bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporality and Alterity: Dimensions of Hermeneutic Distance
Authors: Garfield Jay L
Published: November 2023

Hermeneutic theory is always concerned with historicity and with the horizons, prejudices, and purposes that determine and give urgency to the act of interpretation. So let me begin with a few remarks about the situation in which I find myself, and which leads me to this tentative and open-ended query of my own philosophical activity.
Where Are They?
Authors: Katz Jonathan I
Published: November 2023

The hardest problem in astronomy is to find the distance to an astronomical object. It is not possible to pace out the distance or extend a tape measure. Radar has been used to determine distances in the solar system by measuring the time required for a radar pulse, traveling at the speed of light, to bounce off an object and return to us. This method does not work outside the solar system because the time required for the pulse to return would be too long (8 years for the nearest star), and because the returned signal would be undetectably faint.
Aiming Higher
Authors: Ogilvy James A
Published: November 2023

The future could be better than the present. The future should be better than the present. A large part of the glory of being human lies in our ability to imagine better futures and make them happen. But a large part of our history records the suffering of people who were sold a bill of goods about a better future—holy wars in the name of building the kingdom of God on earth, failed revolutions fought in the name of a better life after the revolution, the final solution that would bring the thousand-year Reich. Idealism can be dangerous. We know this.
Rethinking Representative Government
Authors: Ogilvy James A
Published: November 2023

If markets can’t do all of the things we want them to do, but governments are a relic of the political era we’re leaving behind as we enter the economic era, then how are we going to solve the problems that markets can’t solve? If markets create winners and losers, then a market in education will produce geniuses and illiterates.
Better Education
Authors: Ogilvy James A
Published: November 2023

Back in the early 1980s, well before the Cold War had ended, a very brainy group from the John F. Kennedy School at Harvard convened other experts like Robert MacNamara, the late Representative Les As pin, and a former Ambassador to Austria for a week in Wyoming. The agenda: to entertain alternatives to nuclear deterrence 50 years into the future. I was asked to attend not because I knew anything about strategic arms, but to help manage the process of alternative scenario development.
F
Authors: Castro Rafaela G
Published: November 2023

Literally, a fajita is a little belt, or little strip. It is used to mean a cut of beef that in English is called a skirt steak. Since it is a tough cut, the meat is cooked by first broiling it, and then cooking it in a dry pan with lime juice. When ordering fajitas in a restaurant, most people don’t know that it refers to the cut of the meat and not to the seasonings. The cut was very common in northern Mexico and south Texas before it was found in other parts of the Southwest and in the country as a whole. In Mexico this cut of beef is called arracheras, and has always been eaten, whereas in the United States the cut was ground up for hamburger. Today in contemporary restaurants one can find chicken and shrimp dishes that are called fajitas; they are served sizzling hot, with guacamole, pico de gallo, and tortillas. But in reality fajitas are strictly beef.
L
Authors: Castro Rafaela G
Published: November 2023

La Leyenda Negra is the term used for a myth that describes a very negative attitude many believe pervades the historical perspective regarding Hispanics and Mexicans. The Black Legend embodies a belief that Spaniards are basically a cruel, evil, lazy, greedy, treacherous, and fanatical people. It originated in the era of Inquisitorial Spain and has misrepresented the history of Spain since the l 500s. The printed history of the conquest of the New World depicts a violent and corrupt invasion, but there is a belief that the Black Legend has influenced the way this history has been written.
T
Authors: Castro Rafaela G
Published: November 2023

This word actually means “a bite,” a snack or even a light meal. When unexpected company arrives at a Chicano home, they are often invited to “comer un taco,” to have a snack. This can mean to have a cup of coffee and pan duke (sweet bread), or a cup of soup, or beans and tortillas. If one is eating with a tortilla, flour or corn, the custom is to break off a small piece; use it to scoop up a piece of meat, beans, chile, or whatever one has on one’s plate; and pop the whole thing into the mouth. Some people call these small pieces bocaditos, or “eating your spoon,” but it is basically eating a lot of small tacos. But if the whole tortilla is filled with meat, chile con came, or whatever, and rolled up, it is called a taco. The tortilla may be fried crispy, which also adds flavor, or may be left soft, and the filling mixture may be chicken, beans, beef, fish, vegetables, or cheese. Consequently, a tortilla rolled up and filled with anything is considered a taco. The contemporary American taco is filled with ground beef, cheese, lettuce, tomato, and chile salsa and thanks to many fast food restaurants has become part of the American diet. A corn tortilla rolled up tightly around chicken or cheese, fried crispy, and topped with guacamole, chile, and sour cream, is not a taco but a taquito or a flauta, depending on what state or country you’re in at the moment.
Z
Authors: Castro Rafaela G
Published: November 2023

