bluuebunny/crossref_metadata_2025 huggingface dataset:
A Survey Among Cadets at the United States Military Academy on Knowledge and Wearing of Permethrin-Treated Uniforms and the Risk of Tick-Borne Diseases
Authors: Chellaraj Alyssa H , Nun Dylan J , Johnson Jason Y , Sweet Kiley A , Burgess Alex M , Gordon Galina M , Chauff Skyler A , Millican Benjamin M , Wilkinson Canden J , Davidson Silas A
Published: May 2022

Introduction

The Army uses permethrin-treated uniforms as the primary method to protect soldiers from tick-borne diseases. Permethrin binds strongly to fabric and provides long-term protection against many blood-feeding arthropods. However, protection decreases if the uniforms are not washed and cared for according to label instructions. This study was conducted among cadets at the United States Military Academy (USMA) at West Point, NY, to determine what the cadets know about permethrin and how they care for and wear their uniforms. West Point is in an area with high rates of tick-borne disease transmission. A survey was developed to determine what cadets know about the threat of tick-borne diseases and if they wear and maintain their uniforms in a manner that effectively maintains permethrin levels.

Materials and Methods

A 16-question survey was developed and submitted to the local review board for approval. The study was classified as human subjects research according to 32CFR219 and met the requirements for exempt status under 32CFR219.104(d)(2)(i). After receiving approval, a hard copy survey was distributed among cadets with efforts to sample at least 50 members from each cadet class.

Results

A total of 319 cadets provided responses to the survey questions, representing more than 7% of the cadet population at the USMA. The results showed most cadets knew their uniforms were treated with permethrin, but less than half knew there are specific instructions attached to their uniforms describing how the uniforms should be laundered. From the cadets who knew there were instructions, most admittedly did not follow the instructions. Sixteen percent of cadets said they had dry-cleaned their uniforms. This is a process known to remove most of the permethrin. The majority of cadets viewed the risk of tick-borne disease at West Point to be moderate or lower.

Conclusions

This study provides a basic understanding of the wear patterns of permethrin-treated uniforms among cadets at the USMA. It is also one of the few studies to measure knowledge and uniform-wearing behavior among service members since the Army switched to factory-treated uniforms in 2013. The results indicate that compliance with uniform laundry and care instructions is low. This information is useful to develop training plans and educate cadets how they can wear and take care of their permethrin-treated uniforms to better protect themselves from tick-borne diseases.
Giant Starship Elements Mobilize Accessory Genes in Fungal Genomes
Authors: Gluck-Thaler Emile , Ralston Timothy , Konkel Zachary , Ocampos Cristhian Grabowski , Ganeshan Veena Devi , Dorrance Anne E. , Niblack Terry L. , Wood Corlett W. , Slot Jason C. , Lopez-Nicora Horacio D. , Vogan Aaron A.
Published: May 2022

Accessory genes are variably present among members of a species and are a reservoir of adaptive functions. In bacteria, differences in gene distributions among individuals largely result from mobile elements that acquire and disperse accessory genes as cargo. In contrast, the impact of cargo-carrying elements on eukaryotic evolution remains largely unknown. Here, we show that variation in genome content within multiple fungal species is facilitated by Starships, a newly discovered group of massive mobile elements that are 110 kb long on average, share conserved components, and carry diverse arrays of accessory genes. We identified hundreds of Starship-like regions across every major class of filamentous Ascomycetes, including 28 distinct Starships that range from 27 to 393 kb and last shared a common ancestor ca. 400 Ma. Using new long-read assemblies of the plant pathogen Macrophomina phaseolina, we characterize four additional Starships whose activities contribute to standing variation in genome structure and content. One of these elements, Voyager, inserts into 5S rDNA and contains a candidate virulence factor whose increasing copy number has contrasting associations with pathogenic and saprophytic growth, suggesting Voyager’s activity underlies an ecological trade-off. We propose that Starships are eukaryotic analogs of bacterial integrative and conjugative elements based on parallels between their conserved components and may therefore represent the first dedicated agents of active gene transfer in eukaryotes. Our results suggest that Starships have shaped the content and structure of fungal genomes for millions of years and reveal a new concerted route for evolution throughout an entire eukaryotic phylum.
Deputies
Authors: Walker Michael L.
Published: May 2022

Chapter 4 is exploration of Golden County custodial deputies, the work they did, and the attitudes they apparently possessed. Here the author uses the dichotomy of “cool deps” and “asshole deps” to discuss the nature of deputy–resident relations. The two labels are used as typifications to explore how residents made sense of the maltreatment they received from deputies as well as those moments of care that deputies showed. The focus is on these typifications of behaviors and not of character or identity. This discussion begins with a look into why a person might find themselves in the custodial role. The goal is not to humanize deputies, but to present deputies as what they were—humans.
“Jailing”
Authors: Walker Michael L.
Published: May 2022

