It is often said that the health promoter must be an expert in generalisation and Debates and Dilemmas in Promoting Health is an illustration of the vast range of issues influencing practice and policy health promotion today.The publication is part of The Open University undergraduate course “Promoting Health: Skills, Perspectives and Practice”. It presents a collection of articles by an impressive range of authors, and although the preface states that these aim to challenge preconceptions and evoke a critical understanding of (...) current health issues, some of these are drawn from other publications and are some years old.The book is divided into four sections and the introduction to each section from the editors attempts to summarise the key points and common themes. Overall, the reader should be left in no doubt about the complexity and lack of definitive answers in modern health promotion.In the years since the defining events of the 1970s and 1980s that gave rise to the Alma Ata Declaration and the Ottawa Charter, health promotion has been increasingly subject to debates, dilemmas, and criticisms. The knowledge base for health advice becomes seemingly ever more complex and the balance between individual, community, and government responsibility appears to be in continual flux. The all-embracing definitions of health with which we work present enormous challenges in a climate of increasing need to demonstrate output and cost effectiveness.The first section, “Key issues in health promotion”, aims to explore some of the current thinking at the heart of health promotion, and offers a number of different perspectives on this thinking. Charles Webster and Jeff …. (shrink)

In the past decade donor commitments to health have increased by 200 percent. Correspondingly, there has been a swell of new players in the global health landscape. The unprecedented, global response to a single disease, HIV/AIDS, has been responsible for a substantial portion of this boon. Numerous health success have followed this windfall of funding and attention, yet the food, fuel, and economic crises of 2008 have shown the vulnerabilities of health and development initiatives focused on short term wins and (...) reliant on a constant flow of foreign funding. For too long, the international community has responded to global health and development challenges with emergency solutions that often reflect the donor's priorities, values, and political leanings, rather than funding durable health systems that can withstand crises. Progress towards achieving the Millennium Development Goals has stalled in many countries. Disease specific initiatives have weakened health systems and limited efforts to improve maternal and child health. As we enter this era of scarce resources, there is a need to return to the foundations of the Alma Ata Declaration signed thirty years ago with the goal of providing universal access to primary healthcare. The global health community must now objectively evaluate how we can most effectively respond to the crises of 2008 and take advantage of this moment of extraordinary attention for global health and translate it into long term, sustainable health improvements for all. (shrink)

In her 2018 book, What the Eyes Don’t See, Dr. Mona Hanna-Attisha wrote that it is the duty of doctors to speak out against injustice. In fact, no other physician or institution in Flint had done the research and spoken out, as a whistleblower, against the poisoning of Flint’s children by Michigan government. Why had Dr. Hannah-Attisha? Unfortunately, in the absence of a medical education system that teaches community-oriented primary health care in the tradition of the 1978 Alma Ata (...) Declaration, there is little reward in doing so. This article focuses on three movements that are challenging medical education orthodoxy: 1) primary health care 2) the medical humanities and 3) “Study Up your Town” medicine. How can we create a radical health pedagogy – one that draws the links between several pandemics raging across the planet: capitalist collapse, climate disruption, Covid-19, racism, and an emergent neoliberal fascism – to enable doctors, health professionals and citizens to see them as all of one piece? Medical educators must employ critical pedagogy to create legions of “constructive troublemakers” who challenge the social-structural obstacles that are driving millions to premature death. We have reached the “end times.” A new “planet medicine” is finally emerging. (shrink)

This paper is a commentary on a project application of telemedicine to alleviate primary health care problems in Lundazi district in the Eastern province of Zambia. The project dubbed 'The Virtual Doctor Project' will use hard body vehicles fitted with satellite communication devices and modern medical equipment to deliver primary health care services to some of the neediest areas of the country. The relevance and importance of the project lies in the fact that these areas are hard-to-reach due to rugged (...) natural terrain and have very limited telecommunications infrastructure. The lack of these and other basic services makes it difficult for medical personnel to settle in these areas, which leads to an acute shortage of medical personnel. We comment on this problem and how it is addressed by 'The Virtual Doctor Project', emphasizing that while the telemedicine concept is not new in sub-Saharan Africa, the combination of mobility and connectivity to service a number of villages 'on the go' is an important variation in the shift back to the 1978 Alma Ata principles of the United Nations World Health Organization [WHO].This overview of the Virtual Doctor Project in Zambia provides insight into both the potential for ICT, and the problems and limitations that any "real-world" articulation of this technology must confront. (shrink)

Food Sovereignty is a vibrant discourse in academic and activist circles, yet despite the many shared characteristics between issues surrounding food and public health, the two are often analysed in separate frameworks and the insights from Food Sovereignty are not sufficiently brought to bear on the problems in the public health discourse. In this paper, I will introduce the concept of 'self-organised community viability' as a way to link food and health, and to argue that what I call the 'Health (...) Security' paradigm requires a 'Health Sovereignty' response modelled on Food Sovereignty. (shrink)

