Early intervention to reduce the global health and economic burden of major depression in older adults.

Randomized trials for selective and indicated prevention of depression in both mixed-aged and older adult samples, conducted in high-income countries (HICs), show that rates of incident depression can be reduced by 20-25% over 1-2 years through the use of psychoeducational and psychological interventions designed to increase protective factors. Recurrence of major depression can also be substantially reduced through both psychological and psychopharmacological strategies. Additional research is needed, however, to address the specific issues of depression prevention in older adults in low- and middle-income countries (LMICs). The growing number of older adults globally, as well as workforce issues and the expense of interventions, makes it important to develop rational, targeted, and cost-effective risk-reduction strategies. In our opinion, one strategy to address these issues entails the use of lay health counselors (LHCs), a form of task shifting already shown to be effective in the treatment of common mental disorders in LMICs. We suggest in this review that the time is right for research into the translation of depression-prevention strategies for use in LMICs

The Power of the Weak: How Informal Power-Sharing Shapes the Work of the UN Security Council

To what extent is the work of international organizations shaped by their most powerful members? Can minor powers influence the decisions taken by these organizations? This dissertation presents the argument that great powers engage in power-sharing in order to attain unanimity inside international organizations, which enhances compliance and increases the effect of the signals these organizations convey to the public. The pursuit of unanimity lends weight even to votes that are not needed for the adoption of a proposal under the formal rules. It enables minor powers to exert more influence inside international organizations than they could if the formal rules and/or the balance of material power between member states determined the outcome of decision-making in international organizations. An analysis of the UN Security Council tests this argument. The dissertation identifies a series of informal power-sharing practices in the Security Council, which systematically depart from the organization's formal rules, and which promote consensus and augment minor powers' influence far beyond what one would expect on the basis of the material capabilities and voting power of these states. In turn, these informal power-sharing practices are motivated by great powers' desire to attain unanimous support for the policies enacted in the Security Council, irrespective of the body's formal voting rules. Survey experiments demonstrate the rationale behind great powers' pursuit of unanimity. They show that a policy's endorsement by a united Security Council has a much larger signaling effect on public opinion than the policy's approval by a divided Council. Qualitative case studies and novel design-based causal inference that exploits natural experiments show that minor powers strongly influence the deployment of UN peace operations and UN counter-terrorism sanctions, and that minor powers also use their influence in the Council to attain side-payments. Minor powers' influence is particularly strong during crises, when great powers are most eager to secure small states' votes through power-sharing. Interviews with diplomats in seven countries and quantitative analyses of exogenous variation in minor powers' representation on the Security Council under pre-determined rotation rules trace minor powers' influence to informal power-sharing practices in the Council