Книги з теми "Delayed death"

Lessons from the management of combat trauma are applicable in both the military and civilian sectors. While there are additional challenges in the combat arena, preparing for the various injury patterns commonly encountered from combat-related injury and their management is imperative for medical personnel deployed to a combat zone. Combat-related mortality continues to show haemorrhage as a major cause of death, with most deaths occurring prior to arrival at a medical treatment. For fatalities that are judged to be potentially survivable, missed or delayed life-saving interventions, delayed evacuation, and inadequate haemorrhage control are all contributory factors. To target these areas, medical training and organizational efforts have been focused on improving haemorrhage control, remote resuscitation, and logistical systems. Further study should be aimed at reducing the known contributing factors and developments focused on prehospital management. Treating patients with modern resuscitative and supportive techniques is the hallmark of high-quality injury management, regardless of the mechanism of injury or the setting.

Emergency surgery in the elderly is needed even if elective surgery would not be considered. Often, it is due to trauma or to intra-abdominal, vascular, or neurosurgical emergencies. The time from onset of the cause of the emergency to operative treatment is directly related to complications and death. Delay to accurate diagnosis is common and may be masked by delirium. Sepsis, pain hypotension, and metabolic disorders may all trigger delirium. Resuscitation and optimization should be concurrent with operative management. Important factors considered include the possible cause of a fall (cardiac/neurologic), likelihood of severe hypovolaemia, electrolyte disorders, and ischaemic vascular disease (occlusive and embolic). Emergency laparotomy is reviewed with the possible reasons behind the appalling outcome data, such as delayed diagnosis and poor nutritional state.

Anaphylaxis has been defined as a “severe, life-threatening generalized or systemic hypersensitivity reaction” (Johansson et al., 2004). It is rapid in onset and may cause death or permanent disability. Early recognition and optimal management are critical. During anesthesia, recognition of anaphylaxis is often delayed because the clinical presentation can mimic other conditions. Epinephrine is the drug of choice in the treatment of anaphylaxis and should be given as early as possible.

Salicylates are weak acids that work as neurotoxins. The goal of management is to keep salicylates out of the brain and enhance elimination. Acute salicylate toxicity manifests as tinnitus, nausea, vomiting, and hyperventilation in a patient who takes a single large ingestion. Chronic salicylate toxicity is associated with long-term use, has a more insidious onset, and symptoms tend to be less severe, resulting in delayed diagnosis. It is more commonly seen in elderly patients. Therapeutic interventions for toxicity include gastrointestinal decontamination, serum and urine alkalinization, and haemodialysis. Mechanical ventilation may lead to clinical deterioration and death in a salicylate-poisoned patient due to worsening acidosis from respiratory failure. This results in severe acidosis, cerebral oedema, pulmonary oedema, and cardiac arrest.

CO poisoning is the commonest cause of toxic death. Carbon monoxide is colourless, odourless, and tasteless, and is produced under various conditions. When people inhale CO, the gas diffuses rapidly to the body and replaces oxygen at the level of haemoglobin, myoglobin, and other oxygen carriers. Subsequently, CO causes oxygen deprivation of all body tissues. CO also induces oxidative stress and systemic inflammation. After CO poisoning a broad variety of symptoms may occur. Survivors of CO poisoning often present with persistent neurological sequels or develop delayed neurological symptoms. There is poor correlation between carboxyhaemoglobin levels and clinical symptoms. The presence of coma, underlying co-morbid conditions and need for mechanical ventilation are the main prognostic factors. Management includes prompt extraction from the toxic environment and breathing 100% oxygen, although the role and practicalities of hyperbaric oxygen therapy remain controversial.

Severe sepsis is a hyperimmune response to an infectious stimulus resulting in a surge of cytokines and mediators of inflammation. High circulating levels of pro-inflammatory cytokines lead to shock, multiple organ failure, and death in septic patients. It has been recognized that patients with sepsis progress into a state of immune paralysis characterized by immune cell apoptosis and high levels of anti-inflammatory cytokines… Anti-inflammatory cytokines suppress production of pro-inflammatory cytokines and inhibit monocytes from presenting antigens to other immune cells. Immune paralysis probably leads to the patient’s inability to clear infections resulting in the delayed mortality observed in some septic patients. Beneficial therapies for sepsis are limited to the mechanical eradication of the source of infection, antibiotics, the judicious use of fluids to support organ perfusion, and oxygen supplementation. Strategies to counteract the hyper- and hypo-immune phases of sepsis have been tried thus far with only minimal success.

