Regional Integration of US Border States with Canada: Evidence from US State Exports, 1996 to 2001

This paper examines the nature of regional trade integration between the United States and Canada by using a Similarity Index that summarizes the behavior of exports of states along the US/Canadian border relative to US states that are not on the Canadian border. An export Similarity Index is used to show the considerable importance of industry mix relative to distance. Similarity Index changes suggest that increased export sales between the US and Canada between 1996 and 2001 were not primarily driven by proximity factors that underlie a regional phenomenon. Industry factors independent of location and distance were important contributors to changes in US exports to Canada. The upshot is that global, not regional, factors may underlie increasing trade between the US and Canada. That is, an apparent global phenomenon may have been mistaken for a regional one.

The Gravity of Globalization

Can changes in the trade of the world’s largest trading countries be considered more global? Or should they be labeled as more regional? We investigated these questions for the G7 countries for the time period from 1980 to 1997. We found that the usual dichotomy of global-regional is not rich enough to answer these questions because globalization can be measured in terms of both physical and cultural distance. Our new taxonomy allows for testing these separate impacts on world trade and suggests that trade changes are best described as regional, though with some qualification. With respect to physical distance, we find that trade is clearly becoming more regional. On the cultural dimension, however, we find conflicting results. These results are robust to a series of tests. We find the same pattern at industry level, except for Paper Products and Motor Vehicles. The regionalization pattern holds for both imports to and exports from the G7, but it is stronger for exports.

Update on Allergy Immunotherapy

This article summarizes and provides commentary regarding guidelines on the administration of immunotherapy (IT) for allergic airway disease. Recent investigations have provided important insights into the immunologic mechanism of IT and the prominent role of interleukin-10-producing regulatory T lymphocytes. The most important aspect of successful IT is the administration of an appropriate dose of an extract containing a sufficient concentration of the relevant allergen. This is largely possible now only with standardized extracts. When the major allergen content of successful IT extracts was quantified, efficacy was demonstrated across a surprisingly narrow concentration range (approximately 5-24 μg per injection), irrespective of the extract. This presumably reflects the concentration of an antigen that drives an immune response toward tolerance. It may be predicted that as major allergen content is quantified in currently nonstandardized extracts, effective IT will also be achieved by administering a dose in this range, in contrast to current practices involving fairly arbitrary dosing decisions. With the availability of nonsedating antihistamines, intranasal corticosteroids, and the leukotriene modifiers, inadequate pharmacologic response or intolerable side effects are less commonly the major indications for starting IT for allergic rhinitis (AR). However, with the recognition that a relatively short course (3-5 years) of IT can provide long-term immunomodulation and clinical benefit, a desire to avoid long-term pharmacotherapy and the associated high costs may be the primary indication for IT in AR cases. While evidence overwhelmingly supports the beneficial influences of IT in asthma cases, the positioning of IT for this disorder is not established. The observed prevention of asthma in children who have AR is intriguing, but further studies are required to assess the extent to which the prevalence and severity of chronic asthma will be reduced when these children reach adulthood. Similarly, safety issues overwhelmingly suggest that uncontrolled asthma is the greatest risk factor for mortality associated with IT and that IT therefore may be contraindicated for most patients who have inadequate pharmacologic responses or are unable to tolerate useful pharmacologic agents. Paradoxically, these are the patients for whom a response to IT may be most desirable

DOT Drugs and Alcohol Testing

This three-hour course is identified as core course #2 in the Indiana LTAP Road Scholar program. The Indiana Road Scholar program was established to build a core body of knowledge necessary to perform the duties of a local transportation official. Core course #2 will cover some of the complex issues that arise when managing employees and developing and administering employment policies within a public works or county highway department in Indiana

The relational context of mental health for carers: A qualitative study

The aim of this study was to explore how carers view and describe positive mental health. We interviewed 11 persons with lived experiences of caring for a close relative with a severe mental illness. A thematic analysis of the transcribed data material resulted in the following three themes: 1) Mental health as a relational phenomenon; 2) Dealing with excruciating hopelessness; and 3) Coping strategies for the carer. We discuss our results in relation to existing theory and suggest some clinical implications that follow from study findings.publishedVersio

La recuperación centrada en la persona y sus implicaciones en salud mental

Una fuente importante de la confusión que rodea el uso del término recuperación deriva de la falta de claridad sobre las funciones respectivas de los profesionales de la atención a la salud y de las personas con problemas de salud mental. En este artículo se ofrecen dos definiciones para distinguir entre el proceso de recuperación y la provisión de atención orientada a la recuperación. La recuperación se refiere a las formas en que una persona maneja un problema de salud mental tratando de restaurar o desarrollar un sentido significativo de pertenencia y un sentido positivo de identidad independiente de este problema. La recuperación es un proceso de cambio mediante el cual los individuos mejoran su salud y bienestar, conducen sus vidas de forma autónoma y se esfuerzan por alcanzar su máximo potencial. La atención orientada a la recuperación es lo que los profesionales del tratamiento y rehabilitación en salud mental ofrecen para apoyar los esfuerzos de recuperación de la persona a largo plazo. La promoción del bienestar mediante el autocuidado y la intervención temprana, tanto mental como física, es un componente importante de la misma. La atención orientada a la recuperación requiere que las personas en recuperación se impliquen en todos los aspectos y fases del proceso de la atención. En este artículo se clarifica la terminología y se discuten algunas de las maneras en que la recuperación y la atención orientada a la recuperación se ven comúnmente desde las perspectivas de la política y de la práctica. Así, defendemos que la persona “en recuperación” ha de permanecer en el centro de todas las conceptualizaciones y debates, así como la necesidad de considerar la cultura en la configuración de cómo se ve la recuperación y se promueve en diferentes sociedades. Creemos necesario promover este enfoque con adaptaciones culturales e incluirlo en las escuelas de salud y en los programas de residencia. Así, los estudiantes y futuros profesionales de la salud conocerán el modelo y podrán decidir sobre su integración en la práctica diaria