Secure Relationships Research Articles

Job Insecurity: A Comparative Analysis between Migrant and Native Workers in Australia.

Job insecurity is a modifiable risk factor for poor health outcomes, and exposure to job insecurity varies by population groups. This study assessed if job insecurity exposure varied by migrant status and if the differences varied by gender, age, educational attainment, and occupational skill level. Data were from wave 14 of the Household Income and Labour Dynamics in Australia Survey. The outcome was job insecurity. Exposure was migrant status defined by (1) the country of birth (COB), (2) the dominant language of the COB, and (3) the number of years since arrival in Australia. Data were analysed using linear regression, adjusting for gender, age, educational attainment, and occupational skill level. These covariates were also analysed as effect modifiers for the migrant status–job insecurity relationships. Migrant workers, especially those from non-English speaking countries (non-ESC-born), experienced higher job insecurity than Australia-born workers; however, these disparities disappeared after 11+ years post-arrival. The migrant status–job insecurity relationships were modified by educational attainment. Unexpectedly, the disparities in job insecurity between non-ESC-born migrants and Australia-born workers increased with increasing educational attainment, and for those most highly educated, the disparities persisted beyond 11 years post-arrival. Our findings suggested that continuing language skill support and discrimination prevention could facilitate migrant integration into the Australian labour market.

Balancing Benefits and Risks of Animal-Assisted Activities (AAA) in Child Care Centres

While the importance of secure relationships between children and caregivers has been well established in the literature as an essential feature of healthy child development, the influence of animal-human relationships on healthy development and attachment is also beginning to gain attention. A burgeoning literature supports the developmental and sustainability benefits of such relationships to children. One hundred seventeen directors of childcare centres in Manitoba, Canada (16.5%) caring for 24% of children in licensed care responded to a survey about animals in childcare facilities. Findings showed that only 51% of facilities currently had animals, with fish and caged rodents being the most common. Although centre directors agreed that the benefits of centre-based animals included children learning responsibility as well as increased calmness and happiness in children, the drawbacks in terms of children’s allergies, the costs, and the inconvenience outweighed these benefits in almost half the centres. Given the benefits of animals in young children’s lives, a list of variables for consideration is provided to aid directors in decision-making about animals in childcare centres.

Analysis of Job Insecurity, Job Satisfaction and Organizational Culture on Turnover Intention Mediated by Organizational Commitments in PT. Seraphim Life Center, Jakarta

This research analyzes the effect of Job Insecurity, Job Satisfaction and Organizational Culture on Turnover Intention Mediated by organizational commitment at PT. Seraphim Life Center. Data was collected by survey to 200 samples of PT. Seraphim Life Center employees. The analytical method used is descriptive analysis with Structural Equation Model (SEM) approach to Analysis of Moment Structure (AMOS). The results revealed that Job Satisfaction, organizational culture and organizational commitment had a negative and significant effect on Turnover Intention. Job Insecurity has a positive and significant effect on Turnover Intention. Finally, organizational commitment mediates the relationship of Job Insecurity, Job satisfaction and organizational culture on Turnover Intention. This research can be beneficial for PT. Seraphim Life Center to reduce employee turnover through effective programs. Keywords : Job Insecurity, Job satisfaction, Organizational Culture, organizational commitment, Turnover Intention DOI : 10.7176/JRDM/59-03 Publication date :September 30 th 2019

Attachment Disorders.

The ability to form attachments with other human beings is an essential skill that typically begins early in life. The parent/caregiver-child relationship is the first crucial relationship that an infant forms, and the health of this relationship has a profound effect on the child's social and emotional development. Children who form secure relationships with their parent or other primary caregiver have fewer internalizing and externalizing behaviors, are more socially competent, and have better-quality friendships. Conversely, children with attachment disorders exhibit a varying capacity to form and sustain relationships and demonstrate emotional depth, they and experience a higher level of peer conflict. Children with insecure attachments have a greater likelihood for physical health morbidities and impaired social, psychological, and neurobiological functioning extending into adulthood. It is crucial that pediatric nurse practitioners implement practice behaviors to better identify children at risk for attachment disorders and link them with appropriate interventions. This continuing education article will explore attachment; and attachment theory; and attachment disorders in terms of types, risk factors, consequences, and treatment and will also provide implications for practice.

