Non-governmental Research Articles

Challenges for Formal Organizations Engaging Volunteers During Regular and Crisis Times According to Polish and Italian Volunteer Coordinators

AbstractThe recent crises in Europe impacted the volunteering patterns within formal organizations that provide support in regular and crisis times. In our paper, we investigated how volunteer coordinators from formal entities (public/governmental and non-governmental) perceive (1) the patterns of volunteering engagement (long-term versus episodic) in regular and crisis times, (2) the processes of retaining volunteers during crises; (3) the trust of the community toward various types of organizations during social crises; (4) the role of informal support groups in relation to the tasks of their organization. Between June and October 2023, we performed an online-based study (total N = 55)—in Poland (N = 28) and Italy (N = 27). The survey had multiple-choice and open-ended questions, and the results were analyzed qualitatively using the thematic analysis framework. The findings indicated that volunteer coordinators reckon that long-term and episodic volunteers play crucial and complementary roles in helping organizations achieve their objectives. This implies that organizations should recognize the value of both types of volunteers and consider them essential resources for pursuing organizational goals. The results also suggest that the volunteer retention strategies are worth outlining or revisiting within organizations, and attention should be paid to psychological support. According to coordinators, trust in non-governmental organizations is perceived as crucial in the beneficiaries' decisions about where to seek help. Collaboration with informal groups is advised, given that the goals can be achieved together, mutually using the resources provided by both types of helping entities.

The socioeconomic and environmental niche of protected areas reveals global conservation gaps and opportunities

The global network of protected areas has rapidly expanded in the past decade and is expected to cover at least 30% of land and sea by 2030 to halt biodiversity erosion. Yet, the distribution of protected areas is highly heterogeneous on Earth and the social-environmental preconditions enabling or hindering protected area establishment remain poorly understood. Here, using fourteen socioeconomic and environmental factors, we characterize the multidimensional niche of terrestrial and marine protected areas, which we use to accurately establish, at the global scale, whether a particular location has preconditions favourable for paestablishment. We reveal that protected areas, particularly the most restrictive ones, over-aggregate where human development and the number of non-governmental organizations are high. Based on the spatial distribution of vertebrates and the likelihood to convert non-protected areas into strictly protected areas, we identify ‘potential’ versus ‘unrealistic’ conservation gains on land and sea, which we define as areas of high vertebrate diversity that are, respectively, favourable and unfavourable to protected area establishment. Where protected areas are unrealistic, alternative strategies such as other effective area-based conservation measures or privately protected areas, could deliver conservation outcomes.

Using stakeholder knowledge to co-produce research priorities for a raptor species vulnerable to impacts of wind energy facilities

The global energy transition necessitates a rapid increase in infrastructure in developing countries, including for wind energy facilities (WEFs). Concerns arise regarding the negative impacts of WEFs on biodiversity, especially on birds of prey or raptors and other volant animals. In Africa, South Africa has the largest installed wind energy capacity and also hosts several raptor species of conservation importance. One such raptor is the regionally endemic Jackal Buzzard Buteo rufofuscus (family Accipitridae), which has its core population in South Africa. Despite frequent fatalities from collisions with wind turbine blades, this species is understudied. To address this gap, we conducted interviews with key stakeholders in the wind energy sector, including avifaunal specialists, wind energy developers, government representatives, and conservation nongovernmental organisations. The goal was to begin a cooperative process to identify crucial research gaps and to establish a future research agenda for Jackal Buzzards in the context of wind energy development. Stakeholders expressed confidence in current environmental impact assessment (EIA) techniques but highlighted a concern for direct collisions as a significant threat to Jackal Buzzards. The consensus was that WEFs are more likely to cause local rather than national population-level impacts. Although stakeholders generally shared similar opinions, minor differences emerged between groups. Movement ecology studies were identified as a high priority for future research on this species. By collaboratively formulating research priorities, this study aims to improve the relevance of future investigations, fostering stakeholder buy-in for potential policy and EIA practice recommendations.

