Libros: "Continuous and deep sedation"

1

Sterckx, Sigrid, Kasper Raus y Freddy Mortier, eds. Continuous Sedation at the End of Life. Cambridge: Cambridge University Press, 2013. http://dx.doi.org/10.1017/cbo9781139856652.

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2

Urman, Richard D. y Alan D. Kaye, eds. Moderate and Deep Sedation in Clinical Practice. Cambridge: Cambridge University Press, 2012. http://dx.doi.org/10.1017/cbo9781139084000.

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3

Malamed, Stanley F. Sedation: A guide to patient management. 3^a ed. St. Louis: Mosby, 1995.

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4

G, Reves J. y Sladen Robert N, eds. Anesthesia and sedation by continuous infusion: Proceedings of a symposium, May 31-June 1, 1991. Princeton, N.J: Excerpta Medica, 1992.

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5

L, Quinn Christine, ed. Sedation: A guide to patient management. 2^a ed. St. Louis: Mosby, 1989.

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6

Favaro, Alice. Después de la caída del ‘ángel’. Venice: Edizioni Ca' Foscari, 2020. http://dx.doi.org/10.30687/978-88-6969-416-5.

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Ángel Bonomini was born in Buenos Aires in 1929 where he lived until his death at the age of sixty-four in 1994. He worked for various newspapers and magazines as an art critic and translator, but always maintaining his literary activity. He inherited the tradition of the Argentine fantastic and was a prolific writer: his production includes essays, poems and fantastic tales.Although he lived in a period of great cultural splendor and his literary talent was recognised by authors such as Borges and Bioy Casares, he fell into an unexplained oblivion, disappearing quite early from the contemporary intellectual environment. His first poems, which date back to the 1950s, were published in Sur magazine and some of his tales were included in well-known anthologies of fantastic literature.Among his collections of poems there are: Primera enunciación (1947), Argumento del enamorado. Baladas con Ángel (1952) written with María Elena Walsh, Torres para el silencio (1982) and Poética (1994). In 1972 he achieved great success with the publication of his first collection of fantastic tales, Los novicios de Lerna, followed by the publication of other books: Libro de los casos (1975), Los lentos elefantes de Milán (1978), Cuentos de amor (1982), Historias secretas (1985) and Más allá del puente (1996), posthumously published.A particular use of the fantastic characterises his work and distinguishes him from his contemporary authors. In his tales there is a continuous contrast between metaphysics and existentialism; in this way, he makes a deep investigation of the reality and, at the same time, he tries to go beyond it.This volume aims to analyse some emblematic tales by Bonomini in which it is possible to find the main topoi of Argentine fantastic and to understand why the author’s literary work is worth studying.

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7

Gross. Moderate And Deep Sedation. Not Avail, 2006.

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8

Sterckx, Sigrid y Kasper Raus. Continuous Sedation at the End of Life. Editado por Stuart J. Youngner y Robert M. Arnold. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199974412.013.7.

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This chapter examines continuous sedation as a way to relieve unbearable suffering in patients at the end of life. After considering consensus and guidelines on continuous sedation, it looks at the debate over terminology and definition. It then discusses the practice of continuous sedation in various countries and how it is performed, along with the importance of patient consent and autonomy in all sedation guidelines. The chapter goes on to analyze some of the commonly invoked justifications for continuous sedation, including the doctrine of double effect, last resort and refractory suffering, autonomy and patient consent, and proportionality. It also reviews contentious issues raised by continuous sedation, such as whether it should be restricted to patients with a very short life expectancy, artificial nutrition and hydration, and existential or psychological suffering.

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9

Urman, Richard D. y Alan D. Kaye. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2012.

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10

Kaye, Alan David y Richard D. Urman. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2017.

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11

Kaye, Alan David y Richard D. Urman. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2017.

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12

Urman, Richard D. y Alan David Kaye, eds. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2017. http://dx.doi.org/10.1017/9781316796016.

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13

Urman, Richard D. y Alan D. Kaye. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2012.

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14

Urman, Richard D. y Alan D. Kaye. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2012.

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15

Urman, Richard D. y Alan D. Kaye. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2012.

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16

Kaye, Alan David y Richard D. Urman. Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2017.

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17

Moderate and deep sedation in clinical practice. Cambridge: Cambridge University Press, 2012.

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18

Moderate and Deep Sedation in Clinical Practice. Cambridge University Press, 2024.

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19

Association, American Dental, ed. Guidelines for the use of conscious sedation, deep sedation and general anesthesia for dentists. 1997.

