Journal articles on the topic 'Arthur Burdeu'

The Employment Act of 1946 created the Council of Economic Advisers (CEA)--and served as a convenient marker of the government's acceptance of the burden of stabilizing the macroeconomy. The willingness of post-WWII governments to let automatic stabilizers function in recessions may well have moderated the post-WWII business cycle. The CEA has also served as an advocate of allocative efficiency in economic policy. Its relative success can be primarily ascribed to Chairman Arthur Burns, who hired a CEA staff composed of short-term appointees whose principal loyalty was to economic rationality.

Abstract This article examines the place of religion in the narratives of mothers of children with fragile X syndrome. In semistructured interviews, a majority of women combined narratives of religious practice with illness narratives, interpreting their children's disabilities within a religious framework. Informed by Arthur Frank's (1995) concept of “wounded storytellers,” the authors articulate a reconciliation narrative that mothers commonly used to describe their transition from viewing disability as a burden or challenge to seeing it as a blessing, or as a part of God's purpose or plan for their lives. The authors discuss the significance of narrative for better understanding religious perspectives on disability and conclude with the implications of these findings for practitioners and future research.

Urgency of the research. Difficulties in the macroeco-nomic environment and budgetary issues intensify within the volatile environment of Ukrainian economy. The causes include excessive tax burden. Target setting. Thus tax burden issues analysis taking into consideration resource potential particularities of the economy of the various regions of the country is the priority for their economic growth facilitation. Actual scientific researches and issues analysis. Theoretical and applied framework of tax burden effect on the economy analysis has been started by Arthur Laffer. Valuable contributions into theory and methodology have been done by the following prominent scientists: Yu. Ananiashvili, Ye. Balatskyi, A. Gusev, M. Kakaulina, V. Fedosova, V. O. parina, V. Sutormina, N. Riazanova, O. Girna, O. Sydorovych. Uninvestigated parts of general matters defining. The need in research work at named field still remains, especially taking into account specific features of regions and national economy development in the context of transition economy. The research objective. Laffer's theory special aspects investigation in tax burden optimization of regions sphere, methodological approach extension in terms of tax manage-ment based on the principles of the rational use of of re-sources, optimal tax burden priority directions substantiation with the objective of to provide economic growth. The statement of basic materials. This paper presents specific features of the tax burden in the regions of Ukraine. Methodological approach is proposed which provides means to optimize tax burden of the regions, increase economic feasibility level when making decisions concerning priority ranking of the regions development. Conclusions. Undertaken study allows to claim that re-gions of Ukraine are featured with different effect of the tax burden on economic system. Assessment of Ukrainian regions tax burden optimization pattern to the level facilitating economic growth has shown that even slight increase in output can allow to increase substantially tax revenue level.

Arthur Honegger composed his first sound film scores in 1933–34. For Les misérables, Raymond Bernard, who was under contract at Pathé-Natan to direct big-budget theatrical films that would compete with Paramount's French-language productions, expected Honegger to provide intermittent orchestral underscoring for already filmed sequences that privileged dialogue over music. For Rapt, the musically trained Dimitri Kirsanoff used independent financing to collaborate from the start with Honegger and Arthur Hoérée on what the director called “a hybrid form … in which music, image, and dialogue work together.” The innovative electroacoustic and sound editing techniques in the soundtrack for Rapt have, I argue, overshadowed the strikingly reciprocal relationship between the soundtrack's more conventional instrumental underscoring and the images on screen. Honegger theorized in 1931 that, in sound film, music's “autonomy” would free it from the burden of mimesis. Instead, the images on screen would teach listeners about music's abstract “reality.” In practice, however, in Rapt, mimetic music and musicalized sound effects bridge the gap between aesthetic goals of hybridity and practical demands for intelligible dialogue. My analysis of the abduction, washhouse, storm, and dream sequences in Rapt demonstrates that a successful hybrid of sound and image ultimately has the potential not just to use images to pin down music's elusive “reality,” but also to use music's mimetic possibilities to influence our reading of ambiguous imagery. It also shows that music does not need to be in itself groundbreaking in order to contribute to groundbreaking innovations in sound film.

Over the past two decades, caregiver stress has been the subject of scientific inquiry by investigators around the world representing a variety of disciplines. The knowledge base is extensive and growing, particularly as it relates to the phenomenology and correlates of caregiver stress. The six papers published here represent a snapshot of prevailing lines of inquiry and enhance our knowledge regarding: predictors of psychological distress for dementia family caregivers in Japan (Shikimoto et al., 2017) and for Indonesian and Burmese foreign domestic workers caring for frail older adults in Singapore (Ha et al., 2018); identification of a threshold number of behavioral symptoms in those with dementia associated with caregiver distress (Arthur et al., 2017); the influence of specific illness factors on caregiver stress, including comorbid diabetes in patients with Alzheimer's disease (Li et al., 2018) and a comparison of the effects of behavioral disturbances on caregiver burden across three types of dementia (Liu et al., 2017); and the application of data on caregiver stress to inform the development of a multi-component framework for preventing depression in caregivers of those with dementia (Ying et al., 2017).

Faced with interminable combat over some piece of philosophical terrain, someone will inevitably suggest that the contested ground is nothing more than a philosophically manufactured mirage that is therefore not worth fighting for. Arthur Fine has long advocated such a response — the ‘Natural Ontological Attitude,’ or NOA — to the realism debate in the philosophy of science. Notwithstanding theprima facieincompatibility between the realist's and anti-realist's positions, Fine suggests that there is in fact enough common ground for NOA to stand on its own as a minimal alternative, one that enjoys the advantage of being free of the philosophical burdens of its overweight contenders.Notwithstanding Fine's claim to have identified a position that is neither realist nor anti-realist, critics charge that NOA, as Fine describes it, is a realist position. I endorse this criticism below, with attention to the relation between NOA and Bas van Fraassen's Constructive Empiricism (CE). I show that Fine's repudiation of the globalism he identifies in realism (and in anti-realism) does not insulate him from that charge.

AbstractEnglish common law was applied in the New South Wales penal colony when it was founded by Governor Arthur Phillip in 1788. Phillip’s second commission granted him sole authority to appoint coroners and justices of the peace within the colony. The first paid city coroner was appointed in 1810 and only five coroners served the expanding territory of New South Wales by 1821. To relieve the burden on coroners, justices of the peace were authorised to conduct magisterial inquiries as an alternative to inquests. When the Moreton Bay settlement was established, and land was opened up to free settlers, justices were relocated from New South Wales to the far northern colony. Nonetheless, the administration of justice, along with the function of the coroner, was hindered by issues of isolation, geography and poor administration by a government far removed from the evolving settlement. This article is about death investigation and the role of the coroner in Moreton Bay. By examining a number of case studies, it looks at the constraints faced by coroners, deaths due to interracial violence and deaths not investigated. It concludes that not all violent and unexplained deaths were investigated in accordance with coronial law due to a paucity of legally qualified magistrates, the physical limitations of local conditions and the denial of justice to Aborigines as subjects of the Crown.

The article is a kind of aesthetic experiment that reveals patterns between two stories from the life of the fictional character William Blake from the film "dead Man" by American Director Jim Jarmusch and French theater theorist and philosopher Antonin Artaud. The complexity of the work lies in the fact that the comparison takes place between a fictional hero and a real person who made identical metaphysical trips to the bosom of an ancient civilization. The path is presented as an experience of reincarnation with the possibility of gaining new knowledge, liberation from the burden of pain and illness, fears and anxiety. The author is interested, among other things, in the stages of transformation of the personality and its transition from a reasonable state to a mad state with the exit to purification and liberation of the hero in death. The metamorphosis of the transition to the territory of the transcendent (mad) develops into a holistic individual performance-a challenge to society. Theatricality as the highest form of life itself and its completion determine the initiation process of Artaud and Blake. Artezianka theatricality and tragedy are the tears of all life and the creative forces. Blake's theatricality is realized in a gradual alienation from the everyday world and immersion in the ritual world, which requires him to perform a number of mandatory rites, for example, applying the blood of a slaughtered animal to the face. Comparative analysis takes into account the concept of disease and morbidity, which is considered not from a medical point of view, but in philosophical and aesthetic discourses. For both characters, the fact of theatricalization of life, the Monstration of its aesthetic and moral categories through the optics of ritual and ritual practice of the Indians is postulated.

Abstract Introduction Malignant cells require amino acids for a wide range of core functions. Amino acid deprivation using enzymatic degradation has been used to induce remission in acute lymphoblastic leukemia for decades. Amino acid deprivation may also benefit patients with acute myeloid leukemia (AML). We have previously shown that AML cells lack of argininosuccinate synthetase 1(ASS1), a key enzyme in the pathway that produces arginine (1). Here we tested the effect of an arginine depleting agent, pegylated arginine deiminase (ADI-PEG 20) on primary AML cells in a xenograft model of AML. Methods NOD/SCID/interleukin 2 gamma chain null (NSG) mice were transplanted with 6 primary AML samples. 12 weeks after transplantation of AML mice received either ADI-PEG 20, cytarabine, ADI-PEG 20 plus cytarabine or vehicle. ADI was administered weekly for 4 doses and cytarabine was given for 10 consecutive days (0.2mg per day, roughly equivalent to 40mg in humans). Five weeks after treatment started, mice were killed and the percentage of AML in the bone marrow was determined by flow cytometry. Blood was collected to quantify plasma arginine using liquid chromatography-mass spectrometry/mass spectrometry. Results Plasma arginine levels were depressed following ADI-PEG 20 administration confirming that arginine depletion was achieved in vivo. In all six experiments the combination of ADI-PEG 20 and cytarabine induced a significant reduction in levels of AML compared to control (Figure 1). Critically the combination of ADI-PEG 20 and cytarabine was significantly better than cytarabine alone in three of six experiments. Conclusion Our experiments show that arginine deprivation by ADI-PEG 20 can decrease the leukemic burden in mice transplanted with primary AML cells. The combination of ADI with cytarabine had a greater effect than cytarabine alone in half the experiments. These results provide the rationale to test ADI-PEG 20 with cytarabine in clinical trials. 1. Peter W. Szlosarek, Fiona Luong, Andrew Clear, David Taussig, Simon Joel, Maria Calaminici, Silvana Debernardi, Jude Fitzgibbon, John S. Bomalaski, Arthur E. Frankel, and Dominique Bonnet. Pegylated arginine deiminase (ADI-PEG 20) as a potential novel therapy for argininosuccinate synthetase-deficient acute myeloid leukemia. Cancer Research: April 15, 2011. AACR 102nd Annual Meeting 2011, (AACR Abstract # 467) F. M-M and L. A-M contributed equally D.B., P.W.S. and D.C.T contributed equally Disclosures: Bomalaski: Polaris Group: Employment, Equity Ownership. Szlosarek:Polaris Group: Research Funding.

Apophatic Literary Criticism. Notes of a Non-philologist’ by Marianna Dudareva demonstrates Russian spirit and reflects the immense variety of characters and plots that influence people and manifest the creative power of literature. The author introduces a number of writers, from Sergei Yesenin to Vladimir Korolenko, with unique literary styles and a common apophatic approach to reality. The term apophatic comes from the Greek word to deny and initially referred to religious studies where it served both as a concept and a method. Apophatic theology attempted to approach God by negations rather than affirmations of what God is. M. Dudareva’s work showcases how literature studies instrumentalize the apophatic method of philosophy. This review complements the study with a reflection on the topic of death and its inextricable connection with life. Literature speaks of life and dwells on the struggle for life, that is also key to philosophical thinking. Enough to mention Arthur Schopenhauer and his idea of the will to live. In contrast to philosophy, literature uses a vivid, colorful, and copious language, while philosophy is concerned with universal principles. Some distinguished authors managed to bridge this gap. For instance, Dostoevsky, Nietzsche, and Sartre created works of both literary and philosophical nature. The same can be traced in the short stories by B. Zaytsev and A. Grin, analyzed in the book. B. Zaytsev writes about death approaching us first through others, this idea is also found in V. Jankélévitch’s work Death. Death is never ours for it is always we or our death, but when we see it around it causes anxiety and fear. In Avdot’ya-smert’ (Avdot’ya-Death) the main character says a prayer to be relieved of her mother and son, whom she considers a burden. Once death enters their home it never stops, it gets closer, and at the end of the story it takes Avdot’ya too. In Grin’s Fighting Death, death struck Lorkh falls asleep and herein dreaming is not a harbinger of the darkness of eternal sleep. On the contrary, Lorkh wakes up willful and hopeful, he fights for his life and succeeds. These stories vibrantly illustrate the victory of life over death and death over life as the result of exercising one’s free will. Color in literature is another topic touched upon by the author. M. Dudareva refers to Goethe’s Zur Farbenlehre to speak about contrasts, and R. Steiner to underline the importance of black in creating an image where color range matches the emotional range.

Abstract Breast cancer metastasis accounts for 90% of breast cancer mortality highlighting the need for new therapeutic interventions that can be used in the treatment of advanced disease. Interesting in this regard is the successful development of approaches to increase tumor immunity in several solid tumors although, as yet, these interventions have only been impactful in a small subset of breast cancer patients. Whilst it has been established outside the realm of cancer that sex steroid hormones, especially estrogens, are key regulators of immunological responses, little is known about how these hormones affect immunological responses in the context of breast cancer. It is significant, therefore, that we have demonstrated that estrogen receptor-alpha (ER-α), the major intracellular mediator of responses to estrogens, is expressed in several different immune cells in the tumor microenvironment. How this receptor can be targeted to increase tumor immunity is a major focus of our current research efforts. For this study we utilized estrogen-non-responsive breast cancer cell lines allowing us to evaluate the roles of cancer cell extrinsically expressed ERα on metastasis. Mice were ovariectomized and supplemented with either placebo or an estrogen, 17β-estradiol (E2) in drinking water. Luciferase-labelled breast cancer cells were injected intravenously through the tail vein (for experimental metastasis) or into the mammary fat pad (for spontaneous metastasis) into syngeneic hosts. Metastasis burden was quantified using bioluminescence imaging and flow cytometry was utilized to assess changes in immune cell repertoire and activity. Analogous experiments were also performed in immunocompromised NOD-scid IL2Rgammanull (NSG) mice to assess the specific contribution of immune cells to the phenotypes observed. Interestingly, E2 supplementation in immunocompromised NSG mice led to decreased metastasis of breast cancer cells to the lungs, while the same treatment in immunocompetent C57BL/6 mice resulted in increased metastasis. These findings indicated that E2 negatively impacts anti-tumor immunity in immunocompetent hosts to promote metastasis. Immunoprofiling revealed that E2 decreased natural killer (NK) cell numbers, activation status, and their ability to produce IFNg. Additionally, genetic knockout of ERα specifically in NK cells led to increased NK cell numbers in the lung, increased production of IFNg from NK cells, and decreased metastatic burden. In-vitro, E2 decreased the production of IFNg in a dose-dependent manner in NK-cells and reduced their cytotoxicity against MHC-I low cells. Altogether, these results indicate that targeting the E2-ERα signaling axis in NK cells might be beneficial in the setting of metastatic breast cancer. Our ongoing studies are exploring how mechanistically distinct ERα modulators regulate NK cell activity with a view to developing new approaches to increase breast tumor immunity. Citation Format: Jovita K Byemerwa, Aditi Goyal, Sandeep Artham, Corinne Haines, Chingyi Chang, Donald McDonnell. 17β-estradiol negatively regulates natural killer cells and promotes breast cancer metastasis [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy; 2022 Oct 21-24; Boston, MA. Philadelphia (PA): AACR; Cancer Immunol Res 2022;10(12 Suppl):Abstract nr B06.

Background:Biologics have revolutionized the treatment of axial spondyloarthritis (axSpA). However, there is limited knowledge about factors associated with their use in Canada.Objectives:To evaluate sociodemographic, healthcare and patient-reported outcomes (PROs) associated with the use of biologics in Canadian axSpA patients.Methods:The International Map of Axial Spondyloarthritis (IMAS) is a cross-sectional online survey of non-selected patients with self-reported axSpA, conducted in 21 countries and endorsed by the Axial Spondyloarthritis International Federation (ASIF). IMAS captures the patients’ perspective of the burden of axSpA. The Canadian adaptation included a review of the survey by an advisory board of axSpA patients and a national steering committee composed of the Canadian Spondylitis Association, rheumatologists and patients. Participants were recruited between August 2018 and February 2019. Sociodemographic and healthcare-related variables, as well as PROs (disease activity [BASDAI, 0–10], spinal stiffness [3–12], functional limitation [0–54] and psychological distress [GHQ-12]) were collected. Respondents were divided in 2 groups 1) biologic and 2) NSAIDs or no treatment, based on reported pharmacologic treatments. Statistical analyses were performed to assess associations between variables and biologic use (bivariate) and the relative weight of these associations (multivariate).Results:542 axSpA patients were recruited. Mean age was 44.3±13.9 years, 63.1% were female, 66.4% married and 81.0% educated to university/college level. 22.8% of patients lived >50 km from their rheumatologist. Mean BASDAI was 5.3±2.1 and mean GHQ-12 score (mental health) was 4.0±3.8. Nearly half (49.6%) were currently on a biologic. Reported incidence of side effects was lower for patients having biologics (42.5%) vs. a NSAIDs (53.7%) as part of their treatment armamentarium. Only 15.7% of patients had discontinued biologic therapy, the main reasons for withdrawal being physician recommendation (50%), side effects (50%) and personal choice (34%). Variables associated with biologic use included: membership of a patient support group (p<0.001), non-manual work (p=0.008), higher income level (p=0.039), having a combination of public and private insurance schemes (p<0.001) and diagnosis by a rheumatologist (p<0.001). Associated PROs were spinal stiffness (p=0.011) and diagnostic delay (p=0.030). In the multivariate analysis, all variables except income and diagnostic delay were associated with biologic use (Table 1).Table 1.Analysis of sociodemographic and clinical variables in relation to pharmacologic treatmentVariableUnivariate linear regressionMultivariate stepwise linear regressionB95% CIB95% CIIncome level0.0011.000–1.000NANAEmployment—manual worker–0.7610.266–0.822–0.8380.228–0.820Member of a patient support group0.9371.797–3.6281.1161.754–5.309Health insurance scheme—combination0.2091.162–1.3070.2151.132–1.357Diagnostic delay0.0090.993–1.026NANASpinal Stiffness (3–12)0.0991.022–1.1930.2201.090–1.424Diagnosed by rheumatologist0.5351.412–2.0670.3351.041–1.877B, B coefficient; NA, [not applicable]Conclusion:Canadian axSpA patients with greater social status, disease awareness, and insurance options are more likely to receive biologic therapy. Furthermore, Canadian physicians are more inclined to prescribe biologics to patients with increased spinal stiffness.Disclosure of Interests:Robert Inman: None declared, Marco Garrido-Cumbrera: None declared, Jon Chan: None declared, Martin Cohen: None declared, Artur J. deBrum Fernandes: None declared, Wendy Gerhart: None declared, Nigil Haroon: None declared, Algis Jovaisas: None declared, Gerald Major: None declared, Michael Mallinson: None declared, Sherry Rohekar: None declared, Patrick Leclerc Employee of: Novartis, Julie Schneiderman Employee of: Novartis, Proton Rahman Grant/research support from: Janssen and Novartis, Consultant of: Abbott, AbbVie, Amgen, BMS, Celgene, Lilly, Janssen, Novartis, and Pfizer., Speakers bureau: Abbott, AbbVie, Amgen, BMS, Celgene, Lilly, Janssen, Novartis, Pfizer

Background:Understanding the most limiting daily activities reported by patients is important for a holistic healthcare approach.Objectives:To evaluate the degree of functional limitation on daily activities and its association with PROs in Canada.Methods:The International Map of Axial Spondyloarthritis (IMAS) is a cross-sectional online survey of non-selected patients with self-reported axSpA conducted in 22 countries and endorsed by the Axial Spondyloarthritis International Federation. IMAS captures the patients’ perspective of the burden of axSpA. The Canadian adaptation included a review of the survey by an advisory board of axSpA patients and a national steering committee composed of the Canadian Spondylitis Association, rheumatologists and axSpA patients. Canadian participants were recruited from 2018 to 2019. Socio-demographics variables, BASDAI and mental health (GHQ-12) data were collected. Degree of functional limitation in 18 daily activities was evaluated using a 3-point Likert scale. Bivariate analysis was performed to assess activities associated with poorer BASDAI and mental health status.Table 1.BASDAI and mental health (GHQ-12)- impact on daily activities (N = 542)BASDAIMean ± SDGHQ-12Mean ± SDLow limitationMedium + High Limitationp-valueLow limitationMedium + High Limitationp-valueDressing / undressing5.5 ± 2.06.4 ± 4.4<.001*4.4 ± 3.85.7 ±4.0.007*Washing / personal grooming5.6 ±2.06.3 ± 2.0.002*4.7 ± 4.15.6 ± 4.1.099Taking a bath / shower5.6 ±2.06.6 ±1.8<.001*4.2 ± 4.05.9 ± 4.0.002*Tying shoe laces5.4 ± 2.06.1 ± 2.0.005*4.3 ± 3.85.2 ± 4.1.044*Walking / getting around the house5.5 ± 2.06.4 ± 1.9<.001*4.2 ± 3.95.6 ± 4.1.005*Stair climbing5.1 ±1.96.3 ±1.8<.001*3.4 ± 3.45.4 ± 4.0<.001*Lying down / getting up from bed5.2 ± 2.06.3 ± 1.9<.001*3.6 ± 3.65.5 ± 4.1<.001*Going to the toilet5.4 ± 2.06.7 ± 1.9<.001*4.3 ± 4.25.6 ± 3.9.024*Shopping5.6 ± 1.86.2 ± 1.9.003*4.1 ± 3.75.3 ± 4.1.025*Cooking5.6 ± 1.96.3 ± 1.8.008*3.7 ± 3.65.8 ±4.2<.001*Eating5.9 ± 2.16.9 ± 1.9.024*5.0 ± 4.45.8 ± 3.9.282Housework / cleaning4.9 ± 2.06.0 ± 1.8<.001*3.7 ± 3.64.8 ± 4.0.021*Walking down the street5.4 ± 1.96.1 ± 2.0.005*4.4 ± 3.85.1 ± 4.1.228Using public transportation5.6 ± 1.96.1 ± 1.9.1804.4 ± 4.05.3 ± 4.0.155Driving5.5 ± 2.06.1 ± 2.1.021*4.2 ± 3.95.3 ± 4.2.050Doing physical exercise4.7 ± 2.15.8 ± 1.9<.001*3.4 ± 3.74.7 ± 4.0.002*Engaging in intimate relations5.2 ± 1.96.0 ±1.9<.0014.0 ± 3.85.1 ± 4.0.015*Caring for children / grandchildren5.2 ± 1.96.0 ± 2.0.0033.7 ± 3.85.2 ± 4.1.005* p≤.05Results:542 axSpA patients participated. Mean age was 44.3±13.9 years and 63% were female. Mean BASDAI was 5.3±2.1, mean GHQ-12 score was 4.0±3.8 and 50% were on biologics. 94% reported ≥1 limitation in daily activities, of which physical exercise (30%), house cleaning (22%), intimacy (21%) and stair climbing (21%) were most commonly severely impacted (high limitation). Women reported significantly higher limitations in house cleaning, stair climbing, driving, moving around the house and caring for young children (p<.05 for all activities vs men). Compared with low limitation, medium–high limitation in most activities was significantly associated with higher disease activity and worsened mental health for the overall population (Table 1).Conclusion:Canadian axSpA patients, particularly women, are limited in daily life activities beyond those captured by other validated scales. Strong association between functional limitation, disease activity and mental health emphasizes the need for holistic evaluation of axSpA patients.Disclosure of Interests:Proton Rahman Grant/research support from: Janssen and Novartis, Consultant of: Abbott, AbbVie, Amgen, BMS, Celgene, Lilly, Janssen, Novartis, and Pfizer., Speakers bureau: Abbott, AbbVie, Amgen, BMS, Celgene, Lilly, Janssen, Novartis, Pfizer, Marco Garrido-Cumbrera: None declared, Sherry Rohekar: None declared, Michael Mallinson: None declared, Gerald Major: None declared, Algis Jovaisas: None declared, Nigil Haroon: None declared, Wendy Gerhart: None declared, Artur J. deBrum Fernandes: None declared, Martin Cohen: None declared, Jon Chan: None declared, Patrick Leclerc Employee of: Novartis, Julie Schneiderman Employee of: Novartis, Robert Inman: None declared

