scholarly journals Safer by design: Building a collaborative, integrated and evidence-based framework to inform the regulation and mitigation of gambling product risk

2021 ◽  
pp. 158-201
Author(s):  
Paul Delfabbro ◽  
Jonathan Parke ◽  
Simo Dragecvic ◽  
Chris Percy ◽  
Richard Bayliss

Evidence suggests that harms may result from gambling participation as a result of a complex interaction between individual differences among consumers, environmental factors, and the characteristics of the gambling product. The latter of these factors, broadly referred to in this paper as product risk, has received increased policy attention in recent years. Product-focussed approaches to harm reduction, however, are under-developed relative to other forms of player protection and likely reflects the limitations of existing evidence and relative complexity of the topic. In this position paper, we define and explain the concept of product risk and consider what is currently known regarding the link between gambling products and harm. The paper describes the present barriers to develop effective product risk regulation and harm mitigation strategies. These include the competing interests of stakeholders, limited collaboration and information sharing, clear roles, responsibilities and leadership and a lack of integrated evidence-informed approaches. In response to these challenges, we propose adopting a framework comprised of a series of principles to progress this contested area of policy. The framework encourages better collaboration and communication between stakeholders; the accelerated production of valid and reliable evidence; a strategic alignment of stakeholder activity; and, more effective and efficient approaches to assessing and mitigating product risk.

2019 ◽  
Vol 6 (6) ◽  
pp. 384-393 ◽  
Author(s):  
Renata Cífková ◽  
Mark R Johnson ◽  
Thomas Kahan ◽  
Jana Brguljan ◽  
Bryan Williams ◽  
...  

Abstract Hypertensive disorders are the most common medical complications in the peripartum period associated with a substantial increase in morbidity and mortality. Hypertension in the peripartum period may be due to the continuation of pre-existing or gestational hypertension, de novo development of pre-eclampsia or it may be also induced by some drugs used for analgesia or suppression of postpartum haemorrhage. Women with severe hypertension and hypertensive emergencies are at high risk of life-threatening complications, therefore, despite the lack of evidence-based data, based on expert opinion, antihypertensive treatment is recommended. Labetalol intravenously and methyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available. Induction of labour is associated with improved maternal outcome and should be advised for women with gestational hypertension or mild pre-eclampsia at 37 weeks’ gestation. This position paper provides the first interdisciplinary approach to the management of hypertension in the peripartum period based on the best available evidence and expert consensus.


2018 ◽  
Vol 88 (2) ◽  
Author(s):  
Marinella Sommaruga ◽  
Elisabetta Angelino ◽  
Paola Della Porta ◽  
Mara Abatello ◽  
Giacomo Baiardo ◽  
...  

Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. The steps followed were: i) a review of the latest international guidelines and position papers; ii) analysis of the evidence-based literature; iii) a qualitative analysis of the psychological services operating in some reference Italian cardiac rehabilitation facilities; iv) classification of the psychological activities in CPR as low or high intensity based on the NICE Guidelines on psychological interventions on anxiety and depression. We confirm the existence of an association between depression, anxiety, social factors, stress, personality and illness onset/outcome and coronary heart disease. Evidence for an association between depression, social factors and disease outcome emerges particularly for chronic heart failure. Some positive psychological variables (e.g., optimism) are associated to illness outcome. Evidence is reported on the impact of psychological activities on ‘new’ conditions which are now indicated for cardiac rehabilitation: pulmonary hypertension, grown-up congenital heart, end-stage heart failure, implantable cardioverter-defribrillator and mechanical ventricular assist devices, frail and oldest-old patients, and end-of-life care. We also report evidence related to caregivers. The Panel divided evidence-based psychological interventions into: i) low intensity (counseling, psycho-education, self-care, self-management, telemedicine, self-help); or ii) high intensity (individual, couples and/or family and group psychotherapy, such as stress management). The results show that psychotherapy is mainly consisting of cognitive-behavior therapy, interpersonal therapy, and short-term psycho-dynamic therapy. The current data further refine the working tools available for psychological activities in CPR, giving clear directions about the choice of interventions, which should be evidence-based and have at least a minimum standard. This document provides a comprehensive update on new knowledge and new paths for psychologists working in the CPR settings.


