bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusions and an Agenda for Action
Authors: Desjarlais Robert , Eisenberg Leon , Good Byron , Kleinman Arthur
Published: November 2023

This volume was undertaken with a sense of deep concern about the magnitude of mental health problems in the societies of Africa, Asia, Latin America, and the Middle East. For too long, social, behavioral, and mental health problems have been inadequately addressed by scholars and agencies committed to health and international development. The World Bank’s 1993 World Development Report Investing in Health offers an example. The Bank’s decision to focus its annual development report on health and health care in low- and middle-income countries is enormously welcome. The Report reflects a growing awareness among policymakers that particular strategies of development have important consequences for health, and that health indicators rank with economic indicators as markers of the benefits of development policies. Furthermore, the authors of that report recognize that since ill health has negative consequences for a society’s economic development, “investing” in health is crucial for development as well as for alleviating human misery.
Diet and Food Contaminants
Authors: Manuel Posada DE LA PAZ
Published: November 2023

Diseases caused by food have long been a major concern of humankind and have also been a major concern of environmental epidemiology. Historically, food contamination by microbial agents has caused most outbreaks. Contamination of food by infectious agents such as cholera continues to be extremely important in developing countries, as witnessed by the cholera outbreak in Peru in 1995, for example.
Radiation I:Radon
Authors: Brownson Ross C , Alavanja Michael C R
Published: November 2023

Radon is a gas that is often attached to particles. Inhaled radon emits ionizing radiation to the lung. Radon’s effects have been studied extensively among miners, who were historically exposed to high levels. Although this might generate optimism that the health effects of indoor radon, which involves much lower exposures, would be readily understood as well, this has not been the case.
Famine
Authors: Yip Ray
Published: November 2023

Famine represents the most severe form of food insecurity, during which mass starvation and death take place within a relatively short span of time. Hence famine is often viewed as an acute and discrete event (1). There is compelling evidence, however, that a long-term process is responsible for the development of the underlying socioeconomic vulnerability that is required for famine to occur (2). In fact, famine represents failure to recognize or respond to increasing food insecurity over time. In times of famine, public health workers traditionally have participated in reactive relief efforts to control morbidity and mortality; potentially greater roles are available for public health workers in proactive efforts to prevent and mitigate famine (3). Although many of the underlying factors leading to increasing vulnerability are related to fundamental issues such as political stability and developmental policy-issues that may seem outside the reach of public health-it would be helpful, at least in the process of assessing vulnerability to famine, for public health workers to take some of the fundamental factors into consideration.
Air Pollution
Authors: Etzel Ruth A , French Jean G
Published: November 2023

Pollutants may enter the air from natural or synthetic sources. Air always carries natural pollutants such as pollens, spores, molds, yeast, fungi, and bacteria; and forest fires, windstorms, volcanic eruptions, and droughts cause smoke, dust, and other pollutants to enter the air. Yet all the pollution wrought by nature counts for little when compared with the effects of pollutants associated with human activity (112). The major sources of synthetic air pollutants include the burning of fossil fuels, particularly coal; emissions from smelters, steel plants, and other heavy manufacturing facilities; and emissions from mobile sources such as automobiles, trucks, and airplanes. The primary pollutants from these major sources are sulfur dioxide (S02), nitrogen dioxide (N02), carbon monoxide (CO), suspended particulates, ozone, hydrocarbons, acid aerosols of sulfates and nitrates, and heavy metals. Although emissions from chemical manufacturing may affect the area immediately surrounding the source, they do not have the same impact on regional air pollution as the aforementioned pollutants.
Evolutionary Psychology and Marital Conflict: The Relevance of Stepchildren
Authors: Daly Martin , Wilson Margo
Published: November 2023

The specific focus of this chapter concerns one particular source of conflict between women and men in marital or marital-like relationships, namely the existence or presence of children from prior unions. In explaining our rationale for suggesting that such children might be expected to engender or exacerbate marital conflict, however, we have to synopsize theories of much broader applicability. Our argument is predicated on a more general account of the nature of the marital relationship from the perspective of evolutionary biology, which in turn is predicated on a still more general evolutionary understanding of the nature of sociality and of the male-female phenomenon. Thus, we start with these most basic issues and work toward the specific question of the possible relevance of stepchildren to marital disharmony.
Where are the Gender Differences? Where are the Gender Similarities?
Authors: Hyde Janet Shibley
Published: November 2023

In this chapter, I discuss what psychologists consider to be basic phenomena or “facts” about gender differences. I use the term facts in quotation marks because we do not have facts in psychology–rather, we have theories and scientific data, but we sometimes start thinking that we have facts. My analyses, then, emanate from a social constructionist epistemology (e.g., Gergen, 1985; Hare-Mustin & Marecek, 1988) and a feminist theoretical perspective.

