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"Clavel, Pierre"
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Activists in City Hall : the progressive response to the Reagan era in Boston and Chicago
In 1983, Boston and Chicago elected progressive mayors with deep roots among community activists. Taking office as the Reagan administration was withdrawing federal aid from local governments, Boston's Raymond Flynn and Chicago's Harold Washington implemented major policies that would outlast them. More than reforming governments, they changed the substance of what the government was trying to do: above all, to effect a measure of redistribution of resources to the cities' poor and working classes and away from hollow goals of growth as measured by the accumulation of skyscrapers. In Boston, Flynn moderated an office development boom while securing millions of dollars for affordable housing. In Chicago, Washington implemented concrete measures to save manufacturing jobs, against the tide of national policy and trends.
Activists in City Hall examines how both mayors achieved their objectives by incorporating neighborhood activists as a new organizational force in devising, debating, implementing, and shaping policy. Based in extensive archival research enriched by details and insights gleaned from hours of interviews with key figures in each administration and each city's activist community, Pierre Clavel argues that key to the success of each mayor were numerous factors: productive contacts between city hall and neighborhood activists, strong social bases for their agendas, administrative innovations, and alternative visions of the city. Comparing the experiences of Boston and Chicago with those of other contemporary progressive cities-Hartford, Berkeley, Madison, Santa Cruz, Santa Monica, Burlington, and San Francisco- Activists in City Hall provides a new account of progressive urban politics during the Reagan era and offers many valuable lessons for policymakers, city planners, and progressive political activists.
eBook
Urate lowering therapy in patients starting hemodialysis limit gout flares occurrence: ten years retrospective study
Background
Uncontrolled gout can cause articular impairment but is also associated with a global and cardiovascular excess mortality, especially in dialysis population.
Data documented within existing research is not conclusive regarding gout flares evolution during hemodialysis and their control by urate lowering therapy (ULT).
Without clear guidelines concerning hemodialysis patients management with chronic gout, this study proposes to investigate whether gout flare incidence reduction could be observed on this population treated by urate lowering therapy versus patients without treatment.
Methods
We performed a retrospective cohort study in two hemodialysis centers in France. Were selected patients over 18 years old with a gout history who started hemodialysis between January 2005 and September 2015.
Demographics and clinicals data were recorded at hemodialysis start and throughout 5 years of follow up. Gout flare was defined as presence of uric acid crystal in joint punction or clinically diagnosed as such with a colchicine prescription.
All statistical analysis were performed in SAS® version 9.4 (SAS Institute Inc., Cary, NC).
Results
One hundred eighty-one patients have been included, mean age at dialysis initiation was 68.6 years (± 12.4) with 72% of men, 54% were treated by ULT: 89.7% by allopurinol and 9.3% by febuxostat. One patient received both treatments successively. After hemodialysis initiation, 35.36% patients had experienced at least one gout flare. The appearance of at least one gout flare concerned 50% of patients in no ULT group and 22.68% patients in ULT group (
p
= 0.0002).
Dialysis efficiency was measured at regular interval during follow-up and was similar in both groups.
To study the association strength between clinical factors and gout flares occurrences, a Cox model was performed; ULT is a protector factor of gout flare (HR:0,42, CI 95: 0,25-0,71).
The proportion of serum urate values within the target (median 53% vs 29.3%,
p
< 0.0001) was significantly higher in ULT group versus no ULT group (median 53% vs 29.3%,
p
< 0.0001).
Conclusion
Urate lowering therapy limit new gout flares occurrence in hemodialysis patients with gout historyCollaboration between rheumatologists and nephrologists may help to update guidelines for urate-lowering therapies in patients on dialysis.
