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This chapter introduces an idea that has enjoyed a remarkable, if hotly contested, development in the post-Cold War era: humanitarian intervention. Based on a commitment to principles of humanity and respect for life, such action seeks to alleviate the unnecessary suffering caused by violent conflict through intervening in another state, with force under limited conditions. The chapter outlines the origins of humanitarianism and the history of humanitarian intervention before discussing the shift to the responsibility to protect (R2P). As world politics becomes ever more complex, debate about global responsibilities to protect suffering strangers will continue to shape the theory and practice of international relations. While abuse of human beings has not become less widespread, the preoccupation with COVID-19 and domestic priorities meant that little consideration was given to robust action against middle powers perpetrating mass atrocities in such places as Myanmar and Tigray, let alone against major powers in Ukraine and Xinjiang.
Sedentary occupation of the southern Levantine coast spans from the Pre-Pottery Neolithic C to the Early Bronze Age Ib phase (c. 7000–3100 BC). Sites dating to the Early Pottery Neolithic (c. 6400–5500 BC) are scarce, however, potentially reflecting the effects of the 8.2ka climatic event. Here, the authors present the investigations at the submerged site of Habonim North off the Carmel Coast. Typological and radiocarbon dating indicate an Early Pottery Neolithic occupation and evidence for continuity of subsistence and economic strategies with both earlier and later Neolithic cultures. The results indicate the resilience of coastal communities in the face of significant climatic uncertainty and contribute to understanding human responses to environmental change.
This study investigated the challenges and support needs of adults aged 75 and older during and after treatment for a blood cancer to aid targeted supportive resource development.
Methods
Adults aged 75 and older with a blood cancer participated in in-depth, semi-structured interviews about challenges and unmet support needs. Participants recruited through The Leukemia & Lymphoma Society were (1) in treatment or previously in treatment for a blood cancer at age 75 or older and (2) living in the United States or its territories. A thematic analysis was conducted with findings compared between 2 groups: (1) chronic -living with a chronic blood cancer; (2) acute -living with an acute blood cancer or both an acute and chronic blood cancer.
Results
Participants (n = 50) ranged from 75 to 91 years old. Both groups described similar experiences and identified 5 challenges and support needs: (1) socioemotional impact, (2) activities of daily living and instrumental activities of daily living (ADLs/iADLs), (3) uncertainty management, (4) treatment-related stressors, and (5) COVID-19-related strain. Properties for these themes illustrate challenges and support needs, with some differences between groups. For instance, those living with a chronic blood cancer highlighted financial strain with treatment-related stressors, while those with an acute blood cancer focused more on iADLs.
Significance of results
Findings inform an agenda for targeted resource development for older adults with a blood cancer nearing the end of the life span. Results demonstrate the need for supportive services and family communication interventions to help patients manage iADLs and navigate socioemotional needs and challenges.
Using a cognitive task (mental calculation) and a perceptual-motor task (stylized golf putting), we examined differential proficiency using the CWS index and several other quantitative measures of performance. The CWS index (Weiss & Shanteau, 2003) is a coherence criterion that looks only at internal properties of the data without incorporating an external standard. In Experiment 1, college students (n = 20) carried out 2- and 3-digit addition and multiplication problems under time pressure. In Experiment 2, experienced golfers (n = 12), also college students, putted toward a target from nine different locations. Within each experiment, we analyzed the same responses using different methods. For the arithmetic tasks, accuracy information (mean absolute deviation from the correct answer, MAD) using a coherence criterion was available; for golf, accuracy information using a correspondence criterion (mean deviation from the target, also MAD) was available. We ranked the performances of the participants according to each measure, then compared the orders using Spearman’s rs. For mental calculation, the CWS order correlated moderately (rs =.46) with that of MAD. However, a different coherence criterion, degree of model fit, did not correlate with either CWS or accuracy. For putting, the ranking generated by CWS correlated .68 with that generated by MAD. Consensual answers were also available for both experiments, and the rankings they generated correlated highly with those of MAD. The coherence vs. correspondence distinction did not map well onto criteria for performance evaluation.
