Western Countries Research Articles

Time from admission to the onset of methicillin-resistant Staphylococcus aureus bacteremia in a single acute care hospital in Japan.

The spread of antimicrobial-resistant organisms (AROs) poses a major threat to animal and human health. In Japan, the estimated disability-adjusted life years (DALYs) due to infections with AROs is 137.9 per 100,000 persons, with methicillin-resistant Staphylococcus aureus (MRSA) being the main contributor. The factors that can contribute to DALYs in Japan include younger age and a higher number of deaths in patients with MRSA bacteremia. Moreover, longer hospital stays may contribute to higher rates of MRSA bacteremia in Japan than in Western countries. We reviewed diagnosis procedure combination data collected from January 1, 2016, to December 31, 2020, in an acute care hospital in Tokyo, Japan. We found that the median time from admission to MRSA bacteremia onset was 26 days, which is longer than that in Western countries but similar to that in South Korea. Further, our cohort was older than that in the United States and South Korea, potentially contributing to the higher number of years of life lost in Japan. These results underscore the need to develop strategies to reduce hospitalization in Japan. Larger multicenter studies are needed to comprehensively evaluate the economic and health burden of MRSA bacteremia in Japan.

Management of ulcerative colitis in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023.

Ulcerative colitis (UC) is a chronic inflammation of the gastrointestinal tract and is characterized by alternating periods of inflammation and remission. Although UC incidence is lower in Taiwan than in Western countries, its impact remains considerable, demanding updated guidelines for addressing local healthcare challenges and patient needs. The revised guidelines employ international standards and recent research, emphasizing practical implementation within the Taiwanese healthcare system. Since the inception of the guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease has acknowledged the need for ongoing revisions to incorporate emerging therapeutic options and evolving disease management practices. This updated guideline aims to align UC management with local contexts, ensuring comprehensive and context-specific recommendations, thereby raising the standard of care for UC patients in Taiwan. By adapting and optimizing international protocols for local relevance, these efforts seek to enhance health outcomes for patients with UC.

On the importance of internet access for children’s health and subjective well-being: the case of China

ABSTRACT Digital technology is transforming children’s daily routines and can potentially have long-lasting effects on their lives. This paper studies the impact of internet access on the health and subjective wellbeing of Chinese children. To conduct such analysis, we employ data from the China Education Panel Survey (CEPS), a longitudinal dataset of Chinese seventh-year students representative of the whole country. This database allows us to control for unobserved individual heterogeneity and socio-economic characteristics. We use two alternative methods to address endogeneity concerns. The first one employs a recursive system of equations that allows unobserved individual heterogeneity to simultaneously affect both health outcomes and digital access. The second approach exploits the fact that Chinese students cannot choose which school to attend and employ the proportion of students owning a computer in the same school as an instrumental variable. Regardless of the method, we find that internet access improves health. We also find some positive impact of digital access on subjective wellbeing, albeit the evidence is weaker. This stands in stark contrast to prior research, which has found a negative effect of internet use on mental health in Western countries.

Effect of ferroptosis inhibitors in a murine model of acetaminophen-induced liver injury.

Liver injury caused by acetaminophen (APAP) overdose is the leading cause of acute liver failure in western countries. The mode of APAP-induced cell death has been controversially discussed with ferroptosis emerging as a more recent hypothesis. Ferroptosis is characterized by ferrous iron-catalyzed lipid peroxidation (LPO) causing cell death, which can be prevented by the lipophilic antioxidants ferrostatin-1 and UAMC-3203. To assess the efficacy of these ferroptosis inhibitors, we used two murine models of APAP hepatotoxicity, APAP overdose alone or in combination with FeSO4 in fasted male C57BL/6J mice. APAP triggered severe liver injury in the absence of LPO measured as hepatic malondialdehyde (MDA) levels. In contrast, ferrous iron co-treatment aggravated APAP-induced liver injury and caused extensive LPO. Standard doses of ferrostatin-1 did not affect MDA levels or the injury in both models. In contrast, UAMC-3203 partially protected in both models and reduced LPO in the presence of ferrous iron. However, UAMC-3203 attenuated the translocation of phospho-JNK through downregulation of the mitochondrial anchor protein Sab resulting in reduced mitochondrial dysfunction and liver injury. Thus, APAP toxicity does not involve ferroptosis under normal conditions. The lack of effects of ferroptosis inhibitors in the pathophysiology indicates that ferroptosis signaling pathways are not relevant therapeutic targets.

