James A. Metzger

Prevalence of dust mites in the homes of people with asthma living in eight different geographic areas of the United States.

The density and species prevalence of dust mites were determined at various times over a 5-year-period in 252 homes of dust mite sensitive people with asthma who lived in eight geographic areas of the United States (Cincinnati, Ohio; New Orleans, La.; Memphis, Tenn.; Galveston, Texas; Greenville, N.C.; Delray Beach, Fla.; San Diego and Los Angeles, Calif.). The most common dust mites found in the homes were Dermatophagoides farinae (DF), D. pteronyssinus (DP), Euroglyphus maynei (EM), and Blomia tropicalis. All homes in all locations contained Dermatophagoides spp. mites, but few homes were populated exclusively by either DF or DP alone. Most homes (81.7%) were coinhabitated by both DF and DP. In coinhabited homes one species was predominant and usually made up at least 75% of the total mite population. Prevalence of the dominant or only species present varied between homes within a geographic area. EM occurred in significant numbers in 35.7% of homes in New Orleans, Memphis, Galveston, Delray Beach, and San Diego. Blomia tropicalis occurred in these same cities but in low densities. For all dust samples, only 13 homes of the 252 sampled had 100 or fewer mites/gm dust, which is considered to be the threshold for sensitivity. Most homes had average mite densities of 500 or more mites/gm dust. The results of the present study suggest a significant and widespread occurrence of both DF and DP. Therefore extracts of both mite species should be considered for diagnostic tests and immunotherapy. Significant levels of EM were present in some areas. Thus sensitivity to EM should be considered in these areas.

Evaluation of household dust mite exposure and levels of specific IgE and IgG antibodies in asthmatic patients enrolled in a trial of immunotherapy

BACKGROUND Monitoring the response to immunotherapy entails understanding exposure to relevant allergens. For the major indoor allergens, this requires sampling of dust from the patients house. The objectives of this study were to measure indoor allergen levels during a controlled trial of dust mite immunotherapy for asthma and to relate these results to serum antibody levels. METHODS Eighty-eight asthmatic patients with mite allergy from seven geographic areas in the United States were enrolled in and completed a course of immunotherapy with Dermatophagoides extract or placebo control. Sensitization was evaluated by quantitative measurements of IgG and IgE antibodies. Dust samples were assayed for group I mite (Der p 1 and Der f 1), cat (Fel d 1), and cockroach (Bla g 1) allergens by monoclonal antibody-based ELISA. RESULTS Over the 4 years of the study, each of the houses had at least one sample that contained more than 2 micrograms of group I mite allergen per gram of dust. Mean mite allergen levels, however, varied over a wide range, from 0.2 microgram/gm or less to more than 50 micrograms/gm. IgE antibodies to mite were present in sera from 78% of the patients, whereas IgE antibodies to cat and cockroach allergens were found in sera from 34% and 11% of patients, respectively. Sixty-four percent of the patients had exposure and sensitization to mite, whereas the comparable figure for each of the other allergens was 5%. CONCLUSIONS Examination of the results suggested that allergen exposure, relative to a trial of immunotherapy, could be expressed as (1) the maximum level found in the house, (2) the percentage of sites having greater than 2 micrograms/gm, or (3) the mean value at the site with the maximum level. This report provides a background for evaluating the clinical results of immunotherapy in these patients and a model for the way in which sensitization and exposure should be monitored in studies of this kind.

Consumption and Wealth in Luke's Travel Narrative

While several recent studies have suggested that the Gospel of Luke recommends generous almsgiving or a relatively benign sharing ethic that mimics existing redistibutive measures in early Roman Palestine, this book argues that a much more subversive reading of the Gospels wealth and possessions traditions is defensible.

Where Has Yahweh Gone? Reclaiming Unsavory Images of God in New Testament Studies

It is argued that recent publications in New Testament Studies, including those deploying its most progressive reading strategies, betray a strong predilection for an omnibenevolent, just, compassionate deity who does not offend our sensibilities. Given the rich, variegated profusion of alternative representations of the deity in the Hebrew Bible, a primary intertext for scholars constructing God in the New Testament writings, it is surprising that so few of these portraits are ever invoked or seriously engaged, which suggests a proclivity to religionism in the discipline. After delineating several benefits of the Bibles unsavory portrayals of God and disadvantages to todays fashionable deity of love, mercy, and justice, it is proposed that a broadening of our intertextual repertoire to include unflattering representations of the divine might open up new avenues in our hermeneutical explorations.

