US Approach Research Articles

Effect of Technology-Enhanced Screening in Addition to Standard Targeted Clinician Education on the Duration of Untreated Psychosis

Reducing the duration of untreated psychosis (DUP) is essential to improving outcomes for people with first-episode psychosis (FEP). Current US approaches are insufficient to reduce DUP to international standards of less than 90 days. To determine whether population-based electronic screening in addition to standard targeted clinician education increases early detection of psychosis and decreases DUP, compared with clinician education alone. This cluster randomized clinical trial included individuals aged 12 to 30 years presenting for services between March 2015 and September 2017 at participating sites that included community mental health clinics and school support and special education services. Eligible participants were referred to the Early Diagnosis and Preventative Treatment (EDAPT) Clinic. Data analyses were performed in September and October 2019 for the primary and secondary analyses, with the exploratory subgroup analyses completed in May 2021. All sites in both groups received targeted education about early psychosis for health care professionals. In the active screening group, clients also completed the Prodromal Questionnaire-Brief using tablets at intake; referrals were based on those scores and clinical judgment. In the group receiving treatment as usual (TAU), referrals were based on clinical judgment alone. Primary outcomes included DUP, defined as the period from full psychosis onset to the date of the EDAPT diagnostic telephone interview, and the number of individuals identified with FEP or a psychosis spectrum disorder. Exploratory analyses examined differences by site type, completion rates between conditions, and days from service entry to telephone interview. Twenty-four sites agreed to participate, and 12 sites were randomized to either the active screening or TAU group. However, only 10 community clinics and 4 school sites were able to fully implement population screening and were included in the final analysis. The total potentially eligible population size within each study group was similar, with 2432 individuals entering at active screening group sites and 2455 at TAU group sites. A total of 303 diagnostic telephone interviews were completed (178 [58.7%] female individuals; mean [SD] age, 17.09 years [4.57]). Active screening sites reported a significantly higher detection rate of psychosis spectrum disorders (136 cases [5.6%], relative to 65 [2.6%]; P < .001) and referred a higher proportion of individuals with FEP and DUP less than 90 days (13 cases, relative to 4; odds ratio, 0.30; 95% CI, 0.10-0.93; P = .03). There was no difference in mean (SD) DUP between groups (active screening group, 239.0 days [207.4]; TAU group 262.3 days [170.2]). In this cluster trial, population-based technology-enhanced screening across community settings detected more than twice as many individuals with psychosis spectrum disorders compared with clinical judgment alone but did not reduce DUP. Screening could identify people undetected in US mental health services. Significant DUP reduction may require interventions to reduce time to the first mental health contact. ClinicalTrials.gov Identifier: NCT02841956.

The Sensitivity of Tax Law Highlights the Artificial Nature of the Corporation and Challenges the Corporation’s Separate Identity in Myriad Ways: The US Approach and the UK Approach

The Sensitivity of Tax Law Highlights the Artificial Nature of the Corporation and Challenges the Corporation’s Separate Identity in Myriad Ways: The US Approach and the UK Approach

The Practical Problems of Taxing Capital Gains: The US Approach and the New Zealand Approach

The Practical Problems of Taxing Capital Gains: The US Approach and the New Zealand Approach

Transformation of the US approaches to radical leftist Latin American regimes under the Biden administration

This article is devoted to the transformation of the course of the Biden administration towards radical leftist regimes in Latin America. The purpose of the research is to identify the features of the process of normalizing their interaction, which is complicated by the external and internal political tasks of the White House. In the investigation will be analyzed Washington&amp;apos;s steps to build a dialogue with Cuba, Venezuela and Nicaragua. The results of this study will contribute to a better understanding of the US strategy in the region and the reasons for the conflict continuing in inter-American relations, despite the cooperation pragmatism.