Journal Article
Cumulative incidence of restenosis in the endovascular treatment of extracranial carotid artery stenosis: a meta-analysis
ObjectiveTo assess the cumulative incidence of restenosis and stroke after stenting for cervical carotid artery stenosis.MethodsWe reviewed PubMed, ScienceDirect, and Scopus and included all studies reporting restenosis after stenting. The cumulative incidence of restenosis at 6 and 12 months was calculated. We also estimated the cumulative incidence of ipsilateral stroke within 30 days after stenting. Random effect meta-analysis and meta-regression were performed using relevant study level covariates. Sources of heterogeneity were investigated.ResultsAmong 7765 records, 40 studies were selected. 15 943 patients and 16 337 carotid arteries were considered. The overall pooled cumulative incidence of restenosis >50% at 12 months was 5.7% (95% CI 3.8% to 8.6%), >70% at 12 months was 5.2% (95% CI 3.3% to 8.2%), >50% at 6 months was 3.9% (95% CI 2.2% to 6.8%), and ipsilateral stroke within 30 days after stenting was 1.6% (95% CI 1.0% to 2.5%) without association with the use of an embolic protection device. We did not identify any relevant source of heterogeneity of the cumulative incidence of restenosis >50% at 12 months. Mean age explained 80.9% (R2=80.9%, p=0.01) of heterogeneities of restenosis >70% at 12 months. The presence of hostile neck explained 53.9% (R2=53.9%, p=0.03) of heterogeneities of restenosis >50% at 6 months.ConclusionThis meta-analysis showed a low cumulative rate of restenosis at 12 months and ipsilateral stroke within 30 days after stenting. Older patients and those with hostile neck present a lower risk of in-stent restenosis. The use of an embolic protection device was not associated with a lower risk of stroke.
Journal Article
Activists in City Hall
In 1983, Boston and Chicago elected progressive mayors with deep roots among community activists. Taking office as the Reagan administration was withdrawing federal aid from local governments, Boston's Raymond Flynn and Chicago's Harold Washington implemented major policies that would outlast them. More than reforming governments, they changed the substance of what the government was trying to do: above all, to effect a measure of redistribution of resources to the cities' poor and working classes and away from hollow goals of \"growth\" as measured by the accumulation of skyscrapers. In Boston, Flynn moderated an office development boom while securing millions of dollars for affordable housing. In Chicago, Washington implemented concrete measures to save manufacturing jobs, against the tide of national policy and trends.
Activists in City Hallexamines how both mayors achieved their objectives by incorporating neighborhood activists as a new organizational force in devising, debating, implementing, and shaping policy. Based in extensive archival research enriched by details and insights gleaned from hours of interviews with key figures in each administration and each city's activist community, Pierre Clavel argues that key to the success of each mayor were numerous factors: productive contacts between city hall and neighborhood activists, strong social bases for their agendas, administrative innovations, and alternative visions of the city. Comparing the experiences of Boston and Chicago with those of other contemporary progressive cities-Hartford, Berkeley, Madison, Santa Cruz, Santa Monica, Burlington, and San Francisco-Activists in City Hallprovides a new account of progressive urban politics during the Reagan era and offers many valuable lessons for policymakers, city planners, and progressive political activists.
eBook
Influence of Anatomic Changes on the Outcomes of Carotid Siphon Aneurysms After Deployment of Flow-Diverter Stents
Abstract
BACKGROUND
Flow-diverter stent (FDS) deployment can cause morphological and hemodynamic changes in the carotid siphon (CS), influencing the occlusion rate of aneurysms in this location.
OBJECTIVE
To evaluate morphological changes to the CS after FDS deployment and their relationship with the rate of occlusion of intracranial aneurysms.
METHODS
A cohort of 183 patients with CS aneurysms were treated by deployment of Pipeline® FDS (Medtronic Inc, Dublin, Ireland). Their CSs were classified as type U, V, C, or S, depending on morphology. The posterior and anterior bend angles were measured on strict lateral cerebral angiogram with digital subtraction before FDS deployment, immediately after deployment, and at 6 mo. Differences between angles were analyzed to identify any correlations with rates of aneurysm occlusion, using the O’Kelly-Marotta classification.
