Abstract The use of photo research methods is influenced by underlying ontological and epistemological assumptions. Variant assumptions about reality and knowledge converge to conceive a relationship between the knower and what can be known. These assumptions provide the rationale for decided ways of engaging participants in the process of scientific inquiry. In this paper, we examine how perspectives of realism and relativism may shape epistemological understandings and influence type and use of photo methods in qualitative research. (...) Based on deliberations about underlying ontological and epistemological assumptions and related strengths and challenges of photo methods, we assert that photo methods contribute to the development of knowledge that both matters to participants and informs nursing practice. (shrink)

ABSTRACT This photo-essay considers the other lives of family photographs by offering an analysis of my mother's collection of professional studio portraits and other vernacular photographs shot between the mid 1950s and late 1960s. How do we read the photo-archive of an 'Indian' woman born in 1941 to parents who were wards of the colonial state? A woman who was one generation removed from the sugar-cane plantations and coal mines where Indians were indentured as a coercive labour force? (...) Influenced by Santu Mofokeng's project The Black Photo Album and Tina Campt's method of 'listening to' rather than 'looking at' photos, I refigure the family photo-archive to produce The Brown Photo Album, which is an experiment in seeing and being seen. In a context where the institutional visual archives of colonialism and apartheid have trained South African publics to see and thus know the Indian in very specific ways, this article redirects us away from the violence of the visual to the relationship between race, aesthetics and affect. It positions the family photo album not only as an alternative archive of the Indian experience but also as an archive through which we can begin to comprehend the Indian experience otherwise. This project probes the making of Indianness in the Natal Midlands, shifting the lens from urban centres like Durban and Johannesburg. As a work in progress, I present The Brown Photo Album as an experiment, an iteration of a project, a praxis of refiguring family photos in order to understand what this archive can reveal about our past, presents and futures. (shrink)

Cette conversation raconte deux expériences de mise en capacité de jeunes quant à la connaissance de leur propre alimentation. La première se dénomme Sugar Killer, c’est une expérience artistique qui s’intègre dans une recherche scientifique et pédagogique. Recherche-action d’éducation alimentaire hybridant art, alimentation et transformation du territoire, elle peut se résumer par le sous-titre « quand les collégiens enquêtent sur leurs sucres ». La seconde s’inscrit dans une recherche menée auprès d’étudiants de l’université de Poitiers une année avant le Covid (...) (2019) et durant le Covid (2020). Elle a permis de comparer les mutations de ces pratiques en fonction de la situation familiale des étudiants. Les deux expériences s’appuient sur la méthode Selfood, qui consiste à faire prendre en photo les repas d’une personne sur plusieurs jours consécutifs, pour constituer une forme d’autoportrait alimentaire. Les paysages alimentaires récoltés sont le support d’une réflexion plus large sur le fonctionnement des systèmes agro-alimentaires, sur les choix et pratiques alimentaires des participant·es, et leurs effets sur la santé et l’environnement. (shrink)

Providing good home-based care to people with dementia is becoming an important issue as the size of the elderly population increases. One of the main problems in providing such care is that it must be constantly provided without interruption, and this puts a great burden on caregivers, who are often family members. Networked Interaction Therapy is the name we call our methods designed to relieve the stress of people suffering from dementia as well as that of their family members. (...) This therapy aims to provide a system that interacts with people with dementia by utilizing various engaging stimuli. One such stimulus is a reminiscence video created from old photo albums, which is a promising way to hold a dementia sufferer's attention for a long time. In this paper, we present an authoring tool to assist in the production of a reminiscence video by using photo annotations. We conducted interviews with several video creators on how they used photo annotations such as date, title and subject of photos when they produced the reminiscence videos. According to the creators' comments, we have defined an ontology for representing the creators' knowledge of how to add visual effects to a reminiscence video. Subsequently, we developed an authoring tool that automatically produces a reminiscence video from the annotated photos. Subjective evaluation of the quality of reminiscence videos produced with our tool indicates that they give impressions similar to those produced by creators using conventional video editing software. The effectiveness of presenting such a video to people with dementia is also discussed. (shrink)

Photo ID 72893750 © Rawpixelimages|Dreamstime.com ABSTRACT Solidarity is a concept increasingly employed in bioethics whose application merits further clarity and explanation. Given how vital cooperation and community-level care are to mitigating communicable disease transmission, we use lessons from the COVID-19 pandemic to reveal how solidarity is a useful descriptive and analytical tool for public health scholars, practitioners, and policymakers. Drawing upon an influential framework of solidarity that highlights how solidarity arises from the ground up, we reveal how structural forces (...) can impact the cultivation of solidarity from the top down, particularly through ensuring robust access to important social determinants of health. Public health institutions can support solidarity movements among individuals and communities by adopting a lens of social justice when considering public health priorities and, in turn, promote health equity. INTRODUCTION Over the past two decades, scholars have invoked the concept of solidarity when assessing a wide range of topics in bioethics, from CRISPR-Cas9 technology to organ donation to structural racism.[1] However, the growing literature on solidarity has not fully examined the roles and responsibilities of institutions and governments in fostering solidarity, especially regarding public health measures that implicate entire populations. We argue that it remains unclear how public health institutions should engage with solidarity and how their engagement will affect public health and its ethics. We first take Prainsack and Buyx’ three-tiered framework as an analytical starting point.[2] We then explore how public health institutions can foster solidarity by carefully considering factors that may bolster it on an interpersonal, community, and national scale. We conclude that public health institutions should adopt a lens of social justice to promote solidarity at the interpersonal and community levels, thereby promoting equity in future public health efforts. BACKGROUND Calls for solidarity in bioethics raise longstanding normative questions about the nature and limits of our duties to one another and how to weigh autonomy over considerations of justice.[3] Though the term is diversely applied, Prainsack and Buyx propose a potentially unifying definition in the 2011 Nuffield Council report, “Solidarity: Reflections On An Emerging Concept in Bioethics.” The report defines solidarity as an activity involving “shared practices reflecting a collective commitment to carry financial, social, emotional, and or other ‘costs’ to assist others.” Their conceptualization also includes important features that distinguish solidarity from other values like empathy or altruism: solidarity emphasizes action rather than mere internal feeling and recognition of connection as motivation.[4] Bioethicists have since applied this conceptualization when analyzing issues in public and global health, given that population-level efforts need cooperation from individuals and communities. Prainsack and Buyx further note that solidarity is relevant in bioethics discourses about justice and equity, in support of providing aid to low- and middle-income countries, and as a value exemplified by European welfare states.[5] Other bioethicists have argued that promoting solidarity can contribute to community engagement, partnership with Tribal communities, and global health equity.[6] Most recently, scholars have applied solidarity as a lens to assess the COVID-19 pandemic, highlighting the pitfalls of national mitigation efforts and global disparities in disease outcomes.[7] I. Solidarity at Three Levels It seems impossible to foster solidarity in public health if we cannot identify it in general contexts. Prainsack and Buyx articulate three levels of solidarity: interpersonal solidarity, group solidarity, and legal or contractual codifications of solidarity.[8] They argue that each level inherently informs the one ‘above’ it in a unilateral direction. In other words, solidarity is fundamentally a bottom-up phenomenon. Solidarity among individuals influences group norms, which then have the potential to shape policy and institutional practice.[9] Within the Prainsack and Buyx framework, it would seem nonsensical to posit how solidarity might be expressed vertically or from the “top down.” It appears intuitively odd to imagine how a government entity might ‘be’ in solidarity with a person or group if solidarity requires some cognition about their condition per Prainsack and Buyx’ definition. Some have argued that solidarity does not seem like something that one can impose, as instances of it arise from agents recognizing and acting upon some bond rather than in response to a command. Indeed, people may be rightfully hesitant to engage in solidarity if the official messaging is overly paternalistic or coercive.[10] However, some authors have countered that governments can express solidarity through enacting structural and policy changes, though it is ambiguous how these actions are distinct from a justice-driven approach.[11] If a bottom-up approach is thus the most practical means of achieving policy that reflects solidarity, then it does not add much to public health. Institutions would be ineffective without the population’s initiation of the corresponding social norms. However, we find this conclusion overly pessimistic. Fostering a culture of solidarity to improve public health has potential merit. Prainsack and Buyx’ framework overlooks how public health actors can influence solidarity between individuals and across communities. To clarify, we agree with the view that solidarity is a bottom-up phenomenon. Solidarity may not be able to originate in a top-down fashion, but we suggest that public health institutions can take a more active role in providing the public with accurate information, promoting social justice, and intervening in the social determinants of health. II. The COVID-19 Pandemic as a Case Study Lessons learned from the ongoing COVID-19 pandemic support our argument. The pandemic deepened socioeconomic disparities in the US and hindered access to vital resources such as food, housing, and healthcare.[12] Prainsack recently noted: “[n]ext to the immediate health effects of the virus, poverty and grave inequalities have been the root causes of human suffering during the pandemic.”[13] Prior to the pandemic, many rural and low-income populations lacked reliable access to the internet and devices like laptops or smartphones. This continued lack of access restricts the flow of information and prevents people from accessing telemedicine services.[14] Preexisting social, political, and health inequities worsened health outcomes among many marginalized racial and ethnic groups. It is well-documented that communities of color, including Black, American Indian or Alaska Native, and Latinx populations, had greater COVID-related mortality and morbidity due to the effects of structural racism.[15] Although federal US agencies such as the Centers for Disease Control and Prevention enacted laws that provided safety nets (e.g., the Federal Eviction Moratorium), the majority of such programs have ended, leaving many with little assistance and the threat of further hardship.[16] These disparities are relevant because Prainsack, Buyx, and others note that solidarity arises from agents recognizing and acting on some perceived attainable collective goal(s). Income inequality and disparate access to food, education, and health care may lead people to consider public health goals unattainable. This could limit the desire to work toward those goals collectively.[17] The existing literature on collective action theory supports this intuition. It emphasizes that structural conditions, such as an absence of perceived hope for social change among a group, can lead to low ‘group efficacy’ and little willingness to cooperate, both within and across socioeconomic strata.[18] The pandemic spurred countless messages from public health agencies. The messaging did not recognize or attend to the different material realities and circumstances of the US population. How can people feel comfortable getting vaccinated if they deeply distrust the government, including public health institutions? How can people remain motivated to wear masks and distance themselves if they cannot afford basic necessities and work jobs without adequate pay and leave policies? We ask these questions to illustrate how socioeconomic disparities can marginalize people if they feel ignored, apathetic, or resentful of those better off or those in power whom they perceive to “not be doing enough.” This marginalization precludes the formation of solidarity. There are instances when a population has disparate access to resources and social capital, but solidarity may still emerge from a shared goal or vision for the future. For example, a heterogeneous population living in the same town may come together to protest an environmental injustice that impacts their water supply with the common goal of securing access to safe drinking water. However, many populations in the US failed to recognize shared goals of this kind during the COVID-19 pandemic. A significant minority of the US population was reluctant to acknowledge the severity of COVID-19 infection and thus refused to participate in efforts to mitigate its spread. Even between groups who shared the goal of slowing COVID-19 transmission, the methods were widely debated. Approximately 20 percent of the adult population eligible for vaccination remains unvaccinated.[19] Governmental bodies responsible for disseminating information, coordinating the allocation of resources, and establishing guidelines have a large role in mediating these disagreements and intervening in socioeconomic conditions that impact people's ability and willingness to engage in solidarity. III. Solidarity, Social Justice, and the Role of Public Health Institutions Adopting a lens of social justice provides further insights into how public health actors impact solidarity. Powers and Faden argue that the “foundational moral justification for the social institution of public health is social justice.”[20] Their theory of social justice has two aims. First, it ensures that everyone has a sufficient amount of the six core elements of well-being and that public health institutions are responsible for “adopting policies and creating environments” where all can flourish.[21] Second, public health institutions should distribute resources meant to promote well-being and focus on the “needs of those who are the most disadvantaged.”[22] Public health institutions should enact policies that address injustice. In doing so, public health institutions can seed the opportunity to build solidarity from the bottom up. Equipping individuals and communities with resources will foster cooperation and adherence to policies that require solidarity, such as masking and vaccination. This is consistent with arguments illustrating how institutions such as Tribal governments promote the conditions needed for their group, and especially its most vulnerable members, to flourish.[23] Addressing social determinants of health with a social justice lens will create the circumstances under which more individuals and groups can find common causes and foster solidarity. In the long run, such efforts may result in the establishment of values and practices from the bottom up. There are societal and public health preconditions required before institutions can expect their audience to act in solidarity with one another. Through their great influence over information and resources, public institutions do have the power to impact what values are most widespread. Furthermore, public health may foster trust and hope, which are important psychosocial factors that influence collective action,[24] if policies increase access to resources that promote well-being. Messaging efficacy also depends on the context of public trust, education, and whether the institutions meet one’s basic needs. Disparate messaging across different public institutions may confuse or disillusion individuals. To apply our theory of solidarity to the decision to vaccinate, a policy would be to foster conditions that facilitate access to vaccines and information about vaccine efficacy instead of imposing a top-down mandate without first eliciting public trust. IV. Counterargument Some argue that discordant public health messaging, ineffective government, and inadequate social programs can also bring people together under pressure and foster solidarity. One may argue that the most powerful motivators towards solidarity are strife and disparity, as evidenced throughout history. During the pandemic alone, political struggle and personal hardship inspired solidarity in the US, from individual neighbors helping each other to mutual aid groups forming across communities. We thus do not claim that solidarity is possible only when our government programs and public health institutions are most effective. We instead point out that solidarity can be further hindered when people feel alienated, hopeless, and pitted against each other. CONCLUSION Many competing conceptualizations of solidarity persist in the bioethics literature, and Prainsack and Buyx offer one compelling framework that public health ethicists continue to draw upon.[25] However, their framework fails to acknowledge how public health institutions impact interpersonal and group solidarity. Public health institutions can foster solidarity through actions other than mere messaging, invoking catchphrases like “we are all in this together.” Efforts to address socioeconomic preconditions and alleviate health disparities can cultivate group solidarity. As we saw during the pandemic, cooperation and solidarity go hand-in-hand with disease mitigation efforts; solidarity has clear intrinsic value.[26] As this relationship becomes more apparent, we will continue to see attempts from public health institutions to foster or invoke solidarity. Therefore, public health institutions would be remiss to ignore their role in addressing the social determinants of health. Adopting a social justice lens when planning public health interventions will clarify and strengthen their role in facilitating solidarity. Ultimately, if health disparities continue to persist or widen, it is very hard to imagine how group solidarity can ever be achieved. The widescale adoption of many public health measures needed to promote health and well-being would be conducive to solidarity. - Disclaimer: The opinions expressed are the authors’ and do not represent the views of the NIH, DHHS, or the U.S. government. Funding Disclosure: This work was supported in part by the Intramural Program of the National Institutes of Health Clinical Center. - [1] John J Mulvihill et al., “Ethical Issues of CRISPR Technology and Gene Editing through the Lens of Solidarity,” British Medical Bulletin 122 (2017): 17–29, https://doi.org/10.1093/bmb/ldx002; Ben Saunders, “Altruism or Solidarity? The Motives for Organ Donation and Two Proposals,” Bioethics 26, no. 7 (September 2012): 376–81, https://doi.org/10.1111/j.1467-8519.2012.01989.x; -Vanessa Y Hiratsuka, “SPECIAL REPORT: A Critical Moment in Bioethics: Reckoning with Anti-Black Racism through Intergenerational Dialogue A Call for Solidarity in Bioethics: Confronting Anti-Black Racism Together,” 2022, https://doi.org/10.1002/hast.1380. [2] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [3] Bob Simpson, “A ‘We’ Problem for Bioethics and the Social Sciences: A Response to Barbara Prainsack,” Science, Technology, & Human Values 43, no. 1 (January 12, 2018): 45–55, https://doi.org/10.1177/0162243917735899. [4] Barbara Prainsack and Alena Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics (London: Nuffield Council on Bioethics, 2011). [5] Barbara Prainsack and Alena Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach,” Bioethics 26, no. 7 (September 2012): 343–50, https://doi.org/10.1111/J.1467-8519.2012.01987.X. [6] Bridget Pratt, Phaik Yeong Cheah, and Vicki Marsh, “Solidarity and Community Engagement in Global Health Research,” The American Journal of Bioethics : AJOB 20, no. 5 (May 3, 2020): 43–56, https://doi.org/10.1080/15265161.2020.1745930; Sara Chandros Hull, F. Leah Nez (Diné), and Juliana M. Blome, “Solidarity as an Aspirational Basis for Partnership with Tribal Communities,” The American Journal of Bioethics 21, no. 10 (October 3, 2021): 14–17, https://doi.org/10.1080/15265161.2021.1965258; Mbih J. Tosam et al., “Global Health Inequalities and the Need for Solidarity: A View from the Global South,” Developing World Bioethics 18, no. 3 (September 1, 2018): 241–49, https://doi.org/10.1111/DEWB.12182. [7] Peter West-Oram, “Solidarity Is for Other People: Identifying Derelictions of Solidarity in Responses to COVID-19,” Journal of Medical Ethics 47, no. 2 (February 1, 2021): 65–68, https://doi.org/10.1136/MEDETHICS-2020-106522; Barbara Prainsack, “Solidarity in Times of Pandemics,” Democratic Theory 7, no. 2 (December 1, 2020): 124–33, https://doi.org/10.3167/DT.2020.070215; F. Marijn Stok et al., “Social Inequality and Solidarity in Times of COVID-19,” International Journal of Environmental Research and Public Health 18, no. 12 (June 2, 2021), https://doi.org/10.3390/IJERPH18126339; Ming Jui Yeh, “Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics,” American Journal of Public Health 112, no. 2 (February 1, 2022): 255–61, https://doi.org/10.2105/AJPH.2021.306578; Barbara Prainsack, “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.,” Am J Public Health 112, no. 2 (February 1, 2022): 232–33, https://doi.org/10.2105/AJPH.2021.306619. [8] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [9] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics London: Nuffield Council on Bioethics, 2011; Prainsack and Buyx, “Solidarity in Contemporary Bioethics--towards a New Approach.” Bioethics 26, no. 7 (September 2012): 343–50. https://doi.org/10.1111/J.1467-8519.2012.01987.X. [10] Yeh, “Solidarity in Pandemics, Mandatory Vaccination, and Public Health Ethics”; Prainsack, “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.” [11] Ho, Anita, and Iulia Dascalu. "Relational solidarity and COVID-19: an ethical approach to disrupt the global health disparity pathway." Global Bioethics 32, no. 1 (2021): 34-50; West-Oram, Peter. "Solidarity is for other people: identifying derelictions of solidarity in responses to COVID-19." Journal of Medical Ethics 47, no. 2 (2021): 65-68. [12] Monica Webb Hooper, Anna María Nápoles, and Eliseo J. Pérez-Stable, “COVID-19 and Racial/Ethnic Disparities,” JAMA 323, no. 24 (June 23, 2020): 2466, https://doi.org/10.1001/jama.2020.8598. [13] Prainsack, Barbara. “Beyond Vaccination Mandates: Solidarity and Freedom During COVID-19.” Am J Public Health 112, no. 2 (February 1, 2022): 232–33. https://doi.org/10.2105/AJPH.2021.306619. [14] Camille A Clare, “Telehealth and the Digital Divide as a Social Determinant of Health during the COVID-19 Pandemic,” Network Modeling Analysis in Health Informatics and Bioinformatics 10 (2021): 26, https://doi.org/10.1007/s13721-021-00300-y. [15] Patrick Nana-Sinkam et al., “Health Disparities and Equity in the Era of COVID-19,” Journal of Clinical and Translational Science 5, no. 1 (March 16, 2021): e99, https://doi.org/10.1017/cts.2021.23. [16] Kathryn M Leifheit et al., “Expiring Eviction Moratoriums and COVID-19 Incidence and Mortality,” American Journal of Epidemiology 190, no. 12 (December 1, 2021): 2503–10, https://doi.org/10.1093/aje/kwab196. [17] Barbara Prainsack, “Solidarity in Times of Pandemics,” Democratic Theory 7, no. 2 (December 1, 2020): 124–33, https://doi.org/10.3167/DT.2020.070215 [18] Maximilian Agostini and Martijn van Zomeren, “Toward a Comprehensive and Potentially Cross-Cultural Model of Why People Engage in Collective Action: A Quantitative Research Synthesis of Four Motivations and Structural Constraints.,” Psychological Bulletin 147, no. 7 (July 2021): 667–700, https://doi.org/10.1037/bul0000256. [19] Department of Health and Human Services (HHS) Centers for Disease Control and Prevention (HHS/CDC), “COVID Data Tracker,” 2023, https://covid.cdc.gov/covid-data-tracker. [20] Powers, Madison, and Ruth Faden. Social Justice: The Moral Foundation of Public Health and Health Policy. 1st editio. New York: Oxford Press, 2006, p. 9 and Chapter 4 [21] Powers and Faden, Social Justice: The Moral Foundation of Public Health and Health Policy; Madison Powers and Ruth Faden, Structural Injustice: Power, Advantage, and Human Rights (New York: Oxford University Press, 2019). [22] Powers, Madison, and Ruth Faden. Social Justice: The Moral Foundation of Public Health and Health Policy. 1st editio. New York: Oxford Press, 2006, p. 10 [23] Bobby Saunkeah et al., “Extending Research Protections to Tribal Communities,” The American Journal of Bioethics 21, no. 10 (October 3, 2021): 5–12, https://doi.org/10.1080/15265161.2020.1865477. [24] Agostini and van Zomeren, “Toward a Comprehensive and Potentially Cross-Cultural Model of Why People Engage in Collective Action: A Quantitative Research Synthesis of Four Motivations and Structural Constraints.” [25] Prainsack and Buyx, Solidarity: Reflections on an Emerging Concept in Bioethics. [26] Ruth Chadwick, “COVID‐19 and the Possibility of Solidarity,” Bioethics 34, no. 7 (September 8, 2020): 637–637, https://doi.org/10.1111/bioe.12813. (shrink)

