“I am in a constant state of insecurity trying to make ends meet, like our service users”: Shared austerity reality between social workers and service users: Towards a preliminary conceptualization

This article introduces the concept of an emerging shared austerity reality, which refers to the socio-economic context of austerity that is shared both by social workers and service users, albeit to different degrees. Traditionally, the concept of the shared reality has been utilized to encompass the experiences of welfare professionals working in situations where both they and service users are exposed to the adverse effects of a natural disaster, war or terrorist attack. Here, the concept of shared reality is expanded through the introduction of the context of austerity. Drawing on 21 in-depth interviews with public sector social work practitioners in Greece it discusses, among other things, social anxieties about their children’s future, and their inability to take care of their elderly relatives that suggest an emerging shared austerity reality, reflecting the deterioration of socio-economic conditions. The paper ends with a discussion about the possibilities of alliance and division that emerge from the concept and future research directions. Moreover, it concludes with a reflection on the role of the social work profession and recent political developments in Greece in anti-austerity struggles.

Association Between Results of a Gene Expression Signature Assay and Recurrence-Free Interval in Patients With Stage II Colon Cancer in Cancer and Leukemia Group B 9581 (Alliance)

PURPOSE: Conventional staging methods are inadequate to identify patients with stage II colon cancer (CC) who are at high risk of recurrence after surgery with curative intent. ColDx is a gene expression, microarray-based assay shown to be independently prognostic for recurrence-free interval (RFI) and overall survival in CC. The objective of this study was to further validate ColDx using formalin-fixed, paraffin-embedded specimens collected as part of the Alliance phase III trial, C9581.

PATIENTS AND METHODS: C9581 evaluated edrecolomab versus observation in patients with stage II CC and reported no survival benefit. Under an initial case-cohort sampling design, a randomly selected subcohort (RS) comprised 514 patients from 901 eligible patients with available tissue. Forty-nine additional patients with recurrence events were included in the analysis. Final analysis comprised 393 patients: 360 RS (58 events) and 33 non-RS events. Risk status was determined for each patient by ColDx. The Self-Prentice method was used to test the association between the resulting ColDx risk score and RFI adjusting for standard prognostic variables.

RESULTS: Fifty-five percent of patients (216 of 393) were classified as high risk. After adjustment for prognostic variables that included mismatch repair (MMR) deficiency, ColDx high-risk patients exhibited significantly worse RFI (multivariable hazard ratio, 2.13; 95% CI, 1.3 to 3.5; P < .01). Age and MMR status were marginally significant. RFI at 5 years for patients classified as high risk was 82% (95% CI, 79% to 85%), compared with 91% (95% CI, 89% to 93%) for patients classified as low risk.

CONCLUSION: ColDx is associated with RFI in the C9581 subsample in the presence of other prognostic factors, including MMR deficiency. ColDx could be incorporated with the traditional clinical markers of risk to refine patient prognosis.