Books on the topic 'Lifetime costs'

The final chapter of this book, Chapter 20, goes beyond the two sets of variables that are considered within an economic evaluation: costs and outcomes. The issue here is how equity and fairness can be included in the decision-making process by allowing different threshold values for quality-adjusted life years depending on the distributive implications of healthcare programmes. The fundamental question is what type of inequality that policymakers would seek to reduce. Five equity principles in health are discussed, and compared using diagrams and numerical examples. These are equality in (1) future health, (2) future health losses, (3) the proportion of future health lost, (4) lifetime health losses, and (5) lifetime health. While the debate on equity weighting generally involves arguments for accepting higher threshold values, the chapter ends with the contexts when lower threshold values would be appropriate, that is, being cost-effective does not imply that the programme should be publicly funded.

This chapter reviews recent contributions in positive and normative economics concerned with how individuals plan, over their uncertain lifetime, their consumption and health-affecting activities, and with the design of the optimal public policy in that context. The chapter first emphasizes that contemporary theories aimed at explaining how individuals plan their lives rely on unequal forms and degrees of rationality. On the normative side, it argues that there exists a tension between, on the one hand, optimal policies derived from a utilitarian social welfare function, and, on the other hand, optimal policies derived from an ex post egalitarian social welfare function. Actually, optimal policies under utilitarianism—encouraging savings, annuitization, and prevention—increase expected lifetime well-being, but at the cost of reducing the realized lifetime well-being of the unlucky short-lived, which raises inequalities in realized lifetime well-being.

In developed countries, the lifetime prevalence of kidney stones is around 10% and most commonly affects people in the working age-group. The incidence is increasing internationally. After passage of a first stone, the risk of recurrence is high. Direct and indirect costs involved in treating stones are considerable. Intrinsic risk factors include age, gender, genetics, and metabolic syndromes. The incidence of stone disease peaks between the ages of 20 and 60 years. While historically the male to female ratio was around 3:1, the gender gap is closing. The reasons for increased incidence are due in part to increased detection through better imaging but also due to environmental factors (e.g. diet, obesity, diabetes, dehydration) which put more people with an underlying genetic predisposition at risk. Despite the increasing prevalence of kidney stones, the majority are categorized as idiopathic.

Major depressive disorder is a serious, debilitating, life-shortening illness that affects many persons of all ages and backgrounds. The point prevalence is high (2.3%–3.2% in men, 4.5%–9.3% in women) and the lifetime risk is 7% to 12% for men and 20% to 25% for women. Major depression is a disabling disorder that costs the United States over $200 billion per year in direct and indirect costs. Depression also has detrimental effects on all aspects of social functioning, such as self-care, social role, and family life, including household, marital, kinship, and parental roles. While there have been several treatments that are efficacious, many individuals suffering from depression experience life-long challenges due to the often chronic and episodic nature of the disease. Identifying strategies to find the right treatments for the right patients is critical. Ongoing research has explored the importance of examining physiologic biomarkers as well as clinical characteristics to gain a better understanding of subtypes of depression, which will lead to improved treatments and better outcomes. This book provides an introduction to the etiology and pathophysiology of depression, common comorbidities and differential diagnoses, pharmacotherapy strategies, psychotherapeutic and neuromodulation interventions, novel and nontraditional treatment strategies, and considerations in special populations.

This chapter addresses the interrelated topics of OCD epidemiology, comorbidity, and disease burden. Obsessive-compulsive disorder (OCD) is a frequent condition, especially if subthreshold manifestations are considered. Epidemiological surveys describe current and lifetime prevalence rates of full-blown OCD around 1% and 2.5%, respectively. Subthreshold symptoms occur in up to a third of the general population. Comorbidity is the rule in OCD, which increases the complexity, severity, distress, chronicity, and negative impact of the disorder. Comorbidity may influence the search for, adherence with, and response to treatment. OCD entails significant costs to society, both illness related and care/treatment related. Epidemiological surveys show that only a minority of individuals with OCD are receiving treatment. Recognition and treatment of OCD is often delayed for many years, increasing the morbidity and the burden of sufferers, family members, and society. Increasing public awareness, professional recognition, and access to treatment is an urgent clinical and public health need.

