Books on the topic 'Men;s health'

We encounter the topic of sexuality everywhere: in films and books, in advertising, in press and on the internet. But how is the situation of sexual health in Germany? Although the scientific interest in masculine sexuality has grown over the last few decades, data that is reliable for many aspects is missing. The present Third Men’s Health Report, which was developed in collaboration with the Men´s Health Foundation and the Institute of Applied Sexual Studies at the Merseburg University of Applied Sciences, provides a current insight into the diverse facets of the sexuality of men from both social and medical perspectives. 40 experts from various disciplines have analysed in 31 contributions the level reached and they give extensive recommendations for action. With regard to questions of the social development of sexuality, the Men’s Health Report provides valuable information: How does sexuality develop in the 21st century? How do we avoid sexual discrimination based on sexual orientation? How can sexual offenses be further reduced?

Spirituality and Mental Health Across Cultures explores the implications of religion and spirituality (R/S) for mental health. It provides readers with a succinct and trustworthy review of the latest research, and how this can be applied to clinical care. The first section covers the principles and fundamental questions that relate science, history, philosophy, neuroscience, religion, and spirituality with mental health. The second section discusses the main beliefs and practices related to world religions and their implications for mental health. The third reviews the impact of R/S on specific clinical situations and offers practical guidance on how to handle these appropriately, such as practical suggestions for assessing and integrating R/S in personal history anamnesis or psychotherapy.

This chapter explores the various causes of meningitis and focuses on meningitis caused by Neisseria meningitidis, which can also result in other invasive illnesses (meningococcal disease, e.g. meningococcal septicaemia/meningococcaemia). Background information on the epidemiology and clinical features of meningococcal disease, the steps and principles that need to be followed for timely implementation of public health actions (antibiotic chemoprophylaxis, Men B; Men C; Men ACWY vaccination, and public health advice) in order to prevent secondary cases following the notification of a single case or cluster in an educational setting (nursery) are discussed. Furthermore, potential public health action(s) that can be considered in dealing with cases of meningococcal disease in different circumstances/situations are covered.

To improve or sustain patients’ health-related quality of life (HRQOL) is the main goal of palliative care. In health care, HRQOL encompasses a range of components that are measurable and related to health, disease, illness, and medical interventions. Another term, patient-reported outcome (PRO), is used and understood as any measure that collects responses directly from the patients and measures any aspect of patients’ health status that is reported by the patients without any interpretation by health-care providers or family members. The selection of PRO-instruments (questionnaires) is recommended to follow a sequential approach. Define overall aim(s), define the research question(s), agree upon the key outcome(s), and select the appropriate set of questions/questionnaires guided by the primary and secondary outcomes. In general, it is recommended to use a HRQOL measure of generic or disease-specific character and supplement it with domain-specific measure(s) (such as measurement of fatigue, pain, anxiety, depression, etc.) reflecting the purpose(s) of the data collection.

This book describes real-world examples and practical approaches for integrating behavioral and physical health services in primary care and some specialty medical environments. Integrated care models are patient-centered; delivered by teams of medical professionals, utilize care coordination, and a population-based approach. This book is comfortably accessible to students, residents, faculty, and all mental health professionals, primary care and medical specialists who are working in ambulatory/office-based practices. We examine the integrated care literature and recommend applying collaborative care and other existing models of integrated care based on the existing evidence-based research. When there is no literature supporting a specific approach, our experts offer their ideas and take an aspirational approach about how to manage and treat specific behavioral disorder or problems. We assume the use of a fully integrated team staffing model while also recognizing this an ideal that may need modification based on local resources and practice cultures. The full integrated team includes a primary care or specialist provider(s), front desk staff, medical assistant(s), nurse(s), nurse practitioners, behavioral health specialist(s), health coaches, consulting psychiatrist, and care coordinator(s)/manager(s). The book has four sections: Part 1: Models of Integrated Care provides an overview of the principles and the framework of integrated care focusing on five highly successful integrated practices. We also discuss team-based care, financing, tele-behavioral health, and use of mental health assessments and outcome measures. Part 2: Integrative Care for Psychiatry and Primary Care is a review of existing and proposed models of integrated care for common psychiatric disorders. Our continuity approach emphasizes problem identification, differential diagnosis, brief treatment, and yearlong critical pathways with tables and figures detailing “how to” effectively deliver mental health care and manage substance misuse in an integrated care environment. Part 3: Integrated Care for Medical Sub-Specialties & Behavioral Medicine Conditions in Primary Care focuses on two models of integrating behavioral health care: (1) integrating wellness with behavioral health and (2) integrating psychiatry and neurology. Other chapters are “Women’s Mental Health Across the Reproductive Lifespan,” “Assessing and Treating Sexual Problems in an Integrated Care Environment,” “Integrated Chronic Pain and Psychiatric Management,” and “Death and Dying: Integrated Teams.” Part 4: Psychosocial Treatments in Integrated Care describes brief office-based counseling and psychosocial treatment approaches including: health coaching, crisis intervention, family, and group interventions. All of these brief treatment approaches are patient–centered, tailored to be used effectively integrated care settings and as an important contribution to population management.

This chapter provides a state-of-the-science review of research on religion, spirituality, and health in later life; examines avenues for future research; explores how religion or spirituality may arise in the patient encounter; and describes best practices in terms of assessing and addressing older adults’ spiritual needs related to illness. First, it summarizes quantitative research through 2010 on religion/spirituality (R/S) conducted in older adults in the areas of mental health and physical health. It then describes a selection of studies published within the past two years that illustrate the most recent findings on R/S and health among older adults, discusses research gaps in areas of mental and physical health, and explores high-priority studies needed to advance the field. It concludes with a case that illustrates how R/S may present in the clinical encounter and demonstrates best practices on how clinicians might sensitively and sensibly address this topic.

The current chapter examines the relationship between religion/spirituality (R/S) and medicine through the psychological lens of a religious coping framework. This relationship is considered at the theoretical, patient, caregiver, and care team levels. The R/S beliefs, practices, and coping strategies of patients, informal caregivers, and health care providers in the context of illness is then discussed. A large body of research demonstrates the important role of R/S in how patients and caregivers understand and cope with illness. Similarly, many health care providers view illness and their clinical care through a R/S lens and believe that attending to patients’ spiritual needs is part of their professional role. The chapter concludes with a brief review of psycho-spiritual interventions in medical populations.

