Expanded renal transplantation: a competing risk model approach

Multi-state models (MSMs) are useful to analyze survival data when, besides the event of main interest, one or more intermediate states of the individual are identified. These models take the several existing states and the possible transitions among them into account. At the same time, covariate effects on each transition intensity may be investigated separately and, therefore, MSMs are more flexible than the standard Cox proportional hazards model. In this work, we use MSMs to investigate the impact of the quality of a transplanted kidney for a group of patients at the Hospital Universitario Central de Asturias. Specifically, we use an illness-death model to study the evolution of patients with kidney disease who received a renal transplant after a dialysis period. The intermediate state is defined as the failure of the received organ, while the terminating state is the death of the patient. In order to increase the potential number of organs available for transplant, the standards of quality for the transplanted kidneys were relaxed (the new criteria are labeled expanded criteria), and these ‘expanded kidneys’ were transplanted in appropriate candidates (older patients, with higher prevalence of diabetes mellitus). Results suggest that the expanded kidneys have a minor effect on survival, while both the kidney mortality and the risk of death increase with the patient's age and the serum creatinine and serum hemoglobin levels.     

Immigrants and refugees: two sides of the same problem. A linguistic analysis through newspapers and social network in Spain 2006 and 2015

ABSTRACT

The phenomenon of immigration has been studied from diverse perspectives. It is important to note that immigration is common during times of crisis. The reason for the avalanche of immigrants to the Canary Islands (Spain) is because it is the gateway to Europe, and therefore, immigrants wanted to enter from this point. This research is based on the need to linguistically determine the treatment of the phenomenon of immigration in the Spanish press. This analysis is relevant given the arrival of thousands of foreign citizens to the coast of the Canary Islands, first in 2006 and almost a decade later, in 2015 to the south of Europe in another great population movement. This research attempts to study four Spanish newspapers, two from the Canary Islands (El Día and Canarias 7) and two Spanish mainland national newspapers (El País and ABC), the online version of the newspapers and their websites were analyzed beside one of the most important social networks, Twitter. The role of incorporating social networks to immigration discourse is also analyzed. To support the data analysis of this research, the Iramuteq software was used.     

The impossibility of the Paretian liberal and its relevance to welfare economics

The purpose of this study is to analyse the implications of Sen's impossibility result, the liberal paradox, for orthodox welfare economics. Because the rather special format of social choice theory makes it a little difficult to be sure of the relevance of this result, the whole dilemma is posed here in terms of a rather informal analysis of information al patterns.On the one hand, it is argued that the traditional approach to welfare economics, including both utilitarianism and Paretian ordinalism, contains severe informational constraints eliminating the use of all kinds of independent non-utility information in the social evaluation process. This property, called welfarism, is also present in the weak Pareto principle, which conflicts with even minimal requirements of personal liberty according to Sen's result.On the other hand, it is argued that there is in fact little to be resolved in this problem in spite of several attempts to circumvent the conflict. These studies are argued to be mainly ad hoc solutions to the formal problem and relevant only to the extent they indicate how severe restrictions are needed to avoid the paradox. The analogy with the prisoner's dilemma does not work either. Since liberal values are intrinsically non-welfaristic, the liberal paradox can be interpreted as only one, but a rather powerful, example of the informational deficiency of the orthodox approach.Finally, it is argued that the liberal paradox has striking implications for both the concept of preference and social optimum as well as empirical research on social welfare. This means that if the impossibility is to be taken seriously we need to revalue both the status of utility information and the role of the Pareto principle in social welfare analysis.The author is grateful to Professor Amartya Sen and Matti Tuomala for helpful comments and suggestions.     

Social work is beautiful On the characteristics of social work

Social work is frequently described as a problem-solving activity. Social workers are expected to identify social problems, thoroughly investigate them and take proper measures to solve them. Superficially, this kind of definition is unassailable and harmless (and, of course, partly valid), but in a deeper sense it denies us access to important concepts, perspectives and, hence, possibilities of interpretation, regarding the activity we call social work. Following this line of thought, there is a blind spot in the self-understanding of social work. This article outlines an alternative perspective on social work emphasizing making visible new possibilities of interpretation and action rather than solving problems. In connection with a recently reported research project, Organization and Human Change in Social Work, specific features of social work are suggested and discussed. The aim is to contribute to the development of a theoretical identity of social work, based on its own specific characteristics.     

Ethnicity as a risk indicator for musculoskeletal disease, long consultation times and care utilization A prospective visitor study of 438 consecutive adult consultations of a primary health care centre

This article shows the influence of ethnicity (people born outside Sweden and in Sweden) and social class (socioeconomic class) on the distribution of diagnoses, consultation time and health care utilization in primary health care controlled for sex, age, marital status and educational level. The study was designed as a prospective primary health care utilization study during 7 consecutive weeks. Of a total of 439 adults who lived in the residential area, 290 were born in Sweden and 149 were born elsewhere. The data were analysed unmatched with logistic regression and Poisson regression in main effect models. People born outside Sweden received significantly more diagnoses per consultation than people born in Sweden. The strongest independent risk indicator for musculoskeletal disease was being born outside Sweden, with an estimated odds ratio (OR) of 5.01, 95% confidence interval (CI) = 2.70–8.72. Age over 44 was associated with increased odds for musculoskeletal disease. Respiratory disease, as an indicator of less serious disease, were significantly less common among people born outside Sweden (OR = 0.53, 95% CI = 0.33–0.87). Being born outside Sweden was a risk indicator for consultations longer than 30 minutes (OR = 3.03, 95% CI=1.18–7.43). There were no differences between people born in Sweden and those born elsewhere in health and utilization. Social class was not associated with any of the dependent variables.     

Structural reforms and labor markets in Argentina

Argentina is considered to be one of the most successful cases of structural reforms in Latin America, because of the extent and rapid pace of the reforms after the hyperinflationary process of 1989–1990. At the beginning of 1991, the convertible plan was launched and inflation fell sharply. However, even when the economy is growing fast, the problems in the labor market seem to worsen. Unemployment and underemployment have risen, and an increasing number of people have fallen out of normal work. The article analyzes how changes in labor markets are closely related to the transformation process in the economic system. After a summary of the situation before the crisis of the 1980s, the article analyzes the stabilization plans applied and then discusses the current dynamics of labor markets and the policies implemented to change labor regulations. Finally, some hypotheses about future scenarios are presented.