Almost one-third of adult Americans will have an anxiety disorder in their lifetime, with enormous personal, societal, and financial costs. Among the most disabling of these disorders are post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social anxiety disorder, generalized anxiety disorder, and panic disorder. Although there are evidence-based treatments for these disorders, as many as 50% of patients do not respond, and there is a considerable need for new therapies. This chapter proposes that the excessive generalization seen in patients with pathological anxiety is due to impaired hippocampal functioning, specifically a deficit in the neural process of pattern separation, which relies upon the dentate gyrus and is sensitive to neurogenesis. Preclinical findings indicate that stimulating DG neurogenesis improves pattern separation and reduces anxiety behaviors in mice. As a result the authors hypothesize that pharmacological or environmental manipulations aimed at stimulating neurogenesis will be beneficial for the treatment of anxiety disorders.

Urinary bladder cancer (UBC) ranks ninth in worldwide cancer incidence. The most common histological type in Western countries is transitional cell carcinoma (TCC), while in Africa, a substantial proportion of squamous cell carcinomas (SCC) are observed related to the prevalence of infection with Schistosoma haematobium (bilharziasis). UBC has the highest per-patient lifetime cost for cancer in terms of healthcare expenditure compared to all other types of cancer. It is more frequent in men than in women and age is now widely accepted as the greatest single risk factor for developing UBC. The median age at diagnosis is 70 years. Cigarette smoking and specific occupational exposures, such as carcinogenic dyes for painters, are the main known causes of UBC.

Rechargeable Energy Storage Technologies for Automotive Applications Abstract This paper provides an extended summary of the available relevant rechargeable energy storage electrode materials that can be used for hybrid, plugin and battery electric vehicles. The considered technologies are the existing lithium-ion batteries and the next generation technologies such as lithium sulfur, solid state, metal-air, high voltage materials, metalair and sodium based. This analysis gives a clear overview of the battery potential and characteristics in terms of energy, power, lifetime, cost and finally the technical hurdles. Inhalt Seite Vorwort 1 Alternative Energiespeicher – und Wandler S. Hävemeier, Neue Zelltechnologien und die Chance einer deutschen 3 M. Hackmann, Zellproduktion – Betrachtung von Technologie, Wirtschaft- R. Stanek lichkeit und dem Standort Deutschland N. Omar, Rechargeable Energy Storage Technologies for 7 R. Gopalakrishnan Automotive Applications – Present and Future ...

The use of non-prescription drugs is widespread and has a major impact on the health of the individual user and society. In 2006, the British Crime Survey reported that 10% of adults had used one or more illicit drugs in the preceding year, with 3% reporting using a Class A drug. Over 11 million people in the UK are estimated to have used an illicit drug at least once in their lifetime (35%). Drugs abused vary in their intrinsic potential to cause addiction and, with it, more regular and harmful use. Drug users are influenced by trends and fashions, adopting new compounds such as crack cocaine and experimenting with routes of ingestion. Some drugs may become less popular over time, such as LSD, while others, such as cannabis, experience a revival as more potent strains (e.g. Skunk) are developed. A problem drug user is best defined as a person whose drug taking is no longer controlled or undertaken for recreational purposes and where drugs have become a more essential element of the individual’s life. The true economic and social cost of drug use is likely to be substantially greater than the published figures, which are derived from a variety of health and crime surveys which may overlook vulnerable groups such as the homeless. The majority of non-prescription drugs used in the UK are illegal and covered by the Misuse of Drugs Act 1971. The drugs most commonly abused gave rise in 2003–4 to an estimated financial cost in England and Wales of 15.4 billion pounds to the economy, with Class A drugs such as heroin and cocaine accounting for the majority of this. Some 90% of the cost is due to drug-related crime, with only 3% (£488 million) due to health service expenditure, which is mainly spent on inpatient care episodes. This still represents a major health pressure, which in 2006–7 amounted to 38 000 admissions, in England, for primary and secondary drug-related mental or behavioural problems, and over 10 000 admissions recorded for drug poisoning. Clinicians in all specialities can expect to encounter harmful drug use, especially those working in primary care, A & E, and psychiatric services. Presenting problems are protean, ranging from mood disorders, delirium, and psychosis to sepsis, malnutrition, and hepatitis. Blood-borne infections such as hepatitis C and HIV are widespread, as contaminated needles and syringes are shared by up to a quarter of problem drug users. Even smoking drugs such as crack cocaine can lead to increased transmission of hepatitis C through oral ulceration and contact with hot contaminated smoking pipes. Amongst the UK population, over half of IV drug users have hepatitis C, a quarter have antibodies to hepatitis B, and, by 2006, 4662 had been diagnosed with HIV. Non-prescription drug abuse is a leading cause of death and morbidity amongst the young adult population (those aged 16–35). In 2006 there were 1573 deaths where the underlying cause was poisoning, drug abuse, or dependence on substances controlled under the Misuse of Drugs Act. The vast majority (79%) were male. Young men, in particular, are at greater risk of violent death through associated criminal activity such as drug supplying and from deliberate and accidental overdose. The male-to-female ratio for deaths associated with mental and behavioural disorder is 6:1.

