Separation and Discrimination: The Lived Experience of COVID-19 Survivors in Philippine Isolation Centers

Social isolation in times of pandemic can affect the well-being of individuals infected with a contagious disease. This study explores the lived experience of the 12 COVID-19 survivors placed in community-based isolation centers in Cebu City, Philippines and whose cases were mild and asymptomatic. In describing their lived experience, we employed Max van Manen's phenomenology of practice. Results show that the COVID-19 survivors have suffered more from the consequences of separation and discrimination than the disease's physiological effects. Educating the whole community about social responsibility and ethical behavior in dealing with COVID-19 survivors is essential to minimize social stigma and discrimination.

How could a new universal code of conduct prevent and resolve sovereign debt crises? Proposals for design and implementation

In response to the COVID‐19 crisis, government spending around the world has increased significantly and will continue to grow as interest rates rise. In view of protracted and costly sovereign debt restructurings in the previous decades, contractual and noncontractual instruments of the Global Debt Governance‐system have been insufficient to prevent and to resolve sovereign debt crisis. While statutory and comprehensive approaches to resolve sovereign debt crises lack the political support such as an insolvency procedure for states incomprehensive contractual approaches including collective action clauses (CACs) cannot fully secure a comprehensive debt resolution. Codes of conduct could constitute an essential instrument to contribute to preventing and resolving sovereign debt crises. There are two main impediments for establishing and adopting such codes of conduct effectively. First, a range of codes of conduct with different institutional settings and principles have been established − and partly implemented − including those of the Institute of International Finance, the United Nations, the G20, the IMF and the OECD. However, differing institutional settings do not contribute to preventing or effectively resolving debt crises when the actors concerned apply different codes of conduct. We suggest a new universal code of conduct in which the elements of the various proposals made by the public and private sectors would be combined. Second, the global economic governance structure lacks incentives for creditors and debtors to adhere to this new universal code of conduct. This paper proposes measures providing incentives for creditors and debtors to apply the nonstatutory code of conduct.

The Impact of Emissions Reduction Awareness on Moral Self-Concept: Sustaining Climate-Friendly Behaviour in the Aftermath of the Covid-19 Pandemic

Communication campaigns often highlight environmental progress to encourage further pro-environmental behaviour. Consequently, the drop in carbon emissions caused by the COVID-19 restrictions has been framed as a positive environmental outcome of the pandemic. We conducted an experimental study with a US-representative sample (N = 500) to show that raising awareness of emissions reduction has the contrary effect: an increase in moral self-concept facilitated a negative spillover, namely, it reduced climate-friendly behavioural intentions. Normative influence was able to prevent this negative spillover because activating environmental norms inhibited compensatory feelings. Besides, awareness of recent emissions reduction was less likely to increase the moral self-concept of participants with a strong environmental self-identity. Our findings demonstrate that environmental progress increases moral self-concept which, in turn, could cause a negative spillover (i.e., reduce climate-friendly low-carbon behaviour and increase climate-harmful high-carbon behaviour). Normative influences and environmental self-identity can inhibit this negative spillover.

Infrastructure and Process

The telemedicine industry has evolved as an alternative method of patient contact in the presence of barriers to face-to-face contact such as the current COVID-19 pandemic or other geographic and temporal barriers that prevent patients from accessing healthcare. According to the World Health Organization (WHO), half of the world's population cannot access basic health services. One of the promises of telemedicine is to reduce some of these barriers and improve access to healthcare and global health equity (Darkins and Cary, Telemedicine and telehealth: principles, policies, performance, and pitfalls, Springer, New York, 2000;Norris, Essentials of telemedicine and telecare, Wiley, London, 2002). Although telemedicine holds great promise, its implementation can be complicated by regulatory factors that can vary by country and region. Especially in developed nations, there may be complex laws and policies around aspects of telemedicine such as privacy and billing which can make its implementation difficult (Norris, Essentials of telemedicine and telecare, Wiley, London, 2002;Ackerman et al., Telemed J E Health 8(1):75, 2002). In this chapter, we provide an overview of purposes and mechanisms of telemedicine delivery, and the infrastructural and process requirements for a successful orthopedic telemedicine assessment. We discuss technical infrastructure required for a successful assessment including hardware, software, network, other tools, and physical space set-up. We then discuss the process involved in conducting smooth and effective encounter, both from the healthcare provider's point of view as well as the patient's point of view. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022, corrected publication 2022.

