Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS l. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[1] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[2] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. ll. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[3] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[4] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[5] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[6] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[7] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[8] In democratic societies, one must take into consideration community morals and values.[9] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[10] lll. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[11] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[12] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[13] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[14] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. lV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[15] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[16] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[17] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[18] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[19] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[20] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[21] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. Vl. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[22] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[23] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[24] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. Vll. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [1] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [2] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [3] Moss, p. 1295-1298. [4] Moss, p. 1296. [5] Moss, p. 1295-1298. [6] Moss, p. 1295-1298. [7] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [8] Cohen, p. 1299-1301. [9] Moss, p. 1297. [10] Cohen, p. 1300. [11] Cappelen, p. 478-480. [12] Cappalen, p. 478-480. [13] Cappelen, p.479. [14] Cappelen, p. 479. [15] Cappelen, p. 479 [16] Cohen, p. 1301. [17] Cappelen, p. 478. [18] Cohen, p. 1299-1301. [19] Cohen, p. 1301. [20] Cappelen, p. 476-480. [21] Cappelen, p. 476-480. [22] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [23] Kawachi, p. 18-33. [24] Kawachi, p. 18-33. (shrink)

A Religion of Progress has taken shape over the last 21 centuries, from the Enlightenment to present times. It is quite simple to follow a thread from Hermeticism to today, however, several facts have altered its content, therefore, reformulating some of its promises and vision of the world. This paper attempts to evaluate how that Religion of Progress has become a sort of Techno-Hermeticism 2.0. Digital technologies have redefined old hermetic myths into a high-tech religion with dire environmental consequencies. (...) Some of those myths are the resurrection of the bodies, the construction of the City of God, the Adamic universal language and so forth. Now religion must confront the upcoming collapse, however, it is unable to provide satisfactory answers. This goes for all the different churches, from accelerationists (Nick Land) to extinctionists and believers of digital solutionism. That leaves possible imaginative responses to that sociecological crisis without any relevant proposals. (shrink)

Woods et al. (2015) claim that secular Simple Reaction Time (SRT) slowing (Woodley et al. 2013), disappears once modern studies are corrected for software and hardware lag, and once Galton’s data are corrected for fastest-response selection. Here, this is challenged with a reanalysis of the secular slowing of SRT in the UK amongst large (N>500), population-representative age-matched (≊18-30 years) studies. Starting with Galton’s sample, this is assigned the simulated value estimated by Dodonova and Dodonov (2013, who like Woods et al. (...) were critical of secular SRT slowing, owing to measurement issues) on the basis that he collected the fastest of three trials (207.5ms). The two sexes in Galton’s study are combined (as in Woods et al.), raising the weighted sample mean to 208.5ms. Next is the Wilkinson and Alison (1989) study, which attempted to replicate Galton’s study one century later, collecting SRTs as part of an exhibit in the London Science Museum. An electronic chronoscope recorded SRTs on magnetic tape, and sampled over eight trials with micro-processor-determined variable foreperiods. The mean SRT value for the 1,189 participants aged between 20 and 29 is 245ms. The presence of long and variable foreperiods necessitates a penalty of 10ms (Dodonova & Dodonov, 2013). Another 10ms should be deducted based on key-pressing time (Dodonova & Dodonov, 2013), reducing the mean to 225ms. The studies of Deary and Der (2005) and Der and Deary (2006) are also included. The first utilized the highly representative Scottish Twenty-07 cohort. Dodonova and Dodonov (2013) identified a 53ms lag stemming from liquid crystal stimulus onset delay. This is subtracted from the weighted average of the two sexes (300.8ms), along with another 10ms for key-pressing time. The resultant mean is 237.8ms.Dodonova and Dodonov (2013) cleaned the male data in the Der and Deary (2006) study, collected from the representative UK Health and Lifestyle Survey, by removing cases for which SRT standard deviations exceeded those for choice RT. This reduced the N from 834 to 661, and also reduced the mean from 300ms to 284ms. The estimate was also penalized for LCD onset delay and key-pressing time, reducing the mean to 221ms. When the SRT value for the female sample is penalized equivalently the resulting value is 239ms. In order to simulate the female N for the purposes of taking a weighted average of both sexes, the actual female N is reduced in proportion to the male N (79.3%=881), yielding a weighted mean of 230.9ms for a combined sample-size of 1,472. Table 1 presents the data used in the analysis.Table 1 SRT means, sample sizes and sampling years for four large, age-matched UK samples[Table 1 here]Consistent with Dodonova and Dodonov (2013), N-weighted regression is employed, as the only data on sample variability is sample size. Figure 1 illustrating the secular trend in UK SRT over 100 years.[Figure 1 here] Figure 1. Secular SRT slowing across four large, representative studies from the UK spanning a century. Bubble-size is proportional to sample size. Combined N=6,622. The secular slowing between UK studies is statistically significant (β=0.97; 95% CI=0.969 to 0.971, N=6,622), at –22.8ms a century. Additional evidence for generational SRT slowing comes from Verhaeghen (2014), who suggested that the ratio of longitudinal to cross-sectional age-related slowing might tentatively infer generational changes in processing speed. Verhaeghen reports ratios for two SRT studies (0.91 and 1.15), implying both secular losses and gains. For the study of Deary and Der (2005), the SRT ratios are “censored because they were excessively large” (p. 256). In this study, the ratio of the cross-sectional slowing trend (taking the weighted average of all paired between-cohort differences rescaled in terms of change per decade for males and females), to the weighted average decadal longitudinal slowing trend for both the males and females is 0.73, for an N of 1,926 (cf. Woodley et al., 2014b, for a detailed reanalysis of this dataset). The weighted average of the three SRT ‘Verhaeghen ratios’ is 0.9 (N=4,078) – tentatively consistent with generational declines (i.e. a ratio of <1). In conclusion Woods et al. (2015) have undoubtedly made an important contribution to the debate concerning the role of software and hardware lag in the inflation of contemporary estimates of SRT, however the evidence for generational SRT slowing remains quite compelling. ReferencesDeary, I.J., & Der, G. (2005). Reaction time, age, and cognitive ability: Longitudinal findings from age 16 to 63 years in representative population samples. Aging, Neuropsychology, and Cognition, 12, 187–213.Der, G., & Deary, I.J. (2006). Age and sex differences in reaction time in adulthood: Results from the United Kingdom Health Lifestyle Survey. Psychology and Aging, 21, 62–73.Dodonova, Y.A., & Dodonov, Y.S. (2013). Is there any evidence of historical slowing of reaction time? No, unless we compare apples and oranges. Intelligence, 41, 674–687.Galton, F. (1890). Exhibition of instruments (1) for testing the perception of differences of tint, and (2) for determining reaction-time. Journal of the Anthropological Institute, 19, 27–29.Verhaeghen, P. (2014). The elements of cognitive aging: Meta-analyses of age-related differences in processing speed and their consequences. Oxford: Oxford University Press.Wilkinson, R.T., & Allison, S. (1989). Age and simple reaction time: Decade differences for 5,324 subjects. Journal of Gerontology, 44, 29–35.Woodley, M.A., Madison, G., & Charlton, B.G. (2014b). Possible dysgenic trends insimple visual reaction time performance in the Scottish Twenty-07 cohort: Areanalysis of Deary & Der (2005). Mankind Quarterly, 55, 110-124.Woodley, M.A., te Nijenhuis, J., & Murphy, R. (2013). Were the Victorians cleverer than us? The decline in general intelligence estimated from a meta-analysis of the slowing of simple reaction time. Intelligence, 41, 843–850.Woods, D.L., Wyma, J.M., Yund, E.W., Herron, T.J., & Reed, B. (2015). Factors influencing the latency of simple reaction time. Frontiers in Human Neuroscience, 9:131. (shrink)

Aim of the study was to analyze the posttraumatic stress disorder risk nurses, detecting the relationship between distress experience and personality dimensions in Italian COVID-19 outbreak. A cross-sectional study was conducted based on 2 data detection. Mental evaluation was carried out in Laboratory of Clinical Psychology on n.69 nurses in range age 22–64 years old. Measurement was focused on symptoms anxiety, personality traits, peritraumatic dissociation and post-traumatic stress for all participants. No online screening was applied. Comparisons within the various demographic (...) characteristics demonstrated few significant differences between groups on DASS-21, PDEQ, and ISE-R scores. Correlation analysis was performed among PDEQ, DASS-21, BFI-10 and IES-R and confirmed between anxiety and peritraumatic dissociation and post-traumatic stress; then anxiety is positively correlated to agreeableness variable of BFI-10 test. The emotional distress was protracted overtime but in long-term personality traits resulted mediator facing subjective stress. Our finding drew details for protective and predictive risk factors as well as mental health issues of nurses dealing with pandemic: healthcare workers faced the protracted challenge caring COVID-19 patients over and over again: in short time the impact was relevant, and the prolonged exposition to the stressor was tackled by personal resources such as personality traits. (shrink)

In response to my article “Earth, Technology, Language”, Christopher Müller asks whether use-oriented theory and Wittgensteinian language can capture the structural relations of power that shape habituation and argues that digital media do not provide opportunities for empowerment and democracy because there is no co-ownership. In my reply I argue that I have shown that this can be done with the broader conception of use I propose, that the grammar of technology should also be understood in terms of (...) implicit knowledge, and that technology, like language, also has a public dimension: I claim that there is no such thing as a private technology or private power, and that some degree of co-ownership or resistance is possible. In the second part of the paper I reply to Bas de Boer’s questioning of my criticism of postsphenomenology. I insist that postphenomenology does not have the full instrumentarium to carry out an adequate and comprehensive analysis of the social dimension of technology use, and that it is important to attend to the structural dimension of technology, with or without use of the term ‘transcendental’. I clarify my use of the term as referring to conditions of possibility. (shrink)

During the course of the COVID-19 pandemic, a wide range of digital technologies and data analytics have been incorporated into pandemic response models globally, in the hope of better detecting, tracking, monitoring and containing outbreaks. This increased digital involvement in disease control has offered the prospect of heightened effectiveness in all of the above, but not without raising other concerns. This paper contributes to ongoing discussions of the digital transformation in disease control by proposing a materialist analysis (...) of how such control has become operative and what its effects may be, both now and in the future. Using Taiwan's digital pandemic response as a case study, the paper explores specific ways in which material processes and arrangements have shaped digital measures, as well as the actions that rendered such measures operable, with their ensuing consequences. This analysis illustrates the importance of historical, material and technological specificities and contingencies to our understanding of how digital disease control takes a particular shape. It also demonstrates how shifting regimes of practice continually reconfigure the ways in which digital disease control functions. The paper argues that paying greater attention to the materialities of digital disease control can provide a more nuanced understanding of the complex ways in which society may be protected or harmed by its use, possibly simultaneously. It is hoped that such increased attentiveness may inform more considered and careful preparation for subsequent pandemics. (shrink)

This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The “data protection model” emphasizes privacy protections at the expense of public health benefit, while the “emergency response model” sacrifices transparency and accountability, prompting concerns about excessive governance surveillance. The ethical and effective use (...) of DCT in the future requires a new governance approach that is better suited to this novel use of mobile phone data to promote public health.”. (shrink)

Digital tracing technologies are heralded as an effective way of containing SARS-CoV-2 faster than it is spreading, thereby allowing the possibility of easing draconic measures of population-wide quarantine. But existing technological proposals risk addressing the wrong problem. The proper objective is not solely to maximise the ratio of people freed from quarantine but to also ensure that the composition of the freed group is fair. We identify several factors that pose a risk for fair group composition along with an (...) analysis of general lessons for a philosophy of technology. Policymakers, epidemiologists, and developers can use these risk factors to benchmark proposal technologies, curb the pandemic, and keep public trust. (shrink)

We were interested in exploring the associations and effects of experimental language (i.e., native – L1, or foreign – L2), dilemma type (i.e., personal – D1 or impersonal – D2), the digital device participants used (i.e., PC/laptop or smartphone), along with gender and age in sacrificial COVID-19 and non-COVID moral dilemmas. We performed two studies involving 522 participants aged 18 to 69 in April 2020. In Study 1, we found no significant associations between the dilemma type and the (...) class='Hi'>digital device. However, most participants chose to sacrifice an older COVID-19 patient in a critical medical condition to prioritize rescuing similar, younger patients (i.e., 45-year-old males). Results also suggested that male and younger participants were more likely to choose the utilitarian option when the sacrificial dilemma was presented in French. In study 2 (i.e., non-COVID-19), participants made significantly more utilitarian choices in the personal dilemmas presented in French. Results are discussed concerning the SARS-CoV-2 pandemic context and its emotional impact on moral judgment. (shrink)

Background: The purpose of the current study was to assess the prevalence of sleep disturbances among Chinese people during the COVID-19 pandemic in a large national survey, analyze the relationship between sleep disturbances and mental health status, and explore the influencing factors of the relationship between sleep disturbances and mental health status.Methods: An online survey was accessed by 19,740 people throughout China from February 14 to 21, 2020. The survey included the Depression Anxiety Stress Scale-21 to measure psychological distress and (...) two questions about sleep disturbances. Logistic regression analyses and moderation analysis were performed.Results: Among the 14,505 respondents included in analyses, 3,783 reported sleep disturbances at least 3 days during the past week. Sleep disturbances increased the risk of depression, anxiety, and stress. Gender, age, education, occupation, frequency of attending to epidemic information, nervousness about supplies, receiving provisions of living necessities from the service department during the outbreak, number of correct responses to questions about the epidemic, and isolation/quarantine affected the risk of mental health problems among participants experiencing sleep disturbances. A moderation analysis found that sleep problems were more likely to affect depression, anxiety, and stress scores in men than women during the COVID-19 outbreak.Conclusion: During the COVID-19 outbreak, 26.08% people surveyed experienced sleep disturbances, and the presence of sleep disturbances was positively related to depression, anxiety, and stress, especially among front-line anti-epidemic workers, younger people, people living in isolation/quarantine, people with a college or greater education, and males. (shrink)

