Have US-Funded CARSI Programs Reduced Crime and Violence in Central America? An Examination of LAPOP'S Impact Assessment of US Violence Prevention Programs in Central America

In October 2014, the Latin American Public Opinion Project (LAPOP) at Vanderbilt University published an impact assessment study of community-based violence prevention programs that have been implemented under the umbrella of the US State Department's Central American Regional Security Initiative (CARSI). The study looked at survey data measuring public perceptions of crime in 127 treatment and control neighborhoods in municipalities in El Salvador, Guatemala, Honduras, and Panama where the violence prevention programs have been implemented. The study's authors stated that the data shows that "in several key respects the programs have been a success" and note, for instance, that 51 percent fewer residents of "treated" communities reported being aware of murders and extortion incidents during the previous 12 months, and 19 percent fewer residents reported having heard about robberies having occurred.As the LAPOP study is, to date, the only publicly accessible impact assessment of programs carried out under CARSI -- a notoriously opaque regional assistance scheme that has received hundreds of millions of dollars of US government funding -- a thorough review of the LAPOP study data seemed appropriate.The following report examines the data collected during the LAPOP study and subjects them to a number of statistical tests. The authors find that the study cannot support the conclusion that the areas subject to treatment in the CARSI programs showed better results than those areas that were not.This report identifies major problems with the LAPOP study, namely, the nonrandomness of the selection of treatment versus control areas and how the differences in initial conditions, as well as differences in results between treatment and control areas, have been interpreted. In the case of reported robberies, if the areas subject to treatment have an elevated level of reported robberies in the year prior to treatment, it is possible that there is some reversion to normal levels over the next year. The LAPOP methodology does not differentiate between effective treatment and, for example, an unrelated decline in reported robberies in a treated area following a year with an abnormally high number of reported robberies. The series of statistical tests in this report indicate that this possibility is quite plausible, and cannot be ruled out; and that the LAPOP study, therefore, does not demonstrate a statistically significant positive effect of treatment. The same can be said for the other variables where the LAPOP study finds significant improvement

The French Economy, European Authorities, and the IMF: "Structural Reform" or Increasing Employment?

This paper looks at two competing views among economists and other observers, of how the French economy can overcome mass unemployment and have a more robust recovery. One view sees the unemployment and economic stagnation of the past decade as overwhelmingly structural. An alternative narrative, mostly from the Left but with some elements adopted by the far Right, sees the most immediate problem as one of inadequate demand in the economy.The authors find that France's unemployment rate, which has averaged 9.1 percent over the last decade, is not the product of "structural" barriers, but rather due to political choices made by the French government and European authorities. With inflation well below target, real borrowing costs at about zero, and a low current interest burden on the debt, it would make much more economic sense for the government -- and the eurozone as well -- to pursue an expansionary fiscal policy that increases employment

A Critical Review of the US State Department's 2015 Progress Report on Haiti

This review, published jointly by the Center for Economic and Policy Research and the Haiti Advocacy Working Group, looks at the US State Department's annual reports on US assistance to Haiti mandated under the 2014 Assessing Progress in Haiti Act. The review analyzes the various components of the reports and identifies significant omissions and deficiencies, including incomplete data, a failure to link projects and outcomes, and a failure to adequately identify mistakes and lessons learned.In addition, the review shares feedback from Haitian civil society groups and makes recommendations on how the US Agency for International Development and the State Department can improve future progress reports

Effects of work-related sleep restriction on acute physiological and psychological stress responses and their interactions: A review among emergency service personnel

Emergency work can expose personnel to sleep restriction. Inadequate amounts of sleep can negatively affect physiological and psychological stress responses. This review critiqued the emergency service literature (e.g., firefighting, police/law enforcement, defense forces, ambulance/paramedic personnel) that has investigated the effect of sleep restriction on hormonal, inflammatory and psychological responses. Furthermore, it investigated if a psycho-physiological approach can help contextualize the significance of such responses to assist emergency service agencies monitor the health of their personnel. The available literature suggests that sleep restriction across multiple work days can disrupt cytokine and cortisol levels, deteriorate mood and elicit simultaneous physiological and psychological responses. However, research concerning the interaction between such responses is limited and inconclusive. Therefore, it is unknown if a psycho-physiological relationship exists and as a result, it is currently not feasible for agencies to monitor sleep restriction related stress based on psycho- physiological interactions. Sleep restriction does however, appear to be a major stressor contributing to physiological and psychological responses and thus, warrants further investigation

