Conclusion : The Iraq legacies and the roots of the ‘Islamic State’

With the deadly ISIS advance, the sudden rousing of Shia militias and the threat of Kurdish secession, Iraq faces a host of deep-seated and intractable problems. Together, these events raise a number of serious questions, not just for Iraq and its future but also for the broader Middle East, the United States and its Coalition partners and the international community. While these challenges and questions will drive much academic debate, political analysis and media discussion in the months and years ahead, they are not the central purpose of this chapter. While there is always a risk in commenting on unfolding events, including the potential to overstate their significance and likely long-term impact, it is difficult to ignore the significance of the deadly ISIS advance and all that has happened since. This chapter argues that key to understanding these events is coming to terms with the three varied and complex legacies of the 2003 Iraq War. The first central legacy of the Iraq War is the ongoing consequences of several critical mistakes made by the US-led Coalition before, during and immediately after the 2003 intervention. The second legacy addressed here is the fact that the 2003 war shattered – perhaps irreversibly - Iraqis fragile cultural mosaic and its rich and complex history of overlapping and intersecting communities, ideologies and narratives. The third and final legacy of the 2003 Iraq War detailed in this chapter is its significant regional and global consequences – from spiralling sectarianism across the Middle East to a profound challenge to America’s status as the last remaining superpower and its use of military power for ‘humanitarian’ ends. The argument here is that these three important legacies set in train a sequence of events that have served as the collective catalyst for the expansion of the ‘Islamic State’ from mid-2014.

Game of Tropes: the Orientalist tradition in the Works of G.R.R. Martin

George R.R. Martin's A Song of Ice and Fire novels (and their television adaption, Game of Thrones) have become arguably the most well known fantasy epic of the last decade. However, the world of A Song of Ice and Fire conforms to many of the same Orientalist tropes that have dominated Western literature since the popularisation of the 'Arabian fantasy' in the 18th and 19th centuries and its subsequent perpetuation in film and television. Derivative imaginings of the real world Middle East are commonly reflected in non-Earthly fantasy worlds and Martin's work incorporates this standard vision of the Eastern Other. Owing to its popularity, the A Song of Ice and Fire series represents a significant reinforcement of Orientalist stereotypes and proves that fantasy locations have significant power to cement these ideas in the popular imagination. Moreover, the negative portyal of the East in these works supports Said's argument that the Orient is an invention of the West, and that our depiction of the Other is a means of framing our own cultural superiority.

Persistence, capital account openness, and financial sector health in exchange rate regime choice

This paper investigates empirically the persistence in exchange rate regimes as well as the role of capital account openness and financial sector health (measured by financial development and financial sector fragility) in exchange rate regime determination for a panel of 143 countries covering the post-Bretton Woods period. The results demonstrate that while low- and high-income countries exhibit highly persistent exchange rate regimes, middle-income countries display relatively lower persistence. For middle-income countries, capital account openness and the level of financial development play important roles in exchange rate regime choice. The fragility of the financial sector does not affect the exchange rate regime determination.

Foreign correspondents and international newsgathering: the role of fixers

This book reveals that ‘fixers’—local experts on whom foreign correspondents rely—play a much more significant role in international television newsgathering than has been documented or understood. Murrell explores the frames though which international reporting has traditionally been analysed and then shows that fixers, who have largely been dismissed by scholars as "logistical aides", are in fact central to the day-to-day decision-making that takes place on-the-road. Murrell looks at why and how fixers are selected and what their significance is to foreign correspondence. She asks if fixers help introduce a local perspective into the international news agenda, or if fixers are simply ‘People Like Us’ (PLU). Also included are excerpts from interviews with TV correspondents and fixers and in-depth case studies of correspondents in Iraq and Indonesia.