Nationalism: Past as Prologue began as a single volume being compiled by Ad Akande, a scholar from South Africa, who proposed it to me as co-author about two years ago. The original idea was to examine how the damaging roots of nationalism have been corroding political systems around the world, and creating dangerous obstacles for necessary international cooperation. Since I (Bruce E. Johansen) has written profusely about climate change (global warming, a.k.a. infrared forcing), I suggested a concerted effort in that direction. This is a worldwide existential threat that affects every living thing on Earth. It often compounds upon itself, so delays in reducing emissions of fossil fuels are shortening the amount of time remaining to eliminate the use of fossil fuels to preserve a livable planet. Nationalism often impedes solutions to this problem (among many others), as nations place their singular needs above the common good. Our initial proposal got around, and abstracts on many subjects arrived. Within a few weeks, we had enough good material for a 100,000-word book. The book then fattened to two moderate volumes and then to four two very hefty tomes. We tried several different titles as good submissions swelled. We also discovered that our best contributors were experts in their fields, which ranged the world. We settled on three stand-alone books:” 1/ nationalism and racial justice. Our first volume grew as the growth of Black Lives Matter following the brutal killing of George Floyd ignited protests over police brutality and other issues during 2020, following the police assassination of Floyd in Minneapolis. It is estimated that more people took part in protests of police brutality during the summer of 2020 than any other series of marches in United States history. This includes upheavals during the 1960s over racial issues and against the war in Southeast Asia (notably Vietnam). We choose a volume on racism because it is one of nationalism’s main motive forces. This volume provides a worldwide array of work on nationalism’s growth in various countries, usually by authors residing in them, or in the United States with ethnic ties to the nation being examined, often recent immigrants to the United States from them. Our roster of contributors comprises a small United Nations of insightful, well-written research and commentary from Indonesia, New Zealand, Australia, China, India, South Africa, France, Portugal, Estonia, Hungary, Russia, Poland, Kazakhstan, Georgia, and the United States. Volume 2 (this one) describes and analyzes nationalism, by country, around the world, except for the United States; and 3/material directly related to President Donald Trump, and the United States. The first volume is under consideration at the Texas A & M University Press. The other two are under contract to Nova Science Publishers (which includes social sciences). These three volumes may be used individually or as a set. Environmental material is taken up in appropriate places in each of the three books. * * * * * What became the United States of America has been strongly nationalist since the English of present-day Massachusetts and Jamestown first hit North America’s eastern shores. The country propelled itself across North America with the self-serving ideology of “manifest destiny” for four centuries before Donald Trump came along. Anyone who believes that a Trumpian affection for deportation of “illegals” is a new thing ought to take a look at immigration and deportation statistics in Adam Goodman’s The Deportation Machine: America’s Long History of Deporting Immigrants (Princeton University Press, 2020). Between 1920 and 2018, the United States deported 56.3 million people, compared with 51.7 million who were granted legal immigration status during the same dates. Nearly nine of ten deportees were Mexican (Nolan, 2020, 83). This kind of nationalism, has become an assassin of democracy as well as an impediment to solving global problems. Paul Krugman wrote in the New York Times (2019:A-25): that “In their 2018 book, How Democracies Die, the political scientists Steven Levitsky and Daniel Ziblatt documented how this process has played out in many countries, from Vladimir Putin’s Russia, to Recep Erdogan’s Turkey, to Viktor Orban’s Hungary. Add to these India’s Narendra Modi, China’s Xi Jinping, and the United States’ Donald Trump, among others. Bit by bit, the guardrails of democracy have been torn down, as institutions meant to serve the public became tools of ruling parties and self-serving ideologies, weaponized to punish and intimidate opposition parties’ opponents. On paper, these countries are still democracies; in practice, they have become one-party regimes….And it’s happening here [the United States] as we speak. If you are not worried about the future of American democracy, you aren’t paying attention” (Krugmam, 2019, A-25). We are reminded continuously that the late Carl Sagan, one of our most insightful scientific public intellectuals, had an interesting theory about highly developed civilizations. Given the number of stars and planets that must exist in the vast reaches of the universe, he said, there must be other highly developed and organized forms of life. Distance may keep us from making physical contact, but Sagan said that another reason we may never be on speaking terms