The Caretaking of EVE Online: Institutional Ethics and Enactments at CCP Games

This ethnography examines the Icelandic video game developer CCP Games, the makers of EVE Online—a massively-multiplayer online game (MMO) that takes place in a star cluster far, far away. Through my exploration of CCP Games as an institution over the span of fourteen months, I highlight how corporations are culturally-situated, enacted entities. Simultaneously, I demonstrate that these culturally-located actors who serve as the architects of our digital infrastructures undertake such efforts from their situated vantage points, thereby embedding particular ethical commitments into the digital landscapes they craft and within which we live our social lives. Created with the intent to be a ‘virtual world more meaningful than real life,’ EVE Online serves as the focal point of my observations of the quotidian practices of CCP Games’s employees as they enact multiple versions of the company and, in doing so, show that it, like any corporation, is not a singular being, but rather a composite of social actors and commitments. Simultaneously, I uncover how the Icelandic context of the company informed the company’s creation and the original development of EVE Online while also showing how the evocation of said Icelandic context impacts the company’s development practices to this day. In doing so, I highlight how this “Icelandic” approach to game development impacts the way in which ethical commitments are made and thereby architected into the game. While my ethnographic focus is that of an Icelandic video game maker, this ethnography demonstrates the impact of cultural situatedness on the architecting of digital infrastructures and the importance of further research at the intersection of technology, ethics, and culture

Lactation and neonatal nutrition: defining and refining the critical questions.

This paper resulted from a conference entitled "Lactation and Milk: Defining and refining the critical questions" held at the University of Colorado School of Medicine from January 18-20, 2012. The mission of the conference was to identify unresolved questions and set future goals for research into human milk composition, mammary development and lactation. We first outline the unanswered questions regarding the composition of human milk (Section I) and the mechanisms by which milk components affect neonatal development, growth and health and recommend models for future research. Emerging questions about how milk components affect cognitive development and behavioral phenotype of the offspring are presented in Section II. In Section III we outline the important unanswered questions about regulation of mammary gland development, the heritability of defects, the effects of maternal nutrition, disease, metabolic status, and therapeutic drugs upon the subsequent lactation. Questions surrounding breastfeeding practice are also highlighted. In Section IV we describe the specific nutritional challenges faced by three different populations, namely preterm infants, infants born to obese mothers who may or may not have gestational diabetes, and infants born to undernourished mothers. The recognition that multidisciplinary training is critical to advancing the field led us to formulate specific training recommendations in Section V. Our recommendations for research emphasis are summarized in Section VI. In sum, we present a roadmap for multidisciplinary research into all aspects of human lactation, milk and its role in infant nutrition for the next decade and beyond

Prescribing Prevalence of Medications With Potential Genotype-Guided Dosing in Pediatric Patients

Importance: Genotype-guided prescribing in pediatrics could prevent adverse drug reactions and improve therapeutic response. Clinical pharmacogenetic implementation guidelines are available for many medications commonly prescribed to children. Frequencies of medication prescription and actionable genotypes (genotypes where a prescribing change may be indicated) inform the potential value of pharmacogenetic implementation. Objective: To assess potential opportunities for genotype-guided prescribing in pediatric populations among multiple health systems by examining the prevalence of prescriptions for each drug with the highest level of evidence (Clinical Pharmacogenetics Implementation Consortium level A) and estimating the prevalence of potential actionable prescribing decisions. Design, setting, and participants: This serial cross-sectional study of prescribing prevalences in 16 health systems included electronic health records data from pediatric inpatient and outpatient encounters from January 1, 2011, to December 31, 2017. The health systems included academic medical centers with free-standing children's hospitals and community hospitals that were part of an adult health care system. Participants included approximately 2.9 million patients younger than 21 years observed per year. Data were analyzed from June 5, 2018, to April 14, 2020. Exposures: Prescription of 38 level A medications based on electronic health records. Main outcomes and measures: Annual prevalence of level A medication prescribing and estimated actionable exposures, calculated by combining estimated site-year prevalences across sites with each site weighted equally. Results: Data from approximately 2.9 million pediatric patients (median age, 8 [interquartile range, 2-16] years; 50.7% female, 62.3% White) were analyzed for a typical calendar year. The annual prescribing prevalence of at least 1 level A drug ranged from 7987 to 10 629 per 100 000 patients with increasing trends from 2011 to 2014. The most prescribed level A drug was the antiemetic ondansetron (annual prevalence of exposure, 8107 [95% CI, 8077-8137] per 100 000 children). Among commonly prescribed opioids, annual prevalence per 100 000 patients was 295 (95% CI, 273-317) for tramadol, 571 (95% CI, 557-586) for codeine, and 2116 (95% CI, 2097-2135) for oxycodone. The antidepressants citalopram, escitalopram, and amitriptyline were also commonly prescribed (annual prevalence, approximately 250 per 100 000 patients for each). Estimated prevalences of actionable exposures were highest for oxycodone and ondansetron (>300 per 100 000 patients annually). CYP2D6 and CYP2C19 substrates were more frequently prescribed than medications influenced by other genes. Conclusions and relevance: These findings suggest that opportunities for pharmacogenetic implementation among pediatric patients in the US are abundant. As expected, the greatest opportunity exists with implementing CYP2D6 and CYP2C19 pharmacogenetic guidance for commonly prescribed antiemetics, analgesics, and antidepressants

