The main aim of this study was to analyze hygiene practices in small-scale dairy plants (SSDPs) in Serbia. A total of 60 plants were included in the research. A survey questionnaire used for SSDPs was designed to obtain the main information about hygiene practices they perform, as well as the data about the SSDPs, their production portfolio, and improvement plans. For the purpose of this study, a good hygiene practice score (GHPS) was calculated showing that the average score is 75%, spanning from 71.4% to 80.3% depending on the type of dairy plant. This study showed that the biggest challenges for small-scale dairy plants are associated with adequate labeling and external analysis of their dairy products, followed by record keeping and use of appropriate food contact materials. As expected, registered and approved SSDPs had higher GHPS scores and more information on their labels than those still in the approval or registration process. This study confirms the need for supporting this type of dairy producer to improve two main pillars of their business-the infrastructure for where they produce dairy products and awareness/knowledge of food safety legislative requirements. At the same time, approved processors are significantly underutilizing their processing capacity, which implies the need for both policy change consideration and educational initiatives. The policy changes should aim to align regulations with small-scale dairy processing realities.

Recent years have seen increasing recognition of the scientific, economic and ethical benefits of the use of non-animal models in advancing preclinical research, giving reason to rethink the application and framework of the Three Rs. However, to benefit from the economic advantages of shifting to such alternative methods, and to realise Australia\'s drug development potential, legislative reform is essential. Such reform should be responsive to international regulations that encourage the use of animal-free methods, and be coupled with a corresponding re-evaluation of current Three Rs frameworks and principles. If these supportive changes, and the recommendations from the 2023 Australian Commonwealth Scientific and Industrial Research Organisation (CSIRO) Futures Non-animal models report, are implemented concurrently - with government support paramount- then a new gold standard for scientific research in Australia could be created in which the use of non-animal models and animal-free methods is the default.

BACKGROUND: In December 2018 the Michigan Regulation and Taxation of Marihuana Act legalized the recreational use of cannabis in Michigan. There are now high potency forms of cannabis readily available in the state, which could result in increased emergency department (ED) visit rates due to intoxication in adults and children. Although cannabis related visits account for a small percentage of all adult and pediatric ED visits, they impose a significant burden on the health care system\'s resources. This study aimed to assess the impact of the legalization of recreational marijuana on the rate of ED visits for acute cannabis intoxication.
METHODS: We utilized the legalization of marijuana in the state of Michigan to conduct a natural experiment utilizing a retrospective observational cohort design of ED visits for acute intoxication before and after legalization. The study was conducted at a health system composed of eight hospitals in southeast Michigan, including both academic and community hospitals serving a diverse patient population. We estimated monthly cannabis-related ED visits based on cannabis-related ICD-10 discharge codes and total ED visits using electronic health record data from 2016 to 2022. A negative-binomial (NB) regression model was used to estimate the immediate and cumulative changes in cannabis-related ED visit rate after legalization.
RESULTS: There were a total of 2177 ED visits from 2066 patients for cannabis intoxication in our study cohort. Of the 2177 visits, 671 were before and 1506 were after legalization. In the univariate analysis, recreational cannabis legalization was associated with an increase in the average cannabis-related ED visit rate (Rate Ratio [RR]:1.70, 95% CI: (1.49, 1.94), p-value <0.001). In the multivariate analysis adjusting for age, results remain significant (RR 1.47, 95% CI (1.29, 1.70), p-value <0.001). The increased visit rate occurred in the first month after legalization; however, the slope of the increasing rate of ED visits were similar before and after cannabis legalization (RR, 1.28, 95% CI (1.07, 1.54), p-value <0.001).
CONCLUSIONS: The legalization of recreational cannabis in Michigan was associated with an immediate increase in ED visit rates for acute cannabis intoxications across all ages, especially among middle-aged adults, in the context of an stably increasing ED visit rate.

