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Yemen’s health care system has been critically disrupted by ongoing conflict, resulting in severe deficiencies in toxicology services. Toxicological emergencies, including poisonings, chemical exposures, and drug overdoses, represent a significant and underreported public health burden, compounded by systemic resource and training gaps.
Objective
To evaluate the availability, functionality, and safety of toxicology services in Yemen and identify key challenges faced by health care providers.
Methods
A cross-sectional, mixed-methods study was conducted using online surveys, key informant interviews, and facility audits. Quantitative data from 158 health care workers were analyzed using SPSS version 23, while qualitative data were thematically analyzed to provide contextual insights.
Results
Toxicology services were unavailable in 72.4% of facilities, with 78.8% lacking dedicated toxicology units. Pesticide poisoning (73.1%), chemical exposure (58.3%), and drug overdose (49.1%) were the most frequently encountered emergencies. Significant barriers included a lack of antidotes (80.8%), diagnostic tools (85.4%), and adequately trained personnel (81.5%), with only 20% of health care workers receiving formal toxicology training. Furthermore, 70.1% of respondents reported no access to poison control centers, and 57.7% indicated the absence of referral laboratories.
Conclusion
Yemen’s toxicology services face critical gaps in resources, training, and diagnostics. Practical steps such as basic toxicology training, improved antidote access, and mobile health support can enhance emergency care in this resource-limited setting.
This paper examines the transformation of Anglican identity during a particularly intense period of decolonisation and political activism in Aotearoa New Zealand: 1970s to 1980s. Particular focus is given to the Revd Dr George Armstrong, an icon of Anglican activism in this era. Being at the forefront of demonstrations against nuclear warships, the apartheid-era Springbok Rugby Tour, and racism against Māori, Armstrong redefined his priestly role and the place of liturgy through public resistance. I argue that Armstrong’s emergence as the nation’s foremost priestly activist is best understood within the context of a decolonising New Zealand with implications for how the broader Anglican Church was renegotiating its role with the nation. This paper explores the key events and theological influences shaping Armstrong’s witness, including the role of protests, liturgy, and shifting assessments of settler colonial Anglicanism.
We study the activated random walk model on the one-dimensional ring, in the high-density regime. We develop a toppling procedure that gradually builds an environment that can be used to show that activity will be sustained for a long time. This yields a self-contained and relatively short proof of existence of a slow phase for arbitrarily large sleep rates.
In the first third of the fifteenth century, the University of Vienna actively resisted Wycliffism and Hussitism in various ways. This study explores the early skepticism of Viennese university masters toward peace negotiations with the Hussites, focusing on a previously unknown exhortation in which the Bohemian-Austrian nobility urged King Sigismund to take decisive action against the heretics. The only known manuscript dates the text to 1419, but this early date seems unlikely. Various clues suggest that the letter was written within the University of Vienna as a protest against King Sigismund’s conciliatory policies in the summer of 1429. By that time, the monarch had initiated negotiations for a general truce with the Hussites in preparation for his planned coronation journey to Italy. Given that the author employed literary fiction and symbolic communication to influence the king in a politically sensitive moment, this study also examines innovations in communication and textual media amid the late medieval ecclesiastical crisis (1378–1449). It additionally includes a critical edition of the exhortation’s Latin text, accompanied by an annotated English translation.