In 2020, the COVID-19 pandemic forced many nations to shut-down schools and universities, catapulting teachers and students into a new, challenging situation of 100% distance learning. To explore how the shift to full distance learning represented a break with previous teaching, we asked Austrian students (n = 874, 65% female, 34% male) which digital media they used before and during the first Corona lockdown, as well as which tools they wanted to use in the future. Students additionally reported (...) on their attitudes and experiences with online learning. Results showed that students used certain tools, such as video, audio, e-assessments, and web conferencing systems, much more often during lockdown than they had before. Their use of classic digital media, such as e-mail, social communication tools, such as chat or online forums, and other interactive tools, such as wikis or educational games, hardly changed at all. Their attitudes toward multimedia learning were positively related to their media use. In their open responses (n = 137), students identified advantages of online learning (flexibility and self-directed learning), as well as disadvantages (limited social interaction) and challenges (motivation and self-discipline). As a group, they also expressed a clear preference for a balanced combination of online- and offline teaching in the future. However, individual students did prefer fully online or offline learning modes, depending on their personal circumstances and educational goals. We view this as a call to researchers and educators alike to explore ways in which the advantages of online and face-to-face learning can best be combined to meet the changed needs and expectations of organizations, students, and teachers in a future “after Corona.”. (shrink)

continent. 2.1 (2012): 6–21. The French philosopher and novelist Tristan Garcia was born in Toulouse in 1981. This makes him rather young to have written such an imaginative work of systematic philosophy as Forme et objet , 1 the latest entry in the MétaphysiqueS series at Presses universitaires de France. But this reference to Garcia’s youthfulness is not a form of condescension: by publishing a complete system of philosophy in the grand style, he has already done what none of us (...) in the older generation of speculative realists has done so far. His book is sophisticated, erudite, rigorous, imaginatively rich, and abundant in worldly wisdom– despite the author’s conclusion that wisdom does not exist. The quality and scope of Forme et objet took few observers by surprise, since Garcia has been treated as an emerging philosopher to watch across half a decade of Parisian oral tradition. But Garcia was not just the subject of rumor, being already well known to the French public as a writer of fiction. His debut novel, La meilleure part des hommes , 2 was awarded the 2008 Prix de Flore 3 and has already appeared in English as Hate: A Romance . 4 His follow-up novel, Mémoires de la jungle , 5 made clever use of a chimpanzee narrator. Nor was Garcia only published as a novelist before last November: his philosophical study L’Image 6 had already appeared when the author was just twenty-six, a year before he was crowned by the muses at the historic Café de Flore. And then in 2011, just months before the appearance of Forme et objet , Garcia published a widely distributed work entitled Nous, animaux et humains , 7 with its focus on Jeremy Bentham’s ideas about animals. Given this prolific and versatile track record, an optimistic scenario might envisage the young Garcia as one of those combined literary/philosophical talents who appear intermittently in France across the centuries: Jean-Paul Sartre is merely the most famous recent case. While more time is needed to see how Garcia will channel his impressive mental energies, Forme et objet displays such breadth of insight that its author has a good chance to emerge as one of the leading philosophers of his generation. If we accept Aristotle’s dictum that the peak mental age is fifty-one, then to read Garcia’s massive book is to gain some idea of what European philosophy might look like in the futuristic-sounding 2030’s. The present article is confined to Forme et objet . At 486 pages, the work is obviously daunting in size. Indeed, it is even longer than it sounds, given that many of its early sections are printed in a smaller typeface to designate them as supplemental commentary to the main flow of the argument. But while the length of the book reportedly led to delays in French publication, and will probably slow the inevitable appearance of an English translation, the length of the book should not deter interested readers– much of it results from Garcia’s teacherly writing style. Whereas Quentin Meillassoux’s prose displays an arctic economy of means, Garcia’s style is reminiscent of the repeated lessons of oral classroom proceedings. Rarely is the reader given fewer than three or four chances to master an idea before the author moves on to the next. In practice, the style feels welcoming rather than long-winded. Otherwise, the structure of Forme et objet is surprisingly simple. There is a useful Introduction of less than twenty pages. Then comes Book I: Formally , running to approximately 135 pages. Here Garcia outlines the most basic features of a thing “no matter what it is,” or n’importe quoi , an everyday phrase that Garcia shapes into a technical term. This part of the book feels at times like a more amiable version of Hegel’s Science of Logic , a parallel emphasized further by the threefold articulation of its theme: 1. Thing; 2. Thing and World; 3. Being and Understanding. This is followed by the much longer Book II: Objectively , totaling more than 300 pages. It contains sixteen essay-like meditations on specific kinds of objects—including time, animals, humans, history, gender, and death. Here each chapter rolls smoothly into the next, making this second part of the book feel more like a different work of Hegel: The Phenomenology of Spirit . But these are merely analogies. Garcia is no Hegelian, even if the book contains a few dialectical flourishes that seem to reflect his early enthusiasm for the Frankfurt School. Forme et objet ends with a six-page Coda, followed by the usual page of acknowledgments. In what follows, I will briefly summarize each of these four parts of the book before ending with some more general remarks. Before doing so, it will be useful to situate Garcia biographically (as much as I am able) and philosophically. Though Toulouse is his native city, his formative years were spent largely in Algeria, where his family has deep roots. During our sole private conversation, Garcia mentioned that his parents are professors of literature. 8 As a student of philosopher Garcia flourished so early that many of his current ideas date to his teenaged years: “There are sentences in Forme et objet that I wrote when I was seventeen,” he said in response to a question on that cold night on the Canal St.-Martin. I recalled that remark when reading his brilliant account, late in the book, of the central role of adolescence in contemporary culture. While many prodigies blow through their formal academic training without serious obstruction, Garcia’s student memories are rich in tales of isolation and struggle, though equally rich in gratitude for a half-dozen or so exceptional teachers who provided the intellectual space he needed: Meillassoux and Alain Badiou are simply two of the most prominent figures on that list. Though there are many points of agreement between Garcia’s philosophical position and my own, he not only reached his position years before reading my work, 9 he arrived along a rather different path: not through phenomenology, but via the Frankfurt School, which may be one of the reasons for his profound fascination with aesthetics. Garcia’s cultural background is as broad as one could wish: he is no less informed about punk rock and European football leagues than about the spiritualist roots of Bergson’s philosophy. Curious about everything and contemptuous towards nothing, Garcia can be expected to write insightfully on dozens of topics in the years to come. Given that his philosophy is so personally tantalizing in its agreements and disagreements with my own, and given the great internal richness of Forme et objet itself, the present review is no better than a first effort at coming to terms with the challenges posed by this minstrel from the rising generation. This is especially intriguing for older Generation X’ers like me, since confrontation with the younger generation is one of the many themes treated insightfully in Garcia’s book. 1. Introduction Garcia begins in defense of a so-called “flat ontology,” in which all things are equally things. While Roy Bhaskar 10 used this term pejoratively to refer to anti-realist philosophies that flatten everything onto an epistemic plane of human access, Manuel DeLanda 11 (an admirer of Bhaskar) reversed it into the positive principle that all realities are equally realities. Similar notions can be found in the “absistence” of Alexius Meinong, 12 the “irreduction” of Bruno Latour, 13 and my own critique 14 of the undermining/overmining pair. Also noteworthy is Levi Bryant’s use of the term “flat ontology” throughout The Democracy of Objects 15 and his earlier essay “The Ontic Principle.” 16 But for Garcia, flatness is only one face of the cosmos, and one that he ultimately declares to be rather impoverished. Even so, he always remains an advocate of a flat ontology. Insofar as everything is equally something, no matter what it is ( n’importe qui ), everything is equally a thing, equally solitary in its relation with world. This is why his book abounds in those long lists of random, ontologically equivalent entities that Ian Bogost has playfully termed “Latour Litanies.” 17 The first litany in Garcia’s book runs as follows: “We live in this world of things, where a cutting of acacia, a gene, a computer-generated image, a transplantable hand, a musical sample, a trademarked name, or a sexual service are comparable things.” (7) Yet Garcia is frankly dualistic; his flat ontology only lasts until page 159 and the end of Book I (entitled “Formally”), which deals entirely with things that are equally things. Thereafter Garcia turns his attention from things to objects, which are not flat in the least, but engage in hierarchical relations with one another. In agreement with both DeLanda and the speculative realists, Garcia proclaims that his book “proposes to put to the test a thought about things rather than a thought about our thought about things .” (8) Just as ducklings are “imprinted” (9) after hatching and treat the first creature they see as their mother, philosophers are imprinted by the idea with which they begin. Hence, philosophies that begin with human access will never truly find their way back to things. This makes Garcia rather suspicious of twentieth century philosophy, since “the twentieth century—to which in some way this work proposes to bid adieu—has been a period of theorizing modes of access to things rather than things...” (9) Among other possible benefits of the philosophy of things that Garcia proposes, it is fully able to account for thought as a special variant of things, while the reverse is not possible.(10) In Book I of Forme et objet , Garcia’s “things” are so flat, so de-determined, that he is forced to renounce some of the most basic features ascribed to things by most realists. As he tells us in his foreboding third footnote: “We will maintain that the solitude [of things] is less than unity, less than identity, and that it does not imply acceptance (any more than refusal) of the principle of non-contradiction.” (11) In a contemporary world cluttered with too many things, Garcia’s flat and formal plane provides us with some breathing room: “The formal plan of thought enables or re-enables us to cut short all accumulation—whether of knowing, experience, or action—by a simplicity, an impoverished surface...” (13) As Garcia says elsewhere in responding to a Deleuzian critic of the book, his starting point in flat ontology is designed to obstruct the claims of both analytic philosophy and Hegelianism: “Hence, this work seeks to protect each thing—real, imaginary, inconsistent, contradictory—both against Ockham’s Razor and against the Aufhebung or dialectical process.” 18 Yet contrary to the equalizing spirit of many flat ontologies, “we will add to our formal ontology of the equal, an objective ontology of the unequal.” (13) But initially, Garcia joins all flat ontologists in holding that everything is irreducible: “this irreducibility, which we will term the ‘chance’ of each thing... also marks the refusal of a positive thought that reduces things exclusively to natural things, or social things, or historical things, etc.” (15) This irreducible “chance” of a thing emerges as an important technical term in the book, always paired with its inverted brother, the “price to pay” ( prix à payer ). On pages 17-19, we find the only diagrams in the book. What they illustrate is that Garcia wishes to avoid two equally dangerous extremes. The first is the philosophy of substance, featuring the thing-in-itself as a mighty river fed by attributes as if by subordinate tributary streams. This model can be found in many of the classic thinkers of West and East alike. In it, “there is obviously a hierarchization between that which is dragged towards something other than itself, and this other which serves it as an ontological support while supporting its proper being.” (16) For Garcia, the second extreme worth avoiding is the philosophy of events: “One thus conceives trajectories of being, identified as events, facts, powers, intensities, or intentionality. These vectors of being come first, bearing and supporting being, displacing it, but without ever finding a stopping point, a buffer, an objective consistency.” (17) The first model gives us a thing too wrapped up in itself, too compact . This word “compact” (the French and the English are the same) is another technical term for Garcia. But if the “compact” model of things leads us to something more than things, the philosophy of events gives us less than things, by dissolving them into a play of vectors. Garcia’s alternative lies midway between these two extremes: Being enters the thing, being comes out of it. And a thing is nothing other than the difference between the enters and the being that comes out. Thus, the circuit of being is never halted. In the thing, there is never the thing-in-itself. And the thing is never in-itself, but outside of itself. Nonetheless, being is not eventally “pollinated” by vectors: it possesses an objecting halting-point... (19) This single idea is the key to Garcia’s book: the thing is neither a self-contained durable lump nor some sort of evental flux. Instead, the thing is the difference between its various components and its relations with its environment. Or stated differently: “the price to pay for this disposition is a circulation of being that systematically distinguishes two senses of things: that which is in the thing , and that in which the thing is , or that which encompasses it and that which it encompasses,” (19) translating comprendre here as “encompass.” 19 In a beautiful description of a piece of black slate, Garcia sums up the various minerals, qualities, and shapes that compose [ comprend ] it, and calls them “that which is in the thing,” (20) noting that this tells us nothing about “that in which [the slate] is”—namely, all the various situations in which the black slate can be found. Instead, the slate is the difference between these two: the most characteristic principle of Garcia’s philosophy. 2. Formally Book One of Forme et objet , “Formally,” is concerned with the formal equality of all things in a flat world. “Two questions mark the boundaries of reflection: of what is everything composed [ composé ], and: what do all things compose?” (27) Looking downward, we wish to know what everything is made of; looking upward, we want to know the ultimate result of the combination of all things. Here we must turn our attention to the thing n’importe quoi— no matter what it is. (30) Anything with finite qualities is obviously too specific to be relevant to global ontological questions. To an equal degree, something possessing all qualities (think of Whitehead’s God) 20 would not be n’importe quoi either, since it would still be too definite, even if incredibly vast. The same holds for contradictions, since these all differ from each other. The square circle, the non-white black white, and the non-city city are all too distinct to count as the thing no matter what it is. The n’importe quoi must be devoid of all specific qualities, including contradictory ones. In one of the more intriguing points in his book, so reminiscent of Meinong, Garcia proclaims that “the ‘no matter what it is’ is neither a reality nor an abstract construction, nor both of these at once; the ‘no matter what it is’ is simply the plane of equality of that which is real, that which is possible, that which is inexistent, that which is past, that which is impossible, that which is true, that which is false, that which is bad.”(39-40) Since everything has two faces, it would be a grievous mistake to focus on just one of them at the expense of the other, as physicalism or materialism do when reducing the world to minuscule physical underpinnings. For scientistic materialism, “it is either atoms, particles, or fields of force... which are the things.” (47-48) Moreover, “these more-than-things are accompanied by less-than-things: for example, ideas or facts of consciousness are determined by the state of matter and are not autonomous things, but manifestations reduced to secondary effects of material processes...” (48) On this point, Garcia’s position is in complete accord with my own critique of undermining and overmining. 21 Where we disagree is that Garcia is more deeply suspicious of the notion of substance, which I view as salvageable with a few needed changes, while Garcia sees this operation as hopeless: “A substance, in the history of philosophy, is the more-than-thing par excellence.” (51) Another agreement between our positions is visible when Garcia claims (correctly, in my opinion) “that it is vain to distinguish between things which are material and those which are not.” (52) Yet we also find an even more important disagreement, since for Garcia withdrawal cannot be the quality of a thing. Instead, the absence of a thing is simultaneous with it, embodied in all that is not it– the absence of the sculpture of a woman is to be found in the mold that appears at the same time as it, and thus withdrawal must be viewed as an “event” rather than as something pertaining to an object. For Garcia, nothing withdraws beyond access. Since we must distinguish between “that which is something” and “that which something is,” and since the former is identified with “no matter what it is is” and the latter with “ not no matter what it is,” we can say that “everything is thus a milieu, a fragile link between ‘no matter what it is’ and ‘ not no matter what it is.’” (62) And here we find Garcia’s critique of the thing-in-itself: “A thing is never defined en bloc . We can affirm that a thing is this or that, but that does not suffice. It is still necessary to state precisely that which is this thing .” (62) Stated differently, “something is not in itself : for that which is in the thing is not the thing, and that in which the thing is is not the thing.” (62) And here Garcia and I, facing the same evidence, draw opposite conclusions. For me, the fact that nothing can be identified with either its components or its concrete location means that the thing must be something in-itself distinct from both of these. Yet for Garcia, to be in-itself would mean to be identified with just one of these two extreme terms, and hence the thing can only be the difference between them. Garcia is equally suspicious of the classical tendency to view “unity” as a property of the thing, since in his eyes unity is too relational a property to belong to things. (65) While specific things are situated determinately with respect to other things, we are still speaking here about the thing no matter what it is, and this can be viewed only in terms of solitude, which all things share: a human being, a hand, or a chair or all equally things insofar as they are on their own , not insofar as they are one . (64) A thing is alone, and relates only to the one thing that is not another thing: world. In a striking parallel to my own argument for a partial revival of occasionalism, Garcia tells us that “the things communicate only by their solitude: it is because everything is equally on its own in the world that things can be together, enmeshed in one another.” (67) Alone in their solitude, things all relate to world, which serves as a mediator allowing them to become mixed up in one another. As we have seen, one reason that nothing can be in itself is because everything is in something else. For Garcia, “to be in something and to be something are equivalent.” (69) Stated more broadly, “being is thus the difference between the two aspects of each thing: that which is it, and that which it is.” (70) And even more vividly: “a thing is almost like a sack: there is that which one puts in the sack and that which remains outside the sack.” (70) But not quite like a sack, “since a thing is not a thin skin or film. Instead, a thing is comparable to a sack that is immaterial and without thickness: it is nothing other than the difference between that which is this thing and that which thing is, between content and container.” (71) Nothing can be in-itself because everything is two selves at once. For example, we cannot say that our self is defined by our consciousness: “Everything has a self because nothing is in itself. The self is not the quality of that which is related to itself (which is conscious, for example) or which thinks itself related to itself. Nonetheless, for an entity called ‘conscious’ to be related to itself, it is necessary that this very relation should be another thing than the self to which it is related.” (71) Consciousness cannot be the self, precisely because it is other than that of which it is conscious. Nothing is able to grasp itself. The self is “the function by which being and composition [ compréhension ] are mutually excluded...” (72) The self is “the point of shadow of everything that projects some light...” (72) The in-itself faces two opposite dangers: “For something to be in-itself is to be a self. Something which is a self flies out through one of its two sides... Stated differently, being in-itself is simply the possibility of a double failure.” (73) The in-itself can be termed compact : “There remains to us a means of thinking that which does not fully enter into the world, though without exiting from it. This means is what we call the compact.” (76) In a sense, the compact is the opposite of the world. For in the case of the world, everything enters it and it enters nothing; as for the compact, it enters the world (since it is something, after all) while nothing enters it. (77) The compact marks the presence of the impossible in the world. (78) It is not impossible, but possible only on the condition that it fails. (78) The time has come to speak of where a thing is located. “The sole condition of a thing is that of being in another thing than itself, and thus in another thing than something.” (78) A condition is “that which determines something, that which forms something, that in which something is.” (78) As for humans, “the condition of someone is his situation; my social condition is that which socially determines me, my place and my function...” (79) More generally, “to be conditioned is to find oneself reduced to that in which one is.” (79) Everything is conditioned, but nothing is reducible to this condition. To determine the condition of something is to determine in what it is. A thing is located in that which contradicts it, just as a statue exists in its mold, which is precisely that which it is not. Since the thing is finite and definite, its condition or form must be infinite and indefinite. That in which all things are is the world, which Garcia also terms “the whole.” (81) “To try to be in-itself is to attempt to remain outside the world. And indeed, to try to be in-itself is only a path of entry into the world.” (83) For Garcia, “the world is not the pre-existent container of the things it contains, a priori , nor the construction by the mind of a fictional ensemble of all things, a posteriori .” (85) Instead, the world is simultaneous with all things; the two always go together. The world cannot be a determinate world, such as the physical universe or mathematical space, since these are already too specific and limited. “Every determinate world, which is in fact a universe , is a ‘big thing’ [ grosse chose ]: it is a set, however vast, of composite things which itself embodies a thing.” (85) Every determinate world is really just a “big thing.” Stated differently, “it is nothing other than a balanced milieu between the things that compose it and the thing that it composes.” (85) We generally picture the world as a physical univer. (shrink)