Photo by Thought Catalog on Unsplash INTRODUCTION The coronavirus pandemic is a challenge to educators, policy makers, and ordinary people. In facing the threat from COVID-19, school systems and global institutions need “to address the essential matter of each human being and how they are interacting with, and affected by, a much wider set of biological and technical conditions.”[1] Educators must grapple with the societal issues that come with the intent of ensuring the safety of the public. To some, (...) “these are actually as important as the biological concerns of people.”[2] The current global crisis shows that “scientifically, socially, and politically the economy and technosphere are not just related, they are integral to a comprehensive response to major challenges.”[3] In developing these responses, scientists, government leaders, and policy makers need to consider the vulnerabilities of people, especially those in “thrown away” groups.[4] Jerome Ravetz explains that “microscopic viral predators cull our populations, as ever, but with a selection that is not natural but social and political.”[5] Educators must address the underlying vulnerabilities and evaluate the virus as a threat to academic experiences and access to a fair education. ANALYSIS • Critical Pedagogy By definition, the critical approach to teaching is about the problem-posing method of education developed by Paolo Freire. In his Pedagogy of the Oppressed, he proposed a paradigm shift away from the banking method of learning wherein teachers deposit knowledge into the minds of students. Critical pedagogy is an educational approach that challenges students to develop the ability to recognize and criticize dominating theories and evaluate them in their social context. Teachers press students to recognize oppression and try to remedy oppression in their culture.[6] Despite the lack of in-person interaction between the teacher and the students, the effort to use innovative teaching techniques like critical pedagogy should continue. Online learning is not just about the use of technology, although the internet is crucial in the delivery of content. Since human beings are creators of value, they determine the meaning and purpose of technology. In this way, the set of values people have will influence online learning. Teachers cannot be more concerned about outcomes than about the process itself. The process is crucial since the ability of the student to think critically is developed in the exchange between the student and the teacher. The teacher cannot simply dump loads of information (deposit knowledge) but must pose problems to test the analytical and critical skills of students.[7] Education is about how people humanize the world. Policy makers miss the point when they focus on the delivery but do not pay attention to the substantive aspect of learning, which is human empowerment. Education is meant to expand the freedom of people. Education should be seen as an integrative activity. Learning is a formative process that aims to develop the human person. Without the face-to-face encounter between teacher and students, the challenge is finding ways to make learning an effective means to mold the values of young people. • Online Critical Pedagogy & the Role of Technology Physical distance appears to be an impediment in realizing the ideals of learning. The lack of contact between the teacher and the students may prevent a more meaningful interaction since online instruction is impersonal. It can be argued that there is no alternative to some classroom activities, especially laboratory experiments in science courses. The total classroom environment naturally influences the behavior of students when it comes to academic work: the look in the eyes of the professor, the caring ways of a teacher, or the pressure while taking exams contribute to an experience that only a classroom setting can provide. If implemented properly, technology can facilitate the personal relationships between teachers and students while providing meaningful experiences. With the current need for online learning during the COVID-19 pandemic, gadgets are indispensable. Some would even consider gadgets an extension of the human body. A mobile phone is not just any instrument; it has evolved into a novel way of being in the world. Our gadgets are a means of seeing how the outside world unfolds. Modern technological tools allow the interface of people in many fields of experience in a globalized environment. Computers and other digital devices extend the meaning and value of human freedom. For example, a laptop provided to a poor child can redefine the meaning of and what the future might hold for that child. The device is crucial to the whole learning process. Modern tools are critical to self-discovery and greater freedom. The values that people embrace will matter in the new normal. The internet has provided a new democratic space that empowers groups and individuals to express themselves and to understand the world.[8] In an online class, students and teachers alike need to analyze big picture questions and layers of information. For example, the student in an ethics or philosophy class can reflect on the realities of life. With the proper guidance, online education should help define the meaning of moral commitment and human responsibility. CONCLUSION Before the pandemic, policy makers had been pursuing the goals of a globalized economy. They had been fashioning and promoting programs that cater to the interests of a consumer-driven world that has deprived the poor of opportunity. When the pandemic struck, globalization suddenly came to a halt and people realized the things that truly matter in life – family, love, and life itself. The new normal must now emphasize the role of education as a source of inner strength that can empower the person to live well reinforcing values based on a social consciousness. Critical pedagogy is possible under the new normal. The distance between the teacher and student does not make the educational process less real and in the absence of a vaccine, online learning is the safest strategy. Governments cannot freeze an entire school year since education is the only way out from poverty for millions. The COVID-19 pandemic provides a reason to re-imagine teaching using technology to encourage all students to question systems of oppression or greed, as the persistent pursuit of the truth is what education is all about. [1] Hartsell, Layne, Krabbe, Alexander, & Pastreich, Emmanuel. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene.” Social Ethics Society Journal of Applied Philosophy 6, no. 2 (2020), 3. [2] Ravetz, Jerome. “Science for a Proper Recovery: Post-Normal, not New Normal.” Issues in Science and Technology [Internet] July 15, 2020. https://issues.org/post-normal-science-for-pandemic-recovery/ [3] Hartsell, et al. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene,” 6. [4] Ravetz, “Science for a Proper Recovery: Post-Normal, not New Normal.” [5] Ibid. [6] Freire, Paolo. Pedagogy of the Oppressed. (New York: Continuum Books, 1993). [7] Freire writes that in such a situation “instead of communicating, the teacher issues communiqués and makes deposits which the students patiently receive, memorize, and repeat.” See his Pedagogy of the Oppressed. [8] Bakardjieva, Maria. Internet Society. (London: Sage Publications, 2005). (shrink)

