This chapter elucidates the ways in which “narrative can serve as a tool for the orientation of consciousness.” The dual narrative of the Confessions – nine books of personal narrative, joined by a book on memory to a cosmic narrative of creation and redemption – conveys, and is intended to convey, theological truth. In his theological work Augustine draws on, amplifies, and corrects (as he sees it) such figures as Origen (though only at second hand), Basil of Caesarea, and Ambrose to articulate his own distinctive views on knowing and willing, the condition of the fallen human will, and the source and destiny of creation. In concluding remarks that elegantly distil the unity of the Confessions, that chapter observes that “Augustine cannot give an account of his life that is not also an account of the work of God.”

This chapter explores the importance of coordinated, multidisciplinary ICU follow-up clinics in supporting the recovery of PICS patients, addressing their unique needs across physical, emotional, cognitive, and social domains. By integrating diverse healthcare professionals who craft a unified care plan, ICU follow-up clinics ensure comprehensive care that enhances recovery, reduces complications, and prevents long-term disability. Moreover, the interrelationship between impairments in different areas highlights how interventions targeting one area (e.g., physical therapy) can positively influence others (e.g., mental health). The application of frameworks like facilitated sensemaking helps patients adapt to new limitations and cope with post-traumatic stress. Additionally, the chapter discusses the role of the "four pillars of health"–nutrition, sleep, mental wellness, and movement–within recovery plans. Ultimately, a holistic, patient-centered approach not only improves functional outcomes but also supports post-traumatic growth, fostering a transformative recovery experience that empowers patients with the post intensive care syndrome.

Despite negative effects on their health and social lives, many informal carers of people living with dementia claim to be acting in accordance with a moral obligation. Indeed, feelings of failure and shame are commonly reported by those who later give up their caring responsibilities, suggesting a widespread belief that professional dementia care, whether delivered in the person’s own home or in an institutional setting, ought always to be a last resort. This chapter, however, suggests that this common intuition gets things the wrong way around. The most serious injustices engendered by present-day dementia care services are contingent on broader societal structures – they can thus be ameliorated relatively easily (if resource intensively). Informal dementia care, on the other hand, carries similar risks of injustice and is much more resistant to structural reform. While there may be moral obligations to provide informal dementia care in present-day societies, then, they arise because of the deficiencies of professional care, not the virtues of its informal counterpart.

The waters of theoretical debate are muddied by contested attempts to include National Socialism within a totalitarian model which includes the Marxist-Leninist system of rule, and by debate over the degree to which Hitler's contribution to Nazism made it unique. The role of class interests in the rise of Nazism has produced a substantial body of theory which focuses on the role of the middle classes in the affair. The rise of Nazism relates to a wider pattern of twentieth century European historical development which has witnessed an unmistakable, if hesitant, move away from social confrontation towards attempts at conciliation and integration within national political systems. However, among the complex web of historical forces and influences which explain the rise (and subsequent conduct) of Nazism are also mundane factors which belong to the typical experiences of modern capitalist societies.

Is it ethically justifiable to honor a patient’s request for ongoing blood transfusions for an incurable, relapsed leukemia, particularly in the context of scarcity? Our patient was a thirty-two-year-old Black man who had been hospitalized for six months. Despite daily blood and platelet transfusions, he remained too frail for cancer-directed therapy or discharge home. The clinical team considered ongoing transfusions to be a futile endeavor, especially given their state’s acute shortages of blood products. For the patient however, these transfusions were anything but futile: they were a form of life support, akin to hemodialysis, that allowed him to spend as much time as possible with his young family.

While this case initially appeared relatively straightforward using a utilitarian approach, the consultants have been haunted by our eschewing of alternative viewpoints, particularly in the context of the patient’s race and socioeconomic status. Should we have set aside our “usual commitments to professional polish and position” in favor of a more robust appreciation of the ethical, social, cultural, and economic dimensions of this case? By ignoring or downplaying important social considerations and our patient’s unique attributes, we actually may have tipped the balance towards less fairness and equity.

