Artigos de revistas sobre o tema "Gary Stern"

This review essay examines whether too-big-to-fail is as serious a problem as Gary Stern and Ron Feldman contend. This essay argues that Stern and Feldman overstate the importance of the too-big-to-fail problem and do not give enough credit to the FDICIA legislation of 1991 for improving bank regulation and supervision. However, this criticism of the Stern and Feldman book does not detract from many of its messages. The policy recommendations in their book have merit even if the too-big-to-fail problem is currently not that serious because these policies make it less likely that a banking crisis will occur even if driven by other factors.

Environment and Behavior is a leading international journal that publishes research examining the relationships between human behavior and the built and natural environments since 1969. Motivated by its half-century anniversary, the present article uses the Web of Science Core Collection database to provide a bibliometric overview of the leading trends that have occurred in the journal during the 1969-2018 period. The impact of the journal has increased over the years, Gary W. Evans is the author with most published papers, articles by Paul C. Stern and Thomas Dietz have made a notable scientific impact, the University of Michigan is the institution with the highest number of publications, and there is a growing trend in the number of women and international contributors to the journal. This bibliographic review provides strong evidence of the scientific impact of the journal, and the wider Environment-and-Behavior community should be proud of its story of success.

The 2016 presidential election saw the rise and fall of third-party candidates Jill Stein and Gary Johnson. This essay proposes that such third-party candidates are challenged in navigating the dichotomous nature of the myth of the American Dream that serves as the basis of party master narratives. Suggesting that third-party candidates attempt to create alternative narratives through what Rushing and Frentz called dialectical transformation and dialectical synthesis, the essay examines how such strategies were put to use by Stein and Johnson, and how they demonstrate a significant disadvantage for third parties.

Abstract Hillary Clinton won the national popular vote for president in 2016, but lost to Donald Trump in the Electoral College. Trump’s margin of victory in several decisive battleground states was smaller than the combined vote for the two leading minor party candidates: Gary Johnson, of the Libertarian Party, and Jill Stein, of the Green Party. The perception that Johnson and Stein “stole” the 2016 presidential election from Clinton is widespread, and potentially consequential for future minor party candidacies, but it has not yet been rigorously tested. In this article, we extend the analysis of minor party voting in the 1992 election from Lacy, D., and B. C. Burden. 1999. “The Vote-Stealing and Turnout Effects of Ross Perot in the 1992 U.S. Presidential Election.” American Journal of Political Science 43 (1): 233–55, by using data from the 2016 Cooperative Congressional Election Study to estimate a multinomial probit model of voting behavior—including outcomes for vote choice and abstention—and calculate the predicted probabilities that Johnson and Stein voters would have voted for another candidate or abstained from voting, had one or both of these candidates been excluded from the ballot. We then reallocate Johnson’s and Stein’s votes accordingly, to estimate Clinton’s and Trump’s counterfactual vote shares nationally and within key battleground states. Our analysis indicates that Johnson and Stein did not deprive Clinton of an Electoral College majority, nor Trump the legitimacy of winning the national popular vote. We estimate that most Johnson and Stein voters would have abstained from voting if denied the choice to vote for their preferred candidate, and that most of Johnson’s remaining voters would have supported Trump.

In 1704, Abraham Gugger of Augsburg published a ‘Dance of Death’, whose lengthy German title is best abbreviated as Sterb-Spiegel. Only five acknowledged copies exist. Originally the work of brothers Rudolph Theodor and Conrad Meyer of Zürich, the first iteration of the Sterb-Spiegel had appeared in 1650. The posthumous 1704 version, re-engraved by an unknown artist, differs in one essential regard: the clothing of Death's victims has been modernized to represent the fashions of the beginning of the eighteenth century. The illustrations show that death comes to everyone, represented by the different victims at work, home and play in appropriate settings. The Sterb-Spiegel thus depicts the clothing in context and in ‘action’, and further represents all levels of early eighteenth-century society, divided into the ‘Ruling Class’, and the ‘General Home and Worldly Positions’. All are appropriately attired, and the Sterb-Spiegel accurately portrays non-elite garb and accessories. The Mercure Galant had ceased issuing regular fashion plates in the 1680s, and the Mercure de France resumed consistent publication of current styles only in the 1720s; the Sterb-Spiegel, even though it was not the original intention, provides contemporary insights into early eighteenth-century fashions when documentation is relatively sparse.

-Hy Van Luong, John R. Rickford, Dimensions of a Creole continuum: history, texts, and linguistic analysis of Guyanese Creole. Palo Alto: Stanford University Press, 1987. xix + 340 pp.-John Stewart, Charles V. Carnegie, Afro-Caribbean villages in historical perspective. Jamaica: African-Caribbean Institute of Jamaica, 1987. x + 133 pp.-David T. Edwards, Jean Besson ,Land and development in the Caribbean. London: Macmillan Caribbean, 1987. xi + 228 pp., Janet Momsen (eds)-David T. Edwards, John Brierley ,Small farming and peasant resources in the Caribbean. Winnipeg, Canada: University of Manitoba, 1988. xvii + 133., Hymie Rubenstein (eds)-Diane J. Austin-Broos, Anthony J. Payne, Politics in Jamaica. London and New York: C. Hurst and Company, St. Martin's Press, 1988. xii + 196 pp.-Carol Yawney, Anita M. Waters, Race, class, and political symbols: rastafari and reggae in Jamaican politics. New Brunswick, New Jersey: Transaction Books, 1985. ix + 343 pp.-Judith Stein, Rupert Lewis ,Garvey: Africa, Europe, the Americas. Jamaica: Institute of Social and Economic Research, 1986. xi + 208 pp., Maureen Warner-Lewis (eds)-Robert L. Harris, Jr., Sterling Stuckey, Slave culture: nationalist theory and the foundations of Black America. New York: Oxford University Press, 1987. vii + 425 pp.-Thomas J. Spinner, Jr, Chaitram Singh, Guyana: politics in a plantation society. New York: Praeger Publishers, 1988. xiv + 156 pp.-T. Fiehrer, Paul Buhle, C.L.R. James: The artist as revolutionary. New York & London: Verso, 1988. 197 pp.-Paul Buhle, Khafra Kambon, For bread, justice and freedom: a political biography of George Weekes. London: New Beacon Books, 1988. xi + 353 pp.-Robin Derby, Richard Turits, Bernardo Vega, Trujillo y Haiti. Vol. 1 (1930-1937). Santo Domingo, Dominican Republic: Fundación Cultural Dominicana, 1988. 464 pp.-James W. Wessman, Jan Knippers Black, The Dominican Republic: politics and development in an unsovereign state. Boston, London and Sidney: Allen & Unwin, 1986. xi + 164 pp.-Gary Brana-Shute, Alma H. Young ,Militarization in the non-Hispanic Caribbean. Boulder, Colorado: Lynne Rienner Publishers, Inc., 1986. ix + 178 pp., Dion E. Phillips (eds)-Genevieve J. Escure, Mark Sebba, The syntax of serial verbs: an investigation into serialisation in Sranan and other languages. Amsterdam and Philadelphia: John Benjamins Publishing Company, Creole Language Library = vol. 2, 1987. xii + 228 pp.-Dennis Conway, Elizabeth McClean Petras, Jamican labor migration: white capital and black labor, 1850-1930. Boulder and London: Westview Press, 1988. x + 297 pp.

-William Roseberry, Michel-Rolph Trouillot, Peasants and capital: Dominica in the world economy. Baltimore and London: The Johns Hopkins University Press. Johns Hopkins Studies in Atlantic History and Culture, 1988. xiv + 344 pp.-Michel-Rolph Trouillot, Robert A. Myers, Dominica. Oxford, Santa Barbara, Denver: Clio Press, World Bibliographic Series, volume 82. xxv + 190 pp.-Michel-Rolph Trouillot, Robert A. Myers, A resource guide to Dominica, 1493-1986. New Haven: Human Area Files, HRA Flex Books, Bibliography Series, 1987. 3 volumes. xxxv + 649.-Stephen D. Glazier, Colin G. Clarke, East Indians in a West Indian town: San Fernando, Trinidad, 1930-1970. London: Allen and Unwin, 1986 xiv + 193 pp.-Kevin A. Yelvington, M.G. Smith, Culture, race and class in the Commonwealth Caribbean. Foreword by Rex Nettleford. Mona: Department of Extra-Mural Studies, University of the West Indies, 1984. xiv + 163 pp.-Aart G. Broek, T.F. Smeulders, Papiamentu en onderwijs: veranderingen in beeld en betekenis van de volkstaal op Curacoa. (Utrecht Dissertation), 1987. 328 p. Privately published.-John Holm, Peter A. Roberts, West Indians and their language. Cambridge: Cambridge University Press, 1988 vii + 215 pp.-Kean Gibson, Francis Byrne, Grammatical relations in a radical Creole: verb complementation in Saramaccan. Amsterdam and Philadelphia: John Benjamins Publishing Company, Creole Language Library, vol. 3, 1987. xiv + 294 pp.-Peter L. Patrick, Pieter Muysken ,Substrata versus universals in Creole genesis. Amsterdam and Philadelphia: John Benjamins Publishing Company, Creol Language Library - vol 1, 1986. 315 pp., Norval Smith (eds)-Jeffrey P. Williams, Glenn G. Gilbert, Pidgin and Creole languages: essays in memory of John E. Reinecke. Honolulu: University of Hawaii, 1987. x + 502 pp.-Samuel M. Wilson, C.N. Dubelaar, The petroglyphs in the Guianas and adjacent areas of Brazil and Venezuela: an inventory. With a comprehensive biography of South American and Antillean petroglyphs. Los Angeles: The Institute of Archaeology of the University of California, Los Angeles. Monumenta Archeologica 12, 1986. xi + 326 pp.-Gary Brana-Shute, Henk E. Chin ,Surinam: politics, economics, and society. London and New York: Francis Pinter, 1987. xvii, 192 pp., Hans Buddingh (eds)-Lester D. Langley, Howard J. Wiarda ,The communist challenge in the Caribbean and Central America. With E. Evans, J. Valenta and V. Valenta. Lanham, MD: American Enterprise Institute for Public Policy Research. xiv + 249 pp., Mark Falcoff (eds)-Forrest D. Colburn, Michael Kaufman, Jamaica under Manley: dilemmas of socialism and democracy. London, Toronto, Westport: Zed Books, Between the Lines and Lawrence Hill, 1985. xvi 282 pp.-Dale Tomich, Robert Miles, Capitalism and unfree labour: anomaly or necessity? London. New York: Tavistock Publications. 1987. 250 pp.-Robert Forster, Mederic-Louis-Elie Moreau de Saint-Mery, A civilization that perished: the last years of white colonial rule in Haiti. Translated, abridged and edited by Ivor D. Spencer. Lanham, New York, London: University Press of America, 1985. xviii + 295 pp.-Carolyn E. Fick, Robert Louis Stein, Léger Félicité Sonthonax: the lost sentinel of the Republic. Rutherford, Madison: Fairleigh Dickinson University Press; London and Toronto: Associated University Press, 1985. 234 pp.

-Louis Allaire, Samuel M. Wilson, Hispaniola: Caribbean chiefdoms in the age of Columbus. Tuscaloosa: University of Alabama Press, 1990. xi + 170 pp.-Douglas Melvin Haynes, Philip D. Curtin, Death by migration: Europe's encounter with the tropical world in the nineteenth century. Cambridge: Cambridge University Press, 1989. xviii + 251 pp.-Dale Tomich, J.H. Galloway, The sugar cane industry: An historical geography from its origins to 1914. Cambridge: Cambridge University Press, 1989. xii + 266 pp.-Myriam Cottias, Dale Tomich, Slavery in the circuit of sugar: Martinique and the world economy, 1830 -1848. Baltimore: John Hopkins University Press, 1990. xiv + 352 pp.-Robert Forster, Pierre Dessalles, La vie d'un colon à la Martinique au XIXe siècle. Pré-senté par Henri de Frémont. Courbevoie: s.n., 1984-1988, four volumes, 1310 pp.-Hilary Beckles, Douglas V. Armstrong, The old village and the great house: An archaeological and historical examination of Drax Hall Plantation, St Ann's Bay, Jamaica. Chicago: University of Illinois Press, 1990. xiii + 393 pp.-John Stewart, John A. Lent, Caribbean popular culture. Bowling Green OH: Bowling Green State University Popular Press, 1990. 157 pp.-W. Marvin Will, Susanne Jonas ,Democracy in Latin America: Visions and realities. New York: Bergin & Garvey Publishers, 1990. viii + 224 pp., Nancy Stein (eds)-Forrest D. Colburn, Kathy McAfee, Storm signals: Structural adjustment and development alternatives in the Caribbean. London: Zed books, 1991. xii + 259 pp.-Derwin S. Munroe, Peggy Antrobus ,In the shadows of the sun: Caribbean development alternatives and U.S. policy. Carmen Diana Deere (coordinator), Peter Phillips, Marcia Rivera & Helen Safa. Boulder CO: Westview Press, 1990. xvii + 246 pp., Lynne Bolles, Edwin Melendez (eds)-William Roseberry, Louis A. Pérez, Jr., Lords of the mountain: Social banditry and peasant protest in Cuba, 1878-1918. Pittsburgh: University of Pittsburgh Press, 1989. xvii + 267 pp.-William Roseberry, Rosalie Schwartz, Lawless liberators, political banditry and Cuban independence. Durham NC: Duke University Press, 1989. x + 297 pp.-Robert L. Paquette, Robert M. Levine, Cuba in the 1850's: Through the lens of Charles DeForest Fredricks. Tampa: University of South Florida Press, 1990. xv + 86 pp.-José Sánchez-Boudy, Gustavo Pérez Firmat, The Cuban condition: Translation and identity in modern Cuban literature. Cambridge: Cambridge University Press, 1989. viii + 185 pp.-Dick Parker, Jules R. Benjamin, The United States and the origins of the Cuban revolution: An empire of liberty in an age of national liberation. Princeton: Princeton University Press, 1990. xi + 235 pp.-George Irvin, Andrew Zimbalist ,The Cuban economy: Measurement and analysis of socialist performance. Baltimore: John Hopkins University Press, 1989. xiv + 220 pp., Claes Brundenius (eds)-Menno Vellinga, Frank T. Fitzgerald, Managing socialism: From old Cadres to new professionals in revolutionary Cuba. New York: Praeger, 1990. xiv + 161 pp.-Patricia R. Pessar, Eugenia Georges, The making of a transnational community: Migration, development, and cultural change in the Dominican republic. New York: Columbia University Press, 1990. xi + 270 pp.-Lucía Désir, Maria Dolores Hajosy Benedetti, Earth and spirit: Healing lore and more from Puerto Rico. Maplewood NJ: Waterfront Press, 1989. xvii + 245 pp.-Thomas J. Spinner, Jr., Percy C. Hintzen, The costs of regime survival: Racial mobilization, elite domination and control of the state in Guyana and Trinidad. Cambridge: Cambridge University Press, 1989. x + 240 pp.-Judith Johnson, Morton Klass, Singing with the Sai Baba: The politics of revitalization in Trinidad. Boulder CO: Westview, 1991. xvi + 187 pp.-Aisha Khan, Selwyn Ryan, The Muslimeen grab for power: Race, religion and revolution in Trinidad and Tobago. Port of Spain: Inprint Caribbean, 1991. vii + 345 pp.-Drexel G. Woodson, Patrick Bellegarde-Smith, Haiti: The Breached Citadel. Boulder CO: Westview Press, 1990. xxi + 217 pp.-O. Nigel Bolland, Howard Johnson, The Bahamas in slavery and freedom. Kingston, Jamaica: Ian Randle; London: James Currey, 1991. viii + 184 pp.-Keith F. Otterbein, Charles C. Foster, Conchtown USA: Bahamian fisherfolk in Riviera beach, Florida. (with folk songs and tales collected by Veronica Huss). Boca Raton: Florida Atlantic University Press, 1991. x + 176 pp.-Peter van Baarle, John P. Bennett ,Kabethechino: A correspondence on Arawak. Edited by Janette Forte. Georgetown: Demerara Publishers, 1991. vi + 271 pp., Richard Hart (eds)-Fabiola Jara, Joop Vernooij, Indianen en kerken in Suriname: identiteit en autonomie in het binnenland. Paramaribo: Stichting Wetenschappelijke Informatie (SWI), 1989. 178 pp.-Jay Edwards, C.L. Temminck Groll ,Curacao: Willemstad, city of monuments. R.G. Gill. The Hague: Gary Schwartz/SDU Publishers, 1990. 123 pp., W. van Alphen, R. Apell (eds)-Mineke Schipper, Maritza Coomans-Eustatia ,Drie Curacaose schrijvers in veelvoud. Zutphen: De Walburg Pers, 1991. 544 pp., H.E. Coomans, Wim Rutgers (eds)-Arie Boomert, P. Wagenaar Hummelinck, De rotstekeningen van Aruba/The prehistoric rock drawings of Aruba. Utrecht: Uitgeverij Presse-Papier, 1991. 228 pp.-J.K. Brandsma, Ruben S. Gowricharn, Economische transformatie en de staat: over agrarische modernisering en economische ontwikkeling in Suriname, 1930-1960. Den Haag: Uitgeverij Ruward, 1990. 208 pp.-Henk N. Hoogendonk, M. van Schaaijk, Een macro-model van een micro-economie. Den Haag: STUSECO, 1991. 359 pp.-Bim G. Mungra, Corstiaan van der Burg ,Hindostanen in Nederland. Leuven (Belgium)/ Apeldoorn (the Netherlands): Garant Publishers, 1990. 223 pp., Theo Damsteegt, Krishna Autar (eds)-Adrienne Bruyn, J. van Donselaar, Woordenboek van het Surinaams-Nederlands. Muiderberg: Dick Coutinho, 1989. 482 pp.-Wim S. Hoogbergen, Michiel Baud ,'Cultuur in beweging': creolisering en Afro-Caraïbische cultuur. Rotterdam: Bureau Studium Generale, 1989. 93 pp., Marianne C. Ketting (eds)

