bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Rank, Provider Specialty, and Unit Sustainment Training Frequency on Military Critical Care Air Transport Team Readiness
Authors: Leib Nicole , Cheney Mark , Burkhardt Joshua N , Nelson Eric , Diffley Shannon , Salvator Ann , Davis Tyler , Robinson F Eric , Brown Daniel J , Frasier Lane , Sams Valerie , Strilka Richard J
Published: April 2024

Background

The Critical Care Air Transport (CCAT) Advanced Course utilizes fully immersive high-fidelity simulations to assess personnel readiness for deployment. This study aims to determine whether simple well-defined demographic identifiers can be used to predict CCAT students’ performance at CCAT Advanced.

Materials and Methods

CCAT Advanced student survey data and course status (pass/fail) between March 2006 and April 2020 were analyzed. The data included students’ Air Force Specialty Code (AFSC), military status (active duty and reserve/guard), CCAT deployment experience (yes/no), prior CCAT Advanced training (yes/no), medical specialty, rank, and unit sustainment training frequency (never, frequency less often than monthly, and frequency at least monthly). Following descriptive analysis and comparative tests, multivariable regression was used to identify the predictors of passing the CCAT Advanced course for each provider type.

Results

A total of 2,576 student surveys were analyzed: 694 (27%) physicians (MDs), 1,051 (40%) registered nurses (RNs), and 842 (33%) respiratory therapists (RTs). The overall passing rates were 92.2%, 90.3%, and 85.4% for the MDs, RNs, and RTs, respectively. The students were composed of 579 (22.5%) reserve/guard personnel, 636 (24.7%) with CCAT deployment experience, and 616 (23.9%) with prior CCAT Advanced training. Regression analysis identified groups with lower odds of passing; these included (1) RNs who promoted from Captain to Major (post-hoc analysis, P = .03), (2) RTs with rank Senior Airman, as compared to Master Sergeants (post-hoc analysis, P = .04), and (3) MDs with a nontraditional AFSC (P = .0004). Predictors of passing included MDs and RNs with CCAT deployment experience, odds ratio 2.97 (P = .02) and 2.65 (P = .002), respectively; and RTs who engaged in unit CCAT sustainment at least monthly (P = .02). The identifiers prior CCAT Advanced training or reserve/guard military status did not confer a passing advantage.

Conclusion

Our main result is that simple readily available metrics available to unit commanders can identify those members at risk for poor performance at CCAT Advanced readiness training; these include RNs with rank Major or above, RTs with rank Senior Airman, and RTs who engage in unit sustainment training less often than monthly. Finally, MD specialties which are nontraditional for CCAT have significantly lower CCAT Advanced passing rates, reserve/guard students did not outperform active duty students, there was no difference in the performance between different RN specialties, and for MD and RN students’ previous deployment experience was a strong predictor of passing.
Preparing Future Military Medical Officers to Conduct Emergency Fresh Whole Blood Transfusions in Austere Environments: A Novel Training Curriculum
Authors: Matthews Kevin J , Walther Samuel , Brown Zachery L , Cuestas Joshua P , Shumaker Jonathan T , Moore Durwood W , Cole Rebekah
Published: April 2024

Introduction

Providing resilient Damage Control Resuscitation capabilities as close to the point of injury as possible is paramount to reducing mortality and improving patient outcomes for our nation’s warfighters. Emergency Fresh Whole Blood Transfusions (EFWBT) play a critical role in supporting this capability, especially in future large-scale combat operations against peer adversaries with expected large patient volumes, restrictive operating environments, and unreliable logistical supply lines. Although there are service-specific training programs for whole blood transfusion, there is currently no dedicated EFWBT training for future military medical officers. To address this gap, we developed, implemented, and evaluated a training program to enhance EFWBT proficiency in third-year military medical students at the F. Edward Hebert School of Medicine at the USU.

Materials and Methods

After reviewing both the 75th Ranger Regiment Ranger O-Low Titer program and the Marine Corps’ Valkyrie program, along with the relevant Joint Trauma System Clinical Practice Guidelines, we created a streamlined and abbreviated training curriculum. The training consisted of both online preparatory materials as well as a 2-hour in-person training that included didactic and experiential learning components. Participants were 165 active duty third-year medical students at USU. Participants were assessed using a pre- and post-assessment self-reported questionnaire on their confidence in the practical application and administrative oversight requirements of an EFWBT program. Participants’ performance was also assessed using a pre/post knowledge assessment consisting of 10 multiple choice questions identified as critical to understanding of the academic principles of EFWBT along with the baseline questionnaire.

Results

Differences in the mean scores of the pre- and post-assessment self-reported questionnaire (increased from 2.32 to 3.95) were statistically significant (P < .001). Similarly, there was a statistically significant improvement in student test scores, with the mean score increasing by approximately 3 points or 30%. There was no significant difference in student confidence assessment or test scores based on branch of service. Students who had previously deployed did not show a statistically significant difference in scores compared to students who had not previously deployed.

