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Ana Hedberg Olenina. Psychomotor Aesthetics: Movement and Affect in Modern Literature and Film. New York: Oxford University Press, 2020, 416 pp., $36.95 (paperback), ISBN: 9780190051266.Jennifer O’Meara. Engaging Dialogue: Cinematic Verbalism in American Independent Cinema. Edinburgh: Edinburgh University Press, 2018, 218 pp., $29.95 (paperback), ISBN: 9781474420624.Malcolm Turvey. Play Time: Jacques Tati and Comedic Modernism. New York: Columbia University Press, 2019, 304 pp., $30.00 (paperback), ISBN: 9780231193030.Neil Cohn. Who Understands Comics? London: Bloomsbury, 2020, 240 pp., $42.75 (paperback), ISBN 978-1-3501-5603-6.

The chapter introduces H.D. and Bryher, their powerful relationship near cultural erasure. It begins with their meeting in 1918, pivoting against studies of H.D. that underplay the almost lifelong relationship between H.D. and the shipping heiress and proto-transgender Bryher. It outlines their revival and relevance to our contemporary grappling with nomenclature to designate multiple genders, and the role Bryher’s money played in their conception of psychic exchange. H.D. described her relationship with Bryher as a “whole machine,” a model of their creative collaboration, with herself as a “live wire” for visions and Bryher as conductor, the wire’s wrapping, images expressive of the pair’s complementarity. The chapter sets up the book’s main through lines: ancient wisdom, psychoanalysis, trances, time travel, and activism.

This chapter explores the formative elements in H.D.’s childhood in Bethlehem, Pennsylvania—her Moravian inheritance and her father’s New England ancestry. Her mother, with the auspicious name Helen, married an outsider, Charles Leander Doolittle, an astronomy professor. She taught German and painting at the seminary where H.D.’s grandfather was principal. H.D. was drawn to her father’s telescope dome as well as her grandmother’s ravings about a failed peace plan between indigenous people and early Moravian refugees from Germany. She was exposed to Moravian iconography, depicting Jesus with a “side-hole” wound, welcoming the congregant to imagine entering it to have a womb-like experience. Both her ancestral lines cast huge shadows, showing her childhood aptitude for metaphoric lenses, having “visions” her mother discouraged. When the family moved from Bethlehem, H.D. suffered terrible dislocation.

H.D. headed with Bryher and infant to America to introduce them to her recently widowed mother. They visited Marianne Moore and her mother. The chapter focuses on the dual relationships Bryher developed with Moore, her boyish double, the other with bisexual Robert McAlmon, then a male model working on a low-budget journal, Contact, with William Carlos Williams. McAlmon fell for Bryher. While traveling to California and back through Chicago, Bryher composed West, an autobiographical travelogue and portrait of her crush on Moore. In Carmel, H.D. and Bryher posed nude. In New York again, Bryher announced at tea with the Moores and Scofield Thayer, editor of the Dial, that she had married McAlmon at a registry office. She did it to shield H.D. and Perdita, and in exchange, McAlmon could pursue his great wish to write and explore Europe. The marriage wounded Moore, who thought him unsuitable for the fencing, adventurous Bryher.

This tense period held the pair together almost solely through letters. Bryher was in full-tilt rescue work, passing from New York to London, Paris, and Switzerland annually. In New York, Bryher met Nella Larsen and visited Bethlehem, Pennsylvania. Sylvia Beach and Adrienne Monnier introduced Bryher to Walter Benjamin, who exchanged his Berlin around 1900 for her Paris 1900. Bryher sent funds and encouragement while he was interned as an enemy alien. H.D. underwent her personal terror, facing the courts when Aldington resurfaced for a divorce. Bryher coached her in preparation. After the Anschluss, Bryher carried rat poison when traveling (as she had in World War I) and leaked her fears to the Austrian psychoanalyst Walter Schmideberg and to the couple’s new scholar friend at Yale, Norman Pearson, who would soon join the Office of Strategic Services, precursor to the CIA. He shared Bryher’s anxieties and a desire to foster H.D.’s hypersensitive creative intelligence.

This chapter traces Bryher’s “illegitimate” roots, vaguer than H.D.’s, in spite of her family’s amassed wealth. Her father, an accounting genius, married Bryher’s mother, Hannah Glover, when he had not yet achieved his fame in shipping lines. One of the many invisible women in the working class and in this book, possibly a milliner, Hannah’s origins are shrouded in mystery. John became Sir John Ellerman, his shipping lines buttressing England’s imperial reach. Sir John was suspected of being Jewish, though it cannot be confirmed. Bryher grew up in a house of secrecy but idealized her childhood; her parents, as if they were on the run, took her on many exotic travels. She was in Paris for the 1900 World Exhibition and rode a camel in Egypt. She modeled her inner life on boys’ books.

