Under pressure. Economic constraints, electoral politics and labour market reforms in Southern Europe in the decade of the Great Recession

Even when subject to comparable exogenous constraints during the Eurozone crisis and in its immediate aftermath, governments in Southern Europe have pursued distinct labour market reform agendas. What room for manoeuvre did governments of crisis-struck peripheral countries really have in shaping their labour market reform strategies, and how can we account for the observed variation? We address these questions by making a twofold contribution to the debate on the political economy of austerity in the Eurozone periphery. First, through the first systematic analysis of all labour market and collective bargaining (CB) reforms implemented in Portugal, Spain, Italy and Greece over 2009–2019, we identify those elements of core labour market deregulation common across Southern European countries (namely, the loosening of employment protection for workers on open-ended contracts and the decentralisation of CB to the firm level); and those elements of variation, both cross-country and cross-party, in the content of corollary labour market interventions that accompanied this core deregulation. Second, we explain these similarities and variations in reform outcomes as the product of the interaction of two factors: economic constraints and electoral dynamics. We argue that the implementation of the common core of deregulation is linked to the exogenous pressure to improve export competitiveness to which Southern European countries have been subjected since the crisis. Through the combination of survey data analysis and qualitative evidence, we then show empirically how the variation in the corollary measures accompanying deregulation is linked to the class composition of the electoral social blocs Southern European partisan governments rely on or aim to assemble. Based on this analysis, we identify four ideal-typical labour market reformist strategies attempted by Southern European governments during the decade of the Great Recession. The analysis highlights that although domestic politics plays a crucial role in shaping structural adjustment under crisis conditions, not all reform strategies are equally viable within the framework of Economic and Monetary Union

Business Against Markets: Employer Resistance to Collective Bargaining Liberalization During the Eurozone Crisis

Employer organizations have been presented as strong promoters of the liberalization of industrial relations in Europe. This article, in contrast, argues that the preferences of employers vis-à-vis liberalization are heterogeneous and documents how employer organizations in Spain, Italy, and Portugal have resisted state-led reforms to liberalize collective bargaining during the Euro crisis. It shows that the dominance of small firms in the economies of these countries make employer organizations supportive of selective aspects of sectoral bargaining and state regulation. Encompassing sectoral bargaining is important for small firms for three reasons: it limits industrial conflict, reduces transaction costs related to wage-bargaining, and ensures that member firms are not undercut by rivals offering lower wages and employment conditions. Furthermore, the maintenance of sectoral bargaining and its extension to whole sectors by the state is a matter of survival for employer organizations. The article presents rationales for employer opposition to liberalization that differ from the varieties of capitalism approach.Introduction Collective Bargaining and Employer Preferences in Southern Europe Cases and Methods Italy Spain Portugal Conclusions Acknowledgements Notes Reference

Electoral Coalitions and Policy Reversals in Portugal and Italy in the Aftermath of the Eurozone Crisis

This paper links patterns of deregulatory reforms and post-crisis reversals in Italy and Portugal with the electoral constituencies of political parties. Combining insights from the social coalitions and electoral behaviour debates, we link reform outcomes to the class set-up of the electorate in the two countries by using the class schema developed by Daniel Oesch. We find that governments in both countries reversed austerity measures in order to protect core groups of voters within their electorate in spite of wide ideological differences between governing coalitions in the two countries. There is, however, some variation in the extent of the reversals across policy areas.The politics and administration of institutional chang

BAT2 and BAT3 polymorphisms as novel genetic risk factors for rejection after HLA-related SCT.

The genetic background of donor and recipient is an important factor determining the outcome of allogeneic hematopoietic SCT (allo-HSCT). We applied whole-genome analysis to investigate genetic variants - other than HLA class I and II - associated with negative outcome after HLA-identical sibling allo-HSCT in a cohort of 110 β-Thalassemic patients. We identified two single-nucleotide polymorphisms (SNPs) in BAT2 (A/G) and BAT3 (T/C) genes, SNP rs11538264 and SNP rs10484558, both located in the HLA class III region, in strong linkage disequilibrium between each other (R2 =0.92). When considered as single SNP, none of them reached a significant association with graft rejection (nominal P<0.00001 for BAT2 SNP rs11538264, and P<0.0001 for BAT3 SNP rs10484558), whereas the BAT2/BAT3 A/C haplotype was present at significantly higher frequency in patients who rejected as compared to those with functional graft (30.0% vs 2.6%, nominal P=1.15 × 10-8; and adjusted P=0.0071). The BAT2/BAT3 polymorphisms and specifically the A/C haplotype may represent a novel immunogenetic factor associated with graft rejection in patients undergoing allo-HSCT

