How policy actors assert authority in the governance of food marketing policies

The regulation of unhealthy food marketing is a highly contested space that involves a diverse range of actors and institutions. There is a paucity of research on the strategies used by the different actors to influence these policies. This study examined the use of authority by different regulatory actors to influence food marketing policies. We conducted semi-structured interviews with (N = 24) government, industry, civil society and technical experts involved in the regulation of food and beverage marketing in Australia. We identified five types of authority: institutional, delegated, expert, principled and capacity-based authority. Actors from the advertising, food and media industries claim more authority than technical experts, civil society, and government actors, suggesting that industry actors have multiple pathways to influence policy. The industry's claims of delegated and institutional authority are highly contested by civil society, technical experts, and state/territory government actors and recognised by federal government actors. Claims of circumscribed institutional authority are common among federal government actors such as the National Department of Health, Australian Media and Communications Authority and Food Standards Australia New Zealand. The assertions of authority observed in this study highlight the fragmented manner of the Australian food marketing regulatory system and have implications for which actors should be held accountable for the current challenges in the governance of food marketing policies.</p

The Lithium Salts of Bis(azolyl)borates as Strontium‐ and Chlorine‐free Red Pyrotechnic Colorants

After concerns regarding the use of chlorinated material for pyrotechnic items had reinforced, the action of the U.S. Environmental Protection Agency on health concerns about strontium ushered in a new era in the production of red light. Lithium was shown to impart red color to a pyrotechnic flame, however only a very narrow selection of such formulations can be found in the literature. Dihydrobis(azolyl)borates are a well investigated, easily accessible class of materials which have been proven to be suitable as pyrotechnic coloring agents. With their high nitrogen contents such moieties should also meet the requirements of a low combustion temperature and a reducing flame atmosphere for a lithium‐based red‐burning composition. This work evaluates the capability of the lithium salts of dihydrobis(pyrazol‐1‐yl)borate, dihydrobis(1,2,4‐triazol‐1‐yl)borate, and dihydrobis(tetrazol‐1‐yl)borate to serve as red color imparters. The latter compounds were characterized by multinuclear NMR experiments, IR spectroscopy, elemental analysis, and single‐crystal X‐ray diffraction and were investigated with respect to their thermal stabilities as well as sensitivities toward various ignition stimuli

From Local Action to Global Policy: A Comparative Policy Content Analysis of National Policies to Address Musculoskeletal Health to Inform Global Policy Development

Background: Global policy to guide action on musculoskeletal (MSK) health is in a nascent phase. Lagging behind other non-communicable diseases (NCDs) there is currently little global policy to assist governments to develop national approaches to MSK health. Considering the importance of comparison and learning for global policy development, we aimed to perform a comparative analysis of national MSK policies to identify areas of innovation and draw common themes and principles that could guide MSK health policy. Methods: Multi-modal search strategy incorporating a systematic online search targeted at the 30 most populated nations; a call to networked experts; a specified question in a related eDelphi questionnaire; and snowballing methods. Extracted data were organised using an a priori framework adapted from the World Health Organization (WHO) Building Blocks and further inductive coding. Subsequently, texts were open coded and thematically analysed to derive specific sub-themes and principles underlying texts within each theme, serving as abstracted, transferable concepts for future global policy. Results: The search yielded 165 documents with 41 retained after removal of duplicates and exclusions. Only three documents were comprehensive national strategies addressing MSK health. The most common conditions addressed in the documents were pain (non-cancer), low back pain, occupational health, inflammatory conditions, and osteoarthritis. Across eight categories, we derived 47 sub-themes with transferable principles that could guide global policy for: service delivery; workforce; medicines and technologies; financing; data and information systems; leadership and governance; citizens, consumers and communities; and research and innovation. Conclusion: There are few examples of national strategic policy to address MSK health; however, many countries are moving towards this by documenting the burden of disease and developing policies for MSK services. This review found a breadth of principles that can add to this existing work and may be adopted to develop comprehensive system-wide MSK health approaches at national and global levels

Shape-Based Separation of Micro-/Nanoparticles in Liquid Phases

The production of particles with shape-specific properties is reliant upon the separation of micro-/nanoparticles of particular shapes from particle mixtures of similar volumes. However, compared to a large number of size-based particle separation methods, shape-based separation methods have not been adequately explored. We review various up-to-date approaches to shape-based separation of rigid micro-/nanoparticles in liquid phases including size exclusion chromatography, field flow fractionation, deterministic lateral displacement, inertial focusing, electrophoresis, magnetophoresis, self-assembly precipitation, and centrifugation. We discuss separation mechanisms by classifying them as either changes in surface interactions or extensions of size-based separation. The latter includes geometric restrictions and shape-dependent transport properties

Context and Priorities for Health Systems Strengthening for Pain and Disability in Low- and Middle-Income Countries: A Secondary Qualitative Study and Content Analysis of Health Policies.