Abstract Rapid assessment of therapy for advanced cancer, especially immunotherapy (IO), is critical. For advanced cancers most therapies, even targeted/personalized ones fail. Even worse, IO has been reported to cause more than doubling in the cancer growth rate (defined as hyper-progressive disease or HPD) in 5-40% (typically ~20%) of patients. Early identification of HPD, or any inactive therapy, and switching to an effective therapy can be lifesaving. Though a consensus has not emerged, there are several reports that describe sensitization to chemotherapy following failed immunotherapy, this suggests that, at least in some cases, switching results in dramatic benefit. Due to inflammatory infiltrates causing “pseudoprogression” (false readings of cancer progression) early during treatment with IO, ineffective IO is often continued for 4-6 months before imaging can definitively say the IO is failing. During this time progressive, potentially fatal cancer growth, as well as medical and financial side effects can occur. The cost of this ineffective or counterproductive IO is typically $10,000 to over $20,000 a month. There are numerous reports of highly sensitive mutation based, or methylation sequence based, cfDNA signatures and methods. Unfortunately, they are inherently difficult tests which typically cost thousands of dollars and do not report the results to clinicians for 1 to 2 weeks. They have not been adopted for routine use to monitor on every visit basis and allow near real-time adjustment of therapy. Rapid detection of failure can lead to lifesaving therapy changes; detection of benefit can enhance compliance and improve clinical outcomes. Previously a research lab style solid gold electrode, requiring artful polishing and reuse, has been reported to be selectively sensitive to cancer DNA due to ctDNA’s altered pattern of methylation. Electrochemical detection of the binding of cfDNA, following a 10-minute incubation, has been published. Details of the dramatically revised and optimized binding methodology are in the methods section of this poster. Compared to previous methods an over 2-fold increase in cfDNA binding is shown. Cancer samples not distinguishable from normal with the previous method show statistically significant detection with the new method. Dramatically increased ability to separate cancer from normal DNA is shown. The new method uses inexpensive, clinically and POC suitable, disposable electrodes; it is highly sensitive to clinical samples. 5 µL of a 10 pg/ul sample provides reproducible readings. cfDNA from normal persons generates readings significantly different than from those with cancer (p &lt; .01). Patient time courses illustrate the correlation of the electrode response with cancer burden and suggests this is a monitoring tool that should be compared to, and may have benefits over, previously approved monitoring tests for advanced cancer such as carcinoembryonic antigen (CEA). Citation Format: Floyd Taub, Matt Russo, Shannon Tunney, Suzin Wright, Chuck Henry. A simplified, potentially point-of-care (POC), electrode method detects changes in the amount of cfDNA/ctDNA and evaluates the response of advanced cancer patients to therapy. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P049.

Abstract Background The aims of this study are to (1) determine whether fixation of metastatic long bone fractures with an intramedullary nail (IMN) influences the incidence of lung metastasis in comparison to arthroplasty or ORIF (Arthro/ORIF); and (2) assess this relationship in primary tumor types; and (3) to assess survival implications of lung metastasis after surgery. Methods Retrospective cohort study investigating 184 patients (107 IMN, and 77 Arthro/ORIF) surgically treated for metastatic long bone fractures. Patients were required to have a single surgically treated impending or established pathologic fracture of a long bone, pre-operative lung imaging (lung radiograph or computed tomography) and post-operative lung imaging within 6 months of surgery. Primary cancer types included were breast (n = 70), lung (n = 43), prostate (n = 34), renal cell (n = 37). Statistical analyses were conducted using two-tailed Fisher’s exact tests, and Kaplan-Meier survival analyses. Results Patients treated with IMN and Arthro/ORIF developed new or progressive lung metastases following surgery at an incidence of 34 and 26%, respectively. Surgical method did not significantly influence lung metastasis (p = 0.33). Furthermore, an analysis of primary cancer subgroups did not yield any differences between IMN vs Arthro/ORIF. Median survival for the entire cohort was 11 months and 1-year overall survival was 42.7% (95% CI: 35.4–49.8). Regardless of fixation method, the presence of new or progressive lung metastatic disease at follow up imaging study was found to have a negative impact on patient survival (p < 0.001). Conclusions In this study, development or progression of metastatic lung disease was not affected by long bone stabilization strategy. IM manipulation of metastatic long bone fractures therefore may not result in a clinically relevant increase in metastatic lung burden. The results of this study also suggest that lung metastasis within 6 months of surgery for metastatic long bone lesions is negatively associated with patient survival. Level of evidence III, therapeutic study

About half way through Yann Arthus-Bertrand’s film Home (2009) the narrator describes the fall of the Rapa Nui, the indigenous people of the Easter Islands. The narrator posits that the Rapa Nui culture collapsed due to extensive environmental degradation brought about by large-scale deforestation. The Rapa Nui cut down their massive native forests to clear spaces for agriculture, to heat their dwellings, to build canoes and, most importantly, to move their enormous rock sculptures—the Moai. The disappearance of their forests led to island-wide soil erosion and the gradual disappearance of arable land. Caught in the vice of overpopulation but with rapidly dwindling basic resources and no trees to build canoes, they were trapped on the island and watched helplessly as their society fell into disarray. The sequence ends with the narrator’s biting remark: “The real mystery of the Easter Islands is not how its strange statues got there, we know now; it's why the Rapa Nui didn't react in time.” In their unrelenting desire for development, the Rapa Nui appear to have overlooked the role the environment plays in maintaining a society. The island’s Moai accompanying the sequence appear as memento mori, a lesson in the mortality of human cultures brought about by their own misguided and short-sighted practices. Arthus-Bertrand’s Home, a film composed almost entirely of aerial photographs, bears witness to present-day environmental degradation and climate change, constructing society as a fragile structure built upon and sustained by the environment. Home is a call to recognise how contemporary practices of post-industrial societies have come to shape the environment and how they may impact the habitability of Earth in the near future. Through reflexivity and a ritualised structure the text invites spectators to look at themselves in a new light and remake their self-image in the wake of global environmental risk by embracing new, alternative core practices based on balance and interconnectedness. Arthus-Bertrand frames climate change not as a burden, but as a moment of profound realisation of the potential for change and humans ability to create a desirable future through hope and our innate capacity for renewal. This article examines how Arthus-Bertrand’s ritualised construction of climate change aims to remake viewers’ perception of present-day environmental degradation and investigates Home’s place in contemporary climate change communication discourse. Climate change, in its capacity to affect us globally, is considered a world risk. The most recent peer-reviewed Synthesis Report of the Intergovernmental Panel on Climate Change suggests that the concentration of atmospheric greenhouse gases has increased markedly since human industrialisation in the 18th century. Moreover, human activities, such as fossil fuel burning and agricultural practices, are “very likely” responsible for the resulting increase in temperature rise (IPPC 37). The increased global temperatures and the subsequent changing weather patterns have a direct and profound impact on the physical and biological systems of our planet, including shrinking glaciers, melting permafrost, coastal erosion, and changes in species distribution and reproduction patterns (Rosenzweig et al. 353). Studies of global security assert that these physiological changes are expected to increase the likelihood of humanitarian disasters, food and water supply shortages, and competition for resources thus resulting in a destabilisation of global safety (Boston et al. 1–2). Human behaviour and dominant practices of modernity are now on a path to materially impact the future habitability of our home, Earth. In contemporary post-industrial societies, however, climate change remains an elusive, intangible threat. Here, the Arctic-bound species forced to adapt to milder climates or the inhabitants of low-lying Pacific islands seeking refuge in mainland cities are removed from the everyday experience of the controlled and regulated environments of homes, offices, and shopping malls. Diverse research into the mediated and mediatised nature of the environment suggests that rather than from first-hand experiences and observations, the majority of our knowledge concerning the environment now comes from its representation in the mass media (Hamilton 4; Stamm et al. 220; Cox 2). Consequently the threat of climate change is communicated and constructed through the news media, entertainment and lifestyle programming, and various documentaries and fiction films. It is therefore the construction (the representation of the risk in various discourses) that shapes people’s perception and experience of the phenomenon, and ultimately influences behaviour and instigates social response (Beck 213). By drawing on and negotiating society’s dominant discourses, environmental mediation defines spectators’ perceptions of the human-nature relationship and subsequently their roles and responsibilities in the face of environmental risks. Maxwell Boykoff asserts that contemporary modern society’s mediatised representations of environmental degradation and climate change depict the phenomena as external to society’s primary social and economic concerns (449). Julia Corbett argues that this is partly because environmental protection and sustainable behaviour are often at odds with the dominant social paradigms of consumerism, economic growth, and materialism (175). Similarly, Rowan Howard-Williams suggests that most media texts, especially news, do not emphasise the link between social practices, such as consumerist behaviour, and their environmental consequences because they contradict dominant social paradigms (41). The demands contemporary post-industrial societies make on the environment to sustain economic growth, consumer culture, and citizens’ comfortable lives in air-conditioned homes and offices are often left unarticulated. While the media coverage of environmental risks may indeed have contributed to “critical misperceptions, misleading debates, and divergent understandings” (Boykoff 450) climate change possesses innate characteristics that amplify its perception in present-day post-industrial societies as a distant and impersonal threat. Climate change is characterised by temporal and spatial de-localisation. The gradual increase in global temperature and its physical and biological consequences are much less prominent than seasonal changes and hence difficult to observe on human time-scales. Moreover, while research points to the increased probability of extreme climatic events such as droughts, wild fires, and changes in weather patterns (IPCC 48), they take place over a wide range of geographical locations and no single event can be ultimately said to be the result of climate change (Maibach and Roser-Renouf 145). In addition to these observational obstacles, political partisanship, vested interests in the current status quo, and general resistance to profound change all play a part in keeping us one step removed from the phenomenon of climate change. The distant and impersonal nature of climate change coupled with the “uncertainty over consequences, diverse and multiple engaged interests, conflicting knowledge claims, and high stakes” (Lorenzoni et al. 65) often result in repression, rejection, and denial, removing the individual’s responsibility to act. Research suggests that, due to its unique observational obstacles in contemporary post-industrial societies, climate change is considered a psychologically distant event (Pawlik 559), one that is not personally salient due to the “perceived distance and remoteness [...] from one’s everyday experience” (O’Neill and Nicholson-Cole 370). In an examination of the barriers to behaviour change in the face of psychologically distant events, Robert Gifford argues that changing individuals’ perceptions of the issue-domain is one of the challenges of countering environmental inertia—the lack of initiative for environmentally sustainable social action (5). To challenge the status quo a radically different construction of the environment and the human-nature relationship is required to transform our perception of global environmental risks and ultimately result in environmentally consequential social action. Yann Arthus-Bertrand’s Home is a ritualised construction of contemporary environmental degradation and climate change which takes spectators on a rite of passage to a newfound understanding of the human-nature relationship. Transformation through re-imagining individuals’ roles, responsibilities, and practices is an intrinsic quality of rituals. A ritual charts a subjects path from one state of consciousness to the next, resulting in a meaningful change of attitudes (Deflem 8). Through a lifelong study of African rituals British cultural ethnographer Victor Turner refined his concept of rituals in a modern social context. Turner observed that rituals conform to a three-phased processural form (The Ritual Process 13–14). First, in the separation stage, the subjects are selected and removed from their fixed position in the social structure. Second, they enter an in-between and ambiguous liminal stage, characterised by a “partial or complete separation of the subject from everyday existence” (Deflem 8). Finally, imbued with a new perspective of the outside world borne out of the experience of reflexivity, liminality, and a cathartic cleansing, subjects are reintegrated into the social reality in a new, stable state. The three distinct stages make the ritual an emotionally charged, highly personal experience that “demarcates the passage from one phase to another in the individual’s life-cycle” (Turner, “Symbols” 488) and actively shapes human attitudes and behaviour. Adhering to the three-staged processural form of the ritual, Arthus-Bertrand guides spectators towards a newfound understanding of their roles and responsibilities in creating a desirable future. In the first stage—the separation—aerial photography of Home alienates viewers from their anthropocentric perspectives of the outside world. This establishes Earth as a body, and unearths spectators’ guilt and shame in relation to contemporary world risks. Aerial photography strips landscapes of their conventional qualities of horizon, scale, and human reference. As fine art photographer Emmet Gowin observes, “when one really sees an awesome, vast place, our sense of wholeness is reorganised [...] and the body seems always to diminish” (qtd. in Reynolds 4). Confronted with a seemingly infinite sublime landscape from above, the spectator’s “body diminishes” as they witness Earth’s body gradually taking shape. Home’s rushing rivers of Indonesia are akin to blood flowing through the veins and the Siberian permafrost seems like the texture of skin in extreme close-up. Arthus-Bertrand establishes a geocentric embodiment to force spectators to perceive and experience the environmental degradation brought about by the dominant social practices of contemporary post-industrial modernity. The film-maker visualises the maltreatment of the environment through suggested abuse of the Earth’s body. Images of industrial agricultural practices in the United States appear to leave scratches and scars on the landscape, and as a ship crosses the Arctic ice sheets of the Northwest Passage the boat glides like the surgeon’s knife cutting through the uppermost layer of the skin. But the deep blue water that’s revealed in the wake of the craft suggests a flesh and body now devoid of life, a suffering Earth in the wake of global climatic change. Arthus-Bertrand’s images become the sublime evidence of human intervention in the environment and the reflection of present-day industrialisation materially altering the face of Earth. The film-maker exploits spectators’ geocentric perspective and sensibility to prompt reflexivity, provide revelations about the self, and unearth the forgotten shame and guilt in having inadvertently caused excessive environmental degradation. Following the sequences establishing Earth as the body of the text Arthus-Bertrand returns spectators to their everyday “natural” environment—the city. Having witnessed and endured the pain and suffering of Earth, spectators now gaze at the skyscrapers standing bold and tall in the cityscape with disillusionment. The pinnacles of modern urban development become symbols of arrogance and exploitation: structures forced upon the landscape. Moreover, the images of contemporary cityscapes in Home serve as triggers for ritual reflexivity, allowing the spectator to “perceive the self [...] as a distanced ‘other’ and hence achieve a partial ‘self-transcendence’” (Beck, Comments 491). Arthus-Bertrand’s aerial photographs of Los Angeles, New York, and Tokyo fold these distinct urban environments into one uniform fusion of glass, metal, and concrete devoid of life. The uniformity of these cultural landscapes prompts spectators to add the missing element: the human. Suddenly, the homes and offices of desolate cityscapes are populated by none other than us, looking at ourselves from a unique vantage point. The geocentric sensibility the film-maker invoked with the images of the suffering Earth now prompt a revelation about the self as spectators see their everyday urban environments in a new light. Their homes and offices become blemishes on the face of the Earth: its inhabitants, including the spectators themselves, complicit in the excessive mistreatment of the planet. The second stage of the ritual allows Arthus-Bertrand to challenge dominant social paradigms of present day post-industrial societies and introduce new, alternative moral directives to govern our habits and attitudes. Following the separation, ritual subjects enter an in-between, threshold stage, one unencumbered by the spatial, temporal, and social boundaries of everyday existence. Turner posits that a subjects passage through this liminal stage is necessary to attain psychic maturation and successful transition to a new, stable state at the end of the ritual (The Ritual Process 97). While this “betwixt and between” (Turner, The Ritual Process 95) state may be a fleeting moment of transition, it makes for a “lived experience [that] transforms human beings cognitively, emotionally, and morally.” (Horvath et al. 3) Through a change of perceptions liminality paves the way toward meaningful social action. Home places spectators in a state of liminality to contrast geocentric and anthropocentric views. Arthus-Bertrand contrasts natural and human-made environments in terms of diversity. The narrator’s description of the “miracle of life” is followed by images of trees seemingly defying gravity, snow-covered summits among mountain ranges, and a whale in the ocean. Grandeur and variety appear to be inherent qualities of biodiversity on Earth, qualities contrasted with images of the endless, uniform rectangular greenhouses of Almeria, Spain. This contrast emphasises the loss of variety in human achievements and the monotony mass-production brings to the landscape. With the image of a fire burning atop a factory chimney, Arthus-Bertrand critiques the change of pace and distortion of time inherent in anthropocentric views, and specifically in contemporary modernity. Here, the flames appear to instantly eat away at resources that have taken millions of years to form, bringing anthropocentric and geocentric temporality into sharp contrast. A sequence showing a night time metropolis underscores this distinction. The glittering cityscape is lit by hundreds of lights in skyscrapers in an effort, it appears, to mimic and surpass daylight and thus upturn the natural rhythm of life. As the narrator remarks, in our present-day environments, “days are now the pale reflections of nights.” Arthus-Bertrand also uses ritual liminality to mark the present as a transitory, threshold moment in human civilisation. The film-maker contrasts the spectre of our past with possible visions of the future to mark the moment of now as a time when humanity is on the threshold of two distinct states of mind. The narrator’s descriptions of contemporary post-industrial society’s reliance on non-renewable resources and lack of environmentally sustainable agricultural practices condemn the past and warn viewers of the consequences of continuing such practices into the future. Exploring the liminal present Arthus-Bertrand proposes distinctive futurescapes for humankind. On the one hand, the narrator’s description of California’s “concentration camp style cattle farming” suggests that humankind will live in a future that feeds from the past, falling back on frames of horrors and past mistakes. On the other hand, the example of Costa Rica, a nation that abolished its military and dedicated the budget to environmental conservation, is recognition of our ability to re-imagine our future in the face of global risk. Home introduces myths to imbue liminality with the alternative dominant social paradigm of ecology. By calling upon deep-seated structures myths “touch the heart of society’s emotional, spiritual and intellectual consciousness” (Killingsworth and Palmer 176) and help us understand and come to terms with complex social, economic, and scientific phenomena. With the capacity to “pattern thought, beliefs and practices,” (Maier 166) myths are ideal tools in communicating ritual liminality and challenging contemporary post-industrial society’s dominant social paradigms. The opening sequence of Home, where the crescent Earth is slowly revealed in the darkness of space, is an allusion to creation: the genesis myth. Accompanied only by a gentle hum our home emerges in brilliant blue, white, and green-brown encompassing most of the screen. It is as if darkness and chaos disintegrated and order, life, and the elements were created right before our eyes. Akin to the Earthrise image taken by the astronauts of Apollo 8, Home’s opening sequence underscores the notion that our home is a unique spot in the blackness of space and is defined and circumscribed by the elements. With the opening sequence Arthus-Bertrand wishes to impart the message of interdependence and reliance on elements—core concepts of ecology. Balance, another key theme in ecology, is introduced with an allusion to the Icarus myth in a sequence depicting Dubai. The story of Icarus’s fall from the sky after flying too close to the sun is a symbolic retelling of hubris—a violent pride and arrogance punishable by nemesis—destruction, which ultimately restores balance by forcing the individual back within the limits transgressed (Littleton 712). In Arthus-Bertrand’s portrayal of Dubai, the camera slowly tilts upwards on the Burj Khalifa tower, the tallest human-made structure ever built. The construction works on the tower explicitly frame humans against the bright blue sky in their attempt to reach ever further, transgressing their limitations much like the ill-fated Icarus. Arthus-Bertrand warns that contemporary modernity does not strive for balance or moderation, and with climate change we may have brought our nemesis upon ourselves. By suggesting new dominant paradigms and providing a critique of current maxims, Home’s retelling of myths ultimately sees spectators through to the final stage of the ritual. The last phase in the rite of passage “celebrates and commemorates transcendent powers,” (Deflem 8) marking subjects’ rebirth to a new status and distinctive perception of the outside world. It is at this stage that Arthus-Bertrand resolves the emotional distress uncovered in the separation phase. The film-maker uses humanity’s innate capacity for creation and renewal as a cathartic cleansing aimed at reconciling spectators’ guilt and shame in having inadvertently exacerbated global environmental degradation. Arthus-Bertrand identifies renewable resources as the key to redeeming technology, human intervention in the landscape, and finally humanity itself. Until now, the film-maker pictured modernity and technology, evidenced in his portrayal of Dubai, as synonymous with excess and disrespect for the interconnectedness and balance of elements on Earth. The final sequence shows a very different face of technology. Here, we see a mechanical sea-snake generating electricity by riding the waves off the coast of Scotland and solar panels turning towards the sun in the Sahara desert. Technology’s redemption is evidenced in its ability to imitate nature—a move towards geocentric consciousness (a lesson learned from the ritual’s liminal stage). Moreover, these human-made structures, unlike the skyscrapers earlier in the film, appear a lot less invasive in the landscape and speak of moderation and union with nature. With the above examples Arthus-Bertrand suggests that humanity can shed the greed that drove it to dig deeper and deeper into the Earth to acquire non-renewable resources such as oil and coal, what the narrator describes as “treasures buried deep.” The incorporation of principles of ecology, such as balance and interconnectedness, into humanity’s behaviour ushers in reconciliation and ritual cleansing in Home. Following the description of the move toward renewable resources, the narrator reveals that “worldwide four children out of five attend school, never has learning been given to so many human beings” marking education, innovation, and creativity as the true inexhaustible resources on Earth. Lastly, the description of Antarctica in Home is the essence of Arthus-Bertrand’s argument for our innate capacity to create, not simply exploit and destroy. Here, the narrator describes the continent as possessing “immense natural resources that no country can claim for itself, a natural reserve devoted to peace and science, a treaty signed by 49 nations has made it a treasure shared by all humanity.” Innovation appears to fuel humankind’s transcendence to a state where it is capable of compassion, unification, sharing, and finally creating treasures. With these examples Arthus-Bertrand suggests that humanity has an innate capacity for creative energy that awaits authentic expression and can turn humankind from destroyer to creator. In recent years various risk communication texts have explicitly addressed climate change, endeavouring to instigate environmentally consequential social action. Home breaks discursive ground among them through its ritualistic construction which seeks to transform spectators’ perception, and in turn roles and responsibilities, in the face of global environmental risks. Unlike recent climate change media texts such as An Inconvenient Truth (2006), The 11th Hour (2007), The Age of Stupid (2009), Carbon Nation (2010) and Earth: The Operator’s Manual (2011), Home eludes simple genre classification. On the threshold of photography and film, documentary and fiction, Arthus-Bertrand’s work is best classified as an advocacy film promoting public debate and engagement with a universal concern—the state of the environment. The film’s website, available in multiple languages, contains educational material, resources to organise public screenings, and a link to GoodPlanet.info: a website dedicated to environmentalism, including legal tools and initiatives to take action. The film-maker’s approach to using Home as a basis for education and raising awareness corresponds to Antonio Lopez’s critique of contemporary mass-media communications of global risks. Lopez rebukes traditional forms of mediatised communication that place emphasis on the imparting of knowledge and instead calls for a participatory, discussion-driven, organic media approach, akin to a communion or a ritual (106). Moreover, while texts often place a great emphasis on the messenger, for instance Al Gore in An Inconvenient Truth, Leonardo DiCaprio in The 11th Hour, or geologist Dr. Richard Alley in Earth: The Operator’s Manual, Home’s messenger remains unseen—the narrator is only identified at the very end of the film among the credits. The film-maker’s decision to forego a central human character helps dissociate the message from the personality of the messenger which aids in establishing and maintaining the geocentric sensibility of the text. Finally, the ritual’s invocation and cathartic cleansing of emotional distress enables Home to at once acknowledge our environmentally destructive past habits and point to a hopeful, environmentally sustainable future. While The Age of Stupid mostly focuses on humanity’s present and past failures to respond to an imminent environmental catastrophe, Carbon Nation, with the tagline “A climate change solutions movie that doesn’t even care if you believe in climate change,” only explores the potential future business opportunities in turning towards renewable resources and environmentally sustainable practices. The three-phased processural form of the ritual allows for a balance of backward and forward-looking, establishing the possibility of change and renewal in the face of world risk. The ritual is a transformative experience. As Turner states, rituals “interrupt the flow of social life and force a group to take cognizance of its behaviour in relation to its own values, and even question at times the value of those values” (“Dramatic Ritual” 82). Home, a ritualised media text, is an invitation to look at our world, its dominant social paradigms, and the key element within that world—ourselves—with new eyes. It makes explicit contemporary post-industrial society’s dependence on the environment, highlights our impact on Earth, and reveals our complicity in bringing about a contemporary world risk. The ritual structure and the self-reflexivity allow Arthus-Bertrand to transform climate change into a personally salient issue. This bestows upon the spectator the responsibility to act and to reconcile the spectre of the past with the vision of the future.Acknowledgments The author would like to thank Dr. Angi Buettner whose support, guidance, and supervision has been invaluable in preparing this article. 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Palmer. “Silent Spring and Science Fiction: An Essay in the History and Rhetoric of Narrative.” And No Birds Sing: Rhetorical Analyses of Rachel Carson’s Silent Spring. Ed. Craig Waddell. Carbondale, IL: Southern Illinois UP, 2000. 174–204. Littleton, C. Scott. Gods, Goddesses and Mythology. New York: Marshall Cavendish, 2005. Lorenzoni, Irene, Mavis Jones, and John R. Turnpenny. “Climate Change, Human Genetics, and Post-normality in the UK.” Futures 39.1 (2007): 65–82. Lopez, Antonio. “Defusing the Cannon/Canon: An Organic Media Approach to Environmental Communication.” Environmental Communication 4.1 (2010): 99–108. Maier, Daniela Carmen. “Communicating Business Greening and Greenwashing in Global Media: A Multimodal Discourse Analysis of CNN's Greenwashing Video.” International Communications Gazette 73.1–2 (2011): 165–77. 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ObjectiveWe aim to develop a prediction model for the number of imported cases of infectious disease by using the recurrent neural network (RNN) with the Elman algorithm1, a type of artificial neural network (ANN) algorithm. We have targeted to predict the number of imported dengue cases in South Korea as the number of dengue cases is greater than other mosquito-borne diseases2.IntroductionIn recent years, mosquito-borne diseases such as Zika, chikungunya, and dengue have become particularly problematic due to global climate change. Rising temperatures and changes in precipitation are considered to be associated with habitat suitability of mosquito vectors3 and viruses 4. To address such cross-border infectious diseases, countries have come up with various strategies to control and manage mosquito-borne diseases. In line with this, international efforts have been made to minimize the burden of global infectious diseases. In 2014, Global Health Security Agenda (GHSA)5 has been launched in collaboration with the international organizations, member countries of GHSA, and non-governmental organizations in order to improve national and global capacities against global public health threat. In addition, various quarantine programs have been operated in and between countries borderlines and airports with cutting edge ICT technologies.These efforts could be made more effective when the authorities have reliable predicted future trends or events6, utilize their capacities more efficiently and provide timely alerts to the public. However, very few studies have been conducted to deal with imported disease, while much attention has been paid to the endemic diseases.In this study, we aim to develop a prediction model for imported infectious disease by using the approach of ANN. We have chosen to model the imported cases of dengue in Korea, as the number of imported dengue cases is larger than other mosquito-borne diseases. Additionally, Japan, one of South Korea’s neighboring countries, has recently experienced autochthonous dengue virus transmission, which has raised concerns about localization in Korea as well as in Japan7.MethodsAs our prediction target was the monthly number of imported dengue cases, among the alternative types of ANN, our study used recurrent neural network (RNN) models, which has been developed to model the temporal sequenced data. Specifically, Elman algorithm1 was used to develop an RNN and the model was implemented by an R package “RSNNS”.A conventional autoregressive integrated moving average (ARIMA) model was also developed to compare and verify the predictabilities between the RNN and conventional ARIMA modeling approach. The ARIMA model predicted the number of dengue cases that are likely to be imported from Indonesia in 2016, based on the reported number of imported dengue cases from the country between the year 2011-2015. The analysis was conducted by an R package “forecast.”To develop an RNN, the number of hidden layers and the number of nodes for each hidden layer need to be determined. The grid searching method was employed for the determination based on rooted mean squared error (RMSE), a measurement of the model performance under which a lower value indicates a better model fit. For the grid search, we chose a range of 1-3 for the number of hidden layers, and a range of 10-40 for the number of nodes for each hidden layer (29,791 combinations in total for the RNN model).To this end, we have divided the dengue importation data into two sets, i.e., the training set versus validation set. The training data set included data which had a time period of 48 months from 2012 to 2015, and the validation set had data for over 12 months in 2016, which was the latest data set available during the time of our study. As the sequential external validation approach was adopted, we used 12 RNNs for each data point in the validation set. In other words, we predicted the number of imported dengue cases from the given target country at the point in time in January 2016, using the RNN developed based on the data from January 2012 to December 2015. We then subsequently predicted the cases in February 2016 by using the data from 2012 to January 2016 and iterated the process similarly for predictions at other time points in 2016. Through the process, we have obtained the predicted number of imported dengue cases in 2016, and computed an RMSE by comparing the value to those in the observed data. Via the grid searching method used, a total of 29,791 RMSE values were calculated for models of each target country, and a model with the least RMSE was selected as the best-fitting model.ResultsThe RMSE for the best-fitting RNN model was 14.152. In comparison to the ARIMA model, of which RMSE was 16.466, the RNN model showed improved predictability. The RNN-based prediction model can be utilized to improve the effectiveness of both national and individual level interventions for preventing the imported cases of dengue and its subsequent localization in Korea.ConclusionsSince Dengue’s enlistment in 2000 as nationally notifiable infectious disease, it has been reported to be one of the most common infectious disease imported into South Korea8. Concerning the rapid change in climate and disease patterns, the South Korean government should be prepared to be more responsive towards any potential imported cases of infectious disease (especially Dengue) by developing an active surveillance system and specific countermeasures.In this context, our prediction model can be utilized to enhance the response system which is designed to reduce the number of imported cases in the future and prevent any possible localization of the disease. Our analysis also suggests areas for future research to further advance the prediction models for infectious disease importation in general. Since the current RNN-based prediction model still has its limitations, it would be crucial to put in more efforts in improving the model performance and applicability. The ANN algorithms need further development in order for it to effectively manage the availability of relevant big data in the near future.References1. Elman JL. Finding structure in time. Cognitive science. 1990;14(2):179-211.2. Choe YJ, Choe SA, Cho SI. Importation of travel-related infectious diseases is increasing in South Korea: An analysis of salmonellosis, shigellosis, malaria, and dengue surveillance data. Travel Med Infect Dis. 2017;19:22-7.3. Kraemer MU, Sinka ME, Duda KA, Mylne AQ, Shearer FM, Barker CM, et al. The global distribution of the arbovirus vectors Aedes aegypti and Ae. albopictus. Elife. 2015.4. Alto BW, Bettinardi D. Temperature and dengue virus infection in mosquitoes: independent effects on the immature and adult stages. The American journal of tropical medicine and hygiene. 2013;88(3):497-505.5. Arthur GF, Michael M, Leah FM, Maureen B, Mitsuaki H, Wenshu L, et al. Contributions of the US Centers for Disease Control and Prevention in Implementing the Global Health Security Agenda in 17 Partner Countries. Emerging Infectious Disease journal. 2017;23(13).6. Eisen L, Eisen RJ. Using geographic information systems and decision support systems for the prediction, prevention, and control of vector-borne diseases. Annual review of entomology. 2011;56:41-61.7. Yoshimura Y, Sakamoto Y, Amano Y, Nakaharai K, Yaita K, Hoshina T, et al. Four Cases of Autochthonous Dengue Infection in Japan and 46 Imported Cases: Characteristics of Japanese Dengue. Internal medicine (Tokyo, Japan). 2015;54(23):3005-8.8. Yeom J-S. Current status and outlook of mosquito-borne diseases in Korea. Journal of the Korean Medical Association. 2017;60(6):468-74.