This chapter is an examination of jail culture in action, including the paradoxical nature of routines and the unpredictability of daily life. The chapter is organized by the concept of “jailing”: the set of endurance strategies residents used to manage the psychic, biological, and emotional realities endemic to jail living. After introducing the concept, this chapter dives into the minutiae of jail living to explicate what punishment looked like and how jail time assaulted the body on multiple fronts. The central argument is that the difficulties endemic to jail time could not be overcome—only endured.
Complexities of Care
Authors: Walker Michael L.
Published: May 2022

This chapter explores the complexities of care among penal residents and, in so doing, accomplishes a goal found in Chapter 4: juxtaposing meanness to acts of selflessness to present a more complete human picture of penal residents. The misogynist advocate of rape culture could be the same resident who shared his last food items with an indigent other. More than that, jail was not some emotional desert where residents relied upon stoicism to get through their time. Rather, residents often openly displayed a range of emotions—no more or less appropriate than would be found in another social setting. And when someone was hurting or was in need, it was common for residents to gather in support. In short, care was common across the landscape of jail life.
Translation of judgments of the European Court of Human Rights into non-official languages
Authors: Kjær Anne Lise
Published: May 2022

The chapter examines the role that translation of judgments of the European Court of Human Rights (ECtHR) has played in the dialogue between the Member States of the Council of Europe and the Court over time. The judgments of the ECtHR are produced in the two official languages, English and French, only, and translation into other languages was not an issue until the beginning of the Interlaken reform process in the early 2000s. It was introduced into the reform discourse under the heading of Member States’ knowledge and understanding of the Court’s case law. The chapter traces the development of translation arguments in the reform discourse and argues that considerations regarding translation into the national languages of the Member States indicate the institutional balance that exists at any given time in the interface between the national and European levels of the European human rights system.
King of the World
Authors: Waters Matt
Published: May 2022

Cyrus the Great was a transformational figure: an exceptional leader, general, and visionary. He was also the founder of the Achaemenid Persian Empire, which dominated the world stage from the Mediterranean to the Indus during the sixth through fourth centuries bce. When Cyrus took the royal title “King of the World” in 539 bce, it was closer to a literal reality than for any ruler before him in history. Cyrus the Great thus was an object of fascination even in antiquity, well-regarded among several peoples in almost every accounting of his life. This book treats the stories of Cyrus’ birth, conquests, and reign through multiple perspectives, grounded in analysis of ancient sources from the Persians, Elamites, Babylonians, Judeans, and Greeks. Cyrus the Great remains a worthy object of attention for the imprint he left on world history, anywhere the ancient Achaemenid Empire touched in antiquity, and its legacy thereafter.
An Irresistible Force
Authors: Waters Matt
Published: May 2022

The birth and upbring of Cyrus the Great remains shrouded in legend, mainly preserved in later Greek sources. From Cyrus himself we have preserved only his lineage in the Cyrus Cylinder, but several other ancient Persian and Mesopotamian sources allow us to check and to correct aspects of the Greek accounts. Cyrus’ marriage to the Achaemenid noblewoman Cassandane was likely a linchpin of his early dynastic alliances with other Iranian families, in this case linking the Teispid and Achaemenid lines. Their children included Cambyses, Bardiya, Atossa, and Artystone, the last two powerful queens in their own right, well-attested in the Persepolis bureaucracy, well into the reign of Darius I.
Wordsworth’s Ghostly Language
Authors: Townsend Chris
Published: May 2022

Wordsworth’s ‘crisis of reason’ of the mid-1790s is understood as a formative experience for the young poet, removing him from Godwin’s world of abstract reasoned morality, and ushering in the period of creativity that would give rise to the early versions of The Prelude and the Lyrical Ballads. This chapter reads that crisis historically, to show that Wordsworth’s turn away from Godwin coincided with his first exposure to Berkeley, by way of his meeting with the then ‘Berkleian’ Coleridge. The chapter pursues the idea of a ‘ghostly language’ at work in Wordsworth’s poetry of the 1790s that is derived from Berkeley’s conception of nature as a divine natural language—one that is not a simple metaphor for the world as a book, but one that renders nature as an actually legible and wholly spiritual entity.
Cornelia Sorabji
Authors: Sarker Sonita
Published: May 2022

This chapter presents the ways in which, because of her unique grounding in more than one kind of lineage, land, learning, and labor, Sorabji claims to be a citizen of the British Empire. She is consistently characterized as an “other,” both in England and in an emerging India; her Parsee lineage and cultural as well as intellectual affiliation with the values of imperial England are the basis for her distance from, but also advocacy of, the purdahnashin (Indian women in purdah). This chapter illustrates her problematic relationship with the concept and category of “native,” even as she claims belonging.
Victoria Ocampo
Authors: Sarker Sonita
Published: May 2022