Impact of the interaction between alexithymia and the adult attachment styles in participants with alcohol use disorder.

The current study aims to investigate the effect of the interaction between adult attachment styles and alexithymia among participants with alcohol use disorder (AUD). This study is cross-sectional, conducted between November 2017 and March 2018, which enrolled 789 community-dwelling participants. The interaction between alexithymia and secure relationship tended to significance (p=0.057). Higher interaction between alexithymia and a fearful relationship style (β=0.04) were significantly associated with higher AUD. The interaction model revealed the importance of stratifying the results according to presence/absence of alexithymia. Being a female and having a secure relationship style were significantly associated with lower AUD in both groups. Being divorced was significantly associated with higher AUD in both groups. Increasing age (β=-1.48), secondary (β=-4.65), and university level of education (β=-6.46) were significantly associated with lower AUD in the non-alexithymic group. Intermediate monthly income (β=2.69) and being widowed (β=8.24) were significantly associated with higher AUD in the non-alexithymic group. High monthly income (β=3.46) was significantly associated with higher AUD in the alexithymic group. The results of this study showed that the consideration of the combination between attachment styles and alexithymia is of significance in the diagnosis and therapy of alcohol use disorders.

Association between food insecurity, cardiorenal syndrome and all-cause mortality among low-income adults

Food insecurity is known to be a major public health issue. There is limited data on food insecurity and chronic disease in the general population. We aimed to assess effect of food insecurity on mortality of individuals with chronic disease like cardiorenal syndrome (CRS). The study was conducted on participants aged 20 years or older in the United States living below the 130% Federal Poverty Level. We assessed food insecurity utilizing the Household Food Security Survey Module in NHANES survey for the years 1999 to 2010 with mortality follow-up. Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine the relationship of food insecurity and CRS. Prevalence of food insecurity among the low-income population was 16.1% among males and 21.7% among females. The mean follow-up was 6.5 years. For all-cause mortality, the overall unadjusted hazard ratio (HR) of food insecurity to no food insecurity was 1.28 (95% confidence interval [CI], 1.18-1.37, p < 0.001). Adjusted HR was elevated, 2.81 (CI 1.57-5.05, p < 0.001), among participants who were CRS-positive and food insecure but closer to 1.0 (2.48 CI 1.73-3.55, p < 0.001) among those who were CRS-positive and food secure, after controlling for medical and demographic risk factors. Food insecurity is associated with higher mortality than food security. Food insecurity also may modify the effect of CRS on all-cause mortality in a representative general population. Social policy, when addressing food insecurity, should be inclusive among those with specific chronic diseases.

Food insecurity, acculturation and diagnosis of CHD and related health outcomes among immigrant adults in the USA.

To deepen understanding of the relationship between food insecurity, acculturation, and diagnosis of CHD and related health outcomes among immigrant adults. Using cross-sectional, nationally representative data from the National Health Interview Survey 2011 to 2015, we address two research questions. First, what is the relationship of household food insecurity and acculturation with: CHD, angina pectoris, heart attack, self-rated poor health and obesity? Second, what is the association of food insecurity with these health outcomes over years of living in the USA? We estimate multivariate logistic regressions without (question 1) and with (question 2) an interaction term between food insecurity and acculturation for CHD and related health outcomes. USA. Low-income immigrant adults. Food insecurity and acculturation are both associated with diagnosis of CHD and related health outcomes among immigrant adults. Food insecurity and acculturation are associated with the health of female immigrants more than males. Also, the differences by food security status in the probability of having several poor health outcomes (self-rated heath, obesity, women's angina pectoris) are largest for those in the USA for less than 5 years, decrease for those who have lived in the USA for 5-14 years, and are larger again for those in the USA for 15 or more years. Recent and long-term food-insecure immigrants are more vulnerable to CHD and related health outcomes than those in the USA for 5-14 years. Further research is needed to understand why.

‘He’s my mate you see’: a critical discourse analysis of the therapeutic role of companion animals in the social networks of people with a diagnosis of severe mental illness

There is increasing recognition of the role pets play in the management of mental health conditions. Evidence suggests that pets promote social interaction and provide secure and intimate relationships which...

Prospective Bidirectional Associations between Attachment and Depressive Symptoms from Middle Childhood to Adolescence.