The chapter begins with air raids, narrated in H.D.’s The Gift. Writing this autobiographic novel, H.D. rediscovered ancestral history about her mother’s religion and the dissenter on her father’s side, Thomas Doolittle, who preached during the Great Fire of London. Bryher attended an auction of Violet Hunt’s furniture, obtaining her tripod William Morris table. After they attended Hugh Dowding’s talk at Wigmore Hall, the pair had weekly séances with Arthur Bhaduri; initially most of the messages came for Bryher from her father. Dowding recoiled from H.D.’s suggestion they join his circle, which characteristically gave her energy to finish the second section of Trilogy, Tribute to the Angels. Osbert Sitwell arranged a reading with Eliot, Edith Sitwell, and H.D., among others, with the royal princesses in attendance. Norman Pearson arrived and arranged for Perdita to work for the OSS.

This chapter situates H.D.’s friendship with Silvia Dobson, who shared her passion for astrology. Dobson had a romantic interest in H.D., who flirted, only to reject her. Rescuing analysts driven from Berlin made it logical for Bryher to finance troubled friends in analysis in London; Dobson was the first victim. Demeter-like, Bryher created Trenoweth Farms in Cornwall with her friend Doris Banfield for roots, bulbs, vegetables, while warning that the Nazis inched toward Austria. H.D. wrote a tortured portrait of herself in Nights. Coping with Sir John’s death and hearing of the airplane crash of the man whom she had regularly passed in Freud’s waiting room, H.D. returned to Freud, who thought she might carry on this patient’s quest. J. J. van der Leeuw, a pilot and scholar, had sought to bridge science and mysticism. During this course of analysis, H.D. had a major breakthrough, understanding herself as the “perfect-bi.”

This chapter establishes H.D.’s difficulty at Bryn Mawr, her brief engagement to Ezra Pound and her wilting affection for him, beside her stronger attraction to impoverished Frances Josepha Gregg, who lived with her mother, once an active lesbian. H.D. and Frances thought themselves “witches,” reading each other’s minds. They traveled with Gregg’s mother on a European tour. At this same time, Bryher was isolated, with only her father’s library as refuge. She met Elizabethan cross-dressers like Bellario through her imagination. After her parents had a “Scotch marriage” in 1909, just when her mother gave birth to a male heir, John Jr., she learned they had been unmarried when she was born. Bryher rejected her gender assignment. From World War I on, she kept rat poison by her side, fearful of being locked up for her nonconformity. Bryher was sent to Queenswood as a day student.

Depressed, H.D. longed to travel to Delphi. On the SS Borodino, they met an archaeologist, Peter Rodeck, and H.D. had a supernatural experience she never dismissed, almost sure she had met his “astral body” looking out to sea, revealing a lost Atlantis. Her attraction to this passenger came, she thought, from his sensing Bryher’s longings, allowing “a marriage by proxy.” As other Hellenists, H.D. and Bryher studied Minoan cultures that boasted lost matriarchies. H.D. wrote about Pausanius, Euripides, and Sappho and practiced seeing what preexisted their presence. They visited the Acropolis several times, seeking out Athena Niké. Forbidden as two women alone to go to Delphi, they went to Corfu, and H.D. saw images flash on their hotel wall. Bryher completed her last “hieroglyph.” H.D. memorialized Corfu as her high point. They were initiates.

H.D. traveled to Vienna for her first sessions with Freud in March 1933, mentally anchoring Bryher in the therapy sanctum while she worked through their Corfu visions, which led Freud to think she was “stuck” in the “pre-Oed stage.” Freud also thought H.D. wanted to be Moses and establish a new religion. During her stay, H.D. crossed barbed wire and armed soldiers to reach the opera. Bryher came twice, and in June, their tram was stopped for a bomb search. In July, Sir John died, leaving an emotional vacuum for the illegitimate heiress. After the funeral, her brother announced his plan to marry, just when Bryher thought he might help her care for their mother. Bryher channeled her angry grief, harnessing money to help refugees gain necessary papers, and wrote Manchester based on a trip there to help Bergner’s stage fright, only to be rejected.

H.D. began Sword Went Out to Sea, when she began solo contact with the dead airman, Dowding’s “boys” (the very material of the novel in process), and a fresh rejection from the Admiral, triggered H.D.’s breakdown at Lowndes. H.D. sent Bryher to “the Cave” (the basement), fearing a bomb was about to destroy St. Paul’s, starting the Third World War. H.D. projected her fears upon Bryher, left to arrange for her care, and her difficult transport from Lowndes. The couple’s hiatus in their communication was a first. Dr. Theodore Brunner insisted Bryher not write to the patient. Though H.D. was delusional and severely undernourished, Bryher recognized many of her symptoms as enlarged versions of usual habits, such as assigning metaphoric value to objects. Once recovering, H.D. did not remember how she ended up at the Kusnacht clinic in Zurich, where she was greeted by the couple’s friend, Dr. Schmideberg. Everyone there spoke German. Bryher wrote in spite of the doctor’s insistence not to. Once her connection with Bryher was reestablished and letters resumed, H.D. recovered, though she complained about her captivity and the shock treatments, though eventually she thought they, too, helped. Bryher sent tapestries from Lowndes and fresh colorful wool, encouraging H.D. to weave and to finish her essay on Renaissance poets to join the Claribel poems in By Avon River.