Conclusions

Our results suggest that the implementation of streamlined EFWBT training into the undergraduate medical education of future military medical officers offers an efficient way to improve their baseline proficiency in EFWBTs. Future research is needed to assess the impact of this training on real-world applications in forward-deployed environments.
Prognostic Accuracy of Screening Tools for Clinical Deterioration in Adults With Suspected Sepsis in Northeastern Thailand: A Cohort Validation Study
Authors: Wixon-Genack Jenna , Wright Shelton W , Cobb Ortega Natalie L , Hantrakun Viriya , Rudd Kristina E , Teparrukkul Prapit , Limmathurotsakul Direk , West T Eoin
Published: April 2024

Background

We sought to assess the performance of commonly used clinical scoring systems to predict imminent clinical deterioration in patients hospitalized with suspected infection in rural Thailand.

Methods

Patients with suspected infection were prospectively enrolled within 24 hours of admission to a referral hospital in northeastern Thailand between 2013 and 2017. In patients not requiring intensive medical interventions, multiple enrollment scores were calculated including the National Early Warning Score (NEWS), the Modified Early Warning Score, Between the Flags, and the quick Sequential Organ Failure Assessment score. Scores were tested for predictive accuracy of clinical deterioration, defined as a new requirement of mechanical ventilation, vasoactive medications, intensive care unit admission, and/or death approximately 1 day after enrollment. The association of each score with clinical deterioration was evaluated by means of logistic regression, and discrimination was assessed by generating area under the receiver operating characteristic curve.

Results

Of 4989 enrolled patients, 2680 met criteria for secondary analysis, and 100 of 2680 (4%) experienced clinical deterioration within 1 day after enrollment. NEWS had the highest discrimination for predicting clinical deterioration (area under the receiver operating characteristic curve, 0.78 [95% confidence interval, .74–.83]) compared with the Modified Early Warning Score (0.67 [.63–.73]; P < .001), quick Sequential Organ Failure Assessment (0.65 [.60–.70]; P < .001), and Between the Flags (0.69 [.64–.75]; P < .001). NEWS ≥5 yielded optimal sensitivity and specificity for clinical deterioration prediction.

Conclusions

In patients hospitalized with suspected infection in a resource-limited setting in Southeast Asia, NEWS can identify patients at risk of imminent clinical deterioration with greater accuracy than other clinical scoring systems.
Should Blood Cultures Be Drawn Through an Indwelling Catheter?
Authors: Mermel Leonard A , Rupp Mark E
Published: April 2024

There is no practical way to definitively diagnose a catheter-related bloodstream infection in situ if blood cultures are only obtained percutaneously unless there is the rare occurrence of purulent drainage from a central venous catheter insertion site. That is why the Infectious Diseases Society of America guidelines for diagnosis and management of catheter-related bloodstream infections and Infectious Diseases Society of America guidelines for evaluation of fever in critically ill patients both recommend drawing blood cultures from a central venous catheter and percutaneously if the catheter is a suspected source of infection. However, central venous catheter–drawn blood cultures may be more likely to be positive reflecting catheter hub, connector, or intraluminal colonization, and many hospitals in the United States discourage blood culture collection from catheters in an effort to reduce reporting of central-line associated bloodstream infections to the Centers for Disease Control and Prevention. As such, clinical decisions are made regarding catheter removal or other therapeutic interventions based on incomplete and potentially inaccurate data. We urge clinicians to obtain catheter-drawn blood cultures when the catheter may be the source of suspected infection.
Rational treatment options for T1/2N0M0 squamous cell carcinoma of the anal canal: a population-based study combined with external validation
Authors: Shao Xue , Zhang Qiulei , Huo Ying , Lu Chang
Published: April 2024

Background

Treatment options for T1/2N0M0 anal squamous cell carcinoma include chemotherapy, radiotherapy, chemoradiotherapy, and local excision, although the optimal treatment method has not been determined.

Methods

The National Cancer Institute Surveillance, Epidemiology and Results database was used to search and screen 1465 patients with cT1/2N0M0 anal squamous cell carcinoma who were clinically diagnosed between 2004 and 2016. Survival analysis was performed using the Kaplan-Meier method and log-rank test. Cox proportional hazards regression analysis was performed to screen independent prognostic factors and build a nomogram survival prediction model. According to the risk score, patients were divided into low, medium, and high risk groups using X-tile software.

Results

Age, sex, grade and cT stage were identified as independent prognostic factors for cT1/2N0M0 anal squamous cell carcinoma and were included in the nomogram to construct a prediction model. The C-index of the model was 0.770 [95% confidence interval (CI), 0.693-0.856], which was higher than the C-index of T stage 0.565 (95% CI, 0.550-0.612). Low-risk patients benefited from local resection, moderate-risk patients benefited from radiotherapy, and high-risk patients benefited from radiotherapy or chemoradiotherapy. This was confirmed using external validation data from the center.

