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PubMed2026

Silent crises in the COVID-19 pandemic shadow: a six-year medico-legal review of non-lethal intimate partner violence in Morocco.

Intimate partner violence (IPV) is a major global public health concern and one of the most prevalent forms of gender-based violence, with significant consequences. This study analyzes non-lethal IPV cases reported to a medico-legal unit of Casablanca between 2018 and 2023. Data from 4,784 female victims were reviewed, focusing on socio-demographics, violence types, perpetrator relationships, and judicial involvement across the pre-COVID, peak COVID-19, and post-COVID periods. Married women represented 59.2% of victims. Physical violence predominated (83.1%), while sexual violence was underreported (14.7%). The year 2020 marked a sharp increase in reported non-lethal IPV cases (n = 1,005), correlating with pandemic confinement. Among married women, judicial requisition (legal request for forensic examination) and medico-legal certification (medical documentation for judicial use) rates were high (81.5% and 81.0%, respectively). Post-pandemic years declined moderately but remained above pre-COVID levels. International comparison confirmed a global rise in IPV during COVID-19, with Morocco displaying comparatively higher rates of medico-legal documentation and judicial involvement. IPV in Morocco is entrenched and intensified by COVID-19. While the medico-legal system is robust in documentation, the system must evolve by integrating systematic psychological assessment into medico-legal evaluations, standardizing certification and referral protocols, and strengthening coordination between medico-legal, health, and social support services to improve victim protection.

Humans↗
PubMed2026

Tele-Oncology in the Post-Pandemic Era: Clinical Integration, Access Disparities and Medico-Legal Accountability.

PURPOSE OF THE REVIEW: Tele-health has evolved from a marginal tool confined to rural populations and selected follow-up programs into a structurally integrated component of modern cancer care. Prior to COVID-19, its adoption was constrained by regulatory fragmentation, non-uniform reimbursement, and licensure barriers. This narrative review evaluates the evolutionary integration of tele-health in oncology post-COVID-19, examines digital disparities across patient populations, and addresses the medico-legal implications of this integration, with the objective of providing a comprehensive and clinically actionable framework for the governance of virtual oncology care. RECENT FINDINGS: The pandemic acted as a global catalyst, driving telehealth to over 50% of oncology outpatient encounters in some settings, before stabilising post-pandemic at approximately 10-20% of consultations within hybrid care models. Evidence supports meaningful clinical benefits - improved access to specialist services, reduced travel burden, and sustained continuity of care - with outcomes comparable to in-person care in postoperative follow-up, symptom monitoring, and survivorship. However, persistent disparities in device availability, connectivity, and digital literacy disproportionately affect older, rural, and socioeconomically disadvantaged patients, raising the risk that geographic inequalities are replaced by technological ones. From a medico-legal standpoint, the remote modality does not modify the applicable standard of care, yet restricted physical examination and reliance on patient-reported data introduce risks of diagnostic delay and incomplete clinical assessment, with direct implications for professional liability, data protection under HIPAA and GDPR, cross-border licensure, and multi-party accountability across physicians, institutions, and technology providers. Tele-oncology has become a permanent structural feature of modern cancer care, offering demonstrable benefits in access, continuity, and patient satisfaction. Yet its integration has been uneven, its governance remains fragmented, and its medico-legal landscape is still evolving. Realising the full potential of virtual oncology care - equitably and safely - requires coherent regulatory frameworks, sustained investment in digital infrastructure, and explicit attention to the populations at greatest risk of being left behind.

Humans↗
PubMed2026

A profile of suspected female homicide cases at the Johannesburg and Diepkloof Forensic Pathology Service Medico-legal Mortuaries for 2020-2022.