This chapter shows H.D. and Bryher launching their enduring and prolific intimacy. Not long after their meeting, H.D. discovered she was pregnant with Cecil Gray’s child. With Bryher’s encouragement, she delivered Perdita, surviving severe pneumonia in 1918. As if in Sappho’s gymnasium, H.D. took Bryher under her wing, introducing her to Havelock Ellis and sexology. Ellis confirmed Bryher’s sense that she was really a boy. In the Scillies, H.D. and Bryher shared a vision they called “the jellyfish experience,” suggesting a “womb brain” existed. The world in fragments, they sought intimacy and nudity in nature, throwing off the claustrophobic customs of Victorianism. They cultivated a joined or overlapping psyche as their “receiving station,” trying to re-create the world through their love. Making an unofficial custody arrangement, H.D. let the eager Bryher take charge of Perdita, leaving her to write, rotating in as co-mother. This chapter introduces the idea of “chosen kin.”

Bryher and Pearson increasingly became terrorized during the Cold War, fearing the Soviets and atomic war. Perdita married John Schaffner, and Bryher visited New York to help settle the couple and to outfit Perdita for her first child. They told H.D. a different date for the pregnancy so she would not have sympathetic pains. Bryher now knew Schmideberg was an alcoholic, manipulating her with his neediness. She fled to the Scillies, to New York, to see H.D. in Lausanne and Lugano. Feeling the “old H.D. vibration,” H.D. began Helen in Egypt. From Lugano, she sent Bryher and Pearson typed pages, wanting each to note in the margins any qualms. In fact, Bryher became so interactive with H.D., the latter begged off more inspiration. After returning to Lausanne, and Bryher away with the “Schaffs,” While studying trends in parapsychology, H.D. suffered abdominal cramping, needing immediate surgery to disentangle her intestines. They decided Kusnacht would serve for recuperation.

This chapter examines Borderline, the threesome’s full-length film of 1930, starring Paul and Eslanda Robeson, with H.D. acting a jealous racist. The Robesons bonded with Bryher, opening her eyes to racism in the locals, fueling her decision to build a Bauhaus, Kenwin (after Kenneth and Winifred), in another canton. Borderline was hailed by Pabst as avant-garde; all the participants suffered emotional depletion. Bryher continued work on Close Up as a vehicle for revealing mounting white supremacy. Bryher had a crush on a Viennese film star, Elisabeth Bergner, also suffering from bodily dysphoria—and terror of Nazis. Reporting violence inflicted upon Jews and anyone not Aryan, Bryher ended the innovative journal; she became an activist. Bryher contacted Freud, who agreed to take on H.D. as analysand, and hired a mentally unstable housekeeper, who mirrored H.D.’s and Bryher’s own repressions. Bryher started attending the International Psychoanalytic Congress.

Hilda became H.D. when Pound named her poems “Imagist,” using her trim initials to prove the movement’s aesthetic restraint. She fell in love with Richard Aldington, who joined her and Amy Lowell in writing Imagist poems. The Great War broke into their writing. Aldington enlisted. During the war, H.D. suffered his adultery and fled to Cornwall with a lover, while Bryher found a pen pal in Lowell, who introduced her to H.D.’s poems and the 1916 Sea Garden, with its raw, haunted landscape. Bryher met H.D., just then in Bryher’s favored topography of Druidic Cornwall. Encouraged by H.D., Aldington and Bryher exchanged letters; he enjoyed her autobiographical Development.

H.D. wrote Tribute to Freud believing he outlasted his mortality, and showed her prior credentials as seer to Dowding. She also swiftly finished Flowering of the Rod, full of hope for rebirth and the Aquarian age. When V-E Day came, the couple went to Stratford for Shakespeare. Before V-J Day occurred, H.D. ventured alone to Stratford, there learning of the nuclear attack on Hiroshima and Nagasaki. She wrote the poem “Claribel,” about a half-dead woman, while Bryher began writing The Fourteenth of October. H.D started going solo at the Morris table, finding herself in contact with Dowding’s airmen, pilots who contacted her. With Pearson’s help, she planned to would at Bryn Mawr in 1946.

Bryher and H.D., with the Schmidebergs, were at Kenwin when they heard war was declared. Two and half weeks later, Lady Ellerman died, the same week as Freud. After H.D.’s return to London, communication was censored, so they wrote through Moore and Macpherson in New York. At first, H.D. was excited, joining Londoners against the Nazis. The Battle of Britain made Air Marshall Hugh Dowding one of her heroes. Bryher finally left Kenwin with a refugee, the Jewish daughter of her mother’s best friend, taking a perilous, stop-and-start journey back to London. An explosion destroyed the Life and Letters office; Edith and Osbert Sitwell, friends of Bryher, let Herring stay at Renishaw until he settled in nearby Eckington. After continuous air raids and Virginia Woolf’s suicide, H.D. visited Herring once; he took her to visit “Major Oak,” in an ancient forest.