An intuitive approach to cybersecurity risk assessment for non-governmental organizations

Purpose This study proposes a guided tool for cybersecurity risk assessment tailored for nongovernmental organizations (NGOs), enabling them to comply with cybersecurity policies despite limitations in security awareness, funding and expertise. Design/methodology/approach A digital transformation is indispensable for ensuring the sustainable operation of NGOs. Embracing a digital manifesto necessitates an awareness of cybersecurity risks, highlighting the critical need for a robust cybersecurity risk assessment methodology. Initial research phases revealed significant shortages in security awareness, funding and expertise. Consequently, this study introduces an intuitive approach tailored specifically for NGOs, supported by a customized tool designed to address their unique requirements. The NIST cybersecurity risk assessment framework and National Cyber-security Authority (NCA) were adopted to define the risk assessment approach. The efficacy of this approach is evaluated qualitatively through a case study involving three NGOs in Saudi Arabia, aimed at assessing their capability to utilize the tool effectively. Following the implementation, a Likert-scale survey gauged satisfaction among NGOs regarding the tool’s utility. Findings Results from the case study indicate high satisfaction, affirming its alignment with their operational needs and enhancement of compliance with NCA controls. Furthermore, the use of the tool enhances the awareness of NCA’s cybercity requirements and controls. Originality/value Based on theoretical and empirical grounds, this research proposes a novel design of security assessment framework tailored for NGO requirements and supported by initiative tool enabling complying with cybersecurity policies and enhances the awareness of cybersecurity controls.

Contextual analysis of child labor laws and educational rights for children in Pakistan with a focus on KPK province

Child labor is defined as the exploitation of children in any form of labor that destructively affects the child's mental, social, and physical health and creates hurdles to obtaining a regular education. This study was conducted to investigate the main socio-economic factors contributing to child labor and barriers to education and analyze the practical implications of child labor laws in Pakistan. The study area in this study is Khyber Pakhtunkhwa (KPK) province, Pakistan. The primary data were collected through an online questionnaire survey from teachers, school administrators, government officials responsible for enforcing child labor laws and educational policies, and representatives from non-governmental organizations (NGOs), while personal observations and interviews were used for the collection of data from child laborers, parents or guardians of child laborers. A total of 80 teachers or education experts, 70 children and their guardians, 30 policymakers, and 20 social workers were participants in the data collection process. The outcomes of this study concluded that about 78% of participants lacked awareness of these laws, while 71% perceived them as ineffective. The socioeconomic factors contributing to child labor are quantitatively assessed, with poverty identified as the primary factor (65%). The statistical analysis indicates that the socioeconomic factors have a significant contribution to the implementation of child education laws in Pakistan (a p-value lower than the level of significance (0.05). Discrimination based on gender or social status, high cost of education, and insufficient qualified teachers are significant barriers to providing quality education for children in Pakistan. This study recommends promoting inclusive education and strengthening social welfare programs to support their efficacy in combating child labor and ensuring access to quality education for all children in Pakistan.

Collaborative governance of an integrated system for collecting contributions for social health insurance, pension, and taxes from the informal sector: a synthesis of stakeholder perspectives

