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A victim support service in South Australia has challenged the State Government to follow Victoria's lead and pledge to overhaul its family violence support system.
- Victim Support Service SA commends Victorian response to inquiry findings
- Julian Roffe says domestic violence awareness rising
- Service has seen "49 per cent increase in DV referrals in the last 12 months alone"
Australia's first Royal Commission into Family Violence was today tabled in the Victorian Parliament, with Premier Daniel Andrews committing to implementing all 277 recommendations.
Victim Support Service SA chief executive Julian Roffe commended Mr Andrews' response.
"It will be interesting to see how well South Australia is able to mirror that scale of response," he said.
"We're absolutely hopeful that, although this is a Victorian report, it will resonate with communities in South Australia because the truth is the issue's no different to what it is in Victoria.
"We've got the same scale of problem here as they do over here."
Mr Roffe said the problem of domestic violence (DV) had risen in the Australian public consciousness over the last year, largely through the work of former Australian of the Year Rosie Batty, whose 11-year-old son was murdered by his father.
He said communities were expecting more of governments and more support services as they found confidence to seek help.
"We've seen a 49 per cent increase in DV referrals in the last 12 months alone," Mr Roffe said.
"DV service providers, not only across this state but right across the country, are up to their eyeballs in referrals and unless they [governments] bring more funding to the table, it's going to be increasingly difficult to manage that demand," Mr Roffe said.
"That is going to be one of the real tensions. [There's] great ambition here, but can they actually support it with the level of funding it needs?"
Mr Roffe acknowledged there was a Federal Government commitment to the issue, but said there could be problems if some states instigated change and others did not follow.
"This [Victorian] report gives us a real insight into some of the ways that we can address this issue in our own backyard," Mr Roffe said.
SA initiatives recognised by commission
South Australian Minister for the Status of Women Zoe Bettison said the Government recognised "the devastating impact that violence against women and children has on our community".
She said the Government had provided strong leadership in the response to violence against women and the Victorian commission had visited the state to witness some of its initiatives.
"Some of the recommendations in the report reflect current South Australian initiatives such as the common risk assessment framework, the Multi-Agency Protection Service and the Family Safety Framework," she said.
"South Australia is also about to make a detailed submission to the Federal Government's Senate inquiry into family violence, which will outline how we are addressing gender inequality and violence against women by tackling the underlying issues including economic empowerment and community attitudes."
Later this year the Government plans to release a discussion paper on a domestic violence disclosure scheme similar to Clare's Law in the United Kingdom, which will allow people to investigate a new partner's criminal history.
Family and domestic violence support:
- 1800 Respect national helpline:
1800 737 732
- Women's Crisis Line:
1800 811 811
- Men's Referral Service:
1300 766 491
- Lifeline (24 hour crisis line):
- Relationships Australia:
1300 364 277
- NSW Domestic Violence Line:
1800 656 463
- Qld DV Connect Womensline:
1800 811 811
- Vic Safe Steps crisis response line:
1800 015 188
- ACT 24/7 Crisis Line:
(02) 6280 0900
- Tas Family Violence Counselling and Support Service:
1800 608 122
- SA Domestic Violence Crisis Line:
1800 800 098
- WA Women's Domestic Violence 24h Helpline:
1800 007 339
- NT Domestic violence helpline:
1800 737 732


A soldier from northern Iowa is among the 30 American troops killed late Friday when their helicopter was shot down in Afghanistan.
Thirty-five-year-old Jon Tumilson of Rockford was killed late Friday when a helicopter was shot down in Afghanistan. A U.S. Navy spokesperson confirmed the death on Saturday.
Tumilson was a 1995 graduate of Rockford High School and was among 29 other troops, most of them from the elite Navy SEALS unit that killed al-Quaida leader Osama bin Laden.
It was the deadliest single incident for American forces since the Afgan war began.
(Reporting by Chris Berg, KCHA, Charles City)


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Unformatted text preview: Midterm #2 Rachel Albright Guy Chet Early-American Honors Survey August 18, 2008 Albright 1 Marxist historiography studies the importance of social class and eco- nomic limitations as the reasons behind major events in history. Deciding how you interpret the past is very important because it allows you to recognize significant patterns that occur in order to have a better understanding of why events happened in the past as well as the ability to predict outcomes of events happening in the present. There are many different kinds of historical interpretations- for example, a person could see that key historical phenomenon occurred due to patterns of racism or gender issues. However, for me the structure that seems most prominent in history is the recurrent theme of social and economic repression, revolution, and reorganization that fits the marxist historical model. In this essay, I will use the historical events that caused and were effected by the English Inclosure Acts, Bacon's Rebellion, and Shay's Rebellion as examples of how American (and partially English) history fits into the marxist historical interpretation. The Inclosure Acts are great examples of how the oppression of the lower class and the social battle between them and upper classes can cause major historical events. According to the authors of America's History, the gold and silver Spain and other European countries claimed from the Americas greatly disrupted the European economy in a period that is known as the Price Revolution. This revolution resulted in a huge inflation of goods such as wool and grains. Because of this increase, profit- Midterm #2 Albright 2 minded landowners urged Parliament to pass a series of Inclosure Acts that would close off previously public land in order to grow more crops and graze more sheep. The problem with this was that the common lands supported the poor and landless, allowing them the resources to survive and feed their families. The fencing off of these once shared lands caused a widespread movement of laborers from the countryside to the towns growing due to the forthcoming Industrial Revolution. Without these displaced peoples, the supply of cheap labor which fed the factories that would jump-start the revolution would have been significantly less sizable. However, only a lucky few would get enough work or money to remain in the cities. For the rest of the displaced population, America offered a promise of regular work and guaranteed land through indentured servitude. Thus, the Aristocratic suppression of the landless through the Inclosure Acts not only helped fuel the coming Industrial Revolution, but also helped populate and create a social class in America. As soon as a social class was established in America, the battle for power between the elite and working class began. A prime example of such power struggles can be seen in Virginia in 1676 with Bacon's Rebellion. This rebellion, led by Nathaniel Bacon, was the first revolt in American Colonies in which discontent frontiersmen fought for rights they felt were being withheld from them by the Governor. Bacon and his rioters- which were mostly made up of frontiersmen, Indentured Servants, and Slavesfought for a more aggressive Indian Policy and lower prices for tobacco, and against special privileges given to those close to Governor Berkley. In other words, they were fighting for fairer policies for the working class. An interesting result of this rebellion was a series of laws specifically against any non-christian, non-white laborer (which were Midterm #2 Albright 3 basically the enslaved Africans and Indians). According to Edmund S. Morgan in his book American Slavery, American Freedom, these laws were created in order to forestall another rebellion of poor whites by banding together all of the white classes against the slaves and creating a form of political racism, which did not exist before. Fearing an increase in lower class planters, the gentry urged the Virginian population to turn away from indentured servants (who would eventually join the society as poor planters) and to invest in slaves (who were bound to a lifetime of servitude due to these new laws). In addition, the Virginian elite began to bribe the poor whites by reducing their taxes and allowing them to vote in exchange for their promise to elect the wealthy into the House of Burgesses. Due to this trading, the social position of the planter elite was solidified, and they used their control of the House of Burgesses to out the political power of the Royal Governor. Because of the discontent of the lower working class and the rebellion that followed, racism was instilled in the American political system which would eventually lead to the Civil War and the Civil Rights Movements. In addition, this rebellion gave increasing power to the American elite who were dissatisfied with the imperial treatment and provided a stepping stone to the eventual War of Independence in America. After the American Revolution, the new nation began to work on paying off its wartime debt. While most states tried to assist their indebted farmer-majority through payment instillations and printed currency, Massachusetts' lack of debtor-relief legislation caused a highly regressive tax that would lead to the new nation's first rebellion. The major problem was that the farm lands in western and central Massachusetts had a barter economy, while the industrialized eastern portion's economy was monetary. Midterm #2 Albright 4 When small farmers could not meet their debt, they were forced to sell their land. This not only condemned their families to extreme poverty, but also took away their right to vote. In addition, Massachusetts re-wrote its credit schemes to be administered by elected, rather than appointed, officials. So the poor farmers were unfairly subjected to a higher tax than the wealthy eastern merchants, and the only way they had to voice their opinion was to rebel. Led by Daniel Shays, the armed rebellion alarmed the nation's leaders and made them aware of several issues overlooked by the Articles of Confederation. George Washington, who closely followed the happenings of the rebellion, was alarmed by the helplessness of the confederation in the face of revolt, and consequently ended his retirement in order to fight for a more centralized government. At the same time, James Madison unsuccessfully attempted to change the weakness in the Articles of Confederation. Because his efforts were blocked by a small minority in congress, Madison decided that the only way to resolve the states' problems was to go elsewhere. He called for a gathering of states in 1786, and then again in 1787. The second meeting was the Constitutional Convention where a new, stronger government was created under the U.S. Constitution. Therefore, the economic repression by the merchant elite in Massachusetts cause our nation's leaders to band together to create the document that to this day regulates our government. These are just a few examples of how social class and economic oppres- sion has brought about change in American history. The recurrent theme of repression, revolution, and re-organization has been apparent throughout history and provides an obvious explanation of why a series of events occurred. It is because of this reoccurring pattern that I have taken a marxist interpretation of historical events. Midterm #2 Albright 5 Bibliography Burt, Richard, and John M. Archer, eds. Enclosure Acts: Sexuality, Property, and Culture in Early Modern England. Ithaca: Cornell UP, 1994. Questia Media America, Inc. 21 Mar. 2008 <http://www.questia.com> Henretta, James A., David Brody, Lynn Dumenil, and Susan Ware. America's History. 5th ed. Vol. 1. Boston: Bedford / St. Martin, 2004. Morgan, Edmund S. American Slavery, American Freedom. New York: W. W. Norton & Company, Inc., 1975 ...
