: Much of the discussion surrounding neoliberal urbanism has been empirically grounded in the North. This paper shifts the discussion south to focus on the regulation of indigenous street vendors and beggars in the Andean nation of Ecuador. Inspired by zero tolerance policies from the North, the cities of Quito and Guayaquil have recently initiated urban regeneration projects to cleanse the streets of informal workers, beggars, and street children. In this paper, I explore the particular and pernicious ways in which these neoliberal urban policies affect indigenous peoples in the urban informal sector. Grounded in the literature on space, race and ethnicity in the Andes, I argue that Ecuador's particular twist on revanchism is through its more transparent engagement with the project of blanqueamiento or “whitening”. I further argue that Ecuador's “refinement” of revanchist urban policies only works to displace already marginalised individuals and push them into more difficult circumstances.
Recent left academic work on the consequences of economic restructuring and local labour market change in old industrial cities has been important in emphasising the role of local context and contingency in the shaping of labour market outcomes. However, in such accounts agency is often limited to capital and state actors, albeit working across scales from the local upwards. There is little sense of agency for individuals and communities in the midst of economic restructuring. Instead, they are usually treated as passive victims of deeper underlying processes. In this paper, our purpose is to highlight the autonomy and agency of workers, people and communities in old industrial cities. Rather than starting from the perspective of capital, our starting point is to emphasise how those experiencing economic change forge strategies and practices for “getting by”. This leads us to call for a re‐theorisation of labour agency, drawing upon the Autonomous Marxist tradition and the more recent work of Cindi Katz, in order to offer fresh insight into the agency of labour and the prospect for recovering a class politics based upon lived experience over reified abstractions.
Comprehensive geriatric assessment (CGA) is frequently used in oncology to measure the health status of older adults with cancer, but it has not been studied in allogeneic hematopoietic cell transplantation (HCT). We conducted a prospective pilot study of CGA in allogeneic HCT recipients aged ≥50 years to examine the prevalence of vulnerabilities in this population. Patients aged ≥50 years eligible for HCT were enrolled. CGA consisted mainly of self-reported, performance-based, and chart-extracted measures evaluating domains of comorbidity, physical and mental function, frailty, disability, and nutrition. Of 238 eligible patients, 166 completed CGA and underwent HCT. Only 1% had a Zubrod Performance Status score >1; 44% had high comorbidity defined by the Hematopoietic Cell Transplantation Comorbidity Index, and 66% had high comorbidity defined by the Cumulative Illness Rating Scale-Geriatrics. The presence of additional vulnerability was frequent. Disability was present in 40% by Instrumental Activities of Daily Living. Self-reported physical and mental function were significantly lower than population age group norms, 58% were pre-frail, and 25% were frail. Among those with Zubrod Performance Status score of 0, 28% demonstrated disability, 58% were pre-frail, 15% were frail, 35% reported low physical function, and 55% reported low mental function. CGA uncovers a substantial prevalence of undocumented impairments in functional status, frailty, disability, and mental health in older allogeneic HCT recipients.
BK virus (BKV) is an important pathogen and cause of nephropathy in renal transplant recipients, but its significance following hematopoetic stem cell transplantation (HSCT) is less well described. We measured blood and urine BKV in 124 allogeneic HSCT patients (67 had undergone prior HSCT [surveillance cohort]; 57 were monitored from transplant day 0 [prospective cohort]). BK viruria was manifest in 64.8% of the patients; 16.9% developed viremia. In the prospective cohort, the median time from transplantation to BK viremia development (128 days) was longer than for viruria (24 days; P < 0.0001). Among clinical factors (gender, disease, transplant type, alemtuzumab use, CMV viremia, GVHD, donor HLA C7 allele), only CMV viremia was more common in patients with BKV infection (P ≤ 0.04). There was a direct relationship between blood and urine BKV levels and the occurrence, and degree, of hematuria (P ≤ 0.03). Finally, BKV infection was analyzed along with other clinical factors in relation to the development of post-HSCT renal impairment. On multivariate analysis, only BK viremia (P = 0.000002) and alternative-donor transplantation (P = 0.002) were independent predictors of development of post-HSCT renal impairment, with BK viremia associated with a median 1.62 mg/dL rise in creatinine from the pre-transplant baseline. Among eight patients in the surveillance cohort with BK viremia, two developed biopsy-proven BKV nephropathy requiring hemodialysis. Investigation of whether prophylaxis against, or treatment of, BKV in the post-HSCT setting mitigates the associated morbidities, especially kidney injury, warrants prospective evaluation.
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