SPATIAL JUSTICE: GEOGRAPHICAL CONCEPTUALIZATION IN THE CONTEXT OF WAR IN UKRAINE

As a scientific category, spatial justice requires to be detailed and in-depth theoretical and methodological study, as well as empirical evaluation. Since representatives of different fields of knowledge offer their own definitions of spatial justice, it is impossible to have a systematic view of it, nor to place accents that are important for geo­graphers. The purpose of the study is to analyze and summarize approaches to the definition of “spatial justice”, to outline its main dimensions, and to clarify, through an online expert survey of geographers, the essence of the category and the focus of its study in the context of the military situation in Ukraine. The analysis of the literature and the results of an online survey of geographers on the nature of spatial justice in Ukraine revealed that justice is based on the principle of equal opportunities, which is worth striving for, given the objective geographical inequalities in living conditions, access to services, levels of mobility, etc. Even though the category of “spatial justice” has been defined by geographers in the past, it is not yet clear what the main dimensions of spatial justice are, and what the focus of its study should be. Although the category of spatial justice is most developed in Western countries, its implementation in war and post-war conditions in Ukraine is extremely necessary, especially since the injustice of war is exacerbated by its consequences. According to the majority of respondents, spatial justice can be interpreted as the achievement of a state in which the economic life of a given territory is subordinated to, or at least does not contradict, the interests of the local community, creating benefits and opportunities to meet production, cultural and other needs. In times of war, it is also a fair democratic process of sharing benefits and risks between territories. The definitions chosen by the majority of respondents can be the basis for the further development of theoretical, methodological, and practical tools for the formation of a platform for the implementation of the principles of spatial justice at different territorial levels.

Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease updated in 2023.

Crohn's disease (CD) is a chronic, fluctuating inflammatory condition that primarily affects the gastrointestinal tract. Although the incidence of CD in Taiwan is lower than that in Western countries, the severity of CD presentation appears to be similar between Asia and the West. This observation indicates the urgency for devising revised guidelines tailored to the unique reimbursement system, and patient requirements in Taiwan. The core objectives of these updated guidelines include the updated treatment choices and the integration of the treat-to-target strategy into CD management, promoting the achievement of deep remission to mitigate complications and enhance the overall quality of life. Given the diversity in disease prevalence, severity, insurance policies, and access to medical treatments in Taiwan, a customized approach is imperative for formulating these guidelines. Such tailored strategies ensure that international standards are not only adapted but also optimized to local contexts. Since the inception of its initial guidelines in 2017, the Taiwan Society of Inflammatory Bowel Disease (TSIBD) has acknowledged the importance of continuous revisions for incorporating new therapeutic options and evolving disease management practices. The latest update leverages international standards and recent research findings focused on practical implementation within the Taiwanese healthcare system.

