Western Intervention Research Articles

The changing strategic significance of submarine cables: old technology, new concerns

ABSTRACT The strategic significance accorded to submarine cables has never been a static concept, but it has been homogenous: a focus on protecting cables from external threats. This article argues that because submarine cables have long had strategic value, they provide a means to examine the emerging concept of strategic technology competition between the United States and China. To do so, this article examines major changes to the submarine cable sector since 2015, including the success of Chinese company Huawei Marine, and US and other western government interventions in several cable projects. It characterises the strategic considerations exhibited by submarine cable activity in that period – influence building in third countries, a changing perception among the US and its partners of threat and protection priorities, and closer attention to cable security and surveillance considerations – and compares them with the traditional strategic values attached to submarine cables. It concludes strategic concerns about undersea cables includes a new concept: the construction and installation of cables as a strategic threat, and which adds complexity to a sector in which it is difficult to project influence. This article seeks to make a contribution to scholarship on strategic competition in emerging technologies.

Ear microbiota and middle ear disease: a longitudinal pilot study of Aboriginal children in a remote south Australian setting

BackgroundOtitis media (OM) is a major disease burden in Australian Aboriginal children, contributing to serious long-term health outcomes. We report a pilot analysis of OM in children attending an outreach ear and hearing clinic in a remote south Australian community over a two-year period. Our study focuses on longitudinal relationships between ear canal microbiota characteristics with nasopharyngeal microbiota, and clinical and treatment variables.ResultsMiddle ear health status were assessed in 19 children (aged 3 months to 8 years) presenting in remote western South Australia and medical interventions were recorded. Over the two-year study period, chronic suppurative OM was diagnosed at least once in 7 children (37%), acute OM with perforation in 4 children (21%), OM with effusion in 11 children (58%), while only 1 child had no ear disease. Microbiota analysis of 19 children (51 sets of left and right ear canal swabs and nasopharyngeal swabs) revealed a core group of bacterial taxa that included Corynebacterium, Alloiococcus, Staphylococcus, Haemophilus, Turicella, Streptococcus, and Pseudomonas. Within-subject microbiota similarity (between ears) was significantly greater than inter-subject similarity, regardless of differences in ear disease (p = 0.0006). Longitudinal analysis revealed changes in diagnosis to be associated with more pronounced changes in microbiota characteristics, irrespective of time interval. Ear microbiota characteristics differed significantly according to diagnosis (P (perm) = 0.0001). Diagnoses featuring inflammation with tympanic membrane perforation clustering separately to those in which the tympanic membrane was intact, and characterised by increased Proteobacteria, particularly Haemophilus influenzae, Moraxella catarrhalis, and Oligella. While nasopharyngeal microbiota differed significantly in composition to ear microbiota (P (perm) = 0.0001), inter-site similarity was significantly greater in subjects with perforated tympanic membranes, a relationship that was associated with the relative abundance of H. influenzae in ear samples (rs = − 0.71, p = 0.0003). Longitudinal changes in ear microbiology reflected changes in clinical signs and treatment.ConclusionsChildren attending the ear and hearing clinic in a remote Aboriginal community present with a broad spectrum of OM conditions and severities, consistent with other remote Aboriginal communities. Ear microbiota characteristics align with OM diagnosis and change with disease course. Nasopharyngeal microbiota characteristics are consistent with the contribution of acute upper respiratory infection to OM aetiology.

