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The squeaky wheel gets the grease: Violent civil unrest and global social assistance provision.

ABSTRACT: What are the contemporary determinates of social assistance provision? What is the role of contentious politics? Social assistance literature is dominated by economic and demographic accounts, which under-examine the possibility that governments extend social assistance to contain social unrest. We test factors associated with these "structuralist" and "political" theories on a new panel dataset which includes 54 OECD and emerging market countries between 2002 and 2015. The results indicate social assistance coverage has a significant positive relationship with riots. We explain this outcome as policymakers expanding social assistance as a means of containing violent civil unrest. This effect is more significant in emerging markets, suggesting that the domination of structural explanations is a result of sample bias toward the OECD. Finally, we find that governments consider World Bank social policy recommendations only insofar as there is violent unrest.

SUBMITTER: Cemen R

PROVIDER: S-EPMC9580367 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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The squeaky wheel gets the grease: Violent civil unrest and global social assistance provision.

Çemen Rahmi R Yörük Erdem E

Frontiers in sociology 20221005

What are the contemporary determinates of social assistance provision? What is the role of contentious politics? Social assistance literature is dominated by economic and demographic accounts, which under-examine the possibility that governments extend social assistance to contain social unrest. We test factors associated with these "structuralist" and "political" theories on a new panel dataset which includes 54 OECD and emerging market countries between 2002 and 2015. The results indicate soci ...[more]

PMID: 36276433

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Project description:ObjectivesThe purpose of this study is to map the characteristics of the existing medical literature describing the medications, settings, participants and outcomes of medical assistance in dying (MAID) in order to identify knowledge gaps and areas for future research.DesignScoping review.Search strategyWe searched electronic databases (MEDLINE, EMBASE, PsychINFO, CINAHL and CENTRAL), clinical trial registries, conference abstracts and professional guidelines from jurisdictions where MAID is legal, up to February 2020. Eligible report types included technical summaries, institutional policies, practice surveys, practice guidelines and clinical studies that describe MAID provision in adults who have provided informed consent for MAID.Results163 articles published between 1989 and 2020 met eligibility criteria. 75 studies described details for MAID administered by intravenous medications and 50 studies provided data on oral medications. In intravenous protocols, MAID was most commonly administered using a barbiturate (34/163) or propofol (22/163) followed by a neuromuscular blocker. Oral protocols most often used barbiturates alone (37/163) or in conjunction with an opioid medication (7/163) and often recommended using a prokinetic agent prior to lethal drug ingestion. Complications included prolonged duration of the dying process, difficulty in obtaining intravenous access and difficulty in swallowing oral agents. Most commonly, the role of physicians was prescribing (83/163) and administering medications (75/163). Nurses' roles included administering medications (17/163) and supporting the patient (16/163) or family (13/163). The role of families involved providing support to the patient (17/163) and bringing medications from the pharmacy for self-administration (4/163).ConclusionsWe identified several trends in MAID provision including common medications and doses for oral and parenteral administration, roles of healthcare professionals and families, and complications that may cause patient, family and provider distress. Future research should aim to identify the medications, dosages, and administration techniques and procedures that produce the most predictable outcomes and mitigate distress for those involved.

Project description:BackgroundThere are limited data on the effectiveness of differentiated service delivery (DSD) for HIV care during sociopolitical turmoil. We assessed outcomes with a DSD model of care that includes patient choice between community-based antiretroviral therapy (ART) centres, home-based ART dispensing, or facility-based care at GHESKIO clinic during a period of severe civil unrest in Port-au-Prince, Haiti.MethodsThis retrospective analysis included data on patients with at least one HIV visit at GHESKIO between May 1, 2019, and December 31, 2021. Multivariable logistic regression models were used to assess predictors of attending ≥1 community visit during the study period, and failure to attend timely visits. HIV-1 RNA test results were reported among patients who had been ART for ≥3 months at last visit.FindingsOf the 18,625 patients included in the analysis, 9659 (51.9%) attended at least one community visit. The proportion of community visits ranged from 0.3% (2019) to 44.1% (2021). Predictors of ≥1 community visit included male sex (aOR: 1.13; 95% CI: 1.06, 1.20), secondary education (aOR: 1.07; 95% CI: 1.01, 1.14), income > $USD 1.00/day (aOR: 1.24; 95% CI: 1.14, 1.35), longer duration on ART (aOR: 1.08 per additional year; 95% CI: 1.07, 1.09), and residence in Carrefour/Gressier (p < 0.0001 in comparisons with all other zones). Younger age and shorter time on ART were associated with late visits and loss to follow-up. Among 12,586 patients with an on-time final visit who had been on ART for ≥3 months, 11,131 (88.4%) received a viral load test and 9639 (86.6%) had HIV-1 RNA < 1000 copies/mL.InterpretationThe socio-political situation in Haiti has presented extraordinary challenges to the health care system, but retention and viral suppression rates remain high with a model of community-based HIV care. Additional interventions are needed to improve outcomes for younger patients, and those with shorter time on ART.FundingNo funding.

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The squeaky wheel gets the grease: Violent civil unrest and global social assistance provision.

Publications

The squeaky wheel gets the grease: Violent civil unrest and global social assistance provision.

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