Photo by Richard Catabay on Unsplash ABSTRACT COVID-19 exposed deep-rooted structural inequities. Allocation protocols developed during COVID-19 may cause furtherance of structural inequalities. In this essay, I specifically address the issue of structural inequities in the context of resource allocation during a period of crisis standard of care. In response to the increasing evidence of structural inequities during the pandemic, physicians and bioethicists Douglas White and Bernard Lo proposed incorporating a correction factor into resource allocation protocols. According to them, this would provide an advantage for disadvantaged individuals. The proposed correction factors use the Area Deprivation Index to determine eligibility. I argue that the correction factor is ethically justified and supported by Rawls’s difference principle, Daniels’s equality of opportunity, and Harris’s double jeopardy argument. I also suggest that the proposed correction factor does not go far enough, particularly if used with other objective factors, such as SOFA scoring. At least one study shows that using SOFA scoring for resource allocation during COVID-19 has a discriminatory effect on non-Hispanic black patients. One problem with the correction factor using the ADI is that it only applies to those currently in the reflected socioeconomic status. Additionally, when only one hospital serves a largely socioeconomically disadvantaged community, all admissions will fall within the targeted category for application of the correction factor. Thus, further actions are needed to dismantle structural inequities, such as implementing load balancing or the planned sharing of resources among healthcare systems. INTRODUCTION COVID-19 forced deep-rooted structural inequities to the surface. SARS-CoV-2 was a novel virus, but the connection between structural inequities and the disparate impact of the virus on marginalized populations is not. The history of pandemics reflects how much structural inequities negatively influence health equity.[1] The lack of preparedness and response to the structural inequities exemplify “blistering systemic failures.”[2] Despite warnings from prior threats from SARS and H1N1, we were unprepared for COVID-19. Antommaria and Chelen show that one-half of responding hospitals did not have an allocation protocol in place.[3] When an influx of critically ill patients and limited resources required implementing a crisis standard of care, many hospitals quickly established protocols addressing the allocation of scarce resources. Most crisis standard of care (CSC) protocols reflect public health’s utilitarian focus on saving the most lives.[4] The utilitarian focus ignores the disproportionate impact resulting from structural inequities. In December 2020, two physicians and bioethicists, Douglas White and Bernard Lo responded to the increasing evidence of the disproportionate impact of COVID-19 on disadvantaged communities by adding a correction factor to their CSC resource allocation protocol. The correction factor adjusts triage scores of individuals living in the most disadvantaged neighborhoods by subtracting one point from the triage score.[5] Patients with lower triage scores are more likely to receive life-saving care. Thus, subtracting a point provides an advantage. The correction factor uses a composite measure of disadvantage to determine eligibility called the Area Deprivation Index (ADI).[6] The ADI is a geographic measure of socioeconomic disadvantage that calculates an aggregate disadvantage score on a 10-point scale. The ADI measures seventeen elements of disadvantage related to poverty, education, employment, physical environment, and infrastructure.[7] The correction factor compensates for structural injustices by using ADI scores of patients in the highest quartile of socioeconomic disadvantage or having an ADI score of 8 to 10 since the strongest association between ADI scores and health outcomes occurs at the highest ADI levels.[8] l. Ethical Justifications Various theories of justice support applying the correction factor in the allocation of scarce resources. Rawls’s difference principle provides an ethical justification for the correction factor as it benefits the worse off in the event of resource allocation.[9] Applying the correction factor and subtracting one point from the triage score admittedly creates inequality among two otherwise like patients, but it is justified under Rawls’s theory since it gives the advantage to the least advantaged, addressing equity. Norman Daniels’ argument for protecting fair “equality of opportunity” also supports the correction factor.[10] The correction factor protects the equality of opportunity for those denied access to care because of deep-rooted structural inequities exacerbated by the pandemic. Using the correction factor to provide access to life-saving resources compensates patients with diminished opportunities in other arenas like the social determinants of health. Derek Parfit’s deontic egalitarianism supports the correction factor. Under Parfit’s view of deontic egalitarianism, justification of giving an advantage to the worse off depends on the reason for the inequality. If the unequal status results from circumstances such as a genetic condition or an accidental injury, like Daniel’s equality of opportunity, deontic egalitarianism does not support giving an advantage to the worse-off. If the unequal position results from the unjust actions of another, such as discriminatory treatment of people of color, deontic egalitarianism supports providing the advantage to address the inequity.[11] The disproportionate impact of resource allocation results from unjust treatment such as discrimination and structural inequity.[12] John Harris’s double jeopardy argument adds additional support to the correction factor in that[13] the socioeconomically disadvantaged or those facing racial or ethnic discrimination may have had an increased risk of contracting COVID-19 or having a severe case or death due to structural inequities. If the triage procedures do not compensate for the structural inequities and they are precluded access to critical care based only on traditional triage, they will suffer double jeopardy. The correction factor avoids this double jeopardy. ll. Operationalizing the Correction Factor Those opposing the correction factor might assert the infeasibility of mitigating inequities during a pandemic.[14] Yet one large US health system successfully applied similar criteria in allocating remdesivir[15] and the National Academy of Medicine endorsed disparity-mitigating criteria for allocating scarce vaccines.[16] Applying the correction factor is neither time nor resource intensive. It will not divert resources from the goal of treating illness and reducing morbidity. With the data available about COVID-19’s disproportionate impact, not applying an available tool to lessen inequities is an abrogation of ethical duty. One utilitarian argument asserts that we will save fewer lives if the prioritized patients are more likely to die despite interventions. Yet society bears responsibility for the social policies that created the disparities. Thus, there is an obligation to mitigate those societal problems, even when doing so might save fewer lives.[17] Some clinicians argue that they should have discretion in determining triage scores. This objection to the correction factor in formulating triage procedures reflects the conflict between clinical and public health ethics. Implementing a CSC protocol shifts decision-making from the clinician to a triage committee and from an individual focus to a community focus. Allowing clinicians to determine triage protocols would increase the risk of decisions based on bias and subjectivity. Another open question is whether the correction factor will achieve the intended goal. Nancy Kass suggests that without evidence to support the effectiveness, we cannot ethically implement the policy.[18] Thus, applying the Kass analysis, diverting a scarce resource to someone less likely to survive should require proof that doing so systematically would resolve or improve structural inequity. There is limited empirical evidence, but we may proceed with caution based on the presumptive data and the hypothesis that a triage allocation that uses a correction factor could help. Computer-based modeling or “tabletop” exercises applying the framework to actual patients but not enacting the protocols could assess the possible effects of the protocols.[19] Perhaps the most robust rebuttal in response to the opposition of applying a correction factor is in an argument proffered by Douglas White that no reasonable triage framework maximizes health outcomes if it creates significant inequalities.[20] White’s argument emphasizes the importance of addressing inequity. lll. A More Robust Version of the Correction Factor The burdens associated with any public health intervention typically fall into three categories:[21] privacy and confidentiality, risk to liberty and self-determination, and justice. Most burdens associated with allocating scarce resources fall under the justice category. I not only disagree with the arguments against using a correction factor, but I also argue that the correction factor does not go far enough. First, using the ADI neglects consideration of people of color disproportionately affected by COVID-19 no longer living in a neighborhood with the highest ADI scores. Based on new research, Sequential Organ Failure Assessment (SOFA) scores are also potentially discriminatory and not ideal for addressing structural inequity, racism, or ethnic discrimination in the triage setting, although they are applied to triage.[22] Second, public hospitals in socioeconomically depressed communities and rural locations may serve a population in which nearly the entire community will have ADI scores that qualify for application of the correction factor. lV. Relying on ADI cannot protect all people disadvantaged due to their race or ethnicity The ADI uses seventeen measures of socioeconomic disadvantage. Some racial inequality in healthcare is unrelated to socioeconomic status and can be missed by ADI. Racial inequality in healthcare may be directly related to implicit and explicit bias and past and current discrimination. But the correction factor will not help the Black patient not currently residing in a highly disadvantaged neighborhood or experiencing other vestiges of racism in the form of socioeconomic disadvantage. A correction factor that uses more information than ADI could make up for some of the weaknesses of SOFA as well. V. When all patients have high ADI Scores What happens when triaging occurs in hospitals serving populations where almost all patients have ADI scores of 8 to 10? To illustrate, I will use the example of Belle Glade, Florida, in western Palm Beach County.[23] The overwhelming majority of the neighborhoods served by the one public hospital, Lakeside Medical Center, is at a level 10 state decile, with a few neighborhoods at 8 and 9 state decile.[24] During a surge in that hospital, the correction factor will apply to every patient. The hospital must then resort to other considerations, such as random allocation. This potential dilemma suggests the need to consider further steps, such as load balancing, to lessen the inequities. Vl. Load Balancing Load balancing is a plan in which hospitals report daily census and available beds. Patients are diverted or transferred to hospitals with open beds when one hospital is at maximum capacity. Although identified as a method to avoid the need for triaging, I suggest load balancing is also equity balancing, especially when the overwhelmed hospital is in a high ADI area. Failures in load balancing exacerbate the harm to disadvantaged populations. Disadvantaged individuals are more likely to seek treatment in hospitals with limited ability to increase capacity or care for many critically ill patients. During surges in COVID-19, hospitals in poor neighborhoods were overrun by admissions and lacked resources to treat, while nearby private hospitals had available beds and resources.[25] The Arizona Department of Health Services developed an effective load-balancing system to coordinate the statewide transfer of patients from overloaded hospitals to other hospitals.[26] The system dramatically improved access to care for people of color and rural populations.[27] One of the state’s foremost responsibilities is safeguarding the health and well-being of people threatened when health systems fail to cooperate. Voluntary load balancing is preferable, but if the healthcare systems are unwilling to cooperate and if voluntary efforts are ineffective, state governments should intervene and require private hospitals to take part in load balancing. When needed, public health officials should issue emergency orders to require hospitals to participate in load-balancing efforts, including accepting patient transfers that are not part of their covered population. CONCLUSION Rawls’s difference principle, Daniels’s equality of opportunity, Parfit’s deontic egalitarianism, and Harris’s double jeopardy argument all justify and may even compel using the correction factor. COVID-19 turned academic and hypothetical discussions and debates about allocating scarce resources and making untenable choices of who lives and who dies to real-life responsibilities. Once hospitals move to a crisis standard of care, they may need to allocate scarce resources, so having systems in place that can compensate for past inequities and improve fairness in access to care is the ethical imperative. Dismantling structural inequities and reassessing allocation protocols should incorporate the correction factor as a new foundational framework and then build on it using load balancing and exercising caution if applying SOFA. It is an ethical responsibility to use these tools to dismantle the pervasive structural inequities when allocating scarce resources. - [1] Goldberg, Daniel S. “Against the Medicalization of Public Health (Ethics).” Public Health Ethics 14, no. 2 (2021): 117–19. https://doi.org/10.1093/phe/phab024. [2] Morrissey, Mary Beth, and Jorge L. Rivera-Agosto. “Protecting the Public's Health in Pandemics: Reflections on Policy Deliberation and the Role of Civil Society in Democracy.” Frontiers in Public Health 9 (June 1, 2021): 6. https://doi.org/10.3389/fpubh.2021.678210. [3] Antommaria, Armand H., Tyler S. Gibb, Amy L. McGuire, Paul Root Wolpe, Matthew K. Wynia, Megan K. Applewhite, Arthur Caplan, et al. “Ventilator Triage Policies during the Covid-19 Pandemic at U.S. Hospitals Associated with Members of the Association of Bioethics Program Directors.” Annals of Internal Medicine 173, no. 3 (April 4, 2020): 188–94. https://doi.org/10.7326/m20-1738; Chelan, Julia S., Douglas B. White, Stephanie Zaza, Amanda N. Perry, Deborah S. Feifer, Maia L. Crawford, and Amber E. Barnato. “US Ventilator Allocation and Patient Triage Policies in Anticipation of the Covid-19 Surge.” Health Security 19, no. 5 (2021): 459–67. https://doi.org/10.1089/hs.2020.0166. [4] Lin, Janet Y., and Lisa Anderson-Shaw. “Rationing of Resources: Ethical Issues in Disasters and Epidemic Situations.” Prehospital and Disaster Medicine 24, no. 3 (2009): 215–21. https://doi.org/10.1017/s1049023x0000683x. [5] Executive Summary Allocation of Scarce Critical Care Resources during a ...,” April 9, 2021. https://ccm.pitt.edu/sites/default/files/Model%20hospital%20policy%20for%20allocation%20of%20critical%20care_2020-03-23%20web.pdf. [6]. Executive Summary Allocation of Scarce Critical Care Resources during a ...,” April 9, 2021. https://ccm.pitt.edu/sites/default/files/Model%20hospital%20policy%20for%20allocation%20of%20critical%20care_2020-03-23%20web.pdf. [7] https://www.neighborhoodatlas.medicine.wisc.edu/mapping; Executive Summary Allocation of Scarce Critical Care Resources during a ...,” April 9, 2021. [8] White, Douglas B., and Bernard Lo. “Structural Inequities, Fair Opportunity, and the Allocation of Scarce ICU Resources.” Hastings Center Report 51, no. 5 (2021): 42–47. https://doi.org/10.1002/hast.1285 [9] McKie, John, and Jeff Richardson. “The Rule of Rescue.” Social Science and Medicine 56 (2003): 2407–19 [10] Daniels, Norman. “Justice, Health, and Health Care.” Essay. In Medicine and Social Justice Essays on the Distribution of Health Care, edited by Rosamond Rodes, Margaret P Battin, and Anita Silvers, Seconded., 17–33. Oxford University Press, n.d. [11] Brock, Dan W. “Priority to the Worse Off in Health Care Resource Prioritization .” Essay. In Medicine and Social Justice Essays on the Distribution of Health Care, edited by Rosamond Rhodes, Margaret Battin, and Anita Silvers, 155–64. Oxford University Press, n.d. [12] Brock, Dan W. “Priority to the Worse Off in Health Care Resource Prioritization .” Essay. In Medicine and Social Justice Essays on the Distribution of Health Care, edited by Rosamond Rhodes, Margaret Battin, and Anita Silvers, 155–64. Oxford University Press, n.d. [13] Harris, J. “Qualifying the Value of Life.” Journal of Medical Ethics 13, no. 3 (1987): 117–23. https://doi.org/10.1136/jme.13.3.117. [14] White, Douglas B., and Bernard Lo. “Mitigating Inequities and Saving Lives with ICU Triage during the COVID-19 Pandemic.” American Journal of Respiratory and Critical Care Medicine 203, no. 3 (February 1, 2021): 287–95. https://doi.org/10.1164/rccm.202010-3809cp. [15] White, Douglas B., and Bernard Lo. “Mitigating Inequities and Saving Lives with ICU Triage during the COVID-19 Pandemic.” American Journal of Respiratory and Critical Care Medicine 203, no. 3 (February 1, 2021): 287–95. https://doi.org/10.1164/rccm.202010-3809cp. [16] White, Douglas B., and Bernard Lo. “Mitigating Inequities and Saving Lives with ICU Triage during the COVID-19 Pandemic.” American Journal of Respiratory and Critical Care Medicine 203, no. 3 (February 1, 2021): 287–95. https://doi.org/10.1164/rccm.202010-3809cp. [17] White, Douglas B., and Bernard Lo. “Mitigating Inequities and Saving Lives with ICU Triage during the COVID-19 Pandemic.” American Journal of Respiratory and Critical Care Medicine 203, no. 3 (February 1, 2021): 287–95. https://doi.org/10.1164/rccm.202010-3809cp. [18] Kass, Nancy E. “An Ethics Framework for Public Health.” American Journal of Public Health 91, no. 11 (November 2001): 1776–82. https://doi.org/10.2105/ajph.91.11.1776. [19] White, Douglas B., and Bernard Lo. “Mitigating Inequities and Saving Lives with ICU Triage during the COVID-19 Pandemic.” American Journal of Respiratory and Critical Care Medicine 203, no. 3 (February 1, 2021): 287–95. https://doi.org/10.1164/rccm.202010-3809cp. [20] White, Supra.12 [21] Kass, Nancy E. “An Ethics Framework for Public Health.” American Journal of Public Health 91, no. 11 (November 2001): 1776–82. https://doi.org/10.2105/ajph.91.11.1776. [22] Tolchin, Benjamin, Carol Oladele, Deron Galusha, Nitu Kashyap, Mary Showstark, Jennifer Bonito, Michelle C. Salazar, et al. “Racial Disparities in the SOFA Score among Patients Hospitalized with Covid-19.” PLOS ONE. Public Library of Science, September 17, 2021. https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0257608; SOFA is a prognostic scoring system that assigns points for organ failure evidence within six different organ systems. Higher SOFA scores correlate with higher mortality. New research by Tolchin reveals the flaws in SOFA due to its failure to account for delays in seeking care and overestimates of Black mortality. Also see Antommaria, Armand H., Tyler S. Gibb, Amy L. McGuire, Paul Root Wolpe, Matthew K. Wynia, Megan K. Applewhite, Arthur Caplan, et al. “Ventilator Triage Policies during the Covid-19 Pandemic at U.S. Hospitals Associated with Members of the Association of Bioethics Program Directors.” Annals of Internal Medicine 173, no. 3 (April 4, 2020): 188–94. https://doi.org/10.7326/m20-1738; Chelen, Julia S., Douglas B. White, Stephanie Zaza, Amanda N. Perry, Deborah S. Feifer, Maia L. Crawford, and Amber E. Barnato. “US Ventilator Allocation and Patient Triage Policies in Anticipation of the Covid-19 Surge.” Health Security 19, no. 5 (2021): 459–67. https://doi.org/10.1089/hs.2020.0166; and Pence, Gregory E. Pandemic Bioethics. Peterborough: Broadview Press, 2021. [23] Black – population 59.28 % Median Household income 24,322 Population 20,276 Education: 31.$ HS; 21.71% less than 95 grade, Postsecondary Asso-7%, Bachelors 6.7, ttps://worldpopulationreview.com/us-cities/belle-glade-fl-population [24] Neighborhood atlas®. Neighborhood Atlas - Mapping. (n.d.). Retrieved February 15, 2022, from https://www.neighborhoodatlas.medicine.wisc.edu/mapping [25] White, Douglas, Keynote Address, American Society of Bioethics and Humanities, October 13, 2021, COVID-19 at the Crossroads, https://eventpilotadmin.com/web/planner.php?id=ASBH21 [26] Angelo, A. (2020, May 26). Latest Covid-19 Model Shows Arizona can Meet a Health Care Surge. Retrieved February 15, 2022, from https://communityimpact.com/phoenix/chandler/coronavirus/2020/05/26/latest-covid-19-model-shows-arizona-can-meet-a-health-care-surge/ [27] White, Douglas, Keynote Address, American Society of Bioethics and Humanities, October 13, 2021, COVID-19 at the Crossroads, https://eventpilotadmin.com/web/planner.php?id=ASBH21

