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OBJECTIVES/GOALS: Supported by the State of Alabama, the Alabama Genomic Health Initiative (AGHI) is aimed at preventing and treating common conditions with a genetic basis. This joint UAB Medicine-HudsonAlpha Institute for Biotechnology effort provides genomic testing, interpretation, and counseling free of charge to residents in each of Alabama’s 67 counties. METHODS/STUDY POPULATION: Launched in 2017, as a state-wide population cohort, AGHI (1.0) enrolled 6,331 Alabamians and returned individual risk of disease(s) related to the ACMG SF v2.0 medically actionable genes. In 2021, the cohort was expanded to include a primary care cohort. AGHI (2.0) has enrolled 750 primary care patients, returning individual risk of disease(s) related to the ACMG SF v3.1 gene list and pre-emptive pharmacogenetics (PGx) to guide medication therapy. Genotyping is done on the Illumina Global Diversity Array with Sanger sequencing to confirm likely pathogenic / pathogenic variants in medically actionable genes and CYP2D6 copy number variants using Taqman assays, resulting in a CLIA-grade report. Disease risk results are returned by genetic counselors and Pharmacogenetics results are returned by Pharmacists. RESULTS/ANTICIPATED RESULTS: We have engaged a statewide community (>7000 participants), returning 94 disease risk genetic reports and 500 PGx reports. Disease risk reports include increased predisposition to cancers (n=38), cardiac diseases (n=33), metabolic (n=12), other (n=11). 100% of participants harbor an actionable PGx variant, 70% are on medication with PGx guidance, 48% harbor PGx variants and are taking medications affected. In 10% of participants, pharmacists sent an active alert to the provider to consider/ recommend alternative medication. Most commonly impacted medications included antidepressants, NSAIDS, proton-pump inhibitors and tramadol. To enable the EMR integration of genomic information, we have developed an automated transfer of reports into the EMR with Genetics Reports and PGx reports viewable in Cerner. DISCUSSION/SIGNIFICANCE: We share our experience on pre-emptive implementation of genetic risk and pharmacogenetic actionability at a population and clinic level. Both patients and providers are actively engaged, providing feedback to refine the return of results. Real time alerts with guidance at the time of prescription are needed to ensure future actionability and value.
This is a 1994 translation of one of the classics of the traditions of anarchism and socialism. Pierre-Joseph Proudhon was a contemporary of Marx and one of the most acute, influential and subversive critics of modern French and European society. His What is Property? (1840) produced the answer 'Property is theft'; the book itself has become a classic of political thought through its wide-ranging and deep-reaching critique of private property as at once the essential institution of Western culture and the root cause of greed, corruption, political tyranny, social division and violation of natural law. A critical and historical introduction situates Proudhon's 'diabolical work' (as he called it) in the context of nineteenth-century social and legal controversy and of the history of political thought in general.
How is law related to political thought in modern European history? There are three different answers to this question that apply here. One derives from what may be called the legislative or statutory model of legal philosophy, which, following good classical precedent, identified law with the will of the sovereign, whether located in a monarchical or in a republican form of government. In the eighteenth century the legislative paradigm can be seen in the theory and practice of enlightened despotism and especially in the codification movement, which touched many European states, including Prussia, Austria and France (Tarello 1976; cf. Wisner 1997). European codes, modelled largely on the Corpus Juris Justiniani (ad 529–33), were intended to organise all private law (especially the law of persons and property) into a single system and in this way, whether directly or indirectly, to politicise it. This agenda was realised most famously in the Napoleonic Code, but it can also be seen in monarchists such as Joseph de Maistre, Louis de Bonald, and Friedrich von Stahl and Utilitarians such as Jeremy Bentham and John Austin, who defined law simply as a command of sovereign power.
This collection of essays by some of the most distinguished historians and literary scholars in the English-speaking world explores the overlap, interplay, and interaction between history and fiction in British imaginative and historical writing from the Tudor period to the Enlightenment. The historians discuss the questions of truth, fiction, and the contours of early modern historical culture, while the literary scholars consider some of the fictional aspects of history, and the historical aspects of fiction, in prose narratives of many sorts. The interests and inquiries of these learned, imaginative, and venturesome scholars cross at many points, casting significant light on and offering numerous insights into the problematic and interdisciplinary areas where 'history' and 'story' meet, interact, and sometimes compete. Despite the theoretical questions posed, the discussions primarily focus on concrete works, including those of Thomas More, John Foxe, Thomas Hobbes, Adam Smith, and Edward Gibbon.
Christophe Milieu's De Scribenda Vniversitatis rervm historia libri qvinqve (Basel, 1551) interprets the "universe of things" (universitas return) within an evolutionary and historical framework consisting of five connected and progressive "grades" (gradus) of existence accessible to human understanding: nature (natura), the world of God's creation and man's animal aspect; prudence (prudentia), including the arts of survival; government (principatus), the stage of civil society and political history; wisdom (sapientia), equivalent to civilization and including the higher sciences and philosophy; and literature (litetatura), in which knowledge of the preceding phases of "progress" (progressio) is expressed in writing. Milieu's "narrative" constitutes a pioneering and comprehensive history of western culture.
“History” and “story” are derived from the same root, and they have converged again in modern times, especially through the recognition of their common dependence on imagination. Both history and literature are forms of cultural memory, and in this respect, too, they have a link with imagination. Historians pretend to recapture the past in all its fullness, but in fact they are bound by the limits and conventions of narrative prose. Nor can literary artists, even the most “classic” among them, remain free of the toils of history; for as Shelley admitted, “this is an influence which neither the meanest scribbler nor the sublimest genius of any era can escape.”
Since antiquity the ars historica and the ars poetica were sister genres, with overlapping issues and similar values. From the time of Cicero and Quintilian the art of history has made claims on truth, but like poetry, it has also aimed at beauty, or pleasure (voluptas), and goodness, or utility (utilitas). In more recent times, too, the realization of such a common pedigree and such common purposes has reinforced the ties between historians and literary scholars and opened further what has been called “the open boundary of history and fiction.” As historians have come to recognize the aesthetic dimension of their craft and the necessity to resort to imagination to fill in gaps in the narrative, so literary scholars are acknowledging the historicity of literature, its value as a reflection of bygone worlds not recoverable through conventional documents, and the use of literary criticism for the interpretation of such documentation.
Imagination in its highest form is said to be the creative faculty of the mind, the department engaged in framing new images and conceptions, things and ideas hitherto unknown and previously nonexistent. As such, it has always been connected with the arts, verbal as well as visual. Imagination lives in the realm of fancy and of fiction, the antithesis of observable facts and empirically testable propositions. In a more general sense, however, the word “imagination” refers to the capacity of the mind to form images or concepts of what is not actually present to the senses and to evoke their relations with one another. As such, it can bring into view remote, absent, or previously occurring events as well as purely imaginary ones. In this meaning, it enjoys an intimate connection with the idea of memory, and has a close tie to the work of historians and to the purposes and practices of historical writing. History of necessity deals with the need to make present what has left only traces or remains by which it can be known. As a discipline concerned with recovering the past, history cannot but come to terms with the limits of representation this process entails; so despite its prosaic form, it has enjoyed an affinity, and sometimes an intense sibling rivalry, with poetry, its sister genre, and one of imagination's main fields of play.
This kinship was a subject of particular interest and concern in the early modern period, an era in which strenuous efforts were being made on many fronts – in the institutions of church and state as well as in the various arts and sciences and in popular culture – to recover and emulate the truths and traditions of the past and to command time-bound processes of change or overcome them.