Parental substance use is a major risk factor for child development, heightening the risk of drug problems in adolescence and young adulthood, and exposing offspring to several types of traumatic event. First, prenatal drug exposure can be considered a form of trauma itself, with subtle but long-lasting sequalae at the neuro-behavioural level. Second, parents’ addiction often entails a childrearing environment characterised by poor parenting skills, disadvantaged contexts and adverse childhood experiences, leading to dysfunctional outcomes. Young adults born from/raised by (...) parents with drug problems and who develop a Substance Used Disorder (SUD) themselves might display a particularly severe condition in terms of cognitive deficits and impaired personality function. This preliminary study aims to investigate the role of early exposure to drugs as a traumatic event, capable of affecting the psychological status of young drug addicts. In particular, it intends to examine the neuropsychological functioning and personality profile of young adults with severe SUDs who were exposed to drugs early in their family context. The research involved 3 groups each consisting of 15 young adults (aged 18-24): a group of inpatients diagnosed with SUDs and exposed to drugs early, a comparison group of non-exposed inpatients and a group of non-exposed youth without SUDs. A neuropsychological battery (Esame Neuropsicologico Breve-2), an assessment procedure for personality disorders (Shedler-Westen Assessment Procedure-200) and the Symptom CheckList-90-Revised were administered. According to present preliminary results, young drug addicts exposed to drugs during their developmental age were characterised by elevated rates of neuropsychological impairments, especially at the expense of attentive and executive functions; personality disorders were also common but did not differentiate them from non-exposed young people with SUDs. Alternative multi-focused prevention and intervention programs are needed for children of drug-misusing parents, addressing executive functions and adopting a trauma-focused approach. (shrink)

Antiretroviral pre-exposure prophylaxis (PrEP) is protective against HIV. Low utilization rates amongst HIV vulnerable populations are due in part to the high cost of PrEP. Generic PrEP offers the potential to improve health at significantly reduced costs. In this study, we examine early utilization patterns and prices for generic PrEP. We discuss the opportunities and challenges for generic PrEP to improve health among HIV vulnerable populations.

Nanomedicine is a rapidly growing field in the academic as well as commercial arena. While some had predicted nanomedicine sales to reach $20.1 billion in 2011, the actual growth was much more rapid, with the global nanomedicine market being valued at $53 billion in 2009, and forecast to increase at an annual growth rate of 13.5% to reach more than $100 billion in 2014. In 2006, more than 130 nanotechnology-based drugs and delivery systems had entered preclinical, clinical, or commercial (...) development. The European Medicines Agency reviewed 18 marketing authorization applications for nanomedicines in 2010. In 2011, 22 drugs that had been approved by the FDA, and 87 Phase I and Phase II clinical trials were listed in the U.S. National Institutes of Health data base, www.clinicaltrials.gov. Although the fastest growing areas of nanomedicine are applications in medical imaging and diagnosis using contrast-enhancing agents, most nanomedicine research and commercialization is in the area of cancer drug therapy, including nano gold shells. (shrink)

People who inject drugs are often the target of stigma that puts this already at-risk group at greater risk of harm. Past research has shown that holding stigmatizing views of people who inject drugs increases risky behaviors and is a barrier to their engagement in important medical and public health interventions. One explanation is that the negativity surrounding the group causes increased levels of anticipated emotional exhaustion, discouraging positive engagement. However, there has been minimal research focused on addressing (...) this negativity to reduce levels of held stigma against people who inject drugs. We hypothesized that giving people an imagined positive contact exercise about people who inject would lead to a reduction in stigma, since exposure to positive empathy may create new mental associations between stigmatized groups and more positive emotions and experiences. Secondarily, we hypothesized that positive empathy strategies would be more effective than traditional informational or learning based techniques, and that the latter would be more effective than a control condition. Our sample consisted of 375 participants recruited online. Participants were assigned to one of three study conditions: a positive empathy condition, an informational learning condition, or a control condition, and completed a posttest social distance measure. Results demonstrated that subjects exposed to the positive empathy stigma reduction condition experienced a significant reduction in held stigma while participants exposed to traditional informational learning techniques showed no significant reduction in held stigma. Positive empathy-based stigma interventions should be further researched as a promising avenue to reduce the effects of drug-related stigma. (shrink)

Post-exposure prophylaxis in the form of combination drug therapy is now recommended for healthcare workers following occupational HIV exposure. The expansion of this form of preventive medicine to include other types of HIV transmission, notably through sexual activity, raises a number of ethical concerns.