AbstractSchistosomiasis is a parasitic disease that affects millions of people in 78 countries, where it is held responsible for considerable morbidity and mortality. It is caused by a blood fluke, which provokes an immunological response to hundreds of its antigens. This induces multi-organ pathology through the formation of tissue granulomata or circulating immune complexes. In addition, it is amyloidogenic and carcinogenic, through the interaction of immunological perturbation with confounding metabolic and genetic factors. The primary targets of schistosomiasis are urinary and hepatointestinal.The lower urinary tract is mainly affected in S. haematobium infection, and may lead to chronic pyelonephritis and/or obstructive nephropathy. The colon and liver are the targets of S. mansoni and S. japonicum infection, leading to hepatic fibrosis, portal hypertension, and liver failure. S. mansoni may also lead to immune complex glomerulonephritis, which is discussed elsewhere. Both S. haematobium and S. mansoni ova may be carried with the venous circulation to the lungs, where they provoke granulomatous and immune-mediated endothelial injury leading to cor-pulmonale. Ova may be subsequently carried with the arterial circulation to form ‘metastatic’ granulomas in other tissues, notably the brain (S. japonicum), spinal cord (S. haematobium), skin, conjunctiva, and genital organs.Schistosomiasis is preventable. World Health Organization programmes have successfully eradicated or reduced the incidence of infection in many countries, particularly Egypt and China. Prevention strategies include health education, raising hygiene standards, and interruption of the parasite’s life cycle by snail control and mass treatment. The search for a vaccine continues. Effective antiparasitic treatment is now possible with high elimination rates. Available agents include praziquantel and artemether for all species, metrifonate for S. haematobium, and oxamniquine for S. mansoni. Successful outcome correlates with early intervention, before fibrosis has occurred.

There is awareness among contemporary family physicians of the intersection of religion and spirituality (R/S) and health care. The rigorous examination of R/S and health outcomes continues to be hampered by methodological challenges and the lack of plausible conceptual models. However one important area of investigation, and growing evidence base, can be found in the spiritual care provided at the end of life. In this clinical setting and other related contexts, a health services perspective provides a structured approach to both research and practice, particularly with contemporary movements to value-based health care. For physicians, the following clinical skills are the foundation to spiritual care: (1) empathy and attentiveness; (2) formulating a whole person care plan that is inclusive of spiritual factors; (3) including pastoral and other spiritual care specialists in the care plan, and; (4) identifying and addressing concordant and discordant beliefs and values when they arise.

Most community hospitals have seen a reduction in the use of restraints in inpatient psychiatric units. The use of emergency medication remains a mainstay in emergency departments and inpatient units. The correctional setting makes use of both practices, modified for the unique characteristics of the correctional setting. The use of seclusion and/or restraint (S/R) in mental health settings has long been fraught with legal and ethical concerns; the practice can be dangerous. This is perhaps accentuated in the more punitive environment of jails and prisons within the United States. While some may perceive S/R as an intervention ultimately to be eliminated, facilities that use S/R for mentally ill patients, be they hospitals, jails, or prisons, should not aim to eliminate it as an intervention; in limited cases it is an appropriate option, particularly for acutely aggressive, agitated patients who require immediate intervention. The use of S/R preserves the safety of the patient, other patients or inmates, and staff. This chapter reviews current guidelines on the use of S/R in correctional health care, and discusses pragmatic issues of implementation and management. Of note, the focus is solely on the use of S/R for mentally ill patient-inmates and not their use by custody staff for safety or security reasons. It also highlights the differences between seclusion and restraint in the community compared to jails and prisons. This chapter discusses the use of restraints and emergency medications, legal precedents that guide their use, as well as best practice demonstrated to minimize their routine application.

The health care industry is evolving in response to increasing costs, poor health outcomes, and consumer dissatisfaction. Integrated care is a critical component of health care evolution, recognizing the particular burden of untreated behavioral health issues on both physical and behavioral health care outcomes and costs. Telehealth, the use of technology to provide care at a distance, is a flexible process adaptable to a variety of integrated care applications and models. Telehealth (telepsychiatry, telebehavioral health, telemental health) can help maximize limited resources and expand the reach of psychiatrists and other limited specialty providers. As evidenced in a strong and growing research base, telehealth can support integrated care, as well as forward its application in new and innovative ways across the integration continuum. This chapter provides examples of current telehealth supported care integration models along the Substance Abuse and Mental Health Services Administration (SAMHSA)’s articulated integration continuum.

Rates of chronic health conditions in childhood are increasing, and school-based professionals regularly encounter children with chronic health conditions in the school setting. Students with chronic health conditions often require accommodations, assessment, intervention, and close collaboration with medical providers and families. However, most school-based clinicians (school psychologists, counselors, social workers) who are charged with addressing the special needs of these children have not had coursework or experience related to common pediatric conditions. This book is a practical guide for school-based clinicians working with children with chronic health conditions. Section I provides a broad overview of school-related issues for children with chronic health conditions. This includes a review of common medical conditions and terminology and cross-cutting issues related to social and emotional and academic functioning, as well as the role of the school-based professional in collaborating across systems of care. The section also reviews legal and policy issues and alternative educational settings for students with chronic health needs. Section II focuses on prevention, assessment, intervention, and consultation strategies for individual students and entire school systems. Finally, Section III addresses common groups of medical conditions. Each chapter provides an overview of the condition(s), common school-related concerns, risk and protective factors, and cultural considerations, as well as practical strategies, resources, and handouts for the school-based professional. Case examples are used throughout the book to illustrate key concepts and implications for the school setting.

Heart failure (HF) is a growing problem worldwide and poses an especially large public health burden. It represents a new epidemic of cardiovascular disease, affecting nearly 5.8 million people in the United States, and over 23 million worldwide. Nevertheless, in Europe, fears of an impending HF ‘epidemic’ could not be confirmed in this analysis of trends in prevalence for the period 1990-2007 in patients hospitalized with HF in Sweden. An overall slight decrease in age-adjusted prevalence was observed from 2002. The prevalence in patients under 65 years increased markedly. In absolute numbers, there was a substantial increase among the very old, consistent with demographic changes. The complexity of left ventricular function(s) assessment in HF patients is related to the complexity of heart anatomy, but also to the complexity of electromechanical interaction, and to the load dependency of all the parameters that could be applied in clinical practice.

