Associations, active citizenship, and the quality of democracy in Brazil and Mexico

In many Third Wave democracies large classes of people experience diminished forms of citizenship. The systematic exclusion from mandated public goods and services significantly injures the citizenship and life chances of entire social groups. In democratic theory civil associations have a fundamental role to play in reversing this reality. One strand of theory, known as civic engagement, suggests that associations empower their members to engage in public politics, hold state officials to account, claim public services, and thereby improve the quality of democracy. Empirical demonstration of the argument is surprisingly rare, however, and limited to affluent democracies. In this article, we use original survey data for two large cities in Third Wave democracies-So Paulo and Mexico City-to explore this argument in a novel way. We focus on the extent to which participation in associations (or associationalism) increases "active citizenship"aEuro"the effort to negotiate directly with state agents access to goods and services legally mandated for public provision, such as healthcare, sanitation, and security-rather than civic engagement, which encompasses any voluntary and public spirited activity. We examine separately associationalism's impact on the quality of citizenship, a dimension that varies independently from the level of active citizenship, by assessing differences in the types of citizenship practices individuals use to obtain access to vital goods and services. To interpret the findings, and identify possible causal pathways, the paper moves back-and-forth between two major research traditions that are rarely brought into dialogue: civic engagement and comparative historical studies of democratization

A continuous-scale measure of child development for population based epidemiological surveys: a preliminary study using Item Response Theory for the Denver Test

A method for translating research data from the Denver Test into individual scores of developmental status measured in a continuous scale is presented. It was devised using the Denver Developmental Screening Test (DDST) but can be used for Denver II. The DDST was applied in a community-based survey of 3389 under-5-year-olds in Porto Alegre, Brazil. The items of success were standardised by logistic regression on log chronological age. Each child's ability age was then estimated by maximum likelihood as the age in this reference population corresponding to the child's success and failures in the test. The score of developmental status is the natural logarithm of this ability age divided by chronological age and thus measures the delay or advance in the child's ability age compared with chronological age. This method estimates development status using both difficulty and discriminating power of each item in the reference population, an advantage over scores based on total number of items correctly performed or failed, which depend on difficulty only. The score corresponds with maternal opinion of child developmental status and with the 3-category scale of the DDST. It shows good construct validity, indicated by symmetrical and homogeneous variability from 3 months upwards, and reasonable results in describing gender differences in development by age, the mean score increasing with socio-economic conditions and diminishing among low-birthweight children. If a standardised measure of development status (z-scores) is required, this can be obtained by dividing the score by its standard deviation. Concurrent and discriminant validity of the score must be examined in further studies

Thromboelastography values remain hypercoagulative 6 months after obesity surgery:a pilot study

Abstract Purpose: Obesity causes a prothrombotic state and is known as a predisposing factor for thromboembolic events. In this pilot study, we assessed the impact of surgery for obesity and the subsequent weight loss on blood coagulation using traditional coagulation tests and thromboelastography (TEG). Material and Methods: We studied blood samples from 18 patients receiving bariatric surgery. Besides traditional blood coagulation tests and high-sensitivity C-reactive protein (hsCRP) as a marker of inflammation, the TEG parameters reaction time (R), kinetics time (K), angle (α), maximum amplitude (MA), clot strength (G), and lysis percent at 60 min (LY60) were determined preoperatively and on the first postoperative day and 6 months after surgery. Results: Altogether, 54 samples were analyzed. The median MA (71.3 mm), G (12,403.3 d/sc), and hsCRP (3.5 mg/l) were elevated preoperatively. The median hsCRP further increased on the first day postoperatively, but declined to the normal range 6 months after surgery, while MA and G remained elevated. In traditional coagulation tests, there was an increase in median fibrinogen and D-dimer postoperatively. D-dimer normalized (0.4 mg/l) during the study period, while the fibrinogen level (4.1 g/l) remained above the upper limit of normal. Conclusions: Measured by TEG, patients receiving bariatric surgery have hemostatic abnormalities indicating hypercoagulation at the 6-month follow-up visit, suggesting an elevated risk for thromboembolic events for at least 6 months after surgery