Evaluating sustainable development policies in rural coastal economies

Sustainable development (SD) policies targeting marine economic sectors, designed to alleviate poverty and conserve marine ecosystems, have proliferated in recent years. Many developing countries are providing poor fishing households with new fishing boats (fishing capital) that can be used further offshore as a means to improve incomes and relieve fishing pressure on nearshore fish stocks. These kinds of policies are a marine variant of traditional SD policies focused on agriculture. Here, we evaluate ex ante economic and environmental impacts of provisions of fishing and agricultural capital, with and without enforcement of fishing regulations that prohibit the use of larger vessels in nearshore habitats. Combining methods from development economics, natural resource economics, and marine ecology, we use a unique dataset and modeling framework to account for linkages between households, business sectors, markets, and local fish stocks. We show that the policies investing capital in local marine fisheries or agricultural sectors achieve income gains for targeted households, but knock-on effects lead to increased harvest of nearshore fish, making them unlikely to achieve conservation objectives in rural coastal economies. However, pairing an agriculture stimulus with increasing enforcement of existing fisheries’ regulations may lead to a win–win situation. While marine-based policies could be an important tool to achieve two of the United Nations Sustainable Development Goals (alleviate poverty and protect vulnerable marine resources), their success is by no means assured and requires consideration of land and marine socioeconomic linkages inherent in rural economies.

