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The 70 recommendations summarize the current status of preoperative risk evaluation of adult patients prior to elective non-cardiothoracic surgery. Based on the joint publications of the German scientific societies for anesthesiology and intensive care medicine (DGAI), surgery (DGCH), and internal medicine (DGIM), which were first published in 2010 and updated in 2017, as well as the European guideline on preoperative cardiac risk evaluation published in 2022, a comprehensive re-evaluation of the recommendation takes place, taking into account new findings, the current literature, and current guidelines of international professional societies. The revised multidisciplinary recommendation is intended to facilitate a structured and common approach to the preoperative evaluation of patients. The aim is to ensure individualized preparation for the patient prior to surgery and thus to increase patient safety. Taking into account intervention- and patient-specific factors, which are indispensable in the preoperative risk evaluation, the perioperative risk for the patient should be minimized and safety increased. The recommendations for action are summarized under "General Principles (A)," "Advanced Diagnostics (B)," and the "Preoperative Management of Continuous Medication (C)." For the first time, a rating of the individual measures with regard to their clinical relevance has been given in the present recommendation. A joint and transparent agreement is intended to ensure a high level of patient orientation while avoiding unnecessary preliminary examinations, to shorten preoperative examination procedures, and ultimately to save costs. The joint recommendation of DGAI, DGCH and DGIM reflects the current state of knowledge as well as the opinion of experts. The recommendation does not replace the individualized decision between patient and physician about the best preoperative strategy and treatment. [ABSTRACT FROM AUTHOR]

Background Since publication of Duke criteria for infective endocarditis (IE) diagnosis, several modifications have been proposed. We aimed to evaluate the diagnostic performance of the Duke-ISCVID (International Society of Cardiovascular Infectious Diseases) 2023 criteria compared to prior versions from 2000 (Duke-Li 2000) and 2015 (Duke-ESC [European Society for Cardiology] 2015). Methods This study was conducted at 2 university hospitals between 2014 and 2022 among patients with suspected IE. A case was classified as IE (final IE diagnosis) by the Endocarditis Team. Sensitivity for each version of the Duke criteria was calculated among patients with confirmed IE based on pathological, surgical, and microbiological data. Specificity for each version of the Duke criteria was calculated among patients with suspected IE for whom IE diagnosis was ruled out. Results In total, 2132 episodes with suspected IE were included, of which 1101 (52%) had final IE diagnosis. Definite IE by pathologic criteria was found in 285 (13%), 285 (13%), and 345 (16%) patients using the Duke-Li 2000, Duke-ESC 2015, or the Duke-ISCVID 2023 criteria, respectively. IE was excluded by histopathology in 25 (1%) patients. The Duke-ISCVID 2023 clinical criteria showed a higher sensitivity (84%) compared to previous versions (70%). However, specificity of the new clinical criteria was lower (60%) compared to previous versions (74%). Conclusions The Duke-ISCVID 2023 criteria led to an increase in sensitivity compared to previous versions. Further studies are needed to evaluate items that could increase sensitivity by reducing the number of IE patients misclassified as possible, but without having detrimental effect on specificity of Duke criteria. [ABSTRACT FROM AUTHOR]

The article offers information on the International Children's Advisory Network (iCAN) and its dedication to empowering pediatric patients worldwide. Topics include iCAN's commitment to facilitating active participation of pediatric patients in innovation, research, and medicine, as well as a recent series featuring guest speaker Mary Jenner, RN, who shared her journey from author to entrepreneur in empowering young patients through healthcare innovation.

Markets for international surrogacy often arise in jurisdictions with limited regulations regarding assisted reproductive technologies. In some countries, like Australia, regulated domestic surrogacy services are often sidestepped for international providers. This study describes how Australian intended parents decide where to pursue surrogacy and compares the characteristics and outcomes of arrangements completed within and outside of Australia. The findings show that, although intended parents preferred undergoing surrogacy in Australia, perceiving the process as too long and complicated was a common reason to pursue an international arrangement. Multiple embryo transfer, anonymous gamete donation, and a lack of counselling were common in international surrogacy arrangements. When compared to surrogacy arrangements completed in Australia, where single embryo transfer is mandatory for surrogacy cycles, the rates of multiple birth, preterm birth and neonatal intensive care in international surrogacy were higher. These findings raise concerns about the health and welfare of international surrogacy participants, particularly the surrogates and children. In lieu of any international instrument regulating surrogacy, improving access to surrogacy at a domestic level would reduce the number of people engaging with international arrangements and in turn, reduce the potential for harm. [ABSTRACT FROM AUTHOR]

The article presents the discussion on board of the association faces tries to find a suitable host for the World Congress of Bioethics. Topics include people could have any number of reasons for opposing Qatar as a suitable congress location that have nothing to do with Islam; and academic outputs in international peer reviewed bioethics journals, more than 95% of the content is public reason based.

