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Archive for November 11th, 2012

Where are the very few countries that British Empire forgot to invaded?

At the height of the British Empire, almost three quarter of the atlas was coloured pink, showing the extent of British rule…

Stuart Laycock, who has previously published books on Roman history, began the unusual quest after being asked by his 11-year-old son, Frederick, how many countries the British had invaded.

After almost two years of research Stuart said he was shocked by the answer. “I was absolutely staggered when I reached the total. I like to think I have a relatively good general knowledge. But there are places where it hadn’t occurred to me that these things had ever happened. It shocked me.

From about the 200 currently recognized States, Britain has invaded all but 22 countries in the world in its long and colourful history, new research has found.

Britain has invaded all but 22 countries in the world in its long and colourful history, new research has found

21 of the 22 countries that have NOT been invaded by Britain

A new study has found that at various times the British have invaded almost 90 per cent of the countries around the globe.

The analysis of the histories of the almost 200 countries in the world found only 22 which have never experienced an invasion by the British.

Among this select group of nations are far-off destinations such as Guatemala, Tajikistan and the Marshall Islands, as well some slightly closer to home, such as Luxembourg.

Stuart Laycock, the author, has worked his way around the globe, through each country alphabetically, researching its history to establish whether, at any point, they have experienced an incursion by Britain.

Only a comparatively small proportion of the total in Mr Laycock’s list of invaded states actually formed an official part of the empire.

The remainder have been included because the British were found to have achieved some sort of military presence in the territory – however transitory – either through force, the threat of force, negotiation or payment.

Incursions by British pirates, privateers or armed explorers have also been included, provided they were operating with the approval of their government.

Many countries which once formed part of the Spanish empire and seem to have little historical connection with the UK, such as Costa Rica, Ecuador and El Salvador, make the list because of the repeated raids they suffered from state-sanctioned British sailors.

Among some of the perhaps surprising entries on the list are:

* Cuba, where in 1741, a force under Admiral Edward Vernon stormed ashore at Guantánamo Bay. He renamed it Cumberland Bay, before being forced to withdraw in the face of hostile locals and an outbreak of disease among his men. Twenty one years later, Havana and a large part of the island fell to the British after a bloody siege, only to be handed back to the Spanish in 1763, along with another unlikely British possession, the Philippines, in exchange for Florida and Minorca.

*Iceland, invaded in 1940 by the British after the neutral nation refused to enter the war on the Allies side. The invasion force, of 745 marines, met with strong protest from the Iceland government, but no resistance.

* Vietnam, which has experienced repeated incursions by the British since the seventeenth century. The most recent – from 1945 to 1946 – saw the British fight a campaign for control of the country against communists, in a war that has been overshadowed by later conflicts involving first the French and then Americans.

It is thought to be the first time such a list has been compiled.

Laylock resumed: “Other countries could write similar books – but they would be much shorter. I don’t think anyone could match this, although the Americans had a later start and have been working hard on it in the twentieth century.”

The only other nation which has achieved anything approaching the British total, Mr Laycock said, is France – which also holds the unfortunate record for having endured the most British invasions. “I realise people may argue with some of my reasons, but it is intended to prompt debate,” he added.

He believes the actual figure may well be higher and is inviting the public to get in touch to provide evidence of other invasions.

In the case of Mongolia, for instance – one of the 22 nations “not invaded”, according to the book – he believes it possible that there could have been a British invasion, but could find no direct proof.

The country was caught up in the turmoil following the Russian Revolution, in which the British and other powers intervened. Mr Laycock found evidence of a British military mission in Russia approximately 50 miles from the Mongolian border, but could not establish whether it got any closer.

The research lists countries based on their current national boundaries and names. Many of the invasions took place when these did not apply.

The research covered the 192 other UN member states as well as the Vatican City and Kosovo, which are not member states, but are recognised by the UK government as independent states.

The earliest invasion launched from these islands was an incursion into Gaul – now France – at the end of the second century. Clodius Albinus led an army, thought to include many Britons, across the Channel in an attempt to seize the imperial throne. The force was defeated in 197 at Lyon.

