49755 research outputs found
Sort by
Exploration of Range of Motion in Spinal Muscular Atrophy: The Contribution of Extension at the Hip, Knee and Ankle, and Trajectory Over Time
Full text linkThe natural history of spinal muscular atrophy (SMA) is characterized by progressive muscle weakness and subsequent functional decline. Limited joint range of motion (ROM) and the development of contractures is common and known to negatively impact function. While joint hypermobility (JH) is clinically observed in SMA, its presence and relationship to function remain under-explored, as does the coexistence of normal ROM. Hypermobility has been described in other neuromuscular diseases (NMDs) and is seen to co-exist with contractures.
Therefore, characterizing the presence of lower limb joint hypermobility in SMA warrants investigation. Evaluation of the sagittal arc of ROM, combining both flexion and extension, may provide a more meaningful depiction of ROM in SMA. With the knowledge of the importance of the contribution of extension ROM to the sagittal arc, the trajectory of extension ROM over time and the factors influencing its progression, such as age, baseline ROM, SMA type and disease modifying therapy (DMT) duration deserves investigation.The objectives were to (1) characterize lower-limb joint hypermobility and its relationship to gross motor and ambulatory function; (2) evaluate the contributions of hip and knee extension and ankle dorsiflexion to the sagittal ROM arc and its classification; and (3) describe the trajectory of extension ROM over time and identify factors influencing its change.
This is a secondary analysis of data collected at 4 US sites in a prospective SMA natural history registry. Passive range of motion was assessed in individuals with a confirmed diagnosis using standardized procedures. Measures exceeding normative values were considered hypermobile and used to establish whether hypermobility was associated to measures of function including the 6-minute walk test (6MWT) and the Hammersmith Functional Motor Scale-Expanded (HFMSE). Flexion and extension at the hip, knee, and ankle were combined to determine the sagittal arc ROM. The arc ROM were categorized as hypomobile (HYPO), normal (NORM), or hypermobile (HYPER) based on comparison to normative ROM values. Longitudinal analyses assessed the trajectory of hip and knee extension and ankle dorsiflexion ROM over time, and included factors which may influence the trajectory including age at baseline, SMA type and DMT treatment duration.
Joint hypermobility was prevalent across lower-limb joints but varied by joint and SMA type classification. Most sagittal ROM arcs were hypomobile at the hip (70%), normal at the knee (37%), and normal at the ankle (44%). Extension ROM strongly contributed to the total arc at all joints (hip: rs = .91, knee: rs = .88, ankle: rs = .79; all p < .001) and discriminated between hypomobile and non-hypomobile classifications. Longitudinal analyses revealed that baseline hip extension was the sole significant predictor of its trajectory, with implications for the preservation of knee and ankle ROM. No other variable included (SMA type, baseline age, arc classification and treatment duration) significantly influenced ROM trajectories.
The outcome of this study will guide future treatment decisions and indicate the potential for gains in ROM which is known to impact function.
This dissertation contributes to understanding ROM in SMA by highlighting the clinical relevance of using ROM arc classification, the contribution of extension ROM driving arc classification and the pivotal role of baseline hip extension in preserving mobility. Findings underscore the importance of early identification and holistic ROM assessment to inform therapeutic strategies and early intervention. Future research should incorporate additional clinical factors, such as SMN2 copy number and functional trajectories, to enhance the applicability of results in the era of disease-modifying therapies. This work provides a foundation for optimizing clinical care and improving functional outcomes in individuals with SMA
Impeaching Reality: An action-research study exploring the development of a democratic pedagogy for community-based learning in a context of poverty in the Dominican Republic
Full text linkThis dissertation examines how a community-based learning program within the context of poverty can educate adult learners about their social realities and motivate them to take organized action for social change. The main issue identified in this study was the participants' social precariousness, which affected their involvement in community affairs, including the initiative conducted for this thesis. Additionally, their lack of social support and belief in overcoming the inertia of their circumstances further restricted their engagement. With a Neighborhood Council that typically operated during individual or collective emergencies and minimal hope for change in their lives and environments, participants often adopted a general attitude of resignation and civic passivity (Bourdieu, 1981). This thesis contends that this reality can be challenged and proposes a strategy to encourage participants toward social action.
