At a crossroad: the GATS telecom framework and neo-patrimonial states:the politics of telecom reform in Kenya

Thesis submitted in accordance with the requirements for the degree of Doctor of Philosophy in the School of Social Science and Policy, University of New South WalesThe liberalisation of domestic telecommunication (telecom) markets has become a worldwide trend. As a result, the General Agreement on Trade in Services (GATS), evolving from deliberations within the World Trade Organisation (WTO), has been heralded as the mechanism with which to effect telecom liberalisation domestically. For countries in Africa, the GATS instruments have been translated as a means to establish the principles required for an effective telecom industry supported by key institutions in policy, regulation and implementation. However, the analysis of relevant literature on telecom in Africa has tended to focus on technological developments based on current observable outcomes. This methodology is inadequate because it fails to account for the context-specific nature of the policy arena and framework shaping telecom outcomes. I argue that we must consider telecom outcomes by understanding the nature of political institutions domestically and their interaction with the international arena. To explicate this intersection of ideas, I draw on two seemingly independent theories, Neopatrimonialism and New Institutional Economics (NIE) with reference to the works of van de Walle (2001) and North (1990) respectively, to shed light on the nature of the Kenyan political context and the value of the GATS as an instrument that facilitates credibility and reduces opportunistic ex-post behaviour. It is contended in this study, that for the Kenyan Government, the value of the GATS accession lies in the legitimising role that it facilitates in accessing funds from the international community. This study thus highlights the inevitable tension that arises when domestic policy-reform goals are juxtaposed with international trade obligations undertaken through treaty accession and informed by a liberalisation agenda. A qualitative approach was used to collect the data and involved interviews and documentary analysis. The findings suggest that Kenya is partially in compliance with its GATS telecom commitments. However, this partial reform results from patrimonial tendencies in Kenya and is exacerbated by the need to attract hard currency through aid packages that dictate the nature of the policy process and the relationship between Kenya and the international community. In conclusion, even with policy reforms, state agents always find ways to maintain or create clientelist practises. Unless such reform is accompanied by political changes that provide checks and balances on institutions and state agents, reform policies on their own will not create an effective telecom sector. To truly evaluate telecom reform therefore, we must appreciate the context-specific nature of policy making.The liberalisation of domestic telecommunication (telecom) markets has become a worldwide trend. As a result, the General Agreement on Trade in Services (GATS), evolving from deliberations within the World Trade Organisation (WTO), has been heralded as the mechanism with which to effect telecom liberalisation domestically. For countries in Africa, the GATS instruments have been translated as a means to establish the principles required for an effective telecom industry supported by key institutions in policy, regulation and implementation. However, the analysis of relevant literature on telecom in Africa has tended to focus on technological developments based on current observable outcomes. This methodology is inadequate because it fails to account for the context-specific nature of the policy arena and framework shaping telecom outcomes. I argue that we must consider telecom outcomes by understanding the nature of political institutions domestically and their interaction with the international arena. To explicate this intersection of ideas, I draw on two seemingly independent theories, Neopatrimonialism and New Institutional Economics (NIE) with reference to the works of van de Walle (2001) and North (1990) respectively, to shed light on the nature of the Kenyan political context and the value of the GATS as an instrument that facilitates credibility and reduces opportunistic ex-post behaviour. It is contended in this study, that for the Kenyan Government, the value of the GATS accession lies in the legitimising role that it facilitates in accessing funds from the international community. This study thus highlights the inevitable tension that arises when domestic policy-reform goals are juxtaposed with international trade obligations undertaken through treaty accession and informed by a liberalisation agenda. A qualitative approach was used to collect the data and involved interviews and documentary analysis. The findings suggest that Kenya is partially in compliance with its GATS telecom commitments. However, this partial reform results from patrimonial tendencies in Kenya and is exacerbated by the need to attract hard currency through aid packages that dictate the nature of the policy process and the relationship between Kenya and the international community. In conclusion, even with policy reforms, state agents always find ways to maintain or create clientelist practises. Unless such reform is accompanied by political changes that provide checks and balances on institutions and state agents, reform policies on their own will not create an effective telecom sector. To truly evaluate telecom reform therefore, we must appreciate the context-specific nature of policy makin

Resveratrol given intraperitoneally does not inhibit the growth of high-risk t(4;11) acute lymphoblastic leukemia cells in a NOD/SCID mouse model.

The efficacy of resveratrol as a preventive agent against the growth of t(4;11) acute lymphoblastic leukemia (ALL) was evaluated in NOD.CB17-Prkdcscid/J mice engrafted with the human t(4;11) ALL SEM cell line. SEM cells were injected into the tail vein and engraftment was monitored by flow cytometry. Once engraftment was observed, mice were injected intraperitoneally with resveratrol (10 mg/kg body weight) dissolved in dimethylsulfoxide (DMSO) or DMSO alone (control) every other day, or vincristine (0.5 mg/kg body weight) 3 times per week for 4 weeks (n=16 per group). Comparisons of the percent of human leukemia cells in blood and survival curves showed resveratrol did not inhibit progression of the disease. Liquid chromatography-tandem mass spectrometry analyses of mouse sera showed resveratrol was rapidly metabolized to glucuronidated and sulfated forms 1 h post-injection, with low to no resveratrol or metabolites observed in sera by 24-48 h. These data indicate that in contrast to findings in in vitro models, parenterally administered resveratrol does not have potential as a preventive agent against high risk t(4;11) ALL