Migration, acculturation and environment: determinants of obesity among Iranian migrants in Australia

While migration from low- to high-income countries is typically associated with weight gain, the obesity risks of migration from middle-income countries are less certain. In addition to changes in behaviours and cultural orientation upon migration, analyses of changes in environments are needed to explain post-migration risks for obesity. The present study examines the interaction between obesity-related environmental factors and the pattern of migrant acculturation in a sample of 152 Iranian immigrants in Victoria, Australia. Weight measurements, demographics, physical activity levels and diet habits were also surveyed. The pattern of acculturation (relative integration, assimilation, separation or marginalization) was not related to body mass index, diet, or physical activity behaviours. Three relevant aspects of participants' perception of the Australian environment (physically active environments, social pressure to be fit, unhealthy food environments) varied considerably by demographic characteristics, but only one (physically active environments) was related to a pattern of acculturation (assimilation). Overall, this research highlighted a number of key relationships between acculturation and obesity-related environments and behaviours for our study sample. Theoretical models on migration, culture and obesity need to include environmental factors.

Cardiovascular prevention model from Kenyan slums to migrants in the Netherlands

Cardiovascular diseases (CVD) are the main cause of morbidity and mortality worldwide. As prevention and treatment of CVD often requires active screening and lifelong follow up it is a challenge for health systems both in high-income and low and middle-income countries to deliver adequate care to those in need, with efficient use of resources.We developed a health service model for primary prevention of CVD suitable for implementation in the Nairobi slums, based on best practices from public health and the private sectors. The model consists of four key intervention elements focusing on increasing awareness, incentives for promoting access to screening and treatment, and improvement of long-term adherence to prescribed medications. More than 5,000 slum dwellers aged ≥35 years and above have been screened in the study resulting in more than 1000 diagnosed with hypertension and referred to the clinic.Some marginalized groups in high-income countries like African migrants in the Netherlands also have low rates of awareness, treatment and control of hypertension as the slum population in Nairobi. The parallel between both groups is that they have a combination of risky lifestyle, are prone to chronic diseases such as hypertension, have limited knowledge about hypertension and its complications, and a tendency to stay away from clinics partly due to cultural beliefs in alternative forms of treatment, and lack of trust in health providers. Based on these similarities it was suggested by several policymakers that the model from Nairobi can be applied to other vulnerable populations such as African migrants in high-income countries. The model can be contextualized to the local situation by adapting the key steps of the model to the local settings.The involvement and support of African communities' infrastructures and health care staff is crucial, and the most important enabler for successful implementation of the model in migrant communities in high-income countries. Once these stakeholders have expressed their interest, the impact of the adapted intervention can be measured through an implementation research approach including collection of costs from health care providers' perspective and health effects in the target population, similar to the study design for Nairobi.

Corporate governance and corporate finance practices in a Kuwait Stock Exchange market listed firm: a survey to confront theory with practice

Purpose– This paper aims to explore the issue of corporate governance mechanisms by including the importance of stakeholders, primary objectives of the firm and the ownership of top financial managers of listed firms in Kuwait in the survey tool. It attempts to investigate whether theory aligns with the behaviour of financial managers in practice in an emerging market case.Design/methodology/approach– A survey was developed to focus primarily on the current corporate finance practices implemented by CFOs in listed companies in Kuwait. The target respondents are listed firms in the Kuwaiti Stock Exchange (KSE). The survey includes questions on topics that are closely related to capital budgeting, capital structure, cost of capital and dividend policy. For example, the survey asks the managers how they estimate their cost of equity (CAPM or other methods) and whether the impact of the weighted average cost of equity is taken into consideration in their capital structure choices.Findings– A surprising number of firms are now widely using IRR for decision making. CAPM is also in use, whereas WACC remains the most popular method used. There is some support for the “bird‐in‐hand” dividend theory in the tax‐free environment. Firms in Kuwait do not have any particular source of capital structure choices when it comes to how best to finance their projects as is the case in the US market. Firms in Kuwait are consciously striving for maximizing profits and those managers are regarded as their most important stakeholders. This may indicate the existence of agency problems.Research limitations/implications– The limitation of this study lies in the absence of empirical investigation on how corporate finance decisions may affect firms' performance in Kuwait. Hence, empirical validation will be performed by the authors in the next stage of this research, which will form the basis for further research. Empirical validation for the impact of corporate governance on performance is needed.Practical implications– This research may benefit managers and decision makers in many aspects, including having an understanding of applying popular and the most suitable corporate finance and corporate governance techniques in the management of their companies. In this research, the authors have identified the gap between practice and academia.Originality/value– To the best of the authors' knowledge, this is the first study to examine comprehensively major areas of financial policies and practices and corporate governance in an emerging market case, especially in the Middle East. Kuwait provides a unique institutional setting in its taxation system. Therefore, this study will make a contribution to the general literature in this field.

