11 results
A systematic review of economic evaluations for opioid misuse, cannabis and illicit drug use prevention
- Jan Faller, Long Khanh-Dao Le, Mary Lou Chatterton, Joahna Kevin Perez, Oxana Chiotelis, Huong Ngoc Quynh Tran, Marufa Sultana, Natasha Hall, Yong Yi Lee, Cath Chapman, Nicola Newton, Tim Slade, Matt Sunderland, Maree Teesson, Cathrine Mihalopoulos
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- Journal:
- BJPsych Open / Volume 9 / Issue 5 / September 2023
- Published online by Cambridge University Press:
- 08 August 2023, e149
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Background
Substance use disorders negatively affect global disease burden. Effective preventive interventions are available, but whether they provide value for money is unclear.
AimsThis review looks at the cost-effectiveness evidence of preventive interventions for cannabis use, opioid misuse and illicit drug use.
MethodLiterature search was undertaken in Medline, CINAHL, PsycINFO, EconLit through EBSCOhost and EMBASE, up to May 2021. Grey literature search was conducted as supplement. Studies included were full economic evaluations or return-on-investment (ROI) analyses for preventing opioid misuse, cannabis and illicit drug use. English-language restriction was used. Outcomes extracted were incremental cost-effectiveness ratios (ICER) or ROI ratios, with costs presented in 2019 United States dollars. Quality was assessed with the Drummond checklist.
ResultsEleven full economic evaluation studies were identified from 5674 citations, with all studies conducted in high-income countries. Most aimed to prevent opioid misuse (n = 4), cannabis (n = 3) or illicit drug use (n = 5). Modelling was the predominant methodology (n = 7). Five evaluated school-based universal interventions targeting children and adolescents (aged <18 years). Five cost–benefit studies reported cost-savings. One cost-effectiveness and two cost–utility analysis studies supported the cost-effectiveness of interventions, as ICERs fell under prespecified value-for-money thresholds.
ConclusionsThere are limited economic evaluations of preventive interventions for opioid misuse, cannabis and illicit drug use. Family-based intervention (ParentCorps), school-based interventions (Social and Emotional Training and Project ALERT) and a doctor's programme to assess patient risk of misusing narcotics (‘the Network System to Prevent Doctor-Shopping for Narcotics’) show promising cost-effectiveness and warrant consideration.
Interventions to prevent alcohol use: systematic review of economic evaluations
- Long Khanh-Dao Le, Jan Faller, Mary Lou Chatterton, Joahna Kevin Perez, Oxana Chiotelis, Huong Ngoc Quynh Tran, Marufa Sultana, Natasha Hall, Yong Yi Lee, Cath Chapman, Nicola Newton, Tim Slade, Matt Sunderland, Maree Teesson, Cathrine Mihalopoulos
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- Journal:
- BJPsych Open / Volume 9 / Issue 4 / July 2023
- Published online by Cambridge University Press:
- 27 June 2023, e117
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Background
Alcohol use is a leading risk factor for death and disability worldwide.
AimsWe conducted a systematic review on the cost-effectiveness evidence for interventions to prevent alcohol use across the lifespan.
MethodElectronic databases (EMBASE, Medline, PsycINFO, CINAHL and EconLit) were searched for full economic evaluations and return-on-investment studies of alcohol prevention interventions published up to May 2021. The methods and results of included studies were evaluated with narrative synthesis, and study quality was assessed by the Drummond ten-point checklist.
ResultsA total of 69 studies met the inclusion criteria for a full economic evaluation or return-on-investment study. Most studies targeted adults or a combination of age groups, seven studies comprised children/adolescents and one involved older adults. Half of the studies found that alcohol prevention interventions are cost-saving (i.e. more effective and less costly than the comparator). This was especially true for universal prevention interventions designed to restrict exposure to alcohol through taxation or advertising bans; and selective/indicated prevention interventions, which involve screening with or without brief intervention for at-risk adults. School-based interventions combined with parent/carer interventions were cost-effective in preventing alcohol use among those aged under 18 years. No interventions were cost-effective for preventing alcohol use in older adults.
