Deconstructing and Reconstructing Identity: How Queer Liberation Organizations Deploy Collective Identities

The mainstream gay rights movement has made significant strides toward its agenda, at least in part due to the movement’s claim that it represents all the interests of all LGBTQ communities. However, a queer liberation movement (QLM) led by queer people of color and other marginalized LGBTQ people has existed alongside the mainstream movement since its inception. This movement pursues a radically different agenda and employs organizing strategies distinct from those of the mainstream movement, centering the interests of those LGBTQ people most often left behind by the mainstream agenda. This paper examines how the QLM negotiates and deploys collective identity in and through its work. Collective identity is explored in the context of existing LGBTQ social movement theory and points to how the QLM challenges and extends social movement theorizing regarding collective identity and use of identity as a site for organizing

World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

BACKGROUND: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. METHODS: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40-80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance. FINDINGS: Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0·685 (95% CI 0·629-0·741) to 0·833 (0·783-0·882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40-64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt. INTERPRETATION: We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide. FUNDING: World Health Organization, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence, UK Medical Research Council, and National Institute for Health Research

A Queer Liberation Movement? A Qualitative Content Analysis of Queer Liberation Organizations, Investigating Whether They are Building a Separate Social Movement

In the last forty years, U.S. national and statewide LGBT organizations, in pursuit of equality through a limited and focused agenda, have made remarkably swift progress moving that agenda forward. However, their agenda has been frequently criticized as prioritizing the interests of White, middle-class gay men and lesbians and ignoring the needs of other LGBT people. In their shadows have emerged numerous grassroots organizations led by queer people of color, transgender people, and low-income LGBT people. These queer liberation groups have often been viewed as the left wing of the GRM, but have not been extensively studied. My research investigated how these grassroots liberation organizations can be understood in relation to the equality movement, and whether they actually comprise a separate movement operating alongside, but in tension with, the mainstream gay rights movement. This research used a qualitative content analysis, grounded in black feminism\u27s framework of intersectionality, queer theory, and social movement theories, to examine eight queer liberation organizations. Data streams included interviews with staff at each organization, organizational videos from each group, and the organizations\u27 mission statements. The study used deductive content analysis, informed by a predetermined categorization matrix drawn from social movement theories, and also featured inductive analysis to expand those categories throughout the analysis. This study\u27s findings indicate that a new social movement - distinct from the mainstream equality organizations - does exist. Using criteria informed by leading social movement theories, findings demonstrate that these organizations cannot be understood as part of the mainstream equality movement but must be considered a separate social movement. This queer liberation movement has constituents, goals, strategies, and structures that differ sharply from the mainstream equality organizations. This new movement prioritizes queer people in multiple subordinated identity categories, is concerned with rebuilding institutions and structures, rather than with achieving access to them, and is grounded more in liberation or justice frameworks than equality. This new movement does not share the equality organizations\u27 priorities (e.g., marriage) and, instead, pursues a different agenda, include challenging the criminal justice and immigration systems, and strengthening the social safety net. Additionally, the study found that this new movement complicates existing social movement theory. For decades, social movement scholars have documented how the redistributive agenda of the early 20th century class-based social movements has been replaced by the demands for access and recognition put forward by the identity-based movements of the 1960s New Left. While the mainstream equality movement can clearly be characterized as an identity-based social movement, the same is not true of the groups in this study. This queer liberation movement, although centered on identity claims, has goals that are redistributive as well as recognition-based. While the emergence of this distinct social movement is significant on its own, of equal significance is the fact that it represents a new post-structuralist model of social movement. This study presents a four-domain framework to explain how this movement exists simultaneously inside and outside of other social movements, as a bridge between them, and as its own movement. Implications for research, practice, and policy in social work and allied fields are presented

A Queer Liberation Movement? A Qualitative Content Analysis of Queer Liberation Organizations, Investigating Whether They are Building a Separate Social Movement