Welcome from the policies, socio-economic aspects, and health systems research section

At BMC Obesity, the Policies, Socio-economic Aspects, and Health Systems Research Section provides an opportunity to submit research focussed on what we need to know to support implementation of obesity policies most likely to achieve substantial, sustainable and equitable reductions in the prevalence of obesity globally. Here, we present the aims and objectives of this section, hearing from each of the Associate Editors in turn. The ambition of the Policies, Socio-economic Aspects, and Health Systems Research Section is to foster innovative research combining scientific quality with real world experience. We envisage this will include research addressing the structural drivers of obesity, solution oriented research, research addressing socio-economic inequalities in obesity and obesity prevention in low and middle income countries. We look forward to stimulating research to advance both the methods and substance required to drive uptake of effective and equitable obesity reduction policies globally.

Early protection in sheep against intratypic heterologous challenge with serotype O foot-and-mouth disease virus using high-potency, emergency vaccine

In 2009-2011, spread of a serotype O foot-and-mouth disease virus (FMDV) belonging to the South East Asia topotype led to the culling of over 3.5 million cattle and pigs in Japan and Korea. The O1 Manisa vaccine (belonging to the Middle East-South Asian topotype) was used at high potency in Korea to limit the expansion of the outbreak. However, no data are available on the spread of this virus or the efficacy of the O1 Manisa vaccine against this virus in sheep. In this study, the early protection afforded with a high potency (>6 PD50) FMD O1 Manisa vaccine against challenge with the O/SKR/2010 virus was tested in sheep. Sheep (n=8) were vaccinated 4 days prior to continuous direct-contact challenge with donor sheep. Donor sheep were infected with FMDV O/SKR/2010 by coronary band inoculation 24h prior to contact with the vaccinated animals, or unvaccinated controls (n=4). Three of the four control sheep became infected, two clinically. All eight O1 Manisa vaccinated sheep were protected from clinical disease. None had detectable antibodies to FMDV non-structural proteins (3ABC), no virus was isolated from nasal swabs, saliva or oro-pharyngeal fluid and none became carriers. Using this model of challenge, sheep were protected against infection as early as 4 days post vaccination.

Child and adolescent obesity: part of a bigger picture

The prevalence of childhood overweight and obesity has risen substantially worldwide in less than one generation. In the USA, the average weight of a child has risen by more than 5 kg within three decades, to a point where a third of the country's children are overweight or obese. Some low-income and middle-income countries have reported similar or more rapid rises in child obesity, despite continuing high levels of undernutrition. Nutrition policies to tackle child obesity need to promote healthy growth and household nutrition security and protect children from inducements to be inactive or to overconsume foods of poor nutritional quality. The promotion of energy-rich and nutrient-poor products will encourage rapid weight gain in early childhood and exacerbate risk factors for chronic disease in all children, especially those showing poor linear growth. Whereas much public health effort has been expended to restrict the adverse marketing of breastmilk substitutes, similar effort now needs to be expanded and strengthened to protect older children from increasingly sophisticated marketing of sedentary activities and energy-dense, nutrient-poor foods and beverages. To meet this challenge, the governance of food supply and food markets should be improved and commercial activities subordinated to protect and promote children's health.

