This Viewpoint analyzes policies for covering GLP-1 receptor agonist drugs for obesity treatment across 13 high-income countries. It identifies four key lessons for developing coverage policies: 1) using up-to-date cost-effectiveness analyses that incorporate new evidence of benefits, 2) negotiating lower prices while preserving innovation incentives, 3) prioritizing coverage for specific populations rather than issuing blanket denials, and 4) treating obesity medications similarly to high-cost drugs for other conditions. It argues that blanket coverage denials are unethical and that (...) countries should implement targeted coverage policies that maximize benefits while managing costs. (shrink)

In response to our critics, we clarify and defend key ideas in the report Open and Inclusive: Fair Processes for Financing Universal Health Coverage. First, we argue that procedural fairness has greater value than Dan Hausman allows. Second, we argue that the Report aligns with John Kinuthia’s view that a knowledgeable public and a capable civil society, alongside good facilitation, are important for effective public deliberation. Moreover, we agree with Kinuthia that the Report’s framework for procedural fairness applies not (...) merely within the health sector, but also to the wider budget process. Third, we argue that while Dheepa Rajan and Benjamin Rouffy-Ly are right that robust processes for equal participation are often central to a fair process, sometimes improvements in other aspects of procedural fairness, such as transparency, can take priority over strengthening participation. Fourth, while we welcome Sara Bennett and Maria Merritt’s fascinating use of the Report’s principles of procedural fairness to assess the U.S. President’s Emergency Plan for AIDS Relief, we argue that their application of the Report’s principle of equality to development partners’ decision-making requires further justification. (shrink)

This paper investigates whether search engines and other new modes of online communication should be covered by free speech principles. It criticizes the analogical reason-ing that contemporary American courts and scholars have used to liken search engines to newspapers, and to extend free speech coverage to them based on that likeness. There are dissimilarities between search engines and newspapers that undermine the key analogy, and also rival analogies that can be drawn which don’t recommend free speech protection for search (...) engines. Partly on these bases, we argue that an analogical approach to questions of free speech coverage is of limited use in this context. Credible verdicts about how free speech principles should apply to new modes of online com-munication require us to re-excavate the normative foundations of free speech. This method for deciding free speech coverage suggests that only a subset of search engine outputs and similar online communication should receive special protection against government regulation. (shrink)

Objective: To assess the relation between autocratisation—substantial decreases in democratic traits (free and fair elections, freedom of civil and political association, and freedom of expression)—and countries’ population health outcomes and progress toward universal health coverage (UHC). -/- Design: Synthetic control analysis. -/- Setting and country selection: Global sample of countries for all years from 1989 to 2019, split into two categories: 17 treatment countries that started autocratising during 2000 to 2010, and 119 control countries that never autocratised from 1989 (...) to 2019. The treatment countries comprised low and middle income nations and represent all world regions except North America and western Europe. A weighted combination of control countries was used to construct synthetic controls for each treatment country. This statistical method is especially well suited to population level studies when random assignment is infeasible and sufficiently similar comparators are not available. The method was originally developed in economics and political science to assess the impact of policies and events, and it is now increasingly used in epidemiology. -/- Main outcome measures: HIV-free life expectancy at age 5 years, UHC effective coverage index (0-100 point scale), and out-of-pocket spending on health per capita. All outcome variables are for the period 1989 to 2019. -/- Results: Autocratising countries underperformed for all three outcome variables in the 10 years after the onset of autocratisation, despite some improvements in life expectancy, UHC effective coverage index, and out-of-pocket spending on health. On average, HIV-free life expectancy at age 5 years increased by 2.2% (from 64.7 to 66.1 years) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by 3.5% (95% confidence interval 3.3% to 3.6%, P<0.001) (from 64.7 to 66.9 years) in the absence of autocratisation. On average, the UHC effective coverage index increased by 11.9% (from 42.5 to 47.6 points) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by 20.2% (95% confidence interval 19.6% to 21.2%, P<0.001) (from 42.5 to 51.1 points) in the absence of autocratisation. Finally, on average, out-of-pocket spending on health per capita increased by 10.0% (from $4.00 (£3.1; €3.4) to $4.4, log transformed) during the 10 years after the onset of autocratisation. This study estimated that it would have increased by only 4.4% (95% confidence interval 3.9% to 4.6%, P<0.001) (from $4.0 to $4.2, log transformed) in the absence of autocratisation. -/- Conclusions: Autocratising countries had worse than estimated life expectancy, effective health service coverage, and levels of out-of-pocket spending on health. These results suggest that the noticeable increase in the number of countries that are experiencing democratic erosion in recent years is hindering population health gains and progress toward UHC. Global health institutions will need to adjust their policy recommendations and activities to obtain the best possible results in those countries with a diminishing democratic incentive to provide quality healthcare to populations. (shrink)

We summarize key messages from the World Bank report Open and Inclusive: Fair Processes for Financing Universal Health Coverage. A central lesson of the Report is that in decision-making on the path to UHC, procedural fairness matters alongside substantive fairness. Decision systems should be assessed using a complete conception of procedural fairness that embodies core commitments to impartial and equal consideration of interests and perspectives. These commitments demand that comprehensive information is gathered and disclosed and that justifications for policies (...) are publicly debated; that participation in decision-making is enabled; and that these characteristics of the decision system are institutionalised rather than up to the good will of decision-makers. Procedural fairness can improve equity in outcomes, raise legitimacy and trust, and can help make reforms last. While improving procedural fairness can be costly and there are barriers to achieving it, the range of instruments that countries at varying levels of income and institutional capacity have used with some success shows that, in many contexts, advances in procedural fairness in health financing are possible and worthwhile. (shrink)

The goal of achieving Universal Health Coverage (UHC) can generally be realized only in stages. Moreover, resource, capacity and political constraints mean governments often face difficult trade-offs on the path to UHC. In a 2014 report, Making fair choices on the path to UHC, the WHO Consultative Group on Equity and Universal Health Coverage articulated principles for making such trade-offs in an equitable manner. We present three case studies which illustrate how these principles can guide practical decision-making. These (...) case studies show how progressive realization of the right to health can be effectively guided by priority-setting principles, including generating the greatest total health gain, priority for the worse off, and financial risk protection. They also demonstrate the value of a fair and accountable process of priority setting. (shrink)

This World Bank Report offers a new conception of fair decision processes in health financing. It argues that such procedural fairness can contribute to fairer outcomes, strengthen the legitimacy of decision processes, build trust in authorities, and promote the sustainability of reforms on the path to health coverage for all.

