Assessing the World Health Organization: What does the academic debate reveal and is it democratic?

The World Health Organization (WHO), the leading global authority in public health, routinely attracts loud calls for reform. Although Member States negotiate reform internally, academic debate is more public, and can generate ideas and provide independent accountability. We investigate why authors advocate for WHO reform so commonly. We wondered if this literature had potentially useful themes for WHO, what methods and evidence were used, and we wanted to analyze the geography of participation. We conducted a systematic review using four databases to identify 139 articles assessing WHO or advocating for reform. We discuss these using categories we derived from the management literature on organizational performance. We also analyzed evidence, country of origin, and topic. The literature we reviewed contained 998 claims about WHO's performance or reform, although there were no standard methods for assessing WHO. We developed a framework to analyze WHO's performance and structure a synthesis of the claims, which find WHO imperiled. Its legitimacy and governance are weakened by disagreements about purpose, unequal Member State influence, and inadequate accountability. Contestation of goals and strategies constrain planning. Structure and workforce deficiencies limit coordination, agility, and competence. WHO has technical and normative authority, but insufficient independence and legal power to influence uncooperative states. WHO's identity claims transparency, independence, and courage, but these aspirations are betrayed in times of need. Most articles (88%) were commentaries without specified methods. More than three-quarters (76%) originated from the US, the UK, or Switzerland. A quarter of papers (25%) focused on international infectious disease outbreaks, and another 25% advocated for WHO reform generally. Many criticisms cite wide-ranging performance problems, some of which may relate to obstructive behavior by Member States. This literature is incomplete in the geographic representation of authors, evidence, methods, and topics. We offer ideas for developing more rigorous and inclusive academic debate on WHO.publishedVersio

Sexual abuse of caredependent people

Hintergrund. Sexuelle Gewalt gegen pflegebedürftige Menschen stellt die Langzeitpflege vor Herausforderungen. Oft bleibt Sie unentdeckt, dabei hat Gewalt gegen Pflegebedürftige bedeutsame Folgen hinsichtlich der Morbidität und Mortalität der Patienten. Ziel der Arbeit. Ziel dieser Arbeit ist es, die bisher wenig untersuchte Rolle des Hausarztes bei sexueller Gewalt gegen Pflegebedürftige, hinsichtlich ihrer Einstellung und Verantwortung, des Fortbildungsinteresse und ihrer subjektiven Sicherheit bei Verdacht von sexueller Gewalt gegen pflegebedürftige Menschen zu untersuchen. Material und Methoden. In einer bundesweiten Querschnittsstudie wurden 1.700 Hausärzte in Deutschland zwischen September und November 2016 schriftlich befragt. Die Fragebögen wurden postalisch versandt. Neben soziodemographischen Daten, enthielt der Fragebogen Fragen bezüglich der subjektiven Sicherheit, des Fortbildungsinteresse und der Einstellung bezüglich hausärztlicher Verantwortung bei sexueller Gewalt. Es konnten von 302 Ärzten Fragebögen in die Auswertung eingeschlossen werden. Ergebnisse. Bei zeitgleich hohem ärztlichem Verantwortungsbewusstsein besteht auch eine große Unsicherheit bezüglich des weiteren Vorgehens bei einem Verdacht auf sexuelle Gewalt gegen pflegebedürftige Patienten. Die subjektive Sicherheit hat einen signifikanten Einfluss auf die wahrgenommene Rolle des Hausarztes. Andere erhobene Strukturvariablen zeigten keinen signifikanten Einfluss. Die Befragten geben ein großes Fortbildungsinteresse an. Traditionelle Fortbildungsmaßnamen werden bevorzugt gewünscht. Schlussfolgerung. Durch eine höhere subjektive Sicherheit wird vermehrt und früher gegen sexuelle Gewalt vorgegangen. Die subjektive Sicherheit von Hausätzten sollte daher gesteigert werden. Für geeignete Fortbildungsmaßnahmen kann diese Untersuchung einen thematischen Anhalt liefern und zeigt die gewünschten Fortbildungsformate. Insbesondere sind Fortbildungen für die Unterscheidung von sexueller Gewalt zu alterstypischen Symptomen und Fortbildungen zum richtigen Ton treffen gewünscht.Sexual abuse of people in need of care constitutes a challenge for long-term care since it can have considerable consequences regarding morbidity and mortality. However, in most cases it remains undetected. Aim. The aim of this study was to examine how general practitioners (GPs) in Germany perceive their responsibility in cases of sexual abuse of care-dependent patients. Additionally, we wanted to investigate their interest in further education and personal confidence in handling these kinds of situations. Material and methods. In a cross-sectional study from September to November 2016, 1.700 GPs in Germany were asked to fill out a questionnaire that was designed to answer our objectives including sociodemographic factors. 302 questionnaires could be included in our analysis. Results. Even though nearly all participants see it as their responsibility as doctors to take action in cases of sexual abuse, there are big insecurities about the right course of action. Main interests regarding further education lie especially in diagnostics as well as a guideline on what to do and who to contact if suspicion is raised. Conclusion. Sexual abuse in patient care is a sensitive and scarcely discussed issue that requires further training to strengthen the physician’s security of correctly diagnosing and handling these cases

