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Chapter 5 focuses on broken nation-states during the Arab Spring – Iraq, Syria, and the Islamic State –the human suffering broken states cause (even if they “broke” during efforts to implement and sustain democratic politics) and how elites have tried to put the states back together again.
Chapter 1 describes how Tunisia’s unique success has been based on comparative strength in national unity and state capacities along with an apolitical military, and Islamist and secular political parties exceptionally willing to work together to sustain a democratic bargain. Latent threats to Tunisia’s democracy remain in a security sector fighting reform, socioeconomic struggles, and the resurgence to power of pre–Arab Spring political and economic elites.
In Chapter 2, Egypt enters the Arab Spring with relative strength in national unity and state capacities. However, during the country’s democratic transition, its military took advantage of conflicts between Islamists and secularists in order to stage a coup and reassert its historical dominance of Egypt’s political economy. Both Islamist and secular-oriented political parties were at fault in failing to forge the “twin tolerations” necessary for a political pact or democratic bargain in Egypt. Witnessing the victory of Islamists in transitional elections, secularists turned to the streets and the military to overturn electoral outcomes. For their part, after winning Egypt’s post-Mubarak founding elections, President Morsi and the Muslim Brotherhood made decisions and appointments that raised questions about their commitment to democracy and their willingness to share power at the most delicate point of a democratic transition, the period that includes constitution writing.
This chapter introduces the democratic consolidation framework utilized in the book to explain divergent outcomes of the Arab Spring. It argues for the desirability of socioeconomic pacts and analyzing the history and contours of nation and state formation in analysis of democracy.
In 2011, the world watched as dictators across the Arab world were toppled from power. In Tunisia, Egypt, Libya, Yemen, Syria, and Iraq, ordinary Arab citizens mobilized across the region during the Arab Spring to reinvent the autocratic Arab world into one characterized by democracy, dignity, socioeconomic justice, and inviolable human rights. This unique comparative analysis of countries before, during and after the Arab Spring seeks to explain the divergent outcomes, disappointing and even harrowing results of efforts to overcome democratic consolidation challenges, from the tentative democracy in Tunisia to the emergence of the Islamic State, and civil war and authoritarian retrenchment everywhere else. Tracing the period of the Arab Spring from its background in long-term challenges to autocratic regimes, to the mass uprisings, authoritarian breakdown, and the future projections and requirements for a democratizing conclusion, Stephen J. King establishes a broad but focused history which refines the leading theory of democratization in comparative politics, and realigns the narrative of Arab Spring history by bringing its differing results to the fore.
The Libyan case study in Chapter 3 reveals how harrowing the introduction of democratic elections can be in countries without national unity or any of the attributes of a modern state. Qaddafi’s ideology of a stateless, egalitarian society based on an idiosyncratic blend of Islamic and Marxist concepts left Libya’s transitional regime largely without a bureaucratic apparatus to implement policies. Qaddafi had also reinvigorated Libya’s tribal system by favoring his own and punishing the region and tribes that were the base of support for the prior monarchical regime. Competitive elections in Libya were implemented in a country without a national military that could monopolize the use of violence. In its place, during the civil war, a welter of regional, local, tribal, and ideological militias – some more powerful than the “national military” – emerged and prevented transitional governments from being able to provide peace and security for Libyans. There was also a military strongman in Libya, General Haftar, seeking to utilize the near anarchic conditions to forge a military authoritarian regime – by reining in the militias and providing desperately needed security.
Chapter 4 tracks Yemen’s democratic transition and descent into civil war. Like Libya, Yemen entered the Arab Spring with severe national unity and state-capacity challenges. National unity collapsed in Yemen when the military fired on protestors and some soldiers and officers defected to the uprising. In addition, in Yemen, during the democratic transition, potent political parties never emerged to represent the secular youth who spearheaded the regime. Houthi rebels, the main challengers to the prior regime under Saleh’s rule, also felt left out of the transition process. Lastly, political parties also failed to forge consensus on conflicts between the former North Yemen and South Yemen, which prevented a democratic bargain or political pact. Yemen was also the poorest country in the region making it exceptionally vulnerable to socioeconomic challenges.
Early in the history of schistosomiasis research, children under 5 years of age were known to be infected. Although this problem was recognized over 100 years ago, insufficient action has been taken to address this issue. Under current policy, such infected children only receive their first antiparasitic treatment (praziquantel – PZQ) upon entry into primary school as current mass drug administration programmes typically target school-aged children. For many infected children, they will wait up to 6 years before receiving their first medication and significant schistosomiasis-related morbidity may have already established. This inequity would not be accepted for other diseases. To unveil some of the reasons behind this neglect, it is paramount to understand the intricate historical relationship between schistosomiasis and British Imperial medicine, to underline its lasting influence on today's public health priorities. This review presents a perspective on the historical neglect of paediatric schistosomiasis, focusing on important gaps that persist from the early days after discovery of this parasite. Looking to end this inequity, we address several issues that need to be overcome to move forward towards the lasting success of schistosomiasis control and elimination efforts.
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
Because Madagascar has been isolated from other continents for more than 150 million years (Jernvall & Wright, 1998; Kremen et al., 2008), it is characterized today by an extraordinary biodiversity that is unique to the island. Over the past 1000 years, 90% of Madagascar’s natural habitat has been destroyed, likely due primarily to human impact (Green & Sussman, 1990; Perez et al., 2005). Today many of its endemic species of plants and animals are threatened or endangered due to a combination of habitat destruction and hunting (Banks et al., 2007; Mayor et al., 2004; Wright et al., 2008). In very recent years tourism may have become an additional factor affecting Malagasy biodiversity. Madagascar’s diverse ecosystems, including spiny desert, subtropical dry forest, and rainforests, are all now contained in protected areas visited by tourists (Garbutt, 2009; Mittermeier et al., 2010).
Before the national park system was organized, tourism in Madagascar was primarily limited to beach resorts. A 15-year Environmental Action Plan was started in 1990 through which the national protected area system was established and the Association Nationale pour la Gestion des Aires Protégées (ANGAP) was organized to manage it (Wright & Andriamihaja, 2002). In 1990 there were two national parks in Madagascar, but by 2008, 18 had been established (Figure 7.1). Today the majority of ecologically minded tourists visit three of those parks: Mantadia, Isalo, and Ranomafana. In 2008, ANGAP was renamed Madagascar National Parks (MNP).