Suchergebnisse

Descending from the Throne studies the how medieval and contemporary Byzantine bishops used thrones in monumental art, ritual and text to craft spaces of authority. Constantine the Great and his successors crafted Constantinople innovatively drawing upon the tradition of Rome and Jerusalem to make the imperial city a space of civil and sacred authority.Drawing upon the tradition of the Great Church, Hagia Sophia, in Constantinople, medieval bishops innovated art, text and ritual to stabilize authority in their local circumstances. This dissertation will consider the work of Demetrios Chomatenos, Archbishop of Ohrid and rival of the Despotate of Nicaea for the patriarchal title following the Latin occupation of the Fourth Crusade. Drawing from his years as a canon lawyer in Constantinople, he innovatively crafted a space of legal authority in the upper narthex of Sveti Sophia in Ohrid to preserve Byzantine tradition.Nikephoros Moschopoulos, Archbishop of Crete, served as proedros of Mistra because he was not able to occupy his see due to Venetian control of the island granted by imperial decree. In Mistra, Nikephoros inscribed a space of authority using art and ritual to stabilize his claims to land holdings.Symeon of Thessalonike served as Archbishop of Thessalonike in the last years of Byzantium. The medieval Thessalonians had a deep distrust of nobility and had even ruled the city democratically for a period. Symeon used an ancient liturgical form, called the "Sung Office," to bring the authority of Constantinople to bear on his unruly flock in Thessalonike.Contemporary Byzantine bishops, with the loss of Byzantium in 1453, nevertheless continue to innovate using tradition to craft a space of shared authority as evidenced by the development of the Hierarchical Divine Liturgy.

Cover -- Half Title -- Title -- Copyright -- Dedication -- Contents -- Acknowledgments -- INTRODUCTION The Drum Major Instinct -- CHAPTER 1 Service as the New Norm of Greatness -- CHAPTER 2 The American Dream -- CHAPTER 3 Life's Final Common Denominator -- CHAPTER 4 A Call to Conscience -- EPILOGUE A Leader Tells His Story -- Notes -- Bibliography -- Index -- A -- B -- C -- D -- E -- F -- G -- H -- I -- J -- K -- L -- M -- N -- O -- P -- R -- S -- T -- U -- V -- W -- Y.

Introduction: Renal colic secondary to kidney stone disease is a common reason for emergency department (ED) visits and often leads to patients receiving narcotic medications. The objective of this study was to describe longitudinal analgesia prescribing patterns for kidney stone patients acutely managed in the ED. Methods: This was a retrospective chart review of patients who presented to the ED between 2013 and 2018 and were subsequently diagnosed with a kidney stone. Encounters during which opioids and nonopioids were administered in the ED and prescribed at discharge were stratified by year, race, ethnicity, insurance status, gender, and location of ED (main academic campus and community-based campus). Patients were excluded if they required hospital admission or a stone-related procedure related to the ED encounter. Results: We reviewed 1620 total encounters for 1376 unique patients. Frequency of patients receiving opioids in the ED decreased from 81% in 2013 to 57% in 2018 (p < 0.001). During the same time period, nonopioid administration in the ED remained relatively unchanged (64% vs 67%). The proportion of patients prescribed opioids at discharge decreased from 77% to 59% (p < 0.001), while nonopioid prescriptions at discharge increased from 32% to 41% (p = 0.010). Frequency of administering both a narcotic and non-narcotic during the same ED encounter decreased over the 5-year period from 27% to 8% (p < 0.001). Conclusion: Opioids are being given less both during the ED encounter and at discharge for acute renal colic, while nonopioid prescribing is increasing. These trends may be due to increasing physician awareness to opioid addiction, or as a result of stricter legislation prohibiting opioid prescribing.