Globalization from Above and Below in the San Quintin Valley, Oxnard, and Other Strawberry Production Territories

El artículo analizará diferentes métodos de reclutamiento adoptados por empresas locales ubicadas en el Valle de San Quintín, en Baja California, y por compañías transnacionales que operan en el sector fresero en México, así como en EE. UU. Este valle constituye un pasaje fundamental para los migrantes que proceden del sur de México y viajan hacia el norte del país y a EE. UU. El trabajo de campo en el que se basa este artículo se ha desarrollado durante los años 2016 y 2017, en San Quintín, México, y en Oxnard, EE. UU., donde la presencia de las mismas corporaciones agroalimentarias permite un análisis de sus estrategias económicas y territoriales. La metodología se ha basado en técnicas cuantitativas y, especialmente, cualitativas.The article will analyze different recruiting methods adopted by local farms located in the San Quintin Valley, in Baja California, and transnational companies that operate in the strawberry sector in both Mexico and the United States. This valley is a fundamental route for migrants from southern Mexico who travel to the north of the country and the U.S. The article draws on the fieldwork carried out during 2016 and 2017, in San Quintin and Oxnard (U.S.), where the presence of the same agri-food corporations allows an analysis of their economic and territorial strategies. The methodology has been based on quantitative and especially qualitative techniques

Corporate Food Regime y jornaleros inmigrantes en la recolección de fresas en California

En este artículo se analizará el creciente papel de las compañías multinacionales en las cadenas agroalimentarias, con los impactos en la estructura productiva local y el trabajo agrícola, a través del estudio de caso de las bayas producidas en el área de Oxnard, California (Estados Unidos) y los jornaleros inmigrantes procedentes de México. Se profundizará en la gestión estratégica de los convenios de suministro, de la tecnología agraria y de los territorios por parte de las compañías comerciales, junto a los efectos de la parcial mecanización de la cosecha y el sistema multinivel de intermediación laboral. Se observará cómo la evolución del capital agroalimentario que, según el análisis del régimen alimentario (food regime), constituye una reorganización del capital en general, influye tanto en los procesos de circulación del capital, como en las relaciones sociales de producción. La metodología de investigación se ha basado en una combinación de técnicas cuantitativas y sobre todo cualitativas

Vowel processing in Italian pediatric cochlear-implant users: A behavioral and neurophysiological study

