Reforming Fiscal Institutions in Resource-Rich Arab Economies: Policy Proposals

This paper traces the evolution of fiscal institutions of Resource Rich Arab Economies (RRAEs) over time since their pre-oil days, through the discovery of oil to their build-up of oil exports. It then identifies challenges faced by RRAEs and variations in their severity among the different countries over time. Finally, it articulates specific policy reforms, which, if implemented successfully, could help to overcome these challenges. In some cases, however, these policy proposals may give rise to important trade-offs that will have to be evaluated carefully in individual cases

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Les Etats-Unis et les intérêts pétroliers de la France

Issawi Charles. Les Etats-Unis et les intérêts pétroliers de la France. In: Politique étrangère, n°5-6 - 1971 - 36ᵉannée. pp. 533-549

British Trade and the Rise of Beirut, 1830–1860

In Turkey, foreign trade now confines its principal operations to the cities of Constantinople, Smyrna, and Alexandria … Aleppo, which was before the Middle of the last century the most considerable emporium in Turkey, is now a place of comparatively little commercial importance. The trade began to decline shortly after the above mentioned period, and in the year 1792 the Levant Company finally dissolved the respectable Establishment which they had previously supported there, the Consul in fact being then the only English resident in the city, whereas in former times there had been as many as twenty-eight British merchants attached to that factory. The towns in Syria have been of late supplied with British manufactures from the establishments at Alexandria, but the consumption dose not appear to have been sufficiently extensive to encourage any of the trading houses in that city to form branch establishments on the Syrian coasts.</jats:p

De-industrialization and Re-industrialization in the Middle East since 1800

Like many other parts of the world, in the last two hundred years or so the Middle East has gone through a process of de-industrialization followed by reindustrialization.* The decline in handicrafts continued until well after the First World War. But by then another development was under way: the growth of a modern factory industry that started around the 1890s, gathered increasing momentum in the 1920s and 1930s, and since the Second World War has proceeded at a very rapid pace.</jats:p