This study profiles suspected female homicide victims in Johannesburg, South Africa, during the COVID-19 period marked by socio-environmental changes from lockdown restrictions. Guided by the Socio-Ecological Model, a retrospective case series of 369 victims was reviewed using medico-legal mortuary records from Johannesburg and Diepkloof Forensic Pathology Service facilities. Descriptive analyses were conducted, supplemented by a chi-square test to assess whether distributions of causes of death among women differed between COVID-19 and non-COVID-19 periods. No statistically significant association was found, χ2 (6, N = 339) = 6.68, p = 0.35. Key findings highlight that Black, unemployed, unmarried women aged 21-40 were at greatest risk. Cause of death was established in 97.0% (358/369) of cases, with firearm injuries predominating (43.9%), followed by sharp‑force (24.5%) and blunt‑force trauma (13.1%). Approximately 90% of victims were suspected to have been killed by males, with half of deaths attributed to intimate partner violence. Homicide frequency decreased during strict lockdowns but rose as restrictions eased, suggesting that movement and alcohol controls may reduce risk. Despite temporary disturbance caused by COVID‑19 restrictions, the underlying risk profile of female homicide victims remained unchanged. These findings inform multi-level prevention and intervention strategies in South Africa.

Humans↗
PubMed2026

A profile of abandoned fetal and neonatal remains admitted to the Diepkloof forensic pathology service medico-legal mortuary during the COVID-19 and post-COVID-19 periods.

The abandonment of neonates is a global concern, with a higher prevalence of cases present in South Africa. This study aimed to review cases admitted to the Diepkloof Forensic Pathology Service during the COVID-19 (2020-2021) and post-COVID-19 (2023) periods. A total of 158 cases were analysed to determine prevalence, demographic characteristics, circumstances and causes of death, with a comparative analysis between the COVID-19 and post-COVID-19 periods. Most cases were classified as natural. However, many were undetermined due to decomposition. Non-viable fetuses (< 26 wk gestation) comprised 47% of the cases. Among the viable births (n&#x2009;=&#x2009;72), 23 (32%) were classified as stillbirths, while 11 (15%) were live births. A minority of cases were deemed unnatural, with deaths attributed to trauma (8 cases) or abandonment (2 cases). No statistically significant difference was found between the COVID-19 and post-COVID-19 periods. Decedents were most often found in open spaces, roads or streets, or dumping sites, most commonly wrapped in plastic materials. These findings highlight the severity of fetal and neonatal abandonment. They underscore a pressing need for targeted preventative measures, community outreach, and enhanced support systems in maternal healthcare to address this growing concern.

Humans↗
PubMed2026

A profile of firearm-related fatalities admitted to the Diepkloof Forensic Pathology Service Soweto medico-legal mortuary during the COVID-19 and post COVID-19 periods.

This retrospective descriptive study examined firearm-related fatalities during (April-December 2020; n&#x2009;=&#x2009;241) and after (April-December 2023; n&#x2009;=&#x2009;299) COVID-19 lockdowns using 540 cases from the Diepkloof Forensic Pathology Service, Soweto, South Africa. Data was obtained from autopsy reports, forensic records, police statements, and death scene documentation. Firearm violence affected young adult Black males (22-43&#x2009;years), with only minor demographic shifts post-pandemic. The overall burden and core patterns of violence remained stable, with criminal activity - primarily robbery and interpersonal violence - persisting as the leading contexts, and homicide the dominant manner of death. Post-COVID-19 findings demonstrated contextual shifts, including increased incidents in public and social environments, reflecting greater mobility and resumption of social activity. A significant rise in mean blood alcohol concentration (0.09&#x2009;g/100&#x2009;mL vs 0.14&#x2009;g/100&#x2009;mL; p&#x2009;<&#x2009;0.0001) suggests increased alcohol involvement following easing of restrictions. Unfortunately, persistent information gaps, noted particularly in circumstantial history, incident location, firearm type, highlighting the need for improved data provision and capture systems. While the epidemiology of firearm-related fatalities remained unchanged, the post-COVID-19 period was characterised by increased alcohol involvement, shifts toward public-space violence, and fewer gunshot wounds per victim, suggesting changes in situational and behavioural dynamics rather than underlying drivers of violence.

Humans↗
PubMed2026

Civil liability in oral & maxillofacial surgery: &#x391; systematic review.

