BACKGROUND

The Philippines implemented a law on the inclusion of graphic health warning (GHW) labels in cigarette packs to increase awareness about the health effects of smoking, to quit smoking, or to deter potential users from engaging in cigarettes. Investigating its impact on senior high school (SHS) students may provide insights into enhancing and reinforcing the law to achieve its purpose at the adolescent developmental stage.

The objective of this study was to determine the perceived emotional and cognitive reactions as well as the perceived health risks of GHWs among nonsmoking SHS students in Leyte and their relationship to their level of exposure.

A cross-sectional design was employed involving 247 students from public high schools in Pastrana, Leyte, who were selected through stratified random sampling. A self-report questionnaire was used to gather the data. Spearman’s rho correlation coefficient was used to test the hypothesis.

The majority of the participants reported positive perceptions of GHW labels. Moreover, the majority of them have seen GHW at least once a week on cigarette packs and evoked variable agreement about the high arousal and low arousal negative emotion, but have positive cognitive reactions. They have a strong agreement on the perceived health risks posed by cigarette smoking through GHWs. There was a positive and significant correlation between the level of exposure and the perceived health risks of smoking through the GHWs.

Adolescent learners reported variable agreement on emotional reactions, but had positive cognitive reactions to tobacco GHW labels. They also have reported that GHWs in cigarette packs provide positive visual information on the health effects and other consequences of smoking. Those who have frequent exposure to the GHWs of the cigarette packs were more likely to report knowledge and information on the health risks of smoking. Thus, the GHWs on cigarette packs are still necessary to decrease the new smoker rate, especially among adolescents. Policy implications toward the continuous development of GHWS are offered.

OBJECTIVE

To determine the perceptions of persons with tuberculosis (TB) and health workers on Care TB – a mobile application for the community-led monitoring (CLM) of TB services.

We used a qualitative research method. Six people with tuberculosis and ten health workers were chosen through purposive sampling for semi-structured interviews. The narrative data produced from the interviews were subjected to qualitative content analysis in order to uncover salient themes and patterns.

The community-led monitoring mobile application was shown to be acceptable both to TB healthcare providers and patients. It enhances information access and streamlines the process of reporting care barriers. The application also allows persons with TB to interact with one another, potentially eliminating stigma and discrimination. Potential challenges to implementing the CLM program include issues with internet connectivity, costs, and human resources.

This study provides preliminary evidence of the acceptability and perceived feasibility of a mobile application for the community-led monitoring of TB services. For the CLM initiative to be scaled up across the country, more financial and technical support is required.

In recent years, emerging technology medical devices have developed rapidly. How to more scientifically and more efficiently regulate these novel medical devices so as to improve access to advanced medical technology while ensuring safety and effectiveness is a new challenge faced by regulatory authorities, and is also the core topic of regulatory science. New tools, new standards and new methods are important means to achieve regulatory science. "Medical Device Development Tool" proposed by the U.S. FDA is a novel medical device regulatory science tool, which can help medical device developers to predict and evaluate product performance more efficiently. It is also helpful for regulatory authorities to make regulatory decisions more efficiently. This study introduces the concept, qualification process, role of MDDT in medical device regulation and MDDT examples, and makes some discussion on the device evaluation from the perspective of reliability and validity. MDDT can facilitate the developing of novel medical device.
United States ; Medical Device Legislation ; Reproducibility of Results ; United States Food and Drug Administration ; Technology ; Device Approval

In the personal injury compensation system, the protection and relief of the injured people's rights to life, rights to health, and body rights are generally based on the results of disability assessment. Over the years, with the increased number of personal injury compensation cases, the practice of disability assessment have been greatly developed, and the development of disability assessment standards tends to be mature. However, the lack of basic theories for disability assessment has seriously affected the construction and unification of standards. Starting from the tort legal system of personal injury compensation, this article systematically analyzes the legal theories of disability assessment, and holds that the loss of labor ability is the legal basis for disability assessment in China, and the essence of disability assessment should be understood as the quantitative assessment of an individual's permanent loss of labor ability. This article combines the international disability assessment models and the primary concepts of American Medical Association's Guides to the Evaluation of Permanent Impairment to refine the basic concepts of disability assessment in China, such as impairment, disability, handicap, disabled people and self-care ability, etc. At the same time, it sorts out the critical issues of identification time, promotion principles and compound calculation of multiple injuries in disability assessment. It is expected to be beneficial to the theory and practice of disability assessment in personal injury compensation.
Humans ; Disability Evaluation ; Liability, Legal ; China