Purpose: Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods: An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results: A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion: The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary: This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice. [ABSTRACT FROM AUTHOR]

The article focuses on a proposal for public deliberation on genetic technologies, emphasizing challenges related to agenda setting, inclusion of diverse publics, and the limitations of translating deliberative outcomes into policy impact. Topics discussed include the complexities of agenda setting, the diversity within publics, and the need for participatory governance structures to ensure the effectiveness of deliberative democratic processes.

The article focuses on refining the aims of popular participation in bioethics through the use of randomly selected mini-publics, challenging the need for clear articulation of values served by public engagement. Topics discussed include the distinctive contributions of mini-publics, their limitations in achieving democratic legitimacy, and the unique capacity of non-expert perspectives in countering internal distortions within governance bodies.

Substance use counselors are in a unique position to intervene when exposed to suspected abuse of children. However, mandatory reporting habits of substance use counselors have seen little attention in empirical research. The purpose of this study was to quantify the frequency of mandatory reports of child abuse and/or neglect among substance use counselors. Further, binary and ordinal regression models were used to determine if personal and/or professional characteristics are predictive of reporting frequency. A total of 241 substance use counselors were recruited from national addiction organizations. Results from both the ordinal and binary logistic regressions identified dual-licensure status as a significant positive predictor and a lack of knowledge of the symptoms of child abuse and neglect as a significant negative predictor of reporting behaviors. Given the relationship between reporting habits and knowledge of abuse/neglect, substance use counselors must increase declarative, procedural, and conditional knowledge in order to increase adherence to mandated reporting. [ABSTRACT FROM AUTHOR]

Objective: To summarise and compare the key recommendations on prostate-specific antigen (PSA)-based screening for prostate cancer, and so highlight where more evidence is required to facilitate consistent recommendations. Methods: The Medline database and websites of 18 national screening organisations and professional associations were searched between January 2010 and November 2020 to identify screening guidelines published in English, considering recent clinical trials. Results: Population-based PSA testing of asymptomatic men is not widely recommended. Guidelines emphasize shared patient-clinician decision making. For 'average-risk' men choosing to be screened, the recommended age varies from 50–55 to 70 years, alongside consideration of life expectancy (ranging from 7–15 years). Screening intervals, when specified, are biennial (most common), annual, or determined from baseline PSA. The earliest age for screening high-risk men (frequently defined as of African descent or with a family history of prostate cancer) is 40 years, but recommendations often defer to clinical judgement. Conclusions: Population screening of asymptomatic men is not widely recommended. Instead, balancing the potential harms and benefits of PSA testing is endorsed. Variation between guidelines stems from differing interpretations of key trials and could lead to clinician-dependent screening views. The development of clinical decision aids and international consensus on guidelines may help reduce national and international variation on how men are counselled. [ABSTRACT FROM AUTHOR]

International organizations (IOs) try to incorporate policy-specific best practices and country-specific knowledge to increase well-informed decision-making. However, the relative contribution of the two kinds of knowledge to organizational performance is insufficiently understood. The article addresses this gap by focusing on the role of staff in World Bank performance. It posits that country-specific knowledge, sectoral knowledge, and their combination positively contribute to World Bank projects. The argument is tested drawing on a novel database on the tenure, nationality, and educational background of World Bank Task Team Leaders. Three findings stand out. First, country-specific knowledge seems to matter on average, while sectoral knowledge does not. Second, there is some evidence that staff that combine both kinds of knowledge are empowered to make more positive contributions to performance. Third, the diversity and relevance of experience, not length of tenure, are associated with more success. The findings contribute to discussions on international bureaucracies by highlighting how differences between the knowledge of individual staff shape their decision-making and performance. IOs could better tap into the existing resources in their bureaucracies to enhance their performance by rotating staff less frequently between duty stations. [ABSTRACT FROM AUTHOR]

