The poet sings: “resonance” in Paul Valéry’s poietics

This paper analyses Paul Valéry’s theories relating to his stated goal of poetic production: the attainment of “resonance” and a “singing-state”. My intention is to defend Valéry’s theory as a valid and consistent model of the creative process in poetry. To that end, I will draw support from T. W. Adorno’s claim that Valéry’s manner of reflective journalising in his Notebooks can furnish us with what he calls “aesthetic insight”. The consistency of Valéry’s theory will be supported by comparisons with the inferentialist understanding of semantics. Valéry proves to be a reliable exemplar of what might be called a “practice-led” aesthetics

Writing as life performed

In this chapter I explore the interrelatedness of practice, rehearsal, and performance and their applicability in the domain of “life.” These relationships are complicated when, in reference to Adorno’s Minima Moralia, the content of critical-essayistic production (which is analogous to aesthetic production in many ways) is ultimately that of the life of the author. I propose that to a large extent, the categories of practicing, rehearsing, and performing that are derivable from artistic-productive experience can be extended to lived experience. Working and living seriously and critically have significant points of convergence. What I attempt to disrupt is the presupposition of any “natural” hierarchy between these categories, whereby, for example, performance – connoting the tangible accomplishment of goals and the visibility of that accomplishment – takes precedence over the open-ended tasks of practice and rehearsal

Dwelling and the sacralisation of the air: A note on acousmatic music

This paper adapts Martin Heidegger’s philosophy of ‘dwelling’ in order to effect a liaison between acousmatic music and ecological concern. I propose this as an alternative to both the propagandist use of music as a means of protest and to using the science of ecology as a domain that might furnish new compositional means. I advance the interpretation that acousmatic music ‘occupies the air’ in ways that transform the meaning of that dimension. It allows the sky to be sky and the earth, earth. I use the precedent of bell ringing as an example of sonic activity that occupies the air in order to furthe

Writing as life performed

In this chapter I explore the interrelatedness of practice, rehearsal, and performance and their applicability in the domain of “life.” These relationships are complicated when, in reference to Adorno’s Minima Moralia, the content of critical-essayistic production (which is analogous to aesthetic production in many ways) is ultimately that of the life of the author. I propose that to a large extent, the categories of practicing, rehearsing, and performing that are derivable from artistic-productive experience can be extended to lived experience. Working and living seriously and critically have significant points of convergence. What I attempt to disrupt is the presupposition of any “natural” hierarchy between these categories, whereby, for example, performance – connoting the tangible accomplishment of goals and the visibility of that accomplishment – takes precedence over the open-ended tasks of practice and rehearsal

A qualitative study of experiences of NHS mental healthcare workers during the Covid-19 pandemic.

BackgroundThe Covid-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. We aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic.MethodsThe design was a qualitative interview-based study. We conducted semi-structured, remote (telephone or online) interviews with 35 members of staff from NHS secondary (inpatient and community) mental health services in England. Analysis was based on the constant comparative method.ResultsParticipants reported wide-ranging changes in the organisation of secondary mental health care and the nature of work in response to the pandemic, including pausing of all services deemed to be "non-essential", deployment of staff across services to new and unfamiliar roles, and moves to remote working. The quality of participants' working life was impaired by increasing levels of daily challenge associated with trying to provide care in trying and constrained circumstances, the problems of forging new ways of working remotely, and constraints on ability to access informal support. Participants were confronted with difficult dilemmas relating to clinical decision-making, prioritisation of care, and compromises in ability to perform the therapeutic function of their roles. Other dilemmas centred on trying to balance the risks of controlling infection with the need for human contact. Many reported features of moral injury linked to their perceived failures in providing the quality or level of care that they felt service users needed. They sometimes sought to compensate for deficits in care through increased advocacy, taking on additional tasks, or making exceptions, but this led to further personal strain. Many experienced feelings of grief, helplessness, isolation, distress, and burnout. These problems were compounded by sometimes poor communication about service changes and by staff feeling that they could not take time off because of the potential impact on others. Some reported feeling poorly supported by organisations.ConclusionsMental health workers faced multiple adversities during the pandemic that were highly consequential for their wellbeing. These findings can help in identifying targets for support