Symposium

Patients with first episode psychoses (FEP) have better chances of recovery compared to schizophrenia. Early stages of psychoses are critical in predicting its course and intervention early in the course of illness is important. Outcome of FEP can be improved by intervening early in the course of the illness. The implementation of early treatment for first episode and untreated psychosis is key to reducing the burden of disability due to psychotic disorders. However, the complexity of the Indian healthcare system and differences in cultural context means that simple ‘transplantation’ of western interventions is virtually impossible. Early intervention services focus specifically on reducing the duration of untreated psychosis (DUP), enhancing therapeutic engagement, and improving clinical and social outcomes by providing care in community-based, low-stigma settings. UK and Canada have led the development of early interventions in psychosis nationally and internationally. Combining the expertise from the UK, Canada and India, the Warwick-India-Canada (WIC) Project aimed to improve the health, wellbeing and functioning, and reduce the burden for those with psychotic disorders in India. The focus was tailoring evidence-informed interventions to the Indian socio-cultural context to: 1) transform the outcomes of psychotic disorders; 2) provide high quality research evidence for clinicians and policy makers; and 3) build research capacity, including new methodologies such as economic evaluation and implementation science. As part of the WIC project, two clinical sites – All India Institute of Medical Sciences (AIIMS), New Delhi and Schizophrenia Research Foundation (SCARF), Chennai used common assessment and outcome measures and standard management protocol for patients with FEP. By using validated and reliable assessment and outcomes measures, we planned cross-country and cross- setting comparisons and provide information to develop culturally appropriate, accessible, and acceptable interventions, which can be robustly tested for clinical and economic effectiveness, to improve psychosis outcomes in India and other LMIC. In this symposium, we share assessment and management protocol used for the FEP, their results and implications in two centres in IndiaBackground of the WIC study: SPSStudy Protocol for First Episode Psychosis: RTComparison of two centers: MS Implications of the study: RKC

Decolonizing English Literature Departments At Arab Universities

Education in the Arab world is in need of a revolution, and this revolutionary transformation is inevitably and intricately linked to the production, ordering, and dissemination of revolutionary, anti-colonial knowledge. This article emphasizes the urgency for decolonizing education, specifically English literature departments at Arab universities. Many thinkers have documented the connection between literature, culture, and imperialism on the one hand (Gauri Viswanathan’s Masks of Conquest, 1989 and Edward Said’s Culture and Imperialism, 1993) and literature, culture, and resistance on the other hand (Fanon, Kanafani, Cabral, Said, and others who wrote about zero point epistemology). While there have been some decolonization efforts in different parts of the world, even at Ivy League institutions (Cornell University, for example), Arab universities ironically maintain a very rigid, government accredited English and American literary curriculum with no attempt or intention at decolonizing these colonial era curricula. This article interrogates the aims behind maintaining a purely English (and American) literary curricula, especially as the Arab region continues to undergo the most violent and aggressive forms of Western intervention, which has led to massive destruction of Arab state infrastructures, the loss of Palestine in 1948, the dissolution of the social fabric of Arab societies and thousands of deaths in the past two decades. Against this destructive Western agenda, a constructive, awareness raising impulse embedded in a literature/culture of resistance is in order. It is high time that Arab universities decolonize their English literature departments, a necessary transformation that entails, to quote the title of an essay by Walter D. Mignolo, “Epistemic Disobedience, Independent Thought and Decolonial Freedom” (2009).

Symposium

Patients with first episode psychoses (FEP) have better chances of recovery if detected early and treated rigorously. The implementation of early treatment for first episode and untreated psychosis is key to reducing the burden of disability due to psychotic disorders. However, the complexity of the Indian healthcare system and differences in cultural context means that simple ‘transplantation’ of western interventions is virtually impossible. Early intervention services focus specifically on reducing the duration of untreated psychosis (DUP), enhancing therapeutic engagement, and improving clinical and social outcomes by providing care in community-based, low-stigma settings. UK and Canada have led the development of early interventions in psychosis nationally and internationally.Combining the expertise from the UK, Canada and India, the Warwick-India-Canada (WIC) Project aimed to improve the health, wellbeing, and functioning, and reduce the burden for those with psychotic disorders in India. The focus was tailoring evidence-informed interventions to the Indian socio-cultural context to 1) transform the outcomes of psychotic disorders; 2) provide high quality research evidence for clinicians and policy makers; and 3) build research capacity, including new methodologies such as economic evaluation and implementation science. As part of the WIC project, two clinical sites – All India Institute of Medical Sciences (AIIMS), New Delhi and Schizophrenia Research Foundation (SCARF), Chennai used common assessment and outcome measures and standard management protocol for patients with FEP. The study found substantial improvement on various outcome measures including functioning and family burden. The results offer scope of further application of the management protocol on a larger scale in low- and middle-income countries.In this symposium, the presenters will discuss the background of the study, protocols of assessment and interventions, compare findings at two centres and implications of the findings.Background of the WIC study: Swaran Preet Singh, university of Warwick, UK Study Protocol for First Episode Psychosis: R Thara, SCARF India, Chennai Comparison of two centres: Mamta Sood, AIIMS, New DelhiComorbidity and Physical Activity Intervention: R Padmavati, SCARF India, ChennaiImplications of the study: Rakesh K Chadda, AIIMS, New Delhi

