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The space that refuge makes: rethinking displacements and protection
No full textSpace is foundational to questions of refuge and asylum, but this space is one of conditional hospitality, extended to those deemed worthy of protection by virtue of their victimhood, while physically and discursively excluding others who share similar life circumstances but are deemed unworthy. Space here is understood to be mutually constituted with the social. Hence, refuge is constituted through bodies that are cast out of national belonging, and refugees and asylum-seekers are simultaneously defined through the ‘protection space’ of the refuge and asylum. But in an age of displacement, how do refuge and asylum seek to construct a specific group of people that are distinct from the poor, and how is this distinction problematic? This article sets out to unpack part of this puzzle through an urban lens. Using urban research around shelter and housing, I demonstrate how that is used to separate communities. I argue that refuge and asylum promise safe spaces but strip people of mobility and futures, while poor citizens are denied the promise of secure land and housing, exploited for their labour, and compelled to live a life of constant displacement. This article demonstrates how these differences, shaped against each other, are relational, and asks if we can reimagine the city as a protection space for all
North Macedonia: tapping multilateral climate finance to kickstart an economy-wide just transition
No full textIn March 2024, Climate Investment Funds (CIF) approved a US600 million in funding from the European Bank for Reconstruction and Development (EBRD), the World Bank and other public and private investors. This in turn will mobilise a total of €3 billion (US$3.4 billion) into the country’s wider Just Energy Transition Investment Platform (JETIP) by 2030. This case study explores the just transition elements of the ACT IP in the context of its wider investments in clean energy in North Macedonia
New horizons in improving research capacity in English care homes for older adults
No full textAs the care home sector expands over time, the health and social care needs of both residents and staff intensify and diversify. These sector-wide changes call for significant growth in research capacity to deliver useful, pertinent and timely evidence. In this paper we highlight growing pressures in the care home sector, and the major and enduring barriers to conducting research across that sector, within homes and amongst staff, drawing primarily on our experiences conducting public health research in England. These obstacles include a lack of national infrastructure, tradition and culture, and underdeveloped systems to reimburse providers for the staff and other costs associated with research delivery. Finally, we detail short, medium and long-term actions that could enable the growth of research capacity across the sector. These include leveraging political will, remunerating and crediting research champions, and establishing a feedback loop to showcase the contribution of research in improving both quality of care and resident outcomes. Our suggested actions focus on what would be required to build research capacity in care homes in England; although these also have relevance in other countries where there is a need and wish to build research capacity in adult long-term care facilities
Fossil fuel divestment, directors’ duties, and derivative claims: McGaughey and Davies v. USS Ltd and its directors
No full textA Climate Change Laws of the World insight In July 2023, at that time the hottest ever month in human history, the UK Court of Appeal gave judgment in McGaughey and Davies v. USS Ltd and its Directors [2023] EWCA Civ 873. The author of this note, Professor Ewan McGaughey, and his colleague, Professor Neil Davies, had undertaken the largest crowdfunded drive in the UK so far, to sue the board of directors personally to reverse (the roughly) 30% cuts to defined benefit pensions, and to require the UK’s biggest pension fund, the Universities Superannuation Scheme (USS), to divest of its fossil fuels assets. Out of court, after the Truss mini-budget, years of strikes, and shortly after the complainants got leave to the Court of Appeal, USS capitulated: the CEO announced his resignation, and USS declared it would reverse the pension cuts. Despite this victory, McGaughey and Davies went on to lose in the Court of Appeal, but by then they had already succeeded in most of their goals. The key issue where they had limited success was in fossil fuel divestment. The focus of this Climate Change Laws of the World note is why they lost on the fossil fuel claim, but also how the case sets a positive precedent for beneficiaries seeking to uphold directors’ duties, thus it may be instructive for the future wave of litigation against directors complicit in climate damage
Marx and the Chinese revolution
No full textBy focusing on the “Sinification of Marxism,” the nature of the Communist Party of China, the strategic concepts of class and nation, the theories of a “new democratic revolution” and “continuous revolution,” and the notion of revolutionary modernity, the historical processes, characters and significance of the communist revolution in China can be outlined. Beginning with the shift in Marx’s conception of history that affirms the potential for ‘socialist revolutions’ in the East before Europe, and ends with his methodological illumination for understanding and interpreting world-historical revolutionary transformations, the argument centers on the epic effects and impact of the Chinese revolution and the enduring relevance and power of Marx’s ideas, as well as those creatively developed by Chinese Marxists in practice. However, measured by its original goals of freedom, democracy, and prosperity for the laboring people, it must be recognized as an unfinished revolution. The revolution’s intrinsic and unresolved dilemmas, along with the partial undoing of its groundwork in market reforms, sharpen the predicament of historical communism. 1949 was only the first threshold in China’s ongoing long march
Environmental impact assessment of solar panel production and recycling in Southeast Asia