BackgroundMany low-and middle-income countries have adopted social health insurance schemes. However, the collection of contributions from the large informal sector of these economies poses a significant challenge. Employing an integrated system of contribution collection from all relevant institutions may be cost-effective. We used the integrative framework for collaborative governance, to explore and explain factors that may shape the governance of an integrated system for collecting contributions for social health insurance, pension, and taxes from the informal sector in Zambia.MethodsWe undertook a qualitative case study involving 25 key informants drawn from government ministries and institutions, cooperating partners, non-governmental organizations, and association representatives in the informal sector. Data were analyzed thematically using Emerson’s integrative framework for collaborative governance.ResultsThe main drivers of collaboration included a need for comprehensive policies and legislation to oversee the integrated system for contribution collection, prevent redundancy, reduce costs, and enhance organizational effectiveness. However, challenges such as leadership issues and coordination complexities were noted. Factors affecting principled engagement within the collaborative regime consisted of communication gaps, organizational structure disparities, and the adoption of appropriate strategies to engage the informal sector. Additionally, factors influencing shared motivation involved concerns about power dynamics, self-interests, trust issues, corruption, and a lack of common understanding of the informal sector.ConclusionThis study sheds light on a multitude of factors that may shape collaborative governance of an integrated system for contribution collection for social health insurance, pension, and taxes from the informal sector, providing valuable insights for policymakers and implementers alike. Expanding social health insurance coverage to the large but often excluded informal sector will require leveraging factors identified in this study to enhance collaboration with pension and tax subsystems.

AZERBAIJAN'S NATIONAL SECURITY POLICY IN THE SYSTEM OF MODERN INTERNATIONAL RELATIONS

With the end of the Cold War, the political situation in the world has changed dramatically. The emergence on the world stage of new independent states, non-governmental organizations, transnational companies and threatening the world at the regional and global levels, such as ethnic conflicts, the spread of political and economic instability, imbalance, weapons of mass destruction, terrorism, the struggle for natural resources, etc. contributed to the transformation of international relations. As a result of the process, also accelerated by globalization, the state’s perception of security has changed in parallel with the increase in the types and scale of risks and threats.

The Impact of Administrative Decisions on Commercial Freedom in Saudi Arabia: A Legal Study

This legal study examines the impact of administrative decisions on commercial freedom in Saudi Arabia, exploring the intricate relationship between regulatory frameworks and business operations. The research analyzes the historical context of commercial freedom in the kingdom, tracing its evolution from traditional practices to the current legal landscape. It delves into the constitutional provisions and relevant legislation that shape administrative decision-making processes affecting commercial activities. Through case studies, the study illustrates practical implications of administrative decisions on various aspects of business operations, including visa regulations, residence permits, zoning laws, and regulatory compliance. The research identifies key challenges to commercial freedom, such as regulatory barriers and administrative obstacles, while also highlighting opportunities for enhancement, including improved transparency and modernized regulations. The study emphasizes the crucial roles of key stakeholders - government, private enterprises, and civil society organizations - in shaping commercial freedom. It proposes recommendations for reform, focusing on legislative changes, institutional improvements, and fostering an entrepreneurial culture. While acknowledging Saudi Arabia's progress in developing its commercial legislation and regulatory system, the research identifies areas for improvement. It concludes that the kingdom's efforts to balance regulatory oversight with business needs, coupled with its economic diversification goals, suggest a positive trajectory for commercial freedom. However, success depends on continued reform, stakeholder engagement, and adaptation to global economic trends while respecting local cultural and religious values. This study provides valuable insights for policymakers, business leaders, and researchers interested in understanding and enhancing commercial freedom in Saudi Arabia.

