Austerity for Whom?

In contrast to the recent multi-billion dollar bailouts offered to leading sectors of capital, fiscal austerity is poised to make a comeback worldwide. Labour will be forced to pay for the public debt accumulated in the aftermath of the recent global financial and economic crisis. Notwithstanding change and evolution in the neoliberal model over time, this return to austerity is consistent with overall policy in the neoliberal period which can be considered an era of permanent restraint in most areas of social spending. This article examines a variety of trends that have emerged over the past thirty years of neoliberal rule: the various facets of neoliberal policy and their temporal dimensions; as well as the results of market-reliance and spending reforms: growing affluence for a minority of Canadians while the majority lose ground and inequalities are further entrenched. Asking 'austerity for whom' directs attention at the interconnections between affluence and austerity that exist in Canada. Contrairement aux récents plans de sauvetage impliquant des milliards de dollars offerts aux principaux secteurs de l’économie, l'austérité budgétaire s’apprête à faire un retour à l’échelle planétaire. Les travailleurs n’auront d’autre choix que de rembourser la dette publique engendrée à la suite de la récente crise économique et financière mondiale. Malgré le changement et l'évolution dans le modèle néo-libéral au fil du temps, ce retour à l'austérité concorde avec la politique globale de la période néolibérale pouvant être considérée comme une époque de restrictions permanentes touchant la plupart des domaines de dépenses sociales. Cet article examine une série de tendances ayant émergé au cours des trente dernières années du pouvoir néo-libéral: les différents aspects de la politique néolibérale et leurs dimensions temporelles, ainsi que les résultats du recours au marché financier et de la réforme du contrôle de la dépense: forte croissance d'une minorité de Canadiens alors que la majorité perd du terrain enracinant davantage les inégalités. La question « l’austérité pour qui? » dirige l’attention vers l’interconnexion entre l’affluence et l’austérité qui existent au Canada

Impaired glucose tolerance or newly diagnosed diabetes mellitus diagnosed during admission adversely affects prognosis after myocardial infarction: An observational study

Objective To investigate the prognostic effect of newly diagnosed diabetes mellitus (NDM) and impaired glucose tolerance (IGT) post myocardial infarction (MI). Research Design and Methods Retrospective cohort study of 768 patients without preexisting diabetes mellitus post-MI at one centre in Yorkshire between November 2005 and October 2008. Patients were categorised as normal glucose tolerance (NGT n = 337), IGT (n = 279) and NDM (n = 152) on predischarge oral glucose tolerance test (OGTT). Primary end-point was the first occurrence of major adverse cardiovascular events (MACE) including cardiovascular death, non-fatal MI, severe heart failure (HF) or non-haemorrhagic stroke. Secondary end-points were all cause mortality and individual components of MACE. Results Prevalence of NGT, impaired fasting glucose (IFG), IGT and NDM changed from 90%, 6%, 0% and 4% on fasting plasma glucose (FPG) to 43%, 1%, 36% and 20% respectively after OGTT. 102 deaths from all causes (79 as first events of which 46 were cardiovascular), 95 non fatal MI, 18 HF and 9 non haemorrhagic strokes occurred during 47.2 ± 9.4 months follow up. Event free survival was lower in IGT and NDM groups. IGT (HR 1.54, 95% CI: 1.06–2.24, p = 0.024) and NDM (HR 2.15, 95% CI: 1.42–3.24, p = 0.003) independently predicted MACE free survival. IGT and NDM also independently predicted incidence of MACE. NDM but not IGT increased the risk of secondary end-points. Conclusion Presence of IGT and NDM in patients presenting post-MI, identified using OGTT, is associated with increased incidence of MACE and is associated with adverse outcomes despite adequate secondary prevention

Barriers to CPR initiation and continuation during the emergency call relating to out-of-hospital cardiac arrest: A descriptive cohort study

Aim: To describe the barriers to cardiopulmonary resuscitation (CPR) initiation and continuation in emergency calls for out-of-hospital cardiac arrest (OHCA). Methods: We analysed 295 consecutive emergency calls relating to OHCA over a four-month period (1 January – 30 April 2021). Calls included were paramedic-confirmed, non-traumatic, non-EMS-witnessed OHCA, where the caller was with the patient. Calls were listened to in full and coded in terms of barriers to CPR initiation and continuation, and patient and caller characteristics. Results: Overall, CPR was performed in 69% of calls and, in 85% of these, callers continued performing CPR until EMS arrival. Nearly all callers (99%) experienced barriers to CPR initiation and/or continuation during the call. The barriers identified were classified into eight categories: reluc tance, appropriateness, emotion, bystander physical ability, patient access, leaving the scene, communication failure, caller actions and call-taker instructions. Of these, bystander physical ability was the most prevalent barrier to both CPR initiation and continuation, occurring in 191 (65%) calls, followed by communication failure which occurred in 160 (54%) calls. Callers stopping or interrupting CPR performance due to being fatigued was lower than expected (n = 54, 26% of callers who performed CPR). Barriers to CPR initiation that related to bystander physical ability, caller actions, communication failure, emotion, leaving the scene, patient access, procedural barriers, and reluctance were mostly overcome by the caller (i.e., CPR was performed). Conclusion: Barriers to CPR initiation and continuation were commonly experienced by callers, however they were frequently overcome. Future research should investigate the strategies that were successful

