Répétition, réalité, mondes possibles

Dans cet article, nous allons explorer le rôle de la répétition dans la transformation du rapport à la réalité. L’hypothèse qui nous guidera est que la répétition, conçue comme une figure du plus vaste phénomène du flux, introduit des ruptures perceptives et des transformations dans la construction de l’expérience catégorielle et phénoménale. Ces changements peuvent aboutir à une mise entre parenthèses, voire à une redéfinition plus radicale, des modes perceptifs de l’individu et de sa relation avec la réalité. La définition de cette dernière se trouve pour le moins problématisée.This paper explores the role of repetition in the transformation of one’s relationship with reality. Our hypothesis is that repetition, conceived as a trope of the broader phenomenon of flux, introduces some perceptive alterations and some transformations in the construction of the experience of categories and phenomena. These changes can lead to a rethinking, or even to a more dramatic redefinition, of the individual’s perceptive modes and of one’s relationship with reality. In any case, the definition of reality is put under scrutiny and significantly modified

Objets sans frontières

Cet article concerne l’analyse d’un type particulier d’objets, les « objets sans frontières », dans le cadre d’une lecture sémiotique de la mondialisation. Après avoir rappelé les principales perspectives théoriques utilisées dans l’analyse des objets, nous y définissons les objets mondialisés et identifions leur spécificité dans le type de relation qu’ils entretiennent avec les contextes. Nous proposons ensuite une description du monde possible que ces objets projettent et de la dialectique d’interaction et de renforcement mutuel qui s’établit entre monde possible et monde réel. Cette dialectique montre que la mondialisation, loin d’être une question exclusivement économique, est aussi une affaire d’imaginaire et de représentations.This article presents a semiotic analysis of what can be termed “objects without borders”, described from the standpoint of globalization. After a brief reminder of the principal approaches used in the analysis of objects, we will define what a global object is and argue that its specificity stems from its distinct relation to its context. We will propose a description of the possible worlds created by these objects, then compare these worlds to the real world, and try to define their interactions. These interactions show that the globalization process, far from being solely an economic issue, are also a matter of imagination and representation

Expanding the Capacity of Rural Cancer Care With Teleoncology

Background: In the United States, 6 of the 25 leading causes of death stem from site-specific cancers, resulting in over 1.7 million deaths annually. Yet, this burden is not evenly distributed. While the incidence of cancer is significantly higher in urban areas, rural regions face higher rates of cancer mortality. Identifying the factors contributing rural cancer disparities can facilitate more effective and feasible policy solutions.’ Problem Definition: Rural Americans are geographically isolated from high-quality cancer services and face systemic barriers to NCI designated comprehensive cancer centers. Given this disparity, rural Americans have failed to fully realize the benefits of expanded federal investment in improved cancer care. Efforts to increase the supply of rural oncologists have yielded mixed results. Rather, this policy review identifies an opportunity to expand the capacity of America’s oncologists through provider-to-provider telehealth models. Methods: Federal and state statutes were scanned for telehealth legislation. CMS guidance relating to telehealth capacity building were also reviewed. The tabulated political venues and policy activity were reported by branch and level of government. Policy recommendations were then made by the focusing on states implementing provider-to-provider teleoncology models in rural regions. Policy Report: In 2016, Congress passed the Project ECHO Act which aimed to evaluate all provider-to-provider telehealth capacity building models. However, the 2019 Project ECHO Act, which aimed to build upon the initial pilot, failed to progress through the Senate. Most provider-to-provider teleoncology activity occurred at the state-level through Medicaid Waivers. Conclusion: Neighboring states can build upon the success of these innovative healthcare delivery models by expanding the diffusion of Medicaid waiver demonstrations which authorize reimbursement for provider-to-provider teleoncology in rural areas

Treating a Public Health Crisis for Rural Moms – A Comparative Analysis of Four Rural States Addressing Maternal Opioid Misuse with Medicaid Innovation Models