Background: Evidence-based interventions are necessary for planning and investing in health information systems (HIS) and for strengthening those systems to collect, manage, sort and analyse health data to support informed decision-making. However, evidence and guidance on HIS strengthening in low- and middle-income countries have been historically lacking. Objective: This article describes the approach, methods, lessons learned and recommendations from 5 years of applying our learning agenda to strengthen the evidence base for effective HIS interventions. Methods: The first step was to define key questions about characteristics, stages of progression, and factors and conditions of HIS performance progress. We established a team and larger advisory group to guide the implementation of activities to build the evidence base to answer questions. We strengthened learning networks to share information. Results: The process of applying the learning agenda provided a unique opportunity to learn by doing, strategically collecting information about monitoring and evaluating HIS strengthening interventions and building a body of evidence. There are now models and tools to strengthen HIS, improved indicators and measures, country HIS profiles, documentation of interventions, a searchable database of HIS assessment tools and evidence generated through syntheses and evaluation results. Conclusion: The systematic application of learning agenda processes and activities resulted in increased evidence, information, guidance and tools for HIS strengthening and a resource centre, making that information accessible and available globally. Implications: We describe the inputs, processes and lessons learned, so that others interested in designing a successful learning agenda have access to evidence of how to do so. [ABSTRACT FROM AUTHOR]

El texto analiza algunas de las propuestas que las agencias internacionales más directamente relacionadas con el sector educativo han ofrecido a fin de afrontar las situaciones creadas por la pandemia del Covid-19 y lograr la reactivación de la educación en condiciones similares, o al menos comparables, a las que se encontraba antes de pandemia. A partir de ese análisis, se trazan conexiones entre las agendas educativas, políticas y económicas que enmarcan las actuales respuestas en términos de mediciones, evaluaciones e inversión de recursos y tiempos. Al cierre, despejadas algunas dudas y aclaradas algunas decisiones, se toma distancia frente a las estrategias sugeridas por los organismos multilaterales, y se les ve desde una perspectiva que hace énfasis en las personas y las comunidades, antes que en los sistemas y en el comercio de datos, para sacar conclusiones que permitan repensar las direcciones en las que las acciones han de apuntar. [ABSTRACT FROM AUTHOR]

We examine how analogy-based collective decision-making of member states contributes to the endogenous emergence of informal rules and the incremental change of international organizations (IOs). Decision-making by analogy is an important characteristic of day-to-day decision-making in IOs. Relating current decisions to previous ones through analogies drives incremental change and simultaneously reinforces organizational resilience. Whereas the foreign policy analysis literature shows that analogies can be used as cognitive shortcuts in fuzzy and complex foreign policy situations, we focus on their use to overcome social ambiguity (indeterminacy) of coordination situations in IOs. Drawing on psychological conceptions, we develop two micro-level mechanisms that elucidate the effects of analogy-based collective decision-making in member-driven IOs. Analogy-based collective decisions emphasizing similarity between a current situation and previous ones follow an established problem schema and produce expansive and increasingly well-established informal rules. Collective decisions that are analogy-based but emphasize a crucial difference follow different problem schemas and trigger the emergence of additional informal rules that apply to new classes of cases. The result is an increasingly fine-grained web of distinct organizational solutions for a growing number of problems. Accordingly, an IO can increasingly facilitate collective decision-making and gains resilience. Empirically, we probe these propositions with a documentary analysis of decision-making in the Yugoslavia sanctions committee, established by the United Nations Security Council to deal with a stream of requests for exempting certain goods or services from the comprehensive economic embargo imposed on Yugoslavia in response to the War in the Balkans. [ABSTRACT FROM AUTHOR]

