Responsibility of International Organizations under International Law for the Acts of Global Health Public-Private Partnerships

Public-private partnerships governing global health are making progress in relation to the prevention and treatment of diseases such as AIDS, tuberculosis, and malaria. This progress should not be underestimated as these partnerships are making strides above and beyond efforts of either the public or private sector alone. As a consequence, partnerships are increasingly exercising public power over global health in addition to, or instead of states and international organizations and are thus also becoming capable of adversely impacting the rights of individuals, in particular the right to life and the right to health. Responsibility under international law therefore arises as an issue but, at the moment, partnerships are not directly addressed by the rules of responsibility under international law. This Article describes global health public-private partnerships and discusses how public power over global health is increasingly being exercised by these partnerships thereby necessitating a further discussion on responsibility under international law. It highlights a gap in responsibility and suggests closing this gap by holding international organizations, as partners and/or hosts, responsible under international law for the acts of these partnerships

Studies on the mechanism of action of the chemotherapeutic drug bleomycin on cell lines derived from haemangioma and keloid

Bleomycin has been used successfully in the treatment of haemangioma, keloid and vascular malformation; however the mode of action of this chemotherapeutic drug on these non-malignant dysplasias is not well understood. The aim of this study was to investigate the effects of bleomycin on a range of human primary cell lines to improve our understanding of the mechanism by which bleomycin exerts its effects. This may facilitate the subsequent identification of alternative therapeutic strategies, thereby avoiding the well recognised and potentially life threatening side effects associated with the use of bleomycin. Primary cell lines were isolated from excised lesions using an explant culture technique. The cell lines thus obtained, along with other cell lines previously derived from other tissues, were exposed to a range of concentrations of bleomycin to examine dose response. Results showed that at a dose of l00mU/ml bleomycin, all cell lines underwent a G1 arrest after 48 hours in culture. At higher doses, bleomycin induced a dose-dependent increase in the proportion of cells in sub- Gl with all cell lines treated, a specific marker of apoptosis. Bleomycin induced apoptosis was further confirmed by TUNEL assay and results showed that keloid derived cells had a significantly greater level of DNA strand breaks than foreskin fibroblasts. An antibody specific for cleaved caspase-3 was also used to investigate apoptosis initiation. Both keloid derived cells and foreskin fibroblasts showed a bleomycin-induced cleavage of caspase-3, however the level of caspase-3 cleavage was significantly greater in keloid derived cells. In conclusion, results from this study show that bleomycin induces apoptosis of haemangioma, venous malformation and keloid derived cells in a dose dependent manner. In addition, this study reports for the first time that bleomycin induces a caspase-3 mediated apoptotic cell death in keloid derived cells

Improving Principal Professional Practice Through Communities of Practice

This Organizational Improvement Project (OIP) explores a problem of practice (PoP) where the Association Office (AO), within a large, private school district (District), wishes to facilitate professional development of leadership skills, collaboration, and cooperation amongst the principals. Perspectives on the problem are gained through a thorough assessment of the District and its existing culture and practices. In addition, this OIP examines the District’s readiness for change and how both the internal and external forces for change can be used to create momentum to address the PoP. Various leadership approaches, including adaptive, agile, and servant leadership, and possible solutions are considered in response to the PoP. A change implementation plan that includes the adoption of a community of practice (CoP) is suggested as the focus of the OIP. The change implementation plan within the OIP focuses on planning and communicating the CoP to the various stakeholders. The proposed CoP will form part of a dual operating system of governance that operates outside the traditional hierarchy. The CoP would focus on building instructional and principal leadership skills while encouraging collaboration and cooperation with the principals and the AO. The ethical considerations of implementing a CoP as well as possible next steps are also discussed in this OIP. If implemented, it is proposed that this OIP will be successful in building relationships and leadership capacity among the principals and the AO within the District

The Smiley Faces task and how it can help teach some fundamentals for good clinical trials

Background: Many factors need to be considered when designing a clinical trial. Although structures such as PICOT (Population, Intervention, Comparator, Outcome, Timeline) are helpful, people with little or no prior knowledge can find designing and implementing a trial to be overly complicated. We developed a simple exercise to illustrate key features of trials: the Smiley Faces task.Aim: We describe how the Smiley Faces task can demonstrate the importance of good planning of trials and highlight pitfalls.Method and Results: The Smiley Faces task is centred on the simple, intuitive task to “draw a smiley face”. It requires no existing knowledge about trials or research generally, but can be used to highlight key features of a trial; such as formulating the research question; planning for coding, collection and analysis of data; handling of missing data and drawing of conclusions. We present insights from conducting the exercise dozens of times and collecting hundreds of smiley face drawings in a range of educational settings.Conclusion: The simplicity and accessibility of the task makes it relatively easy to demonstrate key points for careful planning of clinical trials. The approach is generalizable and applicable to researchers and teachers in a variety of medical settings

DNA and pacific commensal models : applications, construction, limitations, and future prospects