This paper comes out of a panel honoring the work of Anne Donchin (1940-2014), which took place at the 2016 Congress of the International Network on Feminist Approaches to Bioethics (FAB) in Edinburgh. My general aim is to highlight the contributions Anne made to feminist bioethics, and to feminist reproductive ethics in particular. My more specific aim, however, is to have a kind of conversation with Anne, through her work, about whether reproductive justice could demand insurance coverage for in (...) vitro fertilization. I quote liberally from Anne’s work for this purpose, but also to shower the reader with her words, reminding those of us who knew her well what a wonderful colleague she was. (shrink)

Universal health coverage (UHC) is at the center of current efforts to strengthen health systems and improve the level and distribution of health and health services. This document is the final report of the WHO Consultative Group on Equity and Universal Health Coverage. The report addresses the key issues of fairness and equity that arise on the path to UHC. As such, the report is relevant for every actor that affects that path and governments in particular, as they (...) are in charge of overseeing and guiding the progress toward UHC. (shrink)

This report by the WHO Consultative Group on Equity and Universal Health Coverage addresses how countries can make fair progress towards the goal of universal coverage. It explains the relevant tradeoffs between different desirable ends and offers guidance on how to make these tradeoffs.

We offer a summary of the WHO Report "Making Fair Choices on the Path to Universal Health Coverage".

This article examines how Žižek’s analysis of “subjective” violence can be used to explore the ways in which media coverage of a terrorist attack is contoured and shaped by less noticeable forms of “objective” (symbolic and systemic) violence. Drawing upon newspaper coverage of the 2017 London Bridge attack, it is noted how examples of “subjective” violence were grounded in the externalization of a clearly identifiable “other”, which symbolically framed the terrorists and the attack as tied to and representative (...) of the UK Muslim community. Examples of “systematic” violence were most notable in the ideological edifice that underpinned this framing but also in the ways in which newspaper reports served to draw upon British values in the aftermath of the attack. This directed attention away from the contradictions within the UK, towards narratives that sought to “fix” these contradictions through eradicating the problem of “the other” and/or by violently protecting the British values “they” seek to undermine. As a consequence, newspaper coverage worked to uphold the illusion that “peace” could be achieved by eradicating terrorism through further forms of objective violence, including, internment without trial; the “ripping up” of human rights; and, closer surveillance of Muslim communities. Indeed, it was this unacknowledged violence that worked to maintain British values in the press’ coverage. (shrink)

This paper examines global English language newspaper coverage of the death of David Bowie. Drawing upon the concept of reification, it is argued that the notion of celebrity is discursively (re)produced and configured through a ‘public face’ that is defined, maintained and shaped via media reports and public responses that aim to know and reflect upon celebrity. In this paper, the findings highlight how Bowie’s reification was supported by discourses that represented him as an observable, reified form. Here, Bowie’s (...) ‘reality’, that is, his authentic/veridical self, was obscured behind a façade of mediation, interpretation and representation, that debated and decided his ‘authenticity’ as a cultural icon. Such debates, however, were engagements with a reified image, enveloped in continual (re)interpretation. As a result, Bowie’s reification was grounded in a polysemous process that allowed numerous versions of ‘himself’ to be aesthetically reimagined, reinvented and repeated. (shrink)

Most people are completely oblivious to the danger that their medical data undergoes as soon as it goes out into the burgeoning world of big data. Medical data is financially valuable, and your sensitive data may be shared or sold by doctors, hospitals, clinical laboratories, and pharmacies—without your knowledge or consent. Medical data can also be found in your browsing history, the smartphone applications you use, data from wearables, your shopping list, and more. At best, data about your health might (...) end up in the hands of researchers on whose good will we depend to avoid abuses of power.2 Most likely, it will end up with data brokers who might sell it to a future employer, or an insurance company, or the government. At worst, your medical data may end up in the hands of criminals eager to commit extortion or identity theft. In addition to data harms related to exposure and discrimination, the collection of sensitive data by powerful corporations risks the creation of data monopolies that can dominate and condition access to health care. -/- This chapter aims to explore the challenge that big data brings to medical privacy. Section I offers a brief overview of the role of privacy in medical settings. I define privacy as having one’s personal information and one’s personal sensorial space (what I call autotopos) unaccessed. Section II discusses how the challenge of big data differs from other risks to medical privacy. Section III is about what can be done to minimise those risks. I argue that the most effective way of protecting people from suffering unfair medical consequences is by having a public universal healthcare system in which coverage is not influenced by personal data (e.g., genetic predisposition, exercise habits, eating habits, etc.). (shrink)

This chapter explores two questions in detail: How should we determine the threshold for costs that individuals are asked to bear through insurance premiums or care-related out-of-pocket costs, including user fees and copayments? and What is an adequate relationship between costs and benefits? This chapter argues that preventing impoverishment is a morally more urgent priority than protecting households against income fluctuations, and that many health insurance plans may not adequately protect individuals from health care costs that threaten to drop their (...) financial status below a decent minimum. A design that places greater emphasis on preventing impoverishment and finances the achievement of that goal by reducing unnecessary subsidies to better-off households would better accord with a sufficientarian approach to health care. -/- . (shrink)

