Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Time's Up: Analysing the Feminist Potential of Time Banks

Time banks are an alternative economic system proposed to address social problems by stimulating work and exchange through time‐based currency. They aim to redefine work and money, through building social capital to alleviate social problems. As women are disproportionately affected by these problems, it follows that membership is predominantly female, often poor. This article takes the position that time banks provide a lens through which to theorise the feminist potential of alternative forms of economic organisation. It examines the ways in which feminists, and time banks, have sought to redefine the concepts of work and money, as well as the context of time banks within the Third Sector. ‘The reality’ of these concepts in practice is then critically analysed using empirical data from a year as an active participant within a time bank. The findings demonstrate the complex issues regarding how the time bank functioned in practice, particularly in relation to how members engaged with it, and articulated their participation. Further, the way in which the system co‐opted feminist potentials of alternative economic practices as part of the Third Sector, through a conception of social capital, is shown to be problematic in terms of exploiting the energies of already exploited women. This research shows the need for ongoing critical examination of initiatives targetted at social problems, particularly those mirroring feminist activism, in order to prevent the co‐option of energies and work

Social housing and urban renewal: an introduction

Book synopsis: This book offers a cross-national perspective on contemporary urban renewal in relation to social rental housing. Social housing estates – as developed either by governments (public housing) or not-for-profit agencies – became a prominent feature of the 20th century urban landscape in Northern European cities, but also in North America and Australia. Many estates were built as part of earlier urban renewal, ‘slum clearance’ programs especially in the post-World War 2 heyday of the Keynesian welfare state. During the last three decades, however, Western governments have launched high-profile ‘new urban renewal’ programs whose aim has been to change the image and status of social housing estates away from being zones of concentrated poverty, crime and other social problems. This latest phase of urban renewal – often called ‘regeneration’ – has involved widespread demolition of social housing estates and their replacement with mixed-tenure housing developments in which poverty deconcentration, reduced territorial stigmatization, and social mixing of poor tenants and wealthy homeowners are explicit policy goals. Academic critical urbanists, as well as housing activists, have however queried this dominant policy narrative regarding contemporary urban renewal, preferring instead to regard it as a key part of neoliberal urban restructuring and state-led gentrification which generate new socio-spatial inequalities and insecurities through displacement and exclusion processes. This book examines this debate through original, in-depth case study research on the processes and impacts of urban renewal on social housing in European, U.S. and Australian cities. The book also looks beyond the Western urban heartlands of social housing to consider how renewal is occurring, and with what effects, in countries with historically limited social housing sectors such as Japan, Chile, Turkey and South Africa

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research