This research draws on literature review and case analyses revealed that the main reasons for Chinese dating violence\'s high prevalence are the long-term influence of patriarchy and gender culture and low recognition and awareness of the issue among students. Current Anti-domestic Violence Act does not apply to dating violence rendering victims devoid of preventive skills or relief recourse critiqued. Research exploring the lack of education on intimate partner violence in colleges has made students oblivious to the risks. Finally, the review provides detailed recommendations on expanding the practical scope of the Anti-domestic Violence Act to include dating violence and provide judges with clarification on the relevant elements of a dating relationship and cooperation of the legal system and education system in preventing dating violence.

The study focuses on the consequences of the pandemic for the further development of higher education. The purpose of the article is to summarize the main consequences of the pandemic, which have become the result of scientific analysis and the object of many scientific studies. These are the degree of students\' satisfaction with online learning, technological readiness of universities, the impact of new learning conditions on the psychological and emotional sphere, the problem of cheating at examinations, the problem of quality of education. Analysis of studies shows that in the academic environment there are different estimates of the pandemic period, sometimes they are of opposite nature. In spite of possibilities of online education universities tend to return to the full-time form of education. The study emphasizes that there are long-term consequences of the pandemic that are on the periphery of researchers\' attention. These are the legal and economic consequences for universities, as the online form of learning has acquired a different legal status. In addition, the introduction of online learning is inevitably associated with additional hardware and software costs. Another important consequence is the impact of the pandemic on academic culture. Under the pandemic, students were isolated from the traditional academic environment, which affected the transformation of social rituals and academic ethics. Academic Values. Since there has been no complete return to previous conditions and the threat of a global pandemic exists, the new experience is integrated into the existing system of academic values and serves as a trigger for change in the long term.

We reviewed Australian mental health legislation to determine what obligations it places on psychiatrists to facilitate second opinions for compulsory patients who request them. Only four jurisdictions-Australian Capital Territory, Queensland, Victoria, and Western Australia-have legislated for \'patient-initiated\' second opinions. Within these four regimes, there is variation in important aspects of the second opinion process, and there is a general absence of direction given to the second opinion providers. Based on research showing the variability of second opinion provision under New Zealand mental health legislation, we argue that this absence is likely to result in significant variation in the quality and depth of second opinions provided in Australia. We argue that New South Wales, the Northern Territory, South Australia, and Tasmania should consider formal provision for patient-initiated second opinions in their mental health legislation. We believe that such legislation ought to be aware of the barriers patients may face in accessing second opinions, and avoid exacerbating these barriers as Queensland\'s legislation appears to. Also, we argue that research on current practice in Australia should be conducted to better understand the effects of legislation on second opinions, and to help determine what amounts to best practice.

UNASSIGNED: This study aimed to characterize the perceived priorities of state and county policy makers for youth mental health services and the factors that influence those priorities.
UNASSIGNED: Mental health agency officials (N=338; N=221 state officials, N=117 county officials) representing 49 states completed a Web-based survey in 2019-2020. On 5-point scales, respondents rated the extent to which 15 issues were priorities for their agency in providing youth mental health services and the extent to which nine factors influenced those priorities.
UNASSIGNED: Suicide was identified as the highest priority (mean±SD rating=4.38±0.94), followed by adverse childhood experiences and childhood trauma and then increasing access to evidence-based treatments. Budget issues (mean=4.27±0.92) and state legislative priorities (mean=4.01±0.99) were perceived as having the greatest influence on setting priorities.
UNASSIGNED: These findings provide insights into youth mental health policy priorities and can be used to guide implementation and dissemination strategies for research and program development within state and county systems.