Has Container Shipping Industry been Fixing Prices in Collusion?: A Korean Market Case

Purpose - The purpose of this study is to analyze the market power of the Korea Container Shipping Market (Intra Asia, Korea-Europe, and Korea-U.S.) to verify the existence of collusion empirically, and to answer whether the joint actions of liner market participants in Korea have formed market dominance for each route. Precisely, it will be verified through the Lerner index as to whether the regional market of Asia is a monopoly, oligopoly, or perfect competition. Design/methodology - This study used a Lerner index adjusted with elasticity presented in the New Imperial Organization (NEIO) studies. NEIO refers to a series of empirical studies that estimate parameters to judge market power from industrial data. This study uses B-L empirical models by Bresnahan (1982) and Lau (1982). In addition, NEIO research data statistically contain self-regression and stability problems as price and time series data. A dynamic model following Steen and Salvanes' Error Correction Model was used to solve this problem. Findings - The empirical results are as follows. First, lambda, representing market power, is nearly zero in all three markets. Second, the Korean shipping market shows low demand elasticity on average. Nevertheless, the markup is low, a characteristic that is difficult to see in other industries. Third, the Korean shipping market generally remains close to perfect competition from 2014 to 2022, but extreme market power appears in a specific period, such as COVID-19. Fourth, there was no market power in the Intra Asia market from 2008 to 2014. Originality/value - Doubts about perfect competition in the liner market continued, but there were few empirical cases. This paper confirmed that the Korea liner market is a perfect competition market. This paper is the first to implement dynamics using ECM and recursive regression to demonstrate market power in the Korean liner market by dividing the shipping market into Deep Sea and Intra Asia separately. It is also the first to prove the most controversial problems in the current shipping industry numerically and academically.

Digital health innovations for non-communicable disease management during the COVID-19 pandemic: a rapid scoping review

ObjectiveTo identify and summarise the digital health interventions (DHIs) implemented for non-communicable disease (NCD) management for COVID-19. DesignRapid scoping review. Three reviewers jointly screened titles-s and full texts. One reviewer screened all excluded records. Data were mapped to WHO DHI Classification and narratively summarised. Data sourcesPubMed, CENTRAL, CINAHL, EMBASE. Eligibility criteria for selecting studiesPeer-reviewed primary research published between 1 November 2019 and 19 September 2021 on DHI for NCD management during the COVID-19 pandemic. Reviews, editorials, letters, commentaries, opinions, conference s and grey literature were excluded. ResultsEighty-three studies drawn from 5275 records were included. A majority of the studies were quantitative in design. Forty per cent of the DHIs were implemented in the Americas. Nearly half of these DHIs targeted mental health conditions. A majority of the interventions were delivered remotely and via telephones. Zoom (26.5%), email (17%) and WhatsApp (7.5%) were the top three platforms for care delivery. Telemedicine, targeted client interventions, personal health tracking and on-demand information services for clients were the most frequently implemented interventions. Details regarding associated costs, sustainability, scalability and data governance of the DHI implementations were not described in the majority of the studies. ConclusionWhile DHIs supported NCD management during the COVID-19 pandemic, their implementation has not been equitable across geographies or NCDs. While offering promise towards supporting the continuum of care during care delivery disruptions, DHIs need to be embedded into healthcare delivery settings towards strengthening health systems rather than standalone parallel efforts to overcome system level challenges.

