The CounterText interview : Simon Critchley

At the end of November 2009, Simon Critchley had been due to fly out to Malta to deliver a keynote address at the ‛Style in Theory / Styling Theory’ Conference.1 In the event, Critchley was unable to travel. Not that the conference was short of keynote speakers – besides Critchley, there was Catherine Belsey, Douglas Burnham, Stefan Herbrechter, Fiona Hughes, Laurent Milesi, Jean-Michel Rabaté, and Stuart Sillars. Critchley’s work, however, had seemed particularly relevant to the concerns of the conference. His experiments with style had always appeared pointedly directed towards bringing out the literary in the philosophical and the philosophical in the literary. So, to ensure that Critchley would still be part of the conversation about style and theory despite him not being physically present at the conference, the next best thing was arranged – a live videolink interview. The text presented here is an edited version of that interview and the question-and-answer session that followed, all of which took place on Friday 27 November 2009.2 The interview carries a fascinating historical situatedness, and it frames a particular moment in Critchley’s intellectual development and in the evolution of ‛theory’ more broadly. It also offers far-reaching and insightful reflections on style in philosophy and literature that render it strikingly relevant to the concerns of CounterText.peer-reviewe

Why choice of metric matters in public health analyses: a case study of the attribution of credit for the decline in coronary heart disease mortality in the US and other populations

RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.Abstract Background Reasons for the widespread declines in coronary heart disease (CHD) mortality in high income countries are controversial. Here we explore how the type of metric chosen for the analyses of these declines affects the answer obtained. Methods The analyses we reviewed were performed using IMPACT, a large Excel based model of the determinants of temporal change in mortality from CHD. Assessments of the decline in CHD mortality in the USA between 1980 and 2000 served as the central case study. Results Analyses based in the metric of number of deaths prevented attributed about half the decline to treatments (including preventive medications) and half to favourable shifts in risk factors. However, when mortality change was expressed in the metric of life-years-gained, the share attributed to risk factor change rose to 65%. This happened because risk factor changes were modelled as slowing disease progression, such that the hypothetical deaths averted resulted in longer average remaining lifetimes gained than the deaths averted by better treatments. This result was robust to a range of plausible assumptions on the relative effect sizes of changes in treatments and risk factors. Conclusions Time-based metrics (such as life years) are generally preferable because they direct attention to the changes in the natural history of disease that are produced by changes in key health determinants. The life-years attached to each death averted will also weight deaths in a way that better reflects social preferences.Peer Reviewe

Population assessment of future trajectories in coronary heart disease mortality.

Background: Coronary heart disease (CHD) mortality rates have been decreasing in Iceland since the 1980s, largely reflecting improvements in cardiovascular risk factors. The purpose of this study was to predict future CHD mortality in Iceland based on potential risk factor trends. Methods and findings: The previously validated IMPACT model was used to predict changes in CHD mortality between 2010 and 2040 among the projected population of Iceland aged 25–74. Calculations were based on combining: i) data on population numbers and projections (Statistics Iceland), ii) population risk factor levels and projections (Refine Reykjavik study), and iii) effectiveness of specific risk factor reductions (published meta-analyses). Projections for three contrasting scenarios were compared: 1) If the historical risk factor trends of past 30 years were to continue, the declining death rates of past decades would level off, reflecting population ageing. 2) If recent trends in risk factors (past 5 years) continue, this would result in a death rate increasing from 49 to 70 per 100,000. This would reflect a recent plateau in previously falling cholesterol levels and recent rapid increases in obesity and diabetes prevalence. 3) Assuming that in 2040 the entire population enjoys optimal risk factor levels observed in low risk cohorts, this would prevent almost all premature CHD deaths before 2040. Conclusions: The potential increase in CHD deaths with recent trends in risk factor levels is alarming both for Iceland and probably for comparable Western populations. However, our results show considerable room for reducing CHD mortality. Achieving the best case scenario could eradicate premature CHD deaths by 2040. Public health policy interventions based on these predictions may provide a cost effective means of reducing CHD mortality in the future

Analyzing Recent Coronary Heart Disease Mortality Trends in Tunisia between 1997 and 2009.

