Influence of prior appendectomy and cholecystectomy on Clostridioides difficile infection recurrence and mortality.

BACKGROUND: Remote appendectomy was linked to increased incidence of Clostridioides difficile infection (CDI). We evaluated the effect of absence of vermiform appendix and/or gallbladder on recurrence rate and severity of CDI. METHODS: We assessed a systemwide patient cohort diagnosed with initial CDI in 2014 (n = 250). The primary outcome was recurrence. RESULTS: Appendix and gallbladder were absent among 47 and 64 patients, respectively. CDI recurrence rate was similar among patients without and with appendix (24/47, 51.1% versus 90/203 patients, 44.3%; p = 0.404) and similar among patients without and with gallbladder (29/64 patients, 45.3% versus 85/186 patients, 45.7%; p = 0.957). Mortality was similar between appendectomy versus appendix in situ patients (3/47, 6.4% versus 9/203, 4.4%; p = 0.573), but higher mortality rate was seen among those without gallbladder (7/64 patients with prior cholecystectomy, 10.9% versus 5/186 patients with intact gallbladder, 2.7%; p = 0.008). CONCLUSION: Clostridioides difficile recurrence rate is not affected by remote appendectomy or cholecystectomy. Patients with prior cholecystectomy experience higher mortality rates associated with their CDI.

American hybrid: Donald Trump and the strange merger of populism and plutocracy.

Any effort to situate Trump's ascendance in the broader currents of cross-national developments, or in the longer course of American political development, must begin by recognizing it as a curious hybrid of populism and plutocracy. Although American right-wing populism has real social roots, it has long been nurtured by powerful elites seeking to undercut support for modern structures of economic regulation and the welfare state. American political institutions offered a distinctive opportunity for a populist figure to draw on this fury to first capture the nomination of the GOP, and from that position to ascend to the White House. Yet the administration's substantive agenda constitutes a full-throated endorsement of the GOP economic elite's long-standing demands for cuts in social spending, tax reductions for the wealthy, and the gutting of consumer, worker and environmental protections. The chasm between Trump's rhetoric and his actions justifies a more skeptical assessment of the breadth and depth of American populism, one that acknowledges how its contours are shaped by the nation's unusual political institutions, its intensifying political polarization and the out-sized influence of the wealthy.

Retrenchment and restructuring in an age of austerity: what (if anything) can be learned from the affluent democracies?

The article discusses some difficulties of drawing implications from welfare state reform in the Organisation for Economic Co-operation and Development for "middle-income countries", and whose welfare states have been less well institutionalized. It is argued that globalization's role in contemporary social policy dynamics were not unimportant, but social processes occurring within national contexts were probably more important. There is not a single "new politics of the welfare state" but distinct political dynamics in different "regimes" or "configurations", which are characterized by different problem loads and different structures of political opportunity. Different factors are crucial in explaining outcomes in different configurations and there is little reason to expect much convergence in social policy outcomes across regime type. Contemporary welfare state reform is depicted as a process of restructuring rather than dismantling, what can encourage the possibilities for developing coalitions advancing multi-dimensional agendas of welfare state reform.

Retrenchment and restructuring in an age of austerity: what (if anything) can be learned from the affluent democracies?

The article discusses some difficulties of drawing implications from welfare state reform in the Organisation for Economic Co-operation and Development for "middle-income countries", and whose welfare states have been less well institutionalized. It is argued that globalization's role in contemporary social policy dynamics were not unimportant, but social processes occurring within national contexts were probably more important. There is not a single "new politics of the welfare state" but distinct political dynamics in different "regimes" or "configurations", which are characterized by different problem loads and different structures of political opportunity. Different factors are crucial in explaining outcomes in different configurations and there is little reason to expect much convergence in social policy outcomes across regime type. Contemporary welfare state reform is depicted as a process of restructuring rather than dismantling, what can encourage the possibilities for developing coalitions advancing multi-dimensional agendas of welfare state reform