Background:Axial spondylarthritis (axSpA) patients treated with a tumour necrosis factor inhibitor (TNFi) may receive a concomitant conventional synthetic disease-modifying anti-rheumatic drug (csDMARD), although the value of combination therapy remains unclear.Objectives:Describe the proportion and phenotype of patients with axSpA initiating their first TNFi as monotherapy compared to TNFi+csDMARD combination therapy, and to compare the 1-year TNFi retention between the two groups.Methods:Data from 13 European registries was collected. Two exposure treatment groups were defined: TNFi monotherapy at baseline (=TNFi start date) and TNFi+csDMARD combination therapy. TNFi retention rates were assessed with Kaplan-Meier curves for each country and combined. Hazard ratios (HR, 95% CI) for discontinuing the TNFi were obtained with Cox models: (i) crude; adjusted for (ii) country, and (iii) country, sex, age, calendar year, disease duration and BASDAI. Participating countries were dichotomized into two strata, depending on their 1-year retention rate being above (stratum A) or below (stratum B) the average retention rate across all countries.Results:22,196 axSpA patients were included with 34% on TNFi+csDMARD combination therapy. Baseline characteristics are presented in table 1. Overall, the crude TNFi retention rate was marginally longer in the combination therapy group (80% (79-81%)) compared to the monotherapy group (78% (77-79%)) and was primarily driven by differences in stratum B (fig. 1). TNFi retention rates varied significantly across countries (range:-11.0% to +11.3%), with a clear distinction between the 2 strata. The HRs for discontinuation over 1-year (reference=TNFi monotherapy) in the 3 models were: (i) 0.88 (0.82-0.93), (ii) 0.87 (0.82-0.92), (iii) 0.88 (0.82-0.93).Table 1Baseline characteristicsAll patients(n=22196)Country stratum ACountry stratum BTNFi mono(n=4940)csDMARD + TNFi(n=2547)TNFi mono(n=9693)csDMARD + TNFi(n=5016)Age (years), mean (SD)42.6 (12.5)43.4 (12.0)42.8 (12.2)41.6 (12.7)43.7 (12.7)Females, %41.137.738.242.044.2Disease duration (yrs), mean (SD)5.7 (8.0)6.2 (7.7)6.7 (7.4)4.9 (8.2)6.1 (8.2)Enthesitis, %50.316.733.957.859.7SJC-28, median (IQR)0 (0-1)0 (0-0)0 (0-2)0 (0-0)0 (0-2)VAS pain (0-100), mean (SD)60.9 (24.5)63.3 (26.5)67.8 (23.3)60.2 (23.4)57.2 (24.3)CRP (mg/L), median (IQR)8 (3-20)7.8 (2-20)18 (6.7-32.6)6.0 (2.7-15)8.0 (3-22)BASDAI (0-10), mean (SD)5.7 (2.1)5.7 (2.2)6.2 (2.1)5.6 (2.0)5.4 (2.2)BASFI (0-10), mean (SD)4.4 (2.5)4.4 (2.6)4.9 (2.5)4.3 (2.4)4.2 (2.9)ASDAS, mean (SD)3.5 (1.1)3.7 (1.0)4.0 (1.0)3.3 (1.0)3.3 (1.1)On Infliximab, %25.721222436Baseline csDMARD use, %-Methotrexate045063-Sulfasalazine068033-Leflunomide0801Conclusion:Considerable differences were observed across countries in the use of combination therapy and TNFi retention in axSpA patients. The overall 1-year TNFi retention was higher with csDMARD co-therapy compared to TNFi monotherapy. TNFi monotherapy had a 12-13% higher risk of treatment discontinuation.Acknowledgments:Novartis Pharma AG and IQVIAMN and BD participated equallyDisclosure of Interests:Michael Nissen Grant/research support from: Abbvie, Consultant of: Novartis, Lilly, Abbvie, Celgene and Pfizer, Speakers bureau: Novartis, Lilly, Abbvie, Celgene and Pfizer, Bénédicte Delcoigne: None declared, Daniela Di Giuseppe: None declared, Lennart T.H. Jacobsson Consultant of: AbbVie, Eli Lilly, Janssen, Novartis and Pfizer, Karen Fagerli: None declared, Anne Gitte Loft Grant/research support from: Novartis, Consultant of: AbbVie, MSD, Novartis, Pfizer and UCB, Speakers bureau: AbbVie, MSD, Novartis, Pfizer and UCB, Adrian Ciurea Consultant of: Consulting and/or speaking fees from AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly, Merck Sharp & Dohme, Novartis and Pfizer., Dan Nordström Consultant of: Abbvie, Celgene, Lilly, Novartis, Pfizer, Roche and UCB., Speakers bureau: Abbvie, Celgene, Lilly, Novartis, Pfizer, Roche and UCB., Ziga Rotar Consultant of: Speaker and consulting fees from Abbvie, Amgen, Biogen, Eli Lilly, Medis, MSD, Novartis, Pfizer, Roche, Sanofi., Speakers bureau: Speaker and consulting fees from Abbvie, Amgen, Biogen, Eli Lilly, Medis, MSD, Novartis, Pfizer, Roche, Sanofi., Florenzo Iannone Consultant of: Speaker and consulting fees from AbbVie, Eli Lilly, Novartis, Pfizer, Roche, Sanofi, UCB, MSD, Speakers bureau: Speaker and consulting fees from AbbVie, Eli Lilly, Novartis, Pfizer, Roche, Sanofi, UCB, MSD, Maria Jose Santos Speakers bureau: Novartis and Pfizer, Manuel Pombo-Suarez Consultant of: Janssen, Lilly, MSD and Sanofi., Speakers bureau: Janssen, Lilly, MSD and Sanofi., Björn Gudbjornsson Speakers bureau: Novartis and Amgen, Heřman Mann: None declared, Nurullah Akkoc: None declared, Catalin Codreanu Consultant of: Speaker and consulting fees from AbbVie, Accord Healthcare, Alfasigma, Egis, Eli Lilly, Ewopharma, Genesis, Mylan, Novartis, Pfizer, Roche, Sandoz, UCB, Speakers bureau: Speaker and consulting fees from AbbVie, Accord Healthcare, Alfasigma, Egis, Eli Lilly, Ewopharma, Genesis, Mylan, Novartis, Pfizer, Roche, Sandoz, UCB, Irene van der Horst-Bruinsma Grant/research support from: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Consultant of: AbbVie, Novartis, Eli Lilly, Bristol-Myers Squibb, MSD, Pfizer, UCB Pharma, Brigitte Michelsen: None declared, Gary Macfarlane: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis, Matija Tomsic: None declared, Burkhard Moeller: None declared, Pedro Ávila-Ribeiro Grant/research support from: Novartis, Carlos Sánchez-Piedra: None declared, Heikki Relas Grant/research support from: Abbvie., Consultant of: Abbvie, Celgene, and Pfizer., Speakers bureau: Abbvie, Celgene, and Pfizer., Arni Jon Geirsson: None declared, Lucie Nekvindova: None declared, Gozde Yildirim Cetin Speakers bureau: AbbVie, Novartis, Pfizer, Roche, UCB, MSD, Ruxandra Ionescu Consultant of: Consulting fees from Abbvie, Eli-Lilly, Novartis, Pfizer, Roche, Sandoz, Speakers bureau: Consulting and speaker fees from Abbvie, Eli-Lilly, Novartis, Pfizer, Roche, Sandoz, Niels Steen Krogh: None declared, Johan Askling Grant/research support from: JA acts or has acted as PI for agreements between Karolinska Institutet and the following entities, mainly in the context of the ARTIS national safety monitoring programme of immunomodulators in rheumatology: Abbvie, BMS, Eli Lilly, Merck, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB Pharma, Bente Glintborg Grant/research support from: Grants from Pfizer, Biogen and Abbvie, Ulf Lindström: None declared