Meaning Well Is Not the Same as Doing Good: The Fraught Circumstances of Allyship With Indigenous Groups

Meaning Well Is Not the Same as Doing Good: The Fraught Circumstances of Allyship With Indigenous Groups

Making China Modern: From the Great Qing to Xi Jinping

Making China Modern: From the Great Qing to Xi Jinping

Integrated Chinese and western medicine interventions for atopic dermatitis: a systematic review and meta-analysis

BackgroundAtopic dermatitis (AD) is a chronic relapsing skin disease characterized by recurring episodes of itchiness with skin erythema and surface damages. Chinese medicine (CM) is widely used for the management of AD in China not only by its own, but also used in combination with conventional therapy (integrated Chinese-Western medicine, ICWM). Although many clinical trials on the effectiveness of ICWM on AD have been conducted, however, up to date, no sound evidence has been established on the clinical effectiveness and safety of ICWM for AD.ObjectivesTo systematically review the currently available clinical evidence on the clinical effectiveness and safety of ICWM for AD.MethodsRandomised and quasi-randomised controlled trials, which investigated ICWM interventions with at least one control group using the same conventional interventions, no treatment or placebo treatment, were included. Four English (CENTRAL, MEDLINE, EMBASE, AMED) and three Chinese (CNKI, CBM, WanFang Med) databases were searched. Risk of bias was assessed according to the Cochrane’s tool. Meta-analysis was performed to pool the data.ResultsFrom 1473 entries, 55 studies were included, involving 5953 participants aged between 35 days and 67 years old. Duration of treatment ranged from 1 to 24 weeks. Only 2 studies were judged to have low risk of bias, 3 studies had unclear risk of bias, and the other 50 studies were with high risk of bias. ICWM was found to be superior over WM alone in improving clinical severity of AD (measured by EASI, SCORAD), health-related quality of life (measured by CDLQI, DLQI), long term control of AD (recurrence rate), patients/investigator global score (clinical effectiveness rate), and serum IgE level. Adverse events associated with ICWM were found to be comparable with WM alone.ConclusionICWM seems to produce superior treatment response than WM alone in managing AD without increased risk of adverse events. However, the current available evidence remains too weak to make a conclusive decision.

Contesting Imperial Feminisms: The Life of an Early Twentieth Century Egyptian Activist

In “Contesting Imperial Feminisms: The Life of an Early Twentieth Century Egyptian Activist,” I make the argument that first-wave Egyptian feminism was inextricably bound to nationalist discourses, and was both produced whole-cloth and adapted from European models by Egyptian activists in response to changing economic and political conditions. Using the life and political work of Huda Sha'arawi, a women’s rights activist and nationalist who lived during the late nineteenth and early twentieth centuries, I complicate the euro-centric view that feminism in Egypt was the result of western intervention and was uncritically adopted by colonized women. Instead I try to draw attention to the ways in which Sha'arawi and her comrades formulated a feminism predicated on decolonial liberation and indigenous values, while navigating the political realities of British colonialism and industrialized modernity. A microhistorical study with far-reaching implications, this article analyzes Sha'arawi’s rhetoric and actions, including her performative political unveiling, to gain a deeper understanding of the political contributions of early twentieth century Egyptian feminism. My objective is to return some agency to intersectional actors whose politics have been unjustly framed within the historiography as derivative of (white, European) feminist and (patriarchal) nationalist frameworks.

Testing the Effectiveness of Two Psychosocial Interventions on Socio-Cognitive Risk Factors for HIV/AIDS in Mozambican Women: A Randomized Controlled Trial.

