Martin Geiger

Background Abdominal aortic aneurysms (AAA) are 4-6 times more frequent among men than among women, but prognosis tends to be worse in women. Objective To compare endovascular procedures to repair infrarenal AAA in men and women, using data from a prospective registry. Methods This registry collected data from five university hospitals in the state of São Paulo (Brazil) from 2012 to 2022. A cross-sectional study was conducted compiling demographic data, anatomic variables (aneurysm diameter, short neck, angulated neck, calcified neck, or thrombosed neck; distal neck < 1.5 cm, and tortuous, abnormal iliac arteries), complications (leaks, conversions, and patency or stenosis of branches) and renal failure and mortality at 30 days. The chi-square test and Student’s t test were applied with a 5% significance level. The study was approved by the Ethics Committee (process 4040-2011). Results A total of 152 (15.9%) of the patients were women and 799 (84.0%) were men (p < 0.05). The majority were white (80.2% of the women and 87.4% of the men). Diabetes and hypertension were significantly more frequent among the women. The most prevalent shape was fusiform, particularly among the women (95.39% vs. 89.86% among men). Mean diameter was smaller among the women (5.96 cm vs. 6.49 cm; p = 0.0056). The iliac arteries were less often involved among the women (89.40% vs. 73.58%; p = 0.00001). Blood loss was greater in the men (321.40 ml vs. 168.84 ml among the women; p < 0.05). Operative mortality was similar in both sexes, but obstructions were more frequent among the women (15.2% vs. 13.51%; p = 0.017296). Conclusions Aneurysmal diameter was smaller and obstructive complications were more frequent among women.

Resumo Contexto O aneurisma da aorta abdominal (AAA) afeta 4-6 vezes mais frequentemente os homens do que as mulheres, porém nas mulheres o prognóstico costuma ser pior. Objetivo Comparar os procedimentos endovasculares para correção de AAA infrarrenal em homens e mulheres, usando dados de um registro prospectivo. Métodos Esse registro foi feito em cinco hospitais universitários do estado de São Paulo entre 2012 e 2022. Foi realizado um estudo transversal, compilando dados demográficos, anatômicos (diâmetro do aneurisma, colo curto, angulado, calcificado ou com trombo; colo distal < 1,5 cm e artérias ilíacas tortuosas, alteradas), complicações (vazamentos, conversões, perviedade ou estenoses de ramos) e insuficiência renal e mortalidade em 30 dias. Foram utilizados o teste de qui-quadrado e teste t de Student, com significância de 5%. O estudo foi aprovado pelo Comitê de Ética (processo 4040-2011). Resultados Um total de 152 (15,9%) dos pacientes eram mulheres e 799 (84,0%) eram homens (p < 0,05). A maior parte eram brancos (80,2% das mulheres e 87,4% dos homens). Diabetes e hipertensão foram significativamente mais frequentes nas mulheres. O formato foi fusiforme, principalmente nas mulheres (95,39% versus 89,86% nos homens). O diâmetro médio foi menor nas mulheres (5,96 cm versus 6,49 cm; p = 0,0056). As artérias ilíacas foram menos envolvidas nas mulheres (89,40% versus 73,58%; p = 0,00001). A perda sanguínea foi maior nos homens (321,40 ml versus 168,84 ml nas mulheres; p < 0,05). A mortalidade operatória foi similar entre os sexos, mas as obstruções foram mais frequentes nas mulheres (15,2% versus 13,51%; p = 0,017296). Conclusões Nas mulheres, o diâmetro aneurismático foi menor e as complicações obstrutivas foram mais frequentes.

International migration is a highly relevant policy field. Over the last three decades it has witnessed a growing involvement of intergovernmental organisations (IGOs). Focusing on the International Organization for Migration (IOM), this chapter advances existing assumptions concerning migration politics and the role of states, IGOs and other actors. It discusses how the concept of ‘migration management’ (an ideational concept created in the 1990s) came to serve the IOM in taking a global lead in migration politics. Migration management has materialised into a tool-based approach, marketed and implemented by the IOM worldwide. As a result, the IOM has become an indispensable organisation which, as this chapter argues, is able to act as a supplementary hegemon in global, regional and even national migration politics. While the IOM as of yet does not replace states and does not contest the existing international order, it is already powerful enough to exercise decisive influence in migration politics. The chapter points out the example of the IOM fostering new alliances, including with China, in a shifting global order, not exclusive to migration politics. The chapter concludes by discussing future scenarios for the IOM as well as global migration politics.

This paper explores the relationship between Canada, one of the world’s leading immigration countries and a country that often serves as an international ‘poster child’ for well managed migration, and the International Organization for Migration (IOM), an intergovernmental organisation that provides migration-related services for Canada and many other countries. Despite growing awareness about the role of the IOM in migration politics, a research gap remains regarding how states cogitate and evaluate their partnership with the IOM. This article draws on publicly available government evaluations, conducted by Citizenship and Immigration Canada, which speak to the strongly inter-dependent, but also highly ambivalent reality of collaboration between Canada and the IOM. In exploring and discussing the nature of this relationship, the article also speaks to the particularities of ‘migration management’ and the larger transformations in global migration governance reflected in Canada’s partnership with the IOM.

While not new, the interest of international organisations (IOs) in migration has increased substantially since the 1990s. This chapter discusses (1) the reasons behind this growing interest, (2) the political positions and policy orientations defended by IOs and (3) their relationship to the securitisation of migration. IOs’ interest in migration is the product of several converging trends: the discovery of migration as a tool in development efforts; the broad interest in socio-economic issues that marked the post-Cold War era (like population issues, racism, and so on); and the (real or perceived) migration crisis that emerged in the 1990s, and that transformed migration into a ‘problem’ of high political importance, thereby legitimizing IOs’ ambition to contribute to find ‘solutions’. At first sight, IOs defend a set of balanced and comprehensive positions on migration policy: unlike many governments, they emphasise the positive impact of migration (on development or demography) and regularly call for more migration, while also stressing the need to protect vulnerable migrants from human rights abuse; they also take into account the interests of sending regions and the need to improve global living conditions. As with other fields of IOs’ interventions, this is formulated in a technocratic manner, exemplified by the frequent use to catchwords such as ‘migration management’. While these policy recommendations seem, at first sight, to be much less security-oriented than the political rhetoric and the policy measures that characterise receiving states, this chapter argues that IOs’ do play a role in the securitisation of migration: they indeed aim at ordering migration and at establishing normative guidelines regarding how people should cross borders; this leads to neat distinctions, for example between ‘good’ and ‘bad’ migration, and to apparently consensual and widely-accepted frameworks through which migration is apprehended, not only by governments but also by civil society groups, for example. In sum, while IOs defend softer positions than other actors, they nevertheless also contribute to the general perception that migration is a social phenomenon that must be steered, controlled – or ‘managed’.

Unwanted migratory flows from Albania serve as a justification for external interventions aimed at regulating migration ‘from within’. Over the last years the exertions of a number of international organizations have led to a situation of deadlock. Overriding vested interests seem to block a national ownership: Albanian government is not yet empowered to assume full control over its migration policy. While remaining in anxiety for new emigration waves, the international stakeholders share a general mistrust in local institutions to regulate migration in an effective manner.