Over the past few decades, China has increasingly challenged the global influence of the United States. In China's Grand Strategy, David B. H. Denoon brings together a group of eminent scholars to explain China's rapid ascendance on the world stage, as well as its future implications for global politics. Contributors address the military, economic, diplomatic, and internal political factors shaping China's strategy, in addition to highlighting Beijing's objectives in different parts of the world, such as Central Asia, Africa, and the Middle East. Ultimately, they explore the promise and perils of China's rapidly changing political ambitions, showing how the country has made its mark on the twenty-first century. China's Grand Strategy provides insight into China's quest to become a global leader, particularly at a time when the future of both China and the US remain uncertain in the context of current crises like the coronavirus pandemic, the ongoing protests in Hong Kong, and escalating tension between top leaders and officials. This book cannot predict the future for China or the US, but the insights offered can help make sense of where we have been and where we are going.
BACKGROUND: Adolescents are being involved in aggressive activities nowadays. Sometimes, involvement in aggressive activities may be fatal for the victim as well as for the doer. It is a matter of great concern for all including parents, teachers, psychologists, social reformers, and others. A momentary expression of anger sometimes may spoil the future life of the adolescents. AIM AND OBJECTIVES: To determine the prevalence of aggression and to identify the psychosocial risk factors associated with aggression among school-going adolescents. METHODOLOGY: The study recruited 480 school-going rural adolescents from eight government senior secondary schools in the rural block of Beri, district Jhajjar (Haryana). OBSERVATIONS: The mean age of the adolescents was 14.11 ± 1.12 years; 49.4% of the adolescents were found to be aggressive. After applying binary logistic regression, there was a statistically significant relation between aggression and determinants like class, gender, occupation of the father. CONCLUSION AND RECOMMENDATIONS: The study concluded that determinants like age, class of students, gender of the subject, occupation of father found a significant association with aggression. To solve this current situation, parents must give love, attention to their children and must act in an appropriate way in front of them and be role models.
Frontmatter -- Contents -- Preface -- Introduction -- 1. How New Technologies Are Shaping China's Military Strategy -- 2. China's Economic and Technological Strategy in the Age of Xi Jinping -- 3. Xi Jinping's Vision of Chinese Foreign Policy: A Coherent Chinese Diplomatic Strategy? -- 4. China's Grand Strategy toward Northeast Asia -- 5. China's Grand Strategy toward Southeast Asia: Assessing the Response and Efficacy -- 6. China's Current South Asia Strategy -- 7. China's Role in Central Asia and Middle East: Geopolitical Vacuum Pragmatist or New International Order Creator? -- 8. China's Policy toward Russia and Europe: The Eurasian Hookup -- 9. China's Grand Strategy toward North America -- Conclusion -- Acknowledgments -- Appendix: Major Stated Chinese National Goals -- About the Editor -- About the Contributors -- Index
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Yong, James S. L. ; Lim Hiap Koon: E-government : enabling sector reform Sin Chong Yoke: In search of e-government excellence Yong, James S. L.: The journey to e-Brunei Yong, James S. L. ; Leong, Janice L. K.: Enter the dragon : informatization in China Yong, James S. L. ; Leong, Janice L. K.: Digital 21 and Hong Kong's advancement in e-government Yong, James S. L. ; Sachdeva, Sameer: India : e-progress in the states Yong, James S. L. ; Tan, Jeffery B. H.: E-Korea : high bandwidth, high growth Yong, James S. L.: Malaysia : advancing public administration into the information age Tan, Jeffery B. H. ; Yong, James S. L.: Many agencies, one government : Singapore's vision of public service delivery Yong, James S. L.: Digital Taiwan : towards a green silicon island Yong, James S. L. ; Phureesitr, Poranee: Thailand : e-government for public service reform Yong, James S. L.; Lim Hiap Koon: The e-services portal : doorway to e-government Nair, Praba: Knowledge management in the public sector Tan, Jeffery B. H. ; Ang, Edwin L. C.: E-government and te security challenge Suan Bok Hai: Making e-governance happen : a practitioner's perspective Cheong Lee Kwok ; Yong, James S. L.: The future of e-government : perspectives and possibilities
Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.
