Inevitably Dying: The Role of Ideological Legacy-Derived Death Anxieties in Subverting Mortality Salience

Existential debates – regarding life, death, and the states which potentially succeed existence – have widespread spiritual and ethical implications for general society. Rather than aimlessly questioning the metaphysical value of death on life, there are clear bioethical applications to exploring exaggerated human death anxieties. These fears are unique to our species and have wide-spread societal repercussions. By and large, discomfort with the notion of mortality permeates unequivocally throughout our species’ histories. We become our own worst enemies when we fail to admit and confront the inevitability of death. The lack of mortality salience encouraged by our trepidations fuels an immortality narrative that dismisses death in favor of a presumption of human invincibility. The repercussions of such attitudes regarding thanatology can be readily observed throughout healthcare, judicial, religious, and funeral sectors, etc. Death anxieties further allow irrationality to proliferate. Therefore, in order to address our trepidations, it is essential that we first identify the source of these fears. Given the status of narrative and storytelling in all aspects of human life, it is proposed that our preoccupations with legacy are preventing us from addressing our fears re mortality and preventing us from attaining sufficient mortality salience. Legacy is defined as an all-inclusive term referencing a subjective evaluation during life that impacts an individual’s reputation posthumously. In order to assert the absurdity of legacy’s influence on our perceptions of death, we will refute potential counterarguments in the forms of posthumous harm and demonstrate the impracticality of the fear-based narrative that currently surrounds mortality. In doing so, we will largely favor Epicurean attitudes towards death, in order to contradict both the generally accepted mortal harm and posthumous harm theses, by claiming that 1) one is not harmed by their own death and 2) one cannot be harmed after their own death. Our argument regarding the harmful effects of legacy on thanatological fears has both theoretical and practical implications, especially with regards to various bioethical concerns. Specifically, regarding the legalization of physician-assisted death, we will be illustrating that, from a utility perspective, such measures appear rational and warrant legal endorsement. Other applied bioethical issues (e.g. presumption of posthumous consent, cadaver organ transplantation procedures, etc.) will also benefit from the implications of studying the effects of legacy-derived death anxieties on mortality salience

The Public Sector HIV/AIDS Treatment Roll-out Campaign in the Western Cape: A case study highlighting success factors and challenges

Word processed copy.Includes bibliographical references (leaves 84-98).Until recently, the national implementation of a public sector Antiretroviral Therapy (ART) programme in South Africa seemed financially impossible. Drastically reduced prices for Antiretrovirals (ARVs) combined with substantial donor funding and the long-awaited adoption of a national treatment plan, have, however, shifted the debate. Now the question is not so much should universal ART be provided by government but, rather, is it possible to implement in severely resource-constrained environments and, if so, what are the best ways to deliver these services

Urban Nomads of Petra: An Alternative Interpretation of the Bedoul Bedouin's Relationship with History and Space

Jordan's efforts to become a stronger state in the global community have frequently conflicted with the Bedouin population‟s desire to continue its semi-nomadic and pastoral tradition. The Bedoul, who claim ancestral heritage to the ancient city of Petra, face a complex conflict with the urbanizing state. This paper offers an alternative evaluation of the relationship between the state and semi-nomadic communities by reexamining historical trends and the Bedoul Bedouin condition through a multi-dimensional analytic, which is inspired by the concept of the global city as defined by Saskia Sassen. By referring to this analytical lens as the “global city aesthetic,” I intend to make use of the analytical method that allowed for the global city to be defined, to make room for the reality of contradictions, and finally, to be sensitive to the imagery and dynamics inspired by the concept of the global city. Furthermore, I hope to demonstrate the ability of this alternative approach to transcend the limitations of historiographical approaches that emphasize divergent over synthetic trends, and thereby to reevaluate conflicts to create space for reconciliation. This analytical method also transcends the temporal hierarchy that overvalues the present and devalues the past by considering historical realities in an assessment of contemporary conditions. Finally, an application to the issue of desertification illustrates the analytic's versatility and relevance to a variety of issues

Shattering the mirage: the FDA’s early COVID-19 pandemic response demonstrates a need for reform to restore agency credibility

The power afforded to the administrative state is heavily reliant on public trust and the perception of evidence-based agency decision-making. Organizational reputation is key to preserving regulatory power. However, recent investigations reveal that existing scientific integrity policies may not be sufficient to preserve the credibility of many federal agencies. In fact, a significant number of career scientists across various entities – including the FDA – have observed unreported incidents of political interference. While political influence exerted by the executive branch to set policy goals and determine agency priorities can be beneficial, political pressures must not undermine public trust in scientific agencies. Recently, public perception regarding the FDA’s COVID-19 response threatened to weaken the agency’s longstanding reputation as the gold standard of review. The COVID-19 pandemic publicized vulnerabilities that exist across agencies, as well as those that are unique to the FDA. The FDA’s evolution as an increasingly public health-focused agency that must function in the landscape of politicized science exposes the agency to a greater risk of political interference. After all, the FDA’s involvement in public health requires increased participation in non-ideal, value-based decision-making. Throughout its history, the FDA has managed to maintain its reputation through its firm responses to scandal. The COVID-19 pandemic provides a platform for the FDA to – once again – look introspectively and institute safeguards addressing vulnerabilities that plagued the agency’s pandemic response. This Article examines the FDA’s early COVID-19 response to propose reforms that promote meaningful transparency, public accountability, and scientific integrity.Published versio

Non-functional immunoglobulin G transcripts in a case of hyper-immunoglobulin M syndrome similar to type 4