Childhood cancer survival is suboptimal in most low- and middle-income countries (LMICs). Radiotherapy plays a significant role in the standard care of many patients. To assess the current status of paediatric radiotherapy, the International Atomic Energy Agency (IAEA) undertook a global survey and a review of practice in eight leading treatment centres in middle-income countries (MICs) under Coordinated Research Project E3.30.31; 'Paediatric radiation oncology practice in low and middle income countries: a patterns-of-care study by the International Atomic Energy Agency.' A survey of paediatric radiotherapy practices was distributed to 189 centres worldwide. Eight leading radiotherapy centres in MICs treating a significant number of children were selected and developed a database of individual patients treated in their centres comprising 46 variables related to radiotherapy technique. Data were received from 134 radiotherapy centres in 42 countries. The percentage of children treated with curative intent fell sequentially from high-income countries (HICs; 82%) to low-income countries (53%). Increasing deficiencies were identified in diagnostic imaging, radiation staff numbers, radiotherapy technology and supportive care. More than 92.3% of centres in HICs practice multidisciplinary tumour board decision making, whereas only 65.5% of centres in LMICs use this process. Clinical guidelines were used in most centres. Practice in the eight specialist centres in MICs approximated more closely to that in HICs, but only 52% of patients were treated according to national/international protocols whereas institution-based protocols were used in 41%. Quality levels in paediatric radiotherapy differ among countries but also between centres within countries. In many LMICs, resources are scarce, coordination with paediatric oncology is poor or non-existent and access to supportive care is limited. Multidisciplinary treatment planning enhances care and development may represent an area where external partners can help. Commitment to the use of protocols is evident, but current international guidelines may lack relevance; the development of resources that reflect the capacity and needs of LMICs is required. In some LMICs, there are already leading centres experienced in paediatric radiotherapy where patient care approximates to that in HICs. These centres have the potential to drive improvements in service, training, mentorship and research in their regions and ultimately to improve the care and outcomes for paediatric cancer patients. • A unique survey of current global paediatric radiotherapy practice. • Data from high-income countries showing what clinicians consider standard of care. • Many low- and middle-income countries lack multidisciplinary team working. • More patients in low-income settings are treated with palliative intent. • Leading centres in middle-income countries can train, mentor and drive up standards. [ABSTRACT FROM AUTHOR]

• The scoping review identified robust examples of municipal youth councils internationally. • The origin, structure, activities, and impacts of municipal youth councils varied considerably. • The impacts were largely focused on the individual youth but there were select examples of community impacts. • There is a need for more systematic research documenting the best practices and impacts of municipal youth councils. Youth engagement in policy decision-making can benefit youth and their communities. Youth bodies at the municipal level, in the form of councils, commissions, and advisory boards, are one common mechanism to engage youth. There are numerous examples of municipal youth councils across the globe, yet no cross-county studies that compile the lessons from these efforts. The aim of the present study was to gather and synthesize research pertaining to municipal youth councils in an international context. The study used a scoping review protocol to collect and analyze data on the existence, origin, structure, activities, barriers, and impacts of municipal youth councils. The results show robust examples of municipal youth councils globally, however, there is wide variation in the origin, structure, and activities. Furthermore, there has been little attention to measure policy and community impacts. The study results demonstrate the promise of youth engagement in policy decision-making, but also the need for more systematic research documenting the best practices and impacts of municipal youth councils. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) has emerged as a growing focus of global attention and a critical factor in public-health decision making. Towards fighting the COVID-19 outbreak, countries worldwide and international organisations have taken various actions, including promoting the transparency of and public access to disease data. In such public communications, maps have played an important role in that a map is worth a thousand words. Most of these have taken the form of a choropleth map. Here, we propose employing cartograms to visualise both the expansion and spread of COVID-19. We designed a combination of six circular cartograms containing the data of confirmed cases every 48 hours from 24 January to 3 February 2020. Such a design conveys both spatial and temporal information more intuitively and efficiently, so it can be expected to facilitate better public participation in the fight against COVID-19. [ABSTRACT FROM AUTHOR]

Background and Objectives The paradigm of active aging has been slowly gaining ground in Europe as the ideal framework for public policy and for responding to the population's aging. Taking the work by Rune Ervik as its point of departure, this article updates his conclusions on conceptualizations and policies of active aging by performing a study of the institutional discourses in the matter produced by the World Health Organization (WHO), the Organization for Economic Cooperation and Development (OECD), and the European Union (EU). Methods A corpus of 15 WHO, OECD, and EU documents published in the period 2002–2015 and tackling active aging were analyzed qualitatively through a combination of content and thematic analysis, based on a scheme integrated by deductive and inductive iterative manual and computerized codification. Results The institutional discourses on active aging analyzed have not changed dramatically in the period considered. However, a divergent path has emerged regarding the accent placed on participation and contribution in the construction of the paradigm: the more socially productive and health-oriented WHO discourse is slowly separating from the more economically productive and labor-oriented discourses of the EU and OECD. Discussion and Implications The institutional paradigm on active aging is evolving into a reductive treatment of a phenomenon that is multidimensional. International institutions and researchers should pay closer attention and forge a path toward an honest and critical examination of the real conditions and expectations of older people concerning the discursive and practical proposals of active aging, in all its different forms. [ABSTRACT FROM AUTHOR]

The article reports on formation of the Perinatal Mental Health workgroup by the National Perinatal Association (NPA) in 2018 aimed at addressing perinatal mental health need. Topics discussed include effect of untreated postpartum mood and anxiety disorders (PMADs), background on Postpartum Support International (PSI), and information on the National Association of Perinatal Social Workers (NAPSW).

