ACKNOWLEDGMENTS v INTRODUCTION 3 ONE. Democratic Theory and Democratization 11 TWO. Democratic Theory and the Formation of a Public Sphere 36 THREE. Democracy and the Latin American Tadition 55 FOUR. The Transformation of the Latin American Public Space 77 FIVE. Democratization in Latin America The Conflict between Public Practices and the Logic of Political Society 103 SIX. Participatory Publics in Brazil and Mexico The Compatibility of Public Deliberation and Complex Administration 135 SEVEN. Concluding Remarks on the Democratizing Role of Participatory Publics 165 NOTES 171 REFERENCES 185 INDEX 199
Nick Bansback, Mina Tadrous, Marie Paul Nisingizwe
et al.
Background The introduction of direct-acting antivirals (DAAs) has allowed countries to reduce the health and economic burden of hepatitis C virus (HCV). However, access to DAAs remains expensive and limited in many countries globally due to wide disparities in HCV drug pricing. We assessed how global use of HCV drugs has changed over time and the effect that COVID-19 might have had on DAA utilisation.Methods We assessed longitudinal changes in DAA sales by country income group, geographical region and drug type. We also conducted an interrupted time series analysis to assess COVID-19-related changes in the trend of DAA units sold globally. Our analysis used DAA sales data from the IQVIA multinational integrated data analysis database of 52 countries and two regions and HCV prevalence data from Polaris from 2014 to 2020. Our primary outcome was the monthly rate of DAAs sold per 100 000 people living with HCV per country, country income group and geographic region. We then compared the pre-post change in DAA units by drug type and country income group. We fitted autoregressive moving average models with a ramp function to assess the impact of COVID-19 on monthly DAA units sold.Results Across all countries, from August 2014 to August 2020, a monthly average of 44 219 DAA units per 100 000 HCV cases was sold. High-income countries purchased more units than other groups. In terms of geographic location, North America (124 144 per 100 000 HCV cases) and Europe (81 001 per 100 000 HCV cases) had the highest DAA sales over time; the newer generation of combination DAAs was mainly used in high-income countries. In contrast, first-generation and second-generation DAAs were the predominant types of DAAs sold in lower middle-income countries (LMICs). The pre-post analysis showed a 23% (p<0.001) average decrease in global sales of DAAs during the first phase of COVID-19. The decrease in LMICs (69%, p<0.001) was approximately double that of high-income countries (33%, p<0.001), while upper middle-income countries (UMICs) had a 34% (p<0.001) increase in DAA sales. The pandemic was associated with an immediate and sustained decrease of 9263 units per month (95% CI −14 668 to −3857.46) in high-income countries, a 73.14 (−850.96 to 997.24) unit increase in UMICs and a 742.58 (95% CI −5505.91 to 4020.75) unit decrease in LMICs.Conclusion Our study showed uneven access to DAAs globally, with higher prevalence-adjusted utilisation in high-income countries compared with lower-income countries. Our study also found that the COVID-19 pandemic has significantly decreased DAA sales in many countries. To counter these trends, additional strategies, such as price reductions, increased competition among manufacturers and licensing agreements, may help to improve access and utilisation of DAAs globally.
INTRODUCTION. Herbal medicinal products are widely used in medical practice. Special considerations apply to the extent of safety and efficacy studies required for herbal medicinal products in different countries, as documented in their marketing authorisation frameworks. Currently, the Eurasian Economic Union (EAEU) lacks guidelines on the extent of preclinical and clinical studies required for herbal medicinal products.AIM. This study aimed to analyse the possibility of using international standards and approaches in the development of the EAEU guidelines for preclinical and clinical studies of the safety and efficacy of herbal medicinal products.DISCUSSION. First of all, marketing authorisation of herbal medicinal products involves special considerations because these medicinal products contain complex mixtures of bioactive substances. According to the analysis of the regulatory approaches of the European Union (EU), the United States of America (USA), and the EAEU, the safety and efficacy testing requirements for herbal medicinal products are harmonised to a certain degree. The terms used for herbal substances and herbal medicinal products have almost identical definitions in all the studied documents. Despite the differences in their typological classifications of herbal medicinal products, the EU and USA documents provide similar principles for determining the required extent of published data and original studies on the safety and efficacy of herbal medicinal products. Mainly, the extent depends on the herbal medicinal product’s history of previous human use and completed preclinical and clinical studies (if any), type (original/generic), intended administration route (traditional/new), and indications (established/new). Some of the approaches presented in the article are only partially included in the current EAEU regulatory documents.CONCLUSIONS. The discussed approaches can be considered in the development of the EAEU guidelines for preclinical and clinical studies of the safety and efficacy of herbal medicinal products. Such guidelines will contribute to providing the population with broad-spectrum herbal medicinal products that meet current safety and efficacy standards.
Margaret E. Tait, Erika Franklin Fowler, Sarah E. Gollust
Objective: To examine the content of public service announcements (PSAs) sponsored by the United States federal government to promote the COVID-19 vaccine and reveal if PSAs included content that countered health skepticism. Methods: A content analysis of televised PSAs airing from December 15th, 2020 through June 30th, 2021 in the U.S. was performed. Coders reviewed PSAs for the visual and audible appeals used to encourage vaccination, such as the opportunity vaccination provided for getting back to ‘normal’, as well as the spokespeople depicted. Messages that could mitigate health skepticism, such as content about safety and efficacy, were also coded for. Results: The first PSA aired in April of 2021, close to five months after the first person was vaccinated in the U.S. Less than 20 % (17.1 %) of PSAs explicitly encouraged vaccination and just over a quarter (25.4 %) provided details about the safety and efficacy of the vaccine. Health professionals were more commonly depicted as spokespeople in content, appearing in just under a third (29.4 %) of PSAs. Conclusions: Content that addressed and potentially reduced views of health skepticism and that may have promoted vaccine uptake, broadly, was largely absent from federally sponsored televised PSAs about the COVID-19 vaccine.
This study explores global video on demand content consumption patterns through a network-based approach. We used Netflix's 'TV-shows' ranking data, spanning 822 days across 71 countries, to construct a network where countries are represented as nodes and consumption similarities are reflected as link weights. By applying the Louvain algorithm, we identified three distinct consumption groups, 'North America and Pan-Europe', 'Asia and Middle East', and 'Central and South America group'. These groups align closely with geographic, historical, and linguistic divisions, despite no predefined grouping criteria. Notably, Turkiye, often considered a cultural and regional crossroads, exhibited some classification ambiguity but was ultimately grouped with Asia and Middle East. Our findings also show that the United States accounts for the largest share of content consumption across all groups, while South Korean content, particularly after the success of "Squid Game" in 2021, has gained and maintained popularity in Asia, the Middle East, and Latin America. This study, based on data, demonstrates that deep-seated cultural histories continue to shape global consumption patterns, even amidst rapid changes in media platforms and content production dynamics.
Hiroshi G. Takahashi, Masashi Kiguchi, Shiori Sugimoto
This chapter introduces flood and drought through the understanding of the water cycle. In addition to the water cycle, we consider the energy cycle. The floods and droughts have strong regional and seasonal characteristics. The causes of the unbalanced water conditions can occur under the various meteorological phenomena, which have strong regional and seasonal varieties. For an understanding of the cause of floods and drought, we first consider the geographical characteristics of the floods and droughts. At the same time, we focus on the spatial and temporal time-scale of the flood or drought. Moreover, because floods and drought can be considered as excess and shortage of water, respectively, they are opposite. However, their spatial and temporal scales are asymmetric.