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Over the last five decades since the first Earth Day, the JIH and environmental history, one newborn and the other already well established, have evolved within the broader context of climate change and the human reaction to it. Two of the JIH’s special issues, “History and Climate” (1980) and the “Little Ice Age: Climate and History Reconsidered” (2014), serve as bookends for an examination of how the journal responded to the latest scientific and historical findings. No other area of research requires interdisciplinary methods from so many branches of learning as does environmental history. Articles published in the JIH during the 1980s and thereafter reveal the advances in both climate research and environmental history that testify to the journal’s influence. All signs point to a vigorous and continuing role for the JIH in keeping these subjects at the forefront of an interdisciplinary endeavor ranging across the entire planet and its deep history.

Purity Lost investigates the porous nature of social, political, and religious boundaries prevalent in the eastern Mediterranean—from the Black Sea to Egypt—during the Middle Ages. In this intriguing study, Steven A. Epstein finds that people consistently defied, overlooked, or transcended restrictions designed to preserve racial and cultural purity in order to establish relationships with those different from themselves. These mixed relationships—among people who did not share language, creed, or skin color—undermined the pervasive claims of purity. They forced people to reflect on their own identities and the bonds—whether social, political, religious, or racial—that defined their lives. Drawing on examples from daily life and interstate politics, Epstein takes a close look at the renegades and rule-breakers of this era. He explores race, master/slave relationships, diplomatic relations between Christian Italians and Muslim Turks, religious conversions from Christian to Muslim and vice versa, and religious boundaries of the human and the angelic. Epstein reveals the modern view of cultural, ethnic, and religious purity in the early modern Mediterranean as a mirage, and he offers new insights into how present-day conceptions about creed, color, ethnicity, and language originated.

Jacopo da Varagine (c. 1228-1298) is remembered today primarily for his immensely popular work The Golden Legend, a massive collection of stories about the saints. Compiled over the years 1260-67, The Golden Legend quickly eclipsed earlier collections of saints' lives. One indication of its popularity is the fact that so many manuscript copies of the work have survived-more than one thousand according to some estimates. Despite the enduring influence of The Golden Legend, Jacopo remains an elusive figure because he left behind so little information about himself. InThe Talents of Jacopo da Varagine, Steven A. Epstein sets out to remedy this situation through a careful study of all Jacopo's works, including many hundreds of sermons and his innovative chronicle of Genoese history. In Epstein's sure hands, Jacopo emerges as one of the most active and talented minds of his day. Indeed, Epstein argues that one needs to read all of Jacopo's books, in a Genoese context, in order to understand the original scope of his thinking, which greatly influenced the ways generations of people across Europe experienced their Christianity. The rich sources for Jacopo's sermons, saints' lives, and history illuminate the traditions that inspired him and shaped his imaginative and artistic powers. Jacopo was also one of the inventors of social history, and his writings reveal complex and new perspectives on family life as well as the histories of gay people, slaves, Jews, and the medieval economy. Filled with impressive insights into the intellectual life of the thirteenth century,The Talents of Jacopo da Varaginewill be of interest to a wide range of medieval scholars and students of religious history, church history, and hagiography as well as intellectual history and Italian history.

This book examines the relationship between humans and nature that evolved in medieval Europe over the course of a millennium. From the beginning, people lived in nature and discovered things about it. Ancient societies bequeathed to the Middle Ages both the Bible and a pagan conception of natural history. These conflicting legacies shaped medieval European ideas about the natural order and what economic, moral and biological lessons it might teach. This book analyzes five themes found in medieval views of nature – grafting, breeding mules, original sin, property rights and disaster – to understand what some medieval people found in nature and what their assumptions and beliefs kept them from seeing.