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This note was uploaded on 08/18/2008 for the course HIST 2675 taught by Professor Chet during the Spring '08 term at North Texas.
- Spring '08

domain: sociology


Government officials and industry gathered just outside DC last week at the CONFERS Global Satellite Servicing Forum to brainstorm solutions for challenges facing the satellite servicing industry. CONFERS = the Consortium for Execution of Rendezvous and Servicing Operations, an industry group with 60+ members that started in 2017.
Here’s a dispatch from the two-day conference with our top takeaways.
The Goldilocks Effect
Officials were clear that the industry needs some standards, but cautioned that too much red tape could hamstring the nascent market. This search for the “just right” amount of rules is starting to play out at the National Space Council, where officials will host two listening sessions next month on mission authorization and novel space capabilities like servicing and on-orbit manufacturing.
The council will use those listening sessions to draft a proposal for Vice President Kamala Harris no later than March 7, said Diane Howard, the council’s head of commercial space. No word on specifics, but Howard said “I think it will be probably more formal than recommendations.”
Across the pond
France has also begun updating five-year-old space regulations, said Florent Lacomba of CNES, who noted the country currently has no rules governing in-orbit servicing. French officials will propose 30 new requirements—more than the total number of rules on the books today—and aim to finish the process by the end of next year.
Snaps for the FCC
Jacob Geer, chief of staff at the UK Space Agency, applauded the FCC’s recent 5-year deorbiting rule. Geer said the US action has provided cover for British companies to take a similar approach. “For a country the size of the UK to…make that change…it’s almost too strong, it’s almost too dangerous,” he said. “But once a big economy like the US does something like that, it takes some of the fear and risk out of it.”
The need for transparency
If companies start servicing satellites in orbit without being very clear about what they’re doing, things could go south quickly. Therefore, transparency was a key theme of the conference. “If we aren’t transparent, people will assume the worst,” said Mike Gold, Redwire’s EVP for civil space. “Conversely, I’ll tell you a group that isn’t a fan of transparency and that’s China.”
Orbital robo-servicers will count civil, commercial, and military space players as customers. Col. Meredith Beg, the deputy director of operations for servicing and maneuver at the Space Force, said that in-space servicing capabilities will be integral for the Pentagon, in part because it would allow troops to maneuver assets to restore capabilities after an attack without worrying about burning through onboard fuel. To that end, the USSF is:
- Establishing a new space mobility logistics program executive officer position within the DoD
- Launching one or more programs to develop and field space mobility logistics tech.
DARPA, which seeded CONFERS, is setting the industry group free at the end of the year. As of Jan. 1, the group will operate outside the US government as a 501(c)(6) organization with a board of directors. Other staffic specifics are are still being finalized, said Astroscale’s COO Chris Blackerby, who serves on the CONFERS executive committee.


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Functional movement disorders (FMDs) are a common cause of disability. With an increasing research interest in FMD, including the emergence of intervention trials, it is crucial that research methodology be examined, and standardized protocols be developed.
To characterize the current inclusion criteria used to select patients for FMD research studies and review the consistency and appropriateness of these criteria.
We identified studies of potential biomarkers for FMD that were published over the last two decades and performed a qualitative analysis on the finally included studies.
We identified 79 articles and found inconsistent inclusion criteria. The Fahn-Williams and DSM-IV criteria were the most commonly applied, but neither accounted for the majority (Fahn-Williams 46%, DSM-IV 32% of the total). The selection of the inclusion criteria depended in part on the phenotype of FMD under investigation. We also identified inclusion methodologies that were not appropriate, such as the inclusion of low-certainty diagnoses and diagnosing by excluding specific biomarkers rather than including patients based on clinical characteristics that commonly are thought to suggest FMD.
Significant variability exists with the inclusion criteria for FMD research studies. This variability could limit reproducibility and the appropriate aggregation of data for meta-analysis. Advancing FMD rehabilitation research will need standardized inclusion criteria. We make some suggestions.
Functional movement disorders (FMDs) are common and disabling conditions (Gelauff & Stone, 2016; Stone, Carson, et al., 2010). These have historically been identified by diverse alternate terms, including “hysteria,” “conversion disorder,” “psychogenic disorder,” and “dissociative disorder.” The term “functional” in recent years has become the accepted term among clinicians who specialize in care for persons with FMD, because it is judged not to be pejorative, but rather it conveys causative neutrality and may increase patient understanding and acceptance (Ding & Kanaan, 2017). Adopting the term “FMD” over prior terms has been viewed as a step toward advancing the scientific evaluation and care for this disorder.
FMDs are thought to involve the impaired voluntary control of movement over parts of the body in the presence of normal intent to move and intact neuromuscular capacity for movement (Espay et al., 2018). Interest in FMD has increased over the last several decades, with a surge of intervention trials in recent years (Pick et al., 2020). The consistency for diagnosing FMD has become all the more important because the National Institutes of Health of the United States recently announced requests for funding applications to validate functional neurological disorder diagnosis through biomarker assessment, thus to generally improve assessment for this illness (National Institute of Neurological Diseases and Stroke, 2021a, 2021b). However, the consistency for diagnosing FMD across studies has not so far been determined. Consistent diagnostic methods would allow accumulating data for meta-analyses of rehabilitation and support replication in the clinical setting. We therefore systematically reviewed a subset of such studies for their consistency of methods of FMD diagnosis.
For this systematic review, we elected to evaluate only studies that investigated laboratory techniques to identify potential FMD biomarkers. We focused on biomarker studies because by their using largely objective measures (e.g., structural or physiological brain imaging, electromyography, electroencephalography), this could eventually support identifying reliable study inclusion criteria that could be used for later clinical trials. We assumed that the diagnostic methods for FMD in biomarker studies would represent the broader body of FMD research.
We modeled our literature search from that of Thomsen et.al. (Thomsen et al., 2020), who evaluated the sensitivity of specific biomarker assessments for diagnosing FMD. We restricted the dates of publication to between 1 January 2001 and 1 January 2021 to represent current diagnostic methods. The inclusion criteria were further modified to select original data studies that investigated biological correlates of abnormal movement, included an FMD experimental group, and publication in English. Studies were excluded based on sample size less than four.
A PubMed search conducted on 28 February 2021 identified 921 records that met the search criteria (Fig. 1) Twelve additional articles were included while reviewing the citations of included articles. Seven hundred ninety-three were excluded from inspecting the titles and abstracts, resulting in 140 full text articles. Seventy-nine articles were finally found to satisfy all criteria. The web-only supplementary table summarizes all data extracted from the studies.
We then subdivided the studies according to the following major categories of inclusion criteria, based on our preliminary observation of the most frequently used inclusion criteria.
(1) The Fahn-Williams criteria and variants (FW). The original FW criteria were published in 1988 with respect to functional dystonia (Fahn & Williams, 1988). The criteria were updated in 1995 to include tremor, parkinsonism, gait disturbances, and myoclonus (Williams et al., 1995). Notably, this update did not include functional paresis. Fahn and Williams established demonstrating inconsistency and incongruence as the diagnostic pillars. Incongruence has been described as “Movements [that] do not present or progress according to the wide phenotypic range of known organic movement disorders (Espay & Lang, 2015),” while inconsistency can refer to symptoms that vary over time.
