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1

Castillo, Rigoberto, und Laura S. Florez-Martelo. „Hard-of-Hearing Individuals’ narratives of Inclusion and Exclusion about their schooled EFL learning“. July/December 27, Nr. 2 (31.08.2020): 31–50. http://dx.doi.org/10.19183/how.27.2.569.

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This paper deals with research on inclusion concentrating on the pedagogical implications derived from a qualitative case study that looked into three hard-of-hearing (HHs) students’ perspectives and retrospectives on their schooled EFL learning. Data came from narratives gathered in autobiographical writings and interviews. Although there is a good body of literature on pedagogy in terms of strategies for dealing with HHs, few works have counted on the student’s perspectives. The authors’ insights, one of them being hard-of-hearing, call for truly inclusive policies and practices that address the categories developed in this case study, namely: 1. Deafness separates HHs from people. 2. Hearing aids are not like glasses, and 3. An exemption is not inclusion. The authors feel that the recommendations made are valid for learners with or without disabilities.
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Hakim, Abdul. „MENAKAR RASA KEADILAN PADA PUTUSAN HAKIM PERDATA TERHADAP PIHAK KETIGA YANG BUKAN PIHAK BERDASARKAN PERSPEKTIF NEGARA HUKUM PANCASILA“. Jurnal Hukum dan Peradilan 6, Nr. 3 (30.11.2017): 361. http://dx.doi.org/10.25216/jhp.6.3.2017.361-378.

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Law is a set of words that are systematically linking an authoritative text, according to Gustav Radbruch, it should contain three (3) elements, namely fairness, certainty and expediency. The application of the authoritative text in social life was an absolute authority of a judge in resolving a civil case. The judge, in the checking-hearing-deciding a case, not only expected to return the case to the original state (restitutio in integrum) before the advent of the dispute, but should attempt made every effort to not create new disputes or disputes derived from the subject matter examined. Therefore, it becomes very important role of the paradigm for a judge in deciding the case in order to fulfill a sense of justice. Therefore, deciding the case in a precise sense of justice will be a judge most important role. Nowadays, the meaning of "justice" in Civil Procedure Code only limited to the authority of the power of the parties bound by the principle of consensualism and the principle of freedom of contract. Therefore, based on the Law Paradigm (Philosophy) of Pancasila, Judge as an interpreter, in defining and applying the law, legal science must have the ability to deconstruct and reconstruct an authoritative text based paradigm embraced by a nation.Keywords: the principle of consensualism, justice, pancasila, paradigm, civil procedural law
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Castillo-Torres, Sergio A., Carlos A. Soto-Rincón, Héctor J. Villarreal-Montemayor und Beatriz Chávez-Luévanos. „Case of neuromyelitis optica: bilateral sensorineural hearing loss and transverse myelopathy following intrathecal chemotherapy“. BMJ Case Reports 13, Nr. 4 (April 2020): e234076. http://dx.doi.org/10.1136/bcr-2019-234076.

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Neurotoxicity from intrathecally administered chemotherapeutic drugs is frequent, particularly with some agents like methotrexate, which are more prone to developing adverse effects. Myelopathy ranks among the most frequently reported neurological entities; with the diagnosis being straightforward, after ruling out infectious, metabolic, autoimmune or paraneoplastic causes. Scarcity of cases precludes evidence-based recommendations for the management of these complications. The most common therapeutic approach consists of the suspension of chemotherapy, exclusion of infectious and neoplastic causes, with prompt administration of high-dose steroids. We report a 21-year-old patient with acute lymphoblastic leukaemia, who developed acute transverse myelitis and bilateral sensorineural hearing loss, after five rounds of intrathecal methotrexate and cytarabine. Although neurotoxicity from both agents has been documented, this combination has not been previously reported.
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Takei, Shogo, Yuki Homma, Ryusei Matsuyama und Itaru Endo. „Hepatectomy for liver metastasis from rectal cancer in a patient with mitochondrial disease“. BMJ Case Reports 14, Nr. 2 (Februar 2021): e238653. http://dx.doi.org/10.1136/bcr-2020-238653.

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We herein report a woman who was suffering from type 1 diabetes and hearing impairment and whose mother had mitochondrial disease. Abdominal ultrasound identified a hepatic tumour, and a further examination led to the diagnosis of rectal cancer with synchronous multiple liver metastases. A genetic test led to the diagnosis of mitochondrial disease with a mitochondrial gene 3243A>G mutation. After neoadjuvant chemotherapy, we performed hepatectomy and low anterior resection in one stage. Hepatic vascular exclusion was not performed in order to prevent damage to hepatocytes due to liver ischaemia, and Ringer’s lactate solution was not used to prevent lactic acidosis. The postoperative course was uneventful. Only one other case involving hepatectomy being performed in a patient with mitochondrial disease has been reported. Considering the extreme rarity of such cases and the importance of perioperative management, we report this case here.
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Sintiana Dewi, I. Gst A. A. „LEGAL STUDY OF VISUM ET REPERTUM IN THE STAGE OF THE INVESTIGATION IN DISCLOSING THE CRIME FOLLOW-UP“. Ganesha Civic Education Journal 2, Nr. 1 (12.04.2020): 30–37. http://dx.doi.org/10.23887/gancej.v2i1.92.

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This study aims to determine and analyze the function of Visum Et Repertum in investigations in revealing rape crime. This type of research is a type of normative juridical research, then the approach in this research is the statutory approach (statute approach), case approach (case approach. As a normative juridical study, this research uses legal materials, consisting of primary legal material, secondary legal material, and tertiary legal material The technique of gathering legal materials used by the study of documents and literature studies The results of the study show (1) the role of the Visum Et Repertum in the examination of a rape crime in addition to assisting investigators in uncovering criminal acts but also plays an important role in the hearing at the hearing, then the effort of the investigator requesting the making of a visum et repertum from the initial stage of the examination of the case is important and must be done. two tools, ma'am The quality required for a judge in deciding a case as this is determined in Article 6 paragraph (2) of Law No. 14 of 1970 concerning the Principal Provisions of Judicial Power, and (2 In Criminal Cases, Visum Et Repertum is located as a valid evidence in Article 184 paragraph (1) of the Criminal Procedure Code. So in this case, investigators should include evidence such as Visum Et Repertum as evidence to strengthen and discover the truth of the occurrence of rape.
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Tatianin, D. V. „PROPERTY LIABILITY OF THE INVESTIGATOR IN THE REHABILITATION OF THE ACCUSED“. Bulletin of Udmurt University. Series Economics and Law 29, Nr. 6 (25.11.2019): 899–903. http://dx.doi.org/10.35634/2412-9593-2019-29-6-899-903.

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The article addresses the issues of the investigator’s liability in deciding on the acquittal of the defendant to whom he or she has been charged and the criminal case was sent to the court with the indictment. The view is maintained that the investigator’s responsibility can only occur if the fact of bringing a knowingly innocent person to criminal responsibility is proved with the investigator playing an active role in the fabrication of criminal case materials. When a person is prosecuted on the basis of an assessment of the totality of the available evidence, which at the hearing did not find confirmation for various reasons, prosecuting an investigator seems unacceptable. The investigator investigates the crime in the context of a pronounced opposition to the investigation process from interested parties, the evidence base is created in the specified conditions, before the criminal case is sent to the court, participants in the process are exposed to various forms in order to obtain the necessary evidence from them. A change in the evidence system may be related to counteracting the investigation process, in this situation it is unacceptable for the investigator to be held accountable for unjustified criminal prosecution.
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Reynaldo, Giovanni, Bernadina Chyntia Carsantiningrum und Harim Priyono. „Tuberculous Otitis Media: a case report of hearing impairment in developing country“. Oto Rhino Laryngologica Indonesiana 50, Nr. 2 (02.01.2021): 159. http://dx.doi.org/10.32637/orli.v50i2.342.

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ABSTRACTBackground: Tuberculosis is one of major health problems in developing countries, especially extrapulmonary tuberculosis. Tuberculous otitis media (TOM) is one of extrapulmonary manifestations which is a rare phenomenon characterized by painless otorrhea, insidious onset of ear discharge, multiple perforations in the tympanic membrane, and pale granulation tissues in middle ear cleft. Purpose: Reporting one rare case of TOM. Case Report: A 58-year-old male came with painless otorrhea and recurrent hearing impairment. Tympanomastoidectomy was carried out to repair the tympanic membrane, to cleanse the secret from the middle ear, and to obtain sample for biopsy. Histopathological examination showed necrotizing granuloma which contained mycobacterium tuberculosis infection. Medical treatment was administration of anti tuberculosis drugs. Clinical Question: How to establish TOM diagnosis? Review Method: Searching for literature evidence through Google Scholar. Result: The search obtained 20 journals which in accordance with the inclusion and exclusion criteria. There were similarities on clinical and therapeutic symptoms with this reported case. Discussion: In the reported case, the probable pathophysiology was bacterial aspiration through the Eustachian tube, which was just diagnosed during pre-operative screening. There was no apparent pulmonary tuberculosis symptom. Diagnosis TOM with mastoiditis was difficult, it required high skilled accuracy. Conclusion: TOM is a rare manifestation of extrapulmonary tuberculosis. High suspicion of TOM is needed in patients who did not respond to standard treatment. Treatment includes administration of anti-tubercular drugs, and surgical procedure to cleanse the secretion and granulation tissues. Permanent hearing loss can occur in cases of delayed diagnosis. ABSTRAKLatar belakang: Tuberkulosis merupakan masalah kesehatan di negara berkembang, terutama tuberkulosis ekstra pulmonal. Otitis media tuberkulosa (OMT) merupakan salah satu manifestasi tuberkulosis ekstra pulmonal yang jarang terjadi dan ditandai dengan gejala klinis berupa keluar cairan dari telinga tanpa disertai rasa nyeri, onset penyakit berjalan lambat, terdapat perforasi multipel pada membran timpani, dan jaringan granulasi pucat di rongga telinga tengah. Tujuan: Melaporkan satu kasus OMT yang jarang ditemukan. Laporan Kasus: Seorang laki-laki 58 tahun datang dengan keluhan keluar cairan dari telinga tanpa disertai rasa nyeri, dan ada gangguan pendengaran berulang. Pada pasien dilakukan tindakan bedah timpanomastoidektomi untuk memperbaiki membran timpani yang rusak, membersihkan sekret, dan melakukan biopsi jaringan. Hasil pemeriksaan histopatologi didapati jaringan granuloma nekrotikans yang menunjukkan adanya infeksi Mycobacterium tuberculosis. Diberikan terapi medikamentosa obat anti tuberkulosa. Pertanyaan Klinis: Bagaimana menegakkan diagnosa OMT? Telaah literatur: Penelusuran bukti kepustakaan melalui Google Scholar. Hasil: Penelusuran menghasilkan 20 jurnal yang memenuhi kriteria inklusi dan eksklusi dan memiliki kesamaan gejala klinis dan terapi dengan kasus yang dilaporkan. Diskusi: Pada kasus ini kemungkinan patofisologinya adalah aspirasi bakteri melalui tuba eustachius, dan OMT baru terdiagnosis saat dilakukan skrining pra-operasi. Tidak didapati gejala tuberkulosis paru. Diagnosis OMT dengan mastoiditis cukup sulit, diperlukan ketelitian yang tinggi. Kesimpulan: OMT merupakan manifestasi tuberkulosis ekstra pulmonal yang jarang terjadi. Perlu kecurigaan yang tinggi adanya OMT pada pasien yang tidak responsif terhadap pengobatan standar. Penatalaksanaan meliputi pemberian obat anti tuberkulosa, dan tindakan bedah untuk mengeluarkan dan membersihkan sekret dan jaringan granulasi. Gangguan pendengaran permanen bisa terjadi pada kasus yang penatalaksaannya terlambat.
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Eren, Mehmet Burtaç, Erkal Bilgiç, Selçuk Çetin, Faik Alev Deresoy, Tahir Öztürk und Orhan Balta. „Sixteen Fractures in a Seven-Month-Old Child Caused by Nonaccidental Trauma“. Case Reports in Orthopedic Research 4, Nr. 2 (09.07.2021): 185–91. http://dx.doi.org/10.1159/000517768.

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Definition of physical child abuse is used to refer to a casualty injured by the caregiver. Health-care professionals providing medical care are responsible for detecting and reporting child abuse. A 7-month-old pediatric patient was referred to us from an outer center with the diagnosis of multiple fractures (14 different bones in 16 different anatomical regions). Skeletal pathologies were evaluated after exclusion of head and abdomen injuries in the emergency department. This child with fractures in 16 different anatomical regions of 14 different bones in her body is alive and does not have an intracranial injury. The number of fractures was too high to be explained even by major trauma. If child abuse is suspected, relevant authorities should be notified immediately. Medical records must be meticulously done as they can contribute to the possible court process. Our case, which contains almost all of the history and physical examination and risk factors of typical child abuse, is instructive enough to guide any health-care professional who may encounter this issue. The threshold in deciding on reporting of child abuse should be low. Every suspicious case should be reported in order to prevent repetitive abuse.
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Tempest, Alison, und Bill Wells. „Alliances and arguments: A case study of a child with persisting speech difficulties in peer play“. Child Language Teaching and Therapy 28, Nr. 1 (Februar 2012): 57–72. http://dx.doi.org/10.1177/0265659011419233.

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The ability to argue and to create alliances with peers are important social competencies for all children, including those who have speech, language and communication needs. In this study, we investigated the management of arguments and alliances by a group of 5-year-old male friends, one of whom has a persisting speech difficulty (PSD). Twelve argument episodes that arose naturally during video-recorded free play at school were analysed, using Conversation Analysis. Overall the data show that the child with PSD was just as likely as one of his friends to be included in, or excluded from, play alliances. Detailed analysis of two episodes reveals that the child with PSD competently used a range of linguistic devices in and around arguments and that his speech difficulties apparently did not impact on his ability to form alliances. This study highlights the need for those of us who work with children to take account of peer interactions and to consider the linguistic strategies that children employ when participating in peer talk and play: the social world in which inclusion and exclusion are accomplished. The study also illustrates the value of qualitative micro-interactional analysis as a research tool for investigating social inclusion and exclusion.
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Pujinoto, Sisno, Anis Mashdurohatun und Achmad Sulchan. „Juridical Analysis Of Application Of Forgiveness (Rechterlijk Pardon) As A Basis Of Judge Consideration In Deciding The Criminal“. Jurnal Daulat Hukum 3, Nr. 2 (01.06.2020): 307. http://dx.doi.org/10.30659/jdh.v3i2.10085.

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The formulation of the problem in this study are: How is the principle position Rechterlijk Pardon in the criminal system in Indonesia, how the principles are applied Rechterlijk Pardon in a criminal ruling Decision Number 241 / Pid.B / 2019 / PN.Mjl andHow the development / concept of the Rechterlijk Pardon principle in the renewal of the Indonesian criminal law that will come related to the draft criminal law on the monodualistic principle?This study uses a sociological juridical approach, with descriptive analytical research specifications. The data used in this study are secondary data obtained through library research and primary data obtained through field research which are then analyzed qualitatively using legal theory, the forgiveness agency theory, criminal justice system theory, and progressive legal theory. Based on the results of that study The position of the Rechterlijk Pardon Principle in the Criminal System in Indonesia is forgiveness is a form of forgiveness / deliverance from mistakes made. As a form of forgiveness, then with forgiveness, someone who is guilty is not sentenced or does not need to feel the punishment. Provisions such as this basically exist in conditional criminal conduct (voorwaardelijke veroordeling) regulated in Article 14a-14f of the Criminal Code. Conditional penalties are also referred to by part of the community with the term criminal trial or there is also termed as conditional punishment. Application of the Rechterlijk Pardon Principle in Criminal Verdicts Number 241 / Pid.B / 2019 / PN.Mjl it is applied later to act as the final safety valve in the criminal justice system if a case is not filtered at the prosecution and preliminary hearing judge stage. Development / Concept of the Rechterlijk Pardon Principle in the Future Renewal of Indonesian Criminal Laws Associated with the Draft Criminal Laws on the Monodualistic Principle are Forgiveness institution, is an important element to answer problems that cannot be accommodated with only 3 (three) types of decisions (free, loose, criminal funds).Keywords : Institutions; Forgiveness; Rechterlijk Pardon; Considerations; Judges; Decisions.
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Fahmi, Muhammad Riza. „Overmacht Dalam Tindak Pidana Penganiayaan Yang Menyebabkan Korban Meninggal Dunia Perspektif Fiqh JinÂyah“. Al-Jinayah: Jurnal Hukum Pidana Islam 1, Nr. 2 (01.12.2015): 327–35. http://dx.doi.org/10.15642/aj.2015.1.2.327-335.

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Abstract: The Judge’s ruling in the legal decition of the Lamongan District Court No. 164/Pid.B/2013/PN.LMG on the crime of persecution that causes the death of the victim is regarded true since it has been fulfilled all elements as required by Article 351 Paragraph (3) of Criminal Code as indicted by the public prosecutor. In deciding this case, the judge also considered the testimony of witnesses, the information from the defendant, the facts revealed at the hearing as well as the things that burdensome and relieve the defendant. Therefore, the defendant shall be sentenced for 5 months in prison and does not have to go through due to the imposed conditional sentence. In Islamic criminal law, the case is equated with a semi-deliberate murder and sanctioned by diyât and kafârat in the form of ta’zîr. In this case, the defendant can not be punished because of his self-defense. So that the defendant is free from a criminal liability in Islam.Keywords: Persecution, victim died, Islamic law. Abstrak: Putusan hukum hakim Nomor: 164/Pid.B/2013/PN.LMG tentang tindak pidana penganiayaan yang mengakibatkan korban meninggal dunia berdasarkan telah terpenuhinya semua unsur-unsur dari pasal 351 ayat (3) KUHP seperti yang didakwakan oleh jaksa penuntut umum. Dalam memutuskan perkara ini hakim juga mempertimbangkan keterangan saksi, keterangan terdakwa, fakta-fakta yang terungkap di persidangan, serta hal yang memberatkan dan meringankan terdakwa. Oleh karena itu, terdakwa dipidana dengan 5 bulan penjara dan tidak perlu menjalaninya dikarenakan dikenakan hukuman bersyarat. Dalam fiqh jinâyah, perkara ini disamakan dengan pembunuhan semi sengaja. Untuk sanksinya yaitu membayar diyat dan kafârat, sedangkan untuk hukuman penggantinya berupa hukuman ta’zîr. Dalam kasus ini, para terdakwa meskipun telah melakukan perbuatan tersebut, namun tidak bisa dikenakan hukuman tersebut, karena adanya unsur pembelaan diri, sehingga terbebas dari pertanggungjawaban pidana dalam Islam.Kata Kunci: Penganiayaan, meninggal dunia, Hukum Islam.
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Capanna, Maria Vittoria, Saima Ali und Robert Bates. „Reducing admission time to Broadmoor High Secure Hospital – a case review“. BJPsych Open 7, S1 (Juni 2021): S313. http://dx.doi.org/10.1192/bjo.2021.826.

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AimsProlonged waiting times for admission to psychiatric hospital settings are a common and widespread issue. Delayed admissions may result in poorer outcomes due to prolonged mental suffering and delays in initiating treatment. Long waiting times also have a negative impact at a service level, impeding patient flow.National guidance has been recently updated, recommending that patient transfers to secure services take no longer than 28 days from referral. These transfers are frequently affected by delays in admission, possibly resulting in increased risk to patients, staff and the public.The aim of this project was to audit all referrals to Broadmoor High Secure Hospital in England within a one year period with special focus taken on calculating the time taken from referral to admission. We aimed to assess if there were any rate limiting steps which could be targeted to reduce time from referral to admission.MethodWe collected data and conducted a retrospective cohort review for all admissions from September 2019-September 2020. Where available, information was obtained for each step of the referrals process. Individual patient records were reviewed where required.Exclusion criteria: data withdrawn, transfers from other high secure services (HSS), incomplete data, “MOJ instruction” or urgent admission bypassing the process.Result18 cases were excluded as per exclusion criteria. 46 patients were included in the study. 16 referrals originated from medium secure psychiatric hospitals, and 30 from prison.The average time from referral to admission was 44.3 days. Admission of patients from MSUs was quicker, taking an average of 40.3 days when compared to prison referrals, which took 45.9 days.The breakdown of timings for each step in the referrals process was calculated to determine if a rate limiting step could be identified.On average it took 2.1 working days to allocate a case to a clinician, 7.6 days for an assessment, 9.2 days to complete a report and 3.5 days to submit this to the admissions panel. The mean time from referral to the date of the panel hearing was 22.5 working days, and admission took a further 21.8 days on average.ConclusionThe current average time to admission exceeds the new 28 day recommendation. This could both be due to the COVID-19 pandemic, and miscommunication about time targets. We will review the process and aim to reduce the time from referral to admission in line with new guidance.
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Oettmeier, Katrin, und Erik Hofmann. „Impact of additive manufacturing technology adoption on supply chain management processes and components“. Journal of Manufacturing Technology Management 27, Nr. 7 (05.09.2016): 944–68. http://dx.doi.org/10.1108/jmtm-12-2015-0113.

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Purpose The purpose of this paper is to provide a systematic analysis about the effects of additive manufacturing (AM) technology adoption on supply chain management (SCM) processes and SCM components in an engineer-to-order environment. Design/methodology/approach Based on two explorative case studies from the hearing systems industry, the impact of AM technology adoption on SCM processes and SCM components is investigated. General systems theory and the contingency approach serve as theoretical underpinning. Findings Not only the internal processes and management activities, e.g. in manufacturing and order fulfillment, of producers are affected by a changeover to AM, but also the SCM processes and components relating to the supply and demand side of a firm’s supply chain. Endogenous and AM technology-related factors are contingency factors that help to explain differing effects of AM technology adoption on SCM processes and SCM components. Research limitations/implications It is proposed that AM’s ability to economically build custom products provides the potential to alleviate the common dilemma between product variety and scale economies. Practical implications Manufacturing firms are encouraged to consider the potential effects of AM on SCM processes and SCM components when deciding whether to adopt AM technologies in the production of industrial parts. Originality/value The research adds to the widely unexplored effects that AM technology usage in customized parts production has on SCM processes and components. Moreover, the general lack of case studies analyzing the implications of AM technology adoption from a supply chain perspective is addressed. The resulting propositions may serve as a starting point for further research on the impact of AM in engineer-to-order supply chains.
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Samaddar, Saikat, Arup Chakraborty, Sangita Bhattacharya Samaddar, Arista Lahiri und Saumendra Nath Bandyopadhyay. „Formal education about hygienic aural care and the relationship between aural hygiene awareness and practices: a cross-sectional study from a super-speciality hospital in West Bengal, India“. International Journal Of Community Medicine And Public Health 6, Nr. 8 (26.07.2019): 3298. http://dx.doi.org/10.18203/2394-6040.ijcmph20193444.

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Background: The result of poor ear care and hygiene behaviours are often encountered in otology practice. There is also lack of any proper guideline of hygienic ear care behaviours. The present study aims to assess the awareness and practice of hygienic ear care behaviours of the community, in the light of the guidelines as per WHO Primary Ear and Hearing Care Training Resources-Basic level.Methods: A cross-sectional descriptive study was conducted at Baruipur Sub-Divisional Hospital serving semi urban population of South 24 Parganas, West Bengal, India. Patients and parents (in case of children below the age of six years) were interviewed. Maintaining the inclusion and exclusion criteria after obtaining informed consent 480 participants were included in the study who responded to a validated self-reported semi structured questionnaire.Results: The mean age was 32.44 (±18.95) years. Around 51.3% were male, 81.25% were professionals. Majority belonged to nuclear family (52.083%) and Islam (53.333%). Around 88.958% of the population had practice of ear care behaviour which was poor. Joint family had an odds of 2.86 (p value=0.002) and Islam by religion had an odds of 1.99 (p value=0.044) for a higher level of awareness. Educated group had an odds of 4.07 (p<0.001) for higher awareness. Aware group had an odds of 19.95 (p<0.001) in favour of having hygienic ear care practices.Conclusions: The study demonstrated lack of formal education regarding ear hygiene at the community level. Dearth in formal knowledge leading to poor practices is compounded with several socio-cultural issues.
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Sawalha, Z., und T. Sayed. „Traffic accident modeling: some statistical issues“. Canadian Journal of Civil Engineering 33, Nr. 9 (01.09.2006): 1115–24. http://dx.doi.org/10.1139/l06-056.

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Accident prediction models are invaluable tools that have many applications in road safety analysis. However, there are certain statistical issues related to accident modeling that either deserve further attention or have not been dealt with adequately in the road safety literature. This paper discusses and illustrates how to deal with two statistical issues related to modeling accidents using Poisson and negative binomial regression. The first issue is that of model building or deciding which explanatory variables to include in an accident prediction model. The study differentiates between applications for which it is advisable to avoid model over-fitting and other applications for which it is desirable to fit the model to the data as closely as possible. It then suggests procedures for developing parsimonious models, i.e., models that are not over-fitted, and best-fit models. The second issue discussed in the paper is that of outlier analysis. The study suggests a procedure for the identification and exclusion of extremely influential outliers from the development of Poisson and negative binomial regression models. The procedures suggested for model building and conducting outlier analysis are more straightforward to apply in the case of Poisson regression models because of an added complexity presented by the shape parameter of the negative binomial distribution. The paper, therefore, presents flowcharts detailing the application of the procedures when modeling is carried out using negative binomial regression. The described procedures are then applied in the development of negative binomial accident prediction models for the urban arterials of the cities of Vancouver and Richmond located in the province of British Columbia, Canada. Key words: accident prediction models, overfitting, parsimony, outlier analysis, Poisson regression, negative binomial regression.
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Severo Rocha, Leonel, und Fernando Tonet Silva. „Por quem cantam as sereias de Homero e o paradoxo sistêmico da decisão“. Revista da Faculdade de Direito da UFG 42, Nr. 1 (20.06.2018): 129–44. http://dx.doi.org/10.5216/rfd.v42i1.44118.

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Resumo: Toda decisão judicial sobre casos difíceis, passa por uma elevada construção interpretativa. Sob um olhar sistêmico, a operatividade do sistema jurídico só pode ser observada se mantida sua integridade, ou seja, por seus próprios códigos. Quando Ulisses busca uma solução para salvar sua vida e de seus grumetes, mantém a estrutura, porém, faz uma decisão através de uma dupla observação: decidir salvar a vida de todos, porém, buscando fundamentos distintos, enquanto uns perdem, momentaneamente, o sentido da audição; Ulisses decide escutar as sereias. A decisão corresponde aos complexos casos, onde mesmo sem o canto das sereias (norma), o caso deve ser resolvido. Nesse sentido, é analisado o acórdão da 7ª Câmara Cível do TJRS, na Apelação nº 70005798004/2003, onde foi discutida a partilha de bens e direitos sucessórios de um genro infiel. O paradoxo apresentado representa o grande santuário da teoria sistêmica e a necessidade de decisão dos Tribunais. Abstract: Every court decision on hard cases goes through a high interpretive construction. From a systemic perspective, the operability of the legal system can only be observed if maintained their integrity, i.e. their own codes. When Ulysses seeks a solution to save your life and his cabin-cleaning boys, he maintains the structure, however, decides by a double observation: deciding to save everyone’s lives, however, looking for different reasoning basis, while some lose, briefly, their hearing; Ulysses decides to listen to the mermaids. The decision corresponds to the complex cases where even without the mermaid’s singing (norm), the case should be solved. Therefore, the 7th Civil Chamber’s decision in Appeal No. 70005798004/2003, where there has been discussed the sharing of inheritance and property rights of an unfaithful son-in-law, is analyzed. The presented paradox represents the great sanctuary of systems theory and the need for decisions from courts.
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Shaffer, Amber D., Matthew D. Ford, Joseph E. Losee, Jesse Goldstein, Bernard J. Costello, Lorelei J. Grunwaldt und Noel Jabbour. „The Association Between Age at Palatoplasty and Speech and Language Outcomes in Children With Cleft Palate: An Observational Chart Review Study“. Cleft Palate-Craniofacial Journal 57, Nr. 2 (24.10.2019): 148–60. http://dx.doi.org/10.1177/1055665619882566.