The pandemic of COVID-19 has afflicted every individual and has initiated a cascade of directly or indirectly involved events in precipitating mental health issues. The human species is a wanderer and hunter-gatherer by nature, and physical social distancing and nationwide lockdown have confined an individual to physical isolation. The present review article was conceived to address psychosocial and other issues and their aetiology related to the current pandemic of COVID-19. The elderly age group has most suffered the wrath of SARS-CoV-2, and social isolation as a preventive measure may further induce mental health issues. Animal model studies have demonstrated an inappropriate interacting endogenous neurotransmitter milieu of dopamine, serotonin, glutamate, and opioids, induced by social isolation that could probably lead to observable phenomena of deviant psychosocial behavior. Conflicting and manipulated information related to COVID-19 on social media has also been recognized as a global threat. Psychological stress during the current pandemic in frontline health care workers, migrant workers, children, and adolescents is also a serious concern. Mental health issues in the current situation could also be induced by being quarantined, uncertainty in business, jobs, economy, hampered academic activities, increased screen time on social media, and domestic violence incidences. The gravity of mental health issues associated with the pandemic of COVID-19 should be identified at the earliest. Mental health organization dedicated to current and future pandemics should be established along with Government policies addressing psychological issues to prevent and treat mental health issues need to be developed. References World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ [Accessed on 23 August 2020] Sim K, Chua HC. The psychological impact of SARS: a matter of heart and mind. CMAJ. 2004; 170:811e2. https://doi.org/10.1503/cmaj.1032003. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatr. 2009; 54:302e11. https://doi.org/10.1177/070674370905400504. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395:912e20. https://doi.org/10.1016/S0140-6736(20)30460-8. Robertson E, Hershenfield K, Grace SL, Stewart DE. The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatr. 2004; 49:403e7. https://doi.org/10.1177/070674370404900612. Barbisch D, Koenig KL, Shih FY. Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Med Public Health Prep. 2015; 9:547e53. https://doi.org/10.1017/dmp.2015.38. Jeong H, Yim HW, Song YJ, Ki M, Min JA, Cho J, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38: e2016048. https://doi.org/10.4178/epih.e2016048. Liu X, Kakade M, Fuller CJ, Fan B, Fang Y, Kong J, et al. Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatr. 2012; 53:15e23. https://doi.org/10.1016/j.comppsych.2011.02.003 Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psychiatry. 2013;55: S299‑ https://dx.doi.org/10.4103%2F0019-5545.105555. Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, et al. Psychological impact of COVID‑19 lockdown: An online survey from India. Indian J Psychiatry. 2020; 62:354-62. https://doi.org/ 10.4103/psychiatry.IndianJPsychiatry _427_20. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010; 40: 218–27. https://dx.doi.org/10.1007%2Fs12160-010-9210-8. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7. Bhandari S, Sharma R, Singh Shaktawat A, Banerjee S, Patel B, Tak A, et al. COVID-19 related mortality profile at a tertiary care centre: a descriptive study. Scr Med. 2020;51(2):69-73. https://doi.org/10.5937/scriptamed51-27126. Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995; 117: 497–529. https://doi.org/10.1037/0033-2909.117.3.497. Caspi A, Harrington H, Moffitt TE, Milne BJ, Poulton R. Socially isolated children 20 years later: risk of cardiovascular disease. Arch Pediatr Adolesc Med. 2006; 160(8):805-11. https://doi.org/10.1001/archpedi.160.8.805. Eaker ED, Pinsky J, Castelli WP. Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. Am J Epidemiol. 1992; 135(8):854-64. https://doi.org/10.1093/oxfordjournals.aje.a116381. Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med. 2012 Mar; 74(6):907-14. https://dx.doi.org/10.1016%2Fj.socscimed.2011.11.028. Olsen RB, Olsen J, Gunner-Svensson F, Waldstrøm B. Social networks and longevity. A 14-year follow-up study among elderly in Denmark. Soc Sci Med. 1991; 33(10):1189-95. https://doi.org/10.1016/0277-9536(91)90235-5. Patterson AC, Veenstra G. Loneliness and risk of mortality: a longitudinal investigation in Alameda County, California. Soc Sci Med. 2010; 71(1):181-6. https://doi.org/10.1016/j.socscimed.2010.03.024. Savikko N, Routassalo P, Tilvis RS, Strandberg TE, Pitkalla KH. Predictors and subjective causes of loneliness in an aged population. Arch Gerontol Geriatrics. 2005; 41:3;223-33. https://doi.org/10.1016/j.archger.2005.03.002. Health Advisory for Elderly Population of India during COVID19. Available at: https://www.mohfw.gov.in/pdf/AdvisoryforElderlyPopulation.pdf [Accessed on 13 August 2020]. Dicks D, Myers R, Kling A. Uncus and amygdala lesions: effects on social behavior in the free-ranging rhesus monkey. Science. 1969; 165:69–71. https://doi.org/10.1126/science.165.3888.69. Kanai R, Bahrami B, Duchaine B, Janik A, Banissy MJ, Rees G. Brain structure links loneliness to social perception. Curr Biol. 2012; 22(20):1975-9. https://dx.doi.org/10.1016%2Fj.cub.2012.08.045. Bender AR, Daugherty A, Raz N. Vascular risk moderates associations between hippocampal subfield volumes and memory. J Cogn Neurosci. 2013; 25:1851–62. https://doi.org/10.1162/jocn_a_00435. Raz N. Diabetes: brain, mind, insulin–what is normal and do we need to know? Nat Rev Endocrinol. 2011; 7:636–7. https://doi.org/10.1038/nrendo.2011.149. Colcombe SJ, Erickson KI, Naftali R, Andrew GW, Cohen NJ, McAuley E, et al. Aerobic fitness reduces brain tissue loss in aging humans. J Gerontol A Biol Sci Med Sci. 2003; 58:176–80. https://doi.org/10.1093/gerona/58.2.m176. Maass A, Düzel S, Goerke M, Becke A, Sobieray U, Neumann K, et al. Vascular hippocampal plasticity after aerobic exercise in older adults. Mol Psychiatry. 2015; 20, 585–93. https://doi.org/10.1038/mp.2014.114. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and Risk of Alzheimer Disease. Arch Gen Psychiatry. 2007;64(2):234–240. https://doi.org/10.1001/archpsyc.64.2.234. Kogan JH, Frankland PW, Silva AJ. Long-term memory underlying hippocampus-dependent social recognition in mice. Hippocampus. 2000;10(1):47-56. https://doi.org/10.1002/(sici)1098-1063(2000)10:1%3C47::aid-hipo5%3E3.0.co;2-6. Yorgason JT, España RA, Konstantopoulos JK, Weiner JL, Jones SR. Enduring increases in anxiety-like behavior and rapid nucleus accumbens dopamine signaling in socially isolated rats. Eur J Neurosci. 2013;37(6):1022-31. https://doi.org/10.1111/ejn.12113. Bledsoe AC, Oliver KM, Scholl JL, Forster GL. Anxiety states induced by post-weaning social isolation are mediated by CRF receptors in the dorsal raphe nucleus. Brain Res Bull. 2011;85(3-4):117-22. https://dx.doi.org/10.1016%2Fj.brainresbull.2011.03.003. Lukkes JL, Engelman GH, Zelin NS, Hale MW, Lowry CA. Post-weaning social isolation of female rats, anxiety-related behavior, and serotonergic systems. Brain Res. 2012; 1443:1-17. https://dx.doi.org/10.1016%2Fj.brainres.2012.01.005. Ago Y, Araki R, Tanaka T, Sasaga A, Nishiyama S, Takuma K, et al. Role of social encounter-induced activation of prefrontal serotonergic systems in the abnormal behaviors of isolation-reared mice. Neuropsychopharmacology. 2013; 38(8):1535-47. https://doi.org/10.1038/npp.2013.52. Veenema AH. Early life stress, the development of aggression and neuroendocrine and neurobiological correlates: what can we learn from animal models? Front Neuroendocrinol. 2009;30(4):497-518. https://doi.org/10.1016/j.yfrne.2009.03.003. Zhao X, Sun L, Jia H, Meng Q, Wu S, Li N, et al. Isolation rearing induces social and emotional function abnormalities and alters glutamate and neurodevelopment-related gene expression in rats. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(7):1173-1177. https://doi.org/10.1016/j.pnpbp.2009.06.016. Sciolino NR, Bortolato M, Eisenstein SA, Fu J, Oveisi F, Hohmann AG, et al. Social isolation and chronic handling alter endocannabinoid signaling and behavioral reactivity to context in adult rats. Neuroscience. 2010;168(2):371-86. https://dx.doi.org/10.1016%2Fj.neuroscience.2010.04.007. Ghasemi M, Phillips C, Trillo L, De Miguel Z, Das D, Salehi A. The role of NMDA receptors in the pathophysiology and treatment of mood disorders. Neurosci Biobehav Rev. 2014; 47:336-358. https://doi.org/10.1016/j.neubiorev.2014.08.017. Olivenza R, Moro MA, Lizasoain I, Lorenzo P, Fernández AP, Rodrigo J, et al. Chronic stress induces the expression of inducible nitric oxide synthase in rat brain cortex. J Neurochem. 2000;74(2):785-791. https://doi.org/10.1046/j.1471-4159.2000.740785.x. Maeng S, Zarate CA Jr, Du J, Schloesser RJ, McCammon J, Chen G, et al. Cellular mechanisms underlying the antidepressant effects of ketamine: role of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. Biol Psychiatry. 2008;63(4):349-352. https://doi.org/10.1016/j.biopsych.2007.05.028. Kalia LV, Kalia SK, Salter MW. NMDA receptors in clinical neurology: excitatory times ahead. Lancet Neurol. 2008;7(8):742-755. https://dx.doi.org/10.1016%2FS1474-4422(08)70165-0. Waxman EA, Lynch DR. N-methyl-D-aspartate Receptor Subtypes: Multiple Roles in Excitotoxicity and Neurological Disease. The Neuroscientist. 2005; 11(1), 37–49. https://doi.org/10.1177/1073858404269012. Hermes G, Li N, Duman C, Duman R. Post-weaning chronic social isolation produces profound behavioral dysregulation with decreases in prefrontal cortex synaptic-associated protein expression in female rats. Physiol Behav. 2011;104(2):354-9. https://dx.doi.org/10.1016%2Fj.physbeh.2010.12.019. Sestito RS, Trindade LB, de Souza RG, Kerbauy LN, Iyomasa MM, Rosa ML. Effect of isolation rearing on the expression of AMPA glutamate receptors in the hippocampal formation. J Psychopharmacol. 2011;25(12):1720-1729. https://doi.org/10.1177/0269881110385595. Toua C, Brand L, Möller M, Emsley RA, Harvey BH. The effects of sub-chronic clozapine and haloperidol administration on isolation rearing induced changes in frontal cortical N-methyl-D-aspartate and D1 receptor binding in rats. Neuroscience. 2010;165(2):492-499. https://doi.org/10.1016/j.neuroscience.2009.10.039. Alò R, Avolio E, Mele M, Storino F, Canonaco A, Carelli A et al. Excitatory/inhibitory equilibrium of the central amygdala nucleus gates anti-depressive and anxiolytic states in the hamster. Pharmacol Biochem Behav. 2014; 118:79-86. https://doi.org/10.1016/j.pbb.2014.01.007. St JP, Petkov VV. Changes in 5-HT1 receptors in different brain structures of rats with isolation syndrome. General pharmacology. 1990;21(2):223-5. https://doi.org/10.1016/0306-3623(90)90905-2. Miachon S, Rochet T, Mathian B, Barbagli B, Claustrat B. Long-term isolation of Wistar rats alters brain monoamine turnover, blood corticosterone, and ACTH. Brain Res Bull. 1993;32(6):611-614. https://doi.org/10.1016/0361-9230(93)90162-5. Van den Berg CL, Van Ree JM, Spruijt BM, Kitchen I. Effects of juvenile isolation and morphine treatment on social interactions and opioid receptors in adult rats: behavioural and autoradiographic studies. Eur J Neurosci. 1999;11(9):3023-3032. https://doi.org/10.1046/j.1460-9568.1999.00717.x. Vanderschuren LJ, Stein EA, Wiegant VM, Van Ree JM. Social play alters regional brain opioid receptor binding in juvenile rats. Brain Res. 1995;680(1-2):148-156. https://doi.org/10.1016/0006-8993(95)00256-p. Moles A, Kieffer BL, D'Amato FR. Deficit in attachment behavior in mice lacking the mu-opioid receptor gene. Science. 