The objective of this study was to evaluate the efficacy of two psychosocial interventions (Didactic and ACCENT) on socio-cognitive risk factors, in vulnerable Mozambican women at risk for HIV/AIDS infection. The study design was a randomized controlled trial on Mozambican women at HIV/AIDS risk (n = 150). The participants were randomized into three groups: Didactic Intervention (experimental group), ACCENT intervention (experimental group), and control group. We used an adapted version of the Women's Health Questionnaire, which includes a series of scales and questionnaires assessing psychosocial relevant dimensions to female protection towards HIV/AIDS: HIV/AIDS knowledge, condom use negotiation self-efficacy, and perceived barriers against safer sex. Both interventions were equally effective in increasing HIV/AIDS knowledge. The ACCENT intervention was especially effective in promoting condom use negotiation self-efficacy and in decreasing perceived barriers against safer sex, essential variables for sexual protection. These results support the adaptation of Western interventions to the African context.

Arab Muslim social workers between the Sharia and Western interventions and their coping mechanisms

ABSTRACT This exploratory study of 34 religious, traditional, and secular Arab Muslim social workers in Israel traces the dilemmas caused by potential clashes between their professional and religious values. The findings suggest that although all the interviewees were aware of such clashes, only the religious ones adopted coping strategies to address them. The traditional workers regarded the conflicts in universal moral terms, and the secular workers distanced themselves from their religion. None of the respondents were familiar with the Islamization of social work in the Arab world that might have helped them resolve their dilemmas.

The Open End of the War of Yugoslav Legacy: the Consequences of the Dissolution of the SFRY Three Decades Later

The article examines the dynamics and prospects of resolving the main confl icts in the Western Balkans three decades after the collapse of Yugoslavia. The most important factors infl uencing the confl ict dynamics in the region are ethnonationalism, ethnic homogenization and external interference. Western intervention made it possible to stop hostilities, but at the same time it actually consolidated the results of ethnic homogenization. The Serbo-Croatian confl ict is close to its exhaustion due to the actual support of the West for Operation “Storm” (1995), the exodus of more than 200 thousand Serbs from Croatia, the integration of Croatia into NATO and the European Union. Despite the negative burden of historical memory, both Zagreb and Belgrade in bilateral relations are increasingly guided by political pragmatism and balanced assessments of the qualitatively changed situation. Against this background, the Dayton model of state structure in Bosnia and Herzegovina, built on the basis of institutional transactions of actors representing competing ethnocultural communities, demonstrates its dysfunctionality. The interaction and cooperation of these actors remain largely limited, carried out under external control and pressure. Regarding the structure of the article, the author, fi rst, discusses some general issues contributing to the enduring confl ict in the Western Balkans; second, the article examines the prospects of antagonism between the Serbs and Croats; third, I analyze the impact of the Dayton Accords on the post-Yugoslav space. I conclude that scenarios for the future of the Western Balkans, to which the European Union and the United States are oriented, do not lead to the elimination of the causes of major confl icts in the post-Yugoslav space and obviously diverge in essential points from the images of the desired future that correspond to the aspirations of a signifi cant part of the population in the region.

The Ultimate Social Network: China's Expansionary, Internationally Oriented United Front Strategies 1923-2020

The Ultimate Social Network: China's Expansionary, Internationally Oriented United Front Strategies 1923-2020

Setting the Strategic Cat among the Policy Pigeons: The Problems and Paradoxes of Western Intervention Strategy

In theory, the idea of strategy is easy to comprehend but in practice it is a hard taskmaster because it often involves calculations of political values that are rarely amenable to the kind of rationalistic application of “expert” opinion to which Western nations invariably default when considering overseas interventions. Based on remarks to the Oxford Changing Character of War Centre, this research note argues that foreign policy experts frequently find themselves out of touch with the sentiments of their own populations, which in part is responsible for the poor strategic outcomes that Western foreign policies have incurred in recent years. A number of remedies are suggested, based principally on returning Western policy making to a tradition of prudential realism.

