Hybrid threats and preparedness strategies: The reconceptualization of biological threats and boundaries in global health emergencies

This is the final version. Available from SAGE via the DOI in this record. Pandemic emergencies are one of the foremost examples of the turn to preparedness. In this article, I discuss how biological threats are conceptualized inside the frame provided by such turn, connecting with novel governance practices aimed at tackling the challenges posed by the constantly shifting boundaries of global health. First, I review existing literature related to the turn to preparedness. This turn has turned virtual biological threats into the main drivers for preparedness planning. Second, I use empirical material to argue a redefinition of biological threats as entities that go beyond the molecular boundaries of viruses, turning hybrid social networks into the main object of interest for global health response before infectious diseases. This reconceptualization is manifested in three different challenges to the boundaries of global health emergencies: (1) a temporal challenge, which forces institutions to struggle with situating the boundary between event and non-event; (2) an institutional challenge, which brings together different actors, institutions, and organizations redefining their internal and external boundaries; and (3) a spatial challenge, whereby the territorial lines of secure and insecure spaces become mobile and unstable. As a conclusion, I will argue that those three challenges and the redefinition of certain boundaries are ways to govern a wider divide constructed by preparedness that aims at separating the threat and an object of protection.Kone FoundationAlfred Kordelin FoundationCIM

Rethinking therapeutic misconception in biobanking – ambivalence between research and treatment

This is the final version. Available on open access via the DOI in this record. Some authors have noted that in biobank re search participants may be guided by what is called therapeutic misconception, whereby participants attribute therapeutic intent to research procedures (Zawati and Knoppers, 2012; Lidz and Appelbaum, 2002).  This article argues that the notion of therapeutic misconception is increasingly less justified when evaluating biobanks. We present four examples taken from recent developments in biobanking to argue why the notion of therapeutic misconception is problematic in that biobanking practices are increasingly seeking to bridge research and treatment in different ways.  In this article we explore examples where the boundary between research and treatment become increasingly blurred, as well as the contextual significance of healthcare systems and their prevailing ideologies in healthcare management. We argue that biobanking practices are challenging the use value, as well as the philosophical and ethical underpinnings for the need to separate research and treatment, and thus the notion of therapeutic misconception in the first place. We call this tension between research and treatment ambivalent research advancement to highlight the difficulties that various actors have in managing such shifts within the healthcare-research systems.Finnish funding agency for innovationUniversity of Copenhage

How to make noncoherent problems more productive: Towards an AMR management plan for low resource livestock sectors

This is the final version. Available on open access from Springer Nature via the DOI in this recordData availability: The datasets generated and analysed during the current study are not publicly available due to ethical considerations, but may be provided upon an appropriate request to the corresponding author.Global policy for managing antimicrobial resistance (AMR) is underpinned by a standardised and coherent global framework for reducing antibiotic use in clinical health, veterinary health, and food production sectors. Within the framework, problematic antibiotic use (a significant driver of AMR) is treated as a knowledge deficit on the part of users and prescribers, which can be remedied by educating them to make better informed treatment decisions. This narrow approach to AMR management conceals the socioeconomic and material drivers of antibiotic decision-making, creating challenges for low resource regions that rely on antibiotic therapies to manage uncertainty and precarity. Thus, there is a need for a global AMR policy that acknowledges the diversity of sociomaterial arrangements and practices that antibiotics form part of, if their use is to be reduced without undermining productivity or the attainment of poverty reduction indicators. Drawing upon research of antibiotic use in West Africa’s livestock sector, this article analyses the interrelation of antibiotics, AMR action plans, and production management strategies in ecologies of livestock breeding practices. We apply the STS-influenced perspective of noncoherence to analyse how seemingly contradictory practices and institutional logics productively coalesce. We argue that observing noncoherent practices increases our understanding of antibiotic use in relation to local breeding conditions that are frequently not of the producers’ making, whilst drawing attention to context-specific possibilities for improving livestock management capacities and reducing reliance on antibiotic therapies in low-resource settings. The article concludes by calling for an AMR global policy that is more responsive to local specificity rather than enforcing universal standardisation.Academy of FinlandMinistry of Foreign Affairs, FinlandKone Foundation, Finlan

Comment on "Evidence from acoustic imaging for submarine volcanic activity in 2012 off the west coast of El Hierro (Canary Islands, Spain)" by Pérez NM, Somoza L, Hernández PA, González de Vallejo L, León R, Sagiya T, Biain A, González FJ, Medialdea T, Barrancos J, Ibáñez J, Sumino H, Nogami K and Romero C [Bull Volcanol (2014) 76:882-896]

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Municipal mortality due to thyroid cancer in Spain

BACKGROUND: Thyroid cancer is a tumor with a low but growing incidence in Spain. This study sought to depict its spatial municipal mortality pattern, using the classic model proposed by Besag, York and Mollié. METHODS: It was possible to compile and ascertain the posterior distribution of relative risk on the basis of a single Bayesian spatial model covering all of Spain's 8077 municipal areas. Maps were plotted depicting standardized mortality ratios, smoothed relative risk (RR) estimates, and the posterior probability that RR > 1. RESULTS: From 1989 to 1998 a total of 2,538 thyroid cancer deaths were registered in 1,041 municipalities. The highest relative risks were mostly situated in the Canary Islands, the province of Lugo, the east of La Coruña (Corunna) and western areas of Asturias and Orense. CONCLUSION: The observed mortality pattern coincides with areas in Spain where goiter has been declared endemic. The higher frequency in these same areas of undifferentiated, more aggressive carcinomas could be reflected in the mortality figures. Other unknown genetic or environmental factors could also play a role in the etiology of this tumor

Dietary animal and plant protein intakes and their associations with obesity and cardio-metabolic indicators in European adolescents: The HELENA cross-sectional study

Background: Previous studies suggest that dietary protein might play a beneficial role in combating obesity and its related chronic diseases. Total, animal and plant protein intakes and their associations with anthropometry and serum biomarkers in European adolescents using one standardised methodology across European countries are not well documented. Objectives: To evaluate total, animal and plant protein intakes in European adolescents stratified by gender and age, and to investigate their associations with cardio-metabolic indicators (anthropometry and biomarkers). Methods: The current analysis included 1804 randomly selected adolescents participating in the HELENA study (conducted in 2006-2007) aged 12.5-17.5 y (47% males) who completed two non-consecutive computerised 24-h dietary recalls. Associations between animal and plant protein intakes, and anthropometry and serum biomarkers were examined with General linear Model multivariate analysis. Results: Average total protein intake exceeded the recommendations of World Health Organization and European Food Safety Authority. Mean total protein intake was 96 g/d (59% derived from animal protein). Total, animal and plant protein intakes (g/d) were significantly lower in females than in males and total and plant protein intakes were lower in younger participants (12.5-14.9 y). Protein intake was significantly lower in underweight subjects and higher in obese ones; the direction of the relationship was reversed after adjustments for body weight (g/(kg.d)). The inverse association of plant protein intakes was stronger with BMI z-score and body fat percentage (BF%) compared to animal protein intakes. Additionally, BMI and BF% were positively associated with energy percentage of animal protein. Conclusions: This sample of European adolescents appeared to have adequate total protein intake. Our findings suggest that plant protein intakes may play a role in preventing obesity among European adolescents. Further longitudinal studies are needed to investigate the potential beneficial effects observed in this study in the prevention of obesity and related chronic diseases