ConclusionsAlcohol prevention interventions show promising evidence of cost-effectiveness. Further economic analyses are needed to facilitate policy-making in low- and middle-income countries, and among child, adolescent and older adult populations.
Ant-ICON - ‘Integrated Science to Inform Antarctic and Southern Ocean Conservation’: a new SCAR Scientific Research Programme
- Kevin A. Hughes, Mercedes Santos, Jilda A. Caccavo, Stephen M. Chignell, Natasha B. Gardiner, Neil Gilbert, Adrian Howkins, Bettine Jansen Van Vuuren, Jasmine R. Lee, Daniela Liggett, Andrew Lowther, Heather Lynch, Antonio Quesada, Hyoung Chul Shin, Alvaro Soutullo, Aleks Terauds
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- Journal:
- Antarctic Science / Volume 34 / Issue 6 / December 2022
- Published online by Cambridge University Press:
- 02 December 2022, pp. 446-455
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Antarctic and Southern Ocean environments are facing increasing pressure from multiple threats. The Antarctic Treaty System regularly looks to the Scientific Committee on Antarctic Research (SCAR) for the provision of independent and objective advice based on the best available science to support decision-making, policy development and effective environmental management. The recently approved SCAR Scientific Research Programme Ant-ICON - ‘Integrated Science to Inform Antarctic and Southern Ocean Conservation‘ - facilitates and coordinates high-quality transdisciplinary research to inform the conservation and management of Antarctica, the Southern Ocean and the sub-Antarctic in the context of current and future impacts. The work of Ant-ICON focuses on three research themes examining 1) the current state and future projections of Antarctic systems, species and functions, 2) human impacts and sustainability and 3) socio-ecological approaches to Antarctic and Southern Ocean conservation, and one synthesis theme that seeks to facilitate the provision of timely scientific advice to support effective Antarctic conservation. Research outputs will address the most pressing environmental challenges facing Antarctica and offer high-quality science to policy and advisory bodies including the Antarctic Treaty Consultative Meeting, the Committee for Environmental Protection and the Scientific Committee of the Commission for the Conservation of Antarctic Marine Living Resources.
Associations of online religious participation during COVID-19 lockdown with subsequent health and well-being among UK adults
- Koichiro Shiba, Richard G. Cowden, Natasha Gonzalez, Yusuf Ransome, Atsushi Nakagomi, Ying Chen, Matthew T. Lee, Tyler J. VanderWeele, Daisy Fancourt
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- Journal:
- Psychological Medicine / Volume 53 / Issue 9 / July 2023
- Published online by Cambridge University Press:
- 22 February 2022, pp. 3887-3896
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Background
In-person religious service attendance has been linked to favorable health and well-being outcomes. However, little research has examined whether online religious participation improves these outcomes, especially when in-person attendance is suspended.
MethodsUsing longitudinal data of 8951 UK adults, this study prospectively examined the association between frequency of online religious participation during the stringent lockdown in the UK (23 March –13 May 2020) and 21 indicators of psychological well-being, social well-being, pro-social/altruistic behaviors, psychological distress, and health behaviors. All analyses adjusted for baseline socio-demographic characteristics, pre-pandemic in-person religious service attendance, and prior values of the outcome variables whenever data were available. Bonferroni correction was used to correct for multiple testing.
ResultsIndividuals with online religious participation of ≥1/week (v. those with no participation at all) during the lockdown had a lower prevalence of thoughts of self-harm in week 20 (odds ratio 0.24; 95% CI 0.09–0.62). Online religious participation of <1/week (v. no participation) was associated with higher life satisfaction (standardized β = 0.25; 0.11–0.39) and happiness (standardized β = 0.25; 0.08–0.42). However, there was little evidence for the associations between online religious participation and all other outcomes (e.g. depressive symptoms and anxiety).
ConclusionsThere was evidence that online religious participation during the lockdown was associated with some subsequent health and well-being outcomes. Future studies should examine mechanisms underlying the inconsistent results for online v. in-person religious service attendance and also use data from non-pandemic situations.