Coastal and island nations are adopting “blue growth” sustainable development (SD) policies to alleviate poverty and conserve vulnerable ocean resources. Generally speaking, SD policies manage resources and direct investments in order to meet current and future human needs and aspirations, without endangering the natural systems (1). The feasibility and potential of SD has been the focus of decades of academic research; many regard the consideration of economic, social, environmental, and institutional needs and linkages as fundamental to successful policy design and implementation (2–6). Given their novelty, what constitutes a blue growth policy is not universal (7), but like traditional SD policies that focus on land-based sectors such as agriculture, manufacturing, and energy sectors (8, 9), blue growth policies seek to achieve social, economic, and environmental goals simultaneously (10). Blue growth policies attempt to achieve these goals by supporting marine-based industries such as offshore fishing, aquaculture, shipping, and tourism (11, 12). The marine focus has reinvigorated SD efforts of international organizations (including the Global Environmental Facility, United Nations Food and Agriculture Organization, the European Union, and The World Bank) that have collectively invested hundreds of millions of dollars into the development and monitoring of blue growth programs (12–16).While small-scale artisanal fishers consider a variety of factors when making fishing decisions (17), evidence suggests allocation of time is, in part, based on relative returns to labor (18–21). Thus, some blue growth policies attempt to alter returns to fishing relative to alternative income-generating activities as a way to achieve both poverty alleviation and conservation objectives. For example, if poor fishing households are incentivized to participate in offshore fishing, it may lead to increased household incomes and reduced fishing pressure on overexploited nearshore fish stocks (22, 23). Policies enforcing and increasing the regulation of fishing activities are also considered important to achieving blue growth objectives (10, 24).Many SD policies are designed to reduce upfront costs of switching to more sustainable livelihoods. Historically, large-scale fisheries receive the majority of subsidy benefits (25), arguably to the detriment of small-scale fisheries who are often outcompeted by industrialized operations (26). Recently, however, developing countries including Kenya, the Philippines, India, Tanzania, Vietnam, and Indonesia have been investing in programs that bolster the fishing capacity of small-scale and artisanal fishermen (27–33). These programs are designed to help small-scale fishers access larger or better vessels and gear, allowing them to reach more plentiful fishing grounds, compete with commercial vessels, and relieve pressure on vulnerable nearshore fisheries.Despite the recent surge in popularity, we lack evidence that these marine-based SD policies will achieve both poverty reduction and conservation objectives when implemented in rural economies. The complexity of coupled natural–human systems makes it difficult to measure the ex post performance of SD policies, especially in marine environments (34, 35). Additionally, local market failures due to high transportation costs and poorly developed marketing infrastructure (36) can lead to locally defined prices that fluctuate with changes in local supply and demand; local prices may distort household responses to policies, leading to unintended environmental consequences (37–40). Because local market failures are more common in rural economies in developing countries, methods and lessons learned from studies of industrialized fisheries in developed countries may not be relevant. Rather, management of fisheries in rural coastal economies may be more successful if market imperfections, alternative livelihood options, and ecological feedback are considered (20, 41–47).Recent studies explore the causal impacts of land-based SD policy instruments in developing countries (48–56). A key finding of these studies is that community heterogeneity is an important factor in policy performance. However, findings from forestry research do not necessarily carry over to marine settings because fish resources are mobile and regenerate relatively quickly, and, typically, access rights to fisheries are not well defined. This study begins to address the need for research examining responses to SD policy in rural coastal economies.We use a coupled natural–human modeling framework to estimate the ex ante impacts of common SD policies. Our ex ante mechanistic approach that includes a general equilibrium local economy model captures important dynamic feedback between the economy and health of the fish stocks. Indeed, other researchers have studied the correlations between markets and ecosystems in coastal communities in developing countries (44, 57–59). However, the theoretical structure of our analysis approach allows us to examine the causal mechanisms between policy and its outcomes. Our model captures the feedback between economic sectors and households within the economy (Fig. 1, details in SI Appendix). This broad scope is necessary to estimate the extent to which policies targeting poor households in a community also impact nontargeted households (knock-on effects). For example, a policy supporting a subset of fishing households could be detrimental to other households that harvest from the same fish stocks and compete in the same input and output markets.Open in a separate windowFig. 1.A conceptual framework for the bioeconomic local general equilibrium model. Households are represented by four representative groups and may produce goods and services (e.g., agricultural, offshore and nearshore fish, retail, and restaurants) available in local, and possibly global, markets. The simulated policies provide different types of capital to poor households and may also restrict use of fishing capital.Here, we estimate the impacts of two common marine fisheries policies (provision of offshore fishing vessels and increased enforcement of fishing regulations) and an alternative agricultural policy (provision of agricultural capital) in a rural coastal economy. To estimate the impacts of these SD policies in coastal economies, we use a modeling approach that has been developed using theory from development economics, natural resource economics, and marine ecology (37, 60). Introducing new features to the framework, we develop a model of a rural economy capable of disentangling fisher participation in two distinct fishing activities and household consumption of two fish goods. We use microeconomic data collected from household and business surveys to parameterize and calibrate our model, allowing us to realistically estimate policy impacts. An inherent strength to our methodology is the ability to adjust the structure of the model to represent alternative economies. We demonstrate how the model can be used to predict policy outcomes for a typology of rural coastal economies.Although combining policies that simultaneously target marine and agricultural sectors is currently not part of the dialogue on the adoption of blue SD policies around the world (e.g., see The World Bank’s strategy document for its Blue Economy Program and PROBLUE (13)), we find that pairing policy instruments that target both sectors—increased enforcement of vessel regulations and capital investments in the agricultural sector—is better able to achieve both conservation and poverty reduction goals.Why is an agricultural policy combined with enforcement capabilities of marine fishing regulations able to achieve a win–win while marine-focused SD policies are not? Our coupled natural–human modeling framework highlights the mechanisms leading to this counterintuitive outcome. That is, investing in the agricultural sector increases the returns to agricultural labor, which in turn creates upward pressure on wages and encourages a reduction in labor allocated to nearshore fishing. At the same time, the increased wealth in the local economy due to greater agricultural productivity drives up demand for nearshore fish. Although higher prices of fish draw some labor back into the fishery, increased enforcement of vessel regulations prevents fishers from illegally using larger boats in the nearshore habitat as a means to increase harvests. Without coupling increased enforcement and agricultural subsidy, the higher demand for fish would lead to increased harvests in the nearshore environment and lower fish stocks over time.     