Many critically ill patients now survive what were previously fatal illnesses, but long-term mortality after critical illness remains high. While study populations vary by country, age, intervention, or specific diagnosis, investigations demonstrate that the majority of additional deaths occur in the first 6 to 12 months after hospital discharge. Patients with diagnoses of cancer, respiratory failure, and neurological disorders leading to the need for intensive care have the highest long-term mortality, while those with trauma and cardiovascular diseases have much lower long-term mortality. Use of mechanical ventilation, older age, and a need for care in a facility after the acute hospitalization are associated with particularly high 1-year mortality among survivors of critical illnesses. Due to challenges of follow-up, less is known about causes of delayed mortality following critical illness. Longitudinal studies of survivors of pneumonia, stroke, and patients who require prolonged mechanical ventilation suggest that most debilitated survivors die from recurrent infections and sepsis. Potential biologic mechanisms for increased risk of death after a critical illness include sepsis-induced immunoparalysis, intensive care unit-acquired weakness, neuroendocrine changes, poor nutrition, and genetic variance. Studies are needed to fully understand how the severity of the acute critical illness interacts with comorbid disease, pre-illness disability, and pre-existing and acquired frailty to affect long-term mortality. Such studies will be fundamental to improve targeting of rehabilitative, therapeutic, and palliative interventions to improve both survival and quality of life after critical illness.

Epilepsy is a Janus-faced disease. It has a bright and a dark side. This chapter discusses the dark side of epilepsy that can harm and can devastate. It provides a perspective on the situation today and how this was arrived at. In about 20% of individuals, seizures once developed can never be fully controlled by drugs and for some, control takes many years or is never achieved. When severe, epilepsy will often destroy health and shorten life. Sudden unexpected death in epilepsy is a dark reality. Treatment of severe epilepsy is sometimes denied, delayed, or inappropriately applied, with devastating consequences; mistreatment, over-treatment, or under-treatment all occur. Modern drugs and devices for uncontrolled seizures often offer a poor value proposition. Millions of people are taking drugs that do not help them, have had operations which have failed to stop the seizures, or have had scans or other tests that carry no benefit. Fraud and scientific misinformation are other shadows which inhabit the dark corners of epilepsy.

Transplantation is the optimal treatment of end-stage dysfunction of many organs and can be life-saving. Despite increases in live donation and donation after circulatory death, donation after brain death remains the most important source of donor organs, and is currently the only source of thoracic organs in most countries. Brain death is associated with profound physiological changes including cardiovascular and respiratory changes, and severe metabolic and endocrine dysfunction that can jeopardize transplantable organ function. Although adequate time must be allowed for the proper confirmation of brain death, unnecessary delays should be avoided because the incidence of systemic complications that jeopardize transplantable organ function increases progressively with time. Aggressive donor management increases the number of potential donors who actually become donors, increases the total number of organs transplanted per donor, and improves transplantation outcomes. Various donor management strategies have been described and these are reviewed in this chapter.

Non-traumatic subarachnoid haemorrhage (ntSAH) is a complex disease affecting multiple systems and the hospital course of affected patients can be variable. ntSAH is associated with high morbidity and mortality, with the causes of early deaths being either rebleeding or hydrocephalus. The risk of rebleeding is reduced by immediate control of arterial blood pressure and early securing of ruptured aneurysms by either endovascular coiling or surgical clipping. Ongoing management focuses on prevention, detection, and management of delayed neurological deficits. Current recommendations include prophylactic use of nimodipine, maintenance of hypertension and euvolaemia or hypervolaemia, and endovascular treatment of vasospasm that fails to respond to medical therapy. Systemic complications following ntSAH include myocardial injury, acute lung injury, venous and pulmonary thromboembolism, fluid and electrolyte abnormalities, and severe sepsis. Each of these complications should be treated on its merits. Due to the complexity of management patients with ntSAH should be treated in a critical care environment by a collaborative team of neurosurgeons, neuroradiologists, neurologists and intensivists.

This chapter focuses on plays written by Georgia Douglas Johnson in the late 1920s as she hosted a literary salon in her Washington, D.C., home. These texts present the black mother/wife, whose existence is shaped by attempts to delay death. In Blue Blood, she prevents the murder of the men in her family by hiding the fact that she has been raped by a powerful white man. In Safe, she becomes desperate to avoid what she believes to be the inevitable fate of her newborn son: humiliating death at the hands of a mob. In Blue-Eyed Black Boy, she protects her adult son, but ultimately her success in stopping the mob underscores her family's vulnerability. In short, Johnson shows that the black mother/wife must forge romantic and parental bonds in a society that allows white men to rape black women and kill black men with impunity.