Low availability of haematin (hemin) in Pakistan

Madam, Acute Intermittent Porphyria (AIP) is an autosomal dominant disorder that results from a defect in the enzyme named porphobilinogen deaminase.1 It is symptomatic porphyria, involving the accumulation of porphyrins and porphyrin precursors due to impaired conversion in haeme synthesis. Acute Intermittent Porphyria is clinically characterized by acute episodes of multiple gastrointestinal and neurologic symptoms; during which the patient remains healthy between episodes.2 Acute Intermittent Porphyria episodes are commonly observed in post pubertal females. The most common symptoms include periodic abdominal pain, vomiting and hypertension followed by neurologic damage that leads to peripheral and autonomic neuropathies (mostly motor) and psychiatric manifestations.2 Hormonal cycle regulation may worsen porphyria, since its symptoms coincide with the menstrual cycle. Although positive response has been noted in hormonal suppression by gonadotropin releasing hormone agonists.3 Currently, the most widely used treatment is hemin, a form of haeme that can be given intravenously. Its administration reduces the haeme deficit, hence limits the production of porphyrins precursors by the body. Availability of hemin in Pakistan is not promising while alternatives such as intravenous infusion of glucose, and pain relievers like Nalbuphine, a man-made opioid analgesic, and Morphine are short-term treatments. Haeme Arginate (HA), a compound of haeme and arginine, is equivalent to hematin in the treatment of AIP. Long-term weekly intravenous infusions of prophylactic HA prevent severity and frequency of porphyric attacks in patients with AIP.4 While haeme therapy is recommended if a patient exhibits neurological impairment, liver transplant appears to be the last resort in patients with recurrent clinical manifestations. To effectively mediate the growing need of Hemin in Pakistan, a systematic plan with effective and immediate steps must be introduced. The regulatory authorities must expedite the approval and licensing process of appropriate medication that would meet the growing need of the country, while not compromising on its quality. The possibility of local production should be explored, while strengthening international ties aimed at importing affordable medication. The government should focus on initiating partnerships with international organizations, non-governmental organizations (NGOs) and global health initiatives. Nationwide workshops and informative campaigns towards healthcare work should be a priority, to raise awareness of the situation and the proper steps that should be taken to minimize its adverse effects. Empowering patient advocacy groups would be beneficial in recognizing any shortcomings of the plan and to divert resources accordingly.

Less than one in five teenage women in Ethiopia know about emergency contraception.

Teenage women's fertility health faces significant challenges from unintended pregnancies and unsafe abortions. Using an emergency contraception within a defined time period could prevent unintended pregnancy and its damaging consequences, like unintended childbirth and unsafe abortion. Despite it being an appropriate contraception, the knowledge of teenage women about emergency contraception is lower among women in developing countries. Therefore, this study aimed to examine the magnitude of emergency contraception knowledge and its associated factors among teenage women in Ethiopia. Data for this study was obtained from the recent Demographic and Health Surveys. A total weighted sample of 3,381 teenage reproductive women were included. The significant associated factors with emergency contraception knowledge among teenage reproductive women were determined by fitting a multilevel mixed-effect binary logistic regression model. Finally, Adjusted Odds Ratio (AOR) with a 95% confidence interval and a P value of less than 0.05 was used to declare statistical significance. In Ethiopia, the magnitude of teenage women who knew about emergency contraception was 19.47% (95%CI: 18.17, 20.84). Age 17 years (AOR = 1.76, 95%CI, 1.24, 2.48) and age 19 years (AOR = 2.18, 95%CI, 1.47, 3.22), primary education level (AOR = 2.76, 95%CI, 1.60, 4.76), secondary and above educational level (AOR = 4.70, 95%CI, 2.62, 8.44), being protestant followers (AOR = 0.63, 95%CI, 0.45, 0.87), being muslim followers (AOR = 0.68, 95%CI, 0.49, 0.93), media exposure (AOR = 3.36, 95%CI, 2.59, 4.34), rural residence (AOR = 0.45; 95%CI: 0.22, 0.86), and high community level education (AOR = 140, 95%CI: 1.32, 2.00) were factors significantly associated with knowledge of emergency contraception among teenage women. This finding concluded that less than one in five teenage women knew about emergency contraception in Ethiopia. The knowledge of emergency contraception among teenage women in Ethiopia was substantially associated with women's age, education level, religion, media exposure, residency and community-level education. Hence, there is a need to implement comprehensive awareness programs and promotion of emergency contraception as a way of curbing cases of unintended pregnancies among teenage women. Government and non-governmental organizations should design targeted educational initiatives and media campaigns to improve emergency contraception knowledge among young teenagers, women with lower educational backgrounds, and rural teenagers.