Children who experience well-being are engaging more confidently and positively with their caregiver and peers, which helps them to profit more from available learning opportunities and support current and later life outcomes. The goodness-of-fit theory suggests that children’s well-being might be a result of the interplay between their temperament and the environment. However, there is a lack of studies that examined the association between children’s temperament and well-being in early childhood education and care, and whether this association is affected by (...) ECEC process quality. Using a multilevel random coefficient approach, this study examines the association between toddlers’ temperament and well-being in Norwegian ECEC and investigates whether process quality moderates this association. Results reveal an association between temperament and well-being. Staff-child conflict moderates the association between shyness and well-being, and between activity and well-being. Moreover, high emotional behavioral support moderates the association between activity and well-being. Extra attention should be paid by the staff to these children’s needs. (shrink)

Despite extinction-based processes demonstrating efficacy in the animal extinction and human anxiety literatures, extinction for substance use disorders has shown poor efficacy. Reasons for this lack of success include common threats to extinction, such as renewal and reinstatement. In recent decades, research on mindfulness for SUD has flourished, and a key aspect of these mindfulness-based interventions includes teaching individuals to stay present with whatever experience they have, even if unpleasant, without trying to change/escape/avoid it. Similarly, CET teaches individuals to not (...) escape/avoid conditioned responses by engaging in drug use behavior. This paper discusses how mindfulness-based research and practices could positively influence CET through future research, with the long-term goal of improving SUD treatment. (shrink)

Considering the abysmal track record of orthodox drug rehabilitation programs, whereby a ten percent abstinence rate after one year of treatment is regarded as successful, a responsible introduction to viable alternative methodologies brings hope and promise along with new insight and information. Medical anthropologist H. K. Heggenhougen reviews the growing body of literature that describes and assesses traditional interventions rooted in other cultures , as well as therapies advanced through alternative achievements like acupuncture, biofeedback, and meditation. Besides exploring their salient (...) features and evaluating their efficacy, Dr. Heggenhougen comments authoritatively on their transferability to conventional American and European addiction programs, and supplies an annotated bibliography for use as an independent resource by theoreticians and practitioners in the fields of detoxification and rehabilitation. Exposure to the cross-cultural perspective, replete with potential for creative adaptation, enriches our understanding as it expands exponentially our repertoire of treatment options. (shrink)

Osteoporosis (OP) is a bone disease which affects a number of post‐menopausal females and puts many at risk for fractures. A large number of patients are taking bisphosphonates (BPs) to treat their OP and a rare complication is the development of atypical femoral fractures (AFF). No real explanations for the mechanisms underlying the basis for development of where AFF develop while on BPs has emerged. The present hypothesis will discuss the possibility that part of the risk for an AFF is (...) a secondary effect of BPs on a subset of vascular cells in a genetically at‐risk population, leading to localized deregulation of the endothelial cell (EC)‐bone cell‐matrix units in nutrient channels/canals of the femur and increased risk for AFF. This concept of targeting ECs is consistent with location of AFF in the femur, the bilateral risk for occurrence of AFF, and the requirement for long term exposure to the drugs. (shrink)

Based on brain imaging findings, we present a model according to which addiction emerges as an imbalance in the information processing and integration among various brain circuits and functions. The dysfunctions reflect (a) decreased sensitivity of reward circuits, (b) enhanced sensitivity of memory circuits to conditioned expectations to drugs and drug cues, stress reactivity, and (c) negative mood, and a weakened control circuit. Although initial experimentation with a drug of abuse is largely a voluntary behavior, continued drug use can (...) eventually impair neuronal circuits in the brain that are involved in free will, turning drug use into an automatic compulsive behavior. The ability of addictive drugs to co‐opt neurotransmitter signals between neurons (including dopamine, glutamate, and GABA) modifies the function of different neuronal circuits, which begin to falter at different stages of an addiction trajectory. Upon exposure to the drug, drug cues or stress this results in unrestrained hyperactivation of the motivation/drive circuit that results in the compulsive drug intake that characterizes addiction. (shrink)