The impact of life experiences on the school disciplinary practices of suburban high school administrators

This narrative study examined how the life experiences of high school administrators impact how they conceptualize and understand school discipline. These experiences were then positioned within the current context of COVID-19 pandemic related school closures and protests associated with George Floyd's death which brought light to systemic racism prevalent in school codes of conduct to determine how these events changed their disciplinary practices. Semi-structured interviews were conducted with eight administrators from suburban schools in the New York metropolitan region that also had a minority student population of at least 10%. Transcripts were analyzed using in vivo and process coding to identify themes across the interviews. Three themes were identified: elements that lead to an initial understanding of school discipline, how these initial practices change over time, and the twin impact of COVID-19 and protests highlighting systemic racism causing a drastic change to how administrators respond to student misbehavior. These findings were then analyzed using Critical Race Theory and situated among the current literature. The first finding was centered on the understanding administrators use their personal experiences as both as student and teacher to establish their understanding of school discipline. The second finding uncovered an awareness that in order to address student behaviors, administrators develop stakeholder connections. Lastly, there was an awareness and discovery that codes of conduct in their respective schools contributed to disproportionate discipline. While some administrators had already been working to enact change, others were in the beginning stages of learning about this problem and were unsure of the next steps. Form these findings, recommendations for practice and research were proposed. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Why should we care about social media codes of conduct in healthcare organisations? A systematic literature review.

Background: The conduct of healthcare organisation employees on social media can impact both their personal reputation and that of the organisation. However, social media has blurred the lines between professional and personal communication, and what is acceptable and ethical conduct is not always clear. Furthermore, the global COVID-19 pandemic has changed how healthcare organisations and their employees approach the use of social media, expediting the need to ensure that employees communicating health-related information adhere to employee codes of conduct. Aims: This review aims to investigate the challenges associated with healthcare organisation employees' use of social media for sharing health-related information, identify the crucial elements for inclusion in social media codes of conduct for healthcare organisations, and examine the enablers for good codes of conduct. Methods: A systematic review of the literature from six research database platforms on articles related to codes of conduct addressing the use of social media for healthcare organisation employees was conducted. The screening process yielded 52 articles. Results: The key finding in this review focuses on privacy, protecting both patients and healthcare organisation employees. While maintaining separate professional and personal social media accounts is a much-discussed approach, training and education on social media codes of conduct can clarify acceptable behaviour both personally and professionally. Conclusion: The results raise essential questions about healthcare organisation employees' use of social media. It is evident that organisational support and a constructive culture will enable healthcare organisations to fully realise the benefits of using social media.

Triaging your human capital: an integrative perspective on strategic human capital asset allocation: MRN

PurposeThe purpose of this paper is to provide an overarching framework to guide the understanding of the allocation and deployment of strategic human capital assets within an organization. Using the concept of medical triage with business units analogous to "patients” and their performance to "symptoms or injuries,” the framework suggests a "steal from the poor” perspective that is counter to conventional organizational decline literature.Design/methodology/approachThis is a conceptual paper proposing that there are five different categories of business unit need for human capital assets: expectant, deceased, immediate, delayed or minimal;all based on the type of environment and holistic performance of the business unit. Based on a business unit's specific situation, the authors suggest a process model guiding how to conduct a triage analysis to optimize the allocation of strategic human capital assets within an organization.FindingsThe authors argue that current trends in assessing strategic human capital assets which make comparisons across organizations are necessary but insufficient (e.g. comparing a store to other stores in its district or region). Each business unit has its own unique internal capabilities and external constraints that also must be accurately assessed to make an informed organizational-level decision about where and how to deploy strategic human capital assets.Originality/valueBorrowing from medical science, this paper demonstrates a new conceptual framework with propositions for researchers and guidance for practitioners.