Conclusion

The nomogram developed in this study effectively and comprehensively evaluated the prognosis of patients with cT1/2N0M0 squamous cell carcinoma of the anal canal. Local excision is recommended for low risk patients, radiotherapy for moderate-risk patients, and radiotherapy or chemoradiotherapy for high-risk patients.
Association of opioid use with survival in patients with cancer treated with immune checkpoint inhibitors: it is time for evidence-based behaviors
Authors: Giusti Raffaele , Porzio Giampiero , Maltoni Marco , Filetti Marco , Cuomo Arturo , Bandieri Elena , Trapani Dario , Bruera Eduardo
Published: April 2024

Cancer is a leading cause of morbidity and mortality worldwide, with pain experienced by most patients undergoing cancer treatment. Opioids are the recommended treatment for cancer pain management, but recent studies suggest a negative association between opioid use and survival rates among patients undergoing immunotherapy. However, conclusions cannot be drawn regarding causality from these observational data. Immunotherapy, which boosts the body’s immune system to fight cancer cells, has emerged as a promising treatment option for all types of cancer. Immune checkpoint inhibitors (ICIs) can activate the anticancer function of exhausted T cells and have shown remarkable survival benefits in patients with multiple malignancies. However, a recent systematic review and meta-analysis suggested that the use of opioids during ICI treatment has an adverse effect on patient prognosis, while the use of NSAIDs is not significantly associated with the prognosis in patients treated with ICIs. These reviews have major limitations due to the retrospective nature of the studies and the multiple factors that can influence the phenomenon. Therefore, caution is required when interpreting results from retrospective data on drug interactions. The findings of this study are alarming and potentially harmful to patients with cancer suffering from pain or other symptoms requiring opioid drugs.
Soldiers’ Hearts
Authors: Fazal Tanisha M.
Published: April 2024

War-induced psychological trauma is as old as war itself. In the Civil War, it was referred to as “nostalgia,” “sunstroke,” and “soldiers’ heart.” The world wars saw the label shift from “shell-shock” to “combat exhaustion.” The term “post-traumatic stress disorder” came into use in 1980. Each new label describes a different, but significantly overlapping, set of symptoms. This chapter traces how this kind of trauma has been relabeled, diagnosed, treated, and viewed by the military and society at large through each war. This chapter also demonstrates how, with each war, the nature of benefits available to military personnel suffering from war-induced psychological trauma has changed.
Conclusion
Authors: Fazal Tanisha M.
Published: April 2024

What might the futures of war, military medicine, and veterans’ benefits look like for the United States? What lessons should we learn from past developments in military medicine and veterans’ benefits? What changes should we enact to increase the odds that we get estimations of the costs of war right in any future conflicts? This chapter focuses on the future of conflict, military medicine, and veterans’ benefits for the United States. It discusses the potential consequences for military medicine in conflicts with China and/or Russia, as well as the relationship between political polarization and future support for veterans’ benefits. It also includes policy recommendations aimed at rectifying current procedures for estimating the costs of war.
Who Was Henry Enfield Roscoe?
Authors: Morris Peter J.T. , Reed Peter
Published: April 2024

In this chapter, after discussing the historiography of scientific biography, the authors explain to the reader who Henry Enfield Roscoe was. Although he was born in London, his family was from Lancashire and he was educated in Liverpool, where his grandfather William Roscoe had been eminent. Thanks to his time in Heidelberg, he was very pro-German and pushed for the introduction of German methods into English education. Roscoe made his career in Manchester, at Owens College, which, thanks to his efforts, became Victoria University. Having developed his own methods of chemical education at Owens, Roscoe campaigned for the reform of technical education. He served on the Samuelson Commission for Technical Education and was knighted for this public service. Roscoe acted as a consultant for industry and became a director of the Castner–Kellner Alkali Company. For 10 years he served as a Liberal member of Parliament in the House of Commons. Roscoe then had an active retirement.
Of Lancastrian Stock and the Formative Years
Authors: Morris Peter J.T. , Reed Peter
Published: April 2024

This chapter explores the formative period of Henry Enfield Roscoe’s life in Liverpool, the personal traits and achievements of his grandfather, William Roscoe, and his father, Henry Roscoe, influences of the family’s nonconformist circle of associates, and how Roscoe’s lifelong interest in experimental chemistry was kindled by William Balmain at the Liverpool Institute High School. William Roscoe (1753–1831) was an influential figure in Liverpool, being a lawyer, an MP, a slavery abolitionist, and a scholar of international repute. Henry Enfield Roscoe was born in London in January 1833 to Henry Roscoe (1800–1836) and his wife Maria (née Fletcher) (1798–1885). His father was a lawyer and legal writer; following his death from consumption in 1836 when his son was just three years old, the family moved to Liverpool, where Roscoe attended the High School of the Liverpool Institute and came under the influence of William Balmain.
A Chemist in the House
Authors: Morris Peter J.T. , Reed Peter
Published: April 2024