The United States Food and Drug Administration , in collaboration with pharmaceutical manufacturers, have recently implemented a heavily revised risk-management program for patients on isotretinoin , a drug with known and pronounced teratogenic effects. This revised risk management plan places significant burdens on both providers and patients in the hopes of achieving its goal of reducing fetal exposure to isotretinoin. The main focus of this paper is to discuss the burdens of various aspects of the program in relationship to (...) potential corresponding benefits. In particular, we evaluate the pregnancy rates of women on isotretinoin therapy compared with that of the general population and the rate changes based on the risk management programs. Additionally, we investigate whether the benefits of the program for women have increased as the benefits have risen. We devote special attention to the ethical implications of the intent of the program and to an analysis of the ethical justification of the restrictions placed on women of childbearing potential as it compares to the risk-benefit relationship of using isotretinoin. (shrink)

Both ethicists and lawyers accept that a provider – be it a researcher or a clinician – should provide sufficient information for a reasonable person to make an informed decision about whether they wish to go ahead with the proposed intervention or treatment.1 They are bound to do so both because they have an ethical responsibility to preserve the individual’s autonomous decision making, and, in many countries, because the law obliges them to. In this month’s issue of the JME, three (...) articles tackle ethical issues relating to consent in different contexts. Overarching these analyses is the pragmatic question of whether the process of taking consent in itself might alter the outcomes, and whether, in doing so, it can undermine the initial therapeutic or research goal – so creating another ethical question of what to prioritise. Psilocybin is entering Phase III trials to evaluate its effect on treatment resistant depression and cancer related depression and anxiety; earlier trials have shown sustained symptom reduction in these populations. Smith and Sisti examine whether a form of enhanced consent is ethically required for these drugs.2 They explore how to adequately consent for ‘therapeutic touch’ in a future altered state; the rare but significant mental health risks including trauma re-exposure; and the potential for a personality change given the intense experiences which many subjects have reported. They illustrate the potential for personality change with an example regarding the spiritual experiences which can occur with serotonergic psychedelics, and suggest that ‘agnostic or atheist patients may take the development of a newfound sense of spirituality or belief in God to …. (shrink)

There is a strong association between reliance on the promotional activities of pharmaceutical companies and a generally less appropriate use of prescription drugs. Pharmaceutical companies direct some of their promotion towards health workers who do not have the authority to prescribe medicines, such as nurses in certain countries. The aim of this study was to determine the impact that exposure to the marketing methods of pharmaceutical companies has on judgments made by nursing students about health worker—pharmaceutical company relationships. (...) A cross-sectional survey was carried out with 442 nursing students in Istanbul, Turkey. The exposure of students to the marketing methods of pharmaceutical companies, whether it be indirectly through observation or directly by first-hand experience, increases the probability that students will adopt rationales that underlie affirmative judgments of health worker—pharmaceutical company relationships. Based on the pervasiveness and ability of drug promotion to influence the perceptions of students, it is imperative that attempts be made to reduce its negative impact. (shrink)

This study focused on the effects of individual characteristics and exposure to ethics education on perceptions of the linkage between organizational ethical practices and business outcomes. Using a stratified sampling approach, 817 students were randomly selected from a population of approximately 1310 business students in an AACSB accredited college of business. Three hundred and twenty eight of the subjects were freshmen, 380 were seniors, and 109 were working managers and professionals enrolled in a night-time MBA program. Overall, the respondents (...) included 438 male students and 379 female students. Exposure to ethics in the curriculum had a significant impact on student perceptions of what should be the ideal linkages between organizational ethical practices and business outcomes. Gender based differences were found with female students having a higher expectation regarding what should be the “ethics practices and business outcomes” link. Exposure to ethics in the curriculum had a positive moderating influence on the gender-based effects on perceptions of ideal ethical climate. The interaction effect showed that exposure to ethical education may have a positive impact on males and allow them to catch up with females in their ethical sensitivities concerning the ideal linkage between organizational ethical behavior and business outcomes. Further, consistent with the literature, the study found that gender differences in ethical attitudes regarding the ideal ethical climate, while significant for undergraduates, appeared to narrow considerably for the working professionals who were part-time MBA students. (shrink)