Is it feasible to conduct a randomised controlled trial of pretransplant exercise (prehabilitation) for patients with multiple myeloma awaiting autologous haematopoietic stem cell transplantation? Protocol for the PREeMPT study

Introduction While myeloma is an incurable malignancy, developments in disease management have led to increased life expectancy in recent years. Treatment typically involves stem-cell transplantation. Increased survival rates equate to more patients living with the burden of both the disease and its treatment for increasing number of years, rendering myeloma a long-term condition. Evidence exists to demonstrate the benefits of exercise for patients recovering from stem-cell transplantation, and prehabilitation—exercise before treatment—has been shown to be effective in other disease areas. To date there has been no research into prehabilitation in patients with myeloma awaiting transplantation treatment. Our objective is to determine whether it is feasible to conduct a randomised controlled trial into pretransplant exercise for patients with multiple myeloma who are awaiting autologous stem-cell transplantation. Methods and analysis This mixed methods study identifies patients with diagnosis of multiple myeloma who have been assigned to the autologous transplantation list and invites them to participate in six weekly sessions of individualised, supervised exercise while awaiting transplantation. Quantitative data to determine feasibility targets include rates of recruitment, adherence and adverse events, and outcome measures including 6 min walking distance test and quality of life. Qualitative interviews are undertaken with a purposive sample of patients to capture their experiences of the study and the intervention. Ethics and dissemination Ethics committee approval has been obtained. Dissemination will be through open-access publications and presentations and will seek to reach multiprofessional bases as well as patients and carer groups, addressing the widespread interest in this area of research. Trial registration number NCT03135925; Pre-results

Fine particulate matter-sudden death association modified by ventricular hypertrophy and inflammation: a case-crossover study

BackgroundSudden death accounts for approximately 10% of deaths among working-age adults and is associated with poor air quality. Objectives: To identify high-risk groups and potential modifiers and mediators of risk, we explored previously established associations between fine particulate matter (PM2.5) and sudden death stratified by potential risk factors.MethodsSudden death victims in Wake County, NC, from 1 March 2013 to 28 February 2015 were identified by screening Emergency Medical Systems reports and adjudicated (n = 399). Daily PM2.5 concentrations for Wake County from the Air Quality Data Mart were linked to event and control periods. Potential modifiers included greenspace metrics, clinical conditions, left ventricular hypertrophy (LVH), and neutrophil-to-lymphocyte ratio (NLR). Using a case-crossover design, conditional logistic regression estimated the OR (95%CI) for sudden death for a 5 μg/m3 increase in PM2.5 with a 1-day lag, adjusted for temperature and humidity, across risk factor strata.ResultsIndividuals having LVH or an NLR above 2.5 had PM2.5 associations of greater magnitude than those without [with LVH OR: 1.90 (1.04, 3.50); NLR > 2.5: 1.25 (0.89, 1.76)]. PM2.5 was generally less impactful for individuals living in areas with higher levels of greenspace.ConclusionLVH and inflammation may be the final step in the causal pathway whereby poor air quality and traditional risk factors trigger arrhythmia or myocardial ischemia and sudden death. The combination of statistical evidence with clinical knowledge can inform medical providers of underlying risks for their patients generally, while our findings here may help guide interventions to mitigate the incidence of sudden death

An evaluation of the Cygnet parenting support programme for parents of children with autism spectrum conditions

Parents of children on the autistic spectrum often struggle to understand the condition and, related to this, manage their child’s behaviour. Cygnet is a parenting intervention which aims to help parents address these difficulties, consequently improving parenting confidence. It is widely used in the United Kingdom (UK). Despite this, there have been few evaluations. This paper reports a small-scale pragmatic evaluation of Cygnet as it was routinely delivered in two English cities. A non-randomised controlled study of outcomes for parents (and their children) was conducted. Data regarding intervention fidelity and delivery costs were also collected. Parents either attending, or waiting to attend, Cygnet were recruited (intervention group: IG, n=35; comparator group: CG, n=32). Parents completed standardised measures of child behaviour and parenting sense of competence pre- and post-intervention, and at three-month follow-up (matched time points for CG). Longer-term outcomes were measured for the IG. IG parents also set specific child behaviour goals. Typically, the programme was delivered as specified by the manual. Attending Cygnet was associated with significant improvements in parenting satisfaction and the specific child behaviour goals. Findings regarding other outcomes were equivocal and further evaluation is required. We conclude that Cygnet is a promising intervention for parents of children with autism in terms of, at least, some outcomes