Maxillofacial surgery is a surgical specialty with anatomical, functional, and aesthetic requirements, which makes it a field at increased risk of medical negligence and subsequent legal claims. The review was conducted in accordance with the PRISMA guidelines and used international medical and legal databases. Studies that analyzed court decisions, insurance claims, or recorded compensation data related to maxillofacial surgery were included. The extracted data included, among others, the year and country of publication, the causes of action, and the amounts of financial compensation. Most lawsuits originate from countries with developed medical liability systems, primarily the United States and the United Kingdom, and there has been an increasing trend in publications over the last two decades. The most common causes of lawsuits involve nerve injuries, delayed or incorrect diagnoses, technical errors during surgery, and inadequate informed consent. The amounts of compensation vary widely, from lower five-digit amounts in milder cases to particularly high amounts in cases of permanent functional or aesthetic damage, placing a significant overall financial burden on health systems. Medical negligence in maxillofacial surgery constitutes an important forensic and socioeconomic issue. Understanding the causes of lawsuits and their financial consequences can help improve clinical practice, inform patients, and prevent legal disputes.

Humans↗
PubMed2026

How Following Medical Artificial Intelligence Advice Can Mitigate Malpractice Liability: Cross-National Insights from a Randomized Trial.

Artificial intelligence (AI) increasingly influences clinical decision-making, yet its recommendations may diverge from standard care. Although malpractice concerns are thought to discourage physicians from following AI advice, experimental evidence from the United States suggests the opposite: lay jurors are more likely to hold physicians liable when they reject AI recommendations. Whether this pattern extends to systems in which court-appointed experts, not lay jurors, determine liability remains unknown. Methods: To examine how physicians and laypeople in expert-based and lay-juror legal systems evaluate physicians' acceptance or rejection of AI recommendations, particularly when those recommendations deviate from standard care, we designed a randomized vignette study: a 2 &#xd7; 2 factorial design varying the AI recommendation (standard vs. nonstandard care) and a fictional physician's decision (accept vs. reject). The study was conducted online in 2023 among nationally representative samples of U.S. and German adults and from 2023 to 2024 among German physicians. In total, 387 German physicians, 2291 U.S. adults, and 2283 German adults participated; those not completing the survey or failing attention checks were excluded per preregistered criteria. Participants were randomly assigned to 1 of 4 vignettes, varying the AI recommendation (standard vs. nonstandard care) and physician's decision (accept vs. reject). The reasonableness of the fictional physician's decision was measured, rated by participants on a Likert scale. Results: Analysis, following preregistered exclusion criteria, included 248 German physicians, 1202 U.S. adults, and 1358 German adults. Physicians accepting standard-care AI recommendations were rated more reasonable than those rejecting them (U.S. laypeople: t = 5.36; 95% CI, 0.45-0.97; P < 0.001; German physicians: t = 2.47; 95% CI, 0.14-1.30; P = 0.02; German laypeople: t = 4.14; 95% CI, 0.27-0.76; P < 0.001). Ratings of physicians accepting versus rejecting AI nonstandard-care recommendations were statistically equivalent. Equivalence was tested at an &#x3b1;-value of 0.05 using a two 1-sided tests procedure, reported with 90% CIs per standard convention (U.S. laypeople: t = -4.90; 90% CI, -0.1 to 0.36; P < 0.001; German physicians: t = -1.76; 90% CI, -0.12 to 0.67; P = 0.04; German laypeople: t = 5.35; 90% CI, -0.35 to 0.06; P < 0.001). Conclusion: Across the United States and Germany, samples representative of lay jurors and court-appointed experts viewed accepting standard-care AI advice as more reasonable, whereas accepting or rejecting nonstandard-care AI advice was judged similarly. Contrary to predictions, malpractice liability regimes do not necessarily pose a barrier to AI use in precision medicine.

Artificial Intelligence↗
PubMed2026

Implementation factors shaping British Columbia's drug decriminalization pilot: A systematic review with narrative synthesis.

