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While human adaptability is regarded as a classical topic in anthropology, recent work provides new insight into metabolic adaptations to cold climates and the role of phenotypic plasticity in human evolution. A growing body of literature demonstrates that adults retain brown adipose tissue (BAT) which may play a role in non-shivering thermogenesis. In this narrative review, we apply the timescales of adaptation framework in order to explore the adaptive significance of human BAT. Human variation in BAT is shaped by multiple adaptive modes (i.e., allostasis, acclimatization, developmental adaptation, epigenetic inheritance, and genetic adaptation), and together the adaptive modes act as an integrated system. We hypothesize that plasticity in BAT facilitated the successful expansion of human populations into circumpolar regions, allowing for selection of genetic adaptations to cold climates to take place. Future research rooted in human energetics and biocultural perspectives is essential for understanding BAT's adaptive and health significance.

Introduction This study explores the recent neo-abolitionist legislation of the Israeli sex industry by illustrating the competing claims of various stakeholders: those leading the legal change and those protesting it. The main question is how Israeli sex workers perceive the public debate over governing the Israeli sex industry. Methods This study combines qualitative methods that include ethnographic observations and interviews. The ethnographic observations were carried out between November 2018 and October 2019 in gatherings, protests, and academic conferences where sex workers were the lead speakers. In addition, 16 in-depth semi-structured interviews were conducted with sex workers across various indoor sectors, and four interviews were conducted with political figures to learn about their efforts to adopt neo-abolitionist legislation. Results the Israeli legislative proceedings initiated in 2007 deny sex workers a voice and exclude them from the political space and policy debates that have a direct bearing on their working lives and wellbeing. Thus, Israeli sex workers perceive sex work governance as controlling their agency and deepening their stigmatization. In this process, we show how contrasting groups became strange bedfellows in their attempt to protect sex workers by incriminating clients of the sex industry. Conclusions We conclude that the binary framings of debates about sex work in Israel do not address the actual needs or political desires of sex workers who are ignored and excluded from the discourse about them. Policy Implications Furthermore, we conclude that the issue at hand is not about permitting sex workers to express their views but rather about the need to listen to their critiques to ensure that policy is built on their knowledge and experience.

This paper considers different approaches to modelling the economic impact of the COVID-19 pandemic/lockdown shocks. We review different modelling strategies and argue that, given the nature of the bottom-up recession caused by the pandemic/lockdowns, simulation models of the shocks should be based on a social accounting matrix (SAM) that includes both disaggregated sectoral data and the national accounts in a unified framework. SAM-based models have been widely used to analyze the impact of natural disasters, which are comparable to pandemic/lockdown shocks. The pandemic/lockdown shocks occurred rapidly, in weeks or months, not gradually over a year or more. In such a short period, adjustments through smooth changes in wages, prices and production methods are not plausible. Rather, initial adjustments occur through changes in quantities, altering demand and supply of commodities and employment in affected sectors. In this environment, we use a linear SAM-multiplier model that specifies a fixed-coefficient production technology, linear demand system, fixed savings rates, and fixed prices. There are three different kinds of sectoral shocks that are included in the model: (1) changes in demand due to household lockdown, (2) changes in supply due to industry lockdown, and (3) changes in demand due to induced macro shocks. At the detailed industry level, data are provided for all three shocks and the model imposes the largest of the three. We applied the model on a monthly time step for the period March to June 2020 for four countries: US, UK, Mexico, and South Africa. The models closely replicate observed macro results (GDP and employment) for the period. The results provide detailed structural information on the evolution of the different economies month-by-month and provide a framework for forward-looking scenario analysis. We also use the SAM-multiplier model to estimate the macro stimulus impacts of policies to support affected households. The model focuses attention on the structural features of the economy that define the multiplier process (who gets the additional income and what do they do with it) and provides a more nuanced analysis of the stimulus impact of income support programs than can be done with aggregated macro models.