Violence is a known risk factor for health problems. In this epidemiological study across 5,385 male patients, we investigate the prevalence of perpetrated violence, exposure to violence, their overlap and the relationship between violence, mental, and psychosomatic health, as well as adverse health behaviors, such as self-harming behavior and the consumption of drugs. Participants completed an anonymous questionnaire addressing violence experience, age of victimization/perpetration, frequency, and perceived severity of violence exposure. We considered physical, psychological as well as (...) sexual violence. Information on health status and adverse health behaviors complemented the data. Results showed that 48.4% of the sample reported having experienced violence. The victim-perpetrator overlap formed the largest group, in which the incidence of having experienced multiple types of violence was significantly higher compared to victims and perpetrators. The age-crime curve flattened more slowly with increasing age in this group. Although the perceived severity of exposure to violence is lower in the overlap group, its health status and adverse health behaviors were worse. Interventions should focus on this group since they constitute a burden for the healthcare system. (shrink)

The relationship between exposure to prosocial media content and prosocial behavior has been extensively explored. However, previous studies mainly explore the effect of prosocial media content exposure by comparing an individual’s exposure to the different types of content, and generally focus on traditional media and video games, with less attention given to the increasingly popular new media platforms. In this study, we explored new dimensions by considering individuals’ exposure to different consequences of the same prosocial behavior (...) in the context of short videos. Drawing upon Social Cognitive Theory and the General Learning Model, this experimental study identified the effect of such exposure on subsequent prosocial behavior among adolescents. We found that compared to the no consequences group, exposure to the reward consequence did not significantly predict moral elevation and subsequent prosocial behavior. Meanwhile, exposure to the punishment consequence had a significantly negative effect on subsequent prosocial behavior via moral elevation. Furthermore, the results revealed that empathy moderated the relationship between moral elevation and prosocial behavior, and moral elevation only positively predicted prosocial behavior among those with low empathy. Theoretically, this study deepens our understanding of the impact of exposure to different consequences of prosocial behavior on adolescents’ subsequent prosocial behavior, and highlights the importance of moral elevation and empathy to understand the underlying mechanism. The study also provides some practical implications for parents and practitioners to nurture prosocial behavior among adolescents. (shrink)

Oxidative damage to DNA has been associated with neurodegenerative diseases. Developmental exposure to lead has been shown to elevate the Alzheimer's disease related beta-amyloid peptide , which is known to generate reactive oxygen species in the aging brain. This study measures the lifetime cerebral 8-hydroxy-2'-deoxyguanosine levels and the activity of the DNA repair enzyme 8-oxoguanine DNA glycosylase in rats developmentally exposed to Pb. Oxo8dG was transiently modulated early in life , but was later elevated 20 months after exposure (...) to Pb had ceased, while Ogg1 activity was not altered. Furthermore, an age-dependent loss in the inverse correlation between Ogg1 activity and oxo8dG accumulation was observed. The effect of Pb on oxo8dG levels did not occur if animals were exposed to Pb in old age. These increases in DNA damage occurred in the absence of any Pb-induced changes in copper/zinc-superoxide dismutase , manganese-SOD , and reduced-form glutathion . These data suggest that oxidative damage and neurodegeneration in the aging brain could be impacted by the developmental disturbances. (shrink)

