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Overriding adolescent refusals of treatment
No full textAdolescents are routinely treated differently to adults, even when they possess similar capacities. In this article, we explore the justification for one case of differential treatment of adolescents. We attempt to make philosophical sense of the concurrent consents doctrine in law: adolescents found to have decision-making capacity have the power to consent to—and thereby, all else being equal, permit—their own medical treatment, but they lack the power always to refuse treatment and so render it impermissible. Other parties, that is, individuals who exercise parental responsibility or a court, retain the authority to consent on an adolescent’s behalf. We explore four defences of the doctrine. We reject two attempts to defend the asymmetry in the power to consent to and refuse medical treatment by reference to transitional paternalism. We then consider and reject a stage of life justification. Finally, we articulate a justification based on the distinctiveness of adolescent well-being
"Se un giorno tornasse quell'ora": la nuova sinistra tra eredità antifascista e terzomondismo
No full textQuesto articolo propone un'inedita genealogia della nuova sinistra in Europa occidentale tra la metà degli anni Cinquanta alla metà degli anni Settanta. Discostandosi dalle interpretazio-ni correnti, riafferma l'importanza storica della Guerra d'indipendenza algerina (1954-62), e più in generale del terzomondismo, nella genealogia delle nuove culture politiche che si svi-lupparono nei global 1960s. Una generazione di militanti si riappropriò della memoria della Resistenza declinandola in un registro non semplicemente difensivo ma attivante, sovrappo-nendo il mito della "Resistenza tradita" all'immagine dell'imperialismo come il "nuovo fascismo". La guerra civile europea, identificata da Enzo Traverso come il tratto caratteristico del-la prima metà del ventesimo secolo, veniva così riconfigurata su scala mondiale come "guerra civile globale".
This contribution proposes a new study of the genealogy of the New Left in Western Europe from the mid-1950s to the mid-1970s. Differently from current interpretations, the article reassesses the historical influence of the Algerian War of Independence (1954-1962), and "Third-Worldism" more generally, in the genealogy of the new political cultures that flourished during the global 1960s. A generation of activists re-appropriated the narrative of the Resistance as not merely defensive but proactive, merging the myth of the "betrayed Resistance" with the image of imperialism as the "new fascism". The European civil war, identified by Enzo Traverso as the main feature of the first half of the 20th century, was hence reconfigured anew worldwide as a "global civil war"
Who decides? Fertility and childbearing experiences of young married couples in Ethiopia
No full textThis working paper explores the way young couples in Ethiopia make decisions about fertility and childbearing, and examines their experiences of contraceptive use. It draws on longitudinal qualitative data and quantitative information from young mothers and fathers, spouses, caregivers, community representatives and service providers in eight communities. The paper focuses on the following research questions: (1) What is the relationship between early marriage and young parenthood? (2) What are the experiences of fertility and childbearing among young married couples? (3) What factors affect the decision-making powers of young married people?
The findings show that early marriage is associated with early fertility, and that women’s autonomy over fertility and childbearing is constrained by poverty, with social and religious norms widening
the gender gap. It also reveals that there are negative perceptions of contraception use, stemming from a lack of knowledge, and that social and religious norms and expectations obstruct contraception uptake among young women in urban and rural settings. Couples in rural areas have limited knowledge and information about contraception and childbearing, while their urban counterparts are better informed.
The paper recommends the implementation of existing gender equality policies (related to Sustainable Development Goal 5) regarding fertility and childbearing, through the creation of stronger and more gendered approaches to family planning policies and programmes to address the health needs and rights of both men and women. Formal communication interventions targeting different actors at different levels with increased reproductive health education need to be strengthened, to address the knowledge and information gap in fertility and childbearing. Finally, adequate laws and interventions that consider encouraging social norms that delay the age of first marriage and childbearing should be in place to address the persistence of deep-rooted gender norms regarding early marriage and early fertility
Hydrodynamic dispersion relations at finite coupling
No full textBy using holographic methods, the radii of convergence of the hydrodynamic shear and sound dispersion relations were previously computed in the N = 4 supersymmetric Yang-Mills theory at infinite ’t Hooft coupling and infinite number of colours. Here, we extend this analysis to the domain of large but finite ’t Hooft coupling. To leading order in the perturbative expansion, we find that the radii grow with increasing inverse coupling, contrary to naive expectations. However, when the equations of motion are solved using a qualitative non-perturbative resummation, the dependence on the coupling becomes piecewise continuous and the initial growth is followed by a decrease. The piecewise nature of the dependence is related to the dynamics of branch point singularities of the energy-momentum tensor finite-temperature two-point functions in the complex plane of spatial momentum squared. We repeat the study using the Einstein-Gauss-Bonnet gravity as a model where the equations can be solved fully non-perturbatively, and find the expected decrease of the radii of convergence with the effective inverse coupling which is also piecewise continuous. Finally, we provide arguments in favour of the non-perturbative approach and show that the presence of non-perturbative modes in the quasinormal spectrum can be indirectly inferred from the analysis of perturbative critical points