Employing satire and humor in facing a pandemic

This research employs the Theory of Planned Behavior and the Focus Theory of Normative Conduct to convey how The Late Show with Stephen Colbert employs humor and satire with the aim of providing information, proffering injunctive norms, and modifying attitudes and subjective norms in its public audience, while exposing the inefficacy of behavioral controls and urging public authorities to adopt effective ones instead. In the earlier stages of the pandemic in the US, the Show primarily appealed to people to change their behavior through providing information, invoking injunctive norms and affiliations, foregrounding appropriate attitudes and subjective norms;at the same time, its repertoire included social and political satire drawing on organizational and institutional mechanisms of behavioral control. As the health crisis became increasingly politicized, the Show redirected its satire to policies and political figures and sought to change the behavior of policymakers in setting proper role models and adopting wiser behavioral controls to lead the nation through the crisis. Meanwhile, individual responsibility was never spared in satiric attempts to change behavior as the Show continued to provide its audience with new scientific information and encouraged them to follow scientific recommendations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Mental Health and Physical Complaints of German Children and Adolescents before and during the COVID-19 Pandemic: A Repeated Cross-Sectional Study.

The potential impact of the COVID-19 pandemic on young people's mental and physical health is of increasing concern. We examined the levels of internalizing and externalizing problem behavior and physical complaints before and during the COVID-19 pandemic in Germany. Data came from a repeated cross-sectional study on child and youth health in schools in Germany. Assessments took place from November to February each year. Two data collections were conducted before the COVID-19 pandemic in 2018-2019 and in 2019-2020. Collections during the pandemic took place in 2020-2021 and 2021-2022. A total of 63,249 data observations were included in the analyses. Multilevel analyses were used to examine temporal trends in mean emotional problems (e.g., often unhappy, downhearted), hyperactivity-inattention (e.g., constantly fidgeting or squirming), conduct problems (e.g., fights with other children), and physical complaints. Models were adjusted for age, gender, school type, socioeconomic status, and sensation seeking. During the COVID-19 pandemic, children and adolescents in Germany experienced an increase in emotional problems from the pre-pandemic cohort 2019-2020 to the pandemic cohort 2021-2022 (ß = 0.56, 95% CI (0.51-0.62)) and, over the course of the pandemic, reported elevated levels of physical complaints (ß = 0.19, 95% CI (0.16-0.21)). Findings of increased emotional problems and physical complaints after the two years of the pandemic support the ongoing demand for low-threshold health promotion and prevention and the need for further monitoring of young people's health in Germany.

Predictors of risky driving among teen drivers with ADHD during U.S. COVID-19 shelter in place orders

Factors associated with continued driving during shelter in place orders have been examined in a community sample of typically developing teen drivers, but not in teens diagnosed with Attention/Deficit-Hyperactivity Disorder (ADHD). Our objective was to examine psychosocial factors that predicted risky driving during shelter in place orders in teens with ADHD, which is important since teens with ADHD are at particular risk for poor driving outcomes. The present study is also novel in that it uses naturalistic data of risky driving rather than self-report of continued driving. Naturalistic in-car data from 56 ADHD participants (M age = 16.875 years, SD = 0.955;55.400 % were male) enrolled in an on-going study were used in the present study. Teens had an average of 26.915 months (SD = 14.343) of driving experience. Risky driving was defined as experiencing an event exceeding 0.600 g-force during the first month of COVID-19 pandemic shelter in place ordinances in Ohio, Kentucky, and Indiana, USA. A hierarchical logistic regression with a post-COVID driving event as the dependent variable was conducted. Baseline ratings of ADHD and oppositional defiant disorder/conduct disorder (ODD/CD) severity were entered in the first step of the model, while anxiety severity and parent behaviors regarding teen driving safety (monitoring and limit setting) were entered in the second step of the model. The first step of the model reached statistical significance (χ2(2, 54) = 7.577, p =.023), with only greater symptoms of ODD/CD significantly predicting a post-COVID driving event (B = 0.144, p =.020). With each point increase in ODD/CD symptoms, there was a 15.5 % increase in the probability of experiencing a high g-force event during COVID-19 restrictions. The model was no longer significant at step 2 when anxiety severity and parent behaviors were added to the model (χ2(3, 55) = 10.97p =.052). We conclude that ODD/CD symptom severity was the strongest predictor of risky driving during COVID-19 restrictions within a sample of teen drivers with ADHD. Study implications may be beneficial for clinicians who work with families of teens with ADHD;suggestions for strategies mitigating this risk are discussed. These findings also have implications for which teens with ADHD may be less positively impacted by other government mitigation strategies such as Graduated Drivers Licensing (GDL) regulations. © 2022