A style of suit worn by African Americans, Filipino Americans, and Mexican Americans during the 1930s and 1940s. In Chicano culture this style of dress is primarily associated with the pachucos of the 1940s. The fashion at that time was to wear very baggy pants with pegged legs, long jackets with high and sharp shoulder pads, thick-soled shoes, and long watch chains dangling from the belt. An addition to the whole style common to Chicanos was a particular haircut, long with a ducktail and a wide-brimmed hat.
Studying the Enemy
Authors: Blee Kathleen M
Published: November 2023

For two decades of studying organized racism, I have been careful to maintain as much anonymity as possible, revealing little about myself to the racist activists I meet. So in writing this chapter I feel particularly exposed, although this is an apt time to reflect on my entanglement in the study of organized racism. After years of emotional gymnastics, I’ve decided to stop doing this kind of research. Studying the racist right has been intellectually and politically rewarding but personally too difficult. The reasons that this is the case may suggest lessons that are useful to other scholars, even those with less unsavory research interests. Since the early 1980s, I have studied racist groups in the United States. Concretely, this means I have spent countless hours in disgusting tasks: reading vicious propaganda about African Americans, Jews, gay men and lesbians, non-Caucasian immigrants, and others; transcribing the messages of racist telephone “hate lines,” radio programs, cable TV shows, and videos; hanging out at racist rallies and headquarters; and locating and interviewing dozens of people who see the meaning of their life as eliminating or expelling from the United States people like me and those I love. How did I, a white woman from the Midwest, a leftist and feminist academic, find myself in this profoundly unpleasant line of work? And why did I then decide to leave it?
Making Problems Reflections on Experience and Research
Authors: Walton John
Published: November 2023

The writer who is to be anything more than an echo of his predecessors must always find expression for something which has never yet been expressed, must master a new set of phenomena which has never yet been mastered. With each such victory of the human intellect, whether in history, in philosophy or in poetry, we experience a deep satisfaction: we have been cured of some ache of disorder, relieved of some oppressive burden of uncomprehended events.
Unscripted: Continuity and Change in the Gendered Life Course
Authors: Moen Phyllis
Published: November 2023

In 2001, Katharine Graham, former publisher of the Washington Post and Newsweek, died as a consequence of a fall while on a trip to give a speech. She had published a Pulitzer Prize-winning autobiography in 1997,1 depicting a life that was as unscripted and accidental as my own. Graham, whose father and husband were publishers of the Washington Post, became the publisher of that newspaper herself quite suddenly and unexpectedly when her husband committed suicide. Graham said that “the only reason I had my job was the good luck of my birth and the bad luck of my husband’s death.”
Confessions of an Accidental Sociologist
Authors: Skolnick Arlene
Published: November 2023

In the fall of 1969, I found myself newly arrived and unemployed in a southern California beach town. We had fled there-my husband, Jerry, and I and our two young sons, Mike and Alex-from the seemingly endless turmoil of Berkeley at the time, especially the tear gas drifting from the campus to our house and my older son’s elementary school. Jerry had taken a job at a newly formed branch of the University of California. I was planning to continue what had seemed a viable academic career as a researcher, as I had done at Berkeley’s Institute of Human Development (IHD). Now, however, in a much smaller and newer university and in a different fiscal climate, it seemed as if that plan wasn’t going to work. The funding for the project I had been invited to join did not come through. Weeks of looking around did not turn up any other possibilities. Despite the sunshine, the sea air, and the beaches, I began to feel discouraged and depressed. One particularly low moment remains vivid. I had gone to talk to the chair of the psychology department, a man I shall call Ted, to see if he knew of any possibilities.
Writing as a Democrat and a Feminist
Authors: Mansbridge Jane
Published: November 2023

Democracy implies feminism, and feminism implies democracy. The two causes that have impelled my research are logically and reciprocally related. In my own life, though, each had separate roots, meeting and intertwining in the 1960s. I was always a bit of a misfit. I attributed my differences from others to my father’s being English. That’s why, I thought, we didn’t have a TV set when everyone else did. That’s why I had a funny accent, saying “bean” instead of “bin” for “been,” so that the kids in third grade danced around me shouting, “‘Been’-bean-stringbean!” (I was pretty skinny). I identified with people who didn’t quite fit in.
Decoding Dichotomies and Pushing the Boundaries: A Lifetime of Research on Women in the Professions
Authors: Epstein Cynthia Fuchs
Published: November 2023

This account of my research on the cultural and structural underpinning of gender distinctions-focusing on women’s participation in the legal profession-begins more than three decades ago. At the time it was initiated, the research topic was unusual, as were the individuals I set out to study: the “deviant cases” of women practitioners in an elite profession. Since that time, women’s roles in society--especially in the workplace and particularly in the top professions-have changed radically and research on them has proliferated, engaging several subsequent generations of researchers. Along with these changes has been the questioning of the analytic frameworks that had accounted for (and often justified) women’s exclusion.
Outlines of Pyrrhonism
Authors: Floridi Luciano
Published: November 2023

We have already encountered the latin translations of Sextus’ writings. This chapter provides a more detailed analysis. In the Appendix 3, the reader will find the stemmatics of the Latin translations of PH and M in relation to the Greek mss.
α1 Antitrypsin Deficiency
Authors: schwarzenberg Sarah jane , Sharp harvey L
Published: November 2023

