Sacred Aid Barnett, Michael; Stein, Janice
08/2012
eBook, Book
The global humanitarian movement, which originated within Western religious organizations in the early nineteenth century, has been of most important forces in world politics in advancing both human ...rights and human welfare. While the religious groups that founded the movement originally focused on conversion, in time more secular concerns came to dominate. By the end of the nineteenth century, increasingly professionalized yet nominally religious organization shifted from reliance on the good book to the public health manual. Over the course of the twentieth century, the secularization of humanitarianism only increased, and by the 1970s the movement's religious inspiration, generally speaking, was marginal to its agenda. However, beginning in the 1980s, religiously inspired humanitarian movements experienced a major revival, and today they are virtual equals of their secular brethren. From church-sponsored AIDS prevention campaigns in Africa to Muslim charity efforts in flood-stricken Pakistan to Hindu charities in India, religious groups have altered the character of the global humanitarian movement. Moreover, even secular groups now gesture toward religious inspiration in their work. Clearly, the broad, inexorable march toward secularism predicted by so many Westerners has halted, which is especially intriguing with regard to humanitarianism. Not only was it a highly secularized movement just forty years ago, but its principles were based on those we associate with “rational” modernity: cosmopolitan one-worldism and material (as opposed to spiritual) progress. How and why did this happen, and what does it mean for humanitarianism writ large?
Disruptions of continuity of care may harm patient outcomes, but existing studies of continuity disruption are limited by an inability to separate the association of continuity disruption from that ...of other physician-related factors.
To examine changes in health care use and outcomes among patients whose primary care physician (PCP) exited the workforce and to directly measure the association of this primary care turnover with patients' health care use and outcomes.
This cohort study used nationally representative Medicare billing claims for a random sample of 359 470 Medicare fee-for-service beneficiaries with at least 1 PCP evaluation and management visit from January 1, 2008, to December 31, 2017. Primary care physicians who stopped practicing were identified and matched with PCPs who remained in practice. A difference-in-differences analysis compared health care use and clinical outcomes for patients who did lose PCPs with those who did not lose PCPs using subgroup analyses by practice size. Subgroup analyses were done on visits from January 1, 2008, to December 31, 2017.
Patients' loss of a PCP.
Primary care, specialty care, urgent care, emergency department, and inpatient visits, as well as overall spending for patients, were the primary outcomes. Receipt of appropriate preventive care and prescription fills were also examined.
During the study period, 9491 of 90 953 PCPs (10.4%) exited Medicare. We matched 169 870 beneficiaries whose PCP exited (37.2% women; mean SD age, 71.4 6.1 years) with 189 600 beneficiaries whose PCP did not exit (36.9% women; mean SD age, 72.0 5.0 years). The year after PCP exit, beneficiaries whose PCP exited had 18.4% (95% CI, -19.8% to -16.9%) fewer primary care visits and 6.2% (95% CI, 5.4%-7.0%) more specialty care visits compared with beneficiaries who did not lose a PCP. This outcome persisted 2 years after PCP exit. Beneficiaries whose PCP exited also had 17.8% (95% CI, 6.0%-29.7%) more urgent care visits, 3.1% (95% CI, 1.6%-4.6%) more emergency department visits, and greater spending ($189 95% CI, $30-$347) per beneficiary-year after PCP exit. These shifts were most pronounced for patients of exiting PCPs in solo practice, whose beneficiaries had 21.5% (95% CI, -23.8% to -19.3%) fewer primary care visits, 8.8% (95% CI, 7.6%-10.0%) more specialty care visits, 4.4% more emergency department visits (95% CI, 2.1%-6.7%), and $260 (95% CI, $12-$509) in increased spending.