No full textSoutheast Asia is world's second largest solar photovoltaic (PV) panel manufacturing region after China. The increases in panel production, domestic installation and end-of-life disposal are resulting in environmental impacts across the region. In particular, appropriate waste disposal methods within Southeast Asia, coupled with assessments of their environmental impacts are ever more critical. While many studies have assessed the environmental impacts of production and waste recovery, those for panels produced in Southeast Asia have received limited attention. This paper aims to assess the environmental impacts of the production and waste recovery of PV produced in Malaysia, Singapore, Thailand and Vietnam, through a cradle-to-grave life cycle assessment (LCA) with intermediate materials produced in China, and two waste recovery methods: laminated glass recycling facility (LGRF) and full recovery end-of-life photovoltaic (FRELP). The results show that the climate change potential of solar panels produced in Southeast Asia range from 10,442 to 10,976 kgCO 2-eq per tonne of modules, compared to 11,052 kgCO 2-eq in China. Waste recovery methods can lower the environmental impacts of solar panels across all impact categories when considering the avoided impacts from the recovery of materials. The reductions were most pronounced for climate change and metal depletion potential. Higher recovery yields would also result in reduced environmental impacts. In conclusion, this paper indicates that a supply chain that includes Southeast Asian PV assembly is a lower carbon option to the prevailing supply chain, especially when enhanced with effective waste recovery policies
First-line cyclin-dependent kinase 4 and 6 inhibitors in combination with an aromatase inhibitor for HR+/HER2- metastatic breast cancer: a real-world cost-effectiveness assessment in a US Medicare-eligible population
No full textBACKGROUND: In hormone receptor-positive, human epidermal growth factor 2-negative (HR+/HER2-) metastatic breast cancer (mBC), cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6is) in combination with an aromatase inhibitor (AI) are the preferred first-line (1L) treatment. Although prior cost-effectiveness models comparing CDK4/6is palbociclib, ribociclib, and abemaciclib have used data from placebo-controlled clinical trials, no analyses in the United States have been conducted using real-world evidence (RWE) for a US Medicare-eligible population. OBJECTIVE: To estimate the long-term clinical outcomes and health care costs of 1L CDK4/6i treatment in patients aged 65 years and older using RWE. METHODS: We developed a partitioned survival model to project patient time in progression-free and progressed disease health states. Progression-free survival (PFS) and overall survival (OS) curves for palbociclib + AI were obtained from an analysis of patients aged 65 years and older treated 1L for HR+/HER2- mBC using the Flatiron Health Analytic Database (Flatiron). Adjusted comparative effectiveness estimates vs palbociclib + AI for both ribociclib + AI (PFS hazard ratio = 0.98 [95% CI = 0.86-1.13]; OS hazard ratio = 1.01 [95% CI: 0.87-1.18]) and abemaciclib + AI (PFS hazard ratio = 0.99 [95% CI = 0.86-1.15]; OS hazard ratio = 1.00 [95% CI = 0.84-1.19]) were obtained from the same analysis. All-cause medical costs and CDK4/6i drug costs were based on an analysis of patients aged 65 years and older in Optum Clinformatics DataMart. We used a Medicare perspective over a lifetime horizon for a cohort of patients with mean age of 73.7 years. Sensitivity analyses were performed to assess the robustness of results to plausible variation in input values. RESULTS: Projected life-years (LYs) with palbociclib + AI, ribociclib + AI, and abemaciclib + AI were similar: 5.16 (95% credible range [CR] = 4.94-5.35), 5.12 (95% CR = 4.53-5.82), and 5.16 (95% CR = 4.49-5.90), respectively. Total lifetime health care costs were also similar (807,400-866,800 [95% CR = 965,000], and 809,000-$1,004,600], respectively). Sensitivity analyses further supported no differences in LYs or total costs between CDK4/6is. CONCLUSIONS: Based on effectiveness and cost estimates from real-world data, our analyses suggest that palbociclib, ribociclib, and abemaciclib produce similar life expectancy and health care costs in US patients aged 65 years and older with HR+/HER2- mBC
Bayesian prevalence of autism and unmet special education needs in Chile in a sample of three million school-age children
No full textAutism spectrum disorder prevalence estimates in Latin America have been limited by a lack of reliable data. This cohort study aimed to estimate autism spectrum disorder prevalence in Chile by linking school registries with electronic health records. Probabilistic data linking was conducted between the 2021 Chilean school registry and 2003−2015 health records from the Araucania Sur Health Service. Bayesian prevalence estimation was used, considering variables such as age, sex, immigration status, ethnicity and rurality. Autism spectrum disorder prevalence across 29 health services was analysed for students aged 6 to 18 years. Regression models assessed unmet needs for special education services, validated using Araucania Sur Health Service health records. The study included 3,056,306 pupils (51.34% boys; mean age 11.6 years), with 14,549 having autism spectrum disorder. The national standardized school prevalence was 0.46%. Boys had 6 times higher odds of receiving special education services support than girls. In Araucania Sur Health Service, the adjusted clinical prevalence from health records was 1.22%. The Bayesian projected national autism spectrum disorder prevalence was 1.31%. This study, the largest of its kind in Latin America, revealed a higher autism spectrum disorder prevalence than previously reported, with one in 76 children affected. Disparities were observed across sex, ethnicity and health services. Lay abstract This project tried to understand how many children in Chile are affected by autism, as reliable data have been lacking not only in Chile but across much of Latin America. To do this, we carried out the largest autism prevalence study ever conducted in the region. We linked national school records from 2021 with over a decade of health records (2003–2015) from the Araucanía Sur Health Service in southern Chile. This allowed us to examine data from more than three million students aged 6 to 18 years across 29 health services. Our results revealed that around one in every 76 children may have autism – almost 3 times higher than what was reported in schools alone. We also found that boys were 6 times more likely than girls to receive special education support. Using advanced statistical modelling, we estimated a national autism prevalence rate of 1.31%. Importantly, we discovered disparities in diagnosis and access to support based on sex, ethnicity, immigration status and whether a child lived in a rural or urban area. These findings highlight the need for more inclusive and equitable approaches to autism identification and care across Chile. This research not only helps to fill a major data gap but also offers a model for how countries with limited resources can use existing administrative data to improve public health planning and educational support for children with autism