BACKGROUND: In January 2023, British Columbia (BC) became the first Canadian province to implement a legally sanctioned drug decriminalization policy, removing criminal penalties for adults possessing 2.5 g or less of opioids, cocaine, methamphetamine, and MDMA. Introduced as a three-year pilot, it aimed to reframe substance use as a public health issue, reduce stigma, and improve health and social service engagement. Criminal penalties were reintroduced for drug possession in most public spaces in May 2024, and the pilot ended in January 2026. Its termination has been interpreted as policy failure; this review aimed to examine how the pilot was implemented in practice and to identify factors that shaped its operationalization and early implementation-relevant outcomes. METHODS: We conducted a systematic review with narrative synthesis of peer-reviewed literature examining implementation-relevant aspects of BC's decriminalization pilot. Six databases were searched (January-February 2026) for studies published May 31, 2022-February 1, 2026. The protocol was registered in PROSPERO (CRD420251271694). RESULTS: Twenty-seven studies were included. Four cross-cutting implementation barriers were identified: pilot design features, public and cross-sector communication gaps, limited frontline training, and insufficient funding and infrastructure. Design features included the 2.5 g possession threshold, misalignment with real-world drug use patterns; the three-year timeframe, which constrained system-level effects; and the May 2024 amendment, which introduced additional instability. The pilot was implemented without commensurate investment in harm reduction, treatment, or housing infrastructure, within already constrained systems. CONCLUSION: BC's decriminalization pilot suggests the effects of legal reform are shaped by implementation context. Early outcomes may reflect design features, institutional readiness, and system capacity rather than legal change alone; longer-term impacts remain uncertain. Future reforms should align legal change with coordinated implementation, operational guidance, public communication, and adequate service infrastructure.

British Columbia↗
PubMed2026

Psychological impacts of APOE genotype disclosure among Latinos in New York City: a randomized controlled trial.

INTRODUCTION: Latinos face increased Alzheimer's disease (AD) risk but are underrepresented in studies of APOE genotype disclosure. We evaluated the psychological impacts of APOE disclosure in the Informaci&#xf3;n de la Enfermedad de Alzheimer para Latinos (IDEAL) study, a randomized controlled trial among Latinos in New York City. METHODS: Latino northern Manhattan residents without self-reported AD (mean age 52, 69% women, 49% college graduates) were randomized in the period August 2021 to July 2024 to receive AD risk estimates to age 85 incorporating APOE genotype, family history, and ethnicity (disclosure) or the same factors excluding APOE (non-disclosure). Bilingual genetic counselors delivered risk estimates to both groups, unmasked to randomization. Follow-up surveys were completed 6&#xa0;weeks, 9 months, and 15 months after risk delivery. Primary outcomes were impact of genetic testing in AD (IGT-AD) and Impact of Event Scale-Revised (IES-R). Secondary outcomes were changes from baseline in depression, anxiety, and perceived AD threat. Analyses used intention-to-treat with multiple imputation. RESULTS: Disclosure (N&#xa0;=&#xa0;194) and non-disclosure (N&#xa0;=&#xa0;180) groups did not differ on IGT-AD (mean disclosure-non-disclosure difference [MD] at 6 weeks: -1.5, p&#xa0;=&#xa0;0.14; 9 months: -1.2, p&#xa0;=&#xa0;0.35; 15 months: -2.0, p&#xa0;=&#xa0;0.07), IES-R (MD at 6 weeks: 0.00, p&#xa0;=&#xa0;0.98; 9 months: 0.01, p&#xa0;=&#xa0;0.84; 15 months: 0.03, p&#xa0;=&#xa0;0.64), or change in secondary outcomes. Occurrence of disclosure-related adverse events was similar in the disclosure (N&#xa0;=&#xa0;2) and non-disclosure (N&#xa0;=&#xa0;3) groups. DISCUSSION: In this Latino cohort, APOE disclosure did not have clinically significant adverse psychological effects, addressing an important evidence gap. TRIAL REGISTRATION: ClinicalTrials.gov NCT04471779.