Primary care physicians play a significant role in depression care, suicide assessment, and suicide prevention. However, little is known about what factors relate to and predict quality of depression care (assessment, diagnosis, and treatment), including suicide assessment. The authors explored the extent to which select patient and physician factors increase the probability of one element of quality of care: namely, intention to conduct suicide assessment. Data were collected from 404 randomly selected primary care physicians after their interaction with CD-ROM vignettes of actors portraying major depression with moderate levels of severity. The authors examined which patient factors and physician factors increase the likelihood of physicians’ intention to conduct a suicide assessment. Data from the study revealed that physician-participants inquired about suicide 36% of the time. A random effects logistic model indicated that several factors were predictive of physicians’ intention to conduct a suicide assessment: patient’s comorbidity status (odds ratio (OR) = 0.61; 95% confidence interval (CI) = 0.37–1.00), physicians’ age (OR = 0.67; 95% CI = 0.49–0.92), physicians’ race (OR = 1.84; 95% CI = 1.08–3.13), and how depressed the physician perceived the virtual patient to be (OR = 0.58; 95% CI = 0.39–0.87). A substantial number of primary care physicians in this study indicated they would not assess for suicide, even though most physicians perceived the virtual patient to be depressed or very depressed. Further study is needed to establish factors that may be modified and targeted to increase the likelihood of physicians’ providing one element of quality of care—suicide assessment—for depressed patients.

ObjectivesWe aimed to identify existing outcome measures for functional neurological disorder (FND), to inform the development of recommendations and to guide future research on FND outcomes.MethodsA systematic review was conducted to identify existing FND-specific outcome measures and the most common measurement domains and measures in previous treatment studies. Searches of Embase, MEDLINE and PsycINFO were conducted between January 1965 and June 2019. The findings were discussed during two international meetings of the FND-Core Outcome Measures group.ResultsFive FND-specific measures were identified—three clinician-rated and two patient-rated—but their measurement properties have not been rigorously evaluated. No single measure was identified for use across the range of FND symptoms in adults. Across randomised controlled trials (k=40) and observational treatment studies (k=40), outcome measures most often assessed core FND symptom change. Other domains measured commonly were additional physical and psychological symptoms, life impact (ie, quality of life, disability and general functioning) and health economics/cost–utility (eg, healthcare resource use and quality-adjusted life years).ConclusionsThere are few well-validated FND-specific outcome measures. Thus, at present, we recommend that existing outcome measures, known to be reliable, valid and responsive in FND or closely related populations, are used to capture key outcome domains. Increased consistency in outcome measurement will facilitate comparison of treatment effects across FND symptom types and treatment modalities. Future work needs to more rigorously validate outcome measures used in this population.

Antiphospholipid syndrome (APS) is a prothrombotic condition characterized by recurrent vascular thrombosis and/or pregnancy morbidity in the presence of circulating antiphospholipid antibodies. Central nervous system (CNS) involvement is a prominent feature of APS, and many neurological manifestations have been described in published reports. There are limited data on psychiatric syndromes occurring in association with APS, and there have been no previous reports of mania associated with APS. The authors present the case of a 31-year-old man who experienced an acute manic episode in association with APS. They review the literature on psychiatric manifestations of APS, discuss potential mechanisms of CNS pathogenesis, and consider diagnostic and treatment implications of the co-occurrence of APS and psychiatric symptoms.

Studies have long shown that some patients receive less than optimal care for depression in primary care settings. However, few studies have uncovered factors that predict and explain this deficiency. The authors administered a survey to 408 primary care physicians. They examined how physicians’ attitudes (eg, feeling positively or negatively about treating depression in their patients), physicians’ beliefs (eg, beliefs about what their patients think and prefer in terms of depression care), and demographic characteristics (independent variables) predicted optimal depression care (dependent variable). Using logistical regression analyses, they identified differences in treatment decisions between family and internal medicine physicians. Physicians’ specialty and race (family physicians and white physicians were more likely to prescribe a medication) were unique determinants of whether the physician treated depression by prescribing medication; physicians’ specialty and race (family physicians and nonwhite physicians were more likely to provide office-based counseling) were unique determinants of whether the physician treated depression by providing office-based counseling; physicians’ beliefs about depression care and physician age were unique statistically significant determinants of whether the physician treated depression by providing a referral to a mental health specialist. These findings help clarify how physicians’ specialty and beliefs about depression care influence treatment. In addition, the results in this study suggest that there are differences between family and internal medicine physicians in terms of their practice patterns and beliefs in types of treatment that patients would be willing to receive. Implications for future research on primary care depression treatment are discussed.