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Prevalence and Correlates of VA-Purchased Community Care Use Among Post-9/11-Era Veterans With Traumatic Brain Injury. 9/11-Era(美国退伍军人协会)后脑外伤退伍军人使用退伍军人协会购买的社区护理服务的普遍性和相关性。
IF 2.4 Q3 POLITICAL SCIENCE Pub Date : 2024-05-01 Epub Date: 2023-08-14 DOI: 10.1097/HTR.0000000000000888
Diana J Govier, Tess A Gilbert, R Lorie Jacob, Megan Lafferty, Abby Mulcahy, Terri K Pogoda, Anna Zogas, Maya E O'Neil, Mary Jo Pugh, Kathleen F Carlson

Objective: Post-9/11-era veterans with traumatic brain injury (TBI) have greater health-related complexity than veterans overall, and may require coordinated care from TBI specialists such as those within the Department of Veterans Affairs (VA) healthcare system. With passage of the Choice and MISSION Acts, more veterans are using VA-purchased care delivered by community providers who may lack TBI training. We explored prevalence and correlates of VA-purchased care use among post-9/11 veterans with TBI.

Setting: Nationwide VA-purchased care from 2016 through 2019.

Participants: Post-9/11-era veterans with clinician-confirmed TBI based on VA's Comprehensive TBI Evaluation (N = 65 144).

Design: This was a retrospective, observational study.

Main measures: Proportions of veterans who used VA-purchased care and both VA-purchased and VA-delivered outpatient care, overall and by study year. We employed multivariable logistic regression to assess associations between veterans' sociodemographic, military history, and clinical characteristics and their likelihood of using VA-purchased care from 2016 through 2019.

Results: Overall, 51% of veterans with TBI used VA-purchased care during the study period. Nearly all who used VA-purchased care (99%) also used VA-delivered outpatient care. Veterans' sociodemographic, military, and clinical characteristics were associated with their likelihood of using VA-purchased care. Notably, in adjusted analyses, veterans with moderate/severe TBI (vs mild), those with higher health risk scores, and those diagnosed with posttraumatic stress disorder, depression, anxiety, substance use disorders, or pain-related conditions had increased odds of using VA-purchased care. Additionally, those flagged as high risk for suicide also had higher odds of VA-purchased care use.

Conclusions: Veterans with TBI with greater health-related complexity were more likely to use VA-purchased care than their less complex counterparts. The risks of potential care fragmentation across providers versus the benefits of increased access to care are unknown. Research is needed to examine health and functional outcomes among these veterans.