Mr Laycock added: “One one level, for the British, it is quite amazing and quite humbling, that this is all part of our history, but clearly there are parts of our history that we are less proud of. The book is not intended as any kind of moral judgment on our history or our empire. It is meant as a light-hearted bit of fun.”

The countries that were Never been invaded by the British:

Andorra, Belarus, Bolivia, Burundi, Central African Republic, Chad, Congo, Republic of Guatemala, Ivory Coast, Kyrgyzstan, Liechtenstein, Luxembourg, Mali, Marshall Islands, Monaco, Mongolia, Paraguay, Sao Tome and Principe, Sweden, Tajikistan, Uzbekistan, and Vatican City

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Community health centers compare well with private practices, researcher finds

Government-funded community health centers, which serve low-income and uninsured patients, provide better care than do private practices, a researcher at the Stanford University School of Medicine has found.

The Affordable Care Act, which the U.S. Supreme Court upheld June 28, depends on community health centers to provide services to previously uninsured patients.

MANDY ERICKSON published in the Stanford School of Medicine on July 10, 21012:

Randall Stafford

Randall Stafford, MD, PhD, professor of medicine at the Stanford Prevention Research Center, and colleagues at University of California-San Francisco looked at the actions physicians took when patients visited private practices versus the actions that were taken at community health centers, also referred to as Federally Qualified Health Centers and FQHC Look-Alikes, both of which receive government support.

Their study was published online July 10 in the American Journal of Preventive Medicine. Stafford is the senior author.

The results of the study are particularly encouraging given that the Affordable Care Act, which the U.S. Supreme Court upheld June 28, depends on community health centers to provide services to previously uninsured patients.

“If community health centers are going to be taking up some of the new demand, we can be confident that they’re giving relatively good care,” Stafford said.

Stafford and his colleagues analyzed records of 73,074 visits to private practices, FQHCs and FQHC Look-Alikes. Both FQHCs and Look-Alikes receive enhanced Medicare and Medicaid reimbursement; FQHCs also receive government grants.

The researchers acquired the records from the National Ambulatory Medical Care Survey, which the National Center for Health Statistics gathered between 2006 and 2008.

They evaluated the physicians’ adherence to professional and federal guidelines for 18 measures, which included treatments for specific diseases, screening for certain conditions, and diet and lifestyle counseling. “We looked at fairly common conditions that are seen in primary care,” said lead author L. Elizabeth Goldman, MD, of UCSF.

The researchers found that community health center physicians performed as well as their private practice colleagues in 13 of the 18 measures.

For the remaining five measures — use of ACE inhibitors for congestive heart failure, use of beta blockers, use of inhaled corticosteroids for adult asthmatics, blood pressure screening and avoidance of electrocardiograms in low-risk patients — the community physicians followed recommendations a higher percent of the time.

Given that patients at community health centers have more health and socioeconomic challenges and therefore take up more physician time, said Stafford, “The fact that community health centers look better is perhaps surprising.”

“On the other hand, having worked in community health centers, I can see how it makes sense,” he added. “These are centers where physicians are not as profit-driven and many have incentives more in line with providing quality care.”

Stafford added that the government has provided the centers with technology that helps manage patient care, which may explain their superior performance. And they are generally larger than private practices: “Having a number of colleagues helps you develop better practices. In a solo practice, you have rare opportunities to debate the best way to practice medicine.”

When the researchers adjusted the data so that the patients’ characteristics were statistically equal, the community health center physicians performed better on three additional measures: aspirin for congestive heart failure, statins for congestive heart failure, and avoidance of benzodiazepine, which has serious long-term side effects, for depression.

(The statistical adjustment did not alter the balance in the other previous measures, and if anything, the magnitude of the difference increased in favor of the community physicians.)

The study was funded by awards from the Agency for Healthcare Research and Quality and the National Heart, Lung and Blood Institute. In addition to Stafford and Goldman, other researchers from UCSF and Johns Hopkins Medical School contributed to the study.

Information about Stanford’s Department of Medicine, which also supported this work, is available at http://med.stanford.edu/medicine.

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