The patient was a 35-year-old white male with 1-antitrypsin deficiency. He received a combined liver-kidney transplant for cirrhosis complicated by portal hypertension, renal insufficiency secondary to membranoproliferative glomerulonephritis, and combined restrictive and obstructive pulmonary disease at age 18 years. Jaundice and pruritus were observed at age 6 weeks and resolved spontaneously after approximately 2 months. He was hospitalized for pneumonia at age 20 months, and an enlarged liver was noted. A percutaneous needle biopsy specimen from the liver was interpreted to show postnecrotic cirrhosis, although reevaluation of the biopsy specimen showed the presence of globules that were periodic acid–Schiff (PAS) positive, diastase resistant (Fig. 4-1). He was then referred to our institution at age 2.5 years for liver transplantation.
Pyruvate Dehydrogenase Complex Deficiency
Authors: Stacpoole Peter W , Gilbert Lesa R
Published: November 2023

Identical twins with the fictitious names Ann and Elizabeth were born 6 weeks prematurely to a healthy 26-year-old mother whose pregnancy was uneventful. The family history was noteworthy for epilepsy in a paternal aunt, congenital deafness in another paternal aunt, and possible mental retardation in a maternal cousin. The twins’ sister was a healthy 3-year-old girl with the same biological father. The birth weight was 3 pounds 9 ounces for Ann and 3 pounds 12 ounces for Elizabeth. Apgar scores (numerical expressions of the condition of a newborn infant; based on assessment of heart rate, respiratory effort, muscle tone, reflex irritability, and color) 1 and 5 minutes after birth were 8 and 9 for both girls (maximum score is 10). Other than prematurity, neither child evidenced physical or laboratory abnormalities, and they were discharged home within 2 weeks (for Ann) and 3 weeks (for Elizabeth), both apparently in good health. The mother subsequently remarried and gave birth to a son, who has remained well through age 6 years.
Mitochondrial Encephalomyopathy, Lactic Acidosis, and Strokelike Episodes (MELAS): A Case of Mitochondrial Disease
Authors: Castora Frank J
Published: November 2023

A 17-year-old Caucasian female was referred to a neurologist following a 3-day episode of severe headache accompanied by repeated vomiting. She complained of weakness in her arms and legs and of a general feeling of fatigue, especially after minor amounts of exercise, which left her “feeling exhausted.” She indicated that she had suffered from migraine headaches “since she was little,” and during her recent episodes she had auditory and visual hallucinations. Her speech was slurred, and she had slight paralysis of the right side (hemiparesis).
Neonatal Hypoglycemia and the Importance of Gluconeogenesis
Authors: Holzman Ian R , milley J Ross
Published: November 2023

Female infant L. weighed 3.98 kg at birth to a 29-year-old mother after a 35-week pregnancy. Mrs. L. was an insulin-requiring diabetic who had had type 1 diabetes since she was 15 years old and had not yet shown signs of vascular disease. Her pregnancy had been complicated by multiple episodes of hyperglycemia (excess sugar in the blood) and glycosuria (presence of abnormal amounts of sugar in the urine). Her prenatal care was only episodic because her husband had been part of a layoff at work, and the family was without health insurance. On the day of delivery, Mrs. L. had a routine nonstress test (a test that records changes in fetal heart rate with fetal movement and is used to assess whether the fetus is suffering from a lack of oxygen or blood flow to the brain) because she noticed that her fetus had decreased movement over the preceding 2 days. The nonstress test showed a flat baseline heart rate without any variation, a finding suggesting that the fetus was at risk for asphyxia (lack of oxygen leading to an accumulation of lactic acid and carbon dioxide in the blood).
Glucose 6-Phosphate Dehydrogenase Deficiency and Oxidative Hemolysis
Authors: Burton Catherine , Kaczmarski Richard
Published: November 2023

A 50-year-old female presented passing black urine after having been unwell for 3 days with fever and headache. There was no previous history of blood disorders, anemia, or similar symptoms. Past medical history included a diagnosis of multiple sclerosis. Treatment included steroids and high-dose vitamins and minerals. Her nephew was reported to suffer from favism (an acute hemolytic condition occurring after ingestion of a certain species of bean [Vicia faba] in individuals with glucose 6-phosphate dehydrogenase [G6PD] deficiency). There was no recent history of travel or malaria exposure.
Neonatal Hyperbilirubinemia
Authors: Fahl Jeffrey C , Vanderjagt David L
Published: November 2023

A newborn male was the product of a 37-week gestation to a primagravida female whose blood type was O and Rh positive. During the pregnancy, the tests for syphilis and hepatitis B were negative. The pregnancy was uncomplicated, and the mother received excellent care. She denies alcohol consumption and does not smoke. The labor was prolonged, but the delivery was spontaneous and vaginal. The child was vigorous, active, and breathing spontaneously. Prior to delivery, the mother decided to breastfeed and the child was allowed to suckle immediately following birth. The initial physical exam revealed a birth weight of 2775 g, a birth length of 48 cm, and a head circumference of 33 cm, which are within normal limits for a near-term male child.
Abetalipoproteinemia
Authors: Rava Paul , Hussain m. Mahmood
Published: November 2023