This chapter describes how Roscoe became a Member of Parliament and explores how being an academic chemist influenced his behavior as an MP. In particular, the chapter explores the relative success of his political career, and the relationship between science, academe, and politics. Elected as Liberal MP for South Manchester, Roscoe won his elections in 1886 and 1892, but lost to a Liberal Unionist, the Marquess of Lorne, in 1895. Roscoe focused on the reform of technical education, helping to obtain the so-called whisky money to fund technical education, but he was also involved with the possible taxation of saccharine, a bill to regulate pharmacies, and the issue of cholera in Mecca. He supported the Royal College of Science and the Science Museum. He played an important role in improving ventilation in the Houses of Parliament. Other leading issues he supported were temperance in Manchester, control of rabies, and metrication.
An Active Retirement
Authors: Morris Peter J.T. , Reed Peter
Published: April 2024

This chapter describes how Roscoe’s activities shifted from Manchester to London after 1885, and his efforts to promote science and scientific medicine in the 1890s and 1900s. The authors place Roscoe’s activities within the context of a broader movement to modernize Britain at the turn of the century. After leaving Parliament in 1895, Roscoe became Vice-Chancellor of the University of London and oversaw its conversion into a teaching university in 1900. He also moved the administration of the university from Burlington Gardens to the Imperial Institute. Roscoe also helped Richard Haldane to create Imperial College in 1907. Roscoe, with Lord Lister, helped to set up the Lister Institute for Preventive Medicine in 1898. He later tried to amalgamate the institute with the forerunner of the National Institute for Medical Research, but was defeated. Roscoe also assisted Norman Lockyer and Robert Morant to set up the Science Museum as an independent body.
Roscoe’s Legacy
Authors: Morris Peter J.T. , Reed Peter
Published: April 2024

When Roscoe died in 1915, he was memorialized as one of the most prominent chemists of his era, yet he now languishes in relative obscurity. This chapter shows his impact on the century after his death. It begins by critiquing his support for Germany, arguing that it was well-intended, but he had overlooked the nationalistic and militaristic aspects of German society which led to World War I. After describing the impact of his textbooks, the authors show how the institutions and societies he supported or founded flourished in the twentieth century, including the University of London, Imperial College, the Science Museum, and the Society of Chemical Industry. The history of technical education reform culminating in the Robbins Report of 1963 is outlined. The authors conclude that although Roscoe may not have been preeminent in chemistry or politics, his role as the campaigning chemist makes him a key figure in the history of educational reform.
Research Ethics
Authors: Gullion Jessica Smartt
Published: April 2024

This chapter explores ethical issues related to research, including legal considerations, historical abuses, the standards for ethical research, mitigation of risks to participants, and working with special populations. The chapter also discusses the role and work of institutional review boards and considers their scope. Finally, different types of ethical considerations, including procedural, situational, and relational ethics, are examined. Ethical problems are seldom straightforward. “First, do no harm” should be the mantra. Research ethics are a social justice issue. Researchers must always uphold high ethical standards in their research. And when in doubt, they should consult with their Institutional Review Boards.
Our Paleolithic Baseline
Authors: Barrett Ron , Zuckerman Molly K. , Dudgeon Matthew R. , Armelagos George J.
Published: April 2024

For more than 100,000 years, the human species lived as mobile foragers in small, scattered, and minimally stratified social groups. Based on findings from paleopathology, bioarchaeology, archaeogenetics, and contemporary ethnographic studies, this chapter explains how these populations faced parasitic and other chronic infections. Yet because of their diverse diets, low population densities, and generalized distribution of essential resources, Paleolithic foragers did not experience as many of the acute and highly virulent infectious diseases that would later occur in the Neolithic. This chapter also draws contrasts with recent infectious diseases such as HIV, Ebola virus disease, and COVID-19.
Agriculture and the First Emerging Infections
Authors: Barrett Ron , Zuckerman Molly K. , Dudgeon Matthew R. , Armelagos George J.
Published: April 2024

Beginning in the Neolithic, the lifestyle changes that accompanied the global shift from primary foraging to primary agriculture brought major health consequences. This chapter describes the methods used to evaluate the health and disease status of ancient populations as well as their strengths and limitations. Comparisons of ancient populations before and after the intensification of agriculture support the theory that agrarian living produced the first rise of acute infectious diseases as a major cause of human mortality, due to reduced dietary diversity, increased population sizes and densities, proximity to domesticated animals, and differential access to resources within increasingly stratified societies. These were humanity’s first truly emerging infections, resulting in demographic changes that constituted the First Epidemiological Transition.
An Honourable Funeral
Authors: Baggott Jim , Heilbron John L.
Published: April 2024

The Bohr atom proved to be unworkable for atoms with more than one electron, even when extended with the inclusion of additional quantum numbers. The correspondence principle offered little help. Progress demanded a spinning electron, and Wolfgang Pauli’s ‘exclusion principle’, which Werner Heisenberg welcomed as a record-breaking swindle. Seeking escape from the thicket of atomic contradictions, Bohr sought to slay the ultimate sacred cow. He had resisted the embrace of Einstein’s light quantum, and in a theory devised with Hendrik Kramers and John Slater, he abandoned the conservation of energy in individual atomic events, leaving it to statistics. The question could be settled experimentally, and Bohr was soon obliged to accept the results. He offered to give Bohr–Kramers–Slater (BKS) theory an honourable funeral, and acknowledged the light quantum. Einstein was more convinced than ever that physics must respect causality and allow descriptions of events taking place in space and time.
Missionaries of the Copenhagen Spirit
Authors: Baggott Jim , Heilbron John L.
Published: April 2024

