China's Political Worldview and Chinese Exceptionalism

This book uses the notion of "Chinese exceptionalism" as a framework to analyze China's international politics and foreign policy. It argues that China's approach to international relations is best understood in the context of these claims to exceptionalism and China's broader political world view. In doing so, it fosters a more comprehensive understanding of China's actions within the realms of foreign policy and international politics, and in the context of the preferred world order, norms and rules that the country seeks to promote

Evaluation of knowledge regarding gestational diabetes mellitus and its association with glycaemic control among gdm participants at O&G ward, Hospital USM

A well-controlled glycaemic level in Gestational Diabetes Mellitus (GDM) will prevent unfavourable outcomes to the mother and child. An individual with adequate knowledge about GDM will has better glycaemic control. The aim of the study was to investigate the association between the extent of knowledge regarding GDM and glycaemic control in GDM participants. A cross sectional study was conducted on 113 GDM participants in the Obstetrics and Gynaecology (O&G) Ward in Hospital USM from April to June 2021. The GDM Knowledge Questionnaires (GDMKQ) was distributed to the participants with guidance and the most recent 1-day 4-times-a-day (QID) daily glucose were taken from participants’ medical folder. After that, the mean daily glucose was counted. A total mean knowledge score of 113 participants was 12.02 ± 1.81 and total mean daily glucose value was 5.22 ± 0.64 mmol/L. Among five knowledge domains, highest mean score was seen for knowledge regarding diet/food values domain (2.89 ± 0.40) and lowest for risk factor of GDM (1.95 ± 0.77). The present study revealed that there is no significant association between the degree of knowledge and glycaemic control (p = 0.515). It is suggested that further study should be conducted to elucidate other possible determinants of poor glycaemic control, so that a clearer understanding of modifiable antecedents of GDM-related complications can be achieved and to avoid unfavourable outcomes in GDM

Chinese exceptionalism: an interpretive framework to understanding China’s rise and relations with the world

The rise of China as a major player global politics over the past few decades has generated substantial debate among scholars and practitioners of international relations. Many have raised questions and concerns as to what China’s long term intentions are, whether it would cooperate or challenge the existing global order, and how countries should respond, react and relate to it. Given the limitations posed by mainstream international relations theories in explaining China’s behavior, this dissertation seeks to delve into the study of China’s international politics and foreign policy actions by examining the Chinese political worldview concerning its preferred world order and the norms and rules that it seeks to promote. To do so, this thesis introduces the notion of “Chinese exceptionalism” as a framework or lens through which to better account for China’s international politics and foreign policy. In this thesis, I will argue that the Chinese political worldview (i.e. how it sees itself and how it sees the world) perceives China itself as being exceptional, that is, it is good and different, and that this has influenced Beijing’s approach to the practice of international politics. Such an exceptionalism mindset, I argue, provides us with a better understanding and a more comprehensive interpretation to China’s international relations as compared to mainstream IR theories. As this dissertation will highlight, China perceives the existing international order as ripe for change and that it ought to play a more influential role whilst having its interests acknowledged by others. Hence the central question in this dissertation is what is the Chinese worldview concerning global order and what are the norms and principles that China seeks to promote seeing itself as an exceptional power? Furthermore, how does Chinese exceptionalism influence Chinese international relations debates concerning its role in the global system and its preferred world order? The following study provides a systematic analysis to flesh out China’s political worldview and how its conceptions of exceptionalism are being reflected in its international practices and global politics. Drawing upon interviews conducted with international relations scholars (particularly those based in East Asia), senior policymakers both from and outside China, Chinese primary sources, and participatory insights gleaned from extended fieldwork working together with Chinese IR specialists based at a Singapore-based defense think-tank, this dissertation explores China’s worldview and its exceptionalism thinking in five different areas. They are, namely, (I) Chinese theories of international relations, (II) Chinese national identity, (III) China’s national image, (IV) China’s global outreach as shown by the Belt and Road Initiative, and finally, (V) in China’s relations with its neighbors. Through locating Chinese exceptionalism discourse within these five areas, this dissertation seeks to unravel what Chinese exceptionalism entails, and how it it frames Beijing’s worldview towards international politics

Study protocol for ELIXIR: an evaluation of learning and exposure to the undergraduate Interventional Radiology curriculum

Background: Despite the initiation of a suggested undergraduate curriculum for Interventional Radiology (IR) by the British Society of Interventional Radiology, there is still a lack of exposure to IR amongst medical students and junior doctors. It is unclear how much of the proposed curriculum is implemented in the undergraduate curricula of the respective medical schools in the UK. Methods and Materials: This is a cross-sectional study that aims to evaluate the level of awareness of IR as a subspecialty amongst medical students in the UK. All final year students from the 34 UK medical universities that award primary medical qualifications are eligible for the study. A student representative from each university will be recruited through a social media drive to distribute a survey. The online questionnaire is divided into five different sections; (i) Particulars, (ii) Basic knowledge on IR, (iii) Medical School Curriculum and Exposure, (iv) Career Prospects and (v) Satisfaction with Medical School Curriculum, with the intent of gauging their exposure and understanding of IR throughout the years of medical school and assessing their perceptions of IR as a potential career choice

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

ASEAN at 45 : a case for principled realism

Regional flare-ups over territorial sovereignty have placed ASEAN’s cohesion and solidarity under the spotlight. The ability of ASEAN to stay neutral in its own backyard is increasingly challenged by the clashing interests of big powers. ASEAN states should temper the pursuit of national interests with established principles

Religious prefixes and imaginings in Singapore's foreign policy.

44 p.This paper focuses on how religious ideas are being understood, codified and expressed within the foreign policy tenets of Singapore, given the secular-realist framework in place. In order to uncover the religious nuances, a discourse analysis of the speeches and writings of three key foreign policy makers is done. The paper uncovered several basic themes in the construction of Singapore's foreign policy that are congruent with religious imaginings: the sense of transcendence, the impartation of moral attributes where normative standards held on to, and the importance of relating with the larger international community. These findings suggest the presence of quasi-religious ideas in place and demonstrates the ongoing saliency of religion -even in secular government.Master of Science (International Relations

Nagorno-Karabakh conflict : the role of airpower

The ongoing war in the Nagorno-Karabakh has been notable for how airpower is deployed. What are its key features?Published versio