This chapter argues that an oral mode of textual circulation, which T. S. Eliot discovered both in obscene, comic, bawdy folk song and in music hall performance, provided him with a vision of social cohesion that contrasts with the fragmentation that is otherwise central to his work. The ability of these genres to figure an otherwise lost social cohesion, however, reflects the fact that they are spaces where men bonded and created a sense of homosocial community. Eliot’s published comments on obscenity confirm his valuation of the comic or humorous obscene as a mode and index of social health; but the instances where Eliot discovers this cohesion are predicated on the exclusion of women.

This chapter examines Abraham Lincoln and Owen Lovejoy's united stand to assure that the nation “can long endure” amidst the war. Lincoln's Emancipation Proclamation intensified the desperation felt by slaveholders in areas close to the invading armies. While resisting and escaping slaves invigorated the political process for emancipation, the Emancipation Proclamation emboldened more resistance to slave masters and enhanced cooperation in the Union's efforts in the Civil War. This chapter begins with a discussion of the debate among antislavery leaders over reconstruction policy, along with Lincoln and Lovejoy's disagreements about issues such as the role that the federal military should take in policing the states during the transition. It then considers Lovejoy's health problems and the support for the Lincoln administration's war effort, as well as two men 's persistence in pursuing their radical agenda. It also looks at Lincoln's appeal for divine help to guide and heal the nation, highlighted by his Thanksgiving Proclamation designating August 6 “a day for National Thanksgiving, Praise and Prayer.”

How did Civil War soldiers endure the brutal and unpredictable existence of army life? This question is at the heart of Peter S. Carmichael’s sweeping study of men at war. Digging deeply into soldier letters, Carmichael focuses not on what soldiers thought, but rather on how they thought. He resists the idea that there was “a common” experience but looks into their own words to find shared threads in soldiers’ experiences.

Research in mental health issues in prisoner populations essentially stopped in the mid 1970’s. It is now re-emerging as a critical component of improving mental health care and helping toward recovery for the incarcerated mentally ill. Mental illness, ranging from acute anxiety to schizophrenia, is endemic within prisons and jails. Unlike their free world counterparts, however, incarcerated people have a constitutional right to mental health treatment. Yet, despite the need for and right to mental health treatment, remarkably little reliable and valid evidence is available on the nature and level of mental illness among incarcerated people, the effects of incarceration on symptomatology, the availability and quality of medication, cognitive, and psychosocial treatment for disorders, and how context impacts the effectiveness of the treatment that is available. Evidence is absent because corrections-based research is constrained by regulation, financing, and inexperience. In this chapter, the history of prisoner research and the evolution of federal regulations to protect prisoners as human subjects will be reviewed and then discussed in terms of how regulation has impacted correctional mental health research, after first defining what is meant by research and why research is needed to inform policy and practice decisions. This will be followed by recommendations for building the correctional mental health research evidence base. The intent here is to help researchers, in collaboration with stakeholders, develop, design, and implement research studies, and disseminate evidence to advance science and the quality of care available to incarcerated people with mental illnesses within the current regulatory environment.

This book is primarily designed for clinicians and researchers interested in learning how to conduct an empirically supported culturally informed therapy for schizophrenia (CIT-S) that integrates core components of evidenced-based family therapy. It is estimated that approximately 1% of adults in the United States will be diagnosed with schizophrenia or a related schizophrenia spectrum disorder. Without treatment, prognosis is generally poor. Fortunately, traditional family therapies have shown increasing promise in reducing relapse rates and improving mental health for this population. As more and more societies become multicultural, however, there is an increasing expectation that mental health providers will also be prepared to meet the needs of unique and culturally diverse clients in an efficient, skillful, and culturally relevant manner. CIT-S is a 15-week, family-focused, cognitive behavioral approach for managing schizophrenia spectrum disorders. The intervention draws upon clients’ cultural beliefs, practices, and traditions to help them conceptualize and manage mental illness. It aims to improve the quality of clients’ lives in a manner that is in line with their values and takes into account their cultural norms when discussing important issues and addressing challenges (such as mental illness) within the family. CIT-S contains five distinct modules: (a) family collectivism, (b) psychoeducation, (c) spirituality, (d) communication training, and (e) problem-solving. For each module, a detailed rationale, background information, therapy instructions, suggested homework assignments, and a sample case vignette are provided in an accessible, easy-to-use manner.

For over 50 years, the definition and classification of cardiomyopathies have remained anchored in the concept of ventricular dysfunction and myocardial structural remodelling due to unknown cause. The concept of idiopathic was first challenged in 2006, when the American Heart Association classification subordinated the phenotype to the aetiology. Cardiomyopathies were classified as genetic, acquired, and mixed. In 2008, the European Society of Cardiology proposed a phenotype-driven classification that separated familial (genetic) from non-familial (non-genetic) forms of cardiomyopathy. Both classifications led the way to a precise phenotypic and aetiological description of the disease and moved away from the previously held notion of idiopathic disease. In 2013, the World Heart Federation introduced a descriptive and flexible nosology—the MOGE(S) classification—describing the morphofunctional (M) phenotype of cardiomyopathy, the involvement of additional organs (O), the familial/genetic (G) origin, and the precise description of the (a)etiology including genetic mutation, if applicable (E); reporting of functional status such as American College of Cardiology/American Heart Association stage and New York Heart Association classification (S) was left optional. MOGE(S) is a bridge between the past and the future. It allows description of comprehensive phenotypic data, all genetic and non-genetic causes of cardiomyopathy, and incorporates description of familial clustering in a genetic disease. MOGE(S) is the instrument of precision diagnosis for cardiomyopathies. The addition of the early and unaffected phenotypes to the (M) descriptor outlines the clinical profile of an early affected family member; the examples include non-dilated hypokinetic cardiomyopathy in dilated cardiomyopathy and septal thickness (13–14 mm) in hypertrophic cardiomyopathy classes.

Infective endocarditis is the fourth leading cause of life-threatening infections, accounting for 40,000 annual U.S. hospital admissions. Due to decline in rheumatic heart disease, a shift in causative organisms from viridans streptococci to S. aureus, Group D Streptococcus, and multidrug-resistant species has been observed. The spectrum of neurological complications ranges widely from cerebrovascular pathologies-including septic embolization, mycotic aneurysms, and intracerebral hemorrhages-to seizures, meningitis, cerebritis, and abscess. Transthoracic echocardiogram remains the standard for initial investigation whereas CT scans, MRI with DWI sequence, and cerebral angiograms are useful for exploring neurological complications. Antibiotic regimens, tailored to culprit organisms, should be initiated early after obtaining blood cultures and continued for 4 to 6 weeks. Antithrombotic treatment may pose increased risk for intracerebral hemorrhage, even in the absence of mycotic aneurysms (MA). Unruptured MA must be treated according to risk of rupture and overall health of the patient. MAs either at risk or previously ruptured should be secured by neurosurgical or endovascular means. Early cardiac surgery is a viable option for prevention of septic embolization for high-risk cardiac diseases such as perivalvular abscess and infection with resistant organisms, but may increase mortality rates for those with decompensated heart failure.

