Suchergebnisse

Background: Complete and partial androgen insensitivity syndrome (CAIS, PAIS) are associated with an increased risk of gonadal germ cell cancer (GGCC). Recent guidelines recommend gonadectomy in women with CAIS in late adolescence. Nevertheless, many adult women prefer to retain their gonads. Aims: This study aims to explore attitudes towards gonadectomy in AIS in centres around the world, estimate the proportion of adults with retained gonads and/or who developed GGCC, and explore reasons for declining gonadectomy. Methods: A survey was performed among health care professionals who use the International DSD Registry (I-DSD). Results: Data were provided from 22 centres in 16 countries on 166 women (CAIS) and 26 men (PAIS). In CAIS, gonadectomy was recommended in early adulthood in 67% of centres; 19/166 (11.4%) women refused gonadectomy. Among 142 women who had gonadectomy, evidence of germ cell neoplasm in situ (GCNIS), the precursor of GGCC, was reported in 2 (1.4%) out of 8 from whom pathology results were formally provided. Nine out of 26 men with PAIS (34.6%) had retained gonads; 11% of centres recommended routine gonadectomy in PAIS. Conclusion: Although development of GGCC seems rare, gonadectomy after puberty is broadly recommended in CAIS; in PAIS this is more variable. Overall, our data reflect the need for evidence-based guidelines regarding prophylactic gonadectomy in AIS. © 2018 S. Karger AG, Basel. ; 201444; European Society for Paediatric Endocrinology; Medical Research Council: G1100236, MR/N003403/1 ; The authors would like to thank all the participating centres for providing all the information needed for this study. Contact details from the participating centres were retrieved through the I-DSD Registry (https://www.i-dsd.org/). The authors would like to thank Jillian Bryce for administrative support. The I-DSD Registry was supported by Medical Research Council partnership award G1100236 and was initially developed under a project grant from the Seventh European Union Framework Program (201444) and a project grant from the Research Unit of the European Society for Paediatric Endocrinology. Martine Cools is supported by a Senior Clinical Investigator grant from the Flanders Research Foundation.

We are told again and again that the world has become increasingly complex and indecipherable. However, this book reminds us that we are no longer alone in the world, that it is time to move away from the mental categories of the Cold War and stop treating all those who challenge our vision of the international order as guilty "deviants" or "Barbarians." The author challenges the diplomacy of Western states, who want to continue to rule the world against history, and in particular that of France, which too often oscillates between arrogance, indecision, and ambiguity. The power play is stuck. The international order can no longer be regulated by a small club of oligarchs who exclude the weaker ones, ignore the demands of societies, and ignore the demands for justice that emerge from a new world where the actors are more numerous, more diverse and more restive to arbitrary disciplines. For this reason, this book also offers ways to think an international order that would be, if not fair, at least less unfair. Bertrand Badie is Emeritus Professor of Political Science at Sciences Po, France. He is the author of numerous articles and books, many of which have been translated into English, including Diplomacy of Connivance (Palgrave Macmillan, 2012).

International students are confronted with copious challenges as they endeavor to study abroad. This study investigates the adjustment challenges international students encounter as they transition to their new environment, and the coping mechanisms or adaptation strategies they use to survive the challenges they experience. The role of the social worker in helping international students adjust, and collaborating with appropriate college offices to strategically position themselves to support international students is also discussed. A mixed method of study was utilized. A modified version of the Michigan International Students Problem Inventory (MISPI) was used in addition to data collected through survey questionnaires. Descriptive and inferential statistical methods (mean, standard deviation, t-test, and One Factor ANOVA) were used to analyze the data. This paper is an extension of my doctoral dissertation. While drawing on useful literature and other important information from my dissertation for the analysis, the work is also different from many perspectives in terms of new scholarly sources, enhanced ideas, and analyses. Results of the study revealed several challenges international students encountered with racism, discrimination and relationship between faculty and students being the greatest. It is imperative for social workers to support institutions to provide resources that caters to the specific needs of international students. Creating a positive and welcoming environment is crucial for the efficacious adjustment of international students.

The ground underneath the entire liberal international order is rapidly shifting. Institutions as diverse as the European Union, International Monetary Fund, United Nations, and World Trade Organization are under major threat. These institutions reflect decades of political investments in a world order where institutionalized cooperation was considered an essential cornerstone for peace and prosperity. Going beyond the politics of the day, this Article argues that the seeds of today's discontent with the international order were in fact sown back when these institutions were first created. We show how states initially design international institutions with features that later haunt them in unexpected ways. In the worst cases, states become so dissatisfied with the institutions they build that they threaten to abandon or dissolve them, shaking the foundations of the international order. Our central argument is that two cooperation problems intersect in unanticipated ways. The first problem – the horizontal conflict – involves the distribution of benefits among states. When states first create an international organization, they seek to capture a big share of the benefits and protect their interests vis-à-vis other states. They do this by demanding voting rules that allow them to block unfavorable decisions, requiring leadership positions for their own nationals, and lobbying to include their priority issues on the organization's agenda. We argue that this initial effort to resolve distributional conflicts is short-sighted, ultimately leaving states dissatisfied with the international organizations they build. The second problem – the vertical conflict among states collectively, on the one hand, and international organization bureaucracies and tribunals, on the other – is worsened by the compromises reached to resolve the horizontal conflict. For example, when states agree that key decisions must be reached by consensus, it becomes difficult to roll back the actions of a wayward secretariat or tribunal down the line. Or, when states place their own nationals in key positions, a multi-national body with an international agenda emerges. Such an international organization can become detached from the national concerns of its creators. Moreover, when states put their key issues on the organization's agenda, a broad mandate results. In turn, a broad mandate empowers the organization's staff to set its own priorities, making state control difficult. Contrary to prior isolated studies on horizontal and vertical conflicts, we are the first to identify how the two conflicts intersect in important and unexpected ways. To find possible solutions, we draw on analogous intersections in corporate law literature, which have been examined more thoroughly.

Liberals have long disagreed about the nature and purposes of international reform. This article juxtaposes two recent research programmes that are premised on typically liberal assumptions and goals — democratic peace theory and the cosmopolitan democracy model. Two central claims are advanced. First, both of these liberal approaches are premised upon radically different depictions of Immanuel Kant's legacy — or at least what his legacy ought to mean to us today. These different conceptions of Kant's relevance suggest that his ambiguous status as a so-called `liberal' supports remarkably different forms of this ideology. Thus, Kant's legacy is not a neutral ground, but is rather a way in which older conflicts within liberalism are becoming reproduced in the post-Cold War era. The second argument is that the cosmopolitan democracy model is a superior vision of international reform because it transcends an anachronistic conception of `popular sovereignty' as the sole liberal means through which to produce freedom and peace.

Democratic governments tie their hands particularly tightly by concluding more and stricter international investment agreements than autocratic governments, even though the domestic institutional framework in democracies alone offers protection for foreign investors. This Perspective argues that political scientists and economists are currently not able to explain this puzzle convincingly.

A companion volume to the International Handbook on the Economics of Corruption published in 2006, the specially commissioned papers in Volume Two present some of the best policy-oriented research in the field. They stress the institutional roots of corruption and include new research on topics ranging from corruption in regulation and procurement to vote buying and private firm payoffs

La visite que les membres du Comité international ont faites aux camps de prisonniers en Autriche-Hongrie, fera l'objet d'un rapport officiel qui sera publié dans la série des Documents. En attendant le compte rendu ci-dessous, qu'ils ont bien voulu faire pour le Bulletin, intéressera nos lecteurs.

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