The experience of dysgeusia in allogenic hematopoietic cell transplantation survivors: A qualitative study

Background: Taste disorders are one of the most common side effects of treatment in oncology patients and often occur after allogeneic hematopoietic cell transplantation (allo-HCT). Dysgeusia is rarely a life-threatening complication, therefore, in many cases it does not receive close medical attention. Furthermore, information about this disorder is largely based on the clinician’s own experience. However, taste disorders, can impact on the quality of life in survivors of allo-HCT, and compromise their enjoyment of eating, food intake, weight and nutritional status. The number of performed annual transplantations continues to grow annually and the number of older long-term survivors increases. There is little literature that is focused on studies of survivors of allo-HCT with taste disorders. We conducted a qualitative descriptive study to explore experiences of dysgeusia in patients that have undergone of allo-HCT and examined what strategies they used to mitigate it. Methods: Using purposive sampling, survivors of allo-HCT were recruited. Audiotape interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and content analyses were performed to extract significant themes and subthemes. Results: Three major themes embracing various aspects of allo-HCT survivors’ experiences were identified: 1) the shape of taste; 2) everything is irritating and it is arduous to eat; 3) finding new strategies to overcome the problems. Together, they highlight the experiences of survivors showing how taste disorders can affect the physical, psychological and social dimensions of a person for the rest of their life. Conclusions: A cumulative burden is the result of dysgeusia and its clinical course reinforced also by related symptoms. Healthcare professionals must focus their attention on the management of these symptoms and offer interventions to safeguard the patient’s social, physical and psychological well-being. Finally, further research is needed to explore the experiences of allo-HTC patients who have taste disorders throughout their cancer journey that introduces a more holistic approach which involves health professionals, caregivers and family members

Laryngectomized patients caregivers' life experience: A phenomenological study

Background: Laryngectomized patients often depend on their caregivers who have a central and difficult role in supporting them dealing with financial, social, and relational issues. In fact, they feel very responsible and committed, especially considering the time devoted to take care of their beloved. Besides, providing care induces caregivers high stress levels, emotional distress, anxiety and the fear of cancer recurrence or progress. Few studies investigated laryngectomized patients caregivers\u2019 life experience during both the whole course of illness and at the end of the treatment. Therefore, the purpose of our study was to explore, through a phenomenological approach, the lived-experience of primary family caregivers of laryngectomized patients undergoing radical surgery. Methods: Qualitative semi-structured and audiotaped interviews were held with 12 laryngectomized patients\u2019 primary family caregivers. Data were analysed using the descriptive phenomenological approach outlined by Colaizzi. Results: Three key themes emerged: the caregivers lived experience of illness; the change of caregivers\u2019 daily life and how they support their sick beloved. The experience of caregivers\u2019 lived relations changes from being a family member to a supportive carer, and the illness of their beloved negatively affects their psychological lived experience. Their perception of time and Quality of Life change as their perception of the future becomes uncertain. Finally, they feel guilty mainly because of the limited amount of time they can devote to their beloved. Conclusions: The study findings allowed to understand in depth how the presence of a laryngectomized person in the family may affect the life of the caregiver, even after the treatment phase. This suggests the need for healthcare professionals to support caregivers throughout the whole care journey and especially in dealing with the perception of time during the diagnosis and care phases. Further research should be conducted on factors contributing to time perception alteration and possible interventions to support caregivers to cope with it

Association of non-alcoholic fatty liver disease with left ventricular changes in treatment-naive patients with uncomplicated hypertension

Background and aims: Cardiac structural and functional changes have been demonstrated in patients with non-alcoholic fatty liver disease (NAFLD). Because of the frequent association of NAFLD with hypertension, we aimed to examine the relationship of liver steatosis with left ventricular (LV) changes in patients with hypertension. Materials and methods: In a cross-sectional study, we included 360 untreated, essential hypertensive patients who were free of major cardiovascular and renal complications. Liver steatosis was assessed by three different biochemical scores (NAFLD Liver Fat Score, LFS; Fatty Liver Index, FLI; Hepatic Steatosis Index, HSI). Echocardiography was performed with standard B-mode and tissue-Doppler imaging. Results: LV hypertrophy was present in 19.4% and LV diastolic dysfunction in 49.2% of patients who had significantly higher body mass index (BMI), blood pressure (BP), and homeostatic model assessment (HOMA) index and higher frequency of the metabolic syndrome and liver steatosis that was defined by presence of 2 or more positive scores. LV mass index increased progressively across patients who had none, 1, or 2 or more liver steatosis scores, with associated progressive worsening of LV diastolic function. LV mass index was significantly and positively correlated with age, BMI, BP, HOMA-index, LFS, and HSI. Logistic regression analysis showed that age, BP, and liver steatosis scores independently predicted LV hypertrophy and diastolic dysfunction. Liver steatosis independently predicted LV dysfunction but not LV hypertrophy even after inclusion in analysis of the HOMA-index. Conclusion: NAFLD is associated with LV hypertrophy and diastolic dysfunction in untreated patients with hypertension. In hypertension, NAFLD could contribute to LV diastolic dysfunction with mechanisms unrelated to insulin resistance

