Empire of Humanityexplores humanitarianism's remarkable growth from its humble origins in the early nineteenth century to its current prominence in global life. In contrast to most contemporary ...accounts of humanitarianism that concentrate on the last two decades, Michael Barnett ties the past to the present, connecting the antislavery and missionary movements of the nineteenth century to today's peacebuilding missions, the Cold War interventions in places like Biafra and Cambodia to post-Cold War humanitarian operations in regions such as the Great Lakes of Africa and the Balkans; and the creation of the International Committee of the Red Cross in 1863 to the emergence of the major international humanitarian organizations of the twentieth century. Based on extensive archival work, close encounters with many of today's leading international agencies, and interviews with dozens of aid workers in the field and at headquarters,Empire of Humanityprovides a history that is both global and intimate.
Avoiding both romanticism and cynicism,Empire of Humanityexplores humanitarianism's enduring themes, trends, and, most strikingly, ethical ambiguities. Humanitarianism hopes to change the world, but the world has left its mark on humanitarianism. Humanitarianism has undergone three distinct global ages-imperial, postcolonial, and liberal-each of which has shaped what humanitarianism can do and what it is. The world has produced not one humanitarianism, but instead varieties of humanitarianism. Furthermore, Barnett observes that the world of humanitarianism is divided between an emergency camp that wants to save lives and nothing else and an alchemist camp that wants to remove the causes of suffering. These camps offer different visions of what are the purpose and principles of humanitarianism, and, accordingly respond differently to the same global challenges and humanitarianism emergencies. Humanitarianism has developed a metropolis of global institutions of care, amounting to a global governance of humanity. This humanitarian governance, Barnett observes, is an empire of humanity: it exercises power over the very individuals it hopes to emancipate.
Although many use humanitarianism as a symbol of moral progress, Barnett provocatively argues that humanitarianism has undergone its most impressive gains after moments of radical inhumanity, when the "international community" believes that it must atone for its sins and reduce the breach between what we do and who we think we are. Humanitarianism is not only about the needs of its beneficiaries; it also is about the needs of the compassionate.
I argue that research on the business case for corporate social responsibility must account for the path-dependent nature of firm-stakeholder relations, and I develop the construct of stakeholder ...influence capacity to fill this void. This construct helps explain why the effects of corporate social responsibility on corporate financial performance vary across firms and time. I develop a set of propositions to aid future research on the contingencies that produce variable financial returns to investment in corporate social responsibility.
This article explains inconsistency in stakeholder punishment for firm misconduct. It does so by developing a cognitive view of the process by which stakeholders allocate their limited attention. ...This cognitive view outlines individual and situational factors that produce variation in a stakeholder’s likelihood of noticing that an act of misconduct has occurred, in how the stakeholder will assess misconduct if he or she does notice it, and in the stakeholder’s decision to punish a firm if he or she judges it to have engaged in misconduct. In sum, this process suggests that as stakeholder attention varies across each step of this process, misconduct often will not result in punishment. This suggests limits on the ability to deter firm misconduct through social control.
Increasing overuse of opioids in the United States may be driven in part by physician prescribing. However, the extent to which individual physicians vary in opioid prescribing and the implications ...of that variation for long-term opioid use and adverse outcomes in patients are unknown.
We performed a retrospective analysis involving Medicare beneficiaries who had an index emergency department visit in the period from 2008 through 2011 and had not received prescriptions for opioids within 6 months before that visit. After identifying the emergency physicians within a hospital who cared for the patients, we categorized the physicians as being high-intensity or low-intensity opioid prescribers according to relative quartiles of prescribing rates within the same hospital. We compared rates of long-term opioid use, defined as 6 months of days supplied, in the 12 months after a visit to the emergency department among patients treated by high-intensity or low-intensity prescribers, with adjustment for patient characteristics.
Our sample consisted of 215,678 patients who received treatment from low-intensity prescribers and 161,951 patients who received treatment from high-intensity prescribers. Patient characteristics, including diagnoses in the emergency department, were similar in the two treatment groups. Within individual hospitals, rates of opioid prescribing varied widely between low-intensity and high-intensity prescribers (7.3% vs. 24.1%). Long-term opioid use was significantly higher among patients treated by high-intensity prescribers than among patients treated by low-intensity prescribers (adjusted odds ratio, 1.30; 95% confidence interval, 1.23 to 1.37; P<0.001); these findings were consistent across multiple sensitivity analyses.