In our recent article, together with more than 60 of our colleagues, we outlined a proposal for drug policy reform consisting of four specific yet interrelated strategies: (1) de jure decriminalization of all psychoactive substances currently deemed illicit for personal use or possession (so-called “recreational” drugs), accompanied by harm reduction policies and initiatives akin to the Portugal model; (2) expunging criminal convictions for nonviolent offenses pertaining to the use or possession of small quantities of such drugs (and releasing (...) those serving time for these offenses), while delivering retroactive ameliorative relief; (3) the ultimate legalization and careful regulation of currently illicit drugs; and (4) the delivery of a new “Marshall Plan” focused on community-building initiatives, expanded harm reduction programs, and social and health care support efforts (Earp et al. 2021). We were gratified to see so many thoughtful commentaries on our proposal, and we respond to them in part in this reply. (shrink)

We previously showed that the illusory sense of ownership and agency over a moving body in immersive virtual reality can trigger subjective and physiological reactions on the real subject’s body and, therefore, an acute improvement of cognitive functions after a single session of high-intensity intermittent exercise performed exclusively by one’s own virtual body, similar to what happens when we actually do physical activity. As well as confirming previous results, here, we aimed at finding in the elderly an increased improvement after (...) a longer virtual training with similar characteristics. Forty-two healthy older subjects completed a parallel-group randomized controlled trial including an adapted version of the virtual training previously used: while sitting, participants observed the virtual body in a first-person perspective or a third-person perspective performing 20 min of virtual high-intensity intermittent exercise. This was repeated twice a week for 6 weeks. During the vHIE, we measured the heart rate and administered questionnaires to evaluate illusory body ownership and agency. Before the beginning of the intervention, immediately after the first session of vHIE, and at the end of the entire intervention, we evaluated the cognitive performance at the Stroop task with online recording of the hemodynamic activity over the left dorsolateral prefrontal cortex. While we confirm previous results regarding the virtual illusion and its physiological effects, we did not find significant cognitive or neural improvement immediately after the first vHIE session. As a novelty, in the 1PP group only, we detected a significant decrease in the response time of the Stroop task in the post-intervention assessment compared to its baseline; coherently, we found an increased activation on left dorsolateral prefrontal cortex after the entire intervention. While the current results strengthen the impact of the virtual full-body illusion and its physiological consequences on the elderly as well, they might have stronger and more established body representations. Perhaps, a longer and increased exposure to those illusions is necessary to initiate the cascade of events that culminates to an improved cognitive performance. (shrink)

Following Professor Obiora Ike’s view and in particular Obiora 2012, 2013, 2017 (see reference below), the more students are exposed to ethics practice, the greater their propensity and capability to seek for ethical living. This important assumption is worth close statistical scrutiny as the author shows. Through empirical researches and the stratified sampling approach, 435 university students are randomly selected to illustrate this claim. The method used is the “Perceived Role of Ethics and Democracy Outcome Scale” (PREDOS) and a survey (...) questionnaire used to measure exposure to common good ethics among the respondents. Descriptive analysis – tables and analysis and covariance (ANCOVA), are aimed at facilitating the analysis of the data collected in the study. In tandem with the conclusions drawn from extant literature and works of Professor Obiora Ike, the findings, as the author see, show that exposure to common good ethics has a significant positive effect on students’ ethics practice and democracy outcomes. (shrink)

In the current study, we aimed at understanding the effect of exposure to complex input on speech sound development, by conducting a systematic meta-analysis review of the existing treatment-based studies employing complex input in children with speech sound disorders. In the meta-analysis review, using a list of inclusion criteria, we narrowed 280 studies down to 12 studies. Data from these studies were extracted to calculate effect sizes that were plotted as forest plots to determine the efficacy of complexity-based treatment (...) approaches. The outcome variables of interest were improvement on the treated and generalization to the untreated sounds. Meta-analysis revealed that the exposure to complex input not only promoted improvement in production of complex speech sounds but also facilitated the production of untreated simple speech sounds. Overall, the current findings revealed that the exposure to complex input promotes acquisition of both complex and simple speech sounds. The current findings are in line with the models of language learnability. The current findings have implications in the treatment of speech sound disorders. (shrink)

