The Shadow of a Doubt: a play in three acts by Edith Wharton

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The Shadow of a Doubt: discovering a new work by Edith Wharton

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Are Barriers to Sustainable Development Endogenous to Drug Control Policies?

This introductory article explains the rationale behind the 12th Thematic Issue of International Development Policy, which explores the tension between devel­opment and drug control goals, both current and historic. The volume of fifteen articles draws on a broad spectrum of thematic issues to address the following key questions: Are prohibition and development mutually exclusive or complementa­ry international agendas? How do the harms associated with drug policy enforce­ment undermine development prospects? The diverse group of authors highlight the corrosive effects of criminalisation and prohibition - based approaches on the livelihoods and fundamental rights of those who are vulnerable, including women, children, people who count on drug cultivation and trafficking to make a living, and people who use drugs. They also address the limitations and feasibility of development - focused interventions in drug control strategies within the context of the prohibition paradigm.Cet article d’introduction présente la logique du douzième numéro thématique de la Revue Internationale de Politique de Développement. Celui-ci explore les tensions entre les objectifs de développement et ceux du contrôle des drogues, aujourd’hui et dans une perspective historique. Le numéro rassemble quinze contributions traitant d’un large éventail de thèmes visant à répondre aux questions suivantes : la prohibition des drogues et le développement représentent-ils des programmes internationaux mutuellement exclusifs ou complémentaires ? Comment les problèmes associés à l’application de la politique anti-drogue sapent-ils les perspectives de développement ? Les auteurs de ce numéro présentent les effets destructeurs de la pénalisation et de la prohibition, à partir de recherches portant sur les moyens de subsistance et sur les droits fondamentaux des populations les plus vulnérables, dont les femmes, les enfants, les individus économiquement dépendants de la culture ou du trafic de drogues, et les consommateurs. Ils interrogent également les limites et la faisabilité des interventions axées sur le développement dans les stratégies de contrôle des drogues, et ce dans le contexte du paradigme de la prohibition.Este artículo introductorio explica los motivos que justifican el 12o número temático de International Development Policy, en el cual se indaga la tensión actual e histórica entre los objetivos de desarrollo y de fiscalización de drogas. Este número compuesto por quince artículos se apoya en un amplia gama de temas para abordar las siguientes preguntas centrales: ¿La prohibición y el desarrollo son prioridades internacionales incompatibles o complementarias? ¿De qué manera los perjuicios vinculados a la aplicación de políticas sobre drogas socavan las posibilidades de desarrollo? Un grupo heterogéneo de autores destaca los efectos dañinos de las estrategias centradas en la penalización y la prohibición para las fuentes de ingreso y los derechos fundamentales de las personas vulnerables, como las mujeres, los menores, las personas que viven del cultivo y el tráfico de drogas, y aquellas que las consumen. También tratan la cuestión de los límites y la viabilidad de las estrategias de fiscalización de drogas centradas en el desarrollo en el contexto de un paradigma de prohibición

Drug Policies and Development

The 12th volume of International Development Policy explores the relationship between international drug policy and development goals, both current and within a historical perspective. Contributions address the drugs and development nexus from a range of critical viewpoints, highlighting gaps and contradictions, as well as exploring strategies and opportunities for enhanced linkages between drug control and development programming. Criminalisation and coercive law enforcement-based responses in international and national level drug control are shown to undermine peace, security and development objectives. Edited by Julia Buxton, Mary Chinery-Hesse and Khalid Tinasti. Paperback reference: Julia Buxton, Mary Chinery-Hesse and Khalid Tinasti (eds.) (2020) Drug Policies and Development, Conflict and Coexistence, International Development Policy series No.12 (Geneva, Boston: Graduate Institute Publications, Brill-Nijhoff). Order your copy on Brill-Nijhoff’s website. Videos and events. Les politiques anti-drogues et le développement. Entre conflit et coexistence. Ce douzième numéro thématique de la Revue internationale de politique de développement s'intéresse aux relations entre la politique internationale de lutte contre les drogues et les objectifs de développement aujourd'hui et dans une perspective historique. Cet ensemble de 15 articles rassemble diverses perspectives critiques qui mettent en avant les lacunes et les contradictions ainsi que les stratégies et les opportunités pour améliorer les relations entre le contrôle des drogues et les programmes de développement. Les auteurs analysent pourquoi la pénalisation et les réponses coercitives de lutte contre la drogue aux niveaux international et national sapent les objectifs de paix, de sécurité et de développement. Edité par Julia Buxton, Mary Chinery-Hesse et Khalid Tinasti. Référence papier (en anglais): Julia Buxton, Mary Chinery-Hesse and Khalid Tinasti (eds.) (2020) Drug Policies and Development, Conflict and Coexistence, International Development Policy series No.12 (Geneva, Boston: Graduate Institute Publications, Brill-Nijhoff). Commandez votre livre sur le site de Brill-Nijhoff. Vidéos et conférences en ligne. Políticas de drogas y desarrollo. Entre conflictos y coexistencia El número temático 12 de International Development Policy explora la relación entre las políticas internacionales en materia de drogas y los objetivos de desarrollo, tanto en la actualidad como según una perspectiva histórica. En sus artículos se analiza el nexo existente entre las drogas y el desarrollo desde una variedad de puntos de vista críticos, destacando las lagunas y contradicciones, así como indagando en las estrategias y posibilidades para reforzar los vínculos entre la fiscalización de drogas y los programas de desarrollo. Se muestra, asimismo, cómo la penalización y las medidas coercitivas nacionales e internacionales de fiscalización de drogas basadas en actividades de detección y represión debilitan la paz, la seguridad y los objetivos de desarrollo. Editado por Julia Buxton, Mary Chinery-Hesse y Khalid Tinasti. Referencia de la versión impresa (en inglés): Julia Buxton, Mary Chinery-Hesse and Khalid Tinasti (eds.) (2020) Drug Policies and Development, Conflict and Coexistence, International Development Policy series No.12 (Geneva, Boston: Graduate Institute Publications, Brill-Nijhoff). Pida su ejemplar en el sitio web de Brill-Nijhoff

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications