Review of \u3cem\u3eWestern Welfare in Decline: Globalization and Women\u27s Poverty.\u3c/em\u3e Catherine Kingfisher. Reviewed by Silvia Borzutsky.

Book review of Catherine Kingfisher, Western Welfare in Decline: Globalization and Women\u27s Poverty. Philadelphia: University of Pennsylvania Press, 2003. $49.95 hardcover,$21.95 papercover

You Win Some, You Lose Some: Pension Reform in Bachelet's First and Second Administrations

This article analyses and compares President Bachelet’s successful efforts to reform the Chilean pension system in 2008 and her failure to achieve the same objective in 2017. The article addresses the impact of electoral promises, policy legacies, policy ideology, presidential power, the role of the private sector, and the role that the government coalitions had in the process of pension reform during the Bachelet administrations. We argue that the 2008 reform was possible because of Bachelet’s personal commitment to reform and the presence of a stable governing coalition that had the will and capacity to legislate. In the second administration, although the policy legacies and ideology had remained the same, the reform did not materialise due to intense conflict within the administration and within the government coalition, as well as conflict between the administration and the coalition. These conflicts, in turn, generated a vicious cycle responsible for Bachelet’s declining popularity, limited political capital, and reduced support for reform. A stagnant economy further undermined these efforts. In brief, this article argues that when assessing success and failure in pension policy reform it is important to analyse not only policy legacies and political ideology but also the strength of the executive, the cohesion of the governing coalition, and the country’s economic performance

Women under Attack: Violence and Poverty in Guatemala

In 2009 Guatemalan women experienced the highest level of violence in Latin America and one of the highest in the world, and death rates have continued to increase in 2010. At the core of the issue are two major problems: pervasive poverty and legal exclusion. In turn, these two issues are closely connected since legal/judicial exclusion is a consequence of poverty. This paper aims to analyze the question of violence against women in Guatemala, to discuss women’s limited political, legal and economic rights, as well as the policies pursued since the end of Guatemala’s civil war to deal with the violence. The fact that crimes against women have not declined, but in fact are on the rise points to the ineffective nature of the existing polices, and the need to make a larger investment in antipoverty and other socioeconomic policies geared to increase women’s economic self-sufficiency

Chile's private pension system at 35: impact and lessons

This paper provides an analysis of Chile's 35 year experience with defined contribution, fully funded pensions and argues that this pension approach should not be emulated by countries seeking to reduce the state role in the provision of pensions. The paper shows that 35 years of privatized pensions have led to a massive accumulation and concentration of capital and profits in the hands of the pension fund administrators and insufficient and unequal pensions for the retirees. This legacy of the Pinochet dictatorship has experienced marginal reforms after the transition to democracy. However, those reforms have not altered the system's structure and have augmented the fiscal role as the state attempts to repair some the most damaging outcomes of the private pension scheme

"The Revolution Will Be Feminist - Or It Won't Be a Revolution": Feminist Response to Inequality in Chile

This article argues that gender inequality, which in Chile is superimposed on a societal and economic structure characterized by deep inequalities that cut across every aspect of society, has been sustained by a political and legal system that has severely limited women's access to economic power and equality. The neoliberal policies implemented by the Pinochet dictatorship and maintained by the democratically elected regimes after 1990 - generally characterized as an elitist democracy - have sustained this pattern of inequality. We argue that this gender inequality gave urgency to the regeneration and evolution of Chile's feminist movement and drove the movement to develop claims against "the precarity of life," uniting Chileans in a common struggle, contributing to the October 2019 "social explosion" and now the writing of a new constitution. We believe the current climate is rooted in the social mobilization that was the response to Chile's economic and political system, and the feminist movement's ability to put the rights of women at the forefront of the political and socio‐economic agenda. In conclusion, we reevaluate the current climate to consider what a significant feminist presence means and how women can be effectively included and benefit from Chile's economy and influence its progress

Desarrollo e implementación de un programa de investigación durante el programa de especialidad médica