Social constructionism stands in opposition to positivism, the latter having been the epistemology of most psychological scientists until recently. Positivism assumes that we can know reality, facts, or phenomena directly and objetively. Constructionism, in contrast, argues that people–including scientists–do not discover reality; instead, they construct or invent it based in part on prior experiences and predispositions. Constructionism, then, questions whether science and scientists can be completely objective.
Male Aggression Against Women: An Evolutionary Perspective
Authors: Smuts Barbara
Published: November 2023

The worldwide prevalence of male violence toward women has recently become disturbingly evident. Russell’s (1984) careful survey of 930 San Franciscan women indicates that one-quarter of American women will experience a completed rape at some time in their lives, and nearly one-half will be victims of attempted or completed rape. Since the age of 14, 27.5% of college women have experienced an attempted or completed rape (Koss, Gidycz, & Wisniewski, 1987). Each year, approximately 1.8 million American wives are beaten by their husbands (Strauss, 1978), and one-eighth of all murders involve husbands killing their wives (Hutchings, 1988).
The Confluence Model of Sexual Aggression: Feminist and Evolutionary Perspectives
Authors: Malamuth Neil M
Published: November 2023

The research that I describe in this chapter was initially inspired by the feminist movement and was designed to test some of the ideas put forth by its writers. Later, however, both in response to findings emerging from the research and in light of my growing interest in evolutionary psychology, my colleagues and I began also to conceptualize some of the work in the framework of evolutionary psychology. In this chapter, I attempt to summarize key points of the feminist and evolutionary analyses concerning causes of sexual coercion and relate them to the research we conducted.
Police Responses to Battered Women: Past, Present, and Future
Authors: Roberts Albert R
Published: November 2023

It was 1400 hours on September 6, 2010. Two police officers were dispatched by headquarters on a report of a domestic violence complaint. Upon arriving at the scene, the officers spoke to the victim, Wilma R. She stated that her boyfriend, Louis, had been drinking the night before and became involved in an argument with her that ended with his punching her in the face and choking her. The officers observed that Wilma had a cut on her upper lip and swelling in the area between her nose and mouth.

When the police officers questioned Louis, he said he never touched her. He insisted that the bruises on her face resulted from her being clumsy and falling down the steps while carrying the laundry. He said she was making up the story of being beaten because she was angry at him for staying out late with his buddies the previous night.

In order to determine whether or not Louis had choked his girlfriend, the police officer went to the car and brought in the compact portable laser unit. By aiming the laser at Wilma’s neck, the officer immediately obtained laser fingerprints, which he compared with Louis’s. The results showed an identical match. While the first officer was matching the fingerprints, the second officer went to the car and turned on the MDT computer to run a computerized criminal history on Louis. In less than thirty seconds, Louis’s history appeared on the screen: two prior convictions for simple assault against a former girlfriend and resisting arrest. The incidents had occurred three years earlier in another state. In addition, Louis’s record showed two arrests during the past three years for driving while intoxicated.
Bangs, Crunches, Whimpers, And Shrieks
Authors: Earman John
Published: November 2023

Almost from its inception, Einstein’s general theory of relativity was known to sanction spacetime models harboring singularities. Until the 1960s, however, spacetime singularities were thought to be artifacts of the idealizations of the models. This attitude evaporated in the face of a series of theorems, due largely to Stephen Hawking and Roger Penrose, which showed that Einstein’s general theory implies that singularities can be expected to occur in a wide variety of conditions in both gravitational collapse and in cosmology. In the light of these results some physicists adopted the attitude that, since spacetime singularities are intolerable, general relativity contains within itself the seeds of its own destruction. Others hoped that peaceful coexistence with singularities could be achieved by proving a form of Roger Penrose’s cosmic censorship hypothesis, which would place singularities safely inside black holes. Whatever the attitude one adopts toward spacetime singularities, it is evident that they raise a number of foundational problems for physics and have profound implications for the philosophy of space and time. However, philosophers of science have been slow to awaken to the significance of these developments. Indeed, this is the first serious book-length study of the subject by a philosopher of science. It features an overview of the literature on singularities, as well as an analytic commentary on their significance to a number of scientific and philosophical issues.
Drawn with The Sword
Authors: McPherson James M
Published: November 2023