THE TRUE NATURE OF ARMENIAN MIGRATION ON THE EASTERN FRONT: THE CASE OF BİTLİS PROVINCE (1914-1922)

On 28 July 1914, when the First World War started, the Russian Caucasian army attacked the Ottoman lands in November 1914 and many Armenians adhere the Russian army. Taking advantage of this rebellion, Russian troops occupied Van on 20 May 1915 and dominated the region. With the occupation of Van, the Ottoman Government enacted the Law on Relocation and Resettlement on 27 May 1915 and relocated some Armenians in the war zones to the southern provinces of the Ottoman Empire for military reasons. In July 1915, the Russians, were forced to migrate the Armenians in the zone of occupation to the Caucasus. With the Russian occupation of Eastern Anatolia in 1916, the Armenians who had migrated returned. In 1917, with the withdrawal of the Russian Caucasian army, these Armenians had fled with the Russians. With the signing of the Armistice of Mudros, some Armenians came to Bitlis. In 1922, with the success of the Turkish War of Independence, Armenians who did not want to stay in Anatolia migrated to Istanbul and various Western countries. With the outbreak of the First World War, Armenians experienced a continuous migration movement due to the war conditions. Bitlis was one of the provinces where this migration movement took place. One of the main reasons for choosing Bitlis as a sample is that it is a province with a high Armenian population density. Secondly, the occupation of Bitlis by the Russians. It is assumed that the Armenian migrations in Bitlis were political in nature rather than war related. In this respect, it was determined that the Armenian population mobility in Bitlis took place eight times. As a result, it is possible to say that the main reason for such frequent mobility was that the Armenians acted with the Allies.

Kratom-From natural remedy to addictive drug and back

Kratom/ketum is apsychoactive herbal preparation that has been used for along time as aremedy and performance-enhancing substance in Southeast Asia. The advancement of globalization is making kratom increasingly more available in the western world, where it is becoming increasingly more used. The current research on kratom and its ingredients is presented. An overview of the use and effects of kratom is exemplary given on the basis of reports. The instrumentalization of the drug and its consequences up to the development of addiction are discussed. Consumption is accompanied by several instrumentalizeable effects so that kratom is used as atherapeutic substance in the self-management of pain, anxiety and depression as well as other substance addictions. Another benefit comes from the performance-enhancing effects on physical work and in a social context. Consumption is usually well controlled, rarely escalates and has few and mostly mild aversive side effects. The danger arises from consumption particularly when there is an escalation of the dose and from mixed consumption with other psychoactive substances. The main alkaloid mitragynine and the more potent 7‑hydroxy-mitragynine are considered mainly responsible for the effect. Both have acomplex pharmacology that involves partial µ‑opioid receptor agonism. Epidemiological, clinical and neurochemical studies have shown that kratom only has alimited addictive drug profile, which might suggest amedical use as aremedy or substitute in addiction treatment.

As Reformas religiosas e o nascimento da escolarização ocidental

The religious reforms of the 16th century served as the midwives of early modernity. At a time when the Iberian expansion was globalizing the continents, these reforms sparked religious wars and deeply fragmented the European landscape. This confessionalization of society led to the emergence of a more rationalized form of Christianity, represented by various Protestant churches and Tridentine Catholicism, particularly exemplified by the Society of Jesus. Diverging from medieval Christianity, Lutherans, Calvinists, and Anglicans invested in creating their own networks of educational institutions, sparking an unprecedented wave of schooling that aimed to solidify the religious practices of their followers. In response, the Catholic Church also equipped itself, establishing parish schools and, notably, a network of Jesuit colleges that spread throughout the Catholic regions of Europe, Asia, and the New World. In 1599, the Society of Jesus unified its educational establishments with the institution of the Ratio Studiorum — a comprehensive set of Jesuit educational rules that became the foundational curriculum for Catholic schooling in the early modern period. This study argues that the religious reforms were instrumental in the birth of Western schooling, emerging from different Christian matrices — both Protestant and Catholic. This represents a historical shift — in the Foucauldian sense — that led to the rise of schooling in the Western world, characterized by modern discipline, manifested through mechanisms such as time control, spatial organization, the arrangement of forces, a climate of competition and student reward, and an emphasis on moral punishments. This issue is examined through three recent historical-sociological works published in Europe and Latin America: Produção da escola/produção da sociedade: Análise sócio-histórica de alguns momentos decisivos da evolução escolar no Ocidente by sociologist André Petitat; Arqueología de la escuela by sociologists Julia Varela and Fernando Álvarez-Uría; and A invenção da sala de aula: Uma genealogia das formas de ensinar by historians Inés Dussel and Marcelo Caruso. This historiographical reflection examines the emergence of Western schooling, aiming to identify common analytical elements across these three books, while also noting differences, particularly those related to theoretical foundations and socio-spatial contexts.