Well before the COVID-19 pandemic, proponents of digital psychiatry were touting the promise of various digital tools and techniques to revolutionize mental healthcare. As social distancing and its knock-on effects have strained existing mental health infrastructures, calls have grown louder for implementing various digital mental health solutions at scale. Decisions made today will shape the future of mental healthcare for the foreseeable future. We argue that bioethicists are uniquely positioned to cut through the hype surrounding digital (...) mental health, which can obscure crucial ethical and epistemic gaps that ought to be considered by policymakers before committing to a digital psychiatric future. Here, we describe four such gaps: The evidence gap, the inequality gap, the prediction-intervention gap, and the safety gap. (shrink)

As COVID-19 spread, clinicians warned of mental illness epidemics within the coronavirus pandemic. Funding for digital mental health is surging and researchers are calling for widespread adoption to address the mental health sequalae of COVID-19. -/- We consider whether these technologies improve mental health outcomes and whether they exacerbate existing health inequalities laid bare by the pandemic. We argue the evidence for efficacy is weak and the likelihood of increasing inequalities is high. -/- First, we review recent trends in (...) digital mental health. Next, we turn to the clinical literature to show that many technologies proposed as a response to COVID-19 are unlikely to improve outcomes. Then, we argue that even evidence-based technologies run the risk of increasing health disparities. We conclude by suggesting that policymakers should not allocate limited resources to the development of many digital mental health tools and should focus instead on evidence-based solutions to address mental health inequalities. (shrink)

ABSTRACT: COVID-19 elicited a rapid emergence of new mutual aid networks in the US, but the practices of these networks are understudied. Using qualitative methods, we explored the empirical ethics guiding US-based mutual aid networks' activities, and assessed the alignment between principles and practices as networks mobilized to meet community needs during 2020–21. We conducted in-depth interviews with 15 mutual aid group organizers and supplemented these with secondary source materials on mutual aid activities and participant observation of mutual aid organizing (...) efforts. We analyzed participants' practices in relation to key mutual aid principles as defined in the literature: 1) solidarity not charity; 2) non-hierarchical organizational structures; 3) equity in decision-making; and 4) political engagement. Our data also yielded a fifth principle, "mutuality," essential to networks' approaches but distinct from anarchist conceptions of mutualism. While mutual aid networks were heavily invested in these ethical principles, they struggled to achieve them in practice. These findings underscore the importance of mutual aid praxis as an intersection between ethical principles and practices, and the challenges that contemporary, and often new, mutual aid networks responding to COVID-19 face in developing praxis during a period of prolonged crisis. We develop a theory-of-change model that illuminates both the opportunities and the potential pitfalls of mutual aid work in the context of structural inequities, and shows how communities can achieve justice-oriented mutual aid praxis in current and future crises. (shrink)

This article investigates the congregation members to the transition from face-to-face worship and fellowship to digital spaces amid the coronavirus disease 2019 (COVID-19) pandemic, with a sample of the Huria Kristen Batak Protestan (HKBP – Batak Protestant Christian Church), specifically in District Daerah Khusus Ibukota (DKI) Jakarta province, Indonesia. This study uses an empirical questionnaire method to assess the level of satisfaction, engagement and future preferences of the congregation regarding digital versus face-to-face worship practices. The questionnaire was built (...) on current theories of encounter and fellowship and what the congregation members need in digital worship services. Data from 421 congregations with a 95% confidence level and 5% margin of error showed a dominant 62.7% preference for returning to face-to-face worship services and a participation decline during the pandemic. Respondents also felt a 60%–90% difference in digital services from church services, especially related to the need for communal fellowship. Participation in digital services correlates with higher education levels, while older congregations preferred face-to-face worship.Contribution: This study highlights the importance of incorporating Batak cultural values into digital ministry strategies to increase community connectivity and engagement. This article suggests further research on integrating cultural elements into digital religious practices, aiming to provide insights for churches navigating the digital transformation of religious services. (shrink)

This study investigated how young Italian people experienced the period of peak spread of COVID-19 in their country by probing their emotions, thoughts, events, and actions related to interpersonal and community bonds. This approach to the pandemic will highlight social dimensions that characterized contextual interactions from the specific perspective of Community Psychology. The aim was to investigate young people's experiences because they are the most fragile group due to their difficulty staying home and apart from their peers and because they (...) are, at the same time, the most potentially dangerous people due to their urge to gather in groups. The research involved 568 university students, 475 females, and 93 males, with an average age of 21.82 years. The collected data were analyzed with the Grounded Theory Methodology, using the Atlas 8.0 software. From the textual data, representative codes were defined and grouped into 10 categories, which reflect the individuals' prosocial attitudes, behaviors, and values. These categories formed three macro-categories, called: “Collective Dimensions,” which includes Connectedness, Solidarity, Italian-ness, Social Problems, and Collective Mourning; “Prosocial Orientation,” which includes Trust and Hope; and “Collective Values,” which includes Values of Freedom, Respect of Social Rules, and Civic-Mindedness. All these macro-categories are indicative of the shared feelings experienced by Italians during the first time of the pandemic. Further practical implications of these results will be discussed, including a consideration of the risk of developing distress and improving well-being, as well as promoting preventive behaviors. (shrink)