James M. McPherson is acclaimed as one of the finest historians writing today and a preeminent commentator on the Civil War. Battle Cry of Freedom, his Pulitzer Prize-winning account of that conflict, was a national bestseller that Hugh Brogan, in The New York Times, called “history writing of the highest order.” Now, in Drawn With the Sword, McPherson offers a series of thoughtful and engaging essays on some of the most enduring questions of the Civil War, written in the masterful prose that has become his trademark. Filled with fresh interpretations, puncturing old myths and challenging new ones, Drawn With the Sword explores such questions as why the North won and why the South lost (emphasizing the role of contingency in the Northern victory), whether Southern or Northern aggression began the war, and who really freed the slaves, Abraham Lincoln or the slaves themselves. McPherson offers memorable portraits of the great leaders who people the landscape of the Civil War: Ulysses S. Grant, struggling to write his memoirs with the same courage and determination that marked his successes on the battlefield; Robert E. Lee, a brilliant general and a true gentleman, yet still a product of his time and place; and Abraham Lincoln, the leader and orator whose mythical figure still looms large over our cultural landscape. And McPherson discusses often-ignored issues such as the development of the Civil War into a modern “total war” against both soldiers and civilians, and the international impact of the American Civil War in advancing the cause of republicanism and democracy in countries from Brazil and Cuba to France and England. Of special interest is the final essay, entitled “What’s the Matter With History?”, a trenchant critique of the field of history today, which McPherson describes here as “more and more about less and less.” He writes that professional historians have abandoned narrative history written for the greater audience of educated general readers in favor of impenetrable tomes on minor historical details which serve only to edify other academics, thus leaving the historical education of the general public to films and television programs such as Glory and Ken Burns’s PBS documentary The Civil War. Each essay in Drawn With the Sword reveals McPherson’s own profound knowledge of the Civil War and of the controversies among historians, presenting all sides in clear and lucid prose and concluding with his own measured and eloquent opinions. Readers will rejoice that McPherson has once again proven by example that history can be both accurate and interesting, informative and well-written. Mark Twain wrote that the Civil War “wrought so profoundly upon the entire national character that the influence cannot be measured short of two or three generations.” In Drawn With the Sword, McPherson gracefully and brilliantly illuminates this momentous conflict.
Tom On The Cross
Authors: McPherson James M
Published: November 2023

“So You’Re The Little Woman Who Wrote The Book That made this great war,” said Abraham Lincoln to Harriet Beecher Stowe when they met at the White House in the fall of 1862. Lincoln’s remark was far from facetious. The extraordinary impact of Uncle Tom’s Cabin may have done more to arouse antislavery sentiments in the North and to provoke angry rebuttals in the South than any other event of the antebellum era—certainly more than any other literary event.
The War that Never Goes Away
Authors: McPherson James M
Published: November 2023

“Americans Just Can’t Get Enough of The Civil War.” So says a man who should know, Terry Winschel, historian of the Vicksburg National Military Park. Millions of visitors come to Vicksburg and a score of other Civil War battlefield parks every year. More than forty thousand Civil War reenactors spend hundreds of dollars each on replica weapons, uniforms, and equipment; many of them travel thousands of miles to help restage Civil War battles. They constituted the thousands of extras in the movies Glory and Gettysburg.
From Limited to Total War 1861–1865
Authors: McPherson James M
Published: November 2023

A Few Years After The Civil War, Mark Twain Described that great conflict as having “uprooted institutions that were centuries old, changed the politics of a people, transformed the social life of half the country, and wrought so profoundly upon the entire national character that the influence cannot be measured short of two or three generations.” This profound transformation was achieved at enormous cost in lives and property. Fully one-quarter of the white men of military age in the Confederacy lost their lives. And that terrible toll does not include an unknown number of civilian deaths in the South. Altogether nearly 4 percent of the Southern people, black and white, civilians and soldiers, died as a consequence of the war.
Why Did The Confederacy Lose?
Authors: McPherson James M
Published: November 2023

Ever Since The Guns Ceased Firing In 1865, Efforts to Explain the causes of Confederate defeat have generated a great deal of controversy. The debate began with the publication in 1866 of The Lost Cause by Richmond journalist Edward Pollard, who blamed Jefferson Davis. Many books and articles since then have addressed the issue explicitly in their titles, as did the anthology of essays published in 1960, Why the North Won the Civil War, and the volume published in 1986 coauthored by four historians, Why the South Lost the Civil War.
How The Confederacy Almost Won
Authors: McPherson James M
Published: November 2023

Many Americans Read Books or Watch Video Documentaries about the Civil War as part of their national history; people south of the Potomac and Ohio rivers still live the war. No Southerner can escape the legacy of the Civil War; few white Southerners have escaped its bewitching spell. “Like more than one present-day Southerner,” wrote the Tennessee-born novelist and literary historian John Bowers in the preface to his biography of Stonewall Jackson, “I fought [against] knowing more about the Civil War then I needed to know. It was too much around me. . . . It was a dark abyss you might fall into and never be heard from again.”
A New Birth of Freedom
Authors: McPherson James M
Published: November 2023

In 1984 I Lectured On Lincoln’s Birthday To The Lincoln Group of Delaware, one of many similar organizations dedicated to preserving the memory of our sixteenth president. I spoke about Lincol n’s leadership in the “Second American Revolution” that abolished slavery and overthrew the power of the planter class. After the talk I agreed to an interview with a Wilmington radio station. The first question the interviewer asked was: “If Lincoln were alive today, what would he do about abortion and the budget deficit?”