Using a sociological lens, this action research study took place in El Progreso, a small, impoverished neighborhood in Santo Domingo, Dominican Republic. Over the course of five weekly workshops, the adult education program encouraged participants to inquire into and reflect on their realities, learn effective methods to assess community needs, discuss and understand their rights regarding public institutions, and plan organized actions based on principles of equity for social justice and compassionate leadership.
At the conclusion of this research experience, several findings emerged: (1) It confirmed that individuals living in historical poverty and social marginalization often channel their vulnerabilities into civic engagement; (2) when participants were encouraged to transform their experiences into an inquiry process that provides names, concepts, numbers, and voices to their realities, their awareness and motivation towards the potential for social action increased; (3) through organized discussions about community issues, participants developed the ability to envision new possibilities and innovative methods for achieving their goals; (4) when the program facilitated dialogue among state agencies, participants, and the PI’s sociological perspective on the community's status, the official narrative was enriched, leading to a deeper understanding of people's perspectives and the validation of social science findings; (5) by positioning participants as the program's protagonists, grounded in their legitimacy as local residents and their experiential knowledge tailored for the occasion through various adult education strategies, their individual and collective dignity was recognized and promoted.
The significance of this study lies in the fact that (1) social learning, which integrates adult education strategies with sociological knowledge and techniques, can enhance social inquiry both as a method and as a goal of empowering adult learners’ awareness and reconstructing shared beliefs; (2) this sociologically informed pragmatism may assist populations from impoverished backgrounds in developing and enhancing community social organization and compassionate leadership, which strengthen local policy perspectives to advance comprehensive local democracy practices and promote social change
Integration Into the Mathematics Community: An Exploratory Interpretative Phenomenological Study Based on Mathematics High School Research Mentorships
Full text linkThis dissertation examines how high school mathematics research mentorships shape students' integration into mathematics through the development of self-efficacy, identity, and values. Using the Tripartite Integration Model of Social Influence (TIMSI) as a theoretical framework, this study investigates the mechanisms through which mentorship experiences foster these developmental constructs.
Through in-depth interviews analyzed using Interpretative Phenomenological Analysis (IPA), the research reveals how adaptive scaffolding, professional skill building, collaborative dynamics, and fostering belonging interact to support mentees' growth.
The findings highlight the importance of domain-specific mentoring strategies, thoughtful selection of research questions, and real-world applications in fostering engagement. The study also reveals significant equity concerns, as most participants attended well-resourced schools with established research cultures. Recommendations include expanding access through virtual mentorships and regional initiatives. While limitations include sample diversity and retrospective design, these constraints inform future research directions in mentorship scalability and longitudinal impact.
This research extends TIMSI to the high school mathematics context while providing actionable recommendations for mentorship program design. The findings inform strategies for expanding access to research mentorships, particularly for students in underserved communities, while maintaining program quality and effectiveness. This study addresses critical gaps in understanding how early research experiences shape students' mathematical development and integration into the field
GRID3 COD - Health Zones v4.0
Full text linkThe GRID3 COD - Health Zones v4.0 dataset consists of health zone boundaries with name, location, and other related attributes for fourteen provinces in the Democratic Republic of the Congo (COD).
Province group 1: Haut-Katanga, Kasaï, Kasaï-Oriental, Kinshasa, and Lomami
Province group 2: Haut-Lomami and Tanganyika
Province group 3: Ituri and Kwilu
Province group 4: Maniema
Province group 5: Kasaï-Central
Province group 6: Tshopo and Mongala
Province group 7: Haut-Katanga, Kasaï, and Kasaï-Oriental (updates); Sankuru
This operational dataset has not been fully validated by government officials or ministries.
This current version supersedes the GRID3 COD - Health Zones v3.0 (https://doi.org/10.7916/hb9r-8p34). The following changes were made:
Updated data for the provinces of Haut-Katanga, Kasaï, Kasaï-Oriental, Tshopo and Mongala.
Data for Sankuru Province have been added.
A data sources table has been included as part of the metadata.