Boxing is a purely masculine activity and it inhabits a purely masculine world. […] Boxing is for men, and it is about men, and is men. (Joyce Carol Oates) IntroductionWriting about boxing is an intimate, private, and unusual activity. Although a decade has passed since I first “stepped into the ring” (sparring or fighting), I have not engaged with boxing in academic terms. I undertook a doctoral degree from 2012 to 2016, during which I competed and won amateur titles in three different countries. Boxing, in a sense, shadowed my research. My fieldwork, researching heritage foods networks, brought me to various locales, situating my body in reference to participants and academics as well as my textual analysis. My daily interactions and reflections in the boxing gym, though, were marginalised to give priority to my doctorate. In a mirrored journey to Wacquant’s “carnal ethnography of the skilled body” (Habitus 87), I boxed as a hobby. It was a means to escape my life as a doctoral student, my thesis, and the library. Research belonged to the realm of academia; boxing, to the realm of the physical. In this paper, I seek to implode this self-imposed distinction.Practising the “noble art,” as boxing is commonly called, profoundly altered not only my body but also my way of seeing the world, myself, and others. I explore these themes through an autoethnographic account of my experience in the ring. Focusing on sparring, rather than competing, I explore conceptualisations of my face as a material, as well as part of my body, and also as a surface for violence and apprenticeship. Reflecting upon a decade of sparring, the analysis presented in this paper is grounded in the phenomenological tradition whereby knowledge is not an abstract notion that exists over and above felt experience: it is sensed and embodied through practice.I delve into the narratives of my personal “social logic of a bodily craft” of boxing (Wacquant, Habitus 85). More specifically, I reflect upon my experiences of getting hit in the face by men in the ring, and the acclimatisation required, evolving from feelings of intrusion, betrayal, and physical pain to habit, and at times, excitement. As a surface for punching, my face became both material and immaterial. It was a tool that had to be tuned to varying degrees of pain to inform me of my performance as well as my opponent’s. Simultaneously, it was a surface that was abstracted and side-lined in order to put myself purposefully in harm’s way as one does when stepping into the ring. Through reflecting on my face, I consider how the sport offered new embodied experiences through which I became keenly aware of my body as a delineated target for—as well as the source of—violence. In particular, my body boundaries were profoundly reconfigured in the ring: sparring partners demonstrated their respect by hitting me, validating both my body and my skill as a boxer. In this manner, I discuss the spatiality of the ring as eliciting transitions of felt and abstracted pain as well as shaping my self-image as a re-gendered boxer in the ring and out. Throughout my account, I briefly engage with Wacquant’s discussion of “pugilistic habitus” (Body 99) and his claims that boxing is the epitome of masculine valour. In the final section, I conclude with deliberations upon the new bodily awareness(es) I gained through the sport, and the re-materiality I experienced as a strong woman.Methodological and Conceptual FrameworksThe analysis in this paper is based on the hybrid narrative of ethnography and autobiography: autoethnography. In the words of Tami Spry, autoethnography is “a self-narrative that critiques the situatedness of self and others in social context” (710). As such, I take stock in hindsight (Bruner; Denzin) of the evolution of my thoughts on boxing, my stance as a boxer, and the ways the ring has affected my sense of self and my body.Unlike Wacquant's “carnal ethnography” (Habitus 83) whose involvement with boxing was foregrounded in an academic context where he wrote detailed field-notes and conducted participant observation, my involvement was deliberately non-academic until I began to write this paper. Based on hindsight, the data collected through this autoethnography are value-inflected in ways that differ from other modes of data collection. But I have sought to recreate a dialectic between perceptual experience and cultural practices and patterns, in a manner aligned with Csordas’s paradigm of embodiment. My method is to “retrospectively and selectively write about epiphanies that stem from, or are made possible by, being part of a culture” (Ellis et al. 276) of boxing. These epiphanies, as sensed and embodied knowledge, were not solely conceptual moments but also physical realisations that my body performed, such as understanding—and executing—a well-timed slip to the side to avoid a punch.Focusing on my embodied experiences in the ring and out, I have sought to uncover “somatic modes of attention:” the “culturally elaborated ways of attending to and with one’s body in surroundings that include the embodied presence of others” (Csordas 138). The aim of this engagement is to convey my self-representation as a boxer in the ring, which emerged in part through the inter-subjectivity of interacting with other boxers whilst prioritising representations of my face. As such, my personal narrative is enmeshed with insights gleaned during embodied epiphanies I had in the ring, interweaving storytelling with theory.I have chosen to use the conventions of storytelling (Ellis and Ellingson) to explore the defining moments that shaped the image I hold of myself as a boxer. My personal narrative—where I view myself as the phenomenon—seeks “to produce aesthetic and evocative thick descriptions of personal and interpersonal experience” (Ellis et al. 287) whilst striving to remain accessible to a broader audience than within academia (Bochner). Personal narratives offer an understanding of the “self or aspect of a life as it intersects with a cultural context, connect to other participants as co-researchers, and invite readers to enter the author's world and to use what they learn there to reflect on, understand, and cope with their own lives” (Ellis 14; see also Ellis et al. 289).As the focus of my narrative is my face, I used my body, in Longhurst et al.’s words, as the “primary tool through which all interactions and emotions filter in accessing subjects and their geographies” (208). As “the foundation of the entire pugilistic regimen”, the body is the site of an intimate self-awareness, of the “body-sense” (Heiskanen 26). Taking my body as the starting point of my analysis, my conceptual framework is heavily informed by Thrift’s non-representational theory, enabling me to inquire into the “skills and knowledges [people] get from being embodied beings” (127), and specifically, embodied boxers. The analysis presented here is thus based on an “epistemic reflexivity” (Wacquant, Habitus 89) and responds to what Wacquant coins the “pugilistic habitus” (Body 99): a set of acquired dispositions of the boxer. Bourdieu believes that people are social agents who actively construct social reality through “categories of perception, appreciation and action” (30). The boxing habitus needs to be grasped with one’s body: it intermingles “cognitive categories, bodily skills and desires which together define the competence and appetence specific to the boxer” (Wacquant, Habitus 87). Through this habitus, I construct an image of myself not only as a boxer, but also as a re-gendered being, directly critiquing Wacquant’s arguments of the “pugilist” as fundamentally male.Resistance to Female BoxingMischa Merz’s manuscript on her boxing experience is the most accurate narrative I have yet read on female boxing, as a visceral as well as incorporeal experience, which led Merz to question and reconsider her own identity. When Merz published her manuscript in 2000, six years before I put the gloves on, the boxing world was still resisting the presence of women in the ring. In the UK, licenses for boxing were refused to women until 1998, and in New South Wales, Australia, it was illegal for women to compete until December 2008. It was not until 2012 that female boxing became internationally recognised as a sport in its own right. During the London Olympics, after a sulphurous debate on whether women should be made to box in skirts to “differentiate” them from men, women were finally allowed to compete in three weight categories, compared to ten for men.When I first started training in 2006 at the age of 21, I was unaware of the long list of determined and courageous women who had carved their way—and facilitated mine—into the ring, fighting for their right to practise a sport considered men’s exclusive domain. By the time I started learning the “sweet science” (another popular term used for boxing), my presence was accepted, albeit still unusual. My university had decreed boxing a violent sport that could not be allowed on campus. As a result, I only started boxing when I obtained a driving licence, and could attend training sessions off-campus. My desire to box had been sparked five years before, when I viewed Girlfight, a film depicting a young woman’s journey into the ring. Until then, I had never imagined a woman could box, let alone be inspirational in the use of her strength, aggression, and violence; to be strong was, for me, to be manly—which, as a woman, translated as monstrous or a perversion. I suddenly recognised in boxing a possibility to rid myself of the burden of what I saw as my bulk, and transform my body into a graceful pugilist—a fighter.First Sparring SessionTwo months after I had first thrown a punch in my coach’s pad—the gear coaches wear to protect their hands when a boxer is punching them to train—I was allowed into the ring to spar. Building up to this moment, I had anticipated and dreaded my first steps in the ring as the test of my skill and worthiness as a boxer. This moment would show my physical conditioning: whether I had trained and dieted correctly, if I was strong or resilient enough to fight. More crucially, it would lay bare my personality, the strength of my character, the extent of my willpower and belief in myself: it would reveal, in boxing terminology, if I had “heart.” Needless to say I had fantasised often about this moment. It was my initiation into the art of being punched and I hoped I would prove myself a hardened individual, capable of withstanding pain without flinching or retreating.The memory of the first punch to my face—my nose, to be exact—remains clear and vivid. My sparring partner was my coach, a retired boxer who hit me repeatedly in the head during the entirety of my first round. Getting hit in the face for the first time is a profound moment of rupture. Until then, my face had been a bodily surface reserved for affective gestures by individuals of trust: kisses of greeting on the cheeks or caresses from lovers. Only once had I been slapped, in an act of aggression that had left me paralysed with shock and feeling violated. Now in the ring, being punched in the face by a man I trusted, vastly more experienced and stronger than I, provoked a violent reaction of indignation and betrayal. Feelings of deceit, physical intrusion, and confusion overwhelmed me; pain was an entirely secondary concern. I had, without realising, assumed my coach would “go easy” on me, softening his punches and giving me time to react adequately to his attacks as we had practised on the pads. A couple of endless minutes later, I stepped out of the ring, breathless and staring at the floor to hide my tears of humiliation and overwhelming frustration.It is a common experience amongst novices, when first stepping into the ring, to forget everything they have been taught: footwork, defence, combinations, chin down, guard up … etc. They often freeze, as I did, with the first physical contact. Suddenly and concretely, with the immediacy of pain, they become aware of the extent of the danger they have purposely placed themselves in. The disturbance I felt was matched in part by my belief that I was essentially a coward. In an act condemned by the boxing community, I had turned my face away from punches: I tried to escape the ring instead of dominating it. Merz succinctly describes this experience in the boxing realm: “aspects of my character were frequently tossed in my face for assessment. I saw gaping holes in my tenacity, my resilience, my courage, my athleticism” (49). That night, I felt an unfamiliar sting as I took my jumper off, noticing a slight yet painful bruise on the bridge of my nose. It reminded me of my inadequacy and, I believed at the time, a fundamental failure of character: I lacked heart.My Face: A Tool for Sensing and Ignoring PainTo get as accustomed as a punching bag to repeated hits without flinching I had to mould my face into a mask of impassivity, revealing little to my opponent. My face also became a calibrated tool to measure my opponent’s skill, strength, and intent through the levels of pain it would experience. If an opponent repeatedly targeted my nose, I knew the sparring session was not a “friendly encounter.” Most often though, we would nod at each other in acknowledgement of the other’s successful “contact,” such as when their punches hurt my body. The ring is the only space I know and inhabit where the display of physical violence can be interpreted as a “friendly gesture” (Merz 12).Boxers, like most athletes, are carefully attuned to measuring the degrees of pain they undergo during a fight and training, whilst accomplishing the paradoxical feat—when they are hit—of setting aside that pain lest it be a distraction. In other words, boxers’ bodies are both material and immaterial: they are sites for accessing sensory information, notably pain levels, as well as tools that—at times detrimentally—have learned to abstract pain in the effort to ignore physical limitations, impediments or fatigue. Boxers with “heart,” I believe, are those who inhabit this duality of material and immaterial bodies.I have systematically been questioned whether I fear bruising or scarring my face. It would seem illogical to many that a woman would voluntarily engage in an activity that could blemish her appearance. Beyond this concern lies the issue, as Merz puts it, that “physical prowess and femininity seem to be so fundamentally incompatible” (476). My face used to be solely a source of concern as a medium of beautification and the platform from which I believed the world judged my degree of attractiveness. It also served as a marker of distinction: those I trusted intimately could touch my face, others could not. Throughout my training, my face evolved and also became an instrument that I conditioned and used strategically in the ring. The bruises I received attested to my readiness to exchange punches, a mark of valour I came to relish more than looking “nice.”Boxing has taught me how to feel my body in new ways. I no longer inhabit an “absent body” (Leder). I intimately know the border between my skin and the world, aware of exactly how far my body extends into that world and how much “punishment” (getting hit) it can withstand: boxing—which Oates (26) observed as a spectator rather than boxer—“is an act of consummate self-determination—the constant re-establishment of the parameters of one’s being.” A strong initial allure of boxing was the strict discipline it gave to my eating habits, an anchor—and at times, a torture—for someone who suffered from decade-long eating disorders. Although boxing plagued me with the need to “make weight”—to fight in a designated weight category—I no longer sought to be as petite as I could manage. As a female boxer, I was reminded of my gender, and my “unusual” body, as I am uncommonly big, strong, and heavy compared to most female fighters. I still find it difficult to find women to spar with, let alone fight. Unlike in the world outside the gym, though, my size is something I continuously learn to value as an advantage in the ring, a tool for affirmation, and significantly, a means of acceptance by, and equality with, men.The Ring: A Place of Re-GenderingAs sparring became routine, I had an epiphany: what I had taken as an act of betrayal from my coach was actually one of respect. Opponents who threw “honest” (painful) punches esteemed me as a boxer. I have, to this day, very rarely sparred with women. I often get told that I punch “like a guy,” an ability with which I have sought to impress coaches and boxers alike. As such, I am usually partnered with men who believe, as they have told me, that hitting a “girl”—and even worse, hitting a girl in the face—is simply unacceptable. Many have admitted that they fear hurting me, though some have quickly wanted to after a couple of exchanges. I have found that their views of “acceptable” violence seem unchanged after a session, as I believe they have come to view me as a boxer first and as a woman second.It would be disingenuous to omit that boxing attracted me as much for the novelty status I have gained within and outside of it. I have often walked a thin line between revelling in the sense of belonging that boxing provides me—anchored in a feeling that gender no longer matters—and the acute sense of feeling special because I am a woman performing as a man in what is still considered a man’s world. I have wavered between feeling as though I am shrugging off the very notion of gender in the ring, to deeply reconsidering what my gender means to me and the world, embracing a more fluid and performative understanding of gender than I had before (Messner; Young).In a way, my sense of self is shaped conflictingly by the ways in which boxers behave towards me in the ring, and how others see me outside of the boxing gym. As de Bruin and de Haan suggest, my body, in its active dimension, is open to the other and grounds inter-subjectivity. This inter-subjectivity of embodiment—how other bodies constitute my own sensory and perceptual experience of being-in-the-world—remains ambivalent. It has led me to feel at times genderless—or rather, beyond gender—in the ring and, because of this feeling, I simultaneously question and continuously re-explore more vividly what can be understood as “female masculinity” (Halberstam). As training progressed, I increasingly felt that:If women are going to fight, we have to be reminded, at every chance available, time and again, that they are still feminine or capable, at least, of wearing the costume of femininity, being hobbled by high heels and constrained by tight dresses. All female athletes in a way are burdened with having to re-iterate this same public narrative. (Merz)As I learned to box, I also learned to delineate myself alongside the ring: as I questioned notions of gender inside, I consequently sought to reaffirm a specific and static idea of gender through overt femininity outside the ring, as other female athletes have also been seen to do (Duncan). During my first years of training, I was the only woman at the gyms I trained in. I believed I had to erase any physical reminders of femininity: my sport clothes were loose fitting, my hair short, and I never wore jewellery or make-up. I wanted to be seen as a boxer, not a woman: my physical attractiveness was, for once, irrelevant. Ironically, I could not conceive of myself as a woman in the ring, and did not believe I could be seen as a woman in the ring. Outside the gym, I increasingly sought to reassert a stereotypical feminine appearance, taking pleasure in subverting another set of beliefs. People are usually hesitant to visualise a woman in a skirt, without a broken nose, as a competitive fighter with a mouth guard and headgear. As Wacquant succinctly put it, “I led a sort of Dr. Jekyll-and-Mr. Hyde existence” (Habitus 86), which crystallised when one of my coaches failed to recognise me on three occasions outside the gym, in my “normal” clothes.I have now come to resent profoundly the marginal, sensationalised status that being a boxer denotes for a woman. This is premised on particular social norms surrounding gender, which dictate that if a woman boxes, she is not “your usual” woman. I have striven to re-gender my experience, especially in light of the recent explosion of interest in female boxing, where new norms are being established. As I have trained around the world, including in Cuba, France, and the USA, and competed in the UK, Mexico, and Belgium, I have valued the tacit connection between those who practice the “noble art.” Boxing fashions a particular habitus (Bourdieu), the “pugilistic habitus” (Wacquant, Body 12). Stepping into the ring, and being able to handle getting hit in the face, constitutes a common language that boxers around the world, male and female, understand, value, and share; a language that transcends the tacit everyday embodiments of gender and class. Boxing is habitually said to give access to an upward mobility (Wacquant, Habitus; Heiskanen). In my case, as a white, educated, middle-class woman, boxing has given me access to cross-class associations: I have trained alongside men who had been shot in Coventry, were jobless in Cuba, or dealt with drug gangs in Mexico. The ring is an equalising space, where social, gender—and in my experience, ethnic—divides can be smoothed down to leave the pugilistic valour, the property of boxing excellence, as the main metric of appreciation.The freedom I have found in the ring is one that has allowed my gendered identity to be thought of in new and creative ways that invite continuous revision. I have discovered myself not solely through the prism of a gendered lens, but as an emotive athlete, and as a person desperate to be accepted despite—or because of—her physical strength. I find myself returning to Merz’s eloquence: “boxing cannot help but make you question who you really are. You cannot hide from yourself in a boxing ring. It might seem a crazy path to self-knowledge, but to me it has been the most rich, rewarding, and perhaps, the only true one” (111). Using Wacquant’s own words to disprove his theory that boxing is fundamentally a virile activity that reaffirms specific notions of masculinity, to become a boxer is to “efface the distinction between the physical and the spiritual [...] to defy the border between reason and passion” (Body 20). In my view, it is to implode the oppositional definitions that have kept males inside the ring and females, out. The ring, in ways unrivalled elsewhere, has shown me that I am not reducible, as the world has at times convinced me, to my strength or my gender. I can, and indeed do, coalesce and transcend both.ConclusionAfter having pondered the significance of the ring to my life, I now begin to understand Merz’s journey as “so much more than a mere dalliance on the dark side of masculine culture” (21). When I box, I am always boxing against myself. The ring is the ultimate space of revelation, where one is starkly confronted with one’s own weaknesses and fears. As a naked mirror, the ring is also a place for redemption, where one can overcome flaws, and uncover facets of who one is. Having spent almost as much time at university as I have boxing, it was in the ring that I learned that “thinking otherwise entails being otherwise, relating to oneself, one’s body, and ambient beings in a new way” (Sharp 749). Through the “boxing habitus,” I have simultaneously developed a boxer’s body and habits as well as integrated new notions of gender. As an exercise in re-gendering, sparring has led me to reflect more purposefully on the multiplicity of meanings that gender can espouse, and on the possibilities of negotiating the world as both strong and female. Practising the “noble art” has given me new tools with which to carve out, within the structures of the society I inhabit, liberating possibilities of being a pugilistic woman. However, I have yet to determine if women have fashioned a space within the ring for themselves, or if they still need to reaffirm a gendered identity in the eyes of others to earn the right to get hit in the face.References Bochner, Arthur P. “It’s about Time: Narrative and the Divided Self.” Qualitative Inquiry 3.4 (1997): 418–438.Bourdieu, Pierre. The Logic of Practice. Stanford, California: Stanford UP, 1990.Bruner, Jerome. “The Autobiographical Process.” The Culture of Autobiography: Constructions of Self-Representation. Ed. Robert Folkenflik. Vol. 6. Stanford UP, 1993. 38–56.Csordas, Thomas. “Somatic Modes of Attention.” Cultural Anthropology 8.2 (1993): 135–156.De Bruin, Leon, and Sanneke de Haan. “Enactivism and Social Cognition: In Search of the Whole Story.” Cognitive Semiotics 4.1 (2009): 225–50.Denzin, Norman K. Interpretive Biography. London: Sage, 1989.Duncan, Margaret C. “Gender Warriors in Sport: Women and the Media.” Handbook of Sports and Media. Eds. Arthur A. Raney and Jennings Bryant. Lawrence Erlbaum Associates, 2006. 231–252.Ellis, Carolyn. The Ethnographic I: A Methodological Novel about Autoethnography. Walnut Creek, CA: AltaMira Press, 2004.Ellis, Carolyn, Tony E. Adams, and Arthur P. Bochner. “Autoethnography: An Overview.” Historical Social Research/Historische Sozialforschung (2011): 273–90.Ellis, Carolyn, and Laura Ellingson. “Qualitative Methods.” Encyclopedia of Sociology. Eds. Edgar F. Borgatta and Rhonda JV Montgomery. Macmillan Library Reference, 2000. 2287–96.Halberstam, Judith. Female Masculinity. Durham: Duke UP, 1998.Heiskanen, Benita. The Urban Geography of Boxing: Race, Class, and Gender in the Ring. Vol. 13. Routledge, 2012.Girlfight. Dir. Karyn Kusama. Screen Gems, 2000.Leder, Drew. The Absent Body. Chicago: U of Chicago P, 1990.Longhurst, Robyn, Elsie Ho, and Lynda Johnston. “Using ‘the Body’ as an Instrument of Research: Kimch’i and Pavlova.” Area 40.2 (2008): 208–17.Messner, Michael. Out of Play: Critical Essays on Gender and Sport. New York: SUNY Press, 2010.Merz, Mischa. Bruising: A Boxer’s Story. Sydney: Pan Macmillan, 2000.Oates, Joyce Carol. On Boxing. Garden City, New York: Harper Collins, 1987.Sharp, Hasana. “The Force of Ideas in Spinoza.” Political Theory 35.6 (2007): 732–55.Spry, Tami. “Performing Autoethnography: An Embodied Methodological Praxis.” Qualitative Inquiry 7.6 (2001): 706–32.Thrift, Nigel. “The Still Point: Resistance, Expressive Embodiment and Dance.” Geographies of Resistance (1997): 124–51.Wacquant, Loïc. Body & Soul. New York: Oxford UP, 2004.———. “Habitus as Topic and Tool: Reflections on Becoming a Prizefighter.” Qualitative Research in Psychology 8.1 (2011): 81–92.Young, Iris Marion. Throwing like a Girl and Other Essays in Feminist Philosophy and Social Theory. Bloomington, Indiana: Indiana UP, 1990.

