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"Point of View"
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Who's writing this? : fifty-five writers on humor, courage, self-loathing, and the creative process
\"After seeing a new translation of Jorge Luis Borges's mini-essay \"Borges and I\" (included here), Halpern asked numerous writers to muse briefly on \"the fictional persona 'behind the scenes, '\" the alter(ed) ego that accompanies creation. He asked some 50 well-known authors-such as Margaret Atwood, Pat Conroy, William Gass, Czeslaw Milosz, James Michener, Joyce Carol Oates, and Cynthia Ozick-to write pieces on this idea. The essays are mostly one- to two-page snapshots and vary widely as to approach. Some are touching, others delightfully silly. Edward Gorey anagrams his name into those of characters including Ogdred Weary. Others, such as Cecil Brown, posit earthier personas: \"He is the proper Negro who is ashamed of me, the nigger.\" And still others are reflective: Susan Sontag recalls her longtime disavowal of her work and finally comes to feel that \"the writer is me: not my double\" and thus she is \"both Dr. Frankenstein and the monster.\" Each contributor also submitted a whimsical self-portrait.\"--Publisher's website.
Book
On the relationship of online and offline social cognition
Social neuroscience studies the neurobiological underpinnings of people making sense of people. Due to both conceptual and methodological constraints, the majority of studies in this field of research, however, has employed experimental paradigms that focus on social cognition from an observer's rather than from an interactor's point of view (offline vs. online social cognition). This calls for an increased effort to systematically investigate the neural bases of participation in real-time social interaction. In light of the ontogenetic primacy of social interaction over observation and the idea that neural networks established during social interaction may be \"re-used\" during observation, other important objectives of the field will be to relate new findings into the neural bases of social interaction to previous work investigating the neural bases of social observation as well as to find ways to directly compare the two.
Journal Article
Racial asymmetries : Asian American fictional worlds
\"Challenging the tidy links among authorial position, narrative perspective, and fictional content, Stephen Hong Sohn argues that Asian American authors have never been limited to writing about Asian American characters or contexts. Racial Asymmetries specifically examines the importance of first person narration in Asian American fiction published in the postrace era, focusing on those cultural productions in which the author's ethnoracial makeup does not directly overlap with that of the storytelling perspective. Through rigorous analysis of novels and short fiction, such as Sesshu Foster's Atomik Aztex, Sabina Murray's A Carnivore's Inquiry and Sigrid Nunez's The Last of Her Kind, Sohn reveals how the construction of narrative perspective allows the Asian American writer a flexible aesthetic canvas upon which to engage issues of oppression and inequity, power and subjectivity, and the complicated construction of racial identity. Speaking to concerns running through postcolonial studies and American literature at large, Racial Asymmetries employs an interdisciplinary approach to reveal the unbounded nature of fictional worlds. Stephen Hong Sohn is Assistant Professor of English at Stanford University. He is the co-editor of Transnational Asian American Literature: Sites and Transits\"-- Provided by publisher.
BOOK
Toward a second-person neuroscience
In spite of the remarkable progress made in the burgeoning field of social neuroscience, the neural mechanisms that underlie social encounters are only beginning to be studied and could - paradoxically - be seen as representing the \"dark matter\" of social neuroscience. Recent conceptual and empirical developments consistently indicate the need for investigations that allow the study of real-time social encounters in a truly interactive manner. This suggestion is based on the premise that social cognition is fundamentally different when we are in interaction with others rather than merely observing them. In this article, we outline the theoretical conception of a second-person approach to other minds and review evidence from neuroimaging, psychophysiological studies, and related fields to argue for the development of a second-person neuroscience, which will help neuroscience to really \"go social\"; this may also be relevant for our understanding of psychiatric disorders construed as disorders of social cognition.
Journal Article
The spectrum of perspective shift
This paper examines a little studied type of perspective shift that I call protagonist projection (PP), following Holton (J Pragmat 28(5):625–628, 1997). (Other names for what is arguably the same phenomenon include non-reflective conscioussness, represented perception, viewpoint shift, etc.) PP is a way of describing the mental state of a protagonist that conveys, to some extent, her perspective. Similarly to its better known cousin free indirect discourse (FID), the shift in perspective is achieved without an overt operator. Unlike FID, PP is not based on a presumed (possibly silent) speechact of a protagonist. Rather, it gives a linguistic form to pre-verbal perceptual content, sensations, feelings or implicit beliefs. I propose to analyse PP in a bi-contextual framework, extending Eckardt’s (The semantics of free indirect discourse: How texts allow us tomind-read and eavesdrop, Brill, Leiden, 2014) approach to FID. Under the resulting analysis, FID and PP are two instances of a more general category of perspective shift.
Journal Article
L’assessment e il valore del farmaco: una sintesi dei focus group della XXII Conferenza Nazionale sulla Farmaceutica
The XXII National Conference on Pharmaceuticals, held in Catania from 29 February to 1 March 2024, involved the participation of representatives from more than forty pharmaceutical industries, national authorities, academia, clinicians and clinical pharmacists. The 22nd edition represented a key forum for the analysis of value assessment of medicines, focusing on the impact of new European and National regulations, including the Italian Medicines Agency (AIFA) reform and the HTA regulation. This point of view summarizes insights from focus groups discussions that took place during the Conference, highlighting the pillar role of the new HTA regulation for homogenizing the evaluation across Europe, and the importance to strengthen the collaboration among the parties involved from an early phase, and implementing adaptive and flexible assessment, especially for orphan medicines. The re-evaluation of the innovativeness criteria and framework of the Pricing and Reimbursement (P&R) dossier are points raised among the different focus groups, especially for aligning these tools to the upcoming HTA regulation. The proposals emerged could be useful for AIFA, which is facing a reorganization aimed to optimizing the reimbursement process in Italy.