Keywords: Health Zone
Climate Creditors: How Credit Ratings Widen the Investment Gap in Climate Finance Access
Full text linkThe rising trend of debt-based climate finance provides a prism through which to view the severity of the capital access divide across the globe. While this gap is often described as one between the Global North and Global South, the discussion below builds on city-level data on urban climate loans from European Investment Bank and green bonds data from the Climate Bonds Initiative to explore the relationship between credit rating and the investment gap
Automated Model Reduction of Atmospheric Chemical Mechanisms
No full textThe atmospheric chemistry of volatile organic compounds (VOC) has a major influence onatmospheric pollutants and particle formation. Accurate modeling of this chemistry is essential for air quality models. Complete representations of VOC oxidation chemistry are far too large for spatiotemporal simulations of the atmosphere, necessitating reduced mechanisms.
This work details several new graph theory-based methods for mechanism reduction, optimization, and evaluation. Our newest algorithm, the Automated MOdel REduction 2.0 (AMORE 2.0), efficiently and accurately reduces VOC oxidation mechanisms to a desired size by removing, merging, and rerouting sections of the graph representation of the mechanism. This algorithm can reduce large mechanisms by over 90%, making them usable in atmospheric simulations. This work will improve our ability to accurately model the atmosphere, thereby supporting air quality management and advancing atmospheric chemical science
Bound Becomings: Essays on Race, Indigeneity, and Life-Making in Prison
No full textThis dissertation consists of three essays that examine how prisons intervene in the lives of incarcerated people. Through analyses of in-depth interviews, archival and legal documents, prison newspapers, and survey data, I explore how incarceration disconnects incarcerated people from their identity and further isolates vulnerable people from social institutions and systems of social support.
The first chapter asks: How is Native Hawaiian identity expressed and navigated in the total institution of Hawaiʻi prisons? Scholars have long argued that prisons strip away identity; but in recent decades, incarcerated Native Hawaiians have found opportunities to connect with their indigeneity behind bars. Drawing on in-depth interviews with people who work or were incarcerated in Hawaiʻi prisons, ethnographic observations, legal documents, and reports from the Department of Corrections and Rehabilitation, I explore how prison administrators and incarcerated people leverage the blurriness of the Native Hawaiian category. Prison administrators rely on Hawaiian culture as a tool to help manage behavior and to promote rehabilitation among incarcerated men and women. Incarcerated men, on the other hand, use ethnoracial markers like language to find community and to engage with their Hawaiian identity in new and meaningful ways. Incarcerated men also frame Hawaiian as a religion to benefit from legal protections that would provide them access to cultural practices. Together, the findings challenge our understanding of racial boundary making processes in prison by revealing how the religious, ethnoracial, and political meanings encompassed by Indigenous categories provide a degree of flexibility that allows prisoners to reclaim—and, in some cases, discover for the first time—Hawaiian identity.
The second chapter takes a long historical perspective to examine the factors that contributed to the emergence of Native Hawaiian identity in prison and how those factors changed over time. A defining feature of incarceration is its consequences for identity and individuality. Some scholars argue that prisoners’ identities are shaped in response to the pains of imprisonment and the conditions of confinement, while others suggest the social roles incarcerated people take on during incarceration are imported into the prison from outside society. Through an analysis of three Hawaiʻi prison newspapers published between 1938-1991 as well as archival administrative documents, I investigate three factors shaping Hawaiian identity over time: 1) the changing organizational structure of punishment; 2) a shifting national socio-political context; and 3) a growing identity-based movement in Hawaiʻi. As penal logics changed over this period, incarcerated people often drew on a broader and national discourse around race, identity, and the struggle against oppression to strategically navigate shifting penal practices and maintain their Hawaiian identity. Identity formation in prison thus plays out under the regulatory constraints of the prison; but prisoners navigate and challenge those boundaries by drawing on external identity frameworks.
