Zechariah Aldāhirī's maqāma collection, Sefer hamusar , is a literary work modeled on the Arabic Maqāmāt of al-Harīrī and the Hebrew Tahkemoni of Alharizi. Although largely fictional in nature, the work offers intriguing evidence of the transmission of kabbalistic thought to Yemen in the sixteenth century. This paper argues that Aldāhirī exploited the text's lighthearted belletristic framework to bring kabbalistic theosophy, literature, and liturgical customs to the attention of a largely uninitiated public in Yemen. But Aldāhirī also conveys an ambivalence (...) towards his project when he parodies the new taste for kabbalistic learning by embedding mystical ideas in complex narratives. (shrink)

Poor quality medical care is sometimes attributed to physicians’ unwillingness to act on evidence about what works best. Evidence-based performance standards (EBPSs) are one response to this problem, and they are increasingly employed by health care regulators and payers. Evidence in this instance is judged according to the precepts of evidence-based medicine (EBM); it is probabilistic, and the randomized controlled trial (RCT) is the gold standard. This means that EBPSs suffer all the infirmities of EBM generally—well rehearsed problems with the (...) external validity of research findings as well as the inferential leap from study results in the aggregate to individual patient care. These theoretical weaknesses promise to have a practical impact on the care of patients. To avoid this, EBPSs should be understood as guidelines indicative of average effectiveness rather than standards to be applied in every case. (shrink)

Recently adopted health care practices and policies describe themselves as “patient-centered care.” The meaning of the term, however, remains contested and obscure. This paper offers a typology of “patient-centered care” models that aims to contribute to greater clarity about, continuing discussion of, and further advances in patient-centered care. The paper imposes an original analytic framework on extensive material covering mostly US health care and health policy topics over several decades. It finds that four models of patient-centered care emphasize: patients versus (...) their parts; patients versus providers; patients/providers/states versus “the system”; and patients and providers as persons. Each type is distinguishable along three dimensions: epistemological orientations, practical accommodations, and policy tools. Based on this analysis, the paper recommends that four questions be asked of any proposal that claims to provide patient-centered care: Is this care a means to an end or an end in itself? Are patients here subjects or objects? Are patients here individuals or aggregates? How do we know what patients want and need? The typology reveals that models are neither entirely compatible nor entirely incompatible and may be usefully combined in certain practices and policies. In other instances, internal contradictions may jeopardize the realization of coherent patient-centered care. (shrink)

Digital games have matured substantially as a narrative medium in the last decade. However, there is still much work to be done to more fully understand the poetics of story-based-games. Game narrative remains an important issue with significant cultural, economic and scholarly implications. In this article, we undertake a critical analysis of the design of narrative within Mass Effect 2: a game whose narrative is highly regarded in both scholarly and vernacular communities. We follow the classic humanities methodology of “close-reading”: (...) the detailed observation, deconstruction, and analysis of a text. Our close-reading employs a critical framework from our previous work to isolate and highlight the central narrative design parameters within digital games. This framework is grounded in the scholarly discourse around games and narrative, and has been tested and revised in the process of close-reading and analyzing contemporary games. The narrative design parameters we examine are character, storyworld, narrativized interface, emotion, and plot coherence. Our analysis uses these parameters to explicate a series of design decisions for the effective creation of narrative experience in Mass Effect 2, and by extension, for game narratives in general. We also expand our previous methodology through a focused “edge-case” strategy for exploring the limits of character, action, and story in the game. Finally, we position our analysis of Mass Effect 2 within contemporary discourses of “bounded agency”, and explore how the game negotiates the tension between player-expression, and narrative inevitability to create opportunities for sophisticated narrative poetics including tragedy and sacrifice. (shrink)

Digital games have matured substantially as a narrative medium in the last decade. However, there is still much work to be done to more fully understand the poetics of story-based-games. Game narrative remains an important issue with significant cultural, economic and scholarly implications. In this article, we undertake a critical analysis of the design of narrative within Mass Effect 2: a game whose narrative is highly regarded in both scholarly and vernacular communities. We follow the classic humanities methodology of “close-reading”: (...) the detailed observation, deconstruction, and analysis of a text. Our close-reading employs a critical framework from our previous work to isolate and highlight the central narrative design parameters within digital games. This framework is grounded in the scholarly discourse around games and narrative, and has been tested and revised in the process of close-reading and analyzing contemporary games. The narrative design parameters we examine are character, storyworld, narrativized interface, emotion, and plot coherence. Our analysis uses these parameters to explicate a series of design decisions for the effective creation of narrative experience in Mass Effect 2, and by extension, for game narratives in general. We also expand our previous methodology through a focused “edge-case” strategy for exploring the limits of character, action, and story in the game. Finally, we position our analysis of Mass Effect 2 within contemporary discourses of “bounded agency”, and explore how the game negotiates the tension between player-expression, and narrative inevitability to create opportunities for sophisticated narrative poetics including tragedy and sacrifice. (shrink)