This question was my initial encounter with a phenomenon familiar to seasoned Lincoln scholars: the “What Would Lincoln Do” syndrome. I was tempted to answer, as did Senator George Norris when asked in the 1930s what Lincoln would do about the Depression, that “Lincoln would be just like me. He would n’t know what the hell to do.”
Cognition and Commibnent in Hume’s Philosophy
Authors: Garrett Don
Published: November 2023

It is widely believed that Hume often wrote carelessly and contradicted himself, and that no unified, sound philosophy emerges from his writings. Don Garrett demonstrates that such criticisms of Hume are without basis. Offering fresh and trenchant solutions to longstanding problems in Hume studies, Garrett's penetrating analysis also makes clear the continuing relevance of Hume's philosophy.
Do Lemmings Commit Suicide?
Authors: Chitty Dennis
Published: November 2023

Unlike nearly all science books which tell of successful ventures and satisfactory conclusions, this book reveals the harsher but more common side of scientific research. Written by one of this century’s most distinguished small mammal ecologists, it is both a personal history of and an apology for a life in science spent working on problems for which no final dramatic closure was reached. Included along the way are important anecdotes and history about Charles Elton and his pioneering work at the Bureau of Animal Population at Oxford University, from which much of modern population has grown, and insights on the philosophy and practice of science. This eye-opening account of a scientific career should be read by everyone in life sciences or the history and philosophy of science.
Pioneering observations, 1929–1939
Authors: Chitty Dennis
Published: November 2023

In 1929-1930 voles destroyed a million young conifers on a single Scottish plantation of the Forestry Commission.4 These plantations had been started to ensure a home-grown supply of timber, which had been in short supply in World War I. They were among the few vole habitats sufficiently undisturbed to be useful for long-term research; and thanks in part to economic losses due to voles, the Forestry Commission provided modest support for a program of pure research. Collecting basic knowledge would have to precede any practical applications, and would not guarantee success in replacing the current ineffective methods of trapping and poisoning. One possibility (remote, as it turned out) was that forecasting peak years might enable a forester to postpone a planting program; but the war put an end to such schemes.
Varying the Circumstances, 1952–1959
Authors: Chitty Dennis
Published: November 2023

For someone studying behavior, the reclusive vole was a poor choice of animal; despite its merits, it was difficult to observe in nature. Partridges are easier to watch though less easy to experiment with. Having both species under study at Oxford gave us the best of both worlds. Partridges were one of the game animals whose fluctuations in numbers were studied by Doug Middleton early in the history of the Bureau. On some estates partridges are managed by gamekeepers, and records of numbers shot have been kept since the 18th century. Shooting is a different sport in England from hunting game birds in North America. Local people are hired as beaters to drive the par tridges over the shooters, who usually have two guns and a man to load them. After the massacre, the birds are laid out in rows while well-dressed ladies and gentlemen sit down to an al fresco lunch spread on trestle tables laid with white linen and groaning with food and drink.
Introduction : Taward a Second Century of the Scientific Analysis of Self and Identity
Authors: Ashmore Richard D , Jussim Lee
Published: November 2023

Among the many gems of William James’s The Principles of Psychology (1890), is chapter 10, “The Consciousness of Self.” Although it is risky to give a single person or publication primacy with regard to any important idea, it is fair to say that this chapter marks the introduction of self as both a major determinant of human thought, feeling, and behavior and as susceptible to understanding by empirical research procedures. In 1900, Mary Whiton Calkins, a student of James, published a paper entitled, “Psychology as Science of Selves.” It is possible, therefore, to identify the 1890s as the beginning of the scientific analysis of self and identity.
Introduction: The Paths Diverge
Authors: Egnal Marc
Published: November 2023

For Peter Kalm, the Swedish traveller and scientist, New France seemed no less prosperous than the northern Thirteen Colonies. Kalm, a student and friend of the great Swedish naturalist, Carl Linnaeus, travelled in North America between I 748 and I 751. He married a woman of Swedish descent in Philadelphia, and published his journals in three volumes after his return. Kalm was unstinting in his praise of Canadian farmers. The high meadows in Canada are excellent and by far preferable to the meadows round Philadelphia and in the other English colonies, he remarked. And he observed in August 1749 that the country on both sides [of the St. Lawrence] was very delightful today, and the fine state of its cultivation added greatly to the beauty of the scene. More generally, he felt that French Canadians lived as well as their English neighbors to the south. Kalm noted that the French here eat nearly as much meat as the English on those days when their religion allows it.
Learning Control Strategies for Object Recognition
Authors: Draper Bruce A
Published: November 2023

Although the field of computer vision has made significant advances over the past 30 years, there remains one notable exception, an area whose major unsolved problems and lack of advancement are severely limiting the application of computer vision technology to problems of practical importance. We have gained little or no insight—at either a theoretical or practical level—into how the many aspects of vision are integrated into functioning systems.