Wrestling with quantum concepts could sometimes take a heavy toll. Paul Ehrenfest committed suicide in 1933. Pauli sought help from Carl Jung. Others saw parallels between quantum physics and human psychology. Bohr sought to define the quantum domain, to complete and package it, so that he would be related to the quantum theory as Einstein was to relativity. He believed that he was called to proclaim the gospel of complementarity, extended to the domain of human affairs and which, ‘better than any religion . . . would afford people the guidance they needed’. He was soon grappling with pronouncements made by more excitable members of his flock, as their intrusions into biology and philosophy were quickly condemned. The missionaries of the Copenhagen spirit enjoyed a success that was limited largely to a few philosophically inclined physicists of continental Europe. Neither British nor American theorists had need of it.
The Theorem of John S. Bell
Authors: Baggott Jim , Heilbron John L.
Published: April 2024

In 1957, Bohm and Yakir Aharonov alighted on experiments on correlated photons performed some years earlier. Although the experimenters had not looked for EPR-type correlations, Bohm and Aharonov found no contradictions with quantum theory, concluding that entanglement is a real property of matter. Inspired by Bohm, in 1964 John Bell first dispatched von Neumann’s impossibility proof, readmitting the possibility of local hidden variables, and showed how experiment could decide if they existed. Many physicists later misunderstood this as a challenge to Copenhagen. But, as Bohm and Aharonov explained: ‘ . . . there is no inconsistency in the quantum-mechanical conclusion that such correlations exist, but there is, in [Bohr’s] point of view, no way even to raise the question of what is their origin’. If the particles cannot be considered as separable, Einstein’s gaping explanatory hole returns. Interested experimenters had first to disinter the question, which Bell had buried in an obscure journal.
Bell Tests and Protests
Authors: Baggott Jim , Heilbron John L.
Published: April 2024

Abner Shimony read a pre-print of Bell’s paper, and realized its brilliance. The old experiments discussed by Bohm and Aharonov were indecisive. New experiments were urgently needed. John Clauser, who as a student had become greatly frustrated by Bohr’s quantum obscurity, reached the same conclusion. Clauser became obsessed, encouraged by support from Bell, Bohm, and de Broglie. Shimony and Clauser agreed to collaborate. They alighted on an experiment in which pairs of entangled photons are produced by atomic cascade emission, and developed a form of Bell’s inequality more suited to laboratory conditions. By 1970, the growing interest in foundations gave birth to a new journal and an international conference at which familiar arguments were aired by the old faithful, and at which newcomers gave fresh perspectives. Clauser published his results in 1972. Quantum mechanics prevails: local hidden variables do not exist. Other results soon followed, one contradictory, most confirmatory.
One Framework for Tax Reform
Authors: Conrad Robert F. , Alexeev Michael
Published: April 2024

This chapter contains a discussion of the motivations for both incremental and significant tax reforms. This discussion is followed by a description, and one critical evaluation, of what will be defined as the standard approach to tax reform; an approach that combines direct and indirect taxes with property taxation. The approach, in general, is useful for thinking about how to structure policy. Some evaluative comments are made in order to provide some context for the collection-driven approach to the evolution of tax systems that is the basis for this volume. This approach is based on a collection driven, but relatively efficient, tax system that can evolve through time based on modifications to the standard approach.
Optimal Taxation
Authors: Conrad Robert F. , Alexeev Michael
Published: April 2024

There is an important and growing literature on optimal taxation. Our intention is to describe some aspects of this literature and how the implications derived from the various results might be used in the applied emerging economy context. That is, it is not our intent to cover the numerous contributions to the economics of optimal taxation.
Open-Ended Pooled Accounting
Authors: Conrad Robert F. , Alexeev Michael
Published: April 2024

We have supported and advocated the use of open-ended pooled asset accounts for a number of years.1,2 Below some aspects of the system are discussed, along with examples and a proposal for depreciation of tangible personal property (generally machinery and equipment), intangible property, research and development, and pre-production expenses for natural resource projects (oil and gas, mining, and forestry).
Tax Incentives, Exemptions, and Allowances
Authors: Conrad Robert F. , Alexeev Michael
Published: April 2024