Re-Strategising Mission (and Development) Intervention into Africa to Avoid Corruption, the Prosperity Gospel and Missionary Ignorance

The notion that Western ways are superior can be used to justify subsidising advocacy to the poor in Africa who might otherwise reject those ways out of ignorance. This ignores differences in culture that can trip up Western logic in Africa. When generosity is the reason to subsidise Western interventions, outside agents can be paid back in honour in ways not appropriate for Christians to accept. Perceived global inequalities used to convince donors to part with their money are impositions when those inequalities are not realised by recipients. When something inherently good, like the gospel, is routinely subsidised, some African people only value it when it comes with money. This disenfranchises poor evangelists. In order to overcome missionary ignorance, promotion of the prosperity gospel, and corruption associated with excessive foreign subsidies, this article advocates that vulnerable mission, namely, foreign intervention using local languages and resources, be permitted.

Explaining Homegrown Western Jihadists: The Importance of Western Foreign Policy

In both the United States and Europe, explanations of homegrown radicalization emphasize the power of Salafi-jihadist ideology and Muslim experiences of discrimination and socioeconomic deprivation in Western countries. Polls of U.S. and European Muslims, and case histories of jihadist plots for attacks in the United States, indicate that another source of homegrown radicalization is Western foreign policy, especially Western interventions in predominantly Muslim countries. Poll results support a two-factor model in which seeing the war on terrorism as a war on Islam is predicted by both perceived discrimination and grievance related to Western foreign policy. Consistent with this model, UK practitioners in counter-radicalization programs find it useful to recognize Muslim grievances related to Western foreign policy in order to argue that violence does not reduce Muslim suffering. These observations indicate that Muslim grievances relating to Western foreign policy are important for under - standing and countering support for jihadist violence in Western countries.

Korea’s and Vietnam’s Encounter and Reaction towards Western Ideas in the Flux of Western Intervention: Focusing on Selective Factors from the Seventeenth to mid- Nineteenth Century

This paper is a comparative research on how Vietnam and Korea struggled to accommodate and interact with Western ideas in the advent of Western intervention in the East Asian region, based on the closely related cultural and historical background between the two East Asian countries. The author specifically focuses on the rise of Western ideas, i.e. Catholicism in the two countries within the dominant impacts of Confucian Sino-centric perception adopted by Confucian scholars and rulers for centuries. The research indicated significant resemblance in the pattern of Korea and Vietnam's reception and reaction toward the influences and challenges inflicted by the West, which was predominantly driven by the Sino-centric world view. In this light, both countries struggled through consistent social and political unrest and finally commenced to close the gates to the outside world in an attempt to protect the ruling powers. Vietnamese rulers, however, were by far less conservative and aggressive against the presence of the West in their domains due to their dependence upon Western advanced military technology, particularly during the internal conflicts between the Trinh and Nguyen factions. However, after the unification under the reign of Nguyen family, despite previous contacts with the West, Vietnam gradually become a fervent Confucian state. Meanwhile, in the same period of the Western provocation in East Asia, Korea was a full-fledged and unified kingdom under the rule of Yi family, Choson was more alerted about the rise of new ideas brought in by the West; thus, their reaction toward Western ideas were more brutal and merciless in order to protect the kingdom's correct ideology. Conclusively, no matter how Vietnamese and Korean scholars and rulers were fascinated by Western advancement in technology, owing to their commitment to the Sino-centric worldview they were reluctant to regard Western ideas in positive ways; thus, gradually failed to adapt themselves to the road to modernization which historically contributed to the decline of the nations in the following periods.

Treatment of primary biliary cirrhosis with ursodeoxycholic acid combined with traditional Chinese medicine: A protocol for systematic review and meta analysis.

Ursodeoxycholic acid is the priority drug of primary biliary cirrhosis (PBC) and is usually combined with traditional Chinese medicine. This study aimed to systematically evaluate the benefits of integrated Chinese and western interventions for PBC. Searched the randomized controlled trials in PubMed, Web of Science, CNKI, CBM, Wanfang, VIP databases. The Cochrane risk of bias tool was used for methodological quality assessment and all data analysis was performed using Revman5.3 and Stata14.2 software. 30 randomized controlled trials involving 10 interventions with a total of 1948 participants were included. Identified the direct and indirect evidence of trials, and used network meta analyses ranked the benefits of different interventions based on pairwise meta analysis. The primary outcom was clinical efficacy rate. Secondary outcome was liver function, including alkaline phosphataseand total bilirubin. The conclusion of this systematic review provide credible evidence - based for the relative advantages of integrated Chinese and western interventions for PBC.