It is important to note that these criteria do not require psychological disturbance, but rely substantially on historical, emotional, and non-movement related findings. Fahn and Williams created categories of grades of diagnostic certainty. The highest level of certainty, clinically-definite, was created in the 1995 update by combining the documented and clinically-established categories originally described in 1988 (Williams et al., 1995). Patients were considered to have documented FMD if the signs were observed to remit when the patients were unobserved or with efficacious therapy. In the clinically-established category, patients had movements that were inconsistent or incongruent but also had to have other “false” signs (equated to “psychogenic” signs, though not specified), multiple somatizations, or obvious psychiatric disturbance. Lesser levels of certainty included probable, where patients could be diagnosed based solely on “false signs” (without inconsistent or incongruent movements), and possible, which simply required emotional disturbance. The categories of probable and possible were subsequently shown to have poor interrater reliability and are of no clinical use (Morgante et al., 2012).
Subsequently, the Shill-Gerber (SG) criteria were intended to expand on the FW by creating an avenue for diagnosis that did not require inconsistent or incongruent movements, although incongruence could still be considered among subsidiary criteria (Shill & Gerber, 2006). “Clinically proven” FMD was diagnosed provide that it either (1) remits with psychotherapy, (2) remits when the patient feels to be unobserved, or (3) has a demonstrated premovement Bereitschaftspotential on electroencephalography (EEG) in cases of myoclonus. [The Bereitschaftspotential, also known as the “readiness potential” or “motor-related cortical potential,” is the slowly rising negative electrocortical activity on EEG that precedes experimentally-verified intended movement (Di Russo et al., 2017).] In contrast, suspected FMD that was not considered to fall under these criteria was classified as “clinically definite” FMD by creating “primary” vs. “secondary” criteria. Under primary criteria, the disease had to either be incongruent with so-called organic disease (including inconsistent symptoms presentations), involve excessive pain or fatigue, or have previous exposure to a disease model or potential for secondary gain. In contrast, the secondary criteria involved “multiple somatizations (other than pain and fatigue) and/or obvious psychiatric disturbance.” To qualify as “clinically definite” FMD, it had to meet “at least three primary criteria and at least one secondary criterion.” The category of “clinically probable” FMD entails two primary criteria and two secondary criteria. Finally, “clinically possible” FMD involves one primary criterion and two secondary, or two primary and one secondary criterion. A major pitfall of this system is that any patient with pain, exposure to a disease model, potential for secondary gain, and multiple somatizations could incorrectly be identified as “clinically definite” FMD.
The still later Gupta-Lang (GL) criteria were intended to address potential problems with FW and to include advances in laboratory-supported evidence of FMD in diagnosis (Gupta & Lang, 2009). To address potential problems, Gupta and Lang removed the probable and possible classifications from their criteria due to their lack of reliability, and rejected the inclusion of patients with consistent/congruent movements. Additionally, they created a laboratory-supported definite category to facilitate diagnosing FMD in cases of tremor and myoclonus where electrophysiological data were available. Specifically, these were entrainment of tremor as reflected by surface electromyography and back-averaged Bereitschaftspotentials during electroencephalography-electromyography of myoclonus.
Subsequently, Espay and Lang expanded on GL by creating a phenotype-specific diagnostic process for FMD (Espay & Lang, 2015). This rejected the requirement of historic and emotional data and updated laboratory evidence (flurorodopa positron emission tomography, or PET; single photon emission computed tomography, or SPECT). To create a phenotype-specific diagnosis process, they identified core features that were individually specific to functional tremor, dystonia, myoclonus, tics, parkinsonism, and gait impairment. This set of criteria requires that all of these core features be present to make a clinically-definite diagnosis. Except for functional dystonia, where rapid onset is considered to be a diagnostic feature, all core features are movement-related phenomena rather than historical data. The core features are specific and generally lack the subjective language of FW, SG, and GL such as “bizarre” and “unusual.” The authors argued against the use of historical and emotional data, citing their prevalence as well in structurally-defined neurological disease (e.g., stroke, brain tumor) and the lack of sensitivity and specificity required to provide clinical usefulness.
(2) The Diagnostic and Statistical Manual (DSM)-IV laid out criteria for diagnosing “conversion disorder” (CD), a term based on the Freudian hypothesis that psychological stress is converted into somatic symptoms (American Psychiatric Association, 1994). Because the earliest DSM editions were published before FW had become standard, the DSM-IV was relatively uninfluenced by the norms established in FW. The diagnosis was considered to be psychological and primarily required the diagnostician to demonstrate that psychological factors were associated with the symptom. This created logistical barriers that impeded accurate and efficient diagnosis.
Many of these limitations were addressed in the DSM-V, which encouraged the clinician to look for signs that are diagnostic for FMD and removed the criteria for psychological association and excluding feigning (American Psychiatric Association, 2000).
(3) The category Other was applied to the studies that did not rely on either the FW variants or the DSM.
As seen in Fig. 2, the FW criteria were the most prevalent diagnostic criteria used in FMD research trials. FW was used in 30 of the 79 investigations. Six additional studies employed a variant of FW—four studies using GL and two using EL. SG were not found to be used as inclusion criteria in any investigation identified by this review. The DSM-IV was the second most common method, involving 25 studies. Two studies used both DSM and FW criteria. Finally, ‘Other’ encompassed 20 studies. Five studies did not specify how subjects were diagnosed. This group included studies that simply used the referring physician’s diagnosis (van der Stouwe et al., 2016), without specifying the physicians’ criteria. Ten studies created their own diagnostic criteria or used some other set of criteria—for example, the ICD-10 criteria for “dissociative disorder” (Liepert et al., 2011). Five studies diagnosed FMD based primarily on excluding structural disease. These studies were mostly investigations of suspected stroke patients who were considered to have a functional etiology after repeated structural imaging ruled out cerebrovascular accident (Benussi et al., 2020; Premi et al., 2017).
3.2Criteria by studied phenotype
As seen in Fig. 3, the selection of inclusion criteria highly depends on the phenotype under investigation. DSM variants are significantly represented in studies that investigated functional paresis. Functional paresis was not included by Fahn and Williams in their original criteria and has not been added to the updates or variants thereafter (Espay & Lang, 2015). There were no instances of studies investigating tremor, dystonia, or myoclonus that employed DSM. Those investigations most often used the FW variants. Of the 23 mixed studies—that is, those investigating more than one phenotype of FMD—FW variants were used in 12 instances, DSM variants in nine, and two publications that used neither. There was considerably more variance compared to the studies of single phenotypes.
3.3Inclusion of probable and possible
The categories of probable and possible are only found within FW and SG. Eight of the 30 studies using FW allowed the inclusion of probable. Given the increasing awareness of the problems with the probable designation over the period investigated, we looked for changes in the allowance of probable over time. As shown in Fig. 4, the inclusion of subjects diagnosed with probable FMD remains pervasive. Between 2016 and 2020, nine studies were identified that employed FW as their primary inclusion method, with three of the nine allowing the inclusion of probable. Consequently, although the majority of studies of biomarkers of FMD that used the FW inclusion criteria did not apply the probable category, nonetheless there remains a continuing minority of studies that use the probable category, despite the published indication that the probable and possible categories are unreliable (Morgante et al., 2012). None of the studies had included subjects who were designated to have possible FMD.
4.1Criteria application in research
This systematic review revealed considerable discrepancies in the choice of diagnostic criteria used to include subjects in FMD research. There is relative consistency within studies that investigate the same phenotype, but the choice of criteria varies depending on what specific phenotype is being studied. For example, it was seen that all of the investigations of functional dystonia employed FW, while no study of paresis employed FW. This variability is likely related to criteria sets (FW, SG, GL, and EL) that did not include methods for diagnosing functional paresis. Because functional paresis investigations cannot use FW variants criteria, these researchers rely on the DSM-IV disproportionately to other groups. This review also found significant variability in the criteria used in mixed studies (those that evaluated more than one phenotype). These studies may or may not include functional paresis (Nahab et al., 2017; Wegrzyk et al., 2018). There is a clear need for a criterion set that may be used to include all patients with symptoms of FMD.
Twenty of the identified studies did not use a variant of FW or DSM. These are not strictly of low quality but do reveal some of the poorer methods that are common in FMD research. One of these is including FMD subjects based purely on exclusion of “organic” disease, without specifying the bases of exclusion. It was also common for researchers to provide unreproducible methods, such as providing no information as to the inclusion criteria or reporting that the diagnosis is based on the expertise of the investigators (Huys et al., 2020).
4.1.2Fahn-Williams criteria and variants
The FW criteria have been accepted by many researchers and clinicians for diagnosing FMDs or including patients in treatment trials. In our literature review, the FW inclusion criteria were the leading measures for FMD studies. However, several limitations pertain to the elements of the criteria, which raise questions on the comparability of study groups and treatment outcomes from different study sites when they have applied these criteria.
