Does Political Incorporation Matter? The Impact of Minority Mayors Over Time

The authors assess the effects of minority political incorporation in large cities. An interrupted time-series research design is used to determine whether the election of a city’s first minority mayor has any short-term or long-term impact on fiscal policies. The authors examined six cities that elected black or Latino mayors and six cities with white mayors from 1972 to 1992. In general, they find that minority political incorporation did not significantly change fiscal policies in different ways from that which occurred in cities without minority incorporation

Local Government Fiscal Burden in Nonmetropolitan America

Rising fiscal pressure on local governments in rural areas of the United States is documented in this study. The level of fiscal burden on taxpayers to support local governments in nonmetropolitan areas is found to be higher than that in metropolitan areas between 1977 and 1987. Using a model from the urban fiscal literature, the level of fiscal burden in nonmetropolitan areas is found to be influenced by a combination of demographic, socioeconomic, intergovernmental, and historical factors. Intergovernmental revenue transfers from the state and federal government play a critical role in determining the level of fiscal burden rural taxpayers bear. These findings have implications for rural economic development and for understanding how rural areas are influenced by the larger society

The Big Sky Model: A Regional Collaboration for Participatory Research on Environmental Health in the Rural West

As an innovative community-based framework for science learning, the Big Sky Model is guiding high school and tribal college students from rural areas of Montana and Idaho in their understanding of chemical, physical, and environmental health concepts in the context of their own homes, schools, and communities. Students participate in classroom lessons and continue with systematic inquiry through actual field research to investigate a pressing, real-world issue: understanding the complex links between poor air quality and respiratory health outcomes. This article provides background information, outlines the procedure for implementing the model, and discusses its effectiveness as demonstrated through various evaluation tools

Data Linkage: A powerful research tool with potential problems

Background: Policy makers, clinicians and researchers are demonstrating increasing interest in using data linked from multiple sources to support measurement of clinical performance and patient health outcomes. However, the utility of data linkage may be compromised by sub-optimal or incomplete linkage, leading to systematic bias. In this study, we synthesize the evidence identifying participant or population characteristics that can influence the validity and completeness of data linkage and may be associated with systematic bias in reported outcomes

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Surgical workload of a foreign medical team after Typhoon Haiyan.

On 8 November 2013, Typhoon Haiyan struck the Philippines causing widespread loss of lives and infrastructures. At the request of the Government of the Philippines, the Australian Government deployed a surgical field hospital to the city of Tacloban for 4 weeks. This paper describes the establishment of the hospital, the surgical workload and handover to the local health system upon the end of deployment. A Microsoft excel database was utilized throughout the deployment, recording demographics, relationship to the typhoon and surgical procedure performed. Over the 21 days of surgical activity, the Australian field hospital performed 222 operations upon 131 persons. A mean of 10.8 procedures were performed per day (range 3-20). The majority (70.2%) of procedures were soft tissue surgery. Diabetes was present in 22.9% and 67.9% were typhoon-related. The Australian Medical Assistance Team field hospital adhered to the World Health Organization guidelines for foreign medical teams, in ensuring informed consent, appropriate anaesthesia and surgery, and worked collaboratively with local surgeons, ensuring adequate documentation and clinical handover. This paper describes the experience of a trained, equipped and collaborative surgical foreign medical team in Tacloban in the aftermath of Typhoon Haiyan. Sepsis from foot injuries in diabetic patients constituted an unexpected majority of the workload. New presentations of typhoon-related injuries were presented throughout the deployment

Local Government Fiscal Burden in Nonmetropolitan America

Rising fiscal pressure on local governments in rural areas of the United States is documented in this study. The level of fiscal burden on taxpayers to support local governments in nonmetropolitan areas is found to be higher than that in metropolitan areas between 1977 and 1987. Using a model from the urban fiscal literature, the level of fiscal burden in nonmetropolitan areas is found to be influenced by a combination of demographic, socioeconomic, intergovernmental, and historical factors. Intergovernmental revenue transfers from the state and federal government play a critical role in determining the level of fiscal burden rural taxpayers bear. These findings have implications for rural economic development and for understanding how rural areas are influenced by the larger society