While Bryher purchased Life and Letters To-Day, making Herring the literary editor, H.D. opened her doors at her new flat, 49 Lowndes, as “semi-professional analyst,” sifting through her friends’ tangles faced in analysis. Frustrated letters from Bryher arrived from Kenwin about Perdita’s desire for more attention from her birth mother. H.D. translated Ion, the play she worked on when they first met and when she was carrying Perdita. This play worked on mother loss and love. After a visit from Gertrude Stein and Thornton Wilder, H.D. reclaimed herself as a poet, applying experimental techniques in her translation. Bryher left for New York, establishing connections for refugees and tracking Bergner’s performance of Escape Me Never. Macpherson, living in New York, showed Perdita the city, while the plays they saw enacted the very crisis faced in Ion, catharsis for mother guilt, the disorientation of exile, and illegitimacy.

T. S. Eliot’s “East Cooker” in 1940 encouraged H.D. as she wrote a vatic and communal antiwar poem, The Walls Do Not Fall. This volume of Trilogy explores survival and “ancient rubrics,” provoking her readers to practice “spiritual realism,” addressing those who need to do their “worm-cycle.” Bryher left Lowndes on jaunts to Trenoweth or Eckington, always inviting H.D., who visited Cornwall twice. Her first “escape” led H.D. to “R.A.F.,” an unusual narrative poem for her, pivoting upon sitting next to a pilot on sick leave on the train from Cornwall to London. She envisioned him at her writing desk. This experience led her to the Institute for Psychical Research; Air Marshall Dowding was himself a member. She met Arthur Bhaduri, a “seer” who would conduct séances for H.D. and Bryher. Perdita worked at Bletchley Park unscrambling codes.

This chapter explores the formation of Contact Press, McAlmon publishing his own work as well as other avant-garde writers in Paris. Bryher quickly became bored with McAlmon’s café and drug life in Berlin, and he resented writing Lady Ellerman about their whereabouts. Meeting Sylvia Beach and Gertrude Stein redeemed the inconvenient marriage for Bryher. Bryher established H.D., her mother and aunt, and Perdita at Riant Chateau in Switzerland. The couple fell in love with film through Joyless Street. H.D.’s mother, H.D., and Bryher traveled to Egypt just after Tutankhamun’s tomb was opened. Working on Palimpsest, a poetic and historical novel, layering several time periods, H.D. worried Aldington plotted divorce. After her divorce, Gregg returned to the scene. Spurned by a young illustrator, Kenneth Macpherson, she sent him to H.D. Bryher divorced McAlmon, marrying Macpherson to adopt Perdita, easing H.D.’s terror of a paternity claim.

The threesome, Macpherson, Bryher, and H.D., established the Pool Group, its logo of spreading concentric rings suggestive of its expansive goal; they made a first film, Wing Beat, drawing Robert Herring into their circle. They created Close Up, the first journal in English devoted to experimental film arts. Bryher and Macpherson visited Berlin for all-day screenings, met G. W. Pabst and Hanns Sachs, the latter becoming Bryher’s psychoanalyst. After making Foothills, H.D. was pregnant by Macpherson and underwent an abortion, leading to tension in the trio. They had tried for a polygamous ménage, but this affair left them all hurting, especially with Macpherson realizing he was exclusively attracted to men. Perdita suffered at boarding school, mirroring the tensions in her experimental family. H.D. grieved her mother’s death in 1927 through HERmione. The group scrapbook resonates with their attempt to innovate diverse spatialized identities.

The purpose of this article is to identify preadmission predictor's variables of National Council Licensure Examination for Registered Nurses (NCLEX-RN) first attempt outcome in associate degree-prepared nurses. As variations in admission criteria exist nationwide, establishing a reliable profile of preadmission requirements is necessary. Through regression analysis, repeated attempts in preadmission science courses were found to be a significant predictor of NCLEX-RN outcome. Continuing to recruit interested students paying close attention to the number of attempts at a science course is recommended.

This essay begins to untangle the complex and ignored erotic friendship and collaboration between Bryher and Marianne Moore, during the years 1920–1923. Until recently, as Wayne Koestenbaum explains in Double Talk, critics have often disparaged and misread collaboration. He contrasts the Goncourt brothers’ exceptional declaration that their work represented one self, one confession, one “I” with the conventional notion of the male genius working alone. Given that “male collaboration had already earned a reputation for perversity,” the dual authorship of