Chapter three draws on data from the Boston Reentry Study, a year-long study of 122 men and women leaving Massachusetts state prisons and returning to the Boston area. On average, incarcerated people have higher rates of poor mental and physical health, and histories of childhood trauma than the general population. Through a mixed methods analysis, I consider the relationship between adverse childhood experiences (ACEs), poor adult health, and incarceration. Analysis of the quantitative data (N=122) indicates that childhood adversity is associated with health problems in adulthood like chronic pain, chronic conditions, and poor mental health; but the strength of this relationship varied by whether the respondent directly experienced or witnessed the traumatic event. The qualitative life history timelines (N=42) contextualize the quantitative findings by revealing two pathways connecting ACEs to poor health and incarceration in adulthood: violence and victimization, and drug use as a coping mechanism. Untreated and undiagnosed mental health conditions emerged as a precursor to both pathways. Prisons step in where the welfare system fails; but prisons lack a meaningful consideration of these early life events and the social structures that result in the high rates of vulnerable people in its care
Hegel on the Concept of the Psyche and Psychic Illness in the “Anthropology"
No full textThis dissertation investigates Hegel’s conception of the psyche [] and psychic illness [] in the a widely neglected, understudied, and opaque part of Hegel’s philosophical system. Despite the fact that constitutes the central subject matter of the , it is, as anyone who has read the can attest to, far from apparent how one ought to understand Hegel’s conception of . The overarching aim of this project is to offer an answer to this question—what is and how are we to understand it?—and to illuminate the surprising and continued relevance of Hegel’s conception of the psyche and psychic illness for domains as far-reaching as philosophy of mind, psychoanalysis, social and political philosophy, and, as I will argue, environmental philosophy, and environmental ethics. Each of the three chapters that make up this project are an attempt to shed light on Hegel’s rich, opaque, and provocative conception of from divergent but interrelated perspectives.
Chapter 1 presents and defends a novel interpretation of Hegel’s conception of as dealing with the most basic and primitive forms of mindedness or subjective experience—that is, self and other awareness. To defend this interpretation, I first consider and ultimately reject two candidates for understanding Hegel’s conception of Seele, beginning with what might appear to be an intuitive starting point, given ' status as the proper subject matter of the —namely, the idea that refers straightforwardly to the human being. What such interpretations of , however, fail to adequately take into account is the way in which Hegel characterizes at the beginning of the , ' role within Hegel’s philosophical system as that which emerges out of nature’s overcoming of itself, and the relatively primitive nature of many, if not all, of the psychic capacities that Hegel explores in the .
The second interpretation of that I consider and ultimately reject is an Aristotelian reading of Hegel’s , which understands Hegel’s conception of on the model of Aristotle’s conception of the psyche [psuchē] and therefore as dealing with life and the capacities of living organisms. There are, however, at least three problems with an Aristotelian interpretation of . The central problem is that such a reading fails to adequately explain the subject matter of the and, therefore, Hegel’s conception of . But I also argue that Aristotelian readings of can obscure both important discontinuities in the kind of account that Aristotle and Hegel’s respective conceptions of the psyche are interested in providing and the way in which Hegel imbues his conception of with an anthropological significance that is distinctively Kantian with respect to the way is bound up with freedom and reimagined as the proper subject matter of anthropology.
Finally, I present a novel interpretation of Hegel’s conception of as dealing with the most basic and primitive forms of self and other awareness. Not only does recasting in terms of self and other awareness avoid the pitfalls of the other two interpretations, but it also emphasizes the fact that the is not simply interested in the conceptual development of subjectivity and self-awareness. It is, I contend, just as much interested in the conceptual development in the sense of the other that corresponds to and occurs in tandem with the development of an increasingly self-aware subject. Self and other develop, in other words, together.
On the basis of this understanding of , Chapter 2 argues that Hegel’s conception of can be understood as an account of psychic health. The first part of this chapter focuses on Hegel’s normative conception of health and disease, arguing that Hegel understands health and disease on the model of conceptual realization. It also considers two markers of health, order and subjective_H vitality, and the corresponding senses of disease to which they give rise, disorder and subjective_H weakness. In doing so, my aim is to spell out some of the implications of a conception of health and disease as modeled on conceptual realization—namely, that health and disease ought not to be understood as mutually exclusive states or conditions; that disease conceptually presupposes and requires some degree of health; that only entities which exhibit the structure of subjectivity_H can be understood as healthy or diseased; and that this model of conceptual realization does not rule out the possibility of conceptual openness.