Nonsuicidal self-injury in Indian adolescents: nonexistent or unacknowledged?

Nonsuicidal self-injury (NSSI) has been a neglected entity in low- and middle-income countries (LMICs). In this correspondence (letter to the editor), authors are advocating for greater research in this area in LMICs as it will help to compare and contrast prevalence rates of NSSI in these countries with high-income countries (HICs), identify context-specific risk and protective factors to better understand the pathophysiology of NSSI and devise context-specific interventions resulting in improvement in adolescent mental health worldwide.

The establishment and development of neurosurgery services in Papua New Guinea

BACKGROUND: Papua New Guinea (PNG) is a developing Pacific Nation of 7.3 million people. Although neurosurgery training was introduced to PNG in the year 2000, it was in 2003 that a neurosurgery service was established. Prior to this time, neurosurgery in PNG was performed by general surgeons, with some assistance from visiting Australian neurosurgeons. Neurosurgical training was introduced to PNG in 2000. The model involved a further 3 years of training for a surgeon who had already completed 4 years of general surgical training. We aim to review the output, outcomes and impact achieved by training the first national neurosurgeon. METHODS: The data on activity (output) and outcomes were collected prospectively from 2003-2012. Ongoing mentoring and continuing professional development were provided through annual neurosurgical visits from Australia. There were serious limitations in the provision of equipment, with a lack of computerized tomographic or MR imaging, and adjuvant oncological services. RESULTS: There were 1618 neurosurgery admissions, 1020 neurosurgical procedures with a 5.74 % overall mortality. Seventy percent of cases presented as emergencies. There were improved outcomes, particularly for head injuries, whilst hydrocephalus was managed with an acceptable morbidity and revision rate. CONCLUSIONS: The training of a neurosurgeon resulted in PNG patients receiving a better range of surgical services, with a lower mortality. The outcomes able to be delivered were limited by late presentations of patients and lack of resources including imaging. These themes are familiar to all low- and middle-income countries (LMICs) and this may serve as a model for other LMIC neurosurgical services to adopt as they consider whether to establish and develop neurosurgical and other sub-specialist surgical services.

Addressing migration-related social and health inequalities in Australia: call for research funding priorities to recognise the needs of migrant populations

Objective Migrants constitute 26% of the total Australian population and, although disproportionately affected by chronic diseases, they are under-represented in health research. The aim of the present study was to describe trends in Australian Research Council (ARC)- and National Health and Medical Research Council (NHMRC)-funded initiatives from 2002 to 2011 with a key focus on migration-related research funding.Methods Data on all NHMRC- and ARC-funded initiatives between 2002 and 2011 were collected from the research funding statistics and national competitive grants program data systems, respectively. The research funding expenditures within these two schemes were categorised into two major groups: (1) people focused (migrant-related and mainstream-related); and (2) basic science focused. Descriptive statistics were used to summarise the data and report the trends in NHMRC and ARC funding over the 10-year period.Results Over 10 years, the ARC funded 15 354 initiatives worth A$5.5 billion, with 897 (5.8%) people-focused projects funded, worth A$254.4 million. Migrant-related research constituted 7.8% of all people-focused research. The NHMRC funded 12 399 initiatives worth A$5.6 billion, with 447 (3.6%) people-focused projects funded, worth A$207.2 million. Migrant-related research accounted for 6.2% of all people-focused initiatives.Conclusions Although migrant groups are disproportionately affected by social and health inequalities, the findings of the present study show that migrant-related research is inadequately funded compared with mainstream-related research. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce these inequalities among migrants.What is known about the topic? Immigration is on the rise in most developing countries, including Australia, and most migrants come from low- and middle-income countries. In Australia, migrants constitute 26% of the total Australian population and include refugee and asylum seeker population groups. Migrants are disproportionately affected by disease, yet they have been found to be under-represented in health research and public health interventions.What does this paper add? This paper highlights the disproportions in research funding for research among migrants. Despite migrants being disproportionately affected by disease burden, research into their health conditions and risk factors is grossly underfunded compared with the mainstream population.What are the implications for practitioners? Migrants represent a significant proportion of the Australian population and hence are capable of incurring high costs to the Australian health system. There are two major implications for practitioners. First, the migrant population is constantly growing, therefore integrating the needs of migrants into the development of health policy is important in ensuring equity across health service delivery and utilisation in Australia. Second, the health needs of migrants will only be uncovered when a clear picture of their true health status and other determinants of health, such as psychological, economic, social and cultural, are identified through empirical research studies. Unless equitable research funding is achieved, it will be impossible to build a strong evidence base for planning effective measures to reduce health and social inequalities among migrant communities.