The Relationship Between Cumulative Risk and Promotive Factors and Violent Behavior Among Urban Adolescents

Resiliency theory posits that some youth exposed to risk factors do not develop negative behaviors due to the influence of promotive factors. This study examines the effects of cumulative risk and promotive factors on adolescent violent behavior and tests two models of resilience—the compensatory model and the protective model—in a sample of adolescent patients (14–18 years old; n = 726) presenting to an urban emergency department who report violent behavior. Cumulative measures of risk and promotive factors consist of individual characteristics and peer, family, and community influences. Hierarchical multiple regression was used to test the two models of resilience (using cumulative measures of risk and promotive factors) for violent behavior within a sample of youth reporting violent behavior. Higher cumulative risk was associated with higher levels of violent behavior. Higher levels of promotive factors were associated with lower levels of violent behavior and moderated the association between risk and violent behaviors. Our results support the risk‐protective model of resiliency and suggest that promotive factors can help reduce the burden of cumulative risk for youth violence.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117187/1/ajcp9541.pd

Mother Knows Best: Dominant Females Determine Offspring Dispersal in Red Foxes (Vulpes vulpes)

Abstract Background: Relatedness between group members is central to understanding the causes of animal dispersal. In many group-living mammals this can be complicated as extra-pair copulations result in offspring having varying levels of relatedness to the dominant animals, leading to a potential conflict between male and female dominants over offspring dispersal strategies. To avoid resource competition and inbreeding, dominant males might be expected to evict unrelated males and related females, whereas the reverse strategy would be expected for dominant females

Dating Violence: Outcomes Following a Brief Motivational Interviewing Intervention Among At‐risk Adolescents in an Urban Emergency Department

Objectives A recent study demonstrated the efficacy of the SafERteens intervention in reducing peer violence among adolescents presenting to the emergency department (ED). The objective of this study was to determine the efficacy of this ED‐based brief intervention (BI) on dating violence 1 year following the ED visit among the subsample of adolescents in the original randomized controlled trial reporting past‐year dating violence. Methods Patients (aged 14 to 18 years) at an ED were eligible for inclusion if they had past‐year violence and alcohol use. Participants were randomized to one of three conditions (BI delivered by a computer [CBI], BI delivered by a therapist and a computer (T+CBI), or control) and completed follow‐ups at 3, 6, and 12 months. In addition to content on alcohol misuse and peer violence, adolescents reporting dating violence received a tailored module on dating violence. The outcome of interest was frequency of moderate and severe dating violence victimization and aggression (baseline and 3, 6, and 12 months after ED visit). Results Among eligible adolescents, 55% ( n  = 397) reported dating violence and were included in these analyses. Compared to the control group (who received a resource brochure only), participants in the CBI showed reductions in moderate dating victimization at 3 months (inter‐rater reliability [IRR] = 0.71; 95% confidence interval [CI] = 0.51 to 0.99; p < 0.05) and 6 months (IRR = 0.56; 95% CI = 0.38 to 0.83; p < 0.01). Models examining interaction effects were significant for the CBI on moderate dating victimization at 3 months (IRR = 0.81; 95% CI = 0.67 to 0.98; p < 0.05) and 6 months (IRR = 0.81; 95% CI = 0.66 to 0.99; p < 0.05). Significant interaction effects were found for the T+CBI on moderate dating violence victimization at 6 months (IRR = 0.81; 95% CI = 0.69 to 0.96; p < 0.01) and 12 months (IRR = 0.76; 95% CI = 0.63 to 0.90; p < 0.001) and severe dating violence victimization at 3 months (IRR = 0.76; 95% CI = 0.59 to 0.96; p < 0.05). Conclusions ED‐based BIs tailored to address multiple risk behaviors (i.e., peer violence, alcohol use, and dating violence) show promise for reducing moderate and severe dating victimization for up to 1 year following an ED visit. Resumen La Violencia de Pareja: Resultados tras una Intervención mediante una Entrevista Breve Motivacional entre los Adolescentes en Riesgo en un Servicio de Urgencias Urbano Objetivos Un estudio reciente demostró la eficacia de la intervención SafERteens en reducir la violencia entre los adolescentes que acuden al servicio de urgencias (SU). El objetivo de este estudio fue determinar la eficacia de esta intervención breve (IB) en los SU en la violencia de pareja al año tras la visita al SU en una muestra de adolescentes del ensayo clínico original controlado y aleatorizado que documentó la violencia de pareja del pasado año. Metodología Se incluyeron los pacientes entre 14 y 18 años de edad del SU que tenían antecedentes de violencia o consumo de alcohol en el pasado año. Los participantes fueron aleatorizados a una de las tres situaciones: IB realizada por un ordenador (IBO), IB realizada por un terapeuta y un ordenador (IBO + T), o control; y completaron 3, 6, y 12 meses de seguimiento. Además de contener abuso de alcohol y violencia entre iguales, los adolescentes que documentaron la violencia de pareja recibieron un módulo adaptado en violencia de pareja. El resultado de interés fue la frecuencia de violencia de pareja moderada o grave como víctima y agresor (basal, 3, 6 y 12 meses tras la visita). Resultados Entre los adolescentes elegibles, el 55% (n=397) documentó datos de violencia de pareja y fueron incluidos en estos análisis. En comparación con el grupo control (que recibieron sólo el recurso de un folleto informativo), los participantes en la IBO mostraron una reducción en la violencia de pareja moderada como víctima a los 3 meses (concordancia entre evaluadores [K] 0,71; IC 95% = 0,51 a 0,99; p < 0,05) y a los 6 meses (K 0,56; IC 95%= 0,38 a 0,83; p < 0,01); los modelos que examinaron los efectos de interacción fueron significativos para la IBO en la violencia de pareja moderada como víctima a los 3 meses (K 0,81; IC 95% = 0,67 a 0,98; p < 0,05) y a los 6 meses (K 0,81; IC 95% = 0,66 a 0,99; p < 0,05). Se hallaron efectos de interacción significativos para la IBO+T en la violencia de pareja moderada como víctima a los 6 meses (K 0,81; IC 95% = 0,69 a 0,96; p < 0,01) y a los 12 meses (K 0,76; IC 95% = 0,63 a 0,90; p < 0,001), y en la violencia de pareja grave como víctima a los 3 meses (K 0.76; IC 95% = 0,59 a 0,96; p < 0,05). Conclusiones Las IB en el SU adaptadas para valorar múltiples comportamientos de riesgo (ej: violencia entre iguales, consumo de alcohol y violencia de pareja) son prometedores para reducir la violencia de pareja moderada y grave como víctima hasta un año tras la visita al SU.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98214/1/acem12151.pd