Ocampo has primarily been read as a modernist cosmopolitan (literally, a citizen of the world), and as quintessentially Argentinian at the same time; she claimed citizenship in “America” as a continent. This chapter explores how her lineage, relationship to land, learning, and labor form the foundation of her “native-ness.” With the advantage of an education in English and French provided to her at home, and with the cultural capital of being from a prominent family, Ocampo undertook a literary career that spanned continents and brought about an international meeting of the minds across the USA, France, Spain, Argentina, and India. Belonging, for Ocampo, was about thinking beyond national borders to a human solidarity against oppression and discrimination.
From Autonomy to Accommodation
Authors: Barbora Sanjay
Published: May 2022

The process of updating National Register of Citizens (NRC) between 2012 and 2018 and subsequent announcement of the Citizenship Amendment Bill (CAB) in 2019 ushered in a new set of conflicts around the issue of citizenship, identity, and resource sharing in Assam. In doing so, it relegated previous causes for conflict in the region to the background. Civil society’s protests against CAB and the acquiesce to the NRC in parts of Assam underline the persistence of history in the analysis of conflicts. This introductory chapter traces the trajectory of conflicts around autonomy and social justice and lays out the way historical details make their presence felt in contemporary political debates in Assam.
When Infrastructure Studies Meets Digital India (DI)
Authors: Ninan Thomas Pradip
Published: May 2022

This chapter provides an introduction to infrastructure theory, to key concepts and contributions includes a review of literature and offers insights into the ways in which infrastructure theory can be applied to an understanding of information infrastructures in India. It includes the example of the Digital India project and critically explores the provisionings of information infrastructures in India. This chapter makes a case for understanding information infrastructures from the perspective of critical political economy and highlights the “tangled” provisionings of information infrastructures in India. Access to infrastructure in India be it to water, electricity, or information is by no means assured for all—and it is therefore important that we understand the gaps between infrastructure ambitions and infrastructure realities.
The Platformized Information State
Authors: Ninan Thomas Pradip
Published: May 2022

This chapters explores infrastructure in the era of platforms, the platformization of infrastructure and the infrastructuralization of platforms. Based on a conversation with the theory of platforms, it highlights the State’s challenges with platforms and its attempts to regulate the platform economy. The chapter uses the example of the “equalization levy”, an attempt by the Indian State to regulate external platforms such as Google and Facebook in India and to bring such regulation in line with the regulation of information infrastructures. Arguably the regulation of this sector has been long overdue and can be compared with attempts to regulate platforms in the EU, USA, Australia, and other countries. The regulation of information platforms is a complex, on-going project, and this chapter provides numerous entry points to understanding some of its complexities.
New Wave Films
Authors: Ingle Hrishikesh Sudhakar
Published: May 2022

In the Marathi film industry, the 1970s new wave emerged from the discursive ferments of the experimental and amateur theatre. Interrogating this theatre network, this chapter deliberates on four aspects of new wave filmmaking. First, along with an overview of the modernist experimental theatre, the alternative space defining the ferment in the theatre movement is discussed. Second, the concept of middle-class realism is conjectured. This is a derivation from the much talked about notion of Hindi middle cinema. Middle-class realism considers the unmistakable linkages of the Marathi middle-class imaginary, through the theatre, in the body of realist films. Third, by an extensive textual and narrative analysis of Samna and Sinhasan, an elaboration of aesthetic in-betweenness of the realist films is presented. Fourth, the notion of a social disjuncture is posited by analysing the film Jait-re-Jait. The chapter draws out the ambivalent expression of realism for Marathi cinema.
From “Religion” to “Spirituality”
Authors: Watts Galen
Published: May 2022

This chapter opens with three character portraits, each of which exhibits a different, though common, way of talking about “spirituality.” Next, the dominant sociological frameworks both within, and beyond, the sociology of religion are interrogated, in order to illuminate their limitations as regards the study of spirituality. It is argued that while the secularization paradigm remains tremendously insightful, secularization theorists’ preoccupation with charting the decline of church religion has stifled our ability to grasp the substantive character of what goes by “spirituality” today. Similarly, cultural approaches within the sociology of religion have tended to obscure the underlying unity of the spiritual turn. It is for this reason that the study of spirituality has taken place across a host of subfields and disciplines, each of which has contributed much to our understanding of the shift from “religion” to “spirituality,” but whose theoretical and empirical insights have yet to be comprehensively compared or synthesized. The chapter concludes by laying out the foundations of the distinctly cultural sociological approach to the study of religion which is used to synthesize the existing scholarship on “spirituality,” and chart the cultural connections underlying the three biographical accounts that opened the chapter.
A Brief History of the Religion of the Heart
Authors: Watts Galen
Published: May 2022