Aged↗
PubMed2026

Pharmacokinetic Differences Between Fast-Acting, Standard, and Placebo Cannabis Edibles.

INTRODUCTION: Edibles have become the second-most used cannabis product in legal U.S. states, wherein 64% of cannabis consumers reported using edibles within the past year. Among expansions to the legal cannabis industry are the newly marketed "fast-acting" edible compounds, which may address many of the issues associated with edible use related to overdose and dose management. The study hypotheses were that fast-acting edibles would reach peak concentration significantly faster than standard edibles and placebo edibles. MATERIALS AND METHODS: Twenty participants completed three arms within-subjects designed study to test hypotheses. The three arms were ingestion of a (1) fast-acting edible, (2) a standard edible, and (3) a &#x394;9-tetrahydrocannabinol (THC) terpene-derived placebo edible that was indistinguishable from the two THC-containing edibles. Blood plasma was analyzed for the presence of THC and THC analytes. The pharmacokinetic parameters tested were time to max concentration (Tmax), maximum concentration (Cmax), terminal half-life (t1/2), and area under the curve (AUC). RESULTS: Results supported study hypotheses in that Tmax was significantly faster for the fast-acting edible, observed 30 min post-ingestion and, on average, 30 min earlier than the Tmax for the standard edible. There were no significant differences between the fast-acting and standard edibles on Cmax, t1/2, and AUC; however, both the fast-acting and standard edibles were significantly different compared with the placebo across all pharmacokinetic parameters. DISCUSSION: The results indicate that the microencapsulation technology used to create the fast-acting edible enabled analyte concentrations to peak significantly faster compared to the standard and placebo edibles.

Humans↗
PubMed2026

Wildlife forensic DNA evidence links a suspected vehicle to a fatal lowland tapir (Tapirus terrestris) collision in Misiones, Argentina.

Vehicle collisions are recognized as a major driver of biodiversity loss, particularly in road-dense landscapes, exceeding the impact of invasive species and wildlife trafficking. For large-bodied, slow-reproducing, and low-abundance species, such as the lowland tapir (Tapirus terrestris), this threat can have major impacts. Here, we present a wildlife forensic investigation in Misiones, Argentina, involving a tapir, a species afforded the highest level of legal protection as a Provincial Natural Monument. The fatal hit-by-vehicle (HBV) incident occurred in northern Misiones on 31 March 2019 along Provincial Route 19, in a portion that bisects Parque Provincial Urugua-&#xed;, with the driver involved in the collision leaving the scene. The suspect was later located and claimed that the damage to the vehicle resulted from a collision with a horse (Equus caballus) rather than a tapir. To legally resolve the incident, DNA (hair and blood) recovered from the suspected vehicle's bumper (evidence) was compared with tissue samples from the tapir carcass (reference). Genetic confirmation of species identity used a 110-bp region of the mitochondrial cytochrome b gene, and individual identity was assessed using 12 species-specific microsatellite loci. These analyses confirmed that all evidence matched the tapir carcass at both species and individual levels, strongly supporting the association between the suspected vehicle and the HBV tapir, and refuting the alternative explanation proposed by the driver. This case demonstrates the value of using wildlife forensic genetics to reconstruct wildlife-vehicle collisions, supporting environmental law enforcement, and strengthening conservation efforts in the Atlantic Forest of Misiones, Argentina.

Animals↗
PubMed2026

Unanticipated Effects of Parental Social Media Use: Guidance for Clinicians.

"Sharenting," the practice of parents posting photographs, videos, and information about their children on social media, has an ever-growing presence in modern society. However, researchers and the public are now recognizing the potential consequences of sharing, including creation of permanent digital footprints, strained familial relationships, and threats to children's safety. Despite this emerging evidence, no U.S. clinical or legal guidelines exist for parents on safe sharing. Visits with behavioral health providers and family physicians can serve as key points for intervention. This column aims to provide clinicians with a better understanding of sharenting and its potential effects on patients and families, guidance on discussing safe online sharing, and a tool for parents and other caregivers to use when deciding whether to post.