АМЕРИКАНО-КИТАЙСКИЕ ПРОТИВОРЕЧИЯ В ОБЛАСТИ ПРОВЕДЕНИЯ МОРСКИХ (НАУЧНЫХ И ВОЕННЫХ) ИССЛЕДОВАНИЙ МИРОВОГО ОКЕАНА

The 1982 UN Convention on the Law of the Sea introduced a regime for conducting marine scientific research. However, a significant flaw in this regime was that the text of the Convention does not specify anywhere what "marine scientific research" is. This has led to the fact that in the maritime zones of sovereignty of coastal States there are no disputes regarding the permissive procedure for their conduct. In the zones of sovereign rights and jurisdiction – exclusive economic zones – the convention requirements on the need to obtain formal consent from the coastal State for their implementation are interpreted differently by different countries. This is especially true for such activities as hydrographic research and military surveys. Some countries, primarily the United States and its closest allies, allow an expansive interpretation of the Convention norms, removing these activities from the category of marine scientific research in order to avoid the prospects of their regulation by coastal States. Among the main opponents of this approach is the People's Republic of China, which has established an extremely strictly regulated regime for conducting marine scientific research, and disputes the US approach to their implementation, primarily in the waters of the South China Sea. These contradictions are extremely conflictual in nature and are one of the main reasons for the US-Chinese confrontation in the region.

The U.S. - German relations in political and military spheres in 2022: cooperation or competition?

Disengagement between the West and the non-West has been becoming more and more noticeable by the early 2020s. The key examples of it are the confrontations between the Euro-Atlantic community and Russia, the USA, its partners and China, degradation of relations between the West and Iran. In such situation cohesion between the liberal democracies should increase. But the Euro-Atlantic faced the phenomena of Trumpism and Brexit. In this regard the article tries to explore the elements of cooperation and competition for the US-German relations in political and military spheres during late February - early November 2022. The article stresses the absence of purely bilateral contacts at the highest level of the dialogue. The determination is shown in the context of the Biden administration’s policy named as «soft hegemony», the US expectations regarding the supply of German weapons to Kyiv. The paper compares the US and German approaches to manning NATO military groupings, especially Forward Presence Force. In 2022 Berlin tries to act symmetrically to the USA. Germany has taken into account the US expectations for growing European member states’ participation in NATO`s activities but at the same time skillfully realized its own ambitions as power. The article also analyses the ratio of approaches on the example of decisions of NATO`s Madrid summit (2022, June) decisions.

Erroneous Conduct of Foreign Policy: A Realism Analysis of US Involvement in the Vietnam War

The Vietnam War is known to be one of the longest wars the US has been involved in. Many may have associated the war as just another one of the many proxy wars the US was involved in during the Cold War. However, there is more to learn from the Vietnam War as the recent conflicts the US was involved in, like that in Afghanistan, bore a resemblance to that of the Vietnam War. Hence, to understand the current state of the US, it is important to take a thorough look into the Vietnam War. The article aims to provide explanations to the driving force behind US involvement, its flawed approaches and perception towards its conduct in Vietnam along with the state of realism after the end of the Vietnam War. The article utilizes the qualitative research method along with the realism school of thought to answer the research questions. The result shows that the national interest on power accumulation and national security considerations were the driving force behind the US involvement. Moreover, on the issue of US approaches throughout the war, the reliance on realist values can be attributed as one of the factors that led to the US failure in Vietnam. In regard to realism's fate following the end of the war, it can be seen that the current and foreign policies made after the Vietnam War are still imbued with it.