Williams et al. (1995) identified the central challenge of diagnosing FMD to be “establishing that the abnormal movements derive in part or fully from an underlying psychological disturbance.” Since that time, the field has come to question the necessity of underlying psychological pathology, has moved away from terms that imply a psychological origin like “psychogenic” or “conversion disorder,” and proposed alternative pathologic mechanisms (Edwards & Bhatia, 2012; Stone, LaFrance, et al., 2010).
One of the pillars of the FW criteria for functional dystonia is its “incongruity” with legacy (or “organic”) dystonia. However, such criterion begs precise definition of legacy dystonia in the first place, given that dystonia is a heterogeneous disorder (Conte et al., 2020) and that the range of self-administered “sensory tricks” or “gestes antagonistes” (maneuvers that can briefly interrupt legacy dystonia) can include widely varying remedies such as bending forward, singing, humming, piano playing, or running in a counterclockwise direction (Ramos et al., 2014). Therefore, establishing the boundary between functional dystonia and legacy dystonia is unclear, to say the least.
Another problem inherent to the criteria for diagnosing functional dystonia can include suspected either factitious disorder (as reflected by self-injury) or malingering (reflected by “false weakness”). Making such judgments by the clinician requires extended evaluation and review of medical records and reports from observers for these behaviors (Bass & Wade, 2019). It is most likely impractical to apply such criteria.
Yet another weakness within the FW design is the observation of beneficial outcomes from adjuvant behavioral therapies, including tricyclic antidepressants and extensive physical therapy. Although tricyclic antidepressants may be initiated to treat depression, however, this class also can treat neuropathic pain. Considering that “pain out of proportion to exam” is a supportive feature of the inclusion criteria, initiating an antidepressant may involve a confounding variable. This could similarly by applied to the initiation of intensive physical therapy. In particular, the outcome of physical therapy may depend in part on the specific content of the treatment or qualifications of the therapist. Hence, absence of benefit from physical therapy should not imply absence of FMD.
As alluded to above, most patients who were included in the creation of FW criteria were diagnosed based on documenting symptom remission rather than signs that are present during a specific clinical evaluation. This is distinctly different from the current application of FW, where the observation of concurrent signs is regarded as the hallmark of the Fahn-Williams criteria (Bhatia et al., 2018; Espay & Lang, 2015). Remission with psychotherapy was the goal of the combined diagnostic and therapeutic process laid out by the publications. In fact, only four of the 21 patients included by Fahn and Williams (1988) were considered to be clinically-established. The stated reasoning for arriving at a clinically-established diagnosis rather than pursuing an established diagnosis was the patient being unwilling to complete the diagnostic process. This is not to say that Fahn and Williams did not regard clinical signs as important. They emphasized the importance of clinical signs as clues for a functional origin but did not consider the recognition of clinical signs as sufficient for a definite diagnosis. Clinical signs, especially those that have been validated, may be diagnostic, but that was not the intention of FW.
The GL and EL criteria addressed many of the limitations with FW but remain flawed. GL removed the criterion regarding intentionality, freeing the clinician from this undue burden. However, GL prematurely places much emphasis on laboratory-supported criteria where clear laboratory markers have not been validated. Additionally, GL does not provide diagnostic guidelines that are phenotype-specific. EL went further to identify criteria that were phenotype-specific. A major problem with EL is that it has strict inclusion criteria based on sensitivities established using FW as a gold standard. Since no gold standard has been established for FMD, strict inclusion requirements are premature. However, EL include phenomenological descriptions of the abnormal movements that provide clinicians the most guidance of any criteria set that was identified in this review.
The DSM-IV was the second most common method of including patients in FMD treatment trials that we identified. Many authors have offered salient critiques of the DSM-IV’s diagnostic criteria for CD, especially in the years leading up to the publication of the DSM-V (Spiegel et al., 2011; Stone et al., 2011). However, researchers continued to turn to the DSM-IV, even after the DSM-V had become available (Blakemore et al., 2015; Hassa et al., 2016). This is especially true of studies that included patients with functional paresis, perhaps because the FW criteria did not include functional paresis among the possible diagnoses. Additionally, large differences exist between the FW criteria and the DSM-IV, which calls into question whether these inclusion methods would enroll comparable groups.
Whereas FW considered factitious and malingering disorders to be FMD and finding evidence of these conditions was considered diagnostic (Williams et al., 1995), the DSM-IV definition of CD requires that “The symptom or deficit is not intentionally produced or feigned” (Association, 2000). This not only demonstrates that the two criteria sets would select different patients, but that the application of the DSM-IV criteria is burdensome and of uncertain reliability. Demonstrating that a patient is not intentionally producing symptoms can be an impossible task, because a person’s intent may not be apparent even with intensive investigation (Stone et al., 2011).
Another problem with the DSM-IV criteria is the requirement for the association of psychological factors. This is both clinically and theoretically problematic. This criterion is derived from research that demonstrates an association between stressful life events and the development of FMD (Binzer et al., 1997). However, it has never been shown that these events cause the functional presentation; in fact, many patients with known FMDs do not have identifiable psychological stressors associated with the symptom (Stone et al., 2009). Clinically, this criterion is problematic because many patients may be reluctant to discuss such matters and they may not be apparent from the available history.
The final major problem with diagnosis by the DSM-IV is that these criteria do not regard the phenomenology of movement in the diagnosis. Abnormal movements or the variable lack of movement are among the presenting symptoms in patients with FMDs (Espay et al., 2018). These criteria do not instruct the clinician in the recognition of diagnostic signs of FMD within these abnormal movements. Without this criterion, the DSM-IV does little to diagnose FMD besides attempt to exclude various other disease states. Researchers who employ FW criteria primarily make the diagnosis based on clinical signs that characterize FMD, whereas researchers using the DSM-IV may not even consider them.
4.4General comments on discrepancies within FMD inclusion criteria
The published criteria for diagnosing FMD contains significant discrepancies that could result in variability within the FMD populations being studied by various investigators. These discrepancies include reliance on historical and emotional data, level of exclusionary diagnosis, and allowance for low certainty diagnoses.
The degree to which sets of criteria rely on historical and emotional features varies significantly. These supportive features include multiple somatizations, psychiatric disturbance, childhood trauma, exposure to disease model, and potential for secondary gain. Supportive features make poor criteria because they have been shown to be neither sufficient nor necessary for the diagnosis (Espay et al., 2018), based on sensitivity and specificity. The low sensitivity of these factors is related to their prevalence within legacy neurological diseases, i.e., those not commonly regarded as functional disorders (LaFaver et al., 2020). The low specificity is related to the poor generalizability of signs found to be specific to a signal phenotype. For example, the sudden onset has been stated to have good specificity for functional dystonia (Frucht et al., 2020), but such information may be vulnerable to recall bias in the patient (Espay & Lang, 2015). The DSM-IV diagnoses CD almost solely based on these supportive features, without regard for movement phenomenology. The DSM-IV considers CD a purely psychological diagnosis and views the role of the neurological investigation as a component of excluding medical diagnosis. This is partially true of SG, where movement phenomenology can be disregarded with sufficient “secondary features.” Both the DSM-IV and SG allow the diagnosis to be made on criteria that are not sufficient for the diagnosis. The FW rejects this idea and requires clinical signs of FMD. However, the criteria require as well historical features. This is problematic because these tests lack the sensitivity to be required and are therefore unnecessary. The EL criteria neither require nor rely on these supportive features.
The criteria vary both on their requirement for movement phenomenology and in the interpretability of the criteria regarding movement-related features. As stated above, some criteria either disregard movement-related features, such as the DSM-IV, or do not require these features, such as the SG. Movement-related features should be core for diagnosing FMD. However, even for the criteria that require movement phenomena, the degree of specificity used to describe movement phenomenology varies widely. Fahn and Williams, and the subsequent variants, described functional movements as being incongruent and inconsistent, which we review next.
18.104.22.168. Incongruence. One of the pillars of diagnosing FMD, established by Fahn and Williams, is that the movement phenomena should be incongruent with legacy neurological diseases. This is problematic because it requires a diagnostician to recognize the nuanced presentations of legacy diseases that are needed to differentiate them from functional presentations (Espay et al., 2018; Gasca-Salas & Lang, 2016; Gupta & Lang, 2009). The lack of clarity has led to criteria including non-scientific, imprecise descriptions such as “bizarre,” “unusual,” and “abnormal” (Espay & Lang, 2015; Fahn & Williams, 1988; Williams et al., 1995). This is further complicated by “incongruent” signs that are not generalizable to all phenotypes. For example, suppressibility of a functional tic is not incongruent with legacy tic disorders. Rather than designating signs as being incongruent with legacy disease, clinical signs that are to be used to rule-in FMD should be phenomenologically specific and not require simply to exclude legacy disease.
