Governing evidence use in the nutrition policy process: evidence and lessons from the 2020 Canada food guide

Nutrition guideline development is traditionally seen as a mechanism by which evidence is used to inform policy decisions. However, applying evidence in policy is a decidedly complex and politically embedded process, with no single universally agreed-upon body of evidence on which to base decisions, and multiple social concerns to address. Rather than simply calling for "evidence-based policy," an alternative is to look at the governing features of the evidence use system and reflect on what constitutes improved evidence use from a range of explicitly identified normative concerns. This study evaluated the use of evidence within the Canada Food Guide policy process by applying concepts of the "good governance of evidence" - an approach that incorporates multiple normative principles of scientific and democratic best practice to consider the structure and functioning of evidence advisory systems. The findings indicated that institutionalizing a process for evidence use grounded in democratic and scientific principles can improve evidence use in nutrition policy making

Color plasma oscillation in strangelets

The dispersion relation and damping rate of longitudinal color plasmons in finite strange quark matter (strangelets) are evaluated in the limits of weak coupling, low temperature, and long wavelength. The property of the QCD vacuum surrounding a strangelet makes the frequency of the plasmons nearly the same as the color plasma frequency of bulk matter. The plasmons are damped by their coupling with individual excitations of particle-hole pairs of quarks, of which the energy levels are discretized by the boundary. For strangelets of macroscopic size, the lifetime of the plasmons is found to be proportional to the size, as in the case of the usual plasma oscillations in metal nanoparticles.Comment: 9 pages (REVTeX), 2 Postscript figures, to be published in Phys. Rev.

A Pandemic Instrument Can Start Turning Collective Problems into Collective Solutions by Governing the Common-Pool Resource of Antimicrobial Effectiveness

To address the complex challenge of global antimicrobial resistance (AMR), a pandemic treaty should include mechanisms that 1) equitably address the access gap for antimicrobials, diagnostic technologies, and alternative therapies; 2) equitably conserve antimicrobials to sustain effectiveness and access across time and space; 3) equitably finance the investment, discovery, development, and distribution of new technologies; and 4) equitably finance and establish greater upstream and midstream infection prevention measures globally. Biodiversity, climate, and nuclear governance offer lessons for addressing these challenges

Type, size, and position of metastatic lesions explain the deformation of the vertebrae under complex loading conditions

Background Bone metastases may lead to spine instability and increase the risk of fracture. Scoring systems are available to assess critical metastases, but they lack specificity, and provide uncertain indications over a wide range, where most cases fall. The aim of this work was to use a novel biomechanical approach to evaluate the effect of lesion type, size, and location on the deformation of the metastatic vertebra. Method Vertebrae with metastases were identified from 16 human spines from a donation programme. The size and position of the metastases, and the Spine Instability Neoplastic Score (SINS) were evaluated from clinical Quantitative Computed Tomography images. Thirty-five spine segments consisting of metastatic vertebrae and adjacent healthy controls were biomechanically tested in four different loading conditions. The strain distribution over the entire vertebral bodies was measured with Digital Image Correlation. Correlations between the features of the metastasis (type, size, position and SINS) and the deformation of the metastatic vertebrae were statistically explored. Results The metastatic type (lytic, blastic, mixed) characterizes the vertebral behaviour (Kruskal-Wallis, p = 0.04). In fact, the lytic metastases showed more critical deformation compared to the control vertebrae (average: 2-fold increase, with peaks of 14-fold increase). By contrast, the vertebrae with mixed or blastic metastases did not show a clear trend, with deformations similar or lower than the controls. Once the position of the lytic lesion with respect to the loading direction was taken into account, the size of the lesion was significantly correlated with the perturbation to the strain distribution (r2 = 0.72, p < 0.001). Conversely, the SINS poorly correlated with the mechanical evidence, and only in case of lytic lesions (r2 = 0.25, p < 0.0001). Conclusion These results highlight the relevance of the size and location of the lytic lesion, which are marginally considered in the current clinical scoring systems, in driving the spinal biomechanical instability. The strong correlation with the biomechanical evidence indicates that these parameters are representative of the mechanical competence of the vertebra. The improved explanatory power compared to the SINS suggests including them in future guidelines for the clinical practice

