Evading the Patronage Trap

Why have Latin American democracies proven unable to confront the structural inequalities that cripple their economies and stymie social mobility? Brian Palmer-Rubin contends that we may lay the blame on these countries’ systems of interest representation, which exhibit “biased pluralism,” a system in which the demands of organizations representing economic elites—especially large corporations—predominate. A more inclusive model of representation would not only require a more encompassing and empowered set of institutions to represent workers, but would also feature spaces for non-eliteproducers—such as farmers and small-business owners to have a say in sectoral economic policies. With analysis drawing on over 100 interviews, an original survey, and official government data, this book focuses on such organizations and develops an account of biased pluralism in developing countries typified by the centrality of patronage—discretionarily allocated state benefits. Rather than serving as conduits for demand-making about development models, political parties and interest organizations often broker state subsidies or social programs, augmenting the short-term income of beneficiaries, but doing little to improve their long-term economic prospects. When organizations become diverted into patronage politics, the economic demands of the masses go unheard in the policies that most affect their lives, and along the way, their economic interests go unrepresented

Measuring Maine’s Marine Economy

Even though Maine’s new license plate no longer features the lobster, the ocean remains central to Maine’s identity and to its economy. As the authors point out, Maine has more than 4,500 miles of coastline and more than 4,600 islands over one acre in size. For many who live here, their way of life is tied to the sea; for many who visit Maine, their stay is tied to the sea. Despite such prominence, it has been difficult to accurately assess the importance of Maine’s marine economy. In part, this is because there clear definition of a marine economy is lacking, as well as a method for measuring its total size. In this article, the authors present a definition of Maine’s marine economy and offer a consistent method for measuring its size relative to other sectors of the state’s economy. In doing so, they provide the first consistent measurement of Maine’s marine economy as a whole. They conclude that the state’s marine economy is not in decline, and further suggest that the potential exists for growth in key areas such as tourism and biotechnology

Gastrointestinal Stromal Tumors: Molecular Mechanisms and Targeted Therapies

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract and are diverse not only in their clinical behavior but also in their histologic appearance. GISTs are insensitive to conventional sarcoma chemotherapy and radiation. However GISTs are sensitive to small-molecule tyrosine kinase inhibitors as 85–90% of GISTs have KIT or platelet-derived growth factor receptor alpha (PDGFRA) mutations, which drive tumorigenesis. This review will briefly touch on the clinicopathological features of GIST, while the majority of the review will focus on the clinical and treatment ramifications of KIT and PDGFRA mutations found in GIST

False-negative upper extremity ultrasound in the initial evaluation of patients with suspected subclavian vein thrombosis due to thoracic outlet syndrome (Paget-Schroetter syndrome)

OBJECTIVE: To assess the utilization and consequences of upper extremity Duplex ultrasound in the initial diagnostic evaluation of patients with suspected subclavian vein (SCV) thrombosis and venous thoracic outlet syndrome (VTOS). METHODS: A retrospective single-center review was conducted for patients that underwent primary surgical treatment for VTOS between 2008 and 2017, in whom an upper extremity ultrasound had been performed as the initial diagnostic test (n = 214). Clinical and treatment characteristics were compared between patients with positive and false-negative ultrasound studies. RESULTS: There were 122 men (57%) and 92 women (43%) that had presented with spontaneous idiopathic arm swelling, including 28 (13%) with proven pulmonary embolism, at a mean age of 30.7 ± 0.8 years (range 14-69). Upper extremity ultrasound had been performed 23.8 ± 12.2 days after the onset of symptoms, with confirmation of axillary-SCV thrombosis in 169 patients (79%) and negative results in 45 (21%). Of the false-negative ultrasound study reports, only 8 (18%) acknowledged limitations in visualizing the central SCV. Definitive diagnostic imaging (DDI) had been obtained by upper extremity venography in 175 (82%), computed tomography angiography in 24 (11%), and magnetic resonance angiography in 15 (7%), with 142 (66%) undergoing catheter-directed axillary-SCV thrombolysis. The mean interval between initial ultrasound and DDI was 48.9 ± 14.2 days with no significant difference between groups, but patients with a positive ultrasound were more likely to have DDI within 48 hours than those with a false-negative ultrasound (44% vs 24%; P = .02). At the time of surgical treatment, the SCV was widely patent following paraclavicular decompression and external venolysis alone in 74 patients (35%). Patch angioplasty was performed for focal SCV stenosis in 76 (36%) and bypass graft reconstruction for long-segment axillary-SCV occlusion in 63 (29%). Patients with false-negative initial ultrasound studies were significantly more likely to require SCV bypass reconstruction than those with a positive ultrasound (44% vs 25%; P = .02). CONCLUSIONS: Duplex ultrasound has significant limitations in the initial evaluation of patients with suspected SCV thrombosis, with false-negative results in 21% of patients with proven VTOS. This is rarely acknowledged in ultrasound reports, but false-negative ultrasound studies have the potential to delay definitive imaging, thrombolysis, and further treatment for VTOS. Initial false-negative ultrasound results are associated with progressive thrombus extension and a more frequent need for SCV bypass reconstruction at the time of surgical treatment

Incentives for Organizational Participation: A Recruitment Experiment in Mexico

While the presence of a strong civil society is recognized as desirable for democracies, an important question is what motivates citizens to join organizations. This article presents novel experimental evidence on the conditions under which citizens join interest organizations. We presented 1,400 citizens in two Mexican states with fliers promoting a new local interest organization. These fliers contain one of four randomly selected recruitment appeals. We find evidence that both brokerage of state patronage and demand-making for local public goods are effective recruitment appeals. The effect for patronage brokerage is especially pronounced among respondents with prior organizational contact, supporting our hypothesis of a “particularistic socialization” effect wherein organizational experience is associated with greater response to selective material benefits. Our findings suggest that under some conditions, rather than generating norms of other-regarding, interest organizations can reinforce members’ individualistic tendencies

What information do citizens want? Evidence from one million information requests in Mexico

While scholars have emphasized the importance of information for accountability, little research has addressed the demand for government information by real citizens. We study the totality of information requests filed with Mexican federal government agencies from 2003 to 2015, over 1 million requests in all. We use unsupervised methods to categorize requests, revealing the diversity of topics including environment, security, budgets, and government procurement and employees. While many topics have clear public accountability-seeking purposes, others are focused on more private, micro-political goals. Analysis over time and across states reveals linkage between information demand and issues of public interest such as environmental impacts and criminal violence. Our results demonstrate that, given functioning access-to-information institutions, citizens in a transitional democracy really do demand information relevant to public accountability