Journal Article
Accesso precoce ai farmaci: una proposta di riforma per il Servizio Sanitario Nazionale
The present paper illustrates a reform proposal on early access for medicines. In this proposal early access stands for patient’s access, outside of clinical trials and covered by the Italian National Health Service (Servizio Sanitario Nazionale, SSN), to a new medicine or an indication of an already approved medicine before the approval o in between the approval and the decision on price and reimbursement status. The proposal emerged from a multi-stakeholder working group within the Sixth Edition of the “Seminari di Mogliano Veneto”. The reform proposal is aimed at converting the current early access programs (mainly, the programs introduced with Laws 648/96 and 326/03) into a single program inspired by the one introduced in France in 2021. The proposal provides indications on eligibility criteria for drugs and patients, application procedure, evaluation process, economic safeguard clauses, data collection, issues derived from the circumstance that the drug/indication included into the early access program is not reimbursed afterwards and the actions to implement this program.
Journal Article
Regolamento HTA: come si sta muovendo l’Italia?
Within the European evolutionary framework concerning citizens’ health, the focus shifts to the new HTA regulation, set to alter processes and influence decision-making at the individual country level regarding reimbursement and pricing. The ambitious goal of achieving faster and more uniform access will significantly reshape the evaluative model stabilized over the years, characterized by the creation of different rules and processes among member states and diverse output timelines across the countries. The imminent adoption of a more collaborative process necessitates member countries and companies to address several steps to ensure a smooth transition without penalizing the unique aspects of individual countries or impeding real access. Italy, actively participating in European preparatory activities with AIFA, faces challenges in adapting its formal process due to AIFA’s ongoing reform since November 2022, which is not yet materialized. National-level companies heavily depend on leadership and involvement rules from their HTA agencies, with the risk that agencies with more established engagement models with external stakeholders may present themselves on January 12, 2025, the start date of the new process for oncological and ATMP drugs, better prepared and may excel in designing scoping meetings and in formulating PICO. Therefore, the activation of a country culture of HTA and a robust and extended “readiness” phase involving all stakeholders are desirable, along with the establishment of collaboration networks with universities and scientific societies to make valuable knowledge and qualified resources more readily available, crucial element for the delicate transition from the old to the new evaluative system.
Journal Article
Life-long tailoring of management for patients with hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease, characterised by complex pathophysiology and extensive genetic and clinical heterogeneity. In most patients, HCM is caused by mutations in cardiac sarcomere protein genes and inherited as an autosomal dominant trait. The clinical phenotype ranges from severe presentations at a young age to lack of left ventricular hypertrophy in genotype-positive individuals. No preventative treatment is available as the sequence and causality of the pathomechanisms that initiate and exacerbate HCM are unknown. Sudden cardiac death and end-stage heart failure are devastating expressions of this disease. Contemporary management including surgical myectomy and implantable cardiac defibrillators has shown significant impact on long-term prognosis. However, timely recognition of specific scenarios – including transition to the end-stage phase – may be challenging due to limited awareness of the progression patterns of HCM. This in turn may lead to missed therapeutic opportunities. To illustrate these difficulties, we describe two HCM patients who progressed from the typical hyperdynamic stage of asymmetric septal thickening to end-stage heart failure with severely reduced ejection fraction. We highlight the different stages of this complex inherited cardiomyopathy based on the clinical staging proposed by Olivotto and colleagues. In this way, we aim to provide a practical guide for clinicians and hope to increase awareness for this common form of cardiac disease.
Journal Article
Prezzo e rimborso dei farmaci in caso di estensione delle indicazioni: i risultati di una survey sui soci di ISPOR Italy Rome Chapter
Multi-indication pricing models for medicines and some international impact evidence are available in the literature. Data on the Italian context are more limited. This paper illustrates the results of a study aimed at gathering the opinion on this topic of experts, members of the ISPOR Italy Rome Chapter. The opinion was collected through a structured questionnaire, validated by two potential responders, and administered online in the period October/July 2022. There were 45 responders (20% of the members); 67% of responders work in pharmaceutical companies and 13% in consultancy firms. The remainder belongs to regulators/payers and universities. The survey highlighted a preference for (i) non-automatic models, as automatic approaches are mainly based on price cuts/discount increases in relation to an increase in volumes, (ii) an “indication-based-pricing” model (where prices are differentiated by indication through discounts/risk sharing agreements), since it is more consistent with a value-based approach, even if more complex to manage, (iii) a mix of discounts/agreements according to existing evidence. The opinion collected is consistent with the opinions available in the literature, but not consistent with the Italian trend, where, compared to the past, a blended approach is prevailing. A blended pricing envisages a renegotiation of the single price for all indications, essentially based on a change in the discount. Our hope is that in the future the experts’ opinion will be taken into consideration and that a targeted indication-based-pricing will be adopted again.
Journal Article