The article focuses on guidelines to provide overview of Good Manufacturing Practices (GMP) requirements for radiopharmaceuticals and mentions that GMP are described in detail for pharmaceutical products. Topics discussed include production of radiopharmaceuticals in hospital radiopharmacies, compounding of non-radioactive compounds and analytical tests designed to demonstrate compliance of the quality.

Treaties are more than just pieces of paper. In order to fulfill the obligations set forth on paper, a vitalized process is created that can be affected both positively and negatively by the actions of those who are members and by the geopolitical context in which the treaty resides. It is the actions of those who are party to a treaty that largely determine the success or failure, as each member periodically examines whether the benefits of being part of the treaty outweigh any negative obligations and other costs. In 2001, the members of the Biological Weapons Convention (BWC) decided upon a series of intersessional meetings which, although instigated as a rescue operation from a series of major internal and external shocks, were judged as useful, and a second series was approved. In December, States Parties to the BWC will gather for a seventh time to review the operation of the treaty and make decisions about the next five years, including whether to approve a third series of annual meetings. But would a third series in its current format be for the good of the BWC? Would a third intersessional process support States Parties in their evaluation that they are better off as members of the BWC? By reviewing the origins of the intersessional process and providing an analysis of activities thus far, the author offers suggestions to be considered for organizing a third intersessional review process. [ABSTRACT FROM AUTHOR]

This article discusses agency problems in sport organizations in which the same individuals are involved in both the management and control of decision making. We focus our analysis on the case of the International Olympic Committee (IOC) by reviewing the behavior of selected IOC members with regard to the bidding process for the Olympic Games and the resulting reform attempts made by the IOC in an effort to address issues of corruption. After a review of examples of corrupt behavior on the part of IOC members, agency theory is introduced to discuss IOC reforms and provide some suggestions for future reform. We propose incorporating other stakeholders (in addition to the IOC members), such as corporate partners, media conglomerates, and other members of the Olympic movement (e.g., athletes, coaches, officials), into management and control functions. More specifically, it is suggested that these stakeholders comprise a board that oversees the operations of the IOC (similar to the IOC's current executive committee) and be given the ability to remove and/or sanction IOC members who act self-interestedly to the detriment of the Olympic movement. Thus, by delegating the control function of decision making to a board and the management function to internal agents, greater accountability for all organization members can be achieved. [ABSTRACT FROM AUTHOR]

Summary: Economic evaluations are increasingly used to assess the value of health interventions, but variable quality and heterogeneity limit the use of these evaluations by decision-makers. These recommendations provide guidance for the design, conduct, and reporting of economic evaluations in osteoporosis to improve their transparency, comparability, and methodologic standards.Introduction: This paper aims to provide recommendations for the conduct of economic evaluations in osteoporosis in order to improve their transparency, comparability, and methodologic standards.Methods: A working group was convened by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis to make recommendations for the design, conduct, and reporting of economic evaluations in osteoporosis, to define an osteoporosis-specific reference case to serve a minimum standard for all economic analyses in osteoporosis, to discuss methodologic challenges and initiate a call for research. A literature review, a face-to-face meeting in New York City (including 11 experts), and a review/approval by a larger group of experts worldwide (including 23 experts in total) were conducted.Results: Recommendations on the type of economic evaluation, methods for economic evaluation, modeling aspects, base-case analysis and population, excess mortality, fracture costs and disutility, treatment characteristics, and model validation were provided. Recommendations for reporting economic evaluations in osteoporosis were also made and an osteoporosis-specific checklist was designed that includes items to report when performing an economic evaluation in osteoporosis. Further, 12 minimum criteria for economic evaluations in osteoporosis were identified and 12 methodologic challenges and need for further research were discussed.Conclusion: While the working group acknowledges challenges and the need for further research, these recommendations are intended to supplement general and national guidelines for economic evaluations, improve transparency, quality, and comparability of economic evaluations in osteoporosis, and maintain methodologic standards to increase their use by decision-makers. [ABSTRACT FROM AUTHOR]

