The Mutualities of Conscience: Satire, Community, and Individual Agency in Late Medieval and Early Modern England

<p>This study examines the representation of "conscience" in English literature, theology, and political theory from the late fourteenth century to the late seventeenth. In doing so it links up some prominent conceptual history of the term, from Aquinas to Hobbes, with its imaginative life in English narrative. In particular, beginning with William Langland's <italic>Piers Plowman</italic> and moving through texts in the "<italic>Piers Plowman</italic> tradition" and on to John Bunyan's allegories and polemics, I explore what I call the "satiric" dimensions of conscience in an allegorical tradition that spans a long and varied period of reform in England, medieval and early modern. As I argue, conscience in this tradition is linked up with the jolts of irony as with the solidarities of mutual recognition. Indeed, the ironies of conscience depend precisely on settled dispositions, shared practices, common moral sources and intellectual traditions, and relationships across time. As such, far from simply being a form of individualist self-assurance, conscience presupposes and advocates a social body, a vision of communal life. Accordingly, this study tracks continuities and transformations in the imagined communities in which the judgment that is conscience is articulated, and so too in the capacities of prominent medieval literary forms to go on speaking for others in the face of dramatic cultural upheaval.</p><p>After an introductory essay that examines the relationship between conscience, irony, and literary form, I set out in chapter one with a study of Langland's <italic>Piers Plowman</italic> (ca. 1388 in its final version), an ambitious, highly dialectical poem that gives a figure called Conscience a central role in its account of church and society in late medieval England. While Langland draws deeply on scholastic accounts of <italic>conscientia</italic>--an act of practical reason, as Aquinas says, that is binding as your best judgment and yet vexing in its capacity for error and need for formation in the virtues--he dramatizes error in terms of imagined practice, pressing the limits of theory. A long, recursive meditation on how one's socially embodied life constitutes distinctive forms of both blindness and vision, Langland's poem searches out the forms of recognition and mutuality that he takes a truth-seeking irony of conscience to require in his contemporary moment. My reading sets the figure of Conscience in <italic>Piers Plowman</italic> alongside the figure of Holy Church to explore some of these themes, and so also to address why the beginning of Langland's poem matters for its ending. In chapter two I turn to an anonymous early fifteenth-century poem of political complaint called <italic>Mum and the Sothsegger</italic> (ca. 1409) that was written in response to new legislation introducing capital punishment for heresy in England. In Mum I show how an early "<italic>Piers Plowman</italic> tradition" gets taken up into a rhetoric of royal counsel and so subtly, but decisively, revises aspects of Langland's political and ecclesial vision. In a final chapter moving across several of John Bunyan's works from the 1670s and 1680s, I show how Bunyan conceptualizes coercion in terms of the state and the market, and so defends a "liberty" of conscience that resists both Hobbesian assimilations of moral judgment to the legal structures of territorial sovereignty and an emergent market nominalism, in which exchange value trumps all moral reflection. In part two of Bunyan's The Pilgrim's Progress, Bunyan draws surprisingly on medieval sources to display the forms of mutuality that he thinks are required to resist "consent" to such unjust forms of coercion.</p>Dissertatio

The Role of Family Interactions in HIV Risk for Gay and Bisexual Male Youth: A Pilot Study

Despite ongoing prevention efforts, young gay and bisexual males continue to engage in sexual behaviors that place them at disproportionately high risk for HIV infection. Parental monitoring and parent-child communication have been found to be associated with low-risk sexual behavior among heterosexual youth, but the role of family interactions for gay and bisexual male youth remains largely unexplored. To help address this gap, an exploratory study of recorded and coded interactions among 35 gay and bisexual youth and their parents was done to begin to identify which types of family interactions were associated with youth high-risk sexual behavior. Parent-son communication that was mutual and low in conflict was found to be most prevalent among youth with the fewest reported high-risk sexual behaviors. These preliminary findings, along with a case example, demonstrate how social workers can coach families to engage in productive and potentially influential interactions that reduce HIV-related sexual behaviors among young gay and bisexual males