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Objective: To determine whether timing of palatoplasty (early, standard, or late) is associated with speech and language outcomes in children with cleft palate. Design: Retrospective case series. Setting: Tertiary care children’s hospital. Participants: Records from 733 children born between 2005 and 2015 and treated at the Cleft Craniofacial Clinic of a tertiary children’s hospital were retrospectively reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, syndromes, staged palatoplasty, and introduction to clinic after 12 months of age. Data from 232 children with cleft palate ± cleft lip were analyzed. Interventions: Palatoplasty. Main Outcome Measures: Speech/language delays and disorders at 20 months and 5 years of age based on formal hospital or community-based testing or screening evaluation in the Cleft Craniofacial Clinic; additional speech surgery. Results: Median age at palatoplasty was 12.6 months (range: 8.8-21.9 months). Age at palatoplasty was classified as early (<11 months, n = 28), standard (11-13 months, n = 158), or late (>13 months, n = 46). Late palatoplasty was associated with increased odds of speech/language delays and speech therapy at 20 months, and language delays at 5 years, compared with standard or early palatoplasty ( P < .05 for all comparisons). However, speech sound production disorders, velopharyngeal incompetence, tube replacement, and hearing loss were not significantly associated with age at palatoplasty. Conclusions: Late palatoplasty may be associated with short- and long-term delays in speech/language development. Future studies with standardized surgical technique/timing and outcome measures are required to more definitively describe the impact of age at palatoplasty on speech/language development.
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Nassani, Najib Antoine, Sassine Ghanem, Elie Kassouf, Lana El Osta, Fadi El Karak und Marwan Ghosn. „The ability of physical performance test and Karnofsky performance status to identify elderly cancer patients requiring a comprehensive geriatric assessment: A comparative study.“ Journal of Clinical Oncology 31, Nr. 15_suppl (20.05.2013): e20534-e20534. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20534.

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e20534 Background: The role of Physical Performance Test (PPT) as a screening tool for patients in geriatric oncology requiring a Comprehensive Geriatric Assessment (CGA) has not been studied so far. We undergo this study to assess PPT as a screening tool in comparison with Karnofsky Performance Status (KPS) and CGA. Methods: One hundred patients, aged ≥ 70 and diagnosed with cancer participated in our study. Inclusion criteria were knowledge of Arabic, French or English and absence of significant cognitive impairment. Exclusion criteria were: KPS<60% or severe medical condition. ROC curves were used to compare PPT and KPS in identifying ≥ 2 impairments on CGA. Results: Median age was 76 years (70 – 89). Most frequent malignancies were: Lung (19%), colo-rectum (16%), and breast (15%). Stage IV was present in half of patients. Patients were at increased risk of malnutrition (46%) and malnourished (15%), had moderate to severe pain uncontrolled by medication (41%), were at risk of falls (42%), were suffering from frequent sleeping problems (43%), had vision (56%) and hearing (36%) impairment, have had urinary incontinence within one year (21%). All had social support in case of emergency. Cardiovascular (67%), diabetes mellitus (30%) and pulmonary (26%) were the most frequent comorbidities. A remarkable prevalence of geriatric problems was noted with 69% having ≥ 2 impairments on CGA. A good correlation existed between KPS and PPT r = 0.68 (p<.0001). PPT (Se=65%, Sp=84%, PPV=90%, NPV=52%, cut-off ≤24) was equivalent to KPS (Se=65%, Sp=81%, PPV=88%, NPV=51%, cut-off ≤80%) in identifying ≥ 2 impairments on CGA. Conclusions: Patients aged ≥ 70, diagnosed with cancer and having a KPS ≤ 80% or a PPT ≤ 24 must be referred to specialists in geriatric oncology or to geriatricians for a thorough assessment.
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Dimaguila, Gerardo Aniano C., Nixon S. See und Francisco A. Victoria. „Surgical Management of Chronic Suppurative Otitis Media with Intracranial Complications“. Philippine Journal of Otolaryngology-Head and Neck Surgery 27, Nr. 2 (03.12.2012): 32–34. http://dx.doi.org/10.32412/pjohns.v27i2.539.

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Intracranial abscess is a serious, life-threatening condition with a dire prognosis. Although the advent of the antibiotic era has drastically reduced the incidence of the disease, predisposing factors such as untreated ear infections, poor personal hygiene, significant trauma with violation of the sterile cranial environment as well as existing co-morbidities such as an immunocompromised state make intracranial abscess a horrifying reality. Ear infections, in particular, are notorious for being the origin of roughly 50% of cerebellar abscesses.1 Chronic suppurative otitis media (CSOM) is one of the leading causes of brain abscess. Shaw and Russell2 reviewed 47 cases of cerebellar abscess and showed that 93% were caused by CSOM; the most common mechanism of entry into the brain parenchyma being direct extension. Chronic infection in the middle ear space could erode through the tegmen tympani and into the temporal lobe or through the tegmen mastoidei into the cerebellum. Neurological symptoms may be delayed as the abscess ‘grows’ in areas around the cerebellum that are regarded as ‘silent’, until vital areas such as those responsible for coordination and balance are violated. We describe a case of cerebellar abscess secondary to CSOM and discuss the possibility of performing ear surgery with simultaneous drainage of a contiguous abscess through a transmastoid approach in cases of chronic suppurative otitis media with intracranial complications. CASE REPORT A 21-year-old man consulted with a chief complaint of headache. The history started 13 years prior to consult, when at the age of 8, he developed ear pain with ear discharge. Since then, ear discharge recurred around 4-5 times a year despite various medications prescribed by different physicians. Each time, an ENT specialty consultation was advised but not availed of. 1 month prior to admission, the patient consulted a physician for recurrent temporal headaches radiating to the periorbital area and described as sometimes crushing, sometimes throbbing, with VAS pain scale 5/10 and associated with nausea. There was also pain in both ears and purulent, foul smelling discharge from the left ear associated with decreased hearing. Unrecalled medications were again prescribed and he was sent home with an ENT specialist referral which he did not comply with. Two weeks prior to admission, the headache grew worse, 8-9/10 on the pain scale with persistent nausea and progressive hearing loss on the left ear despite the unrecalled medications. One week prior to admission, the intolerable condition prompted an ENT specialist consult and diagnosis of chronic suppurative otitis media, AS and chronic otitis media, AD. Cefuroxime 500mg tab every 8 hours, celecoxib 200mg tab every 12 hours and ofloxacin otic drops every 8 hours were started and hospital admission was advised but initially refused. A temporal bone CT scan showed a large cholesteatoma with destruction of the posterior wall of the left mastoid and probable intracranial extension. (Figure 1) The patient then consented to admission. On the day of admission, he now had severe headache, dizziness and occasional vomiting. No neurologic symptoms such as facial asymmetry, lagopthalmos, or paresthesias were reported. A cerebellar abscess was entertained. On the 2nd hospital day, the patient’s neurologic status started to deteriorate with moments of agitation and combative behavior interspersed with drowsiness and lucid behavior. His blood pressure also started to increase from 110/80 on admission to 160/110. Magnetic Resosnance Imaging (MRI) revealed a rim-enhancing destructive lesion in the left mastoid and a left cerebellar abscess. (Figure 2) On the 3rd hospital day, he showed signs of neurologic deterioration despite aggressive medical management, but we opted to continue temporizing rather than risk worsening the situation by performing mastoidectomy alone without the availability of the neurosurgery service. On the 5th hospital day, emergency burr holes with left lateral occipital craniectomy and aspiration of abscess was performed with radical mastoidectomy and meatoplasty, AS. He was discharged improved on the 9th hospital day (4th post-operative day). DISCUSSION A common dictum in our institution about the management of chronic suppurative otitis media (CSOM) with extra- or intra- cranial complications is, ‘never let the sun set without performing ear surgery on the patient.’ Our patient presented at the emergency room with warning signs of an intracranial extension of the ear infection. The frequent headaches and vomiting probably indicated an increase in intracranial pressure. The patient’s deteriorating neurologic status with moments of agitation and combative behavior interspersed with drowsiness and lucid behavior and increasing blood pressure by the second hospital day were further signs of increased intracranial pressure. A cerebellar abscess was confirmed on MRI. Deciding that the risks of herniation and further damage were far greater than potential benefits of performing mastoidectomy alone without aspiration of the cerebellar abscess, we opted to wait until simultaneous left lateral occipital craniectomy and aspiration of abscess could be performed with the mastoidectomy and meatoplasty. A review of the literature shows authors advocating neurosurgery first then performing ear surgery after the patient has been stabilized. This has been emphasized time and again by Shaw and Russel.2 Through the years, the practice has slowly shifted to performing simultaneous neurosurgery and mastoidectomy. Richter et al.3 reported a case of a 39-year-old male diagnosed with otogenic cerebellar abscess surgically managed by performing craniectomy and mastoidectomy together. Other physicians also reported favorable outcomes for concomitant craniectomy and mastoidectomy, including Garayev et al.4 and Kurien et al.5 Another shift in surgical practice advocates evacuation of the brain abscess via a transtemporal approach. Penido Nde et al.6 reported favorable results for 10 patients in whom the brain abscess was drained through open mastoidectomy out of 33 patients with otogenic brain abscess over 15 years. In 2010, Alaani et al.7 reported a series of seven patients where a transtemporal approach to otogenic brain abscess was employed. In all cases, the abscess and ear pathology were successfully treated using a single-stage transmastoid approach. These experiences all show that mastoidectomy and drainage of brain abscess could be done safely together with little risk. In the overall management of patients it is also wise to consider the economic aspects of treating disease. If shorter hospital stays can be attained by alternative methods with the same favorable outcomes as gained by usual practices, it may be time to consider new management approaches. The benefits of waiting for a neurosurgeon versus the risks of evacuating the abscess through a transtemporal approach should be weighed in emergent situations. Based on the current literature, a transtemporal approach to the evacuation of a brain abscess can be performed in the absence of a neurosurgeon but prudence would dictate that a neurosurgical evaluation should be undertaken if readily available.
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Machura, Stefan. „Understanding the German Mixed Tribunal“. Zeitschrift für Rechtssoziologie 36, Nr. 2 (01.01.2016). http://dx.doi.org/10.1515/zfrs-2016-0022.

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Abstract:Germany employs mixed tribunals in a number of its courts, including the criminal, administrative and labour courts. They are markedly different from courts with juries, which separate the professional judge from the lay jury. In a mixed tribunal a professional judge presides over the hearing and deliberation. Side judges, usually the lay assessors, sometimes supplemented by further professional judges, have equal rights when it comes to selecting the legal rules to be applied, making procedural decisions during the hearing, and deciding on the case outcome. Lay members of a mixed court serve for several years, and hear a multitude of cases: they build up experience. Compared to jury courts, mixed courts are more affordable, and able to deal with a larger number of cases.#abs#Mixed courts vary as regards the qualifications required by lay judges. Some courts (e.g. labour and – sometimes – youth criminal courts) employ expert lay judges. Depending on their personality, presiding judges – in whatever kind of tribunal – may dominate their professional colleagues and also lay judges. This is one of the factors endangering the effective participation of lay assessors. Another factor is the drive to settle cases quickly, which tends to curtail or prevent deliberation. While there are deeply engaged honorary judges, others with different personality traits prefer to keep a low profile. This said, empirical research indicates that lay judges are more engaged, if their concern for procedural fairness and justice is aroused in the course of a trial.
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Ribeiro, Georgea Espindola, und Daniela Polo Camargo da Silva. „Audiological implications of COVID-19: an integrative literature review“. Revista CEFAC 23, Nr. 1 (2021). http://dx.doi.org/10.1590/1982-0216/20212319620.

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ABSTRACT Purpose: to survey the national and international literature on the impacts of the coronavirus infection on the auditory system. Methods: an integrative review with search in the BIREME, PubMed, Scopus, and Web of Sciences databases. Inclusion criteria: articles in Portuguese and English whose subject was the coronavirus infection and its effects on the auditory system. Exclusion criteria: information from books and/or chapters, letters to editors, review articles, experience reports. The search strategy was based on the following combined descriptors, respectively in Portuguese and English: “Infecções por coronavírus”, “Audição”, “Perda auditiva”, “Coronavirus infections”, “Hearing”, “Hearing Loss”. Results: out of 43 articles found, two approached the issue. The first study assessed 20 patients that tested positive for COVID-19, though asymptomatic, who underwent pure-tone threshold audiometry and otoacoustic emissions. A significant increase in the auditory thresholds at high frequencies and a smaller response amplitude in the transient evoked otoacoustic emissions of those who tested positive for COVID-19 were observed when compared to that of controls. The second study reported the case of an asymptomatic 35-year-old COVID-19 female patient, who complained of otalgia and tinnitus, after being contaminated. The pure-tone threshold audiometry and tympanometry indicated mild unilateral (right ear) conductive hearing loss, with a type B tympanometric curve on that side. Conclusion: the studies included in this review showed different consequences of COVID-19 on hearing, with possible impairments on the sensory and mechanical structures of the auditory system. The knowledge of COVID-19 is limited, and further studies on its real impact on the auditory system are necessary.
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Orzan, Eva, Giulia Pizzamiglio, Massimo Gregori, Raffaella Marchi, Lucio Torelli und Enrico Muzzi. „Correlation of cochlear aperture stenosis with cochlear nerve deficiency in congenital unilateral hearing loss and prognostic relevance for cochlear implantation“. Scientific Reports 11, Nr. 1 (08.02.2021). http://dx.doi.org/10.1038/s41598-021-82818-9.

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AbstractThe use of neonatal hearing screening has enabled the identification of congenital unilateral sensorineural hearing loss (USNHL) immediately after birth, and today there are several intervention options available to minimize potential adverse effects of this disease, including cochlear implantation. This study aims to analyze the characteristics of the inner ear of a homogeneous group of congenital non-syndromic USNHL to highlight the features of the inner ear, which can help in clinical, surgical, and rehabilitative decision-making. A retrospective chart review was carried out at a tertiary referral center. Systematic diagnostic work-up and rigorous inclusion–exclusion criteria were applied to 126 children with unilateral hearing impairment, leading to a selection of 39 strictly congenital and non-syndromic USNHL cases, undergoing computed tomography (CT) and magnetic resonance (MR) imaging studies. The frequency and type of malformations of the inner ear in USNHL and unaffected contralateral ears were assessed, with an in-depth analysis of the deficiency of the cochlear nerve (CND), the internal auditory canal (IAC) and the cochlear aperture (CA). Inner ear anomalies were found in 18 out of 39 (46%) of the USNHL patients. In 1 subject, the anomalies were bilateral, and the CND resulted in the predominant identified defect (78% of our abnormal case series), frequently associated with CA stenosis. Only 3 out of 14 children with CND presented stenosis of the IAC. CND and CA stenosis (and to a much lesser extent IAC stenosis) are a frequent association within congenital and non-syndromic USNHL that could represent a distinct pathological entity affecting otherwise healthy infants. In the context of a diagnostic work-up, the evaluation with CT and MRI measurements should take place in a shared decision-making setting with thorough counseling. Both imaging techniques have proven useful in differentiating the cases that will most likely benefit from the cochlear implant, from those with potentially poor implant performance.
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„Serum Procalcitonin and C Reactive Protein in as early markers neonatal sepsis- A prospective study“. PERSPECTIVES IN MEDICAL RESEARCH 8, Nr. 2 (16.11.2020): 73–77. http://dx.doi.org/10.47799/pimr.0802.16.

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Neonatal sepsis is one of the commonest causes of morbidity and mortality in neonates in India compared to the developed countries. Aim: To evaluate the Procalcitonin level this is an early marker in the diagnosis of neonatal sepsis and to assess the suitability of this test in the diagnosis of early-onset sepsis. Method: The prospective study was conducted in the Neonatal Division of Department of Pediatrics, Prathima Institute of Medical Sciences over a period of one year. The blood samples from 100 babies meeting the inclusion and exclusion criteria constituted the material for study. Result: Among the n=100 cases n=39 were procalcitonin positive, compared with gestational age 10 (43.5%) cases were positive with a gestation of <37 weeks and 24 (31.2%) cases positive of cases >37 weeks and there was no statistical significance concerning gestational age the association of material characteristics with procalcitonin positive and CRP positive levels. Blood culture was positive in n=9 (9%) of babies with (90% CI, 5.3-14.9) and negative in n=91 (91%) of babies with (90% CI, 85.2-94.7). Conclusion: A positive blood culture is the only definitive and gold standard for confirming a case of sepsis. Since the culture and sensitivity test requires a minimum period of 48 hours which is a precious time in deciding on the treatment of sepsis in the newborn. Rapid diagnosis by using Procalcitonin and CRP gives a reasonable degree of accuracy in diagnosing neonatal sepsis and will also guide antibiotic therapy. Procalcitonin in comparison with CRP has better sensitivity and hence can detect most cases of neonatal sepsis and better negative predictive value.
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Teyateeti, Achiraya, Christopher S. Graffeo, Avital Perry, Eric J. Tryggestad, Paul D. Brown, Bruce E. Pollock und Michael J. Link. „The Effect of Prescription Isodose Variation on Tumor Control and Toxicities in Stereotactic Radiosurgery for Sporadic Vestibular Schwannoma: Propensity Score-Matched Case–Control Study“. Journal of Neurological Surgery Part B: Skull Base, 18.02.2021. http://dx.doi.org/10.1055/s-0040-1718908.

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Abstract Objective Vestibular schwannoma (VS) treated with Gamma Knife stereotactic radiosurgery (SRS) was typically performed at 50% isodose line (IDL50); however, the impact of IDL variation on outcomes is poorly understood. This study aimed to compare tumor control (TC) and toxicities between treatment at 40% (IDL40) and 50% (IDL50). Methods and Materials Sporadic/unilateral VS patients treated with SRS dose 12 to 14 Gy and prescription isodose volume ≤10cm3 were included. Propensity score matching was applied to IDL40 cohort to generate an IDL50 companion cohort, adjusting for age and prescription isodose volume. After exclusion of patients with follow-up <24 months, there were 30 and 28 patients in IDL40 and IDL50 cohorts, respectively. Results Median follow-up time was 96 months (24–225 months). Actuarial and radiographic TC rates were 91.8% and clinical TC was 96.2% both at 5 and 10 years. TC was higher in IDL40 cohort but not significant (96.4 vs. 86.7%; p = 0.243). Hearing preservation (HP) rates were 71.9 and 39.2% at 5- and 10-year intervals, with significantly higher rates of HP noted in IDL40 cohort (83.3 vs. 57.1% at 5-year interval; 62.5 vs. 11.4% at 10-year interval; p = 0.017). Permanent facial neuropathy occurred in two patients, both from the IDL50 cohort (3.5%). Rates of post-SRS steroid treatment or shunt placement for hydrocephalus were slightly higher in IDL50 patients (6.9 vs. 17.9%; p = 0.208 and 3.3 vs. 7.1%; p = 0.532). Conclusion For treatment of VS with SRS, dose prescription at IDL40 or IDL50 provides excellent long-term TC and toxicity profiles. IDL40 may be associated with improved long-term HP.
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Korte, Jessica Lauren. „The Supportive Roles of Adults in Designing with Young Deaf Children“. Journal of Community Informatics 14, Nr. 1 (07.11.2018). http://dx.doi.org/10.15353/joci.v14i1.3404.

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Involving users in the research and design of new technologies is particularly relevant for groups affected by digital exclusion and lacking in cultural power, such as people with disabilities, people from cultural minorities, and children. Design with young Deaf children lies at the intersection of these three groups, as the medical community defines physical deafness as a disability; Deaf communities around the world identify as minority cultural groups with their own languages; and young children traditionally lack power in interactions with adults. Deaf children bring particular needs, abilities and experiences related to their youth, physical deafness and cultural Deafness to the technology design process, making their involvement in design vital. Their involvement presents a unique set of challenges and ethical considerations, including matters of consent and behaviour management. Adult involvement in supportive roles can facilitate young Deaf children’s involvement in design activities and address some of the challenges of designing with Deaf children. This article presents a case study that involved young Australian Deaf children as design partners, with their family members and Deaf and hearing education professionals in supportive roles, for the purpose of providing recommendations to researchers and designers who wish to undertake similar design activities with young Deaf children and supportive adults. The case study involved a series of 30-minute design sessions with four Deaf children (ages 3-5). Reflections on this case study will discuss the roles adult design team members took throughout the design sessions, the benefits and challenges of involving adults as members of design teams with young Deaf children, and ethical considerations to be addressed when designing with young Deaf children in design teams. The article concludes with recommendations for researchers and designers conducting design sessions with young Deaf children and adult supporters, so that young Deaf child designers are well-supported and have the freedom to explore their preferences, desires, requirements, and to contribute to design solutions.
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Collins, Jason M., Alex Reiner, Joann E. Manson, Alexander G. Bick, Pradeep Natarajan, Kathleen M. Hayden, James Stewart et al. „Abstract P451: Aircraft Noise Exposure As A Novel Risk Factor For Clonal Hematopoiesis Of Indeterminate Potential“. Circulation 141, Suppl_1 (03.03.2020). http://dx.doi.org/10.1161/circ.141.suppl_1.p451.

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Background: Although the etiology of clonal hematopoiesis of indeterminate potential (CHIP) remains unclear, CHIP-defining somatic mutations within hematopoietic stem cells appear to expand peripheral blood leukocyte populations, promote inflammation, and thereby increase cardiovascular disease (CVD) risk. Moreover, high noise exposures have been linked to chromosomal aberrations in bone marrow and DNA repair in peripheral blood leukocytes. We therefore examined the potential of aircraft noise exposure as a novel risk factor for CHIP. Methods: We leveraged cross-sectional data on 10,050 postmenopausal women without prior hematologic malignancy in a Women’s Health Initiative (WHI) ancillary study of 5,309 women with stroke and/or venous thromboembolic disease and 4,741 controls. We ascertained CHIP using Trans-Omics for Precision Medicine (TOPMed) whole-genome sequencing data, the GATK Mu TECT2 somatic variant caller, a pre-specified list of leukemogenic driver mutations in 74 genes, and a threshold variant allele frequency of > 0.02. In cooperation with the Federal Aviation Administration, we generated day-night-level (DNL) noise contours around 90 major U.S. airports using the Aviation Environmental Design Tool noise modelling software. The DNL imposes a penalty for nighttime noise exposure and is the primary means for assessing and regulating noise exposure in the U.S. We estimated geocoded participant address-specific, annual average DNL aircraft noise exposures in decibels (dB) from the contours on the day of blood draw and categorized individuals as exposed or non-exposed (DNL ≥ or < 45dB). We estimated the noise-related risk of CHIP as an odds ratio, 95% confidence interval (OR, 95% CI) using logistic regression before and after adjustment for age, race / ethnicity, case-control status, smoking, alcohol use, body mass index, physical activity, hearing loss, education, and neighborhood socioeconomic status. Results: Among this population of postmenopausal women (Mean age: 68.7 years; White: 82.1%; African American: 12.3%), 19.4% were exposed to aircraft noise, and 8.4% had CHIP. The age-adjusted CHIP proportion was higher among whites (8.1%) than African Americans (7.3%) and other racial/ethnic groups (6.4%). CHIP was also more common among women aged ≥ 70 years (11.5%) than those aged 60-69 years (7.5%) or 50-59 years (3.8%). Compared to non-exposed women, those exposed to aircraft noise were not at increased risk of CHIP: OR unadjusted (95% CI) = 0.95 (0.80, 1.14) and OR adjusted (95% CI) = 0.97 (0.81, 1.16). Results were insensitive to dichotomization of noise exposure at 55 dB and further exclusion of women with hearing loss. Conclusion: Our study found no evidence of an association between aircraft noise and CHIP suggesting that aircraft noise may not be a factor contributing to CHIP-defining somatic mutations linked to CVD.
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McDonald, Donna, und Liz Ferrier. „A Deaf Knowingness“. M/C Journal 13, Nr. 3 (28.06.2010). http://dx.doi.org/10.5204/mcj.272.