2004;304(5679):1983-1986. https://doi.org/10.1126/science.1095943. Panksepp J, Herman BH, Vilberg T, Bishop P, DeEskinazi FG. Endogenous opioids and social behavior. Neurosci Biobehav Rev. 1980;4(4):473-487. https://doi.org/10.1016/0149-7634(80)90036-6. Gong JP, Onaivi ES, Ishiguro H, Liu Q, Tagliaferro PA, Brusco A, et al. Cannabinoid CB2 receptors: immunohistochemical localization in rat brain. Brain Res. 2006;1071(1):10-23. https://doi.org/10.1016/j.brainres.2005.11.035. Breivogel CS, Sim-Selley LJ. Basic neuroanatomy and neuropharmacology of cannabinoids. Int Rev Psychiatry 2009; 21:2:113-121. https://doi.org/10.1080/09540260902782760. Haj-Mirzaian A, Amini-Khoei H, Haj-Mirzaian A, Amiri S, Ghesmati M, Zahir M, et al. Activation of cannabinoid receptors elicits antidepressant-like effects in a mouse model of social isolation stress. Brain Res Bull. 2017; 130:200-210. https://doi.org/10.1016/j.brainresbull.2017.01.018. Banach M, Piskorska B, Czuczwar SJ, Borowicz KK. Nitric Oxide, Epileptic Seizures, and Action of Antiepileptic Drugs. CNS & Neurological Disorders - Drug Targets 2011;10: 808. https://doi.org/10.2174/187152711798072347. Förstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J. 2012;33(7):829-37, 837a-837d. https://dx.doi.org/10.1093%2Feurheartj%2Fehr304. Hu Y, Wu D, Luo C, Zhu L, Zhang J, Wu H, et al. Hippocampal nitric oxide contributes to sex difference in affective behaviors. PNAS. 2012, 109 (35) 14224-14229. https://doi.org/10.1073/pnas.1207461109. Khan MI, Ostadhadi S, Zolfaghari S, Mehr SE, Hassanzadeh G, Dehpour, A et al. The involvement of NMDA receptor/NO/cGMP pathway in the antidepressant like effects of baclofen in mouse force swimming test. Neuroscience Letters. 2016; 612:52-61. https://doi.org/10.1016/j.neulet.2015.12.006. Matsumoto K, Puia G, Dong E, Pinna G. GABAA receptor neurotransmission dysfunction in a mouse model of social isolation-induced stress: Possible insights into a non-serotonergic mechanism of action of SSRIs in mood and anxiety disorders. Stress. 2007; 10:1:3-12. https://doi.org/10.1080/10253890701200997. Zlatković J, Filipović D. Chronic social isolation induces NF-κB activation and upregulation of iNOS protein expression in rat prefrontal cortex. Neurochem Int. 2013;63(3):172-179. https://doi.org/10.1016/j.neuint.2013.06.002. Haj-Mirzaian A, Amiri S, Kordjazy N, Momeny M, Razmi A, Balaei MR, et al. Lithium attenuated the depressant and anxiogenic effect of juvenile social stress through mitigating the negative impact of interlukin-1β and nitric oxide on hypothalamic-pituitary-adrenal axis function. Neuroscience. 2016; 315:271-285. https://doi.org/10.1016/j.neuroscience.2015.12.024. Larson HJ. The biggest pandemic risk? Viral misinformation. Nature 2018; 562:309. https://doi.org/10.1038/d41586-018-07034-4. Zarocostas J. How to fight an infodemic. Lancet 2020; 395:676. https://doi.org/10.1016/S0140-6736(20)30461-X. World Health Organization, 2019. Ebola Virus Disease – Democratic Republic of the Congo. Geneva, Switzerland: WHO. Available at: https://www.who.int/csr/don/28-november-2019-ebola-drc/en/ [Accessed on August 8, 2020] Times of India. Covid-19: doctors gone to collect samples attacked in Indore. Available at: https://timesofindia.indiatimes.com/videos/news/covid-19-doctors-goneto- collect-samples-attacked-in-indore/videoshow/74942153.cms; 2020 [Accessed on August 8, 2020]. Withnall A. Coronavirus: why India has had to pass new law against attacks on healthcare workers. The Independent. April 23, 2020. Semple K. “Afraid to be a nurse”: health workers under attack. The New York Times. 2020 Apr 27. The Economist. Health workers become unexpected targets during COVID-19. The Economist. May 11, 2020. Turan B, Budhwani H, Fazeli PL, Browning WR, Raper JL, Mugavero MJ, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS Behav. 2017; 21: 283–291. https://doi.org/10.1007/s10461-016-1451-5. James PB, Wardle J, Steel A, Adams J. An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross sectional study. BMC Public Health. 2020; 20: 182. https://doi.org/10.1186/s12889-020-8279-7. Aljazeera, 2020. Iran: Over 700 Dead after Drinking Alcohol to Cure Coronavirus. Aljazeera. Available at: https://www.aljazeera.com/ news/2020/04/iran-700-dead-drinking-alcohol-cure-coronavirus200427163529629.html. (Accessed June 4, 2020) Delirrad M, Mohammadi AB, 2020. New methanol poisoning outbreaks in Iran following COVID-19 pandemic. Alcohol Alcohol. 55: 347–348. https://doi.org/10.1093/alcalc/agaa036. Hassanian-Moghaddam H, Zamani N, Kolahi A-A, McDonald R, Hovda KE. Double trouble: methanol outbreak in the wake of the COVID-19 pandemic in Iran-a cross-sectional assessment. Crit Care. 2020; 24: 402. https://doi.org/10.1186/s13054-020-03140-w. Soltaninejad K. Methanol Mass Poisoning Outbreak: A Consequence of COVID-19 Pandemic and Misleading Messages on Social Media. Int J Occup Environ Med. 2020;11(3):148-150. https://dx.doi.org/10.34172%2Fijoem.2020.1983. Islam MS, Sarkar T, Khan SH, Kamal AM, Hasan SMM, Kabir A, et al. COVID-19–Related Infodemic and Its Impact on Public Health: A Global Social Media Analysis. Am J Trop Med Hyg. 2020; 00(0):1–9. https://doi.org/10.4269/ajtmh.20-0812. Hawryluck L, Gold W, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–1212. https://dx.doi.org/10.3201%2Feid1007.030703. Lee S, Chan LYY, Chau AAM, Kwok KPS, Kleinman A. The experience of SARS-related stigma at Amoy Gardens. Soc Sci Med. 2005; 61(9): 2038-2046. https://doi.org/10.1016/j.socscimed.2005.04.010. Yoon MK Kim SY Ko HS Lee MS. System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea. Int J Ment Health Syst. 2016; 10: 51. https://doi.org/10.1186/s13033-016-0083-5. Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008; 136: 997-1007. https://dx.doi.org/10.1017%2FS0950268807009156. Marjanovic Z, Greenglass ER, Coffey S. The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey. Int J Nurs Stud. 2007; 44(6): 991-998. https://doi.org/10.1016/j.ijnurstu.2006.02.012. Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004; 55: 1055-1057. https://doi.org/10.1176/appi.ps.55.9.1055. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases10May2020.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/AdvisoryformanagingHealthcareworkersworkinginCOVIDandNonCOVIDareasofthehospital.pdf (Accessed on 25 August 2020). Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforInternationalArrivals02082020.pdf [Accessed on 25 August 2020]. Cost of the lockdown? Over 10% of GDP loss for 18 states. Available at: https://timesofindia.indiatimes.com/india/cost-of-the-lockdown-over-10-of-gdp-loss-for-18-states/articleshow/76028826.cms [Accessed on 21 August 2020]. Jorda O, Singh SR, Taylor AM. Longer-Run Economic Consequences of Pandemics. Federal Reserve Bank of San Francisco Working Paper. 2020-09. https://doi.org/10.24148/wp2020-09. Firdaus G. Mental well‑being of migrants in urban center of India: Analyzing the role of social environment. Indian J Psychiatry. 2017; 59:164‑ https://doi.org/10.4103/psychiatry.indianjpsychiatry_272_15. National Crime Record Bureau. Annual Crime in India Report. New Delhi, India: Ministry of Home Affairs; 2018. 198 migrant workers killed in road accidents during lockdown: Report. Available at: https://www.hindustantimes.com/india-news/198-migrant-workers-killed-in-road-accidents-during-lockdown-report/story-hTWzAWMYn0kyycKw1dyKqL.html [Accessed on 25 August 2020]. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020; 20:689-96. https://doi.org/10.1016/S1473-3099(20)30198-5. Dalton L, Rapa E, Stein A. Protecting the psychological health of through effective communication about COVID-19. Lancet Child Adolesc Health. 2020;4(5):346-347. https://doi.org/10.1016/S2352-4642(20)30097-3. Centre for Disease Control. Helping Children Cope with Emergencies. Available at: https://www.cdc.gov/childrenindisasters/helping-children-cope.html [Accessed on 25 August 2020]. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child & Adolesc Health. 2020; 4(5):347-349. https://doi.org/10.1016/S2352-4642(20)30096-1. Sprang G, Silman M. Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters. Disaster Med Public Health Prep. 2013;7(1):105-110. https://doi.org/10.1017/dmp.2013.22. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Community Ment Health J. 2020:1-7. https://doi.org/10.1007/s10597-020-00664-x. Cao W, Fang Z, Hou, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research. 2020; 287:112934. https://doi.org/10.1016/j.psychres.2020.112934. Wang C, Zhao H. The Impact of COVID-19 on Anxiety in Chinese University Students. Front Psychol. 2020; 11:1168. https://dx.doi.org/10.3389%2Ffpsyg.2020.01168. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3): e14. https://doi.org/10.1016/s2215-0366(20)30047-x. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3(3): e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976. Lancee WJ, Maunder RG, Goldbloom DS, Coauthors for the Impact of SARS Study. Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr Serv. 2008;59(1):91-95. https://dx.doi.org/10.1176%2Fps.2008.59.1.91. Tam CWC, Pang EPF, Lam LCW, Chiu HFK. Severe acute respiratory syndrome (SARS) in Hongkong in 2003: Stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34 (7):1197-1204. https://doi.org/10.1017/s0033291704002247. Lee SM, Kang WS, Cho A-R, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018; 87:123-127. https://dx.doi.org/10.1016%2Fj.comppsych.2018.10.003. Koh D, Meng KL, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: What can we learn? Med Care. 2005;43(7):676-682. https://doi.org/10.1097/01.mlr.0000167181.36730.cc. Verma S, Mythily S, Chan YH, Deslypere JP, Teo EK, Chong SA. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singap. 2004; 33(6):743e8. Yeung J, Gupta S. Doctors evicted from their homes in India as fear spreads amid coronavirus lockdown. CNN World. 2020. Available at: https://edition.cnn.com/2020/03/25/asia/india-coronavirus-doctors-discrimination-intl-hnk/index.html. [Accessed on 24 August 2020] Violence Against Women and Girls: the Shadow Pandemic. UN Women. 2020. May 3, 2020. Available at: https://www.unwomen.org/en/news/stories/2020/4/statement-ed-phumzile-violence-against-women-during-pandemic. [Accessed on 24 August 2020]. Gearhart S, Patron MP, Hammond TA, Goldberg DW, Klein A, Horney JA. The impact of natural disasters on domestic violence: an analysis of reports of simple assault in Florida (1999–2007). Violence Gend. 2018;5(2):87–92. https://doi.org/10.1089/vio.2017.0077. Sahoo S, Rani S, Parveen S, Pal Singh A, Mehra A, Chakrabarti S, et al. Self-harm and COVID-19 pandemic: An emerging concern – A report of 2 cases from India. Asian J Psychiatr 2020; 51:102104. https://dx.doi.org/10.1016%2Fj.ajp.2020.102104. Ghosh A, Khitiz MT, Pandiyan S, Roub F, Grover S. Multiple suicide attempts in an individual with opioid dependence: Unintended harm of lockdown during the COVID-19 outbreak? Indian J Psychiatry 2020; [In Press]. The Economic Times. 11 Coronavirus suspects flee from a hospital in Maharashtra. March 16 2020. Available at: https://economictimes.indiatimes.com/news/politics-and-nation/11-coronavirus-suspects-flee-from-a-hospital-in-maharashtra/videoshow/74644936.cms?from=mdr. [Accessed on 23 August 2020]. Xiang Y, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry 2020;(3):228–229. https://doi.org/10.1016/S2215-0366(20)30046-8. Van Bortel T, Basnayake A, Wurie F, Jambai M, Koroma A, Muana A, et al. Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bull World Health Organ. 2016;94(3):210–214. https://dx.doi.org/10.2471%2FBLT.15.158543. Kumar A, Nayar KR. COVID 19 and its mental health consequences. Journal of Mental Health. 2020; ahead of print:1-2. https://doi.org/10.1080/09638237.2020.1757052. Gupta R, Grover S, Basu A, Krishnan V, Tripathi A, Subramanyam A, et al. Changes in sleep pattern and sleep quality during COVID-19 lockdown. Indian J Psychiatry. 2020; 62(4):370-8. https://doi.org/10.4103/psychiatry.indianjpsychiatry_523_20. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4): P300-302. https://doi.org/10.1016/S2215-0366(20)30073-0. Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020; 14(5): 779–788. https://dx.doi.org/10.1016%2Fj.dsx.2020.05.035. Wright R. The world's largest coronavirus lockdown is having a dramatic impact on pollution in India. CNN World; 2020. Available at: https://edition.cnn.com/2020/03/31/asia/coronavirus-lockdown-impact-pollution-india-intl-hnk/index.html. [Accessed on 23 August 2020] Foster O. ‘Lockdown made me Realise What’s Important’: Meet the Families Reconnecting Remotely. The Guardian; 2020. Available at: https://www.theguardian.com/keep-connected/2020/apr/23/lockdown-made-me-realise-whats-important-meet-the-families-reconnecting-remotely. (Accessed on 23 August 2020) Bilefsky D, Yeginsu C. Of ‘Covidivorces’ and ‘Coronababies’: Life During a Lockdown. N. Y. Times; 2020. Available at: https://www.nytimes.com/2020/03/27/world/coronavirus-lockdown-relationships.html [Accessed on 23 August 2020]