Humans↗
PubMed2026

Quo vadis, BGA? A collaborative EDNAP exercise on the challenges and progress in forensic biogeographical ancestry inference.

There is a broad consensus that forensic tests for the prediction of externally visible characteristics (EVC) and analysis of biogeographic ancestry (BGA) of an individual are technically reliable. However, interpretation of the results and population-specific genotype distribution patterns remains challenging. EVC and BGA analyses provide valuable information for population genetics studies and as investigative leads for criminal cases, as well as for historical and contemporary identification tests. However, inaccurate or incorrect predictions, for example, from subjective bias in the interpretations made, have the potential to misdirect police investigations. The legal situation regarding EVC and BGA testing varies by country: ranging from countries where it is explicitly prohibited, to those without specific regulations on biogeographic ancestry prediction, and others that have already enacted laws governing its use. The reluctance to utilize these analyses is not only due to legal restrictions and data protection concerns, but also to initial limited sets of sufficiently comprehensive forensic DNA assays. Forensic BGA marker panels typically contain up to &#x223c;300 SNPs. This relatively small number of genetic markers, along with limited reference population data, complicates the interpretation of results from donors of unknown origin. This paper presents the results of a collaborative EDNAP study, which, for the first time, evaluated the approach to reporting EVC and BGA data between international laboratories. For the study, DNA from nine individuals with self-reported ancestry was collected and analysed using various forensic panels differing in the number and composition of ancestry-informative markers genotyped, comprising: the Precision ID mtDNA Whole Genome Panel, the VISAGE Basic Tool and the VISAGE Enhanced Tool for Appearance and Ancestry Prediction, and the Ion AmpliSeq&#x2122; PhenoTrivium Panel. To ensure full data protection, all SNP genotypes and uniparental marker haplotypes obtained were not shared with third parties. Instead, the genetic data were analysed using a range of commonly used population analysis software packages. These analysis outcomes were then distributed to twelve European forensic laboratories (both academic and law enforcement institutions), who were asked to prepare reports based on their interpretation of the phenotypes and ancestry they inferred from the analysis data. A questionnaire sent alongside the genetic information, aimed to evaluate which difficulties were encountered by the participants in processing the BGA analysis data they were given.

Humans↗
PubMed2026

Access to maternity services for women asylum seekers and refugees: A transnational document analysis of international, European regional, and United Kingdom governance.

Women asylum seekers and refugees face persistent barriers to maternity care (antenatal, intrapartum and postnatal care) across high-income countries, yet the upstream governance shaping access remains under-examined. Although legally distinct, both groups share protection-seeking experiences and are addressed jointly in governance documents. This study examined and synthesised how international (macro), European regional (meso), and United Kingdom (UK, micro) governance documents frame and operationalise maternity service access. Sixty-four documents were analysed using the READ framework. Inductive analysis of macro and meso documents identified six access dimensions: universal coverage; cultural and linguistic adaptation; rights-based approaches; multi-agency collaboration; data, monitoring and accountability; and quality of care. These dimensions structured assessment of UK governance, with jurisdictions rated strong, moderate or weak. Alignment was fragmented: Wales, Scotland and Northern Ireland exempted asylum seekers from charging, whereas England retained charging provisions. Multi-agency collaboration was consistently articulated, yet none of the 35 UK government documents focused on maternity access for this population, and none required outcome monitoring disaggregated by asylum or refugee status. UK governance appears coordinated in form but fragmented in substance. UK-wide minimum standards and routine recording of these data, with safeguards against immigration-related use, could strengthen coherence and accountability and improve visibility of inequities.

Refugees↗
PubMed2026

Genital surgery in children with differences of sex development (DSD): Strengths and concerns across diverging regulations in four European countries.