Precarious and non-precarious work in the informal sector: Evidence from South Africa

The research analyses the precarious and non-precarious work practices within the informal sector. Labour in the informal sector and in regions without strong labour relations is not uniformly precarious but is categorised by a bimodality of incomes, citizenships and conducts. This creates opportunities for insurgent modes of counter-conduct in the interstices of regulations and social conventions, but has also resulted in exclusive local citizenships and revanchist strategies. From numerous in-depth interviews, the study found that the Covid-19 lockdown and economic recession led to a new dialectical relationship between long-term residents and a precariat in-group of non-propertied actors, recent migrants and immigrants in the informal sector. Long-term residents with local citizenship aggregated formal and informal incomes and secondary incomes within the household, elevating them out of precariousness, although primarily active in the informal sector. These included strategies of adverse incorporation and revanchist conducts to maintain incomes for non-precarious workers. Marginalised precarious workers shifted to modes of counter-conduct, hiding the true nature of the business, evading strict social conventions on local trade and pursuing new inter-ethnic citizenships based on strategic partnerships. (English) [ FROM AUTHOR]

Analysis of the Institutional Pillars of a Code of Conduct in a Non-Governmental Organization from the Institutional and Appreciative Perspective

Research Objective: To develop an institutional and appreciative analysis applied to the study of the institutional pillars associated with a code of conduct proposed to a non-governmental organization (NGO). Theoretical framework: Neoinstitutionalism and Appreciative Inquiry (AI) provided support for the analysis of the institutional pillars of a code of conduct. Methodology: A descriptive-exploratory, explanatory and interpretive research was developed, with a qualitative approach. An appreciative-based protocol was adopted to support the 5-D model in the collection and analysis of data obtained from the collaborative research group. A program of interviews and workshops was conducted with the support of electronic technologies/ remotes, due to COVID-19. Originality:The paper presents the combination of neo-institutionalism and AI put into practice through a dialogical-reflexive research strategy facilitating ethical-collective engagement around the code of conduct to be adopted by a NGO. Results:The logical design of the research allowed evidence of the elements pertinent to each institutional pillar connected to the code of conduct, namely: (a) regulatory - legislation influential in the internal processes of the NGO studied;(b) normative - values and norms that make explicit the beliefs, interests and visions of the participants, providing legitimacy to their social and moral base;(c) cultural-cognitive - conceptions shared together with the patterns of meanings attributed to the future code of conduct..ese elements were products of an appreciative and interactionist dynamic, obtaining the integration between the compliance program and the code of conduct, according to the proper stage of institutionalization found in them. Theoretical and practical contributions: The article develops a study agenda that has produced important insights into how the institutional pillars of a code of conduct can be built in a NGO, based on an appreciative ethos used in the empirical study.

Descriptive analysis of patients admitted to a new adolescent inpatient unit in Madrid