Phase I/II open-label study of the biologic effects of the interleukin-2 immunocytokine EMD 273063 (hu14.18-IL2) in patients with metastatic malignant melanoma

BACKGROUND: To explore the biological activity of EMD 273063 (hu14.18-IL2), a humanized anti-GD2 monoclonal antibody fused to interleukin-2 (IL2), in patients with unresectable, stage IV cutaneous melanoma as measured by induction of immune activation at the tumor site and in peripheral blood. METHODS: Nine patients were treated with 4 mg/m(2 )per day of EMD 273063 given as a 4-h intravenous infusion on days 1, 2, and 3 every four weeks (one cycle). Peripheral blood was analyzed for T cell and natural killer cell phenotype and frequency, as well as levels of soluble IL2 receptor (sIL2R), IL10, IL6, tumor necrosis factor alpha and neopterin. Biopsies of tumor metastasis were performed prior to therapy and at day 10 of the first 2 cycles to study lymphocyte accumulation by immunohistochemistry. RESULTS: Treatment was generally well tolerated and there were no study drug-related grade 4 adverse events. Grade 3 events were mainly those associated with IL2, most commonly rigors (3 patients) and pyrexia (2 patients). Best response on therapy was stable disease in 2 patients. There were no objective tumor regressions by standard response criteria. Systemic immune activation was demonstrated by increases in serum levels of sIL2R, IL10, and neopterin. There was evidence of increased tumor infiltration by T cells, but not NK cells, in most post-dosing biopsies, suggesting recruitment of immune cells to the tumor site. CONCLUSION: EMD 273063 demonstrated biologic activity with increased immune-related cytokines and intratumoral changes in some patients consistent with the suspected mechanism of action of this immunocytokine

Yes, research can inform health policy; but can we bridge the 'Do-Knowing It's Been Done' gap?

Copyright @ 2011 Hanney and Gonzalez.Provisional Abstract: This editorial introduces a new Supplement in Health Research Policy and Systems and highlighs the importance of assessing the impact of health research by examining whether we can move from 'Know-Do' to 'Do-Knowing It's Been Done'This article is made available through the Brunel Open Access publishing fund

Disability and HIV/AIDS - a systematic review of literature on Africa

This systematic review focuses on empirical work on disability and HIV/AIDS in Africa in the past decade and considers all the literature currently accessible. The review presents data from different surveys and summarizes the findings. In this way, it convincingly reveals that people with disabilities are very vulnerable to contracting HIV, and lack access to information, testing and treatment. The review further reveals gaps in the research and areas of concern. While vulnerability and accessibility have been investigated, there are few prevalence studies or evaluations available. A certain amount of work has focused on the deaf population, but little has been done for other disability groups. A growing area of concern is sexual abuse and exploitation of people with disabilities. Only a few studies or interventions focus on this crucial area