A framework of NGO inside and outside strategies in the commercial determinants of health:findings from a narrative review

Published online: 10 October 2023. OnlinePublBACKGROUND: Public health scholarship has uncovered a wide range of strategies used by industry actors to promote their products and influence government regulation. Less is known about the strategies used by non-government organisations to attempt to influence commercial practices. This narrative review applies a political science typology to identify a suite of 'inside' and 'outside' strategies used by NGOs to attempt to influence the commercial determinants of health. METHODS: We conducted a systematic search in Web of Science, ProQuest and Scopus. Articles were eligible for inclusion if they comprised an empirical study, explicitly sought to examine 'NGOs', were in English, and identified at least one NGO strategy aimed at commercial and/or government policy and practice. RESULTS: One hundred forty-four studies met the inclusion criteria. Eight industry sectors were identified: extractive, tobacco, food, alcohol, pharmaceuticals, weapons, textiles and asbestos, and a small number of general studies. We identified 18 types of NGO strategies, categorised according to the target (i.e. commercial actor or government actor) and type of interaction with the target (i.e. inside or outside). Of these, five NGO 'inside' strategies targeted commercial actors directly: 1) participation in partnerships and multistakeholder initiatives; 2) private meetings and roundtables; 3) engaging with company AGMs and shareholders; 4) collaborations other than partnerships; and 5) litigation. 'Outside' strategies targeting commercial actors through the mobilisation of public opinion included 1) monitoring and reporting; 2) protests at industry sites; 3) boycotts; 4) directly engaging the public; and 5) creative use of alternative spaces. Four NGO 'inside' strategies directly targeting government actors included: 1) lobbying; 2) drafting legislation, policies and standards; 3) providing technical support and training; and 4) litigation. NGO 'outside' strategies targeting government included 1) protests and public campaigns; 2) monitoring and reporting; 3) forum shifting; and 4) proposing and initiating alternative solutions. We identified three types of NGO impact: substantive, procedural, and normative. CONCLUSION: The analysis presents a matrix of NGO strategies used to target commercial and government actors across a range of industry sectors. This framework can be used to guide examination of which NGO strategies are effective and appropriate, and which conditions enable NGO influence.Belinda Townsend, Timothy D. Johnson, Rob Ralston, Katherine Cullerton, Jane Martin, Jeff Collin, Fran Baum, Liz Arnanz, Rodney Holmes and Sharon Frie

A Q-methodology study of flare help-seeking behaviours and different experiences of daily life in rheumatoid arthritis

© 2014 Lin et al.; licensee BioMed Central Ltd. Background: Previous studies have not addressed rheumatoid arthritis (RA) patients' help-seeking behaviours for RA flares, and only one small qualitative study has addressed how patients experience daily life on current treatment regimes. Thus, this study aims to identify clusters of opinion related to RA patients' experiences of daily life on current treatments, and their help-seeking behaviours for RA flares. Methods: Using Q-methodology (a methodology using qualitative and quantitative methods to sort people according to subjective experience), two separate studies were conducted with the same sample of RA patients (mean age 55, 73% female). Thirty participants sorted 39 statements about daily life (Q-study 1) and 29 participants separately sorted 23 statements about flare help-seeking (Q-study 2). Data were examined using Q-factor analysis. Results: Daily life with RA (Q-study 1): Three factors relating to the experience of living with RA were extracted and explained. Patients belonging to Factor A (mean age 62, 86% female) use effective self-management techniques to control the daily impact of RA. Those in Factor B (mean age 55, 75% male) struggle to self-manage and cope. Whilst patients in Factor C (mean age 42, 100% female) prioritise life responsibilities over their RA, reporting less impact. Flare help-seeking (Q-study 2): Two factors explaining the experience of flare help-seeking (unrelated to the factors from Q-study 1) were extracted and explained. Factor X (68.8% on biologics) reported seeking help quickly, believing the medical team is there to help. Factor Y (0% on biologics) delay help-seeking, concerned about wasting the rheumatologist's time, believing they should manage alone. All participants agreed they sought help due to intense pain and persistent, unmanageable symptoms. Conclusions: Patients with different characteristics appear to manage RA life in different ways and men may struggle more than women. Whilst all patients are prompted to seek help by persistent, unmanageable symptoms, some delay help-seeking. Further research is needed to quantify the severity of daily symptoms, the level of symptoms needed for patients to define themselves as in flare and to understand the support needs of RA men

Decreased shedding of \u3ci\u3eEscherichia coli \u3c/i\u3eO157:H7 by cattle following vaccination with type III secreted proteins

