularly limited by logistical challenges associated with increased outbreak size and speed of infection spread.ConclusionsTimely deployment of contact tracing strategically layered with other nonpharmaceutical interventions could be an effective public health tool for mitigating and suppressing infectious outbreaks by decreasing viral disease incidence, transmission, and resulting hospitalizations and mortality.     

复发性流产血栓前状态病因学及治疗研究进展

复发性流产（RSA）的病因非常复杂,血栓前状态与RSA的关系成为近年来国内外的研究热点。越来越多的研究指明：凝血因子Ⅴ突变、凝血酶原基因多态性、亚甲基四氢叶酸还原酶（MTFHR）基因突变、蛋白C缺陷、蛋白S缺陷、纤维蛋白原基因变异、抗磷脂抗体（APL）阳性、血管紧张素转换酶基因插入和缺失、血浆纤溶酶原激活物抑制剂1（PAI-1）基因多态性均可能是RSA的病因。目前尚无足够证据表明有血栓前状态的RSA患者常规应用低分子肝素可以改善其妊娠结局,但国内外医学工作者们仍积极探索RSA血栓前状态的治疗方法,并总结辅助生殖技术中血栓前状态的治疗经验,提出治疗建议。     

Direct and Indirect Abortion in the Roman Catholic Tradition: A Review of the Phoenix Case

In Roman Catholic Moral Theology, a direct abortion is never permitted. An indirect abortion, in which a life threatening pathology is treated, and the treatment inadvertently leads to the death of the fetus, may be permissible in proportionately grave situations. In situations in which a mother’s life is endangered by the pregnancy before the fetus is viable, there is some debate about whether the termination of the pregnancy is a direct or indirect abortion. In this essay a recent case from a Roman Catholic sponsored hospital in Phoenix is reviewed along with the justifications for and arguments against viewing the pregnancy termination as an indirect abortion. After review of several arguments on both sides of the debate, it is concluded that termination of the pregnancy itself as the means of saving the mother cannot be considered an indirect abortion and that the principle of “double effect” does not justify the termination. In addition, the importance of a breakdown in communication between the local bishop and the administration of the hospital is shown to have contributed to the ultimate loss of Catholic sponsorship of the hospital.     

Singaporean Women's Knowledge of Human Papillomavirus (HPV) and Attitudes Toward HPV Vaccination

With a vaccination program currently planned to protect Singaporean women from human papillomavirus, a need arises for assessing Singaporean women's knowledge of human papillomavirus and attitudes toward human papillomavirus vaccination to identify barriers to a successful program and to help inform health education campaigns. A representative sample of 2,145 women aged between 18 and 49 years were randomly selected from households throughout Singapore and interviewed with a similar questionnaire to that used in a recent study of Australian women. Although Singaporean women's knowledge of human papillomavirus was poor, with only 20% having heard of it, attitudes toward human papillomavirus vaccination were generally positive. The most trusted sources of information about human papillomavirus and vaccination were gynecologists and general practitioners. Based on our findings, an urgent need exists in Singapore for accurate and accessible information about human papillomavirus and the benefits of vaccination.     

Acceptability of Human Papillomavirus Vaccine for Males: A Review of the Literature

The quadrivalent human papillomavirus virus vaccine was recently licensed for use in males in the United States. This study reviews available published literature on acceptability among parents, health care providers, and young males. Among 23 published articles, half were conducted in the United States. The majority (87%) used quantitative survey methodology, and 13% used more explorative qualitative techniques. Convenience samples were used in most cases (74%) and 26% relied on nationally representative samples. Acceptability of a human papillomavirus virus (HPV) vaccine that protects against cervical cancer and genital warts was high in studies conducted among male college students (74%–78%) but lower in a community sample of males (33%). Among mothers of sons, support of HPV vaccination varied widely from 12% to 100%, depending on the mother's ethnicity and type of vaccine, but was generally high for a vaccine that would protect against both genital warts and cervical cancer. Health providers' intention to recommend HPV vaccine to male patients varied by patient age but was high (82%–92%) for older adolescent patients. A preference to vaccinate females over males was reported in a majority of studies among parents and health care providers. Messages about cervical cancer prevention for female partners did not resonate among adult males or parents. Future acceptability studies might incorporate more recent data on HPV-related disease, HPV vaccines, and cost-effectiveness data to provide more current information on vaccine acceptability.     

Heroin-assisted Treatment (HAT) a Decade Later: A Brief Update on Science and Politics

Since the initial Swiss heroin-assisted treatment (HAT) study conducted in the mid-1990s, several other jurisdictions in Europe and North America have implemented HAT trials. All of these studies embrace the same goal-investigating the utility of medical heroin prescribing for problematic opioid users-yet are distinct in various key details. This paper briefly reviews (initiated or completed) studies and their main parameters, including primary research objectives, design, target populations, outcome measures, current status and-where available-key results. We conclude this overview with some final observations on a decade of intensive HAT research in the jurisdictions examined, including the suggestion that there is a mounting onus on the realm of politics to translate the-largely positive-data from completed HAT science into corresponding policy and programming in order to expand effective treatment options for the high-risk population of illicit opioid users.     

Social Jetlag and Related Risks for Human Health: A Timely Review

The term social jetlag is used to describe the discrepancy between biological time, determined by our internal body clock, and social times, mainly dictated by social obligations such as school or work. In industrialized countries, two-thirds of the studying/working population experiences social jetlag, often for several years. Described for the first time in 2006, a considerable effort has been put into understanding the effects of social jetlag on human physiopathology, yet our understanding of this phenomenon is still very limited. Due to its high prevalence, social jetlag is becoming a primary concern for public health. This review summarizes current knowledge regarding social jetlag, social jetlag associated behavior (e.g., unhealthy eating patterns) and related risks for human health.