Objective: There is a lack of consensus on whether e-cigarettes facilitate or threaten existing tobacco prevention strategies. This uncertainty is reflected in organizations' conflicting e-cigarette position statements. We conducted a scoping review of position statements in published and gray literature to map the range and frequency of e-cigarette use recommendations. Methods: We collected 81 statements from international health organizations. Two coders independently performed qualitative content analysis to categorize e-cigarette recommendations. We explored differences based on organization type, geography, and the year recommendations were published. Results: We identified 5 recommendation types: encourage smokers to use ecigarettes as a cessation aid or as an alternative source of nicotine (N = 5); support individuals who use e-cigarettes to quit smoking (N = 20); avoid using until more research is available (N = 19); restrict access based on available evidence (N = 30); and prohibit e-cigarette marketing and sale (N = 7). Conclusion: Organizations presented diverse e-cigarette use recommendations. The variation related to organizations' differing tobacco prevention priorities and level of confidence in current e-cigarette research. These differences may create confusion. Additional research can examine whether this variability influences stakeholders' attitudes or behavior. [ABSTRACT FROM AUTHOR]

Gender equity can be a neglected issue in health system reforms. This paper explores the multiple layered gender dynamics of the Afghan Community Health Worker (CHW) Program within broader health system reforms in Afghanistan using a qualitative research design. We interviewed policy makers, health managers, CHWs and community members in 16 sites in 2013 and 2014. We found that gendered societal norms interact and influence the Afghan CHW program in a dynamic way. Gendered social norms around the division of labour tend to privilege women in terms of access to resources at the community level, but it is men who hold leadership positions that ultimately decide how the resources are to be distributed. The Afghan Ministry of Public Health expresses a commitment to gender equity, but policies on gender are restricted to reproductive health, thus constraining a gender-equity approach as focused on maternal and child health. Our explicit gender analysis not only reveals gender inequities in the Afghan CHW Program and the broader health system, it also uncovers how a highly gendered division of health labour provides some opportunities for women’s empowerment that can disrupt patriarchal role constraints and broader gender inequities. [ABSTRACT FROM AUTHOR]

Public health is about policy, power, and the public and as such might be thought necessarily political. That does not mean, however, that the place of political analysis and engagement in public health is uncontroversial, and there have been longstanding arguments that to discuss politics sullies the scientific nature of public health. This article, introducing a special issue on political science in public health, argues that rigorous use of middle-range theory can inform our analysis of public health problems and avoid the risks of politicization, excessive abstraction or excessive concreteness. It summarizes key political science concepts discussed in the papers: epistemic communities, interest groups, advocacy coalitions, political parties, institutions, legalism, discourse and the political economy of labour. We hope that the series will provide the public health community with some tools and methods for how to integrate public health knowledge into the sphere of decision making in an appropriate way. [ABSTRACT FROM AUTHOR]

Committee 4 of the International Commission on Radiological Protection (ICRP) is charged with the development of principles and recommendations on radiological protection of people and the environment in all exposure situations. For the term beginning in July 2017, the Committee has a total of 18 members from 12 countries. The programme of work includes a wide range of activities in five major thematic areas. The first is the consolidation and preparation of reports elaborating application of the system of protection in existing exposure situations. Second is the continuation of work on emergency exposure situations, and ICRP updates to recommendations in light of the accident at Fukushima Daiichi nuclear power plant. Third is examination of fundamentals of protection recommendations, including the ethical principles underlying the recommendations and application of those principles in practical decision making. Fourth is the new area of integration of protection of the environment into the system of protection. Finally, Committee 4 continues work to prepare specific topical reports on subjects in which additional information is useful to understand and apply the Commission's recommendations in particular circumstances. [ABSTRACT FROM AUTHOR]

The article informs about coevolution of policy and science during the Covid-19 pandemic, and how scientific insights missed by policymakers and scientific advice may affect decision-making. Topics include tendency for policy documents to cite science appears concentrated within intergovernmental organizations (IGOs), such as the World Health Organization (WHO); and substantial gap between scientists and policy-makers, disconnecting research from the policy process.