Loss of a PCP was associated with lower use of primary care and increased use of specialty, urgent, and emergency care among Medicare beneficiaries. Interrupting primary care relationships may negatively impact health outcomes and future engagement with primary care.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an inflammatory neuropathy, classically characterised by a slowly progressive onset and symmetrical, sensorimotor involvement. ...However, there are many phenotypic variants, suggesting that CIDP may not be a discrete disease entity but rather a spectrum of related conditions. While the abiding theory of CIDP pathogenesis is that cell-mediated and humoral mechanisms act together in an aberrant immune response to cause damage to peripheral nerves, the relative contributions of T cell and autoantibody responses remain largely undefined. In animal models of spontaneous inflammatory neuropathy, T cell responses to defined myelin antigens are responsible. In other human inflammatory neuropathies, there is evidence of antibody responses to Schwann cell, compact myelin or nodal antigens. In this review, the roles of the cellular and humoral immune systems in the pathogenesis of CIDP will be discussed. In time, it is anticipated that delineation of clinical phenotypes and the underlying disease mechanisms might help guide diagnostic and individualised treatment strategies for CIDP.
We investigate whether shareholders consider firms’ performance in corporate social responsibility (CSR) when submitting proxy proposals. We find that shareholders are more likely to propose ...governance changes when a firm has more CSR strengths and more CSR concerns. The results hold across popular proposal types, different sponsors, and different categories of CSR. We find similar results for social proposals. Although CSR strengths and concerns are not associated with the percentage of votes received in favor of a proposal, the higher likelihood of receiving shareholder proposals translates into a higher likelihood that at least one shareholder proposal receives majority support at the meeting. Our results suggest managers may avoid distinctively strong (and weak) CSR performance to reduce the costs of standing out.
Many theories of international relations contain a narrative of progress and explain that progress with reference to evolutionary imagery. This article examines critically: the relevance of Darwinian ...and Lamarckian models of international relations to the evolution of international ethics and institutions; and the possibility that the ethics and norms are likely to be more consistent with existing world orders than challengers to it. Specifically, this article draws from evolutionary social science and organizational theory to develop a framework to explore the initial diversity of the meaning and practices of humanitarianism; how the combination of environmental mechanisms and organizational culture led many humanitarian agencies to adapt to their environment in ways that incorporated politics; and the subsequent countermovement by some agencies who wanted to purify humanitarianism. I then apply this framework to explain the recent history of four international aid agencies. I conclude with several observations regarding how the model as applied to these cases allows us to examine critically the selection mechanisms that do and do not account for ethical change and how scholars of international norms, ethics, and progress should be attentive to how principled actors are creatures of the world they want to transform.
The parahippocampal place area (PPA) is a widely studied high-level visual region in the human brain involved in place and scene processing. The goal of the present study was to identify the most ...probable location of place-selective voxels in medial ventral temporal cortex. To achieve this goal, we first used cortex-based alignment (CBA) to create a probabilistic place-selective region of interest (ROI) from one group of 12 participants. We then tested how well this ROI could predict place selectivity in each hemisphere within a new group of 12 participants. Our results reveal that a probabilistic ROI (pROI) generated from one group of 12 participants accurately predicts the location and functional selectivity in individual brains from a new group of 12 participants, despite between subject variability in the exact location of place-selective voxels relative to the folding of parahippocampal cortex. Additionally, the prediction accuracy of our pROI is significantly higher than that achieved by volume-based Talairach alignment. Comparing the location of the pROI of the PPA relative to published data from over 500 participants, including data from the Human Connectome Project, shows a striking convergence of the predicted location of the PPA and the cortical location of voxels exhibiting the highest place selectivity across studies using various methods and stimuli. Specifically, the most predictive anatomical location of voxels exhibiting the highest place selectivity in medial ventral temporal cortex is the junction of the collateral and anterior lingual sulci. Methodologically, we make this pROI freely available (vpnl.stanford.edu/PlaceSelectivity), which provides a means to accurately identify a functional region from anatomical MRI data when fMRI data are not available (for example, in patient populations). Theoretically, we consider different anatomical and functional factors that may contribute to the consistent anatomical location of place selectivity relative to the folding of high-level visual cortex.
•A probabilistic place ROI was created from cortex-based alignment in 24 participants•Cross-validation shows that this ROI predicts place selectivity in new participants•This ROI predicts voxels with peak place selectivity in >500 participants•The collateral/lingual sulcal junction is most predictive of place selectivity•We share this predictive ROI with the field (vpnl.stanford.edu/PlaceSelectivity)
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