‘I Must Decrease’: Spiritual Direction and Power in the Orthodox Tradition

I was prompted to present on the topic of power and spiritual direction by some words of Fr. Alexander Schmemann. They struck me, and have remained etched in my mind ever since: “there is nothing more frightening than the thirst for power over souls. It is the thirst of the anti-christ.” Schmemann knew first-hand the kinds of distortions taking place under the name of Orthodoxy which this line evokes. Distortions, perhaps, should not be surprising. After all, if Lord Acton was right when he declared that “power tends to corrupt, and absolute power corrupts absolutely,” then the potential risks inherent in the ministry of spiritual direction in the Orthodox Church become clear. But this paper is not about the frequent and tragic abuse of spiritual authority and power in the history of Orthodoxy. I want rather to focus on one of the chief ways in which the Orthodox tradition has attempted to promote and protect the Christian integrity of the ministry of the spiritual father (and the spiritual mother), namely through the tactics of the director’s self-abasement, humility, and love. These tactics, I submit, are an attempt at the subversion of models of power as they generally obtain in this world, after the example of, and for the sake of, Christ

Defining and Supplementing Conciliar Trinitarianism

This article constitutes a brief reply to Timothy Pawl's clear and insightful article on Conciliar Trinitarianism (defined as the Trinitarian theology of the Ecumenical Councils from Nicaea I to Nicaea II). The two basic arguments of that article (regarding the relationship between divine persons and divine nature and the debate over possible subordinationism) are celebrated rather than challenged. I instead offer three short comments. The first concerns the limited nature of the conciliar texts for the articulation of highly developed Trinitarian theology, and thus the question of methodology as it applies to Conciliar Trinitarianism. The second comment argues that the question of strict identity in the Godhead can be extended beyond the relationship of divine person and divine nature to the question of divine nature and divine power, will, and energy. The third comment argues that Pawl gives undue weight to a line from Cyril of Alexandria for a discussion of the Holy Spirt's mode of origination, and not enough weight to the clause related to the Holy Spirit articulated at the First Council of Constantinople, which recurs in one way or another at each of the subsequent Ecumenical Councils, up to and including Nicaea II. These three comments serve more as a supplement than a challenge to Pawl's original article, providing three further avenues for scholarly deliberation on the matter of Conciliar Trinitarianism

Power and Authority in Eastern Christian Experience: Papers of the Sophia Institute Academic Conference New York, December 2010

The essays in this volume were delivered at the Third Annual Conference of the Sophia Institute in December 2010 at Union Theological Seminary in New York City. The theme of that conference, “Power and Authority in Eastern Christian Experience,” brought forth a diverse group of scholars who contributed their perspectives on the ways the Eastern Orthodox Church, in its broadest sense, has negotiated the notions of power, authority, (dis)obedience, and resistance over time and space. These insightful essays promise to draw the Orthodox world into a dynamic and productive discourse

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Repentance in christian late antiquity : with special reference to Mark the Monk, Barsanuphius and John of Gaza, and John Climacus

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Mapping Modern Concepts of the Person onto the Greek Patristic Past

The concepts of the person and personhood have received much attention in modern theological as well as philosophical circles. While significant differences exist between the various theologies of the person, they are joined in countering an individualistic or atomistic view of the human being, one which makes of each human an autonomous, almost self-sufficient unit. By contrast, the idea of "person," it is claimed, evokes a sense of interrelationship, a focus on mutual dependence and community which is in some sense constitutive of what it means to be human. A particular interest in the idea of the person flourished in Greek Orthodox theology during the twentieth century (represented most notably by Koutroubis, Gontikakis, Nellas, Zizioulas, and Yannaras), and continues into the twenty-first. Yet the Eastern Orthodox emphasis on the presence of key precedents for their theology (or theologies) of the person in Greek patristic and Byzantine sources has been a significant area of contention. However, while general and occasional specific criticisms have been voiced, there has been no systematic or fully engaged study of the claim made by numerous widely-respected theologians that in Greek patristic and Byzantine texts we are presented with a vision of the human being (and of the divine) which speaks directly to the spiritual, philosophical, and intellectual needs of the modern world. This paper will begin by introducing the topic of personalism more broadly, before delving into the principal elements of the debate over precedents. Having argued that in many specific instances claims for patristic precedent are ill-founded, it will nonetheless be suggested that some conceptual continuity exists, especially, though not exclusively, in the realm of Greek patristic and Byzantine ascetic thought

Repentance in christian late antiquity : with special reference to Mark the Monk, Barsanuphius and John of Gaza, and John Climacus

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Precedents for Palamas' essence-energies theology in the Cappadocian Fathers

Following a brief summary of the main tenets of Palamas’ theology relating to the immanent divine activity, this article will explore possible precedents for such a concept in the Cappadocian Fathers. The aim is twofold: first to argue against the exclusive use of active language in attempting to outline precedents for Palamite thought in the Cappadocians, and second to propose a framework for discussing the topic in terms of sanctification and deification. Through such an approach, I contend, it is possible to remain true to the Cappadocians, whilst concurrently finding striking precedents to the theology of Palamas.</p