Autologous Hematopoietic Stem Cell Transplantation for Chronic Inflammatory Demyelinating Polyradiculoneuropathy
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- Josée Masson-Roy, Ari Breiner, Jodi Warman-Chardon, Catherine E. Pringle, David Allan, Christopher Bredeson, Lothar Huebsch, Natasha Kekre, Michael Lee Kennah, Lisa Martin, Sheryl McDiarmid, Sultan Altouri, Harold Atkins, Pierre R. Bourque
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 48 / Issue 6 / November 2021
- Published online by Cambridge University Press:
- 26 February 2021, pp. 760-766
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Background:
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) refractory to conventional therapy can lead to marked disability and represents a therapeutic challenge.
Objective:To report five cases of treatment-refractory disabling CIDP treated with autologous hematopoietic stem cell transplantation (AHSCT).
Methods:This was a retrospective cohort study from a tertiary care referral center for both neuromuscular disease and AHSCT. Patients with CIDP treated with AHSCT between 2008 and 2020 were included. All patients had major persistent and disabling neuropathic deficits despite combinations of intensive immunosuppressive therapy. The primary outcome measures were: Medical Research Council sum score, Overall Neuropathy Limitations Scale and requirement for ongoing CIDP immunotherapy after transplantation. We also analyzed safety outcomes by documenting all severe AHSCT-related complications.
Results:Five patients with refractory CIDP underwent AHSCT. Three were classified as manifesting a typical syndrome, two were classified as the multifocal Lewis Sumner variant. The mean age at time of CIDP diagnosis was 33.4 years (range 24–46 years), with a median delay of 46 months (range 21–135 months) between diagnosis and AHSCT. The median follow-up period was 41 months. All five patients were able to wean off CIDP-related immunotherapy. Marked improvements in Medical Research Council scale and overall Neuropathy Limitations Scale were noted in 4/5 patients. One patient with longstanding neurogenic atrophy showed no improvement in disability scales. There were no treatment-related deaths or critical illnesses.
Conclusions:AHSCT can achieve marked sustained clinical improvement of refractory CIDP and may allow for weaning off long-term complex immunotherapies.
Cost Savings Associated With Decolonization of Postdischarge MRSA Carriers: Results From the CLEAR Randomized Trial
- Natasha K. Stout, Grace M. Lee, Anastasiia S. Weiland, Caleb S. Chen, Syma Rashid, Raveena D. Singh, Thomas Tjoa, Jiayi He, James A. McKinnell, Loren G. Miller, Susan S. Huang
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
- Published online by Cambridge University Press:
- 02 November 2020, pp. s28-s29
- Print publication:
- October 2020
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Background: Greater than 10% of hospitalized MRSA carriers experience serious MRSA infection in the year following discharge. Prevention opportunities have primarily focused on hospital stays; however postdischarge interventions have the potential to reduce morbidity, mortality and healthcare costs. The CLEAR trial found a 30% hazard reduction in postdischarge MRSA infections among patients who had inpatient MRSA cultures and were given postdischarge decolonization (5 days twice-a-month for 6 months) relative to hygiene education alone. We conducted a cost analysis of the CLEAR intervention to quantify the economic implications and understand the value of adopting this MRSA decolonization strategy. Methods: We constructed a decision model to estimate the one-year healthcare utilization and costs associated with postdischarge decolonization relative to hygiene education. Trial results for MRSA infection risk and downstream outcomes (including outpatient and emergency room visits, hospitalizations, related nursing home stays, and postdischarge antibiotics) were used to parameterize the model. Other medical care and prescription drug costs were based on Medicare Fee Schedules, Red Book and the literature. Patient out-of-pocket costs and time costs associated with subsequent infections were from a survey of trial participants experiencing infection (n=405). All costs were reported in 2019 US dollars. The analysis was conducted using healthcare system and societal perspectives. Sensitivity analyses were conducted on key parameters. Results: Among a hypothetical cohort of 1,000 hospitalized MRSA carriers, we estimated that a postdischarge decolonization intervention versus hygiene education would result in at least 36 fewer subsequent MRSA infections (130 vs 93 of 1,000, respectively) and >40 fewer MRSA-attributable healthcare events including 32 hospitalizations and 6 postdischarge nursing home visits over the course of a year. Assuming an intervention cost of $185 per individual, the program would result in an overall cost savings of $469,000 per 1,000 MRSA carriers undergoing decolonization. This translates to an overall savings of $13,200 per infection averted and $9,000 per infection averted from the healthcare system perspective. Even assuming a lower infection rate or a less effective intervention (15% reduction in infections vs 30% in the CLEAR trial), or a more expensive (up to $653 per patient) intervention, a decolonization program would still result in cost-savings for society, the healthcare system and patients. Conclusions: In addition to health benefits of preventing infections, postdischarge decolonization of MRSA carriers yields substantial savings to society and the healthcare system. Future recommendations for reducing postdischarge MRSA-related disease among MRSA carriers should consider routine decolonization at hospital discharge.