with another intelligent race is (judging from our own example) could be their penchant for destroying themselves in relatively short order after reaching technological complexity. This book’s chapters, introduction, and conclusion examine the worldwide rise of partisan nationalism and the damage it has wrought on the worldwide pursuit of solutions for issues requiring worldwide scope, such scientific co-operation public health and others, mixing analysis of both. We use both historical description and analysis. This analysis concludes with a description of why we must avoid the isolating nature of nationalism that isolates people and encourages separation if we are to deal with issues of world-wide concern, and to maintain a sustainable, survivable Earth, placing the dominant political movement of our time against the Earth’s existential crises. Our contributors, all experts in their fields, each have assumed responsibility for a country, or two if they are related. This work entwines themes of worldwide concern with the political growth of nationalism because leaders with such a worldview are disinclined to co-operate internationally at a time when nations must find ways to solve common problems, such as the climate crisis. Inability to cooperate at this stage may doom everyone, eventually, to an overheated, stormy future plagued by droughts and deluges portending shortages of food and other essential commodities, meanwhile destroying large coastal urban areas because of rising sea levels. Future historians may look back at our time and wonder why as well as how our world succumbed to isolating nationalism at a time when time was so short for cooperative intervention which is crucial for survival of a sustainable earth. Pride in language and culture is salubrious to individuals’ sense of history and identity. Excess nationalism that prevents international co-operation on harmful worldwide maladies is quite another. As Pope Francis has pointed out: For all of our connectivity due to expansion of social media, ability to communicate can breed contempt as well as mutual trust. “For all our hyper-connectivity,” said Francis, “We witnessed a fragmentation that made it more difficult to resolve problems that affect us all” (Horowitz, 2020, A-12). The pope’s encyclical, titled “Brothers All,” also said: “The forces of myopic, extremist, resentful, and aggressive nationalism are on the rise.” The pope’s document also advocates support for migrants, as well as resistance to nationalist and tribal populism. Francis broadened his critique to the role of market capitalism, as well as nationalism has failed the peoples of the world when they need co-operation and solidarity in the face of the world-wide corona virus pandemic. Humankind needs to unite into “a new sense of the human family [Fratelli Tutti, “Brothers All”], that rejects war at all costs” (Pope, 2020, 6-A). Our journey takes us first to Russia, with the able eye and honed expertise of Richard D. Anderson, Jr. who teaches as UCLA and publishes on the subject of his chapter: “Putin, Russian identity, and Russia’s conduct at home and abroad.” Readers should find Dr. Anderson’s analysis fascinating because Vladimir Putin, the singular leader of Russian foreign and domestic policy these days (and perhaps for the rest of his life, given how malleable Russia’s Constitution has become) may be a short man physically, but has high ambitions. One of these involves restoring the old Russian (and Soviet) empire, which would involve re-subjugating a number of nations that broke off as the old order dissolved about 30 years ago. President (shall we say czar?) Putin also has international ambitions, notably by destabilizing the United States, where election meddling has become a specialty. The sight of Putin and U.S. president Donald Trump, two very rich men (Putin $70-$200 billion; Trump $2.5 billion), nuzzling in friendship would probably set Thomas Jefferson and Vladimir Lenin spinning in their graves. The road of history can take some unanticipated twists and turns. Consider Poland, from which we have an expert native analysis in chapter 2, Bartosz Hlebowicz, who is a Polish anthropologist and journalist. His piece is titled “Lawless and Unjust: How to Quickly Make Your Own Country a Puppet State Run by a Group of Hoodlums – the Hopeless Case of Poland (2015–2020).” When I visited Poland to teach and lecture twice between 2006 and 2008, most people seemed to be walking on air induced by freedom to conduct their own affairs to an unusual degree for a state usually squeezed between nationalists in Germany and Russia. What did the Poles then do in a couple of decades? Read Hlebowicz’ chapter and decide. It certainly isn’t soft-bellied liberalism. In Chapter 3, with Bruce E. Johansen, we visit China’s western provinces, the lands of Tibet as well as the Uighurs and other Muslims in the Xinjiang region, who would most assuredly resent being characterized as being possessed by the Chinese of the Han to the east. As a student of Native American history, I had never before thought of the Tibetans and Uighurs as Native peoples struggling against the Independence-minded peoples of a land that is called an adjunct of China on most of our maps. The random act of sitting next to a young woman on an Air India flight out of Hyderabad, bound for New Delhi