Stakeholder analysis in a policy game process in Tunisia

This paper discusses the policy game methodology and design that will be used in a simulation that aims to assess and understand the public health policy making in Tunisia. The policy game aims to analyzes the interactions, alliances and networks formed by the institutions and stakeholders during a policy game intervention that will be organized in Tunis, in which policy makers, civil servants, researchers and practitioners will simulate the use of evidence in real life policy making. The simulation has been realized within the Erasmus+ CONFIDE project focused on enhancing transnational partnerships and building capacity to inform evidence-based policies in Tunisia. This capacity building project and policy game is built on the collaboration of four Tunisian universities, from Tunis, Sfax, Sousse and Monastir, and three universities from the European Union, from Romania, Denmark and Slovakia. The policy game will focus on the drafting and implementation of a national strategy for fighting the increase of drug consumption among the Tunisian youth, a phenomenon which is rather new in Tunisia and spreading rapidly. The policy game will be followed by an analysis aiming to explore the impact of the intervention in enhancing cross-sector collaboration and the use of local stakeholder network regarding drug policy making. The preliminary results showed that the stakeholders approached this problem in a collaborative way and were willing to up-take evidence-based measures in the creation of a national strategy to fight drug consumption. This exercise has also shown that the policy game can be an effective tool in enhancing the use of scientific arguments in policy making and encourage stakeholders to approach policy making in a cross-sector way.

Key messages

Policy game can be an effective tool in enhancing the use of scientific arguments in policy making and encourage stakeholders to approach policy making in an interdisciplinary way. Stakeholders approached this problem in a collaborative way and were willing to up-take evidence-based measures in the creation of a national strategy to fight drug consumption.

Learning from games: stakeholders' experiences involved in local health policy

Since public health problems are complex and the related policies need to address a wide range of sectors, cross-sectoral collaboration is beneficial. One intervention focusing on stimulating collaboration is a 'policy game'. The focus on specific problems facilitates relationships between the stakeholders and stimulates cross-sectoral policymaking. The present study explores stakeholders' learning experiences with respect to the collaboration process in public health policymaking. This was achieved via their game participation, carried out in real-life stakeholder networks in the Netherlands, Denmark and Romania. The policy game (In2Action) was developed and implemented as a 1-day role-play. The data consisted of: (i) observations and evaluation notes during the game and (ii) participant questionnaire after the game. All three countries showed similar results in learning experience during the collaboration processes in local policymaking. Specific learning experiences were related to: (i) the stakeholder network, (ii) interaction and (iii) relationships. The game also increased participant's understanding of group dynamics and need for a coordinator in policymaking. This exploratory study shows that the game provides participants with learning experiences during the collaboration process in policymaking. Experiencing what is needed to establish cross-sectoral collaboration is a first step towards enhancing knowledge exchange and more effective public health policies.

[Premature elevated intraocular pressure after cataract surgery]

We evaluated the frequency of elevated intraocular pressure (IOP) the first 1-3 postoperative days for a group of patients undergoing standard or phacoemulsification extracapsular cataract extraction (ECCE). IOP was measured in the pre and postoperative period using non-contact tonometer. From the 356 operated patients, 21 patients (6%) had early elevated IOP. The frequency of elevated IOP was greater among the patients that received anterior chamber (AC) IOL (25%) as compared to that of patients that received posterior chamber (PC) IOL (5.5%). The viscoelastic substance was responsible for a great percentage of cases (51%). The results show that the majority of elevated IOP is transient, recovered spontaneously or by treatment with carbonic anhydrase inhibitors or beta-adrenergic blockers. Elevated postoperative IOP occurs more frequently in the presence of glaucoma, cataract associated with systemic diseases, in complicated and traumatic cataract.

[Post-traumatic glaucoma]

This paper presents theoretical aspects concerning the physiopathological mechanisms involved in producing the glaucoma following trauma, especially the lens related glaucoma, correct identification of the ethiopathogeny of the intraocular pressure elevation in this situation is essential for the appropriate management. These aspects are illustrated by two cases of recent glaucoma following trauma lens related (lens subluxation) treated by medication and surgery. The surgical procedure consisted of intracapsular extraction of the lens, anterior vitrectomy, iridectomy and implantation of sulcus sutured posterior chamber lens. We present the technique, the difficulties met intra- and postoperative, evolution and prognosis.

[The role of basic fibroblast growth factor on expression of mineralization of periodontal ligament cell population and clones]

OBJECTIVE

To determine the effect of basic fibroblast growth factor (bFGF) on mineraliztion of PDL cell clone.

METHODS

The PDL tissue that derived from three human donors was cultured and cells were cloned. The mineralizing ability were detected with or without bFGF treatment in the presence of dexamethasone. Cloned progenitor populations were assayed for their constitutive capacity to bind CAP and express ALP.

RESULTS

The results show that bFGF increases clone mineralization (11%), but not in PDL cell population. The cell clones that mineralized only in the presence of bFGF have higher CAP binding ability and lower ALP expression compared with other mineralized clone cells.

CONCLUSION

bFGF enhances mineralizing expression of PDL clone. The clones that mineralized only with bFGF treatment are different cell types from the bFGF-undependent mineralized clones.

Two novel endogenous digoxin-like immunoreactive substances isolated from human plasma ultrafiltrate

Two digoxin-like immunoreactive substances (DLIS 1 and DLIS-2) were isolated from human plasma by ultrafiltration, alkaline solvent extraction, and HPLC. Both inhibit canine Na, K-ATPase and cross-react with anti-digoxin antibodies. Their UV spectra are similar, with absorption peaks at 190 and 220 nm. FAB mass spectral analysis of both compounds yield a single dominant (M+H)+ component at m/z 532 otherwise, the fragmentation patterns are slightly different. The spectral data are consistent with the postulate that these compounds are related. Their identity as the natriuretic hormone is being investigated.