continent. 1.3 (2011): 149-155. The world is teeming. Anything can happen. John Cage, “Silence” 1 Autonomy means that although something is part of something else, or related to it in some way, it has its own “law” or “tendency” (Greek, nomos ). In their book on life sciences, Medawar and Medawar state, “Organs and tissues…are composed of cells which…have a high measure of autonomy.”2 Autonomy also has ethical and political valences. De Grazia writes, “In Kant's enormously influential moral philosophy, autonomy (...) , or freedom from the causal determinism of nature, became prominent in justifying the human use of animals.”3 One of the oldest uses of autonomy in English is a description of the French civil war from the late sixteenth century: “Others of the…rebellion entred in counsell, whether they ought to admit the King vpon reasonable conditions, specially hauing their autonomy.”4 Life, and in particular human life, and in particular human politics, is well served by the usages of autonomy . What about the rest of reality, however? Should it be thought of, if it's even considered real and mind-independent, as pure stuff for the manipulation or decorative tastes of truly autonomous beings? We tend to think of things such as paperweights and iPhones as mere tools of human design and human use. To use them is to cause them to exist as fully and properly as they can. But according to Martin Heidegger, when a tool such as a paperweight is used, it disappears, or withdraws ( Entzug ). We are preoccupied with copying the page that the paperweight is holding down. We are concerned with an essay deadline, and the paperweight simply disappears into this general project. If the paperweight slips, or if the iPhone freezes, we might notice it. All of a sudden it becomes vorhanden (present-at-hand) rather than zuhanden (ready-to-hand).5 Yet Heidegger is unable to draw a meaningful distinction between what happens to a paperweight when it slips from the book I'm copying from and what happens to the paperweight when it presses on the still resilient pages of the thick paperback itself. Further still and related to this point, even when I am using the paperweight as part of some general task, I am not using the entirety of the paperweight as such. My project itself selects a thin slice of paperweight-being for the purposes of holding down a book. Even when it is zuhanden the paperweight is withdrawn. Graham Harman is the architect of this way of thinking.6 Harman discovered a gigantic coral reef of withdrawn entities beneath the Heideggerian submarine of Da-sein, which itself is operating at an ontological depth way below the choppy surface of philosophy, beset by the winds of epistemology, and infested with the sharks of materialism, idealism, empiricism and most of the other isms that have defined what is and what isn't for the last several hundred years. At a moment when the term ontology was left alone like a piece of well chewed old chewing gum that no one wants to have anything to do with, object-oriented ontology (OOO) has put it back on the table. The coral reef isn't going anywhere and once you have discovered it, you can't un-discover it. And it seems to be teeming with strange facts. The first fact is that the entities in the reef—we call them “objects” somewhat provocatively—constitute all there is: from doughnuts to dogfish to the Dog Star to Dobermans to Snoop Dogg. People, plastic clothes pegs, piranhas and particles are all objects. And they are all pretty much the same, at this depth. There is not much of a distinction between life and non-life (as there isn't in contemporary life science). And there is not much of a distinction between intelligence and non-intelligence (as there is in contemporary artificial intelligence theory). A lot of these distinctions are made by humans, for humans (anthropocentrism). And the concept autonomy has come into play in policing such distinctions. In this essay I shall to try to liberate autonomy for the sake of nonhumans. I shall do so by parsing carefully the title, which is taken from Hakim Bey's work The Temporary Autonomous Zone .8 First we shall explore the term autonomous . Then we shall explore what the full meaning of zone is. Finally, we shall investigate what temporary means. Each of these terms is of great value. An object withdraws from access. This means that its very own parts can't access it. Since an object's parts can't fully express the object, the object is not reducible to its parts. OOO is anti-reductionist. But OOO is also anti-holist. An object can't be reduced to its “whole” either, “reduced upwards” as it were. The whole is not greater than the sum of its parts. So we have a strange irreductionist situation in which an object is reducible neither to its parts nor to its whole. A coral reef is made of coral, fish, seaweed, plankton and so on. But one of these things on its own doesn't embody part of a reef. Yet the reef just is an assemblage of these particular parts. You can't find a coral reef in a parking lot. In this way, the vibrant realness of a reef is kept safe both from its parts and from its whole. Moreover, the reef is safe from being mistaken for a parking lot. Objects can't be reduced to tiny Lego bricks such as atoms that can be reused in other things. Nor can be reduced upwards into instantiations of a global process. A coral reef is an expression of the biosphere or of evolution, yes; but so is this sentence, and we ought to be able to distinguish between coral reefs and sentences in English. The preceding facts go under the heading of undermining . Any attempt to undermine an object—in thought, or with a gun, or with heat, or with the ravages of time or global warming—will not get at the withdrawn essence of the object. By essence is meant something very different from essentialism . This is because essentialism depends upon some aspect of an object that OOO holds to be a mere appearance of that object, an appearance-for some object. This reduction to appearance holds even if that object for which the appearance occurs is the object itself! Even a coral reef can't grasp its essential coral reefness. In essentialism, a superficial appearance is taken for the essence of a thing, or of things in general. In thinking essentialism we may be able to discern another way of avoiding OOO. This is what Harman has christened overmining .? The overminer decides that some things are more real than others: say for example human perception. Then the overminer decides that other things are only granted realness status by somehow coming into the purview of the more real entity. When I measure a photon, when I see a coral reef, it becomes what it is. But when I measure a photon, I never measure the actual photon. Indeed, since at the quantum scale to measure means “to hit with a photon or an electron beam” (or whatever), measurement, perception ( aisthesis ), and doing become the same. What I “see” are deflections, tracks in a diffusion cloud chamber or interference patterns. Far from underwriting a world of pure illusion where the mind is king, quantum theory is one of the very first truly rigorous realisms, thinking its objects as irreducibly resistant to full comprehension, by anything.9 So far we have made objects safe from being swallowed up by larger objects and broken down into smaller objects—undermining. And so far we have made objects safe from being mere projections or reflections of some supervenient entity—overmining. That's quite a degree of autonomy. Everything in the coral reef, from the fish to a single coral lifeform to a tiny plankton, is autonomous. But so is the coral reef itself. So are the heads of the coral, a community of tiny polyps. So is each individual head. Each object is like one of Leibniz's monads, in that each one contains a potentially infinite regress of other objects; and around each object, there is a potentially infinite progress of objects, as numerous multiverse theories are now also arguing. But the infinity, the uncountability, is more radical than Leibniz, since there is nothing stopping a group of objects from being an object, just as a coral reef is something like a society of corals. Each object is “a little world made cunningly” (John Donne).10 We are indeed approaching something like the political valance of autonomy . The existence of an object is irreducibly a matter of coexistence. Objects contain other objects, and are contained “in” other objects. Let us, however, explore further the ramifications of the autonomy of objects. We will see that this mereological approach (based on the study of parts) only gets at part of the astonishing autonomy of things. Yet there are some more things to be said about mereology before we move on. Consider the fact that since objects can't be undermined or overmined, it means that there is strictly no bottom object . There is no object to which all other objects can be reduced, so that we can say everything we want to say about them, hypothetically at least, based on the behavior of the bottom object. The idea that we could is roughly E.O Wilson's theory of consilience .11 Likewise, there is no object from which all things can be produced, no top object . Objects are not emanations from some primordial One or from a prime mover. There might be a god, or gods. Suppose there were. In an OOO universe even a god would not know the essential ins and outs of a piece of coral. Unlike even some forms of atheism, the existence of god (or nonexistence) doesn't matter very much for OOO. If you really want to be an atheist, you might consider giving OOO a spin. If there is no top object and no bottom object, neither is there a middle object . That is, there is no such thing as a space, or time, “in” which objects float. There is no environment distinct from objects. There is no Nature (I capitalize the word to reinforce a sense of its deceptive artificiality). There is no world, if by world we mean a kind of “rope” that connects things together.12 All such connections must be emergent properties of objects themselves. And this of course is well in line with post-Einsteinian physics, in which spacetime just is the product of objects, and which may even be an emergent property of a certain scale of object larger than 10?¹?cm).13 Objects don't sit in a box of space or time. It's the other way around: space and time emanate from objects. How does this happen? OOO tries to produce an explanation from objects themselves. Indeed, the ideal situation would be to rely on just one single object. Otherwise we are stuck with a reality in which objects require other entities to function, which would result in some kind of undermining or overmining. We shall see that we have all the fuel we need “inside” one object to have time and space, and even causality. We shall discover that rather than being some kind of machinery or operating system that underlies objects, causality itself is a phenomenon that floats ontologically “in front of” them. In so doing, we will move from the notion of autonomy and begin approaching a full exploration of the notion of zone , which was promised at the outset of this essay. Since an object is withdrawn, even “from itself,” it is a self-contradictory being. It is itself and not-itself, or in a slightly more expanded version, there is a rift between essence and appearance within an object (as well as “between” them). This rift can't be the same as the clichéd split between substance and accidents , which is the default ontology. On this view, things are like somewhat boring cupcakes with somewhat less boring sugar sprinkles on them of different colors and shapes. But on the OOO view, what is called substance is just another limited slice of an object, a way of apprehending something that is ontologically fathoms deeper. What is called substance and what is called accidence are just on the side of what this essay calls appearance. The rift (Greek, chorismos ) between essence and appearance means that an object presents us with something like what in logic is known as the Liar: some version of the sentence “This sentence is false.” The sentence is true, which means that it is a lie, which means that it is false. Or the sentence is false, which means that it is telling the truth, which means that it is true. Now logic since Aristotle has tried desperately to quarantine such beasts in small backwaters and side streets so that they don't act too provocatively.14 But if OOO holds, then at least one very significant thing in the universe is both itself and not-itself: the object. An object is p ? ¬p. To cope with this fact, we shall need some kind of paraconsistent or even fully dialetheic logic, one that is not allergic to dialetheias (double-truthed things). Yet if we accept that objects are dialetheic, p ? ¬p, we can derive all kinds of things easily from objects. Consider the fact of motion. If objects only occupy one location “in” space at any “one” time, then Zeno's paradoxes will apply to trying to think how an object moves. Yet motion seems like a basic, simple fact of our world. Either everything is just an illusion and nothing really moves at all (Parmenides). Or objects are here and not-here “at the same time.”15 This latter possibility provides the basic setup for all the motion we could wish for. Objects are not “in” time and space. Rather, they “time” (a verb) and “space.” They produce time and space. It would be better to think these verbs as intransitive rather than transitive, in the manner of dance or revolt . They emanate from objects, yet they are not the object. “How can we know the dancer from the dance?” (Yeats).16 The point being, that for there to be a question, there must be a distinction—or there must not be (p ? ¬p).17 It becomes impossible to tell: “What constitutes pretense is that, in the end, you don't know whether it's pretense or not.”18 In this notion of the emergence of time and space from an object we can begin to understand the term zone . Zone can mean belt , something that winds around something else. We talk of temperate zones and war zones. A zone is a place where a certain action is taking place: the zone winds around, it radiates heat, bullets fly, armies are defeated. To speak of an autonomous zone is to speak of a place that a certain political act has carved out of some other entity. Cynically, Tibet is called TAR, the Tibetan Autonomous Region, for this very reason. In this phrase, Region tries to emulate zone : it sounds as if the place has its own rules, but of course, it is very much under the control of China. What action is taking place? “[N]ot something that just is what it is, here and now, without mystery, but something like a quest…a tone on its way calling forth echoes and responses…water seeking its liquidity in the sunlight rippling across the cypresses in the back of the garden.”19 If as suggested earlier there is no functional difference between substance and accidence; if there is no difference between perceiving and doing; if there is no real difference between sentience and non-sentience—then causality itself is a strange, ultimately nonlocal aesthetic phenomenon. A phenomenon, moreover, that emanates from objects themselves, wavering in front of them like the astonishingly beautiful real illusion conjured in this quotation of Alphonso Lingis. Lingis's sentence does what it says, casting a compelling, mysterious spell, the spell of causality, like a demonic force field. A real illusion: if we knew it was an illusion, if it were just an illusion, it would cease to waver. It would not be an illusion at all. We would be in the real of noncontradiction. Since it is like an illusion, we can never be sure: “What constitutes pretense…” A zone is what Lingis calls a level . A zone is not entirely a matter of “free will”: this concept has already beaten down most objects into abject submission. Objects are far more threateningly autonomous, and sensually autonomous, than the Kantian version of autonomy cited in the first paragraph of this essay. A zone is not studiously decided upon by an earnest committee before it goes into action. One of its predominant features is that it is already happening . We find ourselves in it, all of a sudden, in the late afternoon as the shadows lengthen around a city square, giving rise to an uncanny sensation of having been here before. Objects emit zones. Wherever I find myself a zone is already happening, an autonomous zone. It is the nonautonomous zones that are impositions on what is already the case. Or rather, these zones are autonomous zones that exclude and police. They are brittle. Every object is autonomous, but some objects try to maintain themselves through rigidity and brittleness, like (and such as) a police state. Paradoxically, the more rigidly one tries to exclude contradiction, the more virulent become the dialetheias that are possible. I can get around “This sentence is false” by imagining that there are metalanguages that explain what counts as a sentence. Then I can decide that this isn't a real sentence. This is basically Alfred Tarski's strategy, since he invented the notion of metalanguage specifically to cope with dialetheias.20 For example we might claim that sentences such as “This sentence is false” are neither true nor false. But then you can imagine a strengthened version of the Liar such as: “This sentence is not true”; or “This sentence is neither true nor false.” And we can go on adding to the strengthened Liar if the counter-attack tries to build immunity by specifying some fourth thing that a sentence can be besides true, false, and neither true nor false: “This sentence is false, or neither true nor false, or the fourth thing.” And so on.21 It seems as if language becomes more brittle the more it tries to police the Liars of this world. Why? I believe that this increasing brittleness is a symptom of a deep fact about reality. What is this deep fact? Simply that there are objects, that these objects are withdrawn, and that they are walking contradictions. This means indeed that (as Lacan put it) “there is no metalanguage,” since a metalanguage would function as a “middle object” that gave coherency and evenness to the others.22 Since there is no metalanguage, there is no rising above the disturbing illusory play of causality. This may even have political implications: no global critique is therefore possible, and attempts to smooth out or totalize are doomed to fail. To think the zone is to think the notion of temporary , which we shall now begin to discuss in greater detail. The zone is not in time: rather it “times.” But because a zone is an emanation of an object, it is based on a wavering fragility, since objects are p ? ¬p. When an object is born, that means that it has broken free of some other object. An object can be born because it and other objects are fragile. If not, no movement would be possible. Objects contain the seeds of their own destruction, a dialetheic sentence that says something like “This sentence cannot be proved.” Kurt Gödel argues that every true system of propositions contains at least one sentence that the system cannot prove. In order to be true, the system must have a minimum incoherence. To be real, it has to be fragile. Imagine a record player. Now imagine a record called I Cannot Be Played on This Record Player . When you play it on this record player, it produces sympathetic vibrations that cause the record player to shudder apart. No matter how many defense mechanisms you build in, there will always be the possibility of at least one record that destroys the record player.23 That is what being physical is. An object is inherently fragile because it is both itself and not-itself. When the rift between appearance and essence collapses, that is called destruction, ending, death. When an object breaks, several new objects are born. An opera singer sings a loud note in tune with the resonant frequency of a wine glass. (See the movie included below.) The singing is a zone, an autonomous level of intensity, opening a rift between appearance and essence. The glass ripples—for a moment it is nakedly a glass and a not-glass—almost as if it were having an orgasm, a little death. It is caught in the rift of the singing. Then its structure can't handle the coherence of the sound waves, and it breaks. It is incoherence and inconsistency that is the mark of existence, not consistency and noncontradiction. When things break or die, they become coherent. Essence disappears into appearance. I become the memories of friends. A glass becomes a dancing wave. Instantly, there are glass fragments, new temporary autonomous zones. The fragments have broken free from the glass. They are no longer its parts, but emanate their own time and space, becoming perhaps accidental weapons as they bury themselves in my flesh. Thus Hakim Bey's instructions on creating temporary autonomous zones oscillate disturbingly between performance art and politics, circus clowning and revolution. To play with the aesthetic is to play with causality, to rip from the sensual ether emanating from things new regions, new zones. Anarchist politics is the creation of fresh objects in a reality without a top or a bottom object, or for that matter a middle object: Everything in nature is perfectly real including consciousness, there's absolutely nothing to worry about. Not only have the chains of the Law been broken, they never existed; demons never guarded the stars, the Empire never got started, Eros never grew a beard. … There is no becoming, no revolution, no struggle, no path; already you're the monarch of your own skin—your inviolable freedom waits to be completed only by the love of other monarchs: a politics of dream, urgent as the blueness of sky.24 Bey imagines that this is because chaos is a primordial “undifferentiated oneness-of-being.” A Parmenides or a Spinoza or a Laruelle would read this a certain way. Individual objects, or decisions to talk about this rather than that, are just maggot-like things crawling around on the surface of the giant cheese of oneness.25 Yet he also describes chaos as “Primordial uncarved block, sole worshipful monster, inert & spontaneous, more ultraviolet than any mythology.” This image is of an inconsistent object, not of an undifferentiated field. An object, indeed, that can be distinguished from other things. If not, then the first part of The Temporary Autonomous Zone , subtitled “The Broadsheets of Ontological Anarchism,” is a kind of onto-theology. Onto-theology proclaims that some things are more real than others. Bey, however, is writing poetically, and thus ambiguously. We are at liberty to read “undifferentiated oneness-of-being” as something like the irreducibility of a thing to its parts and so forth (undermining and overmining). This certainly seems closer to the language in the following paragraph: “There is no becoming … already you're the monarch of your own skin.”26 On this view, there is no difference between art and politics: “When ugliness, poor design & stupid waste are forced upon you, turn Luddite, throw your shoe in the works, retaliate.” Since Romanticism this has been the war cry of the vanguard artist.27 To say to is to fall prey to the tired axioms of the avant-garde, and we think we know how the game goes. But OOO is not simply a way to advocate “new and improved” versions of this shock-the-bourgeoisie boredom. Bey's text is certainly full enough of that. Rather, since causality as such is aesthetic, and since nonhumans are not that different from humans, the new approach would be to form aesthetic–causal alliances with nonhumans. These alliances would have to resist becoming brittle, whether that brittleness is right wing (authoritarianism) or left wing (the endless maze of critique). No “ism,” especially not the ultimate forms, nihilism and cynicism, is in any sense effective at this point. All forms of brittleness are based on the mistaken assumption that there is a metalanguage and that therefore “Anything you can do, I can do meta.” I will not be listing any approaches here, as Bey does. Such lists and manifestos belong to the vanguardism that no longer works. Why? Not because of some marvelous revolution in human consciousness, but because nonhumans have so successfully impinged upon human social, psychic and aesthetic space. It is the time after the end of the world. That happened in 1945, when a thin layer of radioactive materials was deposited in Earth's crust. Geology now calls it this era the Anthropocene . Ironically, this period, named after humans, is the moment at which even the most thick headed of us make decisive contact with nonhumans, from mercury in our blood to manta rays to magnesium. Richard Dawkins, Pat Robertson and Lady Gaga all have to deal with global warming and mass extinction, somehow. We now live in an Age of Asymmetry marked by a skewed, spiraling relationship between vast knowledge and vast nonhuman things—both become vaster and vaster because of one another and for the same reasons.28 This means that coming up with the perfect attitude or the perfect aesthetic prescription just won't work any more. Even the most hardened anthropocentrist now has to pay through the nose for basic food supplies, and has to use more sunscreen. Whether he knows it or acknowledges it, he is already acting with regard towards nonhumans. There is nothing special to think, no special critique that will get rid of the stains of coexistence. The problem won't fit into the well-established modern boxes, which is why the “mystical,” “spiritual” quality of Bey's prose is welcome. Of course, when I put it this way, you may immediately close off and decide that I am talking about perfect attitudes after all, or something outside of politics, or other ways that the radical left marshals to police its thinking of the nonhuman. Because that is what is really at stake in all this: the nonhuman in its coexistence with the human—bosons, gods, clouds, spirits, lifeforms, experiences, the sunlight rippling across the cypresses. Bey begins to get at this in a Latour litany in the second part of The Temporary Autonomous Zone , “The Assassins”: Pomegranate, mulberry, persimmon, the erotic melancholy of cypresses, membrane-pink shirazi roses, braziers of meccan aloes & benzoin, stiff shafts of ottoman tulips, carpets spread like make-believe gardens on actual lawns—a pavilion set with a mosaic of calligrammes—a willow, a stream with watercress—a fountain crystalled underneath with geometry— the metaphysical scandal of bathing odalisques, of wet brown cupbearers hide-&-seeking in the foliage—“water, greenery, beautiful faces.”29 This will be conveniently dismissed as orientalism. If we're never allowed to escape the crumbling prison of modernity for fear of imperialism there is truly no hope. In a similar way, the fear of anthropocentrism and anthropomorphism is very often staged from a place that just is anthropocentrism .30 Critique turns into ressentiment . An object radiates a zone that is aesthetic and therefore causal. Because objects “time” they are temporary. Not because they exist “in” time that eventually gets the better of them. Their very existence implies the possibility of their non-existence. Since objects are not consistent, they can cease to exist. But nothing, no one, will ever be able to insert a blade between appearance and existence, even thought there is a rift there. Now that's what I call autonomy. NOTES 1. John Cage, Silence: Lectures and Writings (Middletown, CT: Wesleyan University Press, 1973), 96. 2. P. B. Medawar and J. S. Medawar, The Life Science: Current Ideas in Biology (London: Wildwood House, 1977), 8. 3. David DeGrazia, Animal Rights: A Very Short Introduction (Oxford: Oxford University Press, 2002), 5. 4. Antony Colynet, A True History of the Civil Warres in France (London, 1591), 480. 5. Martin Heidegger, Being and Time , tr. Joan Stambaugh (Albany, N.Y: State University of New York Press, 1996) 62–71. 6. Graham Harman, Tool-Being: Heidegger and the Metaphysics of Objects (Peru, IL: Open Court, 2002). 7. Hakim Bey, The Temporary Autonomous Zone (Brooklyn: Autonomedia, 1991). 8. Graham Harman, The Quadruple Object (Ripley: Zero Books, 2011), 7–18. 9. This is not the place to get into an argument about quantum theory, but I have argued that quanta also do not endorse a world that I can't speak about because it is only real when measured. This world is that of the reigning Standard Model proposed by Niels Bohr and challenged by De Broglie and Bohm (and now the cosmologist Valentini, among others). See Timothy Morton, “Here Comes Everything: The Promise of Object-Oriented Ontology,” Qui Parle 19.2 (Spring–Summer, 2011), 163–190. 10. John Donne, Holy Sonnets 15, in The Major Works: Including Songs and Sonnets and Sermons , ed. John Carey (Oxford: Oxford University Press, 2009). 11. Edward O. Wilson, Consilience: The Unity of Knowledge (New York: Knopf, 1998). 12. Martin Heidegger, What Is a Thing? (Washington: Regnery, 1968), 243. 13. Albert Einstein, Relativity: The Special and the General Theory (London: Penguin, 2006); Petr Horava, “Quantum Gravity at a Lifshitz Point,” arXiv:0901.3775v2 [hep-th]. 14. Graham Priest, In Contradiction (Oxford University Press, 2006), passim: the most notable recent quarantine officers have been Tarski, Russell, and Frege. 15. Priest, In Contradiction , 172–181. 16. William Butler Yeats, “Among School Children,” Collected Poems , ed. Richard J. Finneran (New York: Scribner, 1996). 17. Paul de Man, “Semiology and Rhetoric,” Diacritics 3.3 (Autumn, 1973), 27–33 (30). 18. Jacques Lacan, Le seminaire, Livre III: Les psychoses (Paris: Editions de Seuil, 1981), 48. See Slavoj Zizek, The Parallax View (Cambridge, Mass.: MIT Press, 2006), 206. 19. Alphonso Lingis, The Imperative (Bloomington: Indiana University Press, 1998), 29. 20. Priest, In Contradiction , 9–27. 21. See Graham Priest and Francesco Berto, “ Dialetheism ,” The Stanford Encyclopedia of Philosophy (Summer 2010 Edition), ed. Edward N. Zalta. 22. Jacques Lacan, Écrits: A Selection , tr. Alan Sheridan (London: Tavistock, 1977), 311. 23. The analogy can be found at length in Douglas Hofstadter, “Contracrostipunctus,” Gödel, Escher, Bach: An Eternal Golden Braid (New York: Basic Books, 1999), 75–81. 24. Bey, “ Chaos: The Broadsheets of Ontological Anarchism ,” Temporary Autonomous Zone . 25. This is closest to the language of François Laruelle in Philosophies of Difference: A Critical Introduction to Non-Philosophy (New York: Continuum, 2011) 179. 26. Bey, “ Chaos: The Broadsheets of Ontological Anarchism ,” Temporary Autonomous Zone . 27. Peter Bürger, Theory of the Avant Garde (Minneapolis: University of Minnesota Press, 1984). 28. For further discussion see Timothy Morton, “From Modernity to the Anthropocene: Ecology and Art in the Age of Asymmetry,” The International Social Science Journal 209 (forthcoming). 29. Bey, “ The Assassins ,” Temporary Autonomous Zone . 30. Timothy Morton, The Ecological Thought (Cambridge, Mass.: Harvard University Press, 2010), 75–76. (shrink)