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20

Knape, Johannes (Hans) T. A. Conscious sedation. Editado por Michel M. R. F. Struys. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0050.

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After a thorough introduction to conscious sedation, including the reasons for the increase in demand for assistance for moderate (conscious)-to-deep sedation in medicine over recent decades, this chapter covers some key definitions, before moving on to morbidity, mortality, and safety. The chapter then discusses how to prepare the patient for sedation, including the issue of whether the patient should have fasted prior to sedation and the screening of patients for sedation. It looks at the necessary qualifications and responsibilities of a sedation practitioner, and the monitoring of patients undergoing moderate-to-deep sedation: this includes monitoring of the ventilation via pulse oximetry, monitoring the efficacy of spontaneous ventilation via capnography, monitoring of the circulation, ECG monitoring, and monitoring the depth of sedation. Routine oxygen administration is also discussed, as are emergency interventions and resuscitation, and recovery and discharge of the patient following moderate-to-deep sedation. The chapter finishes with a discussion of the techniques and drugs used in sedation, and specific considerations surrounding sedation in children.

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21

Macauley, Robert C. Palliative Sedation (DRAFT). Editado por Robert C. Macauley. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199313945.003.0009.

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Palliative sedation refers to lowering a patient’s level of consciousness so that she no longer suffers from intolerable and refractory symptoms. Some forms of palliative sedation are ethically uncontroversial, such as emergency or respite sedation. Continuous sedation to unconsciousness (CSU) is controversial in that a patient in such a state is unable to eat or drink and may not be able to protect her airway. Ethically relevant considerations include the inability to participate in subsequent decision-making, the uncertain quality of an unconscious life, and the impact on life expectancy (which is often misunderstood). Special cases of CSU for existential distress and in children demand in-depth analysis.

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22

Continuous Sedation at the End of Life: Ethical, Clinical and Legal Perspectives. Cambridge University Press, 2013.

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23

Sterckx, Sigrid, Freddy Mortier y Kasper Raus. Continuous Sedation at the End of Life: Ethical, Clinical and Legal Perspectives. Cambridge University Press, 2013.

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24

Sterckx, Sigrid, Freddy Mortier y Kasper Raus. Continuous Sedation at the End of Life: Ethical, Clinical and Legal Perspectives. Cambridge University Press, 2013.

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25

Sterckx, Sigrid, Freddy Mortier y Kasper Raus. Continuous Sedation at the End of Life: Ethical, Clinical and Legal Perspectives. Cambridge University Press, 2016.

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26

Asin, Melvin. The Behaviour of Reinforced Concrete Continuous Deep Beams. Delft Univ Pr, 2000.

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27

Malamed, Stanley F. Sedation: A guide to patient management. 2^a ed. Mosby, 1988.

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28

Quinn, Christine L. y Stanley F. Malamed. Sedation: A Guide to Patient Management. 3^a ed. Mosby-Year Book, 1995.

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29

Sury, Michael. Procedural sedation in children. Editado por Jonathan G. Hardman y Neil S. Morton. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0072.

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Sedation is a state of reduced consciousness in which the patient should be rousable. The main concern is that sedation can become too deep, unintentionally, and the patient can be harmed. The practitioner must therefore be trained to cope with all the common side-effects of sedation. Sedation techniques depend on the intended procedure. Four common scenarios are covered in this chapter: painless imaging, painful procedures, endoscopy, and dental procedures. Each of these has specific demands and they are discussed in detail. The anaesthetist should choose short-acting potent drugs to provide effective sedation or anaesthesia. Non-anaesthetists should, unless specifically trained, limit their techniques to those which are truly sedation and have a wide margin of safety. Unfortunately, such drugs are usually less potent and the techniques have a failure rate. In the absence of anaesthetists, high-quality services need to minimize the risk of failure and develop effective sedation techniques by trained staff.

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30

Sedation: A guide to patient management. 5^a ed. St. Louis, Mo: Mosby Elsevier, 2010.

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31

Sedation: A Guide to Patient Management. 4^a ed. Mosby, 2002.

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32

Exhaust ventilation of deep cuts using a continuous-mining machine. Pittsburgh, Pa. (P.O. Box 18070, Pittsburgh 15236): U.S. Dept. of the Interior, Bureau of Mines, 1985.

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33

Mistraletti, Giovanni y Gaetano Iapichino. Sedation assessment in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0358.

