Suchergebnisse

Background: While congenital choledochal malformation (CCM) is relatively well known within the pediatric surgical and pediatric gastroenterological communities, many controversies and questions remain. Methods: In this paper, we will discuss the results of an international Delphi survey among members of the European Reference Network RARE-LIVER and of the faculty of the Biliary Atresia and Related Diseases (BARD) network to identify the most common practices as well as controversies regarding diagnosis, treatment and follow-up of this still enigmatic disease. Results: Twenty-two individual respondents completed the survey. While there seems to be agreement on the definitions of CCM, preoperative workup, surgical approach and follow-up still vary considerably. The mainstay of treatment remains the removal of the entire extrahepatic biliary tract, clearance of debris both proximally and distally, followed by reconstruction with (according to 86% of respondents) a Roux-en-Y hepaticojejunostomy. Nonetheless, both laparoscopic and robotic-assisted resections are gaining ground with the suggestion that this might be facilitated by concentration of care and resources in specialized centers. However, long-term outcomes are still lacking. Conclusions: As even post-surgical CCM has to be considered as having premalignant potential, follow-up should be well-organized and continued into adulthood. This seems to be lacking in many centers. International cooperation for both benchmarking and research is paramount to improving care for this rare disease.

Research in conflict studies and environmental security has largely focused on the mechanisms through which the environment and natural resources foster conflict or contribute to peacebuilding. An understudied area of research, however, concerns the ways in which warfare has targeted civilian infrastructure with long-term effects on human welfare and ecosystems. This article seeks to fill this gap. We focus on better understanding the conflict destruction of water, sanitation, waste, and energy infrastructures, which we term environmental infrastructures, by drawing on an author-compiled database of the post-2011 wars in the Middle East and North Africa (MENA). While research across the social sciences has examined the targeting of civilians and environmental destruction during wars, including the issue of urbicide, we expand the study of targeting environmental infrastructure to (1) examine the role of different types of actors (international vs. subnational), (2) document the type of infrastructure targeted, form of attack, and impacts, and (3) situate increased targeting of environmental infrastructure in the changing context of war-making in the MENA. Comparatively analyzing the conflict zones of Libya, Syria, and Yemen, we show that targeting environmental infrastructure is an increasingly prevalent form of war-making in the MENA, with long-term implications for rebuilding states, sustaining livelihoods, and resolving conflicts.

A notable development in the discipline of international relations has been the recent surge of interest in the economic dimensions of world politics; the profusion of courses labeled "International Political Economy" suggests that a new field may be emerging. The attempt here is to explain & assess this development & to define the field of international political economy by identifying some of the major substantive foci & delineating some of the contending perspectives. The syllabi of 45 recently introduced international relations courses that focus on the relationship of international economic & political processes are examined. These syllabi were solicited from members of the International Political Economy section of the International Studies Assoc. The attempt to delineate patterns of course offerings yielded 4 distinct categories. The analysis of syllabi indicated that a common core of substantive concerns has evolved & certain structural & conceptual frameworks have become established. Thus, some unity & coherence was found amid great diversity & breadth. AA.

The growing tendency towards international arbitration brings into special consideration and importance the relation between the jurisdiction of national courts of justice and international tribunals of arbitration.When one nation urges claims in behalf of its citizens upon the government of another nation and proposes arbitration, how far doea that other nation's respect for its own independent sovereignty and for the integrity of its own judicial system require it to insist that the claims be submitted for final decision to its own national courts?The true basis for the consideration of this question is in the nature oi the obligation which constrains a nation to submit questions to any tribunal whatever.

"This article is an overview of the international strategic context in the next 20 years, designed to guide the work of international security organizations in achieving/consolidating regional and global security. The analysis is based on the work of international organizations as sound judgments on different alternative strategies that focus on the challenges of the most likely future themes. According to the assessment, the period up to 2040 will be a period of transition, characterized by instability, both in the relations between states and in the relations between groups within states. The world is likely to continue to face the reality of a changing climate, rapid population growth, resource scarcity, resurgence of ideologies, and above all, shifts in global power from West to East. No state, group or individual can face these challenges in isolation, only collective responses will be adequate. Therefore, the struggle to establish an effective system of global governance capable of meeting these challenges will continue to be a central theme of the age. Globalization, global inequality, climate change and technological innovation will affect the lives of everyone on the planet. There will be a constant tension between greater interdependence between states, groups and individuals, and increased competition between them. Dependence on complex global systems, such as global supply chains for resources, is likely to increase the risk of systemic problems."

UN peacekeeping became a flagship activity of the liberal international order (LIO) in the post-Cold War era, characterized by globalization, liberal norms and western leadership. Western states' diminished support for LIO UN peacekeeping has left it increasingly open to challenge, but significant changes are only likely if a strong group of states coalesces around an alternative model of UN peacekeeping. This article highlights African actors and China as well positioned to play pivotal roles in such a coalition. African states, who host the preponderance of UN missions and furnish almost half of the UN's uniformed peacekeepers, support globalized UN peacekeeping, show relatively weak support for the most liberal peacebuilding principles and assert the need for African-led solutions to continental crises. China's influence reflects its P5 status, financial and personnel contributions to UN peacekeeping and engagement with regional actors, notably in Africa. Aspiring to global leadership and a 'new world order', China endorses globalized UN peacekeeping but proposes a non-liberal (and non-western led) notion of 'developmental peace' to guide it. The complementarities between African and Chinese priorities raise the possibility of a profound challenge to LIO peacekeeping. Rather than heralding deglobalization, however, this challenge illustrates that post-LIO international institutions may instead be characterized by deliberalization and dewesternization.