Secondary Sanctions: Why the US Approach Is Unlawful and the EU’s Response Is Ineffective

In recent years, the United States has increasingly reverted to imposing secondary sanctions on friends and foes alike. Realizing that other major economic actors, such as the European Union, China and India, are very often unwilling to follow the United States’ foreign policy dictum, and exploiting its position as a major economic power and holder of the world’s reserve currency, the United States has begun penalizing third state actors that continue trading with US primary sanction targets. In some cases, that has gone so far as to lead to the issuance of US arrest warrants and the subsequent arrest of third state citizens for violating US sanction laws while engaged in transactions that took place outside of the US. Seen from an international law perspective, such conduct raises jurisdictional issues. I will explain that the US cannot rely on any jurisdictional principle recognized by the international community to justify its approach to secondary sanctions. In fact, the international community has come to reject the US modus operandi of imposing secondary sanctions as unlawful, creating a customary international law prohibition. I will then examine the European Union’s ineffective response by imposing a Blocking Statute and, in the case of Iran, by creating a Special Purpose Vehicle (SPV). Secondary Sanctions, Customary International Law, Jurisdiction, Blocking Statute, Special Purpose Vehicle

One Religion, Two Paths: Making Sense of US and Belgian Catholic Hospitals' Approaches to IVF

This article comparatively analyses the development of Catholic hospitals' approaches to In‐Vitro Fertilisation (IVF) in Belgium and the U.S. Our comparison highlights the different cultures of Catholic healthcare in each of these countries, and their different relation to Vatican opinion on medical matters. We first discuss the roots of Catholic healthcare in both countries and the history of IVF as a viable medical therapy for infertility. Next, we turn to the Catholic University of Leuven (Belgium) where an infrastructure for bioethics brought patient needs and progressive thinking into conversation with Church pronouncements, creating room for IVF within the walls of a Catholic hospital. We then contrast this trajectory with the subsequent versions of the Ethical and Religious Directives for Catholic Health Care (ERDs) in the U.S. The ERDs came to serve as a binding policy document for American clinicians and centralized medical authority in the hands of the U.S. bishops, who adhered closely to the Vatican ban. Comparing the two contexts, we demonstrate how within the Catholic Church approaches to IVF unfolded along two different paths: one of restriction through a unified conservative voice, controlled by the bishops (U.S.), and one of bio‐ethical decision‐making in dialogue with progressive Catholicism (Belgium).

Global universities’ COVID-19 scientific knowledge production: Collaborative sense-making during a crisis

As the world grapples with the ongoing COVID-19 pandemic, the role universities play in advancing COVID knowledge and long term management of this global crisis is largely unknown. In this study, we document from a comparative perspective the ways in which members from universities in the US, New Zealand, Italy, South Korea and China engage in activities to respond to the pandemic. We apply the sense-making knowledge management model (Choo, 1998) and boundary spanning theory (Tushman, &amp; Scanlan, 1981; Birkinshaw, Ambos &amp; Bouquet, 2017) to identify strategies that university members employ by engaging with members from their university, local government and regional universities to generate scientific knowledge that enhances our global understanding of the evolving pandemic. In analyzing COVID related content via university websites, our findings reveal that response to the pandemic varies by university stratification, specifically by size and research capacity. We identified three distinct lenses by which university members position their leadership and research on COVID. We find universities from China, regardless of status-based characteristics, currently utilize a post-pandemic approach. Whereas universities in the US, Italy, New Zealand and South Korea approach their COVID research activities using an evolving-pandemic anticipatory lens and focus on scientific knowledge creating on current and future-pandemics by engaging in a range of collaborative activities with members of regional universities. Further, we find the role of boundary-spanners (Author &amp; Author, 2018) particularly prominent in enhancing efforts to develop inter-university generated knowledge on COVID-19. Findings also provide policy implications for university-led response to global health challenges.

Reimagining Public Safety, Rebuilding Non-Carceral Alternatives: A Closer Look at US and Spanish Gender Violence Approaches

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Therapeutic Spaces in Public Places

Abstract. The effectiveness of both mental health education and clinical practices is often limited by an overemphasis on US perspectives and approaches. Based on a lens and practice of reflexivity within international community psychology, this article describes a theater-based practice that is both an educational tool for training mental health providers and a community mental health intervention. This practice is based on an integration of the work of three Latin American theorists: Augusto Boal’s Theater of the Oppressed, Ignacio Martín-Baró’s liberation psychology, and Paulo Freire’s Critical Pedagogy. The approach we will describe integrates these Latin American originating theories with the practical and pragmatic clinical and theoretical assumptions of walk-in/single-session therapy. This mental health perspective addresses many of the barriers to services faced by underserved and international populations. We will discuss how we have utilized these ideas and practices by developing a form of street theater that provides educational opportunities for future mental health providers and creates community dialogues about common clinical concerns in Mexico City.