In a context of imperfect risk protection, households may protect against the impact of a health shock by employing various financial and non-financial coping mechanisms, such as foregoing or reducing needed medical care, labor substitution, consumption reduction, borrowing money, dissaving, and selling assets. However, leveraging certain coping mechanisms may reduce future productivity, potentially trapping households in chronic or persistent poverty. Resources and risk are not necessarily shared equitably within a household; the ability and willingness of the household to leverage coping (...) mechanisms, or the choice of coping mechanism may depend on the social protection policy context, household socioeconomic status, and type of intrahousehold risk sharing. Vietnam has been making policy changes aimed towards achieving Universal Health Coverage for the past several decades, culminating in a 2015 change mandating universal insurance coverage. This can potentially influence both providers in making decisions around service delivery and households around financing care. This research aims to contribute to the literature exploring the relationships among direct and indirect health care costs, potentially maladaptive coping mechanisms, and household living standards, within the particular health financing and social protection environment in Vietnam. (shrink)

The vertiginous rise of right-wing populism, especially in its “nationalist, xenophobic and conservative form”, and some “racist, anti-Semitic, homophobic and sexist” drifts associated with this phenomenon – whether real or perceived as such – make the mainstream media play a double role. On the one hand, the mainstream media reflect the struggle for political hegemony between different vested interests; on the other hand, they engage in the fight against right-wing populism blasting both right-wing populist candidates and their voters or supporters. (...) Many mainstream journalists ask citizens to realize a “sanitary cordon”, a “wall” or a “republican front” to block far-right populism and preserve liberal democracy. Moreover, they urge people to be wary of all attempts to “dediabolize” or “normalize” some tokens of right-wing populism. The main idea of this article is that right-wing populism is more harmless than is generally believed and, if excessive, negative media coverage doesn’t baffle but feed it. Populism is essentially a latent side effect of liberal democracy. Populism rises and becomes obtrusive only if a significant part of society perceives a regime of illiberal majoritarianism instead of one of liberal democracy. Right-wing populists are chiefly frustrated “ci-devants” who feel dispossessed of their past, identity, properties, qualities, privileges or titles. Inasmuch as the causes of collective frustration are many and varied (e.g. the real or just perceived corruption of the elites, the “system”, the deep state, the relocation of jobs, immigration, national sovereignty, national identity, communitarianism, radical Islamism, the status of some traditional institutions, some chapters of official history, etc.), there will always be right-wing populists, whether they are self-declared or covert. By adopting David G. Hackett’s thesis that the media are “agents of hegemony”, we applied the critical analysis of discourse to a set of 346 media articles in order to reveal the discursive sources of power, domination, inequality and partiality. The articles appeared in The New York Times and Le Monde during the period 2016-2017, at the time when the presidential elections took place in the United States and France. The articles were selected according to the occurrence of the keywords “Donald Trump” – “populism” and “Marine Le Pen” – “populisme” within the titles. The analysis of these articles reveals a divisive discursive structure that correspond to a real political cleavage in society. It is true that populism presents a “Manichean outlook”, in which there are only friends and foes” and no compromise is possible. It is also true that mainstream media reinforce this Manichean perspective on society and make populists feel marginalized and politically disempowered. The mainstream media may appease right-wing populism if they treat its followers as legitimate and equal political actors. For this, they have to give up the narrative structures that underscore insurmountable divergences and irreconcilable interests. In a liberal democracy, mass media should chiefly play the role of mediator. They may not aim to defeat or re-educate certain categories of citizens just because they advocate “wrong” political solutions. (shrink)

Lieto’s Minimal Cognitive Grid (MCG) for assessing artificial agents, augmented as the method MCG+, has two implications: (1) MCG+ can advance the mathematical science of universal intelligence/cognition. (2) (a) pre-Lieto, this science lacks of coverage of perception; (b) heralded artificial agents of today are devoid of human-level perceptual intelligence.

Insufficient vaccination coverage is an important public health problem in many countries, since it leads to the loss of herd protection and the resurgence of previously exterminated diseases. However, policies of mandatory childhood vaccination capable of raising vaccination rates continue to be controversial. In this article I review the arguments for mandatory childhood vaccination, setting out the strongest teleological argument in favour, and then critically examining the two strongest potential objections: paternalism and the parental prerogative. I argue that the (...) challenge of paternalism fails because it confuses the identities of those subject to restricted liberty and those who autonomously dissent, and because non-vaccination imposes risks on others. I argue that the challenge of a parental prerogative fails because it cannot be intuitively or theoretically supported in a form that would make it permissible to impose risks on others. I conclude that in lieu of further and more plausible objections at least some policies of mandatory childhood vaccination are morally permissible. (shrink)

[To readers: Please consider visiting the journal's website to read this work.] In spite of referring to the human tendency to "breath together" or share the same spirit, the word "conspire" has developed a negative connotation in contemporary society, specifically as it pertains to theorizing about conspiracies as a result of the human proclivity to recognize patterns recognition and coalesce common themes amongst those with shared perceptions into something resembling a unified narrative. This proclivity has only become more pronounced with (...) the dawn of the Internet age, and as a result, the tendency to assume the actuality of certain conspiracies and insulate ourselves from viable, competing ideas has led to a series of microenvironments not dissimilar from those that allow for the proliferation of cancerous cells in the human body. In this article, I draw out the analogy between cancer and conspiracy theorizing in order to present readers with a clearer picture of the deleterious effects of the contemporary phenomena such as unbridled political polarization and the effect of sociopolitical news coverage presented by low-correlation outlets, otherwise known as "echo chambers.". (shrink)