Evaluation of the medical humanities/health humanities is contentious. Medicine, steeped in a world of accountability, seeks evidence of effectiveness or impact, where evidence is confined to the measurable. Medical humanities, an eclectic interdisciplinary field, values the experiential, more suited to descriptive, qualitative forms of investigation. Rather than prize one approach over the other, clinician educators need to be methodologically flexible. The decision about which approach to use is best determined by the question(s) they wish to answer. This chapter briefly reviews some of the tensions medical educators face when deciding how to evaluate their teaching. It outlines a number of approaches to evaluation and gives examples from the medical humanities literature. Finally, it provides some resources to direct further inquiry.

The complexity of left ventricular (LV) function(s) assessment in heart failure patients is related to the complexity of heart anatomy, but also to the complexity of electromechanical interaction, and to the load dependency of all the parameters that could be applied in clinical practice. Three perpendicular axes orienting the global geometry of the LV define the local cardiac coordinate system: radial, circumferential, and longitudinal. Speckle tracking is the technique of choice for quantifying myocardial deformation (regional and global). Longitudinal LV deformation, which is predominantly governed by the subendocardial region, is the most vulnerable component of LV mechanics and therefore most sensitive to the presence of myocardial disease.

Immunotherapy in critically-ill patients is only feasible at clinical experimental level; no therapy has been approved so far. To develop a potential therapeutic strategy we need to know the pathogen, immune status of the patient, and interaction between the particular pathogen and immune cells to readjust the patient´s individually imbalanced immunological responsiveness. Giving the right treatment at the right time is crucial for a better outcome and the best economic use of resources. The process starts by matching the therapeutic selection to the clinical need. Personalized immunotherapy, highly dependent on the available biomarker, is required. Future studies on new immunotherapeutic approaches in critically-ill patients can only be interpreted in combination with immunological biomarker analyses. Immune modulation is a promising approach despite many disappointing results and there is a clear need for immunological stratification of critically-ill patients for improved efficacy. The search continues for new clinical endpoints in surviving patients with medical and health-economical impact.

There are many unscheduled contacts between children and clinicians, and therefore many opportunities for clinicians to identify previously unsuspected problems that parents may not already have suspected. There are three distinct foci during assessment, namely the child, the parent(s), and the parent–child relationship. Any of these can alert the practitioner to potential concerns, regardless of the presenting issue. Practitioners need to be aware of, and alert to, concerns about physical and social/emotional development, as well as signs of maltreatment and neglect. In addition, it is important to be able to evaluate the quality of parenting a child experiences, as this is a strong predictor of future mental and physical health. While this is an area in which clinicians may feel less confident or skilled, there is evidence to suggest that continuity of care and a trusting parent–clinician relationship provide an arena in which problems can be raised, aired, and more satisfactorily addressed.

Infectious endocarditis (IE) is an infection of the heart’s innermost layer, the endothelium. Most cases require a predisposing injury to the endocardium to serve as a nidus for thrombus development, which in turn acts as nidus for bloodstream microorganisms. These intravascular microorganisms can result from dental and other invasive procedures, infected vascular catheters, and skin lesions. However, most episodes of IE result from transient bacteremia during menial tasks, such as chewing and brushing one’s teeth. Blood cultures and echocardiograms are critical for IE diagnosis. Transesophageal echocardiogram (TEE) is the preferred diagnostic tool for prosthetic valve endocarditis and cardiovascular implantable electronic device (CIED) infections. IE complicated by heart failure and cerebral emboli has high rates of morbidity and mortality. Large vegetation, mobile lesions, mitral valve vegetation, and infection by S. aureus and fungi are more likely to result in embolic phenomena. Indications for surgery include severe heart failure, persistent infection, fungal infection, heart block, and abscess formation.

The urinary system is the primary target of Schistosoma haematobium infection, which leads to granuloma formation in the lower urinary tract that heals with fibrosis and calcification. While the early lesions may be associated with distressing acute or subacute symptoms, it is the late lesions that constitute the main clinical impact of schistosomiasis. The latter include chronic cystitis, ureteric fibrosis, ureterovesical obstruction or reflux which may lead to chronic pyelonephritis. Secondary bacterial infection and bladder cancer are the main secondary sequelae of urinary schistosomiasis.The kidneys are also a secondary target of S. mansoni infection, attributed to the systemic immune response to the parasite. Specific immune complexes are responsible for early, often asymptomatic, possibly reversible, mesangioproliferative lesions which are categorized as ‘class I’. Subsequent classes (II–VI) display different histopathology, more serious clinical disease, and confounding pathogenic factors. Class II lesions are encountered in patients with concomitant salmonellosis; they are typically exudative and associated with acute-onset nephrotic syndrome. Classes III (mesangiocapillary glomerulonephritis) and IV (focal segmental sclerosis) are progressive forms of glomerular disease associated with significant hepatic pathology. They are usually associated with immunoglobulin A deposits which seem to have a significant pathogenic role. Class V (amyloidosis) occurs with long-standing active infection with either S. haematobium or S. mansoni. Class VI is seen in patients with concomitant HCV infection, where the pathology is a mix of schistosomal and cryoglobulinaemic lesions, as well as amyloidosis which seems to be accelerated by the confounded pathogenesis.Early schistosomal lesions, particularly those of the lower urinary tract, respond to antiparasitic treatment. Late urological lesions may need surgery or endoscopic interventions. As a rule, glomerular lesions do not respond to treatment with the exception of class II where dual antiparasitic and antibiotic therapy is usually curative. Patients with end-stage kidney disease may constitute specific, yet not insurmountable technical and logistic problems in dialysis or transplantation. Recurrence after transplantation is rare.