TOPIC. Despite substantive advances in understanding of genetic and biochemical basis of substance abuse and addiction in the last decade, little information has been translated into alternative treatment models for the addicted patient. Rapid detox, an alternative form of detox treatment, is gaining in both acceptance and popularity. PURPOSE. To increase readers' understanding of the neurobiology of addiction and the mode of action of new detox approaches for patients addicted to opiate drugs. SOURCES. A review of the current literature pertaining to rapid detox. CONCLUSIONS. Rapid detox is a viable alternative for selected patients attempting to detox from opiate agents of abuse. Increasing knowledge of new treatment approaches allows nurses working to assist addicted patients in planning and receiving treatment based on new awareness of the neurobiology of addiction. Key words: Detox, neurobiology of addiction, opiate, rapid detox Substance abuse and dependency persist as major health concerns in America. While the economic costs to our society are huge, the human cost is harder to quantify and remains far more damaging. Enormous healthcare resources have been devoted to reducing substance abuse and dependency (Scott, 1996), with the number of drug and alcohol treatment facilities almost doubling between 1980 and 1994 (Substance Abuse & Mental Health Services Administration [SAMHSA], 1996), and with national and state expenditures doubling during the same period (Huber, Pope, & Dayhoff, 1994). Current drug abuse treatment approaches, developed primarily during the 1960s and 1970s, have changed very little since their inception (Metzger, McKay, Durell, Alterman, & O'Brien, 1996). The changes that have occurred in treatment in the last decade have been primarily structural and have been propelled by the tide of managed care reforms rather than the emergence of new treatment models. Managed care and cost-containment policies have affected substance abuse treatment by decreasing the type and intensity of services; shifting treatment from inpatient and residential care to outpatient settings, with 87% of patients now treated in outpatient programs (SAMHSA, 1996); and in the blurting of public and private programs (D'Aunno & Vaughn, 1995). While these structural changes have altered the landscape in which treatment occurs, the nature of treatment has remained constant. The Development of New Models of Treatment Substantive advances have occurred in our understanding of the genetic and biochemical basis of substance abuse and addiction in the last decade, yet little of this information has been translated into alternative treatment models for the addicted patient. Abstinence remains the goal of traditional addiction treatment. Abstinence, and the concomitant sudden cessation of drug use in addicted individuals, causes a predictable cascade of symptoms collectively referred to as withdrawal syndrome. Medically supervised detoxification treatment has traditionally been seen as the gold standard and as the logical starting point of treatment. Traditional detox has involved treatment with prescription medications, which produce similar physiological responses, less psychoactivation, and which can be more precisely regulated and tapered as the patient's metabolism readjusts to functioning without the addictive drug (McLellan, Arndt, Metzger, Woody, & O'Brien, 1993). Taking an average of 3 to 15 days, depending on the abused drug, medical detox controls but does not eliminate subjectively uncomfortable withdrawal symptoms (Delfs, Zhu, Druhan, & Aston-Jones, 2000). Universally accepted addiction treatment approaches are beginning to be challenged by the emergence of innovative treatment approaches based on new understanding of the neurochemistry of addiction. One such approach, rapid detox, has emerged as an alternative that is gaining in both acceptance and popularity, evidenced by its recent showcasing in television episodes of both "E. …

TOPIC. Complementary and alternative medicine agents (CAMs) PURPOSE. To summarize the current empirical data about the major CAMs purporting to have psychotherapeutic value. SOURCES OF INFORMATION. Extant literature. CONCLUSIONS. Available evidence indicates that CAMs, while generally safe, are not risk free. While CAM use grows, nurses and other health professionals have a limited knowledge base about the action, side effects, and interactions of common CAM agents. Nurses need to increase their knowledge base about CAMs in order to help patients in decision making regarding the use of these agents to treat common psychiatric symptoms. Search terms: Alternative treatments, CAMs, herbal agents ********* From depression to dementia, Americans are increasingly self-medicating symptoms and illnesses with a wide array of herbal, or complementary and alternative medicines (CAMs) as these agents are known. CAMs are becoming an increasingly popular way to treat a wide array of healthcare concerns, many of them psychiatric in nature. CAMs represent a broad range of healing-oriented therapies that can be used as either a complement to, or an alternative for, traditional medical treatment. The 1994 Dietary Supplement, Health, and Education Act (Ramsey, Ross, & Fischer, 2000) classified almost all CAM agents as "dietary supplements," allowing them to avoid regulation by the Food and Drug Administration (FDA). Yet, while CAMs are available to anyone, without prescription and regardless of age, an increasing body of evidence supports these agents have clinically significant side effects and potential drug-drug interactions. With patients using more CAMs, healthcare providers are increasingly needing to gain a broader understanding of the use, efficacy, and risks of CAM agents. This article examines the common CAM agents used for psychiatric-related symptoms and summarize the current empirical data about the major CAM agents purporting to have psychotherapeutic value. What Are the Facts About CAMs? CAMs are perhaps most distinguished by their lack of acceptance by mainstream Western medicine. Because of this, most healthcare providers do not commonly prescribe or embrace the use of these agents (Fetrow & Avila, 1999). With little mainstream acceptance, little empirical study has occurred and, therefore, few hard data exist regarding the efficacy of CAM agents (Fugh-Berman, 2000). Yet despite the lack of acceptance and testing by health professionals, patients are buying more and spending more on CAM agents than ever before. It is estimated that 42% of American adults use CAM agents, reflecting an increase from 34% of adults in 1993 (Eisenberg et al., 1993, 1998). Increased use means increased cost, and Americans spent $27 billion in 1997, exceeding out-of-pocket hospitalization spending for the use of these agents (Fetrow & Avila). Considered natural products, CAMs are viewed by most consumers as safe, yet many side effects and potential drug-drug interactions have been identified. This is problematic when one considers that most patients using CAMs do not inform their healthcare providers (Weiss & Takakuwa, 2001). Given that conservative estimates indicate that 80% of the world's population uses a CAM for medicinal purposes, the issues surrounding CAM use are multiple for providers and consumers (Fetrow & Avila). The most commonly used CAMs are herbal preparations, sometimes referred to as "botanicals" or "phytomedicine," and the largest empirical knowledge base exists for these CAM agents. Megadose vitamin and mineral agents are the second most popular group of CAM agents, and a much smaller, far less clear knowledge base exists for these agents. Table 1 identifies the most common complaints for which people take CAMs, along with the common CAM agents used to treat those health concerns. …