A Blaze of Light in Every Word presents a conceptual model for analyzing vocal delivery in popular song recordings focused on three overlapping areas of inquiry: pitch, prosody, and quality. The domain of pitch, which refers to listeners’ perceptions of frequency, considers range, tessitura, intonation, and registration. Prosody, the pacing and flow of delivery, comprises phrasing, metric placement, motility, embellishment, and consonantal articulation. Qualitative elements include timbre, phonation, onset, resonance, clarity, paralinguistic effects, and loudness. Intersecting all three domains is the area of technological mediation, which considers how external technologies, such as layering, overdubbing, pitch modification, recording transmission, compression, reverb, spatial placement, delay, and other electronic effects, impact voice in recorded music. Though the book focuses primarily on the sonic and material aspects of vocal delivery, it situates these aspects among broader cultural, philosophical, and anthropological approaches to voice with the goal to better understand the relationship between sonic content and its signification. Drawing upon transcription and spectrographic analysis as the primary means of representation, as well as modes of analysis, this book features in-depth analyses of a wide array of popular song recordings spanning genres from indie rock to hip-hop to death metal, develops analytical tools for understanding how individual dimensions make singing voices both complex and unique, and synthesizes how multiple aspects interact to better understand the multidimensionality of singing voices.

The practice of integrative nutrition therapy aims to use food therapeutically in order to stimulate the body’s innate healing mechanisms and optimize health. Studies exploring the link between longevity and diet have reinforced the idea that health-promoting lifestyle habits delay the onset of age-related illness and death. As inflammatory processes drive chronic disease, any dietary intervention should aim to mitigate inflammation and promote the anti-inflammatory cascade. Practitioners can personalize the dietary interventions through the use of nutrigenomics and ancestral diets. This chapter covers nutrition assessment methods and key interventions to prevent weight loss, anorexia of aging, and malnutrition.

This book considers a promise left unfulfilled in Sigmund Freud’s Beyond the Principle of Pleasure. There Freud suggests that he will investigate a psychic tendency that is not subject to the pleasure principle, but in fact for Freud the latter remains sovereign. Following Jacques Derrida, Martínez argues that when the pleasure principle comes into contact with the death drive (a tendency toward aggression or cruelty), the psyche can take detours that, without exceeding the limit of the pleasure principle, can nevertheless defer it. Eros: Beyond the Death Drive reflects on these deviations of the pleasure principle, which Martínez finds both in the political sphere and in intimate relations. Following these erotic paths, Martínez argues that the forces of the death drive can only be resisted if resistance is understood as an ongoing process in which erotic action and the construction of pathways for sublimation are interminable tasks. We know that the final accomplishment of these tasks is impossible, but, like Freud’s “impossible professions,” they remain imperative. Though always incomplete, they remain undeniably urgent, and psychoanalysis and deconstruction remind us of their urgency. In complementary ways, both Freud and Derrida teach us that the death drive is insurmountable, but that through political action we can delay, defer, and postpone it. Martínez shows us that this effort of resistance must be uninterrupted. Calling for the creation and maintenance of a “community of mourning duelists,” this book builds toward the affirmation of the kind of “erotic battalion” that must always be mobilized.

Technological advances allow healthcare providers to delay the dying process for critically and terminally ill patients. For patients lingering between life and death, decisions frequently need to be made regarding withholding or withdrawing life-sustaining treatments such as withholding and withdrawing antibiotics, blood products, dialysis, and artificial nutrition. Biomedical ethics guide all health care. The ethical principle of autonomy offers patients or their surrogate decision-maker the right to accept or reject any treatment. The benefits and burdens of treatment often guide care and should be aligned with preferences, values, and goals of care. This chapter reviews these treatments and the decision-making process that must be a part of any discussion to discontinue treatments.

Initially always lethal, the prognosis of infective endocarditis (IE) has been revolutionized by antibacterial therapy and valve surgery. Nevertheless, it remains one of the deadliest infectious diseases, with ≥30% of patients dying within a year of diagnosis. Its incidence has also remained stable at 25–50 cases per million per year, and results predominantly from a combination of bacteraemia and a predisposing cardiac condition, including endocardial lesions and/or intracardiac foreign material. While antibiotic prophylaxis is recommended by various learned societies to cover healthcare procedures with the potential of causing bacteraemia in at-risk patients, there is no evidence to support this strategy. Even though the benefits are hypothetical, national guidelines should still be followed to avoid medico-legal issues. General preventive measures, such as education of clinicians and at-risk patients appear to be more crucial. Invasive procedures, especially intravenous catheterization, should be kept to the minimum possible. The severity of IE mandates a multidisciplinary and standardized approach to treatment, with involvement of dedicated surgeons within specialist centres. Standardized antibiotic protocols have produced dramatic reductions in hospital and 1-year mortality in reference centres. Most deaths now result from complications that constitute definite surgical indications, so optimization of surgical management and avoidance of delay will clearly improve prognosis. This disease has now entered an ‘early surgery’ era, with a more aggressive surgical approach showing promising results. Conditions such as septic shock, sudden death, and vancomycin-resistant staphylococcal endocarditis still constitute therapeutic and research challenges, and justify an important role for specialist centres.