Miracles rarely appear in novels, yet Graham Greene includes several of them in The End of the Affair. Sarah Miles heals a boy suffering from appendicitis and a man with a disfigured cheek. Like a saint, she seems to heal or revive through her compassionate touch, as when she raises her lover, who may or may not have died in a bomb blast, by touching his hand. This chapter locates Sarah’s interventions amidst debates about miracles, beginning with David Hume’s sceptical rejection of inexplicable phenomena, through such mid-century books as C. S. Lewis’s Miracles and Dorothy Sayers’ The Mind of the Maker. The inherent godlessness of novels, as Georg Lukacs puts the matter in Theory of the Novel, would seem to ban mystical content altogether from novelistic discourse. Yet this chapter argues for the revaluation of mystical content—the ordeals of the whisky priest in The Power and the Glory, for example—within the generic precincts of the novel.

Cardiovascular disease is a leading cause of mortality. Hypertension is one of the major risk factors for cardiovascular disease. Classically, hypertension is subdivided according to the aetiology into primary and secondary hypertension. Ischaemic heart disease constitutes a major concern for perioperative morbidity and mortality. Therefore important efforts are directed towards the identification of the patient at risk for perioperative cardiac complications and towards optimization of the cardiac status before intervention. Cardiac rhythm disturbances fall into two general classes: bradyarrhythmias and tachyarrhythmias. While single isolated extra or skipped heart beats are usually harmless, serious heart rhythm disturbances are caused by an underlying heart disease. Valvular heart disease refers to any disease process involving any valve of the heart. Valvular heart disease may be as a result of a stenosis or an insufficiency of the valve, or both. It is characterized by pressure or volume overload to the atria and the ventricles (or both). It is this overload that will be responsible for the symptomatology of the disease. As a result of significant advances in prenatal diagnosis, cardiac surgery, interventional cardiology, and perioperative medicine, about 90% of infants with congenital heart disease are currently expected to reach adulthood. Management of these patients requires insight into (1) the primary cardiac lesion, (2) the type of cardiac surgical or interventional procedure(s) performed, (3) the presence of residual defects or sequelae, (4) the current physical status (i.e. balanced vs unbalanced), (5) the effects of surgery or pregnancy on their pathophysiological condition, and (6) the presence of comorbidity.

This book tells the full history of the British musical, from The Beggar's Opera (1728) to the present, by isolating the unique qualities of the form and its influence on the American model. To place a very broad generalization, the American musical is regarded as largely about ambition fulfilled, whereas the British musical is about social order. Oklahoma!'s Curly wins the heart of the farmer Laurey—or, in other words, the cowboy becomes a landowner, establishing a truce between the freelancers on horseback and the ruling class. Half a Sixpence, on the other hand, finds a working-class boy coming into a fortune and losing it to fancy Dans, whereupon he is reunited with his working-class sweetheart, his modest place in the social order affirmed. Anecdotal and evincing a strong point of view, the book covers not only the shows and their authors but the personalities as well—W. S. Gilbert trying out his stagings on a toy theatre, Ivor Novello going to jail for abusing wartime gas rationing during World War II, fabled producer C. B. Cochran coming to a most shocking demise for a man whose very name meant “classy, carefree entertainment.”

Vasculitis represents a spectrum of disorders that are often divided on the basis of the predominant vessel size affected into large-, medium- and small-vessel vasculitides. This chapter will focus on the pathogenesis of the anti-neutrophil cytoplasmic antibody (ANCA)-associated medium- and small-vessel vasculitides (AAV), and large-vessel vasculitis, Takayasu arteritis, and giant cell arteritis. Underlying pathogenic mechanisms in vasculitis remain to be fully understood. In particular, the initiating event(s) are not known. A combination of infectious or other environmental triggers on a susceptible genetic background is currently favoured. In addition to the vessel size affected, the mechanisms of vascular injury vary. Moreover, extravascular granulomatosis may play an important role in disease manifestations. The innate and adaptive immune systems contribute to its pathogenesis. Although pathogenic antibodies have not been identified in large-vessel vasculitis, ANCA are directly implicated in small- and medium-vessel AAV. Disease manifestations are varied and diverse and may include arterial stenosis or aneurysms, glomerulonephritis and renal failure, gastro-intestinal, pulmonary, cutaneous, and neurological complications, visual disturbance, deafness, and nasal bridge collapse. Life-threatening cardiovascular disease is also seen, with myocarditis, pericarditis, valvular heart disease, thrombosis, systemic and pulmonary arterial hypertension, and accelerated coronary heart disease all reported. Despite this, the prognosis for patients with vasculitis has improved significantly in recent decades. Further understanding of the pathogenesis of vasculitis will lead to the discovery of further therapeutic targets and novel, safer biologic therapies.

Multiple and mixed heart valve disease are highly prevalent. Echocardiography is the cornerstone technique for imaging these patients. As with patients with single-valve stenosis or regurgitation, one should aim to evaluate the aetiology, the mechanism(s) of dysfunction, as well as the consequences and the possibility of repair. There are, however, specific issues, which include the followings: (1) the lack of published data; (2) most indices of valvular regurgitation and of stenosis severity have been validated in patients with single-valve/single-lesion disease; and (3) the haemodynamic interactions that may affect the severity and the diagnosis of these lesions. A global assessment of the consequences of the lesions is of the utmost importance in the decision-making process: whereas only severe regurgitation or stenosis is usually considered for surgery by current guidelines in a single-valve lesion, the combination of two or more less-than-severe lesions causing symptoms, left ventricular dysfunction, and/or pulmonary pressure increase may warrant surgery. This chapter focuses on the echocardiographic assessment of these sometimes complex lesions, emphasizing some pitfalls and tips to take into account when managing these patients.

RAINBOW: A Child- and Family-Focused Cognitive-Behavioral Treatment for Pediatric Bipolar Disorder is a comprehensive, evidence-based treatment manual designed specifically for children ages 7–13 with bipolar spectrum disorders and their families. Developed by experts in pediatric mood disorders and tested in a randomized clinical trial (RCT), RAINBOW integrates psychoeducation and cognitive-behavioral therapy (CBT) with complementary techniques from mindfulness-based intervention, positive psychology, and interpersonal therapy to address the range of therapeutic needs of families affected by this disorder. Guided by the evidence on the neurobiological and psychosocial difficulties accompanying pediatric bipolar disorder, this treatment targets the child and family across seven core components: Routine, Affect Regulation, I Can Do It, No Negative Thoughts and Live in the Now, Be a Good Friend/Balanced Lifestyle for Parents, Oh How Do We Solve This Problem, and Ways to Get Support. Throughout the treatment, the child and family will learn how to identify mood states and triggers of mood dysregulation, and develop cognitive and behavioral strategies for improving mood stability. Children will build social skills, and caregivers will develop greater balance and self-care in their own lives. The family will learn ways to use routines, problem-solving, and social support to improve overall family functioning. Intended for qualified child-focused mental health professionals, this manual includes the conceptual background of the treatment and user-friendly step-by-step instruction in delivering RAINBOW with families, including handy session outlines and engaging worksheets for the child and caregiver(s).

