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During the 1970s, governments increasingly expressed concerns about the loss of revenue through the use of tax havens by both individuals and corporations. This article explores a covert international working group (the Group of Four) set up between France, Germany, the United Kingdom, and the United States in 1969 in response to such concerns. At regular meetings, officials exchanged information gathered by their respective tax authorities in auditing multinational companies. In the 1980s, under increasing pressure from governments in a now much more hostile climate to tax authorities, the Group’s work shifted away from multinationals and toward more general, technical questions. The history of the Group of Four illustrates the importance of the 1960s and 1970s as a period for regulating economic actors and the impact of broader circumstances on the success or failure of anti-tax avoidance measures.
When we conceptualized this symposium, Roe v. Wade1 was still the law of the land, albeit precariously. We aimed to commemorate its fiftieth anniversary by exploring historical, legal, medical, and related dimensions of access to abortion as well as the challenges ahead to secure reproductive justice. With the leak of the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization on May 2, 2022, we shifted to mark the dawn of a new era. In the nearly identical official opinion announced on June 24, 2022,2 Justice Samuel Alito, writing for the majority (6-3), overturned Roe and Planned Parenthood of Southeastern Pennsylvania v. Casey.3
To assess whether measurement and feedback of chlorhexidine gluconate (CHG) skin concentrations can improve CHG bathing practice across multiple intensive care units (ICUs).
Design:
A before-and-after quality improvement study measuring patient CHG skin concentrations during 6 point-prevalence surveys (3 surveys each during baseline and intervention periods).
Setting:
The study was conducted across 7 geographically diverse ICUs with routine CHG bathing.
Participants:
Adult patients in the medical ICU.
Methods:
CHG skin concentrations were measured at the neck, axilla, and inguinal region using a semiquantitative colorimetric assay. Aggregate unit-level CHG skin concentration measurements from the baseline period and each intervention period survey were reported back to ICU leadership, which then used routine education and quality improvement activities to improve CHG bathing practice. We used multilevel linear models to assess the impact of intervention on CHG skin concentrations.
Results:
We enrolled 681 (93%) of 736 eligible patients; 92% received a CHG bath prior to survey. At baseline, CHG skin concentrations were lowest on the neck, compared to axillary or inguinal regions (P < .001). CHG was not detected on 33% of necks, 19% of axillae, and 18% of inguinal regions (P < .001 for differences in body sites). During the intervention period, ICUs that used CHG-impregnated cloths had a 3-fold increase in patient CHG skin concentrations as compared to baseline (P < .001).
Conclusions:
Routine CHG bathing performance in the ICU varied across multiple hospitals. Measurement and feedback of CHG skin concentrations can be an important tool to improve CHG bathing practice.
In the first decades of the twentieth century, several same-sex couples populated the professional workforce of the Young Women’s Christian Association of the USA (YWCA), one of the largest and most influential US women’s organizations. At the same time, discourses of medicine and law hardened around binary categories of sexual identity, giving rise to the regulation of homosexuality as a pathology and crime. Contesting assumptions that Christianity has historically served to suppress and punish same-sex romance and sexuality, this article investigates how middle-class white women employed by the national administration of the YWCA carved out an institutional space that was at once welcoming to female couples and deeply dedicated to Protestant faith traditions. While the ongoing influence of nineteenth-century ideals of homosocial romantic friendship had considerable influence on this space, an inquiry into the work of the YWCA theologian Winnifred Wygal reveals the ways in which liberal Christianity could be used to authorize, rather than prohibit, love between women in the face of modern frameworks of sexual identity.
The Dobbs decision will directly affect patients and reproductive rights; it will also impact patients indirectly in many ways, one of which will be changes in the physician workforce through its impact on graduate medical education. Current residency accreditation standards require training in all forms of contraception in addition to training in the provision of abortion. State bans on abortions may diminish access to training as approximately half of obstetrics and gynecology residency programs are in states with significant abortion restrictions. The Dobbs decision creates numerous hurdles for trainees and their programs. Trainees in restrictive states will have to travel to learn in a different program in a protective state. As training opportunities diminish, potentially leading to a decline in clinical skills, knowledge, and experience in the provision of abortion, the rate of complications and maternal mortality are likely to rise. This will likely have a disproportionately negative effect on preexisting disparities in reproductive health fueled by a longstanding history of systemic racism and inequities. This work aims to both define the looming problem in abortion training created by Dobbs and propose solutions to ensure that an adequate workforce is available in the future to serve patient needs.
Scholarly and public interest in the nexus of capitalism and global governance has intensified in recent years. The persistence of economic inequality, the rise of populism, the backlash against globalization, the Covid-19 pandemic and supply chain fragility, the resurgence of open conflict in Europe, and the urgency of the climate change crisis have only drawn further attention to the relationships of markets and trade to norms and institutions. Solutions to many of these challenges, which are closely tied to capitalist dynamics, require interventions on a scale that only institutions of global governance can provide. At the same time, these challenges compromise governance institutions by making them susceptible to private influence. Moreover, critics have raised alarm about the ways some forms of global governance – such as powerful philanthropic institutions, private summitry forums, and international organizations that enforce economic globalization on nation-states – evade democratic accountability. Such developments have prompted scholars to analyze the entangled histories of capitalism and global governance and the evolution of the global economy and its regulation as well as collective efforts to provide for the well-being of humans and their environments.
This paper will review the strategies and learning trajectories followed to tap the opportunities opened by the successive waves of biotechnologies: early imitators followed by late imitators in the first generation of biosimilars (erythropoietin, insulins, interferons), and then sequential entry and skipping stages during the second generation (monoclonal antibodies).
This Special Issue is dedicated to Professor Pier Luigi Nimis on the occasion of his 70th birthday and retirement. It was our aim to publish papers addressing the three major research fields that Pier Luigi dealt with during his career: systematics and taxonomy, biomonitoring and ecology, and data resources and digitization. The papers in this Special Issue provide a vivid overview of the state of the art in the three research fields, and they reflect on Pier Luigi's outstanding contribution to lichenology. They offer a wide array of different methodologies, from the traditional approaches investigating lichen diversity and taxonomy by means of morpho-anatomical analyses, culture isolations and phylogenetic systematics, to the most modern sequencing techniques, and to the development of computer-aided tools and databases for facilitating lichen identification.