Almost all countries have used, and still use, tax incentives. We believe tax incentives are popular because of political considerations and not economic criteria. Other than limited accelerated depreciation, we have consistently argued against almost all tax incentives, investment incentives in particular. Our reasons for this opposition are described here. The discussion is divided into two parts. First, some arguments in favour of, and against, tax incentives are discussed, with the balance being strongly opposed to incentives. Second, a series of standard tax incentives are described, with a discussion of what issues need to be considered. Our hope is that a discussion of what is necessary to design a reasonable tax incentive is so cumbersome that policymakers and administrators will have ample ammunition to defeat interest groups and politicians from granting such incentives.
Introducing Arts in Healthy Aging Policy and Practice
Authors: Lambert Patricia Dewey , Blandy Doug , Wyszomirski Margaret J.
Published: April 2024

“Introduction to Creative Aging Policy and Practice” begins with presenting data on America’s aging population, a demographic profile of older Americans, and the urgent need for programs and services that are designed to support healthy aging. The chapter introduces America’s arts and culture sector as an instrument that can be used to support the health and well-being of older adults throughout their aging process. The chapter also introduces the current state of creative aging policy and practices, as well as relevant interdisciplinary domains of knowledge that intersect across arts policy and management, health policy and management, and aging policy and management. This first chapter of the book provides an essential sociocultural context, an introduction to key concepts and terms, and an introduction to the entire book.
Foundational Concepts in Creative Aging
Authors: Lambert Patricia Dewey , Blandy Doug , Wyszomirski Margaret J.
Published: April 2024

“Foundational Concepts in Creative Aging” begins by developing theoretical frames for conceptualizing aging and argues that the contemporary field of creative aging would be more effectively framed as the arts in healthy aging. The chapter positions this field of policy and professional practice as a subfield of arts in health. By discussing functional ability, the chapter unpacks the distinct needs of older adults as a targeted population group for programs and services. Engaging in arts and culture is discussed as a basic human need, and the chapter introduces a detailed framework for understanding choice-based arts participation. Essential elements of a logic model are introduced in discussing how the benefits of the arts accrue to both individuals and communities as distinct societal impacts. The chapter concludes with introducing the authors’ 8Ps Framework for Arts in Healthy Aging.
Arts Programs in Hospice and End-of-Life Care
Authors: Lambert Patricia Dewey , Blandy Doug , Wyszomirski Margaret J.
Published: April 2024

“Arts Programs in Hospice and End-of-Life Care” extends the care continuum beyond the settings discussed in the previous chapter with a focus on arts programs supporting the needs of older adults and their care partners at the very end of life. This chapter describes important human development tasks that take place at the end of life and illustrates how the arts can assist older adults and their loved ones with attending to these final tasks. Hospice is introduced in depth, with a particular focus on the use of the arts in supporting spiritual care within hospice services. The chapter profiles how the arts can be used specifically to support activities of reminiscence, legacy, and ritual at the end of life.
Informer File-Stories
Authors: Drumbl Mark A. , Holá Barbora
Published: April 2024

Chapter 4 features ‘up close’ the file-stories of six actual informers. These gripping, high-resolution narratives demonstrate the complexities of the relationships between state and society in Communist Czechoslovakia. They reveal the social engineering effects of the state and the agentic contributory role of individuals. Each file-story showcases a deeply personal cocktail of emotions that pulled informers towards and pushed informers away from the StB and vivifies how these sentiments changed and morphed over time. In the Czechoslovak context, this granular and detailed portrayal unsettles assumptions of the uniformity of informer motivations which largely infuse transitional justice mechanisms and historical narratives.
Adulatio in Performance
Authors: Russo Martina
Published: April 2024

This chapter proposes a new interpretation of the Consolatio ad Polybium, illustrating the subtle and unexpected ways in which Seneca absorbed and transformed consolatory topoi, regarding the circumstances, and, above all, the addressees. By adapting Stoic ideas and principles to the recipient, Seneca displays his skill in the psychological shaping of the piece to suit the needs of the addressee. After inspecting how Seneca praises Polybius, this chapter analyses the blatant praise of Claudius, commended, first of all, for his clementia. Chapter 1 suggests a new interpretation of the Consolatio ad Polybium, elucidating how Seneca coalesces the consolatory topoi with the panegyrical purpose implied in the consolation.
The Opposite of Flattery
Authors: Russo Martina
Published: April 2024

Chapter 5 features the figure of Iulius Canus, an exemplum of ‘missing’ flattery. The first part discusses the concept of simplicitas as the very opposite of flattery and its evolution in the passage from Republic into Empire. Seneca seems to mourn the old simplicitas and often draws on daily life to show how frequently men need to simulate and/or dissimulate their feelings not only in front of power but also in front of ordinary people. At the core of Chapter 5 is a passage from the De tranquillitate animi where Seneca introduces the figure of Iulius Canus, who, differently from the courtiers analysed in Chapter 4, does not flatter the ruler. Not only does Canus not put on any mask, but Seneca presents him as a prefiguration of the wise man who engages in necessary confrontation with the tyrant. Seneca reuses and adapts philosophical and rhetorical topoi to describe the wise Canus and the tyrant Caligula.
Seneca’s Flattery of Nero
Authors: Russo Martina
Published: April 2024