Resilience is an interdisciplinary concept that has been interrogated and investigated in a number of fields of research and practice including psychology, climate change, trauma studies, education and disaster planning. This paper considers its position within critical disability studies, popular understandings of disability and the emergence of a disability culture. Patrick Martin-Breen and J. Marty Anderies offer a colloquial definition of resilience as: Bouncing back after stress, enduring greater stress, and being less disturbed by a given amount of stress. … To be resilient is to withstand a large disturbance without, in the end, changing, disintegrating, or becoming permanently damaged; to return to normal quickly; and to distort less in the face of such stresses. (1182) Conversely, Glenn E. Richardson argues that resiliency is a ‘metatheory’ that can best be described as ‘growth or adaptation through disruption rather than to just recover or bounce back’ (1184). He argues that resiliency theory has progressed through several stages, from the recognition of characteristics of resilient individuals to an appreciation of the support structures required beyond the level of the individual. In her memoir Resilience, Ann Deveson describes resilience as a concept that people think they understand until they are called upon to define it. Deveson offers many definitions and examples of resilience throughout her book, beginning with stories about disability, people with disability and their experiences of changing levels of social inclusion and exclusion (632). She paints an evocative picture of a young mother whose five year old son has cerebral palsy giving evidence before a Royal Commission into Human Relationships during a period of significant social change involving the deinstitutionalisation of people with disabilities: A few years earlier, this child with cerebral palsy would have been placed in an institution. His mother might not even have seen him. Now she had care of her child but the pendulum had swung in the opposite direction. (632) During the 1980s a number of large institutions caring for people with developmental impairments and psychiatric illnesses were closed in favour of community care (Clear 652). Although giving an appearance of endorsing equality of disabled people in the community, the ‘hidden agenda’ of this initiative was to cut public expenditure on social services (Ellis 163). As a result, an undue burden fell to women who became primary carers with little support such as the woman Deveson remembers. She questions where this young mother mustered such ‘magnificent resilience’ when she had such little support: When he was born, she had been discharged from the hospital with her baby, a feeding formula and a tiny pink plate for the child’s cleft palate. The only advice she received was to come back later to have the plate refitted. Her general practitioner prescribed her sedatives for depression, and she and her husband found their own way to the Royal Blind society by asking a blind man they saw outside a supermarket. She had only learned accidentally from one of the nurses that her baby was blind. ‘He’s mentally retarded too,’ the nurse had added, almost as an afterthought. (632) Thus Deveson’s consideration of resilience includes both an individual’s response to what could be described as tragedy and the importance of social support and the drive to demand it. Despite her child’s impairment and the lack of community resources made available to her family to cope, this young woman was leading public discussion about the plight of people with disabilities and their families in the hopes the government would intervene to help improve the situation (Deveson 632). Indeed, when it comes to the experience of disability, resilience is implied and generally understood to mean an attribute of the individual. However, as resilience theory has progressed, resilience can no longer be considered as existing exclusively within the domain of an individual’s personal qualities. Environmental support structures are vital in fostering resilience (Wilkes). Despite resiliency theory moving on from the level of the individual, popular discourses of resiliency as an individual’s attribute continue to dominate disability. As such, some critical disability commentators have redefined resilience as a response to a disabling social world. My aim in this paper is to explore this discourse by engaging with ideas about disability and resilience that emerge in popular culture. Despite the changing social position of people with disabilities in the community, notions of resilience are often invoked to describe the experience of people with disability and attributes of successful (often considered ‘inspiring’) people with disability. I begin by offering a definition of resilience as it is bound up in notions of inspiration and usually applied to people with disabilities. The second part of the paper explores disability as a cultural signifier to comment on the ways in which disability offers cultural meanings that may work to reassure nondisabled people of their privileged position. Finally, the paper considers interpretations of disability as a personal tragedy before exploring the emergence of a disability culture that recognises the social and cultural oppression experienced by people with disabilities and reworks definitions of resilience as a response to that oppression. Defining Resilience: Good Outcomes in Spite of Serious Threats Disability is often invoked in stories about resilience. Gillian King, Elizabeth Brown, and Linda Smith argue that a clear link exists between resilience and feeling that life is meaningful. They argue that the experiences of people with disabilities can offer a template for how to develop resilience and cope with life changes (King, Brown and Smith 633). According to the Oxford English Dictionary Online, resilience is ‘the action or an act of rebounding or springing back’ (653). King et al add that several concepts are associated with resilience such as hardiness, a sense of coherence and learned optimism (633). Deveson, resilience ‘has come to mean an ability to confront adversity and still find hope and meaning in life’. She comments that it conjures up notions of heroism, endurance and determination (632). Each of these characteristics we might describe as inspirational. It is telling that both Deveson and King et al use people with disabilities as signifiers of resilience in practice. However, Katherine Runswick-Cole and Dan Goodley argue that this definition of resilience has not necessarily been useful to people with disabilities and instead recommend a definition of resilience that Deveson only alludes to. For Runswick-Cole and Goodley resilience can be located in social processes. They argue that a thorough investigation of resilience in the lives of people with disabilities considers the broader social and cultural restrictions placed on top of impairments rather than simply individualising resilience as a character trait of people who can ‘overcome the odds’: An exploration of resilience in the lives of disabled people must, then, focus on what resources are available and who is accessing those resources. Crucially, in seeking to build resilience in the lives of disabled people, this can never simply be a matter of building individual capacity or family support, it must also be a case of challenging social, attitudinal and structural barriers which increase adversity in the lives of disabled people. (634) This is an alternative approach to disability that sees ‘the problem’ located in social structures and inaccessible environments. This so-called social model of disability is based on principles of empowerment and argues that able-bodied mainstream society disables people who have impairments through an inaccessible built environment and the perpetuation of stereotypes and prejudicial attitudes. Disability Dustbins and Inspirational Cripples Arthur Frank, sociologist and author of The Wounded Storyteller, explains that ‘the human body, for all its resilience, is fragile; breakdown is built into it. Bodily predictability, if not the exception, should be regarded as exceptional; contingency ought to be accepted as normative’ (634). Frank argues that we do not want to admit that our bodies are unpredictable and could ‘break down’ at any moment. Those bodies that do break down therefore become representatives of many of the things [the able-bodied, normal world] most fear-tragedy, loss, dark and the unknown. Involuntarily we walk- or more often sit- in the valley of the shadow of death. Contact with us throws up in people's faces the fact of sickness and death in the world … A deformed and paralysed body attacks everyone's sense of well-being and invincibility. (Hunt 186) People with disabilities therefore become loaded cultural signifiers, as Tom Shakespeare argues in Cultural Representations of Disabled People: Dustbins for Disavowal: ‘it is non-disabled people’s embodiment which is the issue: disabled people remind non-disabled people of their own vulnerability’ (139). As a result, people with disabilities are culturally othered. Several disability theorists have argued that this makes the non-disabled feel better about themselves and their tenuous privileged position (Barnes; Ellis; Kumari Campbell; Oliver, Goggin and Newell; Shakespeare). Disability, as a concept, is both everywhere and nowhere. Generally considered a medical experience or personal tragedy, the discipline of critical disability studies has emerged to question why disability is considered an inherently negative experience and if there is more to disability than a body that has something wrong with it. Fiona Kumari Campbell suggests ableism – ‘the network of beliefs, processes and practices that produces a particular kind of self and body (the corporeal standard) that is projected as the perfect, species typical and therefore essential and fully human’ – is repeatedly performed in our culture. This cultural project is difficult to sustain because by their very nature all bodies are out of control. People with disability are an acute reminder of the temporariness of an able bodied ontology (650). In order to maintain this division and network of beliefs, the idea that disability is a personal tragedy rather than a set of social relations designed to exclude some bodies but not others is culturally reproduced through stereotypes such as the idea that people with disabilities who achieve both ordinary and extraordinary things are sources of inspiration. Resilience as a personal quality is implicated in this stereotype. In a powerful Ramp Up blog that was republished on the ABC’s Drum and the influential popular culture/mummy blogging site website Mamamia, Stella Young takes issues with the media’s framing of disability as inspirational: We all learn how to use the bodies we're born with, or learn to use them in an adjusted state, whether those bodies are considered disabled or not. So that image of the kid drawing a picture with the pencil held in her mouth instead of her hand? That's just the best way for her, in her body, to do it. For her, it's normal. I can't help but wonder whether the source of this strange assumption that living our lives takes some particular kind of courage is the news media, an incredibly powerful tool in shaping the way we think about disability. Most journalists seem utterly incapable of writing or talking about a person with a disability without using phrases like "overcoming disability", "brave", "suffers from", "defying the odds", "wheelchair bound" or, my personal favourite, "inspirational". If we even begin to question the way we're labelled, we slide immediately to the other end of the scale and become "bitter" and "ungrateful". We fail to be what people expect. (610) These phrases, that Young claims the media rely on to isolate people with disabilities, are synonyms for the qualities Deveson attributes to resilient individuals (632). As Beth Haller notes, although disabled activists and academics attempt to progress important political work, the news media continue to frame people with disability as courageous and inspirational simply for living their lives (216). By comparison, disability theorist Irving Zola describes rejecting his leg braces (symbolic of his professional status) electing instead to use a wheelchair: If we lived in a less healthiest, capitalist, and hierarchal society, which spent less time finding ways to exclude and disenfranchise people and more time finding ways to include and enhance the potentialities of everyone, then there wouldn’t have been so much for me to overcome. (654) Harilyn Russo agrees, and in her memoir Don’t Call Me Inspirational highlights the socially created barriers put in her way and the ways these are ignored in favour of individualising social disablement as something inspirational people ‘overcome’: I’ll tell you why I am inspirational: I put up with the barriers, the barricades, the bullshit you put between us to avoid confronting something—probably yourself—and still pay the rent on time and savor dark chocolate. Now that takes real courage. (651) Throughout her book, Russo seeks to ‘overcome disability prejudice’ rather than ‘overcome disability’. Russo establishes herself and her experiences as normal and every day while articulating the tedium she finds in being pigeon holed as inspirational. These authors are constructing a new way of thinking about disability. Michael Oliver first described this as the ‘social model of disability’ in 1981. He sought to overturn the pathologisation of disability by giving people ‘a way of applying the idea that it was society not people with impairments that should be the target for professional intervention and practice’ (Runswick-Cole and Goodley 634). Resilience: A Key Concept Fiona Kumari Campbell questions whether resilience is a useful concept in the context of disability and reflects on its use to obscure “the ‘real’ problem, namely disability oppression” (649). She interrogates traditional definitions of resilience as they draw on notions of good outcomes in spite of risk factors or experiences of severe trauma and calls for an understanding of the interactive and dynamic features of resilience as opposed to ‘individualised psychological attributes’. Thus, individualised notions of resilience as they are implicated in the cultural stories of inspirational people with disabilities are embedded within the ableist relations that Kumari Campbell seeks to expose. In Empowerment, Self-Advocacy and Resilience, Dan Goodley argues that resilience is a key concept that has repeatedly emerged throughout his research into disability and self-advocacy. He draws on the reflections of people with disabilities to offer a re-definition of resilience as a response to a disabling society that includes five interrelated aspects (648). First is resilience as contextual, which recognises resilience as the result of the contexts in which it emerges, including through relationships with others and the experience of disabling and enabling environments. Secondly, resilience complicates preconceived notions about people with disabilities such as the view that they are passive. Goodley’s third feature of resilience is optimism. He notes resistance toward oppression as a key characteristic of optimistic resilience. Goodley again considers the importance of interpersonal relationships and group identity when he argues that the fourth feature of resilience relies on people with disabilities forming relationships with each other and group identities to question their oppression. Finally, Goodley argues ‘resilience is indicative of disablement’ and suggests that people with disability must be resilient in everyday life because we live in a disabling society. Kumari Campbell posits that individualised notions of resilience are a ‘cop out’ designed to ‘distract and defuse the reality of people labouring under very difficult circumstances of which the solution is better access to quality services’. She is hopeful, like Goodley, that resilience can be redefined as a political project, and encourages people with disabilities to develop a critical consciousness and find a new sense of community through art, humour and peer support. Therefore, according to Kumari Campbell and Goodley, resilience can be redefined as a response to social disablement rather than bodily impairment. Disability Culture: Acts of Resilience in a Disabling Society Russo and Zola’s work is part of a disability culture that has emerged in response to narrow ways of understanding disability. Steven Brown emphasises the importance of experience and personal identity in his definition of disability culture: People with disabilities have forged a group identity. We share a common history of oppression and a common bond of resilience. We generate art, music, literature, and other expressions of our lives and our culture, infused from our experience of disability. Most importantly, we are proud of ourselves as people with disabilities. We claim our disabilities with pride as part of our identity. (520) Brown’s definition of disability culture therefore draws on all five of Goodley’s features of resilience. Disability culture is contextual, complicating, optimistic, interpersonal and indicative of disablement. The forging of a group identity reveals the resilience of disability culture as contextual and interpersonal. The creation of art, music, literature and other cultural artefacts reveals resilience as optimistic. The notion that people with disabilities are proud of their identity complicates traditional understandings of disability as a personal tragedy. Brown’s emphasis on the common history of the oppression of people with disabilities, as it initiated the whole disability culture movement, is ‘indicative of disablement’. The bonds of resilience that create the disability cultural movement are a result of the social oppression of people with disabilities (Gill; Martin; Brown; Goodley). Conclusion Whereas people with disabilities going about their every day lives have often been considered inspirational and as possessing resilient qualities, a new disability culture is emerging that repositions the resilience of people with disabilities as a political response to social oppression. Drawing on Runswick-Cole and Goodley’s argument that individualising qualities of resilience in inspirational people with disabilities has not benefitted people with disabilities, this paper sought to reveal the importance of resilience as a response to social oppression. People with disabilities in their formation of a disability cultural movement are reworking and redefining resilience as a response to oppression. Throughout this paper I have drawn on the reflections of a number of people with disabilities to illustrate the emergence of a disability culture as it has begun the work of redefining resilience as a political project that “‘outs’ the problems that disabled people face and names and prioritises the concerns” (Kumari Campbell 649). As Goodley argues, people with disabilities have developed a politics of resilience ‘in the face of a disabling world’. References Barnes, Colin. “Disabling Imagery and the Media: An Exploration of the Principles for Media Representations of Disabled People.” 1992. Brown, Steven. “What Is Disability Culture?” Disability Studies Quarterly 22.2 (2002). Clear, Mike. Promises, Promises: Disability and Terms of Inclusion. Leichhardt: Federation Press, 2000. Deveson, Ann. Resilience. Crows Nest: Allen & Unwin, 2003. 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LANGUAGE NOTE | Document text in Chinese; abstract also in English. 在西遊叙述中，神魔鬥法前時常出現的，就是孫行者頻繁召唤土地，方能問明妖精、妖魔的出處，其頻率極高而關注者卻少，原因就是土地神僅被視爲陪襯性小神。世德堂本（以下簡稱世本）叙述其出場的方式及用意，作者其實交互使用兩種聲音：顯聲音即表現滑稽性的遊戲筆調，目的即在掩飾其真正的潛聲音，主要即借此諷喻、影射當世。這種文學旨趣在兩種聲音間交織，若隱若現，亟待解讀。世本寫定者雖曾吸收先行材料，但本身自有其創意所在，即化用當時道、佛二教的文化資源。這一點學界雖有關注者，此處即針對“召唤土地”情節，詳細解讀其使用的手法，認爲其背後皆有宗教、尤其道教知識的支持。運用從淺到深的叙述層次，其顯聲音即召唤土地的方式，軟硬兼用，從唤出到拘得，形成表面的叙述趣味；而關鍵的召唤叙述，也是簡繁俱有的捻訣、唸真言，從唵字到唵㘕淨法界，按照當時的宗教文化的理解，即採用明代流行於文人間的準提信仰，致使作者挪用密教準提咒，並未襲用道教的召土地神咒。最值得注意的是召唤過程，叙寫行者對待土地、山神的使唤態度，而相對地，土地、山神則表現惶恐的滑稽表情。這種顯話語背後隱藏作者的潛話語，即運用“縱放之嫌”的叙述筆法，首即化用道教的鬼律、黑律知識，規範城隍———土地：境内凡有精邪而未能通告者，即有縱放之嫌而會被杖或流放；故作者叙寫土地既知妖精、妖魔存在卻任令其活動，即襲用“縱放之嫌”，而叙寫行者欲用金箍棒威脅“欲打”而未打，此爲化用了道教的鬼律叙述；其次則是諷喻性的影射層次，明代中葉以前實行里甲制，小説家曾活用其兩件事：官方推動禮制性的里社壇制，但里甲居民仍然崇拜土地神，以致里社壇荒廢不用；其次里長、甲首負責里甲内的催税、徭役，但税役過重後導致居民脱逃，小説乃有逃門户、大户負擔元宵燈油等，此種叙述爲顯話語；而描述妖精、妖魔據洞稱王、差使土地，尤其後者俱從天界私下凡間，此種潛話語即諷喻明代王府與地方豪族。西遊叙述交錯活用顯、潛兩種聲音，即可知表面愈荒唐、嬉戲的語言，愈是掩飾當時習知的社會怪現狀，故時人自然領會其諷喻旨趣，今人則需從“縱放之嫌”切入，方能進行深刻的文學詮釋，確定世本能巧用多層次的語言藝術，從而爲其“奇書”作文學史的定位。 In the narratives of Journey to the West, there is a customary scene of Monkey summoning the gnome before each battle between deities and goblins, whereby he may find out the identity of the goblins. This scene occurs very frequently but has drawn little attention, simply because the gnomes are regarded as low-ranking deities who serve only as a foil of the main characters. In the common editions, in narrating the method and intent of the gnome’s debut, the author alternately uses two voices. The first one is the manifested voice, a playful writing style that represents the comedy content. The real intent of using this voice is to hide the second voice, namely the suppressed voice. The main purpose is to satirize and insinuate the current situation of the time. The aesthetic appeal lies in the indirect expression in these two interwoven voices, which the reader finds tantalizing to decipher. Although the editor of the common edition must have relied on an earlier version, he must also have been creative when producing his own version, in which he made use of the prevalent resources of Daoism and Buddhism. This has indeed drawn attention in relevant scholarship. In the present study, however, I would like to focus on the plot of “summoning the gnome” and analyze its literary devices. I argue that there must be some religious background, especially Daoist knowledge, behind it as support. The narrative level follows a low-to-high development discourse, in which the manifested voice summons the gnome in both forceful and soft manners, and forms a kind of joyful process in the summoning and capture. The summoning per se is a process that contains complete and simple religious content, such as making religious gestures, and chanting spells and words of the Perfected One, from the word om to om ram of the Pure Realm of Reality. According to the then-prevalent religious practice, it is observed that the summoning ritual is based on the belief in Cundhi Buddha that was popular in the Ming dynasty. As a result, the author borrowed the Cundhi spells from esoteric Buddhism, instead of following the Daoist spells for summoning the gnome. The most noteworthy point is the summoning process. The narrative of the Practitioner (Sun Wukong) shows his attitude towards summoning the gnomes and mountain spirits, as well as its counterparts, the funny facial experience of the gnomes and mountain spirits’ fear of the Practitioner. Behind this manifested discourse is hidden a suppressed discourse of the author. This is the use of a narrative of “suspicious indulgence.” In the beginning, he uses the knowledge of “ghosts’ laws” and “dark laws” in the Daoist tradition to regulate the guards of walls and moats — the gnomes. In accordance with these laws, if there are spirts and devils in the area but the gnome fails to report, he is thus suspected of indulging and will be hit with a rod and/or exiled. Likewise, when writing about the gnome who was aware of the existence of goblins and devils but still let them act at will, the author inherited the notion of “suspicious indulgence.” When describing the Practitioner who was about to hit with his Gold Circle Rod but had not done so, the author borrowed a narrative mode derived from the Daoist laws of the ghosts. The second level is an insinuative one. Before the middle of the Ming, Lijia (lit. ,“lane and alley”; li = 110 households; jia = 10 households) was an administrative system, which became inspiration for novelists for their creative writing in two respects, namely: 1) a ritual system called “Lane Altar” promoted by the government, but the lijia residents still worshiped gnomes and therefore the “Lane Altar” was abandoned; 2) the li mayors and jia magistrates were in charge of taxation and levies, but as this became a burden the residents fled; this gave rise to the themes of “evading households” and “wealthy households paying lamp oil for the fifteenth of the first month,” which became the main fiction discourses. As for the narratives about demons who declared kingship in a grotto and gave orders to gnomes, they (especially the latter) were all previously in Heaven but later fled to the mortal world. These suppressed discourses are all satires for Ming princedoms and regional powerful clans. The narrative in Journey to the West alternately speaks in these two voices, from which we are informed: the more absurd and playful on the surface the more it covers up the strange phenomena of society that were widely known. Therefore, the intended gist was easily understood by people of that time, but in our time we must rely on “suspicious indulgence” to conduct an in-depth literary interpretation. We must recognize the various artful means in the common versions of the novel and thereby render the novel a status of “book of wonder.”