This paper presents the Obstetric and Neonatal Ontology (OntONeo). This ontology has been created to provide a consensus representation of salient electronic health record (EHR) data and to serve interoperability of the associated data and information systems. More generally, it will serve interoperability of clinical and translational data, for example deriving from genomics disciplines and from clinical trials. Interoperability of EHR data is important to ensuring continuity of care during the prenatal and postnatal periods for both mother and child. As (...) a strategy to advance such interoperability we use an approach based on ontological realism and on the ontology development principles of the Open Biomedical Ontologies Foundry, including reuse of reference ontologies wherever possible. We describe the structure and coverage domain of OntONeo and the process of creating and maintaining the ontology. (shrink)

This paper discusses the coverage of ordinary language philosophy in Scott Soames' Philosophical Analysis in the Twentieth Century. After praising the book's virtues, I raise three points where I dissent from Soames' take on the history. First, I suggest that there is more to ordinary language philosophy than the rather implausible version of it that Soames sees to have been destroyed by Grice. Second, I argue that confusions between analyticity, necessity and priority are less important to the ordinary language (...) period than Soames takes them to be. Finally, I claim that Soames' criticisms of Ryle turn in part on attributing reductionist positions to Ryle that Ryle did not hold. (shrink)

This paper sketches a framework for the separation of church and state and, with the framework in view, indicates why a government’s maintaining such separation poses challenges for balancing two major democratic ideals: preserving equality before the law and protecting liberty, including religious liberty. The challenge is particularly complex where healthcare is either provided or regulated by government. The contemporary problem in question here is the contraception coverage requirement in the Obama Administration’s healthcare mandate. Many institutions have mounted legal (...) challenges to the mandate on grounds of religious freedom. The paper proposes a number of interconnected principles toward a resolution of the problem: for the institutional realm, specific principles for church-state separation and a principle concerning the protection of citizens’sense of identity; and for the ethics of citizenship in the conduct individuals, principles that provide an adequate place for natural (thus secular) reason in lawmaking and political decisions. (shrink)

Several vaccines against COVID-19 have now been developed and are already being rolled out around the world. The decision whether or not to get vaccinated has so far been left to the individual citizens. However, there are good reasons, both in theory as well as in practice, to believe that the willingness to get vaccinated might not be sufficiently high to achieve herd immunity. A policy of mandatory vaccination could ensure high levels of vaccination coverage, but its legitimacy is (...) doubtful. We investigate the willingness to get vaccinated and the reasons for an acceptance (or rejection) of a policy of mandatory vaccination against COVID-19 in June and July 2020 in Germany based on a representative real time survey, a random sub-sample (SOEP-CoV) of the German Socio-Economic Panel (SOEP). Our results show that about 70 percent of adults in Germany would voluntarily get vaccinated against the coronavirus if a vaccine without side effects was available. About half of residents of Germany are in favor, and half against, a policy of mandatory vaccination. The approval rate for mandatory vaccination is significantly higher among those who would get vaccinated voluntarily (around 60 percent) than among those who would not get vaccinated voluntarily (27 percent). The individual willingness to get vaccinated and acceptance of a policy of mandatory vaccination correlates systematically with socio-demographic and psychological characteristics of the respondents. We conclude that as far as people’s declared intentions are concerned, herd immunity could be reached without a policy of mandatory vaccination, but that such a policy might be found acceptable too, were it to become necessary. (shrink)

Providing the most thorough coverage available in one volume, this comprehensive, broadly based collection offers a wide variety of selections in four major genres, and also includes a section on film. Each of the five sections contains a detailed critical introduction to each form, brief biographies of the authors, and a clear, concise editorial apparatus. Updated and revised throughout, the new Fourth Edition adds essays by Margaret Mead, Russell Baker, Joan Didion, Annie Dillard, and Alice Walker; fiction by Nathaniel (...) Hawthorne, Ursula K. LeGuin, Anton Chekov, James Joyce, Katherine Mansfield, F. Scott Fitzgerald, William Faulkner, Alice Walker, Louise Erdrich, Donald Barthelme, and James McPherson; poems by John Donne, Robert Browning, Walt Whitman, Edwin Arlington Robinson, e.e. cummings, Langston Hughes, W.H. Auden, Philip Levine, and Louise Gluck; and plays by August Wilson, Marsha Norman, Wendy Wasserstein, and Vaclav Havel. The chapter devoted to film examines the relation of film to literature and gives the complete screenplay for Citizen Kane plus close analysis of a scene from the film. With its innovative structure, comprehensive coverage, and insightful and stimulating presentation of all kinds of literature, this is an anthology readers will turn to again and again. (shrink)

Under one of the last remaining single-party communist regimes, Vietnam’s in-progress transition is a hybrid between post-Soviet reforms and Chinese authoritarian compromise. This chapter provides a brief account of the historical events and cultural attributes that have shaped the current political and economic configuration of the country, a coverage of globalization and entrepreneurial endeavours in relation to trade liberalization, an analysis of growing consumerist tendencies and the solidification of a circle of economic elites, an overview of Vietnamese foreign trade, (...) with a focus on the Association of Southeast Asian Nations (ASEAN) and China as significant partners, and a macroeconomic assessment of the country. (shrink)

