(224 words)A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent 'players' in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we explore the case of private Argentinean fertility clinics that market reproductive services via the Internet, to examine the context-specific ethical and policy implications. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopt safe and responsible medical practices.

Food allergy in children is a growing public health problem that carries a significant risk of anaphylaxis such that schools and child care facilities have enacted emergency preparedness policies for anaphylaxis and methods to prevent the inadvertent consumption of allergens. However, studies indicate that many facilities are poorly prepared to handle the advent of anaphylaxis and policies for the prevention of allergen exposure are missing essential components. Furthermore, certain policies are inappropriate because they are blatantly discriminatory. This article aims to provide further guidance for school health officials involved in creating food allergy policies. By structuring policies around ethical principles of confidentiality and anonymity, fairness, avoiding stigmatization, and empowerment, policy makers gain another method to support better policy making. The main ethical principles discussed are adapted from key values in the bioethics and public health ethics literatures and will be framed within the specific context of food allergy policies for schools.

INTRODUCTION:The pharmacological treatment of Major Depressive Disorder (MDD) continues to rely predominantly on a trial-and-error approach. Here, we introduce an artificial intelligence (AI) model aiming to personalize treatment and improve outcomes, which was deployed in the Artificial Intelligence in Depression -Medication Enhancement (AID-ME) Study.OBJECTIVES: 1) Develop a model capable of predicting probabilities of remission across multiple pharmacological treatments for adults with at least moderate major depression. 2) Validate model predictions and examine them for amplification of harmful biases. METHODS: Data from previous clinical trials of antidepressant medications were sourced from the NIMH, collaborating researchers, and pharmaceutical open science platforms, and standardized into a common framework. Our analysis included 9,042 adults with moderate to severe major depression from 22 studies, each lasting 8-14 weeks, and covering 10 different treatments. The data was divided into training, validation, and held-out test sets. Feature selection selected 25 clinical and demographic variables. Using Bayesian optimization, a deep learning model was trained on the training set and refined using the validation set before being tested once on the held-out test set. Pre-specified post-hoc testing was performed to assess for potential clinical utility as well as risk of the amplification of harmful biases and biased subgroup performance.RESULTS: In the evaluation on the held-out test set, the model demonstrated a performance with an AUC (Area Under the Curve) score of 0.65. The model outperformed a null model on the test set (p = 0.01). The model demonstrated notable clinical utility, achieving an absolute improvement in population remission rate from 43.15% to 53.99% under hypothetical "naive" analysis and an improvement from 43.21 to 55.08% improvement under actual improvement "conservative" analysis on the testing data. While the model did identify one drug (escitalopram)

Medical tourism is a general term that describes patients traveling to obtain health services. The growth of medical tourism is due to a broad range of motivators and increasingly, developing countries are seeking to capitalize on these flows and are linking medical care with actual tourist activities. This commercial linkage between healthcare and tourism is a rapidly developing and profitable industry that is attracting growing interest amongst health researchers. This article summarizes seven leading issues concerning medically-motivated travel that were identified by academic researchers during a November 2009 Symposium on the Implications of Medical Tourism for Canadian Health and Health Policy. These issues include emerging technologies, particular vulnerable populations, Canadian business ties to the industry, patient populations excluded from analysis, and comparative analyses between health service providers for medical travelers. This article aims to help guide researchers as they investigate ethical, legal, social, public health, and economic issues related to the growing medical tourism industry.

Despite over a century of clinical use and a well-documented record of efficacy and safety, a growing minority in society questions the validity of vaccination and fear that this common public health intervention is the root-cause of severe health problems. This article questions whether growing public anti-vaccine sentiments might have the potential to spill-over into other therapies distinct from vaccination, namely allergen-immunotherapy. Allergen-immunotherapy shares certain medical vernacular with vaccination (e.g., allergy shots, allergy vaccines), and thus may become "guilty by association" due to these similarities. Indeed, this article demonstrates that anti-vaccine websites have begun unduly discrediting this allergy treatment regimen. Following an explanation of the anti-vaccine movement, the article aims to provide guidance on how clinicians can respond to patient fears towards allergen-immunotherapy in the clinical setting. This guide focuses on the provision of reliable information to patients in order to dispel misconceived associations between vaccination and allergen-immunotherapy, and the discussion of the risks and benefits of both therapies in order to assist patients in making autonomous decisions about their choice of allergy treatment.