Strengthening Global Security: Critique on the NPT and NSG Mechanisms of Nuclear Export Control Regime

An export control regime plays a vital tool in the effort to counter the proliferation of traditional weapons and weapons of mass destruction. However, there are new and fundamental challenges with this system. The article emphasizes the importance of understanding and implementing nuclear export control mechanisms to advance international security and prevent the spread of nuclear weapons. The research will apply descriptive analysis of the mechanisms of nuclear export controls. Critical analysis of the nuclear export control apparatuses will be applied as a technique to review the loopholes in the enforcement mechanisms of these initiatives. The debate covers key aspects of nuclear export control, including legislative frameworks, industry compliance, licensing and authorization procedures, verification and monitoring systems and control scope. Understanding these elements will enable stakeholders to support responsible and peaceful transfers of nuclear technology while ensuring compliance with international commitments and nonproliferation standards. The paper further delves into the context of these regimes, which are constructed in a way that provides cushion to the international community led by the Western states. The article emphasizes the critical role of the mechanisms of nuclear export control in preserving international security by preventing the unauthorized transfer of sensitive nuclear materials and technology. It also emphasizes the need for industry and national collaboration in this regard.

Including Marine-Related Items in the ISSP Environment Module is Important for a More Holistic Measure of Public Environmental Perceptions

In this study, we examine public perceptions of the importance of addressing marine ecosystem problems by including an item (which we treated as a dependent variable) in the Environment IV module of the International Social Survey Programme (ISSP) in New Zealand. Overall importance perception was high (mean rating of 4.44 on a 5-point scale). However, our hypotheses that ratings on ISSP items, which implicitly represent marine stressors (e.g., air pollution, nuclear waste), would be consistently associated with high-importance ratings for addressing marine ecosystem problems were not supported. This observation suggests that perceptions of marine issues are not necessarily underpinned by an understanding of multiple marine stressors. Including compulsory marine-related items in the ISSP could provide a clearer understanding of public perceptions of marine ecosystems and assist in informing public education and communication. This inclusion would offer a valuable global perspective, given that the ISSP is implemented in Western and non-Western countries. The ISSP offers questions on multiple environmental domains, including attitudinal, behavioral, and political and unique demographic questions that would enable in-depth country-comparative analyses of marine-related perceptions not possible in existing international environmental perception surveys.

Re-Emerging, Under-Recognized Zoonotic, and Neglected Tropical Diseases in Hawai'i.

Hawai'i, the United States' most western geographic state in the Pacific, lies between the North and South American continents and the Indo-Pacific regions, including Japan. The tropical environmental conditions of the Hawaiian Islands provide favorable ecosystems for various infectious pathogens, their vectors, and reservoirs. This creates an environment conducive to the transmission of zoonotic diseases affecting both humans and animals. Hawai'i has experienced an increase in dengue, leptospirosis, and murine typhus outbreaks. Furthermore, toxoplasmosis and neuroangiostrongyliasis cases remain prevalent throughout the state, and the putative presence of autochthonous Zika cases identified in a retrospective study may be of national public health concern. Understanding the factors that affect the transmission and distribution of zoonoses is necessary to identify at-risk locations and populations. The One Health approach seeks to understand, report, and interpret these factors and requires collaboration between private and governmental institutions. One Health should focus on neglected tropical diseases (NTD) and prioritize development of interventions to control and prevent the transmission of diseases that spread between animals and humans. This review focuses on the epidemiological and clinical characteristics of under-recognized zoonotic and NTD affecting Hawai'i, including leptospirosis, murine typhus, neuroangiostrongyliasis, toxoplasmosis, dengue, and Zika.

