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Challenges and Prospects
The introduction of antiretroviral therapy (ART) in middle and low income countries is arguably one of the most meaningful outcomes recorded in the fight against HIV and AIDS. A record number of some 6.2 million people living with HIV and AIDS are reported to be benefiting from the treatment, which is reported to have risen by 19 per cent between 2010 and 2011 and as a result of this, the region has also enjoyed a significant decline in AIDS mortality. This volume is the outcome of the ëcall for abstractsí put out by OSSREA in 2011 for senior researchers, social scientists and practitioners to write scientific articles on issues surrounding ARVs. The volume contains eight chapters organized into four sections: ART and quality of life; Adherence to ART; Traditional medicine and ART; and Sexual behaviour of ART attendants. The chapters are contributed by Academics and researchers from three different African countries: four from Ethiopia, two from Uganda and two from Zimbabwe.
A Short History
More people today report feeling anxious than ever before—even while living in relatively safe and prosperous modern societies. Almost one in five people experiences an anxiety disorder each year, and more than a quarter of the population admits to an anxiety condition at some point in their lives. Here Allan V. Horwitz, a sociologist of mental illness and mental health, narrates how this condition has been experienced, understood, and treated through the ages—from Hippocrates, through Freud, to today. Anxiety is rooted in an ancient part of the brain, and our ability to be anxious is inherited from species far more ancient than humans. Anxiety is often adaptive: it enables us to respond to threats. But when normal fear yields to what psychiatry categorizes as anxiety disorders, it becomes maladaptive. As Horwitz explores the history and multiple identities of anxiety—melancholia, nerves, neuroses, phobias, and so on—it becomes clear that every age has had its own anxieties and that culture plays a role in shaping how anxiety is expressed.
The Case of Iago
This book is a concise philosophical meditation on Iago and the nature of evil, through the exploration of the enduring puzzle found in Shakespeare's Othello. What drives Iago to orchestrate Othello's downfall? Instead of treating Iago's lack of motive as the play's greatest weakness, The Apologetics of Evil shows how this absence of motive is the play's greatest strength. Richard Raatzsch determines that Iago does not seek a particular end or revenge for a discrete wrong; instead, Iago is governed by a passion for intriguing in itself. Raatzsch explains that this passion is a pathological version of ordinary human behavior and that Iago lacks the ability to acknowledge others; what matters most to him is the difference between himself and the rest of the world.
The book opens with a portrait of Iago, and considers the nature and moral significance of the evil that he represents. Raatzsch addresses the boundaries dividing normality and pathology, conceptualizing evil as a pathological form of the good or ordinary. Seen this way, evil is conceptually dependent on the ordinary, and Iago, as a form of moral monster, is a kind of nonbeing. Therefore, his actions might be understood and defended, even if they cannot be justified. In a brief epilogue, Raatzsch argues that literature's presentation of what is monstrous or virtuous can constitute an understanding of these concepts, not merely illustrate them.
The Challenge of Mental Health
This thoughtful, compassionate book makes a major contribution to our understanding of the Southern Appalachian child -- his mental disorders and his adaptive strengths. Drawing upon his extensive fieldwork as a clinical child psychiatrist in Eastern Kentucky, Dr. Looff suggests means by which these children can be helped to bridge the gap between their subculture and the mainstream of American life today.
The children described in this book, the author points out, are in a real sense not "all children." Since no child grows up in a vacuum, the children of Eastern Kentucky cannot be understood apart from the historical, geographic, and socioeconomic characteristics of the area in which they grow. Knowledge of the children requires some knowledge of the lives of parent, teachers, and the many others upon whom they are dependent. That is to say, mental disorder -- or mental health -- is embedded in a social matrix. Dr. Looff therefore examines the milieu of these Southern Appalachian children, their future as adults, and how they can achieve their potential -- whether in their native or an urban setting. In viewing the children within their own cultural framework, Dr. Looff shows how they develop toward mental health or psychopathology, suggesting supportive techniques that build upon the strengths inherent in each child. These strengths, he suggests, rise out of the same culture that burdens the child with handicaps.
Dr. Looff's position is one of guarded optimism, based on the successes of the techniques he has used and observed in seven years of work in Appalachian field clinics. Although he details instances of mental disorder in children, and instances of failure in family functioning, he notes at the same time family strengths and sees these strengths as sources of hope.
Although this book is based on fieldwork techniques within a specific area and culture, it is paradigmatically suggestive of wider application. Dr. Looff demonstrates effectively and clearly the profound need for increased concern about what is happening to the rising generation -- the children of Eastern Kentucky, the children of the Southern Appalachian region, and the children of the rural south.
Appalachians have been characterized as a population with numerous disparities in health and limited access to medical services and infrastructures, leading to inaccurate generalizations that inhibit their healthcare progress. Appalachians face significant challenges in obtaining effective care, and the public lacks information about both their healthcare needs and about the resources communities have developed to meet those needs.
In Appalachian Health and Well-Being, editors Robert L. Ludke and Phillip J. Obermiller bring together leading researchers and practitioners to provide a much-needed compilation of data- and research-driven perspectives, broadening our understanding of strategies to decrease the health inequalities affecting both rural and urban Appalachians. The contributors propose specific recommendations for necessary research, suggest practical solutions for health policy, and present best practices models for effective health intervention. This in-depth analysis offers new insights for students, health practitioners, and policy makers, promoting a greater understanding of the factors affecting Appalachian health and effective responses to those needs.