taught me that the Tibetans had something to share with the Lakota, the Iroquois, and hundreds of other Native American states and nations in North America. Active resistance to Chinese rule lasted into the mid-nineteenth century, and continues today in a subversive manner, even in song, as I learned in 2018 when I acted as a foreign adjudicator on a Ph.D. dissertation by a Tibetan student at the University of Madras (in what is now in a city called Chennai), in southwestern India on resistance in song during Tibet’s recent history. Tibet is one of very few places on Earth where a young dissident can get shot to death for singing a song that troubles China’s Quest for Lebensraum. The situation in Xinjiang region, where close to a million Muslims have been interned in “reeducation” camps surrounded with brick walls and barbed wire. They sing, too. Come with us and hear the music. Back to Europe now, in Chapter 4, to Portugal and Spain, we find a break in the general pattern of nationalism. Portugal has been more progressive governmentally than most. Spain varies from a liberal majority to military coups, a pattern which has been exported to Latin America. A situation such as this can make use of the term “populism” problematic, because general usage in our time usually ties the word into a right-wing connotative straightjacket. “Populism” can be used to describe progressive (left-wing) insurgencies as well. José Pinto, who is native to Portugal and also researches and writes in Spanish as well as English, in “Populism in Portugal and Spain: a Real Neighbourhood?” provides insight into these historical paradoxes. Hungary shares some historical inclinations with Poland (above). Both emerged from Soviet dominance in an air of developing freedom and multicultural diversity after the Berlin Wall fell and the Soviet Union collapsed. Then, gradually at first, right wing-forces began to tighten up, stripping structures supporting popular freedom, from the courts, mass media, and other institutions. In Chapter 5, Bernard Tamas, in “From Youth Movement to Right-Liberal Wing Authoritarianism: The Rise of Fidesz and the Decline of Hungarian Democracy” puts the renewed growth of political and social repression into a context of worldwide nationalism. Tamas, an associate professor of political science at Valdosta State University, has been a postdoctoral fellow at Harvard University and a Fulbright scholar at the Central European University in Budapest, Hungary. His books include From Dissident to Party Politics: The Struggle for Democracy in Post-Communist Hungary (2007). Bear in mind that not everyone shares Orbán’s vision of what will make this nation great, again. On graffiti-covered walls in Budapest, Runes (traditional Hungarian script) has been found that read “Orbán is a motherfucker” (Mikanowski, 2019, 58). Also in Europe, in Chapter 6, Professor Ronan Le Coadic, of the University of Rennes, Rennes, France, in “Is There a Revival of French Nationalism?” Stating this title in the form of a question is quite appropriate because France’s nationalistic shift has built and ebbed several times during the last few decades. For a time after 2000, it came close to assuming the role of a substantial minority, only to ebb after that. In 2017, the candidate of the National Front reached the second round of the French presidential election. This was the second time this nationalist party reached the second round of the presidential election in the history of the Fifth Republic. In 2002, however, Jean-Marie Le Pen had only obtained 17.79% of the votes, while fifteen years later his daughter, Marine Le Pen, almost doubled her father's record, reaching 33.90% of the votes cast. Moreover, in the 2019 European elections, re-named Rassemblement National obtained the largest number of votes of all French political formations and can therefore boast of being "the leading party in France.” The brutality of oppressive nationalism may be expressed in personal relationships, such as child abuse. While Indonesia and Aotearoa [the Maoris’ name for New Zealand] hold very different ranks in the United Nations Human Development Programme assessments, where Indonesia is classified as a medium development country and Aotearoa New Zealand as a very high development country. In Chapter 7, “Domestic Violence Against Women in Indonesia and Aotearoa New Zealand: Making Sense of Differences and Similarities” co-authors, in Chapter 8, Mandy Morgan and Dr. Elli N. Hayati, from New Zealand and Indonesia respectively, found that despite their socio-economic differences, one in three women in each country experience physical or sexual intimate partner violence over their lifetime. In this chapter ther authors aim to deepen understandings of domestic violence through discussion of the socio-economic and demographic characteristics of theit countries to address domestic violence alongside studies of women’s attitudes to gender norms and experiences of intimate partner violence. One of the most surprising and upsetting scholarly journeys that a North American student may take involves Adolf Hitler’s comments on oppression of American Indians and Blacks as he imagined the construction of the Nazi state, a genesis of nationalism that is all but unknown in the United States of America, traced in this volume (Chapter 8) by co-editor