No abstract

China is on the cusp of a breast cancer epidemic. Although some risk factors associated with economic development are largely unavoidable, the substantial predicted increase in new cases of breast cancer calls for urgent incorporation of this disease in future health care infrastructure planning.

How can international organizations shape national welfare states? The answer depends on why national governments comply with international organization mandates. Enforcement theories predict that states' policy preferences determine implementation, whereas managerial theories attribute noncompliance to states' capability limitations and to institutions. This article derives specific compliance mechanisms from these theories and examines the implementation of European Union social policy directives through a new quantitative data set and qualitative case studies of Greece and Spain. Countries whose preferences diverge from social policy directives, specifically countries lacking related early national legislation, and countries with low labor costs, delay implementation. However, delays from capability limitations are much greater—poor bureaucracies, federal states, coalition governments, and parliaments that do not prepare for directives cause big delays. These findings suggest that international organizations can shape national social policies by reorienting the axes of contestation from left-right to supranational-subnational.

Many argue that international norms influence government behavior, and that policies diffuse from country to country, because of idea exchanges within elite networks. However, politicians are not free to follow their foreign counterparts, because domestic constituencies constrain them. This article examines how electoral concerns shape diffusion patterns and argues that foreign templates and international organization recommendations can shift voters' policy positions and produce electoral incentives for politicians to mimic certain foreign models. Experimental individual-level data from the field of family policy illustrates that even U.S. voters shift positions substantially when informed about UN recommendations and foreign countries' choices. However, voters receive limited information about international developments, biased towards the policy choices of large and proximate countries. Aggregate data on the family policy choices of OECD countries show how voters' limited information about international models shapes government decisions: governments are disproportionately likely to mimic countries whose news citizens follow, and international organizations are most influential in countries with internationally oriented citizens.

Objectives To draw attention to sex related disparities in academic medical leadership by investigating the representation of female leaders compared with leaders with moustaches.Design Cross sectional analysis.Setting Academic medical departments in the United States.Participants Clinical department leaders (n=1018) at the top 50 US medical schools funded by the National Institutes of Health (NIH). Main outcome measuresThe proportions of female leaders and moustachioed leaders across institutions and specialties (n=20). Additionally, the moustache index: the proportion of women compared with the proportion of moustaches, analyzed with multinomial logistic regression models.Results Women accounted for 13% (137/1018) of department leaders at the top 50 NIH funded medical schools in the US. Moustachioed leaders accounted for 19% (190/1018). The proportion of female department leaders ranged from 0% (0/20) to 26% (5/19) across institutions and 0% (0/53) to 36% (19/53) across specialties. Only seven institutions and five specialties had more than 20% of female department leaders. The overall moustache index of all academic medical departments studied was 0.72 (95% confidence interval 0.58 to 0.90; P=0.004). Only six of 20 specialties had more women than moustaches (moustache index >1). ConclusionsMoustachioed individuals significantly outnumber women as leaders of medical departments in the US. We believe that every department and institution should strive for a moustache index ≥1. Known, effective, and evidence based policies to increase the number of women in leadership positions should be prioritized.