Darwin taught us that animals (like literary texts) are cultural entities with long histories. In order to test and explain his theory of artificial selection, he chose, "after deliberation," to breed pigeons: I have kept every breed which I could purchase or obtain, ... [and] associated with several eminent fanciers and have been admitted to join two of the London Pigeon Clubs. The diversity of the breeds is somewhat astonishing. (Annotated 20). Between 1855 and 1858 he joined several exclusive pigeon clubs, built a pigeon house behind his garden, and at one point sported nearly ninety birds. He shared the fancier's obsession with scrutinizing these creatures' equipage, carriage, and feathers as he studied the mechanisms of their propagation. In his research he discovered that the pigeon had an illustrious career as a domesticated creature, with its "earliest known record" in "the fifth Egyptian dynasty, about 3000 B.C." (27). To conclude that domesticated varieties can be traced to the Rock Pigeon, he surveyed the vast scene ("variation has been extraordinarily great") in long paragraphs packed with interesting detail: "Pigeons were much valued by Akber Khan in India, about the year 1600; never less than 20,000 pigeons were taken with the court" (28). The pigeon had evolved over distinct periods, mutating in response to human breeding. Once a messenger of "valentines and messages/of state" (Moore, A-Quiver 103), the pigeon had become a one-way postal worker, fulfilling both human and evolutionary missions. The pigeon is an important motif in this essay as I trace Darwin's impact on Marianne Moore, whose influence on Elizabeth Bishop was perhaps equal to Darwin's own, not so much as a figure in itself as a carrier of Darwin's idea of artificial selection. My larger argument is that Moore and Bishop, modern queer women poets, would have found Darwin's theories far more amenable to their sense of sexual and aesthetic deviation than those offered by Freud, who shaped much of how writers at the turn of the century and well into the twentieth century conceived of sexuality and identity. I use queer in a broad rather than specific sense. Bishop lived a lesbian life, though she was not "out." Moore is difficult to pin down, but as Linda Leavell argues, Although [Moore] may never have had a sexually intimate relationship, she did participate in what [Adrienne] Rich has defined broadly as a "lesbian continuum" that can include many forms of "primary intensity between and among women." (222) I argue that Darwin's vivid presentation of slow transitions over extended geological time, peculiar forms, gradual adaptations, and transitional states held out a less binary model than either sexology's invert or Freud's female homosexual. In this sense, Darwin offered these poets a way of reading desire beyond Freud's "masculine woman" who refuses to identify with the normative mother's domesticated and passive role. While the word queer in our contemporary currency does not enter Darwin's writings, he focused on deviations that prove the rule: artificial selection and the selecting hand could go too far and breed monstrosity. Nevertheless, his array of possible embodiments encouraged these poets as modern naturalists to bypass Freud's human-centered oedipal structure and the sexual drama it dictates. Both Moore and Bishop read Darwin widely. He gave them an unsentimental, even depersonalized vision of nature, but one filled with attractive anomalies and "originals." Further, Moore and Bishop identified with his monumental acuity for collecting details and his doubts about readiness for publication. Darwin published On the Origin of Species in 1859 partly because he feared a preemptive publication by Alfred Russel Wallace, who had, during his own journey in the Malay Archipelago, discovered natural selection, but without the detailed and elaborate evidence Darwin had long been compiling. …

We have created a new column that will focus on the state of psychiatric nursing around the world and on the increasingly important need for all of us, the family of psychiatric nurses, to begin to explore more deeply, and strengthen in more focused ways, the ties that bind all of us. We begin with an article that presents an international perspective on psychiatric illness and mental health promotion and ends by identifying common concerns often shared by the world's psychiatric nurses. Susan McCabe has a unique ability to blend the hard-core facts with a compassionate and intelligent point of view that is compelling and understandable. She is currently an associate professor at the Fay W. Whitney School of Nursing, University of Wyoming. She is an international speaker who presented at many international venues including the Sigma Theta Tau International Nursing Research Conference in the Virgin Islands in 2003 and the International Conference for Mental Health Nurses in Malta in 2002, a gathering that explored and discussed global issues of mental illness and psychiatric nursing. She is also frequently a keynote speaker or presenter at numerous psychiatric nursing conferences and has published extensively in several refereed journals and book chapters. She has expressed a deep desire for other psychiatric nurses to add their voices to hers and to comment and dialogue about our practice lives via the journal.