This paper studies the necessity of the current legislation on the supervision of medical devices in China from the perspectives of strengthening administration according to law, protecting public health, perfecting the legal system of medicine and promoting the development of the medical device industry. This study analyzes and summarizes the legislative experiences and forms in the field of medical device regulation in the United States, the European Union, Japan and other countries and regions, at present, the conditions of carrying out the legislation of medical device supervision in China are quite mature, and some policy suggestions are put forward for the enactment of the law of medical device management in China.
Equipment and Supplies ; European Union ; Feasibility Studies ; Industry ; Medical Device Legislation ; United States ; United States Food and Drug Administration

Objective: A multi-phase, sequential mixed methods study aimed to determine acceptable age-appropriate physical intimate behaviors shared between Filipino parents and children that are related to hygiene, affection and privacy. Methods: Following an exploratory qualitative phase (Phase 1) and an instrumentation phase (Phase 2), the quantitative survey phase (Phase 3) utilized the resultant Filipino Family Behavior Questionnaire (FFBQ). A total of 145 participants from Cabuyao, Laguna and selected urban communities in Metro Manila were comprised of 72 parents and 73 adult children. Results: Parents and adult children view the affection-related behaviors of hugging (magyakapan/ magyapusan) and kissing on the cheeks (humalik sa pisngi) as most acceptable among the list of parent-child intimate behaviors in the FFBQ, and is allowed without any age limit set for children (up to age 18 years). The lowest accepted age-appropriate intimate behaviors were hygiene related, specifically on washing genitalia (median 5 years, range 0,18), co-bathing (3 years, range 0,18), and holding/kissing genitals (0, range 0,17). Generally, adult children accept higher age-limits compared to parent participants. Both groups placed higher age-acceptable limits on mothers compared to fathers. When comparing parent-child pairs, same-gender pairs have significantly higher age-acceptable limits compared to mixed gender pairs. Ranked in order of highest to lowest age-acceptable limits, the most accepted gender pair in performing intimate behavior is mother-daughter; father-son; mother-son; and father-daughter. Perceptions of acceptable age limits were comparable between parents with adverse childhood experiences (ACEs) compared to those without ACE, except for hugging between mother-daughter (17.21 vs 18 years, p=0.04) and father-daughter (17.21 vs 14.22 years, p<0.01) as well as co-dressing of mother-son (3.76 vs 2.19 years, p=0.02).For children, differences in perception were noted only for hugging between mother and son (17.95 vs 15.37 years, p<0.01), and kissing on lips between father and son (5.33 vs 8.94 years, p=0.03). Respondents in Phase 4 believe that mothers are seen as nurturing and caring towards children, thus rendering acceptance of higher age limits for engaging in intimate behavior, specifically for hygiene and privacy. Similar-gender pairs tend to be more at ease with each other, hence the persistence of intimate behavior even at older ages. Conclusion This study was able to identify Filipino intimate behaviors of parents and children including their age-appropriateness. Parents and adult children had similar valuations for healthy boundaries in intimate behavior, as evidenced by the older perceived mean ages for hugging, kissing on the cheek (affection) and co-sleeping (privacy), as well as younger perceived mean ages for hygiene-related intimate behavior such as holding/kissing genitalia, washing genitalia and co-bathing. Parent-child intimate behavior is more acceptable for same-gender pairs, and is least appropriate for older ages in father-daughter pairs. Moreover, adult children appear to be more permissible in exhibiting lower cutoffs for age limits of acceptability compared to parents.
Hygiene ; Affection ; Privacy

BACKGROUND: A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries.METHODS: A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries.RESULTS: Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51–147.72).CONCLUSION: The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.
Caregivers ; Child ; Cross-Sectional Studies ; Emergencies ; Hospitalization ; Humans ; Korea ; Logistic Models ; Lower Extremity ; Odds Ratio ; Play and Playthings ; Risk Factors ; Social Control, Formal ; Wounds and Injuries