This chapter argues that, despite the allegedly nebulous nature of the concept, most talk of “spirituality” signals a coherent cultural structure, which the author refers to as the religion of the heart. After explaining why this term is apt, the chapter draws from a wide array of historical, philosophical, and sociological studies in order to offer a brief history of the religion of the heart, by examining some of its key carrier movements and representative voices. It argues that we can see the religion of the heart at work in the Romantic, Transcendentalist, Theosophist, and New Thought movements of the eighteenth and nineteenth centuries, as well as the New Age, Charismatic Christian, and Human Potential movements of the 1960s. Supplementing historical analysis with empirical data, the chapter provides compelling evidence that identifying as “spiritual” does not signal an escape from religious tradition, so much as place one squarely within a longstanding tradition that, paradoxically, denies its status as a tradition.
Mapping the Romantic Liberal Institutional Order
Authors: Watts Galen
Published: May 2022

This chapter maps the seven institutional fields that collectively constitute the religious sphere of romantic liberal modernity—what the author calls the romantic liberal institutional order. These are: (1) the holistic milieu, (2) the Charismatic wing of the congregational domain, (3) popular culture and entertainment media institutions, (4) arts institutions, (5) healthcare institutions, (6) educational institutions, and (7) certain dimensions of the economic sphere. These various institutional fields offer social support and plausibility to the religion of the heart. The chapter then draws from interview and fieldwork data in order to make the case that attraction to “spirituality” in romantic liberal modernity follows one of a number of distinct social pathways.
Romantic Liberal Modernity and Its Critics
Authors: Watts Galen
Published: May 2022

Although it has rarely been acknowledged explicitly, the spiritual turn is, for many, a paradigmatic test case for the ills of romantic liberal modernity—critics view in “spirituality” all of the sins of the late modern social order. These include: the erosion of the authority of reason and science, the corrosion of community and the weakening moral commitment, the devaluation of civic membership and political solidarity, the legitimation of neoliberal capitalism, and the mystification of insidious forms of social control. The chapter draws from the Durkheimian tradition in order to defend romantic liberal modernity against these five criticisms, while at the same time flagging the concerns that romantic liberals cannot afford to ignore. These are as follows: (1) To what extent does the religion of the heart (“spirituality”) mitigate or exacerbate the pathologies of romantic liberal modernity—anomie and egoism? And (2) Does the religion of the heart lead to a colonization of competing social spheres, thereby impeding shifting involvements and the adoption of rival social perspectives and moral traditions? These two concerns orient the enquiries pursued in the subsequent case studies.
Introduction
Authors: Plested Marcus
Published: May 2022

The introduction offers a general outline of the theme of wisdom focussing on its contemporary relevance, global character, and place within higher education. The introduction provides a delineation and description of the principal levels of Christian wisdom discourse (S1–S3). A distinction is made between ‘sapiential theology’ and ‘sophiology’. Modern Russian Sophiology is also introduced. The nature of the question of patristic fidelity within modern Orthodox theology is discussed. The plan and the scope of the book are given and the contents of Chapters 1–7 are summarized. The chapter also introduces the concept of ‘unmodern theology’ and emphasizes the ongoing importance of Sophiology.
Prolegomena
Authors: Plested Marcus
Published: May 2022

Chapter 2 provides a preliminary account of biblical and classical wisdom traditions. Within the Old Testament, wisdom themes are found especially but not exclusively in wisdom literature (notably the quasi-divine figure of wisdom in Proverbs 8-9). A survey is also provided of the place of wisdom within classical culture, whose chief achievement is summed up precisely as the ‘love of wisdom’ (philosophy). Particular attention is paid to Platonic, Aristotelian, and Stoic understandings of wisdom. Within the context of the New Testament, pre-existing wisdom traditions, both biblical and classical, helped make some sense of the encounter with the person of Jesus Christ (for example as teacher and as pre-eternal) while also being soundly exploded by that same encounter, as most ably expressed by St Paul.
Doing Physico-theology
Authors: von Greyerz Kaspar
Published: May 2022

Chapter 6 concentrates primarily physico-theological practice, as visible above all in contemporary correspondence, rather than in treatises. One of the purposes of this chapter is to point to the common ground shared by practitioners of the argument from design and physico-theological palaeontologists: collections and the practice of collecting. It shows not only how correspondence helped to strengthen the transnational and cross-cultural networks among physico-theologians but also how letters were frequently accompanied by parcels and boxes containing presents or objects of exchange, the things that helped to complete seventeenth- and eighteenth-century natural collections. While the increasing exchange of objects led to the proliferation of individual collections as part of the household of scientists and virtuosi, it also encouraged the interest in taxonomy and order. At the same time, it experienced an extra boost occasioned by the shift away from an anthropocentric to a more systemic view of nature, discussed in the preceding chapter.
Diluvialism
Authors: von Greyerz Kaspar
Published: May 2022