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Patient comfort is a primary goal in ICU, but achieving and maintaining the appropriate balance of analgesia, sedation, and treatment of delirium is frequently challenging. International guidelines recommend keeping critically-ill patients calm and cooperative, awake in daytime and asleep at night, always avoiding deep sedation. To state the actual level of sedation and the desired one, it is necessary to frequently perform a sedation assessment with validated tools. Subjective methods are the most useful guides in ICU consciously-sedated patients, representing the gold standard for good clinical practice. Use of such a scale is a key component of sedation algorithms. The ideal scoring system should be easy, reliable, sensitive, and with minimal interobserver variability, giving no or minimal additional discomfort to the patient. Most of the proposed tools are a compromise between accuracy and time required for evaluation; the most used are the Richmond Agitation-Sedation Scale and the Sedation-Agitation Scale.

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34

Krakauer, Eric L. Sedation at the end of life. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0182.

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Palliative sedation is a well-accepted therapy that should be considered in the rare situations when a terminally ill patient whose overriding goal is comfort experiences severe suffering that is refractory to all available standard palliative interventions. Typically, such suffering is caused by physical or neuropsychiatric symptoms such as pain, dyspnoea, vomiting, seizures, agitated delirium, anxiety, or depression. The level of sedation should be proportional to an individual patient’s suffering and should be just deep enough to provide the desired relief. In some cases, sedation to unconsciousness is necessary. The intention of palliative sedation should be only to relieve suffering, never to hasten death. Informed consent must be obtained, and clinicians should demonstrate their intentions by documenting the regimen used and the patient’s response. Ideal medications have a rapid onset of action and a short duration of action that facilitate titration to the desired effect. The best agents are barbiturates such as pentobarbital and anaesthetic induction agents such as propofol.

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35

Lacombe, Gabriel F. Comparison of remifentanil infusion with fentanyl for use with propofol for deep sedation in oral surgery. 2003, 2003.

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36

Sessler, Curtis N. y Katie M. Muzevich. Sedatives and anti-anxiety agents in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0042.

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Sedative and anti-anxiety agents are administered to many mechanically-ventilated intensive care unit (ICU) patients. While commonly considered supportive care, suboptimal administration of sedatives has been linked to longer duration of mechanical ventilation and longer ICU length of stay. The use of a structured multidisciplinary approach can help improve outcomes. The level of consciousness, as well as the presence and severity of agitation should be routinely evaluated using a validated sedation–agitation scale. The approach to delivery of sedation should be based upon specific goals, particularly mechanical ventilation, while maintaining the lightest possible level of sedation. Selection should be based upon clinical circumstances and patient characteristics, however, when continuous infusion sedation is required, experts suggest using non-benzodiazepine agents. A variety of strategies for sedation management have been demonstrated to be effective in clinical trials including use of protocols, targeting light sedation, preference of analgesics for initial therapy, use of intermittent, rather than continuous drug delivery when possible, and daily interruption of sedation. Finally, light sedation should be linked to performance of spontaneous breathing trials, as well as early mobilization.

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37

Assessment of deep conventional and continuous-type (unconventional) natural gas plays in the United States. Reston, VA: U.S. Dept. of the Interior, U.S. Geological Survey, 1996.

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38

Metzner, Julia y Karen B. Domino. Outcomes, Regulation, and Quality Improvement. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190495756.003.0010.

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To improve the safety of patients undergoing procedures in remote locations, practitioners should be familiar with rigorous continuous quality improvement systems, national and regulatory patient safety efforts, as well as complications related to anesthesia/sedation in out of the operating room (OOOR) settings. This chapter discusses severe outcomes and mechanisms of injury in OOOR locations, national patient safety and regulatory efforts that may be adapted to the OOOR setting, and quality improvement efforts essential to track outcomes and improve patient safety. Patient safety can be improved by adherence to respiratory monitoring (e.g., pulse oximetry and capnography), sedation standards/guidelines and national patient safety and regulatory efforts, and development of vigorous quality improvement systems to measure outcomes and make changes.

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39

Vespa, Paul M. Electroencephalogram monitoring in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0221.

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Electroencephalography monitoring provides a method for monitoring brain function, which can complement other forms of monitoring, such as monitoring of intracranial pressure and derived parameters, such as cerebral perfusion pressure. Continuous electroencephalogram (EEG) monitoring can be helpful in seizure detection after brain injury and coma. Seizures can be detected by visual inspection of the raw EEG and/or processed EEG data. Treatment of status epilepticus can be improved by rapid identification and abolition of seizures using continuous EEG. Quantitative EEG can also be used to detect brain ischaemia and seizures, to monitor sedation and aid prognosis.