On the usefulness of turning to the experience of the Warsaw Pact Organization

At the beginning of the 2020s, the formation of a new world order became obvious. In parallel, there are two large-scale processes. One of them is a partial reformatting of connections within camps of Western democracies, the other is the emergence of a community of a number of states outside the West. The emergence of this commonality presupposes a noticeable increase in cooperation of the armed forces between interested players. Here it becomes necessary to use experience of functioning of specialized structures without the participation of Western countries. Studying the experience allows us to take into account a number of schemes that have proved their effectiveness and usefulness, primarily developed under the auspices of the Warsaw Pact Organization. Their wasps thinking is becoming especially in demand in the context of a noticeable tightening of the Western approach to contain opponents – Russia, China, Iran. The article points out the limited attention to the internal affairs of domestic historiography and political science, despite the obvious value of the experience of functioning of this organization. The author notes that a significant part of the gaps in the study of the strategy and practice of internal affairs can be filled by the fundamental work “Organization of the Warsaw Pact. 1955–1991. Story. Strategy. Policy”, prepared by a team of authors under the leadership of V.A. Zolotarev.

Seeds of Modern Education: American Influence in Turkey

American private foundations invested huge financial resources in institutions and individuals in the Republic of Turkey in the process of westernization of the country. This study seeks to present a detailed historical perspective of the activities of American philanthropic foundations and their influence on the development and the process of modernization of Turkey. Due to the war-torn state and poor socio-economic situation, the modernization process in Turkey implied comprehensive help from the Western countries, which Ataturk took as a model. Based on charity and humanitarian work, first American organizations arrived in Turkey at the beginning of 19th century. Popularly known as ‘‘missionary organizations’’ or simply ‘‘missionaries’’, they devoted their work to religious conversion of dominantly Christian minorities in the Ottoman Empire, charity activities and education. From the period of the first arrivals until 1920s, missionary organizations established number of hospitals and schools that proved beneficial to people and students across Turkey. At the beginning of 20th century, some of the American richest industrialists and businessmen in that period like Andrew Carnegie, John D. Rockefeller and Russell Sage have decided to establish private grant-providing foundations for the melioration of life standards of humankind all around the world – investing dominantly in education, infrastructure and public health. In terms of time scale, growth of the foundation imbricates with the establishment of modern Turkey in 1923. Led by Mustafa Kemal Ataturk, the new government of Turkey was dedicated to the process of modernization of the country – a project that seriously needed support from the external powers. Therefore, this study aims to analyze the role of American private foundations in the process of development of education, health sector, and overall Turkey’s modernization. These findings suggest that American private organizations such as Rockefeller and Ford foundations had a strong hold in the development of institutions and education and training of individuals from Turkey in various fields.

Outcomes of Resectable Gallbladder Cancer: A Retrospective Analysis From a Tertiary Care Centre in India.

