Public Banks + Public Water = SDG 6?

Sustainable Development Goal 6 aims to achieve universal access to water and sanitation services by 2030; this is expected to cost an estimated US$150 billion per year. Where will this funding come from? One possibility is private finance in the form of direct equity investment from private water companies and lending from commercial banks. Evidence suggests, however, that private investments in water and sanitation have not materialised as planned due to the sector's risk - return profile. Water and sanitation are considered ‘too risky’ by private investors and returns insufficiently rewarding. One alternative that may help to fill the water supply and sanitation (WSS) funding gap is an as yet untapped source of public finance: public banks. There are over 900 public banks in the world, with US$49 trillion in assets; they have, however, been largely underestimated as an important source of water and sanitation funding and have also been neglected by academic research and by mainstream policy organisations such as the World Bank. There is a need to better understand how public banks can be mobilised as effective funders of public water. In this article we provide a brief history of public banking practices in the water sector, review their pros and cons, and discuss the significance of the emergence of a new type of public water operator and the potential these entities offer for financing in this sector

The Neo-developmentalism Alternative: Capitalist crisis, popular movements, and economic development in Argentina since the 90s

After the economic meltdown of 2001 Argentina appeared to enter a new period of sustainable economic growth and relative political stability. After the crisis, changes in public policies were so far-reaching that several authors have argued that Argentina underwent a transition from neoliberal rule to an altogether new period of neo-developmentalism.1 This chapter argues that while neo-developmentalism represents a break with neoliberalism in some respects, the changes in macroeconomic policies also express profound continuities with past neoliberal policies. Furthermore, any changes must be understood as the result of shifts in the correlation of political forces in the broader regional and international context, rather than a conscious policy ‘choice’ per se. The chapter is structured as follows. The first section discusses the dynamics of neoliberal rule and its crisis in Argentina between 1991 and 2001. The second section presents the main structural continuities of the current process in relation to earlier periods of neoliberal orthodoxy. The third section analyses the new political foundations of neo-developmentalism, while the following section discusses changes in public policies showing how they manifest the particular articulation of continuity and change. We finish our discussion with a few preliminary conclusions.Facultad de Humanidades y Ciencias de la Educació

The Neo-developmentalism Alternative: Capitalist crisis, popular movements, and economic development in Argentina since the 90s

After the economic meltdown of 2001 Argentina appeared to enter a new period of sustainable economic growth and relative political stability. After the crisis, changes in public policies were so far-reaching that several authors have argued that Argentina underwent a transition from neoliberal rule to an altogether new period of neo-developmentalism.1 This chapter argues that while neo-developmentalism represents a break with neoliberalism in some respects, the changes in macroeconomic policies also express profound continuities with past neoliberal policies. Furthermore, any changes must be understood as the result of shifts in the correlation of political forces in the broader regional and international context, rather than a conscious policy ‘choice’ per se. The chapter is structured as follows. The first section discusses the dynamics of neoliberal rule and its crisis in Argentina between 1991 and 2001. The second section presents the main structural continuities of the current process in relation to earlier periods of neoliberal orthodoxy. The third section analyses the new political foundations of neo-developmentalism, while the following section discusses changes in public policies showing how they manifest the particular articulation of continuity and change. We finish our discussion with a few preliminary conclusions.Facultad de Humanidades y Ciencias de la Educació

Management of patients with intermittent claudication

Intermittent claudication is the first and mildest manifestation of peripheral arterial disease, caused by the atherosclerotic process of progressive narrowing of one or more of the arteries of the peripheral circulation.1 If the arterial system fails, it results in a progressive oxygen debt, experienced by the patient as cramping muscle pain during walking or other physical activity, which forces the patient to pause. The incidence of intermittent claudication increases with age, especially among men, with an annual incidence rate of 0.7%, 3.9%, and 10.6% among 35-44 year, 45-54 year, and 55-64 year old men respectively.2 In women, the incidence rates are approximately 50% lower than in men.2 The development of intermittent claudication is accelerated by the same cardiovascular risk factors as known for other expressions of atherosclerotic disease (i.e. coronary heart disease and cerebro-vascular disease). These risk factors are smoking, diabetes mellitus, hypertension, and hyperlipidaemia

Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands

Use of neoadjuvant chemotherapy in locally advanced breast cancer in the Netherlands P.E.R. Spronk1, A.C.M. Van Bommel1, S. Siesling2,3, M.J.T. Baas- Vrancken Peeters4, C.H. Smorenburg5. 1Leiden University Medical Centre, Surgery, Leiden, Netherlands; 2Comprehensive Cancer Centre the Netherlands IKNL, Epidemiology, Utrecht, Netherlands; 3University of Twente, MIRA Biomedical science and Technical Medicine, Twente, Netherlands; 4Netherlands Cancer Institute/Antoni van Leeuwenhoek, Surgery, Amsterdam, Netherlands; 5Netherlands Cancer Institute/Antoni van Leeuwenhoek, Medical Oncology, Amsterdam, Netherlands Background: Neoadjuvant chemotherapy (NAC) is the treatment of choice for patients with locally advanced breast cancer (LABC). The aim of this study is to examine the use of NAC for LABC in all Dutch hospitals participating in breast cancer care and to assess what patient, tumour and hospital characteristics influence its use. Material and Methods: Data were derived from the national multidisciplinary NABON Breast Cancer Audit (NBCA), regarding all women aged >18 years and newly diagnosed with LABC from January 2011 to September 2013. Multivariable logistic regression was used to assess the association between the use of NAC and patient, tumour and hospital related factors. Results: Of 1419 woman diagnosed with LABC, 70% were treated with NAC. This percentage varied from 12.5% to 90% between hospitals and did not increase over time. Factors associated with the use of NAC included young age, large tumour size, more advanced nodal disease and triple negative or hormone-receptor negative tumours. Also patients treated in hospitals with a multidisciplinary preoperative work-up and participation in neoadjuvant studies were more likely to receive NAC. However, considerable variation between hospitals remained after casemix correction. Table 1. Multivariable odds ratios (ORs) for receipt of NAC among 1419 stage III patients 2011 through 2013 OR 95% CI P-value Age 0.000 5 cm 5.68 2.34−13.79 Clinical nodal status 0.000 cNx/N0 ref. cN1 1.32 0.86−2.04 cN2 2.93 1.18−7.29 cN3 10.28 4.18−25.25 Receptor status 0.000 Triple negative 2.35 1.40−3.93 HR−, Her2+ 3.37 1.67−6.78 HR+, Her2+ 0.91 0.51−1.60 HR+, Her2− ref. Type of surgery 0.026 Breast conservation therapy 2.05 1.09−3.84 Mastectomy ref. Multidisciplinary team 0.021 Yes 1.98 1.11−3.53 No ref. Type of hospital 0.569 General 1.20 0.73−1.98 Top clinical ref. Academic 1.50 0.64−3.47 Hospital surgical volume 0.729 200 1.27 0.70−2.31 Study participation 0.005 Yes 1.80 1.20−2.70 No ref. Conclusions: There is considerable variation in the use of NAC for LABC in the Netherlands. Although various patient, tumor and institutional factors are associated with the use of NAC in LABC, these can only explain part of the observed variation in treatment patterns between hospitals

Conventional and retrospective change in health-related quality of life of trauma patients: An explorative observational follow-up study

Background: Within trauma care measurement of changes in health-related quality of life (HRQL) is used in understanding patterns of recovery over time. However, conventionally-measured change in HRQL may not always reflect the change in HRQL as perceived by the patient. Recall bias and response shift may contribute to disagreement between conventional and retrospective change in HRQL. This study aimed to measure conventional and retrospective change of HRQL and assess to which extent recall bias and resp