This chapter deals with the second most prominent physico-theological genre, diluvialism. Diluvialists established a connection between the Flood as recorded by the biblical Genesis and the making of fossils. Increasingly, diluvialism also contributed to palaeontological taxonomy, which was frequently marred by the fact that some of the fossilized creatures were extinct, something nobody was ready to admit during the period under review. This problem is illustrated in detail in reference to the contemporary discussion about belemnites and of fossilized parts of ‘elephants’, in fact of mammoths. John Woodward and his continental counterpart, Johann Jacob Scheuchzer, formed the centre of diluvialist ‘orthodoxy’ while other diluvialists grouped in concentrical circles around them. The lifespan of diluvialism was shorter than that of the argument from design. It began to lose credit toward the mid-eighteenth century due to the fact that the traditional biblical chronology insisting on the earth’s age of about 6,000 years was increasingly being questioned.
Protestants and Catholics
Authors: von Greyerz Kaspar
Published: May 2022

Physico-theology primarily was the concern of Protestants. This chapter identifies biblicism as the foremost reason for this confessional pattern. Protestants were more interested in demonstrating that the observation of nature was compatible with the biblical record than Catholics. But I argue against the thesis that this was due to the hermeneutical heritage of the Reformation: few physico-theologians actually adhere to any strict biblical literalism and most of them are in favour of the theory of accommodation which claimed that the Mosaic books of the Bible chiefly addressed the common people in their own language and not in natural-philosophical terms. Furthermore, I establish that a considerable number of physico-theologians cannot be considered run of the mill Protestants. Some adhered to Pietism, others were anti-trinitarians, others still were deists. Only a handful of Catholic adherents to physico-theology can be found in France. With one exception, they were Jansenists, and searching for physico-theologians in Catholic Italy is almost pointless.
Who Owned Waterloo?
Authors: Reynolds Luke
Published: May 2022

Between 1815 and the Duke of Wellington’s death in 1852, the Battle of Waterloo became much more than simply a military victory. While other countries marked the battle and its anniversary, only Britain actively incorporated the victory into their national identity, guaranteeing that it would become a ubiquitous and multi-layered presence in British culture. By examining various forms of commemoration, celebration, and recreation, Who Owned Waterloo? demonstrates that Waterloo’s significance to Britain’s national psyche resulted in a different kind of war altogether: one in which civilian and military groups fought over and established their own claims on different aspects of the battle and its remembrance. By weaponizing everything from memoirs, monuments, rituals, and relics to hippodramas, panoramas, and even shades of blue, veterans pushed back against civilian claims of ownership; English, Scottish, and Irish interests staked their claims; and conservatives and radicals duelled over the direction of the country. Even as ownership was contested among certain groups, large portions of the British population purchased souvenirs, flocked to spectacles and exhibitions, visited the battlefield itself, and engaged in a startling variety of forms of performative patriotism, guaranteeing not only the further nationalization of Waterloo, but its permanent place in nineteenth-century British popular and consumer culture.
Introduction
Authors: Reynolds Luke
Published: May 2022

This chapter outlines the central themes and thesis of the book, positions it within the multiple areas of scholarship/historiographies that it engages with, and provides an outline of the book’s chapters while explaining the reasoning behind their order and division. It also clarifies the scope and certain definitions used throughout the text. Who Owned Waterloo? defines ownership as control of the battle’s narrative and commemoration, and through that, the curation of Waterloo and the men who fought there in the nation’s collective memory. This is a domestic definition of ownership set entirely within the context of Great Britain that deliberately excludes not only the other countries that fought at Waterloo, but also the British Empire.
‘Demonstrations of true British feeling and exultation’
Authors: Reynolds Luke
Published: May 2022

The annual commemorations and other forms of remembrance that comprise this chapter provide multiple examples of general and local nationalization of the battle. What started as a shared day of national triumph, where officers and men were feted by civilian society, slowly began to diverge into a standardized series of fetes, parades, and dinners where military and civilian worlds were deliberately separated. Towns seized the day as another opportunity to outshine their neighbours, while a variety of civilian clubs and venues across the country started hosting their own celebrations, often without the involvement of a single individual who had fought at Waterloo. Nor did the civilian co-option end there. Strictly military events, such as grand reviews and Wellington’s Waterloo banquet were claimed as national celebrations and public entertainments by both the press and Britain’s crowds. By the time of Wellington’s funeral in 1852, 18 June was used as a general day of festivity, often hosting fairs, meetings, and celebrations that had no connection to Waterloo.
Are All Practical Reasons Based on Value?
Authors: Kiesewetter Benjamin
Published: May 2022

According to an attractive and widely held view, all practical reasons are explained in terms of the (instrumental or final) value of the action supported by the reason. Chapter 2 argues that this theory is incompatible with plausible assumptions about the practical reasons that correspond to certain moral rights, including the right to a promised action and the right to an exclusive use of one’s property. The argument is an explanatory rather than extensional one: while the actions supported by the relevant reasons (e.g. keeping a valid promise or respecting property) can be argued to have a certain kind of value, the chapter argues that this value presupposes a moral right, and therefore cannot explain the reason. Reflection on such cases suggests the conclusion that reasons that are subject to normative powers are generally not value-based. This also has important implications for the dialectic between ‘value-first’ and ‘reasons-first’ approaches to normativity.
Deliberation and Moral Motivation
Authors: King Zoë Johnson
Published: May 2022