Background Gallbladder carcinoma (GBC) has deleterious outcomes, but due to its reduced incidence in Western countries, there is a paucity of data on this disease. Here we report the outcomes of a retrospective analysis of resectable gallbladder cancer from a tertiary cancer centre in eastern India. The primary objective of this study is to evaluate the overall survival (OS) and relapse-free survival (RFS) rates among patients with resectable GBC. Methods A retrospective analysis was carried out on patients who underwent radical surgery between 2007 and 2022 and received various neoadjuvant and adjuvant chemotherapy methods. Patients who had adjuvant chemoradiotherapy concurrently or who did not receive adjuvant therapy were excluded. All the baseline clinicopathological characteristics were retrieved from electronic medical records. The survival data were collected from records of follow-up visits as well as telephonic calls to the patients who were lost to follow-up. Simple proportions were used for baseline characteristics, and the Kaplan-Meier method was used for survival analysis. Results A total of 161 patients were identified, and data were captured from electronic medical records. The included patients' ages ranged between 26 and 80 years, with a median age of 56 years. Among the participants, 103 were female (64%) and 58 (36%) were male. Among the 161 patients, the median number of lymph nodes harvested was nine (ranging from one to 43), and only three patients were margin-positive. The tumour, nodes, and metastasis (TNM) distributions were as follows: pT2 in 111 patients (70.25%), pT3 in 44 patients (27.85%), and pT4 in three patients (1.90%). The nodal statuses were pN0 in 91 patients (61.9%), pN1 in 51 patients (34.69%), and pN2 in five patients (3.4%). The majority (64%) received single-agent capecitabine, 27% received gemcitabine-based platinum doublet therapy, and 4.3% received neoadjuvant therapy. Of the full sample, 2.4% received concurrent adjuvant chemo plus radiation therapy, and three patients did not receive any adjuvant therapy. Additionally, among the 161 patients, 34.16% had a relapse, with 47% being local and 52% being distant relapses. The median follow-up was 49 months (interquartile range (IQR) 23-71 months). The 24-month RFS rate was 67.1% (SD+/- 4.3%), and the 24-month OS rate was 78.1% (SD+/- 4.1%). Conclusion Our data, which is from one of the largest samples from India, show that resectable gallbladder cancer has very good outcomes after radical surgery and adjuvant chemotherapy. There was a higher proportion of T2 and node-negative disease, which could have led to better survival compared to published literature.

The politics of immigration policy in Malaysia: What is behind the foreign worker’s administration?

The formation and implementation of migration policy cannot avoid being influenced by political elements, particularly political actors who have a direct or indirect interest in migration issues. Previous studies show that the influence on the administration and migration policy of a country has created the concept of ‘client politics’, that is, employers have a certain influence on the administration of foreign workers, especially in western countries. This situation has also created two groups which are pro-migrants consisting of employers, fundamental rights groups and trade unions; and anti-migrants are often associated with bureaucrats, nationalists and others. This study has used qualitative methods and has interviewed the informants consisting of government agencies, academics, employers, trade unions and NGOs. The results of the study show that those actors have a certain influence on the management of foreign workers including in the aspects of policy making and implementation. The concept of ‘client politics’ is seen to only apply to certain sectors, especially the manufacturing sector. Therefore, practically in Malaysia it is considered as ‘sectoral client politics’. In conclusion, the influence of both groups is not pursuing the interests of the country but rather on the interests of their respective sectors and entities.

Silenced Survivors: A Systematic Review of the Barriers to Reporting, Investigating, Prosecuting, and Sentencing of Adult Female Rape and Sexual Assault.

Sexual victimization of adult women remains an underreported crime. This systematic review identified and synthesized the barriers to reporting, investigating, prosecuting, and sentencing cases of sexual assault and rape against adult women in Western countries. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was conducted on August 3, 2023, across databases including PsycINFO, MEDLINE, Cochrane Library, Scopus, ProQuest Central, Web of Science, MedNar, and ProQuest Dissertations & Theses. Studies meeting the inclusion criteria provided relevant information on the decision not to formally disclose, investigate, prosecute, or convict incidents of sexual assault and rape of adult women. We included 28 studies and identified 70 barriers in total. Identified barriers were most prevalent to reporting, followed by investigating, prosecuting, and, lastly, sentencing. Key themes in the barriers included lack of trust in the criminal justice system, internal reactions, rape myths and societal norms, and perpetrator characteristics. The identified barriers emphasize an urgent need for reform of the criminal justice system's response to sexual assault and rape. Prioritizing victim-survivors' needs, enhancing transparency of the criminal justice system, and addressing attrition rates are crucial. Future studies need to engage with diverse population to address all victim-survivors' needs and provide further insights into the challenges across all stages of the criminal justice system to enhance the outcome of rape and sexual assault cases.