Understanding the information needs of public health practitioners: A literature review to inform design of an interactive digital knowledge management system

AbstractThe need for rapid access to information to support critical decisions in public health cannot be disputed; however, development of such systems requires an understanding of the actual information needs of public health professionals. This paper reports the results of a literature review focused on the information needs of public health professionals. The authors reviewed the public health literature to answer the following questions: (1) What are the information needs of public health professionals? (2) In what ways are those needs being met? (3) What are the barriers to meeting those needs? (4) What is the role of the Internet in meeting information needs? The review was undertaken in order to develop system requirements to inform the design and development of an interactive digital knowledge management system. The goal of the system is to support the collection, management, and retrieval of public health documents, data, learning objects, and tools.Method:The search method extended beyond traditional information resources, such as bibliographic databases, tables of contents (TOC), and bibliographies, to include information resources public health practitioners routinely use or have need to use—for example, grey literature, government reports, Internet-based publications, and meeting abstracts.Results:Although few formal studies of information needs and information-seeking behaviors of public health professionals have been reported, the literature consistently indicated a critical need for comprehensive, coordinated, and accessible information to meet the needs of the public health workforce. Major barriers to information access include time, resource reliability, trustworthiness/credibility of information, and “information overload”.Conclusions:Utilizing a novel search method that included the diversity of information resources public health practitioners use, has produced a richer and more useful picture of the information needs of the public health workforce than other literature reviews. There is a critical need for public health digital knowledge management systems designed to reflect the diversity of public health activities, to enable human communications, and to provide multiple access points to critical information resources. Public health librarians and other information specialists can serve a significant role in helping public health professionals meet their information needs through the development of evidence-based decision support systems, human-mediated expert searching and training in the use information retrieval systems

Chagas Disease in the New York City Metropolitan Area.

Background:Chagas disease, caused by the parasite Trypanosoma cruzi, once considered a disease confined to Mexico, Central America, and South America, is now an emerging global public health problem. An estimated 300 000 immigrants in the United States are chronically infected with T. cruzi. However, awareness of Chagas disease among the medical community in the United States is poor. Methods:We review our experience managing 60 patients with Chagas disease in hospitals throughout the New York City metropolitan area and describe screening, clinical manifestations, EKG findings, imaging, and treatment. Results:The most common country of origin of our patients was El Salvador (n = 24, 40%), and the most common detection method was by routine blood donor screening (n = 21, 35%). Nearly half of the patients were asymptomatic (n = 29, 48%). Twenty-seven patients were treated with either benznidazole or nifurtimox, of whom 7 did not complete therapy due to side effects or were lost to follow-up. Ten patients had advanced heart failure requiring device implantation or organ transplantation. Conclusions:Based on our experience, we recommend that targeted screening be used to identify at-risk, asymptomatic patients before progression to clinical disease. Evaluation should include an electrocardiogram, echocardiogram, and chest x-ray, as well as gastrointestinal imaging if relevant symptoms are present. Patients should be treated if appropriate, but providers should be aware of adverse effects that may prevent patients from completing treatment

A new spectral classification system for the earliest O stars: Definition of type O2