Introduction: Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units. Objective(s): Adolescent mental health problems may have increased after COVID-19 worldwide pandemic. Therefore it seems necessary to study the state of mental health inpatient adolescent units. Method(s): An observational and descriptive analysis of the sample of patients between 12 and 17 years-old, that were admitted to the inpatient mental health unit since its opening on April 2021. Result(s): A total of 205 patients were admitted from April 2021 until October 2021. We have observed sex diferences within patients admitted, as the 82.9% of them were female. The mean age was 14.7, being 14.6 for girls and 15.3 for boys. The most common reason for admission (RFA) were suicidal ideation/attempt, eating disorders, affective disorders, conduct disorders/challenging behaviors and psychosis. Suicidal ideation/attempt was the most common RFA (57.07%) in both sexes, being higher among females (60.3%) than males (42.9%). Eating disorders were the second most common RFA in girls (17.7%) while psychosis (17.1%) and mood disorders (17.1%) were the second most common RFA within boys. Conclusion(s): Findings on how COVID-19 affected adolescents mental health are controversial in the literature, our data suggest that there is a need of developing quality studies that analyse how the pandemic might be influencing adolescents suicidal ideation/ attempt and its protective and risk factors.

The impact of Covid-19 on the well-being of young people with conduct disorder and their families

Introduction: The Covid-19 pandemic has significantly changed family dynamics and parents experience greater psychological distress. Conduct problems in young people have increased by 35%. However, it is not known how Covid-19 associated stresses have affected parenting practice, conduct problems, and comorbidities and what additional support is needed for families at risk. Objective(s): This study uses self-report measures and semistructured interviews to examine and explore the impact of Covid-19 on the families of young people with conduct problems and comorbid mental health conditions. Method(s): This is a sequential mixed-methods study. Eligible families with children aged between 11-18 years have participated. One-hundred-and-eighty-two families have completed eight online questionnaires and 12 have participated in semi-structured followup interviews. Result(s): Analyses indicate that parental harshness, warmth, educational background, and employment have a significant impact on Covid-19 exposure and worries, as well as significantly higher scores of conduct disorder symptoms. Interview codes reveal that young peoples' behaviour became more severe during the pandemic, and this was associated with reduced in-person support services, reduced personal space at home, and parents taking on the additional role of educator. Conclusion(s): The findings suggest that Covid-19 is a significant risk factor to young people with conduct problems and their families. For example, reduced parental warmth and increased parental harshness increased conduct problems for young people during the lockdown. This study highlights that policies and services should work to better support such families. Future online psychosocial interventions are needed to empower families and improve parenting practice at home during the lockdown period and in general.

Employing satire and humor in facing a pandemic

This research employs the Theory of Planned Behavior and the Focus Theory of Normative Conduct to convey how The Late Show with Stephen Colbert employs humor and satire with the aim of providing information, proffering injunctive norms, and modifying attitudes and subjective norms in its public audience, while exposing the inefficacy of behavioral controls and urging public authorities to adopt effective ones instead. In the earlier stages of the pandemic in the US, the Show primarily appealed to people to change their behavior through providing information, invoking injunctive norms and affiliations, foregrounding appropriate attitudes and subjective norms;at the same time, its repertoire included social and political satire drawing on organizational and institutional mechanisms of behavioral control. As the health crisis became increasingly politicized, the Show redirected its satire to policies and political figures and sought to change the behavior of policymakers in setting proper role models and adopting wiser behavioral controls to lead the nation through the crisis. Meanwhile, individual responsibility was never spared in satiric attempts to change behavior as the Show continued to provide its audience with new scientific information and encouraged them to follow scientific recommendations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Predictors of Risky Driving among Teen Drivers with ADHD during U.S. COVID-19 Shelter in Place Orders