Remote care for mental health:qualitative study with service users, carers and staff during the COVID-19 pandemic

Objectives: To explore the experiences of service users, carers and staff seeking or providing secondary mental health services during the COVID-19 pandemic. Design: Qualitative interview study, co-designed with mental health service users and carers. Methods: We conducted semi-structured, telephone or online interviews with a purposively constructed sample; a lived experience researcher conducted and analysed interviews with service users. Analysis was based on the constant comparison method. Setting: NHS secondary mental health services in England between June and August 2020. Participants: Of 65 participants, 20 had either accessed or needed to access English secondary mental healthcare during the pandemic; 10 were carers of people with mental health difficulties; 35 were members of staff working in NHS secondary mental health services during the pandemic. Results: Experiences of remote care were mixed. Some service users valued the convenience of remote methods in the context of maintaining contact with familiar clinicians. Most participants commented that a lack of non-verbal cues and the loss of a therapeutic ‘safe space’ challenged therapeutic relationship building, assessments, and identification of deteriorating mental wellbeing. Some carers felt excluded from remote meetings and concerned that assessments were incomplete without their input. Like service users, remote methods posed challenges for clinicians who reported uncertainty about technical options and a lack of training. All groups expressed concern about intersectionality exacerbating inequalities and the exclusion of some service user groups if alternatives to remote care are lost. Conclusions: Though remote mental healthcare is likely to become increasingly widespread in secondary mental health services, our findings highlight the continued importance of a tailored, personal approach to decision-making in this area. Further research should focus on which types of consultations best suit face-to-face interaction, and for whom and why, and which can be provided remotely and by which medium.This research was funded by The Healthcare Improvement Studies Institute (THIS Institute), University of Cambridge. THIS Institute is supported by the Health Foundation, an independent charity committed to bringing about better health and healthcare for people in the UK. Grant number not applicable. All contracted parties contributed to the study under agreements through the same funding. PBJ is supported by the NIHR Applied Research Collaboration East of England and by RP-PG-0161-20003. Mary Dixon-Woods is an NIHR Senior Investigator (NF-SI-0617-10026)

Qualitative study of candidacy and access to secondary mental health services during the COVID-19 pandemic.

Funder: The Health FoundationCandidacy, a construct describing how people's eligibility for care is negotiated between themselves and services, has received limited attention in the context of mental health care. In addition, candidacy research has only rarely studied the views of carers and health professionals. In this article, we use concepts relating to candidacy to enable a theoretically informed examination of experiences of access to secondary mental health services during the first wave of the COVID-19 pandemic in England. We report a qualitative study of the views and experiences of service users, carers, and healthcare professionals. Analysis of 65 in-depth interviews was based on the constant comparative method. We found that wide-ranging service changes designed to address the imperatives of the pandemic were highly consequential for people's candidacy. Macro-level changes, including increased emphasis on crisis and risk management and adapted risk assessment systems, produced effects that went far beyond restrictions in the availability of services: they profoundly re-structured service users' identification of their own candidacy, including perceptions of what counted as a problem worthy of attention and whether they as individuals needed, deserved, and were entitled to care. Services became less permeable, such that finding a point of entry to those services that remained open required more work of service users and carers. Healthcare professionals were routinely confronted by complex decisions and ethical dilemmas about provision of care, and their implicit judgements about access may have important implications for equity. Many of the challenges of access exposed by the pandemic related to pre-existing resource deficits and institutional weaknesses in care for people living with mental health difficulties. Overall, these findings affirm the value of the construct of candidacy for explaining access to mental healthcare, but also enable deepened understanding of the specific features of candidacy, offering enduring learning and implications for policy and practice.This project was funded by THIS Institute’s grant from the Health Foundation. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. All contracted parties contributed to the study under agreements through the same funding. PBJ is supported by the NIHR Applied Research Collaboration East of England and by RP-PG-0161-20003. Mary Dixon-Woods is an NIHR Senior Investigator (NF-SI-0617-10026). The views expressed in this article are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care