Throughout Iran and various countries, the recent calls of the “Zan, Zendegi, Azadi” (in Persian), “Jin, Jiyan, Azadi” (in Kurdish), or “Woman, Life, Freedom” (in English) movement call for change to acknowledge the importance of women. While these feminist protests and demonstrations have been met with brutality, systematic oppression, and internet blackouts within Iran, they have captured significant social media attention and coverage outside the country, especially among the Iranian diaspora and various international organizations. This article, grounded in feminist (...) urban theories of the Global South, analyzes the digital feminist placemaking movement in Iran. As the first counter‐revolution led by women, the movement utilizes digital art, graffiti, and protest movements to embody women’s solidarity groups and sympathy rallies. Our analysis employs various digital research methods, including social media scrutiny and the study of protest illustrations. Analyzing the digital feminist placemaking in Iran will enable us to compare the commonalities, differences, challenges, and opportunities between the minorities and majorities in the world’s countries. The outcomes of this research can help international organizations such as Amnesty International and the United Nations Agency for Gender Equality and Women’s Empowerment (UN Women), as well as policymakers, institutions, academics, and NGOs, to highlight the various ways in which broader public participation could be encouraged in the process of digital feminist insurgent placemaking. (shrink)

The data collected by these sensors are transmitted to a centralized system where optimization algorithms, such as Genetic Algorithms (GA), Particle Swarm Optimization (PSO), and Simulated Annealing (SA), are applied to optimize sensor placement, data transmission, and processing efficiency. This ensures accurate, real-time pollution monitoring and data analysis, providing actionable insights for policymakers, environmental agencies, and the general public. The system's performance is evaluated through simulations and real-world experiments, demonstrating its capability to deliver reliable and timely pollution data. Future work (...) will explore the integration of machine learning techniques for predictive analytics and the expansion of the sensor network for broader coverage. (shrink)

The world is on the cusp of an epoch known as the Fourth Industrial Revolution (4IR). Despite the much-publicised promise of enhanced productivity, flexibility, efficiency and improved quality, Industry 4.0 is a daunting prospect for less-developed nations without the human labour to cope with and embrace the anticipated technological advancement. The paper explores the various opportunities and challenges associated with entrepreneurship in the Fourth Industrial Revolution in developing countries to ascertain their readiness. An in-depth, systematic literature review was conducted. In (...) doing that, we were mindful of the coverage, and data collection was carried out through a rigorous process to ensure the accuracy of findings while keeping the study’s objective. This paper argues for entrepreneurs to rethink and initiate the development of strategies that would make them relevant in the future, through innovation of business models, in preparation for possible disruptions with the evolution of Industry 4.0, while also advocating that more should be done to address the causes of policy and institutional failures. (shrink)

In this paper, we aim to provide an in-depth discussion of nickel's crucial position in the manufacturing sector in the context of the United Nations' Sustainable Development Goals (SDGs), which represent growing environmental imperatives. These SDGs have gained unprecedented urgency due to looming concerns of incompletion. It should be emphasized that the information compiled herein is derived from authoritative sources and is limited in its ability to give comprehensive coverage within the scope of this article. The raised issues are (...) of broad interest in terms of environmental dynamics in the global nickel mining, extraction, and refining arenas. As a result, the content given below may not precisely comply with the local situations dictated by geographical, geological, and socio-economic characteristics. The fundamental goal of this discussion is to clarify the economic-environmental interaction and the pragmatic meanings of the term "sustainable" in the context of the nickel industry. (shrink)

In Groenendijk & Stokhof [1989] a system of dynamic predicate logic (DPL) was developed, as a compositional alternative for classical discourse representation theory (DRT ). DPL shares with DRT the restriction of being a first-order system. In the present paper, we are mainly concerned with overcoming this limitation. We shall define a dynamic semantics for a typed language with λ-abstraction which is compatible with the semantics DPL specifies for the language of first-order predicate logic. We shall propose to use this (...) new logical system as the semantic component of a Montague-style grammar (referred to as dynamic Montague grammar, DMG), which will enable us to extend the compositionality of DPL to the subsentential level. Furthermore, we shall extend this analysis also in this sense that we shall add new, dynamic interpretations for logical constants which in DPL were treated in a static fashion. This will substantially increase the descriptive coverage of DMG. (shrink)

We discuss the role of prior authorization (PA) in supporting patient-centered care (PCC) by directing health system resources and thus the ability to better meet the needs of individual patients. We begin with an account of PCC as a standard that should be aimed for in patient care. In order to achieve widespread PCC, appropriate resource management is essential in a healthcare system. This brings us to PA, and we present an idealized view of PA in order to argue how (...) at its best, it can contribute to the provision of PCC. PA is a means of cost saving and as such it has mixed success. The example of the US demonstrates how implementation of PA has increased health inequalities whereas best practice has the potential to reduce them. In contrast, systems of universal coverage, like those in Europe, may use the cost savings of PA to better address individuals' care and PCC. The conclusion we offer therefore is an optimistic one, pointing towards areas of supportive overlap between PCC and PA where usually the incongruities are most evident. (shrink)

Article Authors Metrics Comments Media Coverage Abstract Author Summary Introduction Results Discussion Supporting information Acknowledgments Author Contributions References Reader Comments (0) Media Coverage (0) Figures Abstract During language processing, humans form complex embedded representations from sequential inputs. Here, we ask whether a “geometrical language” with recursive embedding also underlies the human ability to encode sequences of spatial locations. We introduce a novel paradigm in which subjects are exposed to a sequence of spatial locations on an octagon, and are (...) asked to predict future locations. The sequences vary in complexity according to a well-defined language comprising elementary primitives and recursive rules. A detailed analysis of error patterns indicates that primitives of symmetry and rotation are spontaneously detected and used by adults, preschoolers, and adult members of an indigene group in the Amazon, the Munduruku, who have a restricted numerical and geometrical lexicon and limited access to schooling. Furthermore, subjects readily combine these geometrical primitives into hierarchically organized expressions. By evaluating a large set of such combinations, we obtained a first view of the language needed to account for the representation of visuospatial sequences in humans, and conclude that they encode visuospatial sequences by minimizing the complexity of the structured expressions that capture them. (shrink)