Philosophers have mistakenly used the phrase “motivation by rightness de re” to refer to motivations whose objects are right-making features. If the “de re” qualifier were used correctly, this phrase would instead refer to a motivation whose object is that the agent acts rightly, but that represents moral rightness under another description. Moreover, many instances of ordinary moral deliberation cannot be fully explained by the hypothesis that deliberators just care about the particular right-making features that they see at stake in their circumstances. They can only be explained by taking deliberators to have a further, overarching concern: a concern to strike the right balance between everything important at stake. And these overarching concerns are often instances of motivation by rightness de re, correctly construed, given the conceptual role of ordinary deliberators’ judgments that a certain action strikes the right balance. These observations challenge various criticisms of motivation by rightness de dicto.
The Sjögren’s Foundation
Authors: Church Janet E.
Published: May 2022

Founded in 1983, the Sjögren’s Foundation is the only nonprofit organization in the United States that has Sjögren’s disease as its sole focus. The efforts of the Sjögren’s Foundation are targeted to both patients and providers and include raising awareness of the disease, building community, providing education, and developing and disseminating both information and resources. Another priority of the Foundation is funding innovative research aimed at improving the understanding, diagnosis, and treatment of this complex disease. The Foundation approaches its work from a patient-first perspective as it continues to foster and grow a community focused on conquering the complexities of Sjögren’s.
The Impact of Living with Sjögren’s
Authors: Makara Matthew
Published: May 2022

The complex nature of Sjögren’s can impact patients in a variety of ways, which can have a compounding effect on patients’ quality of life. Physically, the disease can manifest throughout the entire body. In addition to systemic dryness, Sjögren’s patients experience fatigue, internal organ involvement, neuropathies, and much more. The financial burden due to direct and indirect costs can be immense, with many Sjögren’s patients experiencing disruptions or reductions in their ability to work. A majority of Sjögren’s patients experience “brain fog” and a decreased ability to concentrate. Sjögren’s also has a huge impact on emotional health, with many patients experiencing struggles with coping and negative impacts on mood. A better understanding of how Sjögren’s impacts a patient’s life can help inform optimal healthcare decisions, assist loved ones in better understanding what is happening, and help patients cope and live their best lives possible.
Genetics and Sjögren’s
Authors: Sivils Kathy L.
Published: May 2022

Humans carry approximately 22,000 genes on 23 chromosomes that determine our physical traits and act as a guide to how cells function. Consisting of four nucleotides, DNA is a double-stranded, helical molecule that signals RNA to transcribe molecules made from 20 amino acids. Sjögren’s is characterized by being a complex gene disorder with several distinct single nucleotide polymorphisms. Genotyping is in its infancy as it relates to Sjögren’s, but thus far investigators believe that certain variants in HLA-DQ, HLA-DR haplotypes and STAT4 and IRF genes are associated with it. These markers and variants are associated with T and B cells and promote inflammatory and autoimmune reactions. Epigenetics, a new field of genetics, addresses how genes can be modified by one’s environment or behaviors, and this might also contribute to disease development.
Causes of Exocrine Gland Dysfunction in Sjögren’s
Authors: Kapsogeorgou Efstathia K. , Voulgarelis Michael , Tzioufas Athanasios G.
Published: May 2022

The secretory function of the exocrine glands is a perplexing and tightly regulated process. The glands must readily respond to internal and external stimuli or environmental changes to facilitate the hydration, lubrication, and protection of tissues, organs, or cavities that are easily accessible or in direct contact with exogenous factors and pathogens. Especially in Sjögren’s, identification of the cause is exacerbated by the complexity of the disease, the variety of the pathogenetic mechanisms underlying disease pathogenesis, and our inability to identify the offending factors. The identification of the offending factors of epithelial activation and the role of the latter in the observed epithelial secretory dysfunction is of great importance for the understanding of disease pathogenesis and the development of effective therapeutic interventions.
Dry Mouth
Authors: Wu Ava J. , Daniels Troy E.
Published: May 2022

Sjögren’s disease affects the salivary glands, which are responsible for making and secreting a complex fluid that provides a multitude of protective and essential functions. The reduction or loss of saliva results in a decrease of these essential functions and significant oral discomfort and pathology. However, loss of saliva and a complaint of “dry mouth” can be the result of diverse causes. Some of these diverse causes require different treatment. Thus, it becomes important to evaluate the cause of a complaint of dry mouth and the severity of salivary dysfunction. With this knowledge, individualized preventive measures may be promptly initiated to reduce symptoms and to minimize the impact of dry mouth on the oral cavity.
Management of Dry Eye in Sjögren’s
Authors: Donshik Peter
Published: May 2022

