THE IMPORTANCE OF MONITORING DOMESTIC PUBLIC HEALTH LAW AND LEGAL SYSTEMS SUPPORTING GLOBAL HEALTH GOVERNANCE: DEVELOPMENT OF AN ANALYTICAL FRAMEWORK TO ASSESS THE DOMESTIC PUBLIC HEALTH LAW SITUATION IN THE WESTERN PACIFIC REGION COUNTRIES.

The aims of this study are to present an argument that emphasizes the usefulness of an analysis framework for analyzing public health law and legal systems; identifying methods for improving the application of this framework, including its academic value for public health law; and enhancing the future use of the framework for supporting global health governance. To help formulate the initial analysis framework and tool, we have, along with expert consultations, conducted a literature review on global health governance and public health law. Meetings were also held with World Health Organization (WHO) Western Pacific Regional Office (WPRO) technical staff members on the applicability and benefits of the framework and tool. Monitoring public health laws and legal systems of countries can be used to understand governance and improve people's health.

Developing a tool for assessing public health law in countries.

At present, the World Health Organization (WHO) is in the process of developing a tool designed to assess the status of public health legislation in a given country. An Expert Consultation on Public Health Law was convened in Manila, Philippines, in May 2011. The participants agreed that the tool could serve as a guide for a regional approach to assist Member States in assessing the scope, completeness, and adequacy of their public health law. Given the broad definition of "public health" and the laws that affect health, directly or indirectly, the participants further agreed to narrow the field to 4 areas based on significant WHO works/policies, each organized into an independent module: (1) International Digest on Health Law, (2) Primary Health Care, (3) International Health Regulations 2005, and (4) Framework Convention on Tobacco Control. The tool would be drafted in a questionnaire format that asks the respondent to determine whether primary and/or subsidiary legislation exists in the country on a specific topic and, if so, to cite the relevant law, describe the pertinent points, and attach and/or link to the full text where available. The participants agreed that the respondents should include government officials and/or academics with legal competency. Version 1 of the tool was piloted in the Philippines, the Republic of Korea, Samoa, and Vanuatu. At a 2nd Expert Consultation on Public Health Law, convened in Incheon, Republic of Korea, in October 2011, in conjunction with the 43rd Conference of the Asia-Pacific Academic Consortium on Public Health, the participants determined that the tool was generally usable, certain concerns notwithstanding, such as the risk of standardizing compliance with WHO policies. The agreed next step is to finalize the analysis tool by August 2012, marking the end of stage I in the development process. Stage II will consist of team building and networking of responsible officers and/or professionals in the countries. The tool will be further developed to reflect specific in-country situations.

Biomedical ethics policy in Korea: characteristics and historical development.

Ethical consideration is an inseparable part of policy-making in modern society. Biomedical ethics is an interdisciplinary study of ethical issues that result from advances in medical practices and research. Because these issues often arise at the bedside, society must provide solutions or judgments that are effective and applicable. Thus, the development and progress of biomedical ethics has been made possible via the cooperation of experts from diverse backgrounds. The biomedical ethics discourse should not be seen as a conflict between values but as a collective activity for problem-solving. To support this perspective on ethics discourse, a historical perspective on biomedical ethics in Korea was given emphasis on the participants and their perspectives. Major cases and the changes resulting therefrom were discussed with the agenda proposed. The Korean situation with respect to ethics development shows the interactions between groups participating in policy development and its collaborative nature.

A Korean perspective on developing a global policy for advance directives.

Despite the wide and daunting array of cross-cultural obstacles that the formulation of a global policy on advance directives will clearly pose, the need is equally evident. Specifically, the expansion of medical services driven by medical tourism, just to name one important example, makes this issue urgently relevant. While ensuring consistency across national borders, a global policy will have the additional and perhaps even more important effect of increasing the use of advance directives in clinical settings and enhancing their effectiveness within each country, regardless of where that country's state of the law currently stands. One cross-cultural issue that may represent a major obstacle in formulating, let alone applying, a global policy is whether patient autonomy as the underlying principle for the use of advance directives is a universal norm or a construct of western traditions that must be reconciled with alternative value systems that may place lesser significance on individual choice. A global policy, at a minimum, must emphasize respect for patient autonomy, provision of medical information, limits to the obligations for physicians, and portability. And though the development of a global policy will be no easy task, active engagement in close collaboration with the World Health Organization can make it possible.

The relationship between anatomic variations of paranasal sinuses and chronic sinusitis in children.

CONCLUSIONS: Anatomical variations in the nose and paranasal sinuses are common in children. Due to the absence of a definitive relationship between anatomical variations and sinus disease, local, systemic or environmental factors appear to be more significant in pediatric sinusitis than the anatomic variations. OBJECTIVE: Chronic sinusitis is increasing in the pediatric population. Following the initial reports of functional endoscopic sinus surgery (FESS) for children, the majority of patients undergoing this procedure have experienced improved quality of life. Thus, we need to know the precise anatomy and anatomical variations of the nose, as well as the relationship between such anatomy and chronic sinusitis. PATIENTS AND METHODS: To determine the extent and distribution of disease, as well as associated anatomic abnormalities, computed tomography (CT) scans were performed on 113 children with persistent symptoms of sinusitis after failure of medical therapies. RESULTS: The maxillary sinus was the most commonly involved sinus, followed by the ethmoid, sphenoid, and frontal sinuses. There was no relationship between age and severity of sinusitis. Agger nasi cell was the most common anatomical variation, followed by septal deviation, Haller cell, concha bullosa, paradoxical middle turbinate, and Onodi cell. The prevalence of septal deviation increased with age. There was no significant relationship between the sinusitis and anatomic variations.