Individual attendance data for over 30 years of international climate change talks

The international community has formally negotiated over climate change since 1991. The annual meetings that host these negotiations have seen an ever-growing number of individuals representing countries, international organizations, or non-governmental organizations. These meetings and their attendees have accordingly become the focal point of international climate change cooperation for both the international community and scholars studying climate change politics. Yet, researchers have been unable to access and analyze comprehensive attendee-level data pertaining to these negotiations in terms of attendees’ names, genders, job titles, delegations, divisions, and affiliations. In applying text-as-data techniques to attendance roster PDFs, we extract and build attendee-level datasets for all annual negotiations held under the United Nations Framework Convention on Climate Change and its precursor, 1991–2023. These data include original language and English-translated information on 27,470 unique delegations and 310,200 attendees over a 32-year period. Summaries and validations in turn highlight the promise of our data for the study of attendance patterns and characteristics across delegations and over time.

Phasic and periodic change of drought under greenhouse effect

Purpose Drought is the primary disaster that negatively impacts agricultural and animal husbandry production. It can lead to crop reduction and even pose a threat to human survival in environmentally sensitive areas of China (ESAC). However, the phases and periodicity of drought changes in the ESAC remain largely unknown. Thus, this paper aims to identify the periodic characteristics of meteorological drought changes. Design/methodology/approach The potential evapotranspiration was calculated using the Penman–Monteith formula recommended by the Food and Agriculture Organization of the United Nations, whereas the standardized precipitation evaporation index (SPEI) of drought was simulated by coupling precipitation data. Subsequently, the Bernaola-Galvan segmentation algorithm was proposed to divide the periods of drought change and the newly developed extreme-point symmetric mode decomposition to analyze the periodic drought patterns. Findings The findings reveal a significant increase in SPEI in the ESAC, with the rate of decline in drought events higher in the ESAC than in China, indicating a more pronounced wetting trend in the study area. Spatially, the northeast region showed an evident drying trend, whereas the southwest region showed a wetting trend. Two abrupt changes in the drought pattern were observed during the study period, namely, in 1965 and 1983. The spatial instability of moderate or severe drought frequency and intensity on a seasonal scale was more consistent during 1966–1983 and 1984–2018, compared to 1961–1965. Drought variation was predominantly influenced by interannual oscillations, with the periods of the components of intrinsic mode functions 1 (IMF1) and 2 (IMF2) being 3.1 and 7.3 years, respectively. Their cumulative variance contribution rate reached 70.22%. Research limitations/implications The trend decomposition and periods of droughts in the study area were analyzed, which may provide an important scientific reference for water resource management and agricultural production activities in the ESAC. However, several problems remain unaddressed. First, the SPEI considers only precipitation and evapotranspiration, making it extremely sensitive to temperature increases. It also ignores the nonstationary nature of the hydrometeorological water process; therefore, it is prone to bias in drought detection and may overestimate the intensity and duration of droughts. Therefore, further studies on the application and comparison of various drought indices should be conducted to develop a more effective meteorological drought index. Second, the local water budget is mainly affected by surface evapotranspiration and precipitation. Evapotranspiration is calculated by various methods that provide different results. Therefore, future studies need to explore both the advantages and disadvantages of various evapotranspiration calculation methods (e.g. Hargreaves, Thornthwaite and Penman–Monteith) and their application scenarios. Third, this study focused on the temporal and spatial evolution and periodic characteristics of droughts, without considering the driving mechanisms behind them and their impact on the ecosystem. In future, it will be necessary to focus on a sensitivity analysis of drought indices with regard to climate change. Finally, although this study calculated the SPEI using meteorological data provided by China’s high-density observatory network, deviations and uncertainties were inevitable in the point-to-grid spatialization process. This shortcoming may be avoided by using satellite remote sensing data with high spatiotemporal resolution in the future, which can allow pixel-scale monitoring and simulation of meteorological drought evolution. Practical implications Under the background of continuous global warming, the climate in arid and semiarid areas of China has shown a trend of warming and wetting. It means that the plant environment in this region is getting better. In the future, the project of afforestation and returning farmland to forest and grassland in this region can increase the planting proportion of water-loving tree species to obtain better ecological benefits. Meanwhile, this study found that in the relatively water-scarce regions of China, drought duration was dominated by interannual oscillations (3.1a and 7.3a). This suggests that governments and nongovernmental organizations in the region should pay attention to the short drought period in the ESAC when they carry out ecological restoration and protection projects such as the construction of forest reserves and high-quality farmland. Originality/value The findings enhance the understanding of the phasic and periodic characteristics of drought changes in the ESAC. Future studies on the stress effects of drought on crop yield may consider these effects to better reflect the agricultural response to meteorological drought and thus effectively improve the tolerance of agricultural activities to drought events.