High-quality, blue-violet spectroscopic data are collected for 24 stars that have been classified as type O3 and that display the hallmark N Iv and N v lines, A new member of the class is presented; it is the second known in the Cyg OB2 association, and only the second in the northern hemisphere. New digital data are also presented for several of the other stars. Although the data are inhomogeneous, the uniform plots by subcategory reveal some interesting new relationships. Several issues concerning the classification of the hottest O-type spectra are discussed, and new digital data are presented for the five original O3 dwarfs in the Carina Nebula, in which the N Iv, N v features are very weak or absent. New spectral types O2 and O3.5 are introduced here as steps toward resolving these issues. The relationship between the derived absolute visual magnitudes and the spectroscopic luminosity classes of the O2-O3 stars shows more scatter than at later O types, at least partly because some overluminous dwarfs are unresolved multiple systems, and some close binary systems of relatively low luminosity and mass emulate O3 supergiant spectra. However, it also appears that the behavior of He II λ4686, the primary luminosity criterion at later O types, responds to other phenomena in addition to luminosity at spectral types O2-O3. There is evidence that these spectral types may correspond to an immediate pre-WN phase, with a correspondingly large range of luminosities and masses. A complete census of spectra classified into the original O3 subcategories considered here (not including intermediate O3/WN types or O3 dwarfs without N Iv, N v features) totals 45 stars; 34 of them belong to the Large Magellanic Cloud and 20 of the latter to 30 Doradus.Facultad de Ciencias Astronómicas y Geofísica

A new spectral classification system for the earliest O stars: Definition of type O2

High-quality, blue-violet spectroscopic data are collected for 24 stars that have been classified as type O3 and that display the hallmark N Iv and N v lines, A new member of the class is presented; it is the second known in the Cyg OB2 association, and only the second in the northern hemisphere. New digital data are also presented for several of the other stars. Although the data are inhomogeneous, the uniform plots by subcategory reveal some interesting new relationships. Several issues concerning the classification of the hottest O-type spectra are discussed, and new digital data are presented for the five original O3 dwarfs in the Carina Nebula, in which the N Iv, N v features are very weak or absent. New spectral types O2 and O3.5 are introduced here as steps toward resolving these issues. The relationship between the derived absolute visual magnitudes and the spectroscopic luminosity classes of the O2-O3 stars shows more scatter than at later O types, at least partly because some overluminous dwarfs are unresolved multiple systems, and some close binary systems of relatively low luminosity and mass emulate O3 supergiant spectra. However, it also appears that the behavior of He II λ4686, the primary luminosity criterion at later O types, responds to other phenomena in addition to luminosity at spectral types O2-O3. There is evidence that these spectral types may correspond to an immediate pre-WN phase, with a correspondingly large range of luminosities and masses. A complete census of spectra classified into the original O3 subcategories considered here (not including intermediate O3/WN types or O3 dwarfs without N Iv, N v features) totals 45 stars; 34 of them belong to the Large Magellanic Cloud and 20 of the latter to 30 Doradus.Facultad de Ciencias Astronómicas y Geofísica

The Onfp class in the Magellanic Clouds

The Onfp class of rotationally broadened, hot spectra was defined some time ago in the Galaxy, where its membership to date numbers only eight. The principal defining characteristic is a broad, centrally reversed He II λ 4686 emission profile; other emission and absorption lines are also rotationally broadened. Recent surveys in the Magellanic Clouds (MCs) have brought the class membership there, including some related spectra, to 28. We present a survey of the spectral morphology and rotational velocities, as a first step toward elucidating the nature of this class. Evolved, rapidly rotating hot stars are not expected theoretically, because the stellar winds should brake the rotation. Luminosity classification of these spectra is not possible, because the principal criterion (He II λ4686) is peculiar; however, the MCs provide reliable absolute magnitudes, which show that they span the entire range from dwarfs to supergiants. The Onfp line-broadening distribution is distinct and shifted toward larger values from those of normal O dwarfs and supergiants with >99.99% confidence. All cases with multiple observations show line-profile variations, which even remove some objects from the class temporarily. Some of them are spectroscopic binaries; it is possible that the peculiar profiles may have multiple causes among different objects. The origin and future of these stars are intriguing; for instance, they could be stellar mergers and/or gamma-ray-burst progenitors.Facultad de Ciencias Astronómicas y Geofísica

