Bipolarity and War: The Role of Capability Concentration and Alliance Patterns among Major Powers, 1816-1965

This paper examines the relationship of war to power concentration and alliance configuration among the major powers. It does so by developing a theoretical argument from the literature on bipolarity and multipolarity. The paper suggests that bipolarity has two components — power distribution and alliance clustering. The two, it is argued, have 'opposite' effects on warfare in the major power system: power bipolarity minimizes the magnitude of those wars that do break out, while alliance bipolarity increases the likelihood that a war will occur. Correlational evidence, drawn from the Correlates of War data set, is supportive of both hypotheses for the twentieth century. The power polarity hypothesis is also confirmed for the nineteenth century, but the alliance polarity hypothesis seems disconfirmed for that century, perhaps because of the effects of hostility on the balance of power alliance structures of that era. The con ceptual framework and findings of the present paper allow one the reexamine the classic debate on the relative probabilities of war in bipolar and multipolar systems. The insights of Deutsch and Singer on the one hand and Waltz on the other appear to be more consistent with each other than heretofore recognized. Key elements of both the Waltz and the Deutsch and Singer arguments are supported by the findings. On the other hand, more recent, empirical studies by Bueno de Mesquita and others are critiqued on the basis of the present paper's theoretical perspective and empirical findings.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68829/2/10.1177_002234338402100105.pd

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

Explaining War, Congress, and the Public: Fifty Years of Teaching and Research at the University of Michigan-Dearborn

http://deepblue.lib.umich.edu/bitstream/2027.42/191551/1/230913_Wayman_1-4.mp4http://deepblue.lib.umich.edu/bitstream/2027.42/191551/2/230913_Wayman_2-4.mp4http://deepblue.lib.umich.edu/bitstream/2027.42/191551/3/230913_Wayman_3-4.mp4http://deepblue.lib.umich.edu/bitstream/2027.42/191551/4/230913_Wayman_4-4.mp4-1Description of 230913_Wayman_1-4.mp4 : Legacy Lecture (part 1)SEL

Coups or Military Rule? Some Comments on Zimmermann's Article

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67292/2/10.1177_0095327X8100700312.pd