The Population Decline and Extinction of Darwin's Frogs

Darwin's frogs (Rhinoderma darwinii and R. rufum) are two species of mouth-brooding frogs from Chile and Argentina. Here, we present evidence on the extent of declines, current distribution and conservation status of Rhinoderma spp.; including information on abundance, habitat and threats to extant Darwin's frog populations. All known archived Rhinoderma specimens were examined in museums in North America, Europe and South America. Extensive surveys were carried out throughout the historical ranges of R. rufum and R. darwinii from 2008 to 2012. Literature review and location data of 2,244 archived specimens were used to develop historical distribution maps for Rhinoderma spp. Based on records of sightings, optimal linear estimation was used to estimate whether R. rufum can be considered extinct. No extant R. rufum was found and our modelling inferred that this species became extinct in 1982 (95% CI, 1980-2000). Rhinoderma darwinii was found in 36 sites. All populations were within native forest and abundance was highest in Chiloé Island, when compared with Coast, Andes and South populations. Estimated population size and density (five populations) averaged 33.2 frogs/population (range, 10.2-56.3) and 14.9 frogs/100 m(2) (range, 5.3-74.1), respectively. Our results provide further evidence that R. rufum is extinct and indicate that R. darwinii has declined to a much greater degree than previously recognised. Although this species can still be found across a large part of its historical range, remaining populations are small and severely fragmented. Conservation efforts for R. darwinii should be stepped up and the species re-classified as Endangered

Planetary Antimicrobial Resistance Regimes and Collective Action

This dissertation considers how the enduring phenomenon of antimicrobial resistance (AMR) challenges us to reconsider the way we ask questions about and govern global issues. AMR occurs when disease-causing microbes develop resistance to the antimicrobial agents and medicines that are designed to treat, prevent, and stop the spread of deadly infections. AMR, which this dissertation understands as a primarily social issue, was associated with 4.95 million deaths in 2019. The introduction to this dissertation presents AMR as a defining problem of the Anthropocene. It proceeds to outline the research inquiries and methodologies adopted, the causes and consequences of AMR, and the main arguments and narrative arc across the dissertation’s five chapters. The second chapter explores how the problem of AMR is understood as a series of global collective action problems. It develops a framework to systematically identify the various collective action problems that arise around public and common goods. Applying the framework to AMR, Chapter 2 articulates eight interdependent collective action problems for AMR governance. Chapter 3 then investigates how AMR is governed in today’s interconnected world. It identifies and outlines the emerging ‘regime complex for AMR governance’, which is defined as the array of principles, norms, rules, and procedures that collectively guide human behavior around the challenge. It examines how the complexity of AMR, including its many interlinked collective action problems, has contributed to the rise and evolution of this decentralized global governance structure. Chapter 4 reframes AMR as a socio-ecological problem arising from deep tensions in the relationship between human societies and invisible microbial worlds. It adopts the concept of ecological fit, defined as the alignment between human social systems and biological ecosystems, to diagnose 18 misfits between the social institutions that govern AMR and the ecological nature of the problem. Chapter 4 proposes three principles for designing global health institutions that better fit the problems they are meant to govern. Finally, Chapter 5 concludes the dissertation by distilling cross-cutting insights and implications for the future of global AMR policy. This final chapter defines a safe antimicrobial operating space for humanity

Bridging the commitment-compliance gap in global health politics: Lessons from international relations for the global action plan on antimicrobial resistance

In 2015, 196 countries boldly committed to address global antimicrobial resistance (AMR). Now, five years later, progress reports suggest the implementation of AMR activities is vastly below what was initially promised. The challenge of overcoming the ‘commitment-compliance gap’ is not unique to AMR and is common in other areas of international politics. Global health policymakers can therefore learn from theories of international relations and experience in other sectors. We reviewed international relations scholarship to generate five hypotheses for why states might comply or not comply with their global commitments. We then conducted a public policy analysis of three past international agreements on biological diversity, climate change, and nuclear weapons to test these hypotheses and identify lessons for encouraging country compliance with global health agreements, with specific application to global AMR policies. To bridge the commitment-compliance gap, international leaders should: (1) frame incentives to maximise interests for action; (2) pursue enforcement mechanisms to induce state behaviour; (3) emphasise building a culture of trust by providing mutual assurance for action; (4) include mechanisms for managing poor performers; and (5) find opportunities for continual social learning. Agreements should be designed with flexibility, data sharing, and dispute settlement mechanisms and provide financial and technical assistance to states with less capacity to deliver

Analyzing Antimicrobial Resistance as a Series of Collective Action Problems

Antimicrobial resistance (AMR) causes over 1.27 million deaths annually, making it one of today’s most urgent health threats. Given its urgency, there are often calls for large-scale global initiatives to address AMR. However, collective action theory has yet to be applied to the problem in a systematic and holistic manner. Fuller engagement with collective action theory is necessary to avoid three risks, namely: mischaracterizing the kinds of challenges that AMR presents; over-simplifying the problem by reducing it to a single type of collective action problem; and overstating the ability of collective action theory to formulate effective solutions. This article relies on the work of Elinor Ostrom to develop an analytical framework for collective action problems concerning public goods (non-excludable and non-rivalrous) and common goods (non-excludable and rivalrous). When analyzed through this framework, we find that AMR poses nine distinct collective action problems. This more granular framing of AMR provides, in our view, a better basis to develop policy solutions to address the multifaceted challenge of AMR. We conclude with proposals for future research