Negotiating Change: Ideas, Institutions, and Political Actors in Tobacco Control Policy Making in Mauritius.

CONTEXT: This article explains the policy process that occasioned the development of comprehensive tobacco control policies in Mauritius from 1980 to 2019. It does so by drawing theoretical insights from John Kingdon's streams framework, historical institutionalism, and ideational perspectives to explicate how tobacco control rose to the status of government policy agenda. METHODS: The main sources of data are government documents, media reports, archival studies, grey literature, and published books and articles. These sources were supplemented by key informant interviews with government officials, civil society groups, and other vested interest groups. FINDINGS: This article finds that the prevalence of noncommunicable diseases in the late 1980s, the political commitment of Mauritius's Labour government to comprehensive tobacco control, the institutional legacies of Mauritius's Public Health Act of 1925, and the administrative capacity of Mauritius's Ministry of Health and Quality of Life are the primary factors that drove tobacco control policies in Mauritius. CONCLUSION: The findings from this study will enrich our understanding of policy change and the politics of tobacco control in the global south. Future research should investigate why some countries in Africa have failed to adopt comprehensive tobacco control policies despite ratifying the Framework Convention on Tobacco Control.

Improving Health Risk Assessment as a Basis for Public Health Decisions in the 21st Century.

One-fifth of the way through the 21st century, a commonality of factors with those of the last 50 years may offer the opportunity to address unfinished business and current challenges. The recommendations include: (1) Resisting the tendency to oversimplify scientific assessments by reliance on single disciplines in lieu of clear weight-of-evidence expressions, and on single quantitative point estimates of health protective values for policy decisions; (2) Improving the separation of science and judgment in risk assessment through the use of clear expressions of the range of judgments that bracket protective quantitative levels for public health protection; (3) Use of comparative risk to achieve the greatest gains in health and the environment; and (4) Where applicable, reversal of the risk assessment and risk management steps to facilitate timely and substantive improvements in public health and the environment. Lessons learned and improvements in the risk assessment process are applied to the unprecedented challenges of the 21st century such as, pandemics and climate change. The beneficial application of the risk assessment and risk management paradigm to ensure timely research with consistency and transparency of assessments is presented. Institutions with mandated stability and leadership roles at the national and international levels are essential to ensure timely interdisciplinary scientific assessment at the interface with public policy as a basis for organized policy decisions, to meet time sensitive goals, and to inform the public.

[From "culprits" to "victims:" the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century]. / De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX.

From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

Pharmaceutical Ethics and Grassroots Activism in the United States: A Social History Perspective.

Women's health activists laid the groundwork for passage of the law that created the U.S. Food and Drug Administration in 1906. The pharmaceutical and food industries fought regulatory reforms then and continue to do so now. We examine public health activism in the Progressive Era, the postwar era and the present day. The women's health movement began in the 1960s, and criticized both the pharmaceutical industry and the medical establishment. In the 1990s, patient advocacy groups began accepting industry funds; thousands of commercially-funded groups now dominate the advocacy landscape. As pharma funding became normalized, concerns arose regarding a) the lack of transparency and public accountability regarding funding, b) the distortion of groups' agendas, and c) the ability of pharma-funded groups to dominate the discourse and override less well-resourced patient and health advocacy groups. Although industry-funded groups argue that funding allows them to provide useful services, the trade-off in health risks, exorbitant prices and distorted information is far too high. Sincerity is beside the point; patients and the industry have differing interests when it comes to drug safety and efficacy, drug information and drug prices. A growing resistance movement is asserting the values of its activist predecessors and opposing the prevailing culture of pharma-funded advocacy.

De "culpables" a "víctimas": expansión y profesionalización del sistema de salud en la provincia Mendoza a fines del siglo XIX y principios del XX / From "culprits" to "victims": the expansion and professionalization of the healthcare system in the province of Mendoza in the late nineteenth and early twentieth century

RESUMEN Entre fines del siglo XIX y comienzos del XX, la provincia de Mendoza presentaba un estado sanitario marcado por el crecimiento demográfico y urbanístico, la escasez de los servicios públicos y la destrucción de la antigua ciudad colonial como consecuencia del terremoto de 1861, lo que propiciaba un ambiente favorable para el desarrollo de diversas enfermedades infectocontagiosas. El objetivo de este artículo es indagar cómo se fue profesionalizando y expandiendo el sistema de salud en la provincia de Mendoza a fines del siglo XIX e inicios del XX, y cómo esos factores, junto con las representaciones sobre la enfermedad que predominaban en el discurso de la elite gobernante, incidieron en las políticas públicas para combatir las dolencias de la época. Para ello se consultaron diversos documentos escritos y fotográficos que permitieron analizar las modificaciones del discurso y las políticas públicas implementadas.

