The precautions of clinical waste: disposable medical sharps in the United Kingdom

This article deals with recent changes in UK guidance on clinical waste, in particular a shift to disposable, single-use instruments and sharps. I use interviews conducted with nurses from a GP practice and two clinical waste managers at alternative treatment and incineration sites as a springboard for reflection on the relationship between the legislation on clinical waste management and its implementation. Scrutinizing the UK guidance, European legislation and World Health Organization principles, I draw out interviewees’ concerns that the changed practices lead to an expansion of the hazardous waste category, with an increased volume going to incineration. This raises questions regarding the regulations’ environmental and health effects, and regarding the precautionary approach embedded in the regulations. Tracing the diverse reverberations of the term ‘waste’ in different points along the journeys made by sharps in particular, and locating these questions in relation to existing literature on waste, I emphasize that public health rationales for the new practices are not made clear in the guidance. I suggest that this relative silence on the subject conceals both the uncertainties regarding the necessity for these means of managing the risks of infectious waste, and the tensions between policies of precautionary public health and environmental sustainability

Cardiac troponin measurement at the point of care: educational recommendations on analytical and clinical aspects by the IFCC Committee on Clinical Applications of Cardiac Bio-Markers (IFCC C-CB).

The International Federation of Clinical Chemistry and Laboarator Medicine (IFCC) Committee on Clinical Applications of Cardiac Bio-Markers (C-CB) has provided evidence-based educational resources to aid and improve the understanding of important analytical and clinical aspects of cardiac biomarkers. The present IFCC C-CB educational report focuses on recommendations for appropriate use, analytical performance, and gaps in clinical studies related to the use of cardiac troponin (cTn) by point of care (POC) measurement, often referred to as a point of care testing (POCT). The use of high-sensitivity (hs)-cTn POC devices in accelerated diagnostic protocols used in emergency departments or outpatient clinics investigating acute coronary syndrome has the potential for improved efficacy, reduction of length of stay and reduced costs in the health care system. POCT workflow integration includes location of the instrument, assignment of collection and testing responsibility to (non-lab) staff, instrument maintenance, in-service and recurrent training, quality control, proficiency assessments, discrepant result trapping, and troubleshooting and inventory management

Negative assimilation:how immigrants experience economic mobility in Japan

This paper examines the economic mobility of foreign migrants in Japan. In a country that is largely regarded as homogeneous and closed to outsiders, how and to what extent do immigrants achieve economic success? A survey conducted by the authors revealed that the conventional assimilationist perspective does not fully explain immigrants’ economic success in Japan. Migrants from the West experience what Chiswick and Miller (2011) refer to as “negative assimilation.” That is, their earnings decline over time in Japan. While negative assimilation was not clearly observed among immigrants from neighboring Asian countries, wages among them did not increase with the length of their stay in Japan. For both groups, the skills they brought from abroad were found to be largely accountable for their economic success, while locally specific human capital, such as education acquired in the host society, did not contribute to their earnings

Social cohesion and the notion of 'suspect communities': A study of the experiences and impacts of being 'suspect' for Irish communities and Muslim communities in Britain

In this article, we consider how the practice of conceiving of groups within civil society as 'communities' meshes with conceptualisations of certain populations as 'suspect' and consider some of the impacts and consequences of this for particular populations and for social cohesion. We examine how Irish and Muslim people in Britain have become aware of and have experienced themselves to be members of 'suspect communities' in relation to political violence and counterterrorism policies from 1974 to 2007 and investigate the impacts of these experiences on their everyday lives. The study focuses on two eras of political violence. The first coincides with the Irish Republican Army's (IRA) bombing campaigns in England between 1973 and 1996, when the perpetrators were perceived as 'Irish terrorists'; and the second since 2001, when, in Britain and elsewhere, the main threat of political violence has been portrayed as stemming from people who are assumed to be motivated by extreme interpretations of Islam and are often labelled as 'Islamic terrorists'. We outline why the concept of 'suspect communities' continues to be analytically useful for examining: the impact of 'bounded communities' on community cohesion policies; the development of traumatogenic environments and their ramifications; and for examining how lessons might be learnt from one era of political violence to another, especially as regards the negative impacts of practices of suspectification on Irish communities and Muslim communities. The research methods included discussion groups involving Irish and Muslim people. These demonstrated that with the removal of discourses of suspicion the common ground of Britain's urban multiculture was a sufficient basis for sympathetic exchanges. © 2012 Taylor and Francis Group, LLC

Portuguese emigration to Angola (2000-2015): Strengthening a specific postcolonial relationship in a new global framework?

Outflows to the Portuguese-speaking countries, although not dominant, played an important role in the growth of Portuguese emigration during the economic recession and austerity period, between 2010 and 2016. This chapter examines this migration process, considering that contemporary migration from Portugal to Angola is an example of reverse post-colonial migration within the framework of North-South movements. It presents the historical and socio-demographic background of Angola and some theoretical insights on the issue of North-South migration. The analyses of the migration process and the emigrants’ profiles rely in statistics and academic literature but especially on data gathered in a direct survey. Attention is given to indicators of integration, relations with Portugal and the post-colonial nature of the process. The profile of Portuguese in Angola shows an overrepresentation of highly skilled males over 35 years old, which migrated for professional reasons and sustain relations with Portugal through diverse transnational practices. This supports explanations for the emergence of North-South migration by appeal to economic expansion associated to the increasing insertion of several developing countries into global networks. However, the analysis fails to back up the hypothesis that Portuguese emigration to Angola is a form of reverse post-colonial migration based in ancestral return.info:eu-repo/semantics/publishedVersio

Software-sorted geographies.

This paper explores the central role of computerized code in shaping the social and geographical politics of inequality in advanced societies. The central argument is that, while such processes are necessarily multifaceted, multiscaled, complex and ambivalent, a great variety of ‘software-sorting’ techniques is now being widely applied in efforts to try to separate privileged and marginalized groups and places across a wide range of sectors and domains. This paper’s central demonstration is that the overwhelming bulk of software-sorting applications is closely associated with broader transformations from Keynesian to neoliberal service regimes. To illustrate such processes of software-sorting, the paper analyses recent research addressing three examples of software-sorting in practice. These address physical and electronic mobility systems, online geographical information systems (GIS), and face-recognition closed circuit television (CCTV) systems covering city streets. The paper finishes by identifying theoretical, research and policy implications of the diffusion of software-sorted geographies within which computerized code continually orchestrates inequalities through technological systems embedded within urban environments

Correction to: Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years