IntroducciónLa competencia CanMeds “Académico” (Scholar) incluye la capacidad del médico de contribuir a la creación, diseminación y aplicación del conocimiento. Surge entonces la necesidad de incluir en los programas de Especialización Médica una formación en investigación. El Programa de Especialización en Pediatría PUC fue el primero en nuestra Facultad en implementar un requisito de investigación dentro de los años de formación.ObjetivoDescribir el desarrollo de un programa formal de investigación de un programa de especialización médica. Metodología: A contar del año 2000 se inicia el Programa de Investigación para residentes de Pediatría PUC, quienes debían desarrollar, junto a un académico tutor, un proyecto durante los 3 años de residencia que condujera a un manuscrito publicable. A partir de 2004, comienza a ser requisito haber enviado dicho manuscrito a una revista con comité editorial, para poder rendir el examen final de la especialidad. Ese mismo año se instauran reuniones de presentación formal de proyectos, en que los residentes exponen sus proyectos en distintas etapas de avance y en su etapa final. En 2009 se implementan sesiones con cada residente de primer año para conocer su pregunta de investigación y asesorarlos de manera directa en etapa muy inicial del proyecto. El 2010 se instaura la “Jornada de la Pregunta”. En ella los residentes presentan en forma pública su pregunta de investigación y reciben retro-alimentación de la audiencia. Se analiza si la idea del proyecto es viable de conducirse y terminar en un producto publicable al término de su residencia. Hacia fines del primer año deben tener diseñado el proyecto y obtenido la aprobación del comité de ética, lo que es requisito para rendir el examen de primer año. Durante el segundo de año ejecutan la investigación emitiendo al final de este un informe de avance, requisito para rendir el examen de segundo año. A meses de terminar su formación, presentan sus resultados finales ante toda la División de Pediatría y preparan y envían el manuscrito. Se ha incorporado un módulo teórico de Metodología en Investigación Clínica para residentes de primer año y un mes electivo de investigación en tercer año; se diseñaron pautas de evaluación para cada jornada de presentación, y para el desempeño en cada año, un manual de investigación que contiene el cronograma de trabajo para los 3 años y un manual para tutores.ResultadosDesde sus inicios, 127 residentes han desarrollado un proyecto de investigación como requisito de egreso dentro de su programa de especialización en Pediatría. La gran mayoría de estos han terminado en publicación, varios en revistas extranjeras y algunos han sido premiados como mejores publicaciones del año en categoría Becados en la Revista Chilena de Pediatría

A novel PCFT gene mutation (p.Cys66LeufsX99) causing hereditary folate malabsorption

Hereditary folate malabsorption (HFM) is a rare autosomal recessive disorder which is characterized by impaired intestinal folate malabsorption and impaired folate transport into the central nervous system. Mutations in the intestinal folate transporter PCFT have been reported previously in only 10 individuals with this disorder. The purpose of the current study was to describe the clinical phenotype and determine the molecular basis for this disorder in a family with four affected individuals. A consanguineous family of Pakistani origin with autosomal recessive HFM was ascertained and clinically phenotyped. After genetic linkage studies all coding exons of the PCFT gene were screened for mutations by direct sequencing. The clinical phenotype of four affected patients is described. Direct sequencing of PCFT revealed a novel homozygous frameshift mutation (c.194dupG) at a mononucleotide repeat in exon 1 predicted to result in a truncated protein (p.Cys66LeufsX99). This report extends current knowledge on the phenotypic manifestations of HFM and the PCFT mutation spectrum

Leucine-rich repeat containing 8A (LRRC8A) is essential for T lymphocyte development and function

Lrrc8a is a ubiquitously expressed gene that encodes a leucine-rich repeat (LRR)–containing protein detected at higher levels on the surface of thymocytes than on other immune cells. We generated Lrrc8a−/− mice to investigate the role of LRRC8A in lymphocyte development and function. Lrrc8a−/− mice had increased prenatal and postnatal mortality, growth retardation, and multiple tissue abnormalities. Lrrc8a−/− mice displayed a modest block in B cell development but intact intrinsic B cell function. In contrast, both Lrrc8a−/− mice and Lrrc8a−/−→Rag2−/− bone marrow chimeras exhibited a severe cell-intrinsic block in early thymic development, with decreased proliferation and increased apoptosis of thymocytes, and impaired peripheral T cell function. Thymic epithelial cells expressed an LRRC8A ligand that was critical for double-negative to double-positive thymocyte differentiation and survival in vitro. LRRC8A constitutively associated with the GRB2–GAB2 complex and lymphocyte-specific protein tyrosine kinase (LCK) in thymocytes. LRRC8A ligation activated AKT via the LCK–ZAP–70–GAB2–PI3K pathway, and AKT phosphorylation was markedly reduced in the thymus of Lrrc8a−/− mice. These findings reveal an essential role for LRRC8A in T cell development, survival, and function

DOCK8 Functions as an Adaptor that Links TLR–MyD88 Signaling to B Cell Activation