Funding: This study was supported by a grant from the AHRQ Healthcare-Associated Infections Program (R01HS019388) and by the University of California Irvine Institute for Clinical and Translational Science, which was funded by a grant from the NIH Clinical and Translational Sciences Award program (UL1 TR000153).
Disclosures: Dr. Huang reports conducting clinical studies in which participating nursing homes and hospitals received donated products from Stryker (Sage Products), Mölnlycke, 3M, Clorox, Xttrium Laboratories, and Medline. Ms. Singh reports conducting clinical studies in which participating nursing homes and hospitals received donated products from Stryker (Sage Products), 3M, Clorox, Xttrium Laboratories, and Medline. Dr. Rashid, conducting clinical studies in which participating nursing homes and hospitals received donated products from Stryker(Sage Products), Clorox, and Medline. Dr. McKinnell reports receiving grant support to his institution from Melinta Therapeutics, and fees for serving as a research investigator from Lightship, conducting clinical studies in which participating nursing homes and hospitals received donated products from Stryker (Sage Products), 3M, Clorox, Xttrium Laboratories and Medline, and serving as cofounder of Expert Stewardship. Dr. Miller reports receiving grant support from Gilead Sciences, Merck, Abbott, Cepheid, Genentech, Atox Bio, and Paratek Pharmaceuticals, grant support and fees for serving on an advisory board from Achaogen and grant support, consulting fees, and fees for serving on an advisory board from Tetraphase and conducting clinical studies in which participating nursing homes and hospitals received donated products from Stryker (Sage Products), 3M, Clorox, Xttrium Laboratories, and Medline.
Addressing the knowledge gap of Indigenous public health: reflections from an Indigenous public health graduate
- Natasha Lee
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- Journal:
- The Australian Journal of Indigenous Education / Volume 49 / Issue 2 / December 2020
- Published online by Cambridge University Press:
- 09 September 2020, pp. 110-118
- Print publication:
- December 2020
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The current agenda in public health training in higher education works to produce well-trained public health professionals. Operating within a western pedagogical framework it aims to build a cohort of critical and analytical thinkers, skilful problem solvers and extraordinary communicators across key disciplines in health. Many graduates possess interdisciplinary specialities, skills and knowledge transferable within health and other sectors. Core competencies in the curricula, which notably does not currently include Indigenous health, are considered the foundational platform of theory and practical understandings of public health and the health system. Despite a framework that aims to produce health professionals capable of improving the health of the population as a whole; the lack of engagement with an Indigenous health criticality maintains a longstanding Australian public health tradition of failure when it comes to addressing the health disparities experienced by Indigenous people. As a recent Indigenous public health graduate with practical training and experience working in the public health system, I consider possibilities for decolonising the curricula through an Indigenist approach to health, including theories of transformative learning which could strengthen public health practice and in turn facilitate the changes necessary to improving Indigenous health outcomes.