We explore Peirce’s pragmatic conception of sign action, as a distributed and emergent view of cognition and exemplify with the emergence of classical ballet. In our approach, semiosis is a temporally distributed process in which a regular tendency towards certain future outcomes emerges out of a history of sign actions. Semiosis self-organizes in time, in a process that continuously entails the production of more signs. Emergence is a ubiquitous condition in this process: the translation of signs into signs cannot be (...) inferred from the properties of the components of a semiotic triad alone, but has to take into account a complex interaction between a micro-semiotic and macro-semiotic level of description. This interaction can be understood as an interplay of potentialities and tendencies, or upward constitutive determinative relations and downward selective determinative relations. According to this view, emergence is a central defining condition of processes of meaning. Ballet is a sign in action. The emergence of classical ballet is a self-regulatory process, in which a system of different kinds of cognitive artifacts (musical, bodily/motor, spatial/architectonic) and agents obtained a stable semiotic relation throughout many phases of development between the 16th and the 19th Century. One case is the development of the verticality of dance in classical ballet as a semiotic relation connecting proscenium arch stages, dancing bodies, and audiences. This development is micro-semiotically determined by the spatial constraints of the proscenium arch stage, and macro-semiotically determined by a historical construction of the dancing body as a sign within a network of semiotic chains, such as the intersemiotic regulation of body of the dancer by principles coming from painting. This is not only the emergence of actual meaning, but also the emergence of an open-ended field of potential and general meanings, an autonomous tendency of development. To say that ballet, as sign action, emerges, is to say that cognitive artifacts such as dancer’s bodies, stages and audience’s point of view, musical compositions, costumes, all sorts of supporting institutions, etc, constitute a niche for sign action, interacting according to tendencies of development that didn’t exist before. (shrink)

Journal Name: Semiotica Issue: Ahead of print.

The main purpose of this work is to provide a semiotic ontology for redescription of active cognitive externalism, recently developed by the paradigm 4E (embodied, embedded, enactive, extended cognition). In our approach, distributed cognitive systems (DCSs) are described as semiosis, signs in action. We explored the relationship between semiosis and cognition, as conceived by C. S. Peirce, in association with the notion of distributed cognitive system (DCS). We introduce Peircean externalist approach with an emphasis on the notion of temporal distribution (...) of semiosis, and describe DCSs, and their elements, as “sign in action”. To develop this argument, we describe an example of DCS -- verbal-musical improvisation of repente, repentismo, or viola singing. It is a phenomenon of verbal-musical improvisation that takes the form of a challenge in versified oral poetry. We describe the phenomenon as the embodiment of the formal structure of a cognitive task and an inferential process. This embodiment corresponds to a semiotization of the repente performances as DCSs. The temporally distributed tendency of repentismo organizes the DCS as a system that performs metasemiotic experiments on the action of signs. (shrink)

Turkish Epistemoloji rasyonel inançların felsefi analizini konu edinmesi nedeniyle gerekçelendirme edimine merkezi bir önem atfeder. Gerekçelendirme kişinin bir önermeye inanmak için gerekçeye sahip olunmasını sağlayan koşul veya koşullar dizisinin tespit edilmesini içerir. İnançlarımızın birçoğunun çıkarımsal olmayan gerekçelerinin bulunduğu şeklindeki ılımlı/yanılırcı temelci perspektifle uyum sağlayan bir gerekçelendirme teorisi olarak Michael Huemer tarafından ortaya konan görüngüsel muhafazakarlık ilkesi, bu türden bir koşulu tanımlar. GM formülasyonuna göre eğer S’ye p olarak görünüyorsa, çürütücü etmenlerin yokluğunda S’nin p’ye inanmak için en azından bir dereceye kadar (...) gerekçesi vardır. Görüngüler ise rasyonel inanç oluşturmanın olanağına referans veren, inanç ve inanma eğilimlerinden farklı, sui generis deneyimlerdir. Bu makalede görüngülerin doğasından hareketle GM’yi tanıttım ve GM’ye yöneltilen eleştirilerin bir bölümünü tartıştım. Yer verdiğim eleştiriler, GM’nin irrasyonel/tehlikeli görüngüler ve bilişsel nüfuzdan kaynaklanan inançları dahi gerekçelendirilmiş kabul ettiği, GM teorisyenlerinin görüngülere gerekçelendirme edimi özelinde biçtiği başat rolün ve inanç ve görüngüler arasında öngörülen farklılıkların abartılı olduğu itirazlarını içerir. Bana göre sözü edilen eleştirilerin hiçbiri, GM’nin reddedilmesini gerektiren argümanlar içermez. Görüngülerin epistemik gerekçelendirmedeki rolünü tesis eden GM veya benzeri bir ilkeyi kabul etmek için temel neden ise bunun şüphecilik haricindeki olası alternatiflerinin belirsizliğidir. Çünkü eğer görüngüler, inanç oluşturmada epistemik faile rehberlik edecek göstergeler ise bu, failin ilgili göstergelerden yoksun olduğunda herhangi bir şeye rasyonel olarak inanmasının olanaksızlaşacağı anlamına gelir. English Because epistemology deals with the philosophical analysis of rational beliefs, it assigns central importance to justification. Justification involves identifying the condition or set of conditions that enables one to have grounds for believing a proposition. The principle of phenomenal conservatism, put forward by Michael Huemer as a justification theory that accords with the moderate/fallibilist foundationalist perspective that many of our beliefs have non- inferential justifications, is a principle that defines such a condition. According to the PC formulation, if it seems to S that p, then, in the absence of defeaters, S thereby has at least some degree of justification for believing that p. Seemings/appearances are sui generis experiences that refer to the possibility of rational belief formation and are different from beliefs and dispositions to believe. In this article, I introduce PC based on the nature of seemings and evaluate some of the criticisms directed at PC. The criticisms I discuss include objections that PC even justifies beliefs stemming from irrational/dangerous seemings and cognitive penetration, and that the dominant role that PC theorists assign to seemings in the act of justification and the differences envisaged between beliefs and seemings are exaggerated. In my opinion, none of these criticisms contain arguments that would lead to the rejection of PC. The main reason to accept PC or a similar principle that establishes the role of seemings in epistemic justification is the vagueness of its possible alternatives other than skepticism. For, if seemings are indicators that guide the epistemic agent in forming beliefs, this means that it is impossible for the agent to believe anything rationally when she lacks the relevant indicators. (shrink)