7 results
School-based group interpersonal therapy for adolescents with depression in rural Nepal: a mixed methods study exploring feasibility, acceptability, and cost
- Kelly Rose-Clarke, Prakash B. K., Jananee Magar, Indira Pradhan, Pragya Shrestha, Eliz Hassan, Gerard J. Abou Jaoude, Hassan Haghparast-Bidgoli, Delan Devakumar, Ludovico Carrino, Ginevra Floridi, Brandon A. Kohrt, Helen Verdeli, Kathleen Clougherty, Alexandra Klein Rafaeli, Mark Jordans, Nagendra P. Luitel
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- Journal:
- Global Mental Health / Volume 9 / 2022
- Published online by Cambridge University Press:
- 22 August 2022, pp. 416-428
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Background
Adolescents with depression need access to culturally relevant psychological treatment. In many low- and middle-income countries treatments are only accessible to a minority. We adapted group interpersonal therapy (IPT) for adolescents to be delivered through schools in Nepal. Here we report IPT's feasibility, acceptability, and cost.
MethodsWe recruited 32 boys and 30 girls (aged 13–19) who screened positive for depression. IPT comprised of two individual and 12 group sessions facilitated by nurses or lay workers. Using a pre-post design we assessed adolescents at baseline, post-treatment (0–2 weeks after IPT), and follow-up (8–10 weeks after IPT). We measured depressive symptoms with the Depression Self-Rating Scale (DSRS), and functional impairment with a local tool. To assess intervention fidelity supervisors rated facilitators' IPT skills across 27/90 sessions using a standardised checklist. We conducted qualitative interviews with 16 adolescents and six facilitators post-intervention, and an activity-based cost analysis from the provider perspective.
ResultsAdolescents attended 82.3% (standard deviation 18.9) of group sessions. All were followed up. Depression and functional impairment improved between baseline and follow-up: DSRS score decreased by 81% (95% confidence interval 70–95); functional impairment decreased by 288% (249–351). In total, 95.3% of facilitator IPT skills were rated superior/satisfactory. Adolescents found the intervention useful and acceptable, although some had concerns about privacy in schools. The estimate of intervention unit cost was US $96.9 with facilitators operating at capacity.
ConclusionsSchool-based group IPT is feasible and acceptable in Nepal. Findings support progression to a randomised controlled trial to assess effectiveness and cost-effectiveness.
Cost-effectiveness, cost-utility and the budget impact of antidepressants versus preventive cognitive therapy with or without tapering of antidepressants
- Nicola S. Klein, Ben F. M. Wijnen, Joran Lokkerbol, Erik Buskens, Hermien J. Elgersma, Gerard D. van Rijsbergen, Christien Slofstra, Johan Ormel, Jack Dekker, Peter J. de Jong, Willem A. Nolen, Aart H. Schene, Steven D. Hollon, Huibert Burger, Claudi L. H. Bockting
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- Journal:
- BJPsych Open / Volume 5 / Issue 1 / January 2019
- Published online by Cambridge University Press:
- 15 January 2019, e12
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Background
As depression has a recurrent course, relapse and recurrence prevention is essential.
AimsIn our randomised controlled trial (registered with the Nederlands trial register, identifier: NTR1907), we found that adding preventive cognitive therapy (PCT) to maintenance antidepressants (PCT+AD) yielded substantial protective effects versus antidepressants only in individuals with recurrent depression. Antidepressants were not superior to PCT while tapering antidepressants (PCT/−AD). To inform decision-makers on treatment allocation, we present the corresponding cost-effectiveness, cost-utility and budget impact.
MethodData were analysed (n = 289) using a societal perspective with 24-months of follow-up, with depression-free days and quality-adjusted life years (QALYs) as health outcomes. Incremental cost-effectiveness ratios were calculated and cost-effectiveness planes and cost-effectiveness acceptability curves were derived to provide information about cost-effectiveness. The budget impact was examined with a health economic simulation model.