UNASSIGNED: Organ donation after euthanasia (ODE) has been performed over 100 times in the Netherlands, primarily involving patients suffering from a neurodegenerative or psychiatric disease. In recent years, the number of euthanasia cases related to dementia has increased in the Netherlands, with some patients living with dementia expressing a wish for organ donation after euthanasia.
UNASSIGNED: We describe a unique case of a 67-year-old female diagnosed with primary progressive aphasia as part of frontotemporal dementia who requested and underwent organ donation after euthanasia.
UNASSIGNED: The patient had expressed her explicit wishes for both euthanasia and organ donation, which were discussed with her family physician, the Euthanasia Expertise Center (EE), and an organ donation coordinator. The patient was informed that to proceed with ODE, she should still be capable of voicing a voluntary and well-considered request for organ donation. The legally required euthanasia assessment procedure was carefully completed before ODE. Multiple healthcare professionals assessed the patient\'s competence, voluntariness, and unbearable suffering. Thereafter the patient\'s ODE request was granted, and both lungs and kidneys were successfully donated and transplanted. Post hoc analysis confirmed that all due diligence criteria for euthanasia were met, and the patient\'s relatives received an anonymous letter of gratitude from one of the organ recipients.
UNASSIGNED: This unique case demonstrates that ODE is feasible from medical, ethical, and legal perspectives in patients living with dementia. This case highlights several aspects essential to enable an ODE request by a patient living with dementia to be granted, such as the role of the physician performing euthanasia, the relevance of the decision-making capacity of the patient, the presence of an advance directive, and the involvement of and support by relatives and caregivers. However, several unresolved ethical issues surrounding ODE in patients with dementia, especially in patients with advanced stages of dementia, warrant further exploration, including the timing of discussing organ donation after the initial euthanasia request.

Food fraud (often called fake food in South Africa) the deliberate misrepresentation or adulteration of food products for financial gain, is a growing problem in South Africa (SA) with severe public health and financial consequences for consumers and businesses. The recent public outcry against food fraud practices especially in communities that have lost loved ones due to the consumption of allegedly adulterated foodstuffs, highlights the grave danger that food fraud poses to consumers and the potential for significant reputational damage to food manufacturers. Despite the risks, food fraud often goes undetected, as perpetrators are becoming increasingly sophisticated. The precise magnitude of food fraud remains obscure, as incidents that do not cause consumer illnesses are frequently unreported and, as a result, are not investigated. Food fraud costs the global economy billion annually. This cost is borne by consumers, businesses, and the government. Food fraud can occur at any stage of the food supply chain, from production to processing to retailing or distribution. This is due in part to the limitations of current analytical methods, which are not always able to detect food fraud. This review of food fraud in SA looks at several factors that may be contributing to epidemic of food fraud, including inadequate penalties, inadequate government commitment, a complex labelling regulation, emerging threats such as e-commerce, and shortage of inspectors and laboratories. The review recommends establishing a single food control/safety authority, developing more food safety laboratories, and adopting innovative technologies to detect and prevent food fraud. SA faces a serious food fraud crises unless decisive action is taken.

OBJECTIVE: To describe a process model for assisting partners in addressing requirements of legislation and review policy analysis, planning, and evaluation design processes and tools. Throughout its 25-year history, the United States Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) program has been a forerunner in partnering with organizational leaders to improve health care. The Foundations of Evidence-based Policymaking Act of 2018 provided new opportunities for QUERI and other implementation scientists to support federal agency leaders in implementing, evaluating, and reporting on congressionally mandated programs. Although implementation scientists have the skills to support partnered implementation and evaluation, these skills must be adapted for congressionally mandated projects as many scientists have limited experience in policy analysis and the intersection of data informing organizational policy, programs, and practices (i.e., evidence-based policy).
METHODS: During the conduct of four congressionally mandated projects, our national VA QUERI team developed processes and tools to achieve the goals and aims of our VHA partners and to ensure our collective work and reporting met legislative requirements.
METHODS: Our process model, program planning, and analysis tools were informed by an iterative process of refining and adapting the tools over a period of six years, spanning the years 2017 to 2023.
RESULTS: Work to support our partners was conducted across three phases: preparation and planning, conducting implementation and evaluation, and developing the congressionally mandated report. The processes and tools we developed within the context of mutually respectful and honest partnerships have been critical to our QUERI center\'s success in this area.
CONCLUSIONS: Lessons we learned may help other scientists partnering in VA or other federal agencies to plan, conduct, and report on congressionally mandated projects.