Objective As we enter the third decade of the opioid crisis, opioid misuse continues its devastating toll on young women, specifically mothers on Medicaid in rural areas. The evolving Medicaid policy landscape has led to coverage and benefit expansion, yet gaps remain for pregnant women with opioid misuse. Further, the myriad of state specific policy decisions related to maternal eligibility and substance abuse benefits have created a seemingly disjoint policy arena for tackling a specific subgroup’s unmet needs. This policy scan aims to investigate the newly implemented 1115 demonstration model for Maternal Opioid Misuse by comparing the approaches of four rural states. Methodology All documentation for each demonstration model and waiver were reviewed and analyzed for rural specific content. Policy language referencing rurality or rural concepts were then identified, categorized, and codified for comparison across the four sample states. Finally, policy and programmatic approaches which were inherently rural were identified and compared between the four states. This analysis concludes with a brief synthesis of the results, as well as a discussion on what gaps may remain. Results Of the two states submitting 1115 Waivers, both (IN, MO) expand eligibility to Medicaid for mothers with opioid-use disorder, but only MO expands Medicaid benefits. Of the three states (CO, IN, ME) implementing the demonstration model, two (CO, IN) leverage health insurance payers as partners while ME partners with local health system providers. Three states (CO, MO, ME) add telehealth and peer support services as authorized Medicaid benefits for mothers with an opioid-use disorder. Only ME used the innovation model to authorize Medicaid to reimburse, provider-to-provider telehealth capacity building models. Conclusion This study highlights and reaffirms the variation in Medicaid policy at the state level. Expanding Medicaid benefits to reimburse necessary telehealth and peer support services may help address service availability gaps in rural regions. Future research should leverage the continual expansion of these MOM models, especially evaluating differences between rural and non-rural outcomes. The excessive morbidity facing these young mothers warrants prompt evaluation and dissemination to promote diffusion across the country until this public health crisis is fully extinguished

The effects of a short-term, unilateral, lower-body resistance training program on balance in college-aged resistance-trained participants

Purpose: The purpose of this study was to investigate whether a short-term, unilateral, lower-body resistance training program would significantly improve static and dynamic balance in experienced college-aged resistance-trained participants when compared to a control group’s regular, bilateral lower-body resistance training program. Participants: A total of twenty-four participants were recruited to participate in the study. Four participants ended up dropping out due to injury and time constraints, leaving the final total sample size at twenty. Methods: Participants completed a series of three questionnaires (International Fitness Scale, International Physical Activity, and Sociodemographic Questionnaire) and the informed consent. The participants were randomly divided using the ABBA method, splitting them into two groups (UTG) Unilateral Training Group (n = 10), (CG) Control Group (n =10). The UTG was given a unilateral lower-body resistance training program to perform twice a week for six weeks, whereas the CG continued their regular lower-body program. The participants in the UTG performed ten total training sessions over the course of six weeks. Measures: Pre- and post-testing was performed on the Biodex Balance System SD in the biomechanics laboratory. The Postural Stability test was used to assess unilateral static balance, and the Athlete Single Leg Stability test was used to assess unilateral dynamic balance. Analysis: An a priori power analysis was conducted to determine sample size. A series of two-way mixed methods ANOVAs were used to assess a group by time interaction on static and dynamic balance. Independent and dependent samples t-tests were used to determine post-hoc simple main effects. Data were analyzed using IBM SPSS version 25 with an established alpha level of 0.05. Conclusion: The UTG’s program was effective for improving pre to post static and dynamic balance over time compared to the CG’s regular program

How did the COVID-19 Pandemic impact self-reported cancer screening rates in 12 Midwestern states?

Objective: In the early months of the COVID-19 pandemic, the U.S. healthcare system reallocated resources to emergency response and mitigation. This reallocation impacted essential healthcare services, including cancer screenings. Methods: To examine how the pandemic impacted cancer screenings at the population-level, this study analyzes 2018 and 2020 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate the change in the proportion of eligible adults reporting a recent cancer screen (mammogram, pap smear, colon/sigmoidoscopy, blood stool test). All analyses accounted for response rates and sampling weights, then explored differences by gender and rurality across 12 Midwestern states. Results: We found that the proportion of adult women completing a mammogram declined across all states (-0.9% to -18.1%). The change in colon/sigmoidoscopies, pap smears, and blood stool tests were mixed, ranging from a 9.7% decline in pap smears to a 7.1% increase in blood stool tests. Declines varied considerably between states and within states by gender or metro/urban/rural status. Conclusions: The COVID-19 pandemic led to delayed breast, cervical, and colorectal cancer detection services. Policymakers should aim to advance cancer control efforts by implementing targeted screening initiatives