This study assessed the incidence rate of all-cause pneumonia (ACP) and invasive pneumococcal disease (IPD) and associated medical costs among individuals aged ≥16 in the German InGef database from 2016 to 2019. Incidence rate was expressed as the number of episodes per 100 000 person-years (PY). Healthcare resource utilisation was investigated by age group and by risk group (healthy, at-risk, high-risk). Direct medical costs per ACP/IPD episode were estimated as the total costs of all inpatient and outpatient visits. The overall incidence rate of ACP was 1345 (95% CI 1339–1352) and 8.25 (95% CI 7.76–8.77) per 100 000 PY for IPD. For both ACP and IPD, incidence rates increased with age and were higher in the high-risk and at-risk groups, in comparison to the healthy group. ACP inpatient admission rate increased with age but remained steady across age-groups for IPD. The mean direct medical costs per episode were €8075 (95% CI 7121–9028) for IPD and €1454 (95% CI 1426–1482) for ACP. The aggregate direct medical costs for IPD and ACP episodes were estimated to be €8.5 million and €248.9 million respectively. The clinical and economic burden of IPD and ACP among German adults is substantial regardless of age.
The Khao Wong Prachan Valley of central Thailand is one of four known prehistoric loci of copper mining, smelting and casting in Southeast Asia. Many radiocarbon determinations from bronze-consumption sites in north-east Thailand date the earliest copper-base metallurgy there in the late second millennium BC. By applying kernel density estimation analysis to approximately 100 new AMS radiocarbon dates, the authors conclude that the valley's first Neolithic millet farmers had settled there by c. 2000 BC, and initial copper mining and rudimentary smelting began in the late second millennium BC. This overlaps with the established dates for Southeast Asian metal-consumption sites, and provides an important new insight into the development of metallurgy in central Thailand and beyond.
In prehistoric coastal and western-central Thailand, rice was the dominant cultivar. In eastern-central Thailand, however, the first known farmers cultivated millet. Using one of the largest collections of archaeobotanical material in Southeast Asia, this article examines how cropping systems were adapted as domesticates were introduced into eastern-central Thailand. The authors argue that millet reached the region first, to be progressively replaced by rice, possibly due to climatic pressures. But despite the increasing importance of rice, dryland, rain-fed cultivation persisted throughout ancient central Thailand, a result that contributes to refining understanding of the development of farming in Southeast Asia.
The science of studying diamond inclusions for understanding Earth history has developed significantly over the past decades, with new instrumentation and techniques applied to diamond sample archives revealing the stories contained within diamond inclusions. This chapter reviews what diamonds can tell us about the deep carbon cycle over the course of Earth’s history. It reviews how the geochemistry of diamonds and their inclusions inform us about the deep carbon cycle, the origin of the diamonds in Earth’s mantle, and the evolution of diamonds through time.
Designed for all providers of women's healthcare - including those undertaking Maintenance of Certification programs, trainees preparing for postgraduate examinations, and those initiating or growing a program of quality improvement and patient safety - this practical manual guides those implementing QI and safety programs with specific emphasis on Obstetrics and Gynecology practice. The content contains a strong case-based element to improve accessibility and understanding. An introductory section covers core attributes needed by all physicians to build a culture of patient safety, including leadership, communication and QI skills. Core clinical skills are then reviewed - in a variety of labor ward, office, operating room, and outpatient settings. Finally systems implications are highlighted, including information transparency and disclosure, training programs, and regulatory and legal implications. The editors are involved with national and international initiatives educating physicians in safety aspects of practice. The book is published in collaboration with the Foundation for EXXcellence.
from
Part IV
-
The new agenda: Globalisation and global governance
By
Thomas G. Weiss, Presidential Professor of Political Science and Director of the Ralph Bunche Institute for International Studies at the City University of New York's Graduate Center
This chapter introduces students to an idea that has enjoyed a remarkable, if hotly contested, development in the post-Cold War era: humanitarian intervention. Based on a commitment to principles of humanity, such intervention seeks to alleviate the unnecessary human suffering caused by violent conflict by intervening in another state with force under certain limited conditions. The chapter first outlines the origins of humanitarianism; it then sketches a short history of humanitarian intervention before discussing the shift from humanitarian intervention to responsibility to protect (R2P). As the context of world politics becomes ever more complex, debate about global responsibilities to protect suffering strangers will continue to shape the theory and practice of international relations.
