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This paper discusses competition and cooperation between boundary organizations (BOs) in the field of global health. It embeds its analysis of BOs in health in contemporary theories on institutional fragmentation and governance complexity, arguing that BOs in international politics have been a major driving force behind an often mind-boggling complexity of actors, institutions, and rule systems relevant to many contemporary international issues or “regimes.” The paper argues that growing complexity of global governance structures generates new demands for BOs with regard to how they manage their interactions with other BOs. Accordingly, the framework suggested in this paper builds on a set of hypotheses that do not isolate factors at structural and agent level but rather capture the interplay of BOs and their organizational environment. The paper's empirical analysis investigates two BOs, the Global Polio Eradication Initiative and GAVI, the Vaccine Alliance, working in the field of polio eradication.

The liquid-based Carbo-gel technology enables real-time multimodal image guidance for improved therapeutic precision., Diagnostic imaging often outperforms the surgeon’s ability to identify small structures during therapeutic procedures. Smart soft tissue markers that translate the sensitivity of diagnostic imaging into optimal therapeutic intervention are therefore highly warranted. This paper presents a unique adaptable liquid soft tissue marker system based on functionalized carbohydrates (Carbo-gel). The liquid state of these markers allows for high-precision placement under image guidance using thin needles. Based on step-by-step modifications, the image features and mechanical properties of markers can be optimized to bridge diagnostic imaging and specific therapeutic interventions. The performance of Carbo-gel is demonstrated for markers that (i) have radiographic, magnetic resonance, and ultrasound visibility; (ii) are palpable and visible; and (iii) are localizable by near-infrared fluorescence and radio guidance. The study demonstrates encouraging proof of concept for the liquid marker system as a well-tolerated multimodal imaging marker that can improve image-guided radiotherapy and surgical interventions, including robotic surgery.

The chaperone Hsp90 remodels the structural ensemble of Tau, resulting in the formation of potentially neurotoxic oligomers., Aggregation of the microtubule-associated protein Tau is a hallmark of Alzheimer’s disease with Tau oligomers suspected as the most toxic agent. Tau is a client of the molecular chaperone Hsp90, although it is unclear whether and how the chaperone massages the structure of intrinsically disordered Tau. Using electron paramagnetic resonance, we extract structural information from the very broad conformational ensemble of Tau: Tau in solution is highly dynamic and polymorphic, although “paper clip”–shaped by long-range contacts. Interaction with Hsp90 promotes an open Tau conformation, which we identify as the molecular basis for the formation of small Tau oligomers by exposure of the aggregation-prone repeat domain to other Tau molecules. At the same time, formation of Tau fibrils is inhibited. We therefore provide the nanometer-scale zoom into chaperoning an amyloid client, highlighting formation of oligomers as the consequence of this biologically relevant interaction.

医療人類学は、人類学の応用分野として1960年代アメリカ人類学会を中心に発展した医療・病気・健康に関する社会文化的背景を包括的に研究する学問である。日本では、主に、大学院において専門研究が行われている。また、一部の医療・看護・福祉関係の大学教育において異文化理解の観点から医療人類学が導入され、現在も医学教育に医療人類学がどのように必要かの検討がなされている。一方、医療人類学を大学の一般科目としている大学はほとんど見ない。昨今の医療をめぐる技術の進歩や高齢化に伴う医療現場の変化の中で、医療の選択において、患者や家族が向き合うべき課題は増えている。たとえば、臓器移植、延命治療、人工授精など、患者や家族の意思決定が求められる。医療専門職を目指す学生に限らず、一般の学生にとっても、医療人類学を学ぶことは、人生において遭遇する医療選択において重要である。本稿は、共通教育科目としての医療人類学の教育的意味について、大手前大学の通信教育課程におけるeラーニング制作を振り返り報告する。学生の授業への評価検証は、今後の課題とした。, An e-learning class of introduction to medical anthropology started as a correspondence course of Otemae University in 2017. This paper explains how this syllabus was constructed for the students, from teenagers to over sixties, and for people who had various backgrounds, as well as for healthcare workers. Studying medical anthropology is of importance for all students for choosing medicine independently and understanding different people and culture.

Purpose Current conditions have intensified the need for health systems to engage in the difficult task of priority setting. As the search for a “magic bullet” is replaced by an appreciation for the interplay between evidence, interests, culture, and outcomes, progress in relation to these dimensions requires assessment of achievements to date and identification of areas where knowledge and practice require attention most urgently. The paper aims to discuss these issues. Design/methodology/approach An international survey was administered to experts in the area of priority setting. The survey consisted of open-ended questions focusing on notable achievements, policy and practice challenges, and areas for future research in the discipline of priority setting. It was administered online between February and March of 2015. Findings “Decision-making frameworks” and “Engagement” were the two most frequently mentioned notable achievements. “Priority setting in practice” and “Awareness and education” were the two most frequently mentioned policy and practical challenges. “Priority setting in practice” and “Engagement” were the two most frequently mentioned areas in need of future research. Research limitations/implications Sampling bias toward more developed countries. Future study could use findings to create a more concise version to distribute more broadly. Practical implications Globally, these findings could be used as a platform for discussion and decision making related to policy, practice, and research in this area. Originality/value Whilst this study reaffirmed the continued importance of many longstanding themes in the priority setting literature, it is possible to also discern clear shifts in emphasis as the discipline progresses in response to new challenges.