Multichannel cochlear implant (CI) devices partially restore the auditory sensation in children affected by congenital, bilateral, and severe-to-profound sensorineural hearing loss, especially in the absence of background noise, provided that CI surgery takes place during the sensitive period for maturation of the auditory pathways, which is presumed to end at 3.5 years [Sharma et al. 2002abc, 2005, 2007; 2009; Gilley et al. 2008]. A few previous studies on Italian pediatric CI users investigated the general auditory abilities as well as the speech intelligibility of deaf children [cf. Santarelli et al. 2009; Colletti et al. 2012; Caselli et al. 2012; Martines et al. 2013], by using the usual tests administered by speech therapists. Plenty of previous studies investigated detection, categorization, and discrimination of speech sounds, both consonants and vowels, at the cortical level (automatically), in CI children exposed to languages other than Italian, such English [Kileny et al. 1997; Sharma et al. 2002abc, 2005, 2007; 2009; Gilley et al. 2008; Henkin et al. 2008], Dutch [Beynon et al. 2002], German [Ortmann et al. 2013], Hebrew [Singh et al. 2004], and Croatian [Munivrana & Mildner 2013]. As compared to the above-mentioned studies, the present research introduces three methodological innovations: i) it investigates the processing of vowels; ii) it relies on natural speech stimuli, only minimally normalized; and iii) it combines the use of behavioral measures (e.g., tests of categorization and discrimination of speech sounds, administered attentively) with the use of neurophysiological measures (e.g., the EEG recording for subsequent extraction of the auditory ERPs indexing speech sound detection, categorization, and discrimination). The present study investigates the processing of single vowels (e.g., /u/, /i/, /e/, /o/, /a/) as well as of same-vowel pairs (e.g., /u/-/u/, /i/-/i/, /e/-/e/, /o/-/o/, /a/-/a/) and of different-vowel pairs (e.g., /u/-/i/, /i/-/u/, /e/-/i/, /i/-/e/, /o/-/a/, /a/-/o/) at the behavioral (e.g., conscious) and at the neurophysiological (e.g., automatic) levels in a group of deaf Italian children implanted during the sensitive period for central auditory maturation (range of age at surgery: 2.1 – 4.4 years) and who had been using their CI for at least 2 years (range of duration of CI stimulation: 2.4 – 8.1 years). At the behavioral level, tests of vowel detection and of vowel categorization were administered. At the neurophysiological level, the EEG activity was passively recorded when children were watching a silent movie while hearing vowel stimuli on the background. Subsequently, the P1, N1, and MMN responses of the auditory ERPs are the neural correlates of (speech) sound detection, categorization, and discrimination, in turn, were extracted. The vowel processing performance of the CI children will be compared against the performance exhibited by a group of normal-hearing (NH) children matched for biological age with the CI children. This study also investigated whether, and to what extent, some external factors were able to constrain vowel processing at the behavioral and neurophysiological level in CI children. These factors are the following ones: i) vowel quality; ii) the articulatory characteristics of the five vowels; iii) the larger vs. smaller Euclidean distance characterizing the vowel pairs; iv) the different distinctive feature specification and, more particularly, the direction of change in the distinctive feature specification between the first and the second vowel of each pair; v) the earlier vs. later age at surgery; and vi) the longer vs. shorter duration of CI use. The main findings of the present study are the following ones. First, the main difference between the behavioral and the neurophysiological levels of processing in CI children consists in the fact that the processing of vowel pairs is partially impaired for accuracy only at the behavioral level, whereas the processing of single vowels is partially impaired for accuracy, and rarely delayed, only at the neurophysiological level. Second, at the neurophysiological level, CI children are impaired at the auditory, not at the cognitive, level. In fact, in spite of typically being less accurate in detection and categorization of single vowels, CI children are not impaired in the processing of vowel pairs. Third, age at surgery and duration of implant stimulation are irrelevant for behavioral vowel processing, whereas they constrain cortical vowel processing, although not systematically: deaf children implanted before 3.4 years and/or who had been using their CI for at least 5.8 years may process single vowels as well as vowel pairs faster and more accurately. Vowel quality, the articulatory characteristics of the five vowels, the Euclidean, and the direction of change in the distinctive feature specification, on the other hand, turn out to be irrelevant in constraining vowel processing either at the behavioral and at the neurophysiological level

Atherosclerotic risk factors and complications in patients with non-functioning adrenal adenomas treated with or without adrenalectomy: a long-term follow-up study

Objective: Despite the increased prevalences of hypertension. type 2 diabetes mellitus (T2DM). hyperlipidemy, and obesity in patients with non-functioning adrenal adenomas (NFAAs), there is a paucity of data on long-term atherosclerotic morbidity as well as the long-term cardiovascular effects of adrenalectomy in these patients. Design, patients, and methods: This retrospective study includes the results or baseline and follow-up investigations of 125 patients (29 males and 96 females: mean age 60.1 years) with NFAAs referred for endocrine evaluation between 1990 and 2001. Of the 125 patients, 47 underwent unilateral adrenalectomy, while 78 patients were followed conservatively. These patients were reinvestigated after a mean follow-up time of 9.1 (5-16) years in 2006, with special emphasis on laboratory and other atherosclerotic risk factors (ARF), vascular events, and interventions. Results: The prevalences of hypertension, impaired glucose tolerance or T2DM, hyperlipidemy, and obesity were 82, 43, 58, and 50%, and 89, 58, 82, and 50% at baseline and follow-up, respectively None of the investigated ARF prevalences were different between patients treated and not treated with adrenalectomy, and between patients with and without subclinical Cushing's syndrome. The prevalences of angina pectoris, acute myocardial infarction, coronary and peripheral arterial interventions or cerebrovascular stroke did not differ significantly between patients treated and not treated with adrenalectomy Conclusion: Our study confirms previous investigations reporting markedly increased prevalences of various ARF in patients with NFAAs. Adrenalectomy performed in these patients failed to decrease the prevalence of ARF and atherosclerotic morbidit