Association of arterial stiffness with a prothrombotic state in uncomplicated nondiabetic hypertensive patients

Background and aims: Past studies reported a significant contribution of a prothrombotic state to the development and progression of target organ damage in hypertensive patients. Stiffening of arterial vessels is associated with aging and hypertension, and additional factors could contribute to this process. This study was designed to examine the relationships between arterial stiffening and the hemostatic and fibrinolytic system. Methods: In 128 middle-aged, nondiabetic, essential hypertensive patients without major cardiovascular and renal complications, we measured coagulation markers that express the spontaneous activation of the hemostatic and fibrinolytic system and assessed stiffness of the arterial tree by measurement of the carotid/femoral pulse wave velocity (cfPWV) and pulse wave analysis with calculation of the brachial augmentation index (AIx). Results: Levels of fibrinogen (FBG), D-dimer (D-d), and plasminogen activator-inhibitor 1 (PAI-1) were significantly higher in patients with PWV and AIx above the median of the distribution. FBG, D-d, and PAI-1 were significantly and directly related with both cfPWV and AIx, and multivariate regression analysis indicated that the relationships of D-d and PAI-1 with both cfPWV and AIx and of FBG with AIx, were independent of age, body mass index, severity and duration of hypertension, use of antihypertensive drugs, blood glucose, and plasma lipids. Conclusion: In middle-aged, uncomplicated, nondiabetic patients with essential hypertension, spontaneous activation of plasma hemostatic cascade and impaired fibrinolysis is significantly and independently associated with stiffening of the arterial tree

Insulin Resistance and High Blood Pressure: Mechanistic Insight on the Role of the Kidney

The metabolic effects of insulin predominate in skeletal muscle, fat, and liver where the hormone binds to its receptor, thereby priming a series of cell-specific and biochemically diverse intracellular mechanisms. In the presence of a good secretory reserve in the pancreatic islets, a decrease in insulin sensitivity in the metabolic target tissues leads to compensatory hyperinsulinemia. A large body of evidence obtained in clinical and experimental studies indicates that insulin resistance and the related hyperinsulinemia are causally involved in some forms of arterial hypertension. Much of this involvement can be ascribed to the impact of insulin on renal sodium transport, although additional mechanisms might be involved. Solid evidence indicates that insulin causes sodium and water retention, and both endogenous and exogenous hyperinsulinemia have been correlated to increased blood pressure. Although important information was gathered on the cellular mechanisms that are triggered by insulin in metabolic tissues and on their abnormalities, knowledge of the insulin-related mechanisms possibly involved in blood pressure regulation is limited. In this review, we summarize the current understanding of the cellular mechanisms that are involved in the pro-hypertensive actions of insulin, focusing on the contribution of insulin to the renal regulation of sodium balance and body fluids

Alcohol Intake and Arterial Hypertension: Retelling of a Multifaceted Story

Alcoholic beverages are common components of diets worldwide and understanding their effects on humans’ health is crucial. Because hypertension is the leading risk factor for cardiovascular diseases and all-cause mortality, the relationship of alcohol consumption with blood pressure (BP) has been the subject of extensive investigation. For the purpose of this review, we searched the terms “alcohol”, “ethanol”, and “arterial hypertension” on Pubmed MeSH and selected the most relevant studies. Short-term studies showed a biphasic BP response after ingestion of high doses of alcohol, and sustained alcohol consumption above 30 g/day, significantly, and dose-dependently, increased the risk for hypertension. These untoward effects of alcoholic beverages on BP can be mediated by a multiplicity of neurohormonal mechanisms. In addition to the effects on BP, excess alcohol intake might contribute to cardiac and renal hypertensive organ damage, although some studies suggest possible benefits of moderate alcohol consumption on additional cardiovascular risk factors, such as diabetes and lipoprotein(a). Some intervention studies and cumulative analyses support the evidence of a benefit of the reduction/withdrawal of alcohol consumption on BP and cardiovascular outcomes. This is why guidelines of scientific societies recommend avoidance or limitation of alcohol intake below one unit/day for women and two units/day for men. This narrative article overviews all these topics, providing an update of the current knowledge on the relationship between alcohol and BP