Photo ID 279661800 © Sidewaypics|Dreamstime.com ABSTRACT Decolonization is complex, vast, and the subject of an ongoing academic debate. While the many efforts to decolonize or dismantle the vestiges of colonialism that remain are laudable, they can also reinforce what they seek to end. For decolonization to be impactful, it must be done with epistemic and cultural humility, requiring decolonial scholars, project leaders, and well-meaning people to be more sensitive to those impacted by colonization and not regularly included in the (...) discourse. INTRODUCTION Decolonization is complex. To successfully achieve decolonization, projects should incorporate the voices of those subjugated or silenced. Including such voices requires sincerely exploring who has been affected by colonialism or neocolonialism and how, as well as cultural sensitivity. In its basic use, decolonization refers to countries under colonial rule gaining independence or freedom from forms of subjugation. Additionally, scholars use the term to refer to efforts to dismantle neocolonialism and vestiges of colonialism. The process includes de-silencing subjugated voices.[1] I use decolonization in the latter way to refer to countries with technical independence. While arguably colonization ended formally with independence from colonizing powers, neocolonialism is the indirect, informal, and sometimes subtle control of the people, their economy, and political life despite formal independence from colonizing authorities. I conceptualize neocolonialism as a system that involves direct and involuntary control of another’s political, economic, or social life, impacting their worldview and ways of encountering the world. Decolonization may target actions, places, or systems like health care or AI to overcome the ills of colonialism and neocolonialism. It also may target knowledge and require rethinking how people develop their knowledge base. For example, if people grew up seeing an outside colonizer as superior, they would need to change their knowledge of superiority. Decolonization may target power, for example, changing who owns and distributes COVID-19 vaccines and who distributors exclude in the distribution of vaccines. Decolonization could require looking at those disempowered in the distribution process. Additionally, decolonization may target autonomy of persons by freeing people, ensuring human and individual rights, and respecting cultural traditions. Decolonization projects that try to de-silence by including the voices of those affected by colonialism and neocolonialism must examine inclusiveness in the context of the culture of the subrogated individuals. Examples of decolonization projects include making datasets inclusive of diverse peoples and places, returning to traditional food and eating practices, making sure hospitals in developing countries are led by locals and respectful of cultural traditions, returning unethically obtained artefacts or objects. Another project would be laying the groundwork for equality in formerly colonized countries to ensure that business ownership, education, and financial success will flow fairly to those previously victimized by colonization. Summarily, there are many strategies for decolonizing. However, it is worth asking whether the strategies have risks that undermine the goal of decolonization. I. Understanding Decolonization Discourses Many fields, from AI to politics, economics, health care, aviation, and academia, discuss decolonization. The content of the discourse on decolonization depends on the region and field discussing it. Rather than just reporting on decolonization, the discussions may be calls to action. For example, decolonization discourses reflect activism for cognitive justice, such as equal consideration of Indian or African knowledge systems in global health discourses.[2] In politics and political science, some scholars frame decolonization as an anti-western, anti-colonial movement by Africans to emancipate Africa/ns from subjugation or shift the continent to postcolonialism and post-neo-colonialism. This framing walls off non-African participants and may undermine their capacity to benefit the conversation.[3] There are other political scientists who actively support decolonization and see it as a field of activism in support of anyone and countries where colonization harmed people and development.[4] The point is that two ways of conceptualizing decolonization in politics and political science are discernible. One conceptualization is less inclusive since it alienates scholars and professionals from Western, high-income, or developed countries. The other is more inclusive. In humanitarian studies, including philosophy, some decolonization articles and conversations are efforts to end the destructive force of colonization. They focus on either the form, such as ecocide, genocide, and many others, or the geographic location, such as Africa, Asia, Latin America, and Oceania.[5] Finally, the feelings one brings into this conversation can adversely impact how one engages in them and who they listen to or are willing to hear from. For example, anger, rage, bitterness, and hatred are emotions that are not uncommon in spaces of decolonization conversations. Decolonization conversations that originate from a place of negativity risk deepening the psychological state of victimhood and prevent people from disrupting constructively or critically engaging in the conversation.[6] II. Understanding Decolonization Strategies Decolonization strategies mainly aim to de-silence victims of domination or subjugation. People have proposed many strategies for decolonizing. These strategies may be informed by what the target is for decolonization. Decolonization can target power relations in global health. For example, during the COVID-19 pandemic, public health organizations noted the power imbalance in vaccine distribution. Decolonization could involve de-silencing those affected by neocolonialism to bring about a more balanced distribution of power and a more fair distribution of the vaccine. By analyzing who was adversely impacted by the distribution and who ought to wield power, those engaged in decolonizing advocated for positive change and equitable power relations. Equally, when being is the target of decolonization, the language of unlearning or relearning and mental decolonization take centre stage in the decolonization discourse. For example, the quest to decolonize colonized minds aims to demythologize African inferiority and Western superiority. Demythologizing African inferiority enables those engaged in the decolonization discourse to cultivate and foster African agency.[7] Finally, when knowledge production is the target of decolonization, scholars use inclusion and cognitive justice. For example, they try to alter the knowledge that underlies global health ethics.[8] “[D]decolonizing researchers aim to respectfully understand and integrate theory from Other(ed) perspectives, while also critically examining the underlying assumptions that inform their Western research framework.”[9] One common strategy that scholars use in decolonization is inclusion. It is worth asking, does including people who have been subrogated foster decolonization? Whether that is effective depends on whether included people are more heard or whether the strategies to include them create new forms of silencing. III. Inclusion and the Quest to Decolonize Evaluating how effective inclusion is in the quest to de-silence subjugated voices is important. First, inclusive strategies are not neutral. They are epistemically situated. This situatedness constrains meaning-making in different ways: how and what questions are asked, how social roles are constructed, organized or assigned, and who is admitted to the room where these conversations occur.[10] Inclusion strategies may reinforce (unchallenged) assumptions. For example, to address prejudices and stereotypes in global health images, Arsenii Alenichev and his colleagues[11] successfully inverted “one stereotypical global health image” by prompting a generative AI to produce “an image of a traditional Indian or African healer healing a White Child.” Although there were some problems with the image of the White child, this innovation is a significant, useful effort to de-embed or strip global health images of problematic pictures that mythologize White superiority and Black inferiority. Yet it is possible that using categories like traditional Indian or African reinforces unchallenged assumptions, raising key questions regarding how language and words create new stereotypes. It is common to define traditional as non-conventional, unorthodox, and informal. Yet studies continue to reveal that non-scientifically appraised healing approaches in India or Africa are not only effective but also real, meaningful, fundamental, and primary care-seeking behaviours in many communities in these regions.[12] Suppose inclusive strategies are not un-situated. These conversations may be had within the structures, language, and spaces built by or connected to colonialism. The spaces, language, places, and structures in which these conversations occur can limit who can participate and how they participate. Importantly, some conditions are not conducive to participation as equals. The allocated time for the discussion could also constrain how individuals express themselves. It is unclear who is ultimately heard. Furthermore, epistemic situatedness of inclusion can impact decolonization conversations when participants are beneficiaries of, products of, and trained by structures and systems they seek to dismantle. To enhance the decolonization project and its goals, a pressing task is to unveil and question how the circumstances may inhibit activism. If the vestiges of colonialism continue to structure the decolonization discourse invisibly, the vestiges may undermine decolonization. For example, a public health discussion that includes white Western doctors and Western pharmaceutical executives in Africa may have many local Africans at the table but could still effectively devalue their input based on built-in assumptions and biases that are vestiges of colonialism. Second, exclusion and inclusion are also not binary. Individuals may experience exclusion, even while included (the phenomenon called internal exclusion). In other words, inclusion can fail to be substantial or become a means of enhancing optics, “a way of (un)consciously weakening the radical claims being pursued.”[13] For example, in South Africa, many institutions have made significant efforts to diversify their faculties due to the promulgation of the Employment Equity Act 55.[14] The act requires South African institutions to implement employment equity that redresses the history of harmful discrimination in the country. The act further requires transforming departments and institutional administrations. Although many recognize and support the need to transform departments in South Africa, the rhetoric of transformation departs sharply from the lived experiences.[15] This misalignment between the plan and practice is evident in the underrepresentation of black people and females in senior management teams, professorships in many universities and health departments, and positions of power in some South African institutions. Those selected in the transformation of the departments have also complained of being overworked. The burden of extra work undermines their ability to develop agency and voice in the space they now occupy or fulfil key requirements that have implications for their career trajectory.[16] This is called the minority tax. Notably, "the minority tax… is the burden of extra responsibilities [placed] on faculty of colour to achieve diversity and inclusion and contributes to attrition and impedes academic promotion."[17] One challenge for decolonializing projects will be for decolonial scholars and those selected for decolonization objectives to have the humility to decline invitations, requests, roles, and platforms for which they are either unqualified or lack the capacity to fulfil. At its heart, decolonization strategies must empower those included rather than weaken them. Finally, inclusion can lead to a phenomenon known as elite capture.[18] Elite capture occurs when socially advantaged individuals in a group monopolize or exploit activism to their own benefit at the expense of the larger, struggling group. Elite capture weakens decolonization efforts from within, revealing that those likely to benefit from global inclusive efforts are those who fulfil globally constructed standards, those “already present in the room.” There is no better strategy to weaken decolonial movements than weakening the project from within by strategically positioning individuals who share physical properties with the victims of exclusion and silencing but intellectually, behaviourally, psychologically, and emotionally share more common ground with the colonizer. Such insiders may be unaware they are furthering neocolonial conditions rather than decolonizing. In relation to decolonization, particularly in global health, elite capture reveals that those whose voices are loudest in the room are not necessarily those more impacted by colonialism. They may benefit more from reinforcing colonialism. Opportunism weakens meaningful activism from within, preventing good initiatives and strategies from having their intended impact or taking substantive root.[19] This paper cannot do justice to elite capture, but it is worth noting its negative impacts. IV. Improving the Impact of Decolonization To end neo-colonialism, it is important to understand how it manifests and what to do at each level. Beyond the academic discourse, many tangible efforts exist to decolonize through de-silencing. Examples of these efforts include the ME2 movement that seeks to centre the concerns and experiences of sexually abused or harassed victims in the public discourse. At the funding level, many grant-awarding agencies like Wellcome Trust have dedicated huge budgets to studies that help them understand how they may have perpetrated colonialism or neocolonialism and what they can do differently going forward.[20] In South Africa, promulgating the Employment Equity Act 55 was a tangible attempt to entrench decolonization concerns in a country's regulatory framework. Yet, these decolonization efforts could fail to be substantive if they do not reflect cultural sensitivity. Two key components of cultural sensitivity are worth highlighting here: epistemic and cultural humility. Epistemic humility is an intellectual virtue described as knowing one’s limitations and the limitations of the learning methods employed. At its simplest, it is the ability to admit when one is wrong. Cultural humility includes genuine attempts to learn about and embrace other cultures. Epistemic and cultural humility are signs of academic excellence and strength. Epistemic and cultural humility seriously acknowledge how the state of our knowledge, cognitive limitations, experiences, and backgrounds, while constraining us, also invite us to listen, learn, grow, and change. The limitations-owing account of epistemic and cultural humility suggests that “a person who is aware of her cognitive limitations and owns them is much better positioned to achieve such epistemic goods as true beliefs and understanding than someone who… simply has insight into the epistemic status of her beliefs.”[21] Epistemic and cultural humility may help prevent decolonization projects that unintentionally reinforce what they seek to dismantle. Epistemic humility calls on decolonizers to defer tasks for which they are not qualified to suitably qualified persons. Beyond this, humility supports brave scholarship that imagines and reimagines how featuring the same voices, faces, and perspectives possibly introduces new forms of domination or silencing. Cultural knowledge can lead to a more intentional way of seeking out the right people or a more diverse group than those frequently featured in decolonization conversations. This would give others more opportunities to navigate these spaces and should do so in ways that are familiar to them. One ought to be more sensitive to those who would ordinarily not be included in these conversations. Unless we radically and boldly reimagine these discussions, we risk alienating those most negatively impacted by neocolonialism. CONCLUSION Decolonization conversations are complex and the subject of academic debate. The strategies employed to decolonize can harm or help the victims of neo-colonialism. Inclusion of previously silenced individuals may not be enough to overcome the vestiges of colonialism, leading to a false inclusion, where those included feel excluded or contribute in ways reflecting their own biases and circumstances. Inclusion of an elite or people who do not truly represent the subjugated can lead to elite capture. For decolonization strategies to be impactful, for example, in the context of global health, project leaders and participants must engage in conversations employing epistemic and cultural humility. In many ways, epistemic and cultural humility can help us demythologize our assumptions of any cultural superiority or cognitive authority, allowing for diverse voices, cultures, and perspectives to emerge without domination. - [1] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [2] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [3] Anye-Nkwenti Nyamnjoh 2023. Is decolonisation Africanisation? The politics of belonging in the truly African university. Social Dynamics, 1-20. [4] Rianna Oelofsen 2015. Decolonisation of the African mind and intellectual landscape. Phronimon, 16, 130-146. [5] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [6] Pedro Alexis Tabensky 2008. The Postcolonial Heart of African Philosophy. South African Journal of Philosophy, 27, 285-295. [7] Nicholas M. Creary 2012. African Intellectuals and Decolonization, Ohio, Ohio University Press. [8] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [9] Vivetha Thambinathan & Elizabeth Anne Kinsella 2021. Decolonizing Methodologies in Qualitative Research: Creating Spaces for Transformative Praxis. International Journal of Qualitative Methods, 20, 16094069211014766. [10] Abimbola Seye 2023. Knowledge from the global South is in the global South. Journal of Medical Ethics, 49, 337. [11] A. Alenichev, P. Kingori & K. P. Grietens 2023. Reflections before the storm: the AI reproduction of biased imagery in global health visuals. Lancet Glob Health. [12] Jonathan K. Burns & Andrew Tomita 2015. Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 50, 867-877. [13] Anye-Nkwenti Nyamnjoh & Cornelius Ewuoso 2023. What type of inclusion does epistemic injustice require? Journal of Medical Ethics, jme-2023-109091. [14] 1998. Employment Equity Act. In: GOVERNMENT, S. A. (ed.) 19370. [15] Dina Zoe Belluigi & Gladman Thondhlana 2019. ‘Why mouth all the pieties?’ Black and women academics’ revelations about discourses of ‘transformation’ at an historically white South African university. Higher Education, 78, 947-963. [16] Juliet Ramohai & Khomotso Marumo 2016. Women in Senior Positions in South African Higher Education: A Reflection on Voice and Agency. 231, 135-157. [17] J. Trejo 2020. The burden of service for faculty of color to achieve diversity and inclusion: the minority tax. Mol Biol Cell, 31, 2752-2754. [18] Olufemi Taiwo 2020. Being-in-the-Room Privilege: Elite Capture and Epistemic Deference. The Philosopher, 108, 7. [19] Margarita Kurbatova & Elena Kagan 2016. Opportunism of University Lecturers As a Way to Adaptate the External Control Activities Strengthening. Journal of Institutional Studies, 8, 116-136. [20] Jeremy Farrar. 2022. An update on Wellcome's anti-racist programme. An update on Wellcome's anti-racist programme [Online]. Available from: https://wellcome.org/news/update-wellcomes-anti-racism-programme [Accessed August 10, 2022 2022]. [21] Katherine Dormandy 2018. Does Epistemic Humility Threaten Religious Beliefs? Journal of Psychology and Theology, 46, 292-304. (shrink)