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Introduction: How Do We Learn What We Know? “Deaf.” How do we learn what we know about being deaf and about deafness? What’s the difference between “being deaf” and “deafness” as a particular kind of (non) hearing? Which would you rather be, deaf or blind: children commonly ask this question as they make their early forays into imagining the lives of people different from them. Hearing people cannot know what it is like to be deaf, just as deaf people cannot know what it is like to hear ... or can they? Finally, how can we tell fresh and authentic stories of “being deaf” and the state of “deafness” that disrupt our familiar—perhaps even caricatured—patterns of understanding? In this special “deaf” edition of M/C Journal we wanted to create a body of work in which deaf writers and thinkers would have their say. Mindful that "Deaf history may be characterized as a struggle for Deaf individuals to 'speak' for themselves rather than to be spoken about in medical and educational discourses" (Bauman 47), we were particularly keen to place the contributions of deaf writers and thinkers alongside the mainstream hearing culture. This is why we have chosen not to identify each writer in this edition as deaf or hearing, preferring to leave that biographical auditory detail to the writers themselves. We already knew that "there isn't a large body of literature about the deaf by the deaf" (Henry Kisor 3). Thomas Couser writes that "this should not be surprising, for a number of factors militate against deaf autobiography ... making them unlikely and rare entities" (226). And so we welcomed the diversity of topics and range of genres to this edition: they included a playful ficto-critical exploration of deafness; personal reflections on deafness (ranging from regarding it as a condition of hearing loss to a state of being); poetry; a filmography; and several fresh analyses of representations of deafness, hearing technology and deaf people’s lives in theatre, film and television (this was a particularly popular theme); the poetics of embodiment (indeed, embodiment was a recurring theme across many of the submissions); a commentary on the role of interpreters in deaf-hearing relationships; and an analysis of the role of the Web 2.0 and other technology in deaf people’s communications. However, we noted that most of the uncommissioned submissions in response to our call for papers came from hearing people. We had to seek out contributions from deaf writers and thinkers and wondered why this was so. Mainstream publication avenues for writing by deaf people on the topic of deafness are rare in Australia: perhaps deaf writers lack the necessary confidence or belief that they would be read? In this edition, they certainly reveal that they have much to say ... and inspire us to lean in and think carefully about their words. A Deaf Knowingness In writing her poem “The Triton”, Sandra Hoopman was inspired by her frequent visits to her deaf grandmother at her old Lambert Street, Kangaroo Point home, where she had a huge triton on her wrought iron veranda. Her grandmother would put the triton up to her ear and show Sandra how to 'listen' to it so that she could ‘hear’ the sea. Her poetry recalls to mind Robert Panara's most-quoted poem, “On His Deafness”, in which he imagined that he might even hear 'the rustle of a star!' Following Sandra Hoopman’s poem, we are pleased to feature the essay “Body Language” by Jessica White, shortlisted for the ABR 2010 Calibre Prize, and Sydney Morning Herald Best Young Novelist for 2008 for her first novel A Curious Intimacy (Penguin 2008). In her essay, Jessica playfully explores the idea of not having a singular fixed identity by traversing a dialogue between the imagination and the character of Jessica, showing different selves at play and in conversation, and again in conversation with others at the ficto-critical room and with the ideas articulated by different authors. As with post-structuralist explorations, the essay emphasises the active and formative nature of language, story and ideas, which help us to deconstruct and reformulate versions of our lives and its possibilities. Play is a device that enables people to move beyond the confines of the social world. The joyful spirit of White’s essay is signalled when she writes: For example, there are still immense possibilities thrown up by theorising a jouissance, or pleasure, in the disabled body. As Susan Wendell points out, “paraplegics and quadriplegics have revolutionary things to teach us about the possibilities of sexuality which contradict patriarchal culture’s obsessions with the genitals” (120). Thus if there were more of a focus on the positive aspects of disability and on promoting the understanding that disability is not about lack, people could see how it fosters creativity and imagination. White’s essay is a ‘picaresque’, following a traveller who narrates her adventures and encounters. It is a wonderful model for narratives of difference as it departs, refreshingly, from mainstream Hollywood-style plot conventions, i.e of progress through conflict towards a climax and resolution. Instead, the picaresque allows for a variety of roles, settings and pathways for the wanderer, multiple characters and illuminating dialogues. It demonstrates literally as well as figuratively, productive encounters with the Other, jolting us into new understandings, ways of knowing and possibilities of being. In this way, White’s essay “Body Language” sets a thematically rich tone for this special “deaf” issue of M/C Journal. Through her essay and the following narratives, commentaries, articles and essays, we are immersed in the theme of the importance (and liberating possibilities) of contesting fixed and limited images, disrupting the representations and labels that are so readily assigned to the deaf or deafness. Different strategies and styles are employed, from figurative creative writing or life narrative to the critical essay or media analysis. Yet all contributions emphasise shifting perceptions, commence from a position of not being comfortable with the given representations or ideas that surround deaf identity. The personal narratives and essays assert a strong sense of disjuncture between deaf reality and common representations and ideas of deafness. Reading these contributions, we gain an acute sense of not being at one with the image or idea of a deaf person, not being at one with the social world, not being any one thing but rather many different and varying things and roles. The conditions of possibility are touched upon in the personal reflective pieces, resonating with the critical essays in their exploration of the possibilities of destabilizing hegemonic representations. For example, in “Becoming Deaf”, Karen McQuigg’s personal reflective essay, she describes several stages of the deaf experience. Her description of her son’s responses and adaptations is moving, and Karen mines a range of emotional responses to deafness. She shares with the reader the advice and support she received from other people: some readers will remember with affection the role of Elizabeth Hastings and John Lovett in the Australian Deaf community. McQuigg’s reflections sharply highlight the fluid nature of our individual experience and understanding of deafness. She (and we do too) shifts from what was experienced and understood initially as a blank, a not-comprehending—a ‘blank’ that is linked with loss and constraints, grief, suffering and isolation—to a discovery of how those views and experiences can change, along with changing environment and opportunities. This comes across also in Christy L Reid’s piece “Journey of a Deaf-Blind Woman”: possibilities are linked with where the narrator is living, with life events as varied as training and job opportunities, changes in health, marriage, the birth and development of children, child rearing, and of personal triumphs. Michael Uniacke’s personal essay “Fluid Identities: A Journey of Terminology” has much in common with Jessica White’s essay as he too engages playfully with his ideas. He uses language and figurative play to challenge the reader’s understandings of deaf identity, and to demonstrate the fluid and multiple nature of identity. For example, his opening anecdote about the Hearing Impaired Businessman plays to an embodiment of the idea that many people have, through categories and labels, of a deaf person, as Other, a caricature figure with no interiority or humour or nuanced life. Uniacke engages with this figure in a kind of dialogue, making him surreal, highlighting his typecast nature. By the end of his essay, Michael has shown us how identity can be context-specific and composed of many parts. In “Interpreters in Our Midst”, Breda Carty takes us on a jaunty, personal and engaging commentary that provokes the reader into taking a fresh look at the role of interpreters in mediating/translating relationships between deaf and hearing people. She asks, ‘When interpreters are in our midst, whose interests are they representing? And why are those interests not always clear to the observer?’ Originally written as a short piece for the Australian Sign Language Interpreters' Association (ASLIA), the article is informed by Breda’s immersion in particular professional and personal communities and experiences. While the tone of her commentary is light-hearted, using film screen representations of interpreters to illustrate her points, Breda nevertheless succeeds in politicizing the subject of interpretation and interpreters. She makes us aware of the social assumptions and hierarchies that structure our understanding of interpreting, which, if left unexamined, might seem a neutral and apolitical practice. Rebecca Sánchez makes an exciting contribution to the field of poetry. In her paper “Hart Crane's Speaking Bodies: New Perspectives on Modernism and Deafness”, Rebecca writes about looking for ideas about deafness in unexpected places, namely the poetry of hearing modernist Hart Crane. Taking up the theme of embodiment, evident in several other papers in this edition, Rebecca offers an interesting connection between a poetics of embodiment—Crane was influenced by Walt Whitman, a trail-blazer in embodied language in American poetry—and the more literal embodiment of manual languages. Although Hart Crane was not writing about deafness per se, his work explores the potential of embodied languages to alter the ways in which we interact with one another. When asked to define deafness, most people’s first response is to think of levels of hearing loss, of deficiency, or disability. By contrast, Crane’s non-literal approach provides a more constructive understanding of what communicative difference can mean, and how it can affect our und,erstanding of language itself. Rebecca’s essay's strength arises from its demonstration of Crane's desire to imagine the possibility of a language that lives within the body as rich and enabling, as are manual languages. Miriam Nathan Lerner’s professional training as a librarian is evident in her filmography “The Narrative Function of Deafness and Deaf Characters in Film”. During 2010, she is collaborating with a technical support faculty member at the Rochester National Technical Institute of the Deaf to design a website with quick-time windows so that the reader can click on and watch film clips of the works she references in her filmography. A lively, chatty introduction to some forty-three films with deaf characters and deafness, in which she provides her admittedly quirky approach to categorisation, Miriam Lerner’s filmography will one day be recognised in the same breath as Jonathon Miller’s “Rustle of a Star: An Annotated Bibliography of Deaf Characters in Fiction.” (Miller was also a librarian: they obviously possess the requisite skills of categorisation!) Pamela Kincheloe’s article “Do Androids Dream of Electric Speech? The Construction of Cochlear Implant Identity on American Television and the ‘New Deaf Cyborg’” offers an important analysis of popular (mis)conceptions of deafness and ‘assistive technologies’ as is evident from American television representations of deaf people with Cochlear Implants. She notes the prevalence of cochlear implants in television drama, identifies a couple of very limited narrative frames that dominate such representations, and discusses their implications. In her discussion of the ‘abject’ horror associated in television series with the cochlear implant recipient (often already a corpse) Kincheloe asserts that the Cochlear Implant technology is increasingly used in such narratives to convey intensified anxieties, not only about the deaf Other, but also about technology and the emergent ‘cyborgs’, humans modified by technology. Sharon Pajka-West’s well-researched article “Deaf Characters in Adolescent Fiction”, excerpted from her doctorate thesis, originated in a request from a young deaf reader for a book with which she could connect. Pajka-West takes us on her pursuit to fulfil this request, giving us many fascinating insights along the way. Her blog is essential reading not only for anyone interested in the field of adolescent literature, but also for those who understand the significance of providing young deaf readers access to literature in which the multiple possibilities for deaf lives, deaf identities, and deafness are canvassed. In her article “Marginalising the Mainstream: A Signed Performance of The Miracle Worker”, Caroline Heim places deaf issues centre-stage. Her thesis is that a way needs to be found to increase access to theatrical events for the deaf. She tackles this by viewing a Crossbow Production performance of The Miracle Worker (the story of the teaching relationship between Helen Keller and Annie Sullivan from different perspectives: accessibility, funding, plot construction and actors’ interpretation, the detail of production design (sound, colour and tactile) and the use of theatrical device, and post performance discussion. Arguably, Heim’s article might have benefited from more focus on the concept of inclusion, rather than exclusion. The claim that not enough money is given to providing ‘access’ for the deaf to mainstream productions may be difficult to uphold as a stand-alone argument when the budget of the majority of Australian theatre companies would highlight the fiscal difficulty they have just getting productions on the stage. All the same, Heim’s article provokes us, the reader, into investigating the many layered meanings of ‘access’ and also reminds us, yet again, of theatre’s potential magic in engaging audiences across all spheres of life. In her essay “Looking across the Hearing Line”, Nicole Matthews has written a stimulating paper on youth, Deaf people, and new media. Her paper is especially interesting as an exploration of the intersection between disability and Web 2.0 technologies. In particular, Matthews picks up a thread of Web 2.0 technologies relating to visual communication and expression to provide some insights into the emerging, complex nature of Deaf users’ engagement with digital media in contrast with the continuing problems of inaccessibility and exclusion in the mainstream world. Conclusion: Learning Our Knowingness from What We Don’t Know This special “deaf” issue of M/C Journal is not a “project”, in the Modern sense of that word, i.e. a unified collective effort to define identity, in this case deaf identity, or to consolidate and express a unique world view. Nor does it seek to enlighten the public about what it is to be deaf. Such a totalising project would inevitably suppress heterogeneity and the specificities of people’s lives. Rather, this collection offers many different particular and localised accounts - some personal and poetic, some analytical, some working through critique - which explore the conditions of possibility for human subjects, and in particular, people who are deaf. The contributions highlight in very different ways the complex and shifting fields within which people’s lives and experiences are formed. These works give us insight into the varied and changing social and environmental conditions that not only shape our lives but are in turn shaped by who we are and by our practices and choices. The constraints and possibilities of people’s lives change significantly and differ widely. They are linked inextricably with where people are, in terms of geography or location, and with the circumstances they find themselves in or create for themselves: circumstances of gender, family, social networks, economics, education, work, lifestyle, health or illness, physical abilities, differences and limitations. These works stress the highly contingent nature of human social development and the fluidity of deaf experience rather than identity. Identity shifts and takes on meaning in relation to others and situations; we come to know who we are through a process of differentiating ourselves from others and from identities that we do not feel comfortable with. In almost all of these accounts here experiences of deafness are not the same those conjured up by labels or stereotypes. This act of disassociation from the usual notions of deafness, highlights that our received language and labels do not give us knowledge. Disavowal reminds us that we do not know, except through some disruptive encounter with the Other, whether that is the otherness of our own deafness or the deafness of others. These writings that demonstrate the particularity and detail of deaf people’s experiences, enable us to know the limits and inaccuracies of the labels and identities so commonly assigned to deafness and the deaf. Thus, we come back to the beginning and find our equivocal, tentative answers to the question, ‘how do we learn what we know about being deaf and deafness?’ We learn what we know in various ways, yet hearing or deaf, we are exposed to particular ideas of deafness, limiting labels and assumptions that reinforce ‘ableist’ values. These writings have demonstrated the proliferation of limited stereotypes; they recur in narratives, news stories, television and films, and have power regardless of their disconnection from the real, and from the lived experience of deafness. It is a significant starting point to recognise the limitations of what we think we already know, through our media and social institutions, of deafness. These essays and writings represent a different epistemology; they explore not what deafness is or how it can be defined, but different ways of knowing deafness. References Couser, G. Thomas. “Signs of Life: Deafness and Personal Narrative” Ch. 6 in Recovering Bodies: Illness, Disability, and Life Writing. Wisconsin: University of Wisconsin Press, 1997. Bauman, H-Dirksen L. “Voicing Deaf Identity: Through the ‘I’s’ and Ears of an Other.” In S. Smith, and J. Watson, eds., Getting a Life: Everyday Uses of Autobiography. Minneapolis: University of Minnesota Press, 1989. 47-62. Kisor, Henry. What’s That Pig Outdoors? A Memoir of Deafness. New York: Hill and Wang, 1990.
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Ellis, Katie M., Mike Kent und Kathryn Locke. „Indefinitely beyond Our Reach: The Case for Elevating Audio Description to the Importance of Captions on Australian Television“. M/C Journal 20, Nr. 3 (21.06.2017). http://dx.doi.org/10.5204/mcj.1261.

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IntroductionIn a 2013 press release issued by Blind Citizens Australia, the advocacy group announced they were lodging a human rights complaint against the Australian government and the ABC over the lack of audio description available on the public broadcaster. Audio description is a track of narration included between the lines of dialogue which describes important visual elements of a television show, movie or performance. Audio description is broadly recognised as an essential feature to make television accessible to audiences who are blind or vision impaired (Utray et al.). Indeed, Blind Citizens Australia maintained that audio description was as important as captioning on Australian television:people who are blind have waited too long and are frustrated that audio description on television remains indefinitely beyond our reach. Our Deaf or hearing impaired peers have always seen great commitment from the ABC, but we continue to feel like second class citizens.While audio description as a technology was developed in the 1960s—around the same time as captions (Ellis, “Netflix Closed Captions”)—it is not as widely available on television and access is therefore often considered to be out of reach for this group. As a further comparison, in Australia, while the provision of captions was mandated in the Broadcasting Services Act (BSA) 1992 and television sets had clear Australian standards regarding their capability to display captions, there is no legislation for audio description and no consistency regarding the ability of television sets sold in Australia to display them (Ellis, “Television’s Transition”). While as a technology, audio description is as old as captioning it is not as widely available on television. This is despite the promise of technological advancements to facilitate its availability. For example, Cronin and King predicted that technological change such as the introduction of stereo sound on television would facilitate a more widespread availability of audio description; however, this has not eventuated. Similarly, in the lead up to the transition from analogue to digital broadcasting in Australia, government policy documents predicted a more widespread availability of audio description as a result of increased bandwidth available via digital television (Ellis, “Television’s Transition”). While these predictions paved way for an audio description trial, there has been no amendment to the BSA to mandate its provision.Audio description has been experienced on Australian broadcast television in 2012, but only for a 14-week trial on ABC1. The trial report, and feedback from disability groups, identified several technical impediments and limitations which effected the experience of audio described content during this trial, including: the timing of the trial during a period in which the transition from analogue to digital television was still occurring (creating hardware compatibility issues for some consumers); the limitations of the “ad hoc” approach undertaken by the ABC and manual implementation of audio description; and the need for upgraded digital receivers (ABC “Trial of Audio Description”, 2). While advocacy groups acknowledged the technical complexities involved, the expected stakeholder discussions that were due to be held post-trial, in part to attempt to resolve the issues experienced, were never undertaken. As a result of the lack of subsequent commitments to providing audio description, in 2013 advocacy group Blind Citizens Australia lodged their formal complaints of disability discrimination against the ABC and the Federal Government. Since the 2012 trial on ABC1, the ABC’s catch-up portal iView instigated another audio description trial in 2015. Through the iView trial it was further confirmed that audio description held considerable benefits for people with a vision impairment. They also demonstrated that audio description was technically feasible, with far less ‘technical difficulties’ than the experience of the 2012 broadcast-based trial. Over the 15 month trial on ABC iView 1,305 hours of audio described content was provided and played 158, 277 times across multiple platforms, including iOS, Android, the Freeview app and desktop computers (ABC, “ABC iView Audio Description Trial”).Yet despite repeated audio description trials and the lodgement of discrimination complaints, there remains no audio description on Australian broadcast television. Similarly, whereas 55 per cent of DVDs released in Australia have captions, only 25 per cent include an audio description track (Media Access Australia). At the time of writing, the only audio description available on Australian television is on Netflix Australia, a subscription video on demand provider.This article seeks to highlight the importance of television access for people with disability, with a specific focus on the provision of audio description for people with vision impairments. Research consistently shows that despite being a visual medium, people with vision impairments watch television at least once a day (Cronin and King; Ellis, “Netflix Closed Captions”). However, while television access has been a priority for advocates for people who are Deaf and hard of hearing (Downey), audiences advocating audio description are only recently making gains (Ellis, “Netflix Closed Captions”; Ellis and Kent). These gains are frequently attributed to technological change, particularly the digitisation of television and the introduction of subscription video on demand where users access television content online and are not constrained by broadcast schedules. This transformation of how we access television is also considered in the article, again with a focus on the provision–or lack thereof—of audio description.This article also reports findings of research conducted with Australians with disabilities accessing the emerging video on demand environment in 2016. The survey was run online from January to February 2016. Survey respondents included people with disability, their families, and carers, and were sourced through disability organisations and community groups as well as via disability-focused social media. A total of 145 people completed the survey and 12 people participated in follow-up interviews. Insights were gained into both how people with disability are currently using video on demand and their anticipated usage of services. Of note is that most subscription video on demand services (Netflix Australia, Stan, and Presto) had only been introduced in Australia in the year before the survey being carried out, with only Foxtel Play and Quickflix having been in operation for some time prior to that.Finally, the article ends by looking at past and current advocacy in this area, including a discussion on existing—albeit, to date, limited—political will.Access to Television for People with DisabilitiesTelevision can be disabling in different ways for people with impairments, yet several accessibility features exist to translate information. For example, people who are D/deaf or hard of hearing may require captions, while people with vision impairments prefer to make use of audio description (Alper et al.). Similarly, people with mobility and dexterity impairments found the transition to digital broadcasting difficult, particularly with relation to set top box set up (Carmichael et al.). As Joshua Robare has highlighted, even legislation has generally favoured the inclusion of audiences with hearing impairments, while disregarding those with vision impairments. Similarly, much of the literature in this area focuses on the provision of captions—a vital accessibility feature for people who are D/deaf or hard of hearing. Consequently, research into accessibility to television for a diversity of impairments, going beyond hearing impairments, remains deficient.In a study of Australian audiences with disability conducted between September and November 2013—during the final months of the analogue to digital simulcast period of Australian broadcast television—closed captions, clean audio, and large/colour-coded remote control keys emerged as the most desired access features (see Ellis, “Digital Television Flexibility”). Audio description barely registered in the top five. In a different study conducted two years ago/later, when disabled Australian audiences of video on demand were asked the same question, captions continued to dominate at 63.4 per cent; however, audio description was also seen to be a necessary feature for almost one third of respondents (see Ellis et al., Accessing Subcription Video).Robert Kingett, founder of the Accessible Netflix Project, participated in our research and told us in an interview that video on demand providers treat accessibility as an “afterthought”, particularly for blind people whom most don’t think of as watching television. Yet research dating back to the 1990s shows almost 100 per cent of people with vision impairments watch television at least once a day (Cronin & King). Statistically, the number of Australians who identify as blind or vision impaired is not insignificant. Vision Australia estimates that over 357,000 Australians have a vision impairment, while one in five Australians have a disability of some form. With an ageing population, this number is expected to grow exponentially in the next ten years (Australian Network on Disability). Kingett therefore describes this lack of accessibility as evidence video on demand is “stuck in the dark ages”, and advocates that people with vision impairments do use video on demand and therefore continue to have unmet access needs.Video on Demand—Transforming TelevisionSubscription video on demand services have caused a major shift in the way television is used and consumed in Australia. Prior to 2015, there was a small subscription video on demand industry in this country. However, in 2015, following the launch of Netflix Australia, Stan, and Presto, Australia was described as having entered the “streaming wars” (Tucker) where consumers would benefit from the increased competition. As Netflix gained dominance in the video on demand market internationally, people with disability began to recognise the potential this service could have in transforming their access to television.For example, the growing availability of video on demand services continues to provide disruptive change to the way in which consumers enjoy information and entertainment. While traditional broadcast television has provided great opportunities for participation in news, events, and popular culture, both socially and in the workplace, the move towards video on demand services has seen a notable decline in traditional television viewing habits, with online continuing to increase at the expense of Australian free-to-air programming (C-Scott).For the general population, this always-on, always-available, and always-shareable nature of video on demand means that the experience is both convenient and instant. If a television show is of interest to friends and family, it can be quickly shared through popular social media with others, allowing everyone to join in the experience. For people with disability, the ability to both share and personalise the experience of television is critical to the popularity of video on demand services for this group. This gives them not only the same benefits as others but also ensures that people with disability are not unintentionally excluded from participation—it allows people with disability the choice as to whether or not to join in. However, exclusion from video on demand is a significant concern for people with disability due to the lack of accessibility features in popular subscription services. The lack of captions, audio description, and interfaces that do not comply with international Web accessibility standards are resulting in many people with disability being unable to fully participate in the preferred viewing platforms of family and friends.The impact of this expands beyond the consumption patterns of audiences, shifting the way the audience is defined and conceptualised. With an increasing distribution of audience attention to multiple channels, products, and services, the ability to, and strategies for, acquiring a large audience has changed (Napoli). As audience attention is distributed, it is broken up, into smaller, fragmented groups. The success, therefore, of a new provider may be to amass a large audience through the aggregation of smaller, niche audiences. This theory has significance for consumers who require audio description because they represent a viable target group. In this context, accessibility is reframed as a commercial opportunity rather than a cost (Ellis, “Netflix Closed Captions”).However, what this means for future provision of audio description in Australia is still unclear. Chris Mikul from Media Access Australia, author of Access on Demand, was interviewed as part of this research. He told us that the complete lack of audio description on local video on demand services can be attributed to the lack of Australian legislation requiring it. In an interview as part of this research he explained the central issue with audio description in this country as “the lack of audio description on broadcast TV, which is shocking in a world context”.International providers fare only slightly better. Robert Kingett established the Accessible Netflix Project in 2013 with the stated aim of advocating for the provision of audio description on Netflix. Netflix, despite a lack of a clear accessibility policy, are seen as being in front in terms of overall accessibility—captions are available for most content. However, the provision of audio description was initially not considered to be of such importance, and Netflix were initially against the idea, citing technical difficulties. Nevertheless, in 2015—shortly after their Australian launch—they did eventually introduce audio description on original programming, describing the access feature as an option customers could choose, “just like choosing the soundtrack in a different language” (Wright). However, despite such successful trials, the issue in the Australian market remains the absence of legislation mandating the provision of audio description in Australia and the other video on demand providers have not introduced audio description to compete with Netflix. As the Netflix example illustrates, both legislation and recognition of people with disability as a key audience demographic will result in a more accessible television environment for this group.Currently, it is debatable as to whether this increasingly competitive market, the shifting perception of audience attraction and retention, and the entry of multiple international video on demand providers, has influenced how accessibility is viewed, both for broadcast television and video on demand. Although there is some evidence for an increasing consideration of people with disability as “valid” consumers—take, for example, the iView audio description trial, or the inclusion of audio description by Netflix—our research indicates accessibility is still inconsistently considered, designed for, and applied by current providers.Survey Response: Key Issues Regarding AccessibilityRespondents were asked to provide an overall impression of video on demand services, and to tell us about their positive and negative experiences. Analysis of 68 extended responses, and the responses provided by the interview participants, identified a lack of availability of accessibility features such as audio description as a key problem. What our results indicate is that while customers with a disability are largely accommodating of the inaccessibility of providers—they use their own assistive technology to access content—they are keenly aware of the provisions that could be made. As one respondent put it:they could do a lot better: talking menus, spoken sub titles, and also spoken messages on screen.However, many expressed low expectations due to the continued absence of audio description on broadcast television:so, the other thing is, my expectations are quite low because of years of not having audio descriptions. I have slightly different expectations to other people.This reflection is important in considering both the shifting expectations regarding video on demand providers but also the need for a clear communication of what features are available so that providers can cater to—and therefore capture—niche markets.The survey identified captioning as the main accessibility problem of video on demand services. However, this may not accurately reflect the need for other accessibility features such as audio description. Rather, it may be indicative that this feature is often the only choice given to consumers. As, Chris Mikul identified, “the only disability being catered for to any great extent is deafness/hearing impairment”. Kingett agreed, noting:people who are deaf and hard of hearing are placed way before the rest because captions are beyond easy and cheap to create now. Please, there’s even companies that people use to crowd source captions so companies don’t have to do it anymore. This all came about because the deaf community has [banded] together … to achieve a cause. I know audio description isn’t as cheap to make as captions but, by these companies’ budgets that’s like dropping a penny.Advocacy and Political WillAs noted above, it has been argued by some that accessibility features that address vision impairments have been neglected. The reason behind this is twofold—the perception that this disability is experienced by a minority of the population and that, because blind people “don’t watch television”, it is not an important accessibility feature. This points towards a need for both disability advocacy and political will by politicians to introduce legislation. As one survey respondent identified, the reality is that, in Australia, neither politicians nor people with vision impairments have yet to address the issue on audio description in an organised or sustained way:we have very little audio described content available in Australia. We don’t have the population of blind people nor the political will by politicians to force providers to provide for us.However, Blind Citizens Australia—the coalition of television audiences with vision impairments who lodged the human rights complaint against the government and the ABC—suggest the tide is turning. Whereas advocates for people with vision impairments have traditionally focused on access to the workforce, the issue of television accessibility is increasingly gaining attention, particularly as a result of international activist efforts and the move towards video on demand (see Ellis and Kent).For example, Kingett’s Accessible Netflix Project in the US is considered one of the most successful accessibility movements towards the introduction of audio description. While its members are predominantly US-based, it does include several Australian members and continues to cover Netflix Australia’s stance on audio description, and be covered by Australian media and organisations (including Media Access Australia and Life Hacker). When Netflix launched in Australia, Kingett encouraged Australians to become more involved in the project (Ellis and Kent).However, despite the progress towards mandating of audio description in parliament and the resolution of efforts made by advocacy groups (including Vision Australia and Blind Citizens Australia), the status of audio description remains uncertain. Whilst some support has been gained—specifically through motions made by Senator Siewert and the ABC iView audio description trials—significant change has been slow. For example, conciliation discussions are still ongoing regarding the now four-year-old complaint brought against the ABC and the Federal Government by Blind Citizens Australia. Meanwhile, although the Senate supported Senator Siewert’s motion to change the Broadcasting Services Act to include audio description, the Act has yet to be amended.The results of multiple ABC trials of audio description remain in discussion. Whilst the recently released report on the findings of the April 2015—July 2016 iView trial states that the “trial has identified that those who utilised the audio description service found it a valuable enhancement to their media engagement and their social interactions” (ABC, “ABC iView Audio Description Trial” 18), it also cautioned that “any move to introduce AD services in Australia would have budgetary implications for the broadcasters in a constrained financial environment” and “broader legislative implications” (ABC, “ABC iView Audio Description Trial” 18). Indeed, although the trial was considered “successful”—in that experiences by users were generally positive and the benefits considerable (Media Access Australia, “New Report”)—the continuation of audio description on iView alone was clarified as representing “a systemic failure to provide people who are blind or have low vision with basic access to television now, given that iView is out of reach for many people in the blindness and low vision community” (Media Access Australia, “New Report”). Indeed, the relatively low numbers of plays of audio described content during the trial (158, 277 plays, representing 0.58% of total program plays on iView) were likely a result of a lack of access to smartphones or Internet technology, prohibitive data speeds and/or general Internet costs, all factors which affect the accessibility of video on demand significantly more for people with disability (Ellis et al., “Access for Everyone?”).On a more positive note, the culmination of advocacy pressure, the ABC iView trial, political attention, and increasing academic literature on the accessibility of Australian media has resulted in the establishment of an Audio Description Working Group by the government. This group consists of industry representatives, advocacy group representatives, academics, and “consumer representatives”. The aims of the group are to: identify options to sustainably increase access to audio description services; identify any impediments to the implementation of audio description; provide expert advice on audio description implementation options; and develop a report on the findings due at the end of 2017.ConclusionIn the absence of audio description, people who are blind or vision impaired report a less satisfying television experience (Cronin and King; Kingett). However, with each technological advancement in the delivery of television, from stereo sound to digital television, this group has held hopes for a more accessible experience. The reality, however, has been a continued lack of audio description, particularly in broadcast television.Several commentators have compared the provision of audio description with closed captioning. They find that audio description is not as widely available, and reflect this is likely a result of lack of legislation (Robare; Ellis, “Digital Television Flexibility”)—for example, in the Australian context, whereas the provision of captions is mandated in the Broadcasting Services Act 1992, audio description is not. As a result, there have been limited trials of audio description in this country and inconsistent standards in how to display it. As discussed throughout this paper, people with vision impairments and their allies therefore often draw on the example of the widespread “acceptance” of captions to make the case that audio description should also be more widely available.However, following the introduction of subscription video on demand in Australia, and particularly Netflix, the issue of audio description is receiving greater attention. It has been argued that video on demand has transformed television, particularly the ways in which television is accessed. Video on demand could also potentially transform the way we think about accessibility for audiences with disability. While captions are a well-established accessibility feature facilitating television access for people with a range of disabilities, video on demand is raising the profile of the importance of audio description for audiences with vision impairments.ReferencesABC. “Audio Description Trial on ABC Television: Report to the Minister for Broadband, Communications and the Digital Economy”. Dec. 2012. 8 Apr. 2017 <https://www.communications.gov.au/sites/g/files/net301/f/ABC-Audio-Description-Trial-Report2.pdf>.ABC. “ABC iView Audio Description Trial: Final Report to The Department of Communications and the Arts.” Oct. 2016. 6 Apr. 2017 <https://www.communications.gov.au/documents/final-report-trial-audio-description-abc-iview>.Alper, Meryl, et al. “Reimagining the Good Life with Disability: Communication, New Technology, and Humane Connections.” Communication and the Good Life. Ed. H. Wang. New York: Peter Lang, 2015.Australian Network on Disability. “Disability Statistics.” Mar. 2017. 30 Apr. 2017 <https://www.and.org.au/pages/disability-statistics.html>.Blind Citizens Australia. Government and ABC Fail to Deliver on Accessible TV for Australia’s Blind. Submission. 10 July 2013. 1 May 2017 <http://bca.org.au/submissions/>.C-Scott, Marc. “The Battle for Audiences as Free-TV Viewing Continues Its Decline.” Mumbrella 22 Apr. 2016. 24 May 2016 <https://mumbrella.com.au/the-battle-for-audiences-as-free-tv-viewing-continues-its-decline-362010>.Carmichael, Alex, et al. “Digital Switchover or Digital Divide: A Prognosis for Useable and Accessible Interactive Digital Television in the UK.” Universal Access in the Information Society 4 (2006): 400–16.Cronin, Barry J., and Sharon Robertson King. “The Development of the Descriptive Video Services.” National Center to Improve Practice in Special Education through Technology, Media and Materials. Sep. 1998. 8 May 2014 <https://www2.edc.org/NCIP/library/v&c/Cronin.htm>.Downey, G. “Constructing Closed-Captioning in the Public Interest: From Minority Media Accessibility to Mainstream Educational Technology.” Info 9.2–3 (2007): 69–82.Ellis, Katie. “Digital Television Flexibility: A Survey of Australians with Disability.” Media International Australia 150 (2014): 96.———. “Netflix Closed Captions Offer an Accessible Model for the Streaming Video Industry, But What about Audio Description?” Communication, Politics & Culture 47.3 (2015).———. “Television’s Transition to the Internet: Disability Accessibility and Broadband-Based TV in Australia.” Media International Australia 153 (2014): 53–63.Ellis, Katie, and Mike Kent. “Accessible Television: The New Frontier in Disability Media Studies Brings Together Industry Innovation, Government Legislation and Online Activism.” First Monday 20 (2015). <http://firstmonday.org/ojs/index.php/fm/article/view/6170>.Ellis, Katie, et al. Accessing Subscription Video on Demand: A Study of Disability and Streaming Television in Australia. Australian Communications Consumer Action Network. Aug. 2016. <https://accan.org.au/grants/current-grants/1066-accessing-video-on-demand-a-study-of-disability-and-streaming-television>.Ellis, Katie, et al. “Access for Everyone? Australia’s ‘Streaming Wars’ and Consumers with Disabilities.” Continuum (2017, publication pending).Kingett, Robert. “The Accessible Netflix Project Advocates Taking Steps to Ensure Netflix Accessibility for Everyone.” 2014. 30 Jan. 2014 <https://netflixproject.wordpress.com>.Media Access Australia. “Statistics on DVD Accessibility in Australia.” 2012. 21 Nov. 2014 <https://mediaaccess.org.au/dvds/Statistics%20on%20DVD%20accessibility%20in%20Australia>.———. “New Report on the Trial of A.D. on ABC iView.” 7 Mar. 2017. 30 Apr. 2017 <https://mediaaccess.org.au/latest_news/television/new-report-on-the-trial-of-ad-on-abc-iview>.Napoli, Philip M., ed. Audience Evolution: New Technologies and the Transformation of Media Audiences. New York: Columbia UP, 2011.Robare, Joshua S. “Television for All: Increasing Television Accessibility for the Visually Impaired through the FCC’s Ability to Regulate Video Description Technology.” Federal Communications Law Journal 63.2 (2011): 553–78.Tucker, Harry. “Netflix Leads the Streaming Wars, Followed by Foxtel’s Presto.” News.com.au 24 June 2016. 18 May 2016 <http://www.news.com.au/technology/home-entertainment/tv/netflix-leads-the-streaming-wars-followed-by-foxtels-presto/news-story/7adf45dcd7d9486ff47ec5ea5951287f>.Utray, Francisco, et al. “Monitoring Accessibility Services in Digital Television.” International Journal of Digital Multimedia Broadcasting (2012): 9.
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29