Evidence-based practice (EBP), a derivative of evidence-based medicine (EBM), is ascendant in the United States’ mental health system; the findings of randomized controlled trials and other experimental research are widely considered authoritative in mental health practice and policy. The concept of recovery from mental illness is similarly pervasive in mental health programming and advocacy, and it emphasizes consumer expertise and self-determination. What is the relationship between these two powerful and potentially incompatible forces for mental health reform?This paper identifies four attempts, (...) in the mental health literature, to delineate the role of “evidence” in recovery. One is the strong version of evidence-based practice—an applied science model—and three others address weaknesses in the first by limiting the authority of probabilistic findings. The paper also offers a fifth version, based on the concept of communicative accountability, which is derived from Habermas’ work on communicative action. The fifth version responds to the other four and emphasizes learning, disclosure and respect in clinical and other helping relationships. (shrink)

Why do humans make music? Theories of the evolution of musicality have focused mainly on the value of music for specific adaptive contexts such as mate selection, parental care, coalition signaling, and group cohesion. Synthesizing and extending previous proposals, we argue that social bonding is an overarching function that unifies all of these theories, and that musicality enabled social bonding at larger scales than grooming and other bonding mechanisms available in ancestral primate societies. We combine cross-disciplinary evidence from archeology, anthropology, (...) biology, musicology, psychology, and neuroscience into a unified framework that accounts for the biological and cultural evolution of music. We argue that the evolution of musicality involves gene–culture coevolution, through which proto-musical behaviors that initially arose and spread as cultural inventions had feedback effects on biological evolution because of their impact on social bonding. We emphasize the deep links between production, perception, prediction, and social reward arising from repetition, synchronization, and harmonization of rhythms and pitches, and summarize empirical evidence for these links at the levels of brain networks, physiological mechanisms, and behaviors across cultures and across species. Finally, we address potential criticisms and make testable predictions for future research, including neurobiological bases of musicality and relationships between human music, language, animal song, and other domains. The music and social bonding hypothesis provides the most comprehensive theory to date of the biological and cultural evolution of music. (shrink)

Pietraszewski proposes four triadic “primitives” for representing social groups. We argue that, despite surface differences, these triads can all be reduced to similar underlying welfare trade-off ratios, which are a better candidate for social group primitives. Welfare trade-off ratios also have limitations, however, and we suggest there are multiple computational strategies by which people recognize and reason about social groups.

Consumer-operated services organizations (COSOs) are independent, non-profit organizations that provide peer support and other non-clinical services to seriously mentally ill people. Mental health consumers provide many of these services and make up at least a majority of the organization’s leadership. Although the dominant conception of the COSO is as an adjunct to clinical care in the public mental health system, this paper reconceives the organization as a civic association and thereby a locus of citizenship. Drawing on empirical research on COSOs (...) in one state and the citizenship and civic democracy literatures, COSOs are analyzed here as membership organizations with democratic norms and strong ties to local communities. The suggestion is made that by embracing and enhancing their status as civic associations, COSOs may advance the goals of the social movement that spawned them and avoid predictable obstacles to further growth and development. (shrink)

We compare and contrast the 60 commentaries by 109 authors on the pair of target articles by Mehr et al. and ourselves. The commentators largely reject Mehr et al.'s fundamental definition of music and their attempts to refute (1) our social bonding hypothesis, (2) byproduct hypotheses, and (3) sexual selection hypotheses for the evolution of musicality. Instead, the commentators generally support our more inclusive proposal that social bonding and credible signaling mechanisms complement one another in explaining cooperation within and competition (...) between groups in a coevolutionary framework (albeit with some confusion regarding terminologies such as “byproduct” and “exaptation”). We discuss the proposed criticisms and extensions, with a focus on moving beyond adaptation/byproduct dichotomies and toward testing of cross-species, cross-cultural, and other empirical predictions. (shrink)