This volume is the first to explore broadly many important theoretical and applied issues concerning the mental health of Appalachians. The authors -- anthropologists, psychologists, social workers and others -- overturn many assumptions held by earlier writers, who have tended to see Appalachia and its people as being dominated by a culture of poverty.
While the heterogeneity of the region is acknowledged in the diversity of sub-areas and populations discussed, dominant themes emerge concerning Appalachia as a whole. The result of the authors' varied approaches is a cumulative portrait of a strong regional culture with native support systems based on family, community, and religion.
Some of the contributors examine therapeutic approaches, including family therapy, that consider the implications of the cultural context. Others explore the impact of Appalachian culture on the impact of Appalachian culture on the development of mental health problems and coping skills and the resulting potential for conflict between Appalachian clients and non-Appalachian health providers. Still others examine cultural considerations in therapeutic encounters and mental health service delivery. The book is rich in case studies and empirical data. The practical, applied nature of the essays will enhance their value for practitioners seeking ways to improve mental health care in the region.
Surprisingly little has been written in Western languages about the eighteenth- century Chinese novel Dream of the Red Chamber, perhaps the supreme masterpiece of its entire tradition. In this study, Andrew H. Plaks has used the conceptual tools of comparative literature to focus on the novel's allegorical elements and narrative structure. He thereby succeeds in accounting for the work's greatness in terms that do justice to its own narrative tradition and as well to recent advances in general literary theory.
A close textual reading of the novel leads to discussion of a wide range of topics: ancient Chinese mythology, Chinese garden aesthetics, and the logic of alternation and recurrence. The detailed study of European allegorical texts clarifies the directions taken by comparable works of Chinese literature, and the critical tool of the literary archetype helps to locate the novel within the Chinese narrative tradition from ancient mythology to the more recent "novel" form. Professor Plaks' innovative use of traditional criticism suggests the levels of meaning the eighteenth-century author might have expected to convey to his immediate audience.
This book provides not only an illuminating analysis of this important novel, but also a significant demonstration that critical concepts derived primarily from Western literary models may be fruitfully applied to Chinese narrative works.
Originally published in 1976.
The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These paperback editions preserve the original texts of these important books while presenting them in durable paperback editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.
Insane Asylums in the United States
Elaborately conceived, grandly constructed insane asylums—ranging in appearance from classical temples to Gothic castles—were once a common sight looming on the outskirts of American towns and cities. Many of these buildings were razed long ago, and those that remain stand as grim reminders of an often cruel system. For much of the nineteenth century, however, these asylums epitomized the widely held belief among doctors and social reformers that insanity was a curable disease and that environment—architecture in particular—was the most effective means of treatment.
In The Architecture of Madness, Carla Yanni tells a compelling story of therapeutic design, from America’s earliest purpose—built institutions for the insane to the asylum construction frenzy in the second half of the century. At the center of Yanni’s inquiry is Dr. Thomas Kirkbride, a Pennsylvania-born Quaker, who in the 1840s devised a novel way to house the mentally diseased that emphasized segregation by severity of illness, ease of treatment and surveillance, and ventilation. After the Civil War, American architects designed Kirkbride-plan hospitals across the country.
Before the end of the century, interest in the Kirkbride plan had begun to decline. Many of the asylums had deteriorated into human warehouses, strengthening arguments against the monolithic structures advocated by Kirkbride. At the same time, the medical profession began embracing a more neurological approach to mental disease that considered architecture as largely irrelevant to its treatment.
Generously illustrated, The Architecture of Madness is a fresh and original look at the American medical establishment’s century-long preoccupation with therapeutic architecture as a way to cure social ills.
Carla Yanni is associate professor of art history at Rutgers University and the author of Nature’s Museums: Victorian Science and the Architecture of Display.
Public Health since 9/11
A contemporary history of a critical period, Are We Ready? analyzes the impact of 9/11, the anthrax attacks that followed, and preparations for a possible smallpox attack on the nation's public health infrastructure. David Rosner and Gerald Markowitz interviewed local, state, and federal officials to determine the immediate reactions of key participants in these events. The authors explore the extent to which these emergencies permanently altered the political, cultural, and organizational life of the country and consider whether the nation is now better prepared to withstand another potentially devastating attack. This well-reasoned and well-researched book presents compelling evidence that few with hands-on experience with disease and emergency preparedness believe that an adequate response to terrorism—whether biological, chemical, or radiological—is possible without a strong and vibrant infrastructure to provide everyday services as well as emergency responses.
Are We Ready? begins with an examination of the experiences of local New York officials who were the first responders to 9/11 and follows them as events unfolded and as state and national authorities arrived. It goes on to analyze how various states dealt with changing federal funding for a variety of public health services. Using oral histories of CDC and other federal officials, the book then focuses on the federal reaction to 9/11 and anthrax. What emerges is a picture of dedicated public servants who were overcome by the emotions of the moment yet who were able to react in ways that significantly reduced the public anxiety and public health threat. Despite the extraordinary opportunity to revitalize and reinvigorate the nation’s public health infrastructure, the growing federal and state budget deficits, the refocusing of national attention on the war in Iraq, and the passage of time all combined to undermine many of the needed reforms to the nation’s public health defenses.
Copub: Milbank Memorial Fund