The second part of this chapter finally turns to the concept in question——and articulates how Hegel’s conception of can be understood as an account of psychic health. My contention is that Hegel’s concept of the psyche, in typical Hegelian fashion, turns out to consist of three different, conflicting, and hierarchically interrelated conceptions of the psyche, which are each characterized by their increasingly self and other aware ways of relating to the world. Put simply, the three stages of the psyche can be understood as capturing different modes of self and other awareness that together produce what might be understood as primitive, embodied, and preconscious forms of subjective experience.
Chapter 3 turns to the other half of this account of as an account of psychic health—that is, the sense in which Hegel’s conception of can be understood as an account of psychic illness. In the first part of the chapter, I defend the idea that psychic illness can be understood as a state or condition that is marked by the normative failure of the psyche to realize itself, highlighting three important features of this account of . The first concerns what it means to understand as a disproportion between concept and reality and some of the diagnostic implications that follow such an understanding of . The second aspect of to which I draw our attention to concerns its normative status, as able to accommodate both a certain degree of moral agnosticism as well as the ethical kind of normativity associated with social critique. The third aspect of that I turn to is its broad scope as a concept which captures far more than what we ordinarily today think of as mental illness.
In the second part of the chapter, I turn to the two species of with which this project is primarily concerned—deranged self-feeling [ü] and deranged habit or what is sometimes referred to as ‘death by habit’ in the secondary literature. With regard to ü, I present and defend a novel interpretation of ü that is committed to two claims. The first is that ü can be understood as a disordered mode of psychically relating to the world that is characterized by an aggrandizement of the self and a disregard for the actuality of the other. The second is that ü is a fundamentally broader concept than what we ordinarily think of as mental illness, whose empirical manifestations include not only what we ordinarily think of as mental disorders but also deranged ways of psychically relating to the natural world.
In doing so, I take Hegel’s conception of ü beyond its obvious contemporary relevance for understanding mental health and illness and illuminate its surprising relevance for environmental philosophy and, in particular, an environmental ethics that can be considered Hegelian in spirit. My suggestion is that the provides a fascinating window into the sorts of ideas that could ground a Hegelian environmental ethics, insofar as it precisely explores the normative status of the kinds of entities that living organisms, ecological systems, and the natural world as a whole are, the regard that they are owed on the basis of their normative status, and the way in which human beings ought to normatively and ethically relate to them. My project, in other words, is not simply focused on the extent to which Hegel’s theory of the psyche might be relevant for making sense of the myriad psychic and mental health crises that are so prominent and widespread today. It is also fundamentally interested in the ways in which Hegel’s theory of and diverge from our contemporary ordinary understanding of mental health and illness and the extent to which they can offer rich conceptual resources to formulate a Hegelian account of psychic illness that has relevance for both social and political philosophy as well as environmental philosophy and environmental ethics.
With regard to deranged habit, I contend that death by habit, like ü, can be understood as a type of but one that is characterized by an inversion of the two main features of ü—that is, an aggrandized sense of the other and a disregard for the actuality of the self. In doing so, this project recasts death by habit in a new light as a sister psychic illness to other deranged ways of relating between self and other, illuminating the intimate conceptual ties between excessively habituated ways of relating to our social world, mental disorders, and diseased ways of relating to the natural world. In redrawing the conceptual lines demarcating these phenomena, this project also challenges us to reconsider and interrogate the kinds of self-other relations that can be understood as indicative of psychic health and illness, what it means to be psychically healthy and ill, who is capable of it, and what possibilities there are for treating these disordered ways of relating to the world. Not only does attending to these two types of challenge us to provocatively reimagine what it means to be both mentally well and mentally ill but it also offers us the opportunity to understand our relation to both the natural world and the social worlds which we inhabit in a new light—namely, as more or less psychically well or disordered ways of relating to the world
Toward unitary taxation of MNEs
No full textProtracted debates and negotiations have led to a new approach to taxation of multinationals: apportionment of their global profits based on their real presence in each country. A concerted initiative by willing states could implement this approach using standards now agreed, facilitated through the UN Framework Convention now under negotiation
ASEAN’s expanding role as an FDI rule-maker
No full textThis Perspective argues that the ASEAN-led RCEP agreement and the ASEAN Outlook on the Indo-Pacific have created significant momentum for ASEAN to further reinforce its central role in advancing Asia-Pacific economic integration