On deciding linear arithmetic constraints over -adic integers for all primes
No full textGiven an existential formula Φ of linear arithmetic over p-adic integers together with valuation constraints, we study the p-universality problem which consists of deciding whether Φ is satisfiable for all primes p, and the analogous problem for the closely related existential theory of Büchi arithmetic. Our main result is a coNEXP upper bound for both problems, together with a matching
lower bound for existential Büchi arithmetic. On a technical level, our results are obtained from analysing properties of a certain class of p-automata, finite-state automata whose languages encode
sets of tuples of natural numbers
Brain pathology recapitulates physiology: a network meta-analysis
No full textNetwork architecture is a brain-organizational motif present across spatial scales from cell assemblies to distributed systems. Structural pathology in some neurodegenerative disorders selectively afflicts a subset of functional networks, motivating the network degeneration hypothesis (NDH). Recent evidence suggests that structural pathology recapitulating physiology may be a general property of neuropsychiatric disorders. To test this possibility, we compared functional and structural network meta-analyses drawing upon the BrainMap database. The functional meta-analysis included results from >7,000 experiments of subjects performing >100 task paradigms; the structural meta-analysis included >2,000 experiments of patients with >40 brain disorders. Structure-function network concordance was high: 68% of networks matched (pFWE
Long-term cost-effectiveness of interventions for obesity: a mendelian randomisation study
No full textBackground
The prevalence of obesity has increased in the United Kingdom, and reliably measuring the impact on quality of life and the total healthcare cost from obesity is key to informing the cost-effectiveness of interventions that target obesity, and determining healthcare funding. Current methods for estimating cost-effectiveness of interventions for obesity may be subject to confounding and reverse causation. The aim of this study is to apply a new approach using mendelian randomisation for estimating the cost-effectiveness of interventions that target body mass index (BMI), which may be less affected by confounding and reverse causation than previous approaches.
Methods and findings
We estimated health-related quality-adjusted life years (QALYs) and both primary and secondary healthcare costs for 310,913 men and women of white British ancestry aged between 39 and 72 years in UK Biobank between recruitment (2006 to 2010) and 31 March 2017. We then estimated the causal effect of differences in BMI on QALYs and total healthcare costs using mendelian randomisation. For this, we used instrumental variable regression with a polygenic risk score (PRS) for BMI, derived using a genome-wide association study (GWAS) of BMI, with age, sex, recruitment centre, and 40 genetic principal components as covariables to estimate the effect of a unit increase in BMI on QALYs and total healthcare costs. Finally, we used simulations to estimate the likely effect on BMI of policy relevant interventions for BMI, then used the mendelian randomisation estimates to estimate the cost-effectiveness of these interventions.
A unit increase in BMI decreased QALYs by 0.65% of a QALY (95% confidence interval [CI]: 0.49% to 0.81%) per year and increased annual total healthcare costs by £42.23 (95% CI: £32.95 to £51.51) per person. When considering only health conditions usually considered in previous cost-effectiveness modelling studies (cancer, cardiovascular disease, cerebrovascular disease, and type 2 diabetes), we estimated that a unit increase in BMI decreased QALYs by only 0.16% of a QALY (95% CI: 0.10% to 0.22%) per year.
We estimated that both laparoscopic bariatric surgery among individuals with BMI greater than 35 kg/m2, and restricting volume promotions for high fat, salt, and sugar products, would increase QALYs and decrease total healthcare costs, with net monetary benefits (at £20,000 per QALY) of £13,936 (95% CI: £8,112 to £20,658) per person over 20 years, and £546 million (95% CI: £435 million to £671 million) in total per year, respectively.
The main limitations of this approach are that mendelian randomisation relies on assumptions that cannot be proven, including the absence of directional pleiotropy, and that genotypes are independent of confounders.
Conclusions
Mendelian randomisation can be used to estimate the impact of interventions on quality of life and healthcare costs. We observed that the effect of increasing BMI on health-related quality of life is much larger when accounting for 240 chronic health conditions, compared with only a limited selection. This means that previous cost-effectiveness studies have likely underestimated the effect of BMI on quality of life and, therefore, the potential cost-effectiveness of interventions to reduce BMI
On the sum of positive divisors functions
No full textProperties of divisor functions σk(n)σk(n), defined as sums of k-th powers of all divisors of n, are studied through the analysis of Ramanujan’s differential equations. This system of three differential equations is singular at x=0x=0. Solution techniques suitable to tackle this singularity are developed and the problem is transformed into an analysis of a dynamical system. Number theoretical consequences of the presented dynamical system analysis are then discussed, including recursive formulas for divisor functions