Absent vaccines and pharmaceutical interventions, the only tool available to mitigate its demographic effects is some measure of physical distancing, to reduce contagion by breaking social and economic contacts. Policy makers must balance the positive health effects of strong distancing measures, such as lockdowns, against their economic costs, especially the burdens imposed on low income and food insecure households. The distancing measures deployed by South Africa impose large economic costs and have negative implications for the factor distribution of income. Labor with low education levels are much more strongly affected than labor with secondary or tertiary education. As a result, households with low levels of educational attainment and high dependence on labor income would experience an enormous real income shock that would clearly jeopardize the food security of these households. However, in South Africa, total incomes for low income households are significantly insulated by government transfer payments. From public health, income distribution and food security perspectives, the remarkably rapid and severe shocks imposed because of Covid-19 illustrate the value of having in place transfer policies that support vulnerable households in the event of ‘black swan’ type shocks., Highlights • SAM multiplier analysis is used to assess the burdens on food insecure households imposed by strict lockdowns. • The distancing measures deployed by South Africa impose large reductions in wage income particularly for low-skilled workers. • Initial lockdown policies will jeopardize the food security of low-income households dependent on labor income. • The effects of the COVID-19 pandemic illustrate the value of transfer policies that support vulnerable households.

Recognizing the need for evidence to inform public health officials and health care workers in the U.S. government and low- and middle-income country governments on efficient, effective behavior change policies, strategies, and programs for child health and development, the U.S. government convened the Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. This article summarizes the background and methods for the acquisition and evaluation of the evidence used to the achieve the goals of the summit that is reviewed in other articles in this special issue of the Journal of Health Communication. The process began by identifying focal questions intended to inform the U.S. and low- and middle-income governments about behavior change interventions that accelerate reductions in under-5 mortality and optimize healthy and protective child development to 5 years of age. Experts were selected representing the research and program communities, academia, relevant nongovernmental organizations, and government agencies and assembled into evidence review teams. This was followed by the systematic gathering of relevant peer-reviewed literature that would inform the focal questions. Members of the evidence review teams were invited to add relevant articles not identified in the initial literature review to complete the bibliographies. Details of the search processes and methods used for screening and quality reviews are described. The evidence review teams were asked to comply with a specific evaluation framework for recommendations on practice and policy on the basis of both expert opinion and the quality of the data reviewed.

This paper studies the relevance of agricultural policies for avoiding Dutch disease, which affects many less developed countries experiencing a resource boom. Using a computable general equilibrium model calibrated for Chad, we study the impact of using this country's annual oil revenue for public investment, particularly in the development of road and irrigation infrastructure. Our model takes into account the integration of markets and migration processes. We find that improving water access would reduce Chad's dependence on food aid and entail a substantial improvement in rural household welfare. Copyright 2007 The author 2007. Published by Oxford University Press on behalf of the Centre for the Study of African Economies. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org, Oxford University Press.

In this special edition of Policy in Focus, leading authors and practitioners present their research on how cash transfers can impact the local economy when implemented in a developing country. The aim is to gather and review research results and evidence, obtained from various methodologies ranging from randomised control trials (RCTs) to village economy models and general equilibrium analysis, applied on small-scale programmes to larger-scale policies in Latin America, Africa and South-East Asia. The economic impact of social transfers is analysed here through their effects on investment, productivity, prices, employment and trade and through more general equilibrium effects of redistributive policies. (?)

Providing safety nets to the poor is part of the agenda of most developingcountries. When poverty incidence is high, providing a signiÿcant share ofthe population with social transfers implies substantial mobilization ofresources for the government. It also implies that a large injection of fundswill °ow into the economy and reach a population that will mostly consumethe transfers they receive. This increase in households consumption willincrease demand for all sorts of goods and services and will have varyingeconomic impacts depending on whether it reaches markets that havethe elasticity needed to respond e?ciently and rapidly enoughto prevent prices from increasing.