Giardia is a ubiquitous intestinal protozoan parasite of vertebrates and the most common intestinal pathogen of humans and domestic animals with a worldwide distribution including both temperate and tropical regions.Giardia was first observed in 1681 by Antony van Leeuwenhoek in his own faeces (Dobell 1920), and the organism has intrigued biologists and clinicians ever since. However, the first detailed description of the parasite was not given until two centuries later by Lambl (1859). Koch’s postulation was proven by Rendtorff in 1954 when he successfully transmitted symptomatic Giardia infection to human volunteers following orally administered cysts. The first symptoms of clinical giardiasis were reported in the early 1920s, although the significance of Giardia as a cause of diarrhoeal disease was controversial for many years (see Farthing 1994; Cox 1998), and it is only recently that the significance of Giardia as a cause of chronic disease in children and its association with failure to thrive, wasting and malabsorption syndromes has been fully realised (reviewed in Farthing 1994; Hall 1994; Gracey 1994; Rabbani and Islam 1994; Hesham et al. 2005; Savioli et al. 2006; Thompson 2008).The question of Giardia ’s role as a source of zoonotically transmitted disease again has been controversial. The World Health Organization (WHO) recommended that Giardia should be considered as a zoonotic agent in 1979 (Anon. 1979). Since that time, increasing circumstantial epidemiological evidence from waterborne outbreaks, the results of some cross-infection experiments and molecular characterization studies of Giardia isolates from humans and other animals has led most authorities to conclude that Giardia should be considered a zoonotic parasite (Acha and Szyfres 2003; Savioli et al. 2006; and reviewed in Thompson 2004). However, as discussed below, the frequency of zoonotic transmission is uncertain.