Wide variation in rates of opioid prescribing existed among physicians practicing within the same emergency department, and rates of long-term opioid use were increased among patients who had not previously received opioids and received treatment from high-intensity opioid prescribers. (Funded by the National Institutes of Health.).
The coronavirus disease 2019 (COVID-19) pandemic continues to devastate US nursing homes. Adequate personal protective equipment (PPE) and staffing levels are critical to protect nursing home ...residents and staff. Despite the importance of these basic measures, few national data are available concerning the state of nursing homes with respect to these resources. This article presents results from a new national database containing data from 98 percent of US nursing homes. We find that more than one in five nursing homes reports a severe shortage of PPE and any shortage of staff. Rates of both staff and PPE shortages did not meaningfully improve from May to July 2020. Facilities with COVID-19 cases among residents and staff, as well as those serving more Medicaid recipients and those with lower quality scores, were more likely to report shortages. Policies aimed at providing resources to obtain additional direct care staff and PPE for these vulnerable nursing homes, particularly in areas with rising community COVID-19 case rates, are needed to reduce the national COVID-19 death toll.
In response to the COVID-19 pandemic, many psychiatrists have rapidly transitioned to telemedicine. This qualitative study sought to understand how this dramatic change in delivery has affected ...mental health care, including modes of telemedicine psychiatrists used, barriers encountered, and future plans. The aim was to inform the ongoing COVID-19 response and pass on lessons learned to psychiatrists who are starting to offer telemedicine.
From March 31 to April 9, 2020, semistructured interviews were conducted with 20 outpatient psychiatrists practicing in five U.S. states with significant early COVID-19 activity. Inductive and deductive approaches were used to develop interview summaries, and a matrix analysis was conducted to identify and refine themes.
At the time of the interviews, all 20 psychiatrists had been using telemedicine for 2-4 weeks. Telemedicine encompassed video visits, phone visits, or both. Although many continued to prefer in-person care and planned to return to it after the pandemic, psychiatrists largely perceived the transition positively. However, several noted challenges affecting the quality of provider-patient interactions, such as decreased clinical data for assessment, diminished patient privacy, and increased distractions in the patient's home setting. Several psychiatrists noted that their disadvantaged patients lacked reliable access to a smartphone, computer, or the Internet. Participants identified several strategies that helped them improve telemedicine visit quality.
The COVID-19 pandemic has driven a dramatic shift in how psychiatrists deliver care. Findings highlight that although psychiatrists expressed some concerns about the quality of these encounters, the transition has been largely positive for both patients and physicians.
Coronavirus disease 2019 (COVID-19) spurred a rapid rise in telemedicine, but it is unclear how use has varied by clinical and patient factors during the pandemic. We examined the variation in total ...outpatient visits and telemedicine use across patient demographics, specialties, and conditions in a database of 16.7 million commercially insured and Medicare Advantage enrollees from January to June 2020. During the pandemic, 30.1 percent of all visits were provided via telemedicine, and the weekly number of visits increased twenty-three-fold compared with the prepandemic period. Telemedicine use was lower in communities with higher rates of poverty (31.9 percent versus 27.9 percent for the lowest and highest quartiles of poverty rate, respectively). Across specialties, the use of any telemedicine during the pandemic ranged from 68 percent of endocrinologists to 9 percent of ophthalmologists. Across common conditions, the percentage of visits provided during the pandemic via telemedicine ranged from 53 percent for depression to 3 percent for glaucoma. Higher rates of telemedicine use for common conditions were associated with smaller decreases in total weekly visits during the pandemic.
What determines the strategies by which a state mobilizes resources for war? And does war preparation strengthen or weaken the state in relation to society? In addressing these questions, Michael ...Barnett develops a novel theoretical framework that traces the connection between war preparation and changes in state-society relations, and applies that framework to Egypt from 1952 to 1977 and Israel from 1948 through 1977.Confronting the Costs of Waraddresses major issues in international relations, comparative politics, and Middle Eastern studies.
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