Always Affecting the Wrong People? The Impact of US Sanctions on Poverty

In this paper, we analyze the effect of US economic sanctions on the target countries' poverty gap during the period 1978-2011. Econometrically, we employ a nearest neighbor matching approach to account for differences in the countries' economic and political environment and the likelihood of being exposed to US sanctions. Our results indicate that US sanctions are indeed affecting the wrong people as we observe a 2.3-5.1 percentage points (pp) larger poverty gap in sanctioned countries compared to their nearest neighbors. Severe sanctions, such as fuel embargoes, trade restrictions, the freezing of assets, or embargoes on most or all economic activity are particularly detrimental and lead to an increase in the poverty gap by 6.1-7.4 pp

Major Reduction in Anti-Malarial Drug Consumption in Senegal after Nation-Wide Introduction of Malaria Rapid Diagnostic Tests

BACKGROUND: While WHO recently recommended universal parasitological confirmation of suspected malaria prior to treatment, debate has continued as to whether wide-scale use of rapid diagnostic tests (RDTs) can achieve this goal. Adherence of health service personnel to RDT results has been poor in some settings, with little impact on anti-malarial drug consumption. The Senegal national malaria control programme introduced universal parasite-based diagnosis using malaria RDTs from late 2007 in all public health facilities. This paper assesses the impact of this programme on anti-malarial drug consumption and disease reporting. METHODS AND FINDINGS: Nationally-collated programme data from 2007 to 2009 including malaria diagnostic outcomes, prescription of artemisinin-based combination therapy (ACT) and consumption of RDTs in public health facilities, were reviewed and compared. Against a marked seasonal variation in all-cause out-patient visits, non-malarial fever and confirmed malaria, parasite-based diagnosis increased nationally from 3.9% of reported malaria-like febrile illness to 86.0% over a 3 year period. The prescription of ACT dropped throughout this period from 72.9% of malaria-like febrile illness to 31.5%, reaching close equivalence to confirmed malaria (29.9% of 584,873 suspect fever cases). An estimated 516,576 courses of inappropriate ACT prescription were averted. CONCLUSIONS: The data indicate high adherence of anti-malarial prescribing practice to RDT results after an initial run-in period. The large reduction in ACT consumption enabled by the move from symptom-based to parasite-based diagnosis demonstrates that effective roll-out and use of malaria RDTs is achievable on a national scale through well planned and structured implementation. While more detailed information on management of parasite-negative cases is required at point of care level to assess overall cost-benefits to the health sector, considerable cost-savings were achieved in ACT procurement. Programmes need to be allowed flexibility in management of these funds to address increases in other programmatic costs that may accrue from improved diagnosis of febrile disease

Global report on preterm birth and stillbirth (4 of 7): delivery of interventions

<p>Abstract</p> <p>Background</p> <p>The efficacious interventions identified in the previous article of this report will fail unless they are delivered at high and equitable coverage. This article discusses critical delivery constraints and strategies.</p> <p>Barriers to scaling up interventions</p> <p>Achieving universal coverage entails addressing major barriers at many levels. An overarching constraint is the lack of political will, resulting from the dearth of preterm birth and stillbirth data and the lack of visibility. Other barriers exist at the household and community levels, such as insufficient demand for interventions or sociocultural barriers; at the health services level, such as a lack of resources and trained healthcare providers; and at the health sector policy and management level, such as poorly functioning, centralized systems. Additional constraints involve weak governance and accountability, political instability, and challenges in the physical environment.</p> <p>Strategies and examples</p> <p>Scaling up maternal, newborn and child health interventions requires strengthening health systems, but there is also a role for focused, targeted interventions. Choosing a strategy involves identifying appropriate channels for reaching high coverage, which depends on many factors such as access to and attendance at healthcare facilities. Delivery channels vary, and may include facility- and community-based healthcare providers, mass media campaigns, and community-based approaches and marketing strategies. Issues related to scaling up are discussed in the context of four interventions that may be given to mothers at different stages throughout pregnancy or to newborns: (1) detection and treatment of syphilis; (2) emergency Cesarean section; (3) newborn resuscitation; and (4) kangaroo mother care. Systematic reviews of the literature and large-scale implementation studies are analyzed for each intervention.</p> <p>Conclusion</p> <p>Equitable and successful scale-up of preterm birth and stillbirth interventions will require addressing multiple barriers, and utilizing multiple delivery approaches and channels. Another important need is developing strategies to discontinue ineffective or harmful interventions. Preterm birth and stillbirth interventions must also be placed in the broader maternal, newborn and child health context to identify and prioritize those that will help improve several outcomes at the same time. The next article discusses advocacy challenges and opportunities.</p

The Heterogeneity of FDI in Sub-Saharan Africa How Do the Horizontal Productivity Effects of Emerging Investors Differ from Those of Traditional Players?