Ontogenetic scaling patterns and functional anatomy of the pelvic limb musculature in emus (Dromaius novaehollandiae)

Emus (Dromaius novaehollandiae) are exclusively terrestrial, bipedal and cursorial ratites with some similar biomechanical characteristics to humans. Their growth rates are impressive, as their body mass increases eighty-fold from hatching to adulthood whilst maintaining the same mode of locomotion throughout life. These ontogenetic characteristics stimulate biomechanical questions about the strategies that allow emus to cope with their rapid growth and locomotion, which can be partly addressed via scaling (allometric) analysis of morphology. In this study we have collected pelvic limb anatomical data (muscle architecture, tendon length, tendon mass and bone lengths) and calculated muscle physiological cross sectional area (PCSA) and average tendon cross sectional area from emus across three ontogenetic stages (n = 17, body masses from 3.6 to 42 kg). The data were analysed by reduced major axis regression to determine how these biomechanically relevant aspects of morphology scaled with body mass. Muscle mass and PCSA showed a marked trend towards positive allometry (26 and 27 out of 34 muscles respectively) and fascicle length showed a more mixed scaling pattern. The long tendons of the main digital flexors scaled with positive allometry for all characteristics whilst other tendons demonstrated a less clear scaling pattern. Finally, the two longer bones of the limb (tibiotarsus and tarsometatarsus) also exhibited positive allometry for length, and two others (femur and first phalanx of digit III) had trends towards isometry. These results indicate that emus experience a relative increase in their muscle force-generating capacities, as well as potentially increasing the force-sustaining capacities of their tendons, as they grow. Furthermore, we have clarified anatomical descriptions and provided illustrations of the pelvic limb muscle–tendon units in emus

The AMH genotype (rs10407022 T>G) is associated with circulating AMH levels in boys, but not in girls

Objective: Fetal anti-Müllerian hormone (AMH) is responsible for normal male sexual differentiation, and circulating AMH is used as a marker of testicular tissue in newborns with disorders of sex development. Little is known about the mechanism of action in postnatal life. A recent genome wide association study (GWAS) reported genetic variation of AMH affecting AMH levels in young men. This study investigated the effect of genetic variation of AMH and AMH type II receptor (AMHR2) (AMHrs10407022 T>G and AMHR2rs11170547 C>T) on circulating reproductive hormone levels and pubertal onset in boys and girls. Design and methods: This study is a combined longitudinal and cross-sectional study in healthy Danish boys and girls from the general population. We included 658 boys aged 5.8–19.8 years and 320 girls aged 5.6–16.5 years. The main outcome measures were genotyping of AMH and AMHR2, pubertal staging and serum levels of reproductive hormones. Results: AMHrs10407022T>G was associated with higher serum levels of AMH in prepubertal boys (TT: 575 pmol/L vs TG: 633 pmol/L vs GG: 837 pmol/L, P = 0.002) and adolescents (TT: 44 pmol/L vs TG: 58 pmol/L vs GG: 79 pmol/L, P < 0.001). Adolescent boys carrying the genetic variation also had lower levels of LH (TT: 3.0 IU/L vs TG: 2.8 IU/L vs GG: 1.8 IU/L, P = 0.012). Hormone levels in girls and pubertal onset in either sex did not seem to be profoundly affected by the genotypes. Conclusion: Our findings support recent GWAS results in young adults and expand our understanding of genetic variation affecting AMH levels even in boys prior to the pubertal decline of circulating AMH

Standard- versus intermediate-dose enoxaparin for anti-factor Xa guided thromboprophylaxis in critically ill patients with COVID-19