Several lines of evidence show that systematic exposure to negative social acts at the workplace i.e., workplace bullying, results in symptoms of depression and anxiety among those targeted. However, little is known about the association between bullying, inflammatory genes and sleep problems. In the present study, we examined the indirect association between exposure to negative social acts and sleep through distress, as moderated by the miR-146a genotype. The study was based on a nationally representative survey of 1179 Norwegian (...) employees drawn from the Norwegian Central Employee Register by Statistics Norway. Exposure to workplace bullying was measured with the 9-item version of Negative Acts Questionnaire – Revised (NAQ-R) inventory. Seventeen items from Hopkins Symptom Checklist (HSCL-25) was used to measure distress. Insomnia was assessed with three items reflecting problems with sleep onset, maintenance of sleep and early morning awakening. Genotyping with regard to miR-146a rs2910164, previously linked to inflammatory processes, was carried out using Taqman assay. The data revealed that individuals systematically exposed to negative social acts at the workplace reported higher levels of sleep problems than non-exposed individuals. Moreover, the relationship between distress induced by exposure to negative social acts and insomnia was significantly stronger for individuals with the miR-146a GG genotype. Thus, the miR-146a genotype moderated the association between distress and insomnia among individuals exposed to negative social acts. The present report support the hypothesis that inflammation could play a role in stress-induced insomnia among individuals exposed to workplace bullying. (shrink)

An implicit goal of many interventions intended to enhance integrity is to minimize peoples' exposure to unethical events. The intent of the present effort was to examine if exposure to unethical practices in the course of one's work is related to ethical decision making. Accordingly, 248 doctoral students in the biological, health, and social sciences were asked to complete a field appropriate measure of ethical decision making. In addition, they were asked to complete measures examining the perceived acceptability (...) of unethical events and a measure examining perceptions of ethical climate. When these criterion measures were correlated with a measure examining the frequency with which they had been exposed to unethical events in their day-to-day work, it was found that event exposure was strongly related to ethical decision making but less strongly related to climate perceptions and perceptions of event acceptability. However, these relationships were moderated by level of experience. The implications of these findings for practices intended to improve ethics are discussed. (shrink)

One fundamental assumption often made in the literature on unawareness is that risk preferences are invariant to changes of awareness. We study how exposure to unawareness affects choices under risk. Participants in our experiment choose repeatedly between varying sure outcomes and a lottery in three phases. All treatments are exactly identical in phase 1 and phase 3, but differ in phase 2. There are five different treatments pertaining to the lottery faced in phase 2: The control treatment, the treatment (...) with awareness of unawareness of lottery outcomes but known number of outcomes, the treatment with awareness of unawareness of outcomes but with unknown number of outcomes, the treatment with unawareness of unawareness of some outcomes, and the treatment with an ambiguous lottery. We study both whether behavior differs in phase 3 across treatments and whether differences of subjects’ behavior between phases 1 and phase 3 differ across treatments. We observe no significant treatment effects. (shrink)

The article discusses the forms and ways of the impact of modern digital media on people, groups, and society as a whole. The unilateral communication effect on a person is emphasized. The accent is made on the transmission model of information dissemination, taking into account the formation of its ritualized form. The author pays his particular attention to the status and role of an individual in interaction with mass media; provides arguments about the exclusion of a person from the communication (...) dimension. The activity of modern digital media structures is substantiated as social constructors of reality. The researcher shows the technological and visual possibilities of mass media in the creation of artificial, illusory simulated models of the world perceived by a person as objective, authentic, and real. Mass media are presented as an integral social institution of modern society, operating autonomously, based on its own rules and norms, technological and content principles, conditions of network communication, digitalization, and mediatization of society. The article presents the concepts of theoretical comprehension of mass media as a self-sufficient autopoietic system of N. Luhmann, and consideration of media communication implementation as a non-communication of J. Baudrillard. The author stresses the role of spectacle and visuality in the process of TV influence on the subjects, in the construction of images and models of the world, comparable with the already available information consumers pictures of the world. The contradictory and ambiguous conceptual assessments of the activity and influence of mass media on the modern man are emphasized. (shrink)