La plupart des pays en développement sengage aujourdhui à mettre en place des mesures de protection sociale pour les franges les plus vulnérables de leur population, sous forme entre autres de transferts monétaires aux ménages. Lorsque lincidence de la pauvreté est élevée, de telles mesures impliquent une mobilisation de ressources importante de la part du gouvernement. Elles impliquent également une injection substantielle de fonds publics dans léconomie nationale, pour atteindre une population qui va principalement consommer les transferts quelle reçoit. Laugmentation de la demande des ménages qui en découle va se porter sur toutes sortes de biens et de services et aura un impact économique différent selon quelle atteint les marchés qui ont la capacité nécessaire pour y répondre efficacement et assez rapidement pour empêcher les prix daugmenter.

Providing the poorest with safety nets and some form of social protection is becoming part of the agenda of the majority of developing countries. And while cash transfer programs started 15 years ago with experiments and pilot projects, there is currently a scaling up of policies in many parts of the developing world. These policies involve large financial flows which are likely to impact markets, employment and prices.While previous research on cash transfer programs has primarily concentrated on micro-economic effects, this paper analyzes general equilibrium effects of social transfer policies using a computable general equilibrium model applied to Cambodia. It identifies the potential impact of these transfers on the local economy, looking particularly at prices and market responses to an increase in demand through production and trade. Our findings show that, for goods and services for which domestic supply is not elastic enough to respond to a significant rise in demand, prices will increase, affecting the value of transfers on poverty reduction. However, productivity gains from the health and education component of conditional cash transfers appear to be likely to mitigate the price effects associated with cash transfers alone. Our simulation results also show strong complementarities between social protection and rural development policies. At a given level of public spending, a combination of these two types of policies is likely to generate more poverty reduction than cash transfers alone, while also significantly benefiting the local economy. The results indicate that in the context of weak market integration and insufficient supply response, cash transfers would be more effective if embedded in development strategies that improve trade and domestic production. Social protection programs could therefore become more effective when implemented simultaneously with productivity-enhancing policies.

Background The clinical experience of people living with Huntington’s as they navigate the health system to manage this long term condition is important as this has links with their care and everyday quality of life. Aims The current study aims to examine the patient experience of people living with Huntington’s disease, and also explore receptivity to psychological input. Methods The Huntington’s patient experience within the UK was examined using patient experience survey data from the Neurological Alliance. The use of psychological and counselling services were examined in the context of different allied health services, and we contrast this with our experience of discussing psychological input with patients. Results For Huntington’s disease, occupational therapists (25.6%) were the allied health service most utilised, closely followed by speech and language therapists (23.1%) and then physiotherapists (20.5%); in comparison, psychologists, dieticians and social workers were more rarely seen (10.3%) with counsellors seen the least (5.1%). The data also showed that a significant proportion of patients felt neutral to negative about how they were told of their condition (33.3%), their care and treatment options (51.4%), and additional sources of support (56.8%). Our clinical experience indicates that patients are interested in psychological input from a clinician experienced in working with Huntington’s. Conclusion We conclude that Huntington’s relevant psychological input may be under-utilised in Huntington’s and can be useful given the reception from patients.

Objectives To determine safety and efficacy of the 5HT 1A serotonin partial agonist buspirone on core autism and associated features in children with autism spectrum disorder (ASD). Study design Children 2-6 years of age with ASD (N = 166) were randomized to receive placebo or 2.5 or 5.0 mg of buspirone twice daily. The primary objective was to evaluate the effects of 24 weeks of buspirone on the Autism Diagnostic Observation Schedule (ADOS) Composite Total Score. Secondary objectives included evaluating the effects of buspirone on social competence, repetitive behaviors, language, sensory dysfunction, and anxiety and to assess side effects. Positron emission tomography measures of tryptophan metabolism and blood serotonin concentrations were assessed as predictors of buspirone efficacy. Results There was no difference in the ADOS Composite Total Score between baseline and 24 weeks among the 3 treatment groups ( P = .400); however, the ADOS Restricted and Repetitive Behavior score showed a time-by-treatment effect ( P = .006); the 2.5-mg buspirone group showed significant improvement ( P = .003), whereas placebo and 5.0-mg buspirone groups showed no change. Children in the 2.5-mg buspirone group were more likely to improve if they had fewer foci of increased brain tryptophan metabolism on positron emission tomography ( P = .018) or if they showed normal levels of blood serotonin ( P = .044). Adverse events did not differ significantly among treatment groups. Conclusions Treatment with 2.5 mg of buspirone in young children with ASD might be a useful adjunct therapy to target restrictive and repetitive behaviors in conjunction with behavioral interventions. Trial registration ClinicalTrials.gov: NCT00873509.