In this chapter, clinical practice is addressed from three perspectives. First, what does good clinical practice in suicide prevention look like? Secondly, there are key matters pertaining to how we both maintain patient safety and avoid iatrogenic harm. These include: an excessive focus on risk; the way in which people can and do fall through gaps between services; the continued use of, contrary to evidence, guidance and humane clinical practice, of behavioural management approaches to self-harm and suicidality, and the risks to patients and service users of ‘group think’ and malignant alienation in clinical cultures. Finally, we will consider what needs to be done to maintain positive standards and values in clinical settings.

This chapter examines a commemorative album created by Clara and Robert Schumann for their student Emilie Steffens in 1850. The album’s contents – including manuscripts from prominent composers, Robert’s complex collage of musical fragments and poetry, and concert programs documenting Steffens’ performances – functioned as more than mere keepsakes. Indeed, they served as deliberate means to construct Steffens’ musical identity and validate her status in the world of serious art music. Robert’s inscription, featuring excerpts from his major works linked to specific performances Steffens attended, demonstrates how he and Clara embedded lived musical experiences within material objects. Their inclusion of concert programs from Steffens’s brief public career further reinforced her privileged position as Clara’s student and an emerging pianist. Through their careful selection and arrangement of these materials, the Schumanns created a tangible monument that both commemorated their relationship with Steffens and constructed her lasting musical legacy.

In the first paragraph of the modern translation of the Rationale divinorum officiorum of William Durand (c. 1230–1296) are markers of the change this book seeks to chart. One is immediately visible. The translator, Timothy M. Thibodeau, chose to distinguish through the use of italics what he then identifies, through the use of brackets, as biblical texts. Those italics and those brackets do not simply mark the modern sense of “source,” of a particular relationship between Durand and Scripture, that postdates Durand himself. They distinguish Scripture and, in so doing, obscure Durand’s understanding of revelation and its relationship to “ecclesiasticis officiis, rebus ac ornamentis.” There in the opening paragraph of the Prologue and throughout the Rationale, Durand presents a different relationship entirely among ecclesiasticis officiis, rebus and ornamentis, and biblical history, prophecies, psalms, Gospels, and Epistles.

This chapter explores the support networks surrounding Robert and Clara Schumann, emphasizing how these relationships shaped their identities and careers. Through both friendships and professional ties, they cultivated a rich web of connections that influenced their personal and artistic development. Beyond renowned figures like Mendelssohn and Brahms, the chapter highlights three key individuals: Emilie List, Clara’s lifelong friend who provided emotional and logistical support during pivotal moments; Eduard Krüger, a colleague whose intellectual exchanges with Robert deepened their shared understanding of music, particularly Bach; and Theodor Kirchner, Robert’s student and later Clara’s companion, who benefited from the couple’s support but ultimately did not meet their expectations. These relationships underscore the Schumanns’ reliance on personal and professional networks not only for artistic collaboration but also for emotional resilience. Ultimately, the chapter illustrates the transformative power of community and the couple’s commitment to fostering connections with like-minded artists and intellectuals.

One major aspect involved in the development of post-intensive care syndrome (PICS) is muscle wasting and weakness. In health, augmented dietary protein is required for skeletal muscle maintenance or growth. Critical illness is characterised by complex metabolic alterations including initial hypometabolism followed by hypermetabolism and muscle catabolism. Despite the potential role of nutrition in attenuating extensive muscle wasting observed in critical illness, no large-scale definitive interventional trial has tested the impact of augmented protein delivery on muscle wasting, and observational and small randomised trial data are conflicting. This may be due to the extensive physiological response to critical illness that cannot be easily overcome or untested factors including individualised nutrition interventions delivered beyond the first week of critical illness. Despite the lack of definitive answers, prolonged under-provision of nutrition will likely result in nutrition-related consequences and has been associated with negative clinical outcomes. The aim of this chapter is to summarise the current critical care nutrition evidence and make practical recommendations for clinicians with the aim of preventing the development or progression of malnutrition and reducing the development of PICS following critical illness.