Multidisciplinary Group Clinic Appointments: The Self-Management and Care of Heart Failure (SMAC-HF) Trial

Background—This trial tested the effects of multidisciplinary group clinic appointments on the primary outcome of time to first heart failure (HF) rehospitalization or death. Methods and Results—HF patients (n=198) were randomly assigned to standard care or standard care plus multidisciplinary group clinics. The group intervention consisted of 4 weekly clinic appointments and 1 booster clinic at month 6, where multidisciplinary professionals engaged patients in HF self-management skills. Data were collected prospectively for 12 months beginning after completion of the first 4 group clinic appointments (2 months post randomization). The intervention was associated with greater adherence to recommended vasodilators (P=0.04). The primary outcome (first HF-related hospitalization or death) was experienced by 22 (24%) in the intervention group and 30 (28%) in standard care. The total HF-related hospitalizations, including repeat hospitalizations after the first time, were 28 in the intervention group and 45 among those receiving standard care. The effects of treatment on rehospitalization varied significantly over time. From 2 to 7 months post randomization, there was a significantly longer hospitalization-free time in the intervention group (Cox proportional hazard ratio=0.45 (95% confidence interval, 0.21–0.98; P=0.04). No significant difference between groups was found from month 8 to 12 (hazard ratio=1.7; 95% confidence interval, 0.7–4.1). Conclusions—Multidisciplinary group clinic appointments were associated with greater adherence to selected HF medications and longer hospitalization-free survival during the time that the intervention was underway. Larger studies will be needed to confirm the benefits seen in this trial and identify methods to sustain these benefits

Leaving no-one behind? Informal economies, economic inclusion, and Islamic extremism in Nigeria

This article examines how the Post-2015 commitment to economic inclusion affects informal economic actors in developing countries. It highlights the selective dynamics of inclusive market models which generate new processes of exclusion in which the most vulnerable continue to be left behind. The case of Nigeria reveals how inclusive market initiatives reinforce parallel processes of informalization, poverty and Islamic extremism in the north of the country. Fieldwork in northern Nigeria shows that inclusive initiatives are intensifying competitive struggles within the informal economy in which stronger actors are crowding out poorer, less educated and migrant actors, exacerbating disaffection and vulnerability to radicalization

Postrevolutionary land encroachments in Cairo:Rhizomatic urban space making and the line of flight from illegality

International audienceThis paper explores a case of such land encroachments carried out by waste collectors in the neighbourhood of Manshiet Nasser in Cairo, Egypt. It begins with theoretical debates about the production of urban space, arguing that the de Certeauian paradigm, in which urban marginals poach or hijack others' spaces evanescently, fails to account for the way such encroachments produce permanent new spaces rhizomatically alongside the pre-existing order. The paper then turns to a close examination of the events in Manshiet Nasser. Although in a broad view the actors are marginals living in the 'informal' city, the conditions enabling the encroachments were such that only the wealthiest and most powerful members of the 'commu-nity' benefitted. In a context of generalized 'illegality', the squatters rely on practical norms and de facto recognitions to obtain some degree of tenure security. Since these efforts rely on and play off legal norms even as the squatters violate them, the paper argues that property rights in this context should be understood not in classificatory terms based on the legal/illegal binary, but rather through a trajectory of 'becoming-legal': a 'line of flight' that approaches legality asymptotically

Beyond Remittance: Evading Uselessness and Seeking Personhood in Fouta Djallon, Guinea

Remittance networks built through transnational migration have transformed local economies as well as social lives in many parts of the world. In this article, I examine the relationship between transnational migration and local business practices for ethnic Fulɓe people from the Fouta Djallon highlands of Guinea. Although some Fouta Djallon residents have withstood poverty with the help of remittances from migrant relatives, many migrants fail to earn money abroad. But despite slim chances of success, migration remains a popular undertaking, especially for young men. Meanwhile, non-migrants engage in small business projects that yield little or no income. Analyzing informants’ critiques of “uselessness,” I argue that both near- impossible migration quests and seemingly irrational business practices are linked by a common desire to achieve social personhood under adverse structural conditions. Apparent striving for success mitigates failure to send or earn money, even while reproducing ideals of mobility and entrepreneurship in responsible personhood

Market, morality and (just) price: the case of recycling economy in Turkey

By drawing on ethnographic fieldwork conducted amongst waste-pickers and recycling traders in the waste paper, plastic and scrap metal sectors, and engaging with literature from economic anthropology and history, as well as archival sources, this paper documents changing perceptions of just price, morality and fairness in the Turkish recycling market. The paper suggests that multiple markets imply multiple prices, which are contingent and contested. When dealing with price mechanisms largely outside their control, actors tend to associate a fair price with the going market price, rather than factors such as state regulation. Approaches to morality and assessments of fairness become more ambiguous when prices are mediated by actors? own practices. These range from gift relations to paternalism, envy and deception