A 28-year-old man who immigrated to the United States a few years ago saw his primary care physician for mild recurrent abdominal discomfort and diarrhea. Past medical history was benign except for what the patient referred to as “occasional abdominal distress.” Further discussion revealed this to include diarrhea, flatus, and abdominal pains. He described the stool during these episodes to be greasy, pale, and foul smelling. Family history was unremarkable. Both of his parents, as well as three siblings, had no history of abdominal symptoms. The patient had been diagnosed with celiac disease and treated with a gluten-free diet at a previous visit. Even though he was compliant with dietary instructions, symptoms continued for the next year. The patient noted that he had experienced these symptoms periodically throughout his life, but that they had worsened since his arrival in the United States. He had not traveled since his immigration and had no pets or recent animal exposures, and there was no association between his abdominal discomfort and specific foods. He denied past or present use of drugs or alcohol and took no medications. Concerned that celiac disease may have been a misdiagnosis, a physical examination, blood tests, and a diagnostic procedure were performed.
Vitamin B12 Deficiency
Authors: Vanderjagt Dorothy J , Mccarthy Denis M
Published: November 2023

The patient, an 84-year-old male resident of a veteran’s home, was admitted to the hospital following a fall in which he had sustained a fracture of his left radius and several lacerations. Physical examination on admission revealed a well-nourished elderly male in no great distress (body mass index (BMI), 22.5 kg/m2). He was moderately confused but with prompting was oriented to time, place, and person. There was no obvious pallor, cyanosis, or jaundice, and his skin and mucous membranes were unremarkable apart from the injuries he sustained in the fall. His right lower extremity was swollen and tender, and he walked cautiously and with a pronounced limp. His blood pressure was 145/85 mm Hg (normal is 120/80 mm Hg). His pulse rate was 80 beats per minute (normal is 75 beats per minute), and his respiratory rate was 16 per minute (normal is 12–14 per minute). His temperature was 98.2°F (normal is 98.4°F). Except for a soft systolic ejection murmur in the neck and in the left parasternal area, his cardiovascular, respiratory, abdominal, and genitourinary systems were all normal. The neurological examination was normal except for impaired cognitive function, a positive Romberg sign, and equivocal plantar responses. (A patient is considered to have a positive Romberg sign when, in a standing position, the patient is more unsteady with eyes closed than with eyes open. This indicates a loss of proprioceptive control.) There were no signs of head injury.
Vitamin A Deficiency in Children
Authors: Wongsiriroj Nuttaporn , Wasantwisut Emorn , Blaner william S
Published: November 2023

A boy aged 3 years and 8 months was admitted to a local hospital in Thailand with the following symptoms: high fever, difficulty breathing, and diarrhea with approximately 10 episodes per day lasting 1 week. The child showed eye symptoms (see Fig. 29-1), including Bitot’s spot and corneal xerosis, that were consistent with the early stages of xerophthalmia, the clinical syndrome associated with vitamin A deficiency. (The clinically defined stages of xerophthalmia are provided in Table 29-1.) Night blindness was also identified through interview of the parents using the local term for night blindness. (For cultures in which vitamin A deficiency has been common, there is often a specific term in the local language for night blindness.) Concomitant with vitamin A deficiency, the child was diagnosed as experiencing protein-energy malnutrition type 2 (moderate), pneumonia, and chronic diarrhea. The boy spent 14 days in the hospital and was treated with vitamin A capsules (200,000 IU/day) on days 1, 2, 3, and 14 as well as with standard antibiotics for the infections. Following treatment with vitamin A, the child’s eye symptoms disappeared, and his vision returned to normal. He continued to receive vitamin A capsules providing 200,000 IU every 3–6 months throughout his childhood.
Calcium-Deficiency Rickets
Authors: Vanderjagt Dorothy J , Glew Robert H
Published: November 2023

The patient was a 3-year-old female who lived with her family in a rural village in northern Nigeria that was situated 40 miles distant from the nearest urban center. She was the fifth of eight children. Her parents were subsistence farmers who grew millet and maize that, together with a small vegetable garden, provided most of the family’s diet. Because of their high cost, dairy products were rarely consumed by the parents or children. The patient was brought by her mother to the local community health clinic because the child had a bacterial infection on her knee. The infection was successfully treated with a 10-day course of antibiotics. During that clinic visit, the physician noted that the patient’s legs were severely bowed (genu varum) (Fig. 30-1) and advised the mother that it would be beneficial for the child to receive a more thorough examination at the teaching hospital in the nearby city. She also noticed that the patient’s 6-year-old brother had a pronounced “K-leg” (rotation of knees toward one another, genu valgum). However, the youngest of the eight children, a 1.5-year-old girl who accompanied the mother and who was still being breast-fed, exhibited no evidence of outstanding skeletal problems.
E. P. Thompson and Methodism
Authors: Hempton David , Walsh John
Published: November 2023