The most dramatic advances in the field have come not from researchers building task-focused systems, but rather from those who concentrate on better-defined subproblems that admit to “clean” solutions. As a result, although the catalog of image understanding algorithms keeps growing, relatively few complete computer vision systems are built, and when they are, it is almost always a major effort that is costly in terms of design, integration, and development time. Unfortunately, we will not see the benefits of breakthroughs in the component technologies until we understand, at both theoretical and practical levels, how the many components of a complex vision system are integrated and controlled. It is as though we have the supplies and tools to build a house, but lack the architectural drawings.
Germany A Nonpunitive Model
Authors: Wolff Reinhart
Published: November 2023

Modern child protection initiatives in Germany developed early in the 19th century as a reaction to the growing exploitation of children in the expanding industrial system and to widespread neglect of children as a consequence of poverty and family breakup in the early years of capitalism. At the beginning of the 19th century, many Child Saving Houses (Rettungshiiuser) were established to provide group care for children. In 1829 the first Society for the Betterment of Morally Neglected Children - later to be called Child Saving Association (Verein zur Besserung sittlich verwahrloster Kinder or later Kinderrettungsverein )- was founded in the small town of Koslin near Berlin.

The society was more concerned with the “demoralization of children” than with the economic and social situation, which produced child labor and poverty that led to a high incidence of child neglect and early child death. It prepared the ground for a moralistic approach that has become prominent in many upper-class-oriented child-saving movements in modern society. With a view of the child as being both endangered and dangerous or morally imperfect, the Child Saving Association typically depoliticized and individualized the problem of child maltreatment. The same conceptual orientation governed the beginnings of institutional child care in the middle of the 19th century; these efforts were dominated by religious movements that sought to save children from the poisonous influence of the growing working class and socialist movements.
Theoretical issues
Authors: Bruthiaux Paul
Published: November 2023

If asked to evaluate the relative degrees of linguistic simplicity of, say, a conversation between an adult and a child on the one hand and a legal document on the other, most people would probably and consistently rate the former as simpler than the latter. When it comes to language use, teachers and caregivers, airline pilots and market traders all take it for granted that producing and understanding simple, easily accessible language is a routine aspect of communication, whether the ability to do this comes instinctively or has to be acquired through training.
Conventionalization
Authors: Bruthiaux Paul
Published: November 2023

I have just shown that a dominant characteristic of CAR texts is their minimal level of syntactic elaboration, a feature that the register shares with other simple varieties such as pidgins, for example. Given that this characteristic is widespread in many simple varieties of language, it is tempting to follow Ferguson (1982) in positing a possibly innate sense in language users of what is dispensable whenever form must be tailored to what spatial, temporal, or cognitive constraints will permit. For their part, sociolinguists and discourse analysts in general tend to assume that form will be responsive to the situational and functional circumstances of each text type.
Initial Evaluation and Follow-Up
Authors: Arditii Douglas E , Paauw Douglass. , Spach David H
Published: November 2023

This chapter provides general guidelines for the initial evaluation and routine follow-up of an HIV-infected patient. All HIV-infected individuals who are establishing care will require a thorough health history and physical examination. Because of the time required to gather data and the need to establish rapport, many clinicians limit the first visit to obtaining the health history, perfonning a physical examination, and ordering appropriate laboratory studies. During the second clinic visit, which is usually about 1 week later, the clinician should review pertinent laboratory data, the patient’s stage of disease, and, if applicable, the need for vaccinations, antiretroviral therapy, and opportunistic infection prophylaxis. Generally, during this follow-up visit, an overall plan of care is developed and reviewed with the patient These first two visits provide an excellent opportunity for the clinician to establish rapport with the patient.
Alternative Therapies
Authors: Laury Lili A Sacks , J.Markbray Mckean
Published: November 2023

Alternative medicine encompasses a broad group of therapies beyond the realm of traditional western medical practice. These therapies include drugs with unproven efficacy, drugs obtained through unconventional means, herbal medicines, high-dose vitamins, and manipulations such as acupuncture, massage therapy, and imagery. These therapies may be viewed by patients and providers as truly “alternative” and thus mutually exclusive of conventional western medicine or as complementary adjuncts to traditional therapy.
Fever
Authors: Sheffield John V L
Published: November 2023

Fever occurs frequently in HIV-infected patients, particularly those with advanced immunodeficiency. For patients early in the course of HIV disease, the occurrence of a new fever is approached in a similar fashion to that employed in immunocompetent HIV-negative adults except that tuberculosis and community-acquired pneumonia merit special attention. Late in the course of HIV disease, many patients report occasional temperature spikes and frequent low-grade temperature elevations. These occasional temperature spikes and low-grade fevers are usually not of clinical significance.

When unexplained fever persists for longer than 2 weeks in a patient with a CD4 count less than 200 cells/mm3, it usually heralds an opportunistic infection or AIDS-defining condition. In one study, the most common diagnoses in patients whose fever exceeded 2 weeks were Pneumocystis carinii

pneumonia (PCP), disseminated Mycobacterium avium

complex, and lymphoma. Other important causes of prolonged fever include drug reactions, central venous catheter infection, and bacterial sinusitis.