It's the data, stupid: Inflection point for Artificial Intelligence in Indian healthcare

Indian healthcare is fast growing and with significant chunk of it being in small, fragmented, informal sector; Artificial Intelligence (AI) is pegged as a magical tool for a better healthcare system. There is an inclination to merely mimic the US approach in the on-going policy making and legislative exercises, which can have serious fallouts for Indian healthcare.India needs a different approach to suite her unique requirements. In this regard, each of the five stages in AI development lifecycle has been analyzed in the light of current on-ground realities. These boil down to three fold challenges of how to increase adoption of digital health, prevent data silos and create maximum value from data.Availability of quality data for value addition without barriers and restrictions is the common denominator for leveraging the full potential of AI. This requires liberal policies enabling secondary use of data in developing countries with rapidly growing healthcare sector akin to India. This has to be carefully balanced with data privacy and security.Restrictive healthcare data policies and laws can slow down adoption of digitization, perpetuate status-quo, be biased towards the incumbent players, cause Industry stagnation and thus will do more harm than good. It is therefore the data policies that will make or break AI in Indian healthcare.

Past as Prologue? The United States and European Strategic Autonomy in the Biden Era

Europe breathed a sigh of relief after Joe Biden’s victory in the 2020 presidential election, following a difficult period for transatlantic relations under Donald Trump. Yet, a friendlier tone in Washington has not so far translated into markedly better relations between the US and Europe. This article inquires why Biden – a pro-European President by disposition – is not proving more amenable to transatlantic relations in general, and European strategic autonomy in particular. It suggests that the considerable continuity between Biden and Trump can be explained by an interplay between the historical legacy of transatlantic relations, international and domestic structural factors, and on-going ideational contests over US grand strategy. Considering these factors, the US approach to Europe in the Biden era looks to oscillate between a ‘primacy’ model, marked by a US expectation that it will continue to lead and determine the direction of the transatlantic alliance, as well as ‘benign neglect’ of Europe in an age marked by ‘strategic competition’ with China. Neither approach is particularly conducive to the development of European Union (EU) strategic autonomy. In the meantime, the transition from Trump to the Biden era continues to hold little promise for a mutually negotiated ‘major reform’ of the transatlantic relationship. transatlantic relations – foreign policy – European Union – United States – strategic autonomy, grand strategy – primacy – restraint – Biden – Trump

The implications of Qassem Soleimani assassination on US- Iranian relations: تداعيات اغتيال قاسم سليماني على العلاقات الأمريكية الإيرانية

This study deals with the repercussions of the assassination of Iranian military commander Qassem Soleimani on US- Iranian relations, and the US- Iranian escalation and tension in Iraq and the entire surrounding region. The study tries to determine the indicators of the US- Iranian escalation and the effect of the bombing incident near Baghdad Airport on January 4, 2020, at the interior of Iranian, and at the regional and international level. It seeks to estimate the potential for escalation between the United States of America and Iran; the latter surprised the group of 4 + 1 countries on the anniversary of Soleimani assassination in 2021 by increasing the rate of uranium enrichment to 20%. This step will be taken in consideration in any future negotiations between Iran and the United States of America and the European Union if US President Joe Biden decides to return to the nuclear accord. The results of the study concluded that the previous US approach in the Trump administration affected negatively on any future negotiation about the return of US to the Joint Comprehensive Plan of Action. US President Joe Biden is trying to mitigate his predecessor’s escalation of US- Iranian relations; nonetheless, Israel seeks to obstruct any path that would end the tension between Washington and Tehran.