Introduction This paper explores some specific conjunctions that tie together two nations, Japan and the Philippines. Over the past 30 years both have become entwined as a transfer of people, cultures and societies have connected and formed some interesting developments. Relations between both countries have been highly influenced through the deployment of State intervention (historically colonial and post-colonial), as well as through actors’ initiatives, leading to the development of a complex network that links both countries. It is in these relations that I would like to locate a transition between two stages in Japan-Philippine relations. I argue, this is a transition, where marriages of one kind (international marriages), the bonding of social actors from two distinct cultural spheres, gives way to another form of marriage. This transition locates the term marriage as part of an ongoing process and a discursive realm in a larger ‘affective complex’ that has developed. In this paper, I focus on this term ‘affective complex’ as it offers some interesting avenues in order to understand the continuing development of relations between Japan and the Philippines. By ‘affective complex’ I refer to the ‘cultural responses’ that people use in reaction to situations in which they find themselves which are not mediated by language. I suggest that this complex is a product of a specific encounter that exists between two nations as understood and mediated by Japanese actors’ positionings vis-à-vis foreign resident Filipinos. In tracing a moment between Japan and the Philippines, I delineate emerging properties that currently allude to a transition in relations between both countries. I would like to show that the properties of this transition are creating an emergent phenomena, a complex? This is developing through interactions between human actors whose trajectories as transnational migrants and permanent foreign residents are coming under the scrutiny of Japanese State forces in a heavily contested discursive field. This paper focuses upon the nature of the complex that entwines both countries and examines Japan’s particular restructuring of parts of its workforce in an attempt to include foreign migrants. To do this I first offer an outline of my fieldwork and then delineate the complex that ties both countries within present theoretical boundaries. This paper is based on fieldwork which deals with the theme of International Marriages between Japanese and Filipino couples. In the field I have observed the different ways in which Filipinos or Japanese with a connection to the Philippines orientate themselves within Japanese society vis-à-vis the Philippines. For the purpose of this paper, I will focus exclusively on a particular moment in my field: a care-giver course run privately with approval and recognition from local government. This course was offered exclusively for Filipino nationals with permanent residency and a high level of Japanese. As part of a larger field, a number of overlapping themes and patterns were present within the attitudes of those participating in the course. These were cultural responses that social actors carry with them which constitute part of an ‘affective complex’, its gradual emergence and unfolding. To further locate this fieldwork and its theoretical boundaries, I also position this research within current understandings of complexity. Chesters and Welsh have referred to a complex system as being a non-linear, non-deterministic system. However, from my perspective, these parameters are insufficient if institutions, organisations and human actors exhibit linear and deterministic properties (properties that discursively capture, locate and define elements in a system). In my research, I am dealing with actors, in this case Filipinos who are seen first as recipients and then as providers of welfare services. Japanese actors act as suppliers of a service both to long-term residents and to the State. In this case the following question arises: whose ‘complexes’ may be defined by a mixture of both these parameters and how can it be possible to take into account relationships whose existence cuts across them? Could a complex not be any number of these terrains which have emerged through encounters between two countries? Marriage could be a starting point for complexes that can come under scrutiny at a higher level, that of the State forces. In addition, a study of complexity in the Social Sciences focuses on how structures form rather than by focusing on any prior structured existence. Any focus on a complex system is to analyze holistic multiple elements in order to descriptively locate structures, what they penetrate, and what they are penetrated by. Human actors’ actions, strategies and expectations merge under the influence of these structures, while simultaneously influencing them. As elements interact, emergent phenomena (properties that emerge at a higher level) show a system that is process dependent, organic, and always evolving (Arthur 109). Locating Affect Deleuze and Guattari refined the discursive realm to emphasise how spaces of creation, dialogue and the casting of influence are affective, institutional and State-influenced. Within these spaces I locate the existence of ‘affective complexes’ which are discursively constructed and deployed by local actors. I will to argue that international marriages have laid a groundwork in which ‘affect’ itself has become a catalyst, re-orientating perceptions of and toward Filipinos. Following Deleuze, we can understand ‘affect’ as an intensity which, to repeat, is an expression of human relationships not mediated directly through language (Rodriguez). However, I want to suggest ‘affect’ also comes under the scrutiny of, and is discursively appealed to by, State forces as ‘affective capital’. When I refer to ‘affective capital’ I mean the potential labour discursively constructed. This construction is then “projected and tapped” in response to the changing nature of Japan’s labour market – in particular, the shortage of care-givers. This construction itself exists as an ongoing management strategy that deals with certain foreign nationals in Japan. Here, in response to the transformations of service work, ‘affective capital’ is the commoditised value of care inherent the discourse. It is the kernel of ‘affective labour’. This was very clear in my fieldwork, wherein Filipinos were targeted exclusively as the recipients of training in the health-care sector based on an understanding of the form of ‘affect’ that they possess. In this context, ‘affect’ adds intensity to meaning and is used in a wide range of cultural contexts, yet its very essence eludes description, especially when that essence as used by ‘active agents’ may be misconstrued in its deployment or discursively captured. Returning to the Deleuzian interpretation of ‘affect’, it could be interpreted as the outcome of encounters between actors and as such, a ‘mode’ in which becoming can initiate possibilities. I refer to ‘affect’, the deployment of shared, performed, communicated non-verbal ‘content’, as a powerful tool and an essential component in everyday habituated practice. In other areas of my field (not included in this discussion), ‘affect’ deployed by both actors, husband and wife, within and beyond the family, manifests itself as a mode of being. This at times adds to the location of actors’ intentions, be they spoken or performative. In this sense, locating the ‘affect’ in my research has meant observing the way in which Filipinos negotiate the availability of life strategies and opportunities available to them. At the same time, ‘affect’ is also produced by Japanese actors realigning themselves vis-à-vis both foreign actors and social change, as well as by effectuating strategies to emergent situations in Japan such as care management. ‘Affective capital’ is an inherent long-term strategy which has its roots in the cultural resources at the disposal of non-Japanese partners who, over the years, in the short and long term put to use discursively produced ‘affect’. ‘Affect’, produced in reactions to situations, encounters and events, can work in favour of long-term residents who do not have access to the same conditions Japanese may find in the labour sector. From encounters in my fieldwork, the location of ‘affect’ is an asset not just within immediate relationships, but as a possible expression of strategies that have arisen in response to the recognition of reactionary elements in Japanese society. By reactionary elements I refer to the way in which a complex may realign itself when ‘interfered’ with at another level, that of the State. The Japanese State is facing labour shortages in certain sectors due to social change, therefore they must secure other potential sources of labour. Appropriation of human resources locally available has become one Japanese State solution for this labour shortage. As such, ‘affect’ is brought into the capitalist fold in response to labor shortages in the Health Sector. Background The Philippines is a prime example of a nomad nation, where an estimated eight million of the population currently work or live overseas while remitting home (Phillippines Overseas Employment Agency). Post-colonial global conditions in the Asia Pacific region have seen the Philippines cater to external national situations in order to participate in the global labour market. These have been in the form of flows of labour and capital outsourced to those economies which are entangled with the Philippines. In this context, marriage between both countries has come to be made up almost exclusively of Japanese men with Filipina women (Suzuki). These marriages have created nascent partnerships that have formed links within homes in both countries and supported the creation of a complex system tying together both nations. Yet, in the entanglement of what seems to be two economies of desire, some interesting observations can be drawn from what I consider to be the by-products of these marriages. Yet what does this have to do with a marriage? First, I would like to put forward that certain international marriages may have developed within the above discursive framework and, in the case of the Philippines and Japan, defined certain characteristics that I will explain in more detail. Over the past 20 years, Filipinos who came to Japan on entertainment visas or through encounters with Japanese partners in the Philippines have deployed discursively constructed ‘affective capital’ in strategies to secure relationships and a position in both societies. These strategies may be interpreted as being knowledgeable, creative and possessive of the language necessary for negotiating long-term dialogues, not only with partners and surrounding family, but also with Japanese society. These deployments also function as an attempt to secure additional long term benefits which include strengthening ties to the Philippines through increasing a Japanese spouse’s involvement and interest in the Philippines. It is here that Filipinos’ ‘affect’ may be traced back to a previous deployment of categories that influences local Japanese actors’ decisions in offering a course exclusively for Filipino residents. This offers the first hint as to why only Filipinos were targeted. In Japan, secure permanent work for resident Filipinos can be, at times, difficult even when married to a partner with a stable income. The reality of remitting home to support family members and raising a family in Japan is a double burden which cannot be met solely by the spouse’s salary. This is an issue which means actors (in this case, partners) recourse to their ‘affective capital’ in order to secure means towards a livelihood. In this context, marriages have acted as a primary medium entangling both countries. Yet changes in Japan are re-locating ‘possible’ resources that are rationalised as a surplus from these primary encounters. Shifts in Japan’s social landscape have over the past 10 years led to an increasing awareness of the high stakes involved in care for the ageing and invalid in Japanese society. With over 21% of the population now over 65, the care industry has seen a surge in demand for labour, of which there is currently a shortfall (Statistics Bureau Japan). With the Philippines having strategically relocated its economy to accommodate demands for the outsourcing of health care workers and nurses overseas, Japan, realigning its economy to domestic change, has shown a new type of interest (albeit reluctant) in the Philippines. In 2005, changes and reforms to Japan’s Immigration Control and Refugee Recognition Act successfully curtailed the flow of Filipinos applying to Japan to work as entertainers. This was in part due to pressure from the interventionary power of the U.S: in 2006 the U.S. State department published the Trafficking in Persons Report, which stipulated that Japan had yet to comply in improving the situation of persons trafficked to Japan (U.S. State Department). This watershed reform has become a precursor to the Philippines Economic Partnership Agreement ratified by Japan and the Philippines to promote the ‘trans-border flow of goods, person, services and capital between Japan and the Philippines (Ministry of Foreign Affairs) and has now temporarily realigned both economies into a new relationship. Under the terms ‘movement of natural persons’, Filipino candidates for qualified nurses and certified care workers would be allowed a stay of up to three years as nurses, or four for certified care workers (Ministry of Foreign Affairs). Nonetheless, this lip service in showing openness to admit a new category of Filipino is the continuation of a mode of ‘servicing’ within the Japanese nation, albeit under the guise of ‘care work’, and rests upon the capitalist rationalisation of hired workers for Japan’s tertiary sectors. The Philippines, a nation which is positively export-orientated in terms of its human resources in response to care inequalities that exist between nations at a global level (Parreñas 12-30), is now responding to the problematic issue of care that has become a serious concern in Japan. Fieldwork To place these issues in context I want to locate the above issues within a part of my present fieldwork. In 2006, I participated in a privately funded non-profit venture set up for Filipino residents with the aim of training them to be care-givers. The course was validated and acknowledged by the local prefectural government and primarily limited to a group of 20 participants who paid approximately sixty thousand yen ($485) for the three month course including training and text books. One Filipina acquaintance enthusiastically introduced me to the retired bank manager who had set up a fund for the three month care-giver course for Filipina residents. Through interviews with the course providers, one underlying theme in the planning of the course was clear: the core idea that Filipinos have a predisposition to care for the elderly, reflecting Filipino social values no longer existent in Japan. In particular, two Japanese words employed to reflect these views – ‘omoiyari’ (思いやり), meaning “compassion” or “considerateness” and ‘yasashisa’ (優しさ) meaning “kindness toward others” – were reiterated throughout the course as a requisite for dealing with the elderly or those in need of care. One core presupposition underlining the course was that the Philippines still cherishes values which are on the decline in Japan, offering a care ethos based on Christian values ready for deployment in such work. I believe this marks a transition point in how both countries’ relations are moving away from ‘entertainment-based’ care to ‘care within an institutional setting’, such as private nursing homes or hospitals. In both cases, ‘care’ (as it is ironically known in both industries, the deployment of hospitality and attendance), operates as a dynamic of desire within a social field which orientates how residents (i.e. foreign female residents with permanent residency) are used. Yet, why would the Philippines be such an attractor? It is not difficult to see how ‘affect’ is discursively rationalised and deployed and projected onto Philippine society. This ‘affect’ acts as an attractor and belongs to an ‘imagined’ cultural repertoire that Japan has created in response to its turbulent marriage to the Philippines. In this sense, the care course promoted this ‘caring affective side’ of Filipinas here in Japan, and provided a dynamic engagement for potential negotiation, persuasion and tension between ‘local actors’ (course providers and participants) who come under the direct remit of the Japanese State (care institutions, hospitals and nursing homes). I say “tension”, as to date only a handful (three women out of a total of sixty) of those who participated in the course have taken up employment in the care industry. As one participant, a divorcee, commented, the reluctance to seek work as a qualified care worker resided in an economic framework, she says: this is a useful investment, but I don’t know if I can do this work full time to live off and support my families…but it is another arrow in my bow if the situation changes. Yet, for another woman, care work was an extension of something that they were familiar with. She jokingly added with a sigh of resignation: Oh well, this is something we are used to, after all we did nothing but care for our papa-san (husband)! When I discussed these comments with an N.G.O. worker connected to the course she pessimistically summed up what she thought by saying: The problem of care in Japan was until very recently an issue of unpaid work that women have had to bear. In a sense, looking after the aged living at home has been a traditional way to treat people with respect. Yet, here in Japan we have experienced an excessively long period whereby it was de facto that when a woman married into someone’s family, she would care for the husband and his family. Now, this isn’t an individual problem anymore, it’s a societal one. Care is now becoming an institutional practice which is increasing paid work, yet the State works on the assumption that this is low paid work for people who have finished raising their children; hard labour for low wages. All the women have graduated and are licensed to work, yet at 1000 yen (U.S. $8) an hour for psychologically demanding hard labour they will not work, or start and finish realising the demands. Travelling between locations also is also unpaid, so at the most in one day they will work 2-3 hours. It is the worst situation possible for those who choose to work. The above opinion highlights the ambiguities that exist in the constant re-alignment of offering work to foreign residents in the effort to help integrate people into Japan’s tertiary ‘care sector’ in response to the crisis of a lack of manpower. To date most women who trained on this course have not pursued positions within the health sector. This indicates a resistance to the social beliefs that continue to categorise female foreign residents for gendered care work. Through three successive batches of students (sixty women in total) the president, staff and companies who participated in this pilot scheme have been introduced to Filipino residents in Japanese society. In one respect, this has been an opportunity for the course providers to face those who have worked, or continue to work at night. Yet, even this exposure does not reduce the hyper-feminisation of care; rather, it emphasises positions. One male coordinator brazenly mentioned the phrase ashi wo aratte hoshii, meaning ‘we want to give them a clean break’. This expression is pregnant with the connotation that these women have been involved in night work have done or still participate in. These categorisations still do not shake themselves free from previous classifications of female others located in Japanese society; the ongoing legacy that locates Filipinos in a feminised discursive space. As Butler has elucidated, ‘cultural inscriptions’ and ‘political forces with strategic interests’ work to keep the ‘body bounded and constituted’ (Butler 175). It is possible to see that this care course resides within a continuously produced genealogy that tries to constitute bodies. This resides under the rubric of a dominant fantasy that locates the Philippines in Japan as a source of caring and hospitality. Now, those here are relocated under a restructuring industry outsourcing work to those located in the lower tiers of the labour sector. Why other nationals have not been allowed to participate in the course is, I stress, a testimony to this powerful discourse. Major national and international media coverage of both the course and company and those women who found employment has also raised interest in the curious complex that has arisen from this dynamic, including a series of specials aired on Japanese television by NHK (NHK Kaigo no Jinzai ga Nigete iku). This is very reminiscent of a ‘citationary’ network where writings, news items and articles enter into a perpetuating relationship that foments and bolsters the building up of a body of work (Said) to portray Japan’s changing circumstances. As seen from a traced genealogy, initial entanglements between two nations, in conjunction with societal change in Japan, have created a specific moment in both countries’ trajectories. Here, we can see an emergent phenomena and the relocation of a discursive structure. An affective complex can be located that marks a shift in how foreign residents are perceived and on what terms they can participate or contribute to Japanese society. Within this structure, ‘care’ is relocated – or, rather, trapped – and extracted as labour surplus that resides in an antagonistic relationship of domination highlighting how a specific moment existing between two countries can be ‘structured’ by needs in the ‘engaging’ country, in this case Japan. Non-linear elements in a complex system that contest how discursive practices in Japanese society locate foreign residents, within the rubric of an ‘imagined’ ethos of compassion and kindness that emanates from outside of Japan, seem to display ‘affective’ qualities. Yet, are these not projected categories deployed to continue to locate migrant labour (be they permanent or temporary residents) within an ongoing matrix that defines what resources can be discursively produced? However, these categories do not take into account the diverse structures of experience that both Japanese nationals and Filipino nationals experience in Japan (Suzuki). Conclusion In this paper I have briefly delineated a moment which rests between specific trajectories that tie two nations. A complex of marriages brought about within a specific historic post-colonial encounter has contributed to feminising the Philippines: firstly, for women in marriages, and now secondly for ‘potential resources’ available to tackle societal problems in Japan. As I have argued a discursively produced ‘affective complex’ is an authorising source of otherness and could be part of a precursor complex which is now discursively relocating human resources within one country (Japan) as a ‘reluctant source’ of labour, while entering into a new discursive mode of production that shapes attitudes toward others. I also suggest that there is a very specific complex at work here which follows an as of yet faint trajectory that points to the re-organisation of a relationship between Japan and the Philippines. Yet, there are linear elements (macro-level forces rooted in the Japanese State’s approach to care vis-à-vis the Philippines) operating at the fundamental core of this care-giver course that are being constantly challenged and cut across by non-linear elements, that is, human actors and their ambivalence as the beneficiaries/practitioners of such practices. This is the continued feminisation of a highly gendered dynamic that locates labour as and when it sees fit, but through the willing coercion of local agents, with an interest in mediating services through and for the State, for the welfare of the Nation. The desiring-machine that brings together Japan and the Philippines is also one that continues to locate the potential in foreign actors located within Japan’s institutional interpellation for its care market. Within these newly emergent relationships, available political and social capital is being reshaped and imagined in reaction to social change in Japan. By exploring two entangled nations situated within global capitalist production in the twenty-first century, my research points towards new ways of looking at emerged complexes (international marriages) that precludes the reconfigurations of ongoing emerging complexes that discursively locate residents as caregivers, who fall under the jurisdiction and glare of political powers, government subjects and State forces. References Artur, W. Brian. “Complexity and the Economy.” Science 284.2 (1999): 107-109. Butler, Judith. Gender Trouble: Feminism and the Subversion of Identity. New York: Routledge, 2006. Chester, Graeme, and Ian Welsh. “Complexity and Social Movement(s): Process and Emergence in Planetary Action Systems.” Theory, Culture & Society 22.5 (2005): 187-211. Deleuze, Giles, and Felix Guattari. A Thousand Plateaus: Capitalism and Schizophrenia. Minnesota: U of Minnesota P, 1987. Ministry of Foreign Affairs (Japan). Japan-Philippines Economic Partnership Agreement Press Statement. 29 Nov. 2004. 29 Mar. 2007 http://www.mofa.go.jp/region/asia-paci/philippine/joint0411.html>. NHK Kaigo no Jinzai ga Nigete iku. 介護の人材が逃げて行く (“Care Workers Are Fleeing.”) Televised 11 Mar. 2007. 29 Mar. 2007 http://www.nhk.or.jp/special/onair/070311.html>. Parreñas, Rachel Salazar. Children of Global Migration: Transnational Families and Gendered Woes. Stanford: Stanford UP, 2005. Philippines Overseas Employment Agency. “Stock Estimates of Filipinos Overseas.” 2 May 2007 http://www.poea.gov.ph/html/statistics.html>. Rodriguez, Encarnación Gutiérrez. “Reading Affect – On the Heterotopian Spaces of Care and Domestic Work in Private Households.” Forum: Qualitative Social Research 8 (2007). 2 May 2007 http://www.qualitative-research.net/fqs-texte/2-07/07-2-11-e.pdf>. Said, Edward. Orientalism. London: Penguin, 1995. Statistics Bureau and Statistical Research and Training Institute. Ministry of Internal Affairs and Communications (Philippines). 2005. 2 May 2007 http://www.poea.gov.ph/docs/STOCK%20ESTIMATE%202004.xls>. Suzuki, Nobue. “Inside the Home: Power and Negotiation in Filipina-Japanese Marriages.” Women’s Studies: An Interdisciplinary Journal 33.4 (2004): 481-506. “Trafficking in Persons Report.” U.S. State Department. 2006. 29 Apr. 2007. http://www.state.gov/documents/organization/66086.pdf>. Citation reference for this article MLA Style Lopez, Mario. "From Bride to Care Worker?: On Complexes, Japan and the Philippines." M/C Journal 10.3 (2007). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0706/04-lopez.php>. APA Style Lopez, M. (Jun. 2007) "From Bride to Care Worker?: On Complexes, Japan and the Philippines," M/C Journal, 10(3). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0706/04-lopez.php>.