Gary Yohe of Wesleyan University reviews “The Global Deal: Climate Change and the Creation of a New Era of Progress and Prosperity” by Nicholas Stern,. The EconLit Abstract of the reviewed work begins “Considers how to create a global deal to take action to reduce the impact and damage of climate change in the world. Discusses why there is a problem and how we can deal with it; the dangers; how emissions can be reduced, and at what cost; adapting to climate change; ethics, discounting, and the case for action; policies to reduce emissions; individuals, firms, communities--the power of example; the structure of a global deal; building and sustaining action; and a planet in peril. Stern is IG Patel Chair in Economics and Government and Chair of the Grantham Research Institute on Climate Change at the London School of Economics. Bibliography; index.”

Using thermometer score data from the ANES, we show that while there may have been no clear-cut Condorcet winner among the 2016 US presidential candidates, there appears to have been a Condorcet loser: Donald Trump. Thus the surprise is that the electorate preferred not only Hillary Clinton, but also the two “minor” candidates, Gary Johnson and Jill Stein, to Trump. Another surprise is that Johnson may have been the Condorcet winner. A minimal normative standard for evaluating voting systems is advanced, privileging those systems that select Condorcet winners if one exists, and critiquing systems that allow the selection of Condorcet losers. A variety of voting mechanisms are evaluated using the 2016 thermometer scores: Condorcet voting, plurality, Borda, (single winner) Hare, Coombs, range voting, and approval voting. We conclude that the essential problem with the existing voting procedure—Electoral College runoff of primary winners of two major parties—is that it (demonstrably) allows the selection of a Condorcet loser.

Cairns, Alan C. Citizens Plus: Aboriginal Peoples and the Canadian State. By Joyce Green 623Flanagan, Tom. First Nations? Second Thoughts. Par Jean-François Savard 625Manfredi, Christopher P. Judicial Power and the Charter: Canada and the Paradox of Liberal Constitutionalism. By Miriam Smith 627Corbo, Claude, sous la direction de. Repenser l'École : une anthologie des débats sur l'éducation au Québec de 1945 au rapport Parent. Par Annie Mercure 629Howe, R. Brian and David Johnson. Restraining Equality. By Paul Groarke 632Stewart, David K. and Keith Archer. Quasi-Democracy? Parties and Leadership Selection in Alberta. By Harold J. Jansen 634Adkin, Laurie E. Politics of Sustainable Development: Citizens, Unions and the Corporations. By Milton Fisk 635Gibson, Robert B., ed. Voluntary Initiatives. The New Politics of Corporate Greening. By Jean Mercier 637Vosko, Leah F. Temporary Work: The Gendered Rise of a Precarious Employment Relationship. By David Camfield 639Amar, Akhil Reed. The Bill of Rights: Creation and Reconstruction. By Matthew DeBell 640Kagan, Robert A. and Lee Axelrad, eds. Regulatory Encounters: Multinational Corporations and American Adversarial Legalism. By Susan Summers Raines 641Barbier, Maurice. La modernité politique. Par Jean-François Lessard 643Badie, Bertrand. The Imported State: The Westernization of the Political Order. By Geoff Martin 645Gill, Graeme. The Dynamics of Democratization: Elites, Civil Society and the Transition Process. By Daniel M. Brinks 646Gunther, Richard and Anthony Mughan, eds. Democracy and the Media: A Comparative Perspective. By Bartholomew Sparrow 648Klieman, Aharon. Compromising Palestine: A Guide to Final Status Negotiations. By Julie Trottier 650Huang, Jing. Factionalism in Chinese Communist Politics. By Chih-Yu Shih 652Kim, Samuel S., ed. Korea's Globalization. By Hoon Jaung Chung-Ang 654Powell, Jr., G. Bingham. Elections as Instruments of Democracy: Majoritarian and Proportional Visions. By Richard Johnston 655Tesh, Sylvia Noble. Uncertain Hazards: Environmental Activists and Scientific Proof. By William Chaloupka 657Watts, Ronald L. Comparing Federal Systems. By Michael Stein 658Eisenstadt, S. N. Paradoxes of Democracy; Fragility, Continuity, and Change. By Brian Donohue 660Castles, Stephen and Alastair Davidson. Citizenship and Migration: Globalization and the Politics of Belonging. By Triadafilos Triadafilopoulos 661Sidjanski, Dusan. The Federal Future of Europe: From European Community to the European Union. By Emmanuel Brunet-Jailly 663DeWiel, Boris. Democracy: A History of Ideas. By Florian Bail 664Newell, Waller R. Ruling Passion: The Erotics of Statecraft in Platonic Political Philosophy. By Andrew Hertzoff 666Hueglin, Thomas O. Early Modern Concepts for a Late Modern World: Althusius on Community and Federalism. By Phillip Hansen 668Slomp, Gabriella. Thomas Hobbes and the Political Philosophy of Glory. By Don Carmichael 670Thompson, Norma, ed. Instilling Ethics. By Gary K. Browning 671Boutwell, Jeffrey and Michael T. Klare, eds. Light Weapons and Civil Conflict: Controlling the Tools of Violence. By Kirsten E. Schulze 672Falk, Richard. Predatory Globalization: A Critique. By Stella Ladi 674Meyer, Mary K. and Elisabeth Prügl. Gender Politics in Global Governance. By Naomi Black 675

