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Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a “planned second-look” laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.
Smith (1968) argues that poems may end with formal changes which produce an experience of closure in the reader. I argue that formal changes do not directly cause an experience of closure. Instead, changes in poetic form always demand increased processing effort from the reader, whether they involve new forms, shifts from more to less regular form, or from less to more regular form. I use relevance theory (Sperber and Wilson 1995) to argue that the increased processing effort encourages the reader to formulate rich and relevant thoughts, including the thought "this poem has closure". Closure is thus the content of a thought rather than a type of experience. I further argue that "closure" is a term whose meaning cannot be fully understood, which makes the thought "this poem has closure" into a schematic belief of the kind which Sperber shows has great richness and productivity. This is one of the reasons that the thought "this poem has closure" achieves sufficient relevance to justify the effort put into processing the end of the poem.
It’s intuitively plausible to suppose that there are many things that we can be rationally certain of, at least in many contexts. The present paper argues that, given this principle of Abundancy, there is a Preface Paradox for (rational) credence. Section 1 gives a statement of the paradox, discusses its relation to its familiar counterpart for (rational) belief, and points out the congeniality between Abundancy and broadly contextualist trends in epistemology. This leads to the question whether considerations of context-sensitivity might lend themselves to solving the Preface for credence. Sections 2 and 3 scrutinize two approaches in this spirit—one mimicking Hawthorne’s (2002) Semantic Contextualist approach to an epistemic version of the Preface, the other one analogous to Clarke’s (2015) Sensitivist approach to the doxastic version—arguing that neither approach succeeds as it stands.
Resolution
(2019)
Many parodies operate through temporal strategies that distort the narrative proportions of their targets. This essay discusses two texts that manipulate time for parodic purposes: the contemporary animated sitcom "Bojack Horseman" and the twelfth-century romance "Ipomedon". Their shared method involves the absurd prolongation of narrative structures of resolution and satisfaction in order to reveal these structures' arbitrary nature. But this method, in turn, shows that resolution - a retrospective determination of shape and meaning - can never be avoided entirely, even if it can be deferred.