BACKGROUND: In Tunisia, Cardiovascular Diseases are the leading causes of death (30%), 70% of those are coronary heart disease (CHD) deaths and population studies have demonstrated that major risk factor levels are increasing. OBJECTIVE: To explain recent CHD trends in Tunisia between 1997 and 2009. METHODS: DATA SOURCES: Published and unpublished data were identified by extensive searches, complemented with specifically designed surveys. ANALYSIS: Data were integrated and analyzed using the previously validated IMPACT CHD policy model. Data items included: (i)number of CHD patients in specific groups (including acute coronary syndromes, congestive heart failure and chronic angina)(ii) uptake of specific medical and surgical treatments, and(iii) population trends in major cardiovascular risk factors (smoking, total cholesterol, systolic blood pressure (SBP), body mass index (BMI), diabetes and physical inactivity). RESULTS: CHD mortality rates increased by 11.8% for men and 23.8% for women, resulting in 680 additional CHD deaths in 2009 compared with the 1997 baseline, after adjusting for population change. Almost all (98%) of this rise was explained by risk factor increases, though men and women differed. A large rise in total cholesterol level in men (0.73 mmol/L) generated 440 additional deaths. In women, a fall (-0.43 mmol/L), apparently avoided about 95 deaths. For SBP a rise in men (4 mmHg) generated 270 additional deaths. In women, a 2 mmHg fall avoided 65 deaths. BMI and diabetes increased substantially resulting respectively in 105 and 75 additional deaths. Increased treatment uptake prevented about 450 deaths in 2009. The most important contributions came from secondary prevention following Acute Myocardial Infarction (AMI) (95 fewer deaths), initial AMI treatments (90), antihypertensive medications (80) and unstable angina (75). CONCLUSIONS: Recent trends in CHD mortality mainly reflected increases in major modifiable risk factors, notably SBP and cholesterol, BMI and diabetes. Current prevention strategies are mainly focused on treatments but should become more comprehensive

The hypothesis, the context, the messianic, the political, the economic, the technological - on derrida’s specters of Marx

In this paper I give a detailed critical discussion of Derrida’s important 1994 book Specters of Marx. I begin by discussing the hypothesis advanced in the book and then make a number of remarks about its context. I then go on to discuss the central theme of Specters of Marx: the messianic. As a way of unpacking this theme, I address a number of subthemes in Specters of Marx: the injunction of différance, democracy to come, justice, religion and the es spukt (it spooks). As a consequence of this discussion, I turn to the theme of the political and address the subthemes of hegemony, the decision and the New International. I conclude the paper with a discussion of two more speculative themes that arise out of Specters of Marx: the question of the economic and the technological.In this paper I give a detailed critical discussion of Derrida’s important 1994 book Specters of Marx. I begin by discussing the hypothesis advanced in the book and then make a number of remarks about its context. I then go on to discuss the central theme of Specters of Marx: the messianic. As a way of unpacking this theme, I address a number of subthemes in Specters of Marx: the injunction of différance, democracy to come, justice, religion and the es spukt (it spooks). As a consequence of this discussion, I turn to the theme of the political and address the subthemes of hegemony, the decision and the New International. I conclude the paper with a discussion of two more speculative themes that arise out of Specters of Marx: the question of the economic and the technological

Surfaciality: Some Poems by Fernando Pessoa, one by Wallace Stevens, and the Brief Sketch of a Poetic Ontology

In this paper, I attempt to give a reading of some poems by the great Por­tuguese poet, Fernando Pessoa, focusing in particular on the relation be­tween thought and things or mind and world as it is figured in poetry. On this basis, I seek to develop a poetic ontology using certain insights of Heidegger's on language, interpretation and world. In the closing pages, I pursue this ontology through a reading of a key poem by Wal­lace Stevens

Forecasting Tunisian type 2 diabetes prevalence to 2027: validation of a simple model.

BACKGROUND: Most projections of type 2 diabetes (T2D) prevalence are simply based on demographic change (i.e. ageing). We developed a model to predict future trends in T2D prevalence in Tunisia, explicitly taking into account trends in major risk factors (obesity and smoking). This could improve assessment of policy options for prevention and health service planning. METHODS: The IMPACT T2D model uses a Markov approach to integrate population, obesity and smoking trends to estimate future T2D prevalence. We developed a model for the Tunisian population from 1997 to 2027, and validated the model outputs by comparing with a subsequent T2D prevalence survey conducted in 2005. RESULTS: The model estimated that the prevalence of T2D among Tunisians aged over 25 years was 12.0% in 1997 (95% confidence intervals 9.6%-14.4%), increasing to 15.1% (12.5%-17.4%) in 2005. Between 1997 and 2005, observed prevalence in men increased from 13.5% to 16.1% and in women from 12.9% to 14.1%. The model forecast for a dramatic rise in prevalence by 2027 (26.6% overall, 28.6% in men and 24.7% in women). However, if obesity prevalence declined by 20% in the 10 years from 2013, and if smoking decreased by 20% over 10 years from 2009, a 3.3% reduction in T2D prevalence could be achieved in 2027 (2.5% in men and 4.1% in women). CONCLUSIONS: This innovative model provides a reasonably close estimate of T2D prevalence for Tunisia over the 1997-2027 period. Diabetes burden is now a significant public health challenge. Our model predicts that this burden will increase significantly in the next two decades. Tackling obesity, smoking and other T2D risk factors thus needs urgent action. Tunisian decision makers have therefore defined two strategies: obesity reduction and tobacco control. Responses will be evaluated in future population surveys