目的:与整体退伍军人相比,9/11 后退伍军人脑外伤 (TBI) 患者的健康状况更为复杂,可能需要退伍军人事务部 (VA) 医疗保健系统内的 TBI 专家提供协调护理。随着《选择法案》和《使命法案》的通过,越来越多的退伍军人开始使用退伍军人事务部购买的、由社区医疗服务提供者提供的医疗服务,而这些医疗服务提供者可能缺乏 TBI 培训。我们探讨了 9/11 事件后患有 TBI 的退伍军人使用退伍军人事务部购买的医疗服务的普遍性和相关性:2016年至2019年全国退伍军人事务部购买的护理:根据退伍军人事务部的 TBI 综合评估(N = 65 144),临床医生确认患有 TBI 的 9/11 后退伍军人:设计:这是一项回顾性观察研究:使用退伍军人事务部购买的护理服务以及退伍军人事务部购买的和退伍军人事务部提供的门诊护理服务的退伍军人比例,包括总体比例和按研究年份分列的比例。我们采用多变量逻辑回归来评估退伍军人的社会人口学、军事历史和临床特征与他们在 2016 年至 2019 年期间使用退伍军人事务部购买的医疗服务的可能性之间的关联:总体而言,51%患有创伤性脑损伤的退伍军人在研究期间使用了退伍军人事务部购买的医疗服务。几乎所有使用退伍军人事务部购买的护理服务的退伍军人(99%)也使用了退伍军人事务部提供的门诊护理服务。退伍军人的社会人口、军事和临床特征与他们使用退伍军人事务部购买的护理服务的可能性有关。值得注意的是,在调整分析中,患有中度/重度创伤性脑损伤(与轻度创伤性脑损伤相比)、健康风险评分较高以及被诊断患有创伤后应激障碍、抑郁症、焦虑症、药物使用障碍或疼痛相关疾病的退伍军人使用退伍军人购买的护理的几率增加。此外,自杀风险高的退伍军人使用退伍军人购买的医疗服务的几率也更高:结论:与复杂程度较低的退伍军人相比,患有与健康相关的复杂性较高的创伤性脑损伤的退伍军人更有可能使用退伍军人事务部购买的护理服务。目前尚不清楚不同医疗服务提供者之间潜在的医疗服务分散风险与增加医疗服务可及性所带来的益处。需要对这些退伍军人的健康和功能结果进行研究。
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引用次数: 0
Mapping the Scope of China’s Soft Power in Estonia 绘制中国在爱沙尼亚的软实力地图
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000272
Agnieszka NITZA-MAKOWSKA, K. D. Bhutia, Urmas Hõbepappel, Lelde Luik, Anastasia Sinitsyna, Elo Süld
This article examines China’s soft power in Estonia since the launch of the Belt and Road Initiative in 2013. Findings have suggested that while Beijing’s domestic political values do not inform its projection of soft power, the Estonian government and general public perceive China mainly through the prism of its state-centric governance model and consequently view most of China’s deployment of supposedly “soft” power as sharp.
本文探讨了自 2013 年 "一带一路 "倡议提出以来中国在爱沙尼亚的软实力。研究结果表明,虽然中国政府的国内政治价值观并不影响其软实力的投射,但爱沙尼亚政府和公众主要通过以国家为中心的治理模式来看待中国,因此认为中国部署的大多数所谓 "软 "实力都是尖锐的。
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引用次数: 0
Initiative Diplomacy: China’s New Rules for Global Governance, Security and Development 倡议外交:中国的全球治理、安全与发展新规则
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000260
Paul Haenle, Nathaniel Sher
Since 2022, Chinese officials have embarked on an international mobilisation campaign to promote China’s new Global Security Initiative (GSI), Global Development Initiative (GDI) and Global Civilisation Initiative (GCI). The three new initiatives espouse China’s principles of global governance, security and development in order to reinforce the domestic legitimacy of the Chinese Communist Party, reform the global governance system, expand China’s international influence, especially in the developing world, and compete with the United States’ conception of the liberal rules-based international order.
自 2022 年以来,中国官员开始了一场国际动员运动,宣传中国新提出的 "全球安全倡议"(GSI)、"全球发展倡议"(GDI)和 "全球文明倡议"(GCI)。这三项新倡议拥护中国的全球治理、安全和发展原则,以加强中国共产党在国内的合法性,改革全球治理体系,扩大中国的国际影响力,尤其是在发展中国家的影响力,并与美国基于自由规则的国际秩序理念相抗衡。
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引用次数: 0
Hong Kong–Taiwan Relations from the Handover to the Anti-extradition Law Movement—How Sub-state Diplomacy Has Failed 从香港回归到反引渡法运动的港台关系--次国家外交的失败之道
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000338
Adrian Chi-yeung Chiu, Kam-yee Law
After Hong Kong’s handover in 1997, the development of its relations with Taiwan has been full of twists and turns. Formal and bureaucratic interactions have stifled the strategic ambiguity needed to utilise Hong Kong as a buffer for cross-strait tensions. The subtle interaction between Hong Kong and Taiwan, being leveraged to reduce tension and facilitate communication in the cross-strait conflict, has been weakened since the mid-2010s even though institutionalisation was enhanced. Thus, the future development of Hong Kong–Taiwan relations may seem even more pessimistic than cross-strait relations.
1997 年香港回归后,香港与台湾的关系发展一波三折。正式和官僚的互动扼杀了利用香港作为两岸紧张局势缓冲所需的战略模糊性。自 2010 年代中期以来,尽管制度化程度有所提高,但香港与台湾之间的微妙互动却被削弱了,而这种互动曾被用来缓解两岸冲突中的紧张局势并促进沟通。因此,港台关系的未来发展似乎比两岸关系更加悲观。
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引用次数: 0
Japanese Peacebuilding Diplomacy in Southeast Asia and Beyond in the New World Order 新世界秩序下日本在东南亚及其他地区的和平建设外交
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000302
Miyoko Taniguchi
This article addresses the complex landscape of Japan’s diplomatic engagement in Southeast Asia, spanning from the late 1990s to the present day, and explores the transformative role that Japan has played in post-conflict peacebuilding and regional security. Japan has reinforced diplomatic relations with conflict-affected Southeast Asian countries in the post-Cold War era, contributing to security cooperation in the region under the recent Japan’s diplomatic direction of the Free and Open Indo-Pacific vision.
本文论述了从 20 世纪 90 年代末至今日本在东南亚外交参与的复杂局面,并探讨了日本在冲突后和平建设和地区安全方面所发挥的变革性作用。在后冷战时代,日本加强了与受冲突影响的东南亚国家的外交关系,在日本最近提出的 "自由开放的印度洋-太平洋愿景 "的外交方向下,为该地区的安全合作做出了贡献。
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引用次数: 0
Zero-COVID Policy in China: Epidemic Control and the Mode of Politics 中国的零感染政策:疫情控制与政治模式
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000296
Hongyi Lai