Photograph by Gonzalo Echeverria (2010)Declaring War Soon after Al Qaeda’s terrorist attacks on 11 September 2001, the Bush Administration described its new grand strategy: the “Global War on Terror”. This underpinned the subsequent counter-insurgency in Afghanistan and the United States invasion of Iraq in March 2003. Media pundits quickly applied the Global War on Terror label to the Madrid, Bali and London bombings, to convey how Al Qaeda’s terrorism had gone transnational. Meanwhile, international relations scholars debated the extent to which September 11 had changed the international system (Brenner; Mann 303). American intellectuals adopted several variations of the Global War on Terror in what initially felt like a transitional period of US foreign policy (Burns). Walter Laqueur suggested Al Qaeda was engaged in a “cosmological” and perpetual war. Paul Berman likened Al Qaeda and militant Islam to the past ideological battles against communism and fascism (Heilbrunn 248). In a widely cited article, neoconservative thinker Norman Podhoretz suggested the United States faced “World War IV”, which had three interlocking drivers: Al Qaeda and trans-national terrorism; political Islam as the West’s existential enemy; and nuclear proliferation to ‘rogue’ countries and non-state actors (Friedman 3). Podhoretz’s tone reflected a revival of his earlier Cold War politics and critique of the New Left (Friedman 148-149; Halper and Clarke 56; Heilbrunn 210). These stances attracted widespread support. For instance, the United States Marine Corp recalibrated its mission to fight a long war against “World War IV-like” enemies. Yet these stances left the United States unprepared as the combat situations in Afghanistan and Iraq worsened (Ricks; Ferguson; Filkins). Neoconservative ideals for Iraq “regime change” to transform the Middle East failed to deal with other security problems such as Pakistan’s Musharraf regime (Dorrien 110; Halper and Clarke 210-211; Friedman 121, 223; Heilbrunn 252). The Manichean and open-ended framing became a self-fulfilling prophecy for insurgents, jihadists, and militias. The Bush Administration quietly abandoned the Global War on Terror in July 2005. Widespread support had given way to policymaker doubt. Why did so many intellectuals and strategists embrace the Global War on Terror as the best possible “grand strategy” perspective of a post-September 11 world? Why was there so little doubt of this worldview? This is a debate with roots as old as the Sceptics versus the Sophists. Explanations usually focus on the Bush Administration’s “Vulcans” war cabinet: Vice President Dick Cheney, Secretary of Defense Donald Rumsfield, and National Security Advisor Condoleezza Rice, who later became Secretary of State (Mann xv-xvi). The “Vulcans” were named after the Roman god Vulcan because Rice’s hometown Birmingham, Alabama, had “a mammoth fifty-six foot statue . . . [in] homage to the city’s steel industry” (Mann x) and the name stuck. Alternatively, explanations focus on how neoconservative thinkers shaped the intellectual climate after September 11, in a receptive media climate. Biographers suggest that “neoconservatism had become an echo chamber” (Heilbrunn 242) with its own media outlets, pundits, and think-tanks such as the American Enterprise Institute and Project for a New America. Neoconservatism briefly flourished in Washington DC until Iraq’s sectarian violence discredited the “Vulcans” and neoconservative strategists like Paul Wolfowitz (Friedman; Ferguson). The neoconservatives' combination of September 11’s aftermath with strongly argued historical analogies was initially convincing. They conferred with scholars such as Bernard Lewis, Samuel P. Huntington and Victor Davis Hanson to construct classicist historical narratives and to explain cultural differences. However, the history of the decade after September 11 also contains mis-steps and mistakes which make it a series of contingent decisions (Ferguson; Bergen). One way to analyse these contingent decisions is to pose “what if?” counterfactuals, or feasible alternatives to historical events (Lebow). For instance, what if September 11 had been a chemical and biological weapons attack? (Mann 317). Appendix 1 includes a range of alternative possibilities and “minimal rewrites” or slight variations on the historical events which occurred. Collectively, these counterfactuals suggest the role of agency, chance, luck, and the juxtaposition of better and worse outcomes. They pose challenges to the classicist interpretation adopted soon after September 11 to justify “World War IV” (Podhoretz). A ‘Two-Track’ Process for ‘World War IV’ After the September 11 attacks, I think an overlapping two-track process occurred with the “Vulcans” cabinet, neoconservative advisers, and two “echo chambers”: neoconservative think-tanks and the post-September 11 media. Crucially, Bush’s “Vulcans” war cabinet succeeded in gaining civilian control of the United States war decision process. Although successful in initiating the 2003 Iraq War this civilian control created a deeper crisis in US civil-military relations (Stevenson; Morgan). The “Vulcans” relied on “politicised” intelligence such as a United Kingdom intelligence report on Iraq’s weapons development program. The report enabled “a climate of undifferentiated fear to arise” because its public version did not distinguish between chemical, biological, radiological or nuclear weapons (Halper and Clarke, 210). The cautious 2003 National Intelligence Estimates (NIE) report on Iraq was only released in a strongly edited form. For instance, the US Department of Energy had expressed doubts about claims that Iraq had approached Niger for uranium, and was using aluminium tubes for biological and chemical weapons development. Meanwhile, the post-September 11 media had become a second “echo chamber” (Halper and Clarke 194-196) which amplified neoconservative arguments. Berman, Laqueur, Podhoretz and others who framed the intellectual climate were “risk entrepreneurs” (Mueller 41-43) that supported the “World War IV” vision. The media also engaged in aggressive “flak” campaigns (Herman and Chomsky 26-28; Mueller 39-42) designed to limit debate and to stress foreign policy stances and themes which supported the Bush Administration. When former Central Intelligence Agency director James Woolsey’s claimed that Al Qaeda had close connections to Iraqi intelligence, this was promoted in several books, including Michael Ledeen’s War Against The Terror Masters, Stephen Hayes’ The Connection, and Laurie Mylroie’s Bush v. The Beltway; and in partisan media such as Fox News, NewsMax, and The Weekly Standard who each attacked the US State Department and the CIA (Dorrien 183; Hayes; Ledeen; Mylroie; Heilbrunn 237, 243-244; Mann 310). This was the media “echo chamber” at work. The group Accuracy in Media also campaigned successfully to ensure that US cable providers did not give Al Jazeera English access to US audiences (Barker). Cosmopolitan ideals seemed incompatible with what the “flak” groups desired. The two-track process converged on two now infamous speeches. US President Bush’s State of the Union Address on 29 January 2002, and US Secretary of State Colin Powell’s presentation to the United Nations on 5 February 2003. Bush’s speech included a line from neoconservative David Frumm about North Korea, Iraq and Iran as an “Axis of Evil” (Dorrien 158; Halper and Clarke 139-140; Mann 242, 317-321). Powell’s presentation to the United Nations included now-debunked threat assessments. In fact, Powell had altered the speech’s original draft by I. Lewis “Scooter” Libby, who was Cheney’s chief of staff (Dorrien 183-184). Powell claimed that Iraq had mobile biological weapons facilities, linked to Abu Musab al-Zarqawi. However, the International Atomic Energy Agency’s (IAEA) Mohamed El-Baradei, the Defense Intelligence Agency, the State Department, and the Institute for Science and International Security all strongly doubted this claim, as did international observers (Dorrien 184; Halper and Clarke 212-213; Mann 353-354). Yet this information was suppressed: attacked by “flak” or given little visible media coverage. Powell’s agenda included trying to rebuild an international coalition and to head off weather changes that would affect military operations in the Middle East (Mann 351). Both speeches used politicised variants of “weapons of mass destruction”, taken from the counterterrorism literature (Stern; Laqueur). Bush’s speech created an inflated geopolitical threat whilst Powell relied on flawed intelligence and scientific visuals to communicate a non-existent threat (Vogel). However, they had the intended effect on decision makers. US Under-Secretary of Defense, the neoconservative Paul Wolfowitz, later revealed to Vanity Fair that “weapons of mass destruction” was selected as an issue that all potential stakeholders could agree on (Wilkie 69). Perhaps the only remaining outlet was satire: Armando Iannucci’s 2009 film In The Loop parodied the diplomatic politics surrounding Powell’s speech and the civil-military tensions on the Iraq War’s eve. In the short term the two track process worked in heading off doubt. The “Vulcans” blocked important information on pre-war Iraq intelligence from reaching the media and the general public (Prados). Alternatively, they ignored area specialists and other experts, such as when Coalition Provisional Authority’s L. Paul Bremer ignored the US State Department’s fifteen volume ‘Future of Iraq’ project (Ferguson). Public “flak” and “risk entrepreneurs” mobilised a range of motivations from grief and revenge to historical memory and identity politics. This combination of private and public processes meant that although doubts were expressed, they could be contained through the dual echo chambers of neoconservative policymaking and the post-September 11 media. These factors enabled the “Vulcans” to proceed with their “regime change” plans despite strong public opposition from anti-war protestors. Expressing DoubtsMany experts and institutions expressed doubt about specific claims the Bush Administration made to support the 2003 Iraq War. This doubt came from three different and sometimes overlapping groups. Subject matter experts such as the IAEA’s Mohamed El-Baradei and weapons development scientists countered the UK intelligence report and Powell’s UN speech. However, they did not get the media coverage warranted due to “flak” and “echo chamber” dynamics. Others could challenge misleading historical analogies between insurgent Iraq and Nazi Germany, and yet not change the broader outcomes (Benjamin). Independent journalists one group who gained new information during the 1990-91 Gulf War: some entered Iraq from Kuwait and documented a more humanitarian side of the war to journalists embedded with US military units (Uyarra). Finally, there were dissenters from bureaucratic and institutional processes. In some cases, all three overlapped. In their separate analyses of the post-September 11 debate on intelligence “failure”, Zegart and Jervis point to a range of analytic misperceptions and institutional problems. However, the intelligence community is separated from policymakers such as the “Vulcans”. Compartmentalisation due to the “need to know” principle also means that doubting analysts can be blocked from releasing information. Andrew Wilkie discovered this when he resigned from Australia’s Office for National Assessments (ONA) as a transnational issues analyst. Wilkie questioned the pre-war assessments in Powell’s United Nations speech that were used to justify the 2003 Iraq War. Wilkie was then attacked publicly by Australian Prime Minister John Howard. This overshadowed a more important fact: both Howard and Wilkie knew that due to Australian legislation, Wilkie could not publicly comment on ONA intelligence, despite the invitation to do so. This barrier also prevented other intelligence analysts from responding to the “Vulcans”, and to “flak” and “echo chamber” dynamics in the media and neoconservative think-tanks. Many analysts knew that the excerpts released from the 2003 NIE on Iraq was highly edited (Prados). For example, Australian agencies such as the ONA, the Department of Foreign Affairs and Trade, and the Department of Defence knew this (Wilkie 98). However, analysts are trained not to interfere with policymakers, even when there are significant civil-military irregularities. Military officials who spoke out about pre-war planning against the “Vulcans” and their neoconservative supporters were silenced (Ricks; Ferguson). Greenlight Capital’s hedge fund manager David Einhorn illustrates in a different context what might happen if analysts did comment. Einhorn gave a speech to the Ira Sohn Conference on 15 May 2002 debunking the management of Allied Capital. Einhorn’s “short-selling” led to retaliation from Allied Capital, a Securities and Exchange Commission investigation, and growing evidence of potential fraud. If analysts adopted Einhorn’s tactics—combining rigorous analysis with targeted, public denunciation that is widely reported—then this may have short-circuited the “flak” and “echo chamber” effects prior to the 2003 Iraq War. The intelligence community usually tries to pre-empt such outcomes via contestation exercises and similar processes. This was the goal of the 2003 NIE on Iraq, despite the fact that the US Department of Energy which had the expertise was overruled by other agencies who expressed opinions not necessarily based on rigorous scientific and technical analysis (Prados; Vogel). In counterterrorism circles, similar disinformation arose about Aum Shinrikyo’s biological weapons research after its sarin gas attack on Tokyo’s subway system on 20 March 1995 (Leitenberg). Disinformation also arose regarding nuclear weapons proliferation to non-state actors in the 1990s (Stern). Interestingly, several of the “Vulcans” and neoconservatives had been involved in an earlier controversial contestation exercise: Team B in 1976. The Central Intelligence Agency (CIA) assembled three Team B groups in order to evaluate and forecast Soviet military capabilities. One group headed by historian Richard Pipes gave highly “alarmist” forecasts and then attacked a CIA NIE about the Soviets (Dorrien 50-56; Mueller 81). The neoconservatives adopted these same tactics to reframe the 2003 NIE from its position of caution, expressed by several intelligence agencies and experts, to belief that Iraq possessed a current, covert program to develop weapons of mass destruction (Prados). Alternatively, information may be leaked to the media to express doubt. “Non-attributable” background interviews to establishment journalists like Seymour Hersh and Bob Woodward achieved this. Wikileaks publisher Julian Assange has recently achieved notoriety due to US diplomatic cables from the SIPRNet network released from 28 November 2010 onwards. Supporters have favourably compared Assange to Daniel Ellsberg, the RAND researcher who leaked the Pentagon Papers (Ellsberg; Ehrlich and Goldsmith). Whilst Elsberg succeeded because a network of US national papers continued to print excerpts from the Pentagon Papers despite lawsuit threats, Assange relied in part on favourable coverage from the UK’s Guardian newspaper. However, suspected sources such as US Army soldier Bradley Manning are not protected whilst media outlets are relatively free to publish their scoops (Walt, ‘Woodward’). Assange’s publication of SIPRNet’s diplomatic cables will also likely mean greater restrictions on diplomatic and military intelligence (Walt, ‘Don’t Write’). Beyond ‘Doubt’ Iraq’s worsening security discredited many of the factors that had given the neoconservatives credibility. The post-September 11 media became increasingly more critical of the US military in Iraq (Ferguson) and cautious about the “echo chamber” of think-tanks and media outlets. Internet sites for Al Jazeera English, Al-Arabiya and other networks have enabled people to bypass “flak” and directly access these different viewpoints. Most damagingly, the non-discovery of Iraq’s weapons of mass destruction discredited both the 2003 NIE on Iraq and Colin Powell’s United Nations presentation (Wilkie 104). Likewise, “risk entrepreneurs” who foresaw “World War IV” in 2002 and 2003 have now distanced themselves from these apocalyptic forecasts due to a series of mis-steps and mistakes by the Bush Administration and Al Qaeda’s over-calculation (Bergen). The emergence of sites such as Wikileaks, and networks like Al Jazeera English and Al-Arabiya, are a response to the politics of the past decade. They attempt to short-circuit past “echo chambers” through providing access to different sources and leaked data. The Global War on Terror framed the Bush Administration’s response to September 11 as a war (Kirk; Mueller 59). Whilst this prematurely closed off other possibilities, it has also unleashed a series of dynamics which have undermined the neoconservative agenda. The “classicist” history and historical analogies constructed to justify the “World War IV” scenario are just one of several potential frameworks. “Flak” organisations and media “echo chambers” are now challenged by well-financed and strategic alternatives such as Al Jazeera English and Al-Arabiya. Doubt is one defence against “risk entrepreneurs” who seek to promote a particular idea: doubt guards against uncritical adoption. Perhaps the enduring lesson of the post-September 11 debates, though, is that doubt alone is not enough. What is needed are individuals and institutions that understand the strategies which the neoconservatives and others have used, and who also have the soft power skills during crises to influence critical decision-makers to choose alternatives. Appendix 1: Counterfactuals Richard Ned Lebow uses “what if?” counterfactuals to examine alternative possibilities and “minimal rewrites” or slight variations on the historical events that occurred. The following counterfactuals suggest that the Bush Administration’s Global War on Terror could have evolved very differently . . . or not occurred at all. Fact: The 2003 Iraq War and 2001 Afghanistan counterinsurgency shaped the Bush Administration’s post-September 11 grand strategy. Counterfactual #1: Al Gore decisively wins the 2000 U.S. election. Bush v. Gore never occurs. After the September 11 attacks, Gore focuses on international alliance-building and gains widespread diplomatic support rather than a neoconservative agenda. He authorises Special Operations Forces in Afghanistan and works closely with the Musharraf regime in Pakistan to target Al Qaeda’s muhajideen. He ‘contains’ Saddam Hussein’s Iraq through measurement and signature, technical intelligence, and more stringent monitoring by the International Atomic Energy Agency. Minimal Rewrite: United 93 crashes in Washington DC, killing senior members of the Gore Administration. Fact: U.S. Special Operations Forces failed to kill Osama bin Laden in late November and early December 2001 at Tora Bora. Counterfactual #2: U.S. Special Operations Forces kill Osama bin Laden in early December 2001 during skirmishes at Tora Bora. Ayman al-Zawahiri is critically wounded, captured, and imprisoned. The rest of Al Qaeda is scattered. Minimal Rewrite: Osama bin Laden’s death turns him into a self-mythologised hero for decades. Fact: The UK Blair Government supplied a 50-page intelligence dossier on Iraq’s weapons development program which the Bush Administration used to support its pre-war planning. Counterfactual #3: Rogue intelligence analysts debunk the UK Blair Government’s claims through a series of ‘targeted’ leaks to establishment news sources. Minimal Rewrite: The 50-page intelligence dossier is later discovered to be correct about Iraq’s weapons development program. Fact: The Bush Administration used the 2003 National Intelligence Estimate to “build its case” for “regime change” in Saddam Hussein’s Iraq. Counterfactual #4: A joint investigation by The New York Times and The Washington Post rebuts U.S. Secretary of State Colin Powell’s speech to the United National Security Council, delivered on 5 February 2003. Minimal Rewrite: The Central Intelligence Agency’s whitepaper “Iraq’s Weapons of Mass Destruction Programs” (October 2002) more accurately reflects the 2003 NIE’s cautious assessments. Fact: The Bush Administration relied on Ahmed Chalabi for its postwar estimates about Iraq’s reconstruction. Counterfactual #5: The Bush Administration ignores Chalabi’s advice and relies instead on the U.S. State Department’s 15 volume report “The Future of Iraq”. Minimal Rewrite: The Coalition Provisional Authority appoints Ahmed Chalabi to head an interim Iraqi government. Fact: L. Paul Bremer signed orders to disband Iraq’s Army and to De-Ba’athify Iraq’s new government. Counterfactual #6: Bremer keeps Iraq’s Army intact and uses it to impose security in Baghdad to prevent looting and to thwart insurgents. Rather than a De-Ba’athification policy, Bremer uses former Baath Party members to gather situational intelligence. Minimal Rewrite: Iraq’s Army refuses to disband and the De-Ba’athification policy uncovers several conspiracies to undermine the Coalition Provisional Authority. AcknowledgmentsThanks to Stephen McGrail for advice on science and technology analysis.References Barker, Greg. “War of Ideas”. PBS Frontline. Boston, MA: 2007. ‹http://www.pbs.org/frontlineworld/stories/newswar/video1.html› Benjamin, Daniel. “Condi’s Phony History.” Slate 29 Aug. 2003. ‹http://www.slate.com/id/2087768/pagenum/all/›. Bergen, Peter L. The Longest War: The Enduring Conflict between America and Al Qaeda. New York: The Free Press, 2011. Berman, Paul. Terror and Liberalism. W.W. Norton & Company: New York, 2003. Brenner, William J. “In Search of Monsters: Realism and Progress in International Relations Theory after September 11.” Security Studies 15.3 (2006): 496-528. Burns, Alex. “The Worldflash of a Coming Future.” M/C Journal 6.2 (April 2003). ‹http://journal.media-culture.org.au/0304/08-worldflash.php›. Dorrien, Gary. Imperial Designs: Neoconservatism and the New Pax Americana. New York: Routledge, 2004. Ehrlich, Judith, and Goldsmith, Rick. The Most Dangerous Man in America: Daniel Ellsberg and the Pentagon Papers. Berkley CA: Kovno Communications, 2009. Einhorn, David. Fooling Some of the People All of the Time: A Long Short (and Now Complete) Story. Hoboken NJ: John Wiley & Sons, 2010. Ellison, Sarah. “The Man Who Spilled The Secrets.” Vanity Fair (Feb. 2011). ‹http://www.vanityfair.com/politics/features/2011/02/the-guardian-201102›. Ellsberg, Daniel. Secrets: A Memoir of Vietnam and the Pentagon Papers. New York: Viking, 2002. Ferguson, Charles. No End in Sight, New York: Representational Pictures, 2007. Filkins, Dexter. The Forever War. New York: Vintage Books, 2008. Friedman, Murray. The Neoconservative Revolution: Jewish Intellectuals and the Shaping of Public Policy. New York: Cambridge UP, 2005. Halper, Stefan, and Jonathan Clarke. America Alone: The Neo-Conservatives and the Global Order. New York: Cambridge UP, 2004. Hayes, Stephen F. The Connection: How Al Qaeda’s Collaboration with Saddam Hussein Has Endangered America. New York: HarperCollins, 2004. Heilbrunn, Jacob. They Knew They Were Right: The Rise of the Neocons. New York: Doubleday, 2008. Herman, Edward S., and Noam Chomsky. Manufacturing Consent: The Political Economy of the Mass Media. Rev. ed. New York: Pantheon Books, 2002. Iannucci, Armando. In The Loop. London: BBC Films, 2009. Jervis, Robert. Why Intelligence Fails: Lessons from the Iranian Revolution and the Iraq War. Ithaca NY: Cornell UP, 2010. Kirk, Michael. “The War behind Closed Doors.” PBS Frontline. Boston, MA: 2003. ‹http://www.pbs.org/wgbh/pages/frontline/shows/iraq/›. Laqueur, Walter. No End to War: Terrorism in the Twenty-First Century. New York: Continuum, 2003. Lebow, Richard Ned. Forbidden Fruit: Counterfactuals and International Relations. Princeton NJ: Princeton UP, 2010. Ledeen, Michael. The War against The Terror Masters. New York: St. Martin’s Griffin, 2003. Leitenberg, Milton. “Aum Shinrikyo's Efforts to Produce Biological Weapons: A Case Study in the Serial Propagation of Misinformation.” Terrorism and Political Violence 11.4 (1999): 149-158. Mann, James. Rise of the Vulcans: The History of Bush’s War Cabinet. New York: Viking Penguin, 2004. Morgan, Matthew J. The American Military after 9/11: Society, State, and Empire. New York: Palgrave Macmillan, 2008. Mueller, John. Overblown: How Politicians and the Terrorism Industry Inflate National Security Threats, and Why We Believe Them. New York: The Free Press, 2009. Mylroie, Laurie. Bush v The Beltway: The Inside Battle over War in Iraq. New York: Regan Books, 2003. Nutt, Paul C. Why Decisions Fail. San Francisco: Berrett-Koelher, 2002. Podhoretz, Norman. “How to Win World War IV”. Commentary 113.2 (2002): 19-29. Prados, John. Hoodwinked: The Documents That Reveal How Bush Sold Us a War. New York: The New Press, 2004. Ricks, Thomas. Fiasco: The American Military Adventure in Iraq. New York: The Penguin Press, 2006. Stern, Jessica. The Ultimate Terrorists. Boston, MA: Harvard UP, 2001. Stevenson, Charles A. Warriors and Politicians: US Civil-Military Relations under Stress. New York: Routledge, 2006. Walt, Stephen M. “Should Bob Woodward Be Arrested?” Foreign Policy 10 Dec. 2010. ‹http://walt.foreignpolicy.com/posts/2010/12/10/more_wikileaks_double_standards›. Walt, Stephen M. “‘Don’t Write If You Can Talk...’: The Latest from WikiLeaks.” Foreign Policy 29 Nov. 2010. ‹http://walt.foreignpolicy.com/posts/2010/11/29/dont_write_if_you_can_talk_the_latest_from_wikileaks›. Wilkie, Andrew. Axis of Deceit. Melbourne: Black Ink Books, 2003. Uyarra, Esteban Manzanares. “War Feels like War”. London: BBC, 2003. Vogel, Kathleen M. “Iraqi Winnebagos™ of Death: Imagined and Realized Futures of US Bioweapons Threat Assessments.” Science and Public Policy 35.8 (2008): 561–573. Zegart, Amy. Spying Blind: The CIA, the FBI and the Origins of 9/11. Princeton NJ: Princeton UP, 2007.

