Policing 2016 To Deliver Safety, Police Need Legitimacy and Accountability

Much of the national debate on policing in 2015 has rested on a false premise—that community demands for greater police accountability come at the expense of effectively addressing crime. In fact, police need accountability and legitimacy in the communities they serve if they are to deliver safety. While policing is a local governmental function, federal policymakers have an important role to play in helping policing practice reflect this truth. The next president will have a wide range of funding, agenda setting, and enforcement tools that can elevate and spread the best in policing and compel reform where necessary

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Diversidade funcional: a diferença e o histórico modelo de homem-padrão Differently abled: difference and the historical model of the standard man

Analisa criticamente as formas como a diferença notada nas pessoas com deficiência foi percebida e tratada, desde a Antiguidade, nos âmbitos social, educacional político e terapêutico, até alcançar as mudanças observadas no país em décadas recentes. Para designar as pessoas com deficiência, independentemente do tipo ou grau da deficiência, utilizam-se os termos 'diversidade funcional' e 'diferença funcional', que não enfatizam os aspectos negativos, comum na terminologia vigente. Com base em levantamento historiográfico, apresenta a influência do pensamento religioso e das práticas nele fundamentadas, bem como a do desenvolvimento da medicina e da noção de normalidade, sobre a imagem social das pessoas cujos corpos apresentam alguma diferença funcional.<br>The article offers a critical analysis of how the differences displayed by people with disabilities have been perceived and dealt with in the social, educational, political, and therapeutic realms from ancient times until recent decades, when changes have been observed in Brazil. Whatever the type or degree of disability, we now use the terms 'differently abled' and 'different abilities', reflecting a current trend in terminology that avoids placing emphasis on negative aspects. Based on a historiographic survey, the article indicates how religious thought and practices and the development of medicine and of the notion of normalcy have influenced the social image of people whose bodies are differently abled