Security sector reform (SSR) in Kosovo remains complex and challenging. The existing approach is heavily driven by international agencies. This article addresses the question: What role is played by local research in Kosovo’s SSR? This study focuses on the challenges that local research poses to internationally led SSR in Kosovo, and the contribution that local researchers make to the decision-making of international practitioners. In Kosovo, local research organizations produce research analysing and critiquing international SSR and offering alternative approaches. The study builds on existing studies of epistemic communities and research use in policy-making and new evidence based on the author’s interview survey of researchers and policy-makers in Kosovo. The article argues that focusing on the interaction between local researchers and international policy practitioners provides valuable insight into the construction of Kosovo’s SSR. The study deconstructs the structures, processes and agencies at the heart of the local/international relationship. It explains how local research on topics of security, justice and rule of law, and its interaction with international practitioners, challenges international SSR and contributes to international SSR decision-making. [ABSTRACT FROM AUTHOR]

Recommendations and guidelines for the collection, generation, source and usage of utility data for health technology assessment (HTA) vary across different countries, with no international consensus. Many international agencies generate their own guidelines providing details on their preferred methods for HTA submissions, and there is variability in both what they recommend and the clarity and amount of detail provided in their guidelines. This article provides an overview of international regulations and recommendations for utility data in HTA for a selection of key HTA countries: Australia, Canada, France, Germany, the Netherlands, Spain (Catalonia), Sweden and the UK (England/Wales and Scotland). International guidelines are typically clear and detailed for the selection of countries assessed regarding the source description of health states (e.g. generic preference-based measure) and who should provide preference weights for these health states (e.g. general population for own country). Many guidelines specify the use of off-the-shelf generic preference-based measures, and some further specify a measure, such as EQ-5D. However, international guidelines are either unclear or lack detailed guidance regarding the collection (e.g. patients report own health), source (e.g. clinical trial) and usage (e.g. adjusting for comorbidities) of utility values. It is argued that there is a need for transparent and detailed international guidelines on utility data recommendations to provide decision makers with the best possible evidence. Where this is not possible it is recommended that best practice should be used to inform the collection, source and usage of utility values in HTA. [ABSTRACT FROM AUTHOR]

Sociologists have long examined how states, intergovernmental organizations (IGOs), international nongovernmental organizations (INGOs), and professional groups interact in order to institutionalize their preferred norms at the transnational level. Yet, explanations of global norm-making that emphasize inter-organizational negotiations do not adequately explain the intra-organizational script-writing--that is, the codification of norms in prescriptive behavioral templates--that underpins this process. This article opens the black box of how scripts emerge and institutionalize within IGOs. Script-writing is a function of both world-cultural frames and material interests, held by different intra-organizational actors: scientific IGO staff and state representatives in governing bodies, respectively. The interplay between these frames and interests determines whether scripts will institutionalize. In this theoretical model, world-cultural and power-political explanations are pertinent to different, mutually informing, and coexisting aspects of the script-writing process. As a corollary of our approach, we present a conceptual framework for the study of intra-IGO script-writing, which is contingent on three normative struggles: among IGO staff, within an IGO's board of directors, and between the staff and the board. To empirically substantiate our arguments, we examine scripts on taxation and capital controls by the International Monetary Fund. We conclude by discussing the broader implications of our model for the study of international organizations and the engines of global norm-making. [ABSTRACT FROM AUTHOR]

Global governance and market failures mean that it is not possible to ensure access to antimicrobial medicines of sustainable effectiveness. Many people work to overcome these failures, but their institutions and initiatives are insufficiently coordinated, led and financed. Options for promoting global collective action on antimicrobial access and effectiveness include building institutions, crafting incentives and mobilizing interests. No single option is sufficient to tackle all the challenges associated with antimicrobial resistance. Promising institutional options include monitored milestones and an inter-agency task force. A global pooled fund could be used to craft incentives and a special representative nominated as an interest mobilizer. There are three policy components to the problem of antimicrobials -- ensuring access, conservation and innovation. To address all three components, the right mix of options needs to be matched with an effective forum and may need to be supported by an international legal framework. [ABSTRACT FROM AUTHOR]

This article enquires about the place of the social during the presidencies of Eugene R. Black (1949–1963) and Robert McNamara (1968–1981) at the World Bank. Black made technical assistance an integral part of the Bank’s mission. McNamara announced social policy as part of the Bank’s economic agenda in 1970. The article asks why it took so long for social policies to arrive and why the initial concern was not the well-being of the population but reducing its number. Using a political ontology approach, I argue that in the process of establishing a global authority over ‘one-world’, the Bank did not recognize differences. I pay attention to the mechanisms translating a pluriverse into one-world and the effects on the presence and absence of social programs. I conclude that the process within the Bank was far from consistent. The expectation is that knowing how one-world is re-enacted would open spaces for a pluriversal world. [ABSTRACT FROM AUTHOR]