This paper analyzes the horizontal productivity effects of foreign direct investment (FDI) from industrialized and developing countries in 10 sub-Saharan African countries. We establish a unique data set by combining data from the World Bank Enterprise Surveys that allow us to distinguish between foreign investors from sub-Saharan Africa, Asia, Europe, the Middle East, and North Africa. We find strong evidence of horizontal productivity spillovers to domestic firms derived from foreign-firm presence. However, these effects are clearly dependent on domestic firms' absorptive capacity. The largest productivity effects seem to be driven by investors from sub-Saharan Africa. Our analysis also shows that productivity effects differ according to the income level of host countries. Overall, the strongest productivity effects seem to materialize in lower-middle-income countries. These key findings emphasize the increasing importance of emerging investors, beyond the traditional players from industrialized countries, in sub-Saharan Africa

Democracy Does Not Cause Growth:The Importance of Endogeneity Arguments

This article challenges recent findings that democracy has sizable effects on economic growth. As extensive political science research indicates that economic turmoil is responsible for causing or facilitating many democratic transitions, the paper focuses on this endogeneity concern. Using a worldwide survey of 165 country-specific democracy experts conducted for this study, the paper separates democratic transitions into those occurring for reasons related to economic turmoil, here called endogenous, and those grounded in reasons more exogenous to economic growth. The behavior of economic growth following these more exogenous democratizations strongly indicates that democracy does not cause growth. Consequently, the common positive association between democracy and economic growth is driven by endogenous democratization episodes (i.e., due to faulty identification)

Helix Dipole and Membrane Electrostatics Delineate Conformational Transitions in the Self-Assembly of Amyloidogenic Peptides

The self-assembly of amyloidogenic peptides on membrane surfaces is associated with the death of neurons and β-cells in Alzheimer\u27s disease and type 2 diabetes, respectively. The early events of self-assembly in vivo are not known, but there is increasing evidence for the importance of the α-helix. To test the hypothesis that electrostatic interactions involving the helix dipole play a key role in membrane-mediated peptide self-assembly, we studied IAPP[11-25(S20G)-NH2] (R11LANFLVHSGNNFGA25-NH2), which under certain conditions self-assembles in hydro to form β-sheet assemblies through an α-helix-containing intermediate. In the presence of small unilamellar vesicles composed solely of zwitterionic lipids, the peptide does not self-assemble presumably because of the absence of stabilizing electrostatic interactions between the membrane surface and the helix dipole. In the presence of vesicles composed solely of anionic lipids, the peptide forms a long-lived α-helix presumably stabilized by dipole-dipole interactions between adjacent helix dipoles. This helix represents a kinetic trap that inhibits β-sheet formation. Intriguingly, when the amount of anionic lipids was decreased to mimic the ratio of zwitterionic and anionic lipids in cells, the α-helix was short-lived and underwent an α-helix to β-sheet conformational transition. Our work suggests that the helix dipole and membrane electrostatics delineate the conformational transitions occurring along the self-assembly pathway to the amyloid

LGBTQ+ Workers

LGBTQ+ people face unique organizational communication dilemmas at work. In the United States, LGBTQ+ workers communicate their gender, sexuality, and other intersecting identities and experiences through complex interactions with coworkers, supervisors, customers, publics, organizations, and institutions. They also utilize specific communication strategies to navigate exclusionary policies and practices and organize for intersectional justice. Five central research themes for LGBTQ+ workers in the current literature include (a) workplace discrimination, (b) disclosure at work, (c) navigating interpersonal relationships at work, (d) inclusive and exclusive policies, and (e) intersectional work experiences and organizing. First, the lived experiences of discrimination, exclusion, and violence in organizations, including from coworkers, managers, and customers, present a plethora of challenges from organizational entry to exit. LGBTQ+ workers face high levels of unemployment and underemployment and experience frequent microaggressions. Queer, trans, and intersex workers also experience prevalent workplace discrimination, uncertainty, and systemic barriers when attempting to use fluctuating national and state laws for workplace protections. Second, such discrimination creates unique risks that LGBTQ+ workers must navigate when it comes to disclosing their identities at work. The complexities of workplace disclosure of LGBTQ+ identities and experiences become apparent through closeting, passing, and outing communication. These three communication strategies for queer, trans, and intersex survival are often read as secretive or deceptive by heterosexual or cisgender coworkers and managers. Closeting communication may also involve concealing information about personal and family relationships at work and other identity intersections. Third, LGBTQ+ people must navigate workplace relationships, particularly with heterosexual and/or cisgender coworkers and managers and in organizations that assume cisheteronormativity. Fourth, policies structure LGBTQ+ workers’ lives, including both the positive impacts of inclusive policies and discrimination and violence via exclusionary policies. Fifth and finally, intersectionality is crucial to theorize when examining LGBTQ+ workers’ communication. It is not enough to just investigate sexuality or gender identity, as they are interwoven with race, class, disability, religion, nationality, age, and more. Important exemplars also showcase how intersectional organizing can create transformative and empowering experiences for LGBTQ+ people. By centering LGBTQ+ workers, this article examines their unique and complex organizational communication needs and proposes future research.</p