E. P. Thompson’s general picture of religion and the working classes in early industrial England arose from his controversial portrait of English Methodists. The dramatic brilliance of his influential book, The Making of the English Working Class, in which that portrait appears, has generated enormous interest on both sides of the Atlantic since its publication in 1963. There is scarcely a serious wott: of historical scholarship on the Methodist tradition in tl1e North Atlantic world that does not cite Thompson, either as exemplar or pariah1. Although Thompson was hardly an uncritical admirer of Methodism in Wesley’s day, he turned most of his firepower on the generation that emerged after Wesley’s deatl1 in 1791. His picture of second-generation Metl1odists becoming, wittingly or unwittingly, the facilitators of dehumanizing industrialization and political repression has become such an important reference point for all those interested in the modern social history of religion tl1at an examination of Thompson’s own history with Methodism is long overdue. Thompson’s striking account of evangelical Protestantism, money, and industrial capitalism arose not from disinterested observation but, as this chapter will show, from a personal history steeped in tl1e very tradition he came to challenge.
Competitive Militance: Civilian Military Organizations and the Destabilization of American National Security
Authors: Kaufman Jason
Published: November 2023

It has been customary, since at least the late nineteenth century, to view military power as an extension of the legitimate authority of the state (except, of course, in cases of unsanctioned violence or insurrection).1 The American experience, however, gives lie to the assumption that there is a clean analytical divide between state and civil society when it comes to military matters. Lacking either a sizable standing army or an effective state militia, nineteenth-century American national defense policy relied on the military preparedness of ordinary citizens in time of need. Until 1903, in fact, when Congress officially reorganized the National Guard, responsibility for defense was loosely divided among federal, state, and independent forces. Among the independents were voluntary militia companies, shooting clubs, and paramilitary organizations, many explicitly organized around ethnoreligious lines. German-American turner vereine and schutzenbunde, the Irish-American Hibernian Guards, and Czech sokol societies were all nineteenth-century incarnations of this tradition of ethnic military training and self-protection.2
Ethnogenesis: Social Capital, Racial Protectionism, and Sectarian Social Organization
Authors: Kaufman Jason
Published: November 2023

Thus far, I have argued that competitive voluntarism contributed to sectarianism and self-segregation in the United States by providing organizational boundaries dedicated to the perpetuation thereof. Admittedly, however, American associationalism may not have flourished without the impetus of racial hatred, religious disrespect, gender segregation, and ethnic suspicion fueling it from below. In the face of such outward hostility and discrimination, many identity groups turned inward, relying on fraternal organizations and mutual aid societies for help and support in an otherwise hostile world. As one history of the Knights of Columbus organization declares, “Fraternalism was the chosen medium for fashioning a unique expression of Catholic Americanness. … The ceremonials of the Order instructed the initiates in these lessons and satisfied their need for forging strong fraternal ties in an otherwise antagonistic social and cultural climate.”1
Spectral Classes, Temperatures, and Doppler Shifts
Authors: Pickover Clifford A
Published: November 2023

The next morning Bob slowly sits up in bed, pushes aside his blankets, and turns on The Today Show. The remote control is temporarily embedded in his right hand. Bob pushes a button, and one of the Picasso paintings on his wall suddenly transforms into a TV screen.
The Psychiatric Evaluation
Authors: Cohen Bruce J
Published: November 2023

In taking the psychiatric history and performing the mental status examination, the goal of eliciting the key data necessary to generate a differential diagnosis must be balanced against the goal of establishing some rapport and an initial alliance with the patient, who may be quite distressed at the time. Sometimes the clinician has to take a step backward from one goal in order to step forward toward the other, especially in the case of patients who are cognitively impaired, agitated, or suspicious. A third goal is to achieve the first two goals in a timely manner. The less time that is available for the interview, the more structured and directive the interview must be. An evaluation in the emergency room setting may take 30–60 minutes, while a more comprehensive outpatient evaluation may last for over 90 minutes. Here is one version of the history and mental status examination. Where possible, I have indicated the minimum requirements for those situations where a briefer assessment is appropriate. The major sections of the psychiatric history are listed in Table 2–1, while the major elements of the psychiatric mental status examination are listed in Table 2–2. Following discussion of the history and mental status examination, we will discuss the physical examination and the use ancillary services such as psychological testing and clinical laboratory assessment.
Dementia
Authors: Cohen Bruce J
Published: November 2023

