Aufhebung and Negativity: A Hegelianism without Transcendence

This article defends Hegelian dialectics against the critique of Derrida and Bataille. This defense revolves around the fate of abstract negation in dialectical sublation. Focusing on the Lordship-Bondage section of the Phenomenology of Spirit, it is proposed that in the sublated figure of the slave there remains an absolute detachment irreducible to any capitalistic, ‘restricted' economy of preservation. The consequence of such a reading of sublation is that no move outside or beyond dialectics, no transcendent escape from the Aufhebung, is called upon in order to account for notions of alterity, detachment, or transformation

Heidegger with Dewey: Mitsein, solicitude, and education

Contra la acusación que afirma la ausencia de una ética de los otros en Ser y tiempo, de Martin Heidegger, interpreto el verdadero ser del Dasein como ser-con (Mitsein) y la ontología como ética. Sobre la base de esta interpretación ética de la ontología heideggeriana, extraigo las implicaciones que ella tiene sobre nuestro conmportamiento óntico, solícito con los otros. Considero el "vorausspringen" un modo de solicitud positiva, en cuanto abre la posibilidad de una cierta orientación pedagógica que actúa como aliado práctico, institucional, a la ontología de Heidegger. Argumento que esta pedagogía heideggeriana no es individualista ni autocrática, sino que refleja la "la libertad dirigida" de John Dewey.Contra claims that depict Martin Heidegger's Sein und Zeit as lacking an ethics of Others, I interpret the very Being of Dasein as Mitsein, ontology as ethics. On the basis of this ethical interpretation of Heideggerian ontology, I draw out the implications such an interpretation has on our ontic, solicitous comportment towards Others. I consider vorausspringen, a mode of positive solicitude, as opening  up the possibility of a certain pedagogical orientation that serves as a practical, institutional counterpart to Heidegger's ontology. I argue that this Heideggerian pedagogy is neither individualistic nor autocratic, but instead mirrors John Dewey's "directed freedom.

Heidegger with Dewey: Mitsein, solicitude, and education

Contra claims that depict Martin Heidegger's Sein und Zeit as lacking an ethics of Others, I interpret the very Being of Dasein as Mitsein, ontology as ethics. On the basis of this ethical interpretation of Heideggerian ontology, I draw out the implications such an interpretation has on our ontic, solicitous comportment towards Others. I consider vorausspringen, a mode of positive solicitude, as opening  up the possibility of a certain pedagogical orientation that serves as a practical, institutional counterpart to Heidegger's ontology. I argue that this Heideggerian pedagogy is neither individualistic nor autocratic, but instead mirrors John Dewey's "directed freedom.

Methods for identifying health state transitions from administrative data: the case of metastasis in prostate cancer

Introduction Health administrative data are a rich source of population-based information, useful for building state transition models for medical decision making. These models require identification of health state transitions and associated times. Indirect methods are needed to predict this information, as it is rarely available in administrative data. Objectives and Approach We considered a set of criteria to identify transitions to metastasis for prostate cancer patients in administrative data, utilizing dates of diagnostic and medical billing codes for secondary malignancy, palliative radiation therapy, chemotherapy and bone disorders or procedures. We evaluated the criteria using the true date of metastasis from medical charts of 195 patients linked to health care administrative data in Ontario, Canada. We also built a recursive partitioning tree to optimally combine these criteria and construct rules for identifying metastatic patients. For the evaluation, both misclassification and discrepancy between true and predicted dates for the true positives were considered. Results Criteria involving chemotherapy drugs or hospital visits with secondary malignancy ICD10 diagnosis gave the best results, with high sensitivity and specificity. Criteria involving bone related problems, radiation therapy or diagnosis of metastatic cancer in physician billing data were very specific but not sensitive. The criterion involving prescriptions for narcotics was sensitive but not specific. The fitted tree was parsimonious involving only two of the criteria, while improving the accuracy over individual criteria. Most criteria gave a “delayed” prediction, with criterion based on chemotherapy giving on average the smallest delay, as well as exhibiting the least variability. Criteria involving narcotics and bone related problems predicted metastasis date very prematurely, probably triggered by conditions other than prostate cancer. Conclusion/Implications Several criteria from administrative databases satisfactorily classified prostate cancer patients with metastasis. A classification tree was built and improved the results over single criteria, demonstrating the added benefits in using advanced statistical learning methods for this task. However, “transition to metastasis” dates were predicted inaccurately, often with significant delay

Walk well:a randomised controlled trial of a walking intervention for adults with intellectual disabilities: study protocol