Neilsen, Philip. „An extract from "The Internet of Love"“. M/C Journal 5, Nr. 6 (01.11.2002). http://dx.doi.org/10.5204/mcj.2012.

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There are three stages in internet dating: first, the emailing back and forth; second, the phone conversation; and third, the meeting for 'coffee'. But before we discuss the three stages, here are some hints about the preliminary work you have to do. At the outset, you have to trawl through the thousands of people who have placed their profiles on the site. This is aided by limiting your search to a certain age spread, and your city or region. Then you can narrow it down further by checking educational background, whether they have kids, whether they write in New Age jargon, etc You have to try to assess, from their self-descriptions, which ones are likely to be compatible. You also scrutinise their photos, of course, as they will yours — but don't trust these images entirely — more on that later. Self-description. Almost without exception, women and men who describe their main interests as 'romantic walks on the beach and candle-lit dinners' have no real interests and as much personality as a lettuce. Those who say what matters to them is "good food and wine with a classy guy/lady" have a personality, but it's a repugnant one. Here is a useful binary opposition that could provide a useful key to gauging compatibility: people vary in terms of their degree of interiority and exteriority. People with interiority have the ability to think a little abstractly, can discuss emotions, probably read books as well as watch films. They analyse life rather than just describing it. People mainly given to exteriority find their pleasure in doing things — like boating or nightclubs or golf. They see themselves in the world in a different way. Of course, we are all a mixture of the two — and perhaps the best bet is someone who isn't at one extreme end of the spectrum or the other. Useful tip 1. The 'spiritual woman': for reasons unclear, and despite the fact that Australia is one of the most pagan nations on Earth, a disproportionate number of women, rather than men, claim to be religious. Perhaps because in general, women are still more inclined to interiority than men. But most religious women don't expect a partner to be. Instead, the people to be very careful about are the New Agers — they are a large and growing sub-group and apparently spend much of their time devouring books on spirituality, personal growth and self-love. If you have any sort of intellect, or are just a middling humanist who occasionally ponders "Is this all there is? " these people will drive you nuts with their vague platitudes about knowing their inner child. On the other hand, if they seem terrific in all other respects, you can probably gain their respect by saying in a reflective manner, "Is this all there is?" If you can arrange to be gazing at the star-stained night sky while saying this, all the better. This may seem calculating, but we are all putting on a performance when courting. A lot of single people have self-esteem and loneliness issues, and a personal God, the universe, and astrology make them feel less lonely. Useful tip 2: say that although you don't subscribe to mainstream religion, you feel close to some kind of spirituality when gardening — and add how you love to plant herbs. Some okay herbs to mention are: Rosemary, Thyme, Sage. Chuck a couple of these weed-like green things in your garden just in case. Useful tip 3: no matter what else you do, at all costs avoid anyone who smacks of fundamentalism. This cohort takes the Bible literally, think dinosaurs roamed the planet only a few years before Shakespeare, want gay people to admit they are an abomination - and above all, fundos cannot be reasoned with — not in your lifetime. They are deeply insecure and frightened people — which is sad, so be sympathetic to their plight - but don't get drawn into the vortex. Besides, talking about the approach of Armageddon every date gets a bit tedious. Education: It is usually best to pick someone who has an approximately similar level of education to yourself. Having a tertiary education often gives a person a different way of seeing themselves, and of perceiving others. On the other hand, it is possible to do a five year degree in a narrow professional area and know nothing at all useful about human beings and how they operate. (Ref: engineers, dentists, gynaecologists). There are high school graduates who are better-read and more intelligent than most products of a university. So it is up to the individual case. It is a plus to be interested in your partner's work, but not essential. It can be a minus to be in the same field. Ask yourself this: if you were living with this person and you asked them at night how their day had been, would the answer send you to sleep in less than a minute? A lovely man or woman who is an accountant will likely wax lyrical about having just discovered a $245 error in a billing data base. Their face will be flushed with pride. Can your respond appropriately? How often? Or the love of your life may work in an oncology ward, and regale you with the daily triumph of removing sputum from the chests of the moribund. Are you strong enough for that? And worst of all, you may go out with a writer or poet, who regularly drones on about how their rival always gets friendly reviews from his/her newspaper mates, even though they write books full of derivative, precious crap. Sense of humour (SOH): Most men and women will claim in their profile to have a sense of humour — to love to laugh — and, surprisingly often, to have a 'wicked sense of humour'. This is a difficult personal quality to get a bearing on. You may yourself be the kind of person who tricks themselves into thinking their date has a great sense of humour simply because they laughed at your jokes. That is not having a SOH. Having a SOH is possessing the ability to make others laugh — it is active as well as passive. Do they make you laugh? Are their emails touched with wit and whimsy — or just shades of cute? Is one of their close friends, the one who actually possesses a SOH, helping write their emails? It has been known to happen. You will gain a better sense of the SOH situation during the phone call, and definitely during the coffee. Interests: Most internet websites give people the chance to describe themselves by jotting down their favourite music, books, movies, sport. Often this is pretty much all you will know about what interests them, and it is an imperfect instrument. Many internet dating women say they like all music except heavy metal. Why there is this pervasive, gut-wrenching female fear of the E, A and B chords played loudly is a mystery. Anyway, some of those bands even throw in a G or C#m. But who cares. If you are a bloke, hide your Acca Dacca CDs and buy some world music CDs. New Agers of either sex will have collections full of warbling pan pipes, waterfalls and bird calls. If they are a great person in other respects, then you'll just have to get used to the flock of magpies and whip birds in the dining or bedroom. Photographs: Now, the photo on the profile is only a vague guide. It is useful for confirming the person belongs to homo sapiens, but not a lot else. Some people get a professional pic taken, but most include happy snaps, and that is a blow struck for candidness. The more the photo looks like a "glamour" shot, the softer the focus, the less reliable it is. You can get some idea of whether someone is attractive, handsome, cute or weird from the photo. But — and this is really important — they will always look different in the flesh. They will have grown a beard, cut or streaked their hair, and you will for the first time notice they have a nose the size of the AMP building. Fortunately for men, though women are not oblivious to the looks factor, they tend to be more tolerant and less shallow about it. There is a recent trend for women and men with children to put he most attractive and least manic one in the profile photo with them. This signifies: a) love me, love my kid, because I'm proud of James/Jessica/Jade; b) family values; c) at least my kid only has one head. Stage One. The first stage is in some ways the most enjoyable. It is low risk, low stress, you have the pleasurable experience of a comfortable adventure. There is anticipation, getting to know someone, being complimented on your fascinating emails and witty humour (if it's going well), and all the while wearing an old t-shirt and dirty, checked shorts or fluffy slippers. There is the extreme luxury of re-inventing yourself, of telling your favourite story (your own life-story) again and again to a new audience, the little joys of self-disclosures, the discoveries of like-interests, the occasion when they add at the bottom of their letter "looking forward to hearing from you soon". The writing stage is where you try to establish whether you have intellectual, emotional and cultural compatibility — and whether the person is sincere and relatively well-balanced (I stress 'relatively' — no one is perfect). The discovery process is one of exchanging increasingly personal information — work history, enthusiasms and dislikes, family background. She will want to know whether you are 'over' your last girlfriend/partner/wife. Not surprisingly. A lot of internet men are still bitter about their ex — either that, or they rave on about the saintliness of their ex. If encouraged, women will also tell you about the bastard who refused to pay maintenance. There are clearly a lot of those bastards out there. Both of these practices are unwise on the first coffee if you don't want to scare your potential partner off. In reality, you probably are still seething with hurt and injustice as a result of your last dumping, and maybe even the one before that. You may lie in bed at night thinking nostalgically of your ex's face — but this is a dark secret which you must never reveal. People will ask you to be open, but they don't want that open. Involve your friends: without exception, your close friends will enjoy being part of the process when you are deciding which men or women to contact on the internet. You first make a long short list by browsing through the hundreds of profiles. Print off those profiles, then get your friends to sort through them with you. If you have experience in being on selection panels for jobs, this will help. It is a quite complex matter of weighing up a whole range of variables. For example, candidate A will be gorgeous and sexy, have compatible interests, bearable taste in music, be the right age, but have two small children and live on the other side of town. Candidate B will be less attractive, but still look pretty good, have no children, and a very interesting job. Candidate C will be attractive, have two teenage children with whom he/she shares custody, a worthy but dull job, but seems to have an especially self-aware and witty personality. It's tough work rating these profiles, and the best you can do is whittle them down to a top three, and write to all of them. In the emailing stage, you will get more data to either enhance or diminish their desirability. And remember, no one is perfect: if you find someone with a beautiful brain and body who loves Celine Dion — just put up with it. As Buddhists point out, suffering cannot be avoided if you are to live a full life. But let your friends help you with that selection process — they will remind you of important issues that somehow escape your attention; such as: you really don't like other people's children in reality, just in theory. The last time you went out with someone who was newly broken up or divorced he/she hadn't got over his/her girlfriend/husband. Anyone who describes themselves as a 'passionate playmate' is probably unbalanced and tries to find male/female acceptance through over-sexualising or infantalising themselves. It means nothing that someone describes their children as "beautiful" — all mothers/fathers think that, even of the most ghastly, moronic offspring. You really don't like nightclubs any more and you are an awkward dancer. The last time you fell in love with, and tried to rescue, someone with serious emotional 'issues', it led to unimaginable misery, and you swore in future to leave such rescues to the professionals. And so on. Listen to your friends — they know you. And your bad choices impinge on their lives too. Writing is a powerful means of constructing a 'self' to project to others. There is a Thomas Hardy story about a young man who meets a beautiful girl at a fair — but he must return to London. They agree to write to each other. Only the beautiful girl is illiterate, so she asks her employer, an older woman, to ghost-write her love letters to the young man, and the employer kindly agrees. The young man falls in love with the soul and mind of the sensitive and intelligent writer of the letters and assumes the beautiful young girl has authored them. The employer also falls in love with him through his letters. Only on the day he marries the girl does he discover that he has married the wrong woman. This tale tells us about the richness of the written word, but it omits an important point — you can be intrigued and drawn to someone through his or her e-mails, but find on meeting him or her that there is no chemistry at all. Works Cited This creative non-fiction article was based on primary research. The largest Australian internet dating service is RSVP (www.rsvp.com.au). I mainly used that for my research and ensuing coffees/participant observation. There are other sites I checked out, including: www.datenet.com.au www.AussieMatchMaker.com.au www.findsomeone.com.au www.VitalPartners.com.au www.personals.yahoo.com.au There are also internet dating site guides such as: www.shoptheweb.com.au/dating.shtml www.theinternetdatingguide.com www.moonlitwalks.com www.singlesites.com/Australian_Dating.htm Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Neilsen, Philip. "An extract from 'The Internet of Love'" M/C: A Journal of Media and Culture 5.6 (2002). Dn Month Year < http://www.media-culture.org.au/0211/internet.php>. APA Style Neilsen, P., (2002, Nov 20). An extract from "The Internet of Love". M/C: A Journal of Media and Culture, 5,(6). Retrieved Month Dn, Year, from http://www.media-culture.org.au/0211/internet.html
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30

Sivapalan, Pradeesh, Charlotte Suppli Ulrik, Rasmus Dahlin Bojesen, Therese Sophie Lapperre, Josefin Viktoria Eklöf, Kjell Erik Julius Håkansson, Andrea Browatzki et al. „Proactive Prophylaxis With Azithromycin and HydroxyChloroquine in Hospitalised Patients With COVID-19 (ProPAC-COVID): A structured summary of a study protocol for a randomised controlled trial“. Trials 21, Nr. 1 (10.06.2020). http://dx.doi.org/10.1186/s13063-020-04409-9.

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Abstract Objectives The aim of this randomised GCP-controlled trial is to clarify whether combination therapy with the antibiotic azithromycin and hydroxychloroquine via anti-inflammation/immune modulation, antiviral efficacy and pre-emptive treatment of supra-infections can shorten hospitalisation duration for patients with COVID-19 (measured as "days alive and out of hospital" as the primary outcome), reduce the risk of non- invasive ventilation, treatment in the intensive care unit and death. Trial design This is a multi-centre, randomised, Placebo-controlled, 2-arm ratio 1:1, parallel group double-blind study. Participants 226 participants are recruited at the trial sites/hospitals, where the study will take place in Denmark: Aalborg, Bispebjerg, Gentofte, Herlev, Hillerød, Hvidovre, Odense and Slagelse hospitals. Inclusion criteria: • Patient admitted to Danish emergency departments, respiratory medicine departments or internal medicine departments • Age≥ 18 years • Hospitalized ≤48 hours • Positive COVID-19 test / diagnosis during the hospitalization (confirmed). • Men or non-fertile women. Fertile women* must not be pregnant, i.e. negative pregnancy test must be available at inclusion • Informed consent signed by the patient *Defined as after menarche and until postmenopausal (no menstruation for 12 months) Exclusion criteria: • At the time of recruitment, the patient uses >5 LO2/min (equivalent to 40% FiO2 if measured) • Known intolerance/allergy to azithromycin or hydroxychloroquine or hypersensitivity to quinine or 4-aminoquinoline derivatives • Neurogenic hearing loss • Psoriasis • Retinopathy • Maculopathy • Visual field changes • Breastfeeding • Severe liver diseases other than amoebiasis (INR> 1.5 spontaneously) • Severe gastrointestinal, neurological and hematological disorders (investigator-assessed) • eGFR <45 ml/min/1.73 m2 • Clinically significant cardiac conduction disorders/arrhythmias or prolonged QTc interval (QTc (f) of> 480/470 ms). • Myasthenia gravis • Treatment with digoxin* • Glucose-6-phosphate dehydrogenase deficiency • Porphyria • Hypoglycaemia (Blood glucose at any time since hospitalization of <3.0 mmol/L) • Severe mental illness which significantly impedes cooperation • Severe linguistic problems that significantly hinder cooperation • Treatment with ergot alkaloids *The patient must not be treated with digoxin for the duration of the intervention. For atrial fibrillation/flutter, select according to the Cardiovascular National Treatment Guide (NBV): Calcium antagonist, Beta blocker, direct current (DC) conversion or amiodarone. In case of urgent need for digoxin treatment (contraindication for the aforementioned equal alternatives), the test drug should be paused, and ECG should be taken daily. Intervention and comparator Control group: The control group will receive the standard treatment + placebo for both types of intervention medication at all times. If part or all the intervention therapy being investigated becomes standard treatment during the study, this may also be offered to the control group. Intervention group: The patients in the intervention group will also receive standard care. Immediately after randomisation to the intervention group, the patient will begin treatment with: Azithromycin: Day 1-3: 500 mg x 1 Day 4-15: 250 mg x 1 If the patient is unable to take the medication orally by themselves, the medication will, if possible, be administered by either stomach-feeding tube, or alternatively, temporary be changed to clarithromycin 500 mg x 2 (this only in agreement with either study coordinator Pradeesh Sivapalan or principal investigator Jens-Ulrik Stæhr Jensen). This will also be done in the control group if necessary. The patient will switch back to azithromycin when possible. Hydroxychloroquine: Furthermore, the patient will be treated with hydroxychloroquine as follows: Day 1-15: 200 mg x 2 Main outcomes • Number of days alive and discharged from hospital within 14 days (summarises both whether the patient is alive and discharged from hospital) ("Days alive and out of hospital") Randomisation The sponsor (Chronic Obstructive Pulmonary Disease Trial Network, COP:TRIN) generates a randomisation sequence. Randomisation will be in blocks of unknown size and the final allocation will be via an encrypted website (REDCap). There will be stratification for age (>70 years vs. <=70 years), site of recruitment and whether the patient has any of the following chronic lung diseases: COPD, asthma, bronchiectasis, interstitial lung disease (Yes vs. No). Blinding (masking) Participants and study personnel will both be blinded, i.e. neither will know which group the participant is allocated to. Numbers to be randomised (sample size) This study requires 226 patients randomised 1:1 with 113 in each group. Trial Status Protocol version 1.8, from April 16, 2020. Recruitment is ongoing (first patient recruited April 6, 2020; final patient expected to be recruited October 31, 2020). Trial registration ClinicalTrials.gov Identifier: NCT04322396 (registered March 26, 2020) Full protocol The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
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31

Kelen, Christopher. „How fair is fair?“ M/C Journal 5, Nr. 3 (01.07.2002). http://dx.doi.org/10.5204/mcj.1964.