DOCK8 and MyD88 have been implicated in serologic memory. Here we report antibody responses were impaired and $CD27^+$ memory B cells were severely reduced in DOCK8-deficient patients. Toll-like receptor 9 (TLR9)- but not CD40-driven B cell proliferation and immunoglobulin production were severely reduced in DOCK8-deficient B cells. In contrast, TLR9-driven expression of AICDA, CD23 and CD86, and activation of NF-κB, p38 and Rac1 were intact. DOCK8 associated constitutively with MyD88 and the tyrosine kinase Pyk2 in normal B cells. Following TLR9 ligation, DOCK8 became tyrosine phosphorylated by Pyk2, bound the Src family kinase Lyn and linked TLR9 to a Src-Syk-STAT3 cascade essential for TLR9-driven B cell proliferation and differentiation. Thus, DOCK8 functions as an adaptor in a TLR9-MyD88 signaling pathway in B cells

Clinical Presentation and Outcomes of Kawasaki Disease in Children from Latin America: A Multicenter Observational Study from the REKAMLATINA Network

Objetivos: Describir la presentación clínica, el manejo y los resultados de la enfermedad de Kawasaki (EK) en Latinoamérica y evaluar los indicadores pronósticos tempranos de aneurisma de la arteria coronaria (AAC). Diseño del estudio: Se realizó un estudio observacional basado en el registro de la EK en 64 centros pediátricos participantes de 19 países latinoamericanos de forma retrospectiva entre el 1 de enero de 2009 y el 31 de diciembre de 2013, y de forma prospectiva desde el 1 de junio de 2014 hasta el 31 de mayo de 2017. Se recopilaron datos demográficos, clínicos y de laboratorio iniciales. Se utilizó una regresión logística que incorporaba factores clínicos y la puntuación z máxima de la arteria coronaria en la presentación inicial (entre 10 días antes y 5 días después de la inmunoglobulina intravenosa [IGIV]) para desarrollar un modelo pronóstico de AAC durante el seguimiento (>5 días después de la IGIV). Resultados: De 1853 pacientes con EK, el ingreso tardío (>10 días tras el inicio de la fiebre) se produjo en el 16%, el 25% tuvo EK incompleta y el 11% fue resistente a la IGIV. Entre los 671 sujetos con puntuación z de la arteria coronaria notificada durante el seguimiento (mediana: 79 días; IQR: 36, 186), el 21% presentaba AAC, incluido un 4% con aneurismas gigantes. Un modelo pronóstico simple que utilizaba sólo una puntuación z de la arteria coronaria máxima ≥2,5 en la presentación inicial fue óptimo para predecir la AAC durante el seguimiento (área bajo la curva: 0,84; IC del 95%: 0,80, 0,88). Conclusiones: De nuestra población latinoamericana, la puntuación z de la arteria coronaria ≥2,5 en la presentación inicial fue el factor pronóstico más importante que precedió a la AAC durante el seguimiento. Estos resultados resaltan la importancia de la ecocardiografía temprana durante la presentación inicial de la EK. © 2023 Los autoresObjectives: To describe the clinical presentation, management, and outcomes of Kawasaki disease (KD) in Latin America and to evaluate early prognostic indicators of coronary artery aneurysm (CAA). Study design: An observational KD registry-based study was conducted in 64 participating pediatric centers across 19 Latin American countries retrospectively between January 1, 2009, and December 31, 2013, and prospectively from June 1, 2014, to May 31, 2017. Demographic and initial clinical and laboratory data were collected. Logistic regression incorporating clinical factors and maximum coronary artery z-score at initial presentation (between 10 days before and 5 days after intravenous immunoglobulin [IVIG]) was used to develop a prognostic model for CAA during follow-up (>5 days after IVIG). Results: Of 1853 patients with KD, delayed admission (>10 days after fever onset) occurred in 16%, 25% had incomplete KD, and 11% were resistant to IVIG. Among 671 subjects with reported coronary artery z-score during follow-up (median: 79 days; IQR: 36, 186), 21% had CAA, including 4% with giant aneurysms. A simple prognostic model utilizing only a maximum coronary artery z-score ≥2.5 at initial presentation was optimal to predict CAA during follow-up (area under the curve: 0.84; 95% CI: 0.80, 0.88). Conclusion: From our Latin American population, coronary artery z-score ≥2.5 at initial presentation was the most important prognostic factor preceding CAA during follow-up. These results highlight the importance of early echocardiography during the initial presentation of KD. © 2023 The Author(s