A recent study estimated that the annual cost of all forms of dementia in the United States was somewhere between $20 billion and $38 billion and that the annual cost of caring for Alzheimer’s disease patients was as high as $47,000 per patient per year. The cost is expected to increase as the number of patients with dementia increases. In 1985 there were 2.4 million Americans with moderate to severe dementia, and this number is expected to increase to between 6.1 and 9.8 million by 2040; the care of these persons will cost up to $149 billion annually. This projected increase is due to the aging of the U.S. population since the prevalence of dementia increases with advancing age. Five percent of Americans over age 65 have a severe dementia. The prevalence doubles every 5 years through about age 80, reaching about 50% by age 85. However, dementia is not an inevitable part of the aging process, and most elderly patients are not demented. In this chapter, we will discuss dementia primarily from the disease perspective, exploring its phenomenology, the various pathologies associated with dementia, and the etiologies associated with these pathologies. Along the way, we’ll distinguish dementia from two less severe conditions, mild cognitive impairment and amnestic syndrome.
Schizophrenia and Other Psychotic Disorders
Authors: Cohen Bruce J
Published: November 2023

Schizophrenia is a prevalent condition and a significant source of morbidity and mortality. It affects 1% of the population worldwide. In the United States, it accounts for 25% of hospital days, 20% of Social Security benefit days, 10% of the disabled population, and 2% of the gross national product. Thirty percent of patients with schizophrenia attempt to kill themselves at some point; 10% of patients with schizophrenia die by suicide. Schizophrenia can be difficult to treat. Twenty percent to 30% of patients respond poorly or not at all to currently available pharmacologic therapies. Relapse rates are very high: 20% of patients who take their medications appropriately experience relapses despite this, while 70% of patients who stop taking their medication relapse within 1 year. Noncompliance rates are also very high: 40% of patients are not taking their medications as prescribed by 6 months following an acute episode of illness. For several reasons, all clinicians need to know about schizophrenia. First, schizophrenia is extremely common and therefore clinicians are certain to encounter it. Second, patients with schizophrenia have higher rates of medical morbidity and mortality than do people in the general population, and these associated medical illnesses often are unrecognized and untreated by physicians. Third, various medical conditions and medications can cause symptoms that resemble those occurring in schizophrenia, and therefore all clinicians needs to be able to recognize which symptoms are most typical of true schizophrenia. Fourth, the antipsychotic medications used to treat schizophrenia are associated with a variety of general medical complications that may require treatment.
Sexual and Gender Identity Disorders
Authors: Cohen Bruce J
Published: November 2023

Sexual behavior is ubiquitous and diverse. Beyond the sex act itself, sexuality permeates our culture and our daily lives. Therefore, as with all of the behavioral disorders, distinguishing “normal” from “abnormal” sexuality can be difficult. For example, there are no bright lines separating “low” sexual desire from “normal” sexual desire, or “premature” ejaculation from “normal” ejaculation. Whether a person even is bothered by a particular aspect of his or her sexuality is significantly influenced by personality, previous developmental experience, extent of education about sex, satisfaction with one’s relationships in general, and surrounding cultural attitudes about sex. Consider premature ejaculation. DSM-IV defines this as persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration, and before the person wishes it. The definition is deliberately subjective, taking into account the quality of the individual’s sexual relationship. Paradoxically, this subjective definition may be more reliable and valid than a definition based on the exact interval between penetration and ejaculation as measured by a stopwatch. Thus, while a man who ejaculates within a minute of vaginal entry might be considered by some people to be “premature,” if he and his wife engage in a half-hour of very pleasurable foreplay, followed by mutual orgasms after a minute of pleasurable intercourse, he could not be considered to have a sexual “dys function.”
Suicide
Authors: Cohen Bruce J
Published: November 2023

Every physician at some point must deal with patients who either previously have attempted suicide or who will commit suicide while under the physician’s care. Suicide is the ninth leading cause of death in the United States, accounting for 30,000 deaths each year. It is especially important for primary care physicians to have some understanding of how to assess for suicidality since most individuals who attempt or complete suicide seek medical treatment shortly before doing so, most often from their primary care physician. People encountered in the primary care setting are at higher risk for committing suicide than are other members of the general population. This likely reflects the higher rate of suicide among people with medical illnesses and also the fact that persons with mental illnesses that predispose to suicide (such as major depressive disorder or panic disorder) also are more likely to require general medical care. Retrospective studies involving individuals who have successfully committed suicide reveal them to have visited their primary care practitioners more often during the 4-month period before the suicide than during the previous 4 months. About 80% of those who commit suicide visit their physician within 6 months of the suicide, 50% within 1 month of the suicide, and 40% within 1 week of the suicide. However, despite this potential opportunity for intervention, doctors frequently do not detect suicidal ideation in their patients.
Violence
Authors: Cohen Bruce J
Published: November 2023

