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The story of the Annunciation (Lk 1:26–38) inspired a flourishing tradition of homiletic and hymnographic literature in early Christianity. A recurring feature of this strand was the portrayal of characters through dialogue.
Although this text is regularly classed among the early narratives of Mary’s dormition and assumption, the Coptic Homily on the Theotokos attributed to Cyril of Jerusalem is actually an early example of a Life, or vita, of the Virgin Mary, and indeed, it is one of the earliest such texts to survive.
The veneration of the Mother of God and the imagery dedicated to her developed gradually in the Early Christian Church. Scholars still struggle to single out the earliest and most relevant evidence for the cult of the Virgin and to determine the starting point of devotion that is specifically Marian in focus.
This book explores how the Virgin Mary's life is told in hymns, sermons, icons, art, and other media in the Byzantine Empire before AD 1204. A group of international specialists examines material and textual evidence from both Byzantine and Muslim-ruled territories that was intended for a variety of settings and audiences and seeks to explain why Byzantine artisans and writers chose to tell stories about Mary, the Mother of God, in such different ways. Sometimes the variation reflected the theological or narrative purposes of story-tellers; sometimes it expressed their personal spiritual preoccupations. Above all, the variety of aspects that this holy figure assumed in Byzantium reveals her paradoxical theological position as meeting-place and mediator between the divine and created realms. Narrative, whether 'historical', theological, or purely literary, thus played a fundamental role in the development of the Marian cult from Late Antiquity onward.
Sodium valproate and related preparations have recently undergone regulatory review following concern about effects on the unborn child and doctors' failure to communicate risk. The issues are wider. Valproate is overused in psychiatry based on the false perception that ‘ease’ of use equates to better safety than alternatives. Valproic acid can disrupt fundamental physiological processes, the consequences of which are poorly understood and little discussed in the psychiatric literature. Valproate may be useful in a small number of patients with bipolar disorder but current prescribing patterns are unjustified. Perception needs to change.
Declaration of interest
D.C.O. is psychiatric commissioner on the Commission on Human Medicines and a member of the European Medicines Agency's Scientific Advisory Group on Psychiatry. He chaired the European Medicines Agency's review of the psychiatric use of valproate in pregnancy and women of childbearing potential.
Lack of trust toward medical research is a major barrier to research participation, particularly among some population groups. Valid measures of trust are needed to develop appropriate interventions. The study purpose was to compare two previously validated scales that measure trust in biomedical research – one developed by Hall et al. (H-TBR; 2006) and the other by Mainous et al. (M-TBR; 2006) – in relation to socio-demographic variables and attitudes toward research. Differences between Black and White respondents were explored.
Two nearly identical surveys – one with H-TBR and the other with M-TBR – were systematically administered to a convenience sample. Internal consistency reliability of each scale was assessed. Associations were computed between scores on each scale with attitudes toward biomedical research and demographic variables (i.e., gender, age, race, and socioeconomic status). The difference between White and Black respondents on each TBR score while controlling for age, education, and race was also investigated.
A total of 2020 participants completed the H-TBR survey; 1957 completed the M-TBR survey. Mean item scores for M-TBR were higher (F = 56.05, p < 0.001) among Whites than Blacks. Whites also had higher mean item scores than Blacks on H-TBR (F = 7.09, p < 0.001). Both scales showed a strong association with participants’ perceived barriers to research (ps < 0.001) and significant, positive correlations with interest in research participation (ps < 0.001). Age and household income were positive predictors of TBR scores, but the effects of education differed.
Both scales are internally consistent and show associations with attitudes toward research. Whites score higher than Blacks on both TBR scales, even while controlling for age and socioeconomic status.
Through use of a unique, multi-year public opinion survey, this paper seeks to measure changes in self-reported governmental satisfaction among Chinese citizens between 2003 and 2016. Despite the persistence of vast socio-economic and regional inequalities, we find evidence that low-income citizens and residents living in China's less-developed inland provinces have actually reported comparatively greater increases in satisfaction since 2003. These results, which we term the “income effect” and “region effect” respectively, are more pronounced at the county and township levels of government, which are most responsible for public service provision. Our findings also show that the satisfaction gap between privileged and more marginalized populations in China is beginning to close, in large part owing to efforts by the Hu Jintao and Xi Jinping administrations to rebalance the gains of economic growth and shift resources towards the populations most overlooked during China's first few decades of reform.
Lithium-treated patients with polyuria are at increased risk of lithium toxicity. We aimed to describe the clinical benefits and risks of different management strategies for polyuria in community lithium-treated patients.
This is a naturalistic, observational, prospective 12-month cohort study of lithium-treated patients with polyuria attending a community mental health service in Dublin, Ireland. When polyuria was detected, management changed in one of four ways: (a) no pharmacological change; (b) lithium dose decrease; (c) lithium substitution; or (d) addition of amiloride.
Thirty-four participants were diagnosed with polyuria and completed prospective data over 12 months. Mean 24-hour urine volume decreased from 4852 to 4344 ml (p = 0.038). Mean early morning urine osmolality decreased from 343 to 338 mOsm/kg (p = 0.823). Mean 24-hour urine volume decreased with each type of intervention but did not attain statistical significance for any individual intervention group. Mean early morning urine osmolality decreased in participants with no pharmacological change and increased in participants who received a change in medication but these changes did not attain statistical significance. Only participants who discontinued lithium demonstrated potentially clinically significant changes in urine volume (mean decrease 747 ml in 24 hours) and early morning urine osmolality (mean increase 31 mOsm/kg) although this was not definitively proven, possibly owing to power issues.
Managing polyuria by decreasing lithium dose does not appear to substantially improve objective measures of renal tubular dysfunction, whereas substituting lithium may do so. Studies with larger numbers and longer follow-up would clarify these relationships.