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40

Schmidt, Gregory A. y Kevin Doerschug. Promoting physical recovery in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0378.

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Survivors of critical illnesses are often faced with persistent neuromuscular weakness that interferes with daily activities. Advancements in survival from critical illness have led to a rise in the number of patients afflicted with post-intensive care unit (ICU) incapacity. It is clear that the pathology leading to ICU-acquired weakness is present within 24 hours of the start of ICU care. Care-givers must consider interventions to limit or reverse these processes from the onset of critical illness. We suggest strategies both for avoiding harms and for actively promoting recovery of skeletal and respiratory muscles. Muscular silence contributes to, while muscular activity alleviates, myopathy. Thus, limiting sedation and neuromuscular blockade will facilitate spontaneous muscle activity, and allow for active participation in physical therapy. Protocols that aggressively assess for the potential for extubation shorten the duration of ventilation and thus decrease exposure to sedation. Mobility teams should safely guide patients in their progress from a passive range of motion through more active therapies despite ongoing critical illness. Early ICU mobility is not only safe, but reduces the incidence of delirium and duration of mechanical ventilation. Importantly, early ICU mobility increases the likelihood of a return to independent function among ICU survivors. A change in culture from one that practices deep sedation and protective support is suggested, to one that demonstrates an urgency to liberate patients from the confines and perils of critical illness.

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41

Youngner, Stuart J. y Robert M. Arnold. Introduction. Editado por Stuart J. Youngner y Robert M. Arnold. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199974412.013.30.

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This volume explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. The book comprises six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues, Section IV discusses death and dying among various vulnerable populations such as the elderly and persons with disabilities, and Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as a way to address the psychosocial and ethical problems of death and dying.

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42

Dodds, Chris, Chandra M. Kumar y Frédérique Servin. Anaesthesia for orthopaedic surgery in the elderly. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198735571.003.0007.

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Arthritis and falls are common in the elderly and hence lead to major bone and joint surgery. Elderly patients may suffer from significant cardiorespiratory, renal, and neurologic dysfunction, and they may be malnourished; therefore, preoperative assessment is essential. Both general and regional anaesthesia techniques are commonly used, but regional anaesthesia, with or without sedation, is preferred. The use of cement during surgery is known to be associated with intraoperative morbidities, as is the use of a tourniquet. Antibiotics are routinely used, but they must be administered before the tourniquet is inflated. The incidence of deep vein thrombosis and pulmonary embolism is high, and prophylaxis should be considered. Blood loss may be excessive, especially during revision surgery; measures should be taken to minimize blood loss. Regional technique, with or without opioids, provides good analgesia. Patient-controlled analgesia (PCA) with an opioid remains a useful method where possible.

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43

Youngner, Stuart J. y Robert M. Arnold, eds. The Oxford Handbook of Ethics at the End of Life. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199974412.001.0001.

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This handbook explores the topic of death and dying from the late twentieth to the early twenty-first centuries, with particular emphasis on the United States. In this period, technology has radically changed medical practices and the way we die as structures of power have been reshaped by the rights claims of African Americans, women, gays, students, and, most relevant here, patients. Respecting patients’ values has been recognized as the essential moral component of clinical decision making. Technology’s promise has been seen to have a dark side: it prolongs the dying process. For the first time in history, human beings have the ability to control the timing of death. With this ability comes a responsibility that is awesome and inescapable. How we understand and manage this responsibility is the theme of this volume. The book has six sections. Section I examines how the law has helped shape clinical practice, emphasizing the roles of rights and patient autonomy. Section II focuses on specific clinical issues, including death and dying in children, continuous sedation as a way to relieve suffering at the end of life, and the problem of prognostication in patients who are thought to be dying. Section III considers psychosocial and cultural issues. Section IV discusses death and dying among various vulnerable populations, such as the elderly and persons with disabilities. Section V deals with physician-assisted suicide and active euthanasia (lethal injection). Finally, Section VI looks at hospice and palliative care as ways to address the psychosocial and ethical problems of death and dying.

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44

Muders, Thomas y Christian Putensen. Pressure-controlled mechanical ventilation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0096.