In 2022, highly restrictive measures were imposed in China to contain the less deadly Omicron variant of SARS-CoV-2 virus or the COVID-19 virus. This study argues that these measures stemmed from a move away from pragmatic authoritarianism and towards totalitarianism since 2013 and that the lockdown of scores of cities such as Shanghai in 2022 carried quintessential features of totalitarianism. Revived totalitarianism in China has helped explain the longest and likely the most comprehensive strict epidemic control among all nations during the COVID-19 pandemic. The politics and the end of zero-COVID policy in China in 2022 are analysed.
2022 年,中国实施了高度限制性措施,以遏制致命性较低的 SARS-CoV-2 病毒 Omicron 变种或 COVID-19 病毒。本研究认为,这些措施源于中国自2013年以来从实用主义专制主义转向极权主义,2022年对上海等数十个城市的封锁带有极权主义的典型特征。极权主义在中国的复苏有助于解释为什么在 COVID-19 大流行期间,中国在所有国家中实行了时间最长、可能也是最全面的严格疫情控制。本文分析了 2022 年中国零 COVID 政策的政治性和终结。
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引用次数: 0
The Rise, Fall and (Potential) Rise Again of East Asian Middle Powers 东亚中等强国的崛起、衰落和(潜在)再次崛起
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000326
Brendan M Howe
Middle powers have been defined in hierarchical and behavioural terms. They have significantly impacted on the global governance agenda, especially through their leadership within international commissions and through multilateral forums. Recent challenges to multilateralism have created an impression that the middle power moment is over, especially in East Asia. Yet, this article sees a way forward for the stronger, more regionally focused middle powers to continue to influence international governance.
中等强国是按等级和行为定义的。它们对全球治理议程产生了重大影响,特别是通过它们在国际委员会和多边论坛中的领导作用。最近多边主义面临的挑战给人造成了一种印象,即中等强国的时代已经结束,尤其是在东亚。然而,本文认为,更强大、更注重地区的中等强国可以继续影响国际治理。
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引用次数: 0
The Marcos Administration’s Foreign Policy towards the Great Powers: Seeking the Elusive Balance in Dealing a Changing Indo-Pacific Region 马科斯政府的大国外交政策:在应对不断变化的印度洋-太平洋地区时寻求难以实现的平衡
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000314
R. D. de Castro
This article examines the Marcos administration’s efforts to seek the elusive balance in managing its relations with the United States, China and Japan. At the beginning of his term, Philippine President Ferdinand Marcos Jr planned a balanced foreign policy marked by China providing the investments and market for the Philippines while the United States extended its security guarantee. In conclusion, the article argues that Marcos Jr’s foreign policy reflects the Philippines’ acumen in practising ASEAN’s age-old and proven statecraft in dealing with the significant powers that require the smaller Southeast Asian countries to accept the presence of big powers in Southeast Asia as a fact of international relations.
本文探讨了马科斯政府在处理与美国、中国和日本的关系时寻求难以实现的平衡的努力。上任伊始,菲律宾总统小费迪南德-马科斯规划了一项平衡的外交政策,其特点是中国为菲律宾提供投资和市场,而美国则提供安全保障。最后,文章认为,小马科斯的外交政策反映了菲律宾在与大国打交道时实践东盟古老而行之有效的国策的敏锐性,这就要求东南亚小国接受大国在东南亚的存在是国际关系中的一个事实。
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引用次数: 0
Climate Investment in China and the United States: Political, Monetary and Technological Drivers 中国和美国的气候投资:政治、货币和技术驱动因素
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-12-01 DOI: 10.1142/s1793930523000284
Richard Yarrow, Gang Chen
China and the United States have seen expeditious investment growth in renewable energy and climate-related industries. Due to differences in political environments and governance structures, monetary settings, and prevailing market technologies and geographic conditions, the two countries demonstrate varied strengths and weaknesses in promoting climate investment. Both countries can learn from each other’s distinctive strengths and weaknesses to identify potential opportunities both for domestic climate programmes and energy cooperation to jointly pursue pathways to achieve net zero carbon footprints.
中国和美国在可再生能源和气候相关产业的投资增长迅速。由于政治环境和治理结构、货币环境、市场技术和地理条件的不同,两国在促进气候投资方面表现出不同的优势和劣势。两国可借鉴对方的独特优势和弱点,确定国内气候计划和能源合作的潜在机会,共同寻求实现净零碳足迹的途径。
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引用次数: 0
China-Pacific Islands Economic Relations under the Belt and Road 一带一路下的中太平洋经济关系
IF 0.9 Q3 POLITICAL SCIENCE Pub Date : 2023-08-23 DOI: 10.1142/s1793930523000223
Denghua Zhang
This research analyses China-Pacific islands economic relations in merchandise trade, investment and project contracting between 2006 and 2021. Nuances are revealed. The overall finding is that the Pacific is an insignificant partner of China in its global economic outreach, even under the Belt and Road Initiative (BRI). This research also discusses the Chinese government’s perceptions of the Pacific markets and its advice to Chinese companies on thorny issues affecting the BRI.
本研究分析了2006年至2021年中国与太平洋岛国在商品贸易、投资和工程承包方面的经济关系。露出裸体。总体发现是,即使在“一带一路”倡议倡议下,太平洋地区在中国的全球经济拓展中也是微不足道的合作伙伴。本研究还讨论了中国政府对太平洋市场的看法,以及在影响“一带一路”倡议的棘手问题上对中国企业的建议。
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引用次数: 0
期刊
East Asian Policy
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