Factors associated with continued driving during shelter in place orders have been examined in a community sample of typically developing teen drivers, but not in teens diagnosed with Attention/Deficit-Hyperactivity Disorder (ADHD). Our objective was to examine psychosocial factors that predicted risky drivingduring shelter in place orders in teens with ADHD, which is important since teens with ADHD are at particular risk for poor driving outcomes. The present study is also novel in that it uses naturalistic data of risky driving rather than self-report of continued driving. Naturalistic in-car data from 56 ADHD participants (M age =16.875 years,SD= 0.955;55.400% were male) enrolled in an on-going study were used in the present study. Teens had an average of 26.915 months (SD = 14.343) of driving experience. Risky driving was defined as experiencing an event exceeding 0.600 g-force during the first month of COVID-19 pandemic shelter in place ordinances in Ohio, Kentucky, and Indiana, USA. A hierarchical logistic regression with a post-COVID driving event as the dependent variable was conducted. Baseline ratings of ADHD and oppositional defiant disorder/conduct disorder (ODD/CD) severity were entered in the first step of the model, while anxiety severity and parent behaviors regarding teen driving safety (monitoring and limit setting) were entered in the second step of the model. The first step of the model reached statistical significance (χ2(2, 54) =7.577, p = .023), with only greater symptoms of ODD/CD significantly predicting a post-COVID driving event (B = .144, p = .020). With each point increase in ODD/CD symptoms, there was a 15.5% increase in the probability of experiencing a high g-force event during COVID-19 restrictions. The model was no longer significant at step 2 when anxiety severity and parent behaviors were added to the model (χ2(3, 55) =10.97 p = .052).We conclude that ODD/CD symptom severity was the strongest predictor of risky driving during COVID-19 restrictions within a sample of teen drivers with ADHD. Study implications may be beneficial for clinicians who work with families of teenswith ADHD;suggestions for strategies mitigating this risk are discussed. These findings also have implications for which teens with ADHD may be less positively impacted by other government mitigation strategies such as Graduated Drivers Licensing (GDL) regulations.

The Promise of Emergent Nanobiotechnologies for In Vivo Applications and Implications for Safety and Security.

Nanotechnology, the multidisciplinary field based on the exploitation of the unique physicochemical properties of nanoparticles (NPs) and nanoscale materials, has opened a new realm of possibilities for biological research and biomedical applications. The development and deployment of mRNA-NP vaccines for COVID-19, for example, may revolutionize vaccines and therapeutics. However, regulatory and ethical frameworks that protect the health and safety of the global community and environment are lagging, particularly for nanotechnology geared toward biological applications (ie, bionanotechnology). In this article, while not comprehensive, we attempt to illustrate the breadth and promise of bionanotechnology developments, and how they may present future safety and security challenges. Specifically, we address current advancements to streamline the development of engineered NPs for in vivo applications and provide discussion on nano-bio interactions, NP in vivo delivery, nanoenhancement of human performance, nanomedicine, and the impacts of NPs on human health and the environment.

Scientific, ethical, and legal considerations for the inclusion of pregnant people in clinical trials.

Clinical trials to address the COVID-19 public health emergency have broadly excluded pregnant people from participation, illustrating a long-standing trend of clinical trial exclusion that has led to a clear knowledge gap and unmet need in the treatment and prevention of medical conditions experienced during pregnancy and of pregnancy-related conditions. Drugs (includes products such as drugs, biologics, biosimilars and vaccines) approved for a certain medical condition in adults are also approved for use in pregnant adults with the same medical condition, unless contraindicated for use in pregnancy. However, there are limited pregnancy-specific data on risks and benefits of drugs in pregnant people, despite their approval for all adults. The United States Food and Drug Administration-approved medical products are used widely by pregnant people, 90% of whom take at least 1 medication during the course of their pregnancy despite there being sparse data from clinical trials on these products in pregnancy. This overall lack of clinical data precludes informed decision-making, causing clinicians and pregnant patients to have to decide whether to pursue treatment without an adequate understanding of potential effects. Although some United States Food and Drug Administration initiatives and other federal efforts have helped to promote the inclusion of pregnant people in clinical research, broader collaboration and reforms are needed to address challenges related to the design and conduct of trials that enroll pregnant people, and to forge a culture of widespread inclusion of pregnant people in clinical research. This article summarizes the scientific, ethical, and legal considerations governing research conducted during pregnancy, as discussed during a recent subject matter expert convening held by the Duke-Margolis Center for Health Policy and the United States Food and Drug Administration on this topic. This article also recommends strategies for overcoming impediments to inclusion and trial conduct.