"They talked to me like I was dirt under their feet:" Treatment and withdrawal experiences of incarcerated pregnant people with opioid use disorder in four U.S. states.

Background: Many pregnant individuals with opioid use disorder (OUD) spend time in jail, yet access to standard of care medications for OUD (MOUD) in jail is limited. Though qualitative studies of non-incarcerated pregnant and non-pregnant incarcerated individuals with OUD demonstrate complexities that must be considered in delivering effective care, studies with pregnant, incarcerated patients with OUD are lacking.

Methods: We conducted semi-structured qualitative interviews from October 2020-November 2021 with pregnant and postpartum people with OUD who were currently or previously in jail in Florida, Maryland, Ohio, and Virginia.

The Home-Built Environment of Children With Medical Complexity.

This study aimed to describe the home-built environment of children with medical complexity (CMC) using novel photovoice methodology. Parents/guardians of CMC uploaded and discussed photographs of their home environment through semi-structured interviews. Conventional content analysis was applied to interview transcripts embedded with corresponding photographs.

Alterations in care for children with special healthcare needs during the early COVID-19 pandemic: ethical and policy considerations.

Healthcare delivery and access, both in the United States and globally, were negatively affected during the entirety of the COVID-19 pandemic. This was particularly true during the first year when countries grappled with high rates of illness and implemented non-pharmaceutical interventions such as stay-at-home orders. Among children with special healthcare needs, research from the United Kingdom (U.

Act on a mandate to protect research subjects' privacy.

Congress called for the protection of data from legal process.

Perceptions of Molecular HIV Surveillance Among Men Who Have Sex with Men in the United States.

Expanding HIV cluster detection using molecular HIV surveillance (MHS) raises ethical and social concerns, which may impede HIV outbreak detection and response as well as deter people living with HIV from seeking care. This underscores the need for effective communication strategies. We examined two methods for explaining MHS among men who have sex with men (MSM) living with HIV and at-risk without HIV in the United States.

Recognizing the ethical complexity of food policies and the role of the food industry.

Restrictive food policies are often contentious and controversial. Supporters of these policies view them as imperative for achieving public health aims while some opponents view them as overly paternalistic, infringing on consumer choice and potentially inequitable. As a consequence, their ethical status and permissibility are both contested and of importance in decision-making for policy.

Ethical considerations for sharing aggregate results from pragmatic clinical trials.

A growing literature has explored the ethical obligations and current practices related to sharing aggregate results with research participants. However, no prior work has examined these issues in the context of pragmatic clinical trials. Several characteristics of pragmatic clinical trials may complicate both the ethics and the logistics of sharing aggregate results.

Ethical issues in implementation science: perspectives from a National Heart, Lung, and Blood Institute workshop.

Ethical issues arise in the context of implementation science that may differ from those encountered in other research settings. This report, developed out of a workshop convened by the Center for Translation Research and Implementation Science within the United States National Heart, Lung, and Blood Institute, identifies six key themes that are important to the assessment of ethical dimensions of implementation science. First, addressing ethical challenges in implementation science does not require new ethical principles, commitments, or regulations.

Baseline Characteristics and Clinical Outcomes of Patients Seen Through the Free Diabetes Screening (FDS) Program.

Purpose: To characterize the baseline characteristics and clinical outcomes of patients seen through the Free Diabetic Screening (FDS) program, a free diabetic retinopathy screening program for uninsured patients, in the ophthalmology resident clinic at the Wilmer Eye Institute.

Patients And Methods: This retrospective longitudinal cohort study included uninsured patients ≥18 years with diabetes mellitus seen through the FDS clinic from 2013 to 2023. Data extraction was performed using manual chart review of the first FDS visit, and automated extraction of the data warehouse related to all other office visits.

Addressing ethical issues in healthcare artificial intelligence using a lifecycle-informed process.

Objectives: Artificial intelligence (AI) proceeds through an iterative and evaluative process of development, use, and refinement which may be characterized as a lifecycle. Within this context, stakeholders can vary in their interests and perceptions of the ethical issues associated with this rapidly evolving technology in ways that can fail to identify and avert adverse outcomes. Identifying issues throughout the AI lifecycle in a systematic manner can facilitate better-informed ethical deliberation.

Associations between School-Based Vision Program Outcomes and School Characteristics in 410 Schools.

Objective: School-based vision programs (SBVPs) deliver vision care services directly to students at school, helping address disparities in access to pediatric vision care. We aim to evaluate the associations between SBVP outcomes and school-level characteristics.

Design: Retrospective cross-sectional data analysis PARTICIPANTS: Public schools with at least 50 SBVP-enrolled students 5 to 22 years old with complete demographic data.

Justifications and acceptability of coercive public health measures in the COVID-19 response in South Africa: a case study of the jurisprudence of human rights cases.

South Africa implemented a comprehensive response to COVID-19 comprising of several coercive public health measures. As in many countries, COVID-19 measures were subject to a number of legal challenges on the grounds that these measures infringed on individual rights and liberties. Here, courts were required to assess the extent to which these limitations were justifiable against the state's imperative to improve public health.

Optimizing Diversity, Equity and Inclusion in Pragmatic Clinical Trials: Findings from the Pain Management Collaboratory.

The National Institutes of Health, U.S. Department of Defense, and U.

When Black and White Turns Gray: Navigating the Ethical Challenges of Implementing Shared Infant Feeding Decisions for Persons Living with Human Immunodeficiency Virus in the United States.

In 2023, US guidelines for feeding perinatally human immunodeficiency virus (HIV)-exposed infants were revised to encourage collaborative decision-making in lieu of categorical proscription of breastfeeding. This change advances autonomy and health equity for persons living with HIV in the United States, for the first time supporting those who prioritize the maternal and infant benefits of breastfeeding in the setting of effective, well-established HIV risk mitigation. The authors review key moral dilemmas facing clinicians and patients who must navigate the reversal of longstanding dogma against breastfeeding and provide recommendations for implementation of a new ethical paradigm.

Making the Ethical Oversight of All Clinical Trials Fit for Purpose.

Importance: With the increase in trials assessing comparative effectiveness of approved products and alternative care strategies, guidance is needed to ensure ethical oversight is fit for purpose for the risks, burdens, and constraints on choice this research presents.

Observations: US regulations governing human research emerged in response to horrific research abuses, reinforcing the view that research holds greater risks, uncertainties, and potential for abuse than clinical care, and thus protections and oversight are required for research, but not for care. The research oversight system established by these regulations has been effective, with most clinical research reviewed in advance for possible risk and burdens and for threats to autonomy and justice.

Recall and Appraisal of the Risks, Benefits, and Objectives of Interrupting HIV Treatment in an HIV Cure-Related Study.

The goal of HIV cure research is to either eliminate HIV from the body or durably suppress it in the absence of antiretroviral therapy (ART). This research often requires participants to interrupt ART. However, there are numerous risks associated with ART interruptions and therefore it is critical to understand how people with HIV (PWH) who participate recall the elements of consent, to safeguard their rights and welfare.