Chagas Disease in the New York City Metropolitan Area

Background Chagas disease, caused by the parasite Trypanosoma cruzi, once considered a disease confined to Mexico, Central America, and South America, is now an emerging global public health problem. An estimated 300 000 immigrants in the United States are chronically infected with T. cruzi. However, awareness of Chagas disease among the medical community in the United States is poor. Methods We review our experience managing 60 patients with Chagas disease in hospitals throughout the New York City metropolitan area and describe screening, clinical manifestations, EKG findings, imaging, and treatment. Results The most common country of origin of our patients was El Salvador (n = 24, 40%), and the most common detection method was by routine blood donor screening (n = 21, 35%). Nearly half of the patients were asymptomatic (n = 29, 48%). Twenty-seven patients were treated with either benznidazole or nifurtimox, of whom 7 did not complete therapy due to side effects or were lost to follow-up. Ten patients had advanced heart failure requiring device implantation or organ transplantation. Conclusions Based on our experience, we recommend that targeted screening be used to identify at-risk, asymptomatic patients before progression to clinical disease. Evaluation should include an electrocardiogram, echocardiogram, and chest x-ray, as well as gastrointestinal imaging if relevant symptoms are present. Patients should be treated if appropriate, but providers should be aware of adverse effects that may prevent patients from completing treatment

Web‐based Weight Management Programs in an Integrated Health Care Setting: A Randomized, Controlled Trial

Objective : To assess the efficacy of a Web‐based tailored behavioral weight management program compared with Web‐based information‐only weight management materials. Research Methods and Procedures : Participants, 2862 eligible overweight and obese (BMI = 27 to 40 kg/m 2 ) members from four regions of Kaiser Permanente's integrated health care delivery system, were randomized to receive either a tailored expert system or information‐only Web‐based weight management materials. Weight change and program satisfaction were assessed by self‐report through an Internet‐based survey at 3‐ and 6‐month follow‐up periods. Results : Significantly greater weight loss at follow‐up was found among participants assigned to the tailored expert system than among those assigned to the information‐only condition. Subjects in the tailored expert system lost a mean of 3 ± 0.3% of their baseline weight, whereas subjects in the information‐only condition lost a mean of 1.2 ± 0.4% ( p < 0.0004). Participants were also more likely to report that the tailored expert system was personally relevant, helpful, and easy to understand. Notably, 36% of enrollees were African‐American, with enrollment rates higher than the general proportion of African Americans in any of the study regions. Discussion : The results of this large, randomized control trial show the potential benefit of the Web‐based tailored expert system for weight management compared with a Web‐based information‐only weight management program.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93691/1/oby.2006.34.pd

A new spectral classification system for the earliest O stars: Definition of type O2

High-quality, blue-violet spectroscopic data are collected for 24 stars that have been classified as type O3 and that display the hallmark N Iv and N v lines, A new member of the class is presented; it is the second known in the Cyg OB2 association, and only the second in the northern hemisphere. New digital data are also presented for several of the other stars. Although the data are inhomogeneous, the uniform plots by subcategory reveal some interesting new relationships. Several issues concerning the classification of the hottest O-type spectra are discussed, and new digital data are presented for the five original O3 dwarfs in the Carina Nebula, in which the N Iv, N v features are very weak or absent. New spectral types O2 and O3.5 are introduced here as steps toward resolving these issues. The relationship between the derived absolute visual magnitudes and the spectroscopic luminosity classes of the O2-O3 stars shows more scatter than at later O types, at least partly because some overluminous dwarfs are unresolved multiple systems, and some close binary systems of relatively low luminosity and mass emulate O3 supergiant spectra. However, it also appears that the behavior of He II λ4686, the primary luminosity criterion at later O types, responds to other phenomena in addition to luminosity at spectral types O2-O3. There is evidence that these spectral types may correspond to an immediate pre-WN phase, with a correspondingly large range of luminosities and masses. A complete census of spectra classified into the original O3 subcategories considered here (not including intermediate O3/WN types or O3 dwarfs without N Iv, N v features) totals 45 stars; 34 of them belong to the Large Magellanic Cloud and 20 of the latter to 30 Doradus.Facultad de Ciencias Astronómicas y Geofísica