Alex Abou-Chebl, MD Michael Abraham, MD Joseph E. Acker, III, EMT-P, MPH Robert Adams, MD, MS, FAHA Eric Adelman, MD Opeolu Adeoye, MD DeAnna L. Adkins, PhD Maria Aguilar, MD Absar Ahmed, MD Naveed Akhtar, MD Rufus Akinyemi, MBBS, MSc, MWACP, FMCP(Nig) Karen C. Albright, DO, MPH Felipe Albuquerque, MD Andrei V. Alexandrov, MD Abdulnasser Alhajeri, MD Latisha Ali, MD Nabil J. Alkayed, MD, PhD, FAHA Amer Alshekhlee, MD, MSc Irfan Altafullah, MD Arun Paul Amar, MD Pierre Amarenco, MD, FAHA, FAAN Sepideh Amin-Hanjani, MD, FAANS, FACS, FAHA Catherine Amlie-Lefond, MD Aaron M. Anderson, MD David C. Anderson, MD, FAHA Sameer A. Ansari, MD, PhD Ken Arai, PhD Agnieszka Ardelt, MD, PhD Juan Arenillas, MD PhD William Armstead, PhD, FAHA Jennifer L. Armstrong-Wells, MD, MPH Negar Asdaghi, MD, MSc, FRCPC Nancy D. Ashley, APRN,BC, CEN,CCRN,CNRN Stephen Ashwal, MD Andrew Asimos, MD Rand Askalan, MD, PhD Kjell Asplund, MD Richard P. Atkinson, MD, FAHA Issam A. Awad, MD, MSc, FACS, MA (hon) Hakan Ay, MD, FAHA Michael Ayad, MD, PhD Cenk Ayata, MD Aamir Badruddin, MD Hee Joon Bae, MD, PhD Mark Bain, MD Tamilyn Bakas, PhD, RN, FAHA, FAAN Frank Barone, BA, DPhil Andrew Barreto, MD William G. Barsan, MD, FACEP, FAHA Nicolas G. Bazan, MD, PhD Kyra Becker, MD, FAHA Ludmila Belayev, MD Rodney Bell, MD Andrei B. Belousov, PhD Susan L. Benedict, MD Larry Benowitz, PhD Rohit Bhatia, MBBS, MD, DM, DNB Pratik Bhattacharya, MD MPh James A. Bibb, PhD Jose Biller, MD, FACP, FAAN, FAHA Randie Black Schaffer, MD, MA Kristine Blackham, MD Bernadette Boden-Albala, DrPH Cesar Borlongan, MA, PhD Susana M. Bowling, MD Monique M. B. Breteler, MD, PhD Jonathan Brisman, MD Allan L. Brook, MD, FSIR Robert D. Brown, MD, MPH Devin L. Brown, MD, MS Ketan R. Bulsara, MD James Burke, MD Cheryl Bushnell, MD, MHSc, FAHA Ken Butcher, MD, PhD, FRCPC Livia Candelise, MD S Thomas Carmichael, MD, PhD Bob S. Carter, MD, PhD Angel Chamorro, MD, PhD Pak H. Chan, PhD, FAHA Seemant Chaturvedi, MD, FAHA, FAAN Peng Roc Chen, MD Jun Chen, MD Eric Cheng, MD, MS Huimahn Alex Choi, MD Sherry Chou, MD, MMSc Michael Chow, MD, FRCS(C), MPH Marilyn Cipolla, PhD, MS, FAHA Kevin Cockroft, MD, MSc, FACS Domingos Coiteiro, MD Alexander Coon, MD Robert Cooney, MD Shelagh B. Coutts, BSc, MB.ChB., MD, FRCPC, FRCP(Glasg.) Elizabeth Crago, RN, MSN Steven C. Cramer, MD Carolyn Cronin, MD, PhD Dewitte T. Cross, MD Salvador Cruz-Flores, MD, FAHA Brett L. Cucchiara, MD, FAHA Guilherme Dabus, MD M Ziad Darkhabani, MD Stephen M. Davis, MD, FRCP, Edin FRACP, FAHA Deidre De Silva, MBBS, MRCP Amir R. Dehdashti, MD Gregory J. del Zoppo, MD, MS, FAHA Bart M. Demaerschalk, MD, MSc, FRCPC Andrew M. Demchuk, MD Andrew J. DeNardo, MD Laurent Derex, MD, PhD Gabrielle deVeber, MD Helen Dewey, MB, BS, PhD, FRACP, FAFRM(RACP) Mandip Dhamoon, MD, MPH Orlando Diaz, MD Martin Dichgans, MD Rick M. Dijkhuizen, PhD Michael Diringer, MD Jodi Dodds, MD Eamon Dolan, MD, MRCPI Amish Doshi, MD Dariush Dowlatshahi, MD, PhD, FRCPC Alexander Dressel, MD Carole Dufouil, MD Dylan Edwards, PhD Mitchell Elkind, MD, MS, FAAN Matthias Endres, MD Joey English, MD, PhD Conrado J. Estol, MD, PhD Mustapha Ezzeddine, MD, FAHA Susan C. Fagan, PharmD, FAHA Pierre B. Fayad, MD, FAHA Wende Fedder, RN, MBA, FAHA Valery Feigin, MD, PhD Johanna Fifi, MD Jessica Filosa, PhD David Fiorella, MD, PhD Urs Fischer, MD, MSc Matthew L. Flaherty, MD Christian Foerch, MD Gregg C. Fonarow, MD, FAHA Andria Ford, MD Christine Fox, MD, MAS Isabel Fragata, MD Justin Fraser, MD Don Frei, MD Gary H. Friday, MD, MPH, FAAN, FAHA Neil Friedman, MBChB Michael Froehler, MD, PhD Chirag D. Gandhi, MD Hannah Gardener, ScD Madeline Geraghty, MD Daniel P. Gibson, MD Glen Gillen, EdD, OTR James Kyle Goddard, III, MD Daniel A. Godoy, MD, FCCM Joshua Goldstein, MD, PhD, FAHA Nicole R. Gonzales, MD Hector Gonzalez, PhD Marlis Gonzalez-Fernandez, MD, PhD Philip B. Gorelick, MD, MPH, FAHA Matthew Gounis, PhD Prasanthi Govindarajan, MD Manu Goyal, MD, MSc Glenn D. Graham, MD, PhD Armin J. Grau, MD, PhD Joel Greenberg, PhD, FAHA Steven M. Greenberg, MD, PhD, FAHA David M. Greer, MD, MA, FCCM James C. Grotta, MD, FAHA Jaime Grutzendler, MD Rishi Gupta, MD Andrew Gyorke, MD Mary N. Haan, MPH, DrPH Roman Haberl, MD Maree Hackett, PhD Elliot Clark Haley, MD, FAHA Hen Hallevi, MD Edith Hamel, PhD Graeme J. Hankey, MBBS, MD, FRCP, FRCP, FRACP Amer Haque, MD Richard L. Harvey, MD Don Heck, MD Cathy M. Helgason, MD Thomas Hemmen, MD, PhD Dirk M. Hermann, MD Marta Hernandez, MD Paco Herson, PhD Michael D. Hill, MD, MSc, FRCPC Nancy K. Hills, PhD, MBA Robin C. Hilsabeck, PhD, ABPP-CN Judith A. Hinchey, MD, MS, FAHA Robert G. Holloway, MD, MPH William Holloway, MD Sherril K. Hopper, RN Jonathan Hosey, MD, FAAN George Howard, DPH, FAHA Virginia J. Howard, PhD, FAHA David Huang, MD, PhD Daniel Huddle, DO Richard L. Hughes, MD, FAHA, FAAN Lynn Hundley, RN, MSN, ARNP, CCRN, CNRN, CCNS Patricia D. Hurn, PhD, FAHA Muhammad Shazam Hussain, MD, FRCPC Costantino Iadecola, MD Rebecca N. Ichord, MD M. Arfan Ikram, MD Kachi Illoh, MD Pascal Jabbour, MD Bharathi D. Jagadeesan, MD Vivek Jain, MD Dara G. Jamieson, MD, FAHA Brian T. Jankowitz, MD Edward C. Jauch, MD, MS, FAHA, FACEP David Jeck, MD Sayona John, MD Karen C. Johnston, MD, FAHA S Claiborne Johnston, MD, FAHA Jukka Jolkkonen, PhD Stephen C. Jones, PhD, SM, BSc Theresa Jones, PhD Anne Joutel, MD, PhD Tudor G. Jovin, MD Mouhammed R. Kabbani, MD Yasha Kadkhodayan, MD Mary A. Kalafut, MD, FAHA Amit Kansara, MD Moira Kapral, MD, MS Navaz P. Karanjia, MD Wendy Kartje, MD, PhD Carlos S. Kase, MD, FAHA Scott E. Kasner, MD, MS, FAHA Markku Kaste, MD, PhD, FESO, FAHA Prasad Katakam, MD, PhD Zvonimir S. Katusic, MD Irene Katzan, MD, MS, FAHA James E. Kelly, MD Michael Kelly, MD, PhD, FRCSC Peter J. Kelly, MD, MS, FRCPI, ABPN (Dip) Margaret Kelly-Hayes, EdD, RN, FAAN David M. Kent, MD Thomas A. Kent, MD Walter Kernan, MD Salomeh Keyhani, MD, MPH Alexander Khalessi, MD, MS Nadia Khan, MD, FRCPC, MSc Naim Naji Khoury, MD, MS Chelsea Kidwell, MD, FAHA Anthony Kim, MD Howard S. Kirshner, MD, FAHA Adam Kirton, MD, MSc, FRCPC Brett M. Kissela, MD Takanari Kitazono, MD, PhD Steven Kittner, MD, MPH Jeffrey Kleim, PhD Dawn Kleindorfer, MD, FAHA N. Jennifer Klinedinst, PhD, MPH, MSN, RN William Knight, MD Adam Kobayashi, MD, PhD Sebastian Koch, MD Raymond C. Koehler, PhD, FAHA Ines P. Koerner, MD, PhD Martin Köhrmann, MD Anneli Kolk, PhD, MD John B. Kostis, MD Tobias Kurth, MD, ScD Peter Kvamme, MD Eduardo Labat, MD, DABR Daniel T. Lackland, BA, DPH, FAHA Kamakshi Lakshminarayan, MD, PhD Joseph C. LaManna, PhD Catherine E. Lang, PT, PhD Maarten G. Lansberg, MD, PhD, MS Giuseppe Lanzino, MD Paul A. Lapchak, PhD, FAHA Sean Lavine, MD Ronald M. Lazar, PhD Marc Lazzaro, MD Jin-Moo Lee, MD, PhD Meng Lee, MD Ting-Yim Lee, PhD Erica Leifheit-Limson, PhD Enrique Leira, MD, FAHA Deborah Levine, MD, MPh Joshua M. Levine, MD Steven R. Levine, MD Christopher Lewandowski, MD Daniel J. Licht, MD Judith H. Lichtman, PhD, MPH David S. Liebeskind, MD, FAHA Shao-Pow Lin, MD, PhD Weili Lin, PhD Ute Lindauer, PhD Italo Linfante, MD Lynda Lisabeth, PhD, FAHA Alice Liskay, RN, BSN, MPA, CCRC Warren Lo, MD W. T. Longstreth, MD, MPH, FAHA George A. Lopez, MD, PhD David Loy, MD, PhD Andreas R. Luft, MD Helmi Lutsep, MD, FAHA William Mack, MD Mark MacKay, MBBS, FRACP Jennifer Juhl Majersik, MD Marc D. Malkoff, MD, FAHA Randolph S. Marshall, MD John H. Martin, PhD Alexander Mason, MD Masayasu Matsumoto, MD, PhD Elizabeth Mayeda, MPH William G. Mayhan, PhD Avi Mazumdar, MD Louise D. McCullough, MD, PhD Erin McDonough, MD Lisa Merck, MD, MPH James F. Meschia, MD, FAHA Steven R. Messe, MD Joseph Mettenburg, MD,PhD William Meurer, MD BA Brett C. Meyer, MD Robert Mikulik, MD, PhD James M. Milburn, MD Kazuo Minematsu, MD, PhD J Mocco, MD, MS Yousef Mohammad, MD MSc FAAN Mahendranath Moharir, MD, MSc, FRACP Carlos A. Molina, MD Joan Montaner, MD PhD Majaz Moonis, MD, MRCP Christopher J. Moran, MD Henry Moyle, MD, PhD Susanne Muehlschlegel, MD, MPH Susanne Muehlschlegel, MD, MPH Yuichi Murayama, MD Stephanie J. Murphy, VMD, PhD, DACLAM, FAHA Fadi Nahab, MD Andrew M. Naidech, MD, MPh Ashish Nanda, MD Sandra Narayanan, MD William Neil, MD Edwin Nemoto, PhD, FAHA Lauren M. Nentwich, MD Perry P. Ng, MD Al C. Ngai, PhD Andrew D. Nguyen, MD, PhD Thanh Nguyen, MD, FRCPC Mai Nguyen-Huynh, MD, MAS Raul G. Nogueira, MD Bo Norrving, MD Robin Novakovic, MD Thaddeus Nowak, PhD David Nyenhuis, PhD Michelle C. Odden, PhD Michael O'Dell, MD Christopher S. Ogilvy, MD Jamary Oliveira-Filho, MD, PhD Jean Marc Olivot, MD, PhD Brian O'Neil, MD, FACEP Bruce Ovbiagele, MD, MSc, FAHA Shahram Oveisgharan, MD Mayowa Owolabi, MBBS,MWACP,FMCP Aditya S. Pandey, MD Dhruvil J. Pandya, MD Nancy D. Papesh, BSN, RN, CFRN, EMT-B Helena Parfenova, PhD Min S. Park, MD Matthew S. Parsons, MD Aman B. Patel, MD Srinivas Peddi, MD Joanne Penko, MS, MPH Miguel A. Perez-Pinzon, PhD, FAHA Paola Pergami, MD, PhD Michael Phipps, MD Anna M. Planas, PhD Octavio Pontes-Neto, MD Shyam Prabhakaran, MD, MS Kameshwar Prasad, MD, DM, MMSc, FRCP, FAMS Charles Prestigiacomo, MD, FAANS, FACS G. Lee Pride, MD Janet Prvu Bettger, ScD, FAHA Volker Puetz, MD, PhD Svetlana Pundik, MD Terence Quinn, MD, MRCP, MBChb (hons), BSc (hons) Alejandro Rabinstein, MD Mubeen Rafay, MB.BS, FCPS, MSc Preeti Raghavan, MD Venkatakrishna Rajajee, MD Kumar Rajamani, MD Peter A. Rasmussen, MD Kumar Reddy, MD Michael J. Reding, MD Bruce R. Reed, PhD Mathew J. Reeves, BVSc, PhD, FAHA Martin Reis, MD Marc Ribo, MD, PhD David Rodriguez-Luna, MD, PhD Charles Romero, MD Jonathan Rosand, MD Gary A. Rosenberg, MD Michael Ross, MD, FACEP Natalia S. Rost, MD, MA Elliot J. Roth, MD, FAHA Christianne L. Roumie, MD, MPH Marilyn M. Rymer, MD, FAHA Ralph L. Sacco, MS, MD, FAAN, FAHA Edgar A. Samaniego, MD, MS Navdeep Sangha, BS, MD Nerses Sanossian, MD Lauren Sansing, MD, MSTR Gustavo Saposnik, MD, MSc, FAHA Eric Sauvageau, MD Jeffrey L. Saver, MD, FAHA, FAAN Sean I. Savitz, MD, FAHA Judith D. Schaechter, PhD Lee H. Schwamm, MD, FAHA Phillip Scott, MD, FAHA Magdy Selim, MD, PhD, FAHA Warren R. Selman, MD, FAHA Souvik Sen, MD, MS, MPH, FAHA Frank Sharp, MD, FAHA, FAAN George Shaw, MD, PhD Kevin N. Sheth, MD Vilaas Shetty, MD Joshua Shimony, MD, PhD Yukito Shinohara, MD, PhD Ashfaq Shuaib, MD, FAHA Lori A. Shutter, MD Cathy A. Sila, MD, FAAN Gisele S. Silva, MD Brian Silver, MD Daniel E. Singer, MD Robert Singer, MD Aneesh B. Singhal, MD Lesli Skolarus, MD Eric E. Smith, MD Sabrina E. Smith, MD, PhD Christopher Sobey, PhD, FAHA J David Spence, MD Christian Stapf, MD Joel Stein, MD Michael F. Stiefel, MD, PhD Sophia Sundararajan, MD, PhD David Tanne, MD Robert W. Tarr, MD Turgut Tatlisumak, MD, PhD, FAHA, FESO Charles H. Tegeler, MD Mohamed S. Teleb, MD Fernando Testai, MD, PhD Ajith Thomas, MD Stephen Thomas, MD, MPH Bradford B. Thompson, MD Amanda Thrift, PhD, PGDipBiostat David Tong, MD Michel Torbey, MD, MPH, FCCM, FAHA Emmanuel Touze, MD, PhD Amytis Towfighi, MD Richard J. Traystman, PhD, FAHA Margaret F. Tremwel, MD, PhD, FAHA Brian Trimble, MD Georgios Tsivgoulis, MD Tanya Turan, MD, FAHA Aquilla S. Turk, DO Michael Tymianski, MD, PhD, FRCSC Philippa Tyrrell, MB, MD, FRCP Shinichiro Uchiyama, MD, FAHA Luis Vaca, MD Renee Van Stavern, MD Susan J. Vannucci, PhD Dale Vaslow, MD, PHD Zena Vexler, PhD Barbara Vickrey, MD, MPH Ryan Viets, MD Anand Viswanathan, MD, PhD Salina Waddy, MD Kenneth R. Wagner, PhD Lawrence R. Wechsler, MD Ling Wei, MD Theodore Wein, MD, FRCPC, FAHA Babu Welch, MD David Werring, PhD Justin Whisenant, MD Christine Anne Wijman, MD, PhD Michael Wilder, MD Joshua Willey, MD, MS David Williams, MB, BAO, BCh, PhD, Dip.Med.Tox, FRCPE, FRCPI Linda Williams, MD Olajide Williams, MD, MS Dianna Willis, PhD John A. Wilson, MD, FACS Jeffrey James Wing, MPH Carolee J. Winstein, PhD, PT, FAPTA Max Wintermark, MD Charles Wira, MD Robert J. Wityk, MD, FAHA Thomas J. Wolfe, MD Lawrence Wong, MD Daniel Woo, MD, MS Clinton Wright, MD, MS Guohua Xi, MD Ying Xian, MD, PhD Dileep R. Yavagal, MD Midori A. Yenari, MD, FAHA William L. Young, MD Darin Zahuranec, MD Allyson Zazulia, MD, FAHA Adina Zeki Al Hazzouri, PhD John H. Zhang, MD, PhD Justin Zivin, MD, PhD, FAHA Richard Zorowitz, MD, FAHA Maria Cristina Zurru, MD

