title: Drawing the line between essential and nonessential interventions on intersex characteristics with European health care professionals

authors: Hegarty, Peter

subjects: Social Sciences

abstract: Human rights statements on intersex characteristics distinguish legitimate “medically necessary” interventions from illegitimate normalizing ones. Ironically, this binary classification seems partially grounded in knowledge of anatomy and medical interventions; the very expertise that human rights statements challenge. Here, 23 European health professionals from specialist “disorder of sex development” (DSD) multidisciplinary teams located medical interventions on a continuum ranging from “medically essential” to nonessential poles. They explained their answers. Participants mostly described interventions on penile/scrotal, clitoral/labial, vaginal, and gonadal anatomy whose essential character was only partially grounded in anatomical variation and diagnoses. To explain what was medically necessary, health care professionals drew on lay understandings of child development, parental distress, collective opposition to medicalization, patients “coping” abilities, and patients’ own choices. Concepts of “medical necessity” were grounded in a hybrid ontology of patients with intersex traits as both physical bodies and as phenomenological subjects. Challenges to medical expertise on human rights grounds are well warranted but presume a bounded and well-grounded category of “medically necessary” intervention that is discursively flexible. Psychologists’ long-standing neglect of people with intersex characteristics, and the marginalization of clinical psychologists in DSD teams, may contribute to the construction of some controversial interventions as medically necessary.

text: Drawing the line between essential and nonessential interventions on intersex characteristics with European health care professionals Human rights statements on intersex characteristics distinguish legitimate “medically necessary” interventions from illegitimate normalizing ones. Ironically, this binary classification seems partially grounded in knowledge of anatomy and medical interventions; the very expertise that human rights statements challenge. Here, 23 European health professionals from specialist “disorder of sex development” (DSD) multidisciplinary teams located medical interventions on a continuum ranging from “medically essential” to nonessential poles. They explained their answers. Participants mostly described interventions on penile/scrotal, clitoral/labial, vaginal, and gonadal anatomy whose essential character was only partially grounded in anatomical variation and diagnoses. To explain what was medically necessary, health care professionals drew on lay understandings of child development, parental distress, collective opposition to medicalization, patients “coping” abilities, and patients’ own choices. Concepts of “medical necessity” were grounded in a hybrid ontology of patients with intersex traits as both physical bodies and as phenomenological subjects. Challenges to medical expertise on human rights grounds are well warranted but presume a bounded and well-grounded category of “medically necessary” intervention that is discursively flexible. Psychologists’ long-standing neglect of people with intersex characteristics, and the marginalization of clinical psychologists in DSD teams, may contribute to the construction of some controversial interventions as medically necessary.

year: 2020

title: MHD‐driven kinetic dissipation in the solar wind and corona

authors: Leamon, R. J.

subjects: MHD

abstract: Mechanisms for the deposition of heat in the lower coronal plasma are discussed, emphasizing recent attempts to reconcile the fluid and kinetic perspectives. Structures at magnetohydrodynamic (MHD) scales may drive a nonlinear cascade, preferentially exciting high perpendicular wavenumber fluctuations. Relevant dissipative kinetic processes must be identified that can absorb the associated energy flux. The relationship between the MHD cascade and direct cyclotron absorption, including cyclotron sweep, is discussed. We conclude that for coronal and solar wind parameters the perpendicular cascade cannot be neglected and may be more rapid than cyclotron sweep. Solar wind observational evidence suggests the relevance of the ion inertial scale, which is associated with current sheet thickness during reconnection. We conclude that a significant fraction of dissipation in the corona and solar wind likely proceeds through a perpendicular cascade and small-scale reconnection, coupled to kinetic processes that act at oblique wavevectors.