RESULTS
FDS deployment was associated with immediate changes in CS morphology. The mean anterior angle increased from 3.97 ± 25.06° to 22.05 ± 25.18° (P < .001) and the mean posterior angle increased from 71.98 ± 31.27° to 79.43 ± 31.80° (P < .001). Multivariate analysis revealed a progressive, statistically significant increase in frequency of complete (grade D) occlusion at 6-mo follow-up with increasing anterior bend angle (prevalence ratios (PR) = 1.42 for increases between 5.3° and 12°, P = .017; PR = 1.56 for increases between 12.1° and 27.6°, P = .002; PR = 1.83 for increases >27.6°, P < .001, all vs increases <5.3°).
CONCLUSION
FDS deployment induces changes in CS morphology. Specifically, increases in mean anterior angle are associated with better radiological results on 6-mo follow-up digital subtraction angiography.
Journal Article
Speaking Truth to Power
City planners (including e-planners) have at times sought to “speak truth to power,” as when the interests of poor neighborhoods' needs to preserve jobs and housing confront real estate developers promoting urban renewal schemes to replace existing homes and factories with upscale appartments and shopping malls. The planners have tools – writing, speaking, and the array of ICT devices they can employ. But they face powerful forces – not only developers, but builders, investors, professionals, city officials and media. This article – set in 1980s and 1990s Chicago -- presents the story of an alternative approach – an organizer who built a coalition of neighborhoods and employers that prevailed over a period of years. It may be a metaphor for more contemporary times. Can e-planners learn from such an example?
Journal Article
Curative endovascular treatment for low-grade Spetzler-Martin brain arteriovenous malformations: a single-center prospective study
BackgroundThe treatment of low grade Spetzler-Martin (SM) brain arteriovenous malformations (AVMs) has been debated in unruptured cases. Nevertheless, in clinical practice there are cases where treatment is preferred; in these cases a very low complication rate is mandatory. In ruptured cases, early and complete obliteration of the nidus is the preferred strategy.ObjectiveTo achieve curative embolization, ideally in a single session, by dual microcatheterization techniques with arterial and/or venous access, according to the angioarchitecture.Materials and methodsThis is a prospective, single-center study carried out between January 2008 and January 2016. Patients with ruptured and unruptured brain AVMs, with SM grades I and II, treated by endovascular means, were included. Demographics, clinical presentation, angioarchitecture, and procedure-related complications were analyzed. Angiographic and clinical results were reported.ResultsSeventy-three patients, aged 40.5±17.8 years, were included. More than 60% of the patients presented with ruptured AVMs. Initial SM grades were I for 22% and II for 78% of the patients. Preprocedural modified Rankin Scale (mRS) score was 0–2 for 53 (72.6%), 3 for 12 (16.4%), 4 for 5 (6.8%) and 5 for 3 (4.1%) patients. Procedure-related morbidity was 2.7% and procedure-related mortality was 0%. Ninety percent (90.5%) of the patients were independent in their everyday lives (mRS score 0–2) at 6 months. In all but one case (95%) the embolization was curative.ConclusionStand-alone endovascular treatment for SM grade I and II brain AVMs seems safe and effective, allowing for complete obliteration of the nidus, with low complication rates. A study of larger cohorts is needed.
Journal Article
Blogging the City: Research, Collaboration, and Engagement in Urban E-Planning. Critical Notes from a Conference
Academic blogging has typically been a form of digital scholarship that is under-utilized in academia. Although there are both costs and benefits to blogging at different stages in an academic's career, blogs can provide a rewarding platform for bringing research and academic perspectives to a wide-reaching and broader audience. This note explores the different experiences of each of the co-authors in terms of using blogs for their scholarly communication. The experiences and lessons gained are of particular relevance to urban planners, sociologists, and anthropologists, who study the social, economic, and historical elements of the city. The findings suggest that the motivations and approaches of scholarly blogging are diverse but overall add value to the academic community. Moreover, each testimony in this note provides examples of the benefits of blogging for research, collaboration, and engagement.
Journal Article