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Beside reduction in tidal volume limiting peak airway pressure minimizes the risk for ventilator-associated-lung-injury in patients with acute respiratory distress syndrome. Pressure-controlled, time-cycled ventilation (PCV) enables the physician to keep airway pressures under strict limits by presetting inspiratory and expiratory pressures, and cycle times. PCV results in a square-waved airway pressure and a decelerating inspiratory gas flow holding the alveoli inflated for the preset time. Preset pressures and cycle times, and respiratory system mechanics affect alveolar and intrinsic positive end-expiratory (PEEPi) pressures, tidal volume, total minute, and alveolar ventilation. When compared with flow-controlled, time-cycled (‘volume-controlled’) ventilation, PCV results in reduced peak airway pressures, but higher mean airway. Homogeneity of regional peak alveolar pressure distribution within the lung is improved. However, no consistent data exist, showing PCV to improve patient outcome. During inverse ratio ventilation (IRV) elongation of inspiratory time increases mean airway pressure and enables full lung inflation, whereas shortening expiratory time causes incomplete lung emptying and increased PEEPi. Both mechanisms increase mean alveolar and transpulmonary pressures, and may thereby improve lung recruitment and gas exchange. However, when compared with conventional mechanical ventilation using an increased external PEEP to reach the same magnitude of total PEEP as that produced intrinsically by IRV, IRV has no advantage. Airway pressure release ventilation (APRV) provides a PCV-like squared pressure pattern by time-cycled switches between two continuous positive airway pressure levels, while allowing unrestricted spontaneous breathing in any ventilatory phase. Maintaining spontaneous breathing with APRV is associated with recruitment and improved ventilation of dependent lung areas, improved ventilation-perfusion matching, cardiac output, oxygenation, and oxygen delivery, whereas need for sedation, vasopressors, and inotropic agents and duration of ventilator support decreases.

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45

Henning, Jessen. Part I Assessing the UN Institutional Structure for Global Ocean Governance: The UN’s Role in Global Ocean Governance, 3 Advancing the Deep Seabed ‘Mining Code’: Key Environmental Elements of the Regulatory Framework for the Commercial Exploitation of Mineral Resources. Oxford University Press, 2018. http://dx.doi.org/10.1093/law/9780198824152.003.0003.

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This chapter examines the key environmental elements of the International Seabed Authority's (ISA) ‘Mining Code’, a regulatory framework for the commercial exploitation of mineral resources. The term ‘Mining Code’ refers to the whole comprehensive set of rules, regulations and procedures issued by the ISA to regulate prospecting, exploration and exploitation of minerals. The set of rules includes the collaboration of the respective responsibilities of deep seabed explorers and of the ISA in order to ensure environmentally sustainable development of deep seabed mineral resources. The chapter first provides an overview of the general regulatory framework for deep seabed mining, which is a contract-based system, before discussing the continuous legal evolution of the Mining Code. It also considers the generic issues that need to be addressed in relation to the future exploitation of minerals and explains why exploitation-related environmental regulations must be an integral component of advancing the Mining Code.

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46

Turkheimer, Eric. The hard question in psychiatric nosology. Editado por Kenneth S. Kendler y Josef Parnas. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198796022.003.0005.

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Nosology is primarily an exercise in grouping like with like: an empirical, quantitative, and theoretical exercise referred to as taxonomy or cladistics. Consideration of the formal process of making decisions about taxonomy reveals some of the choices that must be made in adopting any particular conceptual system for a complex domain such as psychiatric symptomatology. The psychometrician Louis Guttman and the psychopathologist Paul Meehl made key contributions to our understanding of how multivariate phenomena can be codified. Their contributions clarified the role played by empirical data in nosology, and show that human descriptive convenience also plays a substantial role. Whether psychopathology is best understood as a system of continuous dimensions or discrete categories is underdetermined by data. The hypothesis that psychopathology has a deep structure that can be reflected in a nosological system is an empirical hypothesis that has generally been disconfirmed for most aspects of psychopathology.

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47

Reed, Christopher Robert. Demography and Ethos. University of Illinois Press, 2017. http://dx.doi.org/10.5406/illinois/9780252036231.003.0002.

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The political economy of the 1920s were intricately linked to the demographic changes, emerging social structure, level of racial consciousness, cultural and aesthetic expressions, and religious practices and activities of this pivotal period in Chicago's history. This chapter focuses on demographics and the thinking accompanying the expansion of this population. Between 1910 and 1920, the African American population of Chicago increased by 148.5 percent. By 1927, a head count around the city in all three of the major geographical divisions found 196,569 persons of African descent in residence. The demographic growth of the Black Metropolis rested firmly on the continuous in-migration of primarily adults from the South—not only from the plantations of the Deep South and small towns but also cities such as Birmingham, New Orleans, Atlanta, and Mobile. Chicago's new Negro personality also bloomed and grew enormously in terms of an expanded African American worldview, expectations, and accomplishments.