Background: Men have a higher stroke incidence compared to women until advanced age. The contribution of hormones to these sex differences has been extensively debated. In experimental stroke, estradiol is neuroprotective, whereas androgens are detrimental. However, prior studies have only examined the effects of acute treatment paradigms; therefore, the timing and mechanism by which ischemic sexual dimorphism arises are unknown. Methods: The effects of exogenous neonatal androgen exposure on subsequent injury induced by middle cerebral artery occlusion in adulthood in male rats were examined. Rats were administered vehicle (oil), testosterone propionate (TP) or the non-aromatizable androgen dihydrotestosterone (DHT) for 5 days after birth. At 3 months of age, a focal stroke was induced. Results: Testosterone-treated rats (but not DHT-treated animals) had decreased infarct volumes (20 vs. 33%, p < 0.05) as well as increased estradiol levels (39.4 vs. 18.6 pg/ml, p < 0.0001) compared to oil-treated animals. TP-injected males had increased testicular aromatase (P450arom) levels (3.6 vs. 0.2 ng/ml, p < 0.0001) compared to oil-treated males. The level of X-linked inhibitor of apoptosis, the primary endogenous inhibitor of caspase-induced apoptosis, was increased in TP-treated rats compared with the oil-treated males. Conclusions: Neonatal exposure to exogenous testosterone upregulates testicular aromatase expression in male rats and leads to adult neuroprotection secondary to changes in serum estradiol levels and cell death proteins. This study suggests that early exposure to gonadal hormones can have dramatic effects on the response to adult cerebrovascular injury.

Aneurysmal subarachnoid hemorrhage (aSAH) is an often devastating form of stroke. Aside from the initial hemorrhage, cardiac complications can occur resulting in neurogenic stress cardiomyopathy (NCM), leading to impaired cardiac function. We investigated whether aSAH patients with NCM had poorer long term functional outcomes than patients without NCM. Mortality, vasospasm, and delayed ischemic complications were also evaluated.A retrospective study of all patients admitted for aneurysmal subarachnoid hemorrhage (aSAH) from January 2006 to June 2011 (n=299) was conducted. Those patients who underwent an echocardiogram were identified (n=120) and were assigned to the NCM (n=49) category based on echocardiographic findings defined by a depressed ejection fraction (EF%) along with a regional wall motion abnormality (RWMA) in a non-vascular pattern. Primary outcome measures included in-hospital mortality and functional outcomes as measured by the Modified Barthel Index (mBI) at 3 months and one year. Secondary analysis determined if there was an association between NCM, cerebral vasospasm and delayed cerebral ischemia.16% of aSAH patients developed NCM. Mortality was higher (p.001) in the NCM group (n=23[46.9%]) than in the non-CM group (n=28[11.2%]). Patients with NCM had poorer functional outcomes as measured by the mBI at both 3 months (p=.002) and 12 months (p=.014). The Hunt-Hess score was predictive of functional outcome as measured by the mBI at both 3 months (p=.002) as well as at 1 year (p=.014). NCM was associated with both death (p=.047 CI, 1.012-7.288) and vasospasm (p=.008 CI, 1.34-6.66) after correction for Hunt-Hess grade. Tobacco use (p.001) and a history of diabetes mellitus (p.009) were also associated with vasospasm. NCM was associated with higher in-hospital mortality (p=.047) in multivariate analysis.NCM is seen in a substantial number of aSAH patients and when present, it is associated with higher mortality and poorer long-term functional outcomes. This finding may guide further prospective studies in order to determine if early recognition of NCM as well as optimization of cardiac output would improve mortality.