Jornaleros agrícolas y corporaciones transnacionales en el Valle de San Quintín

El artículo investiga la aplicación del modelo agrícola californiano en el sector fresero del Valle de San Quintín, en Baja California, México. Se analizan las operaciones económicas implementadas por las compañías comerciales transnacionales, así como la movilización anticorporativa de los jornaleros agrícolas. La investigación contribuye al debate sobre cadenas y redes globales de producción, corporaciones transnacionales y estudios agroalimentarios, combinando un análisis de los procesos de circulación del capital y de las relaciones sociales de producción. La investigación se ha desarrollado durante varias etapas en los años 2016 y 2017, con una combinación de técnicas cuantitativas y, sobre todo, cualitativas

Open questions on basal insulin therapy in T2D: a Delphi consensus

Aims: The revolution in the therapeutic approach to type 2 diabetes (T2D) requires a rethinking of the positioning of basal insulin (BI) therapy. Given the considerable number of open questions, a group of experts was convened with the aim of providing, through a Delphi consensus method, practical guidance for doctors. Methods: A group of 6 experts developed a series of 29 statements on: the role of metabolic control in light of the most recent guidelines; BI intensification strategies: (1) add-on versus switch; (2) inertia in starting and titrating; (3) free versus fixed ratio combination; basal-bolus intensification and de-intensification strategies; second generation analogues of BI (2BI). A panel of 31 diabetologists, by accessing a dedicated website, assigned each statement a relevance score on a 9-point scale. The RAND/UCLA Appropriateness Method was adopted to assess the existence of disagreement among participants. Results: Panelists showed agreement for all 29 statements, of which 26 were considered relevant, one was considered not relevant and two were of uncertain relevance. Panelists agreed that the availability of new classes of drugs often allows the postponement of BI and the simplification of therapy. It remains essential to promptly initiate and titrate BI when required. BI should always, unless contraindicated, be started in addition to, and not as a replacement, for ongoing treatments with cardiorenal benefits. 2BIs should be preferred for their pharmacological profile, greater ease of self-titration and flexibility of administration. Conclusion: In a continuously evolving scenario, BI therapy still represents an important option in the management of T2D patients

A sub-analysis of the SAGE study in Italy indicates good glycemic control in type 1 diabetes

Background and aims: Intensive glycemic control minimizes the risk of micro- and macrovascular complications in patients with type 1 diabetes (T1D). We report glycemic control in Italian participants (age groups: 26–44, 45–64, and ≥65 years) of the global SAGE study. Methods and results: The primary endpoint was proportion of participants who achieved an HbA1c <7% in predefined age groups. In the 523 patients with T1D, mean age was 44.6 years and mean body mass index (BMI) was 25 kg/m2. Mean HbA1c was 7.5% and 29.4% had HbA1c <7.0%, with the highest percentage in those 26–45 years (31.7%) and the lowest in those ≥65 years (20%). Altogether, 22.9% of patients achieved their physician-established individualized HbA1c target. Most patients had ≥1 symptomatic hypoglycemic episode in the previous 3 months (≤70 mg/dL 82.5%; ≤54 mg/dL 61%). Severe hypo- and hyperglycemia were experienced by 16.3% and 12% of patients, of which 7.1 and 9.5%, respectively, required hospitalization/emergency visits. More patients achieved HbA1c <7% with CSII (30%) than with multiple daily insulin injections (27.9%). In multivariate analysis, BMI (OR 0.94, 95% CI 0.89–0.99, p = 0.032) and adherence to diet (OR 0.36, 95% CI 0.18–0.70, p = 0.0028) were significantly associated with HbA1c <7.0%. Conclusions: Glycemic control can be considered good in the Italian SAGE cohort, especially in younger patients, who more frequently use pumps/continuous glucose monitoring. Greater patient education and use of technology may further support this achievement. Patients should be encouraged to maintain a low BMI and adhere to their diet

Parea non servin: strategies of exploitation and resistance in the caporalato discourse