Musculoskeletal (MSK) health impairments contribute substantially to the pain and disability burden in low- and middle-income countries (LMICs), yet health systems strengthening (HSS) responses are nascent in these settings. We aimed to explore the contemporary context, framed as challenges and opportunities, for improving population-level prevention and management of MSK health in LMICs using secondary qualitative data from a previous study exploring HSS priorities for MSK health globally and (2) to contextualize these findings through a primary analysis of health policies for integrated management of non-communicable diseases (NCDs) in select LMICs. Part 1: 12 transcripts of interviews with LMIC-based key informants (KIs) were inductively analysed. Part 2: systematic content analysis of health policies for integrated care of NCDs where KIs were resident (Argentina, Bangladesh, Brazil, Ethiopia, India, Kenya, Malaysia, Philippines and South Africa). A thematic framework of LMIC-relevant challenges and opportunities was empirically derived and organized around five meta-themes: (1) MSK health is a low priority; (2) social determinants adversely affect MSK health; (3) healthcare system issues de-prioritize MSK health; (4) economic constraints restrict system capacity to direct and mobilize resources to MSK health; and (5) build research capacity. Twelve policy documents were included, describing explicit foci on cardiovascular disease (100%), diabetes (100%), respiratory conditions (100%) and cancer (89%); none explicitly focused on MSK health. Policy strategies were coded into three categories: (1) general principles for people-centred NCD care, (2) service delivery and (3) system strengthening. Four policies described strategies to address MSK health in some way, mostly related to injury care. Priorities and opportunities for HSS for MSK health identified by KIs aligned with broader strategies targeting NCDs identified in the policies. MSK health is not currently prioritized in NCD health policies among selected LMICs. However, opportunities to address the MSK-attributed disability burden exist through integrating MSK-specific HSS initiatives with initiatives targeting NCDs generally and injury and trauma care

Health systems strengthening to arrest the global disability burden: Empirical development of prioritised components for a global strategy for improving musculoskeletal health

Introduction Despite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health. Methods Design: mixed-methods, three-phase design. Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response. Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci. Phase 3: informed by phases 1-2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions. Results Phase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action. Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model. Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening. Conclusion An empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives

Anti-CD4 monoclonal antibody treatment in acute and early chronic antigen induced arthritis: influence on macrophage activation

Objective: To investigate the indirect effects of anti-CD4 treatment on the functions of macrophages (CD4(–) in mice) in the acute and early chronic phase of mouse antigen induced arthritis (AIA). Methods: C57BL/6 mice with AIA were treated intraperitoneally with the anti-CD4 mAb GK1.5 or control rat IgG on days –1, 0, 1, 3, 5, and 7. Proinflammatory cytokines (IL1ß, IL6, and TNFα) were quantified by sandwich ELISA in joint extracts, serum, and supernatants of ex vivo stimulated spleen/lymph node cells or peritoneal macrophages (+LPS/IFNγ). Nitric oxide (NO) levels in supernatants of ex vivo stimulated peritoneal macrophages were measured by the Griess reaction. Proteolytic activity in joint homogenates was analysed by gelatin, casein, and elastin zymography, and substrate assays. Results: Anti-CD4 treatment significantly reduced joint swelling in acute (days 3, 5) and early chronic AIA (day 7) and diminished inflammation and destruction scores in late chronic AIA (day 21). On day 3, anti-CD4 treatment significantly reduced IL6 levels in all compartments. IL1ß was reduced in joint extracts, unaffected in serum or cells from lymphoid organs, and increased in stimulated peritoneal macrophages. TNFα was significantly increased in the joints, decreased in serum, and otherwise unchanged. NO production by stimulated peritoneal macrophages was significantly reduced by anti-CD4 treatment. Lower activity of matrix metalloproteinases and neutrophil elastase was seen in joint extracts of anti-CD4 treated animals than in IgG treated AIA controls. Conclusion: CD4(+) T cell directed treatment had strong local and systemic effects on macrophages. These indirect effects may contribute to the reduction of destructive mediators/joint destruction in AIA