2021 ◽  
Vol 0 (0) ◽  
pp. 1-57
Author(s):  
C. Hopkins ◽  
P. Surda ◽  
A. Walker ◽  
A. Wolf ◽  
M.M. Speth ◽  
...  

EPOS2020 is the 4th and most recent version of the European Position Paper on Rhinosinusitis and Nasal Polyps which was first published in 2005. It aims to provide the most up to date scientifically robust information on the topic published in the literature which has been critically analysed by an international group of clinicians drawn from all disciplines dealing with these problems together with patients. The guidelines offer evidence-based recommendations and care pathways for acute and chronic rhinosinusitis in both adults and children. Management of these diseases from the patients' perspective is an important part of EPOS2020. Not only is this included in the main document but, for the first time, we have produced a separate supplement dedicated to and in collaboration with patients, EPOS4Patients, which aims to provide information in an accessible format, to answer frequently asked questions about these diseases and their treatment options as well as including useful patient resources and websites. It has never been more important for patients to be actively involved in their care. Being well informed helps you to make the best decisions together with your doctor.


Author(s):  
Chanu Rhee ◽  
Kathleen Chiotos ◽  
Sara E Cosgrove ◽  
Emily L Heil ◽  
Sameer S Kadri ◽  
...  

Abstract The Centers for Medicare & Medicaid Services’ Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) measure has appropriately established sepsis as a national priority. However, the Infectious Diseases Society of America (IDSA and five additional endorsing societies) is concerned about SEP-1’s potential to drive antibiotic overuse because it does not account for the high rate of sepsis overdiagnosis and encourages aggressive antibiotics for all patients with possible sepsis, regardless of the certainty of diagnosis or severity of illness. IDSA is also concerned that SEP-1’s complex “time zero” definition is not evidence-based and is prone to inter-observer variation. In this position paper, IDSA outlines several recommendations aimed at reducing the risk of unintended consequences of SEP-1 while maintaining focus on its evidence-based elements. IDSA’s core recommendation is to limit SEP-1 to septic shock, for which the evidence supporting the benefit of immediate antibiotics is greatest. Prompt empiric antibiotics are often appropriate for suspected sepsis without shock, but IDSA believes there is too much heterogeneity and difficulty defining this population, uncertainty about the presence of infection, and insufficient data on the necessity of immediate antibiotics to support a mandatory treatment standard for all patients in this category. IDSA believes guidance on managing possible sepsis without shock is more appropriate for guidelines that can delineate the strengths and limitations of supporting evidence and allow clinicians discretion in applying specific recommendations to individual patients. Removing sepsis without shock from SEP-1 will mitigate the risk of unnecessary antibiotic prescribing for noninfectious syndromes, simplify data abstraction, increase measure reliability, and focus attention on the population most likely to benefit from immediate empiric broad-spectrum antibiotics.


Author(s):  
Marvin J. Dainoff

A core value of HFES has been the translation of scientific knowledge into information that can be used to improve the design and effectiveness of the systems and equipment used by people. The extent to which HFE knowledge has, in fact, had an impact on the world needs to be systematically and analytically explored. This is necessary for the continued growth of the HFE field. This forum will explore this issue. Three key questions are: (a) In the process of translation from research to practice, to what extent is practice evidence-based? (b) Should the HFE field be constrained in the service of quality control or purely entrepreneurial in style? (c) Can we reframe the benefits of our contributions to conform more closely with the key goals and objectives of customer organizations?


2017 ◽  
Vol 27 (4) ◽  
pp. 418-421 ◽  
Author(s):  
Gil Zalsman ◽  
Keith Hawton ◽  
Danuta Wasserman ◽  
Kees van Heeringen ◽  
Ella Arensman ◽  
...  

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