In this article, we analyse the ideological content of the discursive strategies used by a group of migrant workers subjected to ‘caporalato’, a form of illegal hiring and exploitation of farm day workers through an intermediary. Starting from a series of collective open interviews with farm workers, we examine the way in which the dynamics of both exploitation and resistance are reproduced through linguistic and discursive practices. What emerges from the analysis is a complex set of ambivalent experiences and representations. Despite its inherent exploitative and controlling nature, the workers tend to justify, legitimise and deny the negative aspects of caporalato. Nonetheless, they also use linguistic devices of resistance to reconfigure the meanings of, and their role in, caporalato. Interestingly, the analyses show that caporalato is also perceived as a mechanism of social mobility. Only limited attempts at explicitly challenging its criminal nature are strategically expressed. In questo articolo, analizziamo il contenuto ideologico delle strategie discorsive usate da un gruppo di lavoratori migranti soggetti a ‘caporalato’, una forma illegale di reclutamento e di sfruttamento del lavoro dei braccianti agricoli mediante l’operato di un intermediario. Partendo da una serie di interviste aperte di tipo collettivo con un alcuni braccianti, si esamina il modo con il quale le dinamiche di sfruttamento e resistenza siano riprodotte attraverso pratiche linguistiche e discorsive. Ciò che emerge, è un complesso ed ambivalente sistema di esperienze e rappresentazioni. Nonostante l’intrinseca natura di sfruttamento e controllo, i lavoratori sembrano giustificare, legittimare e perfino negare gli aspetti più critici del caporalato. Pur tuttavia, i braccianti si servono anche di strumenti linguistici di resistenza con l’obiettivo di riconfigurare i significati ed i ruoli del caporalato stesso. Tra questi, si evince come tale fenomeno possa essere altresì percepito come un meccanismo di mobilità sociale. In ultima analisi, l’analisi riflette su come solo esigui tentativi siano strategicamente messi in atto dai braccianti per denunciare la nature criminale del caporalato

Long-term benefits of dapagliflozin on renal outcomes of type 2 diabetes under routine care: a comparative effectiveness study on propensity score matched cohorts at low renal risk

Background: Despite the overall improvement in care, people with type 2 diabetes (T2D) experience an excess risk of end-stage kidney disease. We evaluated the long-term effectiveness of dapagliflozin on kidney function and albuminuria in patients with T2D. Methods: We included patients with T2D who initiated dapagliflozin or comparators from 2015 to 2020. Propensity score matching (PSM) was performed to balance the two groups. The primary endpoint was the change in estimated glomerular filtration rate (eGFR) from baseline to the end of observation. Secondary endpoints included changes in albuminuria and loss of kidney function. Findings: We analysed two matched groups of 6197 patients each. The comparator group included DPP-4 inhibitors (40%), GLP-1RA (22.3%), sulphonylureas (16.1%), pioglitazone (8%), metformin (5.8%), or acarbose (4%). Only 6.4% had baseline eGFR <60 ml/min/1.73 m2 and 15% had UACR >30 mg/g. During a mean follow-up of 2.5 year, eGFR declined significantly less in the dapagliflozin vs comparator group by 1.81 ml/min/1.73 m2 (95% C.I. from 1.13 to 2.48; p < 0.0001). The mean eGFR slope was significantly less negative in the dapagliflozin group by 0.67 ml/min/1.73 m2/year (95% C.I. from 0.47 to 0.88; p < 0.0001). Albuminuria declined significantly in new-users of dapagliflozin within 6 months and remained on average 44.3 mg/g lower (95% C.I. from −66.9 to −21.7; p < 0.0001) than in new-users of comparators. New-users of dapagliflozin had significantly lower rates of new-onset CKD, loss of kidney function, and a composite renal outcome. Results were confirmed for all SGLT2 inhibitors, in patients without baseline CKD, and when GLP-1RA were excluded from comparators. Interpretation: Initiating dapagliflozin improved kidney function outcomes and albuminuria in patients with T2D and a low renal risk. Funding: Funded by the Italian Diabetes Society and partly supported by a grant from AstraZeneca