The term ‘polytrauma’ refers to blunt (or crush) trauma that involves multiple body regions or cavities, and compromises physiology to potentially cause dysfunction of uninjured organs. Polytrauma frequently affects muscles resulting in rhabdomyolysis. In daily life, it mostly occurs after motor vehicle accidents, influencing a limited number of patients; after mass disasters, however, thousands of polytrauma victims may present at once with only surgical features or with additional medical complications (crush syndrome). Among the medical complications, acute kidney injury (AKI) deserves special mention, since it is frequent and has a substantial impact on the ultimate outcome.Several factors play a role in the pathogenesis of polytrauma (or crush)-induced AKI: (1) hypoperfusion of the kidneys, (2) myoglobin-induced direct nephrotoxicity, and intratubular obstruction, and also (3) several other mechanisms (i.e. iron and free radical-induced damage, disseminated intravascular coagulation, and ischaemia reperfusion injury). Crush-related AKI is prerenal at the beginning; however, acute tubular necrosis may develop eventually. In patients with crush syndrome, apart from findings of trauma, clinical features may include (but are not limited to) hypotension, oliguria, brownish discoloration of urine, and other symptoms and findings, such as sepsis, acute respiratory distress syndrome, disseminated intravascular coagulation, bleeding, cardiac failure, arrhythmias, electrolyte disturbances, and also psychological trauma.In the biochemical evaluation, life-threatening hyperkalaemia, retention of uraemic toxins, high anion gap metabolic acidosis, elevated serum levels of myoglobin, and muscle enzymes are noted; creatine phosphokinase is very useful for diagnosing rhabdomyolysis.Early fluid administration is vital to prevent crush-related AKI; the rate of initial fluid volume should be 1000 mL/hour. Overall, 3–6 L are administered within a 6-hour period considering environmental, demographic and clinical features, and urinary response to fluids. In disaster circumstances, the preferred fluid formulation is isotonic saline because of its ready availability. Alkaline (bicarbonate-added) hypotonic saline may be more useful, especially in isolated cases not related to disaster, as it may prevent intratubular myoglobin, and uric acid plugs, metabolic acidosis, and also life-threatening hyperkalaemia.In the case of established acute tubular necrosis, dialysis support is life-saving. Although all types of dialysis techniques may be used, intermittent haemodialysis is the preferred modality because of medical and logistic advantages. Close follow-up and appropriate treatment improve mortality rates, which may be as low as 15–20% even in disaster circumstances. Polytrauma victims after mass disasters deserve special mention, because crush syndrome is the second most frequent cause of death after trauma. Chaos, overwhelming number of patients, and logistical drawbacks often result in delayed, and sometimes incorrect treatment. Medical and logistical disaster preparedness is useful to improve the ultimate outcome of disaster victims.

Drowning is a process beginning with airway submergence under a fluid medium, progressing to aspiration, and ultimately death in the absence of intervention. Aspiration of both fresh- and saltwater can cause pulmonary oedema, decreased compliance, intrapulmonary shunting, and severe hypoxia. Devastating neurological injury resulting from prolonged cerebral hypoxia is proportional to the duration of submersion and delay in effective resuscitation and oxygenation. Victims presenting to the emergency department awake and alert, or even stuporous, are likely to have a good neurological outcome with follow-up intensive care. Those presenting comatose are much more likely to have severe neurological deficits. Keys to survival are: timely rescue from the water, immediate initiation of aggressive supportive care regarding airway, cardiovascular and pulmonary function, and optimization of tissue oxygenation.

