The Cause of War and Role of People by Karl Polanyi: A Change in Realm of International Relations after The Great Transformation

Abstract. The enormous impacts of WWI, WWII, and the Great Depression made Karl Polanyi write a famous book, The Great Transformation (TGT). In it, he wrote about the 'collapse of nineteenth-century civilisation', and clarified the causes and development of civilisation from the perspective of international relations and economic history. ‘Nineteenth-century civilisation’ is located in the centre of his international relations theory, and his ‘institutional system’ comprises of four elements: 1) a self-regulating market, 2) balance-of-power, 3) the international gold standard, 4) and the liberal state. In addition economic thought, Polanyi continued developing his international relations theory in Britain as evidenced by examination of a fresh record, a short booklet issued by the Worker’s Educational Association in the 1940s just after the publication of TGT. First, Polanyi emphasises the political and geographic causes of war instead of economic causes.TGT explains war arises from financial problems, especially the abandonment of the international gold standard system. On the other hand, ‘power vacuum’ is stressed as the origin of war in the booklet. While his civilisation theory presumes the political expansion of each country, the power vacuum theory does not make this supposition. This implies a change in his view to an unwanted war arising from a breakdown in the balance of power. In addition, he described diplomatic alliances as a method to prevent wars. To prevent war, Polanyi insists that people need to be engaged in civil society. This explains his belief that democracy achieved by national integrity is sovereign in our society. Informed citizens can consider government and other authorities imperfect without repercussion and still work towards national unity. Following this logic, socialism is neither centralised nor repressive, but is composed by citizens as a liberal institution.Keywords. Karl Polanyi, Workers Education Association, Economy and War, Civil Society.JEL. B24, B32, B52

Study on Karl Polanyi\u27s social economic thought and \u27Complex society\u27

博士(経済学)同志社大

Survival Benefit of Hepatic Arterial Infusion Chemotherapy over Sorafenib in the Treatment of Locally Progressed Hepatocellular Carcinoma

BACKROUND: Not all patients with hepatocellular carcinoma (HCC) benefit from treatment with molecular targeted agents such as sorafenib. We investigated whether New-FP (fine-powder cisplatin and 5-fluorouracil), a hepatic arterial infusion chemotherapy regimen, is more favorable than sorafenib as an initial treatment for locally progressed HCC. METHODS: To avoid selection bias, we corrected the data from different facilities that did or did not perform New-FP therapy. In total, 1709 consecutive patients with HCC initially treated with New-FP or sorafenib; 1624 (New-FP, n = 644; sorafenib n = 980) were assessed. After propensity score matching (PSM), overall survival (OS) and prognostic factors were assessed (n = 344 each). Additionally, the patients were categorized into four groups: cohort-1 [(without macrovascular invasion (MVI) and extrahepatic spread (EHS)], cohort-2 (with MVI), cohort-3 (with EHS), and cohort-4 (with MVI and EHS) to clarify the efficacy of each treatment. RESULTS: New-FP prolonged OS than sorafenib after PSM (New-FP, 12 months; sorafenib, 7.9 months; p < 0.001). Sorafenib treatment, and severe MVI and EHS were poor prognostic factors. In the subgroup analyses, the OS was significantly longer the New-FP group in cohort-2. CONCLUSIONS: Local treatment using New-FP is a potentially superior initial treatment compared with sorafenib as a multidisciplinary treatment in locally progressed HCC without EHS

National trends in the outcomes of subarachnoid haemorrhage and the prognostic influence of stroke centre capability in Japan: retrospective cohort study

Objectives To examine the national, 6-year trends in in-hospital clinical outcomes of patients with subarachnoid haemorrhage (SAH) who underwent clipping or coiling and the prognostic influence of temporal trends in the Comprehensive Stroke Center (CSC) capabilities on patient outcomes in Japan.Design Retrospective study.Setting Six hundred and thirty-one primary care institutions in Japan.Participants Forty-five thousand and eleven patients with SAH who were urgently hospitalised, identified using the J-ASPECT Diagnosis Procedure Combination database.Primary and secondary outcome measures Annual number of patients with SAH who remained untreated, or who received clipping or coiling, in-hospital mortality and poor functional outcomes (modified Rankin Scale: 3–6) at discharge. Each CSC was assessed using a validated scoring system (CSC score: 1–25 points).Results In the overall cohort, in-hospital mortality decreased (year for trend, OR (95% CI): 0.97 (0.96 to 0.99)), while the proportion of poor functional outcomes remained unchanged (1.00 (0.98 to 1.02)). The proportion of patients who underwent clipping gradually decreased from 46.6% to 38.5%, while that of those who received coiling and those left untreated gradually increased from 16.9% to 22.6% and 35.4% to 38%, respectively. In-hospital mortality of coiled (0.94 (0.89 to 0.98)) and untreated (0.93 (0.90 to 0.96)) patients decreased, whereas that of clipped patients remained stable. CSC score improvement was associated with increased use of coiling (per 1-point increase, 1.14 (1.08 to 1.20)) but not with short-term patient outcomes regardless of treatment modality.Conclusions The 6-year trends indicated lower in-hospital mortality for patients with SAH (attributable to better outcomes), increased use of coiling and multidisciplinary care for untreated patients. Further increasing CSC capabilities may improve overall outcomes, mainly by increasing the use of coiling. Additional studies are necessary to determine the effect of confounders such as aneurysm complexity on outcomes of clipped patients in the modern endovascular era