Components of the Pacific transported landscape have been used as proxies to trace the prehistoric movement of humans across the Pacific for almost two decades. Analyses of archaeological remains and DNA sequences of plants, animals, and microorganisms moved by or with humans have contributed to understanding prehistoric migration, trade, exchange, and sometimes revealed the geographic origins of particular plants and animals. This paper presents the basic elements of a DNA-based commensal model and discusses the phylogenetic and population genetic approaches these models employ. A clear delineation of the underlying assumptions of these models and the background information required to construct them have yet to appear in the literature. This not only provides a framework with which to construct a commensal model but also highlights gaps in current knowledge. The ways in which commensal models have enriched archaeological reconstructions will be highlighted, as will their current limitations. With these limitations in mind, options will be outlined for augmenting commensal models through the application of established techniques and new technologies in order to provide the best tools for reconstructing ancient human mobility and behavior in the Pacific and beyond

What is the role of ICTs in addressing health outcomes and limitations from socio-economic status?

While access to information and communication technologies (ICTs) have been touted as a key determinant for human development, few studies have investigated how ICT implementations assist people with low socioeconomic status (SES) and the impacts this might have on health outcomes. This paper investigates the relation between having access to ICTs, health outcomes, and SES. The association between socioeconomic affluence and health is even recognized by policymakers, which suggests that there is an association between SES status and health. This paper addresses the gap in the literature by investigating the research questions: 1) what is the relation between access to ICTs and fair or poor health? 2) Is there a relation between access to ICTs and socio-economic status? The findings illustrate that having less access to ICTs is related to individuals more frequently reporting fair or poor health and having less access to ICTs relates to low SES communities that are in poverty, have lower education rates, have a high number of uninsured people, have people who experience more physical distress, and live in rural areas. A key contribution is that access to ICTs does have a correlation to health and that access to ICTs have a relation to low SES. This means that ICTs can help people access resources to assist with poverty, insurance, education, physical distress, and people who live in rural populations can take advantage of ICTs to help them lead the lives they choose to live

Financial Disclosure by Australian Residential Aged Care Providers: Are They Suffering Dementia?

Australia’s Residential Aged Care (RAC) Sector is significant in terms of its ageing population, which is consistent with most developed countries. It is therefore vital for stakeholders to have access to RAC providers’ financial information to make informed and timely decisions. It is often difficult for stakeholders to accurately compare the financial information of RAC providers due to there being a small timeframe to make decisions with a high emotional content. This research will enable RAC providers and their stakeholders to consider the current level of disclosure required and the level of voluntary disclosures providers in the sector choose to disclose, and whether this level of disclosure is adequate for stakeholders to make informed decisions. Information was gathered from the RAC provider\u27s annual and/or financial reports, to determine their level of financial disclosure, over a three year period. It was found that the RAC providers’ level of financial disclosure could be more consistent and adequate by complying with the Australian Financial Reporting Framework, including an independent Audit Report. Hence, this research provides new insights and a basis for further research to determine whether the Australian RAC Sector have improved their consistency and adequacy of their financial disclosures through the use of the proposed RAC GPFR Framework

A Global Health Analysis of Socio-Economic Determinants of Health, and Human Digital Development, Health Equity and mHealth

Access to the internet, often via mobile devices, provides individuals with the ability to access the resources and economic opportunities required to live the lives they choose. Using data drawn from the World Health Organization, United Nations Development Program, and World Bank, two levels of analysis are conducted to answer the research questions: “What is the relationship between social determinants of health and human digital development?” and, “What is the relationship between health equity and mHealth?”. First, multiple regression was utilized to test two hypotheses, and second, a k-means cluster analysis was carried out categorize the countries based on these variables. Our results suggest that there is correlation between social determinants of health and human digital development; except in the case of the homelessness variable. Of the health equity variables, only the GINI index correlates with the mobile health index. A four-cluster solution in the cluster analysis illustrates that the majority of countries demonstrate low mHealth, Human Digital Development, GINI and high Education Inequality and Life Expectancy inequality. These findings have implications for how human digital development and mobile health can address social determinants of health. Future research will need to delve deeper into these connections

Disclosure and Reporting of Governance Practices by Australian Residential Aged Care Providers: Accountability to Stakeholders

The Residential Aged Care (RAC) Sector in Australia is significant in terms of the ageing population (consistent with most developed countries), and the fact that it will affect the majority of the population in terms of the need for RAC at some stage in their lives. Having access to information for stakeholders to make informed and timely decisions regarding the comparison of RAC providers is often difficult due to there being higher demand than supply, small timeframe to make decisions with a high emotional content and the difficulty in changing providers. Information was gathered from the RAC provider\u27s website, reports and other publicly available information, to determine their level of governance disclosure, over a three year period. It was found that the RAC providers should not just be limited to their legal reporting requirements (mandatory), but instead should also endeavour to disclose additional voluntary information, in order for their stakeholders to make informed decisions. In addressing the Australian RAC Sector\u27s stakeholder governance information needs, a governance framework (RAC Sector Governance Framework) and the G-CARD (Governance Checklist Aged Residential Disclosure) Model were developed for this sector to improve governance disclosure. This research provides new insights and a basis for further research to determine whether the Australian RAC Sector have improved their consistency and adequacy of their governance disclosure through the use of the proposed G-CARD Model and associated framework