This document provides a description of country-level laws that regulate electronic cigarettes and heated tobacco products. The mechanisms used to regulate e-cigarettes were classified as either new/amended laws or existing laws. The policy domains identified include restrictions or prohibitions related to the product (sale, manufacturing, importation, distribution, use, product design including e-liquid ingredients, advertising/ promotion/ sponsorship, and trademarks) and regulatory requirements (taxation, health warning labels, and child-safety standards). A range of regulatory approaches are currently being applied to e-cigarettes globally; however, many countries still regulate e-cigarettes using legislation not tailored specifically for e-cigarettes. Only a handful of countries levy a tax on e-cigarettes. Evidence on the harmful effects and benefits of e-cigarettes usage has not been clearly established yet. The regulatory treatment of heated tobacco products varies from country to country, with some classifying e-cigarettes and cigarettes under the same legislation, other countries treating e-cigarettes more favorably, and some jurisdictions banning them altogether. As the evidence base grows, we expect additional activity in the regulatory arena.
Electronic Cigarettes ; Hand ; Hot Temperature ; Jurisprudence ; Nicotine ; Taxes ; Tobacco Products ; Tobacco

One person dies every six seconds from a smoking-related disease and this problem is likely to worsen. While many people try to quit smoking on their own or with using medicinal products, many of them fail. There is an ongoing debate within the public health community about e-cigarettes on whether they have a potential role in smoking cessation, whether their use can reduce harm for individual users, whether the widespread use of these devices has the potential to reduce or increase population-level harm, and how best to regulate e-cigarette use to minimize both individual and population-level harm. Although the long-term effects of e-cigarette use among smokers and non-smokers are not known, nicotine aerosol produced from a solution, rather than from burning tobacco, releases fewer harmful substances than cigarette smoke does. Some experts advocate wider availability and softer regulations regarding e-cigarette use and perceive them as having the potential to help smokers quit or switch to a harm-reducing means of consuming nicotine. Based on scientific evidence on e-cigarettes, this article explores its pros and cons to public health in order to guide practice, policy, and regulation through reviews of debate articles. ‘Quit or die’ is no longer the only option for those who cannot quit. Safer nicotine products offer another way. There is substantial international and independent evidence that these products are safer than cigarettes.
Burns ; Electronic Cigarettes ; Harm Reduction ; Humans ; Nicotine ; Public Health ; Smoke ; Smoking ; Smoking Cessation ; Social Control, Formal ; Tobacco ; Tobacco Products

Tobacco products are rapidly evolving. Since the World Health Organization Framework Convention on Tobacco Control came to effect in 2005, the parties of the treaty have been aiming to control tobacco use. Moreover, the social norm of smoking has changed. These changes have prompted the tobacco industry to evolve their products and business model. There have been several evolutions in tobacco products. Firstly, new tobacco products, such as electronic cigarettes and heated tobacco products were introduced into markets that were previously dominated by conventional cigarettes. Thus, smokers are able to select alternative tobacco products. Secondly, new devices for tobacco use, including universal serial bus, smart watch, and car key devices, have been developed and released. These devices are popular among females and youth, who wish to hide their smoking behavior. Thirdly, nicotine, which is used in tobacco products, has also evolved. Typically, ‘free-base nicotine’ has been the main form used in tobacco products, because it helps to deliver nicotine quickly to the smoker's brain. However, a new form of nicotine, ‘nicotine salt’, is used in electronic cigarettes. It can deliver a more highly concentrated dose of nicotine to the smoker’s brain. To regulate these evolving products, laws are required to prevent the easy access of new tobacco products in the Korean market and therefore, a new organization for monitoring the evolution of tobacco products is required. Additionally, we need to encourage young people and scholars to develop interest in tobacco product control, thus ensuring adequate regulation of new tobacco products.
Adolescent ; Brain ; Commerce ; Electronic Cigarettes ; Female ; Hot Temperature ; Humans ; International Cooperation ; Jurisprudence ; Nicotine ; Smoke ; Smoking ; Social Norms ; Tobacco Industry ; Tobacco Products ; Tobacco Use ; Tobacco ; World Health Organization