The purpose of this study was to establish the reliability and validity of the Homeless Satisfaction With Care Scale, a measure of satisfaction with care among homeless clients; and to examine selected predictors of satisfaction with care. A descriptive cross-sectional study was conducted comparing an inductively developed measure of satisfaction with 2 established satisfaction measures in a sample of 168 homeless clients who used a rural or an urban clinic. The inductively developed satisfaction scale had good internal consistency reliability and was significantly related to the established measures of satisfaction, supporting its construct validity. Generally, patient characteristics were not associated with satisfaction level. However, Black clients had significantly lower satisfaction levels than White clients; satisfaction differed between the rural and urban sites. Race and clinical site explained 7% of variance in satisfaction. The inductively developed measure provides a salient and appropriate measure of satisfaction with care for future studies with the unique population of homeless.

Background: The southern Appalachian states show a high prevalence of smoking, with associated high rates of both heart disease and cancer, yet cultural differences raise questions concerning the applicability of the mostfrequently used model for smoking cessation, the transtheoretical model, for smokers from this region of the country. Objective To identify, by examining the applicability of the transtheoretical model for southern Appalachian smokers, the percentage of individuals in each of the five stages of change, the use of the processes of change from the transtheoretical model, and the scores on recognized predictors of smoking cessation including the temptation to smoke, the perceived barriers to cessation, the pros and cons of smoking, and nicotine dependence. Methods: This population-based, descriptive, cross-sectional study used a random sample of 3,800 telephone numbers, which were called up to eight times. The 659 smokers or former smokers who agreed to participate were mailed a written questionnaire consisting of six well-established scales that measure constructs from the transtheoretical model. The final sample consisted of 357 usable questionnaires. Results: The distribution of smokers in northeastern Tennessee differed from national samples across the first three stages of change, with 56% in precontemplation, as compared with previous findings of 40% in national samples. The subjects' scores for the pros of smoking were similar across the stages of change in this sample, and although the scores for the cons differed significantly across the stages in the sample, post hoc analysis indicated that the only significant change occurred between precontemplation and contemplation. The scores for temptation to smoke did not differ significantly across the stages of change in this sample. Discussion: Smokers from Appalachian Tennessee differ from smokers in other parts of the United States, and these findings raise questions about the applicability of the transtheoretical model for this population.

Psychiatric nursing, while vibrant and applicable once, is predicated on an approach to care and an understanding of mental illness that reflects an older time. Psychiatric nursing is in the precarious position of having an aging paradigm of practice, rooted in older knowledge and beliefs and recalcitrant to new knowledge and new realities of clinical practice. This article highlights paradigmatic assumptions and identifies the two dominant knowledge structures that struggle to coexist within that paradigm. Practical consequences of practicing psychiatric nursing with an aging paradigm are reviewed and a beginning point for the development of a new paradigm is presented.

Life in rural America is often idealized, yet rural Americans suffer from mental illness in rates comparable to urban America and require similar types of support and services. However, millions of individuals living in rural areas go without needed mental health services. The dominant care model allows the treatment of mental illness to be delivered by non-mental health professionals with little or no education or training in psychiatric care and who have little desire to provide this type of care, resulting most often in ineffective or inappropriate treatment. Lacking access to appropriate and effective care, rural mentally ill individuals are more often symptomatic than their urban counterparts and may never find relief from the disabling symptoms of treatable mental illnesses. This article will focus on the current state of psychiatric-mental health care in the context of these realities and discuss the impact of the current trend of mental illness being treated by non-mental health professionals. The article will conclude by proposing a model of advanced practice nursing that the authors believe will increase both access and efficacy of treatment for the mentally ill living in rural America. This Integrated Model views the current system of care that completely separates location for traditional physical and mental health care as antithetical to integration and to holism and presents a new model for understanding and provided integrated health care to meet the needs of rural mentally ill individuals and families.