86% of immunoglobulin G (IgG) heavy-chain gene transcripts were found to be non-functional in the peripheral blood B cells of a patient initially diagnosed with common variable immunodeficiency, who later developed raised IgM, whereas no non-functionally rearranged transcripts were found in the cells of seven healthy control subjects. All the patient's IgM heavy-chain and κ light-chain transcripts were functional, suggesting that either non-functional rearrangements were being selectively class-switched to IgG, or that receptor editing was rendering genes non-functional after class-switching. The functional γ-chain sequences showed a normal rate of somatic hypermutation while non-functional sequences contained few somatic mutations, suggesting that most came from cells that had no functional gene and therefore were not receiving signals for hypermutation. However, apoptosis of peripheral blood lymphocytes was not impaired. No defects have been found in any of the genes currently known to be responsible for hyper-IgM syndrome but the phenotype fits best to type 4

The Electronic “Scarlet Letter”: Criminal Backgrounding and a Perpetual Spoiled Identity

Crimes are multifaceted events that are not adequately explained with basic descriptors, yet a considerable amount of significance is afforded to relatively few simplistic labels that make up the contemporary “scarlet letter.” Today\u27s criminal records create a lifetime of stigmatization for a person. These public records employ a limited range of information. By acknowledging the deleterious effects of even one documented criminal event on an individual\u27s self-concept and status in society, we cannot avoid being faced with a serious moral dilemma in light of society\u27s prevalent reliance upon electronic criminal records. The electronic brand carried for life poses great challenges to offender rehabilitation and reintegration

Serum 25-Hydroxyvitamin D and Intact Parathyroid Hormone Influence Muscle Outcomes in Children and Adolescents

Increases in 25-hydroxyvitamin D concentrations are shown to improve strength in adults; however, data in pediatric populations are scant and equivocal. In this ancillary study of a larger-scale, multi-sited, double-blind, randomized, placebo-controlled vitamin D intervention in US children and adolescents, we examined the associations between changes in vitamin D metabolites and changes in muscle mass, strength, and composition after 12 weeks of vitamin D3 supplementation. Healthy male and female, black and white children and adolescents between the ages of 9 and 13 years from two US states (Georgia 34°N and Indiana 40°N) were enrolled in the study and randomly assigned to receive an oral vitamin D3 dose of 0, 400, 1000, 2000, or 4000 IU/d for 12 weeks between the winter months of 2009 to 2011 (N = 324). Analyses of covariance, partial correlations, and regression analyses of baseline and 12-week changes (post-baseline) in vitamin D metabolites (serum 25(OH)D, 1,25(OH)2 D, intact parathyroid hormone [iPTH]), and outcomes of muscle mass, strength, and composition (total body fat-free soft tissue [FFST], handgrip strength, forearm and calf muscle cross-sectional area [MCSA], muscle density, and intermuscular adipose tissue [IMAT]) were assessed. Serum 25(OH)D and 1,25(OH)2 D, but not iPTH, increased over time, as did fat mass, FFST, forearm and calf MCSA, forearm IMAT, and handgrip strength (p < 0.05). Vitamin D metabolites were not associated with muscle strength at baseline nor after the 12-week intervention. Changes in serum 25(OH)D correlated with decreases in forearm IMAT, whereas changes in serum iPTH predicted increases in forearm and calf MCSA and IMAT (p < 0.05). Overall, increases in 25(OH)D did not influence muscle mass or strength in vitamin D-sufficient children and adolescents; however, the role of iPTH on muscle composition in this population is unknown and warrants further investigation

Effect of vitamin D replacement on maternal and neonatal outcomes: a randomised controlled trial in pregnant women with hypovitaminosis D. A protocol

Introduction: The vitamin D recommended doses during pregnancy differ between societies. The WHO guidelines do not recommend routine prenatal supplementation, but they underscore the fact that women with the lowest levels may benefit most. The effects of routine supplementation during pregnancy on maternal and neonatal clinical outcomes have not been investigated in the Middle East, where hypovitaminosis D is prevalent. Our hypothesis is that in Middle Eastern pregnant women, a vitamin D dose of 3000?IU/day is required to reach a desirable maternal 25-hydroxyvitamin D [25(OH)D] level, and to positively impact infant bone mineral content (BMC).Methods and analysis: This is a multicentre blinded randomised controlled trial. Pregnant women presenting to the Obstetrics and Gynaecology clinics will be approached. Eligible women will be randomised to daily equivalent doses of cholecalciferol, 600?IU or 3000?IU, from 15 to 18?weeks gestation until delivery. Maternal 25(OH)D and chemistries will be assessed at study entry, during the third trimester and at delivery. Neonatal anthropometric variables and 25(OH)D level will be measured at birth, and bone and fat mass assessment by dual-energy X-ray absorptiometry scan at 1?month. A sample size of 280 pregnant women is needed to demonstrate a statistically significant difference in the proportion of women reaching a 25(OH)D level ?50?nmol/L at delivery, and a difference in infant BMC of 6 (10)g, for a 90% power and a 2.5% level of significance. The proportions of women achieving a target 25(OH)D level will be compared between the two arms, using ?2. An independent t test will be used to compare mean infant BMC between the two arms. The primary analysis is an intention-to-treat analysis of unadjusted results.Ethics and dissemination: The protocol has been approved by the Institutional Review Board at the American University of Beirut-Lebanon (IM.GEHF.22). The trial results will be published in peer-reviewed medical journals and presented at scientific conferences.Trial registration number: NCT02434380.<br/