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 I. 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.[i] 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.[ii] 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. II. 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.[iii] 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.[iv] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[v] 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.[vi] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[vii] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[viii] In democratic societies, one must take into consideration community morals and values.[ix] 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.[x] III. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[xi] 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.[xii] 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.[xiii] 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.[xiv] 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. IV. 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.[xv] 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.[xvi] 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.[xvii] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[xviii] 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.[xix] 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.[xx] 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.[xxi] 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. VI. 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.[xxii] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[xxiii] 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.[xxiv] 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. VII. 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. - [i] 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 [ii] 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 [iii] Moss, p. 1295-1298. [iv] Moss, p. 1296. [v] Moss, p. 1295-1298. [vi] Moss, p. 1295-1298. [vii] 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 [viii] Cohen, p. 1299-1301. [ix] Moss, p. 1297. [x] Cohen, p. 1300. [xi] Cappelen, p. 478-480. [xii] Cappalen, p. 478-480. [xiii] Cappelen, p.479. [xiv] Cappelen, p. 479. [xv] Cappelen, p. 479 [xvi] Cohen, p. 1301. [xvii] Cappelen, p. 478. [xviii] Cohen, p. 1299-1301. [xix] Cohen, p. 1301. [xx] Cappelen, p. 476-480. [xxi] Cappelen, p. 476-480. [xxii] 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 [xxiii] Kawachi, p. 18-33. [xxiv] Kawachi, p. 18-33. (shrink)

Photo by Hannah Busing on Unsplash INTRODUCTION Religion has long provided guidance that has led to standards reflected in some aspects of medical practices and traditions. The recent bioethical literature addresses numerous new problems posed by advancing medical technology and demonstrates an erosion of standards rooted in religion and long widely accepted as almost axiomatic. In the deep soul-searching that pervades the publications on bioethics, several disturbing and dangerous trends neglect some basic lessons of philosophy, logic, and history. The (...) bioethics discourse on medical aid in dying emphasizes similarity over previously recognized important distinguishing features. For example, it overplays a likeness between assistance in dying and the withdrawal of life-saving technology. In many bioethics’ topics, arguments based on a logical continuum are used to question the lines demarcating important moral differences. l. The Line Between Ethical and Not: Logic Based on Continuum Careful case selection, often either end of a continuum, allows the tearing down or ridiculing of many rules and codes across most professions and fields of interest. This situation holds true for traffic laws as well as medical ethics guidelines. It is relatively simple for those who desire to attack a particular viewpoint by selecting a case that makes that position seem untenable. In the ethics realm, good and bad medicine exist at opposite ends of an ethical continuum, with many practices lying in between. For example, much of medical ethics exists between the Nazi criminal physicians and the most sainted nurse or physician. A gradual progression occurred over less than two decades from a utilitarian position that supported limited euthanasia for those with certain mental illnesses to genocide. German society embraced a utilitarian ethic in which the value of human life no longer was intrinsic but instrumental.[1] Many morally significant points on a continuum were then ignored as the misguided utilitarian policy rampantly continued. A point in the continuum to distinguish between ethically justifiable and that which is not can be difficult to identify compared to the two extremes. This continuum is not unique to ethics but can be applied to almost any other aspect of human life and endeavor. Between a severely ill schizophrenic person and a superbly well-adjusted individual, there is a continuum of mental and psychological function. The existence of a continuum should not paralyze thinking and prevent us from drawing lines and identifying moral differences based on objective criteria as well as moral philosophy. Yet, by focusing on a continuum, many bioethicists use logic to disregard dividing lines between an "ethical" and an "unethical" act. Unfortunately, sometimes bioethicists draw revolutionary conclusions that would change the scope of medical practices which is accepted as ethical. There are many examples of similar shifts on the continuum. Many authors argue for the ethical permissibility of abortion by pointing out that the human fetus is no different in various characteristics, one arguing it is as like an ape or chick as it is like a person,[2] and does not achieve unique human and individual characteristics until well into the first year of life.[3] While human fetuses arguably do not have certain distinctive qualities of personhood, most people shy away from the logical next conclusion: permitting infanticide. For example, Joshua Lederberg condemns infanticide, in the face of biological illogic, because of our emotional commitment to infants, to me, a relatively weak explanation. Sir Francis Crick suggests we might consider birth at two days of life in order to decide whether an infant is a "suitable" member of society.[4] Giublini and Minerva suggest that infanticide should be permissible since late pregnancy abortions are permissible, arguing there is no significant difference between a fetus just before birth and an infant just after birth.[5] Clearly the continuum approach would allow for subjective arguments in favor of later infanticide at other points many days post-birth. Years ago, with a cynical tone, I mentioned infanticide as a further step on the continuum beyond abortion, and I was rightly shouted down as being deliberately provocative to assert the logic would ever stretch so far. While it is not an accepted mainstream position, the movement in academic settings from widespread condemnation to limited possible acceptance of infanticide has taken place in an incredibly short time. Public opinion and medical opinion in these areas have shifted dramatically in a short time. In another area, from a biological and chemical point of view, there is a continuum from man down to a single carbon atom. Yet, it would not seem logical to ignore the emotional differences, the meaning of personhood, or the moral distinction between killing an insect and killing a person. ll. A False Continuum: Medical Aid in Dying I assert that there has been an erosion of ethical guidelines in recent years attributable to using continuums to camouflage important distinctions. James Rachels’ work on active and passive euthanasia, which contends that the two are ethically identical, exemplifies that logic.[6] He illustrates this thesis, using a continuum to compare different scenarios with like consequences as morally equivalent, by comparing the deliberate drowning of a child with a deliberate failure to rescue a drowning child when easily able to do so. The author's comparison proposes that since much of the medical profession has already made peace with withholding treatment in order to hasten death, consistency inexorably demands that we permit active euthanasia as well.[7] When permission for active euthanasia was first introduced, it was limited exclusively to patients suffering severely from an intractable, incurable, and irreversible disease. These guidelines have been continuously eroded. There is now a substantial serious consideration for permitting active euthanasia of healthy elderly individuals who feel that they have completed their lives and are "tired of living."[8] There are many moral and factual differences along the ethical continuum. In human life, there is a difference between a live baby and a fetus, between a viable fetus and one that is not, between a fetus and a zygote, and between a zygote and a sperm cell. Similarly, there is a difference between pulling a trigger to kill someone and not interfering in preventing his death, which is reprehensible though both may be. There is a difference between not resuscitating an 80-year-old man with cancer when his heart stops and injecting him with a fatal dose of potassium chloride. I argue that an overt act of taking life repels civilized human beings is to be commended and encouraged as the reverence for human life or even for just a moment of human life is one of the great contributions of our civilization. CONCLUSION As an orthodox Jew, I feel that divinely inspired guidelines that have stood the test of centuries shape my beliefs, and such guidelines contradict medical aid in dying. I cannot speak to the viewpoint of those who do not access religion in defining their moral stance, nor do I implicate them in the current bioethics' trends, as I am not aware of the personal role of religion in the lives of most such authors. While many nonreligious people have a firm philosophical grounding and oppose medical aid in dying, I suggest that in the absence of any religious or other absolute standards, developing logically defensible ethical guidelines may be challenging. At the least, religion may play a role in defining the points on the continuums that are ethically meaningful and refuting the trending beliefs that if the endpoint is the same, allowing different methods of arriving at that end are somehow ethically equal. The continuum of ways death may result does not negate analysis of whether death is brought about in ways that recognize the importance of life. The German philosopher Hans Jonas said, "It is a question whether without restoring the category of the sacred, the category most thoroughly destroyed by the scientific enlightenment, we can have an ethics able to cope with the extreme powers that we possess today and constantly increase and are compelled to use."[9] While countries vary on the role of religion in policy, with many emphasizing freedoms of religion, a recent position paper released by a group of Jewish, Christian, and Moslem leaders suggested the need for agreement on the unique sanctity of human life.[10] I would recommend that such a document serve as an example of consensus on critical foundational bioethical guidelines for democratic secular societies. - [1] Alexander L Medical science under dictatorship. New England Journal of Medicine, 241, p39-47 DOI10.1056/NEJM194907142410201 [2] Lederberg J. A geneticist looks at contraception and abortion, Annals of Internal Medicine 67, sup 2, 25-27. https:/doi.org/10.7326/0003-4819-67-3-25 [3] Ibid. [4] Editorial, Sociology: Logic of biology. Nature 220, 429 https://www.nature.com/articles/220429b0 [5] Giublini A Minerva F After-birth abortion: why should the baby live. J Med Ethics 39, 261- [6] Rachels J Active and passive euthanasia. New England Journal of Medicine 292, 78-80 [7] Ibid. [8] Cohen-Almagor R Euthanizing people who are "tired of life". in Euthanasia and Assisted Suicide-Lessons from Belgium. Ch 11 of Euthanasia and Assisted Suicide, Cambridge University Press pp173-187. 2017 and DOI; https://doi.org/10.1017/9781108182799.012 [9] Hans Jonas, Technology and Responsibility: Reflections on the New Tasks of Ethics, 1972, found as Chapter IX, Philosophical Essays, 1980. https://inters.org/jonas-technology-responsability [10] A position paper of the Abrahamic Monotheistic religions on matters concerning the end-of-life. Vatican Press 28 October 2019 https://press.vatican.va/content/salastampa/en/bollettino/pubblico/2019/10/28/191028f.html. (shrink)

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)

Maria Goltsman. On some graphic regularities of perception in painting and dance: Mnemonic form of dance. The present article handles some problems of the mechanisms of visual perception in painting and classical ballet. It proceeds from the assumption that the interaction between those arts is based on the similarity of their formal languages. The main attention focuses on the questions of how and why does the classical ballet use the code of painting? The interaction between pictorial art and ballet occurs (...) through the theatre, which is considered to be a picture coming alive in European tradition. This principle is taken here as a main method of analysis of ballet art and it is used in two ways. The first handles a problem of composition of a ballet as a theatrical performance. The second analyses the movement itself — the language of the choreography as such. The last part of the article contains the answer to the question — why does the ballet need such aspects of pictorial code as frontal composition of a picture coming alive, memory photo, multiplication of the similar images and repeating movements. Dance is dynamic, picture is stable. To represent a movement, the painting uses the rhythm and visual repeating of lines and contours. It helps to construct an illusion of motion and brings the temporal aspect into a static piece of art. Whereas different stops, poses and fixations in ballet help it to visualize the movement, to capture the space. This is one of the ways for ballet to leave its trace in space as much as in the memory of the spectators, to become fixed in space, to prevent the dispersion of dance in the thin air and to surmount in such a way the ephemera characteristic of it. (shrink)

The study of cultural evolution has taken on an increasingly interdisciplinary and diverse approach in explicating phenomena of cultural transmission and adoptions. Inspired by this computational movement, this study uses Bayesian networks analysis, combining both the frequentist and the Hamiltonian Markov chain Monte Carlo (MCMC) approach, to investigate the highly representative elements in the cultural evolution of a Vietnamese city’s architecture in the early 20th century. With a focus on the façade design of 68 old houses in Hanoi’s Old Quarter (...) (based on 78 data lines extracted from 248 photos), the study argues that it is plausible to look at the aesthetics, architecture, and designs of the house façade to find traces of cultural evolution in Vietnam, which went through more than six decades of French colonization and centuries of sociocultural influence from China. The in-depth technical analysis, though refuting the presumed model on the probabilistic dependency among the variables, yields several results, the most notable of which is the strong influence of Buddhism over the decorations of the house façade. Particularly, in the top 5 networks with the best Bayesian Information Criterion (BIC) scores and p<0.05, the variable for decorations (DC) always has a direct probabilistic dependency on the variable B for Buddhism. The paper then checks the robustness of these models using Hamiltonian MCMC method and find the posterior distributions of the models’ coefficients all satisfy the technical requirement. Finally, this study suggests integrating Bayesian statistics in the social sciences in general and for the study of cultural evolution and architectural transformation in particular. (shrink)

This study examines adults’ postings of photos of children on social media and offers a unique methodological approach to studying visual data. A major innovation of this study is first, to enact the concept and method of narrative inquiry to the digital photographs. Having applied this method, the study also offers findings about the diverse values that emerge across two specific digital parenting cultures organized via Instagram hashtags of #fashionkids and #letthekids. Values analysis of 500 photographs indicated that these hashtags (...) constitute cultures defined by distinct values of ideal childhoods. While #fashionkids photos emphasized children’s attendance to the photo making activity with stress to their possessions, #letthekids photos expressed mixed values of freedom and domestic happenings with a strong emphasis on unawareness of the photographing and togetherness. While the qualities of childhood images collected in the same period hint at meaningful patterns, the way those qualities interact with each other in distinct cultures suggest that there is not one ideal image that could represent childhood in the best possible way and the photographers’ values very much influence the visual sense-making of what’s being portrayed in children’s photographs. (shrink)