HIV infection itself is thought to be an infrequent cause of sustained fever, except in the setting of acute HIV infection. Therefore, the new onset of localized or systemic symptoms associated with a clearly different and persistent temperature elevation in an HIV-infected person should always prompt a thorough evaluation. Although limited data exist regarding the yield of a fever work-up in this setting, published information suggests that a thorough search for a source of fever usually identifies a cause.
Mycobacterium avium Complex
Authors: Miller Richard A
Published: November 2023

is a mycobacterial organism found throughout nature in water and soil. The specific strains responsible for most human disease, however, are not the most common environmental isolates, suggesting differential levels of strain virulence.
Syphilis
Authors: Lukehart Sheila A
Published: November 2023

Syphilis has been called “the great imitator” because of its potential involvement of many organ systems and its protean manifestations. It is characterized by early active clinical disease, asymptomatic (latent) periods that may last for months to decades, and, in some instances, late active clinical disease.
Blastomycosis
Authors: Panther Lori A , Skerrett Shawn J
Published: November 2023

Blastomycosis is caused by Blastomyces dermatitidis,

a dimorphic fungus that appears as a yeast in tissues at 37°C and as mycelia at room temperature. The reservoir of this organism is probably moist soils enriched with organic matter, particularly along riverbanks and lakeshores. There appears to be an association between blastomycosis and outdoor occupations. Acquisition of blastomycosis usually occurs by inhaling spores.

Endemic disease is found in populations of the midwestern and southeastern United States, especially those bordering the Mississippi and Ohio River basins. Currently, blastomycosis infrequently develops among HIV-infected persons. Nevertheless, as the prevalence of HIV infection increases in the regions endemic for blastomycosis, the incidence of blastomycosis among HIV-infected individuals will likely increase.

Most HIV-infected patients with blastomycosis have significant immunosuppression and have CD4 counts less than 200 cells/mm 3 Host defenses against B. dermatitidis

include intracellular killing by alveolar macrophages and neutrophils and by cell- mediated granuloma formation. HIV-related abnormalities in both B cells and T cells may allow B. dermatitidis

to disseminate. Blastomycosis in HIV-infected patients may represent primary infection or reactivation of prior infection.
Candidiasis
Authors: Paauw Douglass.
Published: November 2023

infections frequently occur among HIV-infected patients, especially those who have a CD4 count less than 300 cells/mm3 or an AIDS-defining diagnosis. The presence of oral candidiasis reflects clinical immunodeficiency and predicts the development of AIDS independent of the patient’s CD4 cell count. This does not apply if the patient develops oral candidiasis as a result of antimicrobial or corticosteroid use.
Coccidioidomycosis
Authors: Panther Lori A , Rosen Henry
Published: November 2023

Endemic foci exist in the southwestern United States (west of El Paso, TX), northern Mexico, Central America, and South America. It is extremely unusual to acquire coccidioidomycosis outside of an endemic area. In the United States, Arizona and southern California are the areas of highest endemicity.
Pneumocystis Carinii
Authors: Kitahata Mari M , Curtis J Randall , Bramante John P
Published: November 2023

Although initial studies suggested that Pneumocystis carinii

was a protowan parasite, recent phylogenetic analyses of ribosomal RNA indicate that P. carinii

is more appropriately classified as a fungus. Because P. carinii

cannot be cultivated in vitro, it is difficult to study. Testing of P. carinii

for susceptibility to antimicrobial agents has been performed in animal models. There are three stages in the life cycle of P. carinii:

cysts (5 to 8 µm in diameter and crescent shaped), sporozoites (found only within cysts), and trophozoites (2 to 5

µmin diameter and found outside the cyst). At each of these three stages, the organism has different staining properties.

According to seroprevalence studies, most people in the United States have acquired infection with P. carinii

by age 2 to 3 years. Clinical disease probably results from reactivation of latent infection in immunocompromised hosts. Therefore, prevention is based on chemoprophylaxis of susceptible individuals.

In 1994, P. carinii

pneumonia (PCP) remained the most common AIDS-defining diagnosis (other than a diagnosis of AIDS based on CD4 cell count). Among high-risk patients who do not receive PCP prophylaxis, 60 to 80 percent will develop PCP. The risk of developing PCP increases as a patient’s CD4 cell count declines below 200 cells/mm3 Despite the widespread use of PCP prophylaxis, there were more than 13,000 cases of PCP in 1995.

Although earlier reports showed poor outcomes in those patients with severe PCP, recent survival rates have improved. Even patients in respiratory failure (as defined by PaO2 less than 60 on an FiO2 greater than 40 percent) have a 30 to 50 percent episode survival rate; of those who survive hospitalization, the median survival is approximately 18 months.
Dermatophytosis
Authors: Vandevelde Karen M
Published: November 2023

The most common forms of dermatophytosis that occur in HIV-infected persons are tinea pedis, onychomycosis, tinea cruris, and tinea corporis. Less commonly, patients may develop a fungal folliculitis (Majocchi’s granuloma). Among HIV-infected individuals, these disorders often have a similar clinical presentation when compared with HN -negative individuals, but they may be more severe and more difficult to treat.

