11 research outputs found

    Money, Love, and Fragile Reciprocity in Contemporary Havana, Cuba

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    Among low-income Havana residents, men frequently give money and other forms of material support to women in whom they have a romantic interest. For women, men's material contributions are expressions of responsibility and care. While men share this view to a degree, they sometimes have more ambiguous emotions regarding such practices. These tensions in different views of gendered reciprocity are influenced by large-scale changes that have taken place in Cuban society since the 1990s. Although, traditionally, state socialism has embraced ideas of gender egalitarianism and women's independent income, the post-Soviet period has seen the emergence of new inequalities, dependencies, and marginalizations that threaten earlier, socialist understandings of intimacy. The importance that women currently place on material wealth in terms of their views of a desirable partner highlights the gendered consequences of Cuba's contemporary economic transformations and their complex interplay with individuals' aspirations for love.Peer reviewe

    Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

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    PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

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    PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Facilitation in an intractable peace process: Understanding Norwegian commitment to the GRP - CPP/NPA/NDFP peace negotiations

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    The Royal Norwegian Government has been facilitating the ongoing peace process between the GRP and the CPP/NPA/NDFP since 2001. This thesis aims to contribute to the literature by scrutinizing Norway\u27s facilitation of the peace process using the theory of mediation as political problem solving. Assumptions on what makes a particular mediator acceptable and what preconditions are crucial for mediation success, are considered. To assess the impact of Norway\u27s facilitation strategy, the two most common categories of mediation success were utilized: mediation as settlement and resolution. In this thesis, settlement refers not only to efforts to reduce or eliminate the destructive sort of conflict generating behavior, but also the attempts to deal with non-substantive agenda issues that are also symptoms of the conflict. On the other hand, resolution refers to efforts to address the root causes of the conflict, or more specifically, the four substantive agenda issues (human rights and international humanitarian law, socioeconomic reforms, political and constitutional reforms, and end of hostilities and disposition of forces) recommended by the 1992 Hague Joint Declaration. Norway\u27s success in facilitating the peace process was analyzed through the contingency between contextual variables (characteristics of the dispute, parties and their interrelationship, characteristics of the mediator, and the international context) and the process variable, or the mediators activities. A typology of stylistic dimensions is used to specify the nuances of Norwegian facilitation. This thesis finds that Norway\u27s facilitation strategy has been ineffective, both as a method of settlement and resolution. Nonetheless, the facilitated peace process was able to make significant strides as a result of the agreement to accelerate negotiations of the substantive agenda. Through an analysis of the dynamics of contextual and process variables, findings indicate that Norway\u27s inadequacy to make significant impact is not a function of its limited operational mandate. Rather, it is the context of the facilitation effort that inhibits the likelihood of success in the peace talks. The most significant contextual factors for both categories of mediation impact include: (1) the inability to sustain conflict ripeness when both parties exhibit conciliatory behavior at the beginning of each new GRP administration (2) the disconnect between the peace objectives during formal talks and the continued violence on the ground and (3) perceptions of the insurgency and minimal public interest in the peace process

    The making of race in colonial Malaya: Political economy and racial ideology

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    Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

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    BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. METHODS: This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. RESULTS: Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. CONCLUSION: Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas

    Elective Cancer Surgery in COVID-19–Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study

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