Nationalism: Past as Prologue began as a single volume being compiled by Ad Akande, a scholar from South Africa, who proposed it to me as co-author about two years ago. The original idea was to examine how the damaging roots of nationalism have been corroding political systems around the world, and creating dangerous obstacles for necessary international cooperation. Since I (Bruce E. Johansen) has written profusely about climate change (global warming, a.k.a. infrared forcing), I suggested a concerted effort in that direction. This is a worldwide existential threat that affects every living thing on Earth. It often compounds upon itself, so delays in reducing emissions of fossil fuels are shortening the amount of time remaining to eliminate the use of fossil fuels to preserve a livable planet. Nationalism often impedes solutions to this problem (among many others), as nations place their singular needs above the common good. Our initial proposal got around, and abstracts on many subjects arrived. Within a few weeks, we had enough good material for a 100,000-word book. The book then fattened to two moderate volumes and then to four two very hefty tomes. We tried several different titles as good submissions swelled. We also discovered that our best contributors were experts in their fields, which ranged the world. We settled on three stand-alone books:” 1/ nationalism and racial justice. Our first volume grew as the growth of Black Lives Matter following the brutal killing of George Floyd ignited protests over police brutality and other issues during 2020, following the police assassination of Floyd in Minneapolis. It is estimated that more people took part in protests of police brutality during the summer of 2020 than any other series of marches in United States history. This includes upheavals during the 1960s over racial issues and against the war in Southeast Asia (notably Vietnam). We choose a volume on racism because it is one of nationalism’s main motive forces. This volume provides a worldwide array of work on nationalism’s growth in various countries, usually by authors residing in them, or in the United States with ethnic ties to the nation being examined, often recent immigrants to the United States from them. Our roster of contributors comprises a small United Nations of insightful, well-written research and commentary from Indonesia, New Zealand, Australia, China, India, South Africa, France, Portugal, Estonia, Hungary, Russia, Poland, Kazakhstan, Georgia, and the United States. Volume 2 (this one) describes and analyzes nationalism, by country, around the world, except for the United States; and 3/material directly related to President Donald Trump, and the United States. The first volume is under consideration at the Texas A & M University Press. The other two are under contract to Nova Science Publishers (which includes social sciences). These three volumes may be used individually or as a set. Environmental material is taken up in appropriate places in each of the three books. * * * * * What became the United States of America has been strongly nationalist since the English of present-day Massachusetts and Jamestown first hit North America’s eastern shores. The country propelled itself across North America with the self-serving ideology of “manifest destiny” for four centuries before Donald Trump came along. Anyone who believes that a Trumpian affection for deportation of “illegals” is a new thing ought to take a look at immigration and deportation statistics in Adam Goodman’s The Deportation Machine: America’s Long History of Deporting Immigrants (Princeton University Press, 2020). Between 1920 and 2018, the United States deported 56.3 million people, compared with 51.7 million who were granted legal immigration status during the same dates. Nearly nine of ten deportees were Mexican (Nolan, 2020, 83). This kind of nationalism, has become an assassin of democracy as well as an impediment to solving global problems. Paul Krugman wrote in the New York Times (2019:A-25): that “In their 2018 book, How Democracies Die, the political scientists Steven Levitsky and Daniel Ziblatt documented how this process has played out in many countries, from Vladimir Putin’s Russia, to Recep Erdogan’s Turkey, to Viktor Orban’s Hungary. Add to these India’s Narendra Modi, China’s Xi Jinping, and the United States’ Donald Trump, among others. Bit by bit, the guardrails of democracy have been torn down, as institutions meant to serve the public became tools of ruling parties and self-serving ideologies, weaponized to punish and intimidate opposition parties’ opponents. On paper, these countries are still democracies; in practice, they have become one-party regimes….And it’s happening here [the United States] as we speak. If you are not worried about the future of American democracy, you aren’t paying attention” (Krugmam, 2019, A-25). We are reminded continuously that the late Carl Sagan, one of our most insightful scientific public intellectuals, had an interesting theory about highly developed civilizations. Given the number of stars and planets that must exist in the vast reaches of the universe, he said, there must be other highly developed and organized forms of life. Distance may keep us from making physical contact, but Sagan said that another reason we may never be on speaking terms with another intelligent race is (judging from our own example) could be their penchant for destroying themselves in relatively short order after reaching technological complexity. This book’s chapters, introduction, and conclusion examine the worldwide rise of partisan nationalism and the damage it has wrought on the worldwide pursuit of solutions for issues requiring worldwide scope, such scientific co-operation public health and others, mixing analysis of both. We use both historical description and analysis. This analysis concludes with a description of why we must avoid the isolating nature of nationalism that isolates people and encourages separation if we are to deal with issues of world-wide concern, and to maintain a sustainable, survivable Earth, placing the dominant political movement of our time against the Earth’s existential crises. Our contributors, all experts in their fields, each have assumed responsibility for a country, or two if they are related. This work entwines themes of worldwide concern with the political growth of nationalism because leaders with such a worldview are disinclined to co-operate internationally at a time when nations must find ways to solve common problems, such as the climate crisis. Inability to cooperate at this stage may doom everyone, eventually, to an overheated, stormy future plagued by droughts and deluges portending shortages of food and other essential commodities, meanwhile destroying large coastal urban areas because of rising sea levels. Future historians may look back at our time and wonder why as well as how our world succumbed to isolating nationalism at a time when time was so short for cooperative intervention which is crucial for survival of a sustainable earth. Pride in language and culture is salubrious to individuals’ sense of history and identity. Excess nationalism that prevents international co-operation on harmful worldwide maladies is quite another. As Pope Francis has pointed out: For all of our connectivity due to expansion of social media, ability to communicate can breed contempt as well as mutual trust. “For all our hyper-connectivity,” said Francis, “We witnessed a fragmentation that made it more difficult to resolve problems that affect us all” (Horowitz, 2020, A-12). The pope’s encyclical, titled “Brothers All,” also said: “The forces of myopic, extremist, resentful, and aggressive nationalism are on the rise.” The pope’s document also advocates support for migrants, as well as resistance to nationalist and tribal populism. Francis broadened his critique to the role of market capitalism, as well as nationalism has failed the peoples of the world when they need co-operation and solidarity in the face of the world-wide corona virus pandemic. Humankind needs to unite into “a new sense of the human family [Fratelli Tutti, “Brothers All”], that rejects war at all costs” (Pope, 2020, 6-A). Our journey takes us first to Russia, with the able eye and honed expertise of Richard D. Anderson, Jr. who teaches as UCLA and publishes on the subject of his chapter: “Putin, Russian identity, and Russia’s conduct at home and abroad.” Readers should find Dr. Anderson’s analysis fascinating because Vladimir Putin, the singular leader of Russian foreign and domestic policy these days (and perhaps for the rest of his life, given how malleable Russia’s Constitution has become) may be a short man physically, but has high ambitions. One of these involves restoring the old Russian (and Soviet) empire, which would involve re-subjugating a number of nations that broke off as the old order dissolved about 30 years ago. President (shall we say czar?) Putin also has international ambitions, notably by destabilizing the United States, where election meddling has become a specialty. The sight of Putin and U.S. president Donald Trump, two very rich men (Putin $70-$200 billion; Trump $2.5 billion), nuzzling in friendship would probably set Thomas Jefferson and Vladimir Lenin spinning in their graves. The road of history can take some unanticipated twists and turns. Consider Poland, from which we have an expert native analysis in chapter 2, Bartosz Hlebowicz, who is a Polish anthropologist and journalist. His piece is titled “Lawless and Unjust: How to Quickly Make Your Own Country a Puppet State Run by a Group of Hoodlums – the Hopeless Case of Poland (2015–2020).” When I visited Poland to teach and lecture twice between 2006 and 2008, most people seemed to be walking on air induced by freedom to conduct their own affairs to an unusual degree for a state usually squeezed between nationalists in Germany and Russia. What did the Poles then do in a couple of decades? Read Hlebowicz’ chapter and decide. It certainly isn’t soft-bellied liberalism. In Chapter 3, with Bruce E. Johansen, we visit China’s western provinces, the lands of Tibet as well as the Uighurs and other Muslims in the Xinjiang region, who would most assuredly resent being characterized as being possessed by the Chinese of the Han to the east. As a student of Native American history, I had never before thought of the Tibetans and Uighurs as Native peoples struggling against the Independence-minded peoples of a land that is called an adjunct of China on most of our maps. The random act of sitting next to a young woman on an Air India flight out of Hyderabad, bound for New Delhi