The Mode 3 Networked University

The idea of a modern university is a constantly changing and often contested concept. This paper traces the idea of a university using three modes. These modes are the Mode 1 Ivory Tower, Mode 2 Factory and Mode 3 Network. This framework draws upon higher education literature as well as three modes of knowledge production. I use these modes as a framework to describe the genealogical and historical development of the university in the Western world. These however are not purely historical and elements of their characteristics can be found within and between university institutions today. A genealogy shows a historical path dependency (i.e a teaching and research institution) of the idea of a university and a new materialism perspective shows the coming together of the many elements of the network assemblage which includes the discourse on the idea of a university clashing with new ideas, technologies and policy. The growth and development of the modern university from small, autonomous, elite and autonomous in mode 1 to large, mass regulated factory with marketplace outputs within neoliberal societies is well documented. The Mode 3 Network University is emerging with a potential for universal access with networked societies and technologies and has many actors influencing its becoming and idea. The 2020 Covid-19 pandemic and a broadening multidisciplinary approach to the field of Networked Learning has been called for and I introduce the possibility of theoretically analysing the becoming and enactment of the Mode 3 Network University using concepts and frameworks from the broad field of New Materialism. Such approaches take into account the complex assemblage and network of actors which are human and non-human in the growing and diversifying university. The growth and marketisation of the university has added to this complexity with commercial 'unbundling' taking place. Degrees, institutions and functions are being unbundled and rebundled and this active complex network of actors including technologies, humans (academics, students, employers, wider public) and the residual path dependency of the three modes are in tension and conflict but come together to enact the modern university. New Material methodologies allow for these many influences to come together in a 'flat ontology' to allow for a more nuanced and new approach to research in Networked Learning.

Vaccine inequalities, hesitancy, and media-focused public health interventions in English-speaking West-African Countries

Background: Vaccine hesitancy poses a significant challenge to public health efforts in English-speaking West-African countries amidst the COVID-19 pandemic. This study aims to examine the multifaceted factors contributing to vaccine hesitancy in the region, including issues of trust, misinformation, cultural beliefs, and access barriers. Methods: This study reviewed data from three African countries, Nigeria, Ghana, and the Gambia, to analyze attitudes towards vaccination. It also assessed variations in attitudes across these countries and compared them with attitudes in the western world. Qualitative and quantitative methods were employed to gather and analyze data on vaccine hesitancy and related factors. Results: The study found substantial variation in attitudes towards vaccination across the surveyed countries and compared to the western world. Factors contributing to vaccine hesitancy included historical injustices, misinformation, cultural beliefs, and access barriers such as limited healthcare infrastructure and vaccine supply constraints. Media-focused public health interventions were identified as crucial in addressing vaccine inequalities and enhancing vaccine acceptance. Conclusion: Overcoming vaccine hesitancy in West Africa requires tailored approaches that acknowledge and address historical injustices and inequities, emphasize culturally appropriate messaging, and utilize existing community infrastructure to deliver accurate information. Targeted communication strategies are essential to combat misinformation and enhance vaccine acceptance. By analyzing the intersection of vaccine hesitancy, media interventions, and public health challenges, this study underscores the need for comprehensive and community-engaged campaigns to promote vaccination and combat the spread of COVID-19 in West Africa.

We need to talk about Jus ad vim

This Review Essay looks at the two recent book-length publications on the emerging topic of Jus ad vim − justice of limited force: Brunstetter’s Just and Unjust Uses of Limited Force: A Moral Argument with Contemporary Illustrations (2021), and Braun’s Limited Force and the Fight for the Just War Tradition (2023). I argue that although both authors offer insightful and original contributions to the debate surrounding the ethics of limited force, their theorisation of jus ad vim provides the moral backing to military actions conducted by powerful Western states, rather than scrutinising them. Importantly, moreover, the project of jus ad vim, theorised in this manner, follows the Western conceptualisation of just war theory which has historically been used to further the interests of Western states at the expense of weaker nations.