IntroductionThe Sydney Opera House is Australia’s, if not the world’s, most recognisable building. It is universally recognised as an architectural icon and as a masterpiece of the built environment, which has captured the imagination of many (Commonwealth of Australia 4). The construction of the Sydney Opera House, between 1959 and 1973, utilised many ground-breaking methods and materials which, together, pushed the boundaries of technical possibilities to the limits of human knowledge at the time (Commonwealth of Australia 36, 45). Typical investigations into the Sydney Opera House focus on its architects, the materials, construction, or the events that occur on its stages. The role of the illumination, in the perception and understanding of Australia’s most famous performing arts centre, is an under-investigated aspect of its construction and its use today (Dwyer Backstage Biography 1; Dwyer “Utzon’s Use” 131).This article examines the illumination of the Sydney Opera House from the perspective of light as a construction material, another element that is used to ‘build’ the structure on Bennelong Point. This article examines the illumination from an historical view as Jørn Utzon’s (1918-2008) concepts for the building, including the lighting design intentions, were not all realised as he did not complete the project. The task of finishing this structure was allocated to the architectural cooperative of Hall, Todd & Littlemore who replaced Utzon in 1966. The Danish-born Utzon was appointed in January 1957 having won an international competition, from a field of over 230 entries, to design a national opera house for Sydney. He quickly began the task of resolving his design, transforming the roughly-sketched concepts presented in his competition entry, into detailed drawings that articulated how the opera house would be realised. The iteration of these concepts can be most succinctly identified in Utzon’s formal design reports to the Opera House Committee which are often referred to based on the colour of their cover design. The first report, the ‘red book’ was issued in 1958 with further developments of the architectural and services designs outlined in the ‘yellow book’ which followed in 1962. The last of the original architects’ publications was the Utzon Design Principles (2002) which was created as part of the reengagement process—between the Government of New South Wales and the Sydney Opera House with the original architect—that commenced in 1999.As with many modern buildings (such as Eero Saarinen’s TWA Flight Center, Richard Meier’s Jubilee Church or Adrian D. Smith’ Burj Khalifa), concrete was selected to form the basic structural element of the Sydney Opera House. Working with the, now internationally-renowned, engineering firm Ove Arup and Partners, Utzon designed some of the most significant shapes and finishes that have become synonymous with the site. The concrete elements range from basic blade walls with lustrous finishes to the complex, shape-changing beams that rise from under the monumental stairs and climb to terminate in the southern foyers. Thus, demonstrating the use of concrete as both a structural element and a high quality architectural finish. Another product used throughout the Sydney Opera House is granite. As a hardwearing stone, it is used in a crushed form as part of the precast panels that line the walls and internal flooring and as setts on the forecourt. As with the concrete the use of the same material inside and out blurs the distinction between interior and exterior. The forecourt forms a wide-open plaza before the building rises like a headland as it meets the harbour. The final, and most recognisable element is that of the shell (or roof) tiles. After many years of research Utzon settled on a simple mix of gloss and matt tiles of approximately 120mm square that, carefully arranged, produced a chevron shaped ‘lid’ and results in an effect likened to snow and ice (Commonwealth of Australia 51).These construction elements would all remain invisible if not illuminated by light, natural or artificial. This paper posits that the illumination reinforces the architecture of the structure and extends the architectural and experiential narratives of the Sydney Opera House across time and space. That, light is—like concrete, granite and tiles—a critical component of the Opera House’s build.Building a Narrative with LightIn creating the Sydney Opera House, Utzon set about harnessing natural and artificial illumination that are intrinsic parts of the human condition. Light shapes every facet of our lives from defining working and leisure hours to providing the mechanism for high speed communications and is, therefore, an obvious choice to reinforce the structure of the building and to link the built environment with the natural world that enveloped his creation. Light was to play a major role in the narrative of the Sydney Opera House starting from a patron’s approach to the site.Utzon’s staged approach to a performance at the Sydney Opera House is well documented, from the opening passages of the Descriptive Narrative (Utzon 1-2) to the Lighting Master Plan (Steensen Varming). The role of artificial light in the preparation of the audience extends beyond the simple visibility necessary to navigate the site. Light provides a linking element that guides an audience member along their ‘journey’ through several phases of transformation from the physicality of the city on the forecourt to “another world–a make believe atmosphere, which will exclude all outside impressions and allow the patrons to be absorbed into the theatre mood, which the actors and the producers wish to create” (Utzon Descriptive Narrative 2) in the theatres. Utzon conceived of light as part of the storytelling process, expressing the building’s narrative in a way that allows illumination is to be so much more than signposts to points of activity such as cloaking areas, theatre entries and the like. The lighting was intended to delineate various stages on the ‘journey’ noted above, to reinforce the transition from one world to another such that the combination of light and architecture would provide a series of successive stimuli that would build until the crescendo of the performance itself. This supports the transition of the visitor from the world of the everyday into the narrative of the Sydney Opera House and a world of make believe. Yet, in providing a narrative between these two ‘worlds’ the lighting becomes an anchor—or an element held in suspension – a mediator in the tension between the city at the beginning of the ‘journey’ and the ‘other world’ of the performance at the end. There is a balance to be maintained between illuminating the Sydney Opera House so that it remains prominent in its harbour location, easily read as a distinct sculptural structure on the peninsular separate from, but still an essential part of, the city that lies beyond Circular Quay to the south. Utzon alludes to the challenges of crafting the illumination so that it meets these requirements, noting that the illumination of the broardwalks “must be compatible with the lighting on the approach roads” (Utzon Descriptive Narrative 68) while maintaining that “the floodlit building will be the first and last impression for [… an audience] to receive” (Utzon Descriptive Narrative 1). These lighting requirements are also tempered by the desire that the “night time [...] view will be all lights and reflections, [that] stretch all along the harbour for many miles” (Utzon Descriptive Narrative 1) reinforcing the use of light as an anchor that provides both a point of reference and serves as a mediator of the Sydney Opera House’s place within the city.The narrative of the materials and elements that are combined to give the final, physical form its striking sensory presence is also told through light, in particular colour. Or, perhaps more precisely in an illumination sense, the accurate reproduction of colour and by extension accurate presentation of the construction materials used in the creation of the Sydney Opera House. Expression of the ‘truth’ in the materials he used was important for Utzon and the faithful representation of details such as the fine grains in timber and the smooth concrete finishes required careful lighting to enhance these features. When extended to the human occupants of the Sydney Opera House, there is a short, yet very descriptive instruction: the lighting is to give “life to the skin and hair on the human form in much the same way as the light from candles” (Utzon Descriptive Narrative 67). Thus, the narrative of the materials and their quality was as important as the final structure and those who would occupy it. It is the role of light to build upon the story of the materials to contribute to the overall narrative of the Sydney Opera House.Building an Experience through IlluminationUtzon envisaged that light would do much more than provide illumination or tell the narrative of the materials he had selected – light was also to build a unique architectural experience for a patron. The experience of light was to be subtle; the architecture was to retain a position of centre stage, reinforced by, rather than ever replaced by, the illumination. In this way, concealed lighting was proposed which would be “designed in close collaboration with the acoustical engineers as they will become an integral part of overall acoustic design” and “installed in carefully selected places based on knowledge gleaned from experimental work” (Utzon Descriptive Narrative 67). Through concealing the light source, the architecture did not become cluttered or over powered by a dazzling array of fixtures and fittings that detracted from the audience’s experiences. For instance, to illuminate the monumental steps, Utzon proposed that the fittings would be recessed into the handrails, while the bar and lounge areas would be lit from discreet fittings installed within the plywood ceiling panels (Utzon Descriptive Narrative 16) to create an experience of light that was unified across the site. In addition to the aesthetical improvements gained from the removal of the light sources from the field of view, unwanted glare is also reduced reinforcing the ‘whole’ of the architectural experience.During the time that Utzon was conceptualising the illumination of the Sydney Opera House, the Major Hall (what is now known as the Concert Hall) was envisaged as what might be considered as a modern multipurpose venue, one that could accommodate among other activities: symphonic concerts; opera; ballet and dance; choral concerts; pageants and mass meetings (NSW Department of Local Government 24). The Concert Hall was the terminus for the ‘journey’—where the actors and audience find themselves in the same space, the ‘other world’—“a make believe atmosphere, which will exclude all outside impressions and allow the patrons to be absorbed into the theatre mood, which the actors and the producers wish to create” (Utzon Descriptive Narrative 2). This other world was to sumptuously explode with rich colours “which uplift you in that festive mood, away from daily life, that you expect when you go to the theatre, a play, an opera or a concert” (Utzon Utzon Design Principles 34). These highly decorated and colourful finishes contrast with the white shells further highlighting the ‘journey’ that has taken place. Utzon proposed to use the illumination to reinforce this distance and provide the link between the natural colours of the raw materials used outside the theatre and highly decorated colours of the performance spaces.The lighting treatment of the theatres extended into the foyers and their public amenities to ensure that the lighting design contributed to the overall enhancement of a patron’s visit and delivered the experience of the ‘journey’ that was envisaged by Utzon (Dwyer “Utzon’s Use” 130-32). This standardised approach was in concert with Utzon’s architectural philosophy where repetitive systems of construction elements were utilised, for instance, in the construction of the shells. Utzon clearly articulated this approach in The Descriptive Narrative, noting that “standard light fittings will be chosen […] to suit each location” (67), however the standardisation would not compromise other considerations of the space such as the acoustical performance, with Utzon noting that the “fittings for auditoria and rehearsal rooms must be of necessity, designed in close collaboration with the acoustical engineers as they will become an integral part of over acoustic design” (Utzon Descriptive Narrative 67). Another parallel between the architectural development of the Sydney Opera House and Utzon’s approach to the lighting concepts was, uncommon at the time, his preference for prototyping and experimentation with lighting effects and various fittings (Utzon Descriptive Narrative 67). A sharp contrast to the usual practices of the day which relied upon more straightforward procurement processes with generic rather than tailored solutions. Peter Hall, of Hall, Todd & Littlemore, discussed the typical method of lighting design which was prevalent during the construction of the Sydney Opera House, as a method which “amounted to the electrical engineers laying out on a plan sufficient off-the-shelf light fittings to achieve the desired illumination levels […] the resulting effects were dull even if brightly lit” (Hall 180). Thus, Utzon’s careful approach to ensure that light and architecture were in harmony as “nothing is introduced into the scheme, before it has been carefully investigated and has proved to be the right solution to the problem” (Utzon Descriptive Narrative 2) was highly innovative for its time.The use of light to provide an experience was not necessarily new, for example RSL Clubs, theme parks and department stores all used light to attract attention to their products and services, however the scale and proposed execution of these concepts was pioneering for Australia in the 1950s and 1960s. Utzon’s concepts provided a highly experiential unified design to provide the patron with a unique architectural experience built through the careful use of light.Building the Scenery with LightArchitecture might be considered set design on a grand scale (for example see Raban, Rasmuseen and Read). Both architects and set designers are concerned with the relationship between the creative designs and the viewers and both set up opportunities for interactions between people (as actors or users) and structure. However, without light, the scene remains literally, in the dark, isolated from its surroundings and unperceetable to an audience.Utzon was acutely aware of the relationship between the Sydney Opera House and the city in which it stands. The positioning of the structure on the site is no accident and the interplay between the ‘sails’ and the sun is perhaps the most recognised lighting feature of the Sydney Opera House. By varying the angle of the shells, the reflections and the effects of the sunlight are constantly varying depending on the viewer’s position and focus. More importantly, these subtle variations in the light enhance the sculptural effect of the direct illumination and help create the effect of “matt snow and shining ice” (Commonwealth of Australia 51): the ‘shimmer of life’ so desired by Utzon as the sunlight strikes the ceramic tiles. This ‘shimmer’ is not the only natural lighting effect. The use of the different angles ensures variation in the light, clouds and resulting shadows to heighten interest and create an ever-changing scene that plays out on the shells as the sun moves across the sky, as Utzon notes, “something new goes on all the time and it is so important–this interplay is so important that together with the sun, the light and the clouds, it makes it a living thing” (Utzon Sydney Opera House 49). This scene is enhanced by the changing quality of the sunlight; the shells appear to be deep amber at first light their shadows long and faint before becoming shorter and stronger as the sun moves towards its midday position with the colour changing slowly to ‘pure’ white before the shadows change sides, the process reverses and they again disappear under the cover of darkness. Although the scene replays daily, the relative location of the sun and changing weather patterns ensure infinite variation in the effect.This changing scene, on a grand scale, with light as the central character is just as important as the theatrical performances taking place indoors on the stages. With a mobile audience, the detailing of the visual scene that is the structure becomes more important. The Sydney Opera House competes for attention with shipping movements in the harbour, the adjacent bridge with the ant-like procession of climbers and the activities of the city to the south. Utzon foresaw this noting that the “position on a peninsular, which is overlooked from all angles makes it important to maintain an all-round elevation. There can be no backsides to the building and nothing can be hidden from the view” (Utzon Descriptive Narrative 1). The use of natural light to enhance the sculptural form and reinforce isolation of the structure on the peninsular, centre stage on the harbour is therefore not a coincidence. Utzon has deliberately harnessed the natural light to ensure that the Sydney Opera House is just as vibrant a performer as its surroundings. In this way, Utzon has used light to anchor the Sydney Opera House both in the city it serves and for the performances it houses.It is not just the natural light that is used as such an anchor point. Utzon planned for artificial lighting of the sails and surrounding site to ensure that after dark the ‘shimmer’ of the white tiles would be maintained with an equivalent, if manufactured, effect. For Utzon, the sculptural qualities of structure were important and should be clearly ‘read’ at night, even against a dark harbour on one side and the brighter city on the other. Through the use of artificial lighting, Utzon set the scene on Bennelong Point with the structure clearly centred in the set that is the Sydney skyline. This reinforced the notion that a journey into the Sydney Opera House was something special, a transition from the everyday to the ‘other’ world.ConclusionFor Utzon light was just as essential as concrete and other building materials for the design of the Sydney Opera House. The traditional bright lights of the stage had no place in the architectural illumination, replaced instead by a much more subtle, understated use of light, and indeed its absence. Utzon planned for the lighting to envelope an audience but not to smother them. Unfortunately, he was unable to complete his project and in 1968 J.M. Waldram was eventually appointed to complete the lighting design. Waldram’s lighting solutions—many of which are still in place today—borrowed or significantly drew upon Utzon’s original illumination concepts, thus demonstrating their strength and timeless qualities. In this way light builds on the story of the structure, reinforcing the architecture of the building and extending the narratives of the construction elements used to build the Sydney Opera House.AcknowledgementsThe author acknowledges the assistance of Rachel Franks for her input on an early draft of this article and thanks the blind peer reviewers for their generous feedback and suggestions, of course any remain errors or omissions are my own. ReferencesCommonwealth of Australia. Sydney Opera House Nomination by the Government of Australia for Inscription on the World Heritage List. Canberra: Commonwealth of Australia, 2006.Cleaver, Jack. Surface and Textured Finishes for Concrete and Their Impact upon the Environment. Sydney: Steel Reinforcement Institute of Australia, 2005.Dwyer, Simon. A Backstage Biography of the Sydney Opera House. Proceedings of the 7th Annual Conference of the Popular Culture Association of Australia and New Zealand (PopCAANZ) 2016: 1-10.———. “Utzon’s Use of Light to Influence the Audience’s Perception of the Sydney Opera House”. Inhabiting the Meta Visual: Contemporary Performance Themes. Eds. Helene Gee Markstein and Arthur Maria Steijn. Oxford: Inter-Disciplinary P, 2016.Hall, Peter. Sydney Opera House: The Design Approach to the Building with Recommendations on Its Conservation. Sydney: Sydney Opera House Trust, 1990.NSW Department of Local Government. An International Competition for a National Opera House at Bennelong Point Sydney, New South Wales, Australia: Conditions and Program (“The ‘Brown’ Book”). Sydney: NSW Government Printer, 1957.Raban, Jonathan. Soft City. London: Picador, 2008.Rasmuseen, Steen. Experiencing Architecture. Cambridge: Massachusetts Institute of Technology P, 1964.Read, Gary. “Theater of Public Space: Architectural Experimentation in the Théâtre de l'Espace (Theater of Space), Paris 1937.” Journal of Architectural Education 58.4 (2005): 53-62.Steensen Varming. Lighting Master Plan. Sydney: Sydney Opera House Trust, 2007.Utzon, Jørn. Sydney Opera House: The Descriptive Narrative. Sydney: Sydney Opera House Trust, 1965.———. The Sydney Opera House. Zodiac, 1965. 48-93.———. Untitled. (The ‘Red’ Book). Unpublished, 1958.———. Untitled. (The ‘Yellow’ Book). Unpublished, 1962.———. Utzon Design Principles. Sydney: Sydney Opera House Trust, 2002.