Ensuring contestability and fairness in digital markets through regulation: a comparative analysis of the EU, UK and US approaches

ABSTRACT In a society where individuals increasingly spend time on the internet, large online platforms have become, for many, unavoidable actors. As it is increasingly argued that competition policy alone cannot address all the systemic problems that they create in digital markets where quick reactions are indispensable, there seems to be a consensus across the globe that legislative action must be taken against a specific sub-set of these large online platforms in order to foster contestability and fairness. This contribution aims to analyse how the EU, UK and US legislators intend to do so through regulation. First, the scope of the digital platforms that would be subject to these regulatory initiatives, and the potential discrepancies in this regard, will be clarified. Then, the general approach and options taken in each of these jurisdictions to address this dependence issue will be outlined. Finally, the main discrepancies between these different approaches will be summarized.

Проблема ближневосточного урегулирования в политике ведущих стран - членов Европейского союза в контексте иракского и ливанского кризиса (2003-2008 гг.)

The article analyzes the Middle East policy of the leading EU member states in the period of the Iraqi and Lebanese crises. The author notes that the war in Iraq caused disagreements between France and Germany and the United States, but in general it did not affect the high level of relations between these countries. The Iraqi crisis contributed to increased tensions in the Middle East. In order to resume Palestinian-Israeli negotiations, a Quartet of international mediators (the United States, the UN, the EU, and Russia) was created, which introduced a “road map” for settlement. But soon there emerged differences in the Quartet on its separate points. They increased because of the actions of Israel on the implementation of the “unilateral disengagement” plan. During the war in Lebanon, the EU member states called for the introduction of UN peacekeepers into the country. The US authorities did not agree with this and proposed to introduce a NATO peacekeeping contingent in Lebanon. In turn, France did not support the American plan, considering it unproductive. The Lebanese crisis revealed differences between France and the United States, preserved since the beginning of the war in Iraq. Within the framework of the EU Middle East strategy, the principles of European policy were developed, among which priority was given to assistance in the establishment of a Palestinian state and assistance to Palestinians in the transition period. The EU launched a plan for the reconstruction and development of the Palestinian state, the Future for Palestine, which would provide financial assistance to the Palestinian government, upbringing and educational measures for Palestinian youth, psychological assistance to victims of the Second Palestinian Intifada, etc. After the victory in the presidential election, the new US administration appealed to the conflicting parties to resume negotiations. New moments in the US approach to the Middle East settlement were met with approval in the European Union. Aware at the same time that the initiative right to the Middle East settlement still belongs to the United States, the leading EU member states had difficulty in putting forward their settlement plan, so they were limited to supporting the American program. After the terrorist attacks of September 11, 2001, in New York and Washington, the influence of political Islam in the Arab world increased markedly, to which the US authorities did not react properly. On the contrary, they sought to thoroughly reconstruct the “Greater Middle East” on the basis of Western democracy. The complex and contradictory nature of the processes developing in Iraq and Afghanistan, as well as the threat of the US military force against Iran, testified to this. In this difficult situation, issues related to the promotion of the Middle East peace process became even more urgent. The article concludes that the Quartet of international mediators should have made efforts to reach a comprehensive agreement as soon as possible, opening the way to peace in the Middle East.