Cattle are an important reservoir of Escherichia coli O157:H7 leading to contamination of food and water, and subsequent human disease. This pathogen colonizes its hosts by producing several proteins such as Tir and EspA that are secreted by a type III secretion system. These proteins play a role in colonization of the intestine, suggesting that they might be useful targets for the development of a vaccine to reduce levels of this organism in cattle. Vaccination of cattle with proteins secreted by E. coli O157:H7 significantly reduced the numbers of bacteria shed in feces, the numbers of animals that shed, and the duration of shedding in an experimental challenge model. Vaccination of cattle also significantly (P=0.04) reduced the prevalence of E. coli O157:H7 in a clinical trial conducted in a typical feedlot setting. This strategy suggests it is possible to vaccinate cattle to decrease the level of E. coli O157:H7 shedding for the purpose of reducing the risk of human disease

Periphyton and phytoplankton response to reduced dry season flows in the Daly River

Final Milestone Report: National River Health Program – Environmental Flows InitiativeThis project evaluates whether phytoplankton, benthic diatoms and macroalgae are directly, or indirectly, responsive to dry season river flow, and provide information for the allocation of water for the environment. Owing to their rapid replication rate of a couple of days, these algae are responsive over a time scale of weeks to changes in the aquatic environment, notably flow and water quality. Flow in the Daly River and its major tributaries, during the dry season, is maintained by groundwater. The extraction of water directly from these rivers or from the groundwater during the "dry" will reduce flows in the Daly River and its tributaries. There is also potential for the river's water quality to be directly affected. In the upper reaches of the catchment, dry season flows originate predominantly from aquifers within Cretaceous sediments. With groundwater inflow from the Daly River Basin, the conductivity of the Daly River increases 20-30 fold, pH and the carbonate buffering capacity increases at least an order of magnitude, whilst soluble phosphorus and nitrate concentrations more then double. In the Douglas River, inflow from the Tindal Limestone results in an almost 100 fold increase in nitrate concentrations but has not resulted in high phytoplankton concentrations due probably to phosphorus limitation. Such a marked increase in nitrate concentrations was not measured elsewhere in the catchment, and may be due to modified land-use and management practices. Extraction from the Daly River Basin for consumptive use would be expected to alter, in addition to flow, river water quality, depending of the change in the mix of river sources.Simon Townsend, Peter Gell, Sophie Bickford, John Tibby, Roger Croome, Malgorzata Przybylska, Armando Padovan and Rodney Metcalf

Meeting Report: Risk Assessment of Tamiflu® use under Pandemic Conditions

On 3 October 2007, 40 participants with diverse expertise attended the workshop Tamiflu and the Environment: Implications of Use under Pandemic Conditions to assess the potential human health impact and environmental hazards associated with use of Tamiflu during an influenza pandemic. Based on the identification and risk-ranking of knowledge gaps, the consensus was that oseltamivir ethylester-phosphate (OE-P) and oseltamivir carboxylate (OC) were unlikely to pose an ecotoxicologic hazard to freshwater organisms. OC in river water might hasten the generation of OC-resistance in wildfowl, but this possibility seems less likely than the potential disruption that could be posed by OC and other pharmaceuticals to the operation of sewage treatment plants. The workgroup members agreed on the following research priorities: a) available data on the ecotoxicology of OE-P and OC should be published ; b) risk should be assessed for OC-contaminated river water generating OC-resistant viruses in wildfowl ; c) sewage treatment plant functioning due to microbial inhibition by neuraminidase inhibitors and other antimicrobials used during a pandemic should be investigated ; and d) realistic worst-case exposure scenarios should be developed. Additional modeling would be useful to identify localized areas within river catchments that might be prone to high pharmaceutical concentrations in sewage treatment plant effluent. Ongoing seasonal use of Tamiflu in Japan offers opportunities for researchers to assess how much OC enters and persists in the aquatic environment

SAPO-18 catalysts and their Brønsted acid sites

The incorporation of silicon via direct synthesis into AlPO4-18 (AEI), which has a framework structure related to, but crystallographically distinct from, that of the well-known solid acid catalyst SAPO-34, was investigated by a range of techniques. Unlike the Si/(Si + Al + P) ratio (typically about 0.10) in SAPO-34, which can be varied only within a very narrow range under normal synthetic conditions, the Si/(Si + Al + P) ratio in SAPO-18 is tunable from O to 0.10 by varying the silicon content in the synthetic gel. 29Si MAS NMR spectroscopy reveals that silicon substitutes for both phosphorus and aluminum in SAPO-18, whereas in SAPO-34, silicon substitutes only for phosphorus. Infrared and 1H MAS NMR spectroscopies and temperature-programmed desorption (TPD) of ammonia were used to examine the Brønsted acid sites borne by SAPO-18 samples. As expected, the concentration of Brønsted acid sites in all SAPO-18 samples is much less than that in SAPO-34. In contrast to the essentially neutral AlPO4-18, which catalyzes methanol conversion only to dimethyl ether, SAPO-18 catalytically converts methanol to light olefins with high activity and selectivity. The maximum conversion of methanol to ethene and propene reaches 80% with a 100% conversion of methanol to hydrocarbons. With an optimum framework composition, SAPO-18 retains its catalytic activity and selectivity longer than SAPO-34.</p