Tragic Errors and Politics of Guilt

Pričujoči članek si prizadeva oceniti implikacije še vedno žive fascinacije z likom Antigone v sodobni literaturi. S tem namenom so obravnavane tri glavne teme: žrtvovanja, transgresije in Heglove Filozofije pravice. Četrti in zadnji del teksta obravnava razmerje med tragedijo, željo in krivdo. Glavne interpretacije Antigone zanemarijo povezavo med politiko in družbenimi silami zaradi spoštovanja podobe transgresivnega lika. V nasprotju s politiko dolga in krivde vpeljem v zaključku članka koncept želeče produkcije in njenega objekta.This article aims to evaluate the implications of the ongoing fascination with the figure of Antigone in contemporary literature. For this purpose, three main themes of sacrifice, transgression and Hegel’s Philosophy of Right are discussed. The fourth and final part of the text discusses the relation between tragedy, desire and guilt. The main interpretative attitudes towards Antigone ignore the conjunction of politics and social forces in deference to the image of a transgressive figure. In opposition to a politics of debt and guilt, in conclusion I introduce the concept of desiring production and its object

The Modern State After Kant A Materialist Approach

This article proposes an encounter between Kant’s political doctrine and Marx’s materialist method. The primary aim of this materialist critique of Kant is to discern the structure that determines the specific mode of functioning of the modern state. The article starts with Kant’s conception of freedom and law and relates these concepts to his theory of history. In the first and second sections, Kant’s political doctrine is subject to a critical reversal that more closely engages with Marx’s critical materialist approach. The article then concludes upon a new, topological approach to the ternary structure involving the intersection of three “rings”—capitalist circulation, the state in its legal effective reality, and measured labor forces in production

The Modern State After Kant A Materialist Approach

This article proposes an encounter between Kant’s political doctrine and Marx’s materialist method. The primary aim of this materialist critique of Kant is to discern the structure that determines the specific mode of functioning of the modern state. The article starts with Kant’s conception of freedom and law and relates these concepts to his theory of history. In the first and second sections, Kant’s political doctrine is subject to a critical reversal that more closely engages with Marx’s critical materialist approach. The article then concludes upon a new, topological approach to the ternary structure involving the intersection of three “rings”—capitalist circulation, the state in its legal effective reality, and measured labor forces in production

Cardiovascular risk scores do not account for the effect of treatment: a review

OBJECTIVE: To compare the strengths and limitations of cardiovascular risk scores available for clinicians in assessing the global (absolute) risk of cardiovascular disease. DESIGN: Review of cardiovascular risk scores. DATA SOURCES: Medline (1966 to May 2009) using a mixture of MeSH terms and free text for the keywords 'cardiovascular', 'risk prediction' and 'cohort studies'. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: A study was eligible if it fulfilled the following criteria: (1) it was a cohort study of adults in the general population with no prior history of cardiovascular disease and not restricted by a disease condition; (2) the primary objective was the development of a cardiovascular risk score/equation that predicted an individual's absolute cardiovascular risk in 5-10 years; (3) the score could be used by a clinician to calculate the risk for an individual patient. RESULTS: 21 risk scores from 18 papers were identified from 3536 papers. Cohort size ranged from 4372 participants (SHS) to 1591209 records (QRISK2). More than half of the cardiovascular risk scores (11) were from studies with recruitment starting after 1980. Definitions and methods for measuring risk predictors and outcomes varied widely between scores. Fourteen cardiovascular risk scores reported data on prior treatment, but this was mainly limited to antihypertensive treatment. Only two studies reported prior use of lipid-lowering agents. None reported on prior use of platelet inhibitors or data on treatment drop-ins. CONCLUSIONS: The use of risk-factor-modifying drugs-for example, statins-and disease-modifying medication-for example, platelet inhibitors-was not accounted for. In addition, none of the risk scores addressed the effect of treatment drop-ins-that is, treatment started during the study period. Ideally, a risk score should be derived from a population free from treatment. The lack of accounting for treatment effect and the wide variation in study characteristics, predictors and outcomes causes difficulties in the use of cardiovascular risk scores for clinical treatment decision

Effectiveness of blood pressure-lowering drug treatment by levels of absolute risk: Post hoc analysis of the Australian National Blood Pressure Study