Significant reduction in abundance of peridomestic mosquitoes (Culicidae) and Culicoides midges (Ceratopogonidae) after chemical intervention in western S\xe3o Paulo, Brazil

BackgroundWe assessed the impact of two sand fly insecticide interventions (insecticide spraying and insecticide-impregnated dog collars) on the peridomestic abundance and distribution of mosquitoes (Culicidae) and biting midges (Ceratopogonidae) in western São Paulo (Brazil) in a long-term (42-month) evaluation. Both of these dipteran groups are vectors of diseases of medical and veterinary relevance to humans and domestic animals in Brazil.MethodsThe interventions in the 3-arm stratified randomised control trial were: pheromone + insecticide (PI) (chicken roosts were sprayed with microencapsulated lambda-cyhalothrin; pheromone lure has no effect on the Diptera pests studied here); dog-collars (DC) (dogs fitted with deltamethrin-impregnated collars); and control (C) (unexposed to pyrethroids) were extended by 12 months. During that time, adult mosquitoes and midges were sampled along 280 households at three household locations (inside human dwellings, dog sleeping sites and chicken roosts).ResultsWe collected 3145 culicids (9 genera, 87.6% Culex spp.) distributed relatively uniformly across all 3 arms: 41.9% at chicken roosts; 37.7% inside houses; and 20.3% at dog sleeping sites. We collected 11,464 Culicoides (15 species) found mostly at chicken roosting sites (84.7%) compared with dog sleeping sites (12.9%) or houses (2.4%). Mosquitoes and Culicoides were most abundant during the hot and rainy season. Increased daytime temperature was marginally associated with increased mosquito abundance (Z = 1.97, P = 0.049) and Culicoides abundance (Z = 1.71, P = 0.087). There was no significant association with daily average rainfall for either group. Household-level mosquito and midge numbers were both significantly reduced by the PI intervention 56% [incidence rate ratio, IRR = 0.54 (95% CI: 0.30–0.97), P ≤ 0.05] and 53% [IRR = 0.47 (95% CI: 0.26–0.85), P ≤ 0.05], respectively, compared to the control intervention. The abundance of both dipteran groups at dog sleeping sites was largely unaffected by the PI and DC interventions. The PI intervention significantly reduced abundance of mosquitoes inside houses (41%) and at chicken roosting sites (48%) and reduced midge abundance by 51% in chicken roosting sites.ConclusionsSprayed insecticide at chicken roosting sites reduced the abundance of mosquitoes and midges at the peridomestic level while dog collars had no effect on numbers for any group.

Work-related stressors among hospital physicians: a qualitative interview study in the Tokyo metropolitan area.

ObjectivesWe explored Japanese physicians’ work-related stressors and identified those unique to this population, as well as clarified the influence of cultural and medical system diversity on these stressors to determine the content of future stress-reducing interventions for hospital physicians in Japan.DesignWe conducted a semistructured, face-to-face interview-based qualitative study between August and October 2017. The collected data were analysed using the grounded theory approach.SettingHospitals around the Tokyo metropolitan area, Japan.ParticipantsSixteen hospital physicians (mean age (SD)=33.9 (4.2) years; 11 men, 5 women). Seven worked in internal medicine and nine in surgery.ResultsWe found unique stressors related to the Japanese medical system and culture, such as continuous all-day work after night shifts, and a hierarchical organisational system called Ikyoku. The results also indicated that Japanese physicians shared several stressors with Western physicians, such as sleep deprivation, high pressure and the limits of medicine.ConclusionsOur study clarifies some sources of work-related stressors among hospital physicians in Japan. While the key components of Western interventions might be useful in a Japanese context, the original evidence obtained from this study highlights the necessity of initiating interventions addressing the unique stressors of Japanese physicians. To reduce physicians’ stress and enhance their well-being, psychological interventions for hospital physicians must be introduced in Japan.