text: MHD‐driven kinetic dissipation in the solar wind and corona Mechanisms for the deposition of heat in the lower coronal plasma are discussed, emphasizing recent attempts to reconcile the fluid and kinetic perspectives. Structures at magnetohydrodynamic (MHD) scales may drive a nonlinear cascade, preferentially exciting high perpendicular wavenumber fluctuations. Relevant dissipative kinetic processes must be identified that can absorb the associated energy flux. The relationship between the MHD cascade and direct cyclotron absorption, including cyclotron sweep, is discussed. We conclude that for coronal and solar wind parameters the perpendicular cascade cannot be neglected and may be more rapid than cyclotron sweep. Solar wind observational evidence suggests the relevance of the ion inertial scale, which is associated with current sheet thickness during reconnection. We conclude that a significant fraction of dissipation in the corona and solar wind likely proceeds through a perpendicular cascade and small-scale reconnection, coupled to kinetic processes that act at oblique wavevectors.

year: 2000

title: The Impact of Colonisation on the Maori community: An exploration of the attitudes and perspectives held by Maori in relation to the active reclamation of Maori sovereignty/tino rangatiratanga.

authors: Baty, Tina Amy

subjects: Maori

abstract: Whāia te iti kahurangi ki te tūohu koe me he maunga teitei
Seek the treasure you value most dearly: If you bow your head, let it be to a lofty mountain
The purpose of my research was twofold. I first sort to explore the attitudes and perspectives held by Māori in relation to the active reclamation of Māori sovereignty, tino rangatiratanga. I further wanted to know how Māori sovereignty, tino rangatiratanga could lead to the improvement of Māori health.
My research collected information pertinent to these two inquiries from current literature and from interviews I conducted with five Māori individuals from different iwi, hapu groups. All whom were actively engaged with the Māori community in some form. My research data found that colonisalism has and continues to negatively impact the Māori community. This negative impact manifests in a variety of behaviours that effect Māori health and leads to poor outcomes for Māori. Māori sovereignty, tino rangatiratanga was thought of as the solution to overcome and neutralise the negative effects of colonialism experienced by Māori. Māori sovereignty, tino rangatiratanga was found to be related with Māori idenity and instrumental in all things pertinent to the Māori communities.
My research found that Māori sovereignty, tino rangatiratanga can be identified as existing on a philosophical level, governance-structural level, and on a day-to-day basis. This research found that the reclamation of Māori sovereignty, tino rangatiratanga is a process that is currently in motion. Finally, the exercising of Māori sovereignty, tino rangatiratanga in relation to Māori health provides a well-established argument that it can produce positive health benefits to the Māori community, because it is responsive to Māori and better meets the needs of our Māori community simply because it is a Māori way of being, doing and knowing.

text: The Impact of Colonisation on the Maori community: An exploration of the attitudes and perspectives held by Maori in relation to the active reclamation of Maori sovereignty/tino rangatiratanga. Whāia te iti kahurangi ki te tūohu koe me he maunga teitei
Seek the treasure you value most dearly: If you bow your head, let it be to a lofty mountain
The purpose of my research was twofold. I first sort to explore the attitudes and perspectives held by Māori in relation to the active reclamation of Māori sovereignty, tino rangatiratanga. I further wanted to know how Māori sovereignty, tino rangatiratanga could lead to the improvement of Māori health.
My research collected information pertinent to these two inquiries from current literature and from interviews I conducted with five Māori individuals from different iwi, hapu groups. All whom were actively engaged with the Māori community in some form. My research data found that colonisalism has and continues to negatively impact the Māori community. This negative impact manifests in a variety of behaviours that effect Māori health and leads to poor outcomes for Māori. Māori sovereignty, tino rangatiratanga was thought of as the solution to overcome and neutralise the negative effects of colonialism experienced by Māori. Māori sovereignty, tino rangatiratanga was found to be related with Māori idenity and instrumental in all things pertinent to the Māori communities.
My research found that Māori sovereignty, tino rangatiratanga can be identified as existing on a philosophical level, governance-structural level, and on a day-to-day basis. This research found that the reclamation of Māori sovereignty, tino rangatiratanga is a process that is currently in motion. Finally, the exercising of Māori sovereignty, tino rangatiratanga in relation to Māori health provides a well-established argument that it can produce positive health benefits to the Māori community, because it is responsive to Māori and better meets the needs of our Māori community simply because it is a Māori way of being, doing and knowing.

year: 2018