Differences of Sex Development (DSD) is a collective term for a heterogeneous group of rare congenital conditions characterized by atypical genetic, gonadal, or genital sexual development. The treatment of children with DSD, particularly the indications for and timing of surgical interventions, has been the subject of debate for decades. In recent years, social developments emphasizing children's rights to self-determination and bodily integrity, along with increasing societal acceptance of atypical sex characteristics, have encouraged a more cautious approach toward early genital surgery in children with DSD. In 2019, the European Parliament adopted a resolution urging Member States to enact legislation prohibiting elective genital surgical interventions on intersex infants and children. Since then, several countries have indeed implemented restrictive measures, including legal bans on early surgical procedures. In this paper, we share the experiences and insights gained in recent years as pediatric urologists working in four neighboring countries in multidisciplinary university centers specializing in DSD care and research. We focus on current approaches to the care of children with DSD, the evolution of relevant national policies over time, and the nature and impact of recently introduced restrictive regulations on early surgical interventions. By presenting perspectives from pediatric urologists across these four countries, we aim to contribute to ongoing discussions on the alignment and refinement of surgical treatment practices for children with DSD.

Humans↗
PubMed2026

The impact of alcohol sale restrictions on unnatural deaths during the COVID-19 pandemic in Johannesburg, South Africa.

The COVID-19-related restrictions on the sale of alcohol in South Africa presented a unique opportunity to examine the association between alcohol availability and the prevalence of unnatural deaths. The study sample included all unnatural deaths investigated by the Johannesburg Forensic Pathology Services Medico-Legal Laboratory during the four COVID-19 alcohol restriction periods compared to the same time periods in the previous year when there were no restrictions. When alcohol sales were initially prohibited, there was a 54.2% decrease in cases of unnatural deaths (p&#x2009;<&#x2009;0.05), suggesting a link between alcohol use and the occurrence of such deaths. Over all four periods of alcohol sale bans, there was a total reduction of unnatural deaths by 26.4% with declining frequencies in all demographics. There were significant decreases (p&#x2009;<&#x2009;0.05) in the frequency of deaths in males, Black and Coloured individuals, and the 21-40 years age group. Deaths whose circumstances were a result of motor vehicle accidents, pedestrian vehicle accidents, and firearm discharges decreased significantly (p&#x2009;<&#x2009;0.05). The cause of death due to blunt forces trauma and gunshot wounds also significantly decreased (p&#x2009;<&#x2009;0.05). This study highlights the significant impact alcohol consumption has on mortality in South Africa.

Humans↗
PubMed2026

Artificial Intelligence Technologies in Nursing Clinical Decision-Making: An Umbrella Review.

AIM: To describe contemporary peer-reviewed literature on artificial intelligence in nurses' clinical decision-making. METHODS: An umbrella review of literature reviews. DATA SOURCES: Four major databases were searched for reviews published between 2019 and 2024. RESULTS: Sixteen literature reviews reported on 965 nursing artificial intelligence primary studies. The studies focused on technology development and emerging performance evaluations, whilst real-world testing or implementation in nursing clinical settings was rare. Rigorous comparative analyses were lacking. While artificial intelligence demonstrates promise in decision-making, challenges such as a lack of controlled studies, algorithmic bias, limited reproducibility and insufficient clinical trials hinder its practical impact. Ethical concerns, transparency and patient data privacy issues pose barriers to AI integration in nursing practice. Ethical and legal guidelines for patient privacy are needed and should be taught along with AI literacy training for nurses. CONCLUSIONS: Artificial intelligence has the potential to enhance clinical nursing decision-making, although evidence is limited by too few examples of nurse participation during development. Underutilisation in administrative nursing functions hinders implementation. Nurses should assume a central role in the design and development of AI applications to ensure that these technologies address the realities of nursing practice. With such improvements, artificial intelligence can transform nursing practice, improve nurses' clinical decision-making and ultimately enhance consumer healthcare outcomes. PATIENT OR PUBLIC INVOLVEMENT: No Patient or Public Involvement. REPORTING METHOD: While there is no reporting checklist for umbrella reviews, the PRISMA guide for systematic reviews was followed.

Artificial Intelligence↗