IntroductionIn 1802 George Howe (1769-1821), the recently appointed Government Printer, published Australia’s first book. The following year he established Australia’s first newspaper; an enterprise that ran counter to all the environmental factors of the day, including: 1) issues of logistics and a lack of appropriate equipment and basic materials to produce a regularly issued newspaper; 2) issues resulting from the very close supervision of production and the routine censorship by the Governor; and 3) issues associated with the colony’s primary purposes as a military outpost and as a penal settlement, creating conflicts between very different readerships. The Sydney Gazette was, critically for Howe, the only newspaper in the infant city for over two decades. Alternative voices would not enter the field of printed media until the 1820s and 1830s. This article briefly explores the birth of an Australian industry and looks at how a very modest newspaper overcame a range of serious challenges to ignite imaginations and lay a foundation for media empires.Government Printer The first book published in Australia was the New South Wales General Standing Orders and General Orders (1802), authorised by Governor Philip Gidley King for the purposes of providing a convenient, single-volume compilation of all Government Orders, issued in New South Wales, between 1791 and 1802. (As the Australian character has been described as “egalitarian, anti-authoritarian and irreverent” [D. Jones 690], it is fascinating that the nation’s first published book was a set of rules.) Prescribing law, order and regulation for the colony the index reveals the desires of those charged with the colony’s care and development, to contain various types of activities. The rules for convicts were, predictably, many. There were also multiple orders surrounding administration, animal husbandry as well as food stuffs and other stores. Some of the most striking headings in the index relate to crime. For example, in addition to headings pertaining to courts there are also headings for a broad range of offences from: “BAD Characters” to “OFFENSIVE Weapons – Again[s]t concealing” (i-xii). The young colony, still in its teenage years, was, for the short-term, very much working on survival and for the long-term developing ambitious plans for expansion and trade. It was clear though, through this volume, that there was no forgetting the colony of New South Wales was first, and foremost, a penal settlement which also served as a military outpost. Clear, too, was the fact that not all of those who were shipped out to the new colony were prepared to abandon their criminal careers which “did not necessarily stop with transportation” (Foyster 10). Containment and recidivism were matters of constant concern for the colony’s authorities. Colonial priorities could be seen in the fact that, when “Governor Arthur Phillip brought the first convicts (548 males and 188 females) to Port Jackson on 26 January 1788, he also brought a small press for printing orders, rules, and regulations” (Goff 103). The device lay dormant on arrival, a result of more immediate concerns to feed and house all those who made up the First Fleet. It would be several years before the press was pushed into sporadic service by the convict George Hughes for printing miscellaneous items including broadsides and playbills as well as for Government Orders (“Hughes, George” online). It was another convict (another man named George), convicted at the Warwick Assizes on March 1799 (Ferguson vi) then imprisoned and ultimately transported for shoplifting (Robb 15), who would transform the small hand press into an industry. Once under the hand of George Howe, who had served as a printer with several London newspapers including The Times (Sydney Gazette, “Never” 2) – the printing press was put to much more regular use. In these very humble circumstances, Australia’s great media tradition was born. Howe, as the Government Printer, transformed the press from a device dedicated to ephemera as well as various administrative matters into a crucial piece of equipment that produced the new colony’s first newspaper. Logistical Challenges Governor King, in the year following the appearance of the Standing Orders, authorised the publishing of Australia’s first newspaper, The Sydney Gazette and New South Wales Advertiser. The publication history of The Sydney Gazette, in a reflection of some of the challenges faced by the printer, is erratic. First published on a Saturday from 5 March 1803, it quickly changed to a Sunday paper from 10 April 1803. Interestingly, Sunday “was not an approved day for the publication of newspapers, and although some English publishers had been doing so since about 1789, Sunday papers were generally frowned upon” (Robb 58). Yet, as argued by Howe a Sunday print run allowed for the inclusion of “the whole of the Ship News, and other Incidental Matter, for the preceeding week” (Sydney Gazette, “To the Public” 1).The Sydney Gazette and New South Wales Advertiser Vol. 1, No. 1, 5 March 1803 (Front Page)Call Number DL F8/50, Digital ID a345001, State Library of New South WalesPublished weekly until 1825, then bi-weekly until 1827 before coming out tri-weekly until 20 October 1842 (Holden 14) there were some notable pauses in production. These included one in 1807 (Issue 214, 19 April-Issue 215, 7 June) and one in 1808-1809 (Issue 227, 30 August-Issue 228, 15 May) due to a lack of paper, with the latter pause coinciding with the Rum Rebellion and the end of William Bligh’s term as Governor of New South Wales (see: Karskens 186-88; Mundle 323-37). There was, too, a brief attempt at publishing as a daily from 1 January 1827 which lasted only until 10 February of that year when the title began to appear tri-weekly (Kirkpatrick online; Holden 14). There would be other pauses, including one of two weeks, shortly before the final issue was produced on 20 October 1842. There were many problems that beset The Sydney Gazette with paper shortages being especially challenging. Howe regularly advertised for: “any quantity” of Spanish paper (e.g.: Sydney Gazette, “Wanted to Purchase” 4) and needing to be satisfied “with a variety of size and colour” (P.M. Jones 39). In addition, the procurement of ink was so difficult in the colony, that Howe often resorted to making his own out of “charcoal, gum and shark oil” (P.M. Jones 39).The work itself was physically demanding and papers printed during this period, by hand, required a great deal of effort with approximately “250 sheets per hour … [the maximum] produced by a printer and his assistant” (Robb 8). The printing press itself was inadequate and the subject of occasional repairs (Sydney Gazette, “We Have” 2). Type was also a difficulty. As Gwenda Robb explains, traditionally six sets of an alphabet were supplied to a printer with extras for ‘a’, ‘e’, ‘r’ and ‘t’ as well as ‘s’. Without ample type Howe was required to improvise as can be seen in using a double ‘v’ to create a ‘w’ and an inverted ‘V’ to represent a capital ‘A’ (50, 106). These quirky work arounds, combined with the use of the long-form ‘s’ (‘∫’) for almost a full decade, can make The Sydney Gazette a difficult publication for modern readers to consume. Howe also “carried the financial burden” of the paper, dependent, as were London papers of the late eighteenth century, on advertising (Robb 68, 8). Howe also relied upon subscriptions for survival, with the collection of payments often difficult as seen in some subscribers being two years, or more, in arrears (e.g.: Sydney Gazette, “Sydney Gazette” 1; Ferguson viii; P.M. Jones 38). Governor Lachlan Macquarie granted Howe an annual salary, in 1811, of £60 (Byrnes 557-559) offering some relief, and stability, for the beleaguered printer.Gubernatorial Supervision Governor King wrote to Lord Hobart (then Secretary of State for War and the Colonies), on 9 May 1803: it being desirable that the settlers and inhabitants at large should be benefitted by useful information being dispersed among them, I considered that a weekly publication would greatly facilitate that design, for which purpose I gave permission to an ingenious man, who manages the Government printing press, to collect materials weekly, which, being inspected by an officer, is published in the form of a weekly newspaper, copies of which, as far as they have been published, I have the honor to enclose. (85)In the same letter, King wrote: “to the list of wants I have added a new fount of letters which may be procured for eight or ten pounds, sufficient for our purpose, if approved of” (85). King’s motivations were not purely altruistic. The population of the colony was growing in Sydney Cove and in the outlying districts, thus: “there was an increasing administrative need for information to be disseminated in a more accessible form than the printed handbills of government orders” (Robb 49). There was, however, a need for the administration to maintain control and the words “Published By Authority”, appearing on the paper’s masthead, were a constant reminder to the printer that The Sydney Gazette was “under the censorship of the Secretary to the Governor, who examined all proofs” (Ferguson viii). The high level of supervision, worked in concert with the logistical difficulties described above, ensured the newspaper was a source of great strain and stress. All for the meagre reward of “6d per copy” (Ferguson viii). This does not diminish Howe’s achievement in establishing a newspaper, an accomplishment outlined, with some pride, in an address printed on the first page of the first issue:innumerable as the Obstacles were which threatened to oppose our Undertaking, yet we are happy to affirm that they were not insurmountable, however difficult the task before us.The utility of a PAPER in the COLONY, as it must open a source of solid information, will, we hope, be universally felt and acknowledged. (Sydney Gazette, “Address” 1)Howe carefully kept his word and he “wrote nothing like a signature editorial column, nor did he venture his personal opinions, conscious always of the powers of colonial officials” (Robb 72). An approach to reportage he passed to his eldest son and long-term assistant, Robert (1795-1829), who later claimed The Sydney Gazette “reconciled in one sheet the merits of the London Gazette in upholding the Government and the London Times in defending the people” (Walker 10). The censorship imposed on The Sydney Gazette, by the Governor, was lifted in 1824 (P.M. Jones 40), when the Australian was first published without permission: Governor Thomas Brisbane did not intervene in the new enterprise. The appearance of unauthorised competition allowed Robert Howe to lobby for the removal of all censorship restrictions on The Sydney Gazette, though he was careful to cite “greater dispatch and earlier publication, not greater freedom of expression, as the expected benefit” (Walker 6). The sudden freedom was celebrated, and still appreciated many years after it was given:the Freedom of the Press has now been in existence amongst us on the verge of four years. In October 1824, we addressed a letter to the Colonial Government, fervently entreating that those shackles, under which the Press had long laboured, might be removed. Our prayer was attended to, and the Sydney Gazette, feeling itself suddenly introduced to a new state of existence, demonstrated to the Colonists the capabilities that ever must flow from the spontaneous exertions of Constitutional Liberty. (Sydney Gazette, “Freedom” 2)Early Readerships From the outset, George Howe presented a professional publication. The Sydney Gazette was formatted into three columns with the front page displaying a formal masthead featuring a scene of Sydney and the motto “Thus We Hope to Prosper”. Gwenda Robb argues the woodcut, the first produced in the colony, was carved by John W. Lewin who “had plenty of engraving skills” and had “returned to Sydney [from a voyage to Tahiti] in December 1802” (51) while Roger Butler has suggested that “circumstances point to John Austin who arrived in Sydney in 1800” as being the engraver (91). The printed text was as vital as the visual supports and every effort was made to present full accounts of colonial activities. “As well as shipping and court news, there were agricultural reports, religious homilies, literary extracts and even original poetry written by Howe himself” (Blair 450). These items, of course, sitting alongside key Government communications including General Orders and Proclamations.Howe’s language has been referred to as “florid” (Robb 52), “authoritative and yet filled with deference for all authority, pompous in a stiff, affected eighteenth century fashion” (Green 10) and so “some of Howe’s readers found the Sydney Gazette rather dull” (Blair 450). Regardless of any feelings towards authorial style, circulation – without an alternative – steadily increased with the first print run in 1802 being around 100 copies but by “the early 1820s, the newspaper’s production had grown to 300 or 400 copies” (Blair 450).In a reflection of the increasing sophistication of the Sydney-based reader, George Howe, and Robert Howe, would also publish some significant, stand-alone, texts. These included several firsts: the first natural history book printed in the colony, Birds of New South Wales with their Natural History (1813) by John W. Lewin (praised as a text “printed with an elegant and classical simplicity which makes it the highest typographical achievement of George Howe” [Wantrup 278]); the first collection of poetry published in the colony First Fruits of Australian Poetry (1819) by Barron Field; the first collection of poetry written by a Australian-born author, Wild Notes from the Lyre of a Native Minstrel (1826) by Charles Tompson; and the first children’s book A Mother’s Offering to Her Children: By a Lady, Long Resident in New South Wales (1841) by Charlotte Barton. The small concern also published mundane items such as almanacs and receipt books for the Bank of New South Wales (Robb 63, 72). All against the backdrop of printing a newspaper.New Voices The Sydney Gazette was Australia’s first newspaper and, critically for Howe, the only newspaper for over two decades. (A second paper appeared in 1810 but the Derwent Star and Van Diemen’s Land Intelligencer, which only managed twelve issues, presented no threat to The Sydney Gazette.) No genuine, local rival entered the field until 1824, when the Australian was founded by barristers William Charles Wentworth and Robert Wardell. The Monitor debuted in 1826, followed the Sydney Herald in 1831 and the Colonist in 1835 (P.M. Jones 38). It was the second title, the Australian, with a policy that asserted articles to be: “Independent, yet consistent – free, yet not licentious – equally unmoved by favours and by fear” (Walker 6), radically changed the newspaper landscape. The new paper made “a strong point of its independence from government control” triggering a period in which colonial newspapers “became enmeshed with local politics” (Blair 451). This new age of opinion reflected how fast the colony was evolving from an antipodean gaol into a complex society. Also, two papers, without censorship restrictions, without registration, stamp duties or advertisement duties meant, as pointed out by R.B. Walker, that “in point of law the Press in the remote gaol of exile was now freer than in the country of origin” (6). An outcome George Howe could not have predicted as he made the long journey, as a convict, to New South Wales. Of the early competitors, the only one that survives is the Sydney Herald (The Sydney Morning Herald from 1842), which – founded by immigrants Alfred Stephens, Frederick Stokes and William McGarvie – claims the title of Australia’s oldest continuously published newspaper (Isaacs and Kirkpatrick 4-5). That such a small population, with so many pressing issues, factions and political machinations, could support a first newspaper, then competitors, is a testament to the high regard, with which newspaper reportage was held. Another intruder would be The Government Gazette. Containing only orders and notices in the style of the London Gazette (McLeay 1), lacking any news items or private advertisements (Walker 19), it was first issued on 7 March 1832 (and continues, in an online format, today). Of course, Government orders and other notices had news value and newspaper proprietors could bid for exclusive rights to produce these notices until a new Government Printer was appointed in 1841 (Walker 20).Conclusion George Howe, an advocate of “reason and common sense” died in 1821 placing The Sydney Gazette in the hands of his son who “fostered religion” (Byrnes 557-559). Robert Howe, served as editor, experiencing firsthand the perils and stresses of publishing, until he drowned in a boating accident in Sydney Harbour, in 1829 leaving the paper to his widow Ann Howe (Blair 450-51). The newspaper would become increasingly political leading to controversy and financial instability; after more changes in ownership and in editorial responsibility, The Sydney Gazette, after almost four decades of delivering the news – as a sole voice and then as one of several alternative voices – ceased publication in 1842. During a life littered with personal tragedy, George Howe laid the foundation stone for Australia’s media empires. His efforts, in extraordinary circumstances and against all environmental indicators, serve as inspiration to newspapers editors, proprietors and readers across the country. He established the Australian press, an institution that has been described asa profession, an art, a craft, a business, a quasi-public, privately owned institution. It is full of grandeurs and faults, sublimities and pettinesses. It is courageous and timid. It is fallible. It is indispensable to the successful on-going of a free people. (Holden 15)George Howe also created an artefact of great beauty. The attributes of The Sydney Gazette are listed, in a perfunctory manner, in most discussions of the newspaper’s history. The size of the paper. The number of columns. The masthead. The changes seen across 4,503 issues. Yet, consistently overlooked, is how, as an object, the newspaper is an exquisite example of the printed word. There is a physicality to the paper that is in sharp contrast to contemporary examples of broadsides, tabloids and online publications. Concurrently fragile and robust: its translucent sheets and mottled print revealing, starkly, the problems with paper and ink; yet it survives, in several collections, over two centuries since the first issue was produced. The elegant layout, the glow of the paper, the subtle crackling sound as the pages are turned. The Sydney Gazette and New South Wales Advertiser is an astonishing example of innovation and perseverance. It provides essential insights into Australia’s colonial era. It is a metonym for making words matter. AcknowledgementsThe author offers her sincere thanks to Geoff Barker, Simon Dwyer and Peter Kirkpatrick for their comments on an early draft of this paper. The author is also grateful to Bridget Griffen-Foley for engaging in many conversations about Australian newspapers. ReferencesBlair, S.J. “Sydney Gazette and New South Wales Advertiser.” A Companion to the Australian Media. Ed. Bridget Griffen-Foley. North Melbourne: Australian Scholarly Publishing, 2014.Butler, Roger. Printed Images in Colonial Australia 1801-1901. Canberra: National Gallery of Australia, 2007.Byrnes, J.V. “Howe, George (1769–1821).” Australian Dictionary of Biography, National Centre of Biography: 1788–1850, A–H. Canberra: Australian National University, 1966. 557-559. Ferguson, J.A. “Introduction.” The Sydney Gazette and New South Wales Advertiser: A Facsimile Reproduction of Volume One, March 5, 1803 to February 26, 1804. Sydney: The Trustees of the Public Library of New South Wales in Association with Angus & Robertson, 1963. v-x. Foyster, Elizabeth. “Introduction: Newspaper Reporting of Crime and Justice.” Continuity and Change 22.1 (2007): 9-12.Goff, Victoria. “Convicts and Clerics: Their Roles in the Infancy of the Press in Sydney, 1803-1840.” Media History 4.2 (1998): 101-120.Green, H.M. “Australia’s First Newspaper.” Sydney Morning Herald, 11 Apr. 1935: 10.Holden, W. Sprague. Australia Goes to Press. Detroit: Wayne State UP, 1961. “Hughes, George (?–?).” Australian Dictionary of Biography, National Centre of Biography: 1788–1850, A–H. Canberra: Australian National University, 1966. 562. Isaacs, Victor, and Rod Kirkpatrick. Two Hundred Years of Sydney Newspapers. Richmond: Rural Press, 2003. Jones, Dorothy. “Humour and Satire (Australia).” Encyclopedia of Post-Colonial Literatures in English. 2nd ed. Eds. Eugene Benson and L.W. Conolly. London: Routledge, 2005. 690-692.Jones, Phyllis Mander. “Australia’s First Newspaper.” Meanjin 12.1 (1953): 35-46. Karskens, Grace. The Colony: A History of Early Sydney. Crows Nest: Allen & Unwin, 2010. King, Philip Gidley. “Letter to Lord Hobart, 9 May 1803.” Historical Records of Australia, Series 1, Governors’ Despatches to and from England, Volume IV, 1803-1804. Ed. Frederick Watson. Sydney: Library Committee of the Commonwealth Parliament, 1915.Kirkpatrick, Rod. Press Timeline: 1802 – 1850. Canberra: National Library of Australia, 2011. 6 Jan. 2017 <https://www.nla.gov.au/content/press-timeline-1802-1850>. McLeay, Alexander. “Government Notice.” The New South Wales Government Gazette 1 (1832): 1. Mundle, R. Bligh: Master Mariner. Sydney: Hachette, 2016.New South Wales General Standing Orders and General Orders: Selected from the General Orders Issued by Former Governors, from the 16th of February, 1791, to the 6th of September, 1800. Also, General Orders Issued by Governor King, from the 28th of September, 1800, to the 30th of September, 1802. Sydney: Government Press, 1802. Robb, Gwenda. George Howe: Australia’s First Publisher. Kew: Australian Scholarly Publishing, 2003.Spalding, D.A. Collecting Australian Books: Notes for Beginners. 1981. Mawson: D.A. Spalding, 1982. The Sydney Gazette and New South Wales Advertiser. “Address.” 5 Mar. 1803: 1.———. “To the Public.” 2 Apr. 1803: 1.———. “Wanted to Purchase.” 26 June 1803: 4.———. “We Have the Satisfaction to Inform Our Readers.” 3 Nov. 1810: 2. ———. “Sydney Gazette.” 25 Dec. 1819: 1. ———. “The Freedom of the Press.” 29 Feb. 1828: 2.———. “Never Did a More Painful Task Devolve upon a Public Writer.” 3 Feb. 1829: 2. Walker, R.B. The Newspaper Press in New South Wales, 1803-1920. Sydney: Sydney UP, 1976.Wantrup, Johnathan. Australian Rare Books: 1788-1900. Sydney: Hordern House, 1987.