Virtually all clinicians at some point must deal with violence in the course of working with patients. Clinicians may have to manage acutely violent patients in the medical setting. They also may be called upon to determine whether particular patients are at higher risk of engaging in violence. For example, a clinical determination that a patient, as a result of a mental illness, is “dangerous” to himself or others is a prerequisite for involuntary psychiatric hospitalization (civil commitment). In addition, under some circumstances clinicians may find it necessary to take appropriate steps to protect “third parties”— that is, other members of society who might be harmed by the patient. In such situations, the clinician’s societal obligations may come into conflict with ethical obligations to the patient (i.e., respecting the patient’s autonomy and safeguarding the confidentiality of the patient’s disclosures). Like suicidality, dangerousness is not a clinical diagnosis. Unlike suicidality, it does not even describe a specific behavior. Rather, it is a legal term of art that refers to an individual’s general propensity to engage in one or more types of aggressive acts. In addition, a patient’s propensity toward “dangerous” behavior must rise to a particular level of severity before being considered “dangerous enough” to justify involuntary containment.
Forensic Psychiatry
Authors: Cohen Bruce J
Published: November 2023

Forensic psychiatry is a subspecialty of psychiatry that deals with the interface between psychiatry and the law. Two types of interactions occur between psychiatry and the law: psychiatry as applied to the law and the law as applied to psychiatry. With regard to the former, psychiatrists sometimes are asked to provide expert testimony in order to assist the court in making more informed decisions when an individual’s mental state or treatment needs are at issue. Such psychiatric participation occurs in both the criminal and civil legal systems. Table 20–1 offers some examples. With regard to the latter, the area of mental health law subsumes attempts by courts, legislatures, and regulatory agencies to resolve conflicts that sometimes arise between psychiatric patients, clinicians, and the state. The goals of these various parties sometimes are at odds with each other, especially in situations where patients’ rights to refuse treatment are in conflict either with their potential need for treatment or with the community’s interest in protecting public safety. Examples include laws regulating involuntary civil commitment to psychiatric hospitals, laws regulating the boundaries of patient confidentiality, and laws regulating when a patient’s refusal of psychiatric treatment must be respected and when the patient can be treated over his objections.
Whom Does God Consign to Hell?
Authors: Davis Stephen T
Published: November 2023

Christianity traditionally teaches that at least some people, after death, live eternally apart from God. Let us call those who believe this doctrine separationists, because they hold that these people are eternally separated both from God and from the people who are with God. Some Christians, on the other hand, espouse the quite different doctrine known as universalism.1 Universalists believe that all all human beings will ultimately live eternally with God, i.e., that no one will be eternally condemned. Though I am sympathetic with the intentions of those who espouse universalism, I am not a universalist myself, and will argue against the doctrine in this paper. What I will do here is: Let me now sketch what I take to be a strong doctrine of universalism: God does indeed hate sin and does indeed judge sinners. But God’s judgment is always therapeutic; it is designed to bring people to repentance. Thus God’s wrath is an integral part of God’s loving strategy for reconciling people to God.
The Way of the Ascetics: Negative or Affirmative?
Authors: Ware Kallistos
Published: November 2023

"Asceticism means the liberation of the human person," states the Russian Orthodox philosopher Nicolas Berdyaev (1873-1948). He defines asceticism as "a concentration of inner forces and command of oneself," and he insists: "Our human dignity is related to this."1 Asceticism, that is to say, leads us to self-mastery and enables us to fulfill the purpose that we have set for ourselves, whatever that may be. A certain measure of ascetic self-denial is thus a necessary element in all that we undertake, whether in athletics or in politics, in scholarly research or in prayer. Without this ascetic concentration of effort we are at the mercy of exterior forces, or of our own emotions and moods; we are reacting rather than acting. Only the ascetic is inwardly free.
Practical, Theoretical, and Cultural Tracings in Late Ancient Asceticism: Response to the Three Preceding Papers
Authors: Shaw Teresa M
Published: November 2023

Our three papers, which share some points of interest on the general landscape of ancient ascetic behavior, suggest directions or trajectories for a broad discussion of the origins and meaning of ascetic behavior and interpretation in religion and culture. They raise questions of particular interest for those of us studying the Greco- Roman religious world of late antiquity. Clark's paper, especially, raises the question of the social and cultural meanings of ascetic behaviors. What does the renunciation of marriage, a meager diet, simple clothing, or communal living communicate to the dominant culture? How do these behaviors critique or validate existing social and power structures? How do physical techniques and practical lifestyles represent theological formulations? To borrow Clark's terms, does the "negative" act of renunciation allow both negative and positive formulations of its religious and social meaning? Rubenson has challenged our assumptions about class, education, and literary production among early desert monastics and illustrated the ways in which those assumptions have shaped our understanding of the formation of Egyptian ascetic theology.
Primitive Christianity as an Ascetic Movement
Authors: M. Derrett J Duncan
Published: November 2023

How far was primitive Christianity ascetic? What input secured its supersubstantial promises? I approve the approach of Marsilius (c.1275-1342) and here contrast my own Ascetic Discourse (1989) with A. E. Harvey's well-wrought Strenuous Commands (1990) and with other "obstructive erudition" (so named by Albert Schweitzer).
Ascetic Moods, Hermeneutics, and Bodily Deconstruction: Response to the Three Preceding Papers
Authors: Vaage Leif E
Published: November 2023