Insecure attachment to parents consistently correlates with adolescent depression. However, the order of cause and effect, the impact of confounding, and gender disparities in this relationship remain unresolved. The present study therefore examined the prospective associations between attachment relationships to mothers and fathers and depressive symptoms in a community sample of Spanish children (n = 904; 49.4% females) assessed biennially from age 10-16 years, net of all unmeasured time-invariant confounding. Insecure relationships predicted depressive symptoms, and more so among girls, but depressive symptoms also forecasted worsened attachment relationships. At ages 12-14, mother-child attachment proved to be more important for the development of depressive symptoms than father-child attachment. These findings reveal a pattern of reciprocal influence between attachment relationships and depressive symptoms that appears to vary as a function of the parental and child's gender and developmental period. Thus, efforts aimed at strengthening the parent-child attachment relationship-across the transition from middle childhood to adolescence-may prevent or reduce depressive symptoms, especially by targeting mothers and female adolescents.

Review: Transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS): a meta-synthesis of parental and professional perspectives.

Transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) can be stressful for the young person and family alike. Previous reviews have focused on specific aspects of transition or perspectives of young people, or have not used systematic approaches to data identification and analysis. The objective of this review was to develop the understanding of the transition between CAMHS and AMHS by systematically identifying and synthesising evidence regarding professionals' and parents/carers' perspectives. A systematic search in July 2018 was conducted on Medline, PsycINFO and CINAHL. Google Scholar and references of selected articleswere also searched. Papers were included if they presented empirical qualitative research in peer-reviewed journals with a primary focus on experiences of parents/carers and/or mental health professionals in relation to adolescents making the CAMHS-AMHS transition. Data were extracted from each full-text paper. The quality of included studies was appraised using an expanded Critical Appraisal Skills Programme (2018) tool, and studies' results were synthesised using meta-ethnography. Fourteen studies of variable quality were identified. Four main third-order constructs were developed through synthesis: (a) Service cultures; (b) Service resources and gaps; (c) Working relationships between the services; and (d) Leaving secure relationships for new ones. Professionals and parents experience adolescents' transition from nurturing and comprehensive CAMHS to more individualistic AMHS as having many barriers. There is desire for better preparation for transition between services and relationships, more joint working and better CAMHS-AMHS communication. AMHS service gaps exist, for example for those with neurodevelopmental conditions.

Moderation of the Association Between Individual Food Security and Poor Mental Health by the Local Food Environment Among Adult Residents of Flint, Michigan.

Purpose: Food insecurity is a psychosocial stressor with deleterious effects on mental health. This study examined whether the local food environment moderates the association of individual food insecurity with poor mental health.Methods: Cross-sectional survey data were collected from adult residents of Flint, Michigan (n=291), in 2015. Multivariate logistic models assessed whether quality of the local food environment moderated the relationship of food insecurity with poor mental health. A binary indicator of poor mental health was created. Participants were asked to rate their overall “mental or emotional health” using a 5-point Likert scale. Individuals were classified as having either good mental health (i.e., ratings of good, very good, or excellent) or poor mental health (i.e., ratings of fair or poor).Results: In fully adjusted models, food insecurity was associated with 3.2 (95% confidence interval [CI]: 1.6–6.2) times higher odds of poor mental health. However, increased proximate access to vegetables and fruits moderated this association. For example, those in the bottom 25th percentile of access to vegetables had 7.4 (95% CI: 2.7–20.5) times higher odds of poor mental health. In contrast, for those in the top 25th percentile of vegetable access, food insecurity was only marginally associated with poor mental health (odds ratio=2.2; 95% CI: 1.0–4.7).Conclusion: Greater proximate access to vegetables and fruits moderated food insecurity's association with poor mental health. Longitudinal evaluation of programs and policies that improve availability of nutrient-rich foods in food insecure communities is needed to determine whether they yield a mental health benefit.