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48

Fung, Victor. A Way of Music Education. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780190234461.001.0001.

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A Way of Music Education: Classic Chinese Wisdoms presents a philosophy of music education rooted in Yijing (I-Ching or The Book of Changes), classic Confucianism, and classic Daoism, which matured in the mid-sixth to mid-third century BC China (pre-Qin period). This philosophy puts the human at the center of an organismic world, in which all matters and events are connected, be they musical or non-musical. It is human-centric and dao-centric. Music educational experiences are key attributes to musical well-being throughout one’s lifetime. Concepts of yin and yang, deep harmony, and the teachings of Confucius, Mencius, Laozi, and Zhuangzi are applied to propose a “trilogy”—change, balance, and liberation—as a way of thinking and practicing music education. Music education is viewed as a lifelong endeavor; the philosophy therefore calls for a dynamic flexibility to maintain a balanced life in constantly changing situations. While principles suggested in this philosophy are simple, it is critical to practice them persistently to achieve continuous improvements. Through extended practice in being musically proactive, a musical liberation can be achieved and a humanly human spirit can be preserved and sustained.

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49

Farrell, David M. y Niamh Hardiman, eds. The Oxford Handbook of Irish Politics. Oxford University Press, 2021. http://dx.doi.org/10.1093/oxfordhb/9780198823834.001.0001.

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Ireland has enjoyed continuous democratic government for almost a century, an unusual experience among countries that gained their independence in the twentieth century. But the way this works has changed dramatically over time. Ireland’s colonial past has had an enduring influence over political life, enabling stable institutions of democratic accountability, while also shaping economic underdevelopment and persistent emigration. More recently, membership of the EU has brought about far-reaching transformation across almost all aspects of life. But the paradoxes have only intensified. Now one of the most open economies in the world, Ireland has experienced both rapid growth and a severe crash in the wake of the Great Recession. By some measures, Ireland is among the most affluent countries in the world, yet this is not the lived experience for many of its citizens. Ireland is an unequivocally modern state, yet public life continues to be marked by ideas and values in which tradition and modernity are uneasy bedfellows. It is a small state that has ambitions to carry more weight on the world stage. Ireland continues to be deeply connected to Britain through ties of culture and trade, now matters of deep concern post-Brexit. And the old fault lines between North and South, between Ireland and Britain, which had been at the core of one of Europe’s longest and bloodiest civil conflicts, risk being reopened. These key issues are teased out in this book, making it the most comprehensive volume on Irish politics to date.

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50

MacMaster, Thomas J. y Angela Zhang, eds. A Cultural History of Slavery and Human Trafficking in The Pre-Modern Era. Bloomsbury Publishing Plc, 2024. http://dx.doi.org/10.5040/9781350053762.

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Slavery was a continuous presence throughout the Pre-Modern Era, roughly 500 CE to 1450 CE, an epoch where changes in geopolitical forces, demography, and cultural background all contributed to who could or could not be enslaved. At the same time, coercion as a way of life differed across socio-cultural and economic realities, ranging what are commonly termed chattel slaves and war captives, to sexual and domestic slaves. This volume destabilizes the deep-seated idea that during the so-called “Middle Age” between antiquity and modernity social and cultural relationships remained stagnant. Drawing upon a wealth of textual, visual, and archeological sources, the authors explore slavery and human trafficking through gender, race and identity, political thought, cultural norms, and religious practice, with a focus on the emergence of systems of bondage, serfdom, dependency, and subordination in distinct domestic, regional, or national settings. During the first centuries of the Pre-Modern era, the decline of expansive empires, a shift toward smaller kingdoms, and changes in regional markets, land use, and tenure created new dependencies and hierarchies that reshaped concepts of ownership, authority, and dependency. And in the centuries immediately prior to the Colombian migrations, the later Pre-Modern Era was witness to the intensification of coercive identities from birth and inheritance. Local slave systems, discrete serf economies, and long-distance trade, coupled with limited trans-regional slave markets, are key to understanding the great variation in labor coercion modalities. Contributors explore a variety of time periods and polities in detail, from Bantu-speaking Africa, via Europe, and the Middle East, to China, to demonstrate a changing and interconnected world.

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