The World Health Organization has recommended that Member States consider taxing energy-dense beverages and foods and/or subsidizing nutrient-rich foods to improve diets and prevent noncommunicable diseases. Numerous countries have either implemented taxes on energy-dense beverages and foods or are considering the implementation of such taxes. However, several major challenges to the implementation of fiscal policies to improve diets and prevent noncommunicable diseases remain. Some of these challenges relate to the cross-sectoral nature of the relevant interventions. For example, as health and economic policy-makers have different administrative concerns, performance indicators and priorities, they often consider different forms of evidence in their decision-making. In this paper, we describe the evidence base for diet-related interventions based on fiscal policies and consider the key questions that need to be asked by both health and economic policy-makers. From the health sector’s perspective, there is most evidence for the impact of taxes and subsidies on diets, with less evidence on their impacts on body weight or health. We highlight the importance of scope, the role of industry, the use of revenue and regressive taxes in informing policy decisions.

"Sunshine" policy, aimed at making financial ties between health professionals and industry publicly transparent, has recently gone global. Given that transparency is not the sole means of managing conflict of interest, and is unlikely to be effective on its own, it is important to understand why disclosure has emerged as a predominant public policy solution, and what the effects of this focus on transparency might be. We used Carol Bacchi's problem-questioning approach to policy analysis to compare the Sunshine policies in three different jurisdictions, the United States, France and Australia. We found that transparency had emerged as a solution to several different problems including misuse of tax dollars, patient safety and public trust. Despite these differences in the origins of disclosure policies, all were underpinned by the questionable assumption that informed consumers could address conflicts of interest. We conclude that, while transparency reports have provided an unprecedented opportunity to understand the reach of industry within healthcare, policymakers should build upon these insights and begin to develop policy solutions that address systemic commercial influence.

Degraded floodplains and valley floors are restored with the goal of enhancing habitat for native fish and aquatic-riparian biota and the protection or improvement of water quality. Recent years have seen a shift toward “process-based restoration” that is intended to reestablish compromised ecogeomorphic processes resulting from site- or watershed-scale degradation. One form of process-based restoration has developed in the Pacific Northwest, United States, that is intended to reconnect rivers to their floodplains by slowing down flows of sediment, water, and nutrients to encourage lateral and vertical connectivity at base flows, facilitating development of dynamic, self-forming, and self-sustaining river-wetland corridors. Synergies between applied practices and the theoretical work of Cluer and Thorne in 2014 have led this form of restoration to be referred to regionally as restoration to a Stage 0 condition. This approach to rehabilitation is valley scale, rendering traditional monitoring strategies that target single-thread channels inadequate to capture pre- and post-project site conditions, thus motivating the development of novel monitoring approaches. We present a specific definition of this new type of rehabilitation that was developed in collaborative workshops with practitioners of the approach. Further, we present an initial synthesis of results from monitoring activities that provide a foundation for understanding the effects of this approach of river rehabilitation on substrate composition, depth to groundwater, water temperature, macroinvertebrate richness and abundance, secondary macroinvertebrate production, vegetation conditions, wood loading and configuration, water inundation, flow velocity, modeled juvenile salmonid habitat, and aquatic biodiversity.

This paper examines the power relations in "patient-centred communication". Drawing on the work of Michel Foucault I argue that while patient-centred communication frees the patient from particular aspects of medical power, it also introduces the patient to new power relations. The paper uses a Foucauldian analysis of power to argue that patient-centred communication introduces a new dynamic of power relations to the medical encounter, entangling and producing the patient to participate in the medical encounter in a particular manner. Keywords: Pastoral power, Patient-centred, Confession, Michel FoucaultFrom the middle of the twentieth century the relationship between the patient and physician has increasingly occupied the attention of sociologists, psychologists and social theorists. Through work of figures such as Talcott Parsons and Michael Balint, the encounter between the patient and the physician came to be questioned and critically examined. A concern that occupied initial studies of the medical encounter and continues to feature heavily in contemporary examinations is medical power, particularly when expressed through forms of paternalism. The concern with paternalism is that the patient's autonomy, liberty and personhood are diminished, resulting in ethical, legal and medical dilemmas. The primary response to the problem has been to establish laws and ethical principles to protect the patient and help guide the conduct of the physician; however, a current approach is "patient-centred" care. The patient-centred approach seeks to remodel the medical encounter to avoid the dangers of paternalism and other practices that negatively impact on the relationship between the patient and physician. Further, the patient-centred approach is not considered to be merely a precautionary but a positive way to guarantee the patient's autonomy, liberty and personhood. As will be demonstrated through a survey of the patient-centred literature, a key component of the patient-centred approach is communication. This literature suggests that through patient-centred communication the potential paternalism of the physician is diminished and the empowerment of the patient is possible.