Insecurity, Conflict and the New Global Disorder

The current neoliberal preoccupation with the benefits of globalisation, which have been hailed as the great panacea for all the world's economic problems, has done little for the 1.3 billion people whose economic circumstances have stagnated or deteriorated in poverty over the last ten years. The neoliberal idea that somehow the benefits of global economic growth will ‘trickle down’ to the world's poor, has been challenged by the stark reality of the experience in the world's poorest societies. Deep polarisation of wealth that has become a structural feature of the global economy has been identified as one of the major threats to future peace and security in the coming millennium. Conflict theorists have for some time been at pains to point out that the unequal distribution of wealth and the failure to meet basic human needs constitute a source of structural violence that lies at the heart of the many conflicts. Endemic poverty is a basic factor that undermines human security. It not only leaves basic needs unmet, but creates the conditions for conflict and violence, as groups compete for access to scarce and often diminishing resources. Facing extremes of economic deprivation and threats to basic human security (life, food, shelter, income), the widespread resort to arms within a growing number of least developed economies can be understood as a Darwinian bid for survival

Precipitation and winter temperature predict long-term range-scale abundance changes in Western North American birds

Predicting biodiversity responses to climate change remains a difficult challenge, especially in climatically complex regions where precipitation is a limiting factor. Though statistical climatic envelope models are frequently used to project future scenarios for species distributions under climate change, these models are rarely tested using empirical data. We used long-term data on bird distributions and abundance covering five states in the western US and in the Canadian province of British Columbia to test the capacity of statistical models to predict temporal changes in bird populations over a 32-year period. Using boosted regression trees, we built presence-absence and abundance models that related the presence and abundance of 132 bird species to spatial variation in climatic conditions. Presence/absence models built using 1970–1974 data forecast the distributions of the majority of species in the later time period, 1998–2002 (mean AUC = 0.79 ± 0.01). Hindcast models performed equivalently (mean AUC = 0.82 ± 0.01). Correlations between observed and predicted abundances were also statistically significant for most species (forecast mean Spearman′s ρ = 0.34 ± 0.02, hindcast = 0.39 ± 0.02). The most stringent test is to test predicted changes in geographic patterns through time. Observed changes in abundance patterns were significantly positively correlated with those predicted for 59% of species (mean Spearman′s ρ = 0.28 ± 0.02, across all species). Three precipitation variables (for the wettest month, breeding season, and driest month) and minimum temperature of the coldest month were the most important predictors of bird distributions and abundances in this region, and hence of abundance changes through time. Our results suggest that models describing associations between climatic variables and abundance patterns can predict changes through time for some species, and that changes in precipitation and winter temperature appear to have already driven shifts in the geographic patterns of abundance of bird populations in western North America

Fine particulate matter-sudden death association modified by ventricular hypertrophy and inflammation: a case-crossover study

Background Sudden death accounts for approximately 10% of deaths among working-age adults and is associated with poor air quality. Objectives: To identify high-risk groups and potential modifiers and mediators of risk, we explored previously established associations between fine particulate matter (PM2.5) and sudden death stratified by potential risk factors. Methods Sudden death victims in Wake County, NC, from 1 March 2013 to 28 February 2015 were identified by screening Emergency Medical Systems reports and adjudicated (n = 399). Daily PM2.5 concentrations for Wake County from the Air Quality Data Mart were linked to event and control periods. Potential modifiers included greenspace metrics, clinical conditions, left ventricular hypertrophy (LVH), and neutrophil-to-lymphocyte ratio (NLR). Using a case-crossover design, conditional logistic regression estimated the OR (95%CI) for sudden death for a 5 μg/m3 increase in PM2.5 with a 1-day lag, adjusted for temperature and humidity, across risk factor strata. Results Individuals having LVH or an NLR above 2.5 had PM2.5 associations of greater magnitude than those without [with LVH OR: 1.90 (1.04, 3.50); NLR > 2.5: 1.25 (0.89, 1.76)]. PM2.5 was generally less impactful for individuals living in areas with higher levels of greenspace. Conclusion LVH and inflammation may be the final step in the causal pathway whereby poor air quality and traditional risk factors trigger arrhythmia or myocardial ischemia and sudden death. The combination of statistical evidence with clinical knowledge can inform medical providers of underlying risks for their patients generally, while our findings here may help guide interventions to mitigate the incidence of sudden death

Taste evaluation of potato glycoalkaloids by the Aymara: A case study in human chemical ecology

A chemical ecological model can be the basis for defining testable hypotheses concerning human interactions with plants. Selection by Aymara subsistence cultivators against toxic glycoalkaloids in the ongoing domestication of the Bolivian potato cultigen Solanum X ajanhuiri was used as a specific case study of human interactions with phytochemicals. In taste perception tests, Aymara subjects were able to discriminate between concentrations of pure glycoalkaloids in solution only above 20 mg/100 ml. Taste panel tests of potato clones indicated that glycoalkaloid levels are important to the Aymara in determining quality only as part of a decision-making process involving two character states: too high or acceptable. Glycoalkaloids in potatoes are regarded as toxic to humans above 20 mg/100 g fresh weight. Among the Aymara, a breakpoint in the curve for glycoalkaloid preference appears to occur between 20–38 mg/100 g. This distinction is evident in the Aymara potato taxonomy which distinguishes bitter (luq'i ch'oke) from nonbitter (ch'oke) potatoes .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44480/1/10745_2004_Article_BF00888308.pd