Participant report of therapist-delivered active ingredients in a telephone-delivered brief motivational intervention predicts taking steps towards change

Objective: Given the widespread potential for disseminating Motivational Interviewing (MI) through technology, the question of whether MI active ingredients are present when not delivered in person is critical to assure high treatment quality. The Participant Rating Form (PRF) was developed and used to evaluate therapist-delivered active ingredients in phone-delivered MI with hazardous drinking Emergency Department patients. Method: A factor analysis of all PRFs completed after receiving one call (n?=?256) was conducted. Multiple regression analysis was used to examine whether PRF factors predicted a measure of motivation to change – taking steps – at the second call (n?=?214). Results: The majority of participants were male (65%), with a mean age of 32 years and with an average alcohol ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) score of 20.5 (SD?=?7.1). Results of the factor analysis for the PRF revealed Relational (working collaboration) and Technical (MI behaviours) factors. After controlling for demographics, alcohol severity and baseline readiness, the technical factor predicted self-report of increased taking steps towards change while the relational factor did not explain any additional variance. Conclusions: Our study adds to the growing literature investigating patient perspectives of therapist skill as a source of information to better understand MI active ingredients. The PRF is a feasible instrument for measuring the patient’s experience of phone-based MI. Results indicate that MI active ingredients of change (relational and technical components) were present in the telephone intervention as hypothesized. Clinical Trial Registration # 01326169.     

Lidoflazine and propranolol combination treatment in chronic stable angina

The short-term (1 month) and long-term (6 months) safety of combination lidoflazine-propranolol therapy was investigated in an open trial of 15 patients with stable angina of effort. The possible advantages of adding lidoflazine (titrated to 360 mg daily) to patients having a therapeutic response to propranolol (80-400 mg daily) was also evaluated. Effects on non-invasive indexes of left ventricular function (echocardiography, systolic time intervals, radionuclide ventriculography) and exercise tolerance (treadmill exercise testing) were determined. There was no change in mean resting heart rate with the combination therapy, although one patient developed sinus bradycardia at a rate of 44 and had to have his propranolol dose reduced. Electrocardiographic analysis showed significant prolongation of the QTc intervals on lidoflazine-propranolol therapy compared to propranolol alone, with 3 patients having QTc interval prolongation to above .53 seconds, but there was no evidence of increased arrhythmogenesis with the combination therapy compared to propranolol alone. Left ventricular end-diastolic volume index tended to rise with combination therapy. However, lidoflazine-propranolol therapy did not produce any significant effects on resting ejection fraction determined by M-mode echocardiography or by radionuclide ventriculography. Radionuclide ventriculography determined peak exercise ejection fractions were also not significantly changed with combination therapy compared to propranolol alone. There were only small, insignificant improvements in exercise tolerance with the lidoflazine-propranolol combination treatment compared to propranolol alone. It is concluded that lidoflazine-propranolol combination therapy is generally safe but has the potential of causing serious adverse effects in certain patients, i.e. those with sick sinus disease, prolonged QTc intervals, and severe baseline left ventricular dysfunction, and that caution must be exercised in its use. Furthermore, it would appear that combination therapy provides only slight, if any, improvements in exercise tolerance in patients with chronic stable angina having a therapeutic response to oral propranolol.     

What is the meaning of colorectal transit time measurement?

This study was done to understand the different available methods used to calculate colorectal transit times. A single abdominal radiograph is taken following six successive daily ingestions of the same number of identical radiopaque markers. This method correlates well (P < 0.001) with that using a single ingestion of markers with daily x-ray films until total expulsion. In techniques used to measure colorectal transit time with multiple ingestion of markers, the number of days of ingestion depends on the kinetics of marker defecation. This was found to differ markedly in various groups of control subjects and constipated patients (P < 0.001) and can be used to obtain reliable data, even in subjects with severe constipation. When they ingest 20 markers, constipated patients are found to retain eight or more markers three days after ingestion, and taking a plain film of the abdomen on that day is sufficient to make a diagnosis of constipation. Transit time studies are reproducible from month to month in patients with an irritable bowel syndrome. Control subjects who claim that their bowel habits are not modified by stress have shorter transit times, similar in both sexes, than those who say they are (P <0.001). This may explain why a large percentage of constipated patients have been found by most authors to have normal colorectal transit times. The choice of control subjects is thus a key element in studies of functional bowel motor disorders. Stool frequency and consistency, in health, correlate only to rectosigmoid transit time.     