Humanism, Illness, and Elective Death: A Case Study in Utilitarian Ethics

The author offers a defense for elective death on utilitarian grounds, but one that is presented specifically from the perspective of someone who: 1) faces a potentially terminal illness and diminishing quality of life; 2) views death as nothing more than a return to prenatal nonbeing; and 3) maintains common humanist ethical commitments. The argument, then, is uniquely situated and limited in scope, rooted both in the particulars of his recent experience with a rheumatic autoimmune illness and non-Hodgkin’s lymphoma as well as in a worldview shaped largely by emerging narratives in the sciences. Drawing upon the work of J.S. Mill and P. Singer, the author begins by assuming that one is generally free to act on a preference for nonbeing so long as others are not unduly harmed or thwarted in pursuing their own aims as a result. But a humanist, he suggests, ideally ought to press beyond this minimum criterion and do one’s best to maximize eudaimonia by carefully weighing how elective death would likely affect others to whom one is currently obligated in significant ways. The focus of one’s ethical reasoning, then, should remain on maximizing well-being and minimizing harm, not on creating a logical flawless and internally coherent defense that may satisfy a set of abstract or universally applicable criteria drawn up by others in an effort to define precisely what might render a given suicide “rational” or “morally permissible.”

Can Liberal Christians Save the Church? A Humanist Approach to Contemporary Progressive Christian Theologies

In contrast to many traditional theologies, today’s progressive theologies offer believers an attractive ethic that is humane, pacific, and Earth-centered. And when God is spoken of, he is generally portrayed as non-coercive, deeply invested in the well-being of all, and attentive to the cries of any who suffer. On the one hand, then, humanists have good reason to celebrate this recent shift in thinking about the sacred and divine-human relations. Indeed, we share with progressive Christians a very similar set of core moral values. But, are progressive theologies really any more persuasive than earlier conceptions of the sacred? Do they offer better evidence for their claims? It is argued here that most all suffer from unresolved and rather serious epistemic issues that ultimately undermine their plausibility – and, therefore, their future viability.

Illness and Deicide

Six years ago, I was diagnosed with an autoimmune disease for which the most unpleasant symptoms are pain, loss of mobility, and fatigue. The illness went undiagnosed for one year, and it took physicians yet one more to devise a cocktail of drugs to bring these symptoms under control. Two years of persistent searing pain and crushing fatigue will do something to a person. In me, they engendered deep resentments and a loss of trust in the basic goodness of life, of feeling at home in the world. The illness need not have had this effect, and even today I cannot say why it had this effect rather than another. Others under similar conditions might simply have shrugged off the ordeal and repressed its most harrowing moments once the medications began to do their job, emerging with their former outlook on life intact. Maybe I do not fall into this category because the pain and fatigue are still with me, and still seem so new. Or maybe because I am constantly made aware that if the illness outwits these costly medications or they are taken away, the partially restrained miscreant within will usher me right back to its lair, eager to pick up right where it left off. During the early months of the illness, before conceding that something serious might be wrong, I pushed through the pain as best I could, confident that a diagnosis and cure would be found, that the disease would recede into the background and trouble me no more. This is, after all, the twentyfirst century: no obstacle devised by Nature, however cleverly conceived or maleficent, can forever outwit us, crown of all creation. But as the pain bore down and help failed to materialize, I began to tire, sensing that perhaps I was battling an enemy that would not reveal itself, and for which I was no match. Enduring pain became a full-time job, and I stalled out: activities once enjoyed were given up, projects were suspended, relationships allowed to founder, eventually to dissolve. I stood and watched as everyone else lived their full lives, as they came and went and did as they pleased, still beckoned forward by a future that held promise. At some point during that first year, the narratives that once infused meaning and purpose into to all the insignificant acts that make up a day

Reclaiming “a dark and malefic sacred” for a Theology of Disability

As theological inquiry on disability has evolved over the past two decades, broad agreement appears to be emerging in four areas: 1) preferred model of disability; 2) epistemological standpoint; 3) overall assessment of biblical and theological traditions; and 4) constructions of God (when God is spoken of at all). After addressing each of these four areas, the author explores a growing edge in the dialogue, namely, how sustained reflection on ambivalent or aversive experiences of disability might be brought to bear on our constructions of deity. For persons who at times have experienced the body not as companionable friend but as unrecognizable foe, contemporary constructions of God as just, loving, and compassionate, now ubiquitous in traditional and progressive Christian communities alike, may seem unpersuasive. For such persons, it is suggested that a reclamation of biblical and theological traditions that testify to an experience of the sacred as indifferent or oppressive may not only resonate but prove beneficial as well.

God as F(r)iend? Reading Luke 11:5-13 & 18:1-8 with a Hermeneutic of Suffering

Employing an optic grounded in suffering and foregrounding intertexts in which God is portrayed unfavorably, it is argued that in Luke 11:5-13 and 18:1-8 Jesus acknowledges a negative experience and conception of the deity among some of early Roman Palestine’s “poor ... captives ... blind ... [and] oppressed” (4:18-19). Jesus does not ask them to suppress their impressions of God or to align them with more traditional representations; rather, they are encouraged to remain in conversation with the deity and not to become discouraged or be afraid, even when their speech pushes beyond socially acceptable limits and becomes accusatory, contemptuous, blasphemous, or outright hostile. Indeed, Jesus recommends impudence and audacious tenacity before God, confident that such conduct will receive a hearing and a response.