Impact of informal cancer caregiving across the cancer experience: A systematic literature review of quality of life
- Carol Y. Ochoa, Natasha Buchanan Lunsford, Judith Lee Smith
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- Palliative & Supportive Care / Volume 18 / Issue 2 / April 2020
- Published online by Cambridge University Press:
- 07 October 2019, pp. 220-240
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Objective
Informal caregiving may likely increase as the number of cancer survivors grows. Caregiving responsibilities can impact caregivers’ quality of life (QOL). Understanding the current state of the science regarding caregiving QOL could help inform future research and intervention development.
MethodsA systematic literature review in PubMed/Medline examined research on QOL among informal cancer caregivers and related psychosocial health outcomes. Original research articles in English, published between 2007 and 2017 about caregivers (aged >18 years) of adult cancer patients in the United States were included. Abstracted articles were categorized according to caregiving recipient's phase of survivorship (acute, middle to long-term, end of life/bereavement).
ResultsOf 920 articles abstracted, 60 met inclusion criteria. Mean caregiver age ranged from 37 to 68 with the majority being female, non-Hispanic white, with at least a high school degree, and middle income. Almost half of the studies focused on caregivers who provided care for survivors from diagnosis through the end of active treatment. Studies examined physical health, spirituality, psychological distress, and social support. Differences in QOL were noted by caregiver age, sex, and employment status.
Significance of ResultsAdditional research includes the examination of the needs of diverse cancer caregivers and determines how additional caregiver characteristics (e.g., physical functioning, financial burden, etc.) affect QOL. This includes studies examining caregiver QOL in the phases following the cessation of active treatment and assessments of health systems, support services, and insurance to determine barriers and facilitators needed to meet the immediate and long-term needs of cancer caregivers.
Safety of tracheal intubation in the presence of cardiac disease in paediatric ICUs
- Eleanor A. Gradidge, Adnan Bakar, David Tellez, Michael Ruppe, Sarah Tallent, Geoffrey Bird, Natasha Lavin, Anthony Lee, Vinay Nadkarni, Michelle Adu-Darko, Jesse Bain, Katherine Biagas, Aline Branca, Ryan K. Breuer, Calvin Brown III, Kris Bysani, Guillaume Emeriaud, Sandeep Gangadharan, John S. Giuliano, Jr, Joy D. Howell, Conrad Krawiec, Jan Hau Lee, Simon Li, Keith Meyer, Michael Miksa, Natalie Napolitano, Sholeen Nett, Gabrielle Nuthall, Alberto Orioles, Erin B. Owen, Margaret M. Parker, Simon Parsons, Lee A. Polikoff, Kyle Rehder, Osamu Saito, Ron C. Sanders, Jr, Asha Shenoi, Dennis W. Simon, Peter W. Skippen, Keiko Tarquinio, Anne Thompson, Iris Toedt-Pingel, Karen Walson, Akira Nishisaki, For National Emergency Airway Registry for Children (NEARKIDS) Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)
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- Journal:
- Cardiology in the Young / Volume 28 / Issue 7 / July 2018
- Published online by Cambridge University Press:
- 25 April 2018, pp. 928-937
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Introduction
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methodsWe sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
ResultsA total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
ConclusionsThe overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.