Chapter 6 focuses on De clementia and explores the multiple strategies adopted by Seneca to address the young emperor Nero. Finally, returning to Rome in 49, Seneca had to tutor Nero, who took over as princeps after Claudius died in 54. Being the only Senecan work directly addressed to the Roman emperor, De clementia is considered another text in which flattery is put into practice, despite Seneca’s explicit denial of flattery. This chapter looks into the discrepancy between Seneca’s assertions in De clementia, and the records of Tacitus and Suetonius which argue that, following the Augustan paradigm, Nero wanted to pursue a politics of mutual collaboration between the Senate and princeps. Instead, in Seneca’s political treatise, Senate is pauperized and becomes destitute of any role or function. By shedding light on this aspect, this chapter investigates how Seneca fawns over Nero and elucidates that in De clementia praise and admonition always go together, inextricably connected.
Seneca’s Theories of Flattery
Authors: Russo Martina
Published: April 2024

Chapters 7 and 8 examine the theory of flattery, as conceived by Seneca. Chapter 7 focuses on the Epistulae morales ad Lucilium by offering an overview of flattery from Seneca’s Letters addressed to Lucilius. This chapter elucidates the extent to which a fragmented but significant theory of adulation can emerge across Seneca’s Letters. Although Seneca does not devote any letter to a systematic analysis of flattery, several letters offer fragmentary insight; Chapter 7 looks at those letters that can help the reader to sketch out an idea of flattery before looking at the Naturales quaestiones, where Seneca theorizes the flatterer. Particularly significant is the absence of Nero in the letters; this chapter looks for the ‘absent presence’ of Nero in Seneca’s Epistulae morales, where the presence of the emperor resonates between the lines.
Rethinking Political Representation
Authors: Evans Elizabeth , Reher Stefanie
Published: April 2024

Rethinking political representation pays attention to the ways in which disability can unsettle or develop the theoretical dimensions of the concept. This chapter explores the intellectual development of political representation in western thought, starting with past theorizations before turning to more recent accounts. It pays particular attention to ideas or assumptions about political representation which could be interpreted as exclusionary of disabled people—either implicitly or explicitly. It draws upon the ideas of a handful of canonical theorists in western historical thought whose work paid attention to the concept, as well as more detailed theoretical work on the political representation undertaken by Hanna Pitkin and feminist thinkers Iris Marion Young and Anne Phillips. The chapter addresses three questions regarding the relationship between political representation and physical, cognitive, developmental, and psychological impairments. What role does rationality play in determining who can be a representative? How should we think about the distinction between who the representative is and what the representative does? And, in what ways does the idea of presence shape our understanding of how and where representation occurs? In answering these three questions the chapter develops the idea of ‘experiential representation’—a form of representation that centralizes the idea of lived experience as a way in which to bridge the descriptive, substantive, and symbolic dimensions of the concept.
Voting Rights and Political Participation
Authors: Evans Elizabeth , Reher Stefanie
Published: April 2024

The right to vote is a key component of a democracy, and yet many disabled people are either directly or indirectly excluded from participating. This chapter provides a comparative analysis of disabled people’s right to vote in the US, UK, and Germany. Although progress has been made in some areas, there is a great deal of variation and barriers to voting continue to exist for certain groups of disabled people. The chapter reviews the legal frameworks which relate to disability and voting, before investigating the accessibility of elections in the three countries. It pays particular attention to the ways in which those with different impairment types are affected by specific laws, regulations, and norms. It concludes with an overview of research on electoral turnout among disabled voters, which shows a ubiquitous disability turnout gap which varies across impairment types and is only partly explained by socio-economic inequalities. To achieve political equality, it is vital that voting is made accessible in order to enable disabled people’s participation in politics; especially asit also appears that disabled people often feel that their voices are not heard through the mainstream channel of elections.
Dissent of the Mind
Authors: Sadiki Larbi , Saleh Layla
Published: April 2024

This chapter zeroes in on student activism in the 1960s–1980s. It contextualizes these struggles, linking them to social, political, and intellectual dynamics. The analysis ascribes the brand of dissent spreading across university campuses to a capacity for translating heightened political awareness into sustained, polyphonous dissent. It links social acting and en-acting of protest to pluralist “ideologies,” social imaginaries, and speech acts. The evidence from interviews, newspapers, and other Tunisian publications maps out the practical dimensions of student protests. It also reveals their moral and normative content, given the focus on freedom, social justice, and rejection of authoritarian oppression. The chapter underscores the emancipatory trajectory followed by anti-regime protests across university campuses. Agency, affect, and cognition intermingle in these struggles. The chapter provides a unique insight into the formulation of democratic identities through a “learning loop.” It displays strategies of dissent such as hand-written wall newspapers, free spaces, and discussion circles.
Miners’ Voices
Authors: Sadiki Larbi , Saleh Layla
Published: April 2024