857-P: Relationship between Housing Insecurity and Diabetes Care and Self-Care Behaviors

Background: The aim of this analysis was to examine the influence that housing insecurity has on diabetes care. Methods: Using nationally representative data from 2014 and 2015 Behavioral Risk Factor Surveillance System (BRFSS), we investigated 16,091 individuals, representing over 7 million adults with diabetes in the U.S. Housing insecurity defined as how often in the past 12 months respondents reported being worried or stressed about having enough money to pay your rent/mortgage; responses of sometimes/often/always were categorized as housing insecure. Unadjusted logistic models for the relationship of housing insecurity on diabetes self-care and quality of care were followed by tests for interaction between housing insecurity and either race/ethnicity or employment. Stratified models were adjusted for age, gender, race/ethnicity, education, marital status, employment status, household income, insurance, and comorbidity count. Results: 38.1% of adults with diabetes reported housing insecurity. Significant interactions existed between housing insecurity and employment on the relationship with seeing a doctor or checking A1c. Significant interactions existed between housing insecurity and race/ethnicity on having an eye exam in the past 12 months or completing physical activity in the past month. Individuals who were employed who reported housing insecurity had a lower likelihood of seeing a doctor in the past 12 months (0.58, 95% CI 0.37, 0.92) and having their A1c checked (0.45, 95% CI 0.26, 0.79). Non-Hispanic blacks who reported housing insecurity had a lower likelihood of having an eye exam (0.67, 95% CI 0.54, 0.83) or being physically active (0.81, 95% CI 0.69, 0.96). Conclusion: Housing insecurity had an influence on diabetes care and self-care behaviors. For those who were employed, seeing a doctor and checking A1c was still negatively associated with housing insecurity. Diabetes care interventions should include a focus on housing insecurity as it has an impact on diabetes care. Disclosure E. Mosley-Johnson: None. R.J. Walker: None. H.L. Prigmore: None. L.E. Egede: Consultant; Self; Novo Nordisk Inc. Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. Funding National Institutes of Health

Are Depressive Symptoms and Attachment Styles Associated with Observed and Perceived Partner Responsiveness in Couples Coping With Genito-Pelvic Pain ?

Partner responsiveness is thought to facilitate relationship adjustment in couples coping with genito-pelvic pain, such as provoked vestibulodynia (PVD). Recent studies suggest that attachment and depressive symptoms may act as a filter in the perception of partner responsiveness, and a barrier to the capacity of being responsive to a partner. Given studies suggesting higher depressive symptoms and relationship insecurities in women experiencing genito-pelvic pain compared to controls, investigating the role of these factors in partner responsiveness may help couples improve their wellbeing in the challenging context of PVD. The aim of this study was to examine the associations between depressive symptoms, attachment, and perceived and observed partner responsiveness in 50 couples coping with PVD. Participants took part in a videotaped discussion and completed self-report measures of depressive symptoms, attachment, and perceived partner responsiveness. Based on the actor-partner interdependence model, results indicated that when women and partners reported greater depressive symptoms and anxious attachment, they perceived each other as being less responsive. When partners experienced greater depressive symptoms, women and partners were rated, by a trained observer, as being less responsive to each other. Targeting depressive symptoms and relationship insecurity in couple therapy could increase responsiveness in couples coping with PVD.

Attachment security is associated with the experience of specific positive emotions in middle childhood

ABSTRACT Adaptive emotion expression characterizes secure parent-child relationships in which children rely on attachment figures for secure base and safe haven support. We hypothesized that more securely attached children would report experiencing greater positive emotion. Children (N=92; M=11.91 years) completed the Friends and Family Interview which was coded for attachment security indicators (narrative coherence, mother and father safe haven support, mother and father secure base support). We analyzed Youth Values in Action Inventory strengths that reflected positive emotions (curiosity, zest, hope, love, gratitude). No attachment security indicators correlated with curiosity, all correlated with zest and gratitude, and four correlated with hope and love. Controlling for IQ, age, and temperament, attachment security significantly predicted positive emotion (12-19% variance); father secure base support uniquely predicted positive emotion. Our findings highlight the important role parental attachment plays in children’s emotion experience and have implications for explaining why attachment might relate to children’s other close relationships.