ABSTRACT From the late 19th century to the beginning of the 20th, the province of Mendoza presented problematic sanitary conditions due to rapid demographic and urban growth, the scarcity of public services, and the poor state of the old colonial city (destroyed by the 1861 earthquake), which facilitated the spread of various infectious diseases. The objective of this article is to inquire into the ways in which the healthcare system in the province of Mendoza both expanded and became increasingly professionalized from the late 19th to early 20th century. We explore how these factors, along with the predominant social representations of disease that permeated the discourses of governing elites, influenced public policy aimed at combating the diseases of the time. To that end, we consulted a wide range of written documents and photographic material that allowed us to analyze changes in discourse as well as public policy.

Award for Distinguished Senior Career Contributions to Psychology in the Public Interest: Brian L. Wilcox.

The APA Awards for Distinguished Contributions to Psychology in the Public Interest recognize persons who have advanced psychology as a science and/or profession by a single extraordinary achievement or a lifetime of outstanding contributions in the public interest. The 2019 recipient of the Award for Distinguished Senior Career Contributions to Psychology in the Public Interest is Brian L. Wilcox. Throughout his extensive career, Wilcox "has worked at the intersection of psychology and social policy, making a unique and valuable contribution to advancing both fields, as well as social justice and the public interest. He most recently served as professor and director of the Center on Children, Families, and the Law at the University of Nebraska. Among the many areas in which his work has had a positive impact are child welfare, child poverty, child maltreatment, early childhood education, adolescent risk behavior, the impact of media and divorce on youth, and the prevention of HIV." (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A Comissão Nacional de Bem-estar Social: planejamento estatal e política social, 1951-1954 / The National Commission of Social Welfare: State planning and social policy, 1951-1954

Resumo O artigo analisa a criação da Comissão Nacional de Bem-estar Social no segundo governo Vargas (1951-1954). A partir das mensagens presidenciais e do acervo privado de Alzira Vargas do Amaral Peixoto, contextualiza o momento de fundação do órgão e suas conexões com órgãos internacionais de planejamento da política de assistência social.

Abstract The article analyzes the creation of the National Commission of Social Welfare (Comissão Nacional de Bem-Estar Social) during the second Vargas administration (1951-1954). Presidential communiqués and the private archive of Alzira do Amaral Peixoto Vargas are used to characterize the context of the founding of the commission and its liaison with international entities involved in the planning of social welfare policies.

LeRoy Walters's Legacy of Bioethics in Genetics and Biotechnology Policy.

LeRoy Walters was at the center of public debate about emerging biological technologies, even as "biotechnology" began to take root. He chaired advisory panels on human gene therapy, the human genome project, and patenting DNA for the congressional Office of Technology Assessment. He chaired the subcommittee on Human Gene Therapy for NIH's Recombinant DNA Advisory Committee. He was also a regular advisor to Congress, the executive branch, and academics concerned about policy governing emerging biotechnologies. In large part due to Prof. Walters, the Kennedy Institute of Ethics was one of the primary sources of talent in bioethics, including staff who populated policy and science agencies dealing with reproductive and genetic technologies, such as NIH and OTA. His legacy lies not only in his writings, but in those people, documents, and discussions that guided biotechnology policy in the United States for three decades.

[Chronicle of a century of public health in Mexico: from public health to social protection in health.] / Crónica de un siglo de salud pública en México: de la salubridad pública a la protección social en salud.

This paper describes the creation of the legal framework and the origin, growth and consolidation of the institutions and interventions (initiatives, programs and policies) that nourished public health in Mexico in the past century. It also discusses the recent efforts to guarantee universal social protection in health. This quest, which lasted a century, developed through three generations of reform that gave birth to a health system that offers protection against sanitary risks, protection of health care quality and financial protection to all the population in the country.