Международно-правовая характеристика регулирования онлайн-торговли в США и ЕС

This article reveals the main trends in the regulation of international trade in modern international law. The aim of the article is to analyze the current sources of international trade law aimed at regulating online commerce in cyberspace, which has become the object of regulation in many regional international agreements, as well as to compare the approaches of the US and the EU to the regulation of commercial activities in cyberspace, in particular on the issue of personal data protection. The authors explore the problem of online commerce regulation by using comparative and critical methods of analysis, i.e. comparing the legal regulation in the United States and the EU and their critical evaluation. The authors also analyze the problem of personal data protection in cyberspace in this kind of commercial activity, taking into account the existing risks. The material for the study is based on the international legal regulation of trade, the so-called “soft law” norms adopted in the framework of UNSTIRAL, the US legislation (for example, the provisions of the Uniform Commercial Code (UCC), the Uniform Electronic Transactions Act (UETA), the Electronic Signatures in International and Internal Commerce Act) and the EU law, especially the EU Regulation 2016/679 of 27 April 2016 on the protection of individuals with regard to the processing of personal data and its free circulation. The article examines online commerce as an object of international law, types of online commerce and existing contracts of sale in cyberspace, then examines in detail the sources of regulation of online commerce in the US and EU, taking into account the legal development, then analyzes the problems of personal data protection and the difference between the US approach, expressed in minimal interference in the activities of entities involved in trade (the so-called “laissez-faire” approach), and the EU “paternalistic” approach, consisting in detailed regulation of rules of commercial activity To conclude, the authors have examined the issue related to the prospects of legal regulation of online commerce, taking into account the differences between the EU and its member states and the United States. A possible way out of this problem could be consistent cooperation based on bilateral agreements on specialized issues, adherence to the principles of international online trade set out in a New EU-U.S. Agenda for Global Change and the creation of a free trade area (FTA) between the EU and the U.S.

Shaping of the U.S. Regional Security Framework in the Indo-Pacific Region in 2012-2020

This article examines the transformation of the US approaches to the implementation of foreign policy in Indo-Pacific region. It is noteworthy that with the change in the approaches of the US leadership to the structuring of the regional subsystem through the creation and maintenance of allied relations with a number of states in the region, the goal remains unchanged — ensuring security in the region while maintaining US leadership. At the present stage, the implementation of this goal is hindered by the growing influence of China in the Indo-Pacific region. The authors of the article focused on identifying criteria that allow assessing the current situation in the region and the effectiveness of existing cooperation between the United States and the countries of the Indo-Pacific region within the framework of organizations and agreements. The research was conducted on the basis of an analysis of the behaviour of some regional players who have agreements with the United States and position themselves as their allies. The criteria for the study were the following aspects: participation in military exercises, the deployment of military bases, signed defence agreements, the availability of information exchange in the field of military technology, the presence of nuclear weapons, the absence of territorial claims at sea and participation in shipping operations. The authors analysed national documents, according to them it was possible to characterize the attitude of countries to the United States, China, as well as to identify the point of view of regional players on the security architecture in Indo-Pacific region and threats significant for the stability of this structure. The study proposed by the authors makes it possible to study the problems of ensuring security in the region, to identify the peculiarities of US policy in the studied space, to determine the tools of the United States to maintain its positions in Indo-Pacific region, as well as to assess the readiness of the allied countries to confront China together with the United States. In conclusion, the authors assess the effectiveness of the transformation of the US-centered regional security system in Indo-Pacific region.

US policy towards Iran in the context of the growth of regionalism

The article identifies Washington&amp;apos;s priorities on the way of its policy implementation towards Iran in the context of the Ukrainian crisis. An analysis of the US approaches to Iran regarding the events in Ukraine is given, the reasons for the increased interest in this country from both the US and the EU are identified. Currently, Tehran, despite extremely tough sanctions from the West - the US and the EU - has significantly strengthened its position on the global arena both in the context of the growing importance of the regionalization factor, as well as one of the main gas suppliers in the world market. Under the sanctions regime, Tehran&amp;apos;s main concern will primarily relate to the prospects associated with the JCPOA, which will influence the choice of the country&amp;apos;s foreign policy priorities in the future. Thus the foreign policy alignment of this country will depend on whether its rapprochement with the US and the EU will become situational or will it be of a long-term and strategic nature. In its turn, currently Washington is of great concern about the penetration of China into the Middle East, in general, and into Iran, aimed at real connection with the Silk Road Initiative, in particular. And although at present this process is determined by the economic dimension, it is clear that this is far from the limit, which the United States cannot but understand.