During the past decades, there has been much debate on food security. A variety of indicators have been proposed in order to establish which countries are in need of improved food security status. The heterogeneity of existing indicators and the lack of consensus on how to compare and rank countries have motivated international organizations to build composite indexes to synthesize the information. The process of building composite indexes involves multiple choices that influence the outcome. This analysis aims at understanding how relevant and discretional may be the analyst’s choice of algorithms to compute composite indexes for food security. To this extent, we have computed several composite indexes for food security by using data provided by the Food and Agriculture Organization, which includes a large set of proxies for food security, as emerged from the Committee on World Food Security Round Table. We compare different methods to impute, homogenize, weight, and aggregate data, in order to compute composite indexes and show how relevant are the choices to be made. We show that normalization and weighting are not very crucial decisions, whereas special attention has to be paid in choosing the data imputation and aggregation methods. By commenting on the implications that different measurement choices may have in terms of global index, we show that the index construction decisions matter. [ABSTRACT FROM PUBLISHER]

In this article, we interrogate the policy response of the International Monetary Fund (IMF) to the global financial crisis, and discuss the likely global health implications, especially in low-income countries. In doing so, we ask if the IMF has meaningfully loosened its fiscal deficit targets in light of the economic challenges posed by the financial crisis and adjusted its macro-economic policy advice to this new reality; or has the rhetoric of counter-cyclical spending failed to translate into additional fiscal space for IMF loan-recipient countries, with negative health consequences? To answer these questions, we assess several post-crisis IMF lending agreements with countries requiring financial assistance, and draw upon recent academic studies and civil society reports examining policy conditionalities still being prescribed by the IMF. We also reference recent studies examining the health impacts of these conditionalities. We demonstrate that while the IMF has been somewhat more flexible in its crisis response than in previous episodes of financial upheaval, there has been no meaningful rethinking in the application of dominant neoliberal macro-economic policies. After showing some flexibility in the initial crisis response, the IMF is pushing for excessive contraction in most low and middle-income countries. We conclude that there remains a wide gap between the rhetoric and the reality of the IMF’s policy and programming advice, with negative implications for global health. [ABSTRACT FROM AUTHOR]

A number of international conflicts and identified new threats encouraged international organizations such as the United Nations and the North Atlantic Treaty Organisation to develop the concept of international assistance force in order to contribute to the principle task of the United Nations and the North Atlantic Treaty Organization -- to maintain international peace and security. Another concept, i.e. legality of the use of force, has to be developed hand in hand with these new developments. Naturally, the Security Council and the General Assembly of the United Nations were bound to respect the provisions of the UN Charter; however, certain functions attributed to the newly established UN peacekeeping force constituted a result of the development of the political climate. From the historical point of view, towards the development of international operations the authors of the article examine particular cases related to the use of international task forces and also the question of legality of use of force and review national legal regulation of the participation in international operations. With regard to the national regulation of Lithuanian participation in international operations, it must be noted that national legal basis enable to deploy national forces according to the provisions of the Constitution of the Republic of Lithuania. This procedure is applicable to the cases of collective defence and other international operations. Thus, only Parliament is authorised to take decisions on the deployment of national military personnel to international operations. In order to deploy troops, the decision on participation in international operations, exercises and other military events is taken by Parliament upon the recommendation of the President. Then, Parliament adopts the decision by setting forth the maximum number of the military personnel able to take part in international operations, the maximum duration of participation, the geographical location (permissible places of dislocation). In order to allocate the troops for exact operation acting within the parliamentary mandate, the Minister of National Defence is taking the decision, which determines the exact number of the troops to be deployed, the defined time period of deployment of national forces and the exact place of deployment (where operations take place). It must be concluded that the current legal regulation corresponds to the constitutional principles and separation of powers. [ABSTRACT FROM AUTHOR]

Preserving the autonomy of individuals with intellectual disabilities in group work is challenging. Group workers often experience inadequate guidance about autonomy—an individual's capability to act independently without influence by others. Group workers can enhance autonomy through group activities that promote self-efficacy, empowerment, and the ability to make decisions. Fostering autonomy requires that the group workers be knowledgeable and aware of personal biases, analyzing their expectations and actions. To promote the autonomy of persons with intellectual disabilities in group work practice, the authors make recommendations to strengthen the IASWG Standards for Social Work Practice with Groups in this area. [ABSTRACT FROM PUBLISHER]