Background - Walking interventions have been shown to have a positive impact on physical activity (PA) levels, health and wellbeing for adult and older adult populations. There has been very little work carried out to explore the effectiveness of walking interventions for adults with intellectual disabilities. This paper will provide details of the Walk Well intervention, designed for adults with intellectual disabilities, and a randomised controlled trial (RCT) to test its effectiveness. Methods/design - This study will adopt a RCT design, with participants allocated to the walking intervention group or a waiting list control group. The intervention consists of three PA consultations (baseline, six weeks and 12 weeks) and an individualised 12 week walking programme. A range of measures will be completed by participants at baseline, post intervention (three months from baseline) and at follow up (three months post intervention and six months from baseline). All outcome measures will be collected by a researcher who will be blinded to the study groups. The primary outcome will be steps walked per day, measured using accelerometers. Secondary outcome measures will include time spent in PA per day (across various intensity levels), time spent in sedentary behaviour per day, quality of life, self-efficacy and anthropometric measures to monitor weight change. Discussion - Since there are currently no published RCTs of walking interventions for adults with intellectual disabilities, this RCT will examine if a walking intervention can successfully increase PA, health and wellbeing of adults with intellectual disabilities

Transethnic Genome-Wide Association Study Provides Insights in the Genetic Architecture and Heritability of Long QT Syndrome

BACKGROUND: Long QT syndrome (LQTS) is a rare genetic disorder and a major preventable cause of sudden cardiac death in the young. A causal rare genetic variant with large effect size is identified in up to 80% of probands (genotype positive) and cascade family screening shows incomplete penetrance of genetic variants. Furthermore, a proportion of cases meeting diagnostic criteria for LQTS remain genetically elusive despite genetic testing of established genes (genotype negative). These observations raise the possibility that common genetic variants with small effect size contribute to the clinical picture of LQTS. This study aimed to characterize and quantify the contribution of common genetic variation to LQTS disease susceptibility. METHODS: We conducted genome-wide association studies followed by transethnic meta-analysis in 1656 unrelated patients with LQTS of European or Japanese ancestry and 9890 controls to identify susceptibility single nucleotide polymorphisms. We estimated the common variant heritability of LQTS and tested the genetic correlation between LQTS susceptibility and other cardiac traits. Furthermore, we tested the aggregate effect of the 68 single nucleotide polymorphisms previously associated with the QT-interval in the general population using a polygenic risk score. RESULTS: Genome-wide association analysis identified 3 loci associated with LQTS at genome-wide statistical significance (P&lt;5×10-8) near NOS1AP, KCNQ1, and KLF12, and 1 missense variant in KCNE1(p.Asp85Asn) at the suggestive threshold (P&lt;10-6). Heritability analyses showed that ≈15% of variance in overall LQTS susceptibility was attributable to common genetic variation (h2SNP 0.148; standard error 0.019). LQTS susceptibility showed a strong genome-wide genetic correlation with the QT-interval in the general population (rg=0.40; P=3.2×10-3). The polygenic risk score comprising common variants previously associated with the QT-interval in the general population was greater in LQTS cases compared with controls (P&lt;10-13), and it is notable that, among patients with LQTS, this polygenic risk score was greater in patients who were genotype negative compared with those who were genotype positive (P&lt;0.005). CONCLUSIONS: This work establishes an important role for common genetic variation in susceptibility to LQTS. We demonstrate overlap between genetic control of the QT-interval in the general population and genetic factors contributing to LQTS susceptibility. Using polygenic risk score analyses aggregating common genetic variants that modulate the QT-interval in the general population, we provide evidence for a polygenic architecture in genotype negative LQTS.</p

New Middle-Class Labor Migrants

Migration researchers have tended to focus on social extremes: either highly skilled elites, on the one hand, or low-wage workers on the other. Less attention has been directed toward “ordinary” middle-class professional movers, and there have been no reviews of this literature to date. The chapter addresses this gap and identifies five important themes to guide future class-orientated migration research. First, the complex relationship between migration, social mobility, place, and middle-class membership is examined. Second, age is shown to be an important consideration in middle-class migration decision-making. Third, the cultural versus economic basis of the mobile middle-class is explored, and the role of lifestyle factors in shaping migration is critically examined. Fourth, middle-class migration decisions are connected to gendered household strategies, with the preponderance of dual-career couples now taking migration decision-making well beyond the individual career path. Finally, the social and communal emplacement of middle-class migrants is considered as an important but neglected dimension of research. Overall, it is clear that the class-based analysis of migration is an important yet neglected field of study, and this is especially true for middle-class movers

Emerging Use of Early Health Technology Assessment in Medical Product Development: A Scoping Review of the Literature

Early health technology assessment is increasingly being used to support health economic evidence development during early stages of clinical research. Such early models can be used to inform research and development about the design and management of new medical technologies to mitigate the risks, perceived by industry and the public sector, associated with market access and reimbursement. Over the past 25 years it has been suggested that health economic evaluation in the early stages may benefit the development and diffusion of medical products. Early health technology assessment has been suggested in the context of iterative economic evaluation alongside phase I and II clinical research to inform clinical trial design, market access, and pricing. In addition, performing early health technology assessment was also proposed at an even earlier stage for managing technology portfolios. This scoping review suggests a generally accepted definition of early health technology assessment to be “all methods used to inform industry and other stakeholders about the potential value of new medical products in development, including methods to quantify and manage uncertainty”. The present review also aimed to identify recent published empirical studies employing an early-stage assessment of a medical product. With most included studies carried out to support a market launch, the dominant methodology was early health economic modeling. Further methodological development is required, in particular, by combining systems engineering and health economics to manage uncertainty in medical product portfolios