Over the past two decades, gamblers have begun taking mathematics into account more seriously than ever before. While probability theory is the only rigorous theory modeling the uncertainty, even though in idealized conditions, numerical probabilities are viewed not only as mere mathematical information, but also as a decision-making criterion, especially in gambling. This book presents the mathematics underlying the major games of chance and provides a precise account of the odds associated with all gaming events. It begins by explaining in (...) simple terms the meaning of the concept of probability for the layman and goes on to become an enlightening journey through the mathematics of chance, randomness and risk. It then continues with the basics of discrete probability, combinatorics and counting arguments for those interested in the supporting mathematics. These mathematic sections may be skipped by readers who do not have a minimal background in mathematics; these readers can skip directly to the Guide to Numerical Results to pick the odds and recommendations they need for the desired gaming situation. Doing so is possible due to the organization of that chapter, in which the results are listed at the end of each section, mostly in the form of tables. The chapter titled The Mathematics of Games of Chance presents these games not only as a good application field for probability theory, but also in terms of human actions where probability-based strategies can be tried to achieve favorable results. Through suggestive examples, the reader can see what are the experiments, events and probability fields in games of chance and how probability calculus works there. The main portion of this work is a collection of probability results for each type of game. Each game s section is packed with formulas and tables. Each section also contains a description of the game, a classification of the gaming events and the applicable probability calculations. The primary goal of this work is to allow the reader to quickly find the odds for a specific gaming situation, in order to improve his or her betting/gaming decisions. Every type of gaming event is tabulated in a logical, consistent and comprehensive manner. The complete methodology and complete or partial calculations are shown to teach players how to calculate probability for any situation, for every stage of the game for any game. Here, readers can find the real odds, returned by precise mathematical formulas and not by partial simulations that most software uses. Collections of odds are presented, as well as strategic recommendations based on those odds, where necessary, for each type of gaming situation. The book contains much new and original material that has not been published previously and provides great coverage of probabilities for the following games of chance: Dice, Slots, Roulette, Baccarat, Blackjack, Texas Hold em Poker, Lottery and Sport Bets. Most of games of chance are predisposed to probability-based decisions. This is why the approach is not an exclusively statistical one, but analytical: every gaming event is taken as an individual applied probability problem to solve. A special chapter defines the probability-based strategy and mathematically shows why such strategy is theoretically optimal.". (shrink)

Introduction: Universal health coverage (UHC) was introduced in Iran in 2014. The aim of this study was to evaluate the usage rate of health services by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients after UHC implementation. Material and methods: In 2018, in a cross-sectional study, we evaluated the outpatients’ needs (within its previous month) and inpatients’ needs (within its previous 6 months) of HIV/AIDS patients in Isfahan province (the center of Iran). Concurrently, we estimated the essential health care (...) services that HIV/AIDS patients have to receive regularly, including vaccination for hepatitis B, measurement of CD4, tuberculosis (TB) assessments and TB treatment, anti-retroviral therapy, examination of viral load, treatment approach, and drug side effects counseling. Two checklists were used for assessing the utilization of health services and essential health cares for HIV/AIDS patients, validated by the Ministry of Health and Medical Education of Iran. Data were analyzed by χ2 test, Pearson’s correlation coefficient, and Spearman’s correlation test. Results: Two hundred and thirteen HIV/AIDS patients completed the questionnaires. The mean age of participants was 41.14 ± 9.23. The outpatient service utilization rate was 31.94% in the previous month and the rate of hospitalization was 126 per 1,000 HIV/AIDS patients in the previous 6 months. The majority of HIV/AIDS patients received essential health services more often than the national standard goals estimation. Conclusions: After UHC implementation, the utilization rate of outpatients and inpatients services in HIV/AIDS patients was more than similar indices in the general population. In addition, HIV/AIDS patients received essential health services adequately. (shrink)

We argue that the interaction of biased media coverage and widespread employment of the recognition heuristic can produce epistemic injustices. First, we explain the recognition heuristic as studied by Gerd Gigerenzer and colleagues, highlighting how some of its components are largely external to, and outside the control of, the cognitive agent. We then connect the recognition heuristic with recent work on the hypotheses of embedded, extended, and scaffolded cognition, arguing that the recognition heuristic is best understood as an instance (...) of scaffolded cognition. In section three, we consider the double-edged sword of cognitive scaffolding. On the one hand, scaffolds can reduce the internal processing demands on cognitive agents while increasing their access to information. On the other hand, the use of scaffolding leaves cognitive agents increasingly vulnerable to forming false beliefs or failing to form beliefs at all about particular topics. With respect to the recognition heuristic, agents rely on third parties (such as the media) to report not just what’s true but also what’s important or valuable. This makes cognitive agents relying on these third parties vulnerable to two erroneous influences: 1) because they don’t recognize something, it isn’t important or valuable, and 2) because they do recognize something, it is important or valuable. Call the latter the Kardashian Inference and the former the Darfur Inference. In section four, we use Fricker’s (2007) concept of epistemic injustice to characterize the nature and harm of these false inferences, with special emphasis on the Darfur Inference. In section five, we use data-mining and an empirical study to show how Gigerenzer’s population estimation task is liable to produce Darfur Inferences. We conclude with some speculative remarks on more important Darfur Inferences, and how to avoid them by scaffolding better. One primary way to accomplish this it to shift the burden of embodying the virtue of epistemic justice from the hearer or consumer of media to the media themselves. (shrink)