Noncommunicable disease prevention and control in Mongolia: a policy analysis

BACKGROUND: Noncommunicable diseases (NCDs) are the major global cause of morbidity and mortality. In Mongolia, a number of health policies have been developed targeting the prevention and control of noncommunicable diseases. This paper aimed to evaluate the extent to which NCD-related policies introduced in Mongolia align with the World Health Organization (WHO) 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. METHODS: We conducted a review of policy documents introduced by the Government of Mongolia from 2000 to 2013. A literature review, internet-based search, and expert consultation identified the policy documents. Information was extracted from the documents using a matrix, mapping each document against the six objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs and five dimensions: data source, aim and objectives of document, coverage of conditions, coverage of risk factors and implementation plan. 45 NCD-related policies were identified. RESULTS: Prevention and control of the common NCDs and their major risk factors as described by WHO were widely addressed, and policies aligned well with the objectives of the WHO 2008-2013 Action Plan for the Global Strategy for the Prevention and Control of NCDs. Many documents included explicit implementation or monitoring frameworks. It appears that each objective of the WHO 2008-2013 NCD Action Plan was well addressed. Specific areas less well and/or not addressed were chronic respiratory disease, physical activity guidelines and dietary standards. CONCLUSIONS: The Mongolian Government response to the emerging burden of NCDs is a population-based public health approach that includes a national multisectoral framework and integration of NCD prevention and control policies into national health policies. Our findings suggest gaps in addressing chronic respiratory disease, physical activity guidelines, specific food policy actions restricting sales advertising of food products, and a lack of funding specifically supporting NCD research. The neglect of these areas may hamper addressing the NCD burden, and needs immediate action. Future research should explore the effectiveness of national NCD policies and the extent to which the policies are implemented in practice.

Diabetes prevention research: a systematic review of external validity in lifestyle interventions

Context

Type 2 diabetes is a major contributor to disease burden globally. A number of systematic reviews support the efficacy of lifestyle interventions in preventing Type 2 diabetes in adults; however, relatively little attention has been paid to the generalizability of study findings. This study systematically reviews the reporting of external validity components and generalizability of diabetes prevention studies.

Evidence acquisition

Lifestyle intervention studies for the prevention of Type 2 diabetes in adults with at least 6 months' follow-up, published between 1990 and 2011, were identified through searches of major electronic databases. External validity reporting was rated using an assessment tool, and all analysis was undertaken in 2011.

Evidence synthesis

A total of 31 primary studies (n=95 papers) met the selection criteria. All studies lacked full reporting on external validity elements. Description of the study sample, intervention, delivery agents, and participant attrition rates were reported by most studies. However, few studies reported on the representativeness of individuals and settings, methods for recruiting settings and delivery agents, costs, and how interventions could be institutionalized into routine service delivery. It is uncertain to what extent the findings of diabetes prevention studies apply to men, socioeconomically disadvantaged individuals, those living in rural and remote communities, and to low- and middle-income countries.

Conclusions

Reporting of external validity components in diabetes prevention studies needs to be enhanced to improve the evidence base for the translation and dissemination of these programs into policy and practice.