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Thou art of purer eyes than to behold evil, and canst not look on iniquity: wherefore lookest thou upon them that deal treacherously, and holdest thy tongue when the wicked devoureth the man that is more righteous than he? - Habakkuk 1:13 Australia's official national anthem since 1984 has been a song entitled 'Advance Australia Fair'1. This paper asks, very simply, what is the meaning of the word fair in the title and the song. The song is about a collective effort, not so much at being a nation as at being seen to be one, being worthy of the name. The claim is justified on two grounds: possession and intention. We have golden soil, wealth, youth, the ability to toil, freedom, a beautiful country possessed of nature's gifts, boundless plains and so on. We make no particular claim to have done anything as yet but we have good intentions, specifically to toil with hearts and hands to make our nation famous as such. The setting of the song then is temporally ambiguous: we have x and we're about to y. The question naturally enough is: who are we? The song is naturally enough, as an anthem, about answering and not answering that question. Note that the hymn-like qualities of 'God save the Queen' are absent from the new anthem. And yet the song begins as if it were a hymn or a prayer, with the formula: 'Let us (pray/sing?)'. A pseudo-hymn. Who is addressed? We are. The temporal setting of the hymn is substituted with the imminence of an imperative: 'Let us rejoice.' Rejoicing is something we should all do for a long list of reasons. That being the case, 'let us sing'. In 'Advance Australia Fair' it is the imminent future to which voices attend in their act of unison. Whose act of unison? Who is the we? Anthems are always coy about this question which touches on their function and their efficacy. The unspoken answer which the song implies is however that the we addressing and addressed the self-identifying we of the song is fair and going to be fair, and will get there by being fair. That kind of fairness I would argue is characteristic of the we of white man's burden. 'Advance Australia Fair' is eat your cake and have it too stuff: we want to be a young nation about to play on the world's stage but at the same time we want to pretend that what is ours has an eternal quality. We want to borrow the timeless land myth; we don't want to acknowledge the time before our coming. We don't anymore even want to acknowledge our coming. We want to have always been here; but in an ahistoric way. The past should be irrelevant to the way we are now. This consciousness of an identity of pretended eternal rights is only achieved by multiple erasure: of time before the historic, of our historic consciousness of time. It is achieved by means of the terra nullius myth, the myth of an empty land prior to our coming. The song as it stands, the anthem as it is, is the perfect representative of that myth. The explanation of 'the historic facts' in the original version has been removed as an embarrassment. The emptiness posited by 'Advance Australia Fair' is deeply ironic. It represents a refusal of the ethical question which must lie under European presence in Australia. The land is empty because we emptied it. We have land to share because we took land. We only get to look generous because of a theft for which we do not wish to acknowledge responsibility. We sing from an emptiness wrought on ourselves in the act of emptying; the emptying of the land and at once the popular consciousness: emptying it of the fact of the emptying. Emptying ourselves of truth is the reflective act of nation: the basis of the collectivity on which a polity is claimed. It is a making colourless. How fair would that be? The 'Australians all...' update leaves untouched two serious problems with the song, these being the ways in which it might be unsatisfactory from the point of view of indigenous Australians (i.e. their erasure) and, linked with this, the serious ambiguity of the title and the chorus: the problem with the word 'fair'. The word-order inversion in the title/chorus is a kind of pseudo-archaism which tilts the song in the direction of the unintelligible. The inscrutable sign of identity becomes a kind of rite of passage; something which needs to be explained to children and migrants alike. Perfect form of mystification to express as collective sentiment the sentiment of collectivity; no one can definitively know what these words mean. The unknowable privileges a teachers' grasp of the archaic as originary lore: the teacher says it means 'Let's all work together to make Australia a beautiful country, a great country' or 'We should all be proud of Australia because it's such a great country, so we should pull together to make it even better.' Fair enough. Who could object? The central ambiguity means that when we sing the song we don't know whether we are describing how things are or how they should be. Advance Australia because it is fair or so that it will be fair or both reasons: to keep the fair fair? Of course this speculation begs the question about the meaning of the word 'fair'. Of all the various dictionary entries for the word fair the three which seem to coalesce in this usage are: fair as in beautiful, fair as in just and fair as in white. I would argue that these three uses coalesce likewise in the use of fair equally in that typically Australian expression, fair enough: characteristic expression of a country seriously worried for most of its European history about the risk of racial impurity even from 'other' Europeans. In the song the line is emphatic because it is actually repeated in each rendition of the chorus. It is the point the song is making. Or we could say it is the question the song asks: how should Australia be advanced? But this form of the question implies an adverbial construction. An adverb in this position would imply process and therefore a future orientation toward the quality of that process: how Australia ought to be advanced. But if the 'fair' of the chorus is really an adjective then the implication is that Australia is already a 'fair' entity; in advancing Australia one advances its already attained quality of fairness. The beautiful inhabit a just polity. A just polity is a white polity. This is the advance, in the song, that is happening, or has happened, in Australia. In fact this is the advance which the European word (Latin made English down here) constitutes for the continent formerly known to Europe as New Holland: Australia is becoming a white man's country. This song is specifically about the civilising process, about the white man's burden, as it applied to this particular far-flung reach of empire. The advance of the title concerns the progress of civilisation; it assigns to this process a very specific metaphor, that of a military movement. The progress of the white race over the continent is an advance. What appears to be an external motion (promote Australia abroad) belies an internal one: the still ongoing process of conquest and likewise the encouragement to get that done without miscegenation. That Aborigines are given no specific role in this song becomes less mysterious in this light: it is not their country or nationality which is being described here; rather the advance of fair Australia, an advance which takes place at the expense of an unmentioned (unmentionable?) non-polity. The non-inclusion of Aboriginal people in the Australian polity prior to the 1967 referendum shocks many today. And it shocks as unjust, unfair, unreasonable. That it did not seem so for long stretches of white Australia's memory indicates that a different logic was then in force. The convergence of moral value or integrity with race, with language, with tribal membership, is certainly a widespread human phenomenon and one with plenty of Old Testament backing (and plenty of Old Testament caveat as well). And it is familiar to anyone over the age of about thirty in Australia today, to anyone who ever sang the hymn 'All things white and wonderful'. That it is a sentiment unacceptable today in a world dominated by human rights consciousness indicates that the ethics of the last couple of decades have evolved radically from those which preceded them. The British Empire may have carted a lot of white man's burden about the globe but it is fairly hard to claim that it did not primarily exist for the benefit of white men. To argue otherwise now is to acquiesce in a rhetoric which those of us who accept universal human rights have no choice but to reject as racist. Today the civilising mission of the white man and the personal gain it brought white men remain spectacularly successful even and perhaps especially as the colour has been drained from the map. The sun sets on one kind of empire but only because that empire has been succeeded by one more lucrative, and, like the words of the successful anthem, harder to pin down than those in the one that preceded it. As to the event of singing ourselves into the 'fair' future: three connotations just, beautiful, white conflate in an ambiguity where through repetition, through emphasis, and through the dignifying effect of an anthem setting, they come to imply each other. The unspoken terms of the song suffice to imply the conflation: the white man (now all the people) toil to make the land beautiful and just. Whether this is an accomplished fact or an uphill battle, regardless of who is now included in this mission, there is no doubt that this notion of progress as 'Australia-making' is owing to the coming of the white man. Should the question be asked of this chorus then: if this is not blatant racism, is it something subtler? Is it a kind of deep-seated racism which survives the bowdlerizing of those for whom white supremacist rhetoric might be a little close to the bone? One can go further: this polysemy, on which nothing can be pinned, might be a closet racist's gift, because it generates paranoia. It accumulates the force of an exclusion without resorting to any culpable act of exclusion as such. Is this racism at the inscrutable and unconscious core of the nation's sense of itself? Is this the taunting of those whom the nation defines itself as excluding? Is this song taunting them to sing themselves out of the picture? If so then note that they would have two ways to go: they could be assimilated (fair enough?) or they could see themselves excluded. If the effect of this chorus is to say that Australia should go forward under the stewardship of the fair=inter alia white race2, then it is not a question of a particular idea of progress being conveyed despite the erasure of a previous story. The erasure of a particular past, which we are too polite to mention, enables the new story. The other past is erased together with the others who inhabited it. In the world outside of the song however, the others, whom we might be too polite to see, do still inhabit. They inhabit the new story, not as flies on the wall but as flies in the ointment. Should the song be scrapped? Should the lyrics be scrapped? The project of dismantling empires and their signs is, as the eastern bloc has been learning, not as straightforward as it may seem. Cutting the star out of the flag may leave a star-shaped hole for all to see. Advance Australia Fair, its evolution, its status, its popular reading, taboo readings (e.g. this one), the suppression of its earlier version, the fact that what it says and fails to say is officially accepted by Australians to represent Australians: all these things are living reminders of where Australians come from, of the thinking that brought us, of what we possess and how we come to possess it. Fostering awareness of these is of great value to Australians both in understanding ourselves and in deciding where we should go with that knowledge. Thanks to my mother, Sylvia Kelen, for help with research on this paper. Notes 1 It first succeeded 'God Save the Queen' in that role in 1974 following a national opinion poll conducted by the Australian Bureau of Statistics for the then Labor government. Incoming Liberal Prime Minister, Malcolm Fraser, reinstated 'God Save the Queen' in 1976. 'Advance Australia Fair' was politically corrected (not a phrase in use at the time) when re-instated as national anthem in 1984, with a view to giving the girls a fair go. The original opening line of Peter Dodds McCormick's nineteenth century song was: 'Australian sons let us rejoice/for we are young and free'. The 'correction' of the present version of the song is noteworthy given the emphasis which the song, and particularly the chorus, places on historical consciousness, more specifically on the self-consciousness of an effort at nationhood. 2 Note that there is plenty of evidence for this in the evolution of the song, especially in the second stanza of the original version: When gallant Cook from Albion sail'd, To trace wide oceans o'er, True British courage bore him onTill he landed on our shore. Then here he raised old England's flag, The standard of the brave; With all her faults we love her still, 'Britannia rules the wave'In joyful, etc The fourth and fifth stanzas of the original version of Peter Dodds McCormick's song describe who would be acceptable as a migrant and what this new political entity would be defending itself from in the case of war:While other nations of the globe Behold us from afar, We'll rise to high renown and shineLike our glorious southern star;From England, Scotia, Erin's Isle, Who come our lot to share, Let all combine with heart and handTo advance and etc.Should foreign foe e'er sight our coast,Or dare a foot to land, We'll rise to arms like sires of yoreTo guard our native strand; Britannia then shall surely know, Beyond wide ocean's roll, Her son's in fair Australia's landStill keep a British soul, In joyful strains and etc. Citation reference for this article MLA Style Kelen, Christopher. "How fair is fair? " M/C: A Journal of Media and Culture 5.3 (2002). [your date of access] < http://www.media-culture.org.au/0207/fairisfair.php>. Chicago Style Kelen, Christopher, "How fair is fair? " M/C: A Journal of Media and Culture 5, no. 3 (2002), < http://www.media-culture.org.au/0207/fairisfair.php> ([your date of access]). APA Style Kelen, Christopher. (2002) How fair is fair? . M/C: A Journal of Media and Culture 5(3). < http://www.media-culture.org.au/0207/fairisfair.php> ([your date of access]).
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32

Gill, Nicholas. „Longing for Stillness: The Forced Movement of Asylum Seekers“. M/C Journal 12, Nr. 1 (04.03.2009). http://dx.doi.org/10.5204/mcj.123.

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IntroductionBritish initiatives to manage both the number of arrivals of asylum seekers and the experiences of those who arrive have burgeoned in recent years. The budget dedicated to asylum seeker management increased from £357 million in 1998-1999 to £1.71 billion in 2004-2005, making the Immigration and Nationality Directorate (IND) the second largest concern of the Home Office behind the Prison Service in 2005 (Back et al). The IND was replaced in April 2007 by the Border and Immigration Agency (BIA), whose expenditure exceeded £2 billion in 2007-2008 (BIA). Perhaps as a consequence the number of asylum seekers applying to the UK has fallen dramatically, illustrating the continuing influence of exclusionary state policies despite the globalisation and transnationalisation of migrant flows (UNHCR; Koser).One of the difficulties with the study of asylum seekers is the persistent risk that, by employing the term ‘asylum seeker’, research conducted into their experiences will contribute towards the exclusion of a marginalised and abject group of people, precisely by employing a term that emphasises the suspended recognition of a community (Nyers). The ‘asylum seeker’ is a figure defined in law in order to facilitate government-level avoidance of humanitarian obligations by emphasising the non-refugeeness of asylum claimants (Tyler). This group is identified as supplicant to the state, positioning the state itself as a legitimate arbiter. It is in this sense that asylum seekers suffer a degree of cruel optimism (Berlant) – wishing to be recognised as a refugee while nevertheless subject to state-defined discourses, whatever the outcome. The term ‘forced migrant’ is little better, conveying a de-humanising and disabling lack of agency (Turton), while the terms ‘undocumented migrant’, ‘irregular migrant’ and ‘illegal migrant’ all imply a failure to conform to respectable, desirable and legitimate forms of migration.Another consequence of these co-opted and politically subjugating forms of language is their production of simple imagined geographies of migration that position the foreigner as strange, unfamiliar and incapable of communication across this divide. Such imaginings precipitate their own responses, most clearly expressed in the blunt, intrusive uses of space and time in migration governance (Lahav and Guiraudon; Cohen; Guild; Gronendijk). Various institutions exist in Britain that function to actually produce the imagined differences between migrants and citizens, from the two huge, airport-like ‘Asylum Screening Units’ in Liverpool and London where asylum seekers can lodge their claims, to the 12 ‘Removal Centres’ within which soon-to-be deported asylum seekers are incarcerated and the 17 ‘Hearing Centres’ at which British judges preside over the precise legal status of asylum applicants.Less attention, however, has been given to the tension between mobility and stillness in asylum contexts. Asylum seeker management is characterised by a complex combination of enforced stillness and enforced mobility of asylum seeking bodies, and resistance can also be understood in these terms. This research draws upon 37 interviews with asylum seekers, asylum activists, and government employees in the UK conducted between 2005 and 2007 (see Gill) and distils three characteristics of stillness. First, an association between stillness and safety is clearly evident, exacerbated by the fear that the state may force asylum seekers to move at any time. Second, stillness of asylum seekers in a physical, literal sense is intimately related to their psychological condition, underscoring the affectual properties of stillness. Third, the desire to be still, and to be safe, precipitates various political strategies that seek to secure stillness, meaning that stillness functions as more than an aspiration, becoming also a key political metric in the struggle between the included and excluded. In these multiple and contradictory ways stillness is a key factor that structures asylum seekers’ experiences of migration. Governing through Mobility The British state utilises both stillness and mobility in the governance of asylum seeking bodies. On the one hand, asylum seekers’ personal freedoms are routinely curtailed both through their incarceration and through the requirements imposed upon them by the state in terms of ‘signing in’ at local police stations, even when they are not incarcerated, throughout the time that they are awaiting a decision on their claim for asylum (Cwerner). This requirement, which consists of attending a police station to confirm the continuing compliance of the asylum seeker, can vary in frequency, from once every month to once every few days.On the other hand, the British state employs a range of strategies of mobility that serve to deprive asylum seeking communities of geographical stillness and, consequently, also often undermines their psychological stability. First, the seizure of asylum seekers and transportation to a Removal Centre can be sudden and traumatic, and incarceration in this manner is becoming increasingly common (Bacon; Home Office). In extreme cases, very little or no warning is given to asylum seekers who are taken into detention, and so-called ‘dawn raids’ have been organised in order to exploit an element of surprise in the introduction of asylum seekers to detention (Burnett). A second source of forced mobility associated with Removal Centres is the transfer of detainees from one Removal Centre to another for a variety of reasons, from the practical constraints imposed by the capacities of various centres, to differences in the conditions of centres themselves, which are used to form a reward and sanction mechanism among the detainee population (Hayter; Granville-Chapman). Intra-detention estate transfers have increased in scope and significance in recent years: in 2004/5, the most recent financial year for which figures are available, the British government spent over £6.5 million simply moving detainees from one secure facility to another within the UK (Hansard, 2005; 2006).Outside incarceration, a third source of spatial disruption of asylum seekers in the UK concerns their relationship with accommodation providers. Housing is provided to asylum seekers as they await a decision on their claim, but this housing is provided on a ‘no-choice’ basis, meaning that asylum seekers who are not prepared to travel to the accommodation that is allocated to them will forfeit their right to accommodation (Schuster). In other words, accommodation is contingent upon asylum seekers’ willingness to be mobile, producing a direct trade-off between the attractions of accommodation and stillness. The rationale for this “dispersal policy”, is to draw asylum seekers away from London, where the majority of asylum seekers chose to reside before 2000. The maintenance of a diverse portfolio of housing across the UK is resource intensive, with the re-negotiation of housing contracts worth over a £1 billion a constant concern (Noble et al). As these contracts are renegotiated, asylum seekers are expected to move in response to the varying affordability of housing around the country. In parallel to the system of deportee movements within the detention estate therefore, a comparable system of movement of asylum seekers around the UK in response to urban and regional housing market conditions also operates. Stillness as SanctuaryIn all three cases, the psychological stress that movement of asylum seekers can cause is significant. Within detention, according to a series of government reports into the conditions of removal centres, one of the recurring difficulties facing incarcerated asylum seekers is incomprehension of their legal status (e.g. HMIP 2002; 2008). This, coupled with very short warning of impending movements, results in widespread anxiety among detained asylum seekers that they may be deported or transferred imminently. Outside detention, the fear of snatch squads of police officers, or alternatively the fear of hate crimes against asylum seekers (Tyler), render movement in the public realm a dangerous practice in the eyes of many marginalised migrants. The degree of uncertainty and the mental and emotional demands of relocation introduced through forced mobility can have a damaging psychological effect upon an already vulnerable population. Expressing his frustration at this particular implication of the movement of detainees, one activist who had provided sanctuary to over 20 asylum seekers in his community outlined some of the consequences of onward movement.The number of times I’ve had to write panic letters saying you know you cannot move this person to the other end of the country because it destabilises them in terms of their mental health and it is abusive. […] Their solicitors are here, they’re in process, in legal process, they’ve got a community, they’ve got friends, they may even have a partner or a child here and they would still move them.The association between governance, mobility and trepidation highlights one characteristic of stillness in the asylum seeking field: in contra-distinction to the risk associated with movement, to be still is very often to be safe. Given the necessity to flee violence in origin countries and the tendency for destination country governments to require constant re-positioning, often backed-up with the threat of force, stillness comes to be viewed as offering a sort of sanctuary. Indeed, the Independent Asylum Commission charity that has conducted a series of reviews of asylum seekers’ treatment in the UK (Hobson et al.), has recently suggested dispensing with the term ‘asylum’ in favour of ‘sanctuary’ precisely because of the positive associations with security and stability that the latter provides. To be in one place for a sustained period allows networks of human trust and reciprocity to develop which can form the basis of supportive community relationships. Another activist who had accompanied many asylum seekers through the legal process spoke passionately about the functions that communities can serve in asylum seekers’ lives.So you actually become substitute family […] I think it’s what helps people in the midst of trauma when the future is uncertain […] to find a community which values them, which accepts them, which listens to them, where they can begin to find a place and touch a creative life again which they may not have had for years: it’s enormously important.There is a danger in romanticising the benefits of community (Joseph). Indeed, much of the racism and xenophobia directed towards asylum seekers has been the result of local community hostilities towards different national and ethnic groups (Boswell). For many asylum seekers, however, the reciprocal relations found in communities are crucially important to their well-being. What is more, the inclusion of asylum seekers into communities is one of the most effective anti-state and anti-deportation strategies available to activists and asylum seekers alike (Tyler), because it arrests the process of anonymising and cordoning asylum seekers as an homogenous group, providing instead a chance for individuals to cast off this label in favour of more ‘humane’ characteristics: families, learning, friendship, love.Strategies for StillnessFor this reason, the pursuit of stillness among asylum seekers is both a human and political response to their situations – stillness becomes a metric in the struggle between abject migrants and the state. Crucial to this political function is the complex relationship between stillness and social visibility: if an asylum seeker can command their own stillness then they can also have greater influence over their public profile, either in order to develop it or to become less conspicuous.Tyler argues that asylum seekers are what she calls a ‘hypervisible’ social group, referring to the high profile association between a fictional, dehumanised asylum seeking figure and a range of defamatory characteristics circulated by the popular printed press. Stillness can be used to strategically reduce this imposed form of hypervisibility, and to raise awareness of real asylum seeker stories and situations. This is achieved by building community coalitions, which require physically and socially settled asylum seeking families and communities. Asylum advocacy groups and local community support networks work together in the UK in order to generate a genuine public profile of asylum seekers by utilising local and national newspapers, staging public demonstrations, delivering speeches, attending rallies and garnering support among local organisations through art exhibitions, performances and debates. Some activist networks specialise explicitly in supporting asylum seekers in these endeavours, and sympathetic networks of journalists, lawyers, doctors and radio producers combine their expertise with varying degrees of success.These sorts of strategies can produce strong loyalties between local communities and the asylum seekers in their midst, precisely because, through their co-presence, asylum seekers cease to be merely asylum seekers, but become active and valued members of communities. One activist who had helped to organise the protection of an asylum seeker in a church described some of the preparations that had been made for the arrival of immigration task forces in her middle class parish.There were all sorts of things we practiced: if they did break through the door what would we do? We set up a telephone tree so that each person would phone two or three people. We had I don’t know how many cars outside. We arranged a safe house, where we would hide her. We practiced getting her out of the room into a car […] We were expecting them to come at any time. We always had people at the back […] guarding, looking at strangers who might be around and [name] was never, ever allowed to be on her own without a whole group of people completely surrounding her so she could feel safe and we would feel safe. Securing stillness here becomes more than simply an operation to secure geographic fixity: it is a symbolic struggle between state and community, crystallising in specific tactics of spatial and temporal arrangement. It reflects the fear of further forced movement, the abiding association between stillness and safety, and the complex relationship between community visibility and an ability to remain still.There are, nevertheless, drawbacks to these tactics that suggest a very different relationship between stillness and visibility. Juries can be alienated by loud tactics of activism, meaning that asylum seekers can damage their chances of a sympathetic legal hearing if they have had too high a profile. Furthermore, many asylum seekers do not have the benefits of such a dedicated community. An alternative way in which stillness becomes political is through its ability to render invisible the abject body. Invisibility is taken to mean the decision to ‘go underground’, miss the appointments at local police stations and attempt to anticipate the movements of immigration removal enforcement teams. Perversely, although this is a strategy for stillness at the national or regional scale, mobile strategies are often employed at finer scales in order to achieve this objective. Asylum seekers sometimes endure extremely precarious and difficult conditions of housing and subsistence moving from house to house regularly or sleeping and living in cars in order to avoid detection by authorities.This strategy is difficult because it involves a high degree of uncertainty, stress and reliance upon the goodwill of others. One police officer outlined the situation facing many ‘invisible’ asylum seekers as one of poverty and desperation:Immigration haven’t got a clue where they are, they just can’t find them because they’re sofa surfing, that’s living in peoples coffee shops … I see them in the coffee shop and they come up and they’re bloody starving! Despite the difficulties associated with this form of invisibility, it is estimated that this strategy is becoming increasingly common in the UK. In 2006 the Red Cross estimated that there were some 36 000 refused and destitute asylum seekers in England, up from 25 000 the previous year, and reported that their organisation was having to provide induction tours of soup kitchens and night shelters in order to alleviate the conditions of many claimants in these situations (Taylor and Muir). Conclusion The case of asylum seekers in the UK illustrates the multiple, contradictory and splintered character of stillness. While some forms of governance impose stillness upon asylum seeking bodies, in the form of incarceration and ‘signing in’ requirements, other forms of governance impose mobility either within detention or outside it. Consequently stillness figures in the responses of asylum seeking communities in various ways. Given the unwelcome within-country movement of asylum seekers, and adding to this the initial fact of their forced migration from their home countries, the condition of stillness becomes desirable, promising to bring with it stability and safety. These promises contrast the psychological disruption that further mobility, and even the threat of further mobility, can bring about. This illustrates the affectual qualities both of movement and of stillness in the asylum-seeking context. Literal stillness is associated with social and emotional stability that complicates the distinction between real and emotional spaces. While this is certainly not the case uniformly – incarceration and inhibited personal liberties have opposite consequences – the promises of stillness in terms of stability and sanctuary are clearly significant because this desirability leads asylum advocates and asylum seekers to execute a range of political strategies that seek to ensure stillness, either through enhanced or reduced forms of social visibility.The association of mobility with freedom that typifies much of the literature surrounding mobility needs closer inspection. At least in some situations, asylum seekers pursue geographical stillness for the political and psychological benefits it can offer, while mobility is both employed as a subjugating strategy by states and is itself actively resisted by those who constitute its targets.ReferencesBack, Les, Bernadette Farrell and Erin Vandermaas. A Humane Service for Global Citizens. London: South London Citizens, 2005.Bacon, Christine. The Evolution of Immigration Detention in the UK: The Involvement of Private Prison Companies. Oxford: Refugee Studies Centre, 2005.Berlant, Lauren. “Cruel Optimism.” differences : A Journal of Feminist Cultural Studies 17.3 (2006): 20—36.Border and Immigration Agency. Business Plan for Transition Year April 2007 – March 2008: Fair, Effective, Transparent and Trusted. London: Home Office, 2007.Boswell, Christina. “Burden-Sharing in the European Union: Lessons from the German and UK Experience.” Journal of Refugee Studies 16.3 (2003): 316—35.Burnett, Jon. Dawn Raids. PAFRAS Briefing Paper Number 4. Leeds: Positive Action for Refugees and Asylum Seekers, 2008. ‹http://www.statewatch.org/news/2008/apr/uk-patras-briefing-paper-4-%2Ddawn-raids.pdf›.Cohen, Steve. “The Local State of Immigration Controls.” Critical Social Policy 22 (2002): 518—43.Cwerner, Saulo. “Faster, Faster and Faster: The Time Politics of Asylum in the UK.” Time and Society 13 (2004): 71—88.Gill, Nick. "Presentational State Power: Temporal and Spatial Influences over Asylum Sector." Transactions of the Institute of British Geographers, 2009 (forthcoming).Granville-Chapman, Charlotte, Ellie Smith, and Neil Moloney. Harm on Removal: Excessive Force Against Failed Asylum Seekers. London: Medical Foundation for the Care of Victims of Torture, 2004.Groenendijk, Kees. “New Borders behind Old Ones: Post-Schengen Controls behind the Internal Borders and inside the Netherlands and Germany”. In Search of Europe's Borders. Eds. Kees Groenendijk, Elspeth Guild and Paul Minderhoud. The Hague: Kluwer International Law, 2003. 131—46.Guild, Elspeth. “The Europeanisation of Europe's Asylum Policy.” International Journal of Refugee Law 18 (2006): 630—51.Guiraudon, Virginie. “Before the EU Border: Remote Control of the 'Huddled Masses'.” In Search of Europe's Borders. Eds. Kees Groenendijk, Elspeth Guild and Paul Minderhoud. The Hague: Kluwer International Law, 2003. 191—214.Hansard, House of Commons. Vol. 440 Col. 972W. 5 Dec. 2005. 6 Mar. 2009 ‹http://www.publications.parliament.uk/pa/cm200506/cmhansrd/vo051205/text/51205w18.htm›.———. Vol. 441 Col. 374W. 9 Jan. 2006. 6 Mar. 2009 ‹http://www.publications.parliament.uk/pa/cm200506/cmhansrd/vo060109/text/60109w95.htm›.Hayter, Theresa. Open Borders: The Case against Immigration Controls. London: Pluto P, 2000.HM Inspectorate of Prisons. An Inspection of Campsfield House Immigration Removal Centre. London: HM Inspectorate of Prisons, 2002.———. Report on an Unannounced Full Follow-up Inspection of Campsfield House Immigration Removal Centre. London: HM Inspectorate of Prisons, 2008. Hobson, Chris, Jonathan Cox, and Nicholas Sagovsky. Saving Sanctuary: The Independent Asylum Commission’s First Report of Conclusions and Recommendations. London: Independent Asylum Commission, 2008.Home Office. “Record High on Removals of Failed Asylum Seekers.” Press Office Release, 27 Feb. 2007. London: Home Office, 2007. 6 Mar. 2009 ‹http://press.homeoffice.gov.uk/press-releases/asylum-removals-figures›. Joseph, Miranda. Against the Romance of Community. Minnesota: U of Minnesota P, 2002.Koser, Khalid. “Refugees, Trans-Nationalism and the State.” Journal of Ethnic and Migration Studies 33 (2007): 233—54.Lahav, Gallya, and Virginie Guiraudon. “Comparative Perspectives on Border Control: Away from the Border and outside the State”. Wall around the West: State Borders and Immigration Controls in North America and Europe. Eds. Gallya Lahav and Virginie Guiraudon. The Lanham: Rowman and Littlefield, 2000. 55—77.Noble, Gill, Alan Barnish, Ernie Finch, and Digby Griffith. A Review of the Operation of the National Asylum Support Service. London: Home Office, 2004. Nyers, Peter. "Abject Cosmopolitanism: The Politics of Protection in the Anti-Deportation Movement." Third World Quarterly 24.6 (2003): 1069—93.Schuster, Lisa. "A Sledgehammer to Crack a Nut: Deportation, Detention and Dispersal in Europe." Social Policy & Administration 39.6 (2005): 606—21.Taylor, Diane, and Hugh Muir. “Red Cross Aids Failed Asylum Seekers” UK News. The Guardian 9 Jan. 2006. 6 Mar. 2009 ‹http://www.guardian.co.uk/news/2006/jan/09/immigrationasylumandrefugees.uknews›.Turton, David. Conceptualising Forced Migration. University of Oxford Refugee Studies Centre Working Paper 12 (2003). 6 Mar. 2009 ‹http://www.rsc.ox.ac.uk/PDFs/workingpaper12.pdf›.Tyler, Imogen. “'Welcome to Britain': The Cultural Politics of Asylum.” European Journal of Cultural Studies 9.2 (2006): 185—202.United Nations High Commission for Refugees. Refugees by Numbers 2006 Edition. Geneva: UNHCR, 2006.
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33

McGrath, Shane. „Compassionate Refugee Politics?“ M/C Journal 8, Nr. 6 (01.12.2005). http://dx.doi.org/10.5204/mcj.2440.