Humanitarianism’s Thin Red Line: Armed Escorts in Theory and Practice

In armed conflicts around the world, armed escorts are increasingly used by civilian actors in the delivery of humanitarian assistance. These escorts, at times, include peacekeepers, counter-insurgents, armed forces, armed groups or even private security companies. The use of armed actors, however, remains a critically underexplored issue. This paper will assess the theory and practice of the use of armed escorts by humanitarian actors, uncovering the legitimising discourse and the impact that armed escorts have on humanitarian principles and acceptance by local communities. It accomplishes this through a critical analysis of humanitarian guidelines and policy documents and draws from the limited research on armed escorts. The article draws from fieldwork in Sudan in 2022 to empirically show these trends in Darfur, demonstrating that the use of armed escorts by one non-governmental organisation can cause a knock-on effect to others, and that once in place, there is a lock-in effect.

Advanced supply chain optimization for emerging market healthcare systems

The complexities of pharmaceutical supply chains in emerging markets present significant challenges that directly impact healthcare outcomes, particularly in underserved regions. This research focuses on the optimization of supply chain systems for the healthcare sector, with an emphasis on enhancing pharmaceutical delivery. By leveraging data analytics and innovative procurement strategies, the study seeks to improve efficiency, reduce operational costs, and ensure the timely distribution of essential medications. Drawing on practical experiences at eMedic Technologies Africa, the research highlights the need for advanced models that integrate real-time data to optimize inventory management, forecast demand, and address bottlenecks in last-mile delivery. The study proposes a multi-faceted approach to addressing common challenges in emerging market supply chains, including unreliable infrastructure, fluctuating demand, and limited access to technology. By utilizing predictive analytics, the proposed models aim to improve accuracy in demand planning, reducing stockouts and overstock situations. Additionally, innovative procurement strategies, such as centralized procurement and strategic partnerships with local suppliers, are explored as key methods for enhancing cost-effectiveness and streamlining supply chain operations. A critical component of the research is the focus on last-mile delivery, which remains a significant hurdle in rural and underserved areas. The study advocates for the use of digital platforms and mobile technologies to enhance delivery tracking and coordination, ensuring that essential medications reach their destination efficiently. Furthermore, it emphasizes the importance of fostering collaboration between governments, non-governmental organizations, and private sector stakeholders to build resilient supply chain systems capable of adapting to local conditions. By providing actionable insights and scalable models for supply chain optimization, this research aims to contribute to improved healthcare delivery in emerging markets. The proposed strategies not only reduce costs and improve efficiency but also ensure a reliable and consistent supply of medications, ultimately leading to better health outcomes in regions most in need. Keywords: Supply Chain Optimization, Data-Driven Procurement, Last-Mile Delivery, Healthcare Efficiency, Emerging Markets