Extrapulmonary tuberculosis (EPTB) is frequently a diagnostic and therapeutic challenge. It is a common opportunistic infection in people living with HIV/AIDS and other immunocompromised states such as diabetes mellitus and malnutrition. There is a paucity of data from clinical trials in EPTB and most of the information regarding diagnosis and management is extrapolated from pulmonary TB. Further, there are no formal national or international guidelines on EPTB. To address these concerns, Indian EPTB guidelines were developed under the auspices of Central TB Division and Directorate of Health Services, Ministry of Health and Family Welfare, Government of India. The objective was to provide guidance on uniform, evidence-informed practices for suspecting, diagnosing and managing EPTB at all levels of healthcare delivery. The guidelines describe agreed principles relevant to 10 key areas of EPTB which are complementary to the existing country standards of TB care and technical operational guidelines for pulmonary TB. These guidelines provide recommendations on three priority areas for EPTB: (i) use of Xpert MTB/RIF in diagnosis, (ii) use of adjunct corticosteroids in treatment, and (iii) duration of treatment. The guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria, which were evidence based, and due consideration was given to various healthcare settings across India. Further, for those forms of EPTB in which evidence regarding best practice was lacking, clinical practice points were developed by consensus on accumulated knowledge and experience of specialists who participated in the working groups. This would also reflect the needs of healthcare providers and develop a platform for future research.
The first of a three-volume series on the interaction of the US and China in different regions of the world, China, the United States, and the Future of Central Asia explores the delicate balance of competing foreign interests in this resource-rich and politically tumultuous region. Editor David Denoon and his internationally renowned set of contributors assess the different objectives and strategies the U.S. and China deploy in the region and examine how the two world powers are indirectly competitive with one another for influence in Central Asia. While the US is focused on maintaining and supporting its military forces in neighboring states, China has its sights on procuring natural resources for its fast-growing economy and preventing the expansion of fundamentalist Islam inside its borders. This book covers important issues such as the creation of international gas pipelines, the challenges of building crucial transcontinental roadways that must pass through countries facing insurgencies, the efforts of the US and China to encourage and provide better security in the region, and how the Central Asian countries themselves view their role in international politics and the global economy. The book also covers key outside powers with influence in the region; Russia, with its historical ties to the many Central Asian countries that used to belong to the USSR, is perhaps the biggest international presence in the area, and other countries on the region's periphery like Iran, Turkey, Pakistan, and India have a stake in the fortunes and future of Central Asia as well. A comprehensive, original, and up-to-date collection, this book is a wide-ranging look from noted scholars at a vital part of the world which is likely to receive more attention and face greater instability as NATO forces withdraw from Afghanistan
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BACKGROUND: We evaluated the effectiveness of integrated care centers (ICCs), which provided single-venue HIV testing, prevention, and treatment services for people who inject drugs (PWID) and men who have sex with men (MSM), in India. METHODS: We conducted baseline respondent-driven sampling (RDS) surveys in 27 sites across India, and selected 22 of these (12 PWID and 10 MSM) for a cluster randomised trial on the basis of high HIV prevalence and logistical considerations. We used stratified (PWID and MSM), restricted randomisation to allocate sites to either the ICC intervention or usual care (11 sites per arm). We implemented ICCs in 11 cities (6 PWID ICCs embedded within opioid agonist treatment centers and 5 MSM PWIDs embedded within locations of government-sponsored health services), with a single ICC per city in all but 1 city. After a 2-year intervention phase, we conducted evaluation RDS surveys of target population members 18 years or older at all sites. The primary outcome was self-reported HIV testing in the prior 12 months (recent testing) in the evaluation survey. We used a biometric identification system to estimate ICC exposure (visited an ICC at least once) among evaluation survey participants at intervention sites. This trial is registered with ClinicalTrials.gov (NCT01686750). FINDINGS: ICCs provided HIV testing for 14,689 unique clients during the intervention phase. In the evaluation phase (August 2016 to May 2017) we surveyed 11,721 PWID and 10,005 MSM participants using RDS. In the primary population-level analysis, recent HIV testing was 31% higher in ICC than usual care sites (adjusted prevalence ratio [aPR] 1·31, 95% confidence interval [CI] 0·95, 1·81, p=0·09). Among survey participants at intervention sites, ICC exposure was lower than expected (median exposure 40% at PWID sites and 24% at MSM sites). In intervention sites, survey participants who visited an ICC were 3·5-fold (95% CI 2·9, 4·1) more likely to report recent HIV testing than participants who had not. Post-hoc analyses ...
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long- term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research.
Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index 60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16-30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77-0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50-0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80-0·88; p<0·001), and full lockdowns (0·57, 0·54-0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services.