There is fast-growing awareness of the role atmospheres play in architecture. Of equal interest to contemporary architectural practice as it is to aesthetic theory, this 'atmospheric turn' owes much to the work of the German philosopher Gernot Böhme. Atmospheric Architectures: The Aesthetics of Felt Spaces brings together Böhme's most seminal writings on the subject, through chapters selected from his classic books and articles, many of which have hitherto only been available in German. This is the only translated version authorised by (...) Böhme himself, and is the first coherent collection deploying a consistent terminology. It is a work which will provide rich references and a theoretical framework for ongoing discussions about atmospheres and their relations to architectural and urban spaces. Combining philosophy with architecture, design, landscape design, scenography, music, art criticism, and visual arts, the essays together provide a key to the concepts that motivate the work of some of the best contemporary architects, artists, and theorists: from Peter Zumthor, Herzog & de Meuron and Juhani Pallasmaa to Olafur Eliasson and James Turrell. With a foreword by Professor Mark Dorrian and an afterword by Professor David Leatherbarrow,, the volume also includes a general introduction to the topic, including coverage of it history, development, areas of application and conceptual apparatus. (shrink)

The data collected by these sensors are transmitted to a centralized system where optimization algorithms, such as Genetic Algorithms (GA), Particle Swarm Optimization (PSO), and Simulated Annealing (SA), are applied to optimize sensor placement, data transmission, and processing efficiency. This ensures accurate, real-time pollution monitoring and data analysis, providing actionable insights for policymakers, environmental agencies, and the general public. The system's performance is evaluated through simulations and real-world experiments, demonstrating its capability to deliver reliable and timely pollution data. Future work (...) will explore the integration of machine learning techniques for predictive analytics and the expansion of the sensor network for broader coverage. (shrink)

The cognitive sciences are facing questions of how to select from competing theories or develop those that suit their current needs. However, traditional accounts of theoretical virtues have not yet proven informative to theory development in these fields. We advance a pragmatic account by which theoretical virtues are heuristics we use to estimate a theory’s contribution to a field’s body of knowledge and the degree to which it increases that knowledge’s ability to solve problems in the field’s domain or problem (...) space. From this perspective, properties that are traditionally considered epistemic virtues, such as a theory’s fit to data or internal coherence, can be couched in terms of problem space coverage, and additional virtues come to light that reflect a theory’s alignment with problem-having agents and the context in a societally embedded scientific system. This approach helps us understand why the needs of different fields result in different kinds of theories and allows us to formulate the challenges facing cognitive science in terms that we hope will facilitate their resolution through further theoretical development. (shrink)

This study aimed to examine the perception of Engineering students about importance of educational needs and satisfaction about it. A descriptive correlational design was used for this study. The present study was conducted at engineering faculties in Dire Dawa University. The present study included a total coverage sample includes all four academic years engineering students during academic year (2021). Total number of students was (n = 727). The study tool consisted of Engineering Education Satisfaction Instrument (EESI) consist of two (...) questions (question one about importance of educational needs and question 2 about satisfaction with the educational needs) contained the same items, the five sub‐scales related to the five levels. This study revealed that, there was a highly statistical significant differences among the four academic years engineering students as all 5th year engineering students had reported that the educational needs is very important and a highly statistical significant differences among the students of the 4 academic years in which the second year and 3rd year students had the highest mean scores according to perception of the engineering students about satisfaction with the educational needs. There was a highly statistically significant positive relationship between perceptions of the engineering students in the four academic years about the importance of educational needs. Also, observed that there was a highly statistically significant negative relationship between perceptions of the engineering students in the four academic years about the satisfaction of educational needs. Ask authoritative persons to improve educational environment through providing more space and educational resources for conducting teaching learning process. (shrink)

I present a novel, collaborative, methodology for linguistics: what I call the ‘explanatory economy’. According to this picture, multiple models/theories are evaluated based on the extent to which they complement one another with respect to data coverage. I show how this model can resolve a long-standing worry about the methodology of generative linguistics: that by creating too much distance between data and theory, the empirical credentials of this research program are tarnished. I provide justifications of such methodologically central distinctions (...) as the competence/performance and core/periphery distinction, and then show how we can understand the push for simplicity in the history of generative grammar in this light. (shrink)

In this paper we propose a formal theory of partitions (ways of dividing up or sorting or mapping reality) and we show how the theory can be applied in the geospatial domain. We characterize partitions at two levels: as systems of cells (theory A), and in terms of their projective relation to reality (theory B). We lay down conditions of well-formedness for partitions and we define what it means for partitions to project truly onto reality. We continue by classifying well-formed (...) partitions along three axes: (a) degree of correspondence between partition cells and objects in reality; (b) degree to which a partition represents the mereological structure of the domain it is projected onto; and (c) degree of completeness and exhaustiveness with which a partition represents reality. This classification is used to characterize three types of partitions that play an important role in spatial information science: cadastral partitions, categorical coverages, and the partitions involved in folk categorizations of the geospatial domain. (shrink)

This paper presents a novel account of focal stress and pitch contour in English dialogue. We argue that one should analyse and treat focus and pitch contour jointly, since (i) some pragmatic interpretations vary with contour (e.g., whether an utterance accepts or rejects; or whether it implicates a positive or negative answer); and (ii) there are utterances with identical prosodic focus that in the same context are infelicitous with one contour, but felicitous with another. We offer an account of two (...) distinct pitch contours that predicts the correct felicity judgements and implicatures, outclassing other models in empirical coverage or formality. Prosodic focus triggers a presupposition, where what is presupposed and how the presupposition is resolved depends on prosodic contour. If resolving the presupposition entails the proffered content, then the proffered content is uninteresting and hence the utterance is in-felicitous. Otherwise, resolving the presupposition may lead to an implicature. We regiment this account in SDRT. (shrink)