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One of the most distinct places the politics of affect have played out in Australia of late has been in the struggles around the mandatory detention of undocumented migrants; specifically, in arguments about the amount of compassion border control practices should or do entail. Indeed, in 1990 the newly established Joint Standing Committee on Migration (JSCM) published its first report, Illegal Entrants in Australia: Balancing Control and Compassion. Contemporaneous, thought not specifically concerned, with the establishment of mandatory detention for asylum seekers, this report helped shape the context in which detention policy developed. As the Bureau of Immigration and Population Research put it in their summary of the report, “the Committee endorsed a tough stance regarding all future illegal entrants but a more compassionate stance regarding those now in Australia” (24). It would be easy now to frame this report in a narrative of decline. Under a Labor government the JSCM had at least some compassion to offer; since the 1996 conservative Coalition victory any such compassion has been in increasingly short supply, if not an outright political liability. This is a popular narrative for those clinging to the belief that Labor is still, in some residual sense, a social-democratic party. I am more interested in the ways the report’s subtitle effectively predicted the framework in which debates about detention have since been constructed: control vs. compassion, with balance as the appropriate mediating term. Control and compassion are presented as the poles of a single governmental project insofar as they can be properly calibrated; but at the same time, compassion is presented as an external balance to the governmental project (control), an extra-political restriction of the political sphere. This is a very formal way to put it, but it reflects a simple, vernacular theory that circulates widely among refugee activists. It is expressed with concision in Peter Mares’ groundbreaking book on detention centres, Borderlines, in the chapter title “Compassion as a vice”. Compassion remains one of the major themes and demands of Australian refugee advocates. They thematise compassion not only for the obvious reasons that mandatory detention involves a devastating lack thereof, and that its critics are frequently driven by intense emotional connections both to particular detainees and TPV holders and, more generally, to all who suffer the effects of Australian border control. There is also a historical or conjunctural element: as Ghassan Hage has written, for the last ten years or so many forms of political opposition in Australia have organised their criticisms in terms of “things like compassion or hospitality rather than in the name of a left/right political divide” (7). This tendency is not limited to any one group; it ranges across the spectrum from Liberal Party wets to anarchist collectives, via dozens of organised groups and individuals varying greatly in their political beliefs and intentions. In this context, it would be tendentious to offer any particular example(s) of compassionate activism, so let me instead cite a complaint. In November 2002, the conservative journal Quadrant worried that morality and compassion “have been appropriated as if by right by those who are opposed to the government’s policies” on border protection (“False Refugees” 2). Thus, the right was forced to begin to speak the language of compassion as well. The Department of Immigration, often considered the epitome of the lack of compassion in Australian politics, use the phrase “Australia is a compassionate country, but…” so often they might as well inscribe it on their letterhead. Of course this is hypocritical, but it is not enough to say the right are deforming the true meaning of the term. The point is that compassion is a contested term in Australian political discourse; its meanings are not fixed, but constructed and struggled over by competing political interests. This should not be particularly surprising. Stuart Hall, following Ernesto Laclau and others, famously argued that no political term has an intrinsic meaning. Meanings are produced – articulated, and de- or re-articulated – through a dynamic and partisan “suturing together of elements that have no necessary or eternal belongingness” (10). Compassion has many possible political meanings; it can be articulated to diverse social (and antisocial) ends. If I was writing on the politics of compassion in the US, for example, I would be talking about George W. Bush’s slogan of “compassionate conservatism”, and whatever Hannah Arendt meant when she argued that “the passion of compassion has haunted and driven the best men [sic] of all revolutions” (65), I think she meant something very different by the term than do, say, Rural Australians for Refugees. As Lauren Berlant has written, “politicized feeling is a kind of thinking that too often assumes the obviousness of the thought it has” (48). Hage has also opened this assumed obviousness to question, writing that “small-‘l’ liberals often translate the social conditions that allow them to hold certain superior ethical views into a kind of innate moral superiority. They see ethics as a matter of will” (8-9). These social conditions are complex – it isn’t just that, as some on the right like to assert, compassion is a product of middle class comfort. The actual relations are more dynamic and open. Connections between class and occupational categories on the one hand, and social attitudes and values on the other, are not given but constructed, articulated and struggled over. As Hall put it, the way class functions in the distribution of ideologies is “not as the permanent class-colonization of a discourse, but as the work entailed in articulating these discourses to different political class practices” (139). The point here is to emphasise that the politics of compassion are not straightforward, and that we can recognise and affirm feelings of compassion while questioning the politics that seem to emanate from those feelings. For example, a politics that takes compassion as its basis seems ill-suited to think through issues it can’t put a human face to – that is, the systematic and structural conditions for mandatory detention and border control. Compassion’s political investments accrue to specifiable individuals and groups, and to the harms done to them. This is not, as such, a bad thing, particularly if you happen to be a specifiable individual to whom a substantive harm has been done. But compassion, going one by one, group by group, doesn’t cope well with situations where the form of the one, or the form of the disadvantaged minority, constitutes not only a basis for aid or emancipation, but also violently imposes particular ideas of modern western subjectivity. How does this violence work? I want to answer by way of the story of an Iranian man who applied for asylum in Australia in 2004. In the available documents he is referred to as “the Applicant”. The Applicant claimed asylum based on his homosexuality, and his fear of persecution should he return to Iran. His asylum application was rejected by the Refugee Review Tribunal because the Tribunal did not believe he was really gay. In their decision they write that “the Tribunal was surprised to observe such a comprehensive inability on the Applicant’s part to identify any kind of emotion-stirring or dignity-arousing phenomena in the world around him”. The phenomena the Tribunal suggest might have been emotion-stirring for a gay Iranian include Oscar Wilde, Alexander the Great, Andre Gide, Greco-Roman wrestling, Bette Midler, and Madonna. I can personally think of much worse bases for immigration decisions than Madonna fandom, but there is obviously something more at stake here. (All quotes from the hearing are taken from the High Court transcript “WAAG v MIMIA”. I have been unable to locate a transcript of the original RRT decision, and so far as I know it remains unavailable. Thanks to Mark Pendleton for drawing my attention to this case, and for help with references.) Justice Kirby, one of the presiding Justices at the Applicant’s High Court appeal, responded to this with the obvious point, “Madonna, Bette Midler and so on are phenomena of the Western culture. In Iran, where there is death for some people who are homosexuals, these are not in the forefront of the mind”. Indeed, the High Court is repeatedly critical and even scornful of the Tribunal decision. When Mr Bennett, who is appearing for the Minister for Immigration in the appeal begins his case, he says, “your Honour, the primary attack which seems to be made on the decision of the –”, he is cut off by Justice Gummow, who says, “Well, in lay terms, the primary attack is that it was botched in the Tribunal, Mr Solicitor”. But Mr Bennett replies by saying no, “it was not botched. If one reads the whole of the Tribunal judgement, one sees a consistent line of reasoning and a conclusion being reached”. In a sense this is true; the deep tragicomic weirdness of the Tribunal decision is based very much in the unfolding of a particular form of homophobic rationality specific to border control and refugee determination. There have been hundreds of applications for protection specifically from homophobic persecution since 1994, when the first such application was made in Australia. As of 2002, only 22% of those applications had been successful, with the odds stacked heavily against lesbians – only 7% of lesbian applicants were successful, against a shocking enough 26% of gay men (Millbank, Imagining Otherness 148). There are a number of reasons for this. The Tribunal has routinely decided that even if persecution had occurred on the basis of homosexuality, the Applicant would be able to avoid such persecution if she or he acted ‘discreetly’, that is, hid their sexuality. The High Court ruled out this argument in 2003, but the Tribunal maintains an array of effective techniques of homophobic exclusion. For example, the Tribunal often uses the Spartacus International Gay Guide to find out about local conditions of lesbian and gay life even though it is a tourist guide book aimed at Western gay men with plenty of disposable income (Dauvergne and Millbank 178-9). And even in cases which have found in favour of particular lesbian and gay asylum seekers, the Tribunal has often gone out of its way to assert that lesbians and gay men are, nevertheless, not the subjects of human rights. States, that is, violate no rights when they legislate against lesbian and gay identities and practices, and the victims of such legislation have no rights to protection (Millbank, Fear 252-3). To go back to Madonna. Bennett’s basic point with respect to the references to the Material Girl et al is that the Tribunal specifically rules them as irrelevant. Mr Bennett: The criticism which is being made concerns a question which the Tribunal asked and what is very much treated in the Tribunal’s judgement as a passing reference. If one looks, for example, at page 34 – Kirby J: This is where Oscar, Alexander and Bette as well as Madonna turn up? Mr Bennett: Yes. The very paragraph my learned friend relies on, if one reads the sentence, what the Tribunal is saying is, “I am not looking for these things”. Gummow J: Well, why mention it? What sort of training do these people get in decision making before they are appointed to this body, Mr Solicitor? Mr Bennett: I cannot assist your Honour on that. Gummow J: No. Well, whatever it is, what happened here does not speak highly of the results of it. To gloss this, Bennett argues that the High Court are making too much of an irrelevant minor point in the decision. Mr Bennett: One would think [based on the High Court’s questions] that the only things in this judgement were the throwaway references saying, “I wasn’t looking for an understanding of Oscar Wilde”, et cetera. That is simply, when one reads the judgement as a whole, not something which goes to the centre at all… There is a small part of the judgement which could be criticized and which is put, in the judgement itself, as a subsidiary element and prefaced with the word “not”. Kirby J: But the “not” is a bit undone by what follows when I think Marilyn [Monroe] is thrown in. Mr Bennett: Well, your Honour, I am not sure why she is thrown in. Kirby J: Well, that is exactly the point. Mr Bennett holds that, as per Wayne’s World, the word “not” negates any clause to which it is attached. Justice Kirby, on the other hand, feels that this “not” comes undone, and that this undoing – and the uncertainty that accrues to it – is exactly the point. But the Tribunal won’t be tied down on this, and makes use of its “not” to hold gay stereotypes at arm’s length – which is still, of course, to hold them, at a remove that will insulate homophobia against its own illegitimacy. The Tribunal defends itself against accusations of homophobia by announcing specifically and repeatedly, in terms that consciously evoke culturally specific gay stereotypes, that it is not interested in those stereotypes. This unconvincing alibi works to prevent any inconvenient accusations of bias from butting in on the routine business of heteronormativity. Paul Morrison has noted that not many people will refuse to believe you’re gay: “Claims to normativity are characteristically met with scepticism. Only parents doubt confessions of deviance” (5). In this case, it is not a parent but a paternalistic state apparatus. The reasons the Tribunal did not believe the applicant [were] (a) because of “inconsistencies about the first sexual experience”, (b) “the uniformity of relationships”, (c) the “absence of a “gay” circle of friends”, (d) “lack of contact with the “gay” underground” and [(e)] “lack of other forms of identification”. Of these the most telling, I think, are the last three: a lack of gay friends, of contact with the gay underground, or of unspecified other forms of identification. What we can see here is that even if the Tribunal isn’t looking for the stereotypical icons of Western gay culture, it is looking for the characteristic forms of Western gay identity which, as we know, are far from universal. The assumptions about the continuities between sex acts and identities that we codify with names like lesbian, gay, homosexual and so on, often very poorly translate the ways in which non-Western populations understand and describe themselves, if they translate them at all. Gayatri Gopinath, for example, uses the term “queer diaspor[a]... in contradistinction to the globalization of “gay” identity that replicates a colonial narrative of development and progress that judges all other sexual cultures, communities, and practices against a model of Euro-American sexual identity” (11). I can’t assess the accuracy of the Tribunal’s claims regarding the Applicant’s social life, although I am inclined to scepticism. But if the Applicant in this case indeed had no gay friends, no contact with the gay underground and no other forms of identification with the big bad world of gaydom, he may obviously, nevertheless, have been a Man Who Has Sex With Men, as they sometimes say in AIDS prevention work. But this would not, either in the terms of Australian law or the UN Convention, qualify him as a refugee. You can only achieve refugee status under the terms of the Convention based on membership of a ‘specific social group’. Lesbians and gay men are held to constitute such groups, but what this means is that there’s a certain forcing of Western identity norms onto the identity and onto the body of the sexual other. This shouldn’t read simply as a moral point about how we should respect diversity. There’s a real sense that our own lives as political and sexual beings are radically impoverished to the extent we fail to foster and affirm non-Western non-heterosexualities. There’s a sustaining enrichment that we miss out on, of course, in addition to the much more serious forms of violence others will be subject to. And these are kinds of violence as well as forms of enrichment that compassionate politics, organised around the good refugee, just does not apprehend. In an essay on “The politics of bad feeling”, Sara Ahmed makes a related argument about national shame and mourning. “Words cannot be separated from bodies, or other signs of life. So the word ‘mourns’ might get attached to some subjects (some more than others represent the nation in mourning), and it might get attached to some objects (some losses more than others may count as losses for this nation)” (73). At one level, these points are often made with regard to compassion, especially as it is racialised in Australian politics; for example, that there would be a public outcry were we to detain hypothetical white boat people. But Ahmed’s point stretches further – in the necessary relation between words and bodies, she asks not only which bodies do the describing and which are described, but which are permitted a relation to language at all? If “words cannot be separated from bodies”, what happens to those bodies words fail? The queer diasporic body, so reductively captured in that phrase, is a case in point. How do we honour its singularity, as well as its sociality? How do we understand the systematicity of the forces that degrade and subjugate it? What do the politics of compassion have to offer here? It’s easy for the critic or the cynic to sneer at such politics – so liberal, so sentimental, so wet – or to deconstruct them, expose “the violence of sentimentality” (Berlant 62), show “how compassion towards the other’s suffering might sustain the violence of appropriation” (Ahmed 74). These are not moves I want to make. A guiding assumption of this essay is that there is never a unilinear trajectory between feelings and politics. Any particular affect or set of affects may be progressive, reactionary, apolitical, or a combination thereof, in a given situation; compassionate politics are no more necessarily bad than they are necessarily good. On the other hand, “not necessarily bad” is a weak basis for a political movement, especially one that needs to understand and negotiate the ways the enclosures and borders of late capitalism mass-produce bodies we can’t put names to, people outside familiar and recognisable forms of identity and subjectivity. As Etienne Balibar has put it, “in utter disregard of certain borders – or, in certain cases, under covers of such borders – indefinable and impossible identities emerge in various places, identities which are, as a consequence, regarded as non-identities. However, their existence is, none the less, a life-and-death question for large numbers of human beings” (77). Any answer to that question starts with our compassion – and our rage – at an unacceptable situation. But it doesn’t end there. References Ahmed, Sara. “The Politics of Bad Feeling.” Australian Critical Race and Whiteness Studies Association Journal 1.1 (2005): 72-85. Arendt, Hannah. On Revolution. Harmondsworth: Penguin, 1973. Balibar, Etienne. We, the People of Europe? Reflections on Transnational Citizenship. Trans. James Swenson. Princeton: Princeton UP, 2004. Berlant, Lauren. “The Subject of True Feeling: Pain, Privacy and Politics.” Cultural Studies and Political Theory. Ed. Jodi Dean. Ithaca and Cornell: Cornell UP, 2000. 42-62. Bureau of Immigration and Population Research. Illegal Entrants in Australia: An Annotated Bibliography. Canberra: Australian Government Publishing Service, 1994. Dauvergne, Catherine and Jenni Millbank. “Cruisingforsex.com: An Empirical Critique of the Evidentiary Practices of the Australian Refugee Review Tribunal.” Alternative Law Journal 28 (2003): 176-81. “False Refugees and Misplaced Compassion” Editorial. Quadrant 390 (2002): 2-4. Hage, Ghassan. Against Paranoid Nationalism: Searching for Hope in a Shrinking Society. Annandale: Pluto, 2003. Hall, Stuart. The Hard Road to Renewal: Thatcherism and the Crisis of the Left. London: Verso, 1988. Joint Standing Committee on Migration. Illegal Entrants in Australia: Balancing Control and Compassion. Canberra: The Committee, 1990. Mares, Peter. Borderline: Australia’s Treatment of Refugees and Asylum Seekers. Sydney: UNSW Press, 2001. Millbank, Jenni. “Imagining Otherness: Refugee Claims on the Basis of Sexuality in Canada and Australia.” Melbourne University Law Review 26 (2002): 144-77. ———. “Fear of Persecution or Just a Queer Feeling? Refugee Status and Sexual orientation in Australia.” Alternative Law Journal 20 (1995): 261-65, 299. Morrison, Paul. The Explanation for Everything: Essays on Sexual Subjectivity. New York: New York UP, 2001. Pendleton, Mark. “Borderline.” Bite 2 (2004): 3-4. “WAAG v MIMIA [2004]. HCATrans 475 (19 Nov. 2004)” High Court of Australia Transcripts. 2005. 17 Oct. 2005 http://www.austlii.edu.au/au/other/HCATrans/2004/475.html>. Citation reference for this article MLA Style McGrath, Shane. "Compassionate Refugee Politics?." M/C Journal 8.6 (2005). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0512/02-mcgrath.php>. APA Style McGrath, S. (Dec. 2005) "Compassionate Refugee Politics?," M/C Journal, 8(6). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0512/02-mcgrath.php>.
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Ellis, Katie. „Complicating a Rudimentary List of Characteristics: Communicating Disability with Down Syndrome Dolls“. M/C Journal 15, Nr. 5 (12.10.2012). http://dx.doi.org/10.5204/mcj.544.

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Apparently some people upon coming across [Down Syndrome dolls] were offended. […] Still, it’s curious, and telling, what gives offense. Was it the shock of seeing a doll not modeled on the normative form that caused such offense? Or the assumption that any representation of Down Syndrome must naturally intend ridicule? Either way, it would seem that we might benefit from an examination of such reactions—especially as they relate to instances of the idealisation of the human form that dolls […] represent. (Faulkner) IntroductionWhen Joanne Faulkner describes public criticism of dolls designed to look like they have Down Syndrome, she draws attention to the need for an examination of the way discourses of disability are communicated. She calls, in particular, for an interrogation of people’s reactions to the disruption of the idealised human form that most dolls adopt. The case of Down Syndrome dolls is fascinating, yet critical discussion of these dolls from a disability or cultural studies perspective is conspicuously lacking. To address this lack, this paper draws upon theories of the cultural construction of disability, beauty, and normalcy (Garland-Thompson, Kumari Campbell, Wendell), to explore the way ideas about disability are communicated and circulated. The dominant discourse of disability is medical, where people are diagnosed or identified as disabled if they meet certain criteria, or lists of physical impairments. These lists have a tendency to subsume the disparate qualities of disability (Garland-Thompson) and remove people considered disabled from the social and cultural world in which they live (Snyder and Mitchell 377). While Down Syndrome dolls, produced by Downi Creations and Helga’s European Speciality Toys (HEST) in the US and Europe respectively, are reflective of such lists, they also perform the cultural function of increasing the visibility of disability in society. In addition, the companies distributing these dolls state that they are striving for greater inclusion of people with Down Syndrome (Collins, Parks). However, the effect of the dominance of medicalised discourses of disability can be seen in the public reaction to these dolls. This paper seeks also to bring an interrogation of disability into dialogue with a critical analysis of the discursive function of lists.The paper begins with a consideration of lists as they have been used to define disability and organise knowledge within medicine, and the impact this has had on the position of disability within society. In order to differentiate itself from medical discourses, the emerging social model also relied on lists during the 1980s and 1990s. However, these lists also decontextualised disability by ignoring certain factors for political advantage. The social model, like medicine, tended to ignore the diversity of humanity it was apparently arguing for (Snyder and Mitchell 377). The focus then shifts to the image of Down Syndrome dolls and the ensuing negative interpretation of them focusing, in particular, on reader comments following a Mail Online (Fisher) article. Although the dolls were debated across the blogosphere on a number of disability, special needs parenting, and Down Syndrome specific blogs, people commenting on The Mail Online—a UK based conservative tabloid newspaper—offer useful insights into communication and meaning making around disability. People establish meanings about disability through communication (Hedlund 766). While cultural responses to disability are influenced by a number of paradigms of interpretation such as superstition, religion, and fear, this paper is concerned with the rejection of bodies that do not ascribe to cultural standards of beauty and seeks to explore this paradigm alongside and within the use of lists by the various models of disability. This paper interrogates the use of lists in the way meanings about disability are communicated through the medical diagnostic list, the Down Syndrome dolls, and reactions to them. Each list reduces the disparate qualities and experiences of disability, yet as a cultural artefact, these dolls go some way towards recognising the social and cultural world that medicalised discourses of disability ignore. Drawing on the use of lists within different frameworks of disability, this paper contrasts the individual, or medical, model of disability (that being disabled is a personal problem) with the social model (that exclusion due to disability is social oppression). Secondly, the paper compares the characteristics of Down Syndrome dolls with actual characteristics of Down Syndrome to conclude that these features aim to be a celebrated, not stigmatised, aspect of the doll. By reasserting alternative notions of the body, the dolls point towards a more diverse society where disability can be understood in relation to social oppression. However, these aims of celebration have not automatically translated to a more diverse understanding. This paper aims to complicate perceptions of disability beyond a rudimentary list of characteristics through a consideration of the negative public response to these dolls. These responses are an example of the cultural subjugation of disability.Lists and the Creation of Normative Cultural ValuesFor Robert Belknap, lists are the dominant way of “organizing data relevant to human functioning” (8). While lists are used in a number of ways and for a variety of purposes, Belknap divides lists into two categories—the practical and the literary. Practical lists store meanings, while literary lists create them (89). Belknap’s recognition of the importance of meaning making is particularly relevant to a cultural interrogation of disability. As Mitchell and Snyder comment:Disability’s representational “fate” is not so much dependant upon a tradition of negative portrayals as it is tethered to inciting the act of meaning-making itself. (6)Disability unites disparate groups of people whose only commonality is that they are considered “abnormal” (Garland-Thompson). Ableism—the beliefs, processes, and practices which produce the ideal body—is a cultural project in which normative values are created in an attempt to neutralise the fact that all bodies are out of control (Kumari Campbell). Medical models use diagnostic lists and criteria to remove bodies from their social and cultural context and enforce an unequal power dynamic (Snyder and Mitchell 377).By comparison, the social model of disability shifts the emphasis to situate disability in social and cultural practices (Goggin and Newell 36). Lists have also been integral to the formation of the social model of disability as theorists established binary oppositions between medical and social understandings of disability (Oliver 22). While these lists have no “essential meaning,” through discourse they shape human experience (Liggett). Lists bring disparate items together to structure meaning and organisation. According to Hedlund, insights into the experience of disability—which is neither wholly medical nor wholly social—can be found in the language we use to communicate ideas about disability (766). For example, while the recent production of children’s dolls designed to reflect a list of the physical features of Down Syndrome (Table 2) may have no inherent meaning, negative public reception reveals recognisable modes of understanding disability. Down Syndrome dolls are in stark contrast to dolls popularly available which assume a normative representation. For Blair and Shalmon (15), popular children’s toys communicate cultural standards of beauty. Naomi Wolf describes beauty as a socially constructed normative value used to disempower women in particular. The idealisation of the human form is an aspect of children’s toys that has been criticised for perpetuating a narrow conception of beauty (Levy 189). Disability is likewise subject to social construction and is part of a collective social reality beyond diagnostic lists (Hedlund 766).Organising Knowledge: The Social vs. Medical Model of DisabilityDisability has long been moored in medical cultures and institutions which emphasise a sterile ideal of the body based on a diagnosis of biological difference as deviance. For example, in 1866, John Langdon Down sought to provide a diagnostic classification system for people with, what would later come to be called (after him), Down Syndrome. He focused on physical features:The hair is […] of a brownish colour, straight and scanty. The face is flat and broad, and destitute of prominence. The cheeks are roundish, and extended laterally. The eyes are obliquely placed, and the internal canthi more than normally distant from one another. The palpebral fissure is very narrow. The forehead is wrinkled transversely from the constant assistance which the levatores palpebrarum derive from the occipito-frontalis muscle in the opening of the eyes. The lips are large and thick with transverse fissures. The tongue is long, thick, and is much roughened. The nose is small. The skin has a slight dirty yellowish tinge, and is deficient in elasticity, giving the appearance of being too large for the body. (Down)These features form what Belknap would describe as a “pragmatic” list (12). For Belknap, scientific classification, such as the description Langdon Down offers above, introduces precision and validation to the use of lists (167). The overt principle linking these disparate characteristics together is the normative body from which these features deviate. Medicalised discourses, such as Down’s list, have been linked with the institutionalisation of people with this condition and their exclusion from the broader community (Hickey-Moody 23). Such emphasis on criteria to proffer diagnosis removes and decontextualises bodies from the world in which they live (Snyder and Mitchell 370). This world may in fact be the disabling factor, rather than the person’s body. The social model emerged in direct opposition to medicalised definitions of disability as a number of activists with disabilities in the United Kingdom formed The Union of Physically Impaired Against Segregation (UPIAS) and concluded that people with disability are disabled not by their bodies but by a world structured to exclude their bodies (Finkelstein 13). By separating disability (socially created) from impairment (the body), disability is understood as society’s unwillingness to accommodate the needs of people with impairments. The British academic and disability activist Michael Oliver was central to the establishment of the social model of disability. Following the activities of the UPIAS, Oliver (re)defined disability as a “form of social oppression,” and created two lists (reproduced below) to distinguish between the social and individual (or medical) models of disability. By utilising the list form in this way, Oliver both provided a repository of information regarding the social model of disability and contextualised it in direct opposition to what he describes as the individual model. These lists present the social model as a coherent discipline, in an easy to understand format. As Belknap argues, the suggestion of order is a major tool of the list (98). Oliver’s list suggests a clear order to the emerging social model of disability—disability is a problem with society, not an individual. However, this list was problematic because it appeared to disregard impairment within the experience of disability. As the “impersonal became political” (Snyder and Mitchell 377), impairment became the unacknowledged ambiguity in the binary opposition the social model was attempting to create (Shakespeare 35). Nevertheless, Oliver’s lists successfully enforced a desired order to the social model of disability. The individual modelThe social modelPersonal tragedy theorySocial oppression theoryPersonal problemSocial problemIndividual treatmentSocial actionMedicalisationSelf helpProfessional dominanceIndividual and collective responsibilityExpertiseExperienceAdjustmentAffirmationIndividual identityCollective identityPrejudiceDiscriminationAttitudesBehaviourCareRightsControlChoicePolicyPoliticsIndividual adaptation Social changeTable 1 The Individual v Social Model of Disability (Oliver)The social model then went through a period of “lists,” especially when discussing media and culture. Positive versus negative portrayals of disability were identified and scholars listed strategies for the appropriate representation of disability (Barnes, Barnes Mercer and Shakespeare). The representations of impairment or the physical markers of disability were discouraged as the discipline concerned itself with establishing disability as a political struggle against a disabling social world. Oliver’s lists arrange certain “facts” about disability. Disability is framed as a social phenomenon where certain aspects are emphasised and others left out. While Oliver explains that these lists were intended to represent extreme ends of a continuum to illustrate the distinction between disability and impairment (33), these are not mutually exclusive categories (Shakespeare 35). Disability is not simply a list of physical features, nor is it a clear distinction between individual/medical and social models. By utilising lists, the social model reacts to and attempts to move beyond the particular ordering provided by the medical model, but remains tied to a system of classification that imposes order on human functioning. Critical analysis of the representation of disability must re-engage the body by moving beyond binaries and pragmatic lists. While lists organise data central to human functioning, systems of meaning shape the organisation of human experience. Down Syndrome dolls, explored in the next section, complicate the distinction between the medical and social models.Down Syndrome DollsThese dolls are based on composites of a number of children with Down Syndrome (Hareyan). Helga Parks, CEO of HEST, describes the dolls as a realistic representation of nine physical features of Down Syndrome. Likewise, Donna Moore of Downi Creations employed a designer to oversee the production of the dolls which boast 13 features of Down Syndrome (Velasquez). These features are listed in the table below. HEST Down Syndrome Dolls Downi CreationsSmall ears set low on head with a fold at the topSmall ears with a fold at the topEars set low on the headSmall mouthSmall mouthProtruding tongueSlightly protruding tongueShortened fingers Shortened fingersPinkie finger curves inwardAlmond shaped eyesAlmond-shaped eyesHorizontal crease in palm of handHorizontal crease in palm of handGap between first and second toeA gap between the first and second toesShortened toesFlattened back of headFlattened back of headFlattened bridge across nose Flattened bridge across noseOptional: An incision in the chest to indicate open-heart surgery Table 2: Down Syndrome Dolls (Parks, Velasquez) Achieving the physical features of Down Syndrome is significant because Parks and Moore wanted children with the condition to recognise themselves:When a child with Down’s syndrome [sic.] picks up a regular doll, he doesn’t see himself, he sees the world’s perception of “perfect.” Our society is so focused on bodily perfection. (Cresswell)Despite these motivations, studies show that children with Down Syndrome prefer to play with “typical dolls” that do not reflect the physical characteristics of Down Syndrome (Cafferty 49). According to Cafferty, it is possible that children prefer typical dolls because they are “more attractive” (49). Similar studies of diverse groups of children have shown that children prefer to play with dolls they perceive as fitting into social concepts of beauty (Abbasi). Deeply embedded cultural notions of beauty—which exclude disability (see Morris)—are communicated from childhood (Blair & Shalmon 15). Notions of bodily perfection dominate children’s toys and Western culture in general as Cresswell comments above. Many bodies, not just those deemed “disabled,” do not conform to these cultural standards. Cultural ideals of beauty and an idealisation of the human body according to increasingly narrow parameters are becoming conflated with conceptions of normality (Wendell 86). Recognition of disability as subject to cultural rejection allows us to see “beauty and normalcy [as] a series of practices and positions [taken] in order to avoid the stigmatization of ugliness and abnormality” (Garland-Thompson). The exaggerated features of the doll problematise the idea that people with disability should strive to appear as nondisabled as possible and in turn highlights that some people, such as those with Down Syndrome, cannot “pass” as nondisabled and must therefore navigate a life and community that is not welcoming. While lists of the features of Down Syndrome store associated medicalised meanings, the discussion of the dolls online (the medium through which they are sold) provides insight into the cultural interpretation of disability and the way meaning is made. The next section of the paper considers a selection of negative responses to the Down Syndrome dolls that followed an article published in Mail Online (Fisher). What Causes Offence? Prior to Down Syndrome dolls, the majority of “disability dolls” were constructed through their accessories rather than through the dolls’ physical form and features. Wheelchairs, white canes, guide dogs and harnesses, plastic walkers, leg braces, and hearing aids could be purchased for use with dolls. Down Syndrome dolls look different as the features of impairment are embedded in the dolls’ construction. While accessories have a more temporary feel about them, the permanence of the impairments attributed to the doll was problematic for some who felt it projected a negative image of disability. Listed below are several negative comments following an article published in Mail Online (Fisher):What a grim world we are living in. No longer are dollies for play, for make believe, or for fun. Now it all about self image and psychological “help.” We “disabled” know we are “disabled”—we don’t need a doll to remind us of that! Stop making everything PC; let children be children and play and laugh once again!I think it’s sick and patronising.Who on earth are those education “experts?” Has nobody told them that you don’t educate children by mirroring their defects/weaknesses/negative traits but by doing exactly the opposite, mirroring back the BEST in them?The Downs Syndrome doll looks like they took the physical traits and presented them in an exaggerated way to make them more noticeable. That doll does not look attractive to me at all. If someone has a child that WANTS such a doll, fine. I can’t really see how it would help many of them, it would be like a huge sign saying “You are different.”The terminology used (grim, sick, patronising, defect, weak, negative, unattractive, different) to describe disability in these posts is significant. These descriptions are ideological categories which disadvantage and devalue “bodies that do not conform to certain cultural standards” (Garland-Thompson). Implicit and explicit in all of these comments is the sense that disability and Downs Syndrome in particular is undesirable, unattractive even. When listed together, like Belknap’s literary lists, they are not random or isolated interpretations; they form part of a larger system of meaning making around disability.These responses are informed by the notion that in order to gain equality in society, people with disability must suppress their difference and focus instead on how they are really just like everybody else. However, this focus ignores barriers to inclusion, such as in the rejection of bodies that do not ascribe to cultural standards of beauty. An increasing visibility of impairment in popular culture such as children’s toys advances an understanding of disability as diversity through difference and not something inherently bad. ConclusionPeter Laudin of Pattycake Doll, a company which sells Black, Hispanic, Asian, and Disabled dolls, has found that children “love all dolls unconditionally whether it’s special needs or not” (Lee Adam). He suggests that the majority of the negative responses to the Down Syndrome dolls stem from prejudice (Lee Adam). Dolls popularly available idealise the human form and assume a normative representation. While this has been criticised for communicating damaging standards of beauty from childhood (Levy, Blair and Shalmon), critiques about disability are not as widely understood. The social and medical models of disability focus attention on certain aspects of disability through lists; however, the reduction of diagnostic criteria in the form of a list (whether medical or social) decontextualises disability from the social and cultural world. Thus, the list form, while useful, has elided the disparate qualities of disability. As Belknap argues, lists “ask us to make them meaningful” (xv). Although the dolls discussed in this paper have been criticised for stereotyping and emphasising the difference between children with disability and those without, an inclusion of the physical features of Down Syndrome is consistent with recent moves within critical disability studies to re-engage the body (Shakespeare 35). As Faulkner notes in the epigraph to this paper, an examination of negative reactions to these dolls reveals much about the cultural position of people with disability. References Abbasi, Jennifer. “Why 6-Year Old Girls Want to be Sexy.” Live Science 16 July (2012). 30 Aug. 2012 ‹http://www.livescience.com/21609-self-sexualization-young-girls.html›. Barnes, Colin. Disabling Imagery and the Media: An Exploration of the Principles for Media Representations of Disabled People. Krumlin Halifax: Ryburn Publishing, 1992. 5 Aug. 2012 http://www.leeds.ac.uk/disability-studies/archiveuk/Barnes/disabling%20imagery.pdf.Barnes, Colin, Geoff Mercer, and Tom Shakespeare. Exploring Disability: A Sociological Introduction. Malden: Polity Press, 1999.Belknap, Robert. The List: The Uses and Pleasures of Cataloguing. New Haven: Yale U P, 2004.Blair, Lorrie, and Maya Shalmon. “Cosmetic Surgery and the Cultural Construction of Beauty.” Art Education 58.3 (2005): 14-18.Cafferty, Diana De Rosa. A Doll Like Me: Do Children with Down Syndrome Prefer to Play with Dolls That Have the Physical Features Associated with Down Syndrome? MS thesis. U of California, 2012. Campbell, Fiona Kumari. Contours of Ableism: The Production of Disability and Abledness. New York: Palgrave Macmillan, 2009.Collins, Allyson. “Dolls with Down Syndrome May Help Kids.” ABC News. 27 Jun. 2008. 4 Oct. 2012 ‹http://abcnews.go.com/Health/Parenting/story?id=5255393&page=1#.UGzQXK6T-XP›. Cresswell, Adam. “Dolls with Disability Divide Opinion.” The Australian 12 Jul. 2008. 26 Dec. 2008 ‹http://www.theaustralian.news.com.au/story/0,25197,24000338-23289,00.html›.Down, John Langdon. “Observations on an Ethnic Classification of Idiots.” Neonatology on the Web. 1866. 3 Aug. 2012 ‹http://www.neonatology.org/classics/down.html›.Faulkner, Joanne “Disability Dolls.” What Sorts of People? 26 Jun. 2008. 29 Aug. 2012 ‹http://whatsortsofpeople.wordpress.com/2008/06/26/disability-dolls/›.Finkelstein, Vic. “Representing Disability.” Disabling Barriers—Enabling Environments. Ed. John Swain, et al. Los Angeles: Sage, 2004. 13-20.Fisher, Lorraine. “Parents’ Fury at ‘Down's Syndrome Dolls’ Designed to Help Children Deal with Disability.” Mail Online 7 Jul. 2008. 26 Dec. 2008. ‹http://www.dailymail.co.uk/femail/article-1032600/Parents-fury-Downs-Syndrome-dolls-designed-help-children-deal-disability.html›. Garland-Thomson, Rosemarie. “Re-Shaping, Re-Thinking, Re-Defining: Feminist Disability Studies.” The Free Library 1 Jan. 2008. 3 Aug. 2012. ‹http://www.thefreelibrary.com/Re-shaping, Re-thinking, Re-defining: Feminist Disability Studies.-a084377500›.Goggin, Gerard and Christopher Newell. Disability in Australia: Exposing a Social Apartheid. Sydney: U of New South Wales, 2005.Hareyan, Armen. “Using Dolls to Reduce the Stigma of Down Syndrome.” EMax Health. 4 Dec. 2008. Jan 2009 ‹http://www.emaxhealth.com/7/22865.html›.Hedlund, Marianne. “Disability as a Phenomenon: A Discourse of Social and Biological Understanding.” Disability & Society. 15.5 (2000): 765-80.Hickey-Moody, Anna. Unimaginable Bodies. Netherlands: Sense Publishers, 2009.Lee Adams, William. “New Dolls on the Block.” Time Magazine 19 Mar. 2009. 13 Dec. 2009. ‹http://www.time.com/time/magazine/article/0,9171,1886457,00.html›.Levy, Ariel. Female Chauvinist Pigs: Women and the Rise of Raunch Culture. Collingwood: Black Inc. 2010.Liggett, Helen. “Stars are not Born: An Interpretive Approach to the Politics of Disability” in Disability Studies: Past Present and Future. Ed. Len Barton and Mike Oliver. Leeds: The Disability Press, 1997. 178-194.Mitchell, David and Sharon Snyder. Narrative Prosthesis: Disability and the Dependencies of Discourse. Ann Arbor, The U of Michigan P, 2000.Morris, Jenny “A Feminist Perspective.” Framed. Ed. Ann Pointon & Chris Davies. London: British Film Institute, 1997. 21-30. Oliver, Michael. Understanding Disability: From Theory to Practice. New York: Palgrave Macmillan, 1996.Parks, Helga. “New Doll Is Child’s Best Friend.” HEST Press Release, 2005. Shakespeare, Tom. Disability Rights and Wrongs. London: Routledge, 2006.Snyder, Sharon, and David Mitchell. “Re-Engaging the Body: Disability Studes and the Resistance to Embodiment.” Public Culture 13.3 (2001): 367-89.Velasquez, Leticia. “Downi Creations.” 2007. 4 Dec. 2009. ‹http://cause-of-our-joy.blogspot.com/2007/08/downi-creations.html›.Wendell, Susan. The Rejected Body: Feminist Philosophical Reflections on Disability. New York: Routledge, 1996.Wolf, Naomi. The Beauty Myth: How Images of Beauty Are Used against Women. New York: Harper Perennial, 2002 [1991].
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35