Previous studies have found a link between red and aggressive behavior. For example, athletes who wear red uniforms in sports are considered to have a competitive advantage. So far, most previous studies have adopted self-report methods, which have low face validity and were easily influenced by the social expectations. Therefore, the study used two implicit methods to further explore the association between red and aggressiveness. A modified Stroop task was used in Experiment 1 to probe college students’ differences (...) between “congruent” tasks and “incongruent” tasks. Result showed that participants responded more quickly to the congruent tasks than the incongruent tasks. Then, in order to adapt to the competitive context, Experiment 2 used an implicit association test with photos of athletes as the stimulus to college students and athletes to evaluate “congruent” tasks as well as “incongruent” tasks, respectively. According to the results, both college students and athletes respond faster to congruent tasks than to incongruent tasks. Besides, athletes’ reactions to the red–aggressiveness association are faster than college students, which may relate to the athletes’ professional experience. The athletes may be more aggressive and impulsive. Overall, the study has attempted to examine the association between red and aggressiveness through implicit methods, but in the future, researches are need to find a deep association from brain mechanism aspect. (shrink)

In this study, after a short introductory information on the etymology, origin, and transition of botanical knowledge in Medieval Islamic Civilisation, we made a comparison of illustrated botanical works in Maghreb and Masriq through two illustrated books. We studied on randomly selected illustrations from Kitab al- Hashaish at-Tibb li-Diskuridus al-Aynzarbi translated by Istefan ibn Basil & Hunayn ibn Ishaq from Dioscorides’ Materia Medica, and Kitab al-Adwiyat al-Mufradat of Abu Ja’far Ahmad al-Ghafiqi, the Andalusian physician, pharmacist, and herbalist. We made comparisons (...) on the illustrations of nine plants and one lichen, chosen from Codex Osler of al-Ghafiqi, and Codices Ayasofya of Istefan-Hunayn, with real photos of plants and lichen, via the methods used currently in the science-art of botanical illustration. With this «botanical illustrative method», we conclude that in the same century, the work of al-Ghafiqi has been copied in a more accurate way than that of Istefan-Hunayn translation. -/- تخصص هذه الدراسة - بعد تقديم معلومات تمهيدية موجزة عن علم أصل الكلمات، وأصول وتطور المعرفة النباتية في الحضارة الإسلامية في العصور الوسطى - للتحليل المقارن للمؤلفات في علم النبات المصور في المغرب والمشرق، من خلال كتابين مصورين. و لهذه الغاية، قمنا بتحليل سلسلة من الرسوم، إختيرت بشكل تلقائي، أُخذت من كتاب النباتات الطبية لصاحبه دِيُسوفُورِيدس، و من ترجمة ابن استيفان ابن باسل و حنين ابن إسحاق لدراسة المادة الطبية لديسوفوريدس، و من كتاب الأدوية البسيطة لأبو جعفر أحمد الغافقي، و هو طبيب و صيدلي و عشاب أندلسي. لقد أجرينا مقارنات لرسوم تسعة نباتات و أشنة وقع الإختيار عليها من كتاب أوسلر للغافقي و من كتب أياصوفيا لإستيفان و حنين، مع صور حقيقية لعينات من هذه الأنواع، باستخدام الطرق المطبقة في وقتنا الراهن في فن وعلم الرسوم النباتية. و بعد تطبيق هذا المنهج التصويري النباتي، نستطيع أن نخلص إلى أنه، و على الرغم من إنتاجها في نفس القرن، فإن نسخ رسوم الغافقي النباتية كانت أكثر دقة من تلك الموجودة في ترجمة استيفان - حنين. الكلمات المفتاحية دِيُسوفُورِيدس، الغافقي، تاريخ علم النبات، الأندلس -/- Este estudio –tras una breve información introductoria sobre etimología, orígenes y evolución del conocimiento botánico en la civilización islámica medieval– está dedicado a un análisis comparativo de los tratados botánicos ilustrados en el Magreb y en el Máshreq, a través de dos libros ilustrados. Para ello, hemos analizado una serie de ilustraciones, elegidas al azar, extraídas del Libro de plantas medicinales de Dioscórides por Anazarba, traducción de Istefan ibn Basil y Hunayn ibn Ishaq del tratado De materia medica de Dioscórides, y del Libro de los medicamentos simples de Abu Ya'far Ahmad al-Gafiqi, médico, farmacéutico y herbolario andalusí. Hemos llevado a cabo comparaciones de las ilustraciones de nueve plantas y un liquen, escogidos del códice Osler de al-Gafiqi y de los códices Ayasofya de Istefan-Hunayn, con fotografías reales de especímenes de dichas especies, acudiendo a los métodos aplicados actualmente en el arte y ciencia de la ilustración botánica. Tras este «método ilustrativo botánico», podemos concluir que, aunque llevadas a cabo en el mismo siglo, las copias de ilustraciones de al-Gafiqi han resultado más precisas que las de la traducción de Istefan-Hunayn. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 35.4 (2002) 297-327 [Access article in PDF] Liberal Irony A Program for Rhetoric James P. McDaniel [Figures] Seeing like a state Perhaps these famous yet simple pictures display not so much the virtuosity of photography or photographers as they statically represent fragments of Mahatma Gandhi's theosophical and political dynamism, his uncanny blend of calm and charisma, thought and play. The compositions are technically simple yet thematically (...) rich. The great leader being led by a boy, the public figure reflecting quietly in private over news reports: these modest representations key awareness of the place of overturning in Gandhi's thought, words, and deeds. A man who encouraged non-violent resistance (ahimsa) to British Imperialists, Gandhi submitted his body to great harshness (himsa). A witness to incredible atrocities committed against his people, Gandhi exhorted his followers to present their bodies before armed imperialist soldiers with full knowledge that they would be brutalized, many killed. Legally prohibited from doing so, Gandhi made salt. Exhausted and hungry, Gandhi walked hundreds of kilometers without rest and fasted for long stretches of time. Hated and feared, Gandhi loved. Perpetually reversing the "logic" of the world he knew, overturning its values to find and clarify truer values, insisting that choices be made between the received and the [End Page 297] promised, the "is" and the "ought," the actual and the possible, Gandhi was an ironist.Each picture can also be seen as an allegory, or taken together as an allegorical complex of mutually illuminating signs, and Gandhi as a political allegorist of human relations for early twentieth-century India and the globe. Allegory's signature inscriptions are everywhere about these simple photos. Personification of virtue, a stock technique of allegorical composition, abounds: Humility becomes Gandhi. Each photograph personifies humility uniquely: sparseness of setting, simplicity of garb, and other visual cues for self-abasement adorn the one; richness of natural setting, playfulness, childlikeness, and such ornament the other. Both images suggest the presence of the eternal in the temporal, but in different ways, another key fixture of allegorical design: Gandhi's stillness sitting near his spinning wheel, itself an image of eternal circuitousness, in the one, and his vigorous exertion against a vast, seemingly static, natural landscape, both "frozen" in time thanks to the technology of photography, in the other. Likewise, time's flow seems in a sense reversed in a manner that mirrors symmetrical ontological reversals: the older follows the younger, the man the boy, and the wise follow the inexperienced. Further allegorical decoding could be endeavored, for instance rearticulating the two texts on four tiers of signification: literal, figural, historical, and anagogical—the "four-level" allegorical hermeneutic initially developed for application to sacred texts and later ascendant as a critical method from the Middle Ages to some versions of poststructuralism in recent years (e.g., Fredric Jameson's Political Unconscious, Frederick Dolan's Allegories of America,Paul de Man's Allegories of Reading). Each tier reveals a unique dimension of discourse: its textual surface (literal), its embedded significations (figural), its reflexive display of placement in time and society (historical), and its alignment with archetypal or ultimate patterns of existence (anagogical).As two approaches to the same texts, irony and allegory are more complementary than exclusive. Neither renders the other invalid or uninteresting, nor do they deplete their common rhetorical resources, yet each features distinctive fixations. The first perspective fixates on a single strategy reflected in the texts and explores the ramifications of that strategy: dialectical reversal. The second fastens on and traverses across myriad textures and patterns of discursive technique displayed in the texts: allegorical personification (e.g., Gandhi as humility), temporality (e.g., fusing of public, private, and eternal time), paratactic association of images (i.e., interplay between visual signs not necessarily regulated by a single code [End Page 298] of meaning), and cosmic ornamentation (e.g., the spinning wheel that, by the way, is not spinning; like Gandhi, it is sitting still in a world of tumult, as if mirroring a moment of individual and universal arrest). Ironic strategizing and inventorying, in this light... (shrink)

An homage to the men and women of science, and an exposition of Einstein's place in scientific history In this fascinating collection of articles and speeches, Albert Einstein reflects not only on the scientific method at work in his own theoretical discoveries, but also eloquently expresses a great appreciation for his scientific contemporaries and forefathers, including Johannes Kepler, Isaac Newton, James Clerk Maxwell, Max Planck, and Niels Bohr. While Einstein is renowned as one of the foremost innovators of modern science, (...) his discoveries uniquely his own, through his own words it becomes clear that he viewed himself as only the most recent in a long line of scientists driven to create new ways of understanding the world and to prove their scientific theories. Einstein's thoughtful examinations explain the "how" of scientific innovations both in his own theoretical work and in the scientific method established by those who came before him. This authorized Philosophical Library book features a new introduction by Neil Berger, PhD, and an illustrated biography of Albert Einstein, which includes rare photos and never-before-seen documents from the Albert Einstein Archives at the Hebrew University of Jerusalem. "What place does the theoretical physicist's picture of the world occupy among all these possible pictures? It demands the highest possible standard of rigorous precision in the description of relations, such as only the use of mathematical language can give" -Albert Einstein, "Principles of Research" Albert Einstein (1879-1955) was born in Germany and became an American citizen in 1934. A world-famous theoretical physicist, he was awarded the 1921 Nobel Prize for Physics and is renowned for his Theory of Relativity. In addition to his scientific work, Einstein was an influential humanist who spoke widely about politics, ethics, and social causes. After leaving Europe, Einstein taught at Princeton University. His theories were instrumental in shaping the atomic age. Neil Berger, an associate professor emeritus of mathematics, taught at the University of Illinois at Chicago in the Mathematics, Statistics, and Computer Science department from 1968 until his retirement in 2001. He was the recipient of the first Monroe H. Martin Prize (1975), which is now awarded by the University of Maryland every five years for a singly authored outstanding applied mathematics research paper. He has published numerous papers and reviews in his fields of expertise, which include elasticity, tensor analysis, scattering theory, and fluid mechanics. (shrink)

Human skin detection is an essential phase in face detection and face recognition when using color images. Skin detection is very challenging because of the differences in illumination, differences in photos taken using an assortment of cameras with their own characteristics, range of skin colors due to different ethnicities, and other variations. Numerous methods have been used for human skin color detection, including the Gaussian model, rule-based methods, and artificial neural networks. In this article, we introduce a novel (...) technique of using the neural network to enhance the capabilities of skin detection. Several different entities were used as inputs of a neural network, and the pros and cons of different color spaces are discussed. Also, a vector was used as the input to the neural network that contains information from three different color spaces. The comparison of the proposed technique with existing methods in this domain illustrates the effectiveness and accuracy of the proposed approach. Tests were done on two databases, and the results show that the neural network has better precision and accuracy rate, as well as comparable recall and specificity, compared with other methods. (shrink)

Background In 1926, Fritz Jahr described bio-ethics (German: bio-ethik) as “the assumption of moral obligations not only towards humans, but towards all forms of life.” Jahr summarized his philosophy by declaring, “Respect every living being on principle as an end in itself and treat it, if possible, as such!.” Bioethics was thus originally an ethical system concerned with the “problems of interference with other living beings… and generally everything related to the balance of the ecosystem” according to the 1978 Encyclopedia (...) of Bioethics. This definition was predicated on the work of Fritz Jahr, Menico Torchio, and Van Rensselaer Potter. Methods In order to proceed with depthful analysis of the origin and major bioethical flare up, we will use critical analysis of existing literature, followed by a study trip to relevant bioethical localities (collecting photo and other documentations regarding Menico Torchio). Results While Jahr and Potter are typically given intellectual credit for developing the field of bioethics, the eco-ethical contributions of Menico Torchio have been forgotten.This article will first trace the origins of “bioethics” – now commonly bifurcated into “biomedical ethics” and “environmental bioethics.” The former was developed by Tom Beauchamp from the Philosophy Department and James Childress of the Religious Studies department at Georgetown University and is based on principlism, with a narrow focus on medical settings. The latter addresses the environmental impact of the medical industry and climate change health hazards. Second, we will present a panorama of Torchio’s significant intellectual contribution to bioethics. Menico Torchio’s concept of bioethics synthesized work of both Jahr and Potter, advocating “the need to expand our ethical obligations and embrace the most developed groups of animals, not only physically but also psychologically.” Third, we will reflect on the lasting legacy of “bioethics” on biomedical and environmental bioethics today. Thematic elements such as interconnectedness of planetary health and human health, dedication to living in harmony with nature, and emphasis on systems and symbiosis remain unchanged from the legacy of Tochio onward. Conclusion Our conclusion will underscore the necessity of understanding the connections between planetary, environmental, and human health. (shrink)

Working in Germany between the two world wars, John Heartfield developed an innovative method of appropriating and reusing photographs to powerful political effect. As a pioneer of modern photomontage, he sliced up mass media photos with his iconic scissors and then reassembled the fragments into compositions that utterly transformed the meaning of the originals. In John Heartfield and the Agitated Image, Andrés Mario Zervigón explores this crucial period in the life and work of a brilliant, radical artist whose desire to (...) disclose the truth obscured by the mainstream press and imperial propaganda made him a de facto prosecutor of Germany’s visual culture. Zervigón charts the evolution of Heartfield’s photomontage from an act of antiwar resistance into a formalized and widely disseminated political art in the Weimar Republic. Appearing on everything from campaign posters to book covers, the photomonteur’s notorious pictures challenged well-worn assumption and correspondingly walked a dangerous tightrope over the political, social, and cultural cauldron that was interwar Germany. Zervigón explains how Heartfield’s engagement with montage arose from a broadly-shared dissatisfaction with photography’s capacity to represent the modern world. The result was likely the most important combination of avant-garde art and politics in the twentieth century. A rare look at Heartfield’s early and middle years as an artist and designer, this book provides a new understanding of photography’s role at this critical juncture in history. (shrink)