Contributors
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- By Brittany L. Anderson-Montoya, Heather R. Bailey, Carryl L. Baldwin, Daphne Bavelier, Jameson D. Beach, Jeffrey S. Bedwell, Kevin B. Bennett, Richard A. Block, Deborah A. Boehm-Davis, Corey J. Bohil, David B. Boles, Avinoam Borowsky, Jessica Bramlett, Allison A. Brennan, J. Christopher Brill, Matthew S. Cain, Meredith Carroll, Roberto Champney, Kait Clark, Nancy J. Cooke, Lori M. Curtindale, Clare Davies, Patricia R. DeLucia, Andrew E. Deptula, Michael B. Dillard, Colin D. Drury, Christopher Edman, James T. Enns, Sara Irina Fabrikant, Victor S. Finomore, Arthur D. Fisk, John M. Flach, Matthew E. Funke, Andre Garcia, Adam Gazzaley, Douglas J. Gillan, Rebecca A. Grier, Simen Hagen, Kelly Hale, Diane F. Halpern, Peter A. Hancock, Deborah L. Harm, Mary Hegarty, Laurie M. Heller, Nicole D. Helton, William S. Helton, Robert R. Hoffman, Jerred Holt, Xiaogang Hu, Richard J. Jagacinski, Keith S. Jones, Astrid M. L. Kappers, Simon Kemp, Robert C. Kennedy, Robert S. Kennedy, Alan Kingstone, Ioana Koglbauer, Norman E. Lane, Robert D. Latzman, Cynthia Laurie-Rose, Patricia Lee, Richard Lowe, Valerie Lugo, Poornima Madhavan, Leonard S. Mark, Gerald Matthews, Jyoti Mishra, Stephen R. Mitroff, Tracy L. Mitzner, Alexander M. Morison, Taylor Murphy, Takamichi Nakamoto, John G. Neuhoff, Karl M. Newell, Tal Oron-Gilad, Raja Parasuraman, Tiffany A. Pempek, Robert W. Proctor, Katie A. Ragsdale, Anil K. Raj, Millard F. Reschke, Evan F. Risko, Matthew Rizzo, Wendy A. Rogers, Jesse Q. Sargent, Mark W. Scerbo, Natasha B. Schwartz, F. Jacob Seagull, Cory-Ann Smarr, L. James Smart, Kay Stanney, James Staszewski, Clayton L. Stephenson, Mary E. Stuart, Breanna E. Studenka, Joel Suss, Leedjia Svec, James L. Szalma, James Tanaka, James Thompson, Wouter M. Bergmann Tiest, Lauren A. Vassiliades, Michael A. Vidulich, Paul Ward, Joel S. Warm, David A. Washburn, Christopher D. Wickens, Scott J. Wood, David D. Woods, Motonori Yamaguchi, Lin Ye, Jeffrey M. Zacks
- Edited by Robert R. Hoffman, Peter A. Hancock, University of Central Florida, Mark W. Scerbo, Old Dominion University, Virginia, Raja Parasuraman, George Mason University, Virginia, James L. Szalma, University of Central Florida
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- The Cambridge Handbook of Applied Perception Research
- Published online:
- 05 July 2015
- Print publication:
- 26 January 2015, pp xi-xiv
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2 - Making history natural in Rousseau's Discourse on the Origins of Inequality
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- By Natasha Lee
- Edited by Christie McDonald, Harvard University, Massachusetts, Stanley Hoffmann, Harvard University, Massachusetts
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- Rousseau and Freedom
- Published online:
- 05 May 2010
- Print publication:
- 22 April 2010, pp 24-43
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Summary
As much as the Enlightenment has come to embody an age of rationalization and the rise of scientific thought for us today, an attentive reading of eighteenth-century texts signals their profound ambivalence toward emerging discourses of natural knowledge and the claims they made to know humans through physical qualities. The Abbé Raynal's Histoire des deux Indes voices such concerns:
Curiosities of nature are a fertile source for deceit; it converts singular phenomena into miracles. One country's natural history becomes supernatural in another. Facts, like plants, are altered when taken from their source: truths are transformed into errors.
Having fought to get away from a culture of wonders and marvels, Enlightenment thinkers sought to circumscribe a knowledge of the material world, but also articulated their unease toward the absoluteness of such expositions.
Before Rousseau voiced his own ambivalence about empirical evidence in his Discours sur l'origine et les fondements de l'inégalité (the Second Discourse), he began his study of the human by discarding his contemporaries' argument that social issues could be understood through the lens of a natural law arrived at through an a priori method. The Second Discourse takes issue with Thomas Hobbes, Hugo Grotius, and John Locke, among others, for constructing a skewed notion of the state of nature and claiming that it can explain the present. In his reassessment of the link between the state of nature and current social phenomena, Rousseau looked instead to conjectural history and to discourses of natural knowledge, including natural history, travel accounts, and inquiries into empirical particulars.
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