Johansen. Beginning in Mein Kampf, during the 1920s, Hitler explicitly used the westward expansion of the United States across North America as a model and justification for Nazi conquest and anticipated colonization by Germans of what the Nazis called the “wild East” – the Slavic nations of Poland, the Baltic states, Ukraine, and Russia, most of which were under control of the Soviet Union. The Volga River (in Russia) was styled by Hitler as the Germans’ Mississippi, and covered wagons were readied for the German “manifest destiny” of imprisoning, eradicating, and replacing peoples the Nazis deemed inferior, all with direct references to events in North America during the previous century. At the same time, with no sense of contradiction, the Nazis partook of a long-standing German romanticism of Native Americans. One of Goebbels’ less propitious schemes was to confer honorary Aryan status on Native American tribes, in the hope that they would rise up against their oppressors. U.S. racial attitudes were “evidence [to the Nazis] that America was evolving in the right direction, despite its specious rhetoric about equality.” Ming Xie, originally from Beijing, in the People’s Republic of China, in Chapter 9, “News Coverage and Public Perceptions of the Social Credit System in China,” writes that The State Council of China in 2014 announced “that a nationwide social credit system would be established” in China. “Under this system, individuals, private companies, social organizations, and governmental agencies are assigned a score which will be calculated based on their trustworthiness and daily actions such as transaction history, professional conduct, obedience to law, corruption, tax evasion, and academic plagiarism.” The “nationalism” in this case is that of the state over the individual. China has 1.4 billion people; this system takes their measure for the purpose of state control. Once fully operational, control will be more subtle. People who are subject to it, through modern technology (most often smart phones) will prompt many people to self-censor. Orwell, modernized, might write: “Your smart phone is watching you.” Ming Xie holds two Ph.Ds, one in Public Administration from University of Nebraska at Omaha and another in Cultural Anthropology from the Chinese Academy of Social Sciences, Beijing, where she also worked for more than 10 years at a national think tank in the same institution. While there she summarized news from non-Chinese sources for senior members of the Chinese Communist Party. Ming is presently an assistant professor at the Department of Political Science and Criminal Justice, West Texas A&M University. In Chapter 10, analyzing native peoples and nationhood, Barbara Alice Mann, Professor of Honours at the University of Toledo, in “Divide, et Impera: The Self-Genocide Game” details ways in which European-American invaders deprive the conquered of their sense of nationhood as part of a subjugation system that amounts to genocide, rubbing out their languages and cultures -- and ultimately forcing the native peoples to assimilate on their own, for survival in a culture that is foreign to them. Mann is one of Native American Studies’ most acute critics of conquests’ contradictions, and an author who retrieves Native history with a powerful sense of voice and purpose, having authored roughly a dozen books and numerous book chapters, among many other works, who has traveled around the world lecturing and publishing on many subjects. Nalanda Roy and S. Mae Pedron in Chapter 11, “Understanding the Face of Humanity: The Rohingya Genocide.” describe one of the largest forced migrations in the history of the human race, the removal of 700,000 to 800,000 Muslims from Buddhist Myanmar to Bangladesh, which itself is already one of the most crowded and impoverished nations on Earth. With about 150 million people packed into an area the size of Nebraska and Iowa (population less than a tenth that of Bangladesh, a country that is losing land steadily to rising sea levels and erosion of the Ganges river delta. The Rohingyas’ refugee camp has been squeezed onto a gigantic, eroding, muddy slope that contains nearly no vegetation. However, Bangladesh is majority Muslim, so while the Rohingya may starve, they won’t be shot to death by marauding armies. Both authors of this exquisite (and excruciating) account teach at Georgia Southern University in Savannah, Georgia, Roy as an associate professor of International Studies and Asian politics, and Pedron as a graduate student; Roy originally hails from very eastern India, close to both Myanmar and Bangladesh, so he has special insight into the context of one of the most brutal genocides of our time, or any other. This is our case describing the problems that nationalism has and will pose for the sustainability of the Earth as our little blue-and-green orb becomes more crowded over time. The old ways, in which national arguments often end in devastating wars, are obsolete, given that the Earth and all the people, plants, and other animals that it sustains are faced with the existential threat of a climate crisis that within two centuries, more or less, will flood large parts of coastal cities, and endanger many species of plants and animals. To survive, we must listen to the Earth, and observe her travails, because they are increasingly our own.