Alzheimer's disease

In his genre-defining Encyclopédie (1765), the French philosopher Denis Diderot defined dementia as “a disease consisting in a paralysis of the spirit characterised by abolition of the reasoning faculty“. For Diderot's generation, dementia (from the Latin demens, “without mind“) was a new frame for an old and diverse set of labels—imbecility, fatuitas, dotage—denoting a progressive and irreversible decline in what we'd now call cognitive and social functioning, typically associated with old age. Over the next three centuries, as more nations experienced the demographic transition associated with industrial capitalism, they have encountered a series of challenges associated with all forms of dementia and Alzheimer's disease in particular. Should old age be seen as a disease in itself? Where do we draw the boundaries between medicine and social care? And how do we provide chronic care for a growing population of older people? Parkinson's diseaseHad James Parkinson never written An Essay on the Shaking Palsy, he might now be remembered as an adventurous activist in an age of turmoil. Born in London, in 1755, he belonged to a generation whose political consciousness was shaped by the French and American Revolutions and the writings of firebrand democrats like Thomas Paine. When some of his colleagues in the London Corresponding Society were charged with treason, Parkinson stood up for them in the witness box, and, in 1796, he was suspected of involvement in the Popgun Plot—an alleged conspiracy to assassinate George III with a poisoned dart from an airgun. Full-Text PDF InfluenzaIn daily life, influenza might seem almost banal: how many of us get through the winter without a bout of flu? For those concerned with global health, however, few diseases provoke more unease. Influenza's history evokes the great themes of modern medicine: the insecure relationship between clinical knowledge and effective treatments; medicine's growing role in global networks of control; and the importance of memory and uncertainty in our responses to disease. Full-Text PDF DepressionMeteorology, economics, and geology—all have their depressions. Mid-19th century laboratory physiologists also spoke of depression—a decline in the biochemical output of an organ—and this usage, with its connotations of functional materialism, haunts the contemporary concept of depression. As the physician and historian Laura D Hirshbein argues, depression is “a twentieth-century phenomenon that incorporates assumptions about gender, profession, and science”, reflecting the shifting balance of power between theories, therapies, and patients' experiences. Full-Text PDF

Pleasure in parenting and father-child attachment security

ABSTRACTThis study examined relations between father-child attachment security and both paternal sensitivity and fathers’ pleasure in parenting. At 12 months of age sensitivity was coded from father-infant interactions and pleasure in parenting was coded from fathers’ interviews assessing attitudes toward the parenting role. Father-child dyads participated in the Strange Situation Procedure assessing attachment relationship quality. Sensitivity was related to more pleasure in parenting, but neither variable alone predicted attachment security. However, pleasure in parenting moderated the association between sensitivity and attachment. Moreover, the concordance between sensitivity and pleasure in parenting differed markedly across attachment classifications. In secure relationships fathers showed strong concordance between sensitivity and pleasure in parenting. Fathers in avoidant relationships demonstrated high sensitivity coupled with low pleasure in parenting, whereas fathers in disorganized relationships showed low sensitivity coupled with high pleasure in parenting. Results speak to the importance of integrating cognitive, affective, and behavioral aspects of parenting in father-child attachment research.

Trauma Exposure in Relation to the Content of Mother-Child Emotional Conversations and Quality of Interaction.

Parent-child conversations contribute to understanding and regulating children’s emotions. Similarities and differences in discussed topics, quality of interaction and coherence/elaboration in mother-child conversations about emotional experiences of the child were studied in dyads who had been exposed to interpersonal trauma (N = 213) and non-trauma-exposed dyads (N = 86). Results showed that in conversations about negative emotions, trauma-exposed children more often discussed trauma topics and focused less on relationship topics than non-trauma-exposed children. Trauma-exposed dyads found it more difficult to come up with a story. The most common topics chosen by dyads to discuss for each emotion were mostly similar between trauma-exposed dyads and non-trauma-exposed dyads. Dyads exposed to interpersonal traumatic events showed lower quality of interaction and less coherence/elaboration than dyads who had not experienced traumatic events. Discussion of traumatic topics was associated with lower quality of mother-child interaction and less coherent dialogues. In conclusion, the effect of the trauma is seen at several levels in mother-child interaction: topics, behavior and coherence. A focus on support in developing a secure relationship after trauma may be important for intervention.

