999 resultados para United States. Works Progress Administration (Ill.).
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There is an ongoing mission in Afghanistan; a mission driven by external political forces. At its core this mission hopes to establish peace, to protect the populace, and to install democracy. Each of these goals has remained just that, a goal, for the past eight years as the American and international mission in Afghanistan has enjoyed varied levels of commitment. Currently, the stagnant progress in Afghanistan has led the international community to become increasingly concerned about the viability of a future Afghan state. Most of these questions take root in the question over whether or not an Afghan state can function without the auspices of international terrorism. Inevitably, the normative question of what exactly that government should be arises from this base concern. In formulating a response to this question, the consensus of western society has been to install representative democracy. This answer has been a recurring theme in the post Cold War era as states such as Bosnia and Somalia bear witness to the ill effects of external democratic imposition. I hypothesize that the current mold of externally driven state-building is unlikely to result in what western actors seek it to establish: representative democracy. By primarily examining the current situation in Afghanistan, I claim that external installation of representative democracy is modally flawed in that its process mandates choice. Representative democracy by definition constitutes a government reflective of its people, or electorate. Thus, freedom of choice is necessary for a functional representative democracy. From this, one can deduce that because an essential function of democracy is choice, its implementation lies with the presence of choice. State-building is an imposition that eliminates that necessary ingredient. The two stand as polar opposites that cannot effectively collaborate. Security, governing capacity, and development have all been targeted as measurements of success in Afghanistan. The three factors are generally seen as mutually constitutive; so improved security is seen as improving governing capacity. Thus, the recent resurgence of the Taliban in Afghanistan and a deteriorating security environment moving forward has demonstrated the inability of the Afghan government to govern. The primary reason for the Afghan government’s deficiencies is its lack of legitimacy among its constituency. Even the use of the term ‘constituency’ must be qualified because the Afghan government has often oscillated between serving the people within its territorial borders and the international community. The existence of the Afghan state is so dependent on foreign aid and intervention that it has lost policy-making and enforcing power. This is evident by the inability of Afghanistan to engage in basic sovereign state activities as maintaining a national budget, conducting elections, providing for its own national security, and deterring criminality. The Afghan state is nothing more than a shell of a government, and indicative of the failings that external state-building has with establishing democracy.
Resumo:
Background and aim. Hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection is associated with increased risk of cirrhosis, decompensation, hepatocellular carcinoma, and death. Yet, there is sparse epidemiologic data on co-infection in the United States. Therefore, the aim of this study was to determine the prevalence and determinants of HBV co-infection in a large United States population of HCV patients. ^ Methods. The National Veterans Affairs HCV Clinical Case Registry was used to identify patients tested for HCV during 1997–2005. HCV exposure was defined as two positive HCV tests (antibody, RNA or genotype) or one positive test combined with an ICD-9 code for HCV. HCV infection was defined as only a positive HCV RNA or genotype. HBV exposure was defined as a positive test for hepatitis B core antibodies, hepatitis B surface antigen, HBV DNA, hepatitis Be antigen, or hepatitis Be antibody. HBV infection was defined as only a positive test for hepatitis B surface antigen, HBV DNA, or hepatitis Be antigen within one year before or after the HCV index date. The prevalence of exposure to HBV in patients with HCV exposure and the prevalence of HBV infection in patients with HCV infection were determined. Multivariable logistic regression was used to identify demographic and clinical determinants of co-infection. ^ Results. Among 168,239 patients with HCV exposure, 58,415 patients had HBV exposure for a prevalence of 34.7% (95% CI 34.5–35.0). Among 102,971 patients with HCV infection, 1,431 patients had HBV co-infection for a prevalence of 1.4% (95% CI 1.3–1.5). The independent determinants for an increased risk of HBV co-infection were male sex, positive HIV status, a history of hemophilia, sickle cell anemia or thalassemia, history of blood transfusion, cocaine and other drug use. Age >50 years and Hispanic ethnicity were associated with a decreased risk of HBV co-infection. ^ Conclusions. This is the largest cohort study in the United States on the prevalence of HBV co-infection. Among veterans with HCV, exposure to HBV is common (∼35%), but HBV co-infection is relatively low (1.4%). There is an increased risk of co-infection with younger age, male sex, HIV, and drug use, with decreased risk in Hispanics.^
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1915
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1913
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The present study was designed to determine the magnitude of the relationship between amount, frequency, and length of shift work completed by female transportation employees and the number, degree, and extent of problems related to physical, menstrual and psychological health including depression. It was hypothesized that workers that are employed in areas such as transportation who are working shift work on a regular basis place themselves at higher risk for developing health or psychosocial related effects. These health related outcomes can have a profound impact on an employee’s job performance, daily functioning, and personal life. The present study sought to understand the potential relationship between working shift work and higher disturbances to the bodies’ natural functioning. The present study has the potential for explaining new ways to decrease the risk factors for those working shift work by contributing to the overall understanding of this multifaceted relationship. This study has many important findings and implications. This study has implications for explaining that the effects of disturbances to the circadian rhythm as a result of certain shift work schedules can result in ill-related health effects. Additionally, this study sought to challenge limitations to current research that has been conducted on the topic as the majority of studies have been performed on men. The overall purpose of the study was to gain a better understanding of the negative effects of shift work on females working within the transportation industry. This study sought to explain the health implications specifically for female workers as fewer studies have been conducted with gender as a main effect in the analysis. The present study suggests that due to the circadian rhythm controlling hormone secretion within the body, disturbances to its natural rhythm can have additional effects on female cycles such as menstruation. Overall, this study offers implications for further research on females working shift work and highlights the continued importance for further exploration into recent developments. These implications have the potential to further our current understanding of the relationship between shift work and ill-health effects, particularly the factors that women face.
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1920
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1919
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1921
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1923
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1908
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1910
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1922
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1914
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1909
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1907