Health policy changes in Nepal displayed struggles against a poor political, geographical, and economic setting; Millennium Development Goal #4 demanded improved infant and child mortality, as well as adequate measles vaccine coverage by the year 2015. Research in this report presents progress and direction of child health care policy across more than a decade of time in attempts of attaining MDG #4 and general child health care advancements. Subsequent observations and suggestions were delineated and offered. Progress since the 1990’s (...) up to 2012 was analyzed by review of serial national survey and report data. Trends and variations between regions were mostly analyzed amongst various child health care determinants. Results indicated many improved factors; Nepal will likely achieve MDG regarding child under-5 mortality, but may not achieve measles vaccine coverage or infant mortality goals. Furthermore, severe regional disparities were evident within Nepal, particularly in the Mid and Far-Western regions. A call for integrated community-based primary health care (CB-PHC) for infants and children became an ultimate ideal. A comprehensive, multidisciplinary, and community based primary care delivery service would address many of the deficits identified as well as reach rural and remote areas that still suffered. Risk and data-based resource allocation promise improved utilization, but also demands more frequent and better data reporting. Coordinated, multi-sector health policy initiatives have been underway; this demonstrated a strong direction in improving child health care from urban to every village. (shrink)

Japanese media coverage since March 11th 2011 suggests that people from Fukushima Prefecture have faced discrimination based on people's fears of radiation, despite the fact that they pose no genuine threat. This discrimination is compared to that faced by survivors of the atomic bombing of Hiroshima during World War II. Survivors from Hiroshima express hopes that people from Tohoku will not face the same fear and discrimination they did. 2011年3月以降に伝達されたメディアでは、福島県の人々が放射能に対する人々の恐怖から、実際にはその恐れが確認されていないにもかかわらず、差別を受けていることが分かる。この差別は、第二次世界大戦中に広 島に落とされた原子爆弾の生存者に対するものと類似する。広島の生存者は、東北の人々が同じような差別を受けてほしくないと希望している。.

This article evaluates seven strategies for managing the high costs of GLP-1 receptor agonists (GLP-1RAs) like semaglutide and tirzepatide for weight management: complete exclusion of coverage, annual cost increase caps, lifetime cost caps, tiered access, formulary reevaluation, subscription payment models, and patent reform. The authors assess each strategy against three ethical objectives: benefiting people and preventing harm, showing equal moral concern, and mitigating disadvantage. Complete coverage exclusions, arbitrary reimbursement caps, and lifetime limits are deemed unethical as they fail (...) to meet these objectives. Tiering access based on relative benefit is considered justifiable, though current implementation often unfairly favors diabetes over obesity treatment. The authors recommend formulary reevaluation as the most ethical approach for smaller health plans, allowing them to prioritize more cost-effective treatments. For larger payers with market power and for governments, subscription payment models and patent reforms are potentially ethical solutions if implemented sustainably. The authors conclude that health plans should avoid ad hoc restrictions on GLP-1RAs in favor of comprehensive policy reforms that ensure sustainable access to these and future breakthrough treatments. (shrink)

Type 1 diabetes (T1D) is a chronic illness that requires intensive lifelong management of blood glucose concentrations by means of external insulin administration. There have been substantial developments in the ways of measuring glucose levels, which is crucial to T1D self-management. Recently, continuous glucose monitoring (CGM) has allowed people with T1D to keep track of their blood glucose levels in near real-time. These devices have alarms that warn users about potentially dangerous blood glucose trends, which can often be shared with (...) ther people. CGM is consistently associated with improved glycemic control and reduced hypoglycemia and is currently recommended by doctors. However, due to the costs of CGM, only those who qualify for hospital provision or those who can personally afford it are able to use it, which excludes many people. In this paper, I argue that unequal access to CGM results in: (1) unjust health inequalities, (2) relational injustice, (3) injustice with regard to agency and autonomy, and (4) epistemic injustice. These considerations provide prima facie moral reasons why all people with T1D should have access to CGM technology. I discuss the specific case of CGM policy in the Netherlands, which currently only provides coverage for a small group of people with T1D, and argue that, especially with additional considerations of cost-effectiveness, the Dutch government ought to include CGM in basic health care insurance for all people with T1D. (shrink)

The Infectious Disease Ontology (IDO) is a suite of interoperable ontology modules that aims to provide coverage of all aspects of the infectious disease domain, including biomedical research, clinical care, and public health. IDO Core is designed to be a disease and pathogen neutral ontology, covering just those types of entities and relations that are relevant to infectious diseases generally. IDO Core is then extended by a collection of ontology modules focusing on specific diseases and pathogens. In this paper (...) we present applications of IDO Core within various areas of infectious disease research, together with an overview of all IDO extension ontologies and the methodology on the basis of which they are built. We also survey recent developments involving IDO, including the creation of IDO Virus; the Coronaviruses Infectious Disease Ontology (CIDO); and an extension of CIDO focused on COVID-19 (IDO-CovID-19).We also discuss how these ontologies might assist in information-driven efforts to deal with the ongoing COVID-19 pandemic, to accelerate data discovery in the early stages of future pandemics, and to promote reproducibility of infectious disease research. (shrink)

Why should musical compositions and artistic images be included among the types of expression covered by free speech principles? One way to answer this question is to show how expression in nonverbal media can be functionally similar to other types of verbal expression. But this leaves us with an intuitively unsatisfying explanation of why free speech principles cover nonverbal creative expression that does not functionally emulate literal speech. In this article, as an alternative justification, we develop and defend the idea (...) that musical and pictorial expression‚ much like literal speech, can be media through which people think aloud, as opposed to mere tools for the transmission of thought. We use this proposal to provide a more robust justification for including nonverbal creative expression in the scope of free speech coverage, and we outline some of the practical policy implications that come with adopting this justificatory strategy. (shrink)