In the last forty years, U.S. national and statewide LGBT organizations, in pursuit of “equality” through a limited and focused agenda, have made remarkably swift progress moving that agenda forward. However, their agenda has been frequently criticized as prioritizing the interests of White, middle-class gay men and lesbians and ignoring the needs of other LGBT people. In their shadows have emerged numerous grassroots organizations led by queer people of color, transgender people, and low-income LGBT people. These “queer liberation” groups have often been viewed as the left wing of the GRM, but have not been extensively studied. My research investigated how these grassroots liberation organizations can be understood in relation to the equality movement, and whether they actually comprise a separate movement operating alongside, but in tension with, the mainstream gay rights movement. This research used a qualitative content analysis, grounded in black feminism’s framework of intersectionality, queer theory, and social movement theories, to examine eight queer liberation organizations. Data streams included interviews with staff at each organization, organizational videos from each group, and the organizations’ mission statements. The study used deductive content analysis, informed by a predetermined categorization matrix drawn from social movement theories, and also featured inductive analysis to expand those categories throughout the analysis. This study’s findings indicate that a new social movement – distinct from the mainstream equality organizations – does exist. Using criteria informed by leading social movement theories, findings demonstrate that these organizations cannot be understood as part of the mainstream equality movement but must be considered a separate social movement. This “queer liberation movement” has constituents, goals, strategies, and structures that differ sharply from the mainstream equality organizations. This new movement prioritizes queer people in multiple subordinated identity categories, is concerned with rebuilding institutions and structures, rather than with achieving access to them, and is grounded more in “liberation” or “justice” frameworks than “equality.” This new movement does not share the equality organizations’ priorities (e.g., marriage) and, instead, pursues a different agenda, include challenging the criminal justice and immigration systems, and strengthening the social safety net. Additionally, the study found that this new movement complicates existing social movement theory. For decades, social movement scholars have documented how the redistributive agenda of the early 20th century class-based social movements has been replaced by the demands for access and recognition put forward by the identity-based movements of the 1960s New Left. While the mainstream equality movement can clearly be characterized as an identity-based social movement, the same is not true of the groups in this study. This queer liberation movement, although centered on identity claims, has goals that are redistributive as well as recognition-based. While the emergence of this distinct social movement is significant on its own, of equal significance is the fact that it represents a new post-structuralist model of social movement. This study presents a “four-domain” framework to explain how this movement exists simultaneously inside and outside of other social movements, as a bridge between them, and as its own movement. Implications for research, practice, and policy in social work and allied fields are presented

Embodying Margin to Center: Intersectional Activism Among Queer Liberation Organizations

Over the past several decades, the mainstream gay rights movement (GRM) has achieved stunning success in its pursuit of a limited political agenda oriented toward achieving “equality” for LGBT people. Securing policy wins in terms of LGBT people\u27s access to the military, passage of hate crime legislation, and, most recently, the 2015 Obergefell v. Hodges Supreme Court decision legalizing same-sex marriage, this movement has advanced a narrow agenda under the guise of representing the interests of LGBT communities across the country. In galvanizing public support around this limited agenda, national gay rights organizations, including but not limited to the Human Rights Campaign (HRC), the National LGBTQ Task Force, Lambda Legal, and GLAAD, as well as the statewide equality groups, have positioned themselves as de facto representatives of LGBT people across the United States, and their victories are framed as victories for all these communities. However, a strong countercurrent in LGBT activism and organizing has existed alongside the dominant movement, challenging the GRM\u27s claim to represent LGBT interests and arguing instead that the movement\u27s agenda has privileged the interests of White, middle-class, and wealthy gays and lesbians to the exclusion of more marginalized LGBT people. Activist organizations in this countercurrent, here called queer liberation organizations, present a nuanced, complex, and radical vision of organizing that attends directly to the interests of the most marginal among queer communities

Deconstructing and Reconstructing Identity: How Queer Liberation Organizations Deploy Collective Identities

The mainstream gay rights movement has made significant strides toward its agenda, at least in part due to the movement’s claim that it represents all the interests of all LGBTQ communities. However, a queer liberation movement (QLM) led by queer people of color and other marginalized LGBTQ people has existed alongside the mainstream movement since its inception. This movement pursues a radically different agenda and employs organizing strategies distinct from those of the mainstream movement, centering the interests of those LGBTQ people most often left behind by the mainstream agenda. This paper examines how the QLM negotiates and deploys collective identity in and through its work. Collective identity is explored in the context of existing LGBTQ social movement theory and points to how the QLM challenges and extends social movement theorizing regarding collective identity and use of identity as a site for organizing

Clinical Practice Patterns in Temporary Mechanical Circulatory Support for Shock in the Critical Care Cardiology Trials Network (CCCTN) Registry.

BACKGROUND: Temporary mechanical circulatory support (MCS) devices provide hemodynamic assistance for shock refractory to pharmacological treatment. Most registries have focused on single devices or specific etiologies of shock, limiting data regarding overall practice patterns with temporary MCS in cardiac intensive care units. METHODS: The CCCTN (Critical Care Cardiology Trials Network) is a multicenter network of tertiary CICUs in North America. Between September 2017 and September 2018, each center (n=16) contributed a 2-month snapshot of consecutive medical CICU admissions. RESULTS: Of the 270 admissions using temporary MCS, 33% had acute myocardial infarction-related cardiogenic shock (CS), 31% had CS not related to acute myocardial infarction, 11% had mixed shock, and 22% had an indication other than shock. Among all 585 admissions with CS or mixed shock, 34% used temporary MCS during the CICU stay with substantial variation between centers (range: 17%-50%). The most common temporary MCS devices were intraaortic balloon pumps (72%), Impella (17%), and veno-arterial extracorporeal membrane oxygenation (11%), although intraaortic balloon pump use also varied between centers (range: 40%-100%). Patients managed with intraaortic balloon pump versus other forms of MCS (advanced MCS) had lower Sequential Organ Failure Assessment scores and less severe metabolic derangements. Illness severity was similar at high- versus low-MCS utilizing centers and at centers with more advanced MCS use. CONCLUSIONS: There is wide variation in the use of temporary MCS among patients with shock in tertiary CICUs. While hospital-level variation in temporary MCS device selection is not explained by differences in illness severity, patient-level variation appears to be related, at least in part, to illness severity