22.214.171.124. Inconsistency. Inconsistency applies to the fluctuating patterns of movement within the individual patient, which may be better described as variability. This variability may be demonstrated in movements that change over time, that are suppressed with complex tasks, or where the disability is disproportionate to exam findings (Espay & Lang, 2015). These features suggest that the symptom can vary with the patient’s self-attention. This thus suggests possible specific pathophysiologic mechanisms and potential for remission with behavioral therapy. Identifying patients whose symptoms are likely to remit with behavioral therapy is one of the most important features of FMD diagnostic criteria. However, the frequency of symptoms can vary considerably also in legacy movement disorders (Lieberman, 2006; Pare s et al., 2012; Stone et al., 2005). Consequently, it will be important to revise the diagnostic criteria of FMD by acknowledging that symptoms of legacy neurological disorders can also fluctuate.
When applying FW or one of its variants, we suggest that only a clinically definite diagnosis should be considered for inclusion in FMD research, and only with respect to inconsistency of movement within the individual, and not with respect to incongruence with other neurological disorders. FW and SG both categorized diagnostic certainty with probable and possible FMD diagnoses included. A significant problem with these categories is that the diagnosis can be made in the absence of movement pathology. Additionally, these designations have been shown to have poor interrater reliability (Morgante et al., 2012). SG did not allow for these low-certainty diagnoses under their criteria, with the EL following suit. This review identified eight studies that allowed for the inclusion of patients diagnosed as probable FMD. This represents 22% of the 37 studies that employed the FW criteria. These studies should be considered poor evidence and caution should be taken when including their results in metanalyses.
This study intentionally restricted its review to studies that related the diagnosis of FMD to objective biomarker evaluations (thus, MRI, EEG, and so forth). We restricted our literature review so as to model our method from that of Thomsen et al (Thomsen et al., 2020), who evaluated the psychometric validation of various biomarker evaluation techniques for diagnosing FMD. We had a simpler objective: to evaluate the consistency of diagnosing FMD among the studies that had used objective biomarkers for making this determination. We intentionally selected studies that had related biomarkers to the diagnosis accuracy of FMD, because such approaches would be regarded as scientifically rigorous. In contrast, we did not evaluate the broader literature for diagnosing FMD regardless of the inclusion of biomarkers, because we felt that our narrowing our literature review would be sufficiently informative with respect to the present status with respect to the consistency of diagnosing FMD. As a result, we found marked inconsistency for diagnosing FMD. We doubt that our evaluating the broader literature on FMD would have changed our conclusions.
This systematic review identified variability in the choice of diagnostic criteria used to include subjects in FMD research studies. The criteria choice was found to vary with the phenotype being investigated. This has implications in mixed studies in which more than one phenotype is investigated but only a single set of diagnostic criteria may be used. Mixed studies were found to have more variable inclusion criteria than studies of a single phenotype. Variability in criteria selection is problematic because significant differences exist between the sets of published diagnostic criteria, as reviewed above. When considering the creation of new criteria, we propose that the criteria should be inclusive of all FMDs, based on demonstrating symptom variability in response to self-attention to the symptoms during clinical examination. A unified set of inclusion criteria for FMD would consequently support future studies for their response to psychological therapy. Furthermore, such criteria should avoid subjective, unscientific language such are “bizarre” and “unusual,” and exclusionary relics such as designating a symptom’s being incongruent with other neurological diseases, given at present unsettled diagnostic criteria for many such diseases.
Conflict of interest
The authors declare that they have no conflicts of interest.
 The supplementary material is available from https://dx.doi.org/10.3233/NRE-228002.
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I can’t believe I’m about to change my position on an issue as important as this…
I think Sammy Hagar might be a better front man than David Lee Roth. Wow. Even now, I can’t believe I’m saying this. Last night’s Van Halen concert featuring Sammy Hagar changed everything. It took seventh row seats and permanent hearing damage to arrive at this conclusion, but I’m officially convinced.
This is not taking anything away from David Lee Roth. He’s a legend. He was one of the few rockers that gratuitously performed the splits on stage. He could pull off the look of sunglasses and a taxi driver’s cap better than anyone. And he put Van Halen on the map.
But after the electrifying show Sammy Hagar and the rest of Van Halen put on last night, I have a hard time envisioning anyone being able to top it. They played over three hours without a break. The audience stood and cheered the entire time. We were losing circulation in our legs and our bladders were uncomfortably full of beer, but nobody left for even a minute. Van Halen flat out rocked. I held a pretty tepid appreciation of Van Halen before last night, but my level of fandom shot up tremendously after seeing them live.
Here are some highlights of the evening in bulleted format…
- Eddie performed a 20-minute guitar solo. Twenty minutes. At one point he crawled into the fetal position and put his head next to a wall of speakers. His guitar screeched as the audience wondered if he was attempting to commit suicide through massive amounts of feedback. It was a stellar performance though. He played like he had bet the Devil his soul against a fiddle made of gold.
- My only complaint against Sammy Hagar was that he wore a pair of red Capri pants during the show. This bothered me the whole concert. I studied his pants closely, and honestly, I think my wife bought the same pair of pants at the GAP last weekend.
- The bass player had a bass guitar painted like a bottle of Jack Daniels. The best part was that his guitar functioned as a Pez dispenser for those little mini liquor bottles you see on airplanes. Periodically throughout the concert, he’d pop out a shot of whiskey, down half the bottle and throw the rest into audience. That, my friends, is showmanship.
- The band split evenly into shirts and skins. Eddie and Alex Van Halen went shirtless, apparently ready for a pickup game of basketball after the show.
- Rest assured, Eddie Van Halen is still the master of doing the jumping scissor kick while playing the guitar. He proved this time and time again.
- Midway through the concert, they announced the score of the Yankees-Red Sox game. Judging by the crowd’s reaction, apparently I am the only person on earth that was rooting for the Yankees. In my opinion, as impossible as this may sound, the Red Sox were less likable than the Yankees.
Let’s face it, most of the Red Sox players look like juvenile delinquents. If you removed their hats, it wouldn’t surprise me to see curse words shaved into their hair. I don’t know, all the wild haircuts, punk behavior, scruffy goatees… They looked like they belonged at a skate park instead of on a baseball diamond. (I know, I know, as the bumper sticker on the Allen family minivan proclaims: “Skateboarding is Not a Crime!!“) The Yankees on the other hand, looked clean-shaven and professional. They looked like they could have been heading to a job interview after the game. Sometimes it’s just nice to see the team with better grooming habits win. I’ll leave it at that.
- Remember the scene in the movie “Old School” where Vince Vaughn performs a gymnastics routine while smoking a cigarette? It is arguably the funniest scene in the movie. Anyway, at one point Eddie lit a cigarette and performed his usual jumps and spins around the stage. It was probably the closest thing I’ve witnessed in real life that essentially duplicated that scene from the movie. There were 10,000 people screaming wildly in the arena that night, but I think I was the only one holding in laughter.
- Throughout the concert, several girls threw their bras and panties up on stage. Sammy would collect these undergarments, hold them up for the crowd, and then drape them over his mic stand. I had no problem with any of this.
- Like a lot of aging rockers, Eddie Van Halen, sadly, is looking a little fried. The few times he addressed the crowd, he mumbled, rambled and managed to say things that were completely unintelligible. Granted, he’s far more coherent than Ozzy Osbourne, but at the same time, I’m not sure if that is a yardstick you want to measure yourself against.
- At one point, an audience member threw a giant banner onto the stage that read: “Sammy for President.” Seizing the moment, Sammy waved it around onstage for several minutes and then tied it around his waist like a sarong. I think I speak for most people when I say this: Provided his whiskey-swilling bass player was his running mate, this is one Presidential ticket we could all get behind.