Implementation and application of kinematic vertex fitting in the software environment of ILD

The vertex reconstruction toolkit RAVE has been extended by an option for the inclusion of kinematic constraints, and embedded into the ILD analysis framework Marlin. The new tools have been tested with an exemplary reconstruction of WW and ZZ decays. The presented results show the improvements achieved in precision of the fitted masses, and demonstrate the usage and functionality of the toolkit.Comment: Proc. 11th Int. Linear Collider Workshop (LCWS'08), UIC, Chicago, USA, 16-20 Nov. 200

A new precedent in international health cooperation from African public health leaders

Peer Reviewe

an analysis of current capacity, needs and barriers

Background In times of increasing global challenges to health, it is crucial to create a workforce capable of tackling these complex issues. Even though a lack of GHE in Germany is perceived by multiple stakeholders, no systematic analysis of the current landscape exists. The aim of this study is to provide an analysis of the global health education (GHE) capacity in Germany as well as to identify gaps, barriers and future strategies. Methods An online search in combination with information provided by student representatives, course coordinators and lecturers was used to create an overview of the current GHE landscape in Germany. Additionally, a semi-structured questionnaire was sent to GHE educators and students engaged in global health (GH) to assess the capacity of German GHE, its barriers and suggested strategies for the future. Results A total of 33 GHE activities were identified at 18 German universities. Even though medical schools are the main provider of GHE (42%), out of 38 medical schools, only 13 (34%) offer any kind of GHE. Modules offered for students of other health-related professions constitute 27% of all activities. Most survey respondents (92%, n = 48) consider current GHE activities in Germany insufficient. Suggested formats were GHE as part of medical curricula (82%, n = 45) and dual degree MD/MPH or PhD programs. Most important barriers mentioned were low priority of GH at faculties and academic management levels (n = 41, 75%) as well as lack of necessary institutional structures (n = 33, 60%). Conclusions Despite some innovative academic approaches, there is clearly a need for more systematic GHE in Germany. GHE educators and students can take an important role advocating for more awareness at university management level and suggesting ways to institutionalize GHE to overcome barriers. This study provides key evidence, relevant perceptions and suggestions to strengthen GHE in Germany

Working From Home and Covid-19: Where Could Residents Move to?

As a protective measure during the Covid-19 pandemic, in Spring 2020, a high number of employees began relocating their workplace to their homes, many for the first time. Recent surveys suggest that the share of those working from home (WFH) will remain higher than before the pandemic in the long term too—with correspondingly fewer commuting journeys. Workplaces are still often concentrated in inner cities, into which workers commute from more outlying areas. However, classical geographical economic theory suggests that a reduced need for commuting might lead to a reorientation of residential preferences amongst employees towards even fewer urban areas, as households trade off the disamenity of commuting against lower housing costs and more living space. This article investigates how such consequences could unfold in space. The Munich Metropolitan Region is characterised by a high share of knowledge-based jobs suitable for WFH and thus serves as our case study. We collect data at the municipality level for relevant aspects of residential location choices and develop an index for the potential of additional residential demand through increased WFH for each municipality in the Munich Metropolitan Region. Crucially, a municipality’s potential depends on the number of commuting days per week. Keeping the weekly commuting time budget constant, an increase in WFH, or a reduction in commuting days allows a longer commuting time per trip. We visualise our results and sensitivities with maps. We observe a gradual yet discontinuous decay of potentials from the region’s core to the fringes with an increase in WFH days

Entwicklung redaktioneller Prozesse zur Erstellung universitärer Weiterbildungsangebote auf Grundlage einer persona-inspirierten Anforderungsanalyse

Der Erfolg berufsbegleitender, universitärer Weiterbildungsangebote hängt insbesondere davon ab, wie gut eine anbietende Institution die Anforderungen der Kursteilnehmer erfüllen kann. Diese Anforderungen sind – abhängig von den jeweiligen Adressaten – sehr vielfältig. Sollen die Weiterbildungsangebote eine sehr praxisnahe Schulung in Kooperation mit Unternehmen beinhalten, sind neben Lernenden und Lehrenden oftmals zusätzliche Stakeholder mit vielfältigen Interessen beteiligt und die zu schulenden Materialien liegen bereits in den unterschiedlichsten Varianten und in verschiedenster Güte vor. Somit ist es essentiell, die Erwartungen der Interessengruppen systematisch zu analysieren, um die Anforderungen an Weiterbildungskurse abzuleiten. Persona-Avatare können hierbei Inspirationen geben. Um gerade in Zusammenarbeit mit teilweise externen Dozierenden Kursmaterialien effizient produzieren zu können, ist es zielführend, redaktionelle Prozesse zu definieren, da diese einen verbindlichen und damit plan- und messbaren Arbeitsfluss vorgeben. (DIPF/Orig.