Hundreds of variants clustered in genomic loci and biological pathways affect human height

Most common human traits and diseases have a polygenic pattern of inheritance: DNA sequence variants at many genetic loci influence the phenotype. Genome-wide association (GWA) studies have identified more than 600 variants associated with human traits, but these typically explain small fractions of phenotypic variation, raising questions about the use of further studies. Here, using 183,727 individuals, we show that hundreds of genetic variants, in at least 180 loci, influence adult height, a highly heritable and classic polygenic trait. The large number of loci reveals patterns with important implications for genetic studies of common human diseases and traits. First, the 180 loci are not random, but instead are enriched for genes that are connected in biological pathways (P = 0.016) and that underlie skeletal growth defects (P < 0.001). Second, the likely causal gene is often located near the most strongly associated variant: in 13 of 21 loci containing a known skeletal growth gene, that gene was closest to the associated variant. Third, at least 19 loci have multiple independently associated variants, suggesting that allelic heterogeneity is a frequent feature of polygenic traits, that comprehensive explorations of already-discovered loci should discover additional variants and that an appreciable fraction of associated loci may have been identified. Fourth, associated variants are enriched for likely functional effects on genes, being over-represented among variants that alter amino-acid structure of proteins and expression levels of nearby genes. Our data explain approximately 10% of the phenotypic variation in height, and we estimate that unidentified common variants of similar effect sizes would increase this figure to approximately 16% of phenotypic variation (approximately 20% of heritable variation). Although additional approaches are needed to dissect the genetic architecture of polygenic human traits fully, our findings indicate that GWA studies can identify large numbers of loci that implicate biologically relevant genes and pathways.

Ecological release in White Sands lizards

Ecological opportunity is any change that allows populations to escape selection from competition and predation. After encountering ecological opportunity, populations may experience ecological release: enlarged population size, broadened resource use, and/or increased morphological variation. We identified ecological opportunity and tested for ecological release in three lizard colonists of White Sands, New Mexico (Sceloporus undulatus, Holbrookia maculata, and Aspidoscelis inornata). First, we provide evidence for ecological opportunity by demonstrating reduced species richness and abundance of potential competitors and predators at White Sands relative to nearby dark soils habitats. Second, we characterize ecological release at White Sands by demonstrating density compensation in the three White Sands lizard species and expanded resource use in White Sands S. undulatus. Contrary to predictions from ecological release models, we observed directional trait change but not increased trait variation in S. undulatus. Our results suggest that ecological opportunity and ecological release can be identified in natural populations, especially those that have recently colonized isolated ecosystems

Parent-of-origin-specific allelic associations among 106 genomic loci for age at menarche.

Age at menarche is a marker of timing of puberty in females. It varies widely between individuals, is a heritable trait and is associated with risks for obesity, type 2 diabetes, cardiovascular disease, breast cancer and all-cause mortality. Studies of rare human disorders of puberty and animal models point to a complex hypothalamic-pituitary-hormonal regulation, but the mechanisms that determine pubertal timing and underlie its links to disease risk remain unclear. Here, using genome-wide and custom-genotyping arrays in up to 182,416 women of European descent from 57 studies, we found robust evidence (P < 5 × 10(-8)) for 123 signals at 106 genomic loci associated with age at menarche. Many loci were associated with other pubertal traits in both sexes, and there was substantial overlap with genes implicated in body mass index and various diseases, including rare disorders of puberty. Menarche signals were enriched in imprinted regions, with three loci (DLK1-WDR25, MKRN3-MAGEL2 and KCNK9) demonstrating parent-of-origin-specific associations concordant with known parental expression patterns. Pathway analyses implicated nuclear hormone receptors, particularly retinoic acid and γ-aminobutyric acid-B2 receptor signalling, among novel mechanisms that regulate pubertal timing in humans. Our findings suggest a genetic architecture involving at least hundreds of common variants in the coordinated timing of the pubertal transition