Patients living with nociplastic pain are at particular risk of being unfairly judged because their symptoms are subjective and occur without measurable abnormalities. Nociplastic pain, now recognized as a third category of pain alongside nociceptive and neuropathic pain, arises in the absence of tissue damage sufficient to explain the clinical presentation. This “unseen” pain affects at least ten percent of the population, commonly involves the musculoskeletal or visceral systems, and leads to substantial suffering and functional impairment. Validation of these chronic symptoms is often contentious because no objective biomarker or physical sign can reliably confirm their presence or severity. The concept of illness without measurable parameters challenges clinicians and conflicts with legal systems that rely heavily on objective evidence in adjudicating health-related questions. Most clinicians have limited training in medicolegal principles, standards of impartiality, or the ethical distinctions between patient advocacy and objective reporting. These challenges are amplified in cases involving chronic nociplastic pain, where the lack of observable findings complicates clinical interpretation and may conflict with traditional expectations for legal evidence. Bias, whether conscious or unconscious, may occur at multiple stages of the medicolegal process. Inaccurate, incomplete, or biased information from patients, treating clinicians, independent medical experts, insurers, or legal representatives can influence fairness, credibility, and decisional outcomes. This review summarizes key considerations in the adjudication of chronic nociplastic pain and examines how various sources of bias may shape medicolegal decision-making. Improving awareness of these risks and implementing strategies to reduce bias may promote a more reliable and equitable interface between clinical assessment and legal adjudication.
Discrepancies in iodized salt coverage rate (ISCR) between household salt and that used in catering establishments may significantly compromise the accuracy of dietary iodine intake assessments. To evaluate this impact, we analyzed data from the 2023 Shanghai Diet and Health Survey, a cross-sectional study involving 2920 adults. Dietary intake was assessed using three 24-hour dietary recalls and a food frequency questionnaire, while condiment intake was collected using the weighed inventory method. Additionally, salt samples from 960 canteens and restaurants were tested to determine the ISCR in dining establishments. Results showed that the ISCR was 85.9% in dining establishments, markedly higher than the 53.3% observed in households. Among employed participants in Shanghai, 51.7%, 56.1%, and 18.7% reported consuming breakfast, lunch, and dinner outside the home at least once during the three-day study period, respectively. The estimated daily iodine intake was 101 μg/day when dining-out salt was assumed to have the same ISCR as household salt, but it increased to 118 μg/day after accounting for the ISCR discrepancy. In conclusion, the rising prevalence of eating out has reshaped residents’ dietary habits, rendering traditional household-centric survey methods inadequate for iodine intake estimation in Shanghai. Incorporating ISCR differences between household and dining settings is essential for more accurate dietary iodine assessments.
This study examines the association between air pollution exposure and health using a representative survey sample from Siddharthanagar municipality of Nepal. Our data on household characteristics, spatial locations and individual lung function allow us to understand heterogeneity in exposure and respiratory health. We examine exposure differential through three potential mechanisms – occupation, residence and exposure avoidance. We employ a simultaneous equations model to account for the endogenous choice of avoidance and spatial error models to control for the spatial spillover of health outcomes. We find that outdoor workers and those residing near brick kilns have lower lung function. Exposure avoidance positively correlates with lung function. Exposure avoidance, however, is low among marginalized outdoor workers and individuals residing in polluted areas, further exacerbating the exposure gap among socioeconomic subgroups. The study advances the case of environmental inequity through the ‘triple jeopardy’ of low socioeconomic status, exposure differences and poor health.
Senatorial scrutiny of judicial nominees has long centered on the role of confirmation hearings in advice and consent, but senators draw on multiple sources of information when evaluating nominees for lifetime appointments to the federal bench. Questions for the Record (QFRs) – written questions submitted to nominees after the conclusion of their hearings – are a common yet understudied component of the Judiciary Committee’s vetting process. I analyze the use of QFRs for all Circuit Court of Appeals nominees from 2001 to 2022, finding that partisan differences between the nominating president and senator strongly structure who submits them, while interest group opposition to a nominee, though significant, plays a more modest role than it does in senators’ question-asking behavior during confirmation hearings. Moreover, senators’ use of QFRs has increased substantially in recent sessions of Congress, especially following reforms to the filibuster in 2013. These findings suggest that QFRs are not simply an extension of hearing questions. Instead, they serve their own vetting functions for Committee senators, particularly for outpartisans, those highly engaged in the process, and when time constraints may limit other means of vetting.