Dry eye is a very common finding and is caused by many conditions. In Sjögren’s, the autoimmune disease causes dry eye. The practitioner should rule out infection, non-immune-related sources, or dryness susceptibilities for infections. Dry eye disease is managed by educating the patient, using ocular lubricants, modifying the local environment (e.g., humidification), lid hygiene, autologous tears, and tear conservation. Additionally, systemic anti-inflammatory approaches are used. While there are now more treatment options, management is an art that should be based on the best scientific evidence available. The stepwise approach discussed in this chapter is an attempt to offer a reasonable approach to the management of dry eye disease rather than a rigid cookbook management tool.
Management of Other Sicca Symptoms in Sjögren’s
Authors: Abboud Soo Kim , Haddad Leila M.
Published: May 2022

Complications of chronic inflammation, dryness, and glandular atrophy are common in Sjögren’s. Nasal symptoms include nosebleeds, sinusitis, septal perforation, and allergic rhinitis. Auditory manifestations may present as hearing deficits, chondritis, and tinnitus. Laryngeal involvement can produce swallowing difficulties and hoarseness and is associated with polyps as well as gastroesophageal symptoms. The underlying cause of these nasal, otologic, and oral symptoms should first be ascertained. A general principle is to promote humidification measures, avoid drying agents (e.g., antihistamines), and use irrigation as needed (nasal saline, neti pot). Associated inflammatory conditions such as chondritis or vestibulitis respond to corticosteroids or other immunosuppressives, but these should be used sparingly due to their side effects. Ear pain can be relieved with a variety of approaches that decrease Eustachian tube dysfunction and improve moisturization of the nasal and oral cavity. Management of laryngeal involvement consists of anti-reflux measures such as proton pump inhibitors as well as mucolytic agents.
Complementary, Alternative, and Integrative Approaches to Health in Sjögren’s
Authors: Makara Matthew
Published: May 2022

People often incorporate non-mainstream or nontraditional approaches to health in hopes of achieving a better quality of life. These approaches can complement traditional medicine (complementary health), replace it (alternative health), or be used along with it in a coordinated fashion (integrated health). Nontraditional approaches include nutritional changes (including supplementation), mind–body techniques, exercise, and body-based methods. In patients with Sjögren’s and other autoimmune diseases, a relatively limited body of research is available about these modalities. However, as our understanding of the disease continues to increase, there is reason to be optimistic that a more precise approach and guidance will be available to manage the many complications of Sjögren’s.
Sjögren’s Foundation Clinical Trials Consortium
Authors: Ford Theresa Lawrence
Published: May 2022

The Sjögren’s Foundation Clinical Trials Consortium is a collaborative effort of industry, patient advocates, academicians, basic scientists, and community practitioners to promote the development of newer and improved treatment for the disease. Its initiatives include online training programs, dissemination of information regarding metrics for ascertaining disease activity, and engagement with governmental agencies such as the U.S. Food and Drug Administration and the National Institutes of Health. During its relatively short time in existence, the consortium has already made a meaningful difference on clinical trials in Sjögren’s. The consortium will continue to work for and support the development of new therapies for Sjögren’s. As it was when the group first formed, its goal of identifying barriers to successful clinical trials and finding ways to bring the international community together to address these barriers will always be the top priority for the Sjögren’s Foundation.
An Awakening: Brazil
Authors: Spalding Andrew
Published: May 2022

The forces described in Chapters 1 and 2 first collided in Brazil as it hosted the 2014 FIFA Men’s World Cup and 2016 Rio de Janeiro Summer Olympics. Brazil may be understood as an awakening to a historic moment in which hosting megasports coincides with human rights and anti-corruption reforms, raising a new possibility. Brazil’s notoriously systemic corruption has deep roots in a history of colonization and military dictatorships. However, in the mid-2000s this BRIC nation became the third country to consecutively host the Olympic Games and FIFA Men’s World Cup. A season of historic economic optimism would abruptly end with the 2008 global financial crisis. Brazil’s resulting recession elicited widespread perceptions that the government was mismanaging money, and megasport spending was among the public’s principal complaints. When mass protests erupted in 2013, the national legislature responded by enacting two significant pieces of anti-corruption legislation. These laws gave prosecutors new tools they used to undertake the most far-reaching anti-corruption enforcement action in history, called Operation Lavo Jato. Megasport corruption scandals were part of a constellation of forces that accelerated the implementation of these standards. Neither megasport organizers nor national lawmakers intended these reforms to be a legacy of the sporting events. Nor did the reforms include a significant human rights component. As such, Brazil presents a legacy this book calls reactive, accidental, and one-dimensional. The Brazilian experience is the first in a series of megasport events that collectively suggest the possibility of a human rights and anti-corruption legacy.
A Pattern Emerges: South Korea
Authors: Spalding Andrew
Published: May 2022