THOU SHALT NOT KILL A FELLOW LIBERAL: PATTERNS OF MILITARIZED DISPUTES BETWEEN LIBERAL STATES, 1816-1992

In this paper, I provide fresh reasoning and evidence about how liberal societies avoid war against each other. While such regimes often use force against each other in militarized inter-state disputes, they have shed blood in such encounters only five times in almost two full centuries of record keeping. When blood has been shed, the states involved are just recently liberal, and almost always have a long and still active history of enduring rivalry against one another. Kant, writing in 1795, was familiar with liberal republics (but not with modern democracy) and more recent authors such as Doyle (1986) and Rummel (1983) have followed Kant's lead by focusing on, and documenting, a virtual absence of inter-state war between liberal or free states. To throw new light on this question, I examine the militarized disputes (MIDs) that have occurred between liberal societies, to see how close their disputes have come to war. In this frame of reference, war is defined as sustained combat resulting in substantial fatalities (at least 1,000 killed). MIDs are armed conflict more broadly conceived -- with 96% of them less violent than war itself -- involving the explicit threat to use force or the display of force as well as the use of force. There have been 128 militarized disputes between liberal societies as defined and measured by Doyle (1986; 1997), with the United States and the United Kingdom the most frequent protagonists. I scrutinize these cases using the combination of scientific method and case study found in Ray (1995), who examines cases that some may have considered wars between democracies. I expand this method to inter-liberal MIDs, first examining severe cases. Wars are discussed (e.g., Israel vs. Lebanon 1948, India vs. Pakistan 1999), but they do not qualify (e.g., Israel was not independent, Pakistan was not free). With no actual wars between liberal states, their most severe MID is a declaration of war, by Britain on Finland, Dec. 6, 1941, when both were democratic and liberal. Thanks to the case-study emphasis, I also have discovered corollary declarations of war not in the MID data set: by Australia and Canada on Finland. But one must question the true severity of these incidents, since none of these three Commonwealth nations actually did go on to engage in combat against Finland. Moving from wars themselves to the MIDs short of war, it is unusual to have such a large number of militarized disputes with so little risk of a war. To see why war is so often avoided, I examine the context of the dispute, as well as the highest severity of action reached by each protagonist in the dispute. Severity is assessed using not only the threat, display, or use of force distinction, but also the more specific underlying action codes, such as blockade, seizure of territory, and mobilization. The context and severity (Maoz 1982) of the actions in the disputes allows an assessment of how close liberal societies have come to waging war against each other. Some incidents involve seizure of fishing boats, or protests about fighter plane incursions into airspace, and hence do not seem to bear the seeds of war. More serious incidents do occur, some in the context of World War I or II, as, e.g., one liberal state seizes another's territory just ahead of an invasion by the Axis powers. In some ways inter-liberal MIDs look as serious as other MIDs. Liberal MIDs often involve the use of force. Liberal MIDs are multilateral (24% of the time) more often than other MIDs (15%). Liberal MIDs are less often reciprocated (44% of the time), but this is not significantly different than the rate for other MIDs (50%). Liberal MIDs tend to be tit-for-tat incidents (i.e., rarely escalate vertically). Most distinctively, liberal MIDs rarely involve bloodshed and, when leading to use of force, tend toward seizures rather than clashes. The results of my hypothesis tests are consistent with the explanation that liberal societies avoid war with each other for two related reasons: (1) consistent with costly signaling theories, liberal targets tend not to respond militarily to liberal states who initiate MIDs against them, but this difference is not strong enough to achieve statistical significance; (2) a vivid norm of avoiding bloodshed characterizes most of their interactions, and provides a powerful pacifying effect. The main peril of inter-liberal MIDs comes from the weakness of another important norm, against ganging up. This study is of value for a number of reasons. First, and straight-forwardly, the findings help us understand what type of situations breed an armed clash between two liberal societies, and consequently how close these clashes have come to warfare. Second, my findings provide new evidence that has relevance to the democratic peace debate. Several authors have emphasized the existence of a "democratic" peace (Ray 1995; Senese 1997). Studies such as mine, on MIDs in the "liberal" peace, can shed light on the democratic peace debate. While the absence of war between two "democracies" has been hailed as the closest to a law-like finding in world politics, and has stimulated enormous research efforts over the last two decades, much of this research has been based on the Polity data on democracy, which in turn seems to be heavily dependent on a measure of constraints on executive authority (Gurr et al. 1989; Gleditsch and Ward 1997). As an indication of the close connections between the liberal and the democratic peace literature, Russett and Oneal (1997), in perhaps the classic empirical study of the peace in question, title their study, "The Classic Liberals Were Right: Democracy, Interdependence, and Conflict (emphasis added)." Much of the research on the inter-democratic peace is inductive and empirical; to gain a large number of cases for multivariate statistics, the analysts typically use the Correlates of War Project's militarized dispute data rather than its war data (Oneal and Russett 1997; Henderson 2002). Using the outbreak of a MID as the dependent variable in these multivariate study of the democratic peace, however, implicitly assumes that inter-liberal MIDs are just as severe as other MIDs. As I show, that assumption is not warranted. Examining the types of militarized clashes that have occurred between liberal societies allows the reader to ponder the meaning and face validity of the many extant empirical tests of the inter-democratic peace. Although my case studies lend a bit of new support to critics of the democratic peace by pointing out declarations of war that even several authorities on the subject are not aware of, the main weight of my findings is strongly supportive of the democratic peace literature. This is because my statistical patterns, especially on battle deaths, reinforce the democratic peace proposition. Because inter-liberal MIDs (which are mostly also inter-democratic MIDs) are much less likely to lead to mass killing than other MIDs, the analysts like Russett who said "the classic liberals are right" got the correct message out, but somewhat underestimated the full degree to which the classic liberals were right. With most cases of inter-liberal MIDs surprisingly low in severity and bloodshed, but with some controversial cases (Lebanon-Israel, India-Pakistan, Britain-Finland, Australia-Finland) of war or declaration of war, the debate over the democratic peace is likely to continue.http://deepblue.lib.umich.edu/bitstream/2027.42/191725/1/PSS02libmidsV9 point 80 (onbutwofinaltable).pdfSEL

Peace and Security in the Nuclear Age

at one of the most perilous periods of the cold war, five specialists reflect on the best path to peace and security for the United States and the world. Panelist are: 1) J. David Singer, founder of the Correlates of War Project and Professor at the University of Michigan. 2) James Blight, Harvard Kennedy Center Associate and Specialist on the history of the Cuban Missile Crisis. 3) Susan Koch, US Defense Department Analyst. 4) Bishop Thomas Gumbleton, Co-author of the US Catholic Bishops' Pastoral Letter on Nuclear War. 5) Frank Wayman, Moderator and Professor of Political Science ant University of Michigan - Dearborn, and Author of Resort to War a summary and expansion of the findings of the Correlates of War Project.http://deepblue.lib.umich.edu/bitstream/2027.42/191724/1/Peace and Security in the Nuclear Age Nov. 1984.mp4Description of Peace and Security in the Nuclear Age Nov. 1984.mp4 : video of panelSEL