It is common for visitors to have rich and varied experiences in the limited space of a classical Chinese garden. This leads to the sense that the garden’s scale is much larger than it really is. A main reason for this perceptual bias is the gardener’s manipulation of visual information. Most studies have discussed this phenomenon in terms of qualitative description with fragmented perspectives taken from static points, without considering ambient visual information or continuously changing observation points. A general question (...) arises, then, on why depth perception can vary from one observation point to another along a garden path. To better understand the spatial experience in classical Chinese gardens, this study focused on variations in perceived depth among different observation points and aimed to identify influential visual information through psychophysical experimentation. As stimuli for the experiment, panoramic photos of Liu garden were taken from three positions at Lvyin Pavilion. Considering the effects of pictorial visual cues on depth perception, the photos were processed to create 18 kinds of stimuli. Two tasks were presented to the participants. In Task 1, 71 participants were asked to rate the depth value of the garden using the magnitude estimation method in a cave automatic virtual environment. Statistical analysis of Task 1 revealed that depth values differed significantly among different viewpoints. In Task 2, participants were asked to compare 18 stimuli and 3D images presented on three connected monitors and to judge the depth of the garden using the adjustment method. The results of Task 2 again showed that depth values differed significantly among different viewpoints. In both tasks, ambient information significantly influenced depth perception. (shrink)

The luminous value is high for many natural scenes, which causes loss of information and occurs in dark images. The High Dynamic Range (HDR) technique captures the same objects or scene for multiple times in different exposure and produces the images with proper illumination. This technique is used in the various applications such as medical imaging and observing the skylight, etc. HDR imaging techniques usually have the issue of lower efficiency due to capturing of multiple photos. In this paper, an (...) efficient method is proposed for HDR imaging technique to achieve better performance and lower noise. The Luminance-Chrominance-Gradient High Dynamic Range (LCGHDR) method is proposed to obtain the proper luminous value of images. The same scenario is captured at different exposure are processed by the proposed method. Based on these feature values extracted from the different images and exposure fusion technique was developed that helps for the proper imaging. This experiment was evaluated and analyzed by comparing with the other methods, which showed the efficiency of the proposed method. This method needs only 124.594 seconds for the computation, while existing method need 139.869 seconds for the same number of images. (shrink)

The greatest intensity of “live” life is captured from as close as possible in order to be borne as far as possible away. Jacques Derrida. Echographies of Television . Rainer Ganahl has made a study of studying. As part of his extensive autobiographical art practice, he documents and presents many of the ambitious educational activities he undertakes. For example, he has been videotaping hundreds of hours of solitary study that show him struggling to learn Chinese, Arabic and a host of (...) other languages. The stacked boxes of tapes are then presented like minimalist monoliths, dense archives of effort. About fifteen years ago, Ganahl began photographing the lectures that he attends. At the time, he hadn’t seen anyone else doing it, so besides his spare selection of images of the speaker and the audience, much of the time the lectures would just pass into memory, undocumented, or recorded in writing alone. Since then, he has felt the transition to digital cause a significant shift in his process. At the same time, he has seen the habit become ubiquitous as others photograph, record, and videotape the lectures all around him. In keeping with the theme of this inaugural issue of continent. , can we propose each small grouping of photographs that result an isthmus stretching between two disparate bodies of mind? The first being the body of the lecture as spelled out in the title of each work – the experience of the event in all its constituent parts. The second is the body of the recipient, the listener, in this case an artist, who plays a minimal role just beyond the prescripted behavior of sitting and listening. He uses a gesture of documentation to draw a line between himself and the event, creating an artwork. Františka + Tim Gilman: As we mentioned before, the theme of the magazine for this issue is "isthmus." It seems like a very good way into your work, and it leads us to ask what connection you see between your photographs of the lecture and the lecture itself? Rainer Ganahl: The relationship is of course a concrete, pictorial one, or if you want a mimetic one but also an abstract one because the photographs carry the title of the lecture, the names of the lecturers, the site, the institution and the time of the lecture. Photos are fixed moments of time and can reproduce images displayed and reproduce visuals presented at a moment but they don’t come with time based recordings that video or sound takes are offering. What remains of a lecture is usually just the memory, some notes and all the announcements of it. In my case I end up with a visual product I declare as my artwork. It might not differ from any snapshot taken by any other student or member of the audience but I do this in a semi-systematic way with certain rules and procedures I have set up. While I am at a lecture I am mainly focusing on the lecture itself. Last night I went to one of Slavoj Žižek which demanded quite some concentration. I even was asking him a question at the end. I took photos as well but still didn’t lose track of the lecture. I didn’t walk around, I was not preoccupied by where I was sitting and what light I was having like some of the other photographing and filming people in the room who came and left, moved around and tried to capture him from this and that angle, from close and far. I just sat there and concentrated on the lecture and yet managed to take about 30 or so images of him, the public around me and of the film clips he presented. Once the lecture is over the story changes: it all becomes a question of the images, their selection, their visual qualities, their labeling and archiving. The function of the images also change: not only do they stand for an intellectual event in a row of lectures that become part of my intellectual history within many possible such histories but they also have to function as art, something not everybody else with images of lecturers demands of their images. This is my specific claim as an artist to impose them as artworks. And as with all artistic propositions the offer can be accepted or rejected. I basically spend my life trying to do exactly that: making what I declare as art, offering something to anybody interested in it as my art, an offer that is not and will never be accepted as such by all people. F+T: What are your criteria for selection, i.e. how do you choose which lectures to photograph, by lecturer, by topic, or do you photograph any and every lecture you can? RG: As everything in my life, I go by my interest which is the result of many factors. If I am aware of a lecturer, read his books or appreciate his works my interest of attending his much higher than if I am not aware of it. I usually don’t go to lecturers simply based on their subjects—something that can happen of course, if the subject, the title of the lecture is promising or at the heart of my interest. Sometimes I also wait for years to get a change to photograph certain people but I do that in a very low-level “keep your ears up” mentality and not in a systematic scanning of all channels and possibilities. I do not go into philosophy departments and photograph everybody teaching there. I go with the flow—and unfortunately a great deal of great talks I also miss because I hear too late of them. Often, I also stumble into them by traveling, by getting emails from friends and by simply being in the right spot at the right time. Somehow you could look at my lecture par cours as some kind of loose intellectual flâneurism . If you know of interesting lectures and events, please, let me know. F+T: Is your selection of images more of a production or post-production method? That is, do you take a lot of photos and select only a few images from each lecture, or do you take them very selectively? Do you have a particular methodology for the selection of images? RG: This all changed a bit with the arrival of digital photography. In the beginning I had to pay a lot of money for film developing. Hence, I was taking either one role - 36 images - or half a role - 13 images - depending on who talked and whether they projected images. With the unlimited capacity of digital imaging I easily end up between 30 and 150 images of one event still depending of whether images are presented or not. In the first years of that project when I wasn’t fully aware yet of what I was doing, I printed at least 2 images of any lecture and sometimes three or even four, a choice that was also constrained by costs. But again, since I have a web site and since images can easily be selected and presented on my web site without generating remarkable costs I have now more and more pain to reduce them to less than ten or eight images for an event. Now, before I have them printed which really is expensive, I can present them already as artwork on my web site without any immediate costs. Thus the economic factor is at the end of the chain which enables me to be more ‘generous’ and include more images. Over the last years I have been mostly selecting at least four photographs for a lecture unit but recently also as many as ten. But so far only one set above four images has been actually printed and sold. What might sound even more shocking is the likely fact that if a curator or a collector demands me to reduce the number of images due to costs, I might compromise at this current stage if the images have not been yet printed or published outside my own web site. This means that to a certain degree any selection that has only seen publication on my web site and not yet been produced runs the risk to change in numbers of images included. Needless to say, I am the last one that finally makes a decision and I do honor all given earlier decision if those were final. F+T: How do you feel the act of photographing the lecture affects your reception of the contents of the lecture? And your recollection afterwards, do you remember the lecture more having photographed it, or just having sat and listened? RG: As mentioned above, I get very little distraction from photographing since I can multitask well and do not obsess about the quality of the image: I photograph from where I am and listen with my ears and not my eyes. I am not sure whether the images serve as a mnemonic devise to the content of the lecture if there are no images involved but they at least remind me that the lecture existed, the title of the lecture and the name of the people and institutions involved. The titles of the hundreds of lectures I took during the past 15 years can also be read as an essay of theoretical life in that period. This will be come more and more visible as time passes by. These images age much better than I do. F+T: You mentioned at the outset of our discussions that you started this practice some time ago and have seen the practice of photographing lecturers become more commonplace. Why do you think that this shift has taken place? RG: The answer is very simple. Photographing is now free of any charge and hence omnipresent. You buy a phone or any other personal digital assistant and it has a camera integrated in it whether you want it or not. There is no need to develop images and there is no hassle to keep images, to distribute images, to organize images and save them. It is all virtual, not creating any costs and doesn’t require any efforts. You don’t spend twenty dollars for photo-developing anymore, you don’t need to walk anymore to your pharmacy or your photo shop to drop off and return to pick up and pay. You don’t need to go to the post office to send somebody a picture. You have a program like Photoshop already built into your camera. Photographing is now a thing for everybody—with functioning cameras made for two year olds. It is technically now nearly impossible to make bad images. The image quality is virtually guaranteed by cheap, high performing, mini-computers packed into miniscule cameras. With all these technological changes, we are undergoing now a cultural paradigm shift that includes permanent recording (not only still image taking) of everything. I wonder even whether babies are just born to be photographed—at least a process where the first photograph is right there. What is interesting now, is how the law is trying to catch up. I am experiencing and expecting more restrictions on photographing and recording—something already in place in many museums and in certain galleries—as the recording devices become more and more invisible and undetectable. It is an interesting cat and mouse play and will end up with some of us that are photographing the world around us in court. The world has become very transparent and everybody is contributing to it with social networking technologies—like twitter and Facebook—that are designed to monitor and communicate every step we make in our lives. F+T: Why did you start the practice? As a way to remember, or to capture the experience of the lecture and the environment there? RG: A couple of years earlier I started to photograph my own reading seminars as part of my art work with results that surprised me positively. I really liked these images of students and people discussing heavy non-fiction with me. The reading seminars justified this kind of pictorialism. Then in 1995 I had the chance to attend an entire seminar by Edward Said entitled “The Representation of Intellectuals at Columbia University,” which really gave me the idea to start this series. Why not also photograph these lectures I visit all the time since this really is a way of representing intellectuals? F+T: The constellation of images and the title seem like a kind of portrait, do you agree? If so, is it a portrait of the speaker, of yourself, or of the event? RG: Well, to follow up on the previous question the lectures are more than just portraits of lecturers since I include not only the speakers but also the audience, an audience that is not named or specifically highlighted as is the speaker. So if we stick with the metaphor of the portrait we would have to extend it also to the environment, the class room, the lecture hall, the arrangements of seats or benches, tables, lecture stands and other stuff typically seen on my images. Often the walls are decorated or even tagged with graffiti or posters and other stuff. There is a big difference between a small seminar room at the English Department of Columbia University, full with books and cabinets and a lecture room at a Paris or Frankfurt university that accommodates 50 to 150 people. We should, maybe, also distinguish between lectures that are one time events—mostly open to the public, free of charge or paid—and events that are weekly, closed to the public and held mostly in universities that can cost fortunes or be paid by the State as it is still predominantly the case in continental Europe. All this, of course, is not necessarily announced in the title of the lecture and is subject to information that isn’t visible on the images. To a certain degree we see also portraits of a general privilege when it comes to the public of certain institutions that are highly selective and extremely costly without forgetting that most of the lectures are dealing with theory, art, philosophy and other highbrow subjects. In general, I would say we see very little if we don’t know already what’s going on, who the lecturer, the institutions, the context are in which we subsequently can zoom into variants like sexual, racial, or age-related make-up without ignoring clothing fashions, hair styling, body mannerisms, gadgets and stuff. F+T: Do you see a relation between this body of work and your other work, for example your language studies? RG: Everything I do is “unfortunately” related. I say unfortunately because this makes my work not so easy to grasp. The relationship to the language studies is relatively clear since both are originally grounded in the domain of education and knowledge production. Nearly all my work comes across that nexus where knowledge and power are addressed. I was at one point wondering what the relationship was to some of my earlier indexical work where I was happy alone with footnotes from books painted on the walls: I came to understand that both are just different manifestations of knowledge and information. F+T: Do you foresee continuing the series indefinitely, or is there an end to it? RG: I think that I will continue this series indefinitely or to be more precise, as long as I go listen to lectures and want to learn something which brings me to your previous question: What do the reading seminars, language studies, historical research and lecture hopping have in common: I learn something. Further Reading Rainer Ganahl’s website William Kaizen. “ Vulgar Politics .” art&education . April 2009. Web. Smith, Roberta. “ Rainer Ganahl: ‘Language of Emigration & Pictures of Emigration .’” New York Times April 23 2010. Web. (shrink)

Objective: To explore the strategies that can help individuals mourning a family member’s death from Covid-19 to cope with the loss. Method: We carried out a narrative review on the PubCovid-19 platform using the descriptors “death,” “mourning,” “Covid-19,” and “coping strategies.” Ten articles were included. Results: The strategies found are phone calls, audio recording, letters, and photos, classified as immediate and long-term. These strategies are focused on mental health, which can be adversely affected by depression and psychological disorders. Conclusions: Creating (...) counseling programs for the relatives of those who died from Covid-19 is urgent. They must offer comprehensive, humanized, and continuous mental health care. (shrink)