As if by script, an astonishingly similar pattern played out in the following Olympic Games. South Korea, host of the 2018 Pyeongchang Winter Olympics, also sought and was awarded the Games at a time of historic economic optimism. But South Korea’s combination of strong-armed leadership and cozy relations with select family-run business conglomerates, called chaebol, led to rising concerns about government corruption. A triggering corruption scandal in 2014, unrelated to megasports, led to the enactment of a landmark anti-corruption law, the Kim Young-ran Act, and a public corruption investigation called Choigate that exposed Olympics-related corruption. Collectively, these events fundamentally altered deeply seated cultural norms and social practices in the public and private sectors. Standing alone, South Korea would not present a particularly compelling case for the human rights and anti-corruption legacy, given the relatively minor role of megasports in the country’s reform movement. Moreover, and similar to Brazil, these reforms were never planned or intended as megasport legacies, and did not significantly involve human rights reforms. As such, South Korea’s legacy is again reactive, accidental, and one-dimensional. Still, juxtaposed with Brazil a pattern emerges, within which lurks an opportunity. These two countries together suggest a possibility that megasports can accelerate the implementation of anti-corruption and/or human rights norms, practices, policies, and laws that endure long after the event. As the next chapters show, subsequent hosts would take further steps in developing the potential of megasports to leave a pro-active, intentional, and two-dimensional legacy.
Why Decolonize?
Authors: Lenette Caroline
Published: May 2022

The potential of Participatory Action Research (PAR) as a decolonial intersectional methodology has been underrecognized. Discussions on PAR, especially in western institutions and scholarship, often gloss over its origins grounded in reflexive research practice and debates in majority-world countries. However, this is precisely why PAR can be an effective tool to decolonize research, knowledge production, and the academy. Chapter 2 explains why it is crucial to engage in decolonial research, using Indigenous PAR and Black Participatory Research as examples. The author describes the significance of the concept of intersectionality and outlines how decolonial intersectionality can enrich participatory research and produce meaningful findings in collaboration with co-researchers who are multiply marginalized. Yusra Price’s vignette recounts two incidents in the context of facilitating decolonial, participatory research activities in South Africa as a brown, Muslim woman from Cape Town. She reflects on her facilitator role and shares insights on how she addressed tricky situations as they emerged during workshops.
How Do We Influence Policy?
Authors: Lenette Caroline
Published: May 2022

Participatory Action Research (PAR) projects yield co-researcher-led recommendations for action that can be translated into strategies to influence policy and effect broader level change. However, without explicit aims to target policymakers from the outset and share or disseminate findings to influence decision-making, collaborative knowledge translation plans can fail to achieve such changes. Chapter 7 describes how PAR outcomes can affect policy and the key obstacles to knowledge translation, such as research–policy gaps and lack of opportunities to disrupt policy. The author outlines the importance of an intersectional feminist policy analysis framework to address enduring inequalities. In Nelli Stavropoulou’s vignette, she reflects on whether participatory research can achieve social justice outcomes, especially in complicated policy contexts. She suggests that participation and action are in fact two constructs along a continuum rather than distinctively different notions. Nelli’s concluding thoughts on the potential of participatory research summarize our responsibilities when engaging in research for social and policy change.
Rise
Authors: Gerstle Gary
Published: May 2022

The New Deal order was established following the dual crises of the Great Depression and the Second World War. In the postwar years, the American public, labor unions, and even business constituencies increasingly accepted the need for government management of the economy, firm regulation of markets, and state provision of welfare paid for by progressive taxation. Although some Republicans, led by Senator Robert Taft, continued to oppose the expansion of state authority, they were neutralized politically by the onset of the Cold War and the threat posed by international communism to American national security. The elevation of Dwight D. Eisenhower to the presidency in 1952 signaled that the Republican Party was acquiescing to the electoral and ideological hegemony of the New Deal. Those who continued to oppose the New Deal order were relegated to the margins of political life.
Ascent
Authors: Gerstle Gary
Published: May 2022

In the 1970s, the business community, and in particular “proprietary capitalists” who resented New Deal regulation, began to funnel funds to a neoliberal “counter-establishment” formed of intellectuals, think tanks, and right-wing media. The leader of the neoliberal revolution was Ronald Reagan, who assembled a winning electoral coalition in 1980 by peeling away disaffected elements of the New Deal coalition, including white urban voters in the North, southern whites, and evangelical Christians. As president, Reagan slashed taxes on the wealthy, accelerated deregulation, and appointed judges who favored an “originalist” interpretation of the constitution to the Supreme Court. The neoliberal order was buttressed by the repeal of the Fairness Doctrine that ensured balance in media reporting and by a neo-Victorian moral code of personal responsibility that neoliberals believed would contain the socially disruptive effects of the free market. Reagan’s electoral success pushed Democrats associated with the Democratic Leadership Conference to embrace neoliberalism.