CLINICAL FEATURES

Tinea pedis usually presents as interdigital maceration and scale, accompanied by fine, dry scale in the “moccasin distribution” of the foot (plantar surface and sides). In addition, tinea pedis can manifest as bullous, vesicular, or hypertrophic (thick) lesions. Focal hypertrophic lesions may resemble a wart or callous; diffuse hypertrophic lesions may resemble keratoderma blenorrhagicum (involvement of palms and soles seen in Reiter’s syndrome).

Onychomycosis, a dermatophyte infection of the nails, commonly occurs in association with tinea pedis. This disorder, which most frequently involves the great toenails, typically manifests as thickened, dystrophic, yellow or opaque nail plates with concomitant formation of subungual debris.

Tinea cruris, which refers to dermatophyte lesions in the groin and genital region, appears as an erythematous, well-demarcated plaque with an elevated, arcuate, scaly border. As the lesion progresses, central clearing frequently develops. The scrotum is spared in most patients. Among patients with low CD4 cell counts, the erythema and central clearing may be absent. In severely immunosuppressed patients, the plaques may involve the scrotum and large areas of the trunk and thighs.
Psoriasis and Reiter’s Syndrome
Authors: Vandevelde Karen M
Published: November 2023

The frequency and severity of psoriasis is increased among HIV-infected individuals. In addition, an estimated 30 to 40 percent of AIDS patients with psoriasis develop either psoriatic arthritis or Reiter’s syndrome. Patients with CD4 counts less than 400 cells/mm3 often develop more severe psoriasis.

Although there appears to be no HLA predominance in patients who develop psoriasis, some authors report an increase in HLA B27 in patients with psoriatic arthritis.

Psoriasis has historically been considered a “bad prognostic sign” in HIV-infected persons. There is often a striking temporal relationship between onset or exacerbation of psoriasis and the development of profound immunodeficiency and opportunistic infections. In contrast, some reports indicate psoriasis may clear in end-stage AIDS.

CLINICAL FEATURES

Although HIV-infected persons with psoriasis may have variable clinical manifestations, most present with classic psoriasis. The classic psoriatic lesions are characterized by pink to red plaques with adherent thick, white scale. They usually occur in a symmetric fashion with a predilection for extensor surfaces, especially the elbows and knees. Less commonly, patients develop small, well circumscribed plaques known as guttate lesions.

These lesions can be precipitated by streptococcal pharyngitis.
Seborrheic Dermatitis
Authors: Velde Karen M Van De
Published: November 2023

Seborrheic dermatitis is a common dermatologic disorder among HIV-infected persons, with a reported prevalence between 20 and 80 percent In contrast, it occurs in 5

to 10 percent of immunocompetent males.

Patients with HIV infection may develop seborrheic dermatitis de novo, or a preexisting condition of seborrheic dermatitis may exacerbate with increasing immunosuppression.

The severity of seborrheic dermatitis often correlates with the degree of immunosuppression, and treatment may be more difficult in those individuals with a low CD4 cell count.

The cause of seborrheic dermatitis is unknown; it has been suggested that the fungus Pityrosporum

may play a role in pathogenesis. Alternative hypotheses include alteration in sebum secondary to HIV infection, candidal overgrowth, or a neurotrophic effect of HIV that causes secondary alteration of the skin.

CLINICAL FEATURES

The typical rash consists of symmetric pink to red erythema with fine scale. Although the rash can appear at various body sites, it most commonly develops at the scalp, ears, glabella, eyebrows, beard, facial folds, central chest, axillae, and groin. Patients frequently develop pruritus that may become severe. Compared with immunocompetent individuals, HIV-infected patients with seborrheic dermatitis generally have more widespread and prominent manifestations.
Adrenal Function
Authors: Moss Gregory B , Weigle D Scott
Published: November 2023

Adrenal insufficiency can be classified as either primary (adrenal gland failure) or secondary (pituitary or hypothalamic failure), with the former most often caused by autoimmune destruction, hemorrhage, tumor, or infection and the latter most often from exogenous steroids.

Although many HIV-infected individuals have symptoms that resemble adrenal insufficiency, relatively few (less than 20 percent) meet cosyntropin stimulation test criteria for adrenal insufficiency and require steroid replacement. HIV-infected individuals, however, frequently have subtle and, as yet, poorly classified disorders of cortisol secretion.

In autopsy studies, 33 to 88 percent of AIDS patients demonstrate adrenal pathology (usually caused by infection with cytomegalovirus or Mycobacterium avium

complex), but the amount of tissue destruction is rarely enough to produce symptomatic adrenal insufficiency. ·

Among HIV-infected individuals without specific symptoms of adrenal insufficiency, slightly elevated basal cortisol levels and subnormal responses to synthetic ACTH tests appear to be common. In these individuals, however, prolonged ACTH infusions usually result in normal cortisol responses. Posssible explanations for these observations include chronic illness and stress, altered glucocorticoid receptors producing peripheral resistance, and anticorticosteroid antibodies.
Nutrition
Authors: Horwitch Carrie A , Maurice Joanne E , Hooton Thomas M
Published: November 2023

Nutrition plays an important role in the overall outcome of RN-infected individuals. There is growing evidence that metabolic and nutritional factors resulting in malnutrition start early in the course of HIV disease, probably during the asymptomatic phase of infection. ·

Nutritional deficiencies alter many aspects of immune function and may result in both a higher incidence and a more severe course of a wide variety of infectious processes. Malnutrition severely compromises the ability of the host to respond effectively to an infectious challenge and greatly increases the chances of more frequent and severe complications as well as increased mortality.