Vein of Galen malformation (VGM) is a high-flow intracranial vascular malformation, presenting in utero or after birth with a range of initial symptoms. The natural history of untreated VGM is grave, with progressive permanent neurological dysfunction, developmental delay, seizures, intracranial hemorrhage, and death. Presentation varies with age, with more severe manifestations resulting in earlier presentation and poorer outcome. The mainstay of treatment is medical stabilization followed by endovascular embolization. The goal is to reduce flow through the malformation such that normal development can proceed without neurological deficit. The past 20 years have seen great advances both in the technical treatment of the vascular lesion and in the overall prognosis of patients treated for this condition. Key to a good outcome is appropriate selection of patients and treatment by physicians familiar with this pathophysiology.

Dairy consumption in Asia has more than doubled over the last 25 years, and has led to more than 50% of the world’s total dairy imports now entering Asian markets. Consequently, Asian countries are seeking to improve their self-sufficiency in dairy produce by developing their local milk industries. Asian livestock importers are looking for increasing numbers of high grade dairy stock from established dairy industries in countries such as Australia and New Zealand. Unfortunately, a major problem encountered throughout Asia has been the poor performance of these exotic high grade dairy heifers when exported from their country of origin to a new, more stressful environment. This has been due to a failure to prepare for their introduction. Exotic dairy cows, particularly those from farms with high levels of herd performance, have high management requirements. If subjected to local and traditional small holder dairy farm practices, they are unlikely to produce acceptable yields of milk or may not even get back into calf. Poor management practices can lead to low growth rates, delayed breeding, stock diseases and even deaths among imported stock both before and after first calving. Managing High Grade Dairy Cows in the Tropics addresses the entire range of management practices found on tropical small holder dairy farms, highlighting those which are likely to adversely impact on heifer and cow performance, hence farm profitability. It is a companion volume to three other manuals written by John Moran: Rearing Young Stock on Tropical Dairy Farms in Asia, Tropical Dairy Farming and Business Management for Tropical Dairy Farmers.

Moral Development and Reality explores the nature of morality, moral development, social behavior, and human connection. By comparing, contrasting, and going beyond the prominent theories mainly of Lawrence Kohlberg, Martin Hoffman, and Jonathan Haidt, the author addresses fundamental questions: What is morality, and how broad is the moral domain? Can we speak of moral development (Kohlberg, Hoffman), or is morality entirely relative to diverse cultures (Haidt)? What are the sources of moral motivation? What factors account for prosocial behavior? What are the typical social perspective-taking limitations of antisocial youths, and how can those limitations be remedied? Does moral development, including moments of moral inspiration, reflect a deeper reality? Exploring these questions elucidates the full range of moral development, from superficial perception to a deeper understanding and feeling. Included are foundations of morality and moral motivation; biology, social intuitions, and culture; social perspective-taking and development; the stage construct and developmental delay; moral exemplars and moral identity; cognitive distortions, social skills deficiencies, and cognitive behavioral interventions or moral education; and, finally, near-death experiences and the underpinnings of the social and moral world.

Oil spills can be difficult to manage, with reporting frequently delayed. Too often, by the time responders arrive at the scene, the slick has moved, dissolved, dispersed or sunk. This Oil Spill Monitoring Handbook provides practical advice on what information is likely required following the accidental release of oil or other petroleum-based products into the marine environment. The book focuses on response phase monitoring for maritime spills, otherwise known as Type I or operational monitoring. Response phase monitoring tries to address the questions – what? where? when? how? how much? – that assist responders to find, track, predict and clean up spills, and to assess their efforts. Oil spills often occur in remote, sensitive and logistically difficult locations, often in adverse weather, and the oil can change character and location over time. An effective response requires robust information provided by monitoring, observation, sampling and science. The Oil Spill Monitoring Handbook completely updates the Australian Maritime Safety Authority’s 2003 edition of the same name, taking into account the latest scientific advances in physical, chemical and biological monitoring, many of which have evolved as a consequence of major oil spill disasters in the last decade. It includes sections on the chemical properties of oil, the toxicological impacts of oil exposure, and the impacts of oil exposure on different marine habitats with relevance to Australia and elsewhere. An overview is provided on how monitoring integrates with the oil spill response process, the response organisation, the use of decision-support tools such as net environmental benefit analysis, and some of the most commonly used response technologies. Throughout the text, examples are given of lessons learned from previous oil spill incidents and responses, both local and international. General guidance of spill monitoring approaches and technologies is augmented with in-depth discussion on both response phase and post-response phase monitoring design and delivery. Finally, a set of appendices delivers detailed standard operating procedures for practical observation, sample and data collection. The Oil Spill Monitoring Handbook is essential reading for scientists within the oil industry and environmental and government agencies; individuals with responder roles in industry and government; environmental and ecological monitoring agencies and consultants; and members of the maritime sector in Australia and abroad, including officers in ports, shipping and terminals.

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.