Podkalicka, Aneta. „To Brunswick and Beyond: A Geography of Creative and Social Participation for Marginalised Youth“. M/C Journal 14, Nr. 4 (18.08.2011). http://dx.doi.org/10.5204/mcj.367.

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This article uses a case study of a Melbourne-based youth media project called Youthworx to explore the processes at stake in cultural engagement for marginalised young people. Drawing on ethnographic research conducted between 2008 and 2010, I identify some ways in which the city is implicated in promoting or preventing access to socially valued spaces of creativity and intended social mobility. The ethnographic material presented here has both empirical and theoretical value. It reveals the important relationships between the experience of place, creativity, and social life, demonstrating potentialities and limits of creativity-focused development interventions for marginalised youth. The articulation of these relationships and processes taking place within a particular city setting has theoretical implications. It opens up an opportunity to consider "suburbs" as enacted by specific forms of access, contingencies, and opportunities for a particular demographic, rather than treating "suburbs" as abstract, analytical constructs. Finally, my empirically grounded discussion draws attention to cultural and social consequences that inhabiting certain social worlds and acts of travelling "to and beyond" them have for young people. Youthworx is a community-based youth media initiative employing pathway-based semi-formal creative practices to re-engage young people who have a history of drug or alcohol abuse or juvenile justice, who have been long disconnected from mainstream education, or who are homeless. The focus on media production allows it to tap into, and in fact leverage, popular creativity, tacit knowledge, and familiar media-based activities that young people bring to bear on their media training and work in this context. Underpinned by social and creative industry policy, Youthworx brings together social service agency The Salvation Army (TSA), educational provider Northern Melbourne Institute of TAFE (NMIT), youth community media organisation SYN Media, and researchers at Institute for Social Research, Swinburne University. Its day-to-day operation is run by contractual, part-time media facilitators, social workers (as part of TSA’s in-kind support), as well as media industry experts who provide casual media training. Youthworx is characterised by the diversity of its young demographic. One can differentiate between at least two groups of participants: those who join Youthworx because of the social opportunities, and those who put more value on its skill-development, or vocational creative industries orientation. This social organisation is, however, far from static. Over the two years of research (2008-2010) we observed evolving ideas about the identity of the program, its key social functions, and how they can be best served. This had proceeded with the construction of what the Youthworx staff term "a community of safe belonging" to a more "serious" media work environment, exemplified by the establishment of a social enterprise (Youthworx Productions) in 2010 that offers paid traineeships to the most capable and determined young creators. To accommodate the diversity of literacy levels, needs, and aspirations of its young participants, the project offers a tailored media education program with a mix of diversionary, educational, and commercial objectives. One-on-one media training sessions, accredited courses in Creative Industries (Media), and industry training within Youthworx Productions are provided to help young people develop a range of skills transferable into a variety of personal, social and professional contexts. Its creative studio, where learning occurs, is located in a former jeans factory warehouse in the heart of an industrial area of Melbourne’s northern inner-city suburb of Brunswick. Young people are referred to Youthworx by a range of social agencies, and they travel to Brunswick from across Melbourne. Some participants are known to spend over three hours commuting from outer suburbs such as Frankston or even regional towns such as King Lake. Unlike community-based creative programs reliant on established community structures within local suburbs (for example, ICE in Western Sydney), Youthworx moved into Tinning Street in Brunswick because its industry partner—The Salvation Army—had existing youth service infrastructure there. The program, however, was not tapping into an existing media “community of practice” (Lane and Wenger); it had to forge its own culture of media participation. In the early days of the program, there were necessary material resources and professional expertise (teachers/social workers/a creative venue), but it took a long while, and a high level of dedication, passion, and practical optimism on the part of the project managers and teaching staff, for young people to genuinely engage in media training and production. Now, Youthworx’s creative space is a “practised place” in de Certeau’s sense. As “the street geometrically defined by urban planning is transformed into a space by walkers” (De Certeau 117), so is the Youthworx space produced by practices of media learning and making by professional creative practitioners and young amateur creators (Raffo; for ideas on institutionalised co-creative practice see Spurgeon et al.). The Brunswick location is where our extensive ethnographic research has taken place, including regular participant observation and qualitative interviews with staff and young participants. The ethnographers frequently travelled with young people to other locations within Melbourne, accompanying them on their trips to youth community radio station SYN Media in the CBD, where they produce a weekly radio show, as well as to film shoots and public social events around the city. As an access learning program for marginalised youth from around Melbourne, Youthworx provides an interesting example to explore how the concerns of material and cultural capital, geographic and cultural distance intersect and shape processes of creative participation and social inclusion. I draw on our ethnographic material to illustrate how these metonymic relationships play out in the ways young participants “travel distance” (Dewson et. al.) on the project and across the city, both figuratively and literally. The idea of “distance travelled” is adapted here from evaluation literature (for other relevant references see Dowmunt et al.; Hayes and Edwards; Holdsworth et al.), and builds on the argument made previously (Podkalicka and Staley 5), to encompass both the geographical mobility and cultural transformation that young people are supported to undergo as an intended outcome of their involvement in Youthworx. This paper also takes inspiration from ethnographic approaches that study a productive and transformative relationship between material culture, spatial geography and processes of identity formation (see Miller). What happens to Youthworx young participants as they travel in a trivial, and at first sight perhaps inconsequential, way between the suburbs they live in, the Youthworx Brunswick location and the city is both experientially real and meaningful. “Suburban space” is then a cultural site that simultaneously refers to concrete, literal places as well as “a state of mind”—that is, identification and connections that are generative of a sense of identity and belonging (Ferber et al.). Youthworx is an intermediary point on these young people’s travels, rather than the final destination (Podkalicka and Staley 5). It provides access to various forms of new spatial, social, and creative experiences and modes of expression. Creating opportunities for highly disenfranchised young people to access and develop new social and creative experiences is an important aspect of Youthworx’s developmental agenda, and is played out at both philosophical and practical levels. On the one hand, a strength-based approach to youth work assumes respect for young people’s potential and knowledges—unlike public discourses that deny them agency due to an assumed lack of life experience (e.g., Poletti). In addition to the material provision of "food and shelter" typical of traditional social work, attention is paid the higher levels of the Maslow hierarchy of human needs, with creativity, self-esteem, and social connectedness at the top of the scale (see also Podkalicka and Campbell; Podkalicka and Thomas). Former Manager of The Salvation Army’s Brunswick Youth Services (BYS)—one of Youthworx’s partners—Craig Campbell argues: Things like truth and beauty are a higher order of dreams for these kids. And by truth I don’t mean the simple lies that can be told to get them out of trouble [but] is there a greater truth to life than a grinding existence in the impoverished neighbourhood, is there something like beauty and aesthetics that wakes us up in the morning and calls a larger life out of us? Most of those kids only faintly dream of such a thing, and this dream is rapidly being extinguished under the weight of drugs and alcohol, abusive family systems, savage interaction with law and justice system, and education as a toxic environment and experience. (Campbell) Campbell's articulate reflection captures the way the Youthworx project has been conceived. It is also a pertinent example of the many reflections on experience and practice at Youthworx that were recorded in my fieldwork, which illustrate the way these kinds of social projects can be understood, interpreted and evaluated. The following personal narrative and contextual description introduce some of the important issues at stake. (The names and other personal details of young people have been changed.) Nineteen-year-old Dave is temporarily staying in an inner-city refuge. Normally, however, like most Youthworx participants, he lives in Broadmeadows, a far northern suburb of Melbourne. To get to Brunswick, where he does his accredited media course three days a week, he either catches a train or waits for a mini-bus to drive him there. The early-morning pick-up for about ten young people is organised by the program’s partner—The Salvation Army. At the Youthworx creative studio, located in the heart of Brunswick, right next to railway tracks, young people produce an array of media products: live and pre-recorded radio programs, digital storytelling, mini-documentaries, and original music. Once at Youthworx, they share the local neighbourhood with other artists who have adapted warehouses into art workshops, studios and galleries. The suburb of Brunswick is well-known for its multicultural profile, a combination of industrial and residential estates, high rates of tertiary students due to its proximity to universities, and its place in the recent history of urban gentrification. However, Youthworx participants don’t seek out or engage with the existing, physically proximate creative base, even within the same street. On a couple of occasions, the opposite has been the case: Youthworx students have been involved in acts of vandalism of local residents’ property, including nearby parked cars. Their connections to the Brunswick neighbourhood remain poor, often reflecting their low social capital as a result of unstable residential situations, isolation, and fraught relationships with family. From Brunswick, they often travel to the city on their own, wander around, sit on the steps of Flinders Street train station—an inner-city hub and popular meeting place for locals and tourists alike. Youthworx plays an important role in these young people’s lives, as an important access point to not only creative digital media-based experiences and skill development, but also to greater and basic geographical mobility and experiences within the city. As one of the students commented: They are giving us chances that we wouldn’t usually get. Every day you’re getting to a place, where it’s pretty damn easy to get into; that’s what’s good about it. There are so many places where you have to do so much to get there and half the time, some people don’t even have the bloody bus ticket to get a [job] interview. But [at Youthworx/BYS], they will pick you up and drive you around if you need it. They are friends. It is reportedly a common practice for many young people at Youthworx and BYS to catch a train or a tram (rather than bus) without paying for a ticket. However, to be caught dodging a fare a few times has legal consequences and young people often face court as a result. The program responds by offering its young participants tickets for public transport, ready for pick-up after afternoon activities, or, if possible, "driving them around"—as some young people told me. The program’s social workers revealed that girls are particularly afraid to travel on their own, especially when catching trains to the outer northern suburbs, for fear of being harassed or attacked. These supported travels are as practical and necessary as they are meaningful for young people’s identity formation, and as such are recognised and built into the project’s design, co-ordination and delivery. At the most basic level, The Salvation Army’s social workers pick young people up from the Broadmeadows area in the mornings. Youthworx creative practitioners assist young people to make trips to SYN Media in the city. For most participants, this is either the first or sporadic experience of travelling to the city, something they enjoy very much but are also somewhat daunted by. Additionally, as part of the curriculum, Youthworx staff make a point of taking young people to inner-city movie theatres or public media events. The following vignette from the fieldwork highlights another important connection between physical journey and creative expression. There is an excitement in Dave’s voice when he talks about his favourite pastime: hanging out around the city. “Why would you walk around the streets?” a curious female friend interjects. Dave replies: “No, it’s not the streets, man. It’s just Federation Square, everywhere … There is just all these young wannabe criminals and shit. People don’t know what goes on; and I want to do a doco on the city, a little doco of the people there, because I know a lot of it.” Dave’s interest in exploring the city may be interpreted as a rather common, mundane routine shared by mildly adventurous adolescents of all walks. And yet, there is much more at stake in his account, and for Youthworx young participants more generally. As mentioned before, for many of these young people, it is the first opportunity to travel to the city. This experience then is crucial in a sense of self-exploration and self-discovery. As they overcome their fear of venturing out into the city on their own, they also learn that they have knowledge which others might lack. This moment of realisation is significant and empowering, and they want to communicate this knowledge to others. Youthworx assists them in learning how to translate this knowledge in a creative and constructive way, through an expression that weaves between the free individual and the social voice constructed to enable a dialogue or understanding (Podkalicka; Podkalicka and Campbell; Podkalicka and Thomas; also Soep and Chavez). For an effective communication to occur, a crafted social voice requires skills and a critical awareness of oneself and an audience, which is very different from the modes of expression that these young people might have accessed previously. Youthworx's young participants draw heavily on their life experiences, geographical locations, the suburbs they come from, and places they visit in the city: their cultural productions often reference their homes, music clubs and hang-out venues, inner city streets, Federation Square, and Youthworx’s immediate physical surroundings, with graffiti-covered narrow alleys and railway tracks. The frequent depiction of Youthworx in young people’s creative outputs is often a token of appreciation of the creative, educational and social opportunities it has offered them. Social and professional connections they make there are found to be very valuable. The existing creative industries literature emphasises the importance of social networks to existing communities of interest and practice for human capacity building. Value is argued to lie not only in specific content produced, but in participatory processes that establish a link between personal growth, individual skills and social and professional networks (Hearn and Bridgestock). In a similar vein, Carlo Raffo uses Granovetter’s concept of “weak ties” to suggest that access to “social relations that go beyond the immediate locality and hence their immediate experiences” can provide marginalised young people with “pathways for authentic and informal learning that go beyond the structuring influences of class, gender and ethnicity and into new and emerging economic experiences” (Raffo 11). But higher levels of confidence or social skills are required to make the most of vocational or professional opportunities beyond the supportive context of Youthworx. Connections between Youthworx participants and other creative practitioners within the creative locality of Brunswick have been absent thus far. Transitions into mainstream education and employment have also proven challenging for this group of heavily marginalised youth. As we found during our ongoing fieldwork, even the most talented students find it hard to get into mainstream education courses, or to get or keep jobs. The project serves as a social basis for young people to develop self-agency and determination so they can start engaging with new opportunities and social networks outside the program (Raffo 15). Indeed, the creative practitioners at Youthworx are key facilitators of connections between young people and the external world. They act as positive role models socially, and illustrate what is possible professionally in terms of media excellence and employment (see also Raffo). There are indications that this very supportive, gradual process of social learning is starting to bear fruit for individual students and the Youthworx community as a whole as they grow more confident with themselves, in interactions with others, and the media work they do. Media projects such as Youthworx are examples of what Leadbeater and Wong call “disruptive innovation,” as they provide new ways of learning for those alienated by formal education. The use of digital hands-on media production makes educational processes relevant and engaging for young people. However, as I demonstrate in this paper, there are tangible, material barriers to releasing creativity, or enhancing self-discovery and sociality. There are, as Leadbeater and Wong observe, persistent links between cultural environment, socio-economic status, corresponding attitudes to learning and educational success in the developed world. In the UK, for example, only small percent of those from the lowest socio-economic background go to university (Leadbeater and Wong 10). Youthworx provides an opportunity and motivation for young people to break a cycle of individual self-destructive behaviour (e.g. getting locked up every 6 months), intergenerational reliance on welfare, or entrenched negative attitudes to learning. At the basic level, it encourages and often insists that young people get up in the morning, with social workers often reporting to have to “knock at people’s houses and get them ready.” The involvement in Youthworx is often an important reason to start delineating between day and night, week and weekend. A couple of students commented: I slept a lot. Yeah, I was always sleeping during the day and out at night; I could have still been doing nothing with my life [were it not for Youthworx]. Now people ask if I want to go out during the week, and I just can’t be bothered. I just want to sleep and then go to [Youthworx] and then weekends are when you go out. It also offers a concrete means to begin exploring the city beyond the constraints of their local suburbs. This literal, geographical mobility is interlocked with potential for a changed perception of opportunities, individual transformation and, consequently, social mobility. Dave, as we have seen, is attracted to the idea of exploring the city but also has creative aspirations, and contemplates professional prospects in the creative industries. It is important to note that the participants are resilient in their negotiation between the suburban, Youthworx and inner city worlds they can inhabit. Accessing learning, despite previous negative schooling experiences, is for many of them very important, and reaffirming of life they aspire to. An opportunity to pursue dreams, creative forms of expression, social networks and education is a vital part of human existence. These aspects of social inclusion are recognised in the current articulation of social policy reconceptualised beyond material, economic equality. Creative industry policy, on the other hand, is concerned with fostering creative outputs and skills to generate engagement and employment opportunities in the knowledge-based economies for wide sections of the population. The value is located in human capacity building, involving basic social as well as vocational skills, and links to social networks. The Youthworx project merges these two policy frameworks of the social and creative to test in practice new collaborative approaches to youth development. The spatial and cultural practices of young people described here serve a basis for proposing a theoretical framework that can help understand the term "suburb" in an intrinsically relational, grounded way. The relationships at stake in cultural and social participation for marginalised young people lead me to suggest that the concept of ‘suburb’ takes on two tightly interwoven meanings. The first refers symbolically to a particular locale for popular creativity (Burgess) or even marginal creativity by a group of young people living at the periphery of the social system. The second meaning refers to the interlocked forms of material and cultural capital (and distance), as theorised in Bourdieu’s work (e.g., Bourdieu). It includes physical, spatial conditions and relations, as well as cultural resources and possibilities made available to young participants by the project (e.g., the instituted, supported travel across the city, or the employment of creative practitioners), and interlinked with everyday dispositions, practices, and status of young people (e.g., taste). This empirically-grounded discussion allows to theorise ‘suburbs’ as perceived and socially enacted by concrete, relational forms of access, contingencies, and opportunities for a particular demographic, rather than analytically pre-conceived, designated spaces within an urban system. The ethnographic material reveals that cultural participation for marginalised youth requires an integrated approach, with a parallel focus on material and creative opportunities made available within creative sites such as Youthworx or even the Brunswick creative area. The important material constraints exemplified in this paper concern socio-economic background, cultural disadvantage and geographical isolation and point to the limits of the creative industries-based interventions to address social inclusion if carried out in isolation. They tap into the very basis of risks for this specific demographic of marginalised youth or "youth at risk." The paper suggests that the productive emphasis on the role of media and communication for (youth) development needs to be contextualised and considered along with the actual realities of everyday existence that often limit young people’s educational and vocational prospects (see Bentley et al.; Leadbeater and Wong). On the other hand, an exclusive focus on material support risks cancelling out the possibilities for positive life transitions, such as those triggered by constructive, non-reductionist engagement with “beauty, aesthetics” (Campbell) and creativity. By exploring how participation in Youthworx engenders both the physical mobility between suburbs and the city, and identity transformation, we are able to gain insights into the nature of social exclusion, its meanings for the youth involved and the project managers and staff. Thinking about Youthworx not just as a hub of creative production but as a cultural site—“a space within a practiced place of identity” (De Certeau 117) in the suburb of Brunswick—opens up a discussion that combines the policy language of opportunity and necessity with concrete creative and material possibilities. Social inclusion objectives aimed at positive youth transitions need to be considered in the light of the connection—or disconnection—between the Youthworx Brunswick site itself, young participants’ suburbs, and, by extension, the trajectory between the inner city and other spaces that young people travel through and inhabit. Acknowledgment I would like to thank all the young participants, staff and industry partners involved in the Youthworx project. I also acknowledge the comments of anonymous peer reviewer which helped to strengthen the argument by foregrounding the value of the empirical material. The paper draws on the larger project funded by the Centre of Excellence in Creative Industries and Innovation. Youthworx research team includes: Prof Denise Meredyth (CI); Prof Julian Thomas (CI); Ass/Prof David MacKenzie (CI); Ass/Prof Ellie Rennie; Chris Wilson (PhD candidate), and Jon Staley (Youthworx Manager and PhD candidate). References Bentley, Tom, and Kate Oakley. “The Real Deal: What Young People Think about Government, Politics and Social Exclusion.” Demos. 12 Jan. 2011 ‹http://www.demos.co.uk/files/theRealdeal.pdf›. Bourdieu, Pierre. Distinction: A Social Critique of the Judgement of Taste. Cambridge: Harvard U P, 1987. Burgess, Jean. “Hearing Ordinary Voices: Cultural Studies, Vernacular Creativity and Digital Storytelling.” Continuum 20.2 (2006): 201–14. Campbell, Craig. Personal Interview. Melbourne, 2009. De Certeau, Michel. The Practice of Everyday Life. Los Angeles: University of California Press, 1984. Dewson, Sara, Judith Eccles, Nii Djan Tackey and Annabel Jackson. “Guide to Measuring Soft Outcomes and Distance Travelled.” The Institute for Employment Studies. 12 Jan. 2011‹http:// www.dwp.gov.uk/docs/distance.pdf›. Dowmunt, Tom, Mark Dunford, and N. van Hemert. Inclusion through Media. London: Open Mute, 2007. Ferber, Sarah, Chris Healy, and Chris McAuliffe. Beasts of Suburbia: Reinterpreting Cultures in Australian Suburbs. Melbourne: Melbourne UP, 1994. Hayes, Alan, Matthew Gray, and Ben Edwards. “Social Inclusion: Origins, Concepts and Key Themes.” Australian Institute of Family Studies, prepared for the Social Inclusion Unit, Department of the Prime Minister and Cabinet. 2008.12 Jan. 2011 ‹http://www.socialinclusion.gov.au/Documents/AIFS_SI_concepts_report_20April09.pdf›. Hearn, Gregory, and Ruth Bridgstock. “Education for the Creative Economy: Innovation, Transdisciplinarity, and Networks. Education in the Creative Economy: Knowledge and Learning in the Age of Innovation. Ed. Daniel Araya and Michael Peters. New York: Peter Lang, 2010. 93–116. Holdsworth, Roger, Murray Lake, Kathleen Stacey, and John Safford. “Doing Positive Things: You Have to Go Out and Do It: Outcomes for Participants in Youth Development Programs.” Australian Youth Research Centre. 12 Jan. 2011 ‹http://www.dest.gov.au/NR/rdonlyres/5385FE14-A74C-4B24-98EA-D31EEA8447B2/21803/doing_positive_things1.pdf›. Lave, Jean, and Etienne Wenger. Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge UP, 1991. Leadbeater, Charles, and Annika Wong. “Learning from the Extremes.” CISCO. 12 Jan. 2011 ‹http://www.socialinclusion.gov.au/Documents/AIFS_SI_concepts_report_20April09.pdf›. Miller, Daniel. Stuff. Cambridge: Polity, 2010. Podkalicka, Aneta. “Young Listening: An Ethnography of Youthworx Media's Radio Project." Continuum: Journal of Media & Cultural Studies 23.4 (2009): 561–72. ———, and Jon Staley. “Youthworx Media: Creative Media Engagement for ‘at Risk’ Young People.” 3CM 5 (2009). ———, and Julian Thomas. “The Skilled Social Voice: An Experiment in Creative Economy and Communication Rights.’’ International Communication Gazette 72.4–5 (2010): 395–406. ———, and Craig Campbell. “Understanding Digital Storytelling: Beyond the Politics of Voice in Youth Participation Programs.” seminar.net: Media Technology and Lifelong Learning 6.2 (2010). ‹http://www.seminar.net/index.php/home/75-current-issue/150-understanding-digital-storytelling-individual-voice-and-community-building-in-youth-media-programs›. Poletti, Anna. Intimate Ephemera: Reading Young Lives in Australian Zine Culture. Melbourne: Melbourne University Press, 2008. Raffo, Carlo. "Mentoring Disenfranchised Young People: An Action Research Project on the Development of 'Weak Ties' and Social Capital Enhancement." Education and Industry in Partnership 6.3 (2000): 22–42. Soep, Elizabeth, and Vivian Chavez. Drop That Knowledge: Youth Radio Stories. Berkeley: University of California Press, 2010. Spurgeon, Christina, Jean Burgess, Helen Klaebe, Kelly McWilliam, Jo Tacchi, and Mimi Tsai. “Co-Creative Media: Theorising Digital Storytelling as a Platform for Researching and Developing Participatory Culture.” 2009 ANZC Conference Proceedings. 2009. 16 Nov. 2010 ‹http://eprints.qut.edu.au/25811/2/25811.pdf›.
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Kozak, Nadine Irène. „Building Community, Breaking Barriers: Little Free Libraries and Local Action in the United States“. M/C Journal 20, Nr. 2 (26.04.2017). http://dx.doi.org/10.5204/mcj.1220.