Research on adolescent-to-parent violence associates specific psychosocial characteristics with adolescents who assault their parents, whether they are within or outside the juvenile justice system, or whether these characteristics are shared by other adolescents convicted of other crimes. The aim of this paper is to compare three groups of adolescents. Those who have been sentenced for APV are compared with adolescents who have committed other crimes, and with a group who have not been involved in the justice system. The sample used (...) consists of 148 male participants between the ages of 14 and 21. A comparison is made regarding type of self-reported behavior, frequency of drug use, academic performance, exposure to violence, self-concept, and parents’ conflict resolution tactics. The results obtained indicate that adolescents with judicial measures, regardless of the crime committed, differ from those who have not been in trouble with the justice system in terms of them having suffered violence in the street, the frequency with which they use drugs and in their academic achievement. Likewise, adolescents convicted of APV differ from the other two groups in the frequency with which they are victims of violence at home, in that their mothers use the tactic of asking somebody else for help as a way of solving marital conflicts, and in having a more negative family self-concept. The results are discussed highlighting the importance of taking into account whether a sample is judicial, clinical, or community, and the specific APV behaviors which are measured. (shrink)

Viewing cute images has been reported to promote performance on tasks requiring carefulness, possibly related to an enhanced positive emotional state. However, it is unclear whether viewing infant...

More than a third of the world's population has no access to essential drugs. More than half of this group of people live in the poorest regions of Africa and Asia. Several factors determine the accessibility of drugs in developing countries. Hardly any medicines for tropical diseases are being developed, but even existing drugs are often not available to the patients who need them.One of the important determinants of access to drugs is the working of the (...) patent system. This paper first maps out some facts about the global patent regime that has emerged as a consequence of the conclusion of the WTO‐TRIPs Agreement in 1994. Attempts to construct a moral justification of the patent system have been based on three grounds: natural rights, distributive justice, and utilitarian arguments. This paper examines to what extent and on which grounds drug patents can be justified. The final section looks at the so‐called ‘Doha Declaration on the TRIPs Agreement and Public Health’, which was adopted by the WTO Ministerial Conference two years ago, recognising the primacy of public health over the interests of patent proprietors. (shrink)

The Hygiene Hypothesis has been recognized as an important cornerstone to explain the sudden increase in the prevalence of asthma and allergic diseases in modernized culture. The recent epidemic of allergic diseases is in contrast with the gradual implementation of Homo sapiens sapiens to the present-day forms of civilization. This civilization forms a gradual process with cumulative effects on the human immune system, which co-developed with parasitic and commensal Helminths. The clinical manifestation of this epidemic, however, became only visible in (...) the second half of the twentieth century. In order to explain these clinical effects in terms of the underlying IgE-mediated reactions to innocuous environmental antigens, the low biodiversity of antigens in the domestic environment plays a pivotal role. The skewing of antigen exposure as a cumulative effect of reducing biodiversity in the immediate human environment as well as in changing food habits, provides a sufficient and parsimonious explanation for the rise in allergic diseases in a highly developed and helminth-free modernized culture. Socio-economic tendencies that incline towards a further reduction of environmental biodiversity may provide serious concern for future health. This article explains that the “Hygiene Hypothesis”, the “Old Friends Hypothesis”, and the “Skewed Antigen Exposure Hypothesis” are required to more fully explain the rise of allergy in modern societies. (shrink)

This study reports findings of gender differences in tax attitude changes influenced by better tax knowledge. Male students are more exposed to tax knowledge in a way that makes them reconsider more easily their attitudes towards their own tax evasion, i.e. tax ethics, than their female peers. Male students get a significantly stricter attitude towards their own tax evasion. On the other hand, female students are more exposed to tax knowledge in a way that makes them reconsider their attitude towards (...) other people's tax evasion than their male peers, i.e. they get a significantly stricter attitude towards others tax evasion. Improved tax knowledge significantly changed both male and female students attitude towards the fairness of the tax system, i.e. they considered the tax system to be more fair. Implications for ethical behaviour of taxpayers are highlighted. (shrink)