Studies on the determinants of school results have shown that they depend largely on the context of learning. Concerning the pandemic, teachers have been forced to find online teaching methods, which leads us to the central issue of this study of whether the effectiveness of online education depends on teachers’ digital skills. Therefore, in this study, we analyzed the perceived digital competences of Romanian pre-tertiary cycle teachers about their professional status, school location, gender, age, taught field, and prior (...) participation in training for online teaching. Using data from 3,419 self-completed questionnaires in an online survey of teachers performed at the beginning of the global lockdown in March 2020, we have built two reliable measures of perceived digital skills, namely the Self-Assessed Multimedia and Online Skills Score and the Self-Assessed Digital Office Skills Score, which were the dependent variables in our study. Hierarchical linear regressions were used to test the hypotheses regarding the variations of dependent variables, measuring the two concepts of self-assessed digital skills. These concepts underlined that both decrease with age and are positively affected by prior attendance at training sessions for online teaching skills and by having ICT and informatics as a taught subject field. However, teachers of all specialties are relatively significantly less skilled in this field. The most important results concern the impact of gender and professional status on the teachers’ self-assessed digital competences. In summary, it appears that self-assessed office digital skills are a specialism demonstrated mainly by female teachers, while multimedia and online skills are perceived by teachers to be a “male” domain. Simultaneously, net of the other variables, a higher status within the teaching profession correlates positively with perceived office digital skills. Lastly, implications for future research, as well as for educational interventions and policies, are discussed. (shrink)

Corporate social responsibility (CSR) is a phenomenon of increasing interest. Today, it is practiced in most countries around the globe and studied in various fields of academia. However, the focus still lies on Western developed countries, their understanding, and implementation of CSR. This paper focuses on the comparison of the orientation towards CSR in Germany and Qatar, thereby closing a research gap by providing insights from a Middle Eastern country. Based on a survey among 265 business students in both countries, (...) the research examines their perception of the economic, legal, ethical, and philanthropic responsibilities of a firm. Findings suggest that, next to economic obligations, Qataris appear more willing to support philanthropic activities of a business while Germans highly value ethical standards. Moreover, females in both countries value economic responsibilities less important than males do. (shrink)

Chronicling the history of gendered and sexualised violence in Zimbabwe, our article upholds the view that what transpired in Judges 19:20–48 offers the contemporary readers some important lessons that are worth pondering over. Looking through feminist hermeneutical lenses, we engage in a comparative analysis of the gender-based violations, human rights abuses, and the lack of hospitality depicted in Judges 19–21 with the lived realities of Zimbabwean women in our contemporary times. The discussion draws to a close by proffering a theology (...) of restorative justice. It is our argument that Zimbabwe needs healing through a non-retaliative response to some wrongdoing that prioritises repairing harm and the recognition that maintaining positive relationships with fellow humans is a core human need. This is the only way forward to reclaim and restore the humanity and dignity of women exposed to diverse forms of gender-based violence in our Mother Earth.Contribution: This article reveals the link between the violations and brutality endured by the woman in Judges 19–21 with the history of sexualised violence in Zimbabwe. It is worth noting that in African Traditional Religion, the three worlds (spiritual, natural, and human) are intertwined and make up the cosmic totality; sexually violating women is tantamount to desecrating Mother Earth. (shrink)

The COVID-19 global pandemic has stretched the capacities of public health institutions and health systems around the world, opening the door to a range of technologically-driven solutions. In this article, we seek to historicize the expanding role of digital health technologies and examine the political-economic context from which they have emerged. Drawing on critical insights from science and technology studies, we maintain that the rise of digital health technologies has been catalyzed by broad shifts in global health governance (...) that have expanded the role of market forces in public health and a unique set of political and economic crises that have accelerated the adoption of digital technologies—often under the guise of appeals to technological innovation to address “unprecedented” crises. These interrelated historical trends, we contend, are critical for understanding current state responses to the pandemic and possibilities for more equitable and democratic applications of technology in public health. (shrink)