The impact of Online Social Networks on human lives is foreseen to be very large with unprecedented amount of data and users. OSN users share their ideas, photos, daily life events, feelings and news. Since OSNs’ security and privacy challenges are more potential than ever before, it is necessary to enhance the protection and filtering approaches of OSNs contents. This paper explores OSNs’ threats and challenges, and categorize them into: account-based, URL-based and content-based threats. In addition, we analyze the existing (...) protection methods and highlight their limitations and weaknesses. Based on that, we propose a comprehensive, user-level, proactive and real-time OSNs’ protection system, called Hybrid Real-time Social Networks Protector. HRSP has three components; a user-level security protocol and two classification models. The protocol defines a structure for OSN’s cryptographic services, including encryption, access control and users’ authentication. The classification models employ machine learning, black lists, white lists and users’ feedback, in order to classify URLs into: Benign, Risk and Inappropriate classes, and contents into: Benign, Hate speech and Inappropriate classes. We constructed two data sets of 150,000 URLs and 22,000 tweets to build and test the two classification models. Results show an overall accuracy of 93.2% for the URL model and 84.4% for the content model, while the protocol implementation produces compatible size and time overhead. The components of HRSP are integrated and have compatible design with OSN platforms. (shrink)

This paper discusses the value in implementing photography as a means of assessment in philosophy courses. I specifically discuss how I utilize this interdisciplinary method in my honors environmental philosophy course with encouraging results, and how it can be easily employed in other philosophy courses as well. Photography is the basis for one of my larger course projects, the environmental philosophy in photo project (EPPP). The EPPP offers students novel methods of applying and understanding environmental ethical theories and (...) new ways of making meaning. In the following, I offer a defense of photographic methods for philosophical assessments, project instructions, student learning objectives and feedback, overall effectiveness of the project, and potential uses of photographic methods in other philosophy courses. (shrink)

During the last two decades, many thinkers on Iranian cinema have had many things to say about censorship, especially the issue of the veil imposed on women’s gender by the authorities in Iran. In this paper, I will describe Hamid Dabashi’s narrative as related to the concept of “truth” to show further that the veil issue has reached a new phase in Iran. Although much of what Dabashi defines as the absented body of women in his article “Body less faces: (...) Mutilating modernity and abstracting women in an ‘Islamic cinema’” may still hold, I believe his over-arching narrative doesn’t contribute enough to our understanding of the new relations among the authorities and actresses’ Fashion styles on red carpets. This paper’s method is connected with cultural and visual studies through Roland Barthes’ semiotics. I first focus on Hamid Dabashi’s conception of “truth” and how he believes “truth” is related to Islamic ideology and embodied in Iranian post-revolutionary cinema to further (through analysing photos of Iranian actresses’ clothing who attend festivals) conclude that Iranian women try to adopt new resistances in choosing their costumes compared to the early two decades of post-revolutionary Iran. The presence of Iranian women in festivals especially regarding what they wear has established a new interwoven relationship with authorities which has somewhat not been surveyed properly. By surveying the photos of their fashion and style I conclude that they are in constant negotiation with authorities through what they rebelliously wear. (shrink)

This article considers the strengths and potential contributions of participatory visual methods for healthcare quality improvement research. It argues that such approaches may enable us to expand our understanding of ‘patient experience’ and of its potential for generating new knowledge for health systems. In particular, they may open up dimensions of people’s engagement with services and treatments which exceed both the declarative nature of responses to questionnaires and the narrative sequencing of self reports gathered through qualitative interviewing. I will (...) suggest that working with such methods may necessitate a more reflexive approach to the constitution of evidence in quality improvement work. To this end, the article will first consider the emerging rationale for the use of visual participatory methods in improvement before outlining the implications of two related approaches—photo-elicitation and PhotoVoice—for the constitution of ‘experience’. It will then move to a participatory model for healthcare improvement work, Experience Based Co-Design. It will argue that EBCD exemplifies both the strengths and the limitations of adequating visual participatory approaches to quality improvement ends. The article will conclude with a critical reflection on a small photographic study, in which the author participated, and which sought to harness service user perspectives for the design of psychiatric facilities, as a way of considering the potential contribution of visual participatory methods for quality improvement. (shrink)

Psychogenic non epileptic seizures (PNES) are clinical events of psychological nature. Video-electroencephalography monitoring (V-EEGM) is a valuable method for the diagnosis of PNES and may be combined with provocative tests to induce seizures. The use of placebo in provocative tests for the diagnosis of PNES is controversial because of associated deception, and contrasts with the use of truly decreasing epileptogenic threshold techniques such as hyperventilation and photo stimulation. We present a clinical case of a pregnant woman with a past (...) history of refractory epilepsy, admitted in the obstetric department due to unremitting seizures. In this clinical context, non-deceiving provocative tests such as hyperventilation and photo stimulation could be potentially harmful, nevertheless, the use of intravenous saline injection presented as a safer alternative to diagnose PNES and hence obviate an urgent caesarean. This case illustrates a disproportionate risk of causing harm when telling the truth, in comparison with the benefit of avoiding such risk, although deceiving the patient. This is a clinical example of how considerations concerning the use of placebo must be evaluated in an individual basis. (shrink)

The role of figurative languages such as metaphor and metonymy in creativity has been studied in cognitive linguistics. These methods can also be applied to analyze non-linguistic data such as pictures and gestures. In this paper we analyze fashion design by focusing on visual metaphor and metonymy. The nature of creativity in fashion design is not fully studied from a cognitive perspective compared to other related fields such as art. We especially focus on the aspect of fashion design as (...) a communication tool between the designer and the audience to convey designer’s image of human. Photos from two fashion shows are analyzed. We carried out an experiment to compare how human images in two shows are interpreted by those who are familiar with fashion and those who are not. We got three results: (1) As far as figurative (metaphorical and metonymic) interpretations of human image are concerned, two groups with different familiarity to fashion have significantly different patterns of responses to two shows. (2) For non-figurative interpretations (such as physical or personal attributes), no significant difference in the pattern of response to the show was observed between two groups. The participants as a whole, however, responded to the two shows differently. (3) In addition for non-figurative interpretation, fashion experts found significantly more attributes in human images than the others. The results show that the analysis of figurative interpreations is effective in seeing how the familiarity to fashion affects the mode of seeing fashion shows. (shrink)

Background: This study developed a photo and video database of 4-to-6-year-olds expressing the seven induced and posed universal emotions and a neutral expression. Children participated in photo and video sessions designed to elicit the emotions, and the resulting images were further assessed by independent judges in two rounds. Methods: In the first round, two independent judges, experts in the Facial Action Coding System, firstly analysed 3,668 emotions facial expressions stimuli from 132 children. Both judges reached 100% agreement (...) regarding 1,985 stimuli, which were then selected for a second round of analysis between judges 3 and 4. Results: The result was 1,985 stimuli were produced from 124 participants. A Kappa index of 0.70 and an accuracy of 73% between experts were observed. Lower accuracy was found for emotional expression by 4-year-olds than 6-year-olds. Happiness, disgust and contempt had the highest agreement. After a sub-analysis evaluation of all four judges, 100% agreement was reached for 1,381 stimuli which compound the ChildEFES database with 124 participants and 51% induced photographs. The number of stimuli of each emotion were: 87 for neutrality, 363 for happiness, 170 for disgust, 104 for surprise, 152 for fear, 144 for sadness, 157 for anger 157, and 183 for contempt. Conclusions: The findings show that this photo and video database can facilitate research on the mechanisms involved in early childhood recognition of facial emotions in children, contributing to the understanding of facial emotion recognition deficits which characterise several neurodevelopmental and psychiatric disorders. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Michael L. MarkPatrice Madura Ward-SteinmanI met Michael Mark at the first Philosophy of Music Education conference held at Indiana University in the summer of 1990. I was a doctoral student at IU then and had studied the writings of many of the conference presenters and so the experience of hearing and meeting them in person was a heady one, indeed. I will never forget those impressions of Phil Alperson, (...) Wayne Bowman, Allen Britton, David Elliott, Peter Kivy, Gerard Knieter, Thomas Regelski, Bennett Reimer, John Shepherd, Ann Stokes, Eleanor Stubley, Keith Swanwick, and many others.I was interested in meeting Michael after hearing his response to the presentation of one of my favorite IU professors of musicology, Austin Caswell. Caswell’s provocative paper, “How We Got into Canonicity and What it has Done to Us: An American Music Historian’s View of Music in Academia,” claimed that “the effect of canonicity on American musical life is destructive,” while Michael’s response was characterized by his style of writing that I came to recognize over the decades as distinct, calm, logical, methodical, and based in an extraordinarily wide and deep wealth of historical knowledge. While I greatly admired my rebellious and passionate professor’s views and temperament which were not unlike my own, I also appreciated hearing Michael’s measured and thoughtful response. Thus began my friendship with Michael, who, I learned, was not only a professor [End Page 92] and dean at Towson State University but also an avid big band woodwind doubler who showed interest in my doctoral research in the art of vocal jazz improvisation. That friendship lasted for almost twenty-eight years and we enjoyed memorable reunions at other conferences. For example, there was the ISPME conference held at UCLA where he invited me to dinner with his good friend and connoisseur of fine wines, Bennett Reimer, and the ISPME conference in Helsinki where, after I tripped and severely broke my ankle, requiring surgery, Michael, Estelle Jorgensen, Iris Yob, and two then-doctoral students (Kasia Bugaj and Leonard Tan) visited me in the Helsinki hospital.When I began teaching at the University of Southern California in 1995, it was fortuitous that Michael’s brother, Brian, lived in the Los Angeles area. His frequent visits allowed him to make several guest lectures to my graduate research methods classes, very welcome opportunities. After one of those lectures, I relayed the history of my family’s ballroom in the Chicago area that was open for business with big band music from 1929 until 1967. He asked if I had any artifacts from Madura’s Danceland, and when I mentioned my father’s stacks of dusty record books, newsletters, photos, and posters in our basement, he became very enthusiastic and told me that I had a “gold mine” of an archive with which to write a book about the place! As a trained quantitative researcher, I began to explore the record books to analyze trends in band pay over the Depression and World War II years.1 Over the next ten years, with help from Michael’s regular prodding and encouragement, I organized the large archive into the history of Madura’s Danceland.2 I owe this personally important accomplishment to Michael Mark.Michael invited me (in his endearing way which I could not refuse) to coauthor a music education textbook with him3 and our writing partnership went so smoothly that he invited me to co-author the 4th edition of his Contemporary Music Education.4 Although our writing styles and areas of expertise were very different, I learned much from his narrative approach which included illustrative scenarios, interviews, and the informal use of contractions, a style of writing that was not second nature for me. We wrote both books without meeting in person, except to celebrate the publication of the first at the Metropolitan Art Museum café in New York with our beloved spouses, Lois Mark and David Ward-Steinman.Dr. Michael L. Mark will long be remembered for his many books, chapters, and articles on the history of music education and his many symposium presentations; for his university teaching and administrative achievements; and for his... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Is Literature Self-Referential?Eric MillerIIs literary language necessarily self-referential? And does this put paradox at the heart of literature? For at least two decades now, affirmative answers to both questions have been articles of faith among critics in the structuralist and poststructuralist mainstream. Literature’s ineluctable paradoxicality attracts us so because a paradox suggests that there are limits to human rationality, and thus strikes a blow for literature and against science. (...) Paradox ensures literature its own special realm, safe from the culturally imperialistic inroads of science’s orderly, rational-empirical constructions. Literature thus gets to be seen as “bigger” than reason, because only literature can live with paradox, and thus only literature reveals those “deeper” truths of contradiction-ridden human existence, whereas science can never penetrate beyond rational manipulations of phenomenal surfaces. Indeed, for anyone who holds all human existence to be fundamentally paradoxical, this special capacity makes literature the only genuine, demystified species of human knowledge. In the war between C. P. Snow’s Two Cultures, a war humanists are now losing badly, we like to regard paradox as our ultimate weapon.Belief in the paradoxicality of literature may also be found among the New Critics, 1 and in fact goes back at least to the Romantics, 2 but they did not derive this belief from a necessary self-referentiality of literary language. This newer way of deriving paradox appears to offer several competitive advantages. Self-reference seems to be the ultimate version of “art for art’s sake”: if all literary language is necessarily self-referential, then literature must be something totally self-contained, and is thus legitimized solely in and through itself. In addition, deriving [End Page 475] literature’s paradoxicality from self-reference seems to ground it in the same conceptual realm as mathematical logic, and thus tempts us to claim for literature a “rigor” normally conceded only to logic, mathematics, and theoretical physics. Self-referentiality would thus seem both to protect literature’s autonomy and to raise its cultural status into the company of mathematics and science.But it is a trap. For behind this new strategy lurks a capitulation to the underlying conceptual scheme of natural science, and literature thus comes to be conceived, in effect, as a science. Self-reference is, after all, still a kind of reference; paradox is still a kind of truth-relational construction;—and truth-relations built around reference constitute the correspondence theory of truth. From such a foundational commitment to reference and correspondence-truth, flows the rest of the scientific worldview: the dualism of referring expression and referent, word and object, sentence and fact, theory and data, language and world, culture and nature. The presentation of literature as a quasi-negation of this ontology changes nothing. The dualism of reference still functions as literature’s conceptual starting point, as its arche. We only appear to be defining a peculiar and radically distinct sphere for literature when we insist on its self-referentiality, on the (recursive) identity, for it, of referring expression and referent. For, this is still to treat the conceptual distinction between the two as foundational, and literature thereby tacitly assimilates science’s fundamental categorial division: the referential language-world duality of correspondence truth. Indeed, literature thus comes to live even more completely in the margins of science: it will have no essence of its own; it will differ at most in being a photo-negative image of science’s positiv(istic) project. In Snow’s war, self-reference is a Trojan horse.With self-reference as the essence of literature, we are thus staking our reputations on literature’s being a special field of formalizable “knowledge about...,” rather than, say, a quality or kind or realm of possible experience—which is to adopt science’s understanding of what is important. Matters are only made worse by that other attempt to define literary studies as a negation of the theory-data dualism of natural science: the poststructuralist denial of the distinction between criticism and literature. For the institutional need professional critics have to be seen as a discipline with a method and a subject, as a form of “knowledge about,” hardly disappears with... (shrink)

