Investing in Freedom: Democracy Support in the U.S. Budget

The U.S. Congress should fully fund the administration's $47.8 billion request for base international affairs for Fiscal Year (FY) 2014. This request represents a 6$38.7 billion for FY 14, 20% less than the President's request, and a staggering 29% less than the FY 12 actual numbers. Cuts of that magnitude would have a devastating effect on the ability of the State Department and U.S. Agency for International Development (USAID) to carry out their diplomatic work and assistance programs. While it is important at present for every federal agency to eliminate redundancies, streamline operations, and reevaluate priorities, such sweeping cuts to an already miniscule budget would do great and needless harm. The Senate budget resolution proposes $45.6 billion in base international affairs funding.Funding for Democracy and Human Rights represents 9% of the total request for foreign assistance for FY 14, less than 1/10th of 1% of the total U.S. budget. The administration's proposal will support important initiatives that protect and promote democracy, rule of law, and human rights, including:Flexible funding to support democratic change in the Middle East through a Middle East and North Africa Incentive Fund.Increased funding for priority regions, including Asia and Africa.Robust funding for priority countries and territories including Afghanistan, Mexico, South Sudan, the West Bank and Gaza, and Burma.Increases in some areas are balanced by decreases in others, including:The elimination of the Assistance for Europe, Eurasia, and Central Asia Account (AEECA) and decreases in the Europe and Eurasia region overall.Large decreases in democracy funding for Iraq and Pakistan.Regional and country-level decreases in the Western Hemisphere and in South and Central Asia.While the administration understandably has had to make difficult tradeoffs to reach budget goals, there are some areas where decreased funding would be harmful to achieving U.S. strategic policy goals and Congress can provide additional support:Congress should fund the State Department's Bureau of Democracy, Human Rights, and Labor (DRL) and USAID's Bureau of Democracy, Conflict, and Humanitarian Assistance (DCHA) at the FY 12 levels. These two bureaus provide leadership within their agencies on democracy and human rights policy and require adequate resources to continue doing so.Congress should allow the administration to meet the United States' assessed obligations to the United Nations for FY14. Moreover, Congress should reinstate funding for the United Nations Educational, Scientific, and Cultural Organization (UNESCO), which supports many cultural, social, and educational programs in line with the U.S.'s own values.The administration must work with Congress to identify innovative ways to support civil society in countries with difficult operating environments, including Russia, Bolivia, Egypt, and Ethiopia.Robust funding for international affairs in FY 14 will give America's diplomats the tools they need to advance U.S. interests abroad and maintain the United States' role as a global leader. Such funding alone is not enough, however. The administration must match a strong budget with clear policy decisions and a consistently forceful message, communicated both publicly and privately, that democracy and human rights are of the utmost importance to the United States.This report summarizes the most notable requests, changes, and new developments within the administration's democracy and human rights budget for FY14. It also offers policy recommendations and suggestions for budget adjustments to better align funding allocations with U.S. interests

The mPower Study, Parkinson Disease Mobile Data Collected Using Researchkit

Current measures of health and disease are often insensitive, episodic, and subjective. Further, these measures generally are not designed to provide meaningful feedback to individuals. The impact of high-resolution activity data collected from mobile phones is only beginning to be explored. Here we present data from mPower, a clinical observational study about Parkinson disease conducted purely through an iPhone app interface. The study interrogated aspects of this movement disorder through surveys and frequent sensor-based recordings from participants with and without Parkinson disease. Benefitting from large enrollment and repeated measurements on many individuals, these data may help establish baseline variability of real-world activity measurement collected via mobile phones, and ultimately may lead to quantification of the ebbs-and-flows of Parkinson symptoms. App source code for these data collection modules are available through an open source license for use in studies of other conditions. We hope that releasing data contributed by engaged research participants will seed a new community of analysts working collaboratively on understanding mobile health data to advance human health

CORRELATES OF REPRODUCTIVE COERCION AND STRATEGIES TO MINIMIZE HARM AMONG LATINA WOMEN

Statement of problem: Reproductive coercion (RC) is abusive or controlling behavior that interferes with autonomous reproductive health decision-making by women. It is understudied, especially in Latina women, and is a critical factor in health outcomes disproportionately experienced by Latina women, such as unintended pregnancy. Methods: This study used an exploratory sequential mixed-methods design. In Phase 1, 13 adult Latina women who reported lifetime experience of RC participated in in-depth interviews to define RC, risk factors and safety strategies, and pregnancy intention. Findings from Phase 1 informed the quantitative phase (Phase 2), the administration of a linguistically appropriate survey on lifetime and past-year prevalence of IPV and RC, risk factors, safety and harm reduction strategies, and unintended pregnancy with 500 Latina women seeking services at an urban health center. Results: The current definition of RC is clearly applicable to Latina women. Cultural norms impacted vulnerability and resistance to RC. Factors that significantly increased risk of RC among the sample, included younger age, concurrent IPV and partner binge-drinking. There was a significant association (p=0.001) between RC and unintended pregnancy, and this relationship was not moderated by the use of safety and harm reduction strategies. Conclusions: This study adds to the growing body of literature on RC by identifying risk factors and outcomes of RC specific to a population of Latina women. Findings support the risk factors that have been identified in other studies as also relevant in this population and highlight areas for providers to have heightened suspicion for RC, such as women presenting with unintended pregnancy or seeking abortion and any woman who is suspected or confirmed to be experiencing IPV. This study also supports increased provider vigilance for RC among young Latina women reporting more than one recent partner. The use of existing provider guidelines for RC is supported in Latina women, with perhaps the greatest benefit to be gained from offering support services to plan for safety and harm reduction when make decisions about leaving unhealthy and unsafe relationships

Nanoscale particle binding in silico: HIV docking and multivalent recruitment under flow

Enveloped viral infection is mediated by the binding of viral proteins with host cell receptors. Small particles are capable of binding with multiple receptors making the calculation of the multivalent saturation state difficult. This dissertation presents a computer simulation model to study the binding of biologically relevant proteins on the surface of nanoscale particles. The prototype of these studies is HIV binding CD4+ host cells. We investigate the role of cellular receptor diffusion on the degree of binding achieved by the virus on both short timescales (where binding has reached steady state, but before substantial receptor accumulation in the viral-cell contact zone has occurred) and long timescales (where the system has reached steady state). On short timescales, viruses with 10-23 env trimers most efficiently form fully engaged trimers. On long timescales, all gp120 in the contact area become bound to CD4. Extending these calculations to include the packing volume of cellular receptors in the contact area reveals that a maximum of 6 env trimers can be fully engaged to both CD4 and CCR5. The time to reach a saturated state is exponentially related to the total number of proteins in the contact area. Finally, we study the effects of cellular coreceptor density on the time to reach a fully saturated state. We predict that combined therapy of two entry inhibiting agents, T-20 and maraviroc, will have synergistic efficacy against viral infection. We use simulations to study the binding of engineered particles to coated surfaces with the goal of predicting multivalent binding in vivo. For systems under flow, the multivalent potential of particle binding does not improve the particle recruitment to a surface, however a higher bond number increases the bound lifetime of the particle. Therefore, the off rate, kr, of the protein interactions is important in tuning the multivalent binding of nanoscale particles. We reconstructed the binding phase of binding experiments monitored with surface plasmon resonance using simulations of particle. Our predicted values of peak binding closely correspond with the measured binding in BIAcore experiments