Street vendors in Mexico and day laborers in the United States, both groups of informal workers who labor in public space, face formidable structural obstacles to securing their rights as workers. Despite their apparent vulnerability, these informal workers have built perhaps the most powerful informal worker organizations in their countries. In this article, we explore and explain to the extent possible the sources, forms, and limits of this unexpected power. We explore organizational and strategic commonalities as well as differences and seek to explain both.
This article analyzes production models of the export-oriented maquila in Mexico, understood as the combinations between technological level and work organization system, labor relations flexibility, manpower characteristics, and business strategies, using for the first time the special module of the ENESTYC representative survey and information resulting from field work in 200 establishments. This work proposes that the maquila crisis in Mexico at the beginning of this century was not only because of the economic recession in the United States and Chinese competition but also because of the structural limitations of the sector's main production models, which have contributed to a crisis in labor productivity growth.
This overview of the recent intellectual history of the sociology of work in Latin America contextualizes this history in economic globalization and restructuring and political institutions in Latin America. The three-stage intellectual history addresses the development of a Latin American discipline whose theoretical models and empirical research strategies reflect crossnational similarities and variations in work, workers, and workplaces within Latin America and questions the acritical application of European and North American theoretical and research approaches. The analysis also describes the important role of social networks in the institutionalization of the discipline, including the establishment of the Latin American Sociology of Work Association in 1993.
BACKGROUND
Liver transplant (LT) is a complex procedure with frequent postoperative complications. In other surgical procedures such as gastrectomy, esophagectomy or resection of liver metastases, these complications are associated with poorer long-term survival. It is possible this happens in LT but there are not enough data to establish this relationship.
AIM
To analyze the possible influence of postoperative complications on long-term survival and the ability of the comprehensive complication index (CCI) to predict this.
METHODS
Retrospective study in a tertiary-level university hospital. The 164 participants were all patients who received a LT from January 2012 to July 2019. The follow-up was done in the hospital until the end of the study or death. Comorbidity and risk after transplantation were calculated using the Charlson and balance of risk (BAR) scores, respectively. Postoperative complications were graded according to the Clavien-Dindo classification and the CCI. To assess the CCI cut-off value with greater prognostic accuracy a receiver operating characteristic (ROC) curve was built, with calculation of the area under the curve (AUC). Overall survival was estimated according to the Kaplan-Meier test and log-rank test. Groups were compared by the Mann-Whitney test. For the multivariable analysis the Cox regression was used.
RESULTS
The mean follow-up time of the cohort was 37.76 (SD = 24.5) mo. A ROC curve of CCI with 5-year survival was built. The AUC was 0.826 (0.730-0.922),
P
< 0.001. The cut-off was calculated by means of the Youden index with a result of 35.95. The sensitivity was 84.6% and the specificity 61.3%. Survival curves for comparison of patients with CCI score < 36
vs
≥ 36 were calculated. The estimated 5-year survival was 57.65 and 43.95 months, respectively (log-rank < 0.001). This suggests that patients with more severe complications exhibit worse long-term survival. Other cut-off values were analysed. Comparison between patients with CCI < 33.5
vs
> 33.5 (33.5 = median CCI value) showed estimated 5-year survival was 57.4 and 45.71 months, respectively (log-rank < 0.0001). Dividing patients according to the mode CCI value (20.9) showed an estimated 5-year survival of 60 mo for a CCI below 20.9
vs
57 mo for a CCI above 20.9 (log-rank = 0.147). The univariate analysis did not show any association between individual complications and long-term survival. A multivariate analysis was carried out to analyse the possible influence of CCI, Charlson comorbidity index, BAR and hepatocellular carcinoma on survival. Only the CCI score showed significant influence on long-term survival.
CONCLUSION
A complicated postoperative period – well-defined by means of the CCI score – can influence not only short-term survival, but also long-term survival.
Background
The Oesophago-Gastric Anastomosis Audit (OGAA) is an international collaborative group set up to study anastomotic leak outcomes after oesophagectomy for cancer. This Delphi study aimed to prioritize future research areas of unmet clinical need in RCTs to reduce anastomotic leaks.
Methods
A modified Delphi process was overseen by the OGAA committee, national leads, and engaged clinicians from high-income countries (HICs) and low/middle-income countries (LMICs). A three-stage iterative process was used to prioritize research topics, including a scoping systematic review (stage 1), and two rounds of anonymous electronic voting (stages 2 and 3) addressing research priority and ability to recruit. Stratified analyses were performed by country income.
Results
In stage 1, the steering committee proposed research topics across six domains: preoperative optimization, surgical oncology, technical approach, anastomotic technique, enhanced recovery and nutrition, and management of leaks. In stages 2 and stage 3, 192 and 171 respondents respectively participated in online voting. Prioritized research topics include prehabilitation, anastomotic technique, and timing of surgery after neoadjuvant chemo(radio)therapy. Stratified analyses by country income demonstrated no significant differences in research priorities between HICs and LMICs. However, for ability to recruit, there were significant differences between LMICs and HICs for themes related to the technical approach (minimally invasive, width of gastric tube, ischaemic preconditioning) and location of the anastomosis.
Conclusion
Several areas of research priority are consistent across LMICs and HICs, but discrepancies in ability to recruit by country income will inform future study design.
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