Along with the dissemination of technical assistance in nearly every part of life, there has been growing interest in the potential of technology to support well-being and human flourishing. “Positive technology” thereby takes the responsible role of a “digital coach,” supporting people in achieving personal goals and behavior change. The design of such technology requires knowledge of different disciplines such as psychology, design and human-computer interaction. However, possible synergies are not yet used to full effect, and it needs common (...) frameworks to support a more deliberate design of the “therapeutic interaction” mediated through technology. For positive technology design, positive psychology, and resource oriented approaches appear as particularly promising starting point. Besides a general fit of the basic theoretical conceptions of human change, many elements of established interventions could possibly be transferred to technology design. However, besides the power of focusing on the positive, another psychological aspect to consider are the bitter components inherent to change, such as the confrontation with a negative status quo, threat of self-esteem, and the effort required. The present research discusses the general potential and challenges within positive technology design from an interdisciplinary perspective with theoretical and practical contributions. Based on the bitter-sweet ambivalence of change as present in many psychological approaches of motivation and behavior change, the bitter-sweet continuum serves as a proxy for the mixed emotions and cognitions related to change. An empirical investigation of those factors among 177 users of self-improvement technologies provides initial support for the usefulness of the bitter-sweet perspective in understanding change dynamics. In a next step, the bitter-sweet concept is transformed into different design strategies to support positive change. The present article aims to deepen the discussion about the responsible role of technology as a well-being enhancement tool and to provide a fruitful frame for different disciplines involved in positive technology. Two aspects are highlighted: First, investigating well-being technology as a form of “therapeutic interaction,” focusing on the need for sensible design solutions in the emerging dialogue between technology and user. Second, a stronger consideration of the bitter-sweet ambivalence of change, utilizing (positive) psychology interventions to full effect. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Making of Roman India by Grant ParkerJoseph L. RifeGrant Parker. The Making of Roman India. Greek Culture in the Roman World. Cambridge: Cambridge University Press, 2008. xv + 357 pp. 11 black-and-white figs. 3 maps. Cloth, $99.India as a strange land—vast, wild, mystical—has long excited the western imagination, even after the British colonial downfall. This vision of danger and desire has deep roots. While India was nearly (...) out of reach of those great ancient empire-builders, the Macedonians and the Romans, on the distant fringe of the Mediterranean sphere of contact and commerce, it was very much on their minds. [End Page 672] Grant Parker’s The Making of Roman India, like the India of fantasy, is sprawling and full of wisdom, if somewhat untidy. Rather than attempting to reconstruct the historical travels and concrete relations between Rome and South Asia, Parker examines the development of a literary discourse during the Empire, a collection of responses to and representations of that faraway place that were “conceived in terms of power relations in Roman society” (5–7). The scale of the inquiry is breathtaking, encompassing an array of texts in various genres from the Achaemenid background to the Christian reception and beyond, as it were, from Darius I to St. Thomas.Parker’s book, which grew from his Princeton dissertation through a Michigan fellowship and an early career at Duke, marks the culmination of a series of publications that include his co-edited volume, Ancient India in its Wider World (with Carla Sinopoli [Ann Arbor, Mich. 2008]), and several notable articles (e.g., Journal of the Economic and Social History of the Orient 45.1 [2002]: 40–95; Ars Orientalis 34 [2007]: 19–37; Journal of Medieval and Early Modern Studies 37 [2007]: 1–7). This ongoing project has established Parker as an important scholar of the classical tradition, cultural criticism, and travel literature. In his preface, Parker comments on the personal impact of Momigliano’s Alien Wisdom and dutifully notes the broad influence of Saïd’s Orientalism, while cautioning against the transposition of postcolonial theory to a preindustrial setting (8). He belongs to an energetic generation of classicists who are drawing a new picture of how the Greeks and Romans envisioned the East in literature and art. The Making of Roman India shares common ground with other recent studies of the dynamic construction of identity, and how one culture defines another under its own conditions, such as those by Phiroze Vasunia and Ian Moyer on Egypt (The Gift of the Nile [Berkeley 2001] and Egypt and the Limits of Hellenism [Cambridge 2011]) and by Nathanael Andrade on Syria (Syrian Identity in the Greco-Roman World [Cambridge 2013]). Parker has a distinct advantage because India, unlike Egypt or Syria, was an uncharted region of little historical consequence which intellectuals could shape and re-shape in line with their evolving interests. His study stands out for its remarkable blend of erudition, philological rigor, and creative insight.The book unfolds as an exploration of Indography through time. Part 1 (11–65) covers the Greek tradition up to the first century b.c.e. in four stages: Greek historiography out of Asia Minor during the Late Archaic to Late Classical periods; the explosion of knowledge emanating from Alexander’s campaign in 327–325 b.c.e.; the diplomatic activities of the Hellenistic kingdoms (particularly Megasthenes chez Chandragupta); and geographical thought. Parker’s handling of disparate, often challenging, sources is always accurate and incisive. His concluding remarks to individual sections can be less than startling: Hecataeus situated India in an ordered, pre-cartographic model of the world (20–21); Ctesias’ taste for marvels set him up for indictments of mendacity (30–33); Eratosthenes tied the subcontinent into his geodetic calculus (52–53). But the readings serve as reliable introductions to many texts that remain hard to access, and here the whole is more than the sum. Parker’s sweeping juxtaposition of a chain of thinkers effectively [End Page 673] reveals how they defined India as a finite structure for physical measurement, a problem for veridical historiography, and a prodigiously fecund environment for scientific... (shrink)

AimTo evaluate the cognitive functioning of subjects practicing trance mediumship in Brazil.MethodThe study was based on the measurement of cognitive functions of 19 spirits mediums through neuropsychological tests such as the Brief Cognitive Screening Battery, the Verbal Fluency Test, the digit span test, the cube test, the five digit test and an evaluation of mental health through scales such as the Beck Depression Inventory, the Self-Report Questionnaire, and the Trauma History Questionnaire. The sample included the participation of spirit mediums divided (...) into two groups. The more experienced group with 11 subjects had more than 10 years of mediumistic practice, while the other less experienced group with 8 subjects had 1–5 years of experience. The inclusion criteria were psychophonic mediums with regular trance practices for at least one year. The data collected were analyzed using the SPSS statistical package.ResultsRegarding performance on the BCSB and digit span test, all subjects reached scores at the median or higher in comparison to standardized scores of Brazilians. Scores of 90% on the cube test and 42% on the FAS were reached in comparison to median or higher values, versus the median of standardized scores among Brazilians. On the FDT, we found statistical significance in the choice stage, with higher performance of subjects whose initial age of trance recognition occurred before 21 years old. On the BDI scale, no participant met the criteria for major depression. The SRQ showed an incidence of common mental disorders in 21% of the sample, which was more prevalent in the LEG.ConclusionThe cognitive functioning of subjects who practice trance mediumship in Brazil is associated with cognitive health. Executive dysfunction may be a tendency in LEG. However, an incidence of common mental disorders in the LEG was observed. Executive processing was higher in the subgroup with early practices of recognizing the phenomenon. (shrink)

International Journal of Philosophical Studies, Volume 19, Issue 2, Page 255-265, May 2011.

COVID-19 caused levels of household food insecurity to spike, but the precarity of so many people in wealthy countries is an outgrowth of decades of eroding public provisions and labour protections that once protected people from hunger, setting the stage for the virus’ unevenly-distributed harms. The prominence of corporate-sponsored foodbanking as a containment response to pandemic-aggravated food insecurity follows decades of replacing rights with charity. We review structural drivers of charity’s growth to prominence as a hunger solution in North America, (...) and of its spread to countries including the UK. By highlighting pre-pandemic pressures shaping foodbanking, including charities’ efforts to retool themselves as health providers, we ask whether anti-hunger efforts during the pandemic serve to contain ongoing socioeconomic crises and the unjust living conditions they cause, or contest them through transformative pathways to a just food system. We suggest that pandemic-driven philanthropic and state funding flows have bolstered foodbanking and the food system logics that support it. By contextualising the complex and variegated politics of foodbanking in broader movements, from community food security to food sovereignty, we reframe simplistic narratives of charity and highlight the need for justice-oriented structural changes in wealth redistribution and food system organisation if we are to prevent the kinds of emergency-within-emergency that we witnessed as COVID-19 revealed the proximity of many to hunger. (shrink)

During the 2020 COVID-19 epidemic a variety of social activities migrated online, including religious ceremonies and rituals. One such instance is the case of Santo Daime, a Brazilian rainforest religion that utilizes the hallucinogenic brew ayahuasca in its rituals. During the pandemic, multiple Santo Daime rituals involving the consumption of ayahuasca took place online, mediated through Zoom and other online platforms. The phenomenon is notable since the effects of hallucinogens are defined by context (set and setting) and Santo Daime rituals (...) are habitually governed by punctilious regulations aimed at directing the experience of participants. The abrupt move to online space thus augurs significant implications in the context of hallucinogenic rituals. This paper looks at this development and its repercussions for entheogenic rituals, as it asks how do psychedelic rituals change when they move online? Building on the author’s previous work on set and setting in the Santo Daime religion, the paper introduces accounts from 12 semi-structured interviews with daimistas participating in online daime rituals, approached through the prism of set and setting, and the study of online religiosity. The analysis points at several key dynamics emerging in the context of virtual rituals. The migration online allowed for the continuation of Santo Daime entheogenic rituals at a time of social distancing, fostered a sense of global brotherhood and opened new possibility for religious participation and learning. Concurrently, online ritual produced an impoverished ritual experience and novel types of challenges including a higher potential for distractions, technical difficulties, and low sensory fidelity. Other novel challenges included social anxiety and an in-built tension between the social and spiritual dimensions of ritual. Finally, some participants were concerned by the cultural context of online rituals: technological mediation, consumerism, commodification, and digital divide. The limitations of digital technology appear amplified by the highly immersive, body oriented, experientially intensified context of the psychedelic experience. This paper contributes to the literature on the extra-pharmacological factors shaping experiences with psychedelics, as well as to the literature on the consequences of the adoption of digital media technologies during the COVID-19 pandemic. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Amazons: Lives and Legends of Warrior Women across the Ancient World by Adrienne MayorAlison KeithAdrienne Mayor. The Amazons: Lives and Legends of Warrior Women across the Ancient World. Princeton: Princeton University Press, 2014. xiv + 519 pp. Cloth, $29.95.Adrienne Mayor is a historian of classical folklore and ancient science and the author of several books whose subjects lie at the intersection of classical myth and ancient history (...) with archaeology and the history of science: an exploration of monsters and heroes in the repertoire of classical myth as a response to the discovery of fossils in The First Fossil Hunters (Princeton 2000); a wide-ranging collection of evidence for biological and chemical warfare in the ancient world, Greek Fire, Poison Arrows, and Scorpion Bombs (New York: Overlook Press, 2003); and a sympathetic biography of Mithradates VI Eupator of Pontus in The Poison King: The Life and Legend of Mithradates, Rome’s Deadliest Enemy (Princeton 2009); as well as an investigation of indigenous North Americans’ accounts of fossils, in Fossil Legends of the First Americans (Princeton 2005). Like her earlier volumes, The Amazons brings together an extraordinarily wide array of evidence, uncovered through prodigious research across such diverse fields as classical mythology, ancient history, and contemporary archaeology of the central Asian steppes, and the results are presented with her trademark narrative brio. As with these earlier volumes, moreover, Mayor has an agenda in The [End Page 174] Amazons: here she seeks the historical reality that lies behind the ancient Greek myths of barbarian warrior women; and she finds it in the recent archaeological discoveries of female warriors interred on the central Asian steppes from the Caucasus to western China.Mayor sets out her premise in a prologue that takes its bearing from the myth of Atalanta, whom she dubs “the Greek Amazon” (1–13): her project is to investigate where the Greeks might have encountered real women warriors like Atalanta, capable of besting men in footraces, on the battlefield, and in the hunt. Her study falls into four parts: Part 1 (17–59) asks, “Who were the Amazons?” and identifies ancient Scythia, with its many horse-riding and horse-herding nomadic tribes, as the homeland of the Amazons. Part 2 (63–246) surveys the archaeological and scientific evidence for female warriors among the nomadic tribes of the central Asian steppes in prehistoric and historic times. In this section, Mayor considers the evidence afforded by the bones of buried nomad warriors misidentified as male (because of the weaponry and horses accompanying the burial) when they were originally excavated but recently recognized as female as a result of newer scientific techniques of examination (chap. 4); the body armor found in the steppe graves, in a discussion which has recourse to comparative ethnography, yielding a rich history of breast suppression (chap. 5); the tattooing practices of the historical nomadic tribes of the steppes in relation to the iconography of Amazons’ tunics and leggings on classical vase paintings (chap. 6); ancient accounts of Amazons’ dress (chap. 7), including their partiality for trousers (chap. 12), sexuality and reproduction (chap. 8), drugs, dance and music (chap. 9), hunting technologies (chap. 11), weapons and warfare (chap. 13), all in relation to the archaeological and historical evidence of steppe women’s practices in these arenas. She even presses into service ethnolinguistics in order to argue that the names of the Amazons can be traced back to a common origin in the Eurasian steppes (chap. 14; cf. Appendix of Names of Amazons and Warrior Women in Ancient Literature and Art from the Mediterranean to China). In Part 3 (249–353), Mayor turns back to “Amazons in Greek and Roman Myth, Legend, and History.” Here she retells the most famous Amazon myths, of Hippolyte and Heracles [sic] (chap. 15), Antiope and Theseus (chap. 16), Penthesilea and Achilles (chap. 18), and the Athenian Amazonomachy (chaps. 17, 19); and classical accounts of their historical counterparts—the dalliance of Thalestris and Alexander the Great (chap. 20) and the love of Hypsicratea and Mithradates (chap. 21). Part 4 (358–429) abandons the Hellenocentric perspective of Part 3 to investigate the evidence for Amazonian women “Beyond the Greek World... (shrink)

The Covid-19 pandemic posed a serious threat to small and medium-sized enterprises (SMEs). This explorative qualitative study of 100 SMEs from 20 industries and 21 countries investigates how entrepreneurs responded to the Covid-19 pandemic and which cognitive frames guided their actions. Observed cognitive frames prioritize either business survival, conversion of business and stakeholder interest, or acceptance of conflicting social and financial goals. These cognitive frames influence the choice of crisis response without determining it. Four response patterns were found: weathering the (...) storm, bricolage, solidarity and support, and social innovation. Strategic innovation creating access to new markets is the most successful response. The findings support a more encompassing definition of the concept of organizational resilience and shed light on motivations for acts of solidarity and social innovation as crisis responses. (shrink)

A physician's lack of humanity is a general complaint in public surveys. The physician-patient relationship is viewed by the public as being reduced to a business relationship where the patient feels that she is merely a 'client' and the physician a healthcare 'practitioner' instead of a 'care giver'. This public perception is not a phenomenon that is peculiar to Lebanon. Yet, the problem has been increasing over the years to the extent that patients feel that physicians are becoming inhumane and (...) business oriented. While this might not characterize all physicians of the 21 st century, this might be true of at least some. Responses were collected from a study that was undertaken based on a questionnaire distributed to a pool of 650 participants from different geographical areas and different social and educational backgrounds in Lebanon. Participants were all older than18 years and mentally competent. None were physicians. The questionnaire was open-ended and initially piloted among a random sample. The physician traits most desired by the public were found to be: moral traits (41%), interpersonal traits (36%), scientific traits (19%) and other (4%). The most unwanted traits/behaviours were a lack of interpersonal traits (57%), a lack of moral traits (40%) and a lack of scientific skills (3%). The physician-patient relationship was perceived, in general, as being a flawed one. What can be done to remedy the image of the Lebanese physician that has been projected in the minds of the patients and the public at large? Nine major recommendations are presented. (shrink)

Judges is about loss: a loss of the individual which leads to a loss of the tribe, and, if circumstances remain unchecked, a loss of the nation.