호텔 기업의 노동시장 유연성, 직무불안정성 및 조직냉소주의 간구조적 관계

본 연구는 호텔 기업 노동시장의 유연성이 구성원들의 직무불안정성 및 조직냉소주의에 어떠한 영향을 미치는지 확인하고자 하였다. 본 연구의 목적을 달성하기 위하여 문헌연구를 바탕으로 국내 호텔의 노동시장 유연성, 직무불안정성, 조직냉소주의와 관련된 속성을 도출하였다. 이러한 속성을 바탕으로 본 연구의 분석을 위해 7개의 특급 호텔의 구성원을 대상으로 총 264부의 유효 설문지가 빈도 분석, 신뢰도 및 확인적 요인분석, 상관관계분석, 구조방정식모형 분석에 사용되었다. 본 연구의 실증 분석 결과, 호텔 기업 노동시장 유연성의 하위요인인 수량적 유연성, 기능적 유연성 및 임금 유연성 모두 직무불안정성의 하위요인인 구성원들의 무력감 및 직무상실가능성에 유의한 정(+)의 영향을 미치는 것으로 나타났다. 또한 호텔 기업 노동시장 유연성의 하위요인인 수량적 유연성 및 기능적 유연성은 조직냉소주의에 정(+)의 영향을 미치는 것으로 나타났다. 그러나, 임금 유연성은 조직냉소주의에 영향을 미치지 않는 것으로 분석되었다. 마지막으로, 직무불안정성의 하위요인인 구성원들의 무력감과 직무상실가능성은 조직냉소주의에 유의한 정(+)의 영향을 미치는 것으로 밝혀졌다. 이를 통하여 본 연구는 호텔 기업이 급격한 노동시장의 유연성을 추진하는 과정에서 발생되는 구성원들의 직무불안정성 및 조직에 대한 냉소주의를 해소할 수 있는 유용한 정보를 제언하고자 한다.

Attachment insecurity and restrictive engulfment in college student relationships: the mediating role of relationship satisfaction

Purpose Studies on restrictive engulfment (RE) – a subtype of psychological aggression in intimate relationships – have focused either on insecure attachment or relationship satisfaction, not both. Therefore, the purpose of this paper is to investigate relationship satisfaction as a potential mediator of the associations between anxious and avoidant attachment and RE perpetration among college students. Design/methodology/approach A sample of 322 college students (178 women, 137 men, and seven other gender-identified) completed the experiences in close relationship inventory, relationship assessment scale, and RE subscale of the multidimensional measure of emotional abuse. Findings Among the sample, 89.3 and 90.5 percent of the college women and men, respectively, reported to have used isolating, restricting, monitoring, and controlling behaviors. The results of structural equation modeling revealed that all direct paths except for that from avoidant attachment to RE were significant. Moreover, significant indirect paths were identified from anxious and avoidant attachment to RE via relationship satisfaction. Research limitations/implications The results of this study should be interpreted with consideration of the study’s limitations. First, the data were drawn from a convenience sample of Turkish college students. Second, the design of the study is correlational; therefore, we cannot assume causality. Finally, this study utilized self-report and retrospective data. Practical implications Though the findings are preliminary, they may inform college counselors and other mental health practitioners about the nature of RE within college students’ dating relationships. College students who are unhappy with their dating relationships but still in those relationships (i.e. they choose not to leave) should be assessed for whether they are the perpetrators and/or recipients of psychological aggression, especially in light of the high rates of this form of aggression in the current and previous studies. Furthermore, assessing psychological dating aggression perpetrators for insecure attachment styles may help mental health professionals who work with college students, envisage the sessions toward areas in the need of improvement, such as their views of themselves and others. Self-esteem, feelings of insecurity and inadequacy in relationships, and dependency can be worked with these clients. Social implications The results of this study also have implications for the prevention of psychological aggression before it occurs. The need for prevention programs is evident in the high rates of psychologically controlling behaviors among college students. It may be useful to implement campus wide programs to raise awareness regarding psychological aggression, such as through events, seminars, posters, flyers, and talks with student groups. Originality/value Despite the limitations of this study, its findings offer insight into the factors that influence the perpetration of psychological aggression within dating relationships among college students. Adult attachment theory offers a useful lens for understanding the possible driving forces behind college students’ controlling behaviors toward their dating partners. In particular, college students who demonstrate an insecure attachment style – and especially an anxious attachment style – combined with low levels of relationship satisfaction appear to be at a high risk for perpetrating RE behaviors.

Influenza

In daily life, influenza might seem almost banal: how many of us get through the winter without a bout of flu? For those concerned with global health, however, few diseases provoke more unease. Influenza's history evokes the great themes of modern medicine: the insecure relationship between clinical knowledge and effective treatments; medicine's growing role in global networks of control; and the importance of memory and uncertainty in our responses to disease.