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This review considers juvenile delinquency and justice from an international perspective. Youth crime is a growing concern. Many young offenders are also victims with complex needs, leading to a public health approach that requires a balance of welfare and justice models. However, around the world there are variable and inadequate legal frameworks and a lack of a specialist workforce. The UK and other high-income countries worldwide have established forensic child and adolescent psychiatry, a multifaceted discipline incorporating legal, psychiatric and developmental fields. Its adoption of an evidence-based therapeutic intervention philosophy has been associated with greater reductions in recidivism compared with punitive approaches prevalent in some countries worldwide, and it is therefore a superior approach to dealing with the problem of juvenile delinquency.

Vaccines are one of our most successful tools for protecting the public's health. It seems simple: a pharmaceutical company develops a new vaccine, the U.S. Food and Drug Administration (FDA) licenses it, health-care providers give it to their patients, and we see disease disappear. But vaccination in the United States is much more complex and only made possible through a robust public-private partnership that begins with the development of the vaccine and continues long after it is used routinely. Along every step of the way, public health-at the national, state, and local levels-plays a fundamental role. The success of the pneumococcal conjugate vaccine (PCV) in preventing suffering, disability, and death is one example that illustrates the essential role of our nation's public health systems and workforce in protecting us from vaccine-preventable diseases (VPDs). Streptococcus pneumoniae (pneumococcus) is a major cause of invasive disease, including meningitis, pneumonia, and bacteremia. In the absence of a pediatric vaccine, pneumococcus was a significant public health concern, causing approximately 63,000 cases of invasive pneumococcal disease and 6,100 deaths in the U.S. each year. 1 Young children and older adults are especially vulnerable, and many children who develop pneumococcal meningitis have long-term complications such as deafness or seizures. In 2000, a pediatric heptavalent PCV (PCV7) was licensed for use in the U.S. There are more than 90 strains of pneumococcal bacteria, and PCV7 provided protection against seven of them. Before PCV7 was introduced, these seven strains caused more than 80% of severe pneumococcal infections among children. 2 Most health-care providers in the U.S. look to public health for guidance in the use of vaccines. After a careful review of the evidence, including data about the burden of disease caused by pneumococcus, the effectiveness and safety of the vaccine, and the feasibility of incorporating it into the immunization program, the Advisory Committee on Immunization Practices (ACIP) made a recommendation for the routine use of PCV7 among children, 2 and the Centers for Disease Control and Prevention (CDC) incorporated it into the immunization schedule, which gives doctors specific recommendations for the use of vaccines across the life span. Public health helps inform people about the vaccines they need and the risks and benefits of receiving vaccines. Parents consider many factors when deciding to vaccinate their children. Using science-based strategies, public health provided parents with information about the risks of pneumococcal disease and the benefits of the new vaccine. State and local public health experts worked with the health-care providers in their communities to make sure they had the National Vaccine Advisory Committee National Vaccine Advisory Committee

The Toxicology Investigators Consortium (ToxIC) Core Registry was established by the American College of Medical Toxicology in 2010. The Core Registry collects data from participating sites with the agreement that all bedside and telehealth medical toxicology consultations will be entered. This twelfth annual report summarizes the registry’s 2021 data and activity with its additional 8552 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from January 1 to December 31, 2021. Detailed data was collected from these cases and aggregated to provide information, which included demographics, reason for medical toxicology evaluation, agent and agent class, clinical signs and symptoms, treatments and antidotes administered, mortality, and whether life support was withdrawn. Gender distribution included 50.4% of cases in females, 48.2% of cases in males, and 1.4% of cases in transgender or gender non-conforming individuals. Non-opioid analgesics were the most commonly reported agent class (14.9%), followed by opioids (13.1%). Acetaminophen was the most common agent reported. Fentanyl was the most common opioid reported and was responsible for the greatest number of fatalities. There were 120 fatalities, comprising 1.4% of all cases. Major trends in demographics and exposure characteristics remained similar to past years’ reports. Sub-analyses were conducted to describe new demographic characteristics, including marital status, housing status and military service, the continued COVID-19 pandemic and related toxicologic exposures, and novel substances of exposure. Supplementary Information The online version contains supplementary material available at 10.1007/s13181-022-00910-6.

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