The governmentality of childhood obesity: Coca-Cola, public health and primary schools

In this paper, we examine the emergence of what might seem an unexpected policy outcome – a large multinational corporation, frequently blamed for exacerbating childhood obesity, operating as an officially sanctioned driver of anti-obesity initiatives in primary schools across the globe. We draw on Foucault\u27s notion of governmentality to examine the pedagogical work of two international programmes devised and funded by Coca-Cola. We demonstrate how these programmes work simultaneously as marketing campaigns and as governmental strategies to position children as responsible for their own health, conflate (ill)health with body weight and strategically employ the concept of energy balance. We argue that these programmes not only act to unite the interests of corporations, governments and schools, but also seek to use schools to reshape the very ideas of health and a ‘healthy life’. We conclude by considering two sets of ethical and political issues that come sharply as corporations like Coca-Cola continue to exploit the policy space created by the ‘obesity epidemic’

Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study

Objective:To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR). Background:There is limited published data to date on the best achievable outcomes after L-LR. Methods:This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs. Results:There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss >= 500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively. Conclusions:This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves

How Islam influences women’s paid non-farm employment: evidence from 26 Indonesian and 37 Nigerian provinces

Studies on women’s employment in Muslim countries often mention Islam, but its influence is undertheorized and tests simply compare ‘Muslim’ women and areas to ‘non-Muslim’ women and areas. Here, multilevel analyses of Indonesia and Nigeria show this focus is not tenable: non-farm employment of Muslim women is not consistently lower than that of non-Muslim women, nor is it lower in Muslim-dominated provinces than in other provinces. A new theoretical frame conceptualizes religion’s influence in terms message and messenger. It is shown how different manifestations of Islam influence women’s non-farm employment, inside and outside the home. Empirically, the ideological strand of Islam is more important than differences between Islam and Christianity. In addition, when a conservative Islam is codified through Shari’a-based law women’s employment outside the home seems to be lower, but the presence of Islamic political parties seems to foster women’s access to the labor market through their focus on support for the poor

Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy

Introduction: Currently, the impact of body mass index (BMI) on the outcomes of laparoscopic liver resections (LLR) is poorly defined. This study attempts to evaluate the impact of BMI on the peri-operative outcomes following laparoscopic left lateral sectionectomy (L-LLS). Methods: A retrospective analysis of 2183 patients who underwent pure L-LLS at 59 international centers between 2004 and 2021 was performed. Associations between BMI and selected peri-operative outcomes were analyzed using restricted cubic splines. Results: A BMI of >27kg/m2 was associated with increased in blood loss (Mean difference (MD) 21 mls, 95% CI 5-36), open conversions (Relative risk (RR) 1.13, 95% CI 1.03-1.25), operative time (MD 11 min, 95% CI 6-16), use of Pringles maneuver (RR 1.15, 95% CI 1.06-1.26) and reductions in length of stay (MD -0.2 days, 95% CI -0.3 to -0.1). The magnitude of these differences increased with each unit increase in BMI. However, there was a "U" shaped association between BMI and morbidity with the highest complication rates observed in underweight and obese patients. Conclusion: Increasing BMI resulted in increasing difficulty of L-LLS. Consideration should be given to its incorporation in future difficulty scoring systems in laparoscopic liver resections