Urban and agricultural communities are interdependent but often differ on approaches for improving water quality impaired by nutrient runoff waterbodies worldwide. Current water quality governance involves an overlapping array of policy tools implemented by governments, civil society organizations, and corporate supply chains. The choice of regulatory and voluntary tools is likely to influence many dimensions of the relationship between urban and agricultural actors. These relationships then influence future conditions for collective decision-making since many actors participate for multiple years in water (...) quality improvement. In this policy analysis, we draw on our professional experiences and research, as well as academic and practitioner literatures, to investigate how different types of water quality interventions influence urban-agricultural relationships, specifically examining policy tools on a regulatory to voluntary spectrum. Interactions between farmers and other rural agricultural interests on one hand, and urban residents and their stormwater managers and wastewater treatment plants on the other, influence dynamics relevant for water quality improvement. We suggest that the selection of policy tools within complex governance contexts influence urban–agricultural relationships through financial exchange, political coalitions, knowledge exchange, interpersonal relationships, and shared sense of place. Policy tools that provide a means to build relationships and engage with people’s emotions and identities have potential to influence personal and community change and adaptive capacity, while processes such as lawsuits can catalyze structural change. Engaging these relationships is particularly critical given the need to move out of polarized positions to solve collective problems. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 45, no. 1. © 2019 by Feminist Studies, Inc. 67 Leila J. Rupp Queer Dilemmas of Desire The dilemmas of desire confronting young women in contemporary US society are all too familiar. In the face of the persistent double standard that separates sluts from good girls, young women mobilize a variety of strategies: they lack desire, deny desire, restrain desire, police desire, and sometimes embrace desire. They (...) confront expectations to be sexy but not too sexual even as they insist on the right to be just as sexually active as men. Even in the hookup scene on college campuses, potentially liberating in its facilitation of noncommittal sexual encounters, young women worry about hooking up too much. It is a familiar story, but one that most often leaves behind young women with queer desires. Where they do appear, there are hints that they are not as likely to suppress their desires as straight women, no doubt because it is hard to ignore one’s desires when they fly in the face of heteronormative expectations. But it is also hard to come to grips with queer desires, and that is why the dilemmas I explore here are different. Unlike young straight women working to control their desires, the queer students whose stories I tell report awareness and acceptance of their attractions, sometimes from a very young age. Yet they encounter other kinds of dilemmas, especially uncertainty about the boundary between erotic love and intense friendship, a dilemma harking back to an earlier world of romantic friendship. And in the end, despite a contemporary social context in which nonnormative sexualities are more visible than ever before, 68 Leila J. Rupp experiencing queer desires continues to elicit confusion. Much has changed, but much has not. We know a great deal about straight dilemmas of desire. On the one hand, the double standard that separates sluts from good girls has persisted, despite the loosening of restrictions we associate with the sexual revolution of the long 1960s. In the face of slut shaming, young women continue to mobilize a variety of strategies, which Deborah Tolman has documented so eloquently in Dilemmas of Desire. Young women of color face additional obstacles to enjoying their desire, as the Latina girls we encounter in Lorena Garcia’s Respect Yourself, Protect Yourself make clear through their policing of their own and other girls’ sexuality in the face of racist stereotypes of unrestrained sexuality and teenage motherhood.1 On the other hand, a whole raft of commentators depict young women increasingly insisting on the right to be just as sexual as men. From Ariel Levy’s Female Chauvinist Pigs to Peggy Orenstein’s Girls and Sex to Nancy Jo Sales’ American Girls, critics lament young women embracing sex as a form of empowerment.2 The tension arising from the contradictory responses of young women to the demands placed on their sexuality is nowhere clearer than in the ongoing debate about the impact of hookup culture on women. Is hooking up good for women because it allows them to be sexual while pursuing their studies and career goals unencumbered by intimate relationships, as Hannah Rosin has suggested? Or is it, as Kathleen Bogle first argued in Hooking Up, exploitative in fashioning sexual encounters around men’s preference for sex without commitment? Or is it somewhere in between, with some 1. See Leora Tanenbaum, Slut! Growing up Female with a Bad Reputation (New York: HarperCollins, 2000); Emily White, Fast Girls: Teenage Tribes and the Myth of the Slut (New York: Berkeley Books, 2002); Sarah A. Miller, “’How You Bully a Girl:’ Sexual Drama and the Negotiation of Gendered Sexuality in High School,” Gender & Society 30, no. 5 (2016): 721–44; Deborah L. Tolman, Dilemmas of Desire: Teenage Girls Talk about Sexuality (Cambridge, MA: Harvard University Press, 2002); and Lorena Garcia, Respect Yourself, Protect Yourself: Latina Girls and Sexual Identity (New York: New York University Press, 2012). 2. Ariel Levy, Female Chauvinist Pigs: Women and the Rise of Raunch Culture (New York: Free Press, 2005). See also Peggy Orenstein, Girls and Sex: Navigating the Complicated New Landscape (New York: HarperCollins, 2016); Nancy Jo Sales, American Girls: Social Media and the Secret Lives of... (shrink)