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Zhovkva - guidebook
Ukr. Жовква, Yid. זשאָלקווע
A perfect city
Established towards the end of the 16th century as a Renaissance “perfect city,” Zhovkva (then Żółkiew) was named in honour of Stanisław Żółkiewski, its founder. The earliest historical reference to the village of Vynnyky (Winniki), around which Zhovkva was subsequently established, dates back to 1368. In 1597, the Crown Hetman Stanisław Żółkiewski began the construction of Zhovkva near Vynnyky, and in 1603, due to a privilege issued by King Sigismund III Vasa, the emerging urban center was granted municipal rights as a private Polish town. The crown privilege gave a powerful boost to the economic life of the town and its vicinity and promoted rapid development of diversified crafts and trade. In the first half of the 17th century, Zhovkva was transformed into a fortified town circumscribed by pompous stone ramparts. The market square located in front of the castle was lined by trading houses on the northern and eastern sides that formed a gallery of stores, known as arcades. The entire town was designed by the famous Italian architect and theorist Pietro di Giacomo Cataneo. The town plan followed the successful experiment of another “perfect” Renaissance town of Zamość, located 100 km north west of Zhovkva and established several years before. Since in the Renaissance art was somatic and anthropocentric, the general town plan and the plans of its environs, including the plots of neighboring lands and houses, reflected in its minute details the system of proportionally interrelated measurements of human anatomy. The famous Italian architects Paolo de Ducato Clemenci (also known as Paweł Szczęśliwy, Ukr. Pavlo Schaslyvyi) and Paolo Dominici (known as Paweł Rzymianin, Ukr. Pavlo Rymlianyn contributed to the creation of the town.
In 1620, Zhovkva became the property of the Daniłowicz noble family, and later became the possession of John III Sobieski (1629–1696), King of the Polish-Lithuanian Commonwealth, who inherited it from his mother, Zofia Teofila. It was during John III Sobieski’s reign that Zhovkva (Żółkiew) saw its heyday. The king transformed the town into a major centre of political and economic life of the 17th-century Polish-Lithuanian Commonwealth. At his Żółkiew residence, he received diplomatic envoys of King Louis XIV of France and King Charles II of Spain. After the victorious battle near Vienna on September 12, 1683, in which the troops of Habsburg Monarchy, the Polish-Lithuanian Commonwealth, and the Holy Roman Empire under the command of King John III Sobieski destroyed the army of the Ottomans and their vassal and tributary states, the papal nuncio arrived in Zhovkva and granted the king with a sword blessed by the pope. In the early 17th century, Zhovkva was home for young Bohdan Khmelnytsky (1595–1657), the future leader of the Cossack revolution, whose father served at Hetman Żółkiewski’s court. The Cossack leader hetman Ivan Mazepa (1639–1709) visited Zovkva too. During the Great Northern War (1700–1721), from December, 1706, to April, 1707, the Zhovkva Castle served as the temporary headquarters of the Russian Tsar Peter I (the Great).
Towards the end of the 18th century, with the partition of Poland between Austria, Prussia, and Russia, Zovkva, together with the entire new province of Galicia, became part of the Austrian domain. The Habsburg authorities began demolishing the town fortifications and reconstructing various centrally-located buildings for administrative purposes. The entire sections of the defensive walls, including the Lwowska (L’viv) and Żydowska (Jewish) Gates were demolished; the castle palace was converted into a prison; plans were underway to rebuild the town hall too. Only in the 19th century did the authorities began the renovation. For example, the Zwierzyniecka Gate was restored, and so were some of the castle walls. Yet in the 19th century, the castle as well as the entire town went into decline.
In September, 1914, as World War I broke out, Zhovkva was captured by the Russian army. In June, 1915, the Austrians recaptured it. From November, 31, 1918, until May 16, 1919, the Lemberg (L’viv) county was under the administration of the Western Ukrainian People’s Republic (ZUNR), and then it was under temporary Polish administration until 1923, when the international community at the Conference of Ambassadors recognised Poland’s sovereignty over Eastern Galicia.
Panorama of Zhovkva. A general bird’s eye view of the town, 1918–1933, collection of the National Digital Archives, Poland
On the Jewish Street
The first Jews settled in Zhovkva as early as the 1590s, immediately after the foundation of the town. In 1600, Stanisław Żółkiewski, the Voivode of Ruthenia, allowed Jews to establish their first prayer house. At that time, the local Jewish community was subordinated to Lviv kahal, but in 1620, it became independent and established its own communal authority. The Jews were granted a privilege of building their residences in a street subsequently called Żydowska (Jewish) Street, which led to the Jewish Gate, one of the town four main gates. The king granted Zhovkva the autonomy according to the Magdeburg law and also exempted it from custom duties and other special taxes. These privileges enabled merchants and craftsmen from other towns to trade freely in Zhovkva. The town also received a privilege of hosting a major trade fair (Jahrmark) four times a year and to have two market days each week. 17th-century Zhovkva was home to more than a hundred Jewish craftsmen, including furriers, silver- and goldsmiths, jewellers, tanners, pharmacists, and tailors. Several dozen Jews received special privileges including the lease of the customs house, of tax collecting, and of propinacja (producing and selling alcoholic beverages). They were also running inns, managing fish ponds, running lumber mills, and freighting timber.
In 1624, a wooden synagogue was opened next to Aron Moshkovich’s house, and in 1626, the kahal appointed first communal rabbi Ezekiel Issachar (d. 1637). In addition to the synagogue, the Jewish quarter enjoyed the operation of all other communal institutions, including a mikveh (ritual bath), a slaughterhouse, the rabbi’s house, a beth midrash (study house for adult Jews), and a hekdesh (shelter for the poor and for the vagabond alms-seekers). In 1640, the town owners allowed the Jews to open a yeshivah. The town’s Jewish community gradually grew and acquired importance. In 1628, 21 houses in Zhovkva were Jewish, and in 1680, 88 houses. When in 1648, the Cossack troops under Bohdan Khmelnytsky approached Zhovkva, thousands of Jewish refugees found safe haven in town and took part in defending the town against the Cossacks along the Polish garrison. In 1765, the Jewish community of Zhovkva boasted more than 1,500 members and possessed more than 270 buildings. Jews owned nearly all the buildings around the market square, which formed a lined-up gallery where most of trade took place. The street leading from the market square to the synagogue also had a commercial importance and was known as the Jewish Market.
The Sobieski's synagogue
As early as 1635, the Jews of Zhovkva were granted the privilege to build a stone synagogue, but it was not built until towards the end of the century. Also known as the Sobieski Shul, it became one of Europe’s most notable Jewish monuments.
The synagogue was called royal not only because of its pompous size and beautiful decorations and ornaments, but also because of 6,000 zlotys that the king lent the Jewish community toward its construction. Built of stone, the synagogue was erected in lieu of the old wooden one, next to the northern ramparts of the town, close to the Jewish Gate. By 1700, the construction was completed under the guidance of the crown architect Piotr Beber. The main nine-bay prayer hall measured 21 to 20 meters, and its height reached 14.5 meters at the highest point of the dome. The interior was lavishly decorated with stuccoes and frescoes. On the western and southern sides, the main hall was adjoined by a vestibule and women’s galleries. The synagogue roof was hidden behind an attic with special decorative visors, which made many believe that the building also allegedly served as part of the town fortifications. The Renaissance-style building (with some manierist elements) looked so elegant that the Catholic clergy forbade painting it in white so that it would not eclipse Zhovkva churches with its radiating beauty.
In the first days of German occupation in 1941, the Nazis tried to demolish the synagogue. Attempts to blow it up totally destroyed the southern women’s gallery; the western part of the building lost its roof and a gallery vault, and in the main prayer hall the dynamite explosion destroyed three sections of the vault, the central columns, and parts of the roof.
In 1963, the synagogue was partially renovated and catalogued in the National Register of Architectural Monuments of the Soviet Ukraine. Despite its state-protected status, the building was used as a warehouse. From the early 1990s, various plans were underway for conservation and restoration purposes, but the lack of adequate financial resources and the complete absence of the local Jewish community made any comprehensive renovation impossible.
In the mid-1990s, the “fortress” synagogue of Zhovkva was listed by the New York-based World Monuments Fund as one of the “100 most endangered heritage sites in the world.” Thanks to this alert, renovation was begun in 2000. However, it was subsequently suspended as the supervising authorities discovered cases of embezzlement and inappropriate use of funds allocated for restoration of the monument. In 2007, the roof of the synagogue was covered with protective copper tiles yet the building has remained in perilous condition.
In 2012, the National Bank of Ukraine introduced memorial coins worth 5 and 10 hryvnias with the images of the Zhovkva synagogue as part of the Architectural Monuments of Ukraine series.