Abstract The prevalence of venous thromboembolism (VTE) is high in critically ill patients with COVID-19. Dosing of Low Molecular Weight Heparin (LMWH) for thromboprophylaxis in patients with severe COVID-19 is subject to ongoing debate. In this brief report, we describe our study where we retrospectively examined the efficacy of standard- versus intermediate-dosing of enoxaparin in attaining and maintaining accepted prophylactic levels of anti-Factor Xa (anti-FXa) in critically ill patients with COVID-19. We collected data for all patients with confirmed COVID-19 who were treated with enoxaparin for thromboprophylaxis in a single Intensive Care Unit (ICU) in the United Kingdom between 31st March and 16th November 2020. Standard-dose of enoxaparin was 40 mg subcutaneously once daily for patients with normal renal function and body weight between 50 and 100 kg; the intermediate-dose was 40 mg subcutaneously twice daily. Anti-FXa peak concentrations between 0.2-0.4 IU/ml were considered appropriate for thromboprophylaxis. Age, sex, weight, Body Mass Index, APACHE II score, ICU length of stay, initial P/F ratio and creatinine were not statistically significantly different between standard- and intermediate-dose thromboprophylaxis cohorts. In the standard-dose group, the median initial anti-FXa level was 0.13 (interquartile range 0.06-0.18) compared to 0.26 (0.21-0.33) in the intermediate-dose cohort (p < 0.001). On repeated measurement, in the standard dose cohort, 44 of 95 (46%) anti-FXa levels were < 0.2 IU/ml compared with 24 of 132 (18%) levels in the intermediate-dose cohort even after dose-adjustment. There was one radiologically confirmed pulmonary embolism (PE) on computed tomography pulmonary angiogram during hospital admission in each cohort. Our study supports starting intermediate-dose thromboprophylaxis for critically ill patients with COVID-19 to achieve anti-FXa levels in the accepted thromboprophylactic range although further study is required to investigate whether anti-FXa guided thromboprophylaxis is safe and effective in reducing the incidence of VTEs in critically ill patients with COVID-19

Poly High Internal Phase Emulsion for the Immobilization of Chemical Warfare Agents

We report a facile method for the absorption (characterized by the weight/weight swelling degree, Q) of a variety of chemical warfare agents (CWAs); including sulfur mustard (HD) (Q = 40) and V-series (VM, VX, i-Bu-VX, n-Bu-VX) of nerve agents (Q ? 45) and a simulant, methyl benzoate (Q = 55), through the use of a poly(styrene-co-vinyl benzyl chloride-co-divinylbenzene) lightly cross-linked poly high internal phase emulsion (polyHIPE). By varying the vinyl benzyl chloride (VBC) content and the volume of the internal phase of the precursor emulsion it is demonstrated that absorption is facilitated both by the swelling of the polymer and the uptake of liquid in the pores. In particular the sample prepared from a 95% internal emulsion water content showed rapid swelling (<5 min to total absorption) and the ability to swell both from a monolithic state and from a compressed state, making these systems ideal practical candidates for the rapid immobilization of CWAs

The impact of sleep restriction and simulated physical firefighting work on acute inflammatory stress responses

OBJECTIVES: This study investigated the effect restricted sleep has on wildland firefighters\u27 acute cytokine levels during 3 days and 2 nights of simulated physical wildfire suppression work. METHODS: Firefighters completed multiple days of physical firefighting work separated by either an 8-h (Control condition; n = 18) or 4-h (Sleep restriction condition; n = 17) sleep opportunity each night. Blood samples were collected 4 times a day (i.e., 06:15, 11:30, 18:15, 21:30) from which plasma cytokine levels (IL-6, IL-8, IL-1&beta;, TNF-&alpha;, IL-4, IL-10) were measured. RESULTS: The primary findings for cytokine levels revealed a fixed effect for condition that showed higher IL-8 levels among firefighters who received an 8-h sleep each night. An interaction effect demonstrated differing increases in IL-6 over successive days of work for the SR and CON conditions. Fixed effects for time indicated that IL-6 and IL-4 levels increased, while IL-1&beta;, TNF-&alpha; and IL-8 levels decreased. There were no significant effects for IL-10 observed. CONCLUSION: Findings demonstrate increased IL-8 levels among firefighters who received an 8-h sleep when compared to those who had a restricted 4-h sleep. Firefighters\u27 IL-6 levels increased in both conditions which may indicate that a 4-h sleep restriction duration and/or period (i.e., 2 nights) was not a significant enough stressor to affect this cytokine. Considering the immunomodulatory properties of IL-6 and IL-4 that inhibit pro-inflammatory cytokines, the rise in IL-6 and IL-4, independent of increases in IL-1&beta; and TNF-&alpha;, could indicate a non-damaging response to the stress of simulated physical firefighting work. However, given the link between chronically elevated cytokine levels and several diseases, further research is needed to determine if firefighters\u27 IL-8 and IL-6 levels are elevated following repeated firefighting deployments across a fire season and over multiple fire seasons