The silent 1930 film Borderline has long attracted the archival interest of modernist scholars because it features Paul and Eslanda Robeson as well as the American expatriate poet Hilda Doolittle (or H.D. as she became known). However, the film has been largely sequestered in the vaults of the Museum of Modern Art, not available commercially and rarely screened. G.W. Pabst (the director H.D. most admired) called Borderline “the only real avant-garde film,” yet its avant-gardism to some extent may have doomed it to obscurity (Cinema and Modernism 389). It recently surfaced as part of a Robeson retrospective on American Movie Classics, which suggests that perhaps the film is breaking out of the circumscribed locus of the archive into a wider cultural forum. As a result of the limited audiences for Borderline, Robeson’s significant role in the film has been understated in the history of black cinema as well as in more general studies of early cinema and modernism. However, to assert that Robeson’s contribution and the film’s place in American film have been overlooked merely as a result of its limited distribution would be a tremendous oversimplification of a complicated intersection of cultural and aesthetic vectors. The film’s experimental methods draw into radical relief the very processes by which racist fantasies are installed. As Hazel Carby gages it, the film relies upon “an almost obsessive use of close-up, in which light and shadow from taut skin and flickering muscle are used to evoke mood and meaning” (67). She further asserts, singling out the white director, Kenneth Macpherson: “The subjectivity dissected and exposed by his camera work was in effect a product of his own modernist desires and anxieties surrounding the formation of masculinity in the modern world. Its racialization was a mediating device” (68). Indeed the filmmakers wield the “dissecting gaze,” but I argue that the white protagonists and creators of the film also become dissected. Racialization becomes more than a mediating device; it is in fact how we become bodies, how we are defined as such. In their rejection of high modernist values of impervious autonomy and transcendent disembodiment, the creators of Borderline were part of an avant-garde aesthetic movement that viewed film as conduit of social change. Film also acted as the medium par excellence to self-consciously manipulate (if often heavy-handedly) psychoanalytic tropes, such as Freud’s proto-cinematic notion of the “bodily ego” as the “projection of a surface.” The body from this perspective is the site and map, from the outset, of libidinal investment. With its focus upon the inscription upon bodily surfaces and through its heightened use of montage, Borderline vivifies how bodies are cut out and constructed along devastating racial and sexual lines.

We report that the tumor neurosis factor homolog APRIL (a proliferation-inducing ligand) stimulates in vitro proliferation of primary B and T cells and increases spleen weight due to accumulation of B cells in vivo. APRIL functions via binding to BCMA (B cell maturation antigen) and TACI (transmembrane activator and CAML-interactor) and competes with TALL-1 (also called BLyS or BAFF) for receptor binding. Soluble BCMA and TACI specifically prevent binding of APRIL and block APRIL-stimulated proliferation of primary B cells. BCMA-Fc also inhibits production of antibodies against keyhole limpet hemocyanin and Pneumovax in mice, indicating that APRIL and/or TALL-1 signaling via BCMA and/or TACI are required for generation of humoral immunity. Thus, APRIL–TALL-1 and BCMA-TACI form a two ligands–two receptors pathway involved in stimulation of B and T cell function.

TALL-1/Blys/BAFF is a member of the tumor necrosis factor (TNF) ligand superfamily that is functionally involved in B cell proliferation. Here, we describe B cell hyperplasia and autoimmune lupus-like changes in transgenic mice expressing TALL-1 under the control of a β-actin promoter. The TALL-1 transgenic mice showed severe enlargement of spleen, lymph nodes, and Peyer's patches because of an increased number of B220+ cells. The transgenic mice also had hypergammaglobulinemia contributed by elevations of serum IgM, IgG, IgA, and IgE. In addition, a phenotype similar to autoimmune lupus-like disease was also seen in TALL-1 transgenic mice, characterized by the presence of autoantibodies to nuclear antigens and immune complex deposits in the kidney. Prolonged survival and hyperactivity of transgenic B cells may contribute to the autoimmune lupus-like phenotype in these animals. Our studies further confirm TALL-1 as a stimulator of B cells that affect Ig production. Thus, TALL-1 may be a primary mediator in B cell-associated autoimmune diseases.

We and others recently reported tumor necrosis factor (TNF) and apoptosis ligand–related leukocyte-expressed ligand 1 (TALL-1) as a novel member of the TNF ligand family that is functionally involved in B cell proliferation. Transgenic mice overexpressing TALL-1 have severe B cell hyperplasia and lupus-like autoimmune disease. Here, we describe expression cloning of a cell surface receptor for TALL-1 from a human Burkitt's lymphoma RAJI cell library. The cloned receptor is identical to the previously reported TNF receptor (TNFR) homologue transmembrane activator and calcium modulator and cyclophilin ligand (CAML) interactor (TACI). Murine TACI was subsequently isolated from the mouse B lymphoma A20 cells. Human and murine TACI share 54% identity overall. Human TACI exhibits high binding affinities to both human and murine TALL-1. Soluble TACI extracellular domain protein specifically blocks TALL-1–mediated B cell proliferation without affecting CD40- or lipopolysaccharide-mediated B cell proliferation in vitro. In addition, when injected into mice, soluble TACI inhibits antibody production to both T cell–dependent and –independent antigens. By yeast two-hybrid screening of a B cell library with TACI intracellular domain, we identified that, like many other TNFR family members, TACI intracellular domain interacts with TNFR-associated factor (TRAF)2, 5, and 6. Correspondingly, TACI activation in a B cell line results in nuclear factor κB and c-Jun NH2-terminal kinase activation. The identification and characterization of the receptor for TALL-1 provides useful information for the development of a treatment for B cell–mediated autoimmune diseases such as systemic lupus erythematosus.