The printing house
In 1690, King John III Sobieski granted Uri Faivush ben Aaron ha-Levi (1625–1715) from Amsterdam with a crown privilege to establish a Jewish printing press in Zhovkva. Uri Faivush had exported books to Poland-Lithuania for many years and was one of the three main Amsterdam book printers. He had also been known as the publisher of one of the first newspapers in Yiddish, Dienstagishe un Freitogishe Kurant (A Thursday and Friday Carillon). In 1692, Uri Faivush brought his unique Amsterdam type to Zhovkva and published his first Zhovkva printingpress book. In 1705, he returned to Amsterdam while the printing press was continued to be run by by his grandsons, two outstanding printers Aharon and Gershon. Due to its excellent layouts and the clarity of its print and despite the restrictive decisions of the Council of Four Lands, Zhovkva printing press suppressed the two other printing presses operating in Poland at that time – Lublin and Krakow – and for almost 80 years remained a monopolist, the only Jewish printing centre in the entire Polish-Lithuanian Commonwealth. This exclusive position of Zhovkva in the printing market changed only after the 1764 dissolution of the Council of Four Lands. Zhovkva printing press published classical works of religious literature and also rabbinic treatises submitted for print by rabbinic scholars from various countries. The descendants of Uri Faivush (under various family names such as Madfes, Mann, Letteris, and Meirhoffer) owned the Zhovkva printing house until the end of the 18th century. The house of Uri Faivush, in which the printing house functioned, is located in the market square at 7 Vicheva Sq.
In the late 18th century, Zhovkva became an important centre of the Haskalah (Jewish Enlightenment) movement, particularly when Nachman Krochmal (1785–1840), one of the leading maskilim (enlightened thinkers) in Eastern Europe lived in town. Krochmal was a religious thinker, historian, theologian, and writer. Born in the town of Brody, he spent a considerable part of his life in Zhovkva, making it one of the centres of the Haskalah. Other maskilim, members of the Haskalah movement such as Salomon Judah Leib Rappaport, Isaac Erter, Halevi Bloch, and others were closely connected to the circle of Krochmal in Zhovkva. After the death of his wife in 1836, Krochmal returned to Brody and two years later settled in Ternopil. Through consistent independent study, Krochmal mastered variousfields, especially history and philosophy. He was one of the first thinkers to turn to the study of Jewish history “for a better knowledge of our essence and our nature.” He penned a renowned philosophical treatise entitled More nevukhey ha-zman (Heb.: A Guide for the Perplexed of Our Times, 1839, published in Lviv in 1851). The title alluded to Maimonidean More nevukhim (Heb.: The Guide for the Perplexed), while the work used categories of rationalist philosophy and elements of German romantic thought with which Krochmal sought to construct paradigms of Jewish historical destiny. He wrote in a renovated Hebrew, enriching it with scientific and scholarly terminology of his own making thus considerably contributing to the development of contemporary Hebrew literature. He died in 1840 in Ternopil. His son Abraham Krochmal (b. 1820 in Zhovkva, d. 1888 in Frankfurt am Main) took after his father as a writer, thinker, and journalist in his own right. His hallmark was a rationalist approach to Judaism, which he treated mainly as an ethical system. As all maskilim of his generation with their aversion to piesistic trends in Judaism, including Kabbalistic thought, he vehemently rejected Hasidism.
A Galician town
In the mid-19th century, Zhovkva turned into a hub of the fur industry providing employment to hundreds of Jewish workers. Towards the end of the 1890s, 3,783 of the 7,143 residents of Zhovkva, or about 53 percent, were members of the Jewish community. After World War I, according to the 1921 census, the Jewish community numbered 3,718 people (47 percent of the town population). In the interwar period, the population of Zhovkva grew, but by 1939, the percentage of Jews had decreased to about 40 percent (4,270 people) of the 11,100 town inhabitants. The town population also included Poles (approx. 35 percent) and Ukrainians (approx. 25 percent).
The Great Synagogue was the centre of town religious life; the community of Zhovkva also maintained a Talmud Torah elementary religious school for poor children, a Tarbut Hebrew-language school with its robust Zionist agenda, an orphanage, and other educational and charity institutions, including modern Polish-, German- and Hebrew-oriented cultural societies and a football team “Hasmonea,” established according to the vision of the “Jew of muscle,” a new type of a modernized secular Jew.
A tour of Zhovkva with Shimon Samet
World War II and the Holocaust
In September 1939, the town was captured by the Red Army. Monuments to King John III Sobieski and Stanisław Żółkiewski were demolished. On June 29, 1941, German troops entered Zhovkva. Before they arrived, the retreating Soviet security police murdered at least 29 Ukrainian and Polish political prisoners in the local NKVD (Soviet secret police) prison located in the castle. The victims were the participants of various national resistance movements, some of them were just cultural figures with nationaldemocratic proclivities. The persecution of the Jews started immediately after the Nazi invasion. The synagogues were leveled. On July, 22, the Germans established Jewish auxiliary police and a Judenrat, a Jewish communal council reporting to the Nazi authorities. Then, in November 1942, the Nazis established a ghetto, stretching from the square in front of the Domincan convent and through Turyniecka Street. Approximately 6,000 people were confined there. The liquidation of the ghetto took place a year later, on November, 25, 1943. More than 4,000 Jews were shot during mass executions in the Bór forest; others were transported to the Janowski concentration camp near L’viv and to the labor camp in Rava-Ruska, where they were subsequently murdered.
After the war, a memorial was erected at the site of the mass grave in the Bór forest. Another memorial was established at the municipal cemetery, at the gravesite where the exhumed remains of the victims of the Zhovkva ghetto were re-buried.
The Jewish cemetery
The Nazis destroyed the old Jewish cemetery, established at the beginning of the 17th century. The oldest matzeva (tomb-stone), which was known to have been there before the war bore the name of certain Yitzhak, son of Abraham (d. 1610). Thelast burials took place in 1943. During the German occupation, tombstones were used to build roads. The Jewish cemetery was eventually destroyed in 1970, when the communist authorities demolished dozens of Jewish cemeteries across the USSR, particularly in Ukraine. The tombstones were removed and a large marketplace was established on the former site of the cemetery. The original Baroque cemetery wall survived partially, and in the south-eastern part, next to the entrance to the marketplace, there is an ohel over the grave of the local 213 righteous man called Yitzhak (d. 1737) and fragments of matzevot embedded in the wall.
After the war
After the war, Zhovkva found itself on the territory of the independent Ukraine. The town’s ethnic composition changed radically. During the war, the almost all Jews were murdered. In 1944, there were only 74 Holocaust survivors in town. In the late 1940s, Polish residents were transferred to the west and replaced by Ukrainians, transferred here from eastern Poland. In 1951, Zhovkva was temporarily renamed Nesterov to honor the Russian pilot Piotr Nesterov, who perished here in 1914 destroying an enemy plane in flight for the first time in the history of aviation. In 1992, the town regained its previous name, and in 1994, Zhovkva was granted the status of the National Reserve of History and Architecture, with 55 monuments of global, national, and regional significance.
A good place to start sightseeing in Zhovkva is the Tourist Information Centre located in the town hall at 1 Vicheva Sq. (tel. +38 032 522 24 98).
Traces of Jewish presence
Apart from the synagogue, the surviving traces of the Jewish community of Zhovkva include the former Hasidic prayer house (2 Vinnikivska St.), the former seat of the kahal’s authorities (7 Zaporizka St.), and the building that housed one of the heders (10 B. Khmelnytskoho St.). The buildings that housed the Tarbut school (8–10 Lvivska St.) and the vocational school for women (76 Lvivska St.) also survived, and also the former 19th-century ritual slaughterhouse (1 Ludkevycha St.). And if one looks closely at the stone portals of the houses around the market square, one finds traces of mezuzot on the door posts.
Authors: Bozhena Zakaliuzna, Anatoliy Kerzhner
The synagogue (1692–1700), Zaporyzska 14
The castle (1594–1606) founded by Stanislaw Żółkiewski, built by Paul the Happy. Now, the "Zhovkva Castle": Museum with an exhibition on the history of Zhovkva since its origins until the modern times, (Vicheva Square 2, tel. +38 067 996 96 68)
Roman Catholic Church of St. Lazarus (1606–1618) – family mausoleum of the Żółkiewskis, Lvivska 21
Monastery (Ukrainian Greek Catholic Church) (1612), printing house of the Basilian friars, which is part of the monastery and still operates; Bazylianska 4
Orthodox Church of the Holy Trinity (1720), UNESCO World Heritage Site since 2013, Sviatoyi Tryicy 1
Orthodox Church of the Nativity of the Virgin Mary (1705), Ivana Franka
Former Dominican monastery (17th century) (now, Greek Catholic church), Lvivska 7
City Hall (1932), Vicheva Square 1
Gates and fortifications (17th century)
Tenements with arcades (17th century)
In the vicinity
Krekhiv (12 km): fortified monastery of St. Nicholas (1612); Orthodox church of St. Paraskeva (17th century)
Lviv (25 km): the largest metropolis of Galicia. Many architectural monuments, numerous well-preserved monuments of the Jewish culture, e.g.: Jacob Glanzer's Hasidic synagogue on Vuhylna 3); Staroyevreyska – houses with traces of mezuzahs and the place where there used to be the "Golden Rose" synagogue; synagogue on Brativ Mikhnovskych; on Sholem-Alejchema 12: a building which housed the first Jewish museum in Lviv; the Maurice Lazarus hospital on Rappaporta; a site commemorating the victims of the Holocaust; a memorial plaque at Shevchenky, where there was the so-called Janowski concentration camp; a memorial to the victims of the Holocaust on Chornovola
Velyki Mosty (25 km): ruins of the synagogue (early 20th century)
Maheriv (25 km): old synagogue (19th century.)
