Power balances, transnational elites, and local economic governance: The political economy of development in Medellín

Applying a non-linear political economy analysis of power balances, institutional mechanisms, and elite structures, this study sheds light on the characteristics of Medellín’s economic development since the early 2000s. Elites with minimal technological capabilities and interests in promoting the advancement of transnational capitalism have successfully secured access to sources of power. These conditions (re)produce neoliberal logics of local governance that focus on economic growth in sectors with perceived global comparative advantages and on sustaining the particular power balances in Medellín’s political settlement. This has led to failures of generating positive forward and backward linkages for productivity growth of local firms, a local labour market marked by low wages and high employment elasticities, and large income inequalities. The local governance model that perpetuates productivity and inequality problems of the city is adopted as an opportunistic discourse of Medellín’s transnationalised capitalist elite in the larger neoliberal context of Colombia’s polity and economic policy agenda. In the absence of structural reforms targeting low wages and incentivising firms to develop technological capabilities, Medellín’s low productivity and high inequality problems are likely to persist

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining https://researchonline.ljmu.ac.uk/images/research_banner_face_lab_290.jpgunderweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity

Urban violence and public health in Latin America: a sociological explanatory framework Violencia urbana y salud pública en Latinoamérica: un marco sociológico explicativo

Interpersonal violence has become one of the main public health issues in Latin American cities. This article presents a framework for sociological interpretation that operates on three levels, expressed in the factors that originate, foment, or facilitate violence. Macro-social factors include: social inequality due to the increase in wealth versus poverty; the paradox of more schooling with fewer employment opportunities; increasing expectations and the impossibility of meeting them; changes in family structure; and loss of importance of religion in daily life. At the meso-social level the analysis highlights: increased density in poor areas and urban segregation; masculinity cult; and changes in the local drug market. The micro-social level includes: an increase in the number of firearms; alcohol consumption; and difficulties in verbal expression of feelings. The article concludes with an analysis of how violence is leading to the breakdown not only of urban life but also of citizenship as a whole in Latin America.<br>La violencia interpersonal se ha convertido en uno de los principales problemas de salud pública de las ciudades de América Latina. El artículo presenta una interpretación sociológica de la violencia en tres niveles: (a) macro-sociales &shy; la desigualdad social debida al incremento de la riqueza y la pobreza; la paradoja del mayor nivel educativo de las personas, pero las menores oportunidades de empleo, el incremento de las expectativas y de la imposibilidad de satisfacerlas; los cambios en la familia y la pérdida de importancia de la religión en la vida cotidiana de las personas; (b) meso-sociales &shy; el incremento de la densidad en las zonas pobres y la segregación urbana, la cultura de la masculinidad y los cambios en el mercado local de la droga; (c) micro-sociales &shy; el incremento de las armas de fuego, el consumo de alcohol y las dificultades de expresión verbal de los sentimientos por las personas. El artículo concluye con un análisis sobre cómo la violencia está llevando no sólo a la pérdida de las ciudades, sino a la ciudadanía en América Latina