Background Ethical principles behind prioritization in healthcare are continuously relevant. However, applying ethical principles during times of increased need, such as during the COVID-19 pandemic, is challenging. Also, little is known about nursing home nurses’ prioritizations in their work to achieve well-being and health for nursing home residents. Aim The aim of this study was to explore nursing home nurses’ priority-setting for older nursing home residents in Sweden during the COVID-19 pandemic. Research design, participants, and research context We conducted a (...) qualitative interview study. Data were collected through in-depth interviews (retrospective self-reports) between February and May 2021 with 21 nursing home nurses. To help respondents to recall their memories, we used the critical incident technique (CIT). We analyzed data within the theoretical framework and the methodological orientation of content analysis. Ethical considerations Written and verbal consent was obtained before the interviews, and information was given to participants informing them that participation was entirely voluntary. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to the research project (Dnr. 2020-05649). Findings We identified an overarching theme—nursing home nurses struggling on multiple fronts, “just do it”—and seven categories: striving for survival and caring about a dignified death; responding sensitively to relatives’ expectations; ranking the urgency of needed care; responding to input from different actors; combating the spread of infection in unconventional ways; taking the lead and doing what is required; and following the ideals of person-centered nursing. Conclusions Nurses’ priority-setting for older nursing homes residents during the COVID-19 pandemic meant strain and struggle. In some cases, nurses had taken responsibility for priorities falling outside their statutory powers. Different demands and interests affected nurses’ priorities. Nursing home nurses need organizational and managerial support to prioritize. (shrink)

Cultural diplomacy is a special form of cultural application to improve diplomatic effectiveness, create, and promote national culture. Since the Cold War until now, South Korea, Japan, and India have been continuously promoting cultural diplomacy based on the dissemination of increasingly interconnected literary and cinematic publications. Cultural diplomacy with Vietnam has also helped South Korea, Japan, and India maximize their role as responsible powers for a typical Southeast Asian country, Vietnam. Through three typical cases in promoting the role of cultural (...) diplomacy to preserve Oriental cultural identity: Japan, India, and South Korea, by using systemic and interdisciplinary methods, the article focuses on four main characteristics that demonstrate the role of cultural diplomacy in preserving Oriental cultural identity in these countries, the quantity, content, implementation situation, and economic - political - social role of cultural products are utilized and promoted in cultural diplomacy of South Korea, Japan, and India. The article shows that cultural diplomacy not only spreads Oriental cultural values, contributing to maintaining economic growth of the Asian countries mentioned in the article, but also helps improve national brand image, enhance the position and national potential in the international stage. (shrink)

Before COVID-19, dementia singing groups and choirs flourished, providing activity, cognitive stimulation, and social support for thousands of people with dementia in the UK. Interactive music provides one of the most effective psychosocial interventions for people with dementia; it can allay agitation and promote wellbeing. Since COVID-19 has halted the delivery of in-person musical activities, it is important for the welfare of people with dementia and their carers to investigate what alternatives to live music making exist, how these alternatives are (...) delivered and how their accessibility can be expanded. This community case study examines recent practice in online music-making in response to COVID-19 restrictions for people with dementia and their supporters, focusing on a UK context. It documents current opportunities for digital music making, and assesses the barriers and facilitators to their delivery and accessibility. Online searches of video streaming sites and social media documented what music activities were available. Expert practitioners and providers collaborated on this study and supplied input about the sessions they had been delivering, the technological challenges and solutions they had found, and the responses of the participants. Recommendations for best practice were developed and refined in consultation with these collaborators. Over 50 examples of online music activities were identified. In addition to the challenges of digital inclusion and accessibility for some older people, delivering live music online has unique challenges due to audio latency and sound quality. It is necessary to adapt the session to the technology's limitations rather than expect to overcome these challenges. The recommendations highlight the importance of accessibility, digital safety and wellbeing of participants. They also suggest ways to optimize the quality of their musical experience. The pandemic has prompted innovative approaches to deliver activities and interventions in a digital format, and people with dementia and their carers have adapted rapidly. While online music is meeting a clear current need for social connection and cognitive stimulation, it also offers some advantages which remain relevant after COVID-19 restrictions are relaxed. The recommendations of this study are intended to be useful to musicians, dementia care practitioners, and researchers during the pandemic and beyond. (shrink)

COVID-19 has been studied extensively for its direct effects on healthcare workers. Despite this, very little is known about the effect of COVID-19 fear on future orientation. Studying medical social workers’ fear of being infected with COVID-19 and their future orientation was the primary method used to examine this relationship. 204 Turkish medical social workers on the pandemic’s front lines were included in the total sample. Social workers were found to be extremely concerned about contracting COVID-19. Although only gender is (...) a significant predictor of the fear of contracting COVID-19 infection, the study also found that female social workers have a higher fear of infection than males. Also, no correlation exists between social workers’ vaccination status and their fear of contracting COVID-19. There was a weak negative correlation between social workers’ fear of contracting COVID-19 and their future orientation, but in general, social workers had a positive future orientation. Medical social workers and front-line health care providers can use these findings to develop effective and culturally appropriate intervention programs to reduce COVID-19 concerns and foster a forward-looking outlook. (shrink)

Smart city is a brand-new city form, in which information and communication technologies are utilized to sense, analyze, and integrate the key information of city operation core system, so that intelligent responses can be immediately and effectively taken to various demands including people’s livelihood, environmental protection, public safety, city services, and industrial and commercial activities. Digital economy is a mixed economy with the coexistence of multiple business models and diversified value creation models based on the information and communication technologies (...) and in the digital economy, many things are undergoing huge changes, and their corresponding economic rules also need to be adjusted. On the basis of analyzing previous research works, this paper expounded the research status and significance of smart city’s resource scheduling and strategic management, elaborated the development background, current status, and future challenges of digital economy, introduced the methods and principles of city-level spatiotemporal data model and spatial full factor coding, formulated resource scheduling strategies for smart city based on digital economy, explored the dynamic fusion, storage, and update of smart city’s multisource heterogeneous data, conducted the information display and analysis of multilevel smart city, proposed strategic management approaches for smart city based on digital economy, analyzed the integrated implementation model of shared resource scheduling and people-oriented social management, and discussed the economic growth factors and standardization mechanism of smart city under the background of digital economy. The results of this study provide a reference for further research studies on the resource scheduling and strategic management of smart city under the background of digital economy. (shrink)