Maria Goltsman. On some graphic regularities of perception in painting and dance: Mnemonic form of dance. The present article handles some problems of the mechanisms of visual perception in painting and classical ballet. It proceeds from the assumption that the interaction between those arts is based on the similarity of their formal languages. The main attention focuses on the questions of how and why does the classical ballet use the code of painting? The interaction between pictorial art and ballet occurs (...) through the theatre, which is considered to be a picture coming alive in European tradition. This principle is taken here as a main method of analysis of ballet art and it is used in two ways. The first handles a problem of composition of a ballet as a theatrical performance. The second analyses the movement itself — the language of the choreography as such. The last part of the article contains the answer to the question — why does the ballet need such aspects of pictorial code as frontal composition of a picture coming alive, memory photo, multiplication of the similar images and repeating movements. Dance is dynamic, picture is stable. To represent a movement, the painting uses the rhythm and visual repeating of lines and contours. It helps to construct an illusion of motion and brings the temporal aspect into a static piece of art. Whereas different stops, poses and fixations in ballet help it to visualize the movement, to capture the space. This is one of the ways for ballet to leave its trace in space as much as in the memory of the spectators, to become fixed in space, to prevent the dispersion of dance in the thin air and to surmount in such a way the ephemera characteristic of it. (shrink)

BackgroundHealth service delivery should ensure ethical principles are observed at all levels of healthcare. Working towards this goal requires understanding the ethics-related priorities and concerns in the day-to-day activities among different health practitioners. These practitioners include community health workers (CHWs) who are involved in healthcare delivery in communities in many low-and middle-income countries such as Uganda. In this study, we used photovoice, an innovative community based participatory research method that uses photography, to examine CHWs' perspectives on ethical concerns in their (...) work.MethodsWe explored perspectives of 10 CHWs (5 females and 5 males) on ethical dimensions of their work for 5 months using photovoice in a rural community in Wakiso district, Uganda. As part of the study, we: 1. Oriented CHWs on photovoice research and ethics; 2. Asked CHWs to take photographs of key ethical dimensions of their work; 3. Held monthly meetings to discuss and reflect on the photos; and 4. Disseminated the findings. The discussions from the monthly meetings were audio recorded, transcribed, and emerging data analysed using conventional content analysis with the help of Atlas ti version 6.0.15.ResultsCHWs were aware of and highly concerned about the need to observe ethical principles while carrying out their roles. The ethical principles CHWs were aware of and endeavoured to observe during their work were: maintaining professional integrity and abiding by ethical principles of practice; ethical responsibility in patient care; maintaining confidentiality while handling clients; respect for persons and communities; and enhancing their knowledge and skills for better practice. However, CHWs also identified challenges concerning their observance of ethical principles including: low commitment to their work due to other obligations; availability of some reference materials and guidelines in English yet majority could only read in the local language; and minimal avenues for knowledge enhancement such as trainings.ConclusionsCHWs were aware of and keen to discuss ethical issues in their work. However, there is need to address the challenges they face so as to facilitate observing ethical principles during the course of their work in communities. (shrink)

Digitised collections and born digital items, such as photos or video, exist beyond the scale of human viewing. New methods are required to read, understand and work with the data, resulting in computation becoming increasingly central to both creation of a cultural reality and as the interpretative tool and practice. If artists’ look, then how might a machine see as a critical tool? Developing work on computational culture and the Next Rembrandt project as unstable digital object, this paper considers (...) how the medium affects computational critical practice. Drawing on Heidegger’s view of causality and Derrida’s grammatology, this paper explores how the medium acts a locus between the human and machine readings and the remediations that occur within the reading. This is developed as through a reading of how the interface translates the signs and symbols and how this affects the reading. By reconsidering the critical assemblage and using it to think with, the human and the machine are seen as critical partners. Attending to the materialities of the reading through a playful approach that decentres potential meaning encourages us to glimpse beneath the surface and gestures towards a critical practice as understanding both computation and its materiality. (shrink)

Eye-tracking studies have revealed a specific visual exploration style characterizing individuals with Autism Spectrum Disorder (ASD). The aim of this study is to investigate the impact of stimulus type (static vs. dynamic) on visual exploration in children with ASD. Twenty-eight children with ASD, 28 children matched for developmental communication age and 28 children matched for chronological age watched a video and a series of photos involving the same joint attention scene. For each stimulus, Areas of Interest (AOI) were determined based (...) on Voronoi diagrams, which were defined around participants’ fixation densities, defined by the mean shift algorithm. To analyze the eye-tracking data on visual exploration, we used a method for creat-ing AOI a posteriori, based on participants’ actual fixations. The results showed the value of both kinds of stimuli. The photos allowed for the identification of more precise AOI, and show similarities in exploration between ASD and typical children. On the other hand, in video, among ASD children only, there are few differences in the way they look at the target depend-ing on the deictic cue used. This raises questions regarding their understanding of a joint atten-tion bid recorded on a video. Finally, whatever the stimulus, pointing seems to be the most im-portant element for children to look at the target. (shrink)

MATTER AND LIGHT The New Physics By LOUIS DE BROGLIE. Originally published in 1937. TRANSLATORS NOTE: THE Author has in certain places modified the original French text for the English translation, for the sake of greater cohesion, and has also revised some passages, in order to bring them into accord with the results of later research. Occasional Translators Notes are shown in square brackets. The chapter on The Undulatory Aspects of the Electron has the special historical interest of having been (...) delivered as a Lecture on the occasion of the Authors receipt of the Nobel Award, while that on Wave Mechanics and its Interpretations was given as an Address at the Glasgow meeting of the British Association in 1928. I am indebted to Dr. J. E. Turner, of the University of Liver pool, for assistance with the translation and the proofs, and to Dr. C. Strachan, of the same University, I am indebted for valuable assistance in dealing with the equations and the more technical passages, as well as for reading the proofs. W. H. J. PREFACE: THE amiable insistence of my friend Andr George has induced me to collect in the present Volume a number of Studies on con temporary Physics written from both the general and the more metaphysical point of view. Each of these Studies forms an inde pendent whole, and can be read by itself. A slight degree of repeti tion which the reader is asked to overlook has been the inevi table result for on more than one occasion I have been compelled to duplicate a summary of the great fundamental stages of con temporary Physics, such as the classification of simple substances, the investigation of the photo-electric effect and the origin of the Theory of Light Quanta and of Wave Mechanics the subjects are somewhat technical, and I cannot well assume that they are common knowledge. But though the same subject is outlined in several of these Studies, I have tried to take up a different point of view in each, and have endeavoured to throw light on different aspects of the essential problems of Quantum Physics in order to facilitate a grasp of their importance. On comparing the different chapters the reader will observe that, while overlapping, they also complement one another and he will feel the fascination and greatness inherent in the vast structure of modern Physics. And while admiring the vast number and the extreme delicacy of experimental facts which laboratory physicists have succeeded in revealing, and the strange and brilliant concepts devised by theorists to explain them, he will appreciate to what a degree the methods and ideas of physicists have grown in subtlety during recent years, and how great has been the progress from the somewhat ingenuous Realism and the over-simplified Mechanics of earlier thinkers. The more deeply we descend into the minutest structures of Matter, the more clearly we see that the concepts evolved by the mind in the course of everyday experience especially those of Time and Space must fail us in an endeavour to describe the new worlds which we are entering. One feels tempted to say that the outlines of our concepts must undergo a progressive blurring, in order that they may retain some semblance of relevance to the realities of the subatomic scales. Time and Space, in other words, are too loose a dress for the elementary entities individuality becomes attenuated in the mysterious pro cesses of interaction, and even Determinism, the darling of an older generation of physicists, is forced to yield... (shrink)

Advancements in digital technology have made it easy to alter faces using editing software, posing challenges for industries in verifying photograph authenticity. Digital image forensics, a scientific method, is employed to gather data and determine the veracity of faces. This study assesses the effectiveness of digital image forensics in detecting fake digital faces using tools such as Foto Forensics, Forensically Beta, and Opanda IExif. Foto Forensics analyzes JPEG picture compression levels to detect image edits, revealing metadata differences compared to the (...) original photo. Forensically Beta examines digital characteristics like color and noise levels to identify alterations. Opanda IExif scrutinizes image metadata, disclosing information about the camera used and subsequent changes. All three forensic methods effectively identify fake digital faces. Analyzing metadata differences and contrast variations between the original and altered faces proves to be an effective method for spotting alterations. Digital image forensics enhances legal and investigative processes, serving as a valuable tool for identifying digital face manipulation. Stronger digital security measures, including improved encryption, authentication, and legal regulations, are needed to protect against facial photograph manipulation. Updating legal and regulatory frameworks for digital security is vital to address increasingly sophisticated techniques used in facial photograph editing. As digital technology advances, continuous development and improvement of forensic techniques are crucial to detect digital face fabrication. Given the growing complexity of digital editing tools and the ease with which facial images can be altered, reliable methods are essential. Digital image forensics provides a systematic approach to gather data and verify the authenticity of digital photographs. (shrink)

Greenway is a kind of corridors in the city that takes natural elements as the main constituent foundation and connects open spaces with functions such as leisure and recreation. The assessment of the built greenway is a review of the past construction experiences, and it is also a supplement and improvement to the future greenway planning concept system, which has important academic and application value. This study will explore how greenway design factors influenced the local cyclists’ perception of the landscape (...) using on-site questionnaire and photo rating method. The results indicated that greenways with continuous cycling paths, high security awareness, open landscapes, and rich human activities evoke positive perceptions. Among the visual elements, natural elements such as plants and sky are more favorable than artificial elements. The research results show that the formation of greenway cyclists’ landscape imagery is affected by visual perception elements, which suggests that special consideration should be given to the laws of cyclists’ mental perception when designing greenways. (shrink)

This article analyses the interplay between the International Federation of Organic Agriculture Movements (IFOAM) standard, Buddhist socio-economic imaginaries, and values within the global production network (GPN) of organic rice. It asks, _“How do transnational standardisation and local values interact in the global production network of organic rice?”_ Little research has been conducted on the imaginaries and values embedded in the GPNs of organic food. This research aims to fill this gap by examining the transition to organic agriculture among two prominent (...) organic rice farming communities in Thailand, namely the Naso Producer Group and the Ban Thap Thai Organic Agricultural Cooperative. The article draws on a combination of desk research; interviews with governmental and non-governmental officials, standard experts/certifiers, and representatives of the IFOAM; focus group discussions and photo-elicitation sessions with organic rice farmers; on-site observations; and participant observations of mindfulness meditation courses and interviews with Buddhist monks. The results show that Buddhist socio-economic imaginaries have informed the way in which Thai organic rice farmers reconnect to their arable land through an organic farming method, enabling them to live meaningfully and mindfully. This implies that the connectivity of the GPNs of organic rice is not created purely by standards and certifications formulated by transnational private actors; rather, it is also shaped to a large extent by community values and shifts in local mindsets. This article contributes to the literature on food philosophy in the developing world and the governance of the GPNs of organic rice. (shrink)

Image restoration is a research hotspot in computer vision and computer graphics. It uses the effective information in the image to fill in the information of the designated damaged area. This has high application value in environmental design, film and television special effects production, old photo restoration, and removal of text or obstacles in images. In traditional sparse representation image restoration algorithms, the size of dictionary atoms is often fixed. When repairing the texture area, the dictionary atom will be (...) too large to cause blurring. When repairing a smooth area, the dictionary atom is too small to cause the extension of the area, which affects the image repair effect. In this paper, the structural sparsity of the block to be repaired is used to adjust the repair priority. By analyzing the structure information of the repair block located in different regions such as texture, edge, and smoothing, the size of the dictionary atom is adaptively determined. This paper proposes a color image restoration method that adaptively determines the size of dictionary atoms and discusses a model based on the partial differential equation restoration method. Through simulation experiments combined with subjective and objective standards, the repair results are evaluated and analyzed. The simulation results show that the algorithm can effectively overcome the shortcomings of blurred details and region extension in fixed dictionary restoration, and the restoration effect has been significantly improved. Compared with the results of several other classic algorithms, it shows the effectiveness of the algorithm in this paper. (shrink)

The DangShi manor is located in Hejiashi Village, Baijiajian Town approximately 20 kilometers from the southeast part of Suide County, Shaanxi Province, the unique architecture in Qing Dynasty that has been preserved almost intact in Suide County, a great cultural county, and is an officially protected site in Shaanxi Province. By means of field survey, mapping and taking photos and recording in Dangshi manor, this article acquires the abundant first-hand data about carving art of the manor. With the methods (...) of comparison and induction from the holistic perspective and detailed analysis in the local perspective, this article makes a meticulous analysis and study on the style, content, connotation, moulding and technique of carving art of Dangshi manor and discusses characteristics and protection and inheritance value of carving art of Dangshi manor in a systematic way. (shrink)

In 2016, the Atlanta Community Food Bank launched the Stabilizing Lives project to develop programs and policies that could better address clients’ needs as well as including clientele as part of the planning process. The ACFB partnered with a research team at the University of Georgia to conduct a participatory research project aimed at developing deeper insights into the factors contributing to both instability and stability in the lives of pantry clientele. This article describes the outcomes this research, offering both (...) a substantive contribution to scholarship on food insecurity and emergency food systems and a methodological innovation through a staged mixed-method participatory research project. Through use of a culture-centered approach, this project created discursive spaces within which to outline emergency food models that support informal networks of care. We used a range of methods, including photo elicitation, concept mapping, individual interviews, and focus groups, to facilitate conversation among agency staff, volunteers, and clientele about the effectiveness of current program models and potential new ideas. Specifically, we suggest that through such practices, food pantries and local agencies may help inform new program models that contribute to household stability, and push back against the sometimes alienating and atomizing paradigm found in current emergency food programs. (shrink)