Antibodies to citrullinated alpha-enolase peptide 1 are specific for rheumatoid arthritis and cross-react with bacterial enolase

OBJECTIVE: To map the antibody response to human citrullinated alpha-enolase, a candidate autoantigen in rheumatoid arthritis (RA), and to examine cross-reactivity with bacterial enolase. METHODS: Serum samples obtained from patients with RA, disease control subjects, and healthy control subjects were tested by enzyme-linked immunosorbent assay (ELISA) for reactivity with citrullinated alpha-enolase peptides. Antibodies specific for the immunodominant epitope were raised in rabbits or were purified from RA sera. Cross-reactivity with other citrullinated epitopes was investigated by inhibition ELISAs, and cross-reactivity with bacterial enolase was investigated by immunoblotting. RESULTS: An immunodominant peptide, citrullinated alpha-enolase peptide 1, was identified. Antibodies to this epitope were observed in 37-62% of sera obtained from patients with RA, 3% of sera obtained from disease control subjects, and 2% of sera obtained from healthy control subjects. Binding was inhibited with homologous peptide but not with the arginine-containing control peptide or with 4 citrullinated peptides from elsewhere on the molecule, indicating that antibody binding was dependent on both citrulline and flanking amino acids. The immunodominant peptide showed 82% homology with enolase from Porphyromonas gingivalis, and the levels of antibodies to citrullinated alpha-enolase peptide 1 correlated with the levels of antibodies to the bacterial peptide (r2=0.803, P<0.0001). Affinity-purified antibodies to the human peptide cross-reacted with citrullinated recombinant P gingivalis enolase. CONCLUSION: We have identified an immunodominant epitope in citrullinated alpha-enolase, to which antibodies are specific for RA. Our data on sequence similarity and cross-reactivity with bacterial enolase may indicate a role for bacterial infection, particularly with P gingivalis, in priming autoimmunity in a subset of patients with RA.     

Perspectives on emerging zoonotic disease research and capacity building in Canada.

Zoonoses are fundamental determinants of community health. Preventing, identifying and managing these infections must be a central public health focus. Most current zoonoses research focuses on the interface of the pathogen and the clinically ill person, emphasizing microbial detection, mechanisms of pathogenicity and clinical intervention strategies, rather than examining the causes of emergence, persistence and spread of new zoonoses. There are gaps in the understanding of the animal determinants of emergence and the capacity to train highly qualified individuals; these are major obstacles to preventing new disease threats. The ability to predict the emergence of zoonoses and their resulting public health and societal impacts are hindered when insufficient effort is devoted to understanding zoonotic disease epidemiology, and when zoonoses are not examined in a manner that yields fundamental insight into their origin and spread.EMERGING INFECTIOUS DISEASE RESEARCH SHOULD REST ON FOUR PILLARS: enhanced communications across disciplinary and agency boundaries; the assessment and development of surveillance and disease detection tools; the examination of linkages between animal health determinants of human health outcomes; and finally, cross-disciplinary training and research. A national strategy to predict, prevent and manage emerging diseases must have a prominent and explicit role for veterinary and biological researchers. An integrated health approach would provide decision makers with a firmer foundation from which to build evidence-based disease prevention and control plans that involve complex human/animal/environmental systems, and would serve as the foundation to train and support the new cadre of individuals ultimately needed to maintain and apply research capacity in this area.     

Status of femoral closure devices

Both sealing and suturing closure devices have been shown to shorten hemostasis time, reduce the discomfort of manual or mechanical compression, and allow for earlier ambulation after cardiac catheterization and percutaneous coronary interventions without increasing vascular complications compared with conventional compression techniques. Several studies now report a reduction in vascular complications for percutaneous coronary intervention patients treated with closure devices compared with manual compression with pronounced benefit seen in patients receiving glycoprotein IIb/IIIa receptor inhibitors. Adoption of a simple predeployment femoral angiogram is now standard practice for use of a closure device. In an attempt to develop devices that are safer and more "user friendly," considerable modifications and improvements have been made in newer generation devices. Ultimately, the acceptance of femoral closure devices will depend on which device provides a simple approach with reliable hemostasis and a cost that can justify their incorporation into routine practice.