The difficulty of reading Allen Ginsberg's poetry is a recurring theme in criticism of his work and that of other post-WWII "Beat Generation" writers. "Even when a concerted effort is made to illuminate [Beat] literature," laments Nancy M. Grace, "doing so is difficult: the romance of the Beat life threatens to subsume the project" (812). Of course, the Beat life is romantic to the extent that it is romantically regaled. Continual romantic portrayals, such as that of Ginsberg in the recent movie Howl (2010), rekindle the Beat romance for new audiences with chicken-and-egg circularity. I explore this difficulty of reading Ginsberg that Grace and other critics identify by articulating it with respect to "Kaddish"—"Ginsberg's most highly praised and his least typical poem" (Perloff 213)—as a difficulty of interpreting Ginsberg suspiciously. Philosopher Paul Ricoeur's theories of interpretation—or "hermeneutics"—provide the theoretical foundation here. Ricoeur distinguishes between a romantic or "restorative" mode of interpretation, where meaning is reverently reconciled to a text assumed to be trustworthy, and a "suspicious" approach, where meaning is aggressively extrapolated from a text held as unreliable. In order to bring these theories to bear on "Kaddish" and its criticism, I draw on Rita Felski's pioneering work in relating Ricoeur's concept of "suspicious reading" to the field of literature. Is it possible to read "Kaddish" suspiciously? Or is there nothing left for suspicious readers to expose in texts such as "Kaddish" that are already self-exposing? In "Kaddish," Ginsberg tells the story of his mother Naomi Ginsberg, a Russian Jewish immigrant, who died in a mental hospital in 1956. It is a lengthy prose poem and spans a remarkable 19 pages in Ginsberg's Collected Poems (1984). In the words of Maeera Y. Shreiber, "Kaddish" "is a massive achievement, comprised of five numbered parts, and an interpellated 'Hymmnn' between parts two and three" (84). I focus on the second narrative part, which forms the bulk of the poem, where the speaker—I shall refer to him henceforth as "Allen" in order to differentiate between Ginsberg's poetic self-representation and Ginsberg-the-author—recounts the nervous breakdowns and hospital movements of his mother, whom he calls by her first name, Naomi. I begin by illustrating the ways in which Allen focalises Naomi in the text, and suggest that his attempts to "read" her suspicious mind alternate between restorative and suspicious impulses. I then take up the issue of reading "Kaddish" suspiciously. Acknowledging Ricoeur's assertion that psychoanalysis is an unequivocal "school of suspicion" (32), I consider James Breslin's psychoanalytic criticism on "Kaddish," in particular, his reading of what is easily the most contentious passage in the poem: the scene where Naomi solicits Allen for sex. I regard this passage as a microcosm of the issues that beset a suspicious reading of "Kaddish"—such as the problem posed by the self-exposing poem and poet—and I find that Breslin's response to it raises interesting questions on the politics of psychoanalysis and the nature of suspicious interpretation. Finally, I identify an unpublished thesis on Ginsberg's poetry by Sarah Macfarlane and classify her interpretation of "Kaddish" as unambiguously suspicious. My purpose is not to advance my own suspicious reading of "Kaddish" but to highlight the difficulties of reading "Kaddish" suspiciously. I argue that while it is difficult to read "Kaddish" suspiciously, to do so offers a fruitful counterbalance to the dominant restorative criticism on the poem. There are as yet unexplored hermeneutical territories in and around this poem, indeed in and around Ginsberg's work in general, which have radical implications for the future direction of Beat studies. Picking her tooth with her nail, lips formed an O, suspicion—thought's old worn vagina— (Ginsberg, "Kaddish" 218)Ginsberg constructs Naomi's suspicion in "Kaddish" via Allen's communication of her visions and descriptions of her behaviour. Allen relates, for example, that Naomi once suspected that Hitler was "in her room" and that "she saw his mustache in the sink" ("Kaddish" 220). Subsequently, Allen depicts Naomi "listening to the radio for spies—or searching the windowsill," and, in an attempt to "read" her suspicious mind, suggests that she envisages "an old man creep[ing] with his bag stuffing packages of garbage in his hanging black overcoat" ("Kaddish" 220). Allen's gaze thus filters Naomi's; he watches her as she watches for spies, and he animates her visions. He recalls as a child "watching over" Naomi in order to anticipate her "next move" ("Kaddish" 212). On one fateful day, Naomi "stared out the window on the Broadway Church corner"; Allen interprets that she "spied a mystical assassin from Newark" ("Kaddish" 212). He likewise observes and interprets Naomi's body language and facial expressions. When she "covered [her] nose with [a] motheaten fur collar" and "shuddered at [the] face" of a bus driver, he deduces that, for Naomi, the collar must have been a "gas mask against poison" and the driver "a member of the gang" ("Kaddish" 212). On the one hand, Allen's impetus to recover "the lost Naomi" ("Kaddish" 216)—first lost to mental illness and then to death—may be likened to Ricoeur's concept of a restorative hermeneutic, "which is driven by a sense of reverence and goes deeper into the text in search of revelation" (Felski 216). As if Naomi's mind constitutes a text, Allen strives to reveal it in order to make it intelligible. What drives him is the cathartic impulse to revivify his mother's memory, to rebuild her story, and to exalt her as "magnificent" and "mourned no more" ("Kaddish" 212), so that he may mourn no more. Like a restorative reader "driven by a sense of reverence" (Felski 216), he lauds Naomi as the "glorious muse that bore [him] from the womb [...] from whose pained head [he] first took Vision" ("Kaddish" 223). Critics of "Kaddish" also observe the poem's restorative impulse. In "Strange Prophecies Anew," Tony Trigilio reads the recovery of Naomi as "the recovery of a female principle of divinity" (773). Diverging from Ginsberg's earlier poem "Howl" (1956), which "represses signs of women in order to forge male prophetic comradeship," "Kaddish" "constructs maternity as a source of vision, an influence that precedes and sustains prophetic language. In 'Kaddish', Ginsberg attempts to recover the voice of his mother Naomi, which is muted in 'Howl'" (776). Shreiber also acknowledges Ginsberg's redemption of "the feminine, figured specifically as the lost mother," but for her it "is central to both of the long poems that make his reputation," namely "Kaddish" and "Howl" (81). She cites Ginsberg's retrospective confession that "Howl" was actually about Naomi to argue that, "it is in the course of writing 'Howl' that Ginsberg discovers his obligation to the elided (Jewish) mother—whose restoration is the central project of 'Kaddish'" (81). On the other hand, Allen's compulsion to "cut through" to Naomi, to talk to her as he "didn't when [she] had a mouth" ("Kaddish" 211), suggests the brutality of a suspicious hermeneutic where meanings "must be wrestled rather than gleaned from the page, derived not from what the text says, but in spite of what it says" (Felski 223). When Naomi was alive and "had a mouth," Allen aggressively "pushed her against the door and shouted 'DON'T KICK ELANOR!'" in spite of her message: "Elanor is the worst spy! She's taking orders!" ("Kaddish" 221). As a suspicious reader wrestles with a resistant text, Allen wrestles with Naomi, "yelling at her" in exasperation, and even "banging against her head which saw Radios, Sticks, Hitlers—the whole gamut of Hallucinations—for real—her own universe" ("Kaddish" 221).Allen may be also seen as approaching Naomi with a suspicious reader's "adversarial sensibility to probe for concealed, repressed, or disavowed meanings" (Felski 216). This is most visible in his facetiously professed "good idea to try [to] know the Monster of the Beginning Womb"—to penetrate Naomi's body in order to access her mind "that way" ("Kaddish" 219). Accordingly, in his psychoanalytic reading of "Kaddish," James Breslin understands Allen's "incestuous desires as expressing [his] wish to get inside his mother and see things as she does" (424). Breslin's interpretation invokes the Freudian concept of "epistemophilia," which Bran Nicol defines as the "desire to know" (48).Freud is one of "three masters" of suspicion according to Ricoeur (32). Freud, Nietzsche, and Marx "present the most radically contrary stance to the phenomenology of the sacred and to any hermeneutics understood as the recollection of meaning" (Ricoeur 35). They "begin with suspicion concerning the illusions of consciousness, and then proceed to employ the stratagem of deciphering" (Ricoeur 34). Freud deciphers the language of the conscious mind in order to access the "unconscious"—that "part of the mind beyond consciousness which nevertheless has a strong influence upon our actions" (Barry 96). Like their therapeutic counterparts, psychoanalytic critics distinguish "between the conscious and the unconscious mind," associating a text's "'overt' content with the former" and "'covert' content with the latter, privileging the latter as being what the work is 'really' about" (Barry 105). In seeking to expose a text's unconscious, they subscribe to a hermeneutic of suspicion's "conviction that appearances are deceptive, that texts do not gracefully relinquish their meanings" (Felski 216). To force texts to relinquish their meanings suspicious readers bear "distance rather than closeness; guardedness rather than openness; aggression rather than submission; superiority rather than reverence; attentiveness rather than distraction; exposure rather than tact" (Felski 222).For the most part, these qualities fail to characterise Breslin's psychoanalytic criticism on "Kaddish" and "Howl." Far from aggressive or superior, Breslin is a highly sympathetic reader of Ginsberg. "Many readers," he complains, are "still not sympathetic to the kind [sic] of form found in these poems" (403). His words echo Trigilio's endorsement of Marjorie Perloff's opinion that critics are too often "unwilling to engage the experimental scope of Ginsberg's poems" (Trigilio 774). Sympathetic reading, however, clashes with suspicious reading, which "involves a sense of vigilant preparedness for attack" (Shand in Felski 220). Breslin is sympathetic not only to the experimental forms of "Kaddish" and "Howl," but also to their attestation to "deep, long-standing private conflicts in Ginsberg—conflicts that ultimately stem from his ambivalent attachment to his mother" (403). In "Kaddish," Allen's ambivalent feelings toward his mother are conspicuous in his revolted and revolting reaction to her exposed body, combined with his blasé deliberation on whether to respond to her apparent sexual provocation: One time I thought she was trying to make me come lay her—flirting to herself at sink—lay back on huge bed that filled most of the room, dress up round her hips, big slash of hair, scars of operations, pancreas, belly wounds, abortions, appendix, stitching of incisions pulling down in the fat like hideous thick zippers—ragged long lips between her legs—What, even, smell of asshole? I was cold—later revolted a little, not much—seemed perhaps a good idea to try—know the Monster of the Beginning Womb—Perhaps—that way. Would she care? She needs a lover. ("Kaddish" 219)In "Confessing the Body," Elizabeth Gregory observes that "Naomi's ordinary body becomes monstrous in this description—not only in its details but in the undiscriminating desire her son attributes to it ('Would she care?')" (47). In exposing Naomi thus, Allen also exposes himself and his own indiscriminate sexual responsiveness. Such textual exposés pose challenges for those who would practice a hermeneutic of suspicion by "reading texts against the grain to expose their repressed or hidden meanings" (Felski 215). It appears that there is little that is hidden or repressed in "Kaddish" for a suspicious reader to expose. As Perloff notes, "the Ginsberg of 'Kaddish' is writing somewhat against the grain" (213). In writing against the grain, Ginsberg inhibits reading against the grain. A hermeneutic of suspicion holds "that manifest content shrouds darker, more unpalatable truths" (Felski 216). "Kaddish," however, parades its unpalatable truths. Although Ginsberg as a Beat poet is not technically included among the group of poets known as the "confessionals," "Kaddish" is typical of a "confessional poem" in that it "dwells on experiences generally prohibited expression by social convention: mental illness, intra-familial conflicts and resentments, childhood traumas, sexual transgressions and intimate feelings about one's body" (Gregory 34). There is a sense in which "we do not need to be suspicious" of such subversive texts because they are "already doing the work of suspicion for us" (Felski 217). It is also difficult to read "Kaddish" suspiciously because it presents itself as an autobiographical history of Ginsberg's relationship with his mother. "Kaddish" once again accords with Gregory's definition of "confessional poetry" as that which "draws on the poet's autobiography and is usually set in the first person. It makes a claim to forego personae and to represent an account of the poet's own feelings and circumstances" (34). These defining features of "Kaddish" make it not particularly conducive to a "suspicious hermeneutic [that] often professes a lack of interest in the category of authorship as a means of explaining the ideological workings of texts" (Felski 222). It requires considerable effort to distinguish Allen, speaker and character in "Kaddish," from Ginsberg, celebrity Beat poet and author of "Kaddish," and to suspend knowledge of Ginsberg's public-private life in order to pry ideologies from the text. This difficulty of resisting biographical interpretation of "Kaddish" translates to a difficulty of reading the poem suspiciously. In his psychoanalytic reading, Breslin's lack of suspicion for the poem's confession of autobiography dilutes his practice of an inherently suspicious mode of interpretation—that of psychoanalysis. His psychoanalysis of Ginsberg shows that he trusts "Kaddish" to confess its author's intimate feelings—"'It's my fault,' he must have felt, 'if I had loved my mother more, this wouldn't have happened to her—and to me'" (Breslin 422)—whereas a hermeneutic of suspicion "adopts a distrustful attitude toward texts" (Felski 216). That said, Breslin's differentiation between the conscious and unconscious, or surface and underlying levels of meaning in "Kaddish" is more clearly characteristic of a hermeneutic of suspicion's theory that texts withhold "meanings or implications that are not intended and that remain inaccessible to their authors as well as to ordinary readers" (Felski 216). Hence, Breslin speculates that, "on an unconscious level the writing of the poem may have been an act of private communication between the poet" and his mother (430). His response to the previously quoted passage of the poem suggests that while a cursory glance will restore its conscious meaning, a more attentive or suspicious gaze will uncover its unconscious: At first glance this passage seems a daring revelation of an incest wish and a shockingly realistic description of the mother's body. But what we really see here is how one post-Freudian writer, pretending to be open and at ease about incestuous desire, affects sophisticated awareness as a defense [sic] against intense longings and anxieties. The lines are charged with feelings that the poet, far from "confessing out," appears eager to deny. (Breslin 422; my emphasis)Breslin's temporary suspicious gaze in an otherwise trusting and sympathetic reading accuses the poet of revealing incestuous desire paradoxically in order to conceal incestuous desire. It exposes the exposé as an ironic guise, an attempt at subterfuge that the poet fails to conceal from the suspicious reader, evoking a hermeneutic of suspicion's conviction that in spite of itself "the text is not fully in control of its own discourse" (Felski 223). Breslin's view of Ginsberg's denial through the veil of his confession illuminates two possible ways of sustaining a suspicious reading of "Kaddish." One is to distrust its claim to confess Ginsberg, to recognise that "confession's reality claim is an extremely artful manipulation of the materials of poetry, not a departure from them" (Gregory 34). It is worth mentioning that in response to his interviewer's perception of the "absolute honesty" in his poem "Ego Confession," Ginsberg commented: "they're all poems, ultimately" (Spontaneous 404–05). Another way is to resist the double seduction operative in the text: Naomi's attempted seduction of Allen, and, in narrating it, Allen's attempted seduction of the psychoanalytic critic.Sarah Macfarlane's effort to unmask the gender politics that psychoanalytic critics arguably protect characterises her "socio-cultural analysis" (5) of "Kaddish" as unmistakably suspicious. While psychoanalytic critics "identify a 'psychic' context for the literary work, at the expense of social or historical context" (Barry 105), Macfarlane in her thesis "Masculinity and the Politics of Gender Construction in Allen Ginsberg" locates Allen's "perception of Naomi as the 'Monster of the Beginning Womb'" in the social and historical context of the 1950s "concept of the overbearing, dominating wife and mother who, although confined to the domestic space, looms large and threatening within that space" (48). In so doing, she draws attention to the Cold War discourse of "momism," which "envisioned American society as a matriarchy in which dominant mothers disrupted the Oedipal structure of the middle-class nuclear family" (Macfarlane 33). In other words, momism engaged Freudian explanations of male homosexuality as arising from a son's failure to resolve unconscious sexual desire for his mother, and blamed mothers for this failure and its socio-political ramifications, which, via the Cold War cultural association of homosexuality with communism, included "the weakening of masculine resolve against Communism" (Edelman 567). Since psychoanalysis effectively colludes with momism, psychoanalytic criticism on "Kaddish" is unable to expose its perpetuation in the poem. Macfarlane's suspicious reading of "Kaddish" as perpetuating momism radically departs from the dominant restorative criticism on the poem. Trigilio, for example, argues that "Kaddish" revises the Cold War "discourse of containment—'momism'—in which the exposure of communists was equated to the exposure of homosexuals" (781). "Kaddish," he claims, (which exposes both Allen's homosexuality and Naomi's communism), "does not portray internal collapse—as nationalist equations of homosexual and communist 'threats' would predict—but instead produces […] a 'Blessed' poet who 'builds Heaven in Darkness'" (782). Nonetheless, this blessed poet wails, "I am unmarried, I'm hymnless, I'm Heavenless" ("Kaddish" 212), and confesses his homosexuality as an overwhelming burden: "a mortal avalanche, whole mountains of homosexuality, Matterhorns of cock, Grand Canyons of asshole—weight on my melancholy head"("Kaddish" 214). In "Confessing the Body," Gregory asks whether confessional poetry "disclose[s] secrets in order to repent of them, thus reinforcing the initial negative judgement that kept them secret," or "to decathect that judgement" (35). While Allen's confession of homosexuality exudes exhilaration and depression, not guilt—Ginsberg critic Anne Hartman is surely right that "in the context of [the 1950s] public rituals of confession and repentance engendered by McCarthyism, […] poetic confession would carry a very different set of implications for a gay poet" (47)—it is pertinent to question his confession of Naomi. Does he expose Naomi in order to applaud or condemn her maternal transgressions? According to the logic of the Cold War "urge to unveil, [which] produces greater containment" (Trigilio 794), Allen's unveiling of Naomi veils his desire to contain her, unable as she is "to be contained within the 1950's [sic] domestic ideal of womanhood" (Macfarlane 44). "Ginsberg has become such a public issue that it's difficult now to read him naturally; you ask yourself after every line, am I for him or against him. And by and large that's the criticism he has gotten—votes on a public issue. (I see this has been one of those reviews.)" (Shapiro 90). Harvey Shapiro's review of Kaddish and Other Poems (1961) in which "Kaddish" first appeared illuminates the polarising effect of Ginsberg's celebrity on interpretations of his poetry. While sympathetic readings and romantic portrayals are themselves reactions to the "hostility to Ginsberg" that prevails (Perloff 223), often they do not sprout the intellectual vigour and fresh perspectives that a hermeneutic of suspicion has the capacity to sow. Yet it is difficult to read confessional texts such as "Kaddish" suspiciously; they appear to expose themselves without need of a suspicious reader. Readers of "Kaddish" such as Breslin are seduced into sympathetic biographical-psychoanalytical interpretations due to the poem's purported confession of Ginsberg's autobiography. As John Osborne argues, "the canon of Beat literature has been falsely founded on biographical rather than literary criteria" (4). The result is that "we are for the immediate future obliged to adopt adversarial reading strategies if we are to avoid entrenching an already stale orthodoxy" (Osborne 4). Macfarlane obliges in her thesis; she succeeds in reading "Kaddish" suspiciously by resisting its self-inscribed psychoanalysis to expose the gender politics of Allen's exposés. While Allen's confession of his homosexuality suggests that "Kaddish" subverts a heterosexist model of masculinity, a suspicious reading of his exposure of Naomi's maternal transgressions suggests that the poem contributes to momism and perpetuates a sexist model of femininity. Even so, a suspicious reading of a text such as "Kaddish" "contains a tacit tribute to its object, an admission that it contains more than meets the eye" (Felski 230). Ginsberg's own prophetic words bespeak as much:The worst I fear, considering the shallowness of opinion, is that some of the poetry and prose may be taken too familiarly, […] and be given the same shallow treatment, this time sympathetic, as, until recently, they were given shallow unsympathy. That would be the very we of fame. (Ginsberg, Deliberate 252)ReferencesBarry, Peter. Beginning Theory: An Introduction to Literary and Cultural Theory. 2nd ed. Manchester: Manchester UP, 2002. Breslin, James. "The Origins of 'Howl' and 'Kaddish.'" On the Poetry of Allen Ginsberg. Ed. Lewis Hyde. Ann Arbor: U of Michigan P, 1984. 401–33.Edelman, Lee. "Tearooms and Sympathy, or, The Epistemology of the Water Closet." The Lesbian and Gay Studies Reader. Ed. Henry Abelove, Michèle Aina Barale, and David M. Halperin. New York: Routledge, 1993. 553–74.Felski, Rita. "Suspicious Minds." Poetics Today 32.2 (2011): 215–34. Ginsberg, Allen. Deliberate Prose: Selected Essays 1952-1995. Ed. Bill Morgan. 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Shreiber, Maeera Y. "'You Still Haven't Finished with Your Mother': The Gendered Poetics of Charles Reznikoff and Allen Ginsberg." Singing in a Strange Land: A Jewish American Poetics. Stanford: Stanford UP, 2007. 46–97.Trigilio, Tony. "'Strange Prophecies Anew': Rethinking the Politics of Matter and Spirit in Ginsberg's Kaddish." American Literature 71.4 (1999): 773–95.