Rava-Ruska (35 km): Jewish cemetery (17th century), around 100 matzevahs
Stradch (38 km): cave monastery (19th century)
Sokal (50 km): old synagogue (18th century)
Niemyriv (50 km): Jewish cemetery; hundreds of matzevahs from the 19th and 20th century
The Yavorivskyi National Park

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Given his notorious fast-food heavy diet and hefty physique, hearing that the former POTUS bunged up the White House sewage systems might lead you to immediately assume his bowel movements were the cause.
Alas, it's alleged that wads of paper were occasionally found blocking up the toilets, which staffers assumed were left there by the former commander-in-chief.
The claim was brought to light from in award-winning journalist Maggie Haberman's new book, Confidence Man.
On Thursday, Axios reporter Mike Allen posted an exclusive report.
"While President Trump was in office, staff in the White House residence periodically discovered wads of printed paper clogging a toilet — and believed the president had flushed pieces of paper," Allen wrote.
The detail also comes as the National Archive reportedly asked the Biden Department of Justice to investigate if Trump illegally or inappropriately removed classified documents with classified information from the White House, as reported by The New York Times on Wednesday.
This isn't the only thing coming back to haunt Trump, so to speak.
As a result of the investigation into the classified information removal, "lock him up" trended on Twitter as critics remembered Trump'sTrump's relentless calls to imprison Hillary Clinton during the 2016 election over her use of private email account for government endeavours while she was secretary of state.
Just when things didn't seem that they would escalate, Haberman also promoted the link to Axios'coverage and highlighted another jaw-dropping detail that has yet to be reported on: Trump still communicates with North Korean leader Kim Jong-un.
Also in the book: Trump has been telling people he's still in touch with Kim Jong-Un since leaving the White House > https://www.axios.com/maggie-haberman-book-trump-papers-2d59d593-8b89-4edd-8623-8ef709af524f.html?utm_source=twitter&utm_medium=social&utm_campaign=editorial&utm_content=politics-maggiehaberman\u00a0\u2026

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text:
1So Isaac summoned Jacob, blessed him, and gave him these orders: “Don’t marry a Canaanite woman. 2Get up and go to Paddan-aram, to the household of Bethuel, your mother’s father, and once there, marry one of the daughters of Laban, your mother’s brother. 3God Almighty#28.3 Heb El Shaddai or God of the Mountain will bless you, make you fertile, and give you many descendants so that you will become a large group of peoples. 4He will give you and your descendants Abraham’s blessing so that you will own the land in which you are now immigrants, the land God gave to Abraham.” 5So Isaac sent Jacob off, and he traveled to Paddan-aram, to Laban son of Bethuel the Aramean and brother of Rebekah, Jacob and Esau’s mother.
6Esau understood that Isaac had blessed Jacob and sent him to Paddan-aram to marry a woman from there. He recognized that, when Isaac blessed Jacob, he had ordered him, “Don’t marry a Canaanite woman,” 7and that Jacob had listened to his father and mother and gone to Paddan-aram. 8Esau realized that his father Isaac considered Canaanite women unacceptable. 9So he went to Ishmael and married Mahalath daughter of Abraham’s son Ishmael and sister of Nebaioth, in addition to his other wives.
Jacob’s dream at Bethel
10Jacob left Beer-sheba and set out for Haran. 11He reached a certain place and spent the night there. When the sun had set, he took one of the stones at that place and put it near his head. Then he lay down there. 12He dreamed and saw a raised staircase, its foundation on earth and its top touching the sky, and God’s messengers were ascending and descending on it. 13Suddenly the LORD was standing on it#28.13 Or beside it or beside him and saying, “I am the LORD, the God of your father Abraham and the God of Isaac. I will give you and your descendants the land on which you are lying. 14Your descendants will become like the dust of the earth; you will spread out to the west, east, north, and south. Every family of earth will be blessed because of you and your descendants. 15I am with you now, I will protect you everywhere you go, and I will bring you back to this land. I will not leave you until I have done everything that I have promised you.”
16When Jacob woke from his sleep, he thought to himself, The LORD is definitely in this place, but I didn’t know it. 17He was terrified and thought, This sacred place is awesome. It’s none other than God’s house and the entrance to heaven. 18After Jacob got up early in the morning, he took the stone that he had put near his head, set it up as a sacred pillar, and poured oil on the top of it. 19He named that sacred place Bethel,#28.19 Or God’s house though Luz was the city’s original name. 20Jacob made a solemn promise: “If God is with me and protects me on this trip I’m taking, and gives me bread to eat and clothes to wear, 21and I return safely to my father’s household, then the LORD will be my God. 22This stone that I’ve set up as a sacred pillar will be God’s house, and of everything you give me I will give a tenth back to you.”
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2011 Common English Bible. All rights reserved.
1Isaac summoned Jacob, blessed him, and commanded him: “Don’t take a wife from the Canaanite women. 2Go at once to Paddan-aram, to the house of Bethuel, your mother’s father. Marry one of the daughters of Laban, your mother’s brother. 3May God Almighty bless you and make you fruitful and multiply you # Gn 1:28 so that you become an assembly of peoples. # Gn 48:4 4May God give you and your offspring the blessing of Abraham # Gn 12:1-3 so that you may possess the land where you live as a foreigner, the land God gave to Abraham.” # Gn 12:7; 15:18 5So Isaac sent Jacob to Paddan-aram, to Laban son of Bethuel the Aramean, the brother of Rebekah, the mother of Jacob and Esau.
6Esau noticed that Isaac blessed Jacob and sent him to Paddan-aram to get a wife there. When he blessed him, Isaac commanded Jacob, “Do not marry a Canaanite woman.” 7And Jacob listened to his father and mother and went to Paddan-aram. 8Esau realized that his father Isaac disapproved of the Canaanite women, # Gn 24:3; 26:34-35; 27:46 9so Esau went to Ishmael and married, in addition to his other wives, Mahalath daughter of Ishmael, Abraham’s son. She was the sister of Nebaioth.
Jacob at Bethel
10Jacob left Beer-sheba and went toward Haran. 11He reached a certain place and spent the night there because the sun had set. He took one of the stones from the place, put it there at his head, and lay down in that place. 12And he dreamed: # Gn 41:1; Nm 12:6; Jb 33:15-16 A stairway was set on the ground with its top reaching heaven, and God’s angels were going up and down on it. # Jn 1:51 13Yahweh was standing there beside him,# Or there above it saying, “I am Yahweh, # Gn 15:7; Ex 6:8 the God of your father Abraham and the God of Isaac. I will give you and your offspring the land that you are now sleeping on. 14Your offspring will be like the dust of the earth, # Gn 13:16 and you will spread out toward the west, the east, the north, and the south. All the peoples on earth will be blessed through you and your offspring. # Gn 12:3 15Look, I am with you and will watch over you wherever you go. I will bring you back to this land, # Gn 48:21; Dt 30:3; 1Kg 8:34; Zph 3:20 for I will not leave you until I have done what I have promised you.”
16When Jacob awoke from his sleep, he said, “Surely the Lord is in this place, and I did not know it.” # Ex 3:4-6; Jos 5:13-15; Ps 139:7-12 17He was afraid and said, “What an awesome place this is! This is none other than the house of God. This is the gate of heaven.”
18Early in the morning Jacob took the stone that was near his head and set it up as a marker. He poured oil on top of it 19and named the place Bethel, # = House of God though previously the city was named Luz. # Gn 35:6; 48:3; Jdg 1:23,26 20Then Jacob made a vow: # Gn 31:13 “If God will be with me and watch over me on this journey, if He provides me with food to eat and clothing to wear, 21and if I return safely to my father’s house, # Gn 33:18; Jdg 11:31; 2Sm 15:7-9 then the Lord will be my God. # Dt 26:17 22This stone that I have set up as a marker will be God’s house, and I will give to You a tenth of all that You give me.” # Gn 14:20; Lv 27:30; Dt 14:22
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