35 research outputs found

    The Americanization Syndrome in the United States-Canadian Relationship

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    The Americanization Syndrome in the United States-Canadian Relationship

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    The ontological security of special relationships: the case of Germany’s relations with Israel

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    This article suggests studying special relationships in international politics from an ontological security perspective. It argues that conceptualising the partners to special relationships as ontological security-seekers provides a promising theoretical angle to address gaps in our understanding of three important dimensions of such relations: their emergence and stability; the processes and practices of maintaining them; and the power relations within special relations. The article illustrates its theoretical argument in a case study on the German-Israeli relationship. The close partnership between the two countries that has developed since the Holocaust ranks as one of the most remarkable examples of special relationships in the international arena. We argue that foregrounding the ontological security which the special relationship provides in particular for Germany sheds important new light on how German-Israeli relations have developed. Specifically, we hold that Germany’s ontological security needs already were an important driver in establishing the relationship and have been a key stabiliser of it ever since; that the ontological security perspective can make sense of three interrelated practices of maintaining the ‘specialness’ of the relationship; and that the asymmetries between the ontological security needs of the two partners help account for Israel’s political leverage in the relationship

    Secretor status and Helicobacter pylori infection are independent risk factors for gastroduodenal disease.

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    The hypothesis that non-secretors of ABO blood group antigens, a group shown to be more susceptible to certain bacterial infections, may be at greater risk of gastroduodenal disease because of increased susceptibility to Helicobacter pylori infection was investigated. Of 101 patients with symptoms of dyspepsia who were undergoing endoscopy, 32% were non-secretors (determined from Lewis blood group phenotype), 36% had endoscopically visible gastroduodenal disease (antral gastritis, gastric ulcer, erosive duodenitis, duodenal ulcer or some combination), and 58% had H pylori detected in antral biopsy specimens. Non-secretors and patients with H pylori infection were significantly more likely to have gastroduodenal disease (p = 0.02 and p = 0.002 respectively). There was, however, no significant association between secretor status and H pylori infection, logistic regression analysis confirming that these were independently associated with gastroduodenal disease. Overall, the relative risk of gastroduodenal disease for non-secretors compared with secretors was 1.9 (95% confidence intervals 1.2, 3.2). Non-secretion of ABO blood group antigens is not related to H pylori infection but is independently and significantly associated with endoscopic gastroduodenal disease. The mechanism of this remains to be explained

    Cost Shifting to Jails after a Change to Managed Mental Health Care

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    OBJECTIVE: To determine whether managed mental health care for Medicaid enrollees in King County, Washington, has led to indirect cost-shifting to substitute treatments, such as jails and state mental hospitals that are free goods to providers. DATA SOURCES: Complete service records for 47,300 adults who used at least one of the following systems from 1993 to 1998: King County jail system, Medicaid, or the King County mental health system. Data were also obtained from the Washington State Hospital System. STUDY DESIGN: A quasi-experimental analysis that compares the difference in outcomes between the pre- and post-managed care periods for Medicaid enrollees compared to non-Medicaid enrollees. The outcomes—jail costs, state hospital costs, and county outpatient mental health costs—were estimated with two-part difference-in-differences models. The regressions control for person-level fixed effects on up to 66 months of data per person. DATA COLLECTION METHODS: Administrative data were collected from the jail, Medicaid, and mental health systems, then merged and cleaned. Additional data on costs were obtained in interviews. PRINCIPAL FINDINGS: There is a striking increase in the probability of jail use for persons on Medicaid following the introduction of managed care. There was a significant decrease in expenditures in the county mental health system for outpatient care. CONCLUSIONS: Managed care led to indirect cost-shifting, probably through poor access to services, which may have led to an increased probability of jail detention
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