PERAN PENYULUH BERBASIS MASYARAKAT DALAM MEMPERTAHANKAN HUTAN JANDA (KAOMBO OHUSII) DI KABUPATEN BUTON SULAWESI TENGGARA

This study aims to explore the management practices of Widow Forest (Kaombo Ohusii) in Buton Regency through the lens of local wisdom and development communication, by revealing the social, cultural, and environmental dynamics involved in forest management. This study uses a variety of data collection methods. Participant observation allows researchers to be directly involved in Widow Forest management activities, observe the practices carried out, and interact with local communities and other parties involved in natural resource management. In-depth interviews will be conducted with widows, poor women, community leaders, government officials, and non-governmental organizations involved in the management of Widow Forest. The results of the study show that community-based extension by traditional officials in Takimpo Village in the management of Widow Forest (Kaombo Ohusii) is an example of effective local participation in sustainable natural resource management. The involvement of this traditional institution also shows the importance of integrating local values in development, ensuring that decisions taken are in accordance with community expectations, and supporting environmental conservation and community empowerment.

ASSESSING YOUTH INVOLVEMENT IN AGRICULTURE IN YOLA-NORTH LOCAL GOVERNMENT AREA OF ADAMAWA STATE

The study examined youth involvement in agriculture in Yola-North Local Government Area of Adamawa State, Nigeria. Data were collected from 230 farmers using a well-structured questionnaire and analyzed using descriptive and inferential statistics. The results show that the most (52.61%) of respondents were male, with an average age of 21 years. Most respondents (55.22%) were single with an average household size of 4 persons. Educationally, 2.61% had primary education, 7.39% had secondary education, 52.61% had diploma, and 37.39% had HND/Degree, indicating that all the respondents were educated. Additionally, most respondents earned between N40,000 and N200,000 annually. Factors influencing youth participation in agriculture revealed that age and sex were positive and significant at 1% level (P<0.01), while educational level was negative but significant at 10% level (P<0.1). Constraints identified included lack of government assistance, insufficient capital, poor road access, inadequate feed supply, poor extension services, and poor marketing prices. Sex (male) and age were positively associated with youth participation in agriculture, whereas the lack of government support was a significant barrier preventing youth from engaging in agricultural activities. The study recommends that inputs such as agrochemicals and credit should be made available on time and at subsidized rates by both governmental and non-governmental organizations to make agriculture more appealing to youths. Furthermore, the government or relevant institutions should strictly monitor and supervise any development or empowerment initiatives to prevent mismanagement by involved dignitaries.

Prosthetic valve dysfunction in patients with mechanical heart valves: Results from the Emergency Salam Centre cohort

IntroductionMechanical heart valve (MHV) replacement requires long-life anticoagulation due to the risk of Prosthetic Valve Dysfunction (PVD) and cardioembolism. MethodsWe report data from a prospective observational study conducted on MHV patients in the Khartoum Salam Centre for Cardiac Surgery built by ‘Emergency,’ an Italian Non-Governmental Organization, to evaluate the occurrence of PVD and associated risk factors. ResultsWe prospectively followed 3647 patients, and 38 patients (rate 1.04 × 100 pt-years) had PVD during follow-up. The time in therapeutic range (TTR) among patients without PVD was 53 % (IQR 37–67), and it was 43 % (IQR 19–58) among patients with PVD (p = 0.04). Twenty-three over 38 patients (60.5 %) were symptomatic, 18 (47.4 %) had obstructive valvular stenosis, 24 patients (63.2 %) had INR <2.0 at diagnosis, and 21 patients (55.3 %) had been off warfarin for a long time: 3 patients for 1 week, 1 patient for 2 weeks, and 17 patients for >4 weeks (6 patients were off warfarin from 3 to 12 months). Ten were uncompliant to treatment, and 8 were pregnant women. Ten patients (26.3 %) with PVD had had a previous episode of PVD, and 14 patients (36.8 %) had 2 or more associated risk factors. Only in 6 cases were no associate risk factors found. ConclusionsAmong MHV patients on warfarin treatment with a sub-optimal quality of anticoagulation, the rate of PVD is 1.04 % pt-years, and the most frequent associated risk factor for PVD occurrence is warfarin withdrawal lasting more than one week.