ResultsMean total costs over 24 months were €6814, €10 264 and €13 282 for AD+PCT, antidepressants only and PCT/−AD, respectively. Compared with antidepressants only, PCT+AD resulted in significant improvements in depression-free days but not QALYs. Health gains did not significantly favour antidepressants only versus PCT/−AD. High probabilities were found that PCT+AD versus antidepressants only and antidepressants only versus PCT/−AD were dominant with low willingness-to-pay thresholds. The budget impact analysis showed decreased societal costs for PCT+AD versus antidepressants only and for antidepressants only versus PCT/−AD.
ConclusionsAdding PCT to antidepressants is cost-effective over 24 months and PCT with guided tapering of antidepressants in long-term users might result in extra costs. Future studies examining costs and effects of antidepressants versus psychological interventions over a longer period may identify a break-even point where PCT/−AD will become cost-effective.
Declaration of interestC.L.H.B. is co-editor of PLOS One and receives no honorarium for this role. She is also co-developer of the Dutch multidisciplinary clinical guideline for anxiety and depression, for which she receives no remuneration. She is a member of the scientific advisory board of the National Insure Institute, for which she receives an honorarium, although this role has no direct relation to this study. C.L.H.B. has presented keynote addresses at conferences, such as the European Psychiatry Association and the European Conference Association, for which she sometimes receives an honorarium. She has presented clinical training workshops, some including a fee. She receives royalties from her books and co-edited books and she developed preventive cognitive therapy on the basis of the cognitive model of A. T. Beck. W.A.N. has received grants from the Netherlands Organisation for Health Research and Development and the European Union and honoraria and speakers' fees from Lundbeck and Aristo Pharma, and has served as a consultant for Daleco Pharma.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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- By Sherese Ali, Danielle Molinari Andrade, Elinor Ben-Menachem, Weerawadee Chandranipapongse, Pamela Crawford, Anne Davis, Carin Dove, Nancy Foldvary-Schaefer, Elizabeth E. Gerard, Cristina Y. Go, Cynthia L. Harden, Dini Hui, Shinya Ito, Jaromir Janousek, Nathalie Jette, Pavel Klein, A. Gabriela Lizama, Kristi A. McIntosh, Georgia Montouris, Brian J. Murray, Ori Nevo, Eugene Ng, Alison M. Pack, Sima Indubhai Patel, Page B. Pennell, Kalliopi A. Petropoulou, Mark Quigg, Alessandra Scaparrotta, Marianna Sebastiani, Patricia Osborne Shafer, O. Carter Snead, Diane T. Sundstrom, Alberto Verrotti, Carla Verrotti, Jonathan H. Waters, Fatima Zahir
- Edited by Esther Bui, Autumn M. Klein
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- Book:
- Women with Epilepsy
- Published online:
- 05 August 2014
- Print publication:
- 31 July 2014, pp vii-x
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Low positive emotionality in young children: Association with EEG asymmetry
- STEWART A. SHANKMAN, CRAIG E. TENKE, GERARD E. BRUDER, C. EMILY DURBIN, ELIZABETH P. HAYDEN, DANIEL N. KLEIN
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- Journal:
- Development and Psychopathology / Volume 17 / Issue 1 / March 2005
- Published online by Cambridge University Press:
- 07 April 2005, pp. 85-98
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Low positive emotionality (PE; e.g., listlessness, anhedonia, and lack of enthusiasm) has been hypothesized to be a temperamental precursor or risk factor for depression. The present study sought to evaluate the validity of this hypothesis by testing whether low PE children have similar external correlates as individuals with depression. This paper focused on the external correlate of EEG asymmetry. Previous studies have reported that individuals at risk for depression exhibited a frontal EEG asymmetry (greater right than left activity). Others have reported an association with posterior asymmetries (greater left than right activity). In the present study, children classified as having low PE at age 3 exhibited an overall asymmetry at age 5–6 with less relative activity in the right hemisphere. This asymmetry appeared to be largely due to a difference in the posterior region because children with low PE exhibited decreased right posterior activity whereas high PE children exhibited no posterior asymmetry. These findings support the construct validity of the hypothesis that low PE may be a temperamental precursor or risk factor for depression.
We gratefully acknowledge Jurgen Kayser's assistance and advice.