This case examines how IBERDROLA, Spain’s leading electricity supplier, shifted the company’s strategic focus to concentrate on sustainability and turned it into a source of competitive edge in a liberalized market. Largely pre-empting the industry obligations that came out of the Kyoto agreement, IBERDROLA decided to put sustainability at the heart of the company’s decision-making processes. IBERDROLA sold off its most polluting facilities and all non-core activities to concentrate on becoming the greenest player on the market. Its success was due (...) to its willingness to walk the talk, to get stakeholders on side, and to demonstrate its determination to be a corporate citizen. An important element of the strategy was to establish a working relationship with important NGOs and effect their involvement with IBERDROLA’s activities. An early and uneasy partnership with WWF/Adena over the production of green energy proved a sharp learning curve for both parties. Then in 2004 a relatively minor event triggered a chain of reactions that led to a revolution in the company’s policy of stakeholder integration. A small group of protected birds was killed when they flew into the blades at one of IBERDROLA’s wind power facilities. When previous similar crises had occurred, IBERDROLA had dealt with them through the time-honoured methods of dialogue and confrontation. This time, IBERDROLA decided to initiate a new approach. They invited SEO/BirdLife (the Spanish Ornithology Society), the oldest Spanish NGO dedicated to the environment, to undertake a study into the implications of similar installations on bird conservation and the environment. The intention is for this collaboration to lead to a strategic agreement between both parties. (shrink)

This case examines how IBERDROLA, Spain’s leading electricity supplier, shifted the company’s strategic focus to concentrate on sustainability and turned it into a source of competitive edge in a liberalized market. Largely pre-empting the industry obligations that came out of the Kyoto agreement, IBERDROLA decided to put sustainability at the heart of the company’s decision-making processes. IBERDROLA sold off its most polluting facilities and all non-core activities to concentrate on becoming the greenest player on the market. Its success was due (...) to its willingness to walk the talk, to get stakeholders on side, and to demonstrate its determination to be a corporate citizen. An important element of the strategy was to establish a working relationship with important NGOs and effect their involvement with IBERDROLA’s activities. An early and uneasy partnership with WWF/Adena over the production of green energy proved a sharp learning curve for both parties. Then in 2004 a relatively minor event triggered a chain of reactions that led to a revolution in the company’s policy of stakeholder integration. A small group of protected birds was killed when they flew into the blades at one of IBERDROLA’s wind power facilities. When previous similar crises had occurred, IBERDROLA had dealt with them through the time-honoured methods of dialogue and confrontation. This time, IBERDROLA decided to initiate a new approach. They invited SEO/BirdLife (the Spanish Ornithology Society), the oldest Spanish NGO dedicated to the environment, to undertake a study into the implications of similar installations on bird conservation and the environment. The intention is for this collaboration to lead to a strategic agreement between both parties. (shrink)

This case examines how IBERDROLA, Spain’s leading electricity supplier, shifted the company’s strategic focus to concentrate on sustainability and turned it into a source of competitive edge in a liberalized market. Largely pre-empting the industry obligations that came out of the Kyoto agreement, IBERDROLA decided to put sustainability at the heart of the company’s decision-making processes. IBERDROLA sold off its most polluting facilities and all non-core activities to concentrate on becoming the greenest player on the market. Its success was due (...) to its willingness to walk the talk, to get stakeholders on side, and to demonstrate its determination to be a corporate citizen. An important element of the strategy was to establish a working relationship with important NGOs and effect their involvement with IBERDROLA’s activities. An early and uneasy partnership with WWF/Adena over the production of green energy proved a sharp learning curve for both parties. Then in 2004 a relatively minor event triggered a chain of reactions that led to a revolution in the company’s policy of stakeholder integration. A small group of protected birds was killed when they flew into the blades at one of IBERDROLA’s wind power facilities. When previous similar crises had occurred, IBERDROLA had dealt with them through the time-honoured methods of dialogue and confrontation. This time, IBERDROLA decided to initiate a new approach. They invited SEO/BirdLife (the Spanish Ornithology Society), the oldest Spanish NGO dedicated to the environment, to undertake a study into the implications of similar installations on bird conservation and the environment. The intention is for this collaboration to lead to a strategic agreement between both parties. (shrink)