Photo ID 71252867© Stepan Popov| Dreamstime.com Abstract While Medical Assistance in Dying (MAiD) has been legalized in Canada since 2016, it still excludes eligibility for persons who have mental illness as a sole underlying medical condition. This temporary exclusion was set to expire on March 17th, 2024, but was set 3 years further back by the Government of Canada to March 17th, 2027. This paper presents a critical appraisal of the case of MAiD for individuals with mental illness as the (...) sole underlying medical condition through the analysis of three ethical theories: principlism, deontology, and utilitarianism. Through evidence and discussion, it will be demonstrated that MAiD, in this context, may be ethically justifiable on the grounds of upholding human rights, protecting dignity, and minimizing suffering. Introduction In June of 2016, Medical Assistance in Dying (MAiD) was legalized in Canada.[1] Throughout the first six years, a temporary exclusion of eligibility for persons suffering solely from mental illness was extended.[2] The exclusion of mental illness as a sole underlying medical condition was set to expire on March 17, 2024.[3] However, on February 1, 2024, just over a month before the set expiration, the Government of Canada once again extended the exclusion, this time setting it back three years to March 17, 2027. There are currently several countries that allow MAiD for mental illness, including Belgium, the Netherlands, and Luxembourg.[4] Some countries, like Spain,[5] do not give specific guidance, leaving the matter under discussion by ethicists and courts. In these countries, there are specific (although different) requirements for the process; overall, for mental illness, the illness must be verifiable and not simply related to a perception of satisfaction with the length of life. This extension ignited discussion on whether MAiD for persons who have mental illness as a sole underlying medical condition in Canada is ethically acceptable. As a complex, multi-faceted, and interdisciplinary issue, ethicists assessing MAiD must take into account various moral obligations and considerations. This paper analyses MAiD in this context through the application of three ethical theories: principlism, deontology, and utilitarianism. This paper concludes that, based on the current evidence and knowledge of this developing situation, MAiD for persons with mental illness in Canada may be ethically justified on the grounds of upholding human rights, labour obligations, and dignity. Through the exploration of research and discussions, it will be demonstrated that society at large ought to protect liberty and act towards relieving suffering, thereby supporting the potential eligibility of MAiD for persons who have mental illness. Principlism: The Capacity and Ability to Assess and Decide for One’s Own Life Principlism is the application of four principles: autonomy, beneficence, non-maleficence, and justice. Principlism supports permitting MAiD for mental illness due to the importance of autonomy in decision-making, equitable and just practices for MAiD assessors, and reducing suffering for patients and their family member(s) and/or friend(s). Carter v. Canada, the Canadian Supreme Court ruling of 2015—which changed Canadian law to allow for MAiD—held that the prohibition of MAiD infringed on Canadians’ right to “life, liberty, and the security of the person.” In a unanimous decision, the Supreme Court of Canada decided that the criminal prohibition of MAiD violates the Canadian Charter of Rights and Freedoms.[6] The Court concluded that the criminal law prohibiting MAiD interfered with people’s autonomy and dignity, which are protected by the rights of liberty and security of the person.[7] The ruling emphasized that Canada’s constitution reflects the fundamental importance of individual autonomy in personal decision-making. Research provides evidence that MAiD improves autonomy: A study among psychiatric patients found that 8 of 48 psychiatric patients said the mere option of accessing MAiD was enough to assess their future options for living wholly.[8] These findings complement a study entailing interviews with 30 adults who have mental illness, which emphasized that the ability to access MAiD allows individuals to analyze their quality of life, envision their desired future, and make decisions accordingly.[9] Although not all participants agreed that mental illness as the only underlying medical condition was appropriate for MAiD eligibility, many participants agreed that patient autonomy in decision-making was paramount and should be respected. However, autonomy as an ethical principle does not immediately grant all persons with mental illness the option to access MAiD. There are multiple eligibility criteria for those who wish to receive MAiD, which still must be approved and assessed. Currently, eligibility criteria for MAiD states that individuals must “give informed consent to receive MAiD, meaning that the person has consented to receiving MAiD after they have received all information needed to make this decision.”[10] Consent requires capability or capacity, which is the ability to understand relevant information, appreciate its potential consequences, and make an informed decision for oneself.[11] Like for many other diseases, disabilities, and conditions, patient capability is determined on a case-by-case basis.[12] Given the stigma surrounding those struggling with mental health, this thorough case-by-case examination of an individual patient’s capability and capacity without prejudice or partiality should lead to equitable and fair treatment. Without appropriate testing, those with mental illness could be wrongly stripped of their decision-making power. Arguments against MAiD for those with mental illness have raised concerns about the potential for individuals to harm themselves and others. A survey of MAiD providers demonstrated that physicians believed that the bereavement experience following MAiD is challenging and profoundly distinct and that bereavement support for all members involved should be required.[13] However, while watching one die (of MAiD) may cause harm to their families, friends, and support system at large, it is also important to recognize that watching someone suffer and struggle through their mental health journey also poses significant harm. Qualitative studies in Ontario, Canada, have interviewed family members of persons with mental illness as a sole medical condition, and interviewees shared that witnessing the illness and its impacts on their close one's lives was a very difficult experience.[14] As it relates to MAiD, participants emphasized that those living with mental illness are in the best position to understand their own pain and suffering and, in turn, make their own decisions about relief.[15] In an interview, a MAiD provider stated that MAiD may provide less suffering and more peace, and that, although it “depends on the family,... usually the family is more prepared and at peace.”[16] On the contrary, a person who has mental illness may perceive choosing MAiD as beneficial to their family member(s) and/or friend(s). Among those who died by MAiD in 2021, 35.7 percent reported that they perceived themselves as a burden on their family and friends.[17] While some authors report their concerns regarding such social burden as a potential driving factor for MAiD requests, others report that there are other additional burdens associated with requesting MAiD that may be financial, societal, and personal.[18] As such, the extension of MAiD eligibility to those with mental illness will likely only allow a small number of people to be granted MAiD.[19] Many others will be diverted to appropriate services and treatments. Patients’ decision to choose MAID noted their ability to make choices about their own care, reflecting the value of autonomy.[20] Although it is difficult to determine what is good for families in individual cases, MAiD presents an option that is both beneficent and non-maleficent. Therefore, these arguments satisfy the principles which do not necessarily conflict with MAiD. Deontology: The Duty to Recognize Vulnerability and Relieve Suffering The argument here begins with the fundamental focus of deontology—that moral duty lies in an action rather than in its consequences. Further discussion is required to analyze the impact of MAiD on healthcare workers. The Canadian Medical Association (CMA) Code of Ethics and Professionalism requires physicians to abide by virtues, commitments, and responsibilities in delivering health care and service.[21] The code states that “a compassionate physician recognizes suffering and vulnerability, … and alleviate[s] the patient’s suffering.”[22] In the context of MAiD for persons with mental illness as a sole underlying medical condition, vulnerabilities could be wide in range. Many Canadians are concerned with the interaction between mental health and other social determinants of health, such as the lack of medical, disability, financial, housing, and social support and resources.[23] As a result, another layer to the ethical issue arises: Does permitting MAiD for mental illness treat the symptoms of the issue rather than the root problem itself (social, economic, and systemic inequities)? Some argue against MAiD, stating that the nation should first focus on developing better quality care and service.[24] Others support MAiD as a potential harm reduction approach, given that most of these unjust conditions require a higher level of long-term structural and public policy overhaul.[25] The CMA Code also calls upon physicians to recognize and alleviate patients’ suffering. Some argue that while physicians and medical professionals do work to relieve suffering, they are trained to do so through a primary care-based diagnose-and-treat approach.[26] Studies that have captured Canadian physicians’ experiences providing MAiD report that, although physicians stated that the work was rewarding, it came with many challenges, including strained relationships with coworkers, increased workload, and inadequate compensation.[27] Physicians report that a part of the problem is that MAiD rules are written by lawyers and experts who are removed from its reality in medical practice. As a result, there is a lack of clarity surrounding practice norms and a lack of support for physicians.[28] Thus, while healthcare practitioners have a duty to relieve patients’ suffering, they should feel adequately trained and supported in doing so. If physicians and healthcare professionals recognize vulnerability and relieve suffering, then they should act accordingly, regardless of potential associations or outcomes. Making persons with mental illness eligible for MAiD ensures that treatment to relieve their suffering is available. However, it is imperative that there are sufficient resources and support available to healthcare professionals to ensure that they feel prepared and supported to provide MAiD, should they wish to do so. Utilitarianism: Minimizing Intolerable Suffering and Dying with Dignity Overall, utilitarianism is largely concerned with the greatest happiness principle—to increase the amount of happiness for the greatest number of people. So far, this paper has analyzed individual, family, and practitioner-based ethical considerations. But if MAiD were to be extended to those with mental illness as a singular underlying medical condition, what implications would this have for the world and society at large? There is a global drive toward authorizing organized ending of life, with an increasing number of countries legalizing MAiD.[29] The medical system is generally seen as a safe and appropriate system to carry out MAiD, especially when suicide and self-harm are regarded as “alternatives.” Yet despite these worldwide efforts, many argue through the theory of utilitarianism that the inability to see long-term consequences renders MAiD a premature solution, particularly for those who are unable or unwilling to seek other forms of potentially healing treatment or for those who may undergo MAiD only for a technological innovation or biomedical advancement to later come along as a potential cure.[30] While it is true that MAiD does not prevent these “premature deaths,” it is also true that it does not claim to.[31] MAiD provides an option to alleviate intolerable suffering. Some individuals with severe mental illness do describe their condition as intolerable suffering. MAiD is seen as an option to minimize suffering. It can also be seen as a way to die with dignity and relief.[32] While predicting outcomes is difficult, extending MAiD eligibility for persons experiencing mental illness does not undermine its ability to end suffering. It allows eligible individuals to take charge of their health, their life, and their future. Conclusion Based on the current evidence, allowing MAiD for persons with mental illness as their sole underlying medical condition presents as an ethically justifiable action. The right to self-determination and fair accessibility demonstrates that there is more harm done by prohibiting MAiD for mental illness than allowing it. Such liberty is a right, and in the context of relieving suffering, it is a duty that healthcare workers must uphold, although the ability to opt out of providing MAiD is well established. Thus, to recognize vulnerability and relieve suffering means to provide methods, such as MAiD, for those deeply impacted by mental illness. These justifications stand at both the individual level and for society at large. Nevertheless, it remains imperative to take an upstream approach that addresses the social determinants of health and aims to prevent mental illness and promote long-term, beneficial social change for those suffering, struggling, and vulnerable in our communities. - [1] Jaro Kotalik and David W. Shannon, Medical Assistance in Dying (MAID) in Canada Key Multidisciplinary Perspectives, 1st ed. 2023., The International Library of Bioethics, 104 (Cham: Springer International Publishing, 2023), https://doi.org/10.1007/978-3-031-30002-8. [2] Department of Justice Government of Canada, “Canada’s Medical Assistance in Dying (MAID) Law,” February 21, 2024, https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html. [3] Health Canada, “Final Report of the Expert Panel on MAiD and Mental Illness,” transparency - other, May 13, 2022, https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advi sory-bodies/expert-panel-maid-mental-illness/final-report-expert-panel-maid-mental-illness.html. [4] Federal Public Service (FPS) Health Belgium, “Federal Commission for the Control and Evaluation of Euthanasia,” n.d., https://consultativebodies.health.belgium.be/en/advisory-and-consultative-bodies/federal-commission- control-and-evaluation-euthanasia.; Government of Netherlands, “Is Euthanasia Allowed in the Netherlands?,” n.d., https://www.government.nl/topics/euthanasia/is-euthanasia-allowed.; “Information on Requesting Euthanasia or Assisted Suicide,” n.d., https://guichet.public.lu/en/citoyens/sante/fin-vie/euthanasie/euthanasie-assistance-suicide.html. [5] Luis Espericueta, First official report on euthanasia in Spain: A comparison with the Canadian and New Zealand experiences, Medicina Clínica (English Edition), Volume 161, Issue 10, 2023, Pages 445-447, ISSN 2387-0206, https://doi.org/10.1016/j.medcle.2023.06.021. [6] Government of Canada, “The Canadian Charter of Rights and Freedoms,” March 15, 2021, https://www.justice.gc.ca/eng/csj-sjc/rfc-dlc/ccrf-ccdl/. [7] Supreme Court of Canada, “Carter v. Canada,” Constitutional Law, 2015, https://scc-csc.lexum.com/scc-csc/scc-csc/en/item/14637/index.do.; Kotalik and Shannon, Medical Assistance in Dying (MAID) in Canada Key Multidisciplinary Perspectives. [8] Karandeep Sonu Gaind, “What Does ‘Irremediability’ in Mental Illness Mean?,” Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie 65, no. 9 (September 2020): 604–6, https://doi.org/10.1177/0706743720928656; Lieve Thienpont et al., “Euthanasia Requests, Procedures and Outcomes for 100 Belgian Patients Suffering from Psychiatric Disorders: A Retrospective, Descriptive Study,” BMJ Open 5, no. 7 (July 27, 2015): e007454, https://doi.org/10.1136/bmjopen-2014-007454. [9] Hamer Bastidas-Bilbao et al., “Walking Alongside: Views of Family Members on Medical Assistance in Dying for Mental Illness as the Sole Underlying Medical Condition,” Qualitative Health Research 33 (September 29, 2023), https://doi.org/10.1177/10497323231197365. [10] Government of Canada, “Canada’s Medical Assistance in Dying (MAID) Law.” [11] Commission sur les soins de fin de vie, “Les conditions de l’admissibilité à l’aide médicale à mourir au Québec: la constance dans l’évolution de la loi concernant les soins de fin de vie,” June 9, 2023, https://csfv.gouv.qc.ca/ fileadmin/docs/autres_rapports/csfv_lcsfv_conditions_ amm_2023-06-29.pdf.; Trudo Lemmens, “When Death Becomes Therapy: Canada’s Troubling Normalization of Health Care Provider Ending of Life,” The American Journal of Bioethics 23, no. 11 (November 2, 2023): 79–84, https://doi.org/10.1080/15265161.2023.2265265. [12] Justine Dembo, Udo Schuklenk, and Jonathan Reggler, “‘For Their Own Good’: A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) Where Mental Illness Is the Sole Underlying Condition,” Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie 63, no. 7 (July 2018): 451–56, https://doi.org/10.1177/0706743718766055. [13] Konia Trouton et al., “Attitudes and Expectations Regarding Bereavement Support for Patients, Family Members, and Friends: Findings from a Survey of MAID Providers,” British Columbia Medical Journal 62, no. 1 (2020). [14] Bastidas-Bilbao et al., “Walking Alongside.” [15] Bastidas-Bilbao et al. [16] Trouton et al., “Attitudes and Expectations Regarding Bereavement Support for Patients, Family Members, and Friends: Findings from a Survey of MAID Providers,” 2020. [17] Ramona Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” Palliative & Supportive Care 21, no. 5 (October 2023): 871–78, https://doi.org/10.1017/S1478951523001025; Health Canada, “Third Annual Report on Medical Assistance in Dying in Canada 2021,” report on plans and priorities;transparency - other, July 26, 2022, https://www.canada.ca/en/health-canada/services/publications/health-system-services/annual-report-me dical-assistance-dying-2021.html; Lemmens, “When Death Becomes Therapy.” [18] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023.; Bastidas-Bilbao et al., “Walking Alongside.” [19] Olivia Stefanovich, “Opposition Parties Call for Indefinite Pause to MAID Expansion for Mental Illness | CBC News,” Canadian Broadcasting Corporation, January 28, 2024, https://www.cbc.ca/news/politics/special-joint-committee-maid-mental-illness-report-1.7095679; Benjamin Lopez Steven, “Number of Assisted Deaths Jumped More than 30 per Cent in 2022, Report Says | CBC News,” Canadian Broadcasting Corporation, October 27, 2023, https://www.cbc.ca/news/politics/maid-canada-report-2022-1.7009704. [20] Hamer Bastidas-Bilbao et al., “Searching for Relief from Suffering: A Patient-Oriented Qualitative Study on Medical Assistance in Dying for Mental Illness as the Sole Underlying Medical Condition,” Social Science & Medicine 331 (August 1, 2023): 116075, https://doi.org/10.1016/j.socscimed.2023.116075. [21] Canadian Medical Association, “Canadian Medical Association Code of Ethics and Professionalism” (Canada: Canadian Medical Association, December 8, 2018), https://policybase.cma.ca/link/policy13937. [22] Canadian Medical Association. [23] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023; Stefanovich, “Opposition Parties Call for Indefinite Pause to MAID Expansion for Mental Illness | CBC News.” [24] John Paul Tasker, “Liberal Government Promoting a ‘culture of Death’ with Medical Assistance in Dying Law, Conservative MP Says | CBC News,” Canadian Broadcasting Corporation, March 6, 2023, https://www.cbc.ca/news/politics/culture-of-death-medical-assistance-in-dying-mental-illness-1.67695 04. [25] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023; Kayla Wiebe and Amy Mullin, “Choosing Death in Unjust Conditions: Hope, Autonomy and Harm Reduction,” Journal of Medical Ethics, April 26, 2023, https://doi.org/10.1136/jme-2022-108871. [26] Ramona Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” Palliative & Supportive Care 21, no. 5 (October 2023): 871–78, https://doi.org/10.1017/S1478951523001025. [27] Konia Trouton et al., “Attitudes and Expectations Regarding Bereavement Support for Patients, Family Members, and Friends: Findings from a Survey of MAID Providers,” British Columbia Medical Journal 62, no. 1 (2020), https://bcmj.org/articles/attitudes-and-expectations-regarding-bereavement-support-patients-family-m embers-and.; William Robert Nielsen, “MAiD in Canada: Ethical Considerations in Medical Assistance in Dying,” Canadian Journal of Bioethics 4, no. 2 (December 9, 2021): 93–98, https://doi.org/10.7202/1084456ar. [28] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023. [29] Lemmens, “When Death Becomes Therapy.” [30] William Robert Nielsen, “MAiD in Canada: Ethical Considerations in Medical Assistance in Dying,” Canadian Journal of Bioethics 4, no. 2 (December 1, 2021): 93–98, https://doi.org/10.7202/1084456ar. [31] Steven, “Number of Assisted Deaths Jumped More than 30 per Cent in 2022, Report Says | CBC News.” [32] A. Plaisance et al., “Quebec Population Highly Supportive of Extending Medical Aid in Dying to Incapacitated Persons and People Suffering Only from a Mental Illness: Content Analysis of Attitudes and Representations,” Ethics, Medicine and Public Health 21 (April 1, 2022): 100759, https://doi.org/10.1016/j.jemep.2022.100759. (shrink)

The COVID-19 pandemic has been a threat to both physical and mental health. The spreading disease and its impacts, the containment measures and the way all of our lives have dramatically changed ha...

Burnout has been recognized as a serious health problem. In Portugal, before COVID-19 Pandemic, there were strong indicators of high prevalence of burnout in physicians and nurses. However, the Portuguese Health Care Service was able to efficiently respond to the increased demands. This study intends to understand how psychosocial variables might have been protective factors for burnout in physicians and nurses in Portugal. Specifically, we considered several psychosocial variables that have been found to be protective factors for burnout in previous (...) research and we compared their predictive and unique impact in the prediction of burnout. These variables are perceptions of justice (distributive, procedural, justice from colleagues, justice from patients, and their families), professional identification, meaningful work and empathy. We also included workload, as a risk factor, and controlled other variables that can be confounds for burnout, such as socio-demographic variables, ideological variables (religiosity, political orientation), and specific variables related with COVID-19 pandemic. The sample of the present study is composed by 229 physicians (aged between 23 and 70 years old,M= 36.54;SD= 10.72; 48% male and 52% female) and 268 nurses (aged between 22 and 69 years old,M= 34.96;SD= 9.52; 27% male and 73% female). An online survey was created using Qualtrics and participants were recruited via Facebook and LinkedIn. The data were collected during 29 days (between the 45th and the 74th days after the first diagnosed case of COVID-19 in Portugal). The results showed that workload was a significant risk factor, except for disengagement in physicians. The most consistent protectors across samples were procedural justice (for both dimensions of burnout, both in physicians and nurses) and professional identification (for disengagement, both in physicians and nurses; for exhaustion only in physicians). This study suggests that decreasing workload and promoting procedural justice and professional identification are key factors that might be simultaneously and independently addressed in interventions for reducing the risk of burnout or preventing it from occurring in the first place. (shrink)

The Luis Palau Mission to Auckland in 1987 attracted major criticism from four Anglican bishops. This centred on the question of the ability of a foreign evangelist to address the Gospel with prophetic relevance to the social situation in New Zealand. The actual response to the mission indicated that the problem of an America-oriented, male, foreign evangelist was not insuperable. The debate illustrated the age-old tension between the established Christianity of the system and the critique of the itinerant evangelist. (...) But the debate missed the important issues of the inclusion of Roman Catholic participation; the possibility of dissociating mass evangelism from North American evangelicalism; the Arminian insistence on human decision; how to preach an immanentist theology in an evangelistic style; the extent to which a guest evangelist can be a prophet in a host country; and the actual function of such crusades in encouraging the faithful rather than converting the unfaithful. (shrink)