From the Images of Science to Science Fiction
- from Part II - Science Fiction in its Social, Cultural and Philosophical Contexts
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- By Gérard Klein, Paris
- Edited by Patrick Parrinder
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- Learning from Other Worlds
- Published by:
- Liverpool University Press
- Published online:
- 04 July 2017
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- 31 December 2000, pp 119-126
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Summary
The question of the relationship between science and science fiction has stayed relatively obscure despite the numerous works of critics and theoreticians interested in the genre. Many of them consider SF as a more or less parasitic literary extension of science, in the mode of speculation and extrapolation, audacious, perhaps irresponsible, often inexact, sometimes ignorant. Thus science fiction would boldly express what science does not yet dare to affirm or suggest, and even what it would find absurd. It would develop the social, ethical, metaphysical or purely logical consequences of science, or set out to confirm its ideological assumptions. In such a perspective, the literature of science fiction would be a continuation, albeit purely verbal and conceptual, imaginary and anticipative, of the real scientific work that itself sometimes uses fictions in the form of so-called ‘thought experiments’.
Such an approach proceeding directly from the difficulty of adequately defining science fiction seems to me to open up a number of problems that the theoreticians have neglected or have been unable to solve. Much of science fiction has—to say the least—a very tenuous relationship with science, but it is impossible to exclude it from the corpus, as perceived by the majority of its readers and by the historians of the field. It is even very easy to find deliberately anti-scientific works of science fiction. Should one reallocate these to another, highly problematic genre or field?
I have given some thought to that difficult question for more than forty years as writer, editor and critic, and I feel I have reached a hypothesis which, though provisional, has the merit of suggesting solutions to some of these problems, and, moreover, of throwing some light on the genesis of ideological productions irrelevant to science fiction but having problematic relationships with science.
(It must be understood that in what follows the word ‘science’ is a convenient shorthand for the full range of science and technology, and that this term does not in any way imply the unity or metaphysical identity of the fields concerned.)
The Images of Science
My feeling is that science fiction does not proceed directly from science, nor from philosophy, but that the sciences (and, for that matter, philosophy) produce, often unknowingly, images (eikons) and representations (eidons). A good example of a scientific image (eikon) is that of Jupiter surrounded by some of its satellites in Galileo's telescope.
The Valley of Echoes
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- By Gérard Klein, New York
- Edited by Franz Rottensteiner
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- Book:
- View from Another Shore
- Published by:
- Liverpool University Press
- Published online:
- 04 July 2017
- Print publication:
- 31 December 1999, pp 42-50
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Summary
This time we ventured a little beyond the pink mountains of Tula, the oasis of crystal, and for days on end we passed between innumerable dunes. The Martian sky was always like itself, very pure, a very dark blue with an occasional hint of grey, and with admirable pink efflorescences at sunrise and sunset.
Our tractors performed quite satisfactorily. We were venturing into regions that had hardly been explored thus far, at least by land, and we were reasonably sure of being the first to negotiate these desolate passes. The first men, at any rate; for what we were more or less vaguely searching for was some trace of an ancient civilization. It has never been admitted on Earth that Mars is not only a dead world, but a world eternally deserted. It has long been hoped that we would discover some remains of defunct empires, or perhaps the fallen descendants of the mythical masters of the red planet. Too many stories have been told about Mars for ten years of scientific and fruitless exploration on this point to undo all the legends.
But neither Ferrier nor La Salle nor I particularly believed in the possibility of so fantastic an encounter. We were mature and slightly disillusioned men, and we had left the Earth some years before to escape the wind of insanity which at that time was sweeping our native planet. This was something that we did not like to talk about, as it pained us. We sometimes thought it was due to the immense solitude of a species that had just achieved self-awareness, that confronted the universe, that hoped to receive a response, even a fatal one, to its challenge. But space remained silent and the planets deserted.
We were descending, then, toward the south, in the direction of the Martian equator. The maps were still imprecise at this time, and we had been assigned to make certain geological reports which could not be done from an airplane. As a psychologist, I was only moderately qualified for this task, but I also knew how to drive a tractor and how the instruments worked, and men were scarce on Mars.
The worst thing was the monotony that prevailed throughout these days.