For the last quarter-century, humanitarian organisations have careened from one major disaster to another. The end of the Cold War unleashed a pent-up demand for acute humanitarian action – that is, protecting and assisting individuals caught in war zones. Analyses of this period typically highlight three defining trends that explain this expansion, as well as second thoughts about the overall direction (Barnett and Weiss 2011). The first is the growing willingness and ability of outsiders to help those at risk. Radical improvements in information technology and logistical capacities, growing international support for coming to the rescue of victims, multiplying numbers of relief organisations and substantial increases in available resources promised an enhanced collective capacity to provide relief, rescue and reconstruction. The second trend reflects the mounting dangers that aid workers confront in war zones where access is difficult, where they are often perceived as a threat or as a resource to be captured, where their own physical safety is in doubt and where civilian populations are the intended victims (Duffield 2001; Kaldor 1999). In addition, the deployment of military force in such arenas for human protection purposes has raised new kinds of questions about the ability of aid workers to remain faithful to their principles (Hoffman and Weiss 2017; Weiss 2013a).
This chapter focuses on the peculiar dynamics of what until recently was called ‘humanitarian intervention’ (forcefully coming to the rescue of civilians without the consent of political authorities in the territories where victims are located), but is now more commonly called ‘R2P’: the emerging norm of the responsibility to protect.
Common mental disorders (CMD) are among the most significant contributors to disability worldwide. Patient-reported disability outcomes should be included as a key metric in the comparative assessment of value across global mental health interventions. This study aims to evaluate the validity of a widely used, cross-cultural tool – the 12-item World Health Organization Disability Assessment Schedule II (WHODAS) – as a functional outcome measure for CMD treatment.
Methods.
The study population includes 1024 participants with CMD enrolled in the MANAS trial in India. CMD was assessed using the Revised Clinical Interview Schedule (CIS-R). Disability was assessed using the 12-item WHODAS II plus a measure of disability days. This analysis presents the correlations between these disability items and CMD symptom severity at 2 months after enrollment (convergent validity) and the items’ associations with CMD recovery 4 months later (external responsiveness).
Results.
All items showed a positive correlation of disability with CMD symptom severity (p < 0.001). The WHODAS items of ‘standing,’ ‘household responsibilities,’ and ‘emotional disturbance’ explained the most variance in CMD symptom severity. Improvements in ‘disability days,’ ‘emotional disturbance,’ ‘standing,’ ‘household responsibilities,’ ‘day-to-day work,’ and ‘concentrating’ were significantly associated with CMD recovery over follow-up.
Conclusions.
Further research is recommended on a CMD-specific WHODAS subscale comprised of the six WHODAS items found to be most strongly associated with CMD severity and recovery. This shorter, CMD-specific disability subscale would critically serve as a common metric to compare intervention impact on patient-centered outcomes and, in turn, to allocate global mental health resources efficiently.
Why, despite well-established and well-publicized intergovernmental processes that date back to the early 1970s, have we been unable to put in place effective mechanisms to combat climate change? Why, despite the existence of extensive global human rights machinery, do we live in a world where mass kidnapping, rape, torture, and murder continue to blight the lives of so many? Why, despite a great deal of effort on the part of intergovernmental organizations (IGOs) and nonstate actors, have we been unable to make much of a difference to the lives of the ultra-poor and attenuate the very worst aspects of growing global inequalities? Most fundamentally, why have the current international system and the outcomes that it has produced remained so inadequate in the postwar period?