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Image 1: A Little Free Library. Image credit: Nadine Kozak.IntroductionLittle Free Libraries give people a reason to stop and exchange things they love: books. It seemed like a really good way to build a sense of community.Dannette Lank, Little Free Library steward, Whitefish Bay, Wisconsin, 2013 (Rumage)Against a backdrop of stagnant literacy rates and enduring perceptions of urban decay and the decline of communities in cities (NCES, “Average Literacy”; NCES, “Average Prose”; Putnam 25; Skogan 8), legions of Little Free Libraries (LFLs) have sprung up across the United States between 2009 and the present. LFLs are small, often homemade structures housing books and other physical media for passersby to choose a book to take or leave a book to share with others. People have installed the structures in front of homes, schools, libraries, churches, fire and police stations, community gardens, and in public parks. There are currently 50,000 LFLs around the world, most of which are in the continental United States (Aldrich, “Big”). LFLs encompass building in multiple senses of the term; LFLs are literally tiny buildings to house books and people use the structures for building neighbourhood social capital. The organisation behind the movement cites “building community” as one of its three core missions (Little Free Library). Rowan Moore, theorising humans’ reasons for building, argues desire and emotion are central (16). The LFL movement provides evidence for this claim: stewards erect LFLs based on hope for increased literacy and a desire to build community through their altruistic actions. This article investigates how LFLs build urban community and explores barriers to the endeavour, specifically municipal building and right of way ordinances used in attempts to eradicate the structures. It also examines local responses to these municipal actions and potential challenges to traditional public libraries brought about by LFLs, primarily the decrease of visits to public libraries and the use of LFLs to argue for defunding of publicly provided library services. The work argues that LFLs build community in some places but may threaten other community services. This article employs qualitative content analysis of 261 stewards’ comments about their registered LFLs on the organisation’s website drawn from the two largest cities in a Midwestern state and an interview with an LFL steward in a village in the same state to analyse how LFLs build community. The two cities, located in the state where the LFL movement began, provide a cross section of innovators, early adopters, and late adopters of the book exchanges, determined by their registered charter numbers. Press coverage and municipal documents from six cities across the US gathered through a snowball sample provide data about municipal challenges to LFLs. Blog posts penned by practising librarians furnish some opinions about the movement. This research, while not a representative sample, identifies common themes and issues around LFLs and provides a basis for future research.The act of building and curating an LFL is a representation of shared beliefs about literacy, community, and altruism. Establishing an LFL is an act of civic participation. As Nico Carpentier notes, while some civic participation is macro, carried out at the level of the nation, other participation is micro, conducted in “the spheres of school, family, workplace, church, and community” (17). Ruth H. Landman investigates voluntary activities in the city, including community gardening, and community bakeries, and argues that the people associated with these projects find themselves in a “denser web of relations” than previously (2). Gretchen M. Herrmann argues that neighbourhood garage sales, although fleeting events, build an enduring sense of community amongst participants (189). Ray Oldenburg contends that people create associational webs in what he calls “great good places”; third spaces separate from home and work (20-21). Little Free Libraries and Community BuildingEmotion plays a central role in the decision to become an LFL steward, the person who establishes and maintains the LFL. People recount their desire to build a sense of community and share their love of reading with neighbours (Charter 4684; Charter 8212; Charter 9437; Charter 9705; Charter 16561). One steward in the study reported, “I love books and I want to be able to help foster that love in our neighbourhood as well” (Charter 4369). Image 2: A Little Free Library, bench, water fountain, and dog’s water bowl for passersby to enjoy. Image credit: Nadine Kozak.Relationships and emotional ties are central to some people’s decisions to have an LFL. The LFL website catalogues many instances of memorial LFLs, tributes to librarians, teachers, and avid readers. Indeed, the first Little Free Library, built by Todd Bol in 2009, was a tribute to his late mother, a teacher who loved reading (“Our History”). In the two city study area, ten LFLs are memorials, allowing bereaved families to pass on a loved one’s penchant for sharing books and reading (Charter 1235; Charter 1309; Charter 4604; Charter 6219; Charter 6542; Charter 6954; Charter 10326; Charter 16734; Charter 24481; Charter 30369). In some cases, urban neighbours come together to build, erect, and stock LFLs. One steward wrote: “Those of us who live in this friendly neighborhood collaborated to design[,] build and paint a bungalow themed library” to match the houses in the neighbourhood (Charter 2532). Another noted: “Our neighbor across the street is a skilled woodworker, and offered to build the library for us if we would install it in our yard and maintain it. What a deal!” (Charter 18677). Community organisations also install and maintain LFLs, including 21 in the study population (e.g. Charter 31822; Charter 27155).Stewards report increased communication with neighbours due to their LFLs. A steward noted: “We celebrated the library’s launch on a Saturday morning with neighbors of all ages. We love sitting on our front porch and catching up with the people who stop to check out the books” (Charter 9673). Another exclaimed:within 24 hours, before I had time to paint it, my Little Free Library took on a life of its own. All of a sudden there were lots of books in it and people stopping by. I wondered where these books came from as I had not put any in there. Little kids in the neighborhood are all excited about it and I have met neighbors that I had never seen before. This is going to be fun! (Charter 15981)LFLs build community through social interaction and collaboration. This occurs when neighbours come together to build, install, and fill the structures. The structures also open avenues for conversation between neighbours who had no connection previously. Like Herrmann’s neighbourhood garage sales, LFLs create and maintain social ties between neighbours and link them by the books they share. Additionally, when neighbours gather and communicate at the LFL structure, they create a transitory third space for “informal public life”, where people can casually interact at a nearby location (Oldenburg 14, 288).Building Barriers, Creating CommunityThe erection of an LFL in an urban neighbourhood is not, however, always a welcome sight. The news analysis found that LFLs most often come to the attention of municipal authorities via citizen complaints, which lead to investigations and enforcement of ordinances. In Kansas, a neighbour called an LFL an “eyesore” and an “illegal detached structure” (Tapper). In Wisconsin, well-meaning future stewards contacted their village authorities to ask about rules, inadvertently setting off a six-month ban on LFLs (Stingl; Rumage). Resulting from complaints and inquiries, municipalities regulated, and in one case banned, LFLs, thus building barriers to citizens’ desires to foster community and share books with neighbours.Municipal governments use two major areas of established code to remove or prohibit LFLs: ordinances banning unapproved structures in residents’ yards and those concerned with obstructions to right of ways when stewards locate the LFLs between the public sidewalk and street.In the first instance, municipal ordinances prohibit either front yard or detached structures. Controversies over these ordinances and LFLs erupted in Whitefish Bay, Wisconsin, in 2012; Leawood, Kansas, in 2014; Shreveport, Louisiana, in 2015; and Dallas, Texas, in 2015. The Village of Whitefish Bay banned LFLs due to an ordinance prohibiting “front yard structures,” including mailboxes (Sanburn; Stingl). In Leawood, the city council argued that an LFL, owned by a nine-year-old boy, violated an ordinance that forbade the construction of any detached structures without city council permission. In Shreveport, the stewards of an LFL received a cease and desist letter from city council for having an “accessory structure” in the front yard (LaCasse; Burris) and Dallas officials knocked on a steward’s front door, informing her of a similar breach (Kellogg).In the second instance, some urban municipalities argued that LFLs are obstructions that block right of ways. In Lincoln, Nebraska, the public works director noted that the city “uses the area between the sidewalk and the street for snow storage in the winter, light poles, mailboxes, things like that.” The director continued: “And I imagine these little libraries are meant to congregate people like a water cooler, but we don’t want people hanging around near the road by the curb” (Heady). Both Lincoln in 2014 and Los Angeles (LA), California, in 2015, cited LFLs for obstructions. In Lincoln, the city notified the Southminster United Methodist Church that their LFL, located between the public sidewalk and street, violated a municipal ordinance (Sanburn). In LA, the Bureau of Street Services notified actor Peter Cook that his LFL, situated in the right of way, was an “obstruction” that Cook had to remove or the city would levy a fine (Moss). The city agreed at a hearing to consider a “revocable permit” for Cook’s LFL, but later denied its issuance (Condes).Stewards who found themselves in violation of municipal ordinances were able to harness emotion and build outrage over limits to individuals’ ability to erect LFLs. In Kansas, the stewards created a Facebook page, Spencer’s Little Free Library, which received over 31,000 likes and messages of support. One comment left on the page reads: “The public outcry will force those lame city officials to change their minds about it. Leave it to the stupid government to rain on everybody’s parade” (“Good”). Children’s author Daniel Handler sent a letter to the nine-year-old steward, writing as Lemony Snicket, “fighting against librarians is immoral and useless in the face of brave and noble readers such as yourself” (Spencer’s). Indeed, the young steward gave a successful speech to city hall arguing that the body should allow the structures because “‘lots of people in the neighborhood used the library and the books were always changing. I think it’s good for Leawood’” (Bauman). Other local LFL supporters also attended council and spoke in favour of the structures (Harper). In LA, Cook’s neighbours started a petition that gathered over 100 signatures, where people left comments including, “No to bullies!” (Lopez). Additionally, neighbours gathered to discuss the issue (Dana). In Shreveport, neighbours left stacks of books in their front yards, without a structure housing them due to the code banning accessory structures. One noted, “I’m basically telling the [Metropolitan Planning Commission] to go sod off” (Friedersdorf; Moss). LFL proponents reacted with frustration and anger at the perceived over-reach of the government toward harmless LFLs. In addition to the actions of neighbours and supporters, the national and local press commented on the municipal constraints. The LFL movement has benefitted from a significant amount of positive press in its formative years, a press willing to publicise and criticise municipal actions to thwart LFL development. Stewards’ struggles against municipal bureaucracies building barriers to LFLs makes prime fodder for the news media. Herbert J. Gans argues an enduring value in American news is “the preservation of the freedom of the individual against the encroachments of nation and society” (50). The juxtaposition of well-meaning LFL stewards against municipal councils and committees provided a compelling opportunity to illustrate this value.National media outlets, including Time (Sanburn), Christian Science Monitor (LaCasse), and The Atlantic, drew attention to the issue. Writing in The Atlantic, Conor Friedersdorf critically noted:I wish I was writing this to merely extol this trend [of community building via LFLs]. Alas, a subset of Americans are determined to regulate every last aspect of community life. Due to selection bias, they are overrepresented among local politicians and bureaucrats. And so they have power, despite their small-mindedness, inflexibility, and lack of common sense so extreme that they’ve taken to cracking down on Little Free Libraries, of all things. (Friedersdorf, n.p.)Other columnists mirrored this sentiment. Writing in the LA Times, one commentator sarcastically wrote that city officials were “cracking down on one of the country’s biggest problems: small community libraries where residents share books” (Schaub). Journalists argued this was government overreach on non-issues rather than tackling larger community problems, such as income inequality, homelessness, and aging infrastructure (Solomon; Schaub). The protests and negative press coverage led to, in the case of the municipalities with front yard and detached structure ordinances, détente between stewards and councils as the latter passed amendments permitting and regulating LFLs. Whitefish Bay, Leawood, and Shreveport amended ordinances to allow for LFLs, but also to regulate them (Everson; Topil; Siegel). Ordinances about LFLs restricted their number on city blocks, placement on private property, size and height, as well as required registration with the municipality in some cases. Lincoln officials allowed the church to relocate the LFL from the right of way to church property and waived the $500 fine for the obstruction violation (Sanburn). In addition to the amendments, the protests also led to civic participation and community building including presentations to city council, a petition, and symbolic acts of defiance. Through this protest, neighbours create communities—networks of people working toward a common goal. This aspect of community building around LFLs was unintentional but it brought people together nevertheless.Building a Challenge to Traditional Libraries?LFL marketing and communication staff member Margaret Aldrich suggests in The Little Free Library Book that LFLs are successful because they are “gratifyingly doable” projects that can be accomplished by an individual (16). It is this ease of building, erecting, and maintaining LFLs that builds concern as their proliferation could challenge aspects of library service, such as public funding and patron visits. Some professional librarians are in favour of the LFLs and are stewards themselves (Charter 121; Charter 2608; Charter 9702; Charter 41074; Rumage). Others envision great opportunities for collaboration between traditional libraries and LFLs, including the library publicising LFLs and encouraging their construction as well as using LFLs to serve areas without, or far from, a public library (Svehla; Shumaker). While lauding efforts to build community, some professional librarians question the nomenclature used by the movement. They argue the phrase Little Free Libraries is inaccurate as libraries are much more than random collections of books. Instead, critics contend, the LFL structures are closer to book swaps and exchanges than actual libraries, which offer a range of services such as Internet access, digital materials, community meeting spaces, and workshops and programming on a variety of topics (American Library Association; Annoyed Librarian). One university reference and instruction librarian worries about “the general public’s perception and lumping together of little free libraries and actual ‘real’ public libraries” (Hardenbrook). By way of illustration, he imagines someone asking, “‘why do we need our tax money to go to something that can be done for FREE?’” (Hardenbrook). Librarians holding this perspective fear the movement might add to a trend of neoliberalism, limiting or ending public funding for libraries, as politicians believe that the localised, individual solutions can replace publicly funded library services. This is a trend toward what James Ferguson calls “responsibilized” citizens, those “deployed to produce governmentalized results that do not depend on direct state intervention” (172). In other countries, this shift has already begun. In the United Kingdom (UK), governments are devolving formerly public services onto community groups and volunteers. Lindsay Findlay-King, Geoff Nichols, Deborah Forbes, and Gordon Macfadyen trace the impacts of the 2012 Localism Act in the UK, which caused “sport and library asset transfers” (12) to community and volunteer groups who were then responsible for service provision and, potentially, facility maintenance as well. Rather than being in charge of a “doable” LFL, community groups and volunteers become the operators of much larger facilities. Recent efforts in the US to privatise library services as governments attempt to cut budgets and streamline services (Streitfeld) ground this fear. Image 3: “Take a Book, Share a Book,” a Little Free Library motto. Image credit: Nadine Kozak. LFLs might have real consequences for public libraries. Another potential unintended consequence of the LFLs is decreasing visits to public libraries, which could provide officials seeking to defund them with evidence that they are no longer relevant or necessary. One LFL steward and avid reader remarked that she had not used her local public library since 2014 because “I was using the Little Free Libraries” (Steward). Academics and librarians must conduct more research to determine what impact, if any, LFLs are having on visits to traditional public libraries. ConclusionLittle Free Libraries across the United States, and increasingly in other countries, have generated discussion, promoted collaboration between neighbours, and led to sharing. In other words, they have built communities. This was the intended consequence of the LFL movement. There, however, has also been unplanned community building in response to municipal threats to the structures due to right of way, safety, and planning ordinances. The more threatening concern is not the municipal ordinances used to block LFL development, but rather the trend of privatisation of publicly provided services. While people are celebrating the community built by the LFLs, caution must be exercised lest central institutions of the public and community, traditional public libraries, be lost. Academics and communities ought to consider not just impact on their local community at the street level, but also wider structural concerns so that communities can foster many “great good places”—the Little Free Libraries and traditional public libraries as well.ReferencesAldrich, Margaret. “Big Milestone for Little Free Library: 50,000 Libraries Worldwide.” Little Free Library. 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Deciding What’s News: A Study of CBS Evening News, NBC Nightly News, Newsweek, and Time. Evanston, IL: Northwestern University Press, 2004.“Good Luck Spencer.” Spencer’s Little Free Library Facebook Page 25 Jun. 2014. 26 Mar. 2017 <https://www.facebook.com/Spencerslittlefreelibrary/photos/pcb.527531327376433/527531260709773/?type=3>.Hardenbrook, Joe. “A Little Rant on Little Free Libraries (AKA Probably an Unpopular Post).” Mr. Library Dude (9 Apr. 2014). 25 Feb. 2017 <https://mrlibrarydude.wordpress.com/2014/04/09/a-little-rant-on-little-free-libraries-aka-probably-an-unpopular-post/>.Harper, Deb. “Minutes.” The Leawood City Council 7 Jul. 2014. <http://www.leawood.org/pdf/cc/min/07-07-14.pdf>. Heady, Chris. “City Wants Church to Move Little Library.” Lincoln Journal Star 9 Jul. 2014. 25 Feb. 2017 <http://journalstar.com/news/local/city-wants-church-to-move-little-library/article_7753901a-42cd-5b52-9674-fc54a4d51f47.html>. Herrmann, Gretchen M. “Garage Sales Make Good Neighbors: Building Community through Neighborhood Sales.” Human Organization 62.2 (2006): 181-191.Kellogg, Carolyn. “Officials Threaten to Destroy a Little Free Library in Texas.” Los Angeles Times (1 Oct. 2015). 25 Feb. 2017 <http://www.latimes.com/books/jacketcopy/la-et-jc-little-free-library-texas-20150930-story.html>.LaCasse, Alexander. “Why Are Some Cities Cracking Down on Little Free Libraries.” Christian Science Monitor (5 Feb. 2015). 25 Feb. 2017 <http://www.csmonitor.com/Books/chapter-and-verse/2015/0205/Why-are-some-cities-cracking-down-on-little-free-libraries>.Landman, Ruth H. Creating the Community in the City: Cooperatives and Community Gardens in Washington, DC Westport, CT: Bergin & Garvey, 1993. Little Free Library. 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Average Prose, Document, and Quantitative Literacy Scores of Adults: 1992 and 2003. National Assessment of Adult Literacy. 25 Feb. 2017 <https://nces.ed.gov/naal/kf_demographics.asp>.Oldenburg, Ray. The Great Good Place: Cafés, Coffee Shops, Bookstores, Bars, Hair Salons, and Other Hangouts at the Heart of a Community. New York: Marlowe & Company, 1999.“Our History.” Little Free Library. Little Free Library Organization (2017). 25 Feb. 2017 <https://littlefreelibrary.org/ourhistory/>.Putnam, Robert D. Bowling Alone: The Collapse and Revival of American Community. New York: Simon & Schuster, 2001.Rumage, Jeff. “Little Free Libraries Now Allowed in Whitefish Bay.” Whitefish Bay Patch (8 May 2013). 25 Feb. 2017 <http://patch.com/wisconsin/whitefishbay/little-free-libraries-now-allowed-in-whitefish-bay>.Sanburn, Josh. “What Do Kansas and Nebraska Have against Small Libraries?” Time 10 Jul. 2014. 25 Feb. 2017 <http://time.com/2970649/tiny-libraries-violating-city-ordinances/>.Schaub, Michael. “Little Free Libraries on the Wrong Side of the Law.” LA Times 4 Feb. 2015. 25 Feb. 2017 <http://www.latimes.com/books/jacketcopy/la-et-jc-little-free-libraries-on-the-wrong-side-of-the-law-20150204-story.html>.Shumaker, David. “Public Libraries, Little Free Libraries, and Embedded Librarians.” The Embedded Librarian (28 April 2014) 26 Mar. 2017 <https://embeddedlibrarian.com/2014/04/28/public-libraries-little-free-libraries-and-embedded-librarians/>.Siegel, Julie. “An Ordinance to Amend Section 16.13 of the Municipal Code with Regard to Exempt Certain Little Free Libraries from Front Yard Setback Requirements.” Village of Whitefish Bay, Wisconsin (5 Aug. 2013).Skogan, Wesley G. Police and Community in Chicago: A Tale of Three Cities. New York: Oxford University Press, 2006.Solomon, Dan. “Dallas Is Regulating ‘Little Free Libraries’ for Some Reason.” Texas Monthly (14 Sept. 2016). 25 Feb. 2017 <http://www.texasmonthly.com/the-daily-post/dallas-regulating-little-free-libraries-reason/>.“Spencer’s Little Free Library.” Facebook 15 Jul. 2014. 25 Feb. 2017 <https://www.facebook.com/Spencerslittlefreelibrary/photos/pcb.527531327376433/527531260709773/?type=3>.Steward, M. Personal Interview. 7 Feb. 2017.Stingl, Jim. “Village Slaps Endnote on Little Libraries.” Milwaukee Journal Sentinel 11 Nov. 2012: 1B, 7B.Streitfeld, David. “Anger as a Private Company Takes over Libraries.” The New York Times (26 Sept. 2010). 25 Feb. 2017 <http://www.nytimes.com/2010/09/27/business/27libraries.html>.Svehla, Louise. “Little Free Libraries—The Possibilities Are Endless.” Public Libraries Online (8 Mar. 2013). 25 Feb. 2017 <http://publiclibrariesonline.org/2013/03/little-free-libraries-the-possibilities-are-endless/>.Tapper, Jake. “Boy Fights Council to Save His Library.” CNN 4 Jul. 2014. 25 Feb. 2017 <http://thelead.blogs.cnn.com/2014/07/04/boy-fights-to-save-his-library/>.Topil, Greg. “Little Free Libraries in Lincoln.” City of Lincoln, Nebraska (n.d.). 25 Feb. 2017 <http://lincoln.ne.gov/City/pworks/engine/row/little-library.htm>.
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