En este artículo se describen la creación de los marcos legales y el origen, crecimiento y consolidación de las instituciones e intervenciones (iniciativas, programas, políticas) que han conformado la salud pública moderna en México. También se discuten los esfuerzos recientes por hacer universal la protección social en salud. Esta gesta, que duró un siglo, se fue abriendo paso a través de tres generaciones de reformas que dieron lugar a un sistema de salud que hoy ofrece protección contra riesgos sanitarios, protección de la calidad de la atención y protección financiera a los habitantes de todo el país.

Crónica de un siglo de salud pública en México: de la salubridad pública a la protección social en salud / Chronicle of a century of public health in Mexico: from public health to social protection in health

Resumen: En este artículo se describen la creación de los marcos legales y el origen, crecimiento y consolidación de las instituciones e intervenciones (iniciativas, programas, políticas) que han conformado la salud pública moderna en México. También se discuten los esfuerzos recientes por hacer universal la protección social en salud. Esta gesta, que duró un siglo, se fue abriendo paso a través de tres generaciones de reformas que dieron lugar a un sistema de salud que hoy ofrece protección contra riesgos sanitarios, protección de la calidad de la atención y protección financiera a los habitantes de todo el país.

Abstract: This paper describes the creation of the legal framework and the origin, growth and consolidation of the institutions and interventions (initiatives, programs and policies) that nourished public health in Mexico in the past century. It also discusses the recent efforts to guarantee universal social protection in health. This quest, which lasted a century, developed through three generations of reform that gave birth to a health system that offers protection against sanitary risks, protection of health care quality and financial protection to all the population in the country.

History and challenges of Brazilian social movements for the achievement of the right to adequate food.

The historical struggles that Brazil faced to overcome malnutrition coincided with the empowerment of civil society and social movements which played a crucial role in the affirmation of health and food as social rights. After two decades under military dictatorship, Brazil went through a redemocratization process in the 1980s when activism emerged to demand spaces to participate in policy-making regarding the social agenda, including food and nutrition security (FNS). From 1988 onward institutional structures were established: the National Council of FNS (CONSEA) convenes government and civil society sectors to develop and monitor the implementation of policies, systems and actions. Social participation has been at the heart of structural changes achieved since then. Nevertheless, the country faces multiple challenges regarding FNS such as the double burden of disease, increasing use of pesticides and genetically modified seeds, weak regulation of ultra-processed products, and marketing practices that affect the environment, population health, and food sovereignty. This article aims at examining the development of the participatory political system and the role played by Brazilian social movements in the country's policies on FNS, in addition to outlining challenges faced by those policies.

Rothschild reversed: explaining the exceptionalism of biomedical research, 1971-1981.

The 'Rothschild reforms' of the early 1970s established a new framework for the management of government-funded science. The subsequent dismantling of the Rothschild system for biomedical research and the return of funds to the Medical Research Council (MRC) in 1981 were a notable departure from this framework and ran contrary to the direction of national science policy. The exceptionalism of these measures was justified at the time with reference to the 'particular circumstances' of biomedical research. Conventional explanations for the reversal in biomedical research include the alleged greater competence and higher authority of the MRC, together with its claimed practical difficulties. Although they contain some elements of truth, such explanations are not wholly convincing. Alternative explanations hinge on the behaviour of senior medical administrators, who closed ranks to ensure that de facto control was yielded to the MRC. This created an accountability deficit, which the two organizations jointly resolved by dismantling the system for commissioning biomedical research. The nature and working of medical elites were central to this outcome.

Psychology and public policy: A 50-year adventure.

This article provides an overview of my research on children, families, and the law over the past 50 years, while also providing the context for psychological research and action during this time period. The general framework requires using autobiographical information to understand my primary goal of contributing to a research base for intervention and policy change, especially within the juvenile justice system. Overall, my research and action endeavors have been related to prevention, children, and the legal system with changing foci over time: (a) changing juvenile correctional settings, (b) understanding and preventing child sexual abuse, (c) intervening with violent juveniles, (d) exploiting the myth of extreme recidivism rates among juvenile sex offenders, (e) understanding decision-making among youth in legal contexts, and (f) examining violence in teen dating relationships. The article concludes with a brief discussion of dissemination of research findings to policymakers. (PsycINFO Database Record (c) 2018 APA, all rights reserved).