As increasingly happens of late, I have again been asked to speak out of my ignorance. It is at least something I enjoy doing, and may even do better than I think. All of us who are interested in understanding the ascetic dimension in human life and culture beyond the confines of a certain area of technical expertise will undoubtedly share this experience to some degree. I hope that you will also share my growing sense of intrigue and fascination with the theme taken up by the three papers under consideration, despite the fact that most of what I have to say is patently awash in an unfinished process of reflection.
Dreaming the Body: An Aesthetics of Asceticism
Authors: Miller Patricia Cox
Published: November 2023

In an essay entitled "Dim Body, Dazzling Body," Jean-Pierre Vernant argues that for Greeks of the archaic period the human body was conceptualized as a dim version of the dazzling bodies of the gods. The human body was perceived by means of a comparative method in which it could be discerned by "deciphering all the signs that mark the human body with the seal of limitation, deficiency, incompleteness, and that make it a sub-body." Further, "this sub-body cannot be understood except in reference to what it presupposes: corporeal plenitude, a super-body, the body of the gods." Judged according to the standards of this divine super-body, the human body is perceived as "ephemeral," "inconstant," "vulnerable to the vicissitudes of time flowing without return," with death as "a witness to its fragility."
Understanding Asceticism—Testing a Typology: Response to the Three Preceding Papers
Authors: Kaelber Walter O
Published: November 2023

Our effort to better understand asceticism might, I suggest, be rewarded if we begin with two interrelated objectives. Our first objective would be to extract from the concrete illustrations presented in these papers a number of cross-cultural, even universal, themes and issues pertaining to asceticism. Our second objective would then be to provide other concrete illustrations and examples of these themes from different religious traditions, thus demonstrating that these themes are indeed crosscultural, perhaps even universal. We would thus move from the concrete and particular to the universal and then back to the particular; now, however, being able to comprehend those varied particulars in a far larger and more meaningful context.
The Significance of Food in Hebraic-African Thought and the Role of Fasting in the Ethiopian Church
Authors: Isaac Ephraim
Published: November 2023

No one would question that food is absolutely central to human existence. The processes of eating, digesting, and nutrition represent fundamental biological necessities of life. These processes promote other related functions of life such as growth and movement. But food is not only an essential and basic biological or economic necessity. It is also a fundamental ingredient of religious life and human thought.
Gender and Uses of the Ascetic in an Islamist Text
Authors: Malti-Douglas Fedwa
Published: November 2023

To say gender and Islam is to evoke a multiplicity of images, not the least of which is that of the patriarchal figure of Khomeini, coupled with wave patterns of veiled women. To add the ascetic dimension to this explosive combination might seem out of place. But as some of the writings of the contemporary religious revival show, nothing is strange in this universe in which the contemporary sits alongside the medieval.
The Ascetic Impulse in Religious Life: A General Response
Authors: Clark Elizabeth A
Published: November 2023

To provide a summation of and response to a set of essays so rich and diverse as these is always a problem for the hapless commentator; to provide one for essays that posit highly divergent views of what constitutes asceticism (or even its characteristic features) seems even more daunting. As several participants wryly noted at the International Conference on the Ascetic Dimension in Religious Life and Culture, members of the group on The Ascetic Impulse in Religious Life and Culture from the American Academy of Religion/Society of Biblical Literature, despite their eight years of cooperative work and their joint production of three volumes, are nonetheless unable—still!—to arrive at a definition of asceticism on which they agree, even for the limited time span and geographical area they study.
The Allegorization of Gender: Plato and Philo on Spiritual Childbearing
Authors: Harrison Verna E F
Published: November 2023

In recent scholarship, Philo of Alexandria has acquired quite a reputation for misogyny. In major studies of his gender concepts and perceptions of women, Richard Baer and Dorothy Sly have noted that in many passages he disparages women for their alleged intellectual and moral weaknesses and vices. His discussions of the intellect as symbolically male and the senses as female often make an imperceptible and perhaps unconscious transition from the allegorical to the literal level, where women in general are characterized as misled by the senses and overly attached to pleasures and material things. This raises the question whether his various allegorical uses of gender language are simply projections of an androcentric anthropology or indeed a gut-level hostility toward women. Sly's study pays close attention to the texts and their nuances and contains much significant analysis, but she appears overall to answer this question in the affirmative. My suggestion in this paper is that the place of gender in Philo's anthropology is far less monolithic and consequently far more interesting than such a reading would indicate.
Practices and Meanings of Asceticism in Contemporary Religious Life and Culture: A Panel Discussion
Authors: Valantasis Richard
Published: November 2023

The unusual combination in this conference of practitioners of asceticism and historians of asceticism, as well as representatives of asceticism across religious and cultural lines, was at once a stroke of genius and a very frightening possibility, because these are groups of people who normally do not speak to one another. Those for whom ascetical texts are still determinative and important do not meet often with those for whom they are important primarily for their historical context, nor with those who find the texts' importance to lie in their contemporary application.