Vitamins are a group of organic substances, other than proteins, carbohydrates, fats, and minerals, that are essential for normal metabolism, growth, and development. They are indispensable for normal function and maintenance of health. They act principally as regulators of metabolic processes and play a role in energy transformation, usually acting as co-enzymes.
Wasting Syndrome
Authors: Horwitch Carrie A , Maurice Joanne E , Hooton Thomas M
Published: November 2023

HIV-associated wasting syndrome is defined as profound involuntary weight loss of greater than 10 percent of baseline body weight plus either (1) chronic diarrhea (at least two stools per day for more than 30 days) or (2) chronic weakness and documented fever (for 30 days or longer, intermittent or constant) in the absence of a concurrent illness or condition other than HIV infection that could explain the findings.

The prevalence of wasting syndrome in HIV-infected patients ranges from 11 to 47 percent. In the United States, HIV-associated wasting syndrome has become the second most common reported AIDS-defining diagnosis. Wasting syndrome as the only AIDS diagnosis is more common among injection-drug users, sex partners of injection-drug users, African-Americans, and Hispanics. Although most of the data on wasting are from studies predominantly involving men, women are also at risk for developing wasting.

Weight loss of 10 percent or greater appears to result in a significant reduction in survival. In addition, a decline in ideal body weight to 66 percent or less and a decline in body cell mass to 54 percent or less is a strong predictor of death. Body fat content is not a reliable marker of wasting, nor is it a reliable predictor of death in AIDS patients. Patients with wasting syndrome convert calories to fat storage concomitant with a loss in lean body mass (the opposite of what occurs in uncomplicated starvation). The progressive loss in lean body mass, which is characterized by protein wasting, appears to be a primary cause of morbidity and subsequent death.
Hodgkin’s Disease
Authors: Kovach Nicholas L
Published: November 2023

The incidence of Hodgkin’s disease in HIV-infected men is approximately 19/100,000 person years; studies have suggested that HIV-infected individuals have a 6.6-fold excess of Hodgkin’s disease compared with non-HIV-infected persons. Hodgkin’s disease, however, is not recognized by the Centers for Disease Control and Prevention (CDC) as an AIDS-defming diagnosis.

The histopathology of HIV-related Hodgkin’s disease shows mixed cellular histology in 55

to 80 percent of HIV-infected patients (the predicted incidence in this age group would be 15 percent). Lymphocyte depleted and nodular sclerosing are the next most common histologic types and occur in 15 to 20 percent of patients; lymphocyte predominant histologic types also occur, but less commonly.

The cause of HIV-related Hodgkin’s disease is unknown. Studies have implicated Epstein-Barr virus in non-HIV Hodgkin’s disease; T-cell stimulation and proliferation also have been speculated as contributing to the development of Hodgkin’s disease.

Patients with AIDS-related Hodgkin’s disease usually have a CD4 count less than 400 cells/mm3 and often less than 200 cells/mm3 The clinical pattern is similar to other HIV-related malignancies: an aggressive course, disseminated cancer at the time of presentation, and poor response to therapy.
Relations of Language and Cognition: What Do Deaf Children Tell Us?
Authors: Marschark Marc , Everhart Victoria S
Published: November 2023

The issue of the relation (or relations) between language and thought is one of the oldest in philosophy, and in many ways, it was the issue that led to the emergence of psychology as a separate discipline. In Aristotle’s time, the debate was about analogy versus anomaly. From his perspective, language development depended on analogy: that is, the assignment of words to meanings on the basis of their rational linkage-even if the details of that analogy had been lost over time due to changes in the language. The anomalists, in contrast, saw language as given by nature and the relations between words and their meanings as entirely arbitrary (see Bates, Bretherton, & Snyder, 1988; Vygotsky, 1934/1986, chap. 1, for discussion). In many ways, this contrast parallels the “nature-nurture” controversy and dovetails well with the more recent “modularity-interactionist” debate. Indeed, the language thought issue and its corollaries emerge in every generation of psychological theory, even if the level of the arguments changes as a function of paradigm shifts and related advances in other fields. In this and the following chapters, we hope to bring the language-thought discussion into clearer focus, both theoretically and practically, by placing it in the context of children who grow up deaf and by considering the influences of having sign language as the primary form of communication (regardless of whether one is deaf or hearing). The discussion is sharpened by the fact that it is carried on by contributors with specialties in different areas, all converging on a common interest on which each has conducted empirical