Performing Critique

Against the backdrop of a growing concern for the fate of critique in the current era, queer video games such as tranxiety, Dream Daddy and Gone Home have begun to engage players in the process of critically examining their own assumptions and immersing them in a performative critique, particularly as it relates to non-normative lived experiences. Alongside exploring whether these games are ‘merely’ the result of critical game design, such that players are enlisted to perform critique, or if queer play is more than a prescribed behavior, this article will utilize examples from across various video game platforms and genres to demonstrate that whether trying to survive daily life as a trans woman in the beginning stages of transition in tranxiety or exploring the dating life of Maple Bay’s latest resident in Dream Daddy, queer video games serve as a platform through which players are encouraged to perform critique via queer play, that is to say, playing outside of traditional video game and character norms. Embracing a productive nexus of critical reflection and performativity, queer video games demonstrate that critique is well served by participatory media. Critique has entered the digital era and, though transformed, it is alive and well

Coming Out

‘Coming out’ has been described as the process through which individuals come to recognise their non-heterosexual or alternate gender identities and subsequently share those identities with others through, “an unambiguous and public declaration” (Jagose, 1996). It represents an internal – almost existential – acceptance of self that requires the individual to redefine the ‘self’ and, for others, their relationship to that ‘self’ (Hill, 2009; Troiden, 1989). It has also been described as a process of identity-centred development, emphasising self-recognition and an internal sense of identity rather one based specifically on sexual acts (Dubé, 2000). ‘Coming out’ is not, as we will see, “a static action, but a range of various motivations, goals, and strategies that people wrap up in a single term, a catch-all for this complex identity management system” (Orne, 2011, p. 699). In this chapter we explore the intricacies of ‘coming out’ and its role in relation to mental health and well-being. We propose a model to better reflect the varied relevance of ‘coming out’ for some today. In line with other chapters in the book, we focus primarily upon LGB populations but acknowledge that there are commonalities in experience for those who are trans, queer, intersex or, indeed asexual

The statistical analysis of roll call data

We develop a Bayesian procedure for estimation and inference for spatial models of roll call voting. This approach is extremely flexible, applicable to any legislative setting, irrespective of size, the extremism of the legislators ’ voting histories, or the number of roll calls available for analysis. The model is easily extended to let other sources of information inform the analysis of roll call data, such as the number and nature of the underlying dimensions, the presence of party whipping, the determinants of legislator preferences, and the evolution of the legislative agenda; this is especially helpful since generally it is inappropriate to use estimates of extant methods (usually generated under assumptions of sincere voting) to test models embodying alternate assumptions (e.g., log-rolling, party discipline). A Bayesian approach also provides a coherent framework for estimation and inference with roll call data that eludes extant methods; moreover, via Bayesian simulation methods, it is straightforward to generate uncertainty assessments or hypothesis tests concerning any auxiliary quantity of interest or to formally compare models. In a series of examples we show how our method is easily extended to accommodate theoretically interesting models of legislative behavior. Our goal is to provide a statistical framework for combining the measurement of legislative preferences with tests of models of legislative behavior. Modern studies of legislative behavior focu