Gafsa and the towns housing the mining work force in the phosphate basin in 2008 burnished an image of anti-systemic resistance. The 2008 protest witnessed an explosion of agency, affect, and cognition that rallied an entire nation. A state development paradigm emphasizing profit and rapid growth, implemented by a centralized, authoritarian political system, helped to trigger the uprising in early 2008. This forms the focus of this protestscape. The chapter analyzes the protest and the wider resistance flowing from it. The interpretation of this resistance reveals coastal/interior schisms in the country, between privileged coastal areas and the marginalized south and interior. Against a longstanding tradition of anti-colonial and postcolonial resistance, the chapter examines the politics around organizing social doing, and the framing of speech acts around social justice. Both proved a boon for the becoming of peoplehood, reflecting past and present sources of self–other identification. The protestscape highlights how the 2008 protests exemplify contests over material and distributional goods and resources. These protests spill into political and moral contests (freedom, power-sharing, inclusiveness, etc.). This chapter draws on a mix of oral history drawn from interviews and testimonies coupled with Tunisian sources in Arabic.
The Virtue of Saving Faith
Authors: Kvanvig Jonathan L.
Published: April 2024

In the Christian tradition, it is standardly noted that it is by faith we are saved, and faith is not only central to the story of salvation, but a virtue as well. These two aspects raise the central problematics for a Christian understanding of faith. First, what is the relation between faith, understood generically, and the kind of faith that saves? Second, what is the relationship between this prudential feature of faith and its moral status as a virtue? An adequate Christian conception of faith must be able to account for how saving faith is really a kind of faith, and not something akin to a decoy duck, and must also do so in a way that allows a path to explaining the importance of faith in a way that doesn’t reduce its significance to mere prudential value.
Hinduism and Science
Authors: Chadha Monima
Published: April 2024

A look at the history and evolution of Hinduism shows that religion and science are necessarily antagonistic. Scientific enterprises flourished in India partly because of the pluralistic and tolerant nature of Hinduism. The pedagogical strategy and the commentary tradition in ancient Hindu schools meant that sages and philosophers were perpetually engaged in reinterpreting the Vedas and defending their interpretation of the doctrine against fellow Hindus and other heterodox traditions like Buddhism, Jainism, and the Cārvākas (the materialists) in ancient India. To support this hypothesis, the author of this chapter offers some examples of scientific enterprises that flourished in ancient India.
Dispensing with Ontological Levels
Authors: van Inwagen Peter
Published: April 2024

It is an increasingly common view among metaphysicians that the world is divided into ontological levels—the lower the level, the more fundamental its inhabitants. It is proposed that this view be evaluated by constructing “complete” metaphysical systems that affirm the existence of ontological levels and systems that do not. The best argument for the reality of ontological levels would be the superiority of the systems that affirm their existence. The best argument for the unreality of ontological levels would be the superiority of the systems that deny or at least fail to affirm their existence. As a first step toward resolving the question of the reality of ontological levels, a system (“lightweight platonism”) is presented that fails to affirm their existence. It is argued that the system is in fact inconsistent with the existence of levels.
Two Problems for a Truth-Centered Ontology
Authors: van Inwagen Peter
Published: April 2024

According to lightweight platonism, propositions are things that can be said (full stop), attributes are things that can be said of things, and proper relations are things that can be said of pluralities of things. And thus, for a property to be a property of a certain thing (for it to belong to, be had by, be instantiated by, be exemplified by that thing) is for it to be a thing that can be said truly of that thing. Similarly, for a proper relation to hold among certain things is for it to be a thing that can be said truly of those things. Lightweight platonism is therefore a “truth-centered” ontology. Truth-centered ontologies face at least two serious problems. One is how to accommodate set theory (rightly regarded as indispensable in logic and mathematics). The other is the problem of how to treat binary relations that are not symmetrical. (Is the relation ‘north of’ true or false of Edinburgh and London when it is true that Edinburgh is north of London and false that London is north of Edinburgh?) Solutions to these problems are tentatively presented.
“Color is an Illusion”
Authors: van Inwagen Peter
Published: April 2024

This chapter is an inquiry into the meaning of the sentence ‘color is illusion’ and an argument for the proposition that, this statement being properly understood, color is not an illusion. The concept “X is an illusion” (where X is general phenomenon) is analyzed. ‘Centrifugal force is an illusion’ serves as a paradigm of ‘X is an illusion’. The position is defended that if color is an illusion, then color sentences—sentences like ‘Her car is dark green’ and ‘The predominant color of the painting is blue’ must express false propositions. It is maintained that this is not the case, and that color therefore is not an illusion.
Synergies of Control
Authors: Burgorgue-Larsen Laurence
Published: April 2024

Chapter 7 looks at the mechanisms that are in place to monitor compliance and shows, once again through a comprehensive approach, that various synergies are at work—hence the title of this chapter, ‘Synergies of Control’. Although each system adapted to the growing number of obstacles and the mounting shortcomings, the steps taken at the level of regional organizations proved to be insufficient. That is why national mechanisms, some of them innovative, have been developed over time to coordinate execution processes. In this case, the coordination landscape is fraught with uncertainty, conditioned as it is by the vagaries of the political and legal culture of each state.