European Nuclear Disarmament: a study of transnational social movement strategy

This thesis is a study of an attempt to help create a transnational movement against the nuclear arms race and the Cold War in the 1980s. The attempt began with the drafting and launch of the Appeal for European Nuclear Disarmament in early 1980. The thesis describes and analyses the work of the British group, European Nuclear Disarmament, or END, which was founded in order to further the aims outlined in the Appeal. The thesis examines END's work in three, overlapping, geographical areas: Britain, where END acted mainly as a pressure group on and/or ginger group within CND in an attempt to internationalize - END-ize - its work; in Western Europe (including Britain), where END (with other Western peace groups) was trying to create and sustain enduring ties amongst Western peace groups; and across the East-West divide, where END was one of a number of groups that engaged in dialogue with independent forces in the Soviet bloc - while maintaining relations with the regimes - with the aim of creating some kind of pan-European alliance that would bring together above all these forces and Western peace groups. The study is conducted in terms of an explanatory framework that emphasizes the pre-existing networks out of which END emerged; the distinctive END worldview or 'frame' and the ways in which END supporters campaigned in its terms, tried to persuade others to adopt it, and/or adapted it - above all in dialogue with independent groups in the Soviet bloc; the resources and structure that helped determine the work END activists could do; the way in which this campaigning was shaped by END's relationship with other peace groups, in Britain above all CND; and the political opportunities and constraints that END activists faced. To date there has been no full-length study of END nor one that analyses the various dimensions of its campaign and how they shaped each other. This thesis thus aims to be a contribution to our knowledge of the West European peace movements of the 1980s; it also hopes to add to our understanding of transnational social-movement campaigning

Multidisciplinary vocational rehabilitation for patients with chronic arthritis

Working gainfully is a major activity of adult life, providing income, structure, social interaction and an opportunity to learn and practice skills, and a source of self-esteem. In people with chronic arthritis work disability is common, having a major impact upon individuals as well as society. In the Netherlands, rheumatic diseases account for about 15% of the costs due to work disability payments. Given this significance, work retention issues have been identified as one of the aims of the management of chronic arthritis. Apart from the optimization of medical treatment, in many countries structured vocational rehabilitation programs are being offered to patients with chronic arthritis, with the aim of preventing the loss of paid employment or enhancing return to work. The aim of the present thesis was to describe the evidence regarding the effectiveness of vocational rehabilitation programs in patients with chronic arthritis. Moreover, this thesis includes an evaluation of a multidisciplinary job retention vocational rehabilitation program aimed at the prevention of work disability in patients with chronic arthritis who were at risk for job loss. In addition, the co-operation between rheumatologists and occupational physicians in the process of vocational rehabilitation was evaluated.Leids Universitair Medisch CentrumKlinische evaluatie en behandeling van reumatische ziekte

When IL-17 inhibitors fail : real-life evidence to switch from secukinumab to adalimumab or ustekinumab

Psoriasis is a chronic, systemic inflammatory disease that in the moderate to severe forms may benefit of biologics, namely TNF and IL-12/23 and IL-17 inhibitors. Loss of response, lack of response or discontinuation due to adverse events represent a concrete therapeutic challenge for dermatologists that have to switch patients to other treatments. Although some evidences already exist toward the switch from IL-12/23 and TNF inhibitors to IL-17 inhibitors, conversely nothing is present toward the switch from IL-17 inhibitors to IL-12/23 and TNF inhibitors. We performed a real-life study enrolling 50 patients randomly switched to adalimuamb, a TNF inhibitor, or ustekinumab, an IL-12/23 inhibitor. Our observational study suggests that switching from IL-17i to TNFi and IL-12/23i is a safe and effective therapeutic strategy

Majority of Fortune 500 Companies in 2018 Did Not Recognize Risk of Epidemics Such as COVID-19

Infectious disease threats, like the 2002 severe acute respiratory syndrome coronavirus (SARS-CoV) disease, 2009 pandemic influenza A (H1N1), and the current coronavirus disease 2019 (COVID-19), pose multisectoral risk with the potential for wide-ranging socioeconomic disruption. In our globally intertwined economy, the impact of such events can elicit economic shock waves that reach far beyond the country of origin. Review of the 2018 Fortune 500 company 10-K filings shows the majority did not document perceived risks associated with epidemics, outbreaks, or pandemics. Enhanced engagement and investment of the public and private sectors in advancing global health security is needed to effectively prevent, detect, and respond to infectious disease events and ensure U.S. economic security

External validation of a referral rule for axial spondyloarthritis in primary care patients with chronic low back pain

Objectives To validate and optimize a referral rule to identify primary care patients with chronic low back pain (CLBP) suspected for axial spondyloarthritis (axSpA). Design Cross-sectional study with data from 19 Dutch primary care practices for development and 38 for validation. Participants Primary care patients aged 18-45 years with CLBP existing more than three months and onset of back pain started before the age of 45 years. Main Outcome The number of axSpA patients according to the ASAS criteria. Methods The referral rule (CaFaSpA referral rule) was developed using 364 CL