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Somalia has a long history of famine and humanitarian crisis. This article focuses on the years 2008–2020, during which governance and aid practices changed substantially and which include three crisis periods. The article examines whether and how governance analysed as a political marketplace can help explain Somalia's repeated humanitarian crises and the manipulation of response. We argue that between 2008 and 2011 the political marketplace was a violent competitive oligopoly which contributed to famine, but that from 2012 a more collusive, informal political compact resulted in a status quo which avoided violent conflict or famine in 2017 and which functioned to keep external resources coming in. At the same time, this political arrangement benefits from the maintenance of a large group of displaced people in permanent precarity as a source of aid and labour.
The COVID-19 pandemic has transformed healthcare significantly and telepsychiatry is now the primary means of treatment in some countries.
Aims
To compare the efficacy of telepsychiatry and face-to-face treatment.
Method
A comprehensive meta-analysis comparing telepsychiatry with face-to-face treatment for psychiatric disorders. The primary outcome was the mean change in the standard symptom scale scores used for each psychiatric disorder. Secondary outcomes included all meta-analysable outcomes, such as all-cause discontinuation and safety/tolerability.
Results
We identified 32 studies (n = 3592 participants) across 11 mental illnesses. Disease-specific analyses showed that telepsychiatry was superior to face-to-face treatment regarding symptom improvement for depressive disorders (k = 6 studies, n = 561; standardised mean difference s.m.d. = −0.325, 95% CI −0.640 to −0.011, P = 0.043), whereas face-to-face treatment was superior to telepsychiatry for eating disorder (k = 1, n = 128; s.m.d. = 0.368, 95% CI 0.018–0.717, P = 0.039). No significant difference was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 26, n = 2290; P = 0.248). Telepsychiatry had significantly fewer all-cause discontinuations than face-to-face treatment for mild cognitive impairment (k = 1, n = 61; risk ratio RR = 0.552, 95% CI 0.312–0.975, P = 0.040), whereas the opposite was seen for substance misuse (k = 1, n = 85; RR = 37.41, 95% CI 2.356–594.1, P = 0.010). No significant difference regarding all-cause discontinuation was seen between telepsychiatry and face-to-face treatment when all the studies/diagnoses were combined (k = 27, n = 3341; P = 0.564).
Conclusions
Telepsychiatry achieved a symptom improvement effect for various psychiatric disorders similar to that of face-to-face treatment. However, some superiorities/inferiorities were seen across a few specific psychiatric disorders, suggesting that its efficacy may vary according to disease type.
Asia’s pharmaceutical sector has experienced remarkable growth over the last two decades, with companies in the region producing bulk of the world’s specialty generics, biologicals, and active pharmaceutical ingredients (APIs). The Asian pharma growth story has had several pillars for a strong and sustainable foundation that provided non-linear growth. This report introduces three models showing how Asian countries at different development stages — India, South Korea, and Singapore — have nurtured their own, self-sustaining pharmaceutical sectors.
The twentieth century is a fascinating time to follow the relationship between global governance and firms because of the persistent tension between principles of mass democracy and private ownership and control. It is possible to narrate the entire century as a series of contestations between firms and international organizations. At times, firms have had the upper hand. At other times, the principle of popular sovereignty has threatened the self-perceived rights and prerogatives of business. In my own work, I have homed in on ruptures at two main points.
Current guidelines and regulatory frameworks create a dilemma that threatens the effectiveness of much needed communication between patients and medical providers: How can patients be presented with detailed facts without creating cognitive “overload”? We explain how this is a false dichotomy and illustrate, using three examples, how fuzzy-trace theory offers a third way of informing patients.
I defend the exclusionary power of political directives. The prevailing account, which I call the additive account, holds that a legitimate directive only provides a pro tanto obligation for subjects to comply. I show that it falls into a Goldilocks dilemma, giving either insufficient or excessive weight to these obligations. Pace the additive account, I argue that a legitimate directive not only gives subjects a pro tanto reason to comply but also excludes all the reasons bearing on its justifiability regarding subjects’ actions as required by the directive. Unlike Raz, who grounds the exclusionary power of legitimate directives on authorities’ supposedly superior epistemic competence, I justify it by drawing on Kantian political philosophy, which grants states a unique moral standing to make coercive decisions on behalf of their citizenry as a solution to the problem of unilateralism.
Over the past decades, the pageantry of selecting the appropriate terminology for representing the Chinese English variety has evolved into a movement promoting the widely celebrated term, China English. In He’s (2020: 14) book of Chinese English in World Englishes: Education and Use in the Professional World, an old Chinese saying, ‘without a legitimate name, without authority to the words’, is conjured to justify the rebranding of the Chinese English variety. However, initially, the term ‘China English’ did not automatically win the bid; many other terms were also pitched for being the representative terminology, including ‘Chinese colored English’ (Huang, 1988), ‘Chinese-style English’ (Gui, 1988), ‘Sinicized English’ (Zhang, 1997; Jin, 2002; Jiang, 2003), and even the widely criticized ‘Chinglish’ (Wang, 1999; Zhuang, 2000; Qiong & Wolff, 2003) had its day in the sun. Gradually, scholarly endorsements of China English begin to grow. However, one might wonder: What is the uniqueness of English in China that could trigger such decades of efforts to assert the ownership of an English variety through a mere terminological update?
In light of a history of categorical exclusion, it is critical that pregnant people are included in research to help improve the knowledge base and interventions needed to address public health. Yet the volatile legal landscape around reproductive rights in the United States threatens to undue recent progress made toward the greater inclusion of pregnant people in research. We offer ethical and practical guidance for researchers, sponsors, and institutional review boards to take specific steps to minimize legal risks and ensure the ethical conduct of research with pregnant people in an evolving legal environment.
This paper is a study of the intersection between aviation and diplomacy in the semi-autonomous Indian state of Jodhpur in the final decades of British colonial rule in India. Jodhpur's Maharaja Umaid Singh established a major international aerodrome, patronized one of India's first flying clubs and collaborated with British authorities to make aviation laws for the Indian states. He would also serve in the Royal Air Force during the war and placed Jodhpur state's aviation resources at the disposal of the king-emperor. This paper argues that Jodhpur was able to leverage its aviation resources to wield substantial influence both within and beyond the British Empire through both war and peace. An analysis of Jodhpur's engagement with aviation diplomacy is also revealing of some of the limitations as well as possibilities for the deployment of science diplomacy frameworks, especially in non-Western contexts.