taught me that the Tibetans had something to share with the Lakota, the Iroquois, and hundreds of other Native American states and nations in North America. Active resistance to Chinese rule lasted into the mid-nineteenth century, and continues today in a subversive manner, even in song, as I learned in 2018 when I acted as a foreign adjudicator on a Ph.D. dissertation by a Tibetan student at the University of Madras (in what is now in a city called Chennai), in southwestern India on resistance in song during Tibet’s recent history. Tibet is one of very few places on Earth where a young dissident can get shot to death for singing a song that troubles China’s Quest for Lebensraum. The situation in Xinjiang region, where close to a million Muslims have been interned in “reeducation” camps surrounded with brick walls and barbed wire. They sing, too. Come with us and hear the music. Back to Europe now, in Chapter 4, to Portugal and Spain, we find a break in the general pattern of nationalism. Portugal has been more progressive governmentally than most. Spain varies from a liberal majority to military coups, a pattern which has been exported to Latin America. A situation such as this can make use of the term “populism” problematic, because general usage in our time usually ties the word into a right-wing connotative straightjacket. “Populism” can be used to describe progressive (left-wing) insurgencies as well. José Pinto, who is native to Portugal and also researches and writes in Spanish as well as English, in “Populism in Portugal and Spain: a Real Neighbourhood?” provides insight into these historical paradoxes. Hungary shares some historical inclinations with Poland (above). Both emerged from Soviet dominance in an air of developing freedom and multicultural diversity after the Berlin Wall fell and the Soviet Union collapsed. Then, gradually at first, right wing-forces began to tighten up, stripping structures supporting popular freedom, from the courts, mass media, and other institutions. In Chapter 5, Bernard Tamas, in “From Youth Movement to Right-Liberal Wing Authoritarianism: The Rise of Fidesz and the Decline of Hungarian Democracy” puts the renewed growth of political and social repression into a context of worldwide nationalism. Tamas, an associate professor of political science at Valdosta State University, has been a postdoctoral fellow at Harvard University and a Fulbright scholar at the Central European University in Budapest, Hungary. His books include From Dissident to Party Politics: The Struggle for Democracy in Post-Communist Hungary (2007). Bear in mind that not everyone shares Orbán’s vision of what will make this nation great, again. On graffiti-covered walls in Budapest, Runes (traditional Hungarian script) has been found that read “Orbán is a motherfucker” (Mikanowski, 2019, 58). Also in Europe, in Chapter 6, Professor Ronan Le Coadic, of the University of Rennes, Rennes, France, in “Is There a Revival of French Nationalism?” Stating this title in the form of a question is quite appropriate because France’s nationalistic shift has built and ebbed several times during the last few decades. For a time after 2000, it came close to assuming the role of a substantial minority, only to ebb after that. In 2017, the candidate of the National Front reached the second round of the French presidential election. This was the second time this nationalist party reached the second round of the presidential election in the history of the Fifth Republic. In 2002, however, Jean-Marie Le Pen had only obtained 17.79% of the votes, while fifteen years later his daughter, Marine Le Pen, almost doubled her father's record, reaching 33.90% of the votes cast. Moreover, in the 2019 European elections, re-named Rassemblement National obtained the largest number of votes of all French political formations and can therefore boast of being "the leading party in France.” The brutality of oppressive nationalism may be expressed in personal relationships, such as child abuse. While Indonesia and Aotearoa [the Maoris’ name for New Zealand] hold very different ranks in the United Nations Human Development Programme assessments, where Indonesia is classified as a medium development country and Aotearoa New Zealand as a very high development country. In Chapter 7, “Domestic Violence Against Women in Indonesia and Aotearoa New Zealand: Making Sense of Differences and Similarities” co-authors, in Chapter 8, Mandy Morgan and Dr. Elli N. Hayati, from New Zealand and Indonesia respectively, found that despite their socio-economic differences, one in three women in each country experience physical or sexual intimate partner violence over their lifetime. In this chapter ther authors aim to deepen understandings of domestic violence through discussion of the socio-economic and demographic characteristics of theit countries to address domestic violence alongside studies of women’s attitudes to gender norms and experiences of intimate partner violence. One of the most surprising and upsetting scholarly journeys that a North American student may take involves Adolf Hitler’s comments on oppression of American Indians and Blacks as he imagined the construction of the Nazi state, a genesis of nationalism that is all but unknown in the United States of America, traced in this volume (Chapter 8) by co-editor Johansen. Beginning in Mein Kampf, during the 1920s, Hitler explicitly used the westward expansion of the United States across North America as a model and justification for Nazi conquest and anticipated colonization by Germans of what the Nazis called the “wild East” – the Slavic nations of Poland, the Baltic states, Ukraine, and Russia, most of which were under control of the Soviet Union. The Volga River (in Russia) was styled by Hitler as the Germans’ Mississippi, and covered wagons were readied for the German “manifest destiny” of imprisoning, eradicating, and replacing peoples the Nazis deemed inferior, all with direct references to events in North America during the previous century. At the same time, with no sense of contradiction, the Nazis partook of a long-standing German romanticism of Native Americans. One of Goebbels’ less propitious schemes was to confer honorary Aryan status on Native American tribes, in the hope that they would rise up against their oppressors. U.S. racial attitudes were “evidence [to the Nazis] that America was evolving in the right direction, despite its specious rhetoric about equality.” Ming Xie, originally from Beijing, in the People’s Republic of China, in Chapter 9, “News Coverage and Public Perceptions of the Social Credit System in China,” writes that The State Council of China in 2014 announced “that a nationwide social credit system would be established” in China. “Under this system, individuals, private companies, social organizations, and governmental agencies are assigned a score which will be calculated based on their trustworthiness and daily actions such as transaction history, professional conduct, obedience to law, corruption, tax evasion, and academic plagiarism.” The “nationalism” in this case is that of the state over the individual. China has 1.4 billion people; this system takes their measure for the purpose of state control. Once fully operational, control will be more subtle. People who are subject to it, through modern technology (most often smart phones) will prompt many people to self-censor. Orwell, modernized, might write: “Your smart phone is watching you.” Ming Xie holds two Ph.Ds, one in Public Administration from University of Nebraska at Omaha and another in Cultural Anthropology from the Chinese Academy of Social Sciences, Beijing, where she also worked for more than 10 years at a national think tank in the same institution. While there she summarized news from non-Chinese sources for senior members of the Chinese Communist Party. Ming is presently an assistant professor at the Department of Political Science and Criminal Justice, West Texas A&M University. In Chapter 10, analyzing native peoples and nationhood, Barbara Alice Mann, Professor of Honours at the University of Toledo, in “Divide, et Impera: The Self-Genocide Game” details ways in which European-American invaders deprive the conquered of their sense of nationhood as part of a subjugation system that amounts to genocide, rubbing out their languages and cultures -- and ultimately forcing the native peoples to assimilate on their own, for survival in a culture that is foreign to them. Mann is one of Native American Studies’ most acute critics of conquests’ contradictions, and an author who retrieves Native history with a powerful sense of voice and purpose, having authored roughly a dozen books and numerous book chapters, among many other works, who has traveled around the world lecturing and publishing on many subjects. Nalanda Roy and S. Mae Pedron in Chapter 11, “Understanding the Face of Humanity: The Rohingya Genocide.” describe one of the largest forced migrations in the history of the human race, the removal of 700,000 to 800,000 Muslims from Buddhist Myanmar to Bangladesh, which itself is already one of the most crowded and impoverished nations on Earth. With about 150 million people packed into an area the size of Nebraska and Iowa (population less than a tenth that of Bangladesh, a country that is losing land steadily to rising sea levels and erosion of the Ganges river delta. The Rohingyas’ refugee camp has been squeezed onto a gigantic, eroding, muddy slope that contains nearly no vegetation. However, Bangladesh is majority Muslim, so while the Rohingya may starve, they won’t be shot to death by marauding armies. Both authors of this exquisite (and excruciating) account teach at Georgia Southern University in Savannah, Georgia, Roy as an associate professor of International Studies and Asian politics, and Pedron as a graduate student; Roy originally hails from very eastern India, close to both Myanmar and Bangladesh, so he has special insight into the context of one of the most brutal genocides of our time, or any other. This is our case describing the problems that nationalism has and will pose for the sustainability of the Earth as our little blue-and-green orb becomes more crowded over time. The old ways, in which national arguments often end in devastating wars, are obsolete, given that the Earth and all the people, plants, and other animals that it sustains are faced with the existential threat of a climate crisis that within two centuries, more or less, will flood large parts of coastal cities, and endanger many species of plants and animals. To survive, we must listen to the Earth, and observe her travails, because they are increasingly our own.