NGO engagement in the creation of public service innovations: A configurational, explorative approach

IMPACT This article offers critical insights for practitioners interested in the evolving landscape of public service innovation. It highlights the significant role that non-governmental organizations (NGOs) play as co-creation partners in government innovation projects, with nearly half of surveyed NGOs participating in such initiatives. Importantly, the study shows that NGOs with experience in service innovation are more likely to collaborate with government, emphasizing the value of past innovation experience in fostering successful partnerships. The authors explain the motivations behind NGO engagement, revealing that improving user experience, gaining insights, and strengthening relationships with government are key drivers. The findings suggest that co-creation is not just about service improvement but also about capacity building for NGOs through knowledge transfer and learning opportunities. Practitioners will benefit from understanding these dynamics, which reinforce the principles of New Public Governance (NPG) by highlighting the importance of collaboration and network-based innovation.

Overview and suggestion about Chinese health-related non-governmental organization's participation in global health governance

Non-governmental organization (NGO) is one of the important non-state actors in global health governance. The importance of NGO's participation in the global health governance tend to be more prominent due to its flexibility, professionalism, voluntariness and autonomy. The World Health Organization (WHO) established a Civil Society Commission (CSC) in 2023 aiming at strengthening dialogue, facilitating collaboration so as to play its bigger role in the global health governance. This paper is to make analysis to the importance of NGO in global health governance, WHOCSC's organizational structure and operational mechanism, current status and problem of Chinese health-related NGO's participation in the global health governance, and to provide policy suggestions for strengthening Chinese health-related NGOs' participation in global health governance, including incubating Chinese NGOs into national strategy for global health, strengthening resources mobilization and coordination, as well as advocating transparency and society involvement, emphasizing international humanitarian, public welfare and propaganda.

The Balance Between Gatekeeper Rules and Free Speech in the EU under the Digital Markets Act and Digital Services Act

Purpose: This article investigates the intricate balance between free speech and content restrictions within the frameworks of the EU Digital Services Act (DSA) and the Digital Markets Act (DMA). It delves into the duties of 'gatekeepers' under the DMA, the challenges of content moderation, and the delicate equilibrium between fostering open communication and curbing harmful material. The primary aim is to contribute to the ongoing debate on digital platform regulation, particularly focusing on the gatekeeper designation under the DMA and its potential to enhance freedom of speech while mitigating excessive compliance and censorship. Methodology: The study employs a mixed-methods approach to provide a comprehensive analysis of the regulatory landscape and its implications. It includes a literature review of academic journals, legal documents, and policy papers; in-depth document analysis of the DMA and DSA; case studies of landmark decisions such as GS Media and Delfi AS v. Estonia; interviews with key stakeholders; a survey of platform users; comparative analysis with other jurisdictions; policy impact assessment; and content analysis of platform policies. The research adheres to ethical guidelines, ensuring informed consent and data protection. Findings: The findings reveal that the DMA's gatekeeper rules have the potential to significantly enhance freedom of speech by curbing platform dominance, promoting content diversity, and encouraging transparent content moderation. However, the risk of over-compliance leading to the suppression of free speech is also identified. The study highlights the importance of independent oversight, clear platform guidelines, and continuous dialogue among stakeholders to maintain a balance between open markets and free speech. Unique Contribution to Theory, Policy and Practice: This article offers a novel perspective on how the DMA's gatekeeper designation improves freedom of speech while avoiding excessive censorship. It provides valuable insights for policymakers, digital platforms, and civil society organizations, emphasizing the need for a nuanced approach to content moderation that respects users' rights. The article also underscores the importance of ongoing review and adaptation of regulations to address the evolving digital landscape, thereby contributing to the development of a safer, more competitive, and fairer online environment.