Objectives: In many current guidelines, blood pressure (BP)-lowering drug treatment for primary prevention of cardiovascular disease (CVD) is based on absolute risk. However, in clinical practice, therapeutic decisions are often based on BP levels alone. We sought to investigate which approach was superior by conducting a post hoc analysis of the Australian National Blood Pressure (ANBP) cohort, a seminal study establishing the efficacy of BP lowering in mild hypertensive' persons. Design: A post hoc subgroup analysis of the ANBP trial results by baseline absolute risk tertile. Setting and participants: 3244 participants aged 35-69 years in a community-based randomised placebo controlled trial of blood pressure-lowering medication. Interventions Chlorothiazide500 mg versus placebo. Primary outcome measures All-cause mortality and non-fatal events (non-fatal CVD, congestive cardiac failure, renal failure, hypertensive retinopathy or encephalopathy). Results: Treatment effects were assessed by HR, absolute risk reduction and number needed to treat. Participants had an average 5-year CVD risk in the intermediate range (10.5±6.5) with moderately elevated BP (mean 159/103 mmHg) and were middle aged (52±8 years). In a subgroup analysis, the relative effects (HR) and absolute effects (absolute risk reduction and number needed to treat) did not statistically differ across the three risk groups except for the absolute benefit in all-cause mortality (p for heterogeneity=0.04). With respect to absolute benefit, drug treatment significantly reduced the number of events in the high-risk group regarding any event with a number needed to treat of 18 (10 to 64), death from any cause with 45 (25 to 196) and major CVD events with 23 (12 to 193). Conclusion: Our analysis confirms that the benefit of treatment was substantial only in the high-risk tertile, reaffirming the rationale of treating elevated blood pressure in the setting of all risk factors rather than in isolation

Metric trees of generalized roundness one

Every finite metric tree has generalized roundness strictly greater than one. On the other hand, some countable metric trees have generalized roundness precisely one. The purpose of this paper is to identify some large classes of countable metric trees that have generalized roundness precisely one. At the outset we consider spherically symmetric trees endowed with the usual combinatorial metric (SSTs). Using a simple geometric argument we show how to determine decent upper bounds on the generalized roundness of finite SSTs that depend only on the downward degree sequence of the tree in question. By considering limits it follows that if the downward degree sequence $(d_{0}, d_{1}, d_{2}...)$ of a SST $(T,\rho)$ satisfies $|\{j \, | \, d_{j} > 1 \}| = \aleph_{0}$, then $(T,\rho)$ has generalized roundness one. Included among the trees that satisfy this condition are all complete $n$-ary trees of depth $\infty$ ($n \geq 2$), all $k$-regular trees ($k \geq 3$) and inductive limits of Cantor trees. The remainder of the paper deals with two classes of countable metric trees of generalized roundness one whose members are not, in general, spherically symmetric. The first such class of trees are merely required to spread out at a sufficient rate (with a restriction on the number of leaves) and the second such class of trees resemble infinite combs.Comment: 14 pages, 2 figures, 2 table

The challenge of overdiagnosis begins with its definition

Overdiagnosis means different things to different people. S M Carter and colleagues argue that we should use a broad term such as too much medicine for advocacy and develop precise, case by case definitions of overdiagnosis for research and clinical purposes The implicit social contract underpinning healthcare is that it will reduce illness and preventable death and improve quality of life. But sometimes these promises are not delivered. Sometimes health services take people who don’t need intervention, subject them to tests, label them as sick or at risk, provide unnecessary treatments, tell them to live differently, or insist on monitoring them regularly.1 These interventions don’t improve things for people; they produce complications or illness, reduce quality of life, or even cause premature death. Active health intervention is not always a good thing: it can be “too much medicine,” or produce what is often called overdiagnosis. Although the concept of overdiagnosis has been described in the literature for nearly 50 years in relation to cancer screening,2 3 it was Welch and colleagues’ 2011 book, Overdiagnosed: Making People Sick in the Pursuit of Health, that popularised the term.4 Overdiagnosis is now an acknowledged problem for patients, clinicians, researchers, and policymakers; it is discussed in journals5 6 7 and at specialist conferences8 and addressed through policy and practice initiatives.9 10 11 There is, however, no formal, agreed definition of overdiagnosis. Rather, the word has become a banner under which disparate people with similar general concerns can unite. This vagueness and breadth allows the appearance of unity but does not serve the more exacting demands of research and healthcare. Here we examine the meanings of overdiagnosis more closely and discuss related challenges for healthcare professionals, patients, and researchers. If overdiagnosis is to be understood and mitigated, the broad concept should be subdivided into different problems and its ethical dimensions better acknowledged.NHMR

On the Quantization of the Chern-Simons Fields Theory on Curved Space-Times: the Coulomb Gauge Approach

We consider here the Chern-Simons field theory with gauge group SU(N) in the presence of a gravitational background that describes a two-dimensional expanding ``universe". Two special cases are treated here in detail: the spatially flat {\it Robertson-Walker} space-time and the conformally static space-times having a general closed and orientable